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1.
World J Gastrointest Surg ; 16(8): 2630-2639, 2024 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-39220054

RESUMEN

BACKGROUND: The incidence and mortality rates of primary hepatocellular carcinoma (HCC) are high, and the conventional treatment is radiofrequency ablation (RFA) with transcatheter arterial chemoembolization (TACE); however, the 3-year survival rate is still low. Further, there are no visual methods to effectively predict their prognosis. AIM: To explore the factors influencing the prognosis of HCC after RFA and TACE and develop a nomogram prediction model. METHODS: Clinical and follow-up information of 150 patients with HCC treated using RFA and TACE in the Hangzhou Linping Hospital of Traditional Chinese Medicine from May 2020 to December 2022 was retrospectively collected and recorded. We examined their prognostic factors using multivariate logistic regression and created a nomogram prognosis prediction model using the R software (version 4.1.2). Internal verification was performed using the bootstrapping technique. The prognostic efficacy of the nomogram prediction model was evaluated using the concordance index (CI), calibration curve, and receiver operating characteristic curve. RESULTS: Of the 150 patients treated with RFA and TACE, 92 (61.33%) developed recurrence and metastasis. Logistic regression analysis identified six variables, and a predictive model was created. The internal validation results of the model showed a CI of 0.882. The correction curve trend of the prognosis prediction model was always near the diagonal, and the mean absolute error before and after internal validation was 0.021. The area under the curve of the prediction model after internal verification was 0.882 [95% confidence interval (95%CI): 0.820-0.945], with a specificity of 0.828 and sensitivity of 0.656. According to the Hosmer-Lemeshow test, χ 2 = 3.552 and P = 0.895. The predictive model demonstrated a satisfactory calibration, and the decision curve analysis demonstrated its clinical applicability. CONCLUSION: The prognosis of patients with HCC after RFA and TACE is affected by several factors. The developed prediction model based on the influencing parameters shows a good prognosis predictive efficacy.

2.
World J Gastrointest Surg ; 16(8): 2574-2582, 2024 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-39220084

RESUMEN

BACKGROUND: Study on influencing factors of gastric retention before endoscopic retrograde cholangiopancreatography (ERCP) background: With the wide application of ERCP, the risk of preoperative gastric retention affects the smooth progress of the operation. The study found that female, biliary and pancreatic malignant tumor, digestive tract obstruction and other factors are closely related to gastric retention, so the establishment of predictive model is very important to reduce the risk of operation. AIM: To analyze the factors influencing preoperative gastric retention in ERCP and establish a predictive model. METHODS: A retrospective analysis was conducted on 190 patients admitted to our hospital for ERCP preparation between January 2020 and February 2024. Patient baseline clinical data were collected using an electronic medical record system. Patients were randomly matched in a 1:4 ratio with data from 190 patients during the same period to establish a validation group (n = 38) and a modeling group (n = 152). Patients in the modeling group were divided into the gastric retention group (n = 52) and non-gastric retention group (n = 100) based on whether gastric retention occurred preoperatively. General data of patients in the validation group and modeling group were compared. Univariate and multivariate logistic regression analyses were performed to identify factors influencing preoperative gastric retention in ERCP patients. A predictive model for preoperative gastric retention in ERCP patients was constructed, and calibration curves were used for validation. The receiver operating characteristic (ROC) curve was analyzed to evaluate the predictive value of the model. RESULTS: We found no statistically significant difference in general data between the validation group and modeling group (P > 0.05). The comparison of age, body mass index, hypertension, and diabetes between the two groups showed no statistically significant difference (P > 0.05). However, we noted statistically significant differences in gender, primary disease, jaundice, opioid use, and gastrointestinal obstruction between the two groups (P < 0.05). Multivariate logistic regression analysis showed that gender, primary disease, jaundice, opioid use, and gastrointestinal obstruction were independent factors influencing preoperative gastric retention in ERCP patients (P < 0.05). The results of logistic regression analysis revealed that gender, primary disease, jaundice, opioid use, and gastrointestinal obstruction were included in the predictive model for preoperative gastric retention in ERCP patients. The calibration curves in the training set and validation set showed a slope close to 1, indicating good consistency between the predicted risk and actual risk. The ROC analysis results showed that the area under the curve (AUC) of the predictive model for preoperative gastric retention in ERCP patients in the training set was 0.901 with a standard error of 0.023 (95%CI: 0.8264-0.9567), and the optimal cutoff value was 0.71, with a sensitivity of 87.5 and specificity of 84.2. In the validation set, the AUC of the predictive model was 0.842 with a standard error of 0.013 (95%CI: 0.8061-0.9216), and the optimal cutoff value was 0.56, with a sensitivity of 56.2 and specificity of 100.0. CONCLUSION: Gender, primary disease, jaundice, opioid use, and gastrointestinal obstruction are factors influencing preoperative gastric retention in ERCP patients. A predictive model established based on these factors has high predictive value.

3.
Oncol Res ; 32(9): 1479-1516, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220130

RESUMEN

Chimeric antigen receptor T-cesll therapy (CAR-T) has achieved groundbreaking advancements in clinical application, ushering in a new era for innovative cancer treatment. However, the challenges associated with implementing this novel targeted cell therapy are increasingly significant. Particularly in the clinical management of solid tumors, obstacles such as the immunosuppressive effects of the tumor microenvironment, limited local tumor infiltration capability of CAR-T cells, heterogeneity of tumor targeting antigens, uncertainties surrounding CAR-T quality, control, and clinical adverse reactions have contributed to increased drug resistance and decreased compliance in tumor therapy. These factors have significantly impeded the widespread adoption and utilization of this therapeutic approach. In this paper, we comprehensively analyze recent preclinical and clinical reports on CAR-T therapy while summarizing crucial factors influencing its efficacy. Furthermore, we aim to identify existing solution strategies and explore their current research status. Through this review article, our objective is to broaden perspectives for further exploration into CAR-T therapy strategies and their clinical applications.


Asunto(s)
Inmunoterapia Adoptiva , Neoplasias , Receptores Quiméricos de Antígenos , Microambiente Tumoral , Humanos , Inmunoterapia Adoptiva/métodos , Inmunoterapia Adoptiva/efectos adversos , Neoplasias/terapia , Neoplasias/inmunología , Receptores Quiméricos de Antígenos/inmunología , Microambiente Tumoral/inmunología , Animales , Linfocitos T/inmunología , Antígenos de Neoplasias/inmunología , Receptores de Antígenos de Linfocitos T/inmunología
4.
Front Public Health ; 12: 1448871, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220455

RESUMEN

Objective: To understand the current situation of nursing manpower allocation, explore the factors affecting nurse staffing, improve nurse staffing level, and provide reference for better formulation of nursing human resources staffing standards. Methods: A descriptive research method was used to conduct semi-structured interviews with 14 nursing managers. The data were analyzed and refined by content analysis. The sample size was subject to content saturation. Results: Nine themes and twenty sub-themes of influencing factors for nursing staffing were identified across four levels: hospital level, department level, patient level, and nurse level. Conclusion: Hospital and department managers need to comprehensively consider the factors of affecting nurse staffing. Adopting multidimensional optimization measures, improving relevant systems, optimizing nurse structure, and establishing flexible and mobile nurse database to cope with public emergencies, so as to effectively improve nurse staffing and nursing service quality.


Asunto(s)
Enfermeras Administradoras , Personal de Enfermería en Hospital , Admisión y Programación de Personal , Investigación Cualitativa , Humanos , Admisión y Programación de Personal/estadística & datos numéricos , Personal de Enfermería en Hospital/estadística & datos numéricos , Masculino , Femenino , Entrevistas como Asunto , Adulto , Persona de Mediana Edad
5.
Front Neurol ; 15: 1419017, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220736

RESUMEN

Background: Many studies have explored the risk factors associated with cognitive impairment in patients with Type 2 diabetes mellitus (T2DM). However, research on determining the optimal threshold for these risk factors and comparative studies on the therapeutic effects of insulin and metformin is limited. This study aims to establish the optimal threshold for cognitive impairment risk factors in T2DM patients and compare the efficacy of insulin and metformin in treating mild cognitive impairment (MCI). Methods: A total of 308 patients with T2DM were included. The optimal threshold for cognitive impairment risk factors was determined using receiver operating characteristic curve and binary logistic regression models. MCI patients were divided into three groups: insulin, metformin, and insulin with metformin. The treatment effect was evaluated after a 6-month follow-up. Results: The study identified several factors that influenced cognitive function in T2DM patients, including female gender, duration of diabetes >13.50 years, years of education >7.50 years, and serum sodium level > 141.90 mmol/L. Metformin and insulin with metformin showed superior therapeutic effects compared to insulin alone, but no difference was observed between metformin and combination therapy. Conclusion: Special attention should be given to female and those with diabetes duration >13.50 years, as well as to individuals with educational level ≤ 7.50 years and serum sodium concentration ≤ 141.90 mmol/L. Metformin and insulin with metformin effectively improve MCI in patients with T2DM and outperform insulin monotherapy. The efficacy of metformin and combination therapy was found to be comparable.

6.
Front Neurol ; 15: 1420915, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39220739

RESUMEN

Background: Thromboelastography (TEG) can objectively reflect the formation, development and rupture process of thrombosis in patients, but there are limited data on whether TEG can be used as a predictive tool for recurrence in patients with acute ischemic stroke. Objective: To explore the TEG risk of recurrence in patients with acute ischemic stroke predictive value. Methods: A total of 441 patients with acute ischemic stroke who met the research criteria in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2020 to December 2021 were selected as the research objects. TEG was measured in all patients, and the main parameters of TEG (R value, indicating coagulation reaction time; K value and Angle, the rate of blood clot formation; MA value, indicating the maximum amplitude). The primary outcome of this study was ischemic stroke recurrence. Recurrent events included cerebral infarction, cerebral hemorrhage, TIA, and were determined by combining imaging events and clinical events. Logistic regression analysis was used to explore the influencing factors of recurrence in patients with acute ischemic stroke. Results: Fifty-six patients (12.7%) had recurrence. Multivariate Logistic regression analysis showed that: Age [OR = 1.078, 95%CI(1.024, 1.135)], triglyceride [OR = 1.541, 95%CI(1.033, 2.298)], glycosylated hemoglobin [OR = 1.401, 95%CI(1.097, 1.790)], history of hypertension [OR = 16.046, p < 0.05], 95%CI(4.726, 54.489), R value [OR = 0.533, 95%CI(0.351, 0.809)], MA value [OR = 1.399, 95%CI(1.004, 1.949)] were independent influencing factors for hemorrhagic transformation in patients with acute ischemic stroke. Conclusion: TEG has some value in predicting recurrence in patients with acute ischemic stroke, and the MA value in TEG [AUC = 0.806 (95%CI:0.747-0.867), with a sensitivity of 78.6% and a specificity of 70.4%], predicted the most significant efficiency of AIS recurrence.

7.
Infect Drug Resist ; 17: 3737-3749, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39221187

RESUMEN

Objective: Rifampin-resistant tuberculosis (RR-TB) remains a serious global public health concern. We assessed treatment outcomes and associated influencing factors among RR-TB patients in China. Methods: This research enrolled 1339 patients who started RR-TB treatment between May 2018 and April 2020 in China retrospectively. Data were collected from the electronic medical records. Multivariable logistic regression analysis was used to identify the influencing factors related to unfavorable outcomes. Results: Of the 1339 RR-TB patients, 78.8% (1055/1339) achieved treatment success (cured or treatment completed), 5.1% (68/1339) experienced treatment failure, 1.1% (15/1339) died during treatment, 10.1% (135/1339) were lost to follow-up, and 4.9% (66/1339) were not evaluated. About 67.7% (907/1339) of patients experienced at least one adverse event (AE). The most common AE was hypohepatia (507/1339, 37.9%), followed by hyperuricemia (429/1339, 32.0%), anemia (368/1339, 27.5%), electrolyte disturbance (318/1339, 23.7%), peripheral neuritis (245/1339, 18.3%), and gastrointestinal reactions (203/1339, 15.2%). Multivariate analysis showed that age ≥60 years [adjusted odds ratio (aOR): 1.96, 95% confidence interval (CI): 1.39-2.77], national minority (aOR: 2.36, 95% CI: 1.42-3.93), smoking (aOR: 1.50, 95% CI: 1.10-2.04), cardiopathy (aOR: 2.90, 95% CI: 1.33-6.31), tumors (aOR: 9.84, 95% CI: 2.27-42.67), immunocompromise (aOR: 2.17, 95% CI: 1.21-3.91), re-treated TB (aOR: 1.46, 95% CI: 1.08-1.97), and experienced gastrointestinal reactions (aOR: 2.27, 95% CI: 1.52-3.40) were associated with unfavorable outcomes. Body mass index (BMI) ≥18.5 kg/m2, regimens containing bedaquiline and experienced adverse events (AEs) such as hypohepatia, leukopenia, peripheral neuritis, and optic neuritis were associated with favorable outcomes. Conclusion: High rates of treatment success were achieved for RR-TB patients at tertiary tuberculosis hospitals in China. Age ≥60 years, national minority, smoking status, comorbidities, re-treated TB, and experienced gastrointestinal reactions were independent prognostic factors for unfavorable treatment outcomes.

8.
Cureus ; 16(8): e66021, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39221409

RESUMEN

BACKGROUND: Determining the influencing factors of choice of medical specialty is key to a balanced distribution of physicians across specialties. Dermatology, the specialty concerned with treating skin disorders, is known for being among the most wanted; however, studies identifying the factors that attract students to this specialty are lacking. Our study aimed to investigate the influencing factors of the choice of dermatology as a career in clinical-year medical students. METHODS: We conducted a cross-sectional study with a sample of clinical-year medical students from King Abdulaziz University, Jeddah, Saudi Arabia, between 2020 and 2021. We collected data using an online self-administered questionnaire; we replicated a questionnaire present in prior research. We compared categorical data using the chi-square and Fisher's exact tests.  Results: In total, there were 252 participants, with 30 (11.9%) choosing dermatology as a specialty. Over half showed an average grade of more than 4.5 (66.7%), and 83.3% were female. The significant influencing factors of students' choice of dermatology as a career were: the likelihood of dermatologists influencing patients' lives (p=0.000), opportunities to conduct research in dermatology (P=0.000), how Dermatology allows people to have a satisfying family life (P=0.001), and opportunities for part-time work in dermatology (p=0.000). CONCLUSION: Many factors influenced the choice of a future medical specialty in our sample. Focusing on these factors while guiding students to choose their specialty may enable a promising next generation of physicians.

9.
Int J Occup Saf Ergon ; : 1-13, 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39258567

RESUMEN

Objectives. How to promote the safety citizenship behavior (SCB) of construction workers has been studied in academic circles. However, most current research methods focus on the 'net effect' between the independent variable and SCB. Methods and Results. Based on the fuzzy set qualitative comparative analysis (fsQCA) method and from the perspective of 'configuration', this article proposes that the emergence of SCB not only depends on a single condition, but also depends on the interaction of safety leadership behavior (SLB), organizational safety climate (OSC), organizational safety support (OSS), safety attitude (SA), safety motivation (SM), safety risk perception (SRP) and psychological belonging (PB). Conclusion. The research shows that the emergence of construction workers' SCB can be realized through different combinations of variables, and both 'external environment-driven' and 'interpersonal relationship-driven' paths can promote the generation of SCB. This research provides a more systematic and practical explanation for how to promote the generation of SCB of construction workers, expand the research scope of safety management and play a positive role in reducing the incidence of safety accidents in the construction industry.

10.
BMC Nurs ; 23(1): 627, 2024 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-39244558

RESUMEN

OBJECTIVE: To investigate the current situation of innovative behavior and organizational structure authorization of ophthalmic specialty nurses in China, and analyze the influencing factors of innovative behavior. METHODS: A cross-sectional survey was carried out among 301 ophthalmic specialty nurses in China, representing Representing 82 hospitals in 25 provinces, using a general data questionnaire, Innovative Behavior Scale(IBS), and conditions of work effectiveness questionnaire(CWEQ-II). RESULTS: The mean total score for innovative behavior among Chinese ophthalmic specialty nurses was (4.73 ± 1.14), and the mean total score for organizational structure authorization was (61.65 ± 14.69). The logistic regression analysis revealed that organizational structure authorization, hospital grade, and ophthalmic specialty nurses primarily engaged in clinical care and clinical research had statistically significant impacts on the level of innovative behavior (P < 0.05). The higher the organizational structure authorization score, the higher the innovative behavior level of ophthalmic specialty nurses, the level of innovation behavior of grade-B tertiary hospitals is higher than that of grade-A tertiary hospitals. The main positions are low level of innovative behavior in clinical care and high level of innovative behavior in clinical research. CONCLUSIONS: The innovative behavior and organizational structure authorization of Chinese ophthalmic specialty nurses are at a medium level, the innovative behavior of ophthalmic specialty nurses is influenced by factors such as organizational structure empowerment level, hospital grade, and main job position. Nursing managers are advised to develop tailored training programs based on the influencing factors of innovative behavior among Chinese ophthalmic specialty nurses, in order to enhance their level of innovation and improve the quality of nursing services provided by Chinese ophthalmic specialty nurses.

11.
Arch Gerontol Geriatr ; 128: 105619, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39243535

RESUMEN

BACKGROUND: Atrial fibrillation (AF) is associated with an increased risk of cognitive impairment. Therefore, exploring factors which may be associated with cognitive impairment is important. Correspondingly, this study aimed to systematically evaluate factors associated with cognitive impairment in AF patients by synthesizing relevant evidence. METHODS: A database search of the PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, Wanfang, and VIP databases was conducted from inception until December 21, 2023. The effect size was expressed as a combined odds ratio (OR) and 95 % confidence interval (95 % CI). The heterogeneity was qualitatively analyzed by Cochran's Q test and quantified by the I2 statistic. RESULTS: A total of 7,128 studies were identified from the 8 databases, and 39 studies of 3,491,423 participants were included. A meta-analysis was performed on 19 influencing factors. Advanced age (OR=1.38, 95 % CI: 1.11-1.71), female sex (OR=2.19, 95 % CI: 1.18-4.06), smoking (OR=2.44, 95 % CI: 1.24-4.80), hypertension (OR=1.61, 95 % CI: 1.27-2.03), diabetes (OR=1.42, 95 % CI: 1.20-1.67), and hearing impairment (OR=1.37, 95 % CI: 1.05-1.81) were risk factors for cognitive impairment. A higher education level (OR=0.57, 95 % CI: 0.46-0.72), oral anticoagulants (OR=0.61, 95 % CI: 0.48-0.78), novel oral anticoagulants (OR=0.63, 95 % CI: 0.54-0.73), warfarin (OR=0.55, 95 % CI: 0.39-0.79), novel oral anticoagulants relative to warfarin (OR=0.88, 95 % CI: 0.81-0.97), catheter ablation (OR=0.74, 95 % CI: 0.58-0.94) and exercise (OR=0.66, 95 % CI: 0.61-0.72) were protective factors for cognitive impairment. CONCLUSIONS: Age, sex, education level, smoking, exercise, hypertension, diabetes, hearing impairment, anticoagulation therapy, and catheter ablation were associated with cognitive impairment in AF patients.

12.
Water Environ Res ; 96(9): e11112, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39245973

RESUMEN

Root channel wetlands, as a new type of nature-imitating wetland system, provide a paradigm for micro-polluted water source purification; however, there is a knowledge gap on root channel wetlands' pollution removal effects and their main influencing factors after longtime operation. This study collected the turbidity, ammonia nitrogen (NH3-N), total nitrogen (TN), total phosphorus (TP), permanganate index (CODMn), dissolved oxygen (DO), and chemical oxygen demand (COD) at the inlet and outlet of Shijiuyang (SJY) wetland and Guanjinggang (GJG) wetland in Jiaxing City, China, from 2019 to 2021. The results showed that root channel wetlands had better water quality improvement effects. The SJY wetland had larger removal rates for DO, CODMn, and turbidity compared with the GJG wetland. In contrast, other water quality indexes have similar removal rates at both wetlands. The influencing factor analysis showed that water purification agent, flow, pH, and water temperature have large influences on the removal rates of pollutants for both wetlands. To address high turbidity and excessive DO, which are the primary pollutants affecting the two wetlands, implementing the diversion river before the pretreatment area and incorporating ecological floating beds in the deep purification area are recommended solutions to mitigate these issues. Compared with conventional general constructed wetlands, root channel wetlands are a more cost-effective and sustainable technology. The research is conducive to improving understanding of root channel wetland purification for micro-polluted water sources and enhancing water supply security capability in the plains water network area of the Yangtze River Delta region. PRACTITIONER POINTS: Compared with conventional general constructed wetlands, root channel wetlands are more cost-effective and sustainable technology. The SJY wetland demonstrated better removal rates for DO, CODMn, and turbidity, indicating a higher purification capacity compared to GJG wetland. Flow rate and pH are the primary factors influencing the GJG wetland, while the waterpurification agent and water temperature are the main factors affecting water quality in the SJY wetland.


Asunto(s)
Contaminantes Químicos del Agua , Purificación del Agua , Humedales , China , Contaminantes Químicos del Agua/química , Purificación del Agua/métodos , Fósforo/química , Nitrógeno , Calidad del Agua , Análisis de la Demanda Biológica de Oxígeno
13.
Environ Pollut ; 361: 124867, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39218200

RESUMEN

Revegetation is a promising strategy for large-scale bauxite residue disposal and management, potentially influencing the geochemical stability of potentially toxic elements (PTEs) through rhizosphere processes. However, the geochemical behaviors of PTEs and the underlying mechanisms during bauxite residue revegetation remain unclear. This study examined the migration and transformation behaviors of PTEs and their underlying mechanisms in the bauxite residue-vegetation-leachate system under various revegetation strategies, including single and co-planting of perennial ryegrass (Lolium perenne L.) and white clover (Trifolium repens L.), over a 100-day microcosm experiment. The results showed significant decreases in pH, EC, Na, Al, and Cr levels in the leachate under various revegetation strategies, with slight increases in Cu, V, As, and Pb. Over time, the pH, EC, Na, Cr, Cu, V, Pb, and As levels in the leachate decreased, while those of Al, Fe, Mn, and Zn increased. The mean pH, EC, and concentrations of Na, Al, Fe, and Cr in the leachate of the revegetated treatments decreased by 6%-8%, 21%-33%, 2%-4%, 19%-27%, 7%-22%, and 15%-26%, respectively, while the mean concentrations of Mn, V, Zn, and As increased by 47%-134%, 26%-46%, 39%-47%, and 3%-10%, respectively, compared to the unamended treatment. Co-planting generally exhibited a greater impact on leachate components compared to single planting. Available contents of Al, Cr, and Pb decreased by 81%-83%, 57%-77%, and 55%-72%, respectively, while those of other PTEs increased in the revegetated bauxite residue. Co-planting significantly reduced the availability of PTEs compared to single planting. Except for Na and Mn, the bioaccumulation and transportation factors of PTEs in both vegetation species remained below 1 under various revegetation strategies. The migration and transformation behaviors of PTEs in the bauxite residue-vegetation-leachate system were mainly influenced by pH and nutrient levels. These findings provide new insights into the migration and transformation behaviors of PTEs during bauxite residue revegetation.

14.
Sci Rep ; 14(1): 20567, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39232100

RESUMEN

In order to explore the influencing factors of spatial and temporal evolution of production-living-ecological space in Beijing Tianjin sandstorm source area, the remote sensing images, natural environment and socio-economic data of Duolun County in Inner Mongolia from 2000 to 2020 were selected, and the spatial auto-correlation model and principal component analysis model were used to analyze the spatial pattern evolution and influencing factors of production-living-ecological space. The results show that: (1) the function of production space decreases slightly, and the degree of spatial agglomeration decreases; (2) The function of living space rose slightly, and its spatial agglomeration degree showed an upward trend; (3) The ecological spatial function showed a slow upward trend, and its spatial agglomeration degree increased; (4) The spatial pattern of production-living-ecological space is characterized by "high in the southwest and low in the northeast"; (5) Precipitation has the greatest impact on the spatial evolution of the production-living-ecological space. The distance from the main residential areas, per capita GDP, the distance from the main roads and the distance from the main waters have strong explanatory power on the spatial evolution of the production-living-ecological space.

15.
Am J Hum Biol ; : e24153, 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39264229

RESUMEN

OBJECTIVES: The regional population mortality patterns in China exhibit substantial geographical distribution characteristics. This paper aims to explore the impact and mechanisms of geographical environmental factors on regional population mortality patterns. METHODS: This study first utilized the data from China's Seventh Population Census to obtain mortality patterns for the 31 provincial-level administrative regions. Subsequently, a functional regression method was employed to explore the geographical environmental driving factors of regional mortality patterns. RESULTS: The study provides a detailed explanation of the mechanisms and marginal contributions of key geographical environmental factors at different age groups. CONCLUSIONS: (1) The impact of geographical environmental factors on mortality patterns shows distinct phased characteristics. Mortality patterns before the age of 40 years are hardly influenced by geographical environmental factors, with a noticeable impact beginning at ages 40-69 years and reaching the maximum influence after the age of 70 years. (2) In mortality patterns at ages 40-69 years, average altitude have the most substantial impact, followed by extreme low-temperature days and PM2.5 concentration. In mortality patterns at ages 70-94 years, high-temperature days have the greatest influence, followed by the impact of SO2 concentration. (3) In comparisons based on gender, socioeconomic factors, and geographical environmental factors, gender and urban-rural differences have the most significant impact on regional population mortality patterns, followed by the influence of other socioeconomic factors, with geographical environmental factors having a relatively smaller impact.

16.
Infect Drug Resist ; 17: 3793-3804, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39247753

RESUMEN

Objective: To assess the efficacy and safety of colistin sulfate in treating infections caused by carbapenem-resistant organisms (CRO) and to analyze potential factors impacting its effectiveness. Methods: In this retrospective study, medical records of CRO-infected patients from June 2020 to June 2023 were analyzed, divided into effective and ineffective treatment groups, and compared for clinical outcomes and adverse reactions. Multifactorial logistic regression and ROC curve analysis were used to identify influencing factors. Results: The study included 226 patients, with 124 in the effective treatment group and 102 in the ineffective group. A total of 293 CRO strains were cultured. The clinical efficacy rate of colistin sulfate was 54.87%, the microbiological efficacy rate 46.46%, and the hospital mortality rate 20.80%, with nephrotoxicity observed in 11.50% of patients. Multifactorial analysis identified APACHE II scores and vasoactive drug use as independent predictors of ineffective treatment, while treatment duration and albumin levels predicted effective treatment. ROC analysis indicated that albumin levels >34 g/L, APACHE II scores <13, and treatment duration >10 days correlated with better clinical efficacy. Conclusion: Colistin sulfate is both safe and effective in clinical settings. Factors such as treatment duration, albumin levels, APACHE II scores, and vasoactive drug use independently affect its clinical efficacy, providing valuable guidance for its informed clinical application.

17.
BMC Infect Dis ; 24(1): 966, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39272017

RESUMEN

BACKGROUND: Rabies is an incessant public health threat in China. The Ministry of Health implemented the Central Payment for Rabies Prevention and Control Project to assist with rabies prevention and control in a few representative provinces in 2006. METHODS: Data on human rabies cases reported by the National Infectious Disease Reporting Information Management System and national surveillance sites from 2006 to 2022 were collected, and statistical and multivariate analyses were then used to assess the effectiveness of current prevention and control efforts. RESULTS: During 2006-2022, a total of 2025 human rabies cases were collected by the national surveillance sites, with incidence rates far above the national average, but the incidence rate was consistent with the national trend. Human rabies cases demonstrated a dual peak distribution in terms of exposure and onset dates, with the peak exposure dates falling mostly in the spring and summer and the peak onset dates occurring mostly in the summer and autumn. Three danger categories are shown by the geographical distribution: high, medium and low. Dogs had a high infection rate (86.93%), with own domesticated dogs accounting for the majority of infections. The rates of post-exposure prophylaxis are not constant. The median incubation period was 71 days. CONCLUSIONS: Various measures and policies implemented by the government have played a key role in reducing the incidence of rabies. To effectively prevent and control the resurgence of epidemics and halt the spread of the virus among host animals, it is imperative to prioritize and implement a robust dog management system, accelerate research and development of animal vaccines and improve the level of post-exposure prophylaxis.


Asunto(s)
Rabia , Rabia/epidemiología , Rabia/prevención & control , Rabia/veterinaria , China/epidemiología , Humanos , Animales , Perros , Incidencia , Masculino , Femenino , Adolescente , Niño , Adulto , Persona de Mediana Edad , Estaciones del Año , Preescolar , Adulto Joven , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/virología , Enfermedades de los Perros/prevención & control , Lactante , Anciano , Profilaxis Posexposición , Vacunas Antirrábicas/administración & dosificación
18.
BMC Oral Health ; 24(1): 1079, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39272063

RESUMEN

OBJECTIVE: To investigate the current state of oral frailty in oldely patients with require dental implants, analyze influencing factors in the characteristics of oral frailty across different patient categories, and provide a reference for clinical staff to identify high-risk groups and develop proactive management strategies. METHODS: Between January 2024 and March 2024, 654 patients with dental implants were selected using convenience sampling from six secondary and tertiary stomatological hospitals in Jiangsu and Zhejiang provinces. Data were collected via a general information questionnaire and the Oral Frailty Index-8. The latent profiles of oral frailty were examined, and univariate and Logistic regression analyses were conducted to determine the impact of various factors on these profiles. RESULTS: In this cross-sectional study, 605 valid questionnaires were returned, yielding an effective rate of 92.58%. The mean oral frailty score was 6.64 ± 1.21, with the sample comprising 223 males and 382 females, averaging 72.54 ± 6.33 years old. Oral frailty was categorized into three latent profiles: high (20.50%), moderate (53.72%), and low (25.78%) frailty groups. Factor analysis indicated that age, gender, education level, family income, number of implants, and dyslipidemia significantly predicted the classification of these profiles (P < 0.05). CONCLUSION: Oral frailty in oldely patients with dental implants exhibits heterogeneity and is influenced by age, sex, education level, family income, number of implants, and dyslipidemia. Clinical staff should recognize the characteristics of different patient categories and implement proactive measures for those at high risk of oral frailty to enhance their quality of life.


Asunto(s)
Implantes Dentales , Fragilidad , Humanos , Masculino , Femenino , Estudios Transversales , Anciano , Fragilidad/complicaciones , Encuestas y Cuestionarios , Factores de Riesgo , Anciano de 80 o más Años , China , Persona de Mediana Edad , Anciano Frágil , Factores de Edad
19.
BMC Public Health ; 24(1): 2493, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39272064

RESUMEN

BACKGROUND: One of the challenges of physical training in extreme condition is frostbite, especially in Northeast China. In this study, we aimed to construct a risk prediction model for frostbite among soldiers in Northeast China, and verify its effect. METHODS: 698 participants were selected via convenience sampling from Northeast China from December 2021 to January 2022 (winter). They were randomly divided into a training set (N = 479) and a testing set (N = 202) in a ratio of 7:3. All participants completed a researcher-made questionnaire on frostbite. The prediction model was constructed through the use of Logistic regression analysis, which was used to predict the independent risk factors for frostbite formation and screen significant indicators. The model's performance was assessed using the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) to evaluate the prediction efficiency and goodness of fit. RESULTS: The incidence of frostbite in the training set was 19.83% (95 people), all of which were first-degree frostbite. Among them, frostbite in multiple parts was the most common (58.95%), followed by singular body parts like hands (24.21%), ears (11.58%) and feet (5.26%). Single factor logistic regression analyses showed that ambient temperature, ambient wind speed, outdoor stationary time, stationary status, and history of frostbite are independent risk factors that affect the occurrence of frostbite. Furthermore, we constructed the frostbite risk prediction model for soldiers in the northeastern region of China. The area under the receiver operating characteristic curve (AUC) for the risk of frostbite in the training set and testing set was 0.816 (95% CI, 0.770 ~ 0.862) and 0.787 (95% CI, 0.713 ~ 0.860), respectively. The Hosmer-Lemeshow test of the model showed χ2 = 11.328 and P = 0.184 (> 0.05). The DCA curve indicated that most of the clinical net benefits of the model are greater than 0, demonstrating good clinical usefulness. CONCLUSION: The constructed frostbite prediction model can effectively identify soldiers with a higher risk of frostbite. It provided theoretical support for commanders to take preventive measures to reduce the incidence of frostbite among soldiers and was of great clinical guiding significance.


Asunto(s)
Congelación de Extremidades , Personal Militar , Humanos , China/epidemiología , Congelación de Extremidades/epidemiología , Personal Militar/estadística & datos numéricos , Masculino , Estudios Transversales , Medición de Riesgo , Adulto , Adulto Joven , Factores de Riesgo , Femenino , Curva ROC , Modelos Logísticos , Encuestas y Cuestionarios
20.
Clinics (Sao Paulo) ; 79: 100495, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39265239

RESUMEN

OBJECTIVES: This thesis aims to provide patients with a preventive and therapeutic basis by analyzing IgE level influencing factors of common allergens for Allergic Rhinitis (AR). METHOD: Multiple linear regression analysis is made upon questionnaires among 749 cases of AR patients that are divided into 5 age-based groups. Perform serum-specific IgE content testing on patients. RESULTS: Cockroach being an allergen, AR patients' IgE Level is influenced by allergic history, home-raised plants and animals. For AR patients with mugwort as an allergen, allergy and asthma history could increase IgE level, respectively, ß = 4.291 and ß = 4.364. If the allergen turns out to be peanut, allergic history would increase the IgE level (ß = 0.171), however, the level would be lower in female patients compared with male patients (ß = -0.078). For patients with egg as an allergen, allergic history, home-raised plants and animals (pets) would all affect the IgE level, respectively, ß = 0.182, ß = 0.118 and ß = -0.101. CONCLUSIONS: IgE level varies according to allergic history, home-raised plants & animals, gender, furniture renewal, asthma, and ages for patients with different allergens including cockroach, mold, mugwort, peanut, egg and crab. For each kind of allergen, the IgE levels react differently to different influencing factors, thus requiring a thorough analysis of each AR patient's allergen and allergenic factors.


Asunto(s)
Alérgenos , Inmunoglobulina E , Rinitis Alérgica , Humanos , Femenino , Inmunoglobulina E/sangre , Masculino , Alérgenos/inmunología , China/epidemiología , Adulto , Niño , Adolescente , Adulto Joven , Rinitis Alérgica/inmunología , Rinitis Alérgica/sangre , Animales , Persona de Mediana Edad , Preescolar , Factores Sexuales , Factores de Edad , Encuestas y Cuestionarios , Anciano
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