RESUMEN

The biofilm-induced "relatively immune-compromised zone" creates an immunosuppressive microenvironment that is a significant contributor to refractory infections in orthopedic endophytes. Consequently, the manipulation of immune cells to co-inhibit or co-activate signaling represents a crucial strategy for the management of biofilm. This study reports the incorporation of Mn2+ into mesoporous dopamine nanoparticles (Mnp) containing the stimulator of interferon genes (STING) pathway activator cGAMP (Mncp), and outer wrapping by M1-like macrophage cell membrane (m-Mncp). The cell membrane enhances the material's targeting ability for biofilm, allowing it to accumulate locally at the infectious focus. Furthermore, m-Mncp mechanically disrupts the biofilm through photothermal therapy and induces antigen exposure through photodynamic therapy-generated reactive oxygen species (ROS). Importantly, the modulation of immunosuppression and immune activation results in the augmentation of antigen-presenting cells (APCs) and the commencement of antigen presentation, thereby inducing biofilm-specific humoral immunity and memory responses. Additionally, this approach effectively suppresses the activation of myeloid-derived suppressor cells (MDSCs) while simultaneously boosting the activity of T cells. Our study showcases the efficacy of utilizing m-Mncp immunotherapy in conjunction with photothermal and photodynamic therapy to effectively mitigate residual and recurrent infections following the extraction of infected implants. As such, this research presents a viable alternative to traditional antibiotic treatments for biofilm that are challenging to manage.

Asunto(s)

RESUMEN

The unsuitable deformation stimulus, harsh urine environment, and lack of a regenerative microenvironment (RME) prevent scaffold-based urethral repair and ultimately lead to irreversible urethral scarring. The researchers clarify the optimal elastic modulus of the urethral scaffolds for urethral repair and design a multilayered PVA hydrogel scaffold for urethral scar-free healing. The inner layer of the scaffold has self-healing properties, which ensures that the wound effectively resists harsh urine erosion, even when subjected to sutures. In addition, the scaffold's outer layer has an extracellular matrix-like structure that synergizes with adipose-derived stem cells to create a favorable RME. In vivo experiments confirm successful urethral scar-free healing using the PVA multilayered hydrogel scaffold. Further mechanistic study shows that the PVA multilayer hydrogel effectively resists the urine-induced inflammatory response and accelerates the transition of urethral wound healing to the proliferative phase by regulating macrophage polarization, thus providing favorable conditions for urethral scar-free healing. This study provides mechanical criteria for the fabrication of urethral tissue-engineered scaffolds, as well as important insights into their design.

Asunto(s)

RESUMEN

Previous methods for robustness evaluation relies on dose calculation for a number of uncertainty scenarios, which either fails to provide statistical meaning when the number is too small (e.g., ~8) or becomes unfeasible in daily clinical practice when the number is sufficiently large (e.g., > 100). Our proposed deep learning-based method addressed this issue by avoiding the intermediate dose calculation step and instead directly predicting the percentile dose distribution from the nominal dose distribution using a deep learning (DL) model. In this study, we sought to validate this a deep learning (DL)-based statistical robustness evaluation (SRE) method for efficient and accurate robustness quantification in head and neck (H&N) intensity-modulated proton therapy with diverse beam configurations and multifield optimization. APPROACH: A dense, dilated 3D U-net was trained to predict the 5th and 95th percentile distributions of planning dose plan using the nominal dose and planning CT images. The data set comprised proton therapy plans for 582 H&N cancer patients. Ground truth percentile values were estimated for each patient through 600 dose recalculations, representing randomly sampled uncertainty scenarios. The comprehensive comparisons of different models were conducted for H&N cancer patients, considering those with and without a beam mask (BM) and diverse beam configurations, including varying beam angles, couch angles, and beam numbers. The performance of our model trained based on a mixture of patients with H&N and prostate cancer was also assessed in contrast with models trained based on data specific for patients with cancer at either site. RESULTS: The DL-based model's predictions of percentile dose distributions exhibited excellent agreement with the ground truth dose distributions. The average gamma index with 2 mm/2%, consistently exceeded 97% for both 5th and 95th percentile dose volumes. Mean dose-volume histogram error analysis revealed that predictions from the combined training set yielded mean errors and standard deviations that were generally similar to those in the specific patient training data sets. SIGNIFICANCE: Our proposed DL-based method for evaluation of the robustness of proton therapy plans provides precise, rapid predictions of percentile dose for a given confidence level regardless of the beam arrangement and cancer site. This versatility positions our model as a valuable tool for evaluating the robustness of proton therapy across various cancer sites.

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by non-specific inflammation. Managing UC presents significant challenges due to its chronic nature and high recurrence rates. Indigo naturalis has emerged as a potential therapeutic agent in clinical UC treatment, demonstrating advantages in alleviating refractory UC and maintaining remission periods compared to other therapeutic approaches. AIM OF REVIEW: This review aims to elucidate the potential mechanisms underlying the therapeutic effects of indigo naturalis in UC treatment, assess its clinical efficacy, advantages, and limitations, and provide insights into methods and strategies for utilizing indigo naturalis in UC management. MATERIALS AND METHODS: Comprehensive data on indigo naturalis were collected from reputable online databases including PubMed, GreenMedical, Web of Science, Google Scholar, China National Knowledge Infrastructure Database, and National Intellectual Property Administration. RESULTS: Clinical studies have demonstrated that indigo naturalis, either alone or in combination with other drugs, yields favorable outcomes in UC treatment. Its mechanisms of action involve modulation of the AHR receptor, anti-inflammatory properties, regulation of intestinal flora, restoration of the intestinal barrier, and modulation of immunity. Despite its efficacy in managing refractory UC and prolonging remission periods, indigo naturalis treatment is associated with adverse reactions, quality variations, and inadequate pharmacokinetic investigations. CONCLUSION: The therapeutic effects of indigo naturalis in UC treatment are closely linked to its ability to regulate the AHR receptor, exert anti-inflammatory effects, mcodulate intestinal flora, restore the intestinal barrier, and regulate immunity. Addressing the current shortcomings, including adverse reactions, quality control issues, and insufficient pharmacokinetic data, is crucial for optimizing the clinical utility of indigo naturalis in UC management. By refining patient-centered treatment strategies, indigo naturalis holds promise for broader application in UC treatment, thereby alleviating the suffering of UC patients.

RESUMEN

We present a rare finding on lung ventilation-perfusion (V/Q) scintigraphy for a woman with longstanding dyspnea. CT of the chest showed volume loss on the right side, which raised concern about possible bronchiolitis obliterans or Swyer-James-MacLeod syndrome; however, the right pulmonary artery could not be visualized. A subsequent V/Q scan showed absence of perfusion and decreased ventilation to the entire right lung, consistent with agenesis of the right pulmonary artery. The patient's clinical course and imaging features mimicked Swyer-James-MacLeod syndrome, which usually presents with a matched perfusion defect in a single lung or lobe on V/Q scanning. This case highlights the importance of a multimodality imaging approach to achieve a diagnosis.

Asunto(s)

RESUMEN

AIM: To comprehensively identify the status and influencing factors on maternal health literacy among postpartum women in Guangzhou urban villages. DESIGN: An explanatory sequential mixed-method research was conducted from November 2021 to July 2022. METHODS: The quantitative survey was conducted among postpartum women in Guangzhou urban villages using the convenience sampling principle, and a questionnaire survey was used to reflect the status and influencing factors on maternal health literacy. The qualitative interview conducted purposive sampling based on the survey and semi-structured interviews with women to supplement the non-quantifiable influencing factors. RESULTS: The quantitative survey showed that the maternal health literacy score of 501 women was 193.84 ± 22.23. The quantitative results suggested that ethnicity, education, income, household registration, delivery mode and social support were important influencing factors (p < .15). The qualitative interviews were conducted with 16 women and revealed three themes and eight sub-themes, including demographic factors (ethnicity, education, income, occupation and family history), pregnancy factors (delivery mode and pregnancy complications) and social factors (social support), which influenced maternal health literacy through three routes: women's motivation, access and ability in screening health information. CONCLUSION: Maternal health literacy among postpartum women in urban villages needs to be improved, especially critical health literacy. Maternal and infant workers need to guide women to develop appropriate health information concepts and consider the realistic knowledge needs of women in different socio-cultural and economic backgrounds. They should also construct a comprehensive social support system for women to better improve maternal health literacy. IMPACT: Highlights the positive benefits of maternal health literacy among postpartum women, as preparation for providing accurate and effective maternal and child health education services. PATIENT OR PUBLIC CONTRIBUTION: The information on maternal health literacy in this study was based on an interview with postpartum women in Guangzhou urban villages during the study period.

RESUMEN

Vanadium (V)-based oxides have garnered significant attention as cathode materials for aqueous zinc-ion batteries (AZIBs) due to their multiple valences and high theoretical capacity. However, their sluggish kinetics and low conductivity remain major obstacles to practical applications. In this study, Mo-doped V2O3 with oxygen vacancies (OVs, Mo-V2O3-x@NC) is prepared from a Mo-doped V-metal organic framework. Ex situ characterizations reveal that the cathode undergoes an irreversible phase transformation from Mo-V2O3-x to Mo-V2O5-x·nH2O and serves as an active material exhibiting excellent Zn2+ storage in subsequent charge-discharge cycles. Mo-doped helps to further improve cycling stability and increases with increasing content. More importantly, the synergistic effect of Mo-doped and OVs not only effectively reduces the Zn2+ migration energy barrier, but also enhances reaction kinetics, and electrochemical performance. Consequently, the cathode demonstrates ultrafast electrochemical kinetics, showing a superior rate performance (190.9 mAh g-1 at 20 A g-1) and excellent long-term cycling stability (147.9 mAh g-1 at 20 A g-1 after 10000 cycles). Furthermore, the assembled pouch cell exhibits excellent cycling stability (313.6 mAh g-1 at 1 A g-1 after 1000 cycles), indicating promising application prospects. This work presents an effective strategy for designing and fabricating metal and OVs co-doped cathodes for high-performance AZIBs.

RESUMEN

Importance: Previous randomized clinical trials did not demonstrate the superiority of endovascular stenting over aggressive medical management for patients with symptomatic intracranial atherosclerotic stenosis (sICAS). However, balloon angioplasty has not been investigated in a randomized clinical trial. Objective: To determine whether balloon angioplasty plus aggressive medical management is superior to aggressive medical management alone for patients with sICAS. Design, Setting, and Participants: A randomized, open-label, blinded end point clinical trial at 31 centers across China. Eligible patients aged 35 to 80 years with sICAS defined as recent transient ischemic attack (<90 days) or ischemic stroke (14-90 days) before enrollment attributed to a 70% to 99% atherosclerotic stenosis of a major intracranial artery receiving treatment with at least 1 antithrombotic drug and/or standard risk factor management were recruited between November 8, 2018, and April 2, 2022 (final follow-up: April 3, 2023). Interventions: Submaximal balloon angioplasty plus aggressive medical management (n = 249) or aggressive medical management alone (n = 252). Aggressive medical management included dual antiplatelet therapy for the first 90 days and risk factor control. Main Outcomes and Measures: The primary outcome was a composite of any stroke or death within 30 days after enrollment or after balloon angioplasty of the qualifying lesion or any ischemic stroke in the qualifying artery territory or revascularization of the qualifying artery after 30 days through 12 months after enrollment. Results: Among 512 randomized patients, 501 were confirmed eligible (mean age, 58.0 years; 158 [31.5%] women) and completed the trial. The incidence of the primary outcome was lower in the balloon angioplasty group than the medical management group (4.4% vs 13.5%; hazard ratio, 0.32 [95% CI, 0.16-0.63]; P < .001). The respective rates of any stroke or all-cause death within 30 days were 3.2% and 1.6%. Beyond 30 days through 1 year after enrollment, the rates of any ischemic stroke in the qualifying artery territory were 0.4% and 7.5%, respectively, and revascularization of the qualifying artery occurred in 1.2% and 8.3%, respectively. The rate of symptomatic intracranial hemorrhage in the balloon angioplasty and medical management groups was 1.2% and 0.4%, respectively. In the balloon angioplasty group, procedural complications occurred in 17.4% of patients and arterial dissection occurred in 14.5% of patients. Conclusions and Relevance: In patients with sICAS, balloon angioplasty plus aggressive medical management, compared with aggressive medical management alone, statistically significantly lowered the risk of a composite outcome of any stroke or death within 30 days or an ischemic stroke or revascularization of the qualifying artery after 30 days through 12 months. The findings suggest that balloon angioplasty plus aggressive medical management may be an effective treatment for sICAS, although the risk of stroke or death within 30 days of balloon angioplasty should be considered in clinical practice. Trial Registration: ClinicalTrials.gov Identifier: NCT03703635.

RESUMEN

As a low-toxicity metal, aluminum has garnered increasing attention in relation to its impact on the human body; however, the specific mechanism of action remains unclear. To bridge this knowledge gap and facilitate practical applications, this study took 8-week-old ICR mice as the research object to study the effects of dietary addition of aluminum potassium sulfate on intestinal flora structure and liver. As the concentration of aluminum increased, it inhibited mice weight growth rate and significantly altered the composition of white blood cells in their bloodstream. Histological examination revealed liver inflammation through HE staining sections. The oxidative stress markers MDA increased, GSH-PX and CAT decreased significantly. And liver function index MAO increased, TC and ALP decreased first and then increased. Moreover, there was a significant increase in pro-inflammatory factor TNF-α content. Further 16S rRNA sequencing analysis demonstrated substantial changes in both composition and structure of mouse intestinal microbiota induced by aluminum exposure; microbial phenotype prediction indicated that aluminum-induced oxidative stress promoted an increase in abundance of oxidation-resistant microbial types. Alterations in gut flora structure also influenced the liver via the gut-liver axis. These findings lay a foundation for further research on the regulation and interaction of aluminum on intestinal flora.

RESUMEN

Recently, a strong interest has been in multiview high-dimensional data collected through cross-domain or various feature extraction mechanisms. Nonnegative matrix factorization (NMF) is an effective method for clustering these high-dimensional data with clear physical significance. However, existing multiview clustering based on NMF only measures the difference between the elements of the coefficient matrix without considering the spatial structure relationship between the elements. And they often require postprocessing to achieve clustering, making the algorithms unstable. To address this issue, we propose minimizing the Schatten p -norm of the tensor, which consists of a coefficient matrix of different views. This approach considers each element's spatial structure in the coefficient matrices, crucial for effectively capturing complementary information presented in different views. Furthermore, we apply orthogonal constraints to the cluster index matrix to make it sparse and provide a strong interpretation of the clustering. This allows us to obtain the cluster label directly without any postprocessing. To distinguish the importance of different views, we utilize adaptive weights to assign varying weights to each view. We introduce an unsupervised optimization scheme to solve and analyze the computational complexity of the model. Through comprehensive evaluations of six benchmark datasets and comparisons with several multiview clustering algorithms, we empirically demonstrate the superiority of our proposed method.

RESUMEN

OBJECTIVES: Immature platelet fraction (IPF) for differentiating bacteremia has been explored, whereas its prognostic correlation remains uncertain. This study aims to confirm the predictive capability of IPF for bacteremia and investigate its association with prognosis. METHODS: Patients with complete blood count (CBC) on the blood culture day (D1) and the preceding day (D0) were retrospectively recruited and categorized into bacteremia and nonbacteremia groups. Immature platelet (IP) analysis, alongside CBC, was conducted. Delta IPF, defined by the absolute values of D1 minus D0 results was calculated. The ability to distinguish bacteremia from nonbacteremia patients, and the correlation with mortality were analyzed. RESULTS: From February to December 2020, a total of 150 patients were enrolled, with 75 having bacteremia. The specificity for delta IPF ≥3.4% to predict bacteremia was 97.3% (95% confidence interval [CI]: 90.7-99.7). When delta IPF ≥3.4% combined with procalcitonin ≥0.5 (ng/mL), the sensitivity was 90.5% (95% CI: 69.6%-98.8%). Within the bacteremia group, delta IPF and the proportion of patients with delta IPF ≥1.5% were significantly higher in nonsurvival, while delta platelet levels did not. Furthermore, delta IPF ≥1.5% was independently associated with 30-day mortality (adjusted odds ratio: 3.88, 95% CI: 1.2%-11.4%; p = 0.020). The 30-day survival curve demonstrated a significant difference between patients with delta IPF ≥1.5% and those without (p < 0.001). CONCLUSIONS: Delta IPF correlates with mortality in bacteremia patients. Our findings suggest IPF not only helps detect bacteremia but also predicts prognosis in the early stage.

RESUMEN

Purpose: Proton FLASH has been investigated using cyclotron and synchrocyclotron beamlines but not synchrotron beamlines. We evaluated the impact of dose rate (ultra-high [UHDR] vs. conventional [CONV]) and beam configuration (shoot-through [ST] vs. spread-out-Bragg-peak [SOBP]) on acute radiation-induced gastrointestinal toxicity (RIGIT) in mice. We also compared RIGIT between synchrotron-based protons and linac-based electrons with matched mean dose rates. Methods and Materials: We administered abdominal irradiation (12-14 Gy single fraction) to female C57BL/6J mice with an 87 MeV synchrotron-based proton beamline (2 cm diameter field size as a lateral beam). Dose rates were 0.2 Gy/s (S-T pCONV), 0.3 Gy/s (SOBP pCONV), 150 Gy/s (S-T pFLASH), and 230 Gy/s (SOBP pFLASH). RIGIT was assessed by the jejunal regenerating crypt assay and survival. We also compared responses to proton [pFLASH and pCONV] with responses to electron CONV (eCONV, 0.4 Gy/s) and electron FLASH (eFLASH, 188-205 Gy/s). Results: The number of regenerating jejunal crypts at each matched dose was lowest for pFLASH (similar between S-T and SOBP), greater and similar between pCONV (S-T and SOBP) and eCONV, and greatest for eFLASH. Correspondingly, mice that received pFLASH SOBP had the lowest survival rates (50% at 50 days), followed by pFLASH S-T (80%), and pCONV SOBP (90%), but 100% of mice receiving pCONV S-T survived (log-rank P = 0.047 for the four groups). Conclusions: Our findings are consistent with an increase in RIGIT after synchrotron-based pFLASH versus pCONV. This negative proton-specific FLASH effect versus linac-based electron irradiation underscores the importance of understanding the physical and biological factors that will allow safe and effective clinical translation.

RESUMEN

A novel approach, the differential Barrett-Joyner-Halenda model (D-BJH), is proposed to address the limitations of the traditional BJH model in determining the pore size distribution (PSD). This method integrates multilayer adsorption and capillary condensation processes using advanced numerical techniques, notably, a Galerkin-based framework for solving the differential BJH equations. The D-BJH model offers a precise analytical framework, establishing itself as a benchmark in adsorption theory. It enables accurate PSD calculations and provides robust theoretical support for interpreting adsorption isotherms. Additionally, a simplified D-BJH method allows for direct point-by-point PSD calculation, reducing computational complexity and eliminating cumulative errors inherent in traditional methods like BJH, DH, CI, and VBS. The D-BJH model demonstrates that PSD is directly related to the differential function of the isotherm and pore size concerning relative pressure. Comparative analyses with BJH, DH, and NLDFT models show that D-BJH effectively explains fundamental adsorption mechanisms, such as the "spurious peak" observed in desorption branches. This work expands the applicability of the BJH model, proving that both the D-BJH model and its simplified method are accurate and comprehensive for characterizing the pore structures of microporous and mesoporous materials.

RESUMEN

Staphylococcus aureus (S. aureus) infection is a primary cause of otitis media (OM), the most common disease for which children are prescribed antibiotics. However, the abuse of antibiotics has led to a global increase in antimicrobial resistance (AMR). Nanozymes, as promising alternatives to traditional antibiotics, are being extensively utilized to combat AMR. Here, we synthesize a series of single-atom nanozymes (metal-C3N4 SANzymes) by loading four metals (Ag, Fe, Cu, Ru) with antibacterial properties onto a crystalline g-C3N4. These metal-C3N4 display a rob-like morphology and well-dispersed metal atoms. Among them, Ru-C3N4 demonstrates the optimal peroxidase-like activity (285.3 U mg-1), comparable to that of horseradish peroxidase (267.7 U mg-1). In vitro antibacterial assays reveal that Ru-C3N4 significantly inhibits S. aureus growth compared with other metal-C3N4 even at a low concentration (0.06 mg mL-1). Notably, Ru-C3N4 acts as a narrow-spectrum nanoantibiotic with relative specificity against Gram-positive bacteria. Biofilms formed by S. aureus are easily degraded by Ru-C3N4 due to its high peroxidase-like activity. In vivo, Ru-C3N4 effectively eliminates S. aureus and relieves ear inflammation in OM mouse models. However, untreated OM mice eventually develop hearing impairment. Due to its low metal load, Ru-C3N4 does not exhibit significant toxicity to blood, liver, or kidney. In conclusion, this study presents a novel SANzyme-based antibiotic that can effectively eliminate S. aureus and treat S. aureus-induced OM.

RESUMEN

The connectivity (valency) of building blocks for constructing 3D covalent organic frameworks (COFs) has long been limited to 4, 6, 8, and 12. Developing a higher connectivity remains a great challenge in the field of COF structural design. Herein, this work reports a hierarchical expansion strategy for making 16-connected building blocks to construct 3D COFs with sqc topology. The [16 + 2] construction achieved by condensation between a 16-connected carbazolyl dicyanobenzene-based building block (CzTPN) and linear diamino linkers (BD or Bpy) affords two 3D COFs (named CzBD COF and CzBpy COF). Furthermore, attributed to the well-organized donor-acceptor (D-A) heterojunction, the Ni chelated CzBpy COF (Ni@CzBpy COF) exhibits excellent performance for photoredox/Ni dual catalytic C(sp3)-C(sp2) cross-coupling of alkyltrifluoroborates with aryl halides, achieving a maximum 98% conversion and 94% yield for various substrates. This work developed the first case of high-connectivity COFs bearing 16-connected units, which is the highest connectivity reported until now, and achieved efficient photocatalysis applications, thus greatly enriching the possibilities of COFs.

RESUMEN

Panoptic Part Segmentation (PPS) unifies panoptic and part segmentation into one task. Previous works utilize separate approaches to handle things, stuff, and part predictions without shared computation and task association. We aim to unify these tasks at the architectural level, designing the first end-to-end unified framework, Panoptic-PartFormer. Moreover, we find the previous metric PartPQ biases to PQ. To handle both issues, we first design a meta-architecture that decouples part features and things/stuff features, respectively. We model things, stuff, and parts as object queries and directly learn to optimize all three forms of prediction as a unified mask prediction and classification problem. We term our model as Panoptic-PartFormer. Second, we propose a new metric Part-Whole Quality (PWQ), better to measure this task from pixel-region and part-whole perspectives. It also decouples the errors for part segmentation and panoptic segmentation. Third, inspired by Mask2Former, based on our meta-architecture, we propose Panoptic-PartFormer++ and design a new part-whole cross-attention scheme to boost part segmentation qualities further. We design a new part-whole interaction method using masked cross attention. Finally, extensive ablation studies and analysis demonstrate the effectiveness of both Panoptic-PartFormer and Panoptic-PartFormer++. Compared with previous Panoptic-PartFormer, our Panoptic-PartFormer++ achieves 2% PartPQ and 3% PWQ improvements on the Cityscapes PPS dataset and 5% PartPQ on the Pascal Context PPS dataset. On both datasets, Panoptic-PartFormer++ achieves new state-of-the-art results. Our models can serve as a strong baseline and aid future research in PPS. The source code and trained models will be available at https://github.com/lxtGH/Panoptic-PartFormer.

RESUMEN

Background: The aim of this study was to investigate the relationship between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) and all-cause mortality in adults with metabolic syndrome (MeS) and explore the mediating role of oxidative stress. Methods: This study included 6131 adults with MeS from the National Health and Nutrition Examination Survey (NHANES). The relationships between TyG index and mortality were elucidated using multivariate Cox proportional hazards models, restricted cubic splines (RCS) Fine-Gray competing risk model. In addition, mediation analysis was used to test the indirect effect of oxidative stress indicators. Results: Over a median 106-month follow-up, a total of 357 CVD and 1292 all-cause deaths were recorded. After multivariate adjustment, there was a J-type relationship between TyG index and CVD and all-cause mortality, with optimal inflection point of 9.13 and 8.92. After the threshold point, TyG index was positively associated with CVD (HR: 4.21, 95%CI: 1.82, 9.78) and all-cause mortality(HR: 2.93, 95%CI: 2.05, 4.18). Even using non-cardiovascular mortality as a competitive risk, the Fine-Gray model also illustrated that the cumulative CVD mortality incidence was higher in MeS with TyG index >9.13 (Fine-Gray P< 0.01). Mediation analysis revealed that biomarkers of oxidative stress, including gamma-glutamyl transferase and uric acid, collectively mediated 10.53% of the association between the TyG index and CVD mortality, and 8.44% of the association with all-cause mortality (P < 0.05). Conclusion: In the cohort study, TyG index was found to have a J-shaped association with CVD mortality and all-cause mortality in MeS population and oxidative stress may play a key mediating role in this relationship.

Asunto(s)

RESUMEN

Hypertensive heart disease was difficult to cure with drugs, and most patients had poor compliance, leading to recurrent disease and poor quality of life. The intelligent management mode based on the Internet of Things avoided the excessive dependence of the elderly patients on medical institutions in the traditional medical model and enabled patients to monitor themselves. This study aimed to explore the impact on self-management ability and prognosis of elderly patients with hypertensive heart disease. A total of 150 elderly patients with hypertensive heart disease who received treatment from April 2020 to April 2022 were selected and divided into control group (n = 75 cases) and observation group (n = 75 cases) by random number table method. The control group was given routine intervention, and the observation group was given intelligent management mode based on the Internet of Things. Blood pressure fluctuation, self-management ability, and prognosis of the 2 groups were compared after intervention. After the intervention of the intelligent management mode based on the Internet of Things, the systolic and diastolic blood pressure levels in the observation group were lower than those in the control group (P < .05). After intervention, the scores of self-management ability in diet control, self-care skills, rehabilitation exercise, and self-monitoring in observation group were higher than those in control group (P < .05). After intervention, the total incidence of chest tightness, dyspnea, arrhythmia, edema, and nausea in the observation group was 5 (6.67%), which was significantly lower than that in the control group 12 (16.00%) (P < .05). The application of intelligent management mode based on the Internet of Things could effectively improve patients' blood pressure level, improve patients' self-management ability, and significantly improve the prognosis, which was worthy of popularization and application.

Asunto(s)

RESUMEN

Seaport infrastructure requires considerable resources and time for a full recovery from accidents caused by hazardous cargo. Despite their severity, the risk to seaport infrastructure from hazardous cargo operations has been insufficiently explored. This study aims to fill that gap by examining the risks to seaport infrastructure from the complex effects of hazardous cargo operations. It draws on literature, incident reports, and expert consultations to identify comprehensive risk factors and their interconnections. The study employs expert judgments alongside logistic regression to develop Conditional Probability Tables (CPTs) and conducts a risk analysis using Bayesian networks (BN). Our findings indicate that, under typical operating conditions, fire and explosion, corrosion, and improper handling are the most significant contributors to seaport infrastructure risk with probabilities of 8.73 %, 5.88 %, and 5.61 % respectively. Inverse propagation indicates that the contribution of improper handling and corrosion is enhanced by 153 % and 96 % respectively towards the increased risk. A sensitivity analysis was carried out to pinpoint critical risk factors. Based on these insights, the study suggests practical measures like the use of tracking and monitoring systems along with third-party audits for effective handling, augmented and virtual reality for advanced training, and automation technology for reduced human roles to subside risks to seaport infrastructure and promote uninterrupted operations.