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Background: To identify the clustering characteristics of individual-, family-, and school-level factors, and examine their associations with health-related physical fitness. Methods: A total of 145,893 Chinese children and adolescents aged 9–18 years participated in this cross-sectional study. The 2-step cluster analysis was conducted to identify clusters among individual-, family-, and school-level factors. Physical fitness indicator was calculated through sex- and age-specific z scores of forced vital capacity, standing long jump, sit-and-reach flexibility, body muscle strength, endurance running, and body mass index. Results: Three, 3, and 5 clusters were automatically identified at individual, family, and school levels, respectively. Students with low physical fitness indicator were more likely to be in the "longest sedentary time and skipping breakfast" cluster (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.12–1.24), and "physical inactivity and insufficient protein consumption" cluster (OR = 1.07; 95% CI, 1.02–1.12) at individual level, the "single children and high parental education level" cluster (OR = 1.15; 95% CI, 1.10–1.21), and "no physical activity support and preference" cluster (OR = 1.30; 95% CI, 1.25–1.36) at family level, and the "physical education occupied" cluster (OR = 1.06; 95% CI, 1.01–1.11), and "insufficient physical education frequency" cluster (OR = 1.16; 95% CI, 1.08–1.24) at school level. Girls were more vulnerable to individual- and school-level clusters, while boys were more susceptible to family clusters; the younger students were more sensitive to school clusters, and the older students were more susceptible to family clusters (P-interaction <.05). Conclusions: This study confirmed different clusters at multilevel factors and proved their associations with health-related physical fitness, thus providing new perspective for developing targeted interventions. [ABSTRACT FROM AUTHOR]

As the global economy, society, and environment are undergoing profound changes and the realization of sustainable development has become the common aspiration of the international community, ecological civilization construction has become an increasingly important issue for China to formulate its long-term development strategies and promote modernization. This study analyzes the characterization of 655 established pilot zones of ecological civilization construction and 'clear waters and green mountains are as valuable as mountains of gold and silver' innovative practices from 2017 to 2022. The spatial distribution of ecological civilization areas in China follows a pattern where more regions are in the southeast than in the northwest (Hu Line). The focus of China's comprehensive ecological civilization construction has been towards the southwest in the first year and has subsequently shifted towards the northwest. The overall Gini coefficient decreased from 0.494 to 0.299, and regional ecological civilization disparities gradually narrowed. Currently, regional construction disparities between the eastern and western regions are a major obstacle to balanced development; therefore, promoting coordinated regional development is necessary. Various factors affecting the pattern of ecological civilization construction, including natural resources, economic development, social progress, policies, and culture, were identified. The availability of natural resources and economic development cause regional differences in construction levels. This research will help promote the coordinated development of Chinese ecological civilization, while the development experiences of different regions can also provide guidance for sustainable development in developing countries. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to quantitatively compare the efficacy and safety of CDK4/6 inhibitors and PI3K/AKT/mTOR inhibitors for ER+/HER2− metastatic breast cancer. Methods: A parametric survival function was used to analyze the time course of overall survival (OS) and progression-free survival (PFS). The objective response rate (ORR) and the incidence of any grade and grade 3–4 adverse events were summarized using the random-effects model of a single-arm meta-analysis. Results: This study included 44 arms from 48 publications, with a total sample size of 7881 patients. Our study revealed that CDK4/6 inhibitors had a median OS of 40.7 months, a median PFS of 14.8 months, and an ORR of 40%, whereas PI3K/AKT/mTOR inhibitors had a median OS of 29.8 months, a median PFS of 8.3 months, and an ORR of 20%. Additionally, this study also found that the proportion of patients with visceral metastases and specific endocrine therapy used in combination significantly impact OS and PFS. In terms of adverse events, CDK4/6 inhibitors exhibited a relatively high incidence of hematological adverse events. Conclusion: Our study provides solid quantitative evidence for the first-line recommendation of CDK4/6 inhibitors combined with endocrine therapy for ER+/HER2− metastatic breast cancer in clinical guidelines. [ABSTRACT FROM AUTHOR]

Nitrous oxide (N2O) is a long-lived greenhouse gas that mainly originates from agricultural soils. More and more studies have explored the sources, influencing factors and effective mitigation measures of N2O in recent decades. However, the hierarchy of factors influencing N2O emissions from agricultural soils at the global scale remains unclear. In this study, we carry out correlation and structural equation modeling analysis on a global N2O emission dataset to explore the hierarchy of influencing factors affecting N2O emissions from the nitrogen (N) and non-N fertilized upland farming systems, in terms of climatic factors, soil properties, and agricultural practices. Our results show that the average N2O emission intensity in the N fertilized soils (17.83 g N ha−1 d−1) was significantly greater than that in the non-N fertilized soils (5.34 g N ha−1 d−1) (p< 0.001). Climate factors and agricultural practices are the most important influencing factors on N2O emission in non-N and N fertilized upland soils, respectively. For different climatic zones, without fertilizer, the primary influence factors on soil N2O emissions are soil physical properties in subtropical monsoon zone, whereas climatic factors are key in the temperate zones. With fertilizer, the primary influence factors for subtropical monsoon and temperate continental zones are soil physical properties, while agricultural measures are the main factors in the temperate monsoon zone. Deploying enhanced agricultural practices, such as reduced N fertilizer rate combined with the addition of nitrification and urease inhibitors can potentially mitigate N2O emissions by more than 60% in upland farming systems. [ABSTRACT FROM AUTHOR]

Glaciers are one of the most active erosional forces sculpting mountainous regions, and understanding the diversity of glacial valleys is a key to advancing knowledge of mountain evolution. 'Inverted trapezoidal' glacial valleys are an important type of glacial erosional landform, and research on their morphologic characteristics and causal mechanisms might contribute to a deeper comprehension of the variety of landforms formed by glacial erosion. In this paper, ALOS 12.5m DEM data and field geomorphologic surveys were used to quantitatively extract 171 transect parameters from 32 valleys in the study area and to quantitatively describe the morphologic characteristics of the inverted trapezoidal glacial valley transects based on the V-index model. The results show that the minimum V-index value for glacial valley cross-sections in the study area is 0.42, the maximum value is 0.86, and the mean value is 0.60. The most important factors influencing the diversity in the morphology of glacial valleys in the study area are the area of glacial action and climatic conditions. The formation of inverted trapezoidal glacial valleys may be attributed to the stable glacial action region of ice caps with gentle topography in Geladandong snow mountain. Research highlights: The minimum value of the V-index for glacial valley cross-sections in the study area was 0.42, the maximum value was 0.86, and the mean value was 0.60. The greatest number of cross-sections were concentrated in the 0.60 ~0.70 interval. The most important factor influencing the diversity in the morphology of glacial valleys in the study area are the area of glacial action and climatic conditions. The formation of inverted trapezoidal glacial valleys may be attributed to the stable glacial action region of ice caps with gentle topography in Geladandong snow mountain. [ABSTRACT FROM AUTHOR]

The inheritance of traditional handicraft of intangible cultural heritage is facing an unprecedented crisis. The essence of inheritance is the process of imparting and inheriting from master to apprentice, but there is acute shortage of research about the parties, the relationship and the behavior of inheritance. Therefore, choosing inherited behavior as a starting point to explore the inner formation mechanism of master and apprentice inheritance in traditional handicraft, as well as determining the influencing factors of the inheritance, have important theoretical value and practical significance for the inheritance of intangible cultural heritage. Using 4 traditional handicraft inheritance institutions in China as case objects, 37 inheritance parties and 21 mentoring matching groups were interviewed. Through standard case analysis and three-step coding method of grounded theory, it is found that skill generation involves the stages of inquiry, interaction and feedback, as well as the following steps:cognition of skill generation, coupling of skill generation, automation of skill generation, etc. Through coding, 12 categories and 33 specific influencing factors are identified. Among them, individual factors influence interaction relation, and the interaction relation has a concrete influence on the process of inheritance, affecting the ultimate effect of inheritance. This study is of reference value for improving the relationship between masters and apprentices and promoting the effective inheritance of traditional handicraft. [ABSTRACT FROM AUTHOR]

HIV-positive men who have sex with men (MSM) are at high risk of suicide and experience intersectional inequalities. The Social Determinants of Health (SDH) framework provides valuable insights into how inequalities can lead to adverse outcomes. This study aimed to employ the SDH framework to identify factors that contribute to suicidal behaviors among this population. 1410 HIV-positive MSM were recruited using a web-based questionnaire, whose mean age was 30.77 ± 6.92 years old. Participants completed questionnaires including baseline information and psychological measurements, such as Suicidal Behaviors Questionnaire-Revised (SBQ-R). Logistic regression analysis was conducted to screen for risk factors associated with suicidal behaviors. More than half of the participants (53.3 %, 752/1410) had an SBQ score of 7 or higher. Binary logistic regression analysis of structural and intermediary determinants (Model 3) revealed that sexual orientation, stigma (ORs: 1.018, 95 % CI: 1.005–1.032), interpersonal needs (ORs: 1.021, 95 % CI: 1.010–1.031), depression (ORs: 1.037, 95 % CI: 1.001–1.074) and entrapment (ORs: 1.018, 95 % CI: 1.004–1.032) were positively correlated with suicidal behaviors. Individuals with other or unknown sexual orientation had significantly higher rates of suicidal behaviors compared to those with a heterosexual sexual orientation (ORs: 5.021, 95 % CI: 1.529–17.640). Sampling of HIV-positive MSM posed challenges in data collection. It may introduce selection bias and affect generalizability. This study identified that sexual orientation, stigma, interpersonal needs, depression, and entrapment were significantly associated with suicidal behaviors among HIV-positive MSM. Additionally, these factors can be social determinants of health that contribute to suicidal behaviors. • This study is the first to apply the SDH framework in HIV-positive MSM. • SBQ scale rather than one or a few questions was used to measure the suicidal behaviors among HIV-positive MSM. • Sexual orientation, stigma, interpersonal needs, depression, entrapment contribute to suicidal behaviors in HIV-positive MSM. [ABSTRACT FROM AUTHOR]

Based on national agricultural trade panel data of Regional Comprehensive Economic Partnership (RCEP) countries from 2002 to 2020, the structural characteristics of the RCEP national agricultural trade spatial network are reconstructed by the social network analysis method in this paper. Specifically, the characteristics consist of overall characteristics, individual characteristics, core-periphery structure analysis, and block models. Moreover, the influence factors on the agricultural trade network are also examined by the QAP regression model. The conclusions are summarized as follows. Firstly, the agricultural trade in RCEP countries has significant spatial correlation, showing favorable stability and accessibility. Secondly, Australia, China, Thailand, and Vietnam are the central actor's leading position in the correlation network. While Cambodia, Laos, Myanmar, and other countries are in the marginal position. Thirdly, the network can be divided into four blocks, including the net benefit block, the two-way spillover block, the broker block, and the net spillover block. The spillover effect between the blocks is transitive. And finally, geographical distance, economic and social conditions, resource endowment, and language proximity index significantly impact the RCEP agricultural trade network structure. [ABSTRACT FROM AUTHOR]

Data Pension Explorer (DAPE) introduces an innovative approach to delve into the intricacies of commercial pension insurance adoption within rural communities in China, particularly amid the challenges posed by an aging population. Leveraging advanced Deep Long Short-Term Memory (LSTM) techniques within the domain of big data analysis, this study pioneers the analysis of extensive datasets. It systematically unravels intricate patterns, correlations, and pivotal determinants shaping the landscape of pension insurance adoption in rural areas. Going beyond conventional analyses, this research provides a nuanced understanding of the multifaceted factors influencing both the sustainability and uptake of pension insurance. The culmination of these efforts yields valuable insights that extend beyond the theoretical realm, directly informing strategic decision-making processes. These insights prove instrumental in designing and implementing policies tailored to address the unique challenges faced by rural communities in China. Thus, DAPE not only navigates the complexities of population aging but also serves as a guiding force in fostering widespread adoption and sustainability of pension insurance within rural landscapes in the Chinese context. [ABSTRACT FROM AUTHOR]

While the industry has produced sugar-derived ethanol from the conventional method of fermentation for hundreds of years, other effective routes involving the direct transformation of carbohydrates still remain extremely rare. Very recently, an innovative chemo-catalytic method driven by the aqueous-phase catalysis was created for the synthesis of cellulosic ethanol, making a great breakthrough in the common ways as it can theoretically utilize all of the carbon atoms in sugars with faster kinetics; up to now, results from the relevant studies have been accumulated to a certain extent, but the periodic conclusions in this field are unfortunately absent. For this reason, this work tries to offer an overview of the cellulosic ethanol produced by chemo-catalytic routes, highlighting the present knowledge in relation to the technical efficiency, catalytic mechanisms as well as practical applications. At first, the advanced progress on the increasing efficiency from a varied type of catalytic systems are extensively discussed, which involves the specific functions of hybrid components from different strategies; meanwhile, the general influences of processing conditions, such as the hydrothermal severity and aqueous environments, are also identified. Subsequently, possible mechanisms behind the chemo-catalytic processes are widely elaborated by analyzing a number of experimental cases associated with the reaction network and its kinetic models. After that, the actual effects of this technique on the real biomass are collected to identify the positive/negative interactions between multiple components, together with the potential solutions on the semi-continuous processes of pilot scale application. The techno-economic analysis (TEA) is also calculated and compared with other similar methods, such as fermentation and gasification. Finally, several proposals aimed at upgrading the whole chain of chemo-catalytic processes are clearly provided, which may function as a guideline for future studies on the production of bio-ethanol from lignocellulosic materials. [ABSTRACT FROM AUTHOR]

With the continuous growth of electric vehicle ownership, energy consumption has become an important factor restricting its development. Real-time and accurate energy consumption estimation is essential to alleviate range anxiety and help with energy-efficient route planning. This study aims to explore the factors affecting energy consumption, and estimate the energy consumption of electric vehicles under different road characteristics. Based on the real-world driving data of electric vehicles in Nanjing over a long period, this study analyzed the influencing factors of energy consumption, including trip conditions, weather, driving behavior, and road characteristics. Based on feature selection and correlation analysis, an energy consumption estimation framework for electric vehicles was proposed to estimate energy consumption under different road characteristics using extreme gradient boosting. The results show that energy consumption is significantly affected by trip conditions, weather, driving behavior, and road characteristics. The modeling of different road characteristics helps improve the accuracy of model estimation. The error of the model proposed in this paper is within the reasonable range (−0.25–0.25 kWh/km), which is better than the random forest and k-nearest neighbor models. [ABSTRACT FROM AUTHOR]

Background: Pulmonary tuberculosis (PTB) is a prevalent chronic disease associated with a significant economic burden on patients. Using machine learning to predict hospitalization costs can allocate medical resources effectively and optimize the cost structure rationally, so as to control the hospitalization costs of patients better. Methods: This research analyzed data (2020–2022) from a Kashgar pulmonary hospital's information system, involving 9570 eligible PTB patients. SPSS 26.0 was used for multiple regression analysis, while Python 3.7 was used for random forest regression (RFR) and MLP. The training set included data from 2020 and 2021, while the test set included data from 2022. The models predicted seven various costs related to PTB patients, including diagnostic cost, medical service cost, material cost, treatment cost, drug cost, other cost, and total hospitalization cost. The model's predictive performance was evaluated using R-square (R2), Root Mean Squared Error (RMSE), and Mean Absolute Error (MAE) metrics. Results: Among the 9570 PTB patients included in the study, the median and quartile of total hospitalization cost were 13,150.45 (9891.34, 19,648.48) yuan. Nine factors, including age, marital status, admission condition, length of hospital stay, initial treatment, presence of other diseases, transfer, drug resistance, and admission department, significantly influenced hospitalization costs for PTB patients. Overall, MLP demonstrated superior performance in most cost predictions, outperforming RFR and multiple regression; The performance of RFR is between MLP and multiple regression; The predictive performance of multiple regression is the lowest, but it shows the best results for Other costs. Conclusion: The MLP can effectively leverage patient information and accurately predict various hospitalization costs, achieving a rationalized structure of hospitalization costs by adjusting higher-cost inpatient items and balancing different cost categories. The insights of this predictive model also hold relevance for research in other medical conditions. [ABSTRACT FROM AUTHOR]

Background: Despite readiness for hospital discharge widespread popularity since readiness for hospital discharge introduction in 1979 and extensive study, readiness for hospital discharge among pulmonary tuberculosis (PTB) patients has not yet been investigated. Moreover, the factors influencing this process remain unclear. Objective: The objective of this study was to investigate the factors influencing readiness for hospital discharge in initially treated PTB patients using the capability, opportunity, motivation-behavior (COM-B) model. Methods: This phenomenological study was conducted from December 2023 to March 2024. Face-to-face individual interviews were conducted with 18 initially treated patients with PTB according to a semistructured interview guide developed on the basis of the COM-B model. The interview data were subjected to analysis using NVivo 14 software and Colaizzi's method. Results: As a result, 6 themes and 14 subthemes were identified. Physical capability for readiness for hospital discharge (subthemes included poor health status, early acquisition of adequate knowledge about PTB, inadequate knowledge about readiness for hospital discharge), psychological capability for readiness for hospital discharge(subthemes included false perceptions about readiness for hospital discharge, high treatment adherence), physical opportunity for readiness for hospital discharge (subthemes included high continuity of transition healthcare, insufficient financial support, insufficient informational support), social opportunity for readiness for hospital discharge (subthemes included stigmatization, inadequate emotional support), reflective motivation for readiness for hospital discharge (subthemes included lack of reflection on coping with difficulties, intention to develop a readiness for hospital discharge plan), and automatic motivation for readiness for hospital discharge (subthemes included strong desire to be cured, negative emotions). Conclusion: We established factors related to readiness for hospital discharge in initially treated PTB patients in terms of capability, opportunity and motivation, which can inform the future development of readiness for hospital discharge plans. To improve patients' readiness for hospital discharge, patients need to be motivated to plan and desire readiness for hospital discharge, patients' knowledge and treatment adherence should be improved, and patients' transition healthcare continuity and emotional support should be focused on. Moreover, the quality of readiness for hospital discharge and discharge education should be assessed in a timely manner to identify impeding factors and provide interventions. [ABSTRACT FROM AUTHOR]

Background: Nurses represent China's largest healthcare workforce. Nurse practitioners (NPs) play an essential role in providing cost-effective quality healthcare and bridging the healthcare gaps. However, NPs are relatively new in China, and limited evidence exists on senior nurses' knowledge of and attitudes toward NPs. Aims: This study aimed to describe senior nurses' knowledge, attitudes, and perceived facilitators and barriers of NPs in China using a self-designed, culturally adaptive questionnaire. Methods: A cross-sectional online survey was conducted among 412 senior nurses in Hunan Province from December 2021 to January 2022. The Knowledge and Attitudes towards Nurse Practitioners Questionnaire (KANPQ) was developed based on the Delphi method, which included 30 items under three dimensions: knowledge (22 items), attitude (2 items), and perceived facilitators and barriers (6 items). Multivariate linear regression was conducted to explore factors associated with senior nurses' attitudes toward NPs. Results: The average KANPQ knowledge score was 68.56 ± 22.69, with 55.09%,10.20%, and 34.71% of participants showing good, moderate, and poor levels of knowledge, respectively. The average KANPQ attitude score was 7.79 ± 1.72, with 65.3% thinking NPs were necessary and 69.9% expressing willingness to become NPs. Nurses with higher professional titles and better knowledge of NPs had more positive attitudes toward NPs. The three most frequently mentioned barriers to NP implementation were patient trust, laws, and education. Conclusions: Approximately one-third of senior nurses have poor knowledge and negative attitudes toward NPs, indicating much room for improvement. Strengthening the education and training of NPs, especially among those with lower professional titles and lower knowledge of NPs, may help improve their knowledge and attitudes toward NPs. In addition, continuous political, social, economic, and individual efforts are needed to facilitate the successful development of NPs in China. [ABSTRACT FROM AUTHOR]

Objective To understand the prognosis of patients with bone metastases from first-treatment non-small cell lung cancer （NSCLC） of different pathological types after different first-line treatment regimens， in order to provide clinical prediction of disease progression， guidance of treatment， and improvement of prognosis. Methods 403 NSCLC patients with bone metastases who received primary treatment with bone metastases from Chaohu Hospital of Anhui Medical University from 1 January 2019 to 31 December 2023 were selected for univariate analysis using survival analysis （Log-rank test） and multifactorial analysis with Cox regression， and it was found that histopathological subtyping was an independent factor affecting the prognosis of patients （P = 0.001， HR = 1.952）， after which the effect of this factor on prognosis was removed， and the total number of patients was divided into two groups according to histopathological classification: adenocarcinoma group （316） and squamous carcinoma group （87）， and then multifactorial analysis was performed again using Cox regression model to analyse the factors affecting survival prognosis. Results In this data analysis， patients with the pathological type of squamous carcinoma had a median overall survival （mOS） of 15 months （95% CI: 12.85 ~ 17.15） and a median progression-free survival （mPFS） of 9 months （95% CI: 7.34 ~ 10.67）， whereas patients in the adenocarcinoma group had a mOS of 25 months （95% CI: 23.26 ~ 26.74） and mPFS was 16 months （95% CI:14.43 ~ 17.57）， a statistically significant difference. The OS of the overall group was affected by multiple factors， including Eastern Cooperative Oncology Group （ECOG） score status （1/> 1） at the time of initial diagnosis， bone metastases to Trunk + limb bones + cranium， number of bone metastases ≥ 4， mutation of ALK target genes， and the use of chemotherapy+targeted therapy as the first line of treatment. therapy； similarly， PFS was also affected by the above factors. In addition， in the adenocarcinoma and squamous carcinoma models based on histopathological classification， chemotherapy + targeted therapy and chemotherapy + immunotherapy were found to be the protective factors for the two groups， and ALK target gene mutation was only a protective factor for the adenocarcinoma group. Conclusion This study further confirmed the prognostic factors influencing the prognosis of patients with bone metastases from primary NSCLC， which provides an important reference for clinical treatment. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Implications The introduction of Small Private Online Courses (SPOCs) in English as a Foreign Language (EFL) instruction at Higher Vocational Colleges (HVCs) signifies a shift in education. Understanding the factors that affect deep learning in this SPOC context is crucial for improving educational outcomes.By employing grounded theory, we seek to explore the key factors that shape deep learning experiences for students in SPOC learning environments at HVCs and clarify the interrelationships among these influencing factors.Semi‐structured interviews were conducted with 18 EFL students and 4 teachers and NVivo 11 software was utilised to aid in the qualitative analysis of the collected data. Through a rigorous three‐tier coding analysis, an “environment‐person‐mediation ‐behaviour” (EPMB) model was constructed, aiming to clarify the mechanisms that influence deep learning among EFL students in HVCs.Our findings reveal that intrinsic motivation and cognitive abilities are crucial for deep learning among EFL students in HVCs. Blended learning settings, English curriculum satisfaction, and English teachers' teaching methods serve as situational influencing factors. These factors are interconnected, mediating positive or negative effects on deep learning through various intermediaries like continuity, attraction, guidance, motivation, and regulation.The findings offer pedagogical insights for HVC stakeholders, enabling them to enhance students' deep learning experiences. [ABSTRACT FROM AUTHOR]

Under the wave of Industry 4.0, traditional pharmaceutical manufacturing enterprises are in urgent need of intelligent manufacturing transformation and upgrading, and exploring the optimal realization path of intelligent manufacturing transformation can help accelerate the transformation process of pharmaceutical manufacturing enterprises. This paper uses grounded theory research methods to conduct a multi-case study to summarize six influencing factors of the intelligent manufacturing transformation of Chinese pharmaceutical manufacturing enterprises; and then analyzes the correlation between the intelligent manufacturing influencing factors based on the DEMATEL method and the NK model, and identifies the key influencing factors according to this, and then draws the fitness landscape map of the intelligent manufacturing transformation, and finally arrives at the optimal path selection of the intelligent manufacturing transformation of pharmaceutical manufacturing enterprises. The study enriches and extends the research paradigm of intelligent manufacturing transformation, and provides lessons for pharmaceutical manufacturing enterprises to realize intelligent manufacturing transformation and upgrading. [ABSTRACT FROM AUTHOR]

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Objective: To explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures. Methods: A cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children. Results: Univariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father's education level (χ2 = 4.207, p < 0.001), mother's education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434–6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354) were risk factors for dental caries. Higher father's educational level (OR = 0.724, 95% CI: 0.564–0.891), higher mother's educational level (OR = 0.641, 95% CI: 0.601–0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643–0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352–0.747) were protective factors against dental caries (all p < 0.05). Conclusion: Multiple factors result in early dental caries in preschool children aged 3–6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption. [ABSTRACT FROM AUTHOR]

Background: The prevalence of oral diseases is subject to change over time. In 2021, Guangdong Province conducted its fourth survey assessing the oral health status of individuals aged 65–74. Materials and methods: Evaluation criteria and potential influencing factors were identified. A sample of residents aged 65–74 from 13 designated monitoring sites in Guangdong Province was randomly selected for the study. Spearman correlation analysis was employed to investigate the clinical correlation between influencing factors and evaluation criteria. Negative binomial and zero-inflated negative binomial regression models were utilized to examine the factors influencing caries prevalence. In contrast, logistic regression was employed to identify the risk factors for caries occurrence. A p-value of ≤0.05 was considered statistically significant. Results: The prevalence of caries rate of crowns, roots, and teeth were 76.36%, 52.25%, and 79.2%, respectively. Individuals with periodontal pockets exhibited a significantly higher risk of root caries. The presence of dental calculus significantly exacerbated the occurrence of crown, root, and dental caries, and increased the risk of crown and dental caries. Consuming sweet foods once or more a week notably increased the average root decayed score (D of roots), the prevalence rate of root caries, and the D score of the Decayed, Missing, and Filled teeth [DMFT] index in individuals already afflicted with this condition. Similarly, the consumption of sweetened drinks significantly elevated the risk of crown and root caries, exacerbating overall caries progression. Frequencies of manual toothbrush and toothpick cleaning showed a negative correlation with average tooth missing score (MT). In contrast, the frequency of manual/electric toothbrush and toothpick cleaning was negatively correlated with the DMFT index. Engaging in dental diagnosis and treatment behaviors significantly increased the number of filled crowns (F), MT, and DMFT scores while reducing the prevalence of dental caries. Conclusions: In Guangdong Province, caries prevalence among older individuals aged 65–74 remains substantial. Relevant professionals and institutions must provide comprehensive guidance and assistance to the older population, emphasizing the importance of reducing the consumption of sweets and sweetened beverages, adopting correct tooth brushing techniques and frequency (at least twice daily), timely treatment of periodontal diseases, conducting regular epidemiological caries surveys, and addressing economic barriers to accessing caries diagnosis and treatment services. [ABSTRACT FROM AUTHOR]

This study aims to assess the global prevalence of kinesiophobia and the potential influencing factors among patients with heart disease. A comprehensive search was conducted in PubMed, Embase, Web of Science, PsycINFO, and Scopus databases to identify studies reporting on the prevalence of kinesiophobia and its influencing factors in heart disease patients up to January 2024. A random-effects model was employed to aggregate prevalence rates. Heterogeneity sources were investigated through subgroup analysis, while differences in the prevalence of kinesiophobia across regions, types of heart disease, and gender were evaluated. Additionally, a qualitative analysis of the factors influencing kinesiophobia was performed. This research incorporated 15 studies from six countries, with 14 providing data on the prevalence of kinesiophobia and nine exploring its potential influencing factors. The findings indicated that the overall prevalence of kinesiophobia among heart disease patients was 61.0% (95% CI 49.4–72.6%). Subgroup analysis revealed that the prevalence in upper-middle-income countries was 71.8% (95% CI 66.2–77.4%), while it stands at 49.9% (95% CI 30.2–69.5%) in high-income countries. The prevalence rates among patients with coronary artery disease, heart failure, and atrial fibrillation were 63.2% (95% CI 45.2–81.3%), 69.2% (95% CI 57.6–80.8%), and 71.6% (95% CI 67.1–76.1%), respectively. Gender-wise, no significant difference was observed in the prevalence of kinesiophobia between men and women (52.2% vs. 51.8%). A total of 24 potential influencing factors of kinesiophobia were identified, with education level, monthly income, anxiety, and exercise self-efficacy being the most recognized. The prevalence of kinesiophobia in patients with heart disease is notably high and is influenced by a multitude of factors. Early implementation of targeted preventive measures is imperative to mitigate the incidence of kinesiophobia in this population. [ABSTRACT FROM AUTHOR]

Background: This study aims to comprehend the levels of dry mouth and thirst in patients after general anesthesia, and to identify the factors influencing them. Methods: The study included all patients transferred to the Post Anesthesia Care Unit (PACU) at the Second Affiliated Hospital of Dalian Medical University between August 2021 and November 2021 after undergoing general anesthesia. A thirst numeric rating scale was utilized to conduct surveys, enabling the assessment of thirst incidence and intensity. Statistical analysis was performed to explore patient thirst levels and the associated factors. Results: The study revealed a thirst incidence rate of 50.8%. Among the thirst intensity ratings, 71.4% of patients experienced mild thirst, 23.0% reported moderate thirst, and 5.6% expressed severe thirst. Single-factor statistical analysis of potential risk factors among the enrolled cases indicated that gender, history of coronary heart disease, surgical duration, intraoperative fluid volume, intraoperative blood loss, intraoperative urine output, and different surgical departments were linked to post-anesthetic thirst in patients undergoing general anesthesia. Multifactorial Logistic regression analysis highlighted age, gender, history of coronary heart disease, fasting duration, and intraoperative fluid volume as independent risk factors for post-anesthetic thirst in patients undergoing general anesthesia. Moreover, age, gender, history of coronary heart disease, and intraoperative fluid volume were also identified as risk factors for varying degrees of thirst. Conclusion: The incidence and intensity of post-anesthetic thirst after general anesthesia are relatively high. Their occurrence is closely associated with age, gender, history of coronary heart disease, fasting duration, and intraoperative fluid volume. [ABSTRACT FROM AUTHOR]

Aim Location Methods Results Conclusions Surf zones are crucial nursery habitats for the early life stages of fish species associated with typical coastal ecosystems. However, little is known about the temporal patterns and drivers of fish assemblages in tropical surf zones. This study aimed to assess the (1) main changes in fish community structure throughout 1 year, (2) seasonal dynamic patterns in fish assemblages, and (3) key factors influencing fish assemblages in the tropical surf zones.Gaolong Bay, Wenchang City, Hainan Island, China.Fish sampling was conducted monthly from June 2021 to May 2022 using a beach seine net. Fish species were identified using both morphological and molecular analyses. Kruskal–Wallis test, analysis of similarity, non‐metric multidimensional scaling analysis, and similarity percentage analysis were used to investigate the temporal fish assemblage patterns. Generalised additive models and canonical correspondence analysis were used to assess how environmental variables influence fish assemblages.We identified 83 fish species, which were grouped into three ecotypes based on their primary habitat: coral reef‐seagrass‐associated species (CS) (35), mangrove‐estuarine‐associated species (ME) (30), and common coastal‐estuarine‐associated species (CE) (18). Most captured individuals were juveniles, and fish abundance and diversity were highest in May. Most CS species were abundant between March and May. ME and most CE species were dominant from June to August, and Mugilidae (CE) was abundant between October and February. Furthermore, surf fish assemblages were substantially influenced by tidal level, water temperature, conductivity, pH, turbidity, and dissolved oxygen.Juvenile fish were abundant in May and fish species with three ecotypes alternate in the surf zones throughout the year. Counter to much current thinking, March maybe the spawn peak of most fish species in the studied area, and we suggest that the fishing ban period could start from March instead of May in the inshore areas of Hainan Island. [ABSTRACT FROM AUTHOR]

Introduction: Kinesiophobia denotes an excessive and irrational apprehension towards physical activity or exercise among patients, stemming from a perception of susceptibility to painful injury or re-injury. Cardiac rehabilitation stands pivotal in the secondary prevention spectrum for individuals with cardiovascular ailments, with exercise constituting a cornerstone of this regimen. However, the emergence of kinesiophobia poses a formidable challenge, diminishing patient adherence to cardiac rehabilitation protocols, particularly among those grappling with chronic heart failure. To bolster exercise-based rehabilitation initiatives in this cohort, a thorough comprehension of the multifaceted factors precipitating kinesiophobia is imperative. This review endeavors to delineate prevailing evidence and prevalence concerning kinesiophobia triggers in chronic heart failure patients, while pinpointing research lacunae for future exploration. Methods: Employing a scoping review methodology, our investigation culled data from diverse scholarly databases, including Embase, PubMed, Scopus, CINAHL, Web of Science, Medline, Sinomed, CNKI, Wangfan, and VIP. Results: After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated. Discussion: Our findings underscore a notable prevalence of kinesiophobia in chronic heart failure patients, predominantly influenced by socio-demographic factors, psychological and cognitive factors, disease and treatment factors, as well as lifestyle and behavior. Armed with these insights, future interventions can be tailored to mitigate kinesiophobia levels, fostering enhanced engagement in exercise-centric cardiac rehabilitation endeavors among patients grappling with chronic heart failure. [ABSTRACT FROM AUTHOR]

Background: The quality of life of elderly patients after vertebroplasty is influenced by various factors. Although the EuroQol 5-Dimension 3-Level (EQ-5D-3L) scale has been widely used to assess quality of life, the factors affecting the long-term postoperative quality of life of elderly vertebroplasty patients in China have not been thoroughly studied. Methods: This retrospective study included 519 patients aged 65 years and older who underwent elective vertebroplasty. We collected baseline data from these patients and conducted telephone follow-ups 12 months postoperation to evaluate their EQ-5D-3L health utility scores and EuroQol Visual Analogue Scale (EQ-VAS) scores. Univariate and multivariate linear regression models were used to analyse the factors affecting quality of life. Results: Of the 519 patients, the majority were female (78.0%), aged 65 to 95 years, with an average age of 75.2 years. Twelve months postoperation, pain/discomfort was the most commonly reported issue for 68.4% of patients. The median EQ-5D-3L health utility score was 0.783, with a range between 0.450 and 0.887; the median EQ-VAS score was 75, ranging from 60 to 85. Multivariate linear regression analysis indicated that older age, hormone use, higher American Society of Anesthesiologists (ASA) grades, nondrinking habits, and low albumin levels were found to be independent risk factors affecting long-term quality of life in elderly patients after vertebroplasty. Additionally, a history of tumours, the number of vertebral compression fractures, and bone mineral density were also crucial influencing factors. Conclusions: Based on the use of the EQ-5D-3L Chinese utility scoring system, we evaluated the quality of life of patients aged 65 and above 12 months after vertebroplasty. This study identified several factors related to postoperative quality of life in elderly vertebroplasty patients, providing crucial evidence for further clinical decisions and patient education. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors influencing accelerated aging in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). Methods: A total of 216 patients diagnosed with T2DM and CHD between August 2019 and August 2023 at Xuzhou Central Hospital were selected. Patients were divided into an aging group and a non-aging group, based on the positive or negative values of phenotypic age acceleration (PhenoAgeAccel). Logistic regression analysis was conducted. Variables that had a univariate analysis P< 0.05 were included in the multivariate analysis to identify factors influencing aging in patients with T2DM and CHD, and the area under the curve of the model was reported. Results: This study included 216 patients, with 89 in the accelerated aging group, and 127 in the non-accelerated aging group. The average age of patients was 70.40 (95% CI: 69.10-71.69) years, with 137 males (63.4%). Compared with the non-accelerated aging group, patients in the accelerated aging group were older, with a higher proportion of males, and a higher prevalence of hypertension, stable angina pectoris, and unstable angina pectoris. Multivariate Logistic regression analysis indicated that the absolute value of neutrophils (NEUT#), urea (UREA), adenosine deaminase (ADA), and the triglycerideglucose index (TyG) were risk factors for accelerated aging, while cholinesterase (CHE) was a protective factor. For each unit increase in NEUT#, UREA, ADA, and TyG, the risk of aging increased by 64%, 48%, 10%, and 789%, respectively. The overall area under the receiver operating characteristic (ROC) curve of the model in the training set was 0.894, with a 95% confidence interval (CI) of 0.851-0.938. Conclusion: NEUT#, CHE, UREA, ADA, and TyG are predictors of accelerated aging in patients with T2DM and CHD, with the model showing favorable overall predictive performance. [ABSTRACT FROM AUTHOR]

Background: Nursing interns encounter numerous professional pressures during clinical practice. Assessing adversity quotient levels and understanding the influencing factors are crucial for supporting students' seamless transition to professional nurses. Purpose: This study examined the adversity quotient subtypes of nursing interns and explored the relationships between adversity quotient and depression, coping styles, positive psychological capital, and professional adaptability. Methods: This study employed a cross-sectional research design, involving a survey of 287 nursing interns in five general hospitals in Shanghai, China. Latent profile analysis was conducted to explore the subtypes of adversity quotient with the four domains as input variables. Multinomial logistic regression models and multiple correspondence analysis were used for subsequent data analysis. Results: The average adversity quotient score of the nursing interns was 116.63 ± 32.22. A three-profile solution was obtained based on the latent profile analysis results. Three distinct subtypes emerged: a high-adversity quotient subtype (n = 50, 17.4%), a medium-adversity quotient subtype (n = 189, 65.9%), and a relatively low-adversity quotient subtype (n = 48, 16.7%). Multinomial logistic regression revealed that nursing interns in the high-adversity quotient subtype tended to be male, and had higher scores for positive psychological capital, negative coping style, and professional adaptability (p < 0.05). Conclusion: Most of the nursing interns were in the medium adversity quotient subtype. Gender, positive psychological capital, negative coping style and professional adaptability were all significantly related to the adversity quotient. Boosting the positive psychological capital of nursing interns is an effective way to improve the adversity quotient. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to explore the influence of GPs'information, motivation and behavior skills on EM prescribing behavior in urban and suburban districts. Method: A cross-sectional study was conducted from June to November 2022 cross 3 urban districts and 4 suburban districts in Beijing. The structural equation model was used to analyze the factors influencing the essential medicine prescription behavior among general practitioners in urban and suburban districts. Results: A total of 511 valid questionnaires were collected. There was a statistically significant difference in mean scores for personal motivation and behavioral skills between urban GPs and suburban GPs. For urban GPs, the path analysis revealed that the social motivation had a direct effect on the essential medicine prescribing behavior (β = 0.225, p < 0.05). In contrast, for suburban GPs, both social motivation and personal motivation had a direct effect on the essential medicine prescribing behavior, respectively (β = 0.175, p < 0.05; β = 0.193, p < 0.01). Conclusion: Social motivation of urban GPs were positively and significantly associated with essential medicine prescribing behavior. Social motivation and personal motivation of suburban GPs were positively and significantly associated with essential medicine prescribing behavior. Therefore, various corresponding policies and measures should be developed to promote the National Essential Medicines Policy in China. [ABSTRACT FROM AUTHOR]

BackgroundAimMethods & ProceduresOutcomes & ResultsConclusionsMaintaining therapy gains in the long term is necessary for therapy to be considered successful. Yet, this topic has received limited attention in aphasia rehabilitation research. Unfortunately, for some people with chronic aphasia, maintaining the gains achieved in therapy can be difficult and many experience reduced communicative functioning over time. Understanding the perspectives of speech-language pathologists (SLPs) on maintenance is vital. As key agents in aphasia therapy, their views are crucial for understanding current practice, identifying service gaps, and informing future research on the maintenance of therapy gains.The aim of this research was to explore speech-language pathologists’ perspectives on maintaining therapy gains in chronic aphasia and to understand their beliefs about the factors that influence the maintenance of gains made during aphasia rehabilitation.In-depth semi-structured interviews were conducted with seven SLPs who worked with people with chronic aphasia. Inductive thematic data analysis was used to identify themes.Six themes were identified, representing SLPs’ beliefs about maintenance and their perceptions of factors important for preserving therapy gains in aphasia rehabilitation. These were: 1) Ongoing communication activity; 2) Meaningful person-centred goals; 3) The challenge of translating functional goals to participation; 4) Individual capacity and resource availability; 5) Home support; and 6) Services. The results illustrate the complexity and interplay of factors that may both facilitate and hinder the maintenance of therapy gains.SLPs in this study believe that aphasia rehabilitation interventions should involve meaningful, personalised, enjoyable real-life experiences to optimise maintenance of therapy gains. Moreover, they believe that maintenance must be at the centre of aphasia rehabilitation research and clinical practice, requiring new models of care for chronic aphasia. These insights may provide direction for the development of future interventions and services to enhance long-term maintenance for people with chronic aphasia. [ABSTRACT FROM AUTHOR]

Background and aim: The teaching profession plays an important role in shaping individuals' lives, with teachers performing complex emotional labour. The management of emotions is an integral part of teachers' professional work, and it is essential to clarify their emotional experiences and the generating of their emotions within a specific cultural context. Methods: Based on a phenomenological approach and the use of anecdotal texts, this study examined six common emotional states among teachers, including happiness, guilt, worry, fear, annoyance, and anger, along with the emotional experiences of two specialised categories of teachers, class supervisors, and pre-service teachers. The factors influencing teachers' emotions and their generative mechanisms were analysed. Results and discussion: This investigation found that key influences on teachers' emotions stem from factors within the teachers' themselves, the contextual nature of their work, and sociocultural dynamics. Drawing on the analytical frameworks of emotional geography theory, ecological theory of human development, and the ecosystem model of teachers' emotional interactions, the study constructs a model highlighting the generative mechanisms of teachers' emotions, and in which three systems are reflected. Conclusion: Teachers' personal attributes are in the direct area of the model and directly govern the formation of their emotions, while their work context consists of a transitional area in emotion formation and the sociocultural system acts as the latent band influencing emotion development. The mechanism model helps us to understand and recognise teachers' emotions and to explore their pedagogical implications. [ABSTRACT FROM AUTHOR]

Background: This study explored risk perception characteristics and influencing factors among informal caregivers of functionally dependent elderly individuals at home, aiming to improve caregivers' caregiving risk perception and coping abilities and ultimately enhance the quality of life for these individuals. Methods: We used purposive sampling to select 22 informal caregivers from a community in Zhengzhou City, Henan Province, China, between March and September 2023 and conducted face-to-face semi-structured in-depth interviews. The data were analyzed using Colaizzi's seven-step analysis method. Results: We extracted two themes, caregiving risk perception characteristics and caregiving risk perception associated factors, and eight sub-themes, perceived risk possibility, perceived risk anticipation, perceived severity of consequences, past caregiving experiences, health literacy, psychological status, caregiving burden, and family social support. Conclusion: There were differences in how informal caregivers perceived the risks associated with caring for functionally dependent elderly individuals at home, which various factors could influence. It was essential to provide training that covered the knowledge and skills needed for caregiving, improve caregivers' awareness of safety risks, and establish a correct perception of caregiving risks. The government must construct and refine a comprehensive framework for caregiver respite services. Simultaneously, healthcare professionals should proactively undertake health education endeavors to augment the recognition of care safety risks among informal caregivers, thereby cultivating an accurate awareness of care risk perception. [ABSTRACT FROM AUTHOR]

In order to study the ecological and atmospheric recovery of the Hexi Corridor region, this paper analyzes the migration changes of land use characteristics and utilizes multivariate data and BenMAP-CE software to study the pollution characteristics of ozone and its precursors and the impact on human health in the Hexi Corridor region. The results showed that the increase of cultivated land area in the Hexi Corridor mainly originated from grassland. The MDA8-O3 concentrations met the primary and secondary standards of the Ambient Air Quality Standards on 43% and 99% of the days, respectively. NO2 showed a negative weekend effect with O3, and HCHO was opposite to it. Temperature, barometric pressure, and vegetation were highly correlated with O3-NO2-HCHO. Ozone pollution in the study area caused about 60% of all-cause premature deaths due to cardiovascular diseases. The study suggests that controlling exogenous transport in Wuwei City during the high ozone period (except August) is mainly dominated by the west and northwest, and that synergistic management of VOCs and NOx emissions can reduce O3 pollution and, consequently, reduce the risk to human health. [ABSTRACT FROM AUTHOR]

This document is a list of academic articles and research papers related to carbon emissions and their effects. The articles cover various topics such as the analysis of carbon emissions in different regions, the driving factors of carbon emissions, and the impact of carbon emissions on the environment. The articles provide valuable insights into the complex issue of carbon emissions and can be useful for library patrons conducting research on this topic. [Extracted from the article]

Objective To analyze the detection of colorectal advanced neoplasms in the population who underwent colonoscopy screening in Henan Province as part of the Urban China Cancer Screening Program and its influencing factors. Methods A cross-sectional study design was employed. Based on the Cancer Screening Program conducted in Henan Province, the study enrolled 7 454 urban residents who manifested no symptoms and were recruited from eight cities in the province, including Zhengzhou, Zhumadian, Anyang, Luoyang, Nanyang, Jiaozuo, Xinxiang, and Puyang from October 2013 to October 2019, and participated in colonoscopy screening. The χ2 test was used to compare the detection rates of colorectal advanced neoplasms among participants with different characteristics, and a multivariate logistic stepwise regression model was used to analyze the factors affecting the detection rates. Results A total of 7 454 subjects underwent colonoscopy screening, and 112 cases of colorectal advanced neoplasms were detected. Multivariate logistic regression analysis suggested that older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative were risk factors for colorectal advanced neoplasms. The detection rate was significantly higher in people aged 60-74 years compared with those aged 40-49 years, with an odds ratio (OR) of 2.04 (95% CI: 1.23-3.38).The rates were higher in people who smoked than those who did not smoke, with an OR of 2.21 (95% CI: 1.48-3.31), and in people who consumed more meat than those who consumed less, with an OR of 1.53 (95% CI: 1.04-2.26). Those with diabetes had a higher detection rate compared with those without, with an OR of 1.69 (95% CI: 1.07-2.69), and those with a first-degree family history of colorectal cancer had a higher detection rate than those without, with an OR of 1.64 (95% CI: 1.09-2.46). Conclusion The detection rate of colorectal advanced neoplasms through colonoscopy screening in Henan Province covered by the Urban China Cancer Screening Program is 1.50%. Older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative are identified as risk factors for colorectal advanced neoplasms. [ABSTRACT FROM AUTHOR]

Objective：To investigate the potential factors influencing the recovery of consciousness levels during the rehabilitation process of patients with prolonged disorders of consciousness (DOC) following brain injury, and to assess the impact of different treatment strategies on consciousness level recovery. Method：A retrospective analysis was conducted on clinical data, consciousness level scores, clinical medication usage, and rehabilitation treatment plans of 72 patients with DOC who were admitted to our rehabilitation medicine department from 2017 to 2022. Result：Factors such as difficulty in tracheostomy tube removal, hydrocephalus, elevated muscular tension abnormalities, poor infection control, and inadequate control of non-infectious complications significantly affected the improvement of consciousness levels. Regarding medications, the injection of botulinum toxin for muscular tension control and the use of amantadine had a significant impact on improving consciousness levels. The use of selective serotonin reuptake inhibitors (SSRIs) showed a trend towards improving consciousness levels, but the differences were not statistically significant. Conclusion：During the rehabilitation process of patients with DOC following brain injury, addressing factors that influence consciousness levels is crucial. These factors include effective infection control, management of complications, early removal of tracheostomy tubes when feasible, active management of hydrocephalus, local injection of botulinum toxin to control elevated muscular tension, and the use of medications that may improve consciousness levels, such as amantadine and SSRIs. [ABSTRACT FROM AUTHOR]

Intangible cultural heritage is the carrier of national memory and a historical witness. Exploring the spatial distribution and chronological evolution of intangible cultural heritage is of great significance to understand the cultural integrity and historical continuity. Taking the intangible cultural heritage along the Grand Canal as an example, this study carries out spatial deconstruction based on the extent of the spread of intangible cultural heritage and reveales the aggregation pattern through spatial autocorrelation analysis. Then, the historical process and the spatial center of gravity are shown through an evolution tree model. The influencing factors are illustrated via the methods of Geodetector and qualitative analysis. The results are as follows: (1) The two ends of the canal exhibit obvious advantages in the number of intangible cultural heritage items; however, the existence of a spatial mismatch at the city–county level makes the southern endpoint occupy a dominant position. (2) Although there is a high–high aggregation pattern along the whole canal, 29.82% of the counties are distributed widely with low–low aggregation. (3) The spatial center of intangible cultural heritage items from different historical periods generally presents a changing path from north to south and returning north. (4) Intangible cultural heritage items are mainly distributed in areas with a prosperous culture, a high level of economic development, and strong policy and financial support from government. Changes in the natural environment, population migration, economic development, war disasters, and canal shipping have profound impacts over time. This study provides a new idea for the methodological advancement of spatial distribution of intangible cultural heritage, as well as studies on local cultural identity and regional consistency. [ABSTRACT FROM AUTHOR]

Colleges and universities are large consumers of energy, with a huge potential for building energy efficiency, and need to reduce energy consumption to build a low-carbon, energy-saving campus. Predicting the energy consumption of campus buildings can help to accurately manage the electricity consumption of buildings and reduce the energy consumption of buildings. However, the electricity consumption of a building's operation is affected by many factors, and it is difficult to establish a model for analysis and prediction. Therefore, in this study, the training building of the BIM education center on campus was selected as the research object, and a digital twin O&M platform was established by integrating IoT, digital twin technology (DDT), smart meter monitoring devices, and indoor environment monitoring devices. The O&M management platform can monitor real-time changes in indoor power consumption data and environmental parameters, and organize data on multiple influencing factors and power consumption. Following training, validation, and testing, the machine learning models (back propagation neural network, support vector model, and multiple linear regression model) were assessed and compared for accuracy. Following the multiple linear regression and support vector models, the backpropagation neural network model exhibited the highest accuracy. Consistent with the actual power consumption detection results in the BIM education center, the backpropagation neural network model produced results. Consequently, the BP model created in this study demonstrated its dependability and ability to forecast campus building power usage, assisting the university in organizing its energy supply and creating a campus that prioritizes conservation. [ABSTRACT FROM AUTHOR]

This study focuses on the potential quantity of soil lead (Pb) remediation in a typical karst region of China, an area where previous research on the potential remediation quantity of Pb in soil has been scarce. In this study, 12,547 surface soil samples and 54 sets of soil-profile samples were collected. This analysis investigated the sources, concentrations, distribution, and reserve properties of soil Pb in the study region. Building upon these findings, a formula for calculating the potential remediation quantity of Pb in karst soils was derived. The results disclose variations in Pb content within the surface soil, with values spanning from 9.4 to 376.4 mg/kg and a background level of 72.97 mg/kg. Additionally, the Pb content in deep soil shows a spectrum from 1.6 to 160.9 mg/kg. Principal component analysis showed that the sources of Pb in karst soil were related to the geological background, agricultural fertilization, and mineral resources. Single-factor variance analysis demonstrated significant influences of topography, parent rock type, soil utilization, and soil type on soil Pb content. The spatial distribution of soil Pb, as determined by principal component analysis, was influenced by mineral distribution, geological background, and agricultural fertilization. The soil profile analysis showed that Pb concentrations followed a logarithmic distribution pattern with increasing depth. A formula for the potential remediation quantity of Pb was derived using a logarithmic model. This rational and representative formula establishes a foundation for the management of Pb-influenced soils in karst regions. [ABSTRACT FROM AUTHOR]

Background: Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach. Methods: This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey. Results: Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters. Conclusions: Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way. [ABSTRACT FROM AUTHOR]

In this article, main process data, notably time–series data such as lance position patterns, are analyzed during converter steelmaking, and methodologies in data processing and transforming are proposed. In this study, utilizing both the transformed key time–series and primary static process data, the influence of various process parameters on the end‐point parameters of converter steelmaking is analyzed. Furthermore, it establishes predictive models for the end‐point content of carbon (C) and phosphorus (P), as well as the end‐point temperature. In the findings, it is indicated that the end‐point carbon content and temperature are primarily influenced by the oxygen flow pattern, lime addition pattern, and key smelting parameters. The end‐point phosphorus content is mainly affected by the oxygen flow pattern, limestone addition pattern, and dolomite addition pattern. Regarding the prediction of end‐point carbon and phosphorus content, and end‐point temperature, compared to seven sub‐models, the hybrid model demonstrates an average accuracy improvement of 37.88%, 25.03%, and 31.51%, respectively, and the end‐point hit rate improves by 18.77%, 19.59%, and 20.41%, respectively. [ABSTRACT FROM AUTHOR]

Background: Patient experience plays an essential role in improving clinical effectiveness and patient safety. It's important to identify factors influencing patient experience and to improve quality of healthcare. Objective: To identify factors that influence patient experience in hospital wards. Methods: We conducted a systematic review including six databases; they were PubMed, CINAHL, Embase, PsycInfo, ProQuest, and Cochrane. Studies were included if they met the inclusion criteria. The JBI checklist was used to perform quality appraisal. We used 5 domains of the ecological model to organize and synthesize our findings to comprehensively understand the multi-level factors influencing the issue. Result: A total of 138 studies were included, and 164 factors were identified. These factors were integrated into 6 domains. All domains but one (survey-related factors) could be mapped onto the attributes of the ecological framework: intrapersonal, interpersonal, institutional, community, and public policy level factors. All factors had mixed effect on patient experience. The intrapersonal level refers to individual characteristics of patients. The interpersonal level refers to interactions between patients and healthcare providers, such as the caring time spent by a nurse. The institutional level refers to organizational characteristics, rules and regulations for operations, such as hospital size and accreditation. The community level refers to relationships among organizations, institutions, and informational networks within defined boundaries, such as a hospital located in a larger population area. Public policy level refers to local, state, national, and global laws and policies, including health insurance policies. The sixth domain, survey-related factors, was added to the framework and included factors such as survey response rate and survey response time. Conclusion: The factors influencing patient experience are comprehensive, ranging from intrapersonal to public policy. Providers should adopt a holistic and integrated perspective to assess patient experience and develop context-specific interventions to improve the quality of care. PROSPERO registration number CRD42023401066: [ABSTRACT FROM AUTHOR]

Objective To systematically review the current status and influencing factors of psychological resilience in stroke patients and to provide a theoretical basis for future personalized rehabilitation support and psychological interventions. Method This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A comprehensive search of databases including PubMed, Web of Science, Medline, PsycINFO, CINAHL, Cochrane Library, CNKI, VIP, CMB, and WANGFANG was conducted from inception until November 22, 2023, resulting in the retrieval of 2099 studies. Literature screening and data extraction were performed by two independent evaluators based on pre-defined inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software. Results The final review included 23 studies. The results showed that self-efficacy, hope, confrontation coping, avoidance coping, functional independence, quality of life, and social support were positively associated with psychological resilience. Conversely, anxiety, depression, and resignation coping were negatively associated with psychological resilience. Conclusions Patients with stroke have a low level of psychological resilience, which was influenced by a variety of factors. However, longitudinal and large sample studies are needed to further confirm these findings. These results should be integrated into clinical practice for early assessment and targeted intervention in psychological resilience to assist patients in coping with the rehabilitation process and life changes after a stroke. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy and childbirth bring not only joy but also a concomitant sense of insecurity, which may adversely affect health, role adaptation, and relationships. This study aimed to explore the risk factors for postpartum mothers' sense of security. Methods: This cross‐sectional study used questionnaires on Parents' Postnatal Sense of Security, Tilburg Pregnancy Distress Scale, and the Emotional Inhibition Scale. Structural equation modeling was used to calculate the mediating effect. Results: The mean postnatal maternal security value was 44.77 ± 9.02. Multiple regression analyses revealed that several factors, including companionship of the partner during pregnancy, number of prenatal visits accompanied by the partner, complications during pregnancy, pregnancy distress, and emotional inhibition, independently predicted maternal security. Moreover, our structural equation model revealed that emotional inhibition significantly influenced maternal postpartum security directly (β = −0.30, P < 0.001). In addition, pregnancy distress affected maternal security directly (β = −0.45, P < 0.001) and indirectly (β = −0.129, P < 0.001) through emotional inhibition. Conclusion: This study indicated a lower level of postpartum maternal sense of security. Emotional inhibition partially mediates the relationship between postpartum maternal sense of security and pregnancy distress. Therefore, health care professionals providing guidance to pregnant and postpartum women on proper emotional regulation and early identification of pregnancy distress may be more effective in enhancing their postpartum sense of security. Synopsis: In China, postpartum mothers generally have a low sense of security, and emotional inhibition mediates the relationship between maternal postpartum security and pregnancy distress. [ABSTRACT FROM AUTHOR]

To compare the transcutaneous oxygen pressure (tcpO2) measurement values and changes in compressed areas of surgical patients before and after surgery and to explore the related factors influencing the tcpO2 changes before and after surgery. Researchers selected 100 patients who underwent elective surgery in a tertiary comprehensive hospital from November 2021 to September 2022. A self-designed general information questionnaire was used to collect patient general information and disease-related data, including gender, age, smoking and drinking history, hypertension, diabetes, local skin temperature and humidity, related biochemical indicators, and activities of daily living score. Researchers used a transcutaneous oxygen pressure meter to measure and record the tcpO2 of the compressed areas (sacrococcygeal area, scapula area, and heel area) before and after surgery. Among the 100 patients, 37.00 % (37/100) developed type I/II pressure ulcers after surgery, and 30 patients (81.08 %) showed regression within 2 h after surgery. There was no statistically significant difference in the preoperative tcpO2 measurement values of the scapula and heel areas between the group with and without pressure ulcers, but the preoperative tcpO2 measurement value of the sacrococcygeal area in the group without pressure ulcers was higher than that in the group with pressure ulcers (P < 0.01). The factors affecting the preoperative tcpO2 measurement value of the sacrococcygeal area were smoking and surgical type. After surgery, the tcpO2 measurement values of the three areas in the group with pressure ulcers were significantly lower than those in the group without pressure ulcers (P < 0.01). Comparing the tcpO2 values of different areas, it was found that the tcpO2 value was lowest in the sacrococcygeal area, followed by the heel area, and the tcpO2 value in the scapula area was highest both before and after surgery (P < 0.01). The main factors affecting the postoperative tcpO2 measurement value were diabetes, Glassgow score, surgical time, and intraoperative red blood cell transfusion. The measurement of tcpO2 is related to the incidence of surgically acquired pressure ulcers, and this technology may become an important tool for quantitative assessment of the risk of pressure ulcers. [ABSTRACT FROM AUTHOR]

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