Denitrification-induced nitrogen(N) losses from croplands may be greatly increased by intensive fertilization.However,the accurate quantification of these losses is still challenging due to insufficient available in s...Denitrification-induced nitrogen(N) losses from croplands may be greatly increased by intensive fertilization.However,the accurate quantification of these losses is still challenging due to insufficient available in situ measurements of soil dinitrogen(N) emissions.We carried out two one-week experiments in a maize-wheat cropping system with calcareous soil using theN gas-flux(NGF) method to measure in situ Nfluxes following urea application.Applications ofN-labeled urea(99 atom%,130-150 kg N ha) were followed by irrigation on the 1 st,3 rd,and 5 th days after fertilization(DAF 1,3,and 5,respectively).The detection limits of the soil Nfluxes were 163-1 565,81-485,and 54-281 μg N mhfor the two-,four-,and six-hour static chamber enclosures,respectively.The Nfluxes measured in 120 cases varied between 159 and 2 943(811 on average) μg N mh.which were higher than the detection limits,with the exception of only two cases.The Nfluxes at DAF 3 were significantly higher(by nearly 80%(P<0.01)) than those at DAF 1 and 5 in the maize experiment,while there were no significant differences among the irrigation times in the wheat experiment.The Nfluxes and the ratios of nitrous oxide(NO) to the NO plus Nfluxes following urea application to maize were approximately 65% and 11 times larger,respectively(P<0.01),than those following urea application to wheat.Such differences could be mainly attributed to the higher soil water contents,temperatures,and availability of soil N substrates in the maize experiment than in the wheat experiment.This study suggests that theNGF method is sensitive enough to measure in situ Nfluxes from intensively fertilized croplands with calcareous soils.展开更多
This paper first analyzes the current situation of land use in Ma'anshan City,and points out some problems in Ma'anshan's construction land use such as obvious contradiction between supply and demand,irrat...This paper first analyzes the current situation of land use in Ma'anshan City,and points out some problems in Ma'anshan's construction land use such as obvious contradiction between supply and demand,irrational land supply,and low level of economical and intensive land use. Then it summarizes Ma'anshan's practice in intensively using land and tapping land potential,and finally brings forward the relevant recommendations.展开更多
Intensive construction methods offer benefits for metro station development,yet they present challenges for seismic design due to the spatially asymmetric configuration of passageway-shaft structures.In this study,a d...Intensive construction methods offer benefits for metro station development,yet they present challenges for seismic design due to the spatially asymmetric configuration of passageway-shaft structures.In this study,a detailed numerical model of a station-passageway-shaft structure system built using intensive construction methods was developed and the deformation and damage modes under seismic loadings were analyzed.The results indicate that inconsistent deformation between the shaft and the station generates interaction through the connecting passageway,leading to damage near the opening of the station structure and both ends of the connecting passageway Damage is more severe under longitudinal excitation.Compared with the opening plan that spans four segments,the opening plan that spans five segments exacerbates the overall degree of damage to the structure system.Under transverse excitation,the presence of interior structures intensifies the damage to the station and connecting passageway,while with such internal structure in place the impact is relatively minor under longitudinal excitation.Reinforcement with steel segments near the station opening can appreciably attenuate the damage.In contrast,introducing flexible joints at both ends of the connecting passageway intensifies the damage.Hence,reinforcement using steel segments emerges as an optimal seismic mitigation strategy.展开更多
Background:Agricultural yields have increased continuously over the last few decades.However,a focus solely on production can harm the environment.Diversification of agriculture has been suggested to increase producti...Background:Agricultural yields have increased continuously over the last few decades.However,a focus solely on production can harm the environment.Diversification of agriculture has been suggested to increase production and sustainability.Biodiversity experiments showed positive effects on ecosystems and productivity.However,application of these results to intensively managed grasslands has been questioned due to differences in plant species and management regimes.Research on whether diversity can benefit multifunctionality,that is,an integrated index of multiple ecosystem functions,under intensive management,is still scarce.Methods:To address this,we manipulated plant species richness from one to six species spanning three functional groups(legumes,herbs,and grasses)in intensively managed multispecies grassland leys and examined seven ecosystem functions.Results:We found that multifunctionality increased with functional group and species richness.Legume+herb mixtures showed high multifunctionality,while grass monocultures and mixtures with high proportions of grasses had low multifunctionality.Different plant species and plant communities drove different ecosystem functions.Legumes and herbs improved productivity and water availability,while grasses enhanced invasion resistance.These results indicate that multifunctionality and individual ecosystem functions can be promoted through targeted combinations of plants with complementary ecological traits.Conclusions:Plant diversity can improve multifunctionality also under intensive management,potentially benefitting agroeconomics and sustainability.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
On December 18,2023,the Jishishan area in Gansu Province was jolted by a M_(S) 6.2 earthquake,which is the most powerful seismic event that occurred throughout the year in China.The earthquake occurred along the NWtre...On December 18,2023,the Jishishan area in Gansu Province was jolted by a M_(S) 6.2 earthquake,which is the most powerful seismic event that occurred throughout the year in China.The earthquake occurred along the NWtrending Lajishan fault(LJSF),a large tectonic transformation zone.After this event,China Earthquake Networks Center(CENC)has timely published several reports about seismic sources for emergency responses.The earthquake early warning system issued the first alert 4.9 s after the earthquake occurrence,providing prompt notification that effectively mitigated panics,injuries,and deaths of residents.The near real-time focal mechanism solution indicates that this earthquake is associated with a thrust fault.The distribution of aftershocks,the rupture process,and the recorded amplitudes from seismic monitoring and GNSS stations,all suggest that the mainshock rupture predominately propagates to the northwest direction.The duration of the rupture process is~12 s,and the largest slip is located at approximately 6.3 km to the NNW from the epicenter,with a peak slip of 0.12 m at~8 km depth.Seismic station N0028 recorded the highest instrumental intensity,which is 9.4 on the Mercalli scale.The estimated intensity map shows a seismic intensity reaching up to IX near the rupture area,consistent with field survey results.The aftershocks(up to December 22,2023)are mostly distributed in the northwest direction within~20 km of the epicenter.This earthquake caused serious casualties and house collapses,which requires further investigations into the impact of this earthquake.展开更多
Cancer is a major cause of morbidity and mortality worldwide,and the incidence is increasing,highlighting the need for effective strategies to treat this disease.Exercise has emerged as fundamental therapeutic medicin...Cancer is a major cause of morbidity and mortality worldwide,and the incidence is increasing,highlighting the need for effective strategies to treat this disease.Exercise has emerged as fundamental therapeutic medicine in the management of cancer,associated with a lower risk of recur-rence and increased survival.Several avenues of research demonstrate reduction in growth,proliferation,and increased apoptosis of cancer cells,including breast,prostate,colorectal,and lung cancer,when cultured by serum collected after exercise in vitro(i.e.,the cultivation of cancer cell lines in an experimental setting,which simplifies the biological system and provides mechanistic insight into cell responses).The underlying mechanisms of exercise-induced cancer suppressive effects may be attributed to the alteration in circulating factors,such as skeletal muscle-induced cytokines(i.e.,myokines)and hormones.However,exercise-induced tumor suppressive effects and detailed information about training interventions are not well investigated,constraining more precise application of exercise medicine within clinical oncology.To date,it remains unclear what role different training modes(i.e.,resistance and aerobic training)as well as volume and intensity have on exercise-condi-tioned serum and its effects on cancer cells.Nevertheless,the available evidence is that a single bout of aerobic training at moderate to vigorous intensity has cancer suppressive effects,while for chronic training interventions,exercise volume appears to be an influential candidate driving cancer inhibitory effects regardless of training mode.Insights for future research investigating training modes,volume and intensity are provided to further our understanding of the effects of exercise-conditioned serum on cancer cells.展开更多
Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with...Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.展开更多
Accurate prediction of tropical cyclone(TC)intensity is challenging due to the complex physical processes involved.Here,we introduce a new TC intensity prediction scheme for the western North Pacific(WNP)based on a ti...Accurate prediction of tropical cyclone(TC)intensity is challenging due to the complex physical processes involved.Here,we introduce a new TC intensity prediction scheme for the western North Pacific(WNP)based on a time-dependent theory of TC intensification,termed the energetically based dynamical system(EBDS)model,together with the use of a long short-term memory(LSTM)neural network.In time-dependent theory,TC intensity change is controlled by both the internal dynamics of the TC system and various environmental factors,expressed as environmental dynamical efficiency.The LSTM neural network is used to predict the environmental dynamical efficiency in the EBDS model trained using besttrack TC data and global reanalysis data during 1982–2017.The transfer learning and ensemble methods are used to retrain the scheme using the environmental factors predicted by the Global Forecast System(GFS)of the National Centers for Environmental Prediction during 2017–21.The predicted environmental dynamical efficiency is finally iterated into the EBDS equations to predict TC intensity.The new scheme is evaluated for TC intensity prediction using both reanalysis data and the GFS prediction data.The intensity prediction by the new scheme shows better skill than the official prediction from the China Meteorological Administration(CMA)and those by other state-of-art statistical and dynamical forecast systems,except for the 72-h forecast.Particularly at the longer lead times of 96 h and 120 h,the new scheme has smaller forecast errors,with a more than 30%improvement over the official forecasts.展开更多
1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to ...1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to achieve health benefits.1-3 Absent from these guidelines are recommendations for light intensity PA(LPA,e.g.,walking at a leisurely pace of 3 km/h or less,equivalent to 1.5-2.9 metabolic equivalents).展开更多
When benefiting other beneficiaries,cushion plants may reciprocally receive feedback effects.The feedback effects on different sex morphs,however,remains unclear.In this study,taking the gynodioecious Arenaria polytri...When benefiting other beneficiaries,cushion plants may reciprocally receive feedback effects.The feedback effects on different sex morphs,however,remains unclear.In this study,taking the gynodioecious Arenaria polytrichiodes as a model species,we aimed to assess the sex-specific facilitation intensity of cushion plant by measuring the beneficiary cover ratio,and to assess the potential costs in cushion reproductive functions by measuring the flower and fruit cover ratios.The total beneficiary cover ratio was similar between females and hermaphrodites.Females produced much less flowers but more fruits than hermaphrodites.These results suggested that females and hermaphrodites possess similar facilitation intensity,and female cushion A.polytrichoides may allocate more resources saved from pollen production to seed production,while hermaphrodites possibly allocate more resources to pollen production hence reducing seed production.The surface areas covered by beneficiaries produced less flowers and fruits than areas without beneficiaries.In addition,strong negative correlations between beneficiary cover and flower cover were detected for both females and hermaphrodites,but the correlation strength were similar for these two sex morphs.However,the correlation between beneficiary cover and fruit cover was only significantly negative for females,suggesting that beneficiary plants negatively affect fruit reproduction of females while have neutral effects on hermaphrodites.All the results suggest that to facilitate other beneficiaries can induce reproductive costs on cushion A.polytrichoides,with females possibly suffering greater cost than hermaphrodites.Such differentiation in reproductive costs between sex morphs,in long-term perspective,may imply sex imbalance in population dynamics.展开更多
China’s low-carbon development path will make significant contributions to achieving global sustainable development goals.Due to the diverse natural and economic conditions across different regions in China,there exi...China’s low-carbon development path will make significant contributions to achieving global sustainable development goals.Due to the diverse natural and economic conditions across different regions in China,there exists an imbalance in the distribution of car-bon emissions.Therefore,regional cooperation serves as an effective means to attain low-carbon development.This study examined the pattern of carbon emissions and proposed a potential joint emission reduction strategy by utilizing the industrial carbon emission intens-ity(ICEI)as a crucial factor.We utilized social network analysis and Local Indicators of Spatial Association(LISA)space-time trans-ition matrix to investigate the spatiotemporal connections and discrepancies of ICEI in the cities of the Pearl River Basin(PRB),China from 2010 to 2020.The primary drivers of the ICEI were determined through geographical detectors and multi-scale geographically weighted regression.The results were as follows:1)the overall ICEI in the Pearl River Basin is showing a downward trend,and there is a significant spatial imbalance.2)There are numerous network connections between cities regarding the ICEI,but the network structure is relatively fragile and unstable.3)Economically developed cities such as Guangzhou,Foshan,and Dongguan are in the center of the network while playing an intermediary role.4)Energy consumption,industrialization,per capita GDP,urbanization,science and techno-logy,and productivity are found to be the most influential variables in the spatial differentiation of ICEI,and their combination in-creased the explanatory power of the geographic variation of ICEI.Finally,through the analysis of differences and connections in urban carbon emissions under different economic levels and ICEI,the study suggests joint carbon reduction strategies,which are centered on carbon transfer,financial support,and technological assistance among cities.展开更多
The aim of this study was to evaluate the factors influencing the inactivation effect of intense pulsed light(IPL)on Aeromonas salmonicida grown on chicken meat and skin,and to further develop prediction models of ina...The aim of this study was to evaluate the factors influencing the inactivation effect of intense pulsed light(IPL)on Aeromonas salmonicida grown on chicken meat and skin,and to further develop prediction models of inactivation.In this work,chicken meat and skin inoculated with meat-borne A.salmonicida isolates were subjected to IPL treatments under different conditions.The results showed that IPL had obvious bactericidal effect in the chicken skin and thickness groups when the treatment voltage and time were 7 V combined with 5 s.In addition,the lethality curves of A.salmonicida were fitted under IPL conditions of 3.5-7.5 V.The comparison of statistical parameters revealed that the Weibull model could best fit the mortality curves and could accurately predict the mortality dynamic of A.salmonicida grown on chicken skin.And further a secondary model between the scale factor b and the treatment voltage in Weibull model was established using linear equations,which determined that the secondary model could accurately predict the inactivation of A.salmonicida.This study provides a theoretical basis for future prediction models of Aeromonas,and also provides new ideas for sterilization approaches of meat-borne Aeromonas.展开更多
For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein th...For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.展开更多
BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient prognosis.Postoperative adjuvant external radiation therapy(RT)has been shown to effectively prevent ...BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient prognosis.Postoperative adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer resection.However,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further investigation.AIM To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal strategy.METHODS This study involved network meta-analyses and followed the PRISMA guidelines.The data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane Library.We included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary endpoints.The magnitudes of the effects were determined using risk ratios with 95%confidential intervals.The results were analyzed using R software and STATA software.RESULTS A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this study.There was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and transitivity.OS analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest DFS.Patients who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent SBRT.CONCLUSION HCC patients who undergo liver cancer resection must consider distinct advantages and disadvantages when choosing between SBRT and 3D-CRT.IMRT,a RT technique that is associated with longer OS than 3D-CRT and longer DFS than SBRT,may be a preferred option.展开更多
Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding s...Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.展开更多
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest d...Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.展开更多
Purpose:The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries(...Purpose:The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries(Denmark,Finland,Iceland,Norway,and Sweden)and published in 2000 or later.Methods:A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search terms.Results:Fourteen unique research projects or surveillance studies were identified.Additionally,2 surveillance studies published by national agencies were included,resulting in a total of 16 studies for inclusion.National surveillance systems exist in Finland and Norway,with regular survey waves in school-aged children/adolescents and adults.In Denmark,recent nationally representative data have been collected in school children only.So far,Sweden has no regular national surveillance system using device-based data collection.No studies were found from Iceland.The first study was conducted in 2001 and the most recent in 2022,with most data collected from 2016 to date.Five studies included children/adole scents 6-18 years,no study included preschoolers.In total 11 studies included adults,of which 8 also covered older adults.No study focused specifically on older adults.The analytical sample size ranged from 205 to 27,890.Detailed methodology is presented,such as information on sampling strategy,device type and placement,wear protocols,and physical activity classification schemes.Levels of physical activity and sedentary time in children/adolescents,adults,and older adults across the Nordic countries are presented.Conclusion:A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been identified.The variety of devices,placement,and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standardized data collection.展开更多
Background:Optimal patterns of accrual of recommended levels of physical activity(PA)for prevention of hypertension and obesity are not known.The overall aim of this study was to investigate whether different patterns...Background:Optimal patterns of accrual of recommended levels of physical activity(PA)for prevention of hypertension and obesity are not known.The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years.Specifically,we investigated whether,for the same weekly volume of PA,the number of sessions(frequency)and vigorousness of PA(intensity)were associated with a reduction in the occurrence of hypertension and obesity in women.Methods:Data from the 1973-1978 and 1946-1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed(n=20,588;12%-16%with a Bachelor's or higher degree).Self-reported PA,hypertension,height,and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021.Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume(metabolic equivalent min/week)(none;33-499;500-999;≥1000,weekly frequency(none;1-2 times;3-4times;5-7 times;≥8 times),and the proportion of vigorous PA to total volume of PA(none;0%;1%-33%;34%-66%;67%-100%)with odds of hypertension and obesity from 2000 to 2021.Results:The cumulative incidence of hypertension was 6%in the 1973-1978 and 23%in the 1946-1951 cohort;27%of women in the 1973-1978;and 15%in the 1946-1951 cohort developed obesity over the period.Overall,a higher volume of PA was associated with reduced odds of hypertension and obesity.When the volume of PA was considered,the odds of hypertension did not vary according to the frequency or intensity of PA.However,increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obe sity.Conclusion:PA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity.Incorporating more sessions,particularly of vigorous-intensity PA,may provide extra benefits for the prevention of obesity.展开更多
基金jointly supported by the National Natural Science Foundation of China(41877333,41830751 and 41761144054)the Basic Research Program of Frontier Sciences of Chinese Academy of Sciences(ZDBSLY-DQCOO7)the National Key Research and Development Program of China(2017YFD0200100)。
文摘Denitrification-induced nitrogen(N) losses from croplands may be greatly increased by intensive fertilization.However,the accurate quantification of these losses is still challenging due to insufficient available in situ measurements of soil dinitrogen(N) emissions.We carried out two one-week experiments in a maize-wheat cropping system with calcareous soil using theN gas-flux(NGF) method to measure in situ Nfluxes following urea application.Applications ofN-labeled urea(99 atom%,130-150 kg N ha) were followed by irrigation on the 1 st,3 rd,and 5 th days after fertilization(DAF 1,3,and 5,respectively).The detection limits of the soil Nfluxes were 163-1 565,81-485,and 54-281 μg N mhfor the two-,four-,and six-hour static chamber enclosures,respectively.The Nfluxes measured in 120 cases varied between 159 and 2 943(811 on average) μg N mh.which were higher than the detection limits,with the exception of only two cases.The Nfluxes at DAF 3 were significantly higher(by nearly 80%(P<0.01)) than those at DAF 1 and 5 in the maize experiment,while there were no significant differences among the irrigation times in the wheat experiment.The Nfluxes and the ratios of nitrous oxide(NO) to the NO plus Nfluxes following urea application to maize were approximately 65% and 11 times larger,respectively(P<0.01),than those following urea application to wheat.Such differences could be mainly attributed to the higher soil water contents,temperatures,and availability of soil N substrates in the maize experiment than in the wheat experiment.This study suggests that theNGF method is sensitive enough to measure in situ Nfluxes from intensively fertilized croplands with calcareous soils.
基金Supported by Fund Project of Ma’anshan Municipal Bureau of Land and Resources:Analysis of Balance between Land Resources Supply and Demand in Ma’anshan City in 2015
文摘This paper first analyzes the current situation of land use in Ma'anshan City,and points out some problems in Ma'anshan's construction land use such as obvious contradiction between supply and demand,irrational land supply,and low level of economical and intensive land use. Then it summarizes Ma'anshan's practice in intensively using land and tapping land potential,and finally brings forward the relevant recommendations.
基金The authors are grateful for the financial support from National Natural Science Foundation of China(Grant Nos.52061135112 and U1934210)the National Key Research and Development Program of China(No.2021YFE0114100)the China Scholarship Council(No.202206260188).
文摘Intensive construction methods offer benefits for metro station development,yet they present challenges for seismic design due to the spatially asymmetric configuration of passageway-shaft structures.In this study,a detailed numerical model of a station-passageway-shaft structure system built using intensive construction methods was developed and the deformation and damage modes under seismic loadings were analyzed.The results indicate that inconsistent deformation between the shaft and the station generates interaction through the connecting passageway,leading to damage near the opening of the station structure and both ends of the connecting passageway Damage is more severe under longitudinal excitation.Compared with the opening plan that spans four segments,the opening plan that spans five segments exacerbates the overall degree of damage to the structure system.Under transverse excitation,the presence of interior structures intensifies the damage to the station and connecting passageway,while with such internal structure in place the impact is relatively minor under longitudinal excitation.Reinforcement with steel segments near the station opening can appreciably attenuate the damage.In contrast,introducing flexible joints at both ends of the connecting passageway intensifies the damage.Hence,reinforcement using steel segments emerges as an optimal seismic mitigation strategy.
基金Science Foundation Ireland Frontiers for the Future program,Grant/Award Number:19/FFP/6888Deutsche Forschungsgemeinschaft,Grant/Award Numbers:GSC 81,ME5474/1-1,WE3081/39-1。
文摘Background:Agricultural yields have increased continuously over the last few decades.However,a focus solely on production can harm the environment.Diversification of agriculture has been suggested to increase production and sustainability.Biodiversity experiments showed positive effects on ecosystems and productivity.However,application of these results to intensively managed grasslands has been questioned due to differences in plant species and management regimes.Research on whether diversity can benefit multifunctionality,that is,an integrated index of multiple ecosystem functions,under intensive management,is still scarce.Methods:To address this,we manipulated plant species richness from one to six species spanning three functional groups(legumes,herbs,and grasses)in intensively managed multispecies grassland leys and examined seven ecosystem functions.Results:We found that multifunctionality increased with functional group and species richness.Legume+herb mixtures showed high multifunctionality,while grass monocultures and mixtures with high proportions of grasses had low multifunctionality.Different plant species and plant communities drove different ecosystem functions.Legumes and herbs improved productivity and water availability,while grasses enhanced invasion resistance.These results indicate that multifunctionality and individual ecosystem functions can be promoted through targeted combinations of plants with complementary ecological traits.Conclusions:Plant diversity can improve multifunctionality also under intensive management,potentially benefitting agroeconomics and sustainability.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
基金supported by China Earthquake Administration Science for Earthquake Resilience(XH23050YB)Natural Science Foundation of China(42304072).
文摘On December 18,2023,the Jishishan area in Gansu Province was jolted by a M_(S) 6.2 earthquake,which is the most powerful seismic event that occurred throughout the year in China.The earthquake occurred along the NWtrending Lajishan fault(LJSF),a large tectonic transformation zone.After this event,China Earthquake Networks Center(CENC)has timely published several reports about seismic sources for emergency responses.The earthquake early warning system issued the first alert 4.9 s after the earthquake occurrence,providing prompt notification that effectively mitigated panics,injuries,and deaths of residents.The near real-time focal mechanism solution indicates that this earthquake is associated with a thrust fault.The distribution of aftershocks,the rupture process,and the recorded amplitudes from seismic monitoring and GNSS stations,all suggest that the mainshock rupture predominately propagates to the northwest direction.The duration of the rupture process is~12 s,and the largest slip is located at approximately 6.3 km to the NNW from the epicenter,with a peak slip of 0.12 m at~8 km depth.Seismic station N0028 recorded the highest instrumental intensity,which is 9.4 on the Mercalli scale.The estimated intensity map shows a seismic intensity reaching up to IX near the rupture area,consistent with field survey results.The aftershocks(up to December 22,2023)are mostly distributed in the northwest direction within~20 km of the epicenter.This earthquake caused serious casualties and house collapses,which requires further investigations into the impact of this earthquake.
文摘Cancer is a major cause of morbidity and mortality worldwide,and the incidence is increasing,highlighting the need for effective strategies to treat this disease.Exercise has emerged as fundamental therapeutic medicine in the management of cancer,associated with a lower risk of recur-rence and increased survival.Several avenues of research demonstrate reduction in growth,proliferation,and increased apoptosis of cancer cells,including breast,prostate,colorectal,and lung cancer,when cultured by serum collected after exercise in vitro(i.e.,the cultivation of cancer cell lines in an experimental setting,which simplifies the biological system and provides mechanistic insight into cell responses).The underlying mechanisms of exercise-induced cancer suppressive effects may be attributed to the alteration in circulating factors,such as skeletal muscle-induced cytokines(i.e.,myokines)and hormones.However,exercise-induced tumor suppressive effects and detailed information about training interventions are not well investigated,constraining more precise application of exercise medicine within clinical oncology.To date,it remains unclear what role different training modes(i.e.,resistance and aerobic training)as well as volume and intensity have on exercise-condi-tioned serum and its effects on cancer cells.Nevertheless,the available evidence is that a single bout of aerobic training at moderate to vigorous intensity has cancer suppressive effects,while for chronic training interventions,exercise volume appears to be an influential candidate driving cancer inhibitory effects regardless of training mode.Insights for future research investigating training modes,volume and intensity are provided to further our understanding of the effects of exercise-conditioned serum on cancer cells.
基金supported by the National Natural Science Foundation of China,Nos.82274611 (to LZ),82104419 (to DM)Capital Science and Technology Leading Talent Training Project,No.Z1 91100006119017 (to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803 (to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006 (to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017 (to DM)Beijing Gold-Bridge Project,No.ZZ20145 (to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
基金supported by National Natural Science Foundation of China(82192900,82192901,82192904,81941018,and 91846303)Peking University Medicine Seed Fund for Interdisciplinary Research(BMU2022MX025)+5 种基金the Fundamental Research Funds for the Central Universitiessupported by a grant from the Kadoorie Charitable Foundation in Hong Kongsupported by grants from the UK Wellcome Trust(212946/Z/18/Z,202922/Z/16/Z,104085/Z/14/Z,and 088158/Z/09/Z)the National Key R&D Program of China(2016YFC0900500)National Natural Science Foundation of China(81390540)Chinese Ministry of Science and Technology(2011BAI09B01)。
文摘Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.
基金supported by the National Key R&D Program of China(Grant No.2017YFC1501604)the National Natural Science Foundation of China(Grant Nos.41875114 and 41875057).
文摘Accurate prediction of tropical cyclone(TC)intensity is challenging due to the complex physical processes involved.Here,we introduce a new TC intensity prediction scheme for the western North Pacific(WNP)based on a time-dependent theory of TC intensification,termed the energetically based dynamical system(EBDS)model,together with the use of a long short-term memory(LSTM)neural network.In time-dependent theory,TC intensity change is controlled by both the internal dynamics of the TC system and various environmental factors,expressed as environmental dynamical efficiency.The LSTM neural network is used to predict the environmental dynamical efficiency in the EBDS model trained using besttrack TC data and global reanalysis data during 1982–2017.The transfer learning and ensemble methods are used to retrain the scheme using the environmental factors predicted by the Global Forecast System(GFS)of the National Centers for Environmental Prediction during 2017–21.The predicted environmental dynamical efficiency is finally iterated into the EBDS equations to predict TC intensity.The new scheme is evaluated for TC intensity prediction using both reanalysis data and the GFS prediction data.The intensity prediction by the new scheme shows better skill than the official prediction from the China Meteorological Administration(CMA)and those by other state-of-art statistical and dynamical forecast systems,except for the 72-h forecast.Particularly at the longer lead times of 96 h and 120 h,the new scheme has smaller forecast errors,with a more than 30%improvement over the official forecasts.
文摘1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to achieve health benefits.1-3 Absent from these guidelines are recommendations for light intensity PA(LPA,e.g.,walking at a leisurely pace of 3 km/h or less,equivalent to 1.5-2.9 metabolic equivalents).
基金supported by the Second Tibetan Plateau Scientific Expedition and Research Program(2019QZKK0502 to H.S.)the Strategic Priority Research Program of the Chinese Academy of Sciences(XDA20050203 to H.S.)+3 种基金the Yunnan Applied Basic Research Project(202001AT070060 to J.G.C.)the National Natural Science Foundation of China(31271552 to J.G.C.)the CAS“Light of West China”Program(J.G.C.)the Young Academic and Technical Leader Raising Foundation of Yunnan Province(202205AC160053 to J.G.C.)。
文摘When benefiting other beneficiaries,cushion plants may reciprocally receive feedback effects.The feedback effects on different sex morphs,however,remains unclear.In this study,taking the gynodioecious Arenaria polytrichiodes as a model species,we aimed to assess the sex-specific facilitation intensity of cushion plant by measuring the beneficiary cover ratio,and to assess the potential costs in cushion reproductive functions by measuring the flower and fruit cover ratios.The total beneficiary cover ratio was similar between females and hermaphrodites.Females produced much less flowers but more fruits than hermaphrodites.These results suggested that females and hermaphrodites possess similar facilitation intensity,and female cushion A.polytrichoides may allocate more resources saved from pollen production to seed production,while hermaphrodites possibly allocate more resources to pollen production hence reducing seed production.The surface areas covered by beneficiaries produced less flowers and fruits than areas without beneficiaries.In addition,strong negative correlations between beneficiary cover and flower cover were detected for both females and hermaphrodites,but the correlation strength were similar for these two sex morphs.However,the correlation between beneficiary cover and fruit cover was only significantly negative for females,suggesting that beneficiary plants negatively affect fruit reproduction of females while have neutral effects on hermaphrodites.All the results suggest that to facilitate other beneficiaries can induce reproductive costs on cushion A.polytrichoides,with females possibly suffering greater cost than hermaphrodites.Such differentiation in reproductive costs between sex morphs,in long-term perspective,may imply sex imbalance in population dynamics.
基金Under the auspices of the Philosophy and Social Science Planning Project of Guizhou,China(No.21GZZD59)。
文摘China’s low-carbon development path will make significant contributions to achieving global sustainable development goals.Due to the diverse natural and economic conditions across different regions in China,there exists an imbalance in the distribution of car-bon emissions.Therefore,regional cooperation serves as an effective means to attain low-carbon development.This study examined the pattern of carbon emissions and proposed a potential joint emission reduction strategy by utilizing the industrial carbon emission intens-ity(ICEI)as a crucial factor.We utilized social network analysis and Local Indicators of Spatial Association(LISA)space-time trans-ition matrix to investigate the spatiotemporal connections and discrepancies of ICEI in the cities of the Pearl River Basin(PRB),China from 2010 to 2020.The primary drivers of the ICEI were determined through geographical detectors and multi-scale geographically weighted regression.The results were as follows:1)the overall ICEI in the Pearl River Basin is showing a downward trend,and there is a significant spatial imbalance.2)There are numerous network connections between cities regarding the ICEI,but the network structure is relatively fragile and unstable.3)Economically developed cities such as Guangzhou,Foshan,and Dongguan are in the center of the network while playing an intermediary role.4)Energy consumption,industrialization,per capita GDP,urbanization,science and techno-logy,and productivity are found to be the most influential variables in the spatial differentiation of ICEI,and their combination in-creased the explanatory power of the geographic variation of ICEI.Finally,through the analysis of differences and connections in urban carbon emissions under different economic levels and ICEI,the study suggests joint carbon reduction strategies,which are centered on carbon transfer,financial support,and technological assistance among cities.
基金supported by projects funded by grants from the Natural Science Foundation of Jiangsu Province in China(BK20221515)the National Natural Science Foundation of China(32172266)the Changzhou Science and Technology Support Program(CE20222002)。
文摘The aim of this study was to evaluate the factors influencing the inactivation effect of intense pulsed light(IPL)on Aeromonas salmonicida grown on chicken meat and skin,and to further develop prediction models of inactivation.In this work,chicken meat and skin inoculated with meat-borne A.salmonicida isolates were subjected to IPL treatments under different conditions.The results showed that IPL had obvious bactericidal effect in the chicken skin and thickness groups when the treatment voltage and time were 7 V combined with 5 s.In addition,the lethality curves of A.salmonicida were fitted under IPL conditions of 3.5-7.5 V.The comparison of statistical parameters revealed that the Weibull model could best fit the mortality curves and could accurately predict the mortality dynamic of A.salmonicida grown on chicken skin.And further a secondary model between the scale factor b and the treatment voltage in Weibull model was established using linear equations,which determined that the secondary model could accurately predict the inactivation of A.salmonicida.This study provides a theoretical basis for future prediction models of Aeromonas,and also provides new ideas for sterilization approaches of meat-borne Aeromonas.
基金supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。
文摘For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
基金Supported by The Science and Technology Plan Project of Guangzhou,No.202102010171National Natural Science Foundation。
文摘BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient prognosis.Postoperative adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer resection.However,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further investigation.AIM To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal strategy.METHODS This study involved network meta-analyses and followed the PRISMA guidelines.The data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane Library.We included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary endpoints.The magnitudes of the effects were determined using risk ratios with 95%confidential intervals.The results were analyzed using R software and STATA software.RESULTS A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this study.There was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and transitivity.OS analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest DFS.Patients who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent SBRT.CONCLUSION HCC patients who undergo liver cancer resection must consider distinct advantages and disadvantages when choosing between SBRT and 3D-CRT.IMRT,a RT technique that is associated with longer OS than 3D-CRT and longer DFS than SBRT,may be a preferred option.
基金Under the auspices of the National Social Science Found of China(No.21XGL019)Hainan Provincial Natural Science Foundation of China(No.421RC1034)Professor/Doctor Research Foundation of Huizhou University(No.2022JB080)。
文摘Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.
文摘Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.
文摘Purpose:The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries(Denmark,Finland,Iceland,Norway,and Sweden)and published in 2000 or later.Methods:A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search terms.Results:Fourteen unique research projects or surveillance studies were identified.Additionally,2 surveillance studies published by national agencies were included,resulting in a total of 16 studies for inclusion.National surveillance systems exist in Finland and Norway,with regular survey waves in school-aged children/adolescents and adults.In Denmark,recent nationally representative data have been collected in school children only.So far,Sweden has no regular national surveillance system using device-based data collection.No studies were found from Iceland.The first study was conducted in 2001 and the most recent in 2022,with most data collected from 2016 to date.Five studies included children/adole scents 6-18 years,no study included preschoolers.In total 11 studies included adults,of which 8 also covered older adults.No study focused specifically on older adults.The analytical sample size ranged from 205 to 27,890.Detailed methodology is presented,such as information on sampling strategy,device type and placement,wear protocols,and physical activity classification schemes.Levels of physical activity and sedentary time in children/adolescents,adults,and older adults across the Nordic countries are presented.Conclusion:A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been identified.The variety of devices,placement,and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standardized data collection.
基金supported by a National Health and Medical Research Council(NHMRC)Investigator Grant(APP2008702)supported by the National Council for Scientific and Technological Developments-CNPq(process number 308772/2022-9)。
文摘Background:Optimal patterns of accrual of recommended levels of physical activity(PA)for prevention of hypertension and obesity are not known.The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years.Specifically,we investigated whether,for the same weekly volume of PA,the number of sessions(frequency)and vigorousness of PA(intensity)were associated with a reduction in the occurrence of hypertension and obesity in women.Methods:Data from the 1973-1978 and 1946-1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed(n=20,588;12%-16%with a Bachelor's or higher degree).Self-reported PA,hypertension,height,and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021.Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume(metabolic equivalent min/week)(none;33-499;500-999;≥1000,weekly frequency(none;1-2 times;3-4times;5-7 times;≥8 times),and the proportion of vigorous PA to total volume of PA(none;0%;1%-33%;34%-66%;67%-100%)with odds of hypertension and obesity from 2000 to 2021.Results:The cumulative incidence of hypertension was 6%in the 1973-1978 and 23%in the 1946-1951 cohort;27%of women in the 1973-1978;and 15%in the 1946-1951 cohort developed obesity over the period.Overall,a higher volume of PA was associated with reduced odds of hypertension and obesity.When the volume of PA was considered,the odds of hypertension did not vary according to the frequency or intensity of PA.However,increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obe sity.Conclusion:PA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity.Incorporating more sessions,particularly of vigorous-intensity PA,may provide extra benefits for the prevention of obesity.
