Blood transfusion risk prediction in spinal tuberculosis surgery: development and assessment of a novel predictive nomogram.

OBJECTIVE: The present study attempted to predict blood transfusion risk in spinal tuberculosis surgery by using a novel predictive nomogram. METHODS: The study was conducted on the clinical data of 495 patients (167 patients in the transfusion group and 328 patients in the non-transfusion group) who underwent spinal tuberculosis surgery in our hospital from June 2012 to June 2021. The least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analyses were used to screen out statistically significant parameters, which were included to establish a novel predictive nomogram model. The receiver operating characteristic (ROC) curve, calibration curves, C-index, and decision curve analysis (DCA) were used to evaluate the model. Finally, the nomogram was further assessed through internal validation. RESULTS: The C-index of the nomogram was 0.787 (95% confidence interval: 74.6%-.82.8%). The C-value calculated by internal validation was 0.763. The area under the curve (AUC) of the predictive nomogram was 0.785, and the DCA was 0.01-0.79. CONCLUSION: A nomogram with high accuracy, clinical validity, and reliability was established to predict blood transfusion risk in spinal tuberculosis surgery. Surgeons must prepare preoperative surgical strategies and ensure adequate availability of blood before surgery.

Quantitative assessment and influence factors of facial wrinkle situation in male construction workers in Beijing.

OBJECTIVE: To investigate current situation of facial wrinkles of male construction workers in Beijing area and to discuss the correlative factors. MATERIALS AND METHODS: A total of 149 male construction works and 63 male non-construction workers in Beijing were required to complete a questionnaire on their exposure to sunlight, dust, noise, and heat in their workplace environment. Their facial wrinkle scores were measured by VISIA Complexion Analysis System. The two-sample t test, chi-square test, and multiple linear regression were used for statistical analysis RESULTS: The exposure to sunlight, dust, noise, and heat of construction workers was significantly higher than that of non-construction workers (P < .01). The wrinkle score of construction workers between 20 and 29 years old was significantly higher than that of non-construction workers (t = 4.077, P < .01). The facial wrinkle score of construction workers(r = 0.657, P < .01) and non-construction workers (r = 0.681, P < .01) was both positively correlated with age. The wrinkle score of construction workers was related to age, sunlight, and noise(P < .01). CONCLUSION: The wrinkle score of male construction workers between 20 and 29 years old is significantly higher than that of non-construction workers in Beijing. Age, sunlight, and noise were the main influencing factors of wrinkle.

How are typical urban sewage treatment technologies going in China: from the perspective of life cycle environmental and economic coupled assessment.

Sewage treatment is an important public service, but it consumes a lot of energy and chemicals in the process of removing wastewater pollutants, which may cause the risk of pollution transfer. To find the corresponding hot issues, this paper took the lead in integrating life cycle assessment (LCA) with life cycle costing (LCC) to evaluate four most typical sewage treatment technologies with more than 85% share in China. It is found that anaerobic/anoxic/oxic (AAO) was the optimal treatment scheme with relatively small potential environmental impact and economic load. The normalized results show that the trends of the four technologies on eleven environmental impact categories were basically the same. Marine aquatic ecotoxicity potential accounted for more than 70% of the overall environmental impact. Contribution analysis indicates that electricity and flocculant consumption were the main processes responsible for the environmental and economic burden. Overall, electricity consumption was the biggest hot spot. Sensitivity analysis verifies that a 10% reduction in electricity could bring high benefits to both the economy and the environment. These findings are expected to provide effective feedback on the operation and improvement of sewage treatment. Graphical abstract.

Predicting the Failure Risk of Internal Fixation Devices in Chinese Patients Undergoing Spinal Internal Fixation Surgery: Development and Assessment of a New Predictive Nomogram.

The current study is aimed at developing and validating a nomogram of the risk of failure of internal fixation devices in Chinese patients undergoing spinal internal fixation. We collected data from a total of 1139 patients admitted for spinal internal fixation surgery at the First Affiliated Hospital of Guangxi Medical University from May 2012 to February 2019. Of these, 1050 patients were included in the spinal internal fixation group and 89 patients in the spinal internal fixation device failure group. Patients were divided into training and validation tests. The risk assessment of the failure of the spinal internal fixation device used 14 characteristics. In the training test, the feature selection of the failure model of the spinal internal fixation device was optimized using the least absolute shrinkage and selection operator (LASSO) regression model. Based on the characteristics selected in the LASSO regression model, multivariate logistic regression analysis was used for constructing the model. Identification, calibration, and clinical usefulness of predictive models were assessed using C-index, calibration curve, and decision curve analysis. A validation test was used to validate the constructed model. In the training test, the risk prediction nomogram included gender, age, presence or absence of scoliosis, and unilateral or bilateral fixation. The model demonstrated moderate predictive power with a C-index of 0.722 (95% confidence interval: 0.644-0.800) and the area under the curve (AUC) of 0.722. Decision curve analysis depicted that the failure risk nomogram was clinically useful when the probability threshold for internal fixation device failure was 3%. The C-index of the validation test was 0.761. This novel nomogram of failure risk for spinal instrumentation includes gender, age, presence or absence of scoliosis, and unilateral or bilateral fixation. It can be used for evaluating the risk of instrumentation failure in patients undergoing spinal instrumentation surgery.

Association between socioeconomic status and obesity in a Chinese adult population.

BACKGROUND: Existing studies which regarding to the association between individual socioeconomic status (SES) and obesity are still scarce in developing countries. The major aim of this study is to estimate such association in an adult population which was drawn from an economically prosperous province of China. METHODS: Study population was determined by multilevel randomized sampling. Education and income were chosen as indicators of individual SES, general obesity and abdominal obesity were measured by body mass index (BMI) and waist circumference (WC). Descriptive statistical methods were used to depict overall and factor-specific distributions of general and abdominal obesity among 16,013 respondents. Two-step logistic regression models were fitted on gender basis. RESULTS: The age-and-sex adjusted rates of general overweight, general obesity, abdominal overweight and abdominal obesity in study population were 28.9% (95%CI: 27.9%-29.9%), 7.5% (95%CI: 7.0%-8.1%), 32.2% (95%CI: 31.2%-33.3%) and 12.3% (95%CI: 11.6%-13.1%), respectively. Based on model fitting results, a significant inverse association between education and obesity only existed in women, while in men, income rather than education was positively related to obesity. CONCLUSIONS: The atypical SES-obesity relationship we found reflected the on-going social economy transformation in affluent regions of China. High-income men and poorly-educated women were at higher risk of obesity in Zhejiang province, thus merit intense focuses.

[Spectral characteristics of normal breast samples in the 350-850 nm wavelength range].

Spectral characteristics of normal female breast samples in the 350-850 nm wavelength range were measured using a UV/Vis/NIR spectrophotometer system with integrating sphere attachment for measuring the diffuse reflectance and transmittance. The optical properties of normal breast tissue in vitro were obtained by the inverse adding doubling method. And then the optical penetration depths in this spectral range were analyzed based on the principle of tissue optics. The results show that the reduced scattering coefficient of normal female breast tissue is significantly higher than the absorption coefficient in the 350-850 nm wavelength range. The reduced scattering coefficient decreases with the wavelength increment. It reaches maximum at shorter wavelengths with a decrease at longer wavelengths and ranges from 9.731 mm(-1) at 350 nm to 1.476 mm(-1) at 850 nm. The absorption coefficient of normal breast tissue is about from 0.798 mm(-1) at 350 nm to 0.102 mm(-1) at 850 nm. The maximal and minimal values are at 350 nm and 850 nm respectively. An absorption peak for the normal breast tissue is at 410 nm of wavelength with the value of 0.506 mm(-1), which belongs to hemoglobin. The absorption coefficient remains relatively constant when the wavelength is longer than 600 nm. The optical penetration depth increases with the wavelength increment and ranges about from 0.199 mm at 350 nm to 1.439 mm at 850 nm. Deep penetration depth noted in normal breast samples, especially at longer wavelengths, reflects the weak absorption and reduced scattering at these wavelengths. The calculated optical parameters of normal breast samples by the inverse adding doubling method agree well with the Monte Carlo simulations. This study may be useful for breast optical biopsy or the optical diagnosis of breast diseases.

[Application of Monte Carlo techniques in designing compensatory scheme of new cooperative medical system].

To design a workable compensatory scheme of new cooperative medical system (NCMS) in rural China, 'Monte Carlo Simulation Techniques' is developed based on the data of a multistage random sampling survey. The total compensation rate, the decreased percentages of poverty caused by diseases and the deficit ratio of fund a 0.3782, 0.6540 and -0.0794 respectively, when the main strategy of inpatient reimbursement is recognized as 'serious illness'. The deficit ratios of funding appeared to be 0.4840, 0.4091 and -0.3789 when the main strategy of outpatient reimbursement is recognized on minor diseases. Compensation for minor diseases is more important than that of serious diseases. Considering the further impact of minor diseases on peasants, we should incorporate compensation for minor diseases into the compensatory scheme of NCMS.