OBJECTIVE: This study aims to conduct an extensive analysis of autoimmune bullous diseases, particularly pemphigus vulgaris and bullous pemphigoid, in Shanghai, China, from 2016 to 2023. It seeks to understand the demographic profiles, comorbidities, mortality rates, risk factors, and socioeconomic impacts associated with autoimmune bullous disease.
METHODS: A cross-sectional study design was employed, enrolling 1,072 patients. Diagnostic measures included clinical manifestations, histopathology, direct immunofluorescence, and serologic tests. The study also involved a detailed socioeconomic analysis and evaluation of occupational risks.
RESULTS: The findings highlight a significant occupational risk in industries requiring enhanced safety measures, with a notable prevalence of autoimmune bullous disease among workers in these sectors. A considerable portion of the patients were from low-income backgrounds with limited literacy, indicating the economic burden of autoimmune bullous disease. A key discovery of the study is the potential pathological link between autoimmune bullous disease and interstitial lung disease.
CONCLUSIONS: This research, one of the first comprehensive studies on autoimmune bullous disease in China, underscores the need for targeted healthcare strategies and further investigation into autoimmune bullous disease, particularly its relationship with interstitial lung disease.

OBJECTIVE: This study aims to extend the Theory of Planned Behavior with Triggers (TPBT) to improve the prediction of physical activity (PA) behavior using the TPB model.
METHODS: Questionnaires, including the TPB scale, PA rating scale (PARS-3), and triggers scale, were administered to 596 Chinese college students, and the data were analyzed using SPSS 23.0 and AMOS 24.0.
RESULTS: Subjective norm (SN), attitude (AT), and perceived behavioral control (PBC) all significantly and positively affected behavioral intention (BI). The path coefficient of PA behavior was significantly influenced by the interaction term of three types of triggers and BI, and the TPB with Triggers (TPBT) model improved the explanation rate of PA behavior.
CONCLUSIONS: Triggers have a moderating effect on the relationship between BI and PA behavior, and the TPBT model better explains college students\' PA behavior. Among the three dimensions of triggers, people are more receptive to facilitator and signal triggers than spark triggers. This has practical implications for practitioners designing interventions to promote PA among college students.

Intelligent responsive packaging provides informative feedback or control the release of active substances like antimicrobial agents in response to stimuli in food or the environment to ensure food safety. This paper provides an overview of two types of intelligent packaging, information-responsive and intelligent controlled-release, focusing on the recent research progress of intelligent controlled-release antimicrobial packaging with enzyme, pH, relative humidity, temperature, and light as triggering factors. It also summarizes the current status of application in different food categories, as well as the challenges and future prospects. Intelligent controlled-release technology aims to optimize the antimicrobial effect and ensure the quality of food products by synchronizing the release of active substances with food preservation needs through sensing stimuli, which is an innovative and challenging packaging technology. The paper seeks to provide a reference for the research and industrial development of responsive intelligent packaging and controlled-release packaging applications in food.

The occurrence of gastroesophageal reflux disease (GERD) and symptom onset are closely associated with diet. We aimed to compare the dietary and lifestyle triggers between non-erosive reflux disease (NERD) and reflux esophagitis (RE) in Chinese patients and to provide evidence for development of practical dietary modifications for GERD. A multicenter cross-sectional survey was conducted. A total of 396 GERD patients with typical gastroesophageal reflux symptoms who received upper endoscopy in the previous month were enrolled, including 203 cases of NERD patients and 193 cases of RE patients. All participants completed questionnaires including demographic data, reflux symptoms, previous management, dietary and lifestyle habits, triggers of reflux symptoms, psychological status, and quality of life. There were no significant differences in GERD symptom scores between NERD and RE. RE patients had a higher male proportion and smoking/drinking and overeating rates than NERD patients. In the NERD group, more patients reported that fruits, dairy products, yogurt, bean products, cold food, and carbonated beverages sometimes and often induced reflux symptoms and had more triggers compared to RE patients. The number of triggers was positively correlated to GERD symptom score and GERD-HRQL score in both NERD and RE patients. However, 74.0% of GERD patients still often consumed the triggering foods, even those foods that sometimes and often induced their reflux symptoms, which might be related to the reflux relapse after PPI withdrawal considering NERD and RE patients had similar GERD symptom severity. There were some differences in terms of dietary habits, dietary and lifestyle triggers, and related quality of life between NERD and RE, and these results may provide evidence of different approaches toward the dietary modification of NERD and RE patients.

BACKGROUND: This study aimed to develop a Physical Activity Triggers Questionnaire for Chinese college students and to evaluate its reliability and validity.
METHODS: On the theoretical basis of the Fogg behavior model and semi-open interviews, an initial questionnaire with 18 items was compiled. The initial questionnaire was administered to 575 students, and to examine its reliability and validity, item discrimination analysis, correlation analysis, homogeneity test, and exploratory factor analysis were conducted using SPSS 26.0. After the examination of the initial questionnaire, the initial 18 items were reduced to 14. The 14-item questionnaire was administered to 621 college students, and with the data, correlation analysis, confirmatory factor analysis, validity test, and reliability test were conducted.
RESULTS: To examine the psychometric properties of the 18 items, exploratory factor analysis and confirmatory factor analysis were conducted, and their reliability and validity were examined. After the first round of item development analysis, four items were removed, and a triggers questionnaire with 14 items was developed. The 14 items had three dimensions, including spark, signal, and facilitator triggers, and the cumulative explained variance of the three dimensions was 61.21%. The confirmatory factor analysis of the three dimensions of the 14 items indicated appropriate scale fit indices. The internal consistency reliability, split-half reliability, and test-retest reliability of the 14 items were 0.925, 0.821, and 0.860, respectively, showing that the items have appropriate reliability.
CONCLUSIONS: The Physical Activity Triggers Questionnaire of the study has acceptable reliability and validity. It is the first questionnaire to measure Chinese college students\' triggers of physical activity and will provide a new basis for the understanding of psychometric properties of physical activity triggers. In addition, the future findings collected from the developed triggers questionnaire can be used to develop strategies to promote health among college students.

Asthma is common in eosinophilic granulomatosis with polyangiitis (EGPA), and the annual incidence of EGPA in patients with asthma is much higher compared with the general population, and the trigger factor for this is unknown. We report a case of a 19-year-old male with a background of severe asthma who presented with eosinophilic lung infiltration after viral infection, which progressed to clinical EGPA. The diagnosis of EGPA was supported by an initial clinical presentation of recurrent cough and wheezing accompanied by a red rash, followed by peripheral eosinophilia, a high eosinophil percentage in bronchoalveolar lavage fluid (BALF), and migratory pulmonary eosinophilic infiltrates. Lung biopsy showed blood vessels with extravascular eosinophils. The patient responded well to high-dose glucocorticoids and cyclophosphamide, and symptoms and biochemical markers improved. Our literature review identified few reports on the triggers of EGPA, which highlights that viral infection may be a risk factor for asthma that progresses to EGPA.

In INTERSTROKE, we explored the association of anger or emotional upset and heavy physical exertion with acute stroke, to determine the importance of triggers in a large, international population.
INTERSTROKE was a case-control study of first stroke in 32 countries. Using 13 462 cases of acute stroke we adopted a case-crossover approach to determine whether a trigger within 1 hour of symptom onset (case period), vs. the same time on the previous day (control period), was associated with acute stroke. A total of 9.2% (n = 1233) were angry or emotional upset and 5.3% (n = 708) engaged in heavy physical exertion during the case period. Anger or emotional upset in the case period was associated with increased odds of all stroke [odds ratio (OR) 1.37, 99% confidence interval (CI), 1.15-1.64], ischaemic stroke (OR 1.22, 99% CI, 1.00-1.49), and intracerebral haemorrhage (ICH) (OR 2.05, 99% CI 1.40-2.99). Heavy physical exertion in the case period was associated with increased odds of ICH (OR 1.62, 99% CI 1.03-2.55) but not with all stroke or ischaemic stroke. There was no modifying effect by region, prior cardiovascular disease, risk factors, cardiovascular medications, time, or day of symptom onset. Compared with exposure to neither trigger during the control period, the odds of stroke associated with exposure to both triggers were not additive.
Acute anger or emotional upset was associated with the onset of all stroke, ischaemic stroke, and ICH, while acute heavy physical exertion was associated with ICH only.

The shortened Abstract is as follows: Therapeutic gas nitric oxide (NO) has demonstrated the unique advances in biomedical applications due to its prominent role in regulating physiological/pathophysiological activities in terms of vasodilation, angiogenesis, chemosensitizing effect, and bactericidal effect. However, it is challenging to deliver NO, due to its short half-life (<5 s) and short diffusion distances (20-160 µm). To address these, various polymeric NO delivery nanoplatforms (PNODNPs) have been developed for cancer therapy, antimicrobial and cardiovascular therapeutics, because of the important advantages of polymeric delivery nanoplatforms in terms of controlled release of therapeutics and the extremely versatile nature. This reviews highlights the recent significant advances made in PNODNPs for NO storing and targeting delivery. The ideal and unique criteria that are required for PNODNPs for treating cancer, cardiovascular diseases and infection, respectively, are summarized. Hopefully, effective storage and targeted delivery of NO in a controlled manner using PNODNPs could pave the way for NO-sensitized synergistic therapy in clinical practice for treating the leading death-causing diseases.

BACKGROUND: Recent studies have reported that the incidence of acne combined with rosacea is increasing. However, the clinical feature and inducing factor of these two diseases co-occurrence is remain unclear.
OBJECTIVE: This study aims to investigate the classification and severity of female patients combining with acne and rosacea.
METHODS: Female patients with facial acne combined with rosacea, 15-50 years old, were included from dermatology outpatient department from January 2019 to December 2019. The severity of acne was classified according to the Pillsbury grading system. Rosacea was diagnosed and classified according to the Standard issued by National Rosacea Society Expert Committee. Questionnaire was designed to collect the information of rosacea triggers from each patient.
RESULTS: 563 vulgaris acne combined with rosacea patients (mean age 23.2 ± 43), included 70.33% severe acne (n = 396), 15.81% moderate acne(n = 89), and 13.85% mild acne(n = 78), had finished the study. In severe acne group, 72.47% combine with erythematotelangiectatic rosacea (ETR), 22.47% combined with papulopustular rosacea (PPR), and 5.05% combine with phymatous rosacea (PHR). In moderate acne group, 53.93% combine with ETR, 43.82% combined with papulopustular rosacea (PPR), and 2.24% combine with PHR. All patients in moderate acne subject group was combined with ETR (100%). Patients that did not use skin care produces presented 12.79 times higher rate to combine with ETR than that frequently using skin care products (P = .014).
CONCLUSIONS: Erythema telangiectasia rosacea is the most common rosacea type in female acne patients. There is a need to be vigilant about the combination of sever/moderate acne and papulopustular rosacea. Rational daily use of skin care products can reduce the incidence of rosacea in acne patients. For acne patients without family history of rosacea, dermatologists should also not ignore the healthy education to avoid potential triggers of rosacea.

The Global Trigger Tool (GTT),which is a method using \"triggers\" to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs.
The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People\'s Hospital.
Thirty-three preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 admissions were 49.0. ADEs/1000 patient days were 46.89. The most common ADE categories were leukocyte disorders, skin disorders and platelet disorders. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs.
The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.