The prevalence of spontaneous resolution among pediatric trigger thumb: a systematic review and meta-analysis.

BACKGROUND: Trigger thumb is a prevalent hand condition observed in children, and its management remains a topic of considerable debate, ranging from mere observation to surgical intervention. In recent times, there has been a growing interest in exploring nonoperative treatments as alternatives to surgical procedures for managing pediatric trigger thumb. Gaining insight into the prevalence of spontaneous resolution in pediatric trigger thumb is of paramount importance. However, the literature presents a wide variation in estimates regarding the prevalence of this spontaneous resolution, highlighting the need for further investigation and consensus. The aim of this review was to estimate the overall prevalence of spontaneous resolution among pediatric trigger thumb. METHODS: This study meticulously followed the PRISMA guidelines and registered in the PROSPERO. The PubMed, Embase, and Cochrane Library databases were searched for all relevant studies up to May 2024.Inclusion criteria were studies reported only observation spontaneous resolution pediatric trigger thumb, aged up to 14 years, reported at least 10 thumbs and followed up time at least 3 months. Confounded intervention treatment measure studies were excluded. To synthesize the prevalence rates from individual studies, we employed a random-effects meta-analysis. In order to uncover the sources of heterogeneity and to compare prevalence estimates across different groups, we performed sensitivity and subgroup analyses. To meticulously evaluate the quality of the included studies, the Joanna Briggs Institute's quality assessment checklist was employed. Furthermore, to assess the heterogeneity among the studies, both Cochran's Q test and the I² statistic were utilized. RESULTS: A total of eleven studies were included for the final analysis, with 599 pediatric trigger thumbs. Our final meta-analysis showed that more than one-third of these pediatric trigger thumb cases resolved spontaneously, with a resolution rate of 43.5% (95% CI 29.6-58.6). Subgroup analyses showed that in terms of age at the first visit, the prevalence of spontaneous resolution in the less than 24 months group and in the 24 months or older group was 38.7%(95% CI 18.1-64.4)and 45.8%(95% CI 27.4-65.4), respectively. There was no significant difference between the two groups(P = 0.690). When analyzing follow up time, the prevalence of spontaneous resolution in the 24 months or longer group and in the less than 24 months group was 58.9%(95% CI 41.6-74.2)and 26.8%(95% CI 14.7-43.8), respectively.There was significant statistical differences between the two groups(P = 0.009). Based on the initial severity of interphalangeal (IP) joint flexion contracture, the prevalence of spontaneous resolution in the 30 degrees or less group and in the other measurements group was 54.1%(95% CI 31.5-75.1)and 37.1%(95% CI 21.9-55.4), respectively.There was no significant difference between the two groups(P = 0.259). CONCLUSION: Our study demonstrates that a significant proportion of pediatric trigger thumbs resolve spontaneously. This finding highlights the benefits of early observation in managing this condition. By prioritizing non-operative observation, both parents and surgeons are better equipped to make informed decisions regarding the treatment of pediatric trigger thumb, potentially reducing the need for surgical intervention.

Association between all-cause mortality and vascular complications in U.S. adults with newly diagnosed type 2 diabetes (NHANES 1999-2018).

AIMS: The impact of macrovascular and microvascular complications, the common vascular complications of type 2 diabetes, on long-term mortality has been well evaluated, but the impact of different complications of newly diagnosed type 2 diabetes (diagnosed within the past 2 years) on long-term mortality has not been reported. We aimed to investigate the relationship between all-cause mortality and vascular complications in U.S. adults (aged ≥ 20 years) with newly diagnosed type 2 diabetes. METHODS: We used data from the 1999-2018 National Health and Nutritional Examination Surveys (NHANES). Cox proportional hazard models was used to assess hazard ratios (HR) and 95% confidence intervals for all-cause mortality. RESULTS: A total of 928 participants were enrolled in this study. At a mean follow-up of 10.8 years, 181 individuals died. In the fully adjusted model, the hazard ratio (HR) (95% confidence interval [CI]) of all-cause mortality for individuals with any single complication compared with those with newly diagnosed type 2 diabetes without complications was 2.24 (1.37, 3.69), and for individuals with two or more complications was 5.34 (3.01, 9.46).Co-existing Chronic kidney disease (CKD) and diabetic retinopathy (DR) at baseline were associated with the highest risk of death (HR 6.07[2.92-12.62]), followed by CKD and cardiovascular disease (CVD) (HR 4.98[2.79-8.89]) and CVD and DR (HR 4.58 [1.98-10.57]). CONCLUSION: The presence of single and combined diabetes complications exerts a long-term synergistic adverse impact on overall mortality in newly diagnosed U.S. adults with type 2 diabetes, underscoring the importance of comprehensive complication screening to enhance risk stratification and treatment.

Influence of cascade reservoirs on the distribution, transport, and retention patterns of biogenic elements in the Jinsha River.

Cascade reservoirs construction can greatly alter flow regime and sediment transport of rivers, further affecting migration and transformation processes of biogenic elements. The Jinsha River (JSR) is the China's largest hydropower base and the main runoff, sediment suspension, and nutrient source areas of the Yangtze River. However, the distribution, transport, and retention patterns of biogenic elements in the JSR are still unclear under the influence of cascade reservoirs. Therefore, monthly concentration monitoring work was conducted from November 2021 to October 2023 for various forms of carbon (C), nitrogen (N), phosphorus (P), and silicon (Si). Results showed that the concentrations and fluxes of total phosphorus (TP) and particulate phosphorus (PP) exhibited continuous decreasing trends along the reservoirs cascade, whereas N exhibited contrasting trends. The concentrations of dissolved total carbon (DTC), dissolved inorganic carbon (DIC), and total silicon also showed decreasing trends from upstream to downstream, whereas their fluxes were primarily influenced by runoff and exhibited upward fluctuations. Compared with other biogenic elements, there was a more pronounced retention effect on TP and PP by reservoirs, with average retention rates of 8.29 % and 16.01 %, respectively. Longer hydraulic retention time (HRT) can retain more TP and PP. Meanwhile, the retention rates of DTC, DIC, and particulate silicon were positively correlated with HRT, while the retention rate of dissolved silicon (DSi) showed a positive correlation with reservoir age. Moreover, the higher ratios of dissolved inorganic nitrogen to dissolved inorganic phosphorus (DIP) and DSi to DIP have occurred, resulting in apparent P limitation, particularly during the non-flood season due to lower DIP concentration. Overall, cascade reservoirs construction exists great influences on the spatial allocation, fluxes transport, and biogeochemical cycles of biogenic elements, potentially affecting the stability of rivers ecosystem along the food chain network.

Integrated Transcriptomics and Proteomics Identified CMPK1 as a Potential Biomarker for Type 2 Diabetes Mellitus.

Aim/Introduction: Type 2 diabetes mellitus (T2DM) is one of the most frequent and widespread disease in the world.Obesity is the most significant predictor of T2DM, but the exact mechanism how obesity promotes T2DM remains unknown. Finding specific biomarkers to assist in diagnosing and treating patients with obese and T2DM is critical. Materials and Methods: We collected liver tissues from obesity patients with and without T2DM for proteomic sequencing and immunohistochemistry assay. Analysis Gene Ontology(GO) enrichment, Kyoto Encyclopedia of Genes and Genomes(KEGG), and protein interaction network (PPI) were performed on the parameters and data derived from the Tandem Mass Tags(TMT)-based proteomics analysis of liver tissues. Transcriptome data were downloaded from the Gene Expression Omnibus(GEO)website and genes that are deferentially expressed in both transcriptome and proteome were selected. Results: We identified 140 deferentially expressed proteins from proteomic sequencing. Six biomarkers were deferentially expressed in both proteome and transcriptome with consistent changes in direction. The protein-protein interaction (PPI) analysis suggested CMPK1, the expression with greatest difference, was the core protein among the six biomarkers. Immunohistochemistry validated CMPK1 was upregulated significantly in the liver tissues of T2DM patients. The correlation analysis revealed that the expression of CMPK1 was significantly associated with key molecules in T2DM-related pathways at both protein and transcriptome levels. Conclusion and Novelty: Our study showed CMPK1 was upregulated in the liver of T2DM patients and provides a possible new target for screening and diagnosing T2DM in patients with obese and a novel theoretical basis for the pathophysiological mechanism of obesity-related metabolic diseases.

Unveiling Hidden Hyperuniformity: Radial Turing Pattern Formation of Marangoni-Driven SiO2 Nanoparticles on Liquid Metal Surface.

Mastering the self-organization of nanoparticle morphologies is pivotal in soft matter physics and film growth. Silicon dioxide (SiO2) nanoparticles are an archetypical model of nanomotor in soft matter. Here, the emphasis is on the self-organizing behavior of SiO2 nanoparticles under extreme conditions. It is unveiled that manipulating the states of the metal substrate profoundly dictates the motion characteristics of SiO2 nanoparticles. This manipulation triggers the emergence of intricate morphologies and distinctive patterns. Employing a reaction-diffusion model, the fundamental roles played by Brownian motion and Marangoni-driven motion in shaping fractal structures and radial Turing patterns are demonstrated, respectively. Notably, these radial Turing patterns showcase hyperuniform order, challenging conventional notions of film morphology. These discoveries pave the way for crafting non-equilibrium morphological materials, poised with the potential for self-healing, adaptability, and innovative applications.

Facilitated transport of ferrihydrite with phosphate under saturated flow conditions.

With increasing phosphate (P) entering the environment during agricultural application, the subsurface flow of particular P has been recently discussed as a vital P transport pathway. Iron (oxyhydr)oxide colloid-facilitated P transport is critical for iron and P biogeochemical processes in the subsurface. This study investigated the ferrihydrite colloid-facilitated P transport through adsorption and column experiments under different P concentrations and three pH conditions. Increased P loading on ferrihydrite colloids decreased the transport of ferrihydrite colloids (< 8.0%) under acid conditions through pore straining and irreversible attachment. Under neutral and alkaline conditions, ferrihydrite colloids exhibited more negative surfaces and smaller diameters with increasing P, which further enhanced ferrihydrite colloid transport (maximum to 95.6%). Ferrihydrite colloid-facilitated P transport was limited under acid conditions, and it was 10% - 57% enhancement under neutral and alkaline conditions with increasing P adsorption. Under neutral conditions, ferrihydrite colloid-facilitated P transport was strongest (maximum to 68.84%) because of its stronger ferrihydrite colloid transport than under acid conditions and larger P adsorption capacity than under alkaline conditions. Our findings indicate that the facilitated transport of ferrihydrite colloids in the presence of P may be appreciable in iron and phosphate-rich soil and subsurface systems, which is essential for evaluating the fate of iron and iron-facilitated P and potential environmental risks of P transport in the subsurface.

The development of the biological soil crust regulates the fungal distribution and the stability of fungal networks.

The heterogeneous composition of fungi plays an indispensable role in the foundation of the multifunctionalities of ecosystems within drylands. The precise mechanisms that govern fluctuations in soil fungal assemblages in dryland ecosystems remain incompletely elucidated. In this study, biological soil crusts (biocrusts) at different successional stages in the Gurbantunggut Desert were used as substrates to examine the characteristics and driving factors that influence fungal abundance and community dynamics during biocrust development using qPCR and high-throughput sequencing of the ITS2 region. The findings showed that the physicochemical properties changed significantly with the development of biocrusts. In particular, total nitrogen increased 4.8 times, along with notable increases in ammonium, total phosphorus (2.1 times) and soil organic carbon (6.5 times). Initially, there was a rise in fungal abundance, which was subsequently followed by a decline as the biocrust developed, with the highest abundance detected in lichen crust (2.66 × 107 copies/g soil) and the lowest in bare sand (7.98 × 106 copies/g soil). Ascomycetes and Basidiomycetes emerged as dominant phyla, collectively forming 85% of the fungal community. As the biocrust developed, noticeable alterations occurred in fungal community compositions, resulting from changes in the relative proportions of Dothideomycetes, Lecanoromycetes and unclassified ascomycetes. Nitrogen, phosphorus, organic carbon content, and pH of biocrusts were identified as direct or indirect regulators of fungal abundance and community structure. The complexity of fungal networks increased as biocrusts developed as revealed by network analysis, but reduced in the stability of fungal communities within algal and lichen crusts. Keystone species within the fungal community also underwent changes as biocrust developed. These results suggested that shifts in interspecies relationships among fungi could further contribute to the variation in fungal communities during the development of biocrusts.

Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model.

Background: Diet and physical activity (PA) are pivotal behaviors for managing energy balance post-bariatric surgery. Given the need for dual behavioral management, understanding the interplay of cognitive factors influencing these behaviors is crucial. This study applied the compensatory carry-over action model (CCAM) to explore the impact of cognitive factors on behaviors and their subsequent effects on subjective health outcomes. Methods: This cross-sectional study was conducted among patients at the third month after bariatric surgery in China. Data on diet and PA status, behavioral cognitive factors (intention, self-efficacy, compensatory belief, transfer cognition), and subjective health outcomes (perceived stress, well-being, quality of life) were collected. Structural equation model (SEM) was employed to test hypotheses in CCAM and assess mediation relationships. Results: Analysis of data from 239 patients revealed the following: (1) Among antecedent cognitive factors, only compensatory belief significantly influenced diet (P<0.001). (2) Intention and self-efficacy directly correlated with their respective behaviors, while compensatory belief affected intention, and transfer cognition impacted self-efficacy (P<0.05), aligning with CCAM hypotheses. (3) PA demonstrated significant influence only on perceived stress (P=0.004), whereas diet significantly affected all subjective health outcomes (P<0.05). (4) Mediation analysis indicated intention partially mediated the relationship between compensatory belief and diet and fully mediated the relationship between compensatory belief and PA. Self-efficacy completely mediated the relationship between transfer cognition and diet and PA. Conclusion: Transfer cognition's carry-over effect did not directly influence behaviors among antecedent cognitions. Interventions should primarily target improving diet by mitigating compensatory belief. Moreover, diet exhibited a more pronounced impact on overall health compared to PA. Consequently, prioritizing dietary intervention over PA intervention is warranted based on the analysis of CCAM and the aim of promoting joint behaviors post-bariatric surgery.

Hierarchical antibiotic delivery system based on calcium phosphate cement/montmorillonite-gentamicin sulfate with drug release pathways.

Antibiotic-loaded calcium phosphate cement (CPC) has emerged as a promising biomaterial for drug delivery in orthopedics. However, there are problems such as the burst release of antibiotics, low cumulative release ratio, inappropriate release cycle, inferior mechanical strength, and poor anti-collapse properties. In this research, montmorillonite-gentamicin (MMT-GS) was fabricated by solution intercalation method and served as the drug release pathways in CPC to avoid burst release of GS, achieving promoted cumulative release ratios and a release cycle matched the time of inflammatory response. The results indicated that the highest cumulative release ratio and release concentration of GS in CPC/MMT-GS was 94.1 ± 2.8 % and 1183.05 µg/mL, and the release cycle was up to 504 h. In addition, the hierarchical GS delivery system was divided into three stages, and the kinetics followed the Korsmeyer-Peppas model, the zero-order model, and the diffusion-dissolution model, respectively. Meanwhile, the compressive strength of CPC/MMT-GS was up to 51.33 ± 3.62 MPa. Antibacterial results demonstrated that CPC/MMT-GS exhibited excellent in vitro long-lasting antibacterial properties to E. coli and S. aureus. Furthermore, CPC/MMT-GS promoted osteoblast proliferation and exhibited excellent in vivo histocompatibility. Therefore, CPC/MMT-GS has favorable application prospects in the treatment of bone defects with bacterial infections and inflammatory reactions.

The engineering of defect-modified boron nitride ribbons: an effective adsorbent to rapid capture for tetracycline.

Antibiotics, the persistent organic pollutants, have brought serious pollution to the aquatic environment. Therefore, it is necessary to select rapid adsorbents to remove them from their long-term threat. Herein, the introduction of defects in BN was employed to enhance its surface chemical activity for rapid capture of tetracycline via hydrothermal and calcination methods. The defect content in BN can be controlled by adjusting the volume ratio of ethanol to water. Among them, when the volume ratio of H2O/ethanol is 4/1 (BN-3), BN-3 has the most N defects at 33%, which increases the adsorption rate of h-BN for TC and promotes the adsorption capacity to 302.15 mg g-1, which is due to the introduction of nitrogen defects significantly regulates the electronic structure of BN. The corresponding theoretical calculations confirm that BN with N defects decreases the absorption energy of BN for TC. Additionally, the adsorption removal rate of tetracycline still reached 95.5% after 5 cycles of TC adsorption by BN-3, indicating that the defect-modified BN has good reusability and is beneficial for its use in pollutant adsorption.

Individual, family and social-related factors of eating behavior among Chinese children with overweight or obesity from the perspective of family system.

Purpose: The purpose of the present study is to examine the factors contributing to the development of eating behavior in overweight and obese children from the perspective of the family system. Methods: A cross-sectional survey was conducted by using convenience sampling method to select 388 participants in two primary schools in Jiangsu, China. Individual, family and social-related factors were collected. Individual factors included age, gender, ethnicity, single child, social anxiety, depression, physical activity, sleep duration, screen time. Family factors included family environment, family structure, family function, family income, parenting style, parental feeding behavior, home food environment and marital satisfaction. Social-related factors included place of residence, number of surrounding restaurants and social support. Univariate analysis, correlation analysis and multivariate analysis were used to identify factors of eating behavior among Chinese children with overweight and obese. Results: In this study, 388 participants took part with a 94.865% response rate. In the univariate analysis, the significant differences regarding Dutch Eating Behavior Questionnaire (DEBQ) scores were found between children aged 6-9 years and those aged >9 years. Correlation analysis indicated that parent's nutrition literacy (r = 0.118, P < 0.05), pressure to eat (r = 0.212, P < 0.01), perception of child weight (r = -0.112, P < 0.05) and family function (r = -0.563, P < 0.01) were associated with children's eating behavior. With regard to psychosocial factors, children's social anxiety (r = 0.299, P < 0.01) and depressive symptoms (r = 0.081, P < 0.05) were in positive correlation with eating behavior. The independent variables included in the initial model were age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight. These variables in the final model accounted for 20.7% of the variance. Conclusion: We found that age, father's employment status, social anxiety, maternal punishment and harshness, parents' nutrition literacy, pressure to eat, family function and perception of child weight have great effect on children's eating behavior who are overweight or obese. As early childhood is a critical timeline for child development, children's social anxiety, parenting style, parent's nutrition literacy, parent's feeding behavior and family function should be intervened to promote eating behavior. Intervention programs aimed at promoting healthy eating behaviors among children, thereby mitigating the risk of pediatric obesity, should primarily target parents.

Boosting the reversibility of Zn anodes via synergistic cation-anion interface adsorption with addition of multifunctional potassium polyacrylate.

Rechargeable aqueous Zn batteries have the edge in resource reserve, cost, energy and conversion efficiency due to the inherent features of metal Zn anodes. However, the application of Zn-based batteries is being seriously hindered by Zn dendrites and water-induced side-reactions. Here, potassium polyacrylate (K-PAM) is proposed as the electrolyte additive to form a synergistic cation-anion interface on Zn surface. The carboxyl anions and K+ cations are preferentially adsorbed on the Zn surface due to the intrinsic surfactant characteristics, which could homogenize Zn plating and suppress parasitic reactions. The synergistic regulation of K-PAM additive endows the ZnZn symmetric cells with excellent cyclic durability of 1250 h at 1 mA cm-2, which is significantly better than the polyacrylic acid additive only with carboxyl anions. Moreover, trace K-PAM addition into traditional ZnSO4 electrolyte endows the ZnCu batteries with a considerable average Coulombic efficiency of 99.2 %. Additionally, higher capacity retention and excellent cycling stability of ZnVO2 cells further mark K-PAM as a potentially impressive aqueous electrolyte additive for high-performance Zn-based batteries. This work will provide a promising method for the synergistic regulation with cations and anions of electrolyte additives to improve the stability and reversibility of Zn anodes.

Identification of a potent palladium-aryldiphosphine catalytic system for high-performance carbonylation of alkenes.

The development of stable and efficient ligands is of vital significance to enhance the catalytic performance of carbonylation reactions of alkenes. Herein, an aryldiphosphine ligand (L11) bearing the [Ph2P(ortho-C6H4)]2CH2 skeleton is reported for palladium-catalyzed regioselective carbonylation of alkenes. Compared with the industrially successful Pd/1,2-bis(di-tert-butylphosphinomethyl)benzene catalyst, catalytic efficiency catalyzed by Pd/L11 on methoxycarbonylation of ethylene is obtained, exhibiting better catalytic performance (TON: >2,390,000; TOF: 100,000 h-1; selectivity: >99%) and stronger oxygen-resistance stability. Moreover, a substrate compatibility (122 examples) including chiral and bioactive alkenes or alcohols is achieved with up to 99% yield and 99% regioselectivity. Experimental and computational investigations show that the appropriate bite angle of aryldiphosphine ligand and the favorable interaction of 1,4-dioxane with Pd/L11 synergistically contribute to high activity and selectivity while the electron deficient phosphines originated from electron delocalization endow L11 with excellent oxygen-resistance stability.

Sensitive, Robust, Wide-Range, and High-Consistency Capacitive Tactile Sensors with Ordered Porous Dielectric Microstructures.

Flexible capacitive tactile sensors show great promise in personalized healthcare monitoring and human-machine interfaces, but their practical application is normally hindered because they rarely possess the required comprehensive performance, that is, high pressure sensitivity and fast response within a broad pressure range, high structure robustness, performance consistency, etc. This paper aims to engineer flexible capacitive pressure sensors with highly ordered porous dielectric microstructures and a 3D-printing-based fully solution-processable fabrication process. The proposed dielectric layer with uniformly distributed interior microporous can not only increase its compressibility and dynamic response within an extended pressure range but also enlarge its contact area with electrodes, contributing to a simultaneous improvement in the sensitivity, response speed, detection range, and structure robustness. Meanwhile, owing to its superior abilities in complex structure manufacturing and dimension controlling, the proposed 3D-printing-based fabrication process enables the consistent fabrication of the porous microstructure and thus guarantees device consistency. As a result, the prepared pressure sensors exhibit a high sensitivity of 0.21 kPa-1, fast response and relaxation times of 112 and 152 ms, an interface bonding strength of more than 455.2 kPa, and excellent performance consistency (≤5.47% deviation among different batches of sensors) and tunability. Encouraged by this, the pressure sensor is further integrated with a wireless readout circuit and realizes wireless wearable monitoring of various biosignals (pulse waves and heart rate) and body movements (from slight finger touch to large knee bending). Finally, the influence law of the feature parameters of the porous microstructure on device performance is established by the finite element method, paving the way for sensor optimization. This study motivates the development of flexible capacitive pressure sensors toward practical application.

Effect of coupled physical and chemical heterogeneity on the transport of pristine and aged pyrogenic carbon colloids in unsaturated porous media.

Due to extensive application and recurrent wildfires, an increasing number of pyrogenic carbon (PyC) colloids are present in the environment, experiencing processes of environmental aging. Subsurface environments are typically heterogeneous in unsaturated conditions, which may affect the transport of PyC colloids. This study focused on the transport of both pristine and aged PyC colloids in physically (clean coarse and fine sand) and physicochemically (iron oxides-coated coarse and clean fine sand) heterogeneous porous media at three different water saturations (100 %, 70 %, and 40 %). In physically heterogeneous porous media, the decrease in water saturation from 100 % to 40 % led to a shift in the main water flow from the clean coarse sand to the clean fine sand domain, resulting in a continuous decrease in the transport of PyC colloids. In physicochemically heterogeneous porous media, the primary water flow shifted from the iron oxides-coated coarse sand to the clean fine sand domain, resulting in an initial increase and subsequent decrease in PyC colloid transport. Aging enhanced the transport of PyC colloids, attributed to the increasingly negative and hydrophilic surface. Retention profiles revealed substantial PyC colloid retention at the interface between coarse and fine sand domains. The release of retained PyC colloids exhibited two peaks at 100 % and 70 % water saturations, along with a single peak at 40 % water saturation. Additionally, the increased irreversible retention was observed at lower water saturation. This study underscores the significance of water content, environmental aging, and heterogeneity in PyC colloid transport. It provides essential insights into the environmental fate of PyC colloids in natural field conditions.

A dynamic online nomogram for predicting the heterogeneity trajectories of frailty among elderly gastric cancer survivors.

BACKGROUND: Frailty is very common among older people with gastric cancer and seriously affects their prognosis. The development of frailty is continuous and dynamic, increasing the difficulty and burden of care. OBJECTIVES: The aims of this study were to delineate the developmental trajectory of frailty in older people with gastric cancer 1 year after surgery, identify heterogeneous frailty trajectories, and further explore their predictors to construct a nomogram for prediction. DESIGN: We conducted a prospective longitudinal observation study. Clinical evaluation and data collection were performed at discharge, and at 1, 3, 6, and 12 months. SETTING AND PARTICIPANTS: This study was conducted in a tertiary hospital and 381 gastric cancer patients over 60 years who underwent radical gastrectomy completed the 1-year follow-up. METHODS: A growth mixture model (GMM) was used to delineate the frailty trajectories, and identify heterogeneous trajectories. A regression model was performed to determine their predictors and further construct a nomogram based on the predictors. Bootstrap with 1000 resamples was used for internal validation of nomogram, a receiver operating characteristic (ROC) curve to evaluate discrimination, calibration curves to evaluate calibration and decision curve analysis (DCA) to evaluate the clinical value. RESULTS: GMM identified three classes of frailty trajectories: "frailty improving", "frailty persisting" and "frailty deteriorating". The latter two were referred to as heterogeneous frailty trajectories. Regression analysis showed 8 independent predictors of heterogeneous frailty trajectories and a nomogram was constructed based on these predictors. The area under ROC curve (AUC) of the nomogram was 0.731 (95 % CI = 0.679-0.781), the calibration curves demonstrated that probabilities predicted by the nomogram agreed well with the actual observation with a mean absolute error of 0.025, and the DCA of nomogram indicated that the net benefits were higher than that of the other eight single factors. CONCLUSIONS: Older gastric cancer patients have heterogeneous frailty trajectories of poor prognosis during one-year postoperative survival. Therefore, early assessment to predict the occurrence of heterogeneous frailty trajectories is essential to improve the outcomes of elderly gastric cancer patients. Scientific and effective frailty interventions should be further explored in the future to improve the prognosis of older gastric cancer patients. CONTRIBUTION OF THE PAPER STATEMENTS: This study constructed a static and dynamic online nomogram with good discrimination and calibration, which can help to screen high-risk patients, implement preoperative risk stratification easily and promote the rational allocation of medical resources greatly. REGISTRATION: ClinicalTrials.gov (Number: NCT05982899). TWEETABLE ABSTRACT: Our findings identified three frailty trajectories and constructed a nomogram to implement preoperative risk stratification and improve patient outcomes.

Summary of best evidence for prevention and management of frailty.

BACKGROUND: Frailty in older people can seriously affect their quality of life and increase the demand for long-term care and health care expenses. Aims of this study are to provide an evidence-based basis for clinical practice of frailty in older people by systematically searching for the best current evidence on interventions for the prevention and management of frailty. METHODS: According to the '6S' evidence resource model, evidence retrieval is searched from the top-down and collected relevant guidelines, best practices, evidence summaries, systematic reviews and expert consensus. The retrieval time limit was from the database establishment to 20 March 2023. Two reviewers independently screened and evaluated the literature, and then extracted and summarised the evidence according to the JBI grading of evidence and recommendation system. RESULTS: A total of 44 publications were finally included, including 12 guidelines, 5 best practices, 4 expert consensus, 5 evidence summaries and 18 systematic reviews. Through the induction and integration of the evidence, the evidence was finally summarised from eight aspects: frailty screening, frailty assessment, exercise intervention, nutrition intervention, multi-domain intervention, drug administration, social support and health education, and 43 best evidences were formed. CONCLUSIONS: This study summarised the best evidence for the prevention and management of frailty from eight aspects, which can provide guidance for clinical or community medical staff to develop and apply frailty intervention and practice programmes for older people and improved the clinical outcome and quality of life of older people.

Identification of early delirium and its outcomes after cardiopulmonary bypass among adult patients with cardiovascular disease: a prospective observational study.

Purpose: To identify the incidence and outcomes of postoperative delirium after cardiopulmonary bypass machine in adult cardiac surgery patients. Method: A prospective observational study was conducted in a single-center institution in the Republic of China. This study included 273 patients who underwent cardiac surgical procedures requiring cardiopulmonary bypass machine utilization. Results: This study used the Confusion Assessment Method to screen for delirium. Univariate analysis identified advanced age, emergency surgery and prolonged aortic cross-clamping time as significant predisposing factors for delirium, which occurred in 19.8% (n = 54) of cases and typically developed in average of 4.8 ± 3.28 days after the surgery. The analysis also identified that delirium was associated with increased complications and external referrals. A total of 142 patients (52.1%) were discharged to their homes, wherein the discharge rate in the delirium group was notably lower, with only 35.2% (n = 19) of patients, than in the delirium-free group with 56.2% (n = 123) of patients. Conclusion: Considering the increased probability of delirium-related complications following cardiac surgery, it is important to develop effective preventive strategies for patients with perioperative risk factors, such as advanced age, emergency surgery and prolonged cross-clamp time, by implementing practical measures to minimize the risk of delirium.

The Role of Seed Users in Nurturing an Online Health Community for Smoking Cessation Among People With HIV/AIDS.

BACKGROUND: To nurture a new online community for health behavior change, a fruitful strategy is to recruit "seed users" to create content and encourage participation. PURPOSE: This study evaluated the impact of support from seed users in an online community for smoking cessation among people living with HIV/AIDS and explored the linguistic characteristics of their interactions. METHODS: These secondary analyses examined data from a randomized trial of a smoking cessation intervention for HIV+ smokers delivered via an online health community (OHC). The analytic sample comprised n = 188 participants randomized to the intervention arm who participated in the community. Independent variables were OHC interactions categorized by participant interlocutor type (study participant, seed user) and interaction type (active, passive). The primary outcome was biochemically verified 7-day abstinence from cigarettes measured 3 months post-randomization; 30-day abstinence was examined for robustness. RESULTS: Logistic regression models showed that participants' interactions with seed users were a positive predictor of abstinence but interactions with other study participants were not. Specifically, the odds of abstinence increased as the number of posts received from seed users increased. Exploratory linguistic analyses revealed that seed users wrote longer comments which included more frequent use of "we" and "you" pronouns and that study participants users used more first-person singular pronouns ("I"). CONCLUSIONS: Seeding a community at its inception and nurturing its growth through seed users may be a scalable way to foster behavior change among OHC members. These findings have implications for the design and management of an OHC capable of promoting smoking cessation.

Online health communities (OHCs) are a popular means for people with similar health concerns to exchange information and support. The success of OHCs depends on members' active participation and on the formation of meaningful relationships. Jumpstarting a new OHC with active members (seed users) can promote engagement and foster its growth. Using data from a multisite randomized controlled trial of a web-based smoking cessation intervention developed specifically for people living with HIV/AIDS (PLWH), we examined whether support provided by seed users in the OHC was a stronger predictor of abstinence from smoking compared with support from other tobacco users who are also trying to quit. These secondary analyses focused on 188 urban, predominantly Black PLWH who smoked that were randomized to the intervention arm and participated in the online community. The primary outcome was biochemically verified 7-day abstinence from cigarettes measured 3 months following study enrollment. Receiving support from seed users was a positive predictor of abstinence among smokers in the trial whereas interactions with other study participants did not relate to abstinence. These findings suggest that for a new OHC, seed users can be critical for generating engagement and promoting health behavior change.

Giant exchange bias field above room temperature in perovskite YbCr1-xFexO3 (x = 0.6-0.9).

Temperature-induced exchange bias is observed in perovskite YbCr1-xFexO3 (x = 0.6-0.9) compounds. This is ascribed to the ferromagnetic (FM) coupling between Fe3+/Cr3+ ions and Yb3+ ions. During demagnetization, the Yb3+ ions will show a tendency to rotate with the direction of the applied magnetic field. However, the antiferromagnetic coupling of Fe3+/Cr3+ ions has a pinning effect, hindering their rotation, and thus producing an exchange bias effect. With increasing Fe3+ ion content, the magnetization and exchange bias field gradually become larger. When x = 0.8 and 0.9, the exchange bias field reaches up to -9.7 kOe and -13.6 kOe at 300 K, respectively. This giant room temperature exchange bias field will be more conducive for practical applications in magnetoelectronic devices.