BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast...Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.展开更多
BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical ...BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical burden profoundly affects healthcare professionals'quality of care and overall well-being.In Somalia,where the healthcare system faces numerous challenges,the escalating demand for medical services and inadequate resources,coupled with overwhelming workloads,long hours,and high-stress levels,make healthcare providers particularly vulnerable to burnout syndrome.This,in turn,affects both the mental health of healthcare personnel and the quality of care they provide.AIM To examine the prevalence and determinants of burnout syndrome among healthcare practitioners in Mogadishu,Somalia.METHODS This cross-sectional prospective study was performed among 246 healthcare providers employed at a tertiary care hospital in Mogadishu,Somalia,who were recruited via random sampling.Data were collected using questionnaires that covered sociodemographic,psychological,work-related characteristics,and burnout syndrome.Bivariate and multivariate logistic regression analyses were performed to identify the variables that correlated with burnout syndrome.The results were presented using adjusted odds ratios(AORs),95%CIs,and P values,with a cutoff of 0.05 for identifying significant associations.RESULTS Among the participants,24%(95%CI:18.8%–29.8%)exhibited symptoms of burnout syndrome.Factors associated with burnout included female gender(AOR=6.60;95%CI:2.29-19.04),being married(AOR=3.07;95%CI:1.14-8.28),being divorced or widowed(AOR=5.84;95%CI:1.35-25.35),working more than 7 night shifts(AOR=3.19;95%CI:1.30–7.82),having less than 5 years of job experience(AOR=5.28;95%CI:1.29-21.65),experiencing poor sleep quality(AOR=5.29;95%CI:1.88-14.89),and exhibiting depressive(AOR=4.46;95%CI:1.59-12.53)and anxiety symptoms(AOR=7.34;95%CI:2.49-21.60).CONCLUSION This study found that nearly one in four healthcare professionals suffers from burnout syndrome.Improving sleep quality,monitoring,and providing mental health support could enhance their well-being and patient care.展开更多
BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP)...Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.展开更多
The risk factors for type 2 diabetes mellitus(T2DM)have been increasingly researched,but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and ...The risk factors for type 2 diabetes mellitus(T2DM)have been increasingly researched,but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and understand all the risk factors,which are categorized in this paper into five categories:Social determinants,lifestyle,checkable/testable risk factors,history of illness and medication,and other factors,which are discussed in a narrative review.Meanwhile,this paper points out the problems of the current research,helps to improve the systematic categorisation and practicality of T2DM risk factors,and provides a professional research basis for clinical practice and industry decision-making.展开更多
BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluat...BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.METHODS A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024.Patients were divided into infected(n=36)and non-infected(n=364)groups based on the occurrence of SSIs.Data collected included age,diabetes mellitus status,use of prophylactic antibiotics,and specific surgical complications.Statistical analyses using SPSS(Version 27.0)involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.RESULTS The use of prophylactic antibiotics significantly reduced the incidence of SSIs(χ²=68.34,P<0.01).Older age(≥60 years)and comorbidities such as diabetes mellitus were identified as significant risk factors.Surgical complications like insufficient cystic duct stump,gallbladder perforation,and empyema also increased SSI risk.Notably,factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.CONCLUSION Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC.Age,diabetes mellitus,and certain surgical complications significantly contribute to the risk.Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.展开更多
Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in ...Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.展开更多
Objective:To investigate the incidence of delirium in elderly patients with Stanford-type B aortic dissection and analyze its risk factors.Methods:A convenience sample of 767 elderly patients with Stanford-type B aort...Objective:To investigate the incidence of delirium in elderly patients with Stanford-type B aortic dissection and analyze its risk factors.Methods:A convenience sample of 767 elderly patients with Stanford-type B aortic dissection admitted to the ICU from January 2020 to December 2023 was selected.Data were collected using a delirium-related questionnaire and the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU).Results:The incidence of delirium in elderly Stanford B aortic dissection patients was 23.73%.Logistic regression analysis showed that gender,length of stay in the ICU,and duration of sedative drug use were independent risk factors for delirium in elderly patients(P<0.05).The model likelihood ratio test x^(2)=28.462,P<0.001;Hosmer-Lemeshow goodness-of-fit test x^(2)=0.715,P=0.878.Conclusion:The incidence of delirium in elderly patients with Stanford-type B aortic dissection is relatively low.Medical staff should conduct adequate and effective preoperative assessment according to the condition of elderly Stanford-type B aortic dissection patients,and use analgesic and sedative drugs reasonably to create a good treatment environment for patients,thereby minimizing the incidence of delirium in elderly patients with Stanford-type B aortic dissection as much as possible.展开更多
As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenop...As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.展开更多
Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial con...Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.展开更多
Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and p...Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and pathological stage as factors influencing the risk of ER.Postoperative monitoring for ER should encompass a thorough medical history review,physical examination,tumour marker testing,and imaging studies.Additionally,noninvasive circulating tumour cell DNA testing can be utilized to predict ER.Treatment strategies may involve radical surgery,radiation therapy,chemotherapy,and immunotherapy.Through a comprehensive analysis of risk factors,the optimization of monitoring methods,and the development of personalized treatment strategies,it is anticipated that both the efficacy of treatment and the quality of life for rectal cancer patients with postoperative recurrence can be significantly improved.展开更多
we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cance...we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.展开更多
Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year....Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.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
BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages ...BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of sui...Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.展开更多
BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneum...BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.展开更多
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
文摘Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.
文摘BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical burden profoundly affects healthcare professionals'quality of care and overall well-being.In Somalia,where the healthcare system faces numerous challenges,the escalating demand for medical services and inadequate resources,coupled with overwhelming workloads,long hours,and high-stress levels,make healthcare providers particularly vulnerable to burnout syndrome.This,in turn,affects both the mental health of healthcare personnel and the quality of care they provide.AIM To examine the prevalence and determinants of burnout syndrome among healthcare practitioners in Mogadishu,Somalia.METHODS This cross-sectional prospective study was performed among 246 healthcare providers employed at a tertiary care hospital in Mogadishu,Somalia,who were recruited via random sampling.Data were collected using questionnaires that covered sociodemographic,psychological,work-related characteristics,and burnout syndrome.Bivariate and multivariate logistic regression analyses were performed to identify the variables that correlated with burnout syndrome.The results were presented using adjusted odds ratios(AORs),95%CIs,and P values,with a cutoff of 0.05 for identifying significant associations.RESULTS Among the participants,24%(95%CI:18.8%–29.8%)exhibited symptoms of burnout syndrome.Factors associated with burnout included female gender(AOR=6.60;95%CI:2.29-19.04),being married(AOR=3.07;95%CI:1.14-8.28),being divorced or widowed(AOR=5.84;95%CI:1.35-25.35),working more than 7 night shifts(AOR=3.19;95%CI:1.30–7.82),having less than 5 years of job experience(AOR=5.28;95%CI:1.29-21.65),experiencing poor sleep quality(AOR=5.29;95%CI:1.88-14.89),and exhibiting depressive(AOR=4.46;95%CI:1.59-12.53)and anxiety symptoms(AOR=7.34;95%CI:2.49-21.60).CONCLUSION This study found that nearly one in four healthcare professionals suffers from burnout syndrome.Improving sleep quality,monitoring,and providing mental health support could enhance their well-being and patient care.
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
文摘Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.
基金National Natural Science Foundation of China,No.T2341018Science and Technology Innovation Project of Chinese Academy of Traditional Chinese Medicine,No.CI2023C049YLL.
文摘The risk factors for type 2 diabetes mellitus(T2DM)have been increasingly researched,but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and understand all the risk factors,which are categorized in this paper into five categories:Social determinants,lifestyle,checkable/testable risk factors,history of illness and medication,and other factors,which are discussed in a narrative review.Meanwhile,this paper points out the problems of the current research,helps to improve the systematic categorisation and practicality of T2DM risk factors,and provides a professional research basis for clinical practice and industry decision-making.
文摘BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.METHODS A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024.Patients were divided into infected(n=36)and non-infected(n=364)groups based on the occurrence of SSIs.Data collected included age,diabetes mellitus status,use of prophylactic antibiotics,and specific surgical complications.Statistical analyses using SPSS(Version 27.0)involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.RESULTS The use of prophylactic antibiotics significantly reduced the incidence of SSIs(χ²=68.34,P<0.01).Older age(≥60 years)and comorbidities such as diabetes mellitus were identified as significant risk factors.Surgical complications like insufficient cystic duct stump,gallbladder perforation,and empyema also increased SSI risk.Notably,factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.CONCLUSION Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC.Age,diabetes mellitus,and certain surgical complications significantly contribute to the risk.Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.
文摘Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.
基金Philosophy and Social Sciences Research Project of the Hubei Provincial Department of Education(Project No.:23D108)。
文摘Objective:To investigate the incidence of delirium in elderly patients with Stanford-type B aortic dissection and analyze its risk factors.Methods:A convenience sample of 767 elderly patients with Stanford-type B aortic dissection admitted to the ICU from January 2020 to December 2023 was selected.Data were collected using a delirium-related questionnaire and the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU).Results:The incidence of delirium in elderly Stanford B aortic dissection patients was 23.73%.Logistic regression analysis showed that gender,length of stay in the ICU,and duration of sedative drug use were independent risk factors for delirium in elderly patients(P<0.05).The model likelihood ratio test x^(2)=28.462,P<0.001;Hosmer-Lemeshow goodness-of-fit test x^(2)=0.715,P=0.878.Conclusion:The incidence of delirium in elderly patients with Stanford-type B aortic dissection is relatively low.Medical staff should conduct adequate and effective preoperative assessment according to the condition of elderly Stanford-type B aortic dissection patients,and use analgesic and sedative drugs reasonably to create a good treatment environment for patients,thereby minimizing the incidence of delirium in elderly patients with Stanford-type B aortic dissection as much as possible.
文摘As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.
文摘Background: Cesarean sections have become increasingly prevalent in both developed and developing nations. Nevertheless, postoperative complications, including surgical site infections (SSIs), remain a substantial concern that contributes to heightened morbidity and mortality. This study is designed to evaluate the frequency and key determining factors associated with surgical site infections following cesarean section procedures in a tertiary care hospital in Bangladesh. Materials and Methods: This observational cross-sectional study, conducted at the Gynecology Department of Dhaka Medical College Hospital, involved 100 patients aged 15 - 45 who had cesarean deliveries. Data was collected during hospitalization and post-discharge and analyzed to determine the prevalence and relationship between socio-demographic characteristics and surgical site infection. Results: Among the study participants, 14% developed surgical site infections following cesarean operations. More than half of these patients were under the age of 25, with a mean age of 24.45 ± 4.44 years. Surgical site infections were more prevalent in individuals over 30 years old (P-value Conclusion: Post-cesarean surgical site infections are notably prevalent among the participants in this study. Several risk factors have been identified, including age, body mass index (BMI), socioeconomic status, anemia, preterm delivery, personal hygiene practices, regular menstrual cycles, and adherence to antenatal check-ups. The implementation of an effective awareness program, coupled with updated antibiotic protocols, is crucial for significantly reducing the incidence of these infections.
基金Supported by the Key Clinical Specialty Discipline Construction Program of Fujian,Fujian Health Medicine and Politics,No.[2022]884.
文摘Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and pathological stage as factors influencing the risk of ER.Postoperative monitoring for ER should encompass a thorough medical history review,physical examination,tumour marker testing,and imaging studies.Additionally,noninvasive circulating tumour cell DNA testing can be utilized to predict ER.Treatment strategies may involve radical surgery,radiation therapy,chemotherapy,and immunotherapy.Through a comprehensive analysis of risk factors,the optimization of monitoring methods,and the development of personalized treatment strategies,it is anticipated that both the efficacy of treatment and the quality of life for rectal cancer patients with postoperative recurrence can be significantly improved.
基金Supported by Consejo Nacional de Investigaciones Científicas y Técnicas,No.PIP11220200103061COAgencia Nacional de promoción Científica y Tecnológica,No.PICT-2020-SERIEA-03440Universidad Nacional del Sur,No.PGI 24/B303 and No.PGI 24/ZB01.
文摘we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.
文摘Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.
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.
文摘BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
文摘Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.
基金approved by the Ethics Committee of the Third Xiangya Hospital in accordance with the Declaration of Helsinki(No.24029).
文摘BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.
