OBJECTIVE: To explore the factors that influence the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-ICC).
METHODS: Between September 2014 to July 2020, the CEUS features of 58 patients with pathologically confirmed cHCC-ICC were retrospectively evaluated and assigned according to the CEUS LI-RADS (version 2017). The pathological characteristics of nodules categorizing as different CEUS LI-RADS categories were compared. Multivariate logistic regression analysis was conducted to explore potential factors that may influence the CEUS LI-RADS classification of cHCC-ICC.
RESULTS: According to CEUS LI-RADS, 32.8% (19/58), 63.8% (37/58), and 3.4% (2/58) were categorized as LR-5, LR-M, and LR-TIV, respectively. There was significant difference between the LR-M and LR-5 groups with regard to the pathological grade, nodule size, and HCC/ICC-component ratio of cHCC-ICC. Multivariate logistic regression analysis identified tumor size and the relative proportions of hepatocellular carcinomas (HCC) and intrahepatic cholangiocarcinomas (ICC) components as the independent influencing factors.
CONCLUSIONS: Tumor size and the relative proportion of HCC and ICC components within the nodule had a significant impact on the CEUS LI-RADS classification of cHCC-ICC.

UNASSIGNED: Myopia is a significant public health problem across the globe. This study aimed to examine the regional disparity in prevalence and correlated factors of myopia in children and adolescents in two typical regions, Gannan Tibetan Autonomous Prefecture (Gannan Prefecture for short, a Tibetan residential area) and Wuwei City (a Han residential area) in Gansu Province, China, and to provide a reference for the prevention and control of regional myopia.
UNASSIGNED: The study was a cross-sectional study of children and adolescents in Gansu Province, China. A total of 6,187 (Wuwei City: 3,266, Gannan Tibetan Autonomous Prefecture: 2,921) students were selected by stratified cluster sampling. Eye examinations and questionnaires were administered to the participants. Myopia is defined as a condition in which the spherical equivalent refractive error of an eye is less than or equal to -0.50 D when ocular accommodation is relaxed. The χ2 test and multivariate logistic regression analysis were used to analyze the correlated factors of myopia.
UNASSIGNED: The myopia rate of 6,187 students was 71.4%, and students had a higher rate of myopia (77.5%) in Wuwei City compared to Gannan Prefecture (64.6%) (p < 0.001). The results of multivariate analysis in Wuwei City showed that girls (odds ratio (OR) = 1.325), junior students (OR = 2.542), senior students(OR = 4.605), distance between eyes and book less than one foot (OR = 1.291), and parents with myopia (one, OR = 2.437; two, OR = 4.453) had higher risks of myopia (all, p < 0.05). For Gannan Prefecture, girls (OR = 1.477), senior students (OR = 1.537), daily time spent doing homework ≥2 h (OR = 1.420), the distance between eyes and book less than one foot (OR = 1.205), mean time continuous eye use (0.25-<0.5 h, OR = 1.345, 0.5-<1 h, OR = 1.317, ≥1 h, OR = 1.313), average daily sleep duration <8 h (OR = 1.399), and parents with myopia (one, OR = 1.852; two, OR = 2.913) had higher risks of myopia (all, p < 0.05).
UNASSIGNED: The prevalence of myopia is at a relatively high level in Gansu Province. The prevalence and risk factors for myopia vary by region.

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.

This study examined the elimination of sulfonamide antibiotics (SAs) by constructed wetland substrates with NaOH-modified corn straw biochar and assessed the impact of environmental conditions on the effectiveness of SAs removal. The study demonstrated that the constructed wetland substrate with NaOH-modified biochar significantly eliminated eight SAs, with a removal rate of over 94 %. During the removal process, the intermediates will undergo regeneration of the parent compounds under low DO concentrations. This was based on the linear stepwise regression analysis and Geodetector models. The results showed that SA types COD, NH4+-N, TN, and DO had a stronger influence. The dominant bacteria in the constructed wetland system were mainly affected by antibiotic concentration, DO, NH4+-N and NO3--N, which affected the removal of antibiotics. Overall, the constructed wetland substrate with NaOH-modified corn straw biochar can be effectively employed as an ecological method for eliminating SAs from the environment.

Ecosystem services are fundamental to human survival on Earth, but studies on ecosystem service value of groundwater (ESV-G) are rare. The multiscale characteristics and influencing factors of ESV-G in China from 2000 to 2020 were analyzed in this study. The results showed that ESV-G decreased first and then increased, the average ESV-G was 130.30 thousand yuan/km2, and ESV-G tended to shift towards middle level (second to fourth class). The Hu Line was the dividing line between the first class (more than half area) and the others. The AI and FRAC values indicated that the patches of ESV-G were more concentrated, with simpler shapes that were more amenable to governance at the province scale. Hot spots and cold spots were mainly located in the eastern and western parts of Hu Line, respectively. The ESV-G of the cold spots per unit area at the province scale was higher than that at the city scale, which indicated that the province scale had the potential for higher ESV-G per unit area and cost advantage. Precipitation and temperature were the main factors affecting ESV-G; the influence of human activities on ESV-G increased on a larger scale as time went by. Combination of precipitation and Digital Elevation Model (DEM) had the greatest influence on ESV-G among the combinational influencing factors. The province scale was the optimal scale to manage ESV-G. Climate change had led to the expansion of hot and cold spots of ESV-G, northern and southern areas should combine existing policies to carry out differentiated governance. This study extended the scope of ecosystem service value studies from land surface to underground, providing a scientific basis for the management of groundwater ecosystem.

UNASSIGNED: To investigate the factors influencing accelerated aging in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD).
UNASSIGNED: 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.
UNASSIGNED: 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 triglyceride-glucose 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.
UNASSIGNED: 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.

The Hemiptera insects are the largest incomplete metamorphosis insect group in Insecta and play a vital role in ecosystems and biodiversity. Previous studies on the spatial distribution of Hemiptera insects mainly focused on a specific region and insect, this study explored the spatial distribution characteristics of Hemiptera insects in China (national scale), and further clarified the dominant factors affecting their spatial distribution. We used spatial autocorrelation analysis, hot spot analysis, and standard ellipse to investigate the spatial distribution characteristics of Hemiptera insects in China. Furthermore, we used geographic detectors to identify the main factors affecting their spatial distribution under China\'s six agricultural natural divisions and explore the influencing mechanism of dominant factors. The results show that: (i) The spatial differentiation characteristics of Hemiptera insects in China are significant, and their distribution has obvious spatial agglomeration. The Hu Huanyong Line is an important dividing line for the spatial distribution of Hemiptera insects in China. From the city scale, the HH type (high-high cluster) is mainly distributed on both sides of the Hu Huanyong Line. (ii) The hot spots of Hemiptera insects are mainly distributed in southwest China, along the Qinling Mountains, the western side of the Wuyi Mountains, the Yinshan Mountains, the Liupanshan Mountains, the Xuefeng Mountains, the Nanling Mountains, and other mountainous areas. (iii) Under agricultural natural divisions, the influence of natural environmental factors on the spatial distribution of Hemiptera insects is obviously different. Temperature and precipitation are the dominant factors. Natural factors and socio-economic factors have formed a positive reinforcement interaction mode on the spatial distribution of Hemiptera insects. These can provide the decision-making basis for biodiversity conservation and efficient pest control.

UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated.
UNASSIGNED: 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.

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.

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.
CONCLUSIONS: 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.