Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress.

Purpose: Stroke is a major disease endangering the health of Chinese people, and patients need to rely on the care of family members, which brings heavy caregiving burdens and pressures to caregivers and families, thus disrupting the stable family structure. In view of this, this study was to analyse the current status of family resilience among caregivers of stroke patients in Chinese nuclear families, and to explore the correlation and mechanism of action among perceived stress, illness uncertainty and family resilience. Patients and Methods: This study used a cross-sectional research design. A total of 350 carers of stroke patients in nuclear families from four tertiary hospitals in Suzhou City, Jiangsu Province, China were selected by convenience sampling method and assessed by using demographic questionnaires, the Chinese Perceived Stress Scale (CPSS), the Parental Perceptions of Uncertainty Scale-Family (PPUS-FM), and a short Chinese version of the Family Resilience Assessment Scale (FRAS-C). Based on the above data, structural equation model was used to test the mediating role of perceived stress between illness uncertainty and family resilience. Results: Family resilience among caregivers of stroke patients in nuclear families was at the medium lower level, illness uncertainty was at the medium level, and perceived stress was at the relatively high level. Illness uncertainty was positively correlated with perceived stress (P<0.01) and negatively correlated with family resilience (P<0.01). Illness uncertainty directly predicted family resilience (ß = -0.516, p < 0.05). And the pathway between illness uncertainty and family resilience was partially mediated by perceived stress (Effect= -0.091, 95% CI [-0.141, -0.055]). Conclusion: Healthcare professionals should pay adequate attention to the level of illness uncertainty and perceived stress among carers of stroke patients, with the need to take measures to reduce carers' illness uncertainty and perceived stress in order to improve family resilience.

Spatial distribution, source identification, and potential risks of 14 bisphenol analogues in soil under different land uses in the megacity of Chengdu, China.

This study explored the levels, distribution, potential sources, ecological risks and estrogenic activities of 14 bisphenol analogues (BPs) in soil under eight land-use types in the megacity of Chengdu, China. Eleven BPs were detected in the soil samples and the total concentrations ranged from 32.3 to 570 ng/g d.w. Levels of bisphenol BP (BPBP) in the soil (up to 208 ng/g d.w.) only second to the most dominant compound bisphenol A (BPA) were found. Relatively higher Σ14BP accumulation in the soil was observed in the commercial and residential areas (median: 136 ng/g d.w. and 131 ng/g d.w.) compared with agricultural area (median: 67.5 ng/g d.w.). Source identification indicated the role of atmospheric particulate deposition and consecutive anthropogenic activities in BP emission. The ecotoxicity assessment implied that BPA, bisphenol S (BPS), bisphenol F (BPF) and bisphenol PH (BPPH) might pose low to medium risk to the ecosystem due to their extensive use and biological effects. The calculated 17ß-estradiol equivalents of BPs were in the range of 0.501-7.74 pg E2/g d.w, and the estrogenic activities were inferior to those contributed by natural estrogens in the soil.

Intracranial calcifications associated with factors related and unrelated to atherosclerosis in older people: A community dwelling cohort study.

The cause of intracranial calcification is not fully understood. The aim of the current study was to identify factors associated with intracranial calcification and to determine whether these factors differ in calcification of different sites. A total of 404 community-dwelling people aged 65 or older were included in the study. All subjects underwent brain computed tomography (CT), blood tests, and a Mini-Mental State Examination (MMSE). Intracranial calcifications were scored using CT. Stepwise regression analysis was performed to examine factors associated with intracranial calcification, with each calcification score used as a dependent variable. Independent variables included age, gender, hemoglobin A1c (HbA1c), dyslipidemia, estimated glomerular filtration rate (eGFR), blood pressure, body mass index (BMI), smoking, serum iron, ferritin, and intact parathyroid hormone (PTH). Stepwise regression analysis detected male gender as a predictor of pineal gland calcification and intact PTH as a predictor of basal ganglia calcification. Age and lifestyle diseases were identified as predictors of calcification of the falx cerebri, internal carotid arteries, and vertebral arteries. These results indicate that the mechanisms of calcifications of the pineal gland and basal ganglia might differ from that of artery calcification, and that causes of intracranial calcification might be classified using factors that are and are not related to atherosclerosis.

Ultrasmall, Amorphous V2O3 Intimately Anchored on a Carbon Nanofiber Aerogel Toward High-Rate Zinc-Ion Batteries.

When considered as a cathode candidate for aqueous Zn-ion batteries, V2O3 faces several problems, such as inherently unsuitable structure, fast structural degradation, and sluggish charge transport kinetics. In this paper, we report the synthesis of a V2O3 intimately coupled carbon aerogel by a controllable ion impregnation and solid-state reaction strategy using bacterial cellulose and ammonium metavanadate as raw materials. In this newly designed structure, the carbonized carbon fiber network provides fast ion and electron transport channels. More importantly, the cellulose aerogel functions as a dispersing and supporting skeleton to realize the particle size reduction, uniform distribution, and amorphous features of V2O3. These advantages work together to realize adequate electrochemical activation during the initial charging process and shorter transport distance and faster transport kinetics of Zn2+. The batteries based on the V2O3/CNF aerogel exhibit a high-rate performance and an excellent cycling stability. At a current density of 20 A g-1, the V2O3/CNF aerogel delivers a specific capacity of 159.8 mAh g-1, and it demonstrates an exceptionally long life span over 2000 cycles at 12 A g-1. Furthermore, the electrodes with active material loadings as high as 10 mg cm-2 still deliver appreciable specific capacities of 257 mAh g-1 at 0.1 A g-1.

Associations between anxiety, depression, and personal mastery in community-dwelling older adults: a network-based analysis.

BACKGROUND: In China, about 18.70% of the population aged 60 years and older are at risk of low personal mastery as well as anxiety and depression for a variety of reasons. The purpose of this study was to construct a symptom network model of the relationship between anxiety, depression, and personal mastery in community-dwelling older adults and to identify central and bridge symptoms in this network. METHODS: Depression, anxiety, and personal mastery were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Personal Mastery Scale (PMS), respectively. A total of 501 older adults in 16 communities in Changzhou and Zhenjiang, Jiangsu Province, China, were surveyed by using a combination of stratified sampling and convenience sampling methods. The R language was used to construct the network. RESULTS: (1) The network structure of anxiety-depression-personal mastery was stable, with "Nervousness" (node GAD1, strength = 1.38), "Sad mood" (node PHQ2, strength = 1.22), " Inability to change" (node PMS2, strength = 1.01) and "Involuntarily" (node PMS3, strength = 0.95) as the central symptoms. (2) "Irritability" (node GAD6, bridge strength = 0.743), "Sad mood" (node PHQ2, bridge strength = 0.655), and "Trouble relaxing" (node GAD4, bridge strength = 0.550) were the bridge symptoms connecting anxiety, depressive symptoms, and personal mastery. (3) In the network comparison test (NCT), residence, somatic chronic comorbidity and gender had no significant effect on network structure. CONCLUSIONS: The construction of the anxiety-depression-personal mastery network structure opens up new possibilities for mechanisms of action and intervention formulation for psychological disorders in community-dwelling older adults. The identification of central symptoms (e.g., nervousness, sad mood, inability to change, involuntarily) and bridge symptoms (e.g., irritability, sad mood, trouble relaxing) in community-dwelling older adults with anxiety, depression, and low sense of mastery can provide a scientific basis for the development of precise interventions.

Partial femoral head replacement: a new innovative hip-preserving approach for treating osteonecrosis of the femoral head and its finite element analysis.

Purpose: Controversy remains regarding the optimal treatment for stage III Osteonecrosis of the femoral head (ONFH). This study presents, for the first time, the precise treatment of stage III ONFH using the "substitute the beam for a pillar" technique and performs a comparative finite element analysis with other hip-preserving procedures. Methods: A formalin-preserved femur of male cadavers was selected to obtain the CT scan data of femur. The proximal femur model was reconstructed and assembled using Mimics 20.0, Geomagic, and UG-NX 12.0 software with four different implant types: simple core decompression, fibula implantation, porous tantalum rod implantation, and partial replacement prosthesis. The finite element simulations were conducted to simulate the normal walking gait, and the stress distribution and displacement data of the femur and the implant model were obtained. Results: The peak von Mises stress of the femoral head and proximal femur in the partial replacement of the femoral head (PRFH) group were 22.8 MPa and 37.4 MPa, respectively, which were 3.1%-38.6% and 12.8%-37.4% lower than those of the other three surgical methods. Conclusion: The PRFH group exhibits better mechanical performance, reducing stress and displacement in the ONFH area, thus maintaining femoral head stability. Among the four hip-preserving approaches, from a biomechanical perspective, PRFH offers a new option for treating ONFH.

Core and bridge symptoms of demoralization in Chinese female cancer patients: a network analysis.

Objective: In this study, we explore the core and bridge symptoms of demoralization in female cancer patients in China, and provide a basis for precise psychological intervention among female cancer patients. Methods: This study used a cross-sectional survey. Participants were recruited from three third-class hospitals in Jiangsu Province from June 2022 to June 2023 using the convenience sampling method. The severity of each symptom of demoralization was investigated in female cancer patients using the Demoralization Scale (DS). Network analysis was performed using the R language to identify core and bridge symptoms in the network and further explore some characteristic edge connections in the network. Results: The network structure model of demoralization had strong accuracy and stability. In the network, the symptoms with the highest strength centrality were "Discouragement" (C3, strength=2.19), "No self-worth" (A3, strength=1.21), "Don't want to live" (A5, strength=1.20), "Hopeless" (D4, strength=0.81), and "Vulnerability" (B3, strength=0.74), respectively. The bridge strength analysis identified "Hopeless" (D4, bridge strength=0.92), "Discouragement" (C3, bridge strength=0.85), "No self-worth" (A3, bridge strength=0.75), "Poor spirits" (E2, bridge strength=0.71), and "Vulnerability" (B3, bridge strength=0.69) as the bridge symptoms. The strongest edge connections of all dimensions were "No self-worth" and "Worthless" (A3-E6, edge weighting=0.27), "Poor spirits" and "Loss of emotional control" (E2-D1, edge weighting=0.22), "Discouragement" and "Vulnerability" (C3-B3, edge weighting=0.14), and "Hopeless" and "No meaning of survival" (D4-A4, edge weighting=0.12). Conclusion: "Discouragement (C3)", "No self-worth (A3)", "Hopeless (D4)", and "Vulnerability (B3)" are both core symptoms and bridge symptoms. These symptoms can not only trigger a patient's demoralization but also stimulate more severe symptom clusters through interactions. The early recognition of and intervention regarding these symptoms could be important for the prevention and treatment of demoralization among female cancer patients.

Occurrence and exposure evaluation of bisphenol A and its analogues in indoor and outdoor dust from China.

Bisphenol A (BPA) and its analogues have been proved to be harmful to human reproduction, endocrine and nervous system. But information on the occurrence and human exposure to bisphenol compounds (BPs) in dust (especially outdoor dust) is limited. In this study, 14 BPs were determined in 174 indoor dust samples and 202 outdoor dust samples from Chinese mainland, Hong Kong, Macau and Taiwan. BPA, BPS, BPAF, BPF, BPAP and BPE were widely detected with detection frequencies of 98.94 %, 98.67 %, 97.87 %, 95.21 %, 87.23 % and 71.54 %, respectively. The median total concentrations of the most detected six BPs in the dust were in the order of south urban indoors (556 ng/g) > south rural outdoors (438 ng/g) > south urban outdoors (432 ng/g) > south rural outdoors (418 ng/g) > north rural indoors (412 ng/g) > north urban outdoors (341 ng/g) > north urban indoors (311 ng/g) > north rural outdoors (246 ng/g). The amounts of garbage incineration, plastic output and recycled paper may have influence on the BPs levels. Some BPs (BPAF, BPAP, BPF and BPS) in the indoor and outdoor samples were significantly positively correlated. In addition, the BPs in the indoor dust from different indoor micro environments in Chengdu were investigated. BPA (median concentration: 571.2 ng/g) and BPF (median concentration: 114.3 ng/g) were the two primary BPs, accounting for 78.1 % of the median total concentrations of the investigated BPs. High concentration of BPA appeared in printing workshops and offices, while high concentration of BPAP, BPC, BPE and BPF appeared in electronic repair shops. Occupational exposure to BPs deserves attention in the future. ΣBPs exposure risk for children and adults in the urban areas of southern China was the highest. To our knowledge, this is the first report in China to study BPs in outdoor dust sample.

Sahara's surface transformation forced an abrupt hydroclimate decline and Neolithic culture transition in northern China.

The remote forcing from land surface changes in the Sahara is hypothesized to play a pivotal role in modulating the intensity of the East Asian summer monsoon (EASM) through ocean-atmospheric teleconnections. This modulation has far-reaching consequences, particularly in facilitating societal shifts documented in northern China. Here, we present a well-dated lake-level record from the Daihai Lake Basin in northern China, providing quantitative assessments of Holocene monsoonal precipitation and the consequent migrations of the northern boundary of the EASM. Our reconstruction, informed by a water-and-energy balance model, indicates that annual precipitation reached ∼700 mm during 8-5 ka, followed by a rapid decline to ∼550 mm between 5 and 4 ka. This shift coherently aligns with a significant ∼300 km northwestward movement of the EASM northern boundary during the Middle Holocene (MH), in contrast to its current position. Our findings underscore that these changes cannot be entirely attributed to orbital forcing, as corroborated by simulation tests. Climate model simulations deployed in our study suggest that the presence of the Green Sahara during the MH significantly strengthened the EASM and led to a northward shift of the monsoon rainfall belt. Conversely, the Sahara's reversion to a desert landscape in the late Holocene was accompanied by a corresponding southward retraction of monsoon influence. These dramatic hydroclimate changes during ∼5-4 ka likely triggered or at least contributed to a shift in Neolithic cultures and societal transformation in northern China. With decreasing agricultural productivity, communities transitioned from millet farming to a mixed rainfed agriculture and animal husbandry system. Thus, our findings elucidate not only the variability of the EASM but also the profound implications of a remote forcing, such as surface transformations of the Sahara, on climatic changes and cultural evolution in northern China.

Photodegradation of anthelmintic drugs under natural sunlight and simulated irradiation: kinetics, mechanisms, transformation products, and toxicity.

Albendazole (ALB) and bithionol (BIT) are two anthelmintic drugs (ADs) with high consumption from benzimidazole group and diphenylsulfide group, respectively. However, information on the transformation of the two anthelmintics under environmental condition is scare. Therefore, in the present study, we investigated the natural attenuation of the two ADs in the aquatic environment, including biodegradation, hydrolysis, and direct and indirect photodegradation. The direct photodegradation occupied a vast portion among other degradation pathways of the two ADs in natural water, with near-surface summer half-lives of 0.272-0.387 h and 0.110-0.520 h for ALB and BIT, respectively. Suspended particles in water were found to facilitate the photodegradation of the two ADs. Study on the indirect photodegradation demonstrated the positive roles of singlet oxygen (1O2) and excited triplet dissolved organic matter (3DOM*) in the photolysis of the two ADs, whereas the hydroxyl radical (•OH) affected little on the overall photodegradation procedures of ALB due to the scavenging effect of HCO3-. Dual effects of DO, DOM, HCO3-, NO3-, and NO2- on the photodegradation of ALB and BIT were perceived. Transformation intermediates (TIs) of the two ADs during photodegradation were analyzed by UHPLC-QTOF-MS. Six TIs of ALB were identified, including a broad-spectrum fungicide carbendazim and another common AD ricobendazole. Two TIs of BIT yielded from dechlorination were also detected. Probable transformation mechanism and predicted aquatic ecotoxicity based on the identified TIs were unveiled.

Medium to long term of self-report outcomes of high tibial osteotomy in advanced age patients.

PURPOSE: This study aimed to investigate the mid- to long-term benefits of high tibial osteotomy in advanced age patients. METHODS: This retrospective study was conducted in our hospital from January 2017 to January 2021 with data prospectively collected, 47 patients with knee osteoarthritis who over 65 years old were included, and a 1:1 propensity score (PS) of patients < 65 years were matched according to gender, body mass index, and side. Patient demographics, intraooperative and postoperative variables, and patient self-reported outcomes were compared. A generalized linear model was used to screen possible risk factors. RESULTS: A total of 94 consecutive patients were included; the average age of advanced age group was 69.47 + 4.26 years and 57.87 + 5.51 years in the younger group. There were no statistically difference in K-L grade, smoke, drink, comorbidity, ASA, blood loss, operative duration, length of stay, surgical site infection, hinge fracture, DVT, and preooperative and postoperative aFTA; significantly statistical difference of the eFI was found between two groups (P < 0.05). Two groups had comparable VAS and MOMAC scores at one year postoperatively (P > 0.05), while the younger group had lower VAS and WOMAC scores than the advanced age group at the end of follow-up (P < 0.05). Generalized linear model showed both age and eFI were associated with WOMAC scores; there was a statistically significant difference in the effect of eFI on WOMAC scores at different ages (P > 0.05). CONCLUSIONS: Compared with younger patients, advanced age patients have similar short-term benefits, but less long-term benefits. We recommend that patients proposed for HTO be discriminated by eFI, and patients with higher scores should be cautiously selected.

Extending Cycling Life Beyond 300 000 Cycles in Aqueous Zinc Ion Capacitors Through Additive Interface Engineering.

Developing low-cost and long-cycling-life aqueous zinc (Zn) ion capacitors (AZICs) for large-scale electrochemical energy storage still faces the challenges of dendritic Zn deposition and interfacial side reactions. Here, an interface engineering strategy utilizing a dibenzenesulfonimide (BBI) additive is employed to enhance the stability of the Zn metal anode/electrolyte interface. The first-principles calculation results demonstrate that BBI anions can be chemically adsorbed on Zn metal. Meanwhile, the experimental results confirm that the BBI-Zn interfacial layer converts the original water-richelectric double layer (EDL) into a water-poor EDL, effectively inhibiting the water related parasitic reaction at the electrode/electrolyte interface. In addition, the BBI-Zn interfacial layer introduces an additional Zn ions (Zn2+) migration energy barrier, increasing the Zn2+ de-solvation activation energy, consequently raising the Zn2+ nucleation overpotential, and thus achieving the compact and uniform Zn deposition behavior. Furthermore, the solid electrolyte interphase (SEI) layer derived from the BBI-Zn interfacial layer during cycling can further maintain the interfacial stability of the Zn anode. Owing to the above favorable features, the assembled AZIC exhibits an ultra-long cycling life of over 300 000 cycles based on the additive engineering strategy, which shows application prospects in high-performance AZICs.

Construction of antibiotic-induced depression mice model and the function of intestinal microbiota.

Many research studies focus on intestinal microbiota-related depression induced by the usage of antibiotics, but the use of antibiotics is fairly different. To construct an effective antibiotic-induced depression mice model and explore the effect of intestinal microbiota in antibiotic-induced depression, we used several kinds of antibiotic mixtures to induce mice depression and used depression-related behavioral tests and neurobiological factors to evaluate the construction of the antibiotic-induced depression mice model. SPSS statistical software was used to analyze the above data, and the optimal model was selected according to the stability of the results and the simplicity of the modeling methods. Metagenomic analysis and fecal microbiota transplantation (FMT) of intestinal microbiota from antibiotic-induced depression mice were performed to analyze the effect of intestinal microbiota. The results showed that antibiotic mixture A (1.25 µg/mL natamycin, 5 mg/mL neomycin sulfate, and 5 mg/mL bacitracin), antibiotic mixture B (24 mg/mL bacitracin, 24 mg/mL neomycin sulfate, 9.6 mg/mL ampicillin, 4.8 mg/mL meropenem, and 1.47 mg/mL vancomycin), and antibiotic solution D (only containing 5 mg/mL neomycin sulfate) could induce depression-like behavior in mice. By using these antibiotics, the concentrations of norepinephrine (NE), 5-hydroxytryptamine (5-HT), and brain-derived neurotrophic factor (BDNF) in mice hippocampus and prefrontal cortex tissues were significantly decreased. All the above results were consistent with those of chronic unpredictable mild stress (CUMS) depression mice. The FMT results showed that fecal microbiota from antibiotic-induced depressed mice transplanted into normal mice (8 weeks-old male C57BL/6J SPF mice) also could induce depression-like behavior and cause similar changes in neurobiological factors. Metagenomic analysis showed that the community structure of microbiota in the intestinal tract of antibiotic-induced depression mice was significantly different from that in control mice, the intestinal microbiota species diversity in antibiotic-induced depression mice was lower, the lipoic acid metabolism pathway was significantly activated, and the abundance of functional gene lipA was explicitly increased. Quantitative real-time PCR (qPCR) further verified the abundance of enriched bacteria in the intestinal microbiota of antibiotic-induced depression mice. In summary, the specific antibiotic mixtures can induce depression by causing changes in intestinal microbiota in mice. Antibiotic-induced depressed mice show differences in intestinal microbiota abundance, high enrichment of the unique metabolic pathway, and the functional gene.

Organophosphorus flame retardants and their metabolites in paired human blood and urine.

Organophosphorus flame retardants (OPFRs) have been shown to be carcinogenic, neurotoxic, and endocrine disruptive, so it is important to understand the levels of OPFRs in human body as well as the modes of external exposure. In this study, we investigated the levels of 13 OPFRs and 7 phosphodiester metabolites in paired human blood and urine, as well as the influencing factors (region, age and gender), and studied the relationship between OPFRs and oxidative stress by urinary metabolites. We found that the concentrations of triphenyl phosphate (TPhP) and tris-(2-ethylhexyl) phosphate (TEHP) in the blood of urban populations were higher than those of rural populations, and that younger populations suffered higher TPhP and 2-ethylhexyl diphenyl phosphate (EHDPP) exposures than older populations. In addition, we found that tris-(2-chloroethyl) phosphate (TCEP), tributyl phosphate (TnBP), TPhP and EHDPP exposure induced oxidative stress. The results of the internal load principal component analysis indicated that dust ingestion, skin exposure, respiration and dietary intake may be the most important sources of TCEP, tris(2-butoxyethyl) phosphate (TBOEP), tri(2-chloroisopropyl) phosphate (TCIPP) and TEHP, respectively, and dust ingestion and skin exposure may be the main sources of TPhP for humans.

Particle size and water content impact breakdown and starch digestibility of chickpea snacks during in vitro gastrointestinal digestion.

Chickpeas are an agriculturally-important legume that are an excellent source of protein, fiber, and minerals. Developing chickpea-based snacks could provide consumers with snack products rich in protein and other nutrients. In this study, chickpea puree (high moisture content) and cracker (low moisture content) were each produced with large (7 mm sieve; coarse) or small (2 mm sieve; fine) particle size to investigate the impact of initial particle size and moisture content on particle breakdown, starch hydrolysis, and protein hydrolysis during in vitro digestion. All treatments underwent static in vitro oral digestion, dynamic gastric digestion in the Human Gastric Simulator (HGS), and static in vitro small intestinal digestion. The emptying rate from the HGS was significantly (p < 0.05) higher for fine puree compared to the other treatments, due to higher saturation ratio and smaller initial particle size. The reducing sugars and free amino groups released (representing starch and protein hydrolysis, respectively) from fine puree were higher than coarse puree, and fine cracker was higher than coarse cracker due to the influence of initial particle size. For example, after 360 min total in vitro digestion, the starch hydrolysis of the fine cracker (48.1 ± 3.2%) was significantly higher than (p < 0.05) the coarse cracker (36.3 ± 5.8%). Overall, crackers had higher protein and starch hydrolysis compared to puree in the liquid phase during digestion. The study showed that both the smaller initial particle size and drying significantly (p < 0.05) increased the particle size reduction during gastric digestion and starch and protein digestibility in chickpea-based snacks.

Relationship between eating problems and the risk of dementia: A retrospective study.

BACKGROUND: Older adults and individuals with decreased cognition often experience appetite changes and weight loss. As weight loss can result in cognitive decline, change in appetite may be an important contributor to the onset of dementia. However, there is a lack of relevant studies on this topic. This study aimed to determine the relationship between appetite changes, weight loss, and dementia onset. METHODS: A total of 135 patients with normal cognitive function, subjective cognitive impairment, and mild cognitive impairment who were assessed using the Neuropsychiatric Inventory 12 item version (NPI-12) and followed up for at least 1 month were enrolled in the study. All patients underwent a Mini-Mental State Examination (MMSE). Eating problems were assessed using the NPI Eating Problems Score. Appetite and weight loss were assessed at the first visit by caregivers. Kaplan-Meier survival analyses with a log-rank test were used to compare the time to the onset of dementia between the presence or absence of the NPI eating problems, appetite loss, weight loss, or NPI depression scores. Cox proportional hazards regression models using the forced entry method were employed to estimate the hazard ratio (HR) for dementia. RESULTS: Weight loss was significantly related to dementia onset (P = 0.027) in the Kaplan-Meier survival analyses, while eating problems, appetite loss, and depression showed no significant association (P = 0.519, P = 0.326, and P = 0.317, respectively). In the Cox proportional hazards regression models, the MMSE score was found to be a significant factor (P = 0.021, HR = 0.871); moreover, weight loss tended to increase the risk of dementia onset (P = 0.057, HR = 1.694). CONCLUSIONS: Weight loss experienced by older adults could contribute to an increased risk of developing dementia.

Research on Global Optimization Algorithm of Integrated Energy and Thermal Management for Plug-In Hybrid Electric Vehicles.

Power distribution and battery thermal management are important technologies for improving the energy efficiency of plug-in hybrid electric vehicles (PHEVs). In response to the global optimization of integrated energy thermal management strategy (IETMS) for PHEVs, a dynamic programming algorithm based on adaptive grid optimization (AGO-DP) is proposed in this paper to improve optimization performance by reducing the optimization range of SOC and battery temperature, and adaptively adjusting the grid distribution of state variables according to the actual feasible region. The simulation results indicate that through AGO-DP optimization, the reduction ratio of the state feasible region is more than 30% under different driving conditions. Meanwhile, the algorithm can obtain better global optimal driving costs more rapidly and accurately than traditional dynamic programming algorithms (DP). The computation time is reduced by 33.29-84.67%, and the accuracy of the global optimal solution is improved by 0.94-16.85% compared to DP. The optimal control of the engine and air conditioning system is also more efficient and reasonable. Furthermore, AGO-DP is applied to explore IETMS energy-saving potential for PHEVs. It is found that the IETMS energy-saving potential range is 3.68-23.74% under various driving conditions, which increases the energy-saving potential by 0.55-3.26% compared to just doing the energy management.

The Proportional Relationship Among the Aesthetic Units of the Upper Lip: A 3-Dimensional Morphological Analysis of Young Adults.

A deep understanding of the proportional relationship among the crucial aesthetic units of the upper lip is essential for lip treatment procedures, yet limited information can be found. The authors used 3-dimensional (D) photogrammetry to analyze the proportional features involving different lip structures. One hundred sixty volunteers (aged 18-35 y) were included, and standardized frontal view 3D images were obtained. A series of anthropometric parameters were measured, including linear, angular, and ratio parameters. The authors took the philtrum as one structure of particular concern. The philtrum was classified into 4 groups according to the shape of philtral columns, and philtrum depth was measured. The authors analyzed the correlations between the philtrum and the vermillion lip. They found significant differences in philtrum depth among different type groups. A significant negative correlation between philtral depth and philtrum length was found, which indicated that a long philtrum was more likely to be accompanied by a flat philtrum with shallow depth. The philtrum width was significantly correlated with the mouth width with a mean ratio of 0.25. The authors also found a significantly negative correlation between philtral depth and angle of Cupid's bow's peak (Achp), and a positive correlation between Achp and mouth width. This study used 3D photography to quantitatively analyze proportional characteristics among labial aesthetic units in young Chinese adults. The results showed that the philtrum and the vermillion lip morphology were closely related, providing helpful references in perioral procedures.

Epidemiological Characteristics and Trends of Primary Hip Arthroplasty in Five Tertiary Hospitals: A Multicenter Retrospective Study.

OBJECTIVE: The number of primary hip arthroplasty (PHA) has increased sharply in recent years. Whether the epidemiological characteristics and trends of PHA have changed are unknown. This study aims to analyze the epidemiological characteristics and trends of those patients are urgent for public health institutions. METHODS: The data of patients who underwent PHA in five tertiary hospitals from January 2011 to December 2020 were retrospectively reviewed. A total of 21,898 patients were included, most of whom were aged 60-69 years (25.1% males and 31.5% females). According to the hospitalization date, the patients were divided into two groups (Group A and Group B). The patients admitted between January 2011 and December 2015 were designated as Group A (7862), and those admitted between January 2016 and December 2020 were designated as Group B (14036). The patient data of the two groups, including sex, age, disease causes, body mass index (BMI), comorbidities, surgical procedures, hospital stay duration, and hospitalization costs, were analyzed by Pearson chi-Square test, Student t test or Mann-Whitney U test. RESULTS: More women were included in Group B than in Group A (58.5% vs 52.5%, P < 0.001). The mean age of Group B was less than that of Group A (62.27 ± 14.77 vs 60.69 ± 14.44 years, P < 0.001). Femoral head necrosis was the primary pathogenic factor in both groups, with a higher proportion in Group B than in Group A (55.5% vs 45.5%, P < 0.001). Significant differences were found between the two groups in BMI, comorbidities, surgical procedures, hospital stay duration, and hospitalization costs. Total hip arthroplasty (THA) was the most common surgical procedure in both groups, with a higher proportion in Group B than in Group A (89.8% vs 79.3%, P < 0.001). The proportion of patients with one or more comorbidities was significantly higher in Group B than in Group A (69.2% vs 59.9%, P < 0.001). In addition, Group B had a shorter hospital stay duration and higher hospitalization costs than Group A. CONCLUSION: Femoral head necrosis was the primary etiology for PHA in this study, followed by femoral neck fracture and hip osteoarthritis. Patients who underwent PHA exhibited a higher percentage of femoral head necrosis; underwent THA more often; and had larger BMIs, more comorbidities, higher medical costs, and younger age in the past decade.

Selective elimination of sulfonamide antibiotics upon periodate/catechol process: Dominance of quinone intermediates.

Natural organic matter, specifically ortho-quinones organics among them, was considered can participate in the transformation of sulfonamide antibiotics (SAs). Herein, based on targeted oxidizing for ortho-dihydroxyl structures (catechol as the model) upon periodate, an efficient approach for SAs elimination was introduced. Results first indicated the generation of ortho-benzoquinone (o-BQ) within periodate/catechol system progresses readily (the energy barriers for 9.6854 kcal/mol). The near-complete eliminations were observed towards sulfamethoxazole (SMX) in periodate/catechol system (with the rate of 0.4229 min-1) as well as other SAs and exhibited unprecedented resistance to operating parameters. Besides, periodate converts little into toxic low-valent iodate species during the reaction process, and both the cytotoxicity and acute toxicity assays revealed a significant decline in antibiotics bioactivity. Mechanistic insight revealed that o-BQ dominated the degradation process, comprehensive analysis further confirmed Michael addition reaction was the first degradation stage, in which electrons flow from o-BQ to SMX and form covalent bonds upon aniline. Furthermore, several catechol derivatives were used to verify the universality of the mechanism, and their wide distribution in both subsurface and wastewater implies the potential applications. Overall, the mechanisms elucidated behind this research proposed an efficient strategy for eliminating trace SAs in aqueous environments and selectively removing SAs from complex wastewater matrices.