RESUMEN
This research investigates the implications of incorporating blockchain technology into the process of making decisions for green supply chains, particularly under conditions of demand uncertainty. A model was formulated to encompass both environmentally friendly products enabled by blockchain technology and those without such enabling technology. The study further explores the optimal method of introducing green input in a duopoly market using game theory. It also examines how consumer uncertainty about green products and acceptance of the technical parameters of blockchain influence this strategy. The findings suggest that increased consumer uncertainty can, in some instances, motivate manufacturers to enhance the eco-friendliness of their products and improve supply chain performance. However, the universal adoption of blockchain does not necessarily ensure better results; on the contrary, it may compromise product sustainability while enhancing supply chain profitability. Moreover, research has indicated that products enabled by blockchain typically have lower prices, thereby offering potential benefits to consumers when acceptance of sustainable energy solutions is high or uncertain. Additionally, this paper analyzes the impact of changes in green supply chain decision-making on system reliability. This involves exploring the relationship between decision parameters and consumer reluctance towards sustainable products and the adoption of blockchain technology. To ensure stable market competition in dynamic complex systems, research shows that feedback control technology can effectively regulate unpredictable behavior.
RESUMEN
BACKGROUND: As digital learning is rapidly developing and being applied to almost all subjects in higher education nursing. Although digital learning has been shown to have a wide range of benefits, little is known about research into Chinese students' perceptions of digital learning, and there is a need to explore students' digital learning experiences. AIM: This study aimed to explore the digital learning experiences of undergraduate nursing students in Chinese higher education institutions, with the aim of informing future improvements in digital teaching and learning. DESIGN: A descriptive qualitative study. SETTINGS: This study was conducted at six universities in three cities in China. PARTICIPANTS: Twenty-six nursing students with at least one year's experience of digital learning. METHOD: Semi-structured online interviews were used to collect the data, and conventional content analysis was used to analyze the data. FINDINGS: Nursing students' digital learning experiences were categorized into three themes: positive digital learning experience, negative digital learning experience, and barriers to digital learning perception of students. CONCLUSIONS: With the help of advanced digital technology, students can access rich and diversified learning resources anytime and anywhere according to their personal learning pace and interests, which greatly enhances their autonomy and interest in learning. Open online courses have effectively compensated for regional differences in teachers' qualifications, enabling students in remote areas to enjoy high-quality teaching from top educational institutions and giving a solid impetus for improving nursing education in China. However, with the popularity of digital teaching, its design and innovation shortcomings have gradually emerged: students feel lonely and alienated when learning online, and long for more of the interaction and care found in traditional teaching. At the same time, the lack of regulation and assessment standards has created inequities in learning and affected student motivation.
RESUMEN
Introduction: The causality between personality and psychiatric traits and lung cancer (LC) remains unclear. Therefore, we aimed to elucidate the causality between these traits and LC. Methods: Bidirectional two-sample Mendelian randomization (MR) and bibliometric approaches were conducted to estimate the causality between personality (neuroticism, extraversion, agreeableness, conscientiousness, and openness) and psychiatric (schizophrenia, attention-deficit/hyperactivity disorder [ADHD], major depressive disorder, autism spectrum disorder, bipolar disorder, insomnia, and anxiety) traits and LC and its subtypes (lung squamous cell carcinoma, lung adenocarcinoma, and small cell LC). Summary data of these traits were extracted from large datasets (17,375-462,341 participants). Inverse variance weighting was used as the primary MR analysis, with supplementary models, including MR-Egger and weighted medians. Sensitivity analyses were conducted to detect pleiotropy. Bibliometric data were retrieved from the Web of Science Core Collection, Scopus, and PubMed. The main mapping techniques adopted were co-word, collaboration, and citation analyses. Results: Schizophrenia was associated with an increased risk of LC (odds ratio [OR] = 1.077, 95% confidence interval [CI] = 1.030-1.126, P = 0.001). Moreover, LC increased the risk of ADHD (OR = 1.221, 95% CI = 1.096-1.362, P < 0.001). No significant bidirectional associations were observed between other mental traits and LC and its subtypes. Causality, psychiatry, and psychiatric comorbidity are emerging keywords. Research dynamics and landscapes were revealed. Conclusion: This study suggests that schizophrenia is a risk factor for LC and that LC is a risk factor for ADHD. Furthermore, causality, psychiatry, and psychiatric comorbidity have become emerging research trends in related fields.
RESUMEN
Microalgae-bacteria consortia (MBC) system has been shown to enhance the efficiency of microalgae in wastewater treatment, yet its effectiveness in treating levofloxacin (LEV) wastewater remains unexplored. This study compared the treatment of LEV wastewater using pure Chlorella pyrenoidosa (PA) and its MBC constructed with activated sludge bacteria. The results showed that MBC improved the removal efficiency of LEV from 3.50-5.41 % to 33.62-57.20 % by enhancing the growth metabolism of microalgae. The MBC increased microalgae biomass and extracellular polymeric substance (EPS) secretion, yet reduced photosynthetic pigment content compared to the PA. At the phylum level, Proteobacteria and Actinobacteriota are the major bacteria in MBC. Furthermore, the transcriptome reveals that the growth-promoting effects of MBC are associated with the up-regulation of genes encoding the glycolysis, the citrate cycle (TCA cycle), and the pentose phosphate pathway. Enhanced carbon fixation, coupled with down-regulation of photosynthetic electron transfer processes, suggests an energy allocation mechanism within MBC. The up-regulation of porphyrin and arachidonic acid metabolism, along with the expression of genes encoding LEV-degrading enzymes, provides evidence of MBC's superior tolerance to and degradation of LEV. Overall, these findings lead to a better understanding of the underlying mechanisms through which MBC outperforms PA in treating LEV wastewater.
Asunto(s)
Antibacterianos , Chlorella , Levofloxacino , Microalgas , Transcriptoma , Aguas Residuales , Chlorella/metabolismo , Chlorella/genética , Chlorella/crecimiento & desarrollo , Chlorella/efectos de los fármacos , Levofloxacino/farmacología , Microalgas/metabolismo , Microalgas/genética , Microalgas/crecimiento & desarrollo , Contaminantes Químicos del Agua/metabolismo , Contaminantes Químicos del Agua/toxicidad , Bacterias/metabolismo , Bacterias/genética , Bacterias/efectos de los fármacos , Eliminación de Residuos Líquidos/métodos , Consorcios Microbianos/genética , Biodegradación Ambiental , Aguas del Alcantarillado/microbiología , FotosíntesisRESUMEN
This study aimed to assess the current status and changing trends of the disease burden of stroke and its subtypes due to low dietary fiber intake in China from 1990 to 2019. In cases of stroke and its subtypes attributable to low dietary fiber, deaths, disability-adjusted life-years (DALYs), age-standardized mortality rates (ASMR), age-standardized DALYs rates (ASDR), and percentage change were used to assess disease burden. Data were obtained from the 2019 global burden of disease study. Trends were assessed using Joinpoint regression and age-period-cohort analysis. Between 1990 and 2019, there was a declining trend in stroke and its subtypes, ASDR and ASMR, as well as the corresponding number of deaths and DALYs, due to low dietary fiber intake in China. Subarachnoid hemorrhage (SH) showed the greatest decrease, followed by intracerebral hemorrhage (IH) and ischemic stroke (IS). Local drift curves showed a U-shaped distribution of stroke, IS, and IH DALYs across the whole group and sex-based groups. For mortality, the overall and male trends were similar to those for DALYs, whereas female stroke, IH, and IS showed an upward trend. The DALYs for stroke and IH showed a clear bimodal distribution, IS showed an increasing risk with age. For mortality, the SH subtype showed a decreasing trend, whereas other subtypes showed an increasing risk with age. Both the period and cohort rates of stroke DALYs and motality due to low dietary fiber have declined. Males had a higher risk of DALYs and mortality associated with low fiber levels. The burden of stroke and its subtypes associated with a low-fiber diet in China has been declining over the past 30 years, with different patterns of change for different stroke subtypes and a higher burden for males, highlighting the differential impact of fiber intake on stroke and its subtypes.
Asunto(s)
Fibras de la Dieta , Accidente Cerebrovascular , Humanos , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/mortalidad , Hemorragia Subaracnoidea/mortalidad , Hemorragia Subaracnoidea/epidemiología , Adulto , Años de Vida Ajustados por Discapacidad , Años de Vida Ajustados por Calidad de Vida , Anciano de 80 o más Años , Costo de Enfermedad , Factores de Riesgo , Carga Global de Enfermedades/tendencias , Hemorragia Cerebral/mortalidad , Hemorragia Cerebral/epidemiología , Accidente Cerebrovascular Isquémico/epidemiología , Accidente Cerebrovascular Isquémico/mortalidadRESUMEN
As the aging process accelerates, the incidence of chronic diseases in the elderly is rising. As a result, it is crucial to optimize health education for the elderly. Pulmonary aspiration and aspiration pneumonia are significant concerns endangering the health of the elderly. The health education paradigm now in use to prevent pulmonary aspiration in the elderly has numerous flaws, including a lack of home-based health education and the digital divide. Large language model (LLM), an example of artificial intelligence technology, is anticipated to bring a chance to address these issues and offer easily comprehensible health information for the prevention of pulmonary aspiration in the elderly. Our multidisciplinary research team fully understood the needs from the perspective of physicians, nurses and patients, built a knowledge graph (KG), and developed an intelligent Health EducAtion system based on LLM for the prevention of elderly Pulmonary Aspiration (iHEAL-ePA system).
Asunto(s)
Inteligencia Artificial , Educación en Salud , Neumonía por Aspiración , Humanos , Anciano , Neumonía por Aspiración/prevención & controlRESUMEN
Internet + Nursing Services began operating from 2019 in China. The Internet+Nursing Service offers convenience to patients with limited mobility. As the application gains traction and order volume increases, guaranteeing service quality becomes the next challenge. Nonetheless, there is still a dearth of study on service quality assurance. In order to investigate nurses' experiences in the service process, this study used a qualitative research approach from the perspectives of the nurses. It is intended to serve as a guide for the creation of Internet+ nursing services. Two primary topics emerged from the analysis: Factors influencing service motivation (Getting Returns, Discontent, Concerns) and Experience of the service process (Trust contributes to smooth service delivery, Nurses' competence affects service quality, Correct assessment of whether the service is available or not, Shortcomings existing in the service process).
Asunto(s)
Internet , China , Investigación Cualitativa , Humanos , Actitud del Personal de Salud , Calidad de la Atención de SaludRESUMEN
Background: The burden of ischemic stroke (IS) linked to high consumption of red meat is on the rise. This study aimed to analyze the mortality and disability-adjusted life years (DALYs) trends for IS attributed to high red meat intake in China between 1990 and 2019 and to compare these trends with global trends. Methods: This study extracted data on IS attributed to diets high in red meat in China from 1990 to 2019 from the Global Burden of Disease Study (GBD) database. Key measures, including mortality, DALYs, age-standardized mortality rates (ASMR), and age-standardized DALYs rates (ASDR), were used to estimate the disease burden. The estimated annual percentage change and joinpoint regression models were employed to assess the trends over time. An age-period-cohort analysis was used to assess the contribution of a diet high in red meat to the age, period, and cohort effects of IS ASMR and ASDR. Results: Between 1990 and 2019, deaths and DALYs from IS attributed to a diet high in red meat in China, along with corresponding age-standardized rates, significantly increased. The overall estimated annual percentage change for the total population and across sex categories ranged from 1.01 to 2.08. The average annual percentage changes for overall ASDR and ASMR were 1.4 and 1.33, respectively, with male ASDR and ASMR average annual percentage changes at 1.69 and 1.69, respectively. Contrastingly, female ASDR and ASMR average annual percentage changes were 1.07 and 0.87, respectively. Except for a few periods of significant decrease in females, all other periods indicated a significant increase or nonsignificant changes. Incidence of IS linked to a diet high in red meat rose sharply with age, displaying increasing period and cohort effects in ASDR. Female ASMR period and cohort effect ratios initially increased and then decreased, whereas the male ratio showed an upward trend. Conclusion: This study comprehensively analyzed epidemiological characteristics that indicated a marked increase in mortality and DALYs from IS attributable to high red meat consumption, contrasting with a global downtrend. This increase was more pronounced in males than females. This research provides valuable insights for enhancing IS prevention in China.
RESUMEN
Triclocarban (TCC), an emerging contaminant in water environments, its effects on freshwater biofilms remain insufficiently understood. This study investigates the effects of TCC exposure (at concentrations of 10 µg L-1 and 10 mg L-1) on mature freshwater biofilms. TCC was found to inhibit biofilm activity as evidenced by changes in surface morphology and the ratio of live/dead cells. Moreover, both concentrations of TCC were observed to modify the structure of the biofilm community. Metabolomics analysis revealed an overlap in the toxicity mechanisms and detoxification strategies triggered by various concentrations of TCC in biofilms. However, the higher toxicity induced by 10 mg L-1 TCC resulted from the downregulation of proline betaine, disrupting the homeostasis of cellular osmotic pressure regulation in biofilms. Notably, lipid and lipid-like molecules showed high sensitivity to different concentrations of TCC, indicating their potential as biomarkers for TCC exposure. Annotation of the differential metabolites by KEGG revealed that alterations in amino acid and carbon metabolism constituted the primary response mechanisms of biofilms to TCC. Moreover, the biofilm demonstrated enhanced nucleic acid metabolism, which bolstered resistance against TCC stress and heightened tolerance. Furthermore, elevated TCC concentrations prompted more robust detoxification processes for self-defense. Overall, short-term exposure to TCC induced acute toxicity in biofilms, yet they managed to regulate their community structure and metabolic levels to uphold oxidative homeostasis and activity. This research contributes to a deeper comprehension of TCC risk assessment and policy control in aquatic environments.
Asunto(s)
Biopelículas , Carbanilidas , Agua Dulce , Microbiota , Contaminantes Químicos del Agua , Biopelículas/efectos de los fármacos , Carbanilidas/toxicidad , Contaminantes Químicos del Agua/toxicidad , Microbiota/efectos de los fármacos , Metaboloma/efectos de los fármacos , MetabolómicaRESUMEN
The CRISPR system is an adaptive immune system found in prokaryotes that defends host cells against the invasion of foreign DNA1. As part of the ongoing struggle between phages and the bacterial immune system, the CRISPR system has evolved into various types, each with distinct functionalities2. Type II Cas9 is the most extensively studied of these systems and has diverse subtypes. It remains uncertain whether members of this family can evolve additional mechanisms to counter viral invasions3,4. Here we identify 2,062 complete Cas9 loci, predict the structures of their associated proteins and reveal three structural growth trajectories for type II-C Cas9. We found that novel associated genes (NAGs) tended to be present within the loci of larger II-C Cas9s. Further investigation revealed that CbCas9 from Chryseobacterium species contains a novel ß-REC2 domain, and forms a heterotetrameric complex with an NAG-encoded CRISPR-Cas-system-promoting (pro-CRISPR) protein of II-C Cas9 (PcrIIC1). The CbCas9-PcrIIC1 complex exhibits enhanced DNA binding and cleavage activity, broader compatibility for protospacer adjacent motif sequences, increased tolerance for mismatches and improved anti-phage immunity, compared with stand-alone CbCas9. Overall, our work sheds light on the diversity and 'growth evolutionary' trajectories of II-C Cas9 proteins at the structural level, and identifies many NAGs-such as PcrIIC1, which serves as a pro-CRISPR factor to enhance CRISPR-mediated immunity.
Asunto(s)
Bacterias , Bacteriófagos , Proteína 9 Asociada a CRISPR , Sistemas CRISPR-Cas , Bacterias/virología , Bacterias/genética , Bacterias/inmunología , Bacteriófagos/genética , Bacteriófagos/inmunología , Chryseobacterium/genética , Chryseobacterium/inmunología , Chryseobacterium/virología , Proteína 9 Asociada a CRISPR/química , Proteína 9 Asociada a CRISPR/genética , Proteína 9 Asociada a CRISPR/metabolismo , Sistemas CRISPR-Cas/genética , Sistemas CRISPR-Cas/inmunología , División del ADN , Sitios Genéticos/genética , Modelos Moleculares , Dominios ProteicosRESUMEN
BACKGROUND: Acute nutrition-related adverse outcomes are common in head and neck cancer patients undergoing radiotherapy. Predictive models can assist in identifying high-risk patients to enable targeted intervention. We aimed to systematically evaluate predictive models for predicting severe acute nutritional symptoms, insufficient intake, tube feeding, sarcopenia, and weight loss. METHODS: We searched PubMed, Web of Science, EBSCO, Embase, WanFang, CNKI, and SinoMed. We selected studies developing predictive models for the aforementioned outcomes. Data were extracted using a predefined checklist. Risk of bias and applicability assessment were assessed using the Prediction model Risk of Bias Assessment Tool. A narrative synthesis was conducted to summarize the model characteristics, risk of bias, and performance. RESULTS: A total of 2941 studies were retrieved and 19 were included. Study outcome measure were different symptoms (n = 11), weight loss (n = 5), tube feeding (n = 3), and symptom or tube feeding (n = 1). Predictive factors mainly encompassed sociodemographic data, disease-related data, and treatment-related data. Seventeen studies reported area under the curve or C-index values ranging from 0.610 to 0.96, indicating moderate to good predictive performance. However, candidate predictors were incomplete, outcome measures were diverse, and the risk of bias was high. Most of them used traditional model development methods, and only two used machine learning. CONCLUSIONS: Most current models showed moderate to good predictive performance. However, predictors are incomplete, outcome are inconsistent, and the risk of bias is high. Clinicians could carefully select the models with better model performance from the available models according to their actual conditions. Future research should include comprehensive and modifiable indicators and prioritize well-designed and reported studies for model development.
Asunto(s)
Neoplasias de Cabeza y Cuello , Humanos , Neoplasias de Cabeza y Cuello/radioterapia , Pérdida de Peso , Nutrición Enteral , Estado Nutricional , Sarcopenia/etiologíaRESUMEN
PURPOSE: To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS: A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS: A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION: Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS: Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
RESUMEN
Ribozymes are catalytic RNAs with diverse functions including self-splicing and polymerization. This work aims to discover natural ribozymes that behave as hydrolytic and sequence-specific DNA endonucleases, which could be repurposed as DNA manipulation tools. Focused on bacterial group II-C introns, we found that many systems without intron-encoded protein propagate multiple copies in their resident genomes. These introns, named HYdrolytic Endonucleolytic Ribozymes (HYERs), cleaved RNA, single-stranded DNA, bubbled double-stranded DNA (dsDNA), and plasmids in vitro. HYER1 generated dsDNA breaks in the mammalian genome. Cryo-electron microscopy analysis revealed a homodimer structure for HYER1, where each monomer contains a Mg2+-dependent hydrolysis pocket and captures DNA complementary to the target recognition site (TRS). Rational designs including TRS extension, recruiting sequence insertion, and heterodimerization yielded engineered HYERs showing improved specificity and flexibility for DNA manipulation.
Asunto(s)
División del ADN , Endonucleasas , ARN Catalítico , Animales , Microscopía por Crioelectrón , Endonucleasas/química , Endonucleasas/genética , Hidrólisis , Intrones , Conformación de Ácido Nucleico , Empalme del ARN , ARN Catalítico/química , ARN Catalítico/genéticaRESUMEN
This study mainly explored the role of nicorandil in regulating ferroptosis and alleviating septic cardiomyopathy through toll-like receptor (TLR) 4/solute carrier family 7 member 11 (SLC7A11) signaling pathway. Twenty-four male SD rats were randomly divided into control, Nic (nicorandil), LPS (lipopolysaccharide), and LPS + Nic groups and given echocardiography. A detection kit was applied to measure the levels of lactic dehydrogenase (LDH), cardiac troponin I (cTnI), and creatine kinase-MB (CK-MB); HE staining and the levels of glutathione (GSH), malondialdehyde (MDA), total iron, and Fe2+ of myocardial tissues were detected. Moreover, the expression of TLR4 and SLC7A11 were measured by qRT-PCR and the proteins regulating ferroptosis (TLR4, SLC7A11, GPX4, ACSL4, DMT1, Fpn, and TfR1) were checked by western blot. Myocardial cells (H9C2) were induced with lipopolysaccharide (LPS) and transfected with si-TLR4 or SLC7A11-OE. Then, the viability, ferroptosis, and TLR4/SLC7A11 signaling pathway of cells were examined. Nicorandil could significantly increase left ventricular (LV) ejection fraction (LVEF) while reduce LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV). Also, it greatly reduced the levels of LDH, cTnI, and CK-MB; alleviated the pathological changes of myocardial injury; notably decreased MDA, total iron, and Fe2+ levels in myocardial tissues; and significantly increased GSH level. Besides, nicorandil obviously raised protein levels of GPX4, Fpn, and SLC7A11, and decreased protein levels of ACSL4, DMT1, TfR1, and TLR4. After knockdown of TLR4 or overexpression of SLC7A11, the inhibition effect of nicorandil on ferroptosis was strengthened in LPS-induced H9C2 cells. Therefore, nicorandil may regulate ferroptosis through TLR4/SLC7A11 signaling, thereby alleviating septic cardiomyopathy.
Asunto(s)
Cardiomiopatías , Ferroptosis , Nicorandil , Ratas Sprague-Dawley , Sepsis , Transducción de Señal , Receptor Toll-Like 4 , Animales , Masculino , Ratas , Sistema de Transporte de Aminoácidos y+/efectos de los fármacos , Sistema de Transporte de Aminoácidos y+/metabolismo , Cardiomiopatías/tratamiento farmacológico , Cardiomiopatías/metabolismo , Línea Celular , Ferroptosis/efectos de los fármacos , Lipopolisacáridos/toxicidad , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismo , Miocitos Cardíacos/patología , Nicorandil/farmacología , Nicorandil/uso terapéutico , Sepsis/tratamiento farmacológico , Sepsis/metabolismo , Transducción de Señal/efectos de los fármacos , Receptor Toll-Like 4/efectos de los fármacos , Receptor Toll-Like 4/metabolismoRESUMEN
Background: Thyroid cancer (TC) is the most common endocrine system malignancy with a rapidly increasing incidence in China. Epidemiological data on TC at the national level are lacking. This study aimed to quantify the TC disease burden in China between 1990 and 2019 and evaluate the current status and trends of the disease burden attributed to a high body mass index (HBMI). Methods: The 2019 Global Burden of Disease Study dataset was used to explore the TC disease burden. Age-standardized rates of incidence (ASIR), prevalence (ASPR), deaths (ASDR), and disability-adjusted life years (DALYs) were considered and the estimated annual percentage change (EAPC) was calculated as a measure of the average change in age-standardized rates. The trend in TC-related mortality and DALYs attributed to an HBMI, accounting for different age groups and sexes, was examined. Results: Between 1990 and 2019, the ASDR and DALYs for TC decreased by 0.02/100000 and 1.17/100000, respectively. The ASPR and ASIR increased by 9.88/100000 and 1.04/100000, respectively. The EAPC for ASDR, age-standardized rates of DALYs, ASPR, and ASIR were 0.06 (95% CI: -0.09, 0.21), -0.20 (95% CI: -0.31, -0.10), 3.52 (95% CI: 3.35, 3.68), and 2.73 (95% CI: 2.58, 2.88), respectively. TC-related deaths, DALYs, and their prevalence and incidence in China increased by 118%, 350%, 81%, and 290%, respectively. The disease burden of TC was higher among male than female patients in different age groups, with varying distributions. The disease burden attributed to HBMI gradually increased over the past 30 years according to age-standardized DALYs, particularly in male patients. Conclusion: The TC burden has increased in China over the past 30 years, and population aging poses a challenge to TC prevention and control. HBMI has become an important factor in the TC disease burden and further research should focus on reducing the disease burden among Chinese male patients with TC.
RESUMEN
Background: Complete resection of the tumor and the ipsilateral thyroid lobe at the primary surgery is the "gold standard" for the treatment of parathyroid carcinoma (PC). However, differences in the overall survival (OS) of patients with PC who underwent partial and total surgical resection remain to be determined. Methods: Data on patients with PC who underwent partial and total surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database (2000-2018). The X-tile software (https://medicine.yale.edu/lab/rimm/research/software/) was used to define the optimal cut-off values for continuous variables. The inverse probability of treatment weighting (IPTW) method was used to reduce the selection bias. IPTW-adjusted Kaplan-Meier curves and Cox proportional hazards models were used to compare the OS of patients with PC in the partial and total surgical resection groups. Results: A total of 334 patients with PC were included in this study (183 and 151 in the partial and total surgical resection groups, respectively). The optimal cut-off values for age at diagnosis were 53 and 73 years, respectively, while that for tumor size was 34 mm. In both the Kaplan-Meier analysis and univariable Cox proportional hazards regression analysis before IPTW, the difference in OS between the partial and total surgical resection groups was not statistically significant (p>0.05). These findings were confirmed in the IPTW-adjusted Kaplan-Meier analysis and multivariate Cox proportional hazards regression analysis (p>0.05). Subgroup analysis revealed that total surgical resection was beneficial for OS only in the subgroup with unknown tumor size. Conclusion: There was no significant difference in the prognosis of patients who underwent partial and total surgical resection. This finding may provide a useful reference for the treatment of PC.
Asunto(s)
Neoplasias de las Paratiroides , Humanos , Estimación de Kaplan-Meier , Neoplasias de las Paratiroides/epidemiología , Neoplasias de las Paratiroides/cirugía , Probabilidad , Pronóstico , Modelos de Riesgos Proporcionales , Masculino , Femenino , Persona de Mediana Edad , AncianoRESUMEN
BACKGROUND: The migration of lymphocytes shares many similarities in mode and mechanism with the metastasis of lung cancer tumor cells. But changes in the expression of lymphocyte migration regulation related proteins in urine exosomes remain unclear. This study is to investigate the expression changes of lymphocyte migration regulation related proteins in urine exosomes of lung cancer patients, and further verify their correlation with the development and progression of lung cancer. METHODS: Urine exosomes were collected from lung cancer patients and healthy people aged 15-79 years. Mass spectrometry was used to screen and explore the expression changes of lymphocyte migration regulation related proteins in healthy people of different ages. Enzyme-linked immunosorbent assay and western blotting were used to detect the expression changes of lymphocyte migration regulation related proteins in lung cancer patients. RESULTS: Analyzing the data of urine exosome proteomics, a total of 12 lymphocyte related proteins were identified, 5 of which were lymphocyte migration regulation related proteins. Among these proteins, WASL and STK10 proteins showed a gradual decrease in expression with age, and WNK1 protein showed a gradual increase. Lung cancer patients had reduced expression of WASL and increased expression of STK10 and WNK1 proteins in urine exosomes compared to normal people. Urine exosome WASL, STK10, and WNK1 were diagnosed with lung cancer, with a combined AUC of 0.760. CONCLUSIONS: Lymphocyte migration regulation related proteins were differentially expressed in the urine exosome of lung cancer patients, and WASL, STK10 and WNK1 may serve as potential biomarkers for lung cancer diagnosis.
Asunto(s)
Exosomas , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/patología , Exosomas/metabolismo , Pulmón/patología , Biomarcadores/análisis , Factores de Transcripción/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismoRESUMEN
BACKGROUND: Venous thromboembolism (VTE) is a common postoperative complication in patients undergoing surgery for gastric cancer (GC). Although VTE incidence may vary among cancers, guidelines rarely stratify preventive methods for postoperative VTE by cancer type. The risk of VTE in patients undergoing surgery for GC remains unclear. METHODS: A systematic review and meta-analysis was undertaken to determine the risk of VTE after GC surgery and discuss the clinical value of pharmacological thromboprophylaxis in these cases. Medline, Embase, Web of Science, and Cochrane Library databases were searched for articles published from their inception to September 2022. RESULTS: Overall, 13 studies (111,936 patients) were included. The overall 1-month incidence of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE) after GC surgery was 1.8% (95% CI, 0.8-3.1%; I²=98.5%), 1.2% (95% CI, 0.5-2.1%; I²=96.1%), and 0.4% (95% CI, 0.1-1.1%; I²=96.3%), respectively. The prevalence of postoperative VTE was comparable between Asian and Western populations (1.8% vs. 1.8%; P > 0.05). Compared with mechanical prophylaxis alone, mechanical plus pharmacological prophylaxis was associated with a significantly lower 1-month rate of postoperative VTE and DVT (0.6% vs. 2.9% and 0.6% vs. 2.8%, respectively; all P < 0.05), but not PE (P > 0.05). The 1-month postoperative incidence of VTE was not significantly different between laparoscopic and open surgery (1.8% vs. 4.3%, P > 0.05). CONCLUSION: Patients undergoing GC surgery do not have a high risk of VTE. The incidence of VTE after GC surgery is not significantly different between Eastern and Western patients. Mechanical plus pharmacological prophylaxis is more effective than mechanical prophylaxis alone in postoperative VTE prevention. The VTE risk is comparable between open and laparoscopic surgery for GC.
Asunto(s)
Embolia Pulmonar , Neoplasias Gástricas , Tromboembolia Venosa , Humanos , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & control , Anticoagulantes/uso terapéutico , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/complicaciones , Embolia Pulmonar/epidemiología , Embolia Pulmonar/etiología , Embolia Pulmonar/prevención & control , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Factores de RiesgoRESUMEN
Previous studies mainly focus on the game analysis of green building development under carbon tax policy, while carbon trading, as one of the important means to promote low-carbon development, is rarely mentioned in promoting the development of the green building market. Based on this, to study the impact of carbon trading policy on the development of the green building market, this study combines prospect theory for carbon trading to build a three-way evolutionary game model of developer-government-consumer. It studies the influencing causes of green building market development under the carbon trading mechanism from the whole perspective. The study shows the existence of a carbon trading policy helps the development of the green building market. In the presence of a carbon trading market, the government's punishment, subsidies, and the setting of carbon prices influence the development of the green building market. In addition, the percentage of carbon emissions bought, the potential benefits, and the selling price also affect the chance of consumers buying green buildings to a greater or lesser extent. This study introduces prospect theory into the developer-government-consumer three-way evolutionary game model, which enriches the research perspective of each subject's behavior in the green building market. It provides theoretical support for developers, governments, and consumers to collaborate to promote the coordination and development of the green building market. It has policy implications for promoting the green and high-quality development of the construction industry.
Asunto(s)
Carbono , Industria de la Construcción , Carbono/análisis , Simulación por Computador , Políticas , Comportamiento del Consumidor , ChinaRESUMEN
Thermoplastic composite structures possess superior properties compared with thermosetting composites, including recyclability and high damage tolerance. However, the poor adhesion properties of thermoplastic composites make their joining process challenging. In this research, three bonding techniques, namely adhesive, mechanical joining, and hybrid bonding, are investigated using lap shear specimens to evaluate their mechanical properties and failure modes. The stress distributions at the joints of the three bonding techniques are analyzed by numerical simulation. The findings demonstrate that hybrid bonding enhances the strength of composite joints, albeit at the expense of some stiffness due to the presence of an open hole. This method is particularly suitable for applications that necessitate robust connections requiring high strength.