Rivers worldwide are warming due to the impact of climate change and human interventions. This study investigated river heatwaves in the Vistula River Basin, one of the largest river systems in Europe using long-term observed daily river water temperatures from the past 30 years (1991-2020). The results showed that river heatwaves are increased in frequency and intensity in the Vistula River Basin. The total number of river heatwaves showed clear increasing trend with an average rate of 1.400 times/decade, the duration of river heatwaves increased at an average rate of 14.506 days/decade, and the cumulative intensity of river heatwaves increased at an average rate of 53.169 °C/decade. The Mann-Kendall (MK) test was also employed, showing statistically significant increasing trends in the total number, duration, and intensity of heatwaves for all rivers, including the main watercourse of the Vistula River and its tributaries, with few exceptions. Air temperature is the major controller of river heatwaves for each hydrological station, and with the increase of air temperatures, river heatwaves will increase in frequency and intensity. Another impacting factor is flow, and with the increase of flow, river heatwaves tend to decrease in number, duration and intensity. The results suggested that mitigation measures shall be taken to reduce the effect of climate change on river systems.

Dust events in Northwest China have become more variable under regional climate change. Prior research has largely overlooked the spatial-temporal distribution of dust event duration (DED) and its long-term trend. This study systematically analyzed the spatial and temporal variations of DED in Northwest China and explored their associated factors using satellite-derived air quality datasets during 2000-2021. We find that dust event frequency (DEF) and DED generally showed a significant decreasing trend since 2000, but in 2013, DEF and DED started to rebound, with DED in particular, showing a more pronounced rebound in most parts of Northwest China. Correlation analysis with many factors suggests that the rise in near-surface wind speed since 2013 may primarily account for the increase in DEF and DED by enhancing dust generation and suppressing dust dry deposition processes. Further projections reveal that regions close to dust sources are likely to have more frequent and prolonged dust events, while areas far from dust sources will experience a decrease in DEF and DED in the future. These findings are crucial for understanding dust event variations and for guiding local dust management strategies.

This letter discusses the publication by Feng et al. Iodine, selenium, and vitamin D are closely associated with thyroid hormone production in humans; however, the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus (T2DM) patients with Hashimoto\'s thyroiditis (HT) remains controversial. In the retrospective study we discuss herein, the authors highlighted significant improvements in thyroid function, thyroid antibodies, blood glucose, and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens, underscoring the value of these supplements. Our team is currently engaged in research exploring the relationship between micronutrients and HT, and we have obtained invaluable insights from the aforementioned study. Based on this research and current literature, we recommend a regimen of 4000 IU/day of vitamin D and 100-200 μg/day of selenium for over three months to six months for patients with HT, particularly for those with concurrent T2DM.

UNASSIGNED: Although impaired auditory mismatch negativity (MMN) has consistently been found in individuals with schizophrenia, there are few and inconsistent reports on nonclinical individuals with schizotypy. To date, no studies have thoroughly assessed MMN with different degrees of deviant oddballs in nonclinical schizotypal samples. The aim of this study was to examine the extent of duration MMN (dMMN) amplitudes under two deviant duration conditions (large and small) in nonclinical participants with high schizotypal traits.
UNASSIGNED: An extreme-group design was utilized, in which 63 participants from the schizotypy and control groups were selected from a pool of 1519 young adults using the Schizotypal Personality Questionnaire (SPQ). MMN was measured using passive duration oddball paradigms. Basic demographic information and musical backgrounds were assessed and matched, while depression and anxiety were evaluated and controlled for. The repeated measures analysis of covariance was utilized to evaluate differences in dMMN between groups. The Bonferroni correction was applied for multiple comparisons. Partial correlation and multiple linear regression analyses were conducted to investigate the association between dMMN amplitudes and SPQ scores.
UNASSIGNED: The amplitudes of dMMN at Cz were significantly increased under the large deviance condition in nonclinical schizotypal individuals (F = 4.36, p = .04). Large-deviance dMMN amplitudes at Fz were positively correlated with mild cognitive-perceptual symptoms in the control group (rp = .42, p = .03). However, as schizophrenia-like symptoms worsened and approached the clinical threshold for schizophrenia, small-deviance dMMN amplitudes at Cz showed negative associations with the cognitive-perceptual factor in the schizotypy group (rp = -.40, p = .04).
UNASSIGNED: These results suggest the importance of considering the degree of deviation in duration when implementing the auditory oddball paradigm among nonclinical participants with schizotypal traits. In addition, our findings reveal a potential non-linear relationship between bottom-up auditory processing and the positive dimension of the schizophrenia spectrum.

OBJECTIVE: To evaluate the duration of subsyndromal delirium (SSD) in intensive care unit (ICU) patients and the factors associated with SSD duration.
METHODS: This retrospective study included adult patients admitted to the ICU of Affiliated Hospital of Nantong University between December 2019 and June 2020. All patients with Richmond Agitation Sedation Scale scores of ≥-2 were evaluated every 8 h using the confusion assessment method of the intensive care unit (CAM-ICU) until the patients with SSD were negative, progressed to delirium, fell into a coma, died, or were discharged from the ICU. Multivariable Cox regression analyses were performed to determine the factors associated with SSD duration.
RESULTS: Of the 388 patients, 53.6% had SSD, and 20.7% progressed from SSD to delirium. The duration of SSD ranged from 8 to 248 h, and the median duration was 48 h (interquartile range, 24-72). Age (hazard ratio [HR] = 0.985, 95% confidence interval [CI], 0.971-0.999, p = 0.035), surgery or not (HR = 0.514; 95% CI, 0.310-0.850; p = 0.010), duration of ventilation (HR = 1.003; 95% CI, 1.000-1.006; p = 0.044), duration of hypoxia (HR = 0.212; 95% CI, 0.103-0.438; p < 0.001), and adapted cognitive exam scores (HR = 1.057; 95% CI, 1.030-1.085; p < 0.001) were independently associated with the duration of SSD.
CONCLUSIONS: The duration of SSD was associated with age, surgery, duration of ventilation, duration of hypoxia, and cognitive function. SSD has a high incidence among ICU patients, and many patients progress to delirium.
UNASSIGNED: The study team met with public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation.
CONCLUSIONS: ICU staff should pay attention to SSD patients with older age, history of surgery, longer duration of ventilation, prolonged duration of hypoxia, and lower ACE scores.

OBJECTIVE: The aim of this work was to resolve the uncertainty of whether transfusion of fresher red blood cells (RBCs) is better or not with regard to the safety and efficacy.
METHODS: This systematic review was performed in accordance with our protocol registered on PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183).
RESULTS: After a literature search, 13,247 records were identified, and 26 randomized controlled trials (RCTs) involving 53,859 participants were eligible and included in this review. The results in our review suggested that there was no significant effect of fresher vs older RBCs on mortality (relative risk [RR] = 1.04; 95% CI, 0.99-1.09; P = .39; I2 = 0%), transfusion reactions (RR = 0.87; 95% CI, 0.57-1.33; P = .64; I2 = 0%). However, the transfusion of fresher RBCs might increase the risk of nosocomial infection (RR = 1.11; 95% CI, 1.02-1.20; P = .02; I2 = 0%), whereas there was no significant difference in the fresh vs old subgroup (RR = 0.87; 95% CI, 0.68 to 1.12; P = .28; I2 = 0%).
CONCLUSIONS: Our study updated and reinforced the evidence of previously published systematic reviews that support the safety and efficiency of current practice of issuing the oldest available RBCs in the blood bank inventory.

Dietary supplement use is common among US adults. We aimed to investigate the quantity, duration, adherence, and reasons for supplement use in individuals who take supplements. Data from 2011 to 2018 from the National Health and Nutrition Examination Survey (NHANES) dataset were analyzed. Four cycles of data were combined to estimate these outcomes. Results are presented as overall group and by subgroups. All analyses were weighted to be nationally representative. The Taylor Series Linearization approach was used to generate variance estimates. A total of 12,529 participants were included. Over 70% of these individuals reported taking more than one unit of dietary supplements daily. Notably, approximately 40% had been taking supplements for more than five years and about 67% were highly adherent to at least one supplement. However, only 26.9% of these supplements were taken following a doctor\'s recommendation. The primary reasons for dietary supplements intake included improving overall health (37.2%), maintaining health (34.7%), bone health (21.4%), and diet supplementation (20.3%). Our findings indicate that most participants proactively used multiple dietary supplements focused on self-managed health and prevention, with substantial dedication to long-term use and high adherence. Healthcare professionals should play a more active role in guiding such behaviors to optimize the health outcomes of dietary supplement users across the United States.

UNASSIGNED: Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder, which can cause serious damage to multiple human systems. Although polysomnography (PSG) is the current gold standard for diagnosis, it is complex and expensive. Therefore, it is of great significance to find a simple, economical and rapid primary screening and diagnosis method to replace PSG for the diagnosis of OSA.
UNASSIGNED: The purpose of this study is to propose a new method for the diagnosis and classification of OSA, which is used to automatically detect the duration of sleep apnea hypopnea events (AHE), so as to estimate the ratio(S) of the total duration of all-night AHE to the total sleep time only based on the sound signal of sleep respiration, and to identify OSA.
UNASSIGNED: We performed PSG tests on participants and extracted relevant sleep breathing sound signal data. This study is carried out in two stages. In the first stage, the relevant PSG report data of eligible subjects were recorded, the total duration of AHE in each subject\'s data was extracted, and the S value was calculated to evaluate the severity of OSA. In the second stage, only the sleep breath sound signal data of the same batch of subjects were used for automatic detection, and the S value in the sleep breath sound signal was extracted, and the S value was compared with the PSG diagnosis results to calculate the accuracy of the experimental method.
UNASSIGNED: Among 225 subjects. Using PSG as the reference standard, the S value extracted from the PSG diagnostic data report can accurately diagnose OSA(accuracy rate 99.56%) and distinguish its severity (accuracy rate 95.11%). The accuracy of the S value detected in the sleep breathing sound signal in the diagnosis of severe OSA reached 100%.
UNASSIGNED: The results show that the experimental parameter S value is feasible in OSA diagnosis and classification. OSA can be identified and evaluated only by sleep breathing sounds. This method helps to simplify the diagnostic grading of traditional OSA and lays a foundation for the subsequent development of simple diagnostic grading equipment.

UNASSIGNED: Azvudine was approved for the treatment of coronavirus disease 2019 (COVID-19) in China and has been widely used since the outbreak in December 2022. However, real-world research on the adherence of Azvudine is lacking. Additionally, limited research exists on determining the optimal duration for Azvudine treatment.
UNASSIGNED: We studied adult patients with COVID-19 who got Azvudine or supportive treatment at an outpatient department between December 19, 2022 and January 5, 2023. The enrolled patients were divided into two groups: the Azvudine group, which received Azvudine, and the control group, which only received supportive care. We recorded their information and analyzed it using descriptive statistics. The primary outcome of this study was the compliance of outpatients with Azvudine, and the secondary outcome of this study was the optimal duration of Azvudine. Inverse probability weighting (IPW) was used to address the imbalance between groups when comparing the optimal duration of Azvudine, and Cox regression to evaluate the effect of Azvudine on the 28-day disease progression rate.
UNASSIGNED: We enrolled a total of 882 patients, of which 382 received Azvudine. Among the patients, 94.0 % (359) had good compliance, and non-compliance was primarily attributed to dosage errors. Azvudine appeared to have a beneficial therapeutic effect when administered for at least 7 days.
UNASSIGNED: Outpatients have relatively good compliance with Azvudine, and optimal therapeutic effects were observed with the recommended duration of at least 7 days.

BACKGROUND: Bismuth-containing quadruple therapy is the first-line treatment for eradicating Helicobacter pylori (H. pylori). The optimal duration for H. pylori eradication using bismuth-containing quadruple therapy remains controversial. Therefore, we aimed to compare the clinical effects of the 10- and 14-day bismuth-containing quadruple treatment regimen to eradicate H. pylori.
METHODS: Treatment-naïve patients with H. pylori infection (n = 1300) were enrolled in this multicenter randomized controlled study across five hospitals in China. They were randomized into 10- or 14-day treatment groups to receive bismuth-containing quadruple therapy as follows: vonoprazan 20 mg twice daily; bismuth 220 mg twice daily; amoxicillin 1000 mg twice daily; and either clarithromycin 500 mg twice daily or tetracycline 500 mg four times daily. At least 6 weeks after treatment, we performed a 13C-urea breath test to evaluate H. pylori eradication.
RESULTS: The per-protocol eradication rates were 93.22% (564/605) and 93.74% (569/607) (p < 0.001) and the intention-to-treat eradication rates were 88.62% (576/650) and 89.38% (581/650) (p = 0.007) for the 10- and 14-day regimens, respectively. Incidence of adverse effects was lower in patients who received 10- vs. 14 days of treatment (22.59% vs. 28.50%, p = 0.016). We observed no significant differences in the compliance to treatment or the discontinuation of therapy because of severe adverse effects between the groups.
CONCLUSIONS: Compared with the 14-day bismuth-containing quadruple regimens, the 10-day regimen demonstrated a non-inferior efficacy and lower incidence of adverse effects. Therefore, the 10-day regimen is safe and tolerated and could be recommended for H. pylori eradication (NCT05049902).