Network structure of complex interactions of premenstrual syndrome and influencing factors in young adult women

BACKGROUND

In the transition phase from adolescence to adulthood, premenstrual syndrome (PMS) occurs more commonly, with a variety of symptoms. The occurrence of PMS may be the result of a combination of demographic, physiological, psychological and sociological factors. This study aimed to identify the central symptoms of PMS, and explored the complex influencing factors especially the one-to-one inter-relationships factors with specific symptoms.

METHOD

This is a cross-sectional study conducted in mainland China. 3458 young adult women were assessed. Using the Premenstrual Syndrome Scale (PSS) to assess the PMS, and PSS score was over 6 divided into PMS group, and vice versa. Influencing factors were assessed by a set of self-reported questionnaire. Network analysis was used to examined the interplay of PMS, whilst also considering the influencing factors of PMS.

RESULTS

In summary, 1479 participants were in PMS group. Anxiety had the highest strength centrality (1.12/1.09), shown higher centrality in the both network. Swelling of the hands or feet also shown higher strength centrality (0.89) in PMS group. PMS is associated with a higher history of dysmenorrhea, and neurotic personality. Neurotic personality - depressed mood/nervousness (0.27/0.23), history of dysmenorrhea - abdominal distension (0.21), had significantly higher weight than other edges in PMS group.

CONCLUSION

Anxiety was the most central symptom in the network, and was closely associated with other symptoms like depressed mood, which provided additional evidence for the centrality of emotional features in PMS. Moreover, the influencing factors of PMS combined demographic, physiological, psychological, and sociological factors. According to the central symptoms and factors affecting the specific PMS symptoms in young adult women, targeted intervention is helpful to prevent and alleviate PMS.

LIMITATION

Cross-sectional design cannot infer the directionality of the associations between variables. All data is self-reported with recall bias and the edge weights across the constructs of influencing factors and PMS were fairly small.

Multi-process production occurs in the iron and steel industry, supporting 'dual carbon' target: An in-depth study of CO2 emissions from different processes

Reducing CO2 emissions of the iron and steel industry, a typical heavy CO2-emitting sector, is the only way that must be passed to achieve the 'dual-carbon' goal, especially in China. In previous studies, however, it is still unknown what is the difference between blast furnace-basic oxygen furnace (BF-BOF), scrap-electric furnace (scrap-EF) and hydrogen metallurgy process. The quantitative research on the key factors affecting CO2 emissions is insufficient. There is also a lack of research on the prediction of CO2 emissions by adjusting industrial structure. Based on material flow analysis, this study establishes carbon flow diagrams of three processes, and then analyze the key factors affecting CO2 emissions. CO2 emissions of the iron and steel industry in the future is predicted by adjusting industrial structure. The results show that: (1) The CO2 emissions of BF-BOF, scrap-EF and hydrogen metallurgy process in a site are 1417.26, 542.93 and 1166.52 kg, respectively. (2) By increasing pellet ratio in blast furnace, scrap ratio in electric furnace, etc., can effectively reduce CO2 emissions. (3) Reducing the crude steel output is the most effective CO2 reduction measure. There is still 5.15 × 108-6.17 × 108 tons of CO2 that needs to be reduced by additional measures.

Influence of soil composition and environmental factors on the adsorption of per- and polyfluoroalkyl substances: A review

Per- and polyfluoroalkyl substances (PFASs) have garnered considerable scientific and regulatory scrutiny due to their widespread distribution across environments and their potential toxicological impacts on human health. The pedosphere serves as a vital reservoir for these chemicals, significantly determining their environmental trajectory and chemical transformations. This study offers a comprehensive synthesis of the current understanding regarding the adsorption mechanics of PFASs in soil matrices. Due to their unique molecular structure, PFASs predominantly engage in hydrophobic and electrostatic interactions during soil adsorption. This work thoroughly evaluates the influence of various factors on adsorption efficiency, including soil properties, molecular characteristics of PFASs, and the prevailing environmental conditions. The complex nature of soil environments complicates isolating individual impacts on PFAS behavior, necessitating an integrated approach to understanding their environmental destinies better. Through this exploration, we seek to clarify the complex interplay of factors that modulate the adsorption of PFASs in soils, highlighting the urgent need for future research to disentangle the intricate and combined effects that control the environmental behavior of PFAS compounds.

A comprehensive evaluation of influencing factors of neonicotinoid insecticides (NEOs) in farmland soils across China: First focus on film mulching

Neonicotinoid insecticide (NEO) residues in agricultural soils have concerning and adverse effects on agroecosystems. Previous studies on the effects of farmland type on NEOs are limited to comparing greenhouses with open fields. On the other hand, both NEOs and microplastics (MPs) are commonly found in agricultural fields, but their co-occurrence characteristics under realistic fields have not been reported. This study grouped farmlands into three types according to the covering degree of the film, collected 391 soil samples in mainland China, and found significant differences in NEO residues in the soils of the three different farmlands, with greenhouse having the highest NEO residue, followed by farmland with film mulching and farmland without film mulching (both open fields). Furthermore, this study found that MPs were significantly and positively correlated with NEOs. As far as we know this is the first report to disclose the association of film mulching and MPs with NEOs under realistic fields. Moreover, multiple linear regression and random forest models were used to comprehensively evaluate the factors influencing NEOs (including climatic, soil, and agricultural indicators). The results indicated that the random forest model was more reliable, with MPs, farmland type, and total nitrogen having higher relative contributions.

Luminol and the postmortem interval estimation - influence of taphonomic factors

The estimation of the postmortem interval (PMI) is one of the key challenges for forensic anthropologists. Although there are several methods referenced for this purpose, none is sufficiently effective. One of the main reasons justifying the complexity of this task is the influence of several taphonomic factors.The study of the Luminol technique has stood out as a promising method for estimating PMI, complementing the existing methods, since it is an economic, easy and reproducible method that operates as a presumptive test. However, it is not known which taphonomic factors can influence the results obtained by this technique.The aim of this study is to test the influence of taphonomic factors, such as temperature, humidity, soil type and pH, on the estimation of the PMI by the Luminol technique.In order to test the influence of the referred factors, a sample consisting of 30 clavicles, with known and similar PMI, collected from autopsies, was distributed as evenly as possible by six vases and buried with different decomposition conditions for a period of 12 months. After the exhumation and sample preparation, the Luminol technique was applied.It was possible to clearly observe differences in the results. Thus, according to our research, it is possible to conclude that the results obtained by the application of Luminol are influenced by taphonomic factors. Therefore, the context in which a body is found should always be considered for applying this technique.

Spatial-temporal trends in leprosy burden and its associations with socioeconomic and physical geographic factors: results from the Global Burden of Disease Study 2019

OBJECTIVES

The purpose of our study was to assess the multiscalar changes in leprosy burden and its associated risk factors over the last three decades.

STUDY DESIGN

We conducted an in-depth examination of leprosy's spatial-temporal trends at multiple geographical scale (global, regional, and national), utilizing information from Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2019).

METHODS

Incidence and the estimated annual percentage change (EAPC) in age-standardized incidence rate (ASIR) of leprosy were determined, with countries categorized based on leprosy incidence changes. We examined socioeconomic and physical geography influences on leprosy incidence via Spearman correlation analysis, using ternary phase diagrams to reveal the synergetic effects on leprosy occurrence.

RESULTS

Globally, incident cases of leprosy decreased by 27.86% from 1990 to 2019, with a reduction in ASIR (EAPC = -2.53), yet trends were not homogeneous across regions. ASIR and EAPC correlated positively with sociodemographic index (SDI), and an ASIR growth appeared in high SDI region (EAPC = 3.07). Leprosy burden was chiefly distributed in Tropical Latin America, Oceania, Central Sub-Saharan Africa, and South Asia. Negative correlations were detected between the incidence of leprosy and factors of SDI, GDP per capita, urban population to total population, and precipitation, whereas the number of refugee population, temperature, and elevation showed opposite positive results.

CONCLUSIONS

Despite a global decline in leprosy over the past three decades, the disparities of disease occurrence at regional and national scales still persisted. Socioeconomic and physical geographic factors posed an obvious influence on the transmission risk of leprosy. The persistence and regional fluctuations of leprosy incidence necessitate the ongoing dynamic and multilayered control strategies worldwide in combating this ancient disease.

Factors controlling accumulation and bioavailability of selenium in paddy soils: A case study in Luxi County, China

Selenium (Se) accumulation in rice (Oryza sativa L.) has become a major global concern. Se offers multiple health benefits in humans; however, its inadequate or excessive intake can be harmful. Therefore, determining the factors driving Se abundance and bioavailability in paddy soils is essential to ensure the safety of human Se intake. This study investigated the accumulation, bioavailability, and distribution of Se in 820 paddy soil and rice grain samples from Luxi County, China to assess how soil properties (soil organic matter [SOM], cation exchange capacity [CEC], and pH), geographical factors (parent materials, elevation, and mean annual precipitation [MAP] and temperature [MAT]), and essential micronutrients (copper [Cu], zinc [Zn], and manganese [Mn]) govern Se accumulation and bioavailability in paddy soils. Results showed that the average soil Se content was 0.36 mg kg-1, which was higher than that in China (0.29 mg kg-1). Alternatively, the average rice grain Se content was 0.032 mg kg-1, which was lower than the minimum allowable content in Se-rich rice grains (0.04 mg kg-1). Five studied parent materials all had a significant effect on soil Se content but had little effect on Se bioavailability (p < 0.05). CEC, elevation, and SOM, as well as the soil contents of Cu, Zn, and Mn were positively correlated with soil Se content, but pH, MAP, and MAT were negatively correlated. Correspondingly, Se bioavailability was negatively correlated with SOM and soil Zn content, but positively correlated with MAP and grain contents of Cu, Zn, and Mn. Furthermore, partial least squares path analysis revealed the interactive impacts of the influencing factors on Se accumulation and bioavailability in soils. On this basis, prediction models were established to predict Se accumulation and bioavailability in paddy soils, thereby providing theoretical support for developing efficient control measures to meet Se challenges in agriculture.

Influencing factors on ammonia emissions from gasoline vehicles: A systematic review and meta-analysis

Ammonia, a significant precursor for secondary inorganic aerosols, plays a pivotal role in new particle formation. Inventories and source apportionment studies have identified vehicular exhaust as a primary source of atmospheric ammonia in urban regions. Existing research on the factors influencing ammonia emissions from gasoline vehicles exhibits substantial inconsistencies in both test results and analyses. The lack of a uniform pattern in ammonia emissions across different standard vehicles and the significant overlap in test results across diverse operational conditions highlight the complexities in this field of study. While individual results can be interpreted through a mechanistic lens, disparate studies often lack a common explanatory framework. To address this gap, our study leverages the robust and comprehensive approach of meta-analysis to reconcile these inconsistencies and provide a more precise understanding of the factors influencing ammonia emissions from gasoline vehicles. A large number (N = 537) of ammonia emission factors were extracted after screening >1628 publications. The combined ammonia emission factor was 23.57 ± 24.94 mg/km. Emission standards, engine type, ambient temperatures, mileage, vehicle speed, and engine displacement have a significant impact on ammonia emission factors, explaining the ammonia emission factor by up to 50.63 %, with speed being the most significant factor. All these factors are attributed to the interplay of catalyst properties, lambda, and residence time (space velocity). In the current fleet, ammonia emission control is relatively insufficient under low-speed and ultra-high speed, low temperature, and ultra-high mileage conditions. Since ammonia emission factors do not monotonically decrease with the upgrading of motor vehicle emission standards, it is called for the addition of ammonia emission factors indicators in motor vehicle emission standards, and stipulation of targeted testing procedures and testing instruments.

Stigma and its influencing factors for seeking professional psychological help among pregnant women: A cross-sectional study

BACKGROUND

Although the stigma associated with seeking professional psychological help has received significant attention, few studies have focused on the status and factors influencing this stigma among pregnant women, especially those with a Chinese cultural background. This study aimed to assess the status of stigma associated with seeking professional psychological help and its influencing factors.

METHODS

A total of 1325 pregnant women were recruited from Hunan Province, China. The Stigma for Seeking Professional Psychological Help questionnaire, Patient Health Questionnaire-9, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and questionnaires on sociodemographic characteristics and pregnancy-related information were used. Descriptive, univariate, correlation, and multivariate linear regression analyses were used to investigate the status of stigma and identify its influencing factors.

FINDINGS

Pregnant Chinese women experienced a mild to moderate level of stigma associated with seeking professional psychological help, and self-stigma was more common than social stigma associated with seeking psychological help. The results of the multivariate analysis suggested that perceived social support, positive coping styles, negative coping styles, and depressive symptoms were the factors influencing self-stigma and social stigma associated with seeking professional psychological help. Advanced age and a low educational level were the only predictors associated with self-stigma, while a history of multiple pregnancies had an effect only on social stigma associated with seeking professional psychological help.

CONCLUSION

Chinese pregnant women experienced a mild to moderate level of stigma associated with seeking professional psychological help. Destigmatizing interventions focusing on self-stigma and social stigma should be designed according to maternal characteristics, social support, coping style, and depressive symptoms.

Long-term variations in surface ozone at the Longfengshan Regional Atmosphere Background Station in Northeast China and related influencing factors

Surface ozone (O3) is a crucial air pollutant that affects air quality, human health, agricultural production, and climate change. Studies on long-term O3 variations and their influencing factors are essential for understanding O3 pollution and its impact. Here, we conducted an analysis of long-term variations in O3 during 2006-2022 at the Longfengshan Regional Atmosphere Background Station (LFS; 44.44°N, 127.36°E, 330.5 m a.s.l.) situated on the northeastern edge of the Northeast China Plains. The maximum daily 8-h average (MDA8) O3 fluctuated substantially, with the annual MDA8 decreasing significantly during 2006-2015 (-0.62 ppb yr-1, p < 0.05), jumping during 2015-2016 and increasing clearly during 2020-2022. Step multiple linear regression models for MDA8 were obtained using meteorological variables, to decompose anthropogenic and meteorological contributions to O3 variations. Anthropogenic activities acted as the primary drivers of the long-term trends of MDA8 O3, contributing 73% of annual MDA8 O3 variability, whereas meteorology played less important roles (27%). Elevated O3 at LFS were primarily associated with airflows originating from the North China Plain, Northeast China Plain, and coastal areas of North China, primarily occurring during the warm months (May-October). Based on satellite products of NO2 and HCHO columns, the O3 photochemical regimes over LFS revealed NOx-limited throughout the period. NO2 increased first, reaching peak in 2011, followed by substantial decrease; while HCHO exhibited significant increase, contributing to decreasing trend in MDA8 O3 during 2006-2015. The plateauing NO2 and decreasing HCHO may contribute to the increase in MDA8 O3 in 2016. Subsequently, both NO2 and HCHO exhibited notable fluctuations, leading to significant changes in O3. The study results fill the gap in the understanding of long-term O3 trends in high-latitude areas in the Northeast China Plain and offer valuable insights for assessing the impact of O3 on crop yields, forest productivity, and climate change.

The second dose of COVID-19 vaccine booster hesitancy among health care workers in China: A multicenter cross-sectional study

BACKGROUND

The COVID-19 outbreak in China exposed health care workers (HCWs) to an increased risk of infection. The acquired immunity rapidly diminishes after the previous COVID-19 vaccination and the second booster vaccination has been recommended in several countries. HCWs are a priority group for vaccination because they are at increased risk of being infected, however, a certain amount of HCWs were hesitant.

METHODS

The survey was conducted among 5805 HCWs in China from January 5 to February 9, 2023. Questionnaire included sociodemographic information, COVID-19-related variables, psychological factors, and the COVID-19 vaccine hesitancy scale. Multiple logistic regression analysis was used to assess the influencing factors of the second dose of COVID-19 vaccine booster hesitancy.

RESULTS

42.2% of HCWs self-reported having the second dose of COVID-19 vaccine booster hesitancy. Occupations, years of working, COVID-19 infection status were associated with less vaccine hesitancy. HCWs who had received 3 doses of COVID-19 vaccine were less likely to be hesitant compared to those had not received. HCWs with PTSD symptoms and anxiety symptoms were more likely to be hesitant. No relation was observed between COVID-19 vaccine booster hesitancy and age, marriage, salary, and perceived an increased risk of COVID-19 infection due to work (all P > 0.05).

CONCLUSIONS

A considerable proportion of HCWs were hesitant to accept the second dose of the COVID-19 booster vaccine. Incorporating vaccine knowledge and new evidence into routine health educations and procedures to raise confidence and reduce complacency may be effective and feasible in promoting the vaccination and implementing future vaccination programs.

Analysis of spatial characteristics and influencing factors of the flow network of highly educated talents from national and local perspective

Based on dynamic monitoring data on China's population, by using complex networks, spatial analysis and mathematical measurement, this study reveals the spatial characteristics and influencing factors of the network of flows of highly educated talents in the Yangtze River Delta region from the national and local perspectives. In the two perspectives, the network has strong isomorphism and certain differences. The in-flow of highly educated talents from cities with high administrative levels and more developed economies to Shanghai constitutes the core of the entire network. From a national perspective, highly educated talents tend to converge to the Yangtze River Delta region. From a local perspective, it was found that these talents cluster towards a limited number of cities in the region. From both perspectives, the flow network has developed into a "core-periphery" progressive hierarchical structure, with Shanghai becoming the sole core city. There is little difference in the influencing factors of talent mobility from both macro and meso perspectives. Highly educated talents would frequently flow between cities with strong economic development levels, and cities with high education level, scientific and technological level, complete infrastructure, and good aesthetics. However, geographical distance still plays a hindering role in the flow of highly educated talents, and factors such as cultural identity, institutional, and social modality differences among regions also have a certain effect on the flow of these talents.

A Systematic review of the factors that affect soccer players' short-passing ability-based on the Loughborough Soccer Passing Test

OBJECTIVE

This study synthesizes evidence from the Loughborough Passing Test to evaluate the short-passing ability of soccer players and summarizes the reported variables that affect this ability to provide support for the development and improvement of short-passing abilities in soccer players.

METHODS

In this systematic review using the PRISMA guidelines, a comprehensive search was conducted in Web of Science, PubMed, and EBSCOhost from inception to July 2023 to identify relevant articles from the accessible literature. Only studies that used the Loughborough test to assess athletes' short-passing ability were included. The quality of the included studies was independently assessed by two reviewers using the PEDro scale, and two authors independently completed the data extraction.

RESULTS

Based on the type of intervention or influencing factor, ten studies investigated training, nine studies investigated fatigue, nine studies investigated supplement intake, and five studies investigated other factors.

CONCLUSION

Evidence indicates that fitness training, small-sided games training, and warm-up training have positive effects on athletes' short-passing ability, high-intensity special-position training and water intake have no discernible impact, mental and muscular exhaustion have a significantly negative effect, and the effect of nutritional ergogenic aid intake is not yet clear. Future research should examine more elements that can affect soccer players' short-passing ability.

TRIAL REGISTRATION

https://inplasy.com/ ., identifier: INPLASY20237.

Influencing factors of length of stay among repeatedly hospitalized patients with mood disorders: a longitudinal study in China

BACKGROUND

Patients with mood disorders usually require repeated and prolonged hospitalization, resulting in a heavy burden on healthcare resources. This study aims to identify variables associated with length of stay(LOS) of repeatedly hospitalized patients with mood disorders and to provide information for optimizing psychiatry management and healthcare resource allocation.

METHODS

Electronic medical records (EMRs) of repeatedly hospitalized patients with mood disorders from January 2010 to December 2018 were collected and retrospectively analyzed. Chi-square and t-test were adopted to investigate the differences in characteristics between the two groups of short LOS and long LOS. Generalized estimating equation (GEE) was conducted to investigate potential factors influencing LOS.

RESULTS

A total of 2,009 repeatedly hospitalized patients with mood disorders were enrolled, of which 797 (39.7%) had a long LOS and 1,212 (60.3%) had a short LOS. Adverse effects of treatment, continuous clinical manifestation, chronic onset type, suicide attempt, comorbidity and use of antidepressants were positively associated with long LOS among all repeatedly hospitalized patients with mood disorders (P < 0.050). For patients with depression, factors associated with long LOS consisted of age, monthly income, adverse effects of treatment, continuous clinical manifestation, suicide attempt and comorbidity (P < 0.050). Whereas, for patients with bipolar disorder (BD), adverse effects of treatment, four or more hospitalizations and use of antidepressants contributed to the long LOS (P < 0.050). Influencing factors of LOS also vary among patients with different effectiveness of treatment.

CONCLUSION

The LOS in repeatedly hospitalized patients with mood disorders was influenced by multiple factors. There were discrepancies in the factors affecting LOS in patients with different diagnoses and effectiveness of treatment, and specific factors should be addressed when evaluating the LOS.

Resilience and its influencing factors after emergency percutaneous coronary intervention in young and middle-aged patients with first acute myocardial infarction

Mental health after acute myocardial infarction (AMI) influences the prognosis of patients. Resilience may contribute to improving a patient's mental health. However, no study has investigated resilience and its associated factors in young and middle-aged patients undergoing emergency percutaneous coronary intervention (PCI) after the first AMI. This study aimed to identify critical associated factors influencing resilience in these patients. This cross-sectional study recruited 161 young and middle-aged patients with first-episode AMI using a purposive sampling method. These patients were assessed 48 h after emergency PCI using the General Information Questionnaire, the Connor-Davidson Resilience Scale-10, the Perceived Social Support Scale, the General Self-Efficacy Scale, and the Post-traumatic Stress Disorder Scale Civilian Version. Stepwise and logistic regression were conducted to analyze the factors influencing resilience. Receiver operating characteristics (ROC) were used to compare the area under the curves (AUC) for each indicator. The resilience of the 161 participants was 29.50 ± 4.158. Monthly household income, self-efficacy, social support, and post-traumatic stress disorder explained 51.4% of the variance in resilience. Self-efficacy (OR 0.716, CI 0.589-0.870, P < 0.01) and social support (OR 0.772, CI 0.635-0.938, P < 0.01) were protective factors for psychological resilience, while post-traumatic stress disorder (OR 1.278, CI 1.077-1.515, P < 0.01) was a risk factor. ROC curve revealed that self-efficacy, social support, and PTSD had an AUC of 0.822, 0.855, and 0.889, respectively. Self-efficacy and social support improve, and PTSD degrades psychological resilience in young and middle-aged AMI patients undergoing emergency PCI.

The impacts of national centralized drug procurement policy on drug utilization of medical institutions: an empirical study in a county-level hospital in China

PURPOSE

Under the background of the regular implementation of the National Centralized Drug Procurement (NCDP) policy, this study aimed to assess the impacts of the NCDP policy on drug utilization of county-level medical institutions, and probe into the influencing factors of the changes in drug utilization.

METHOD

A pre-post study was applied using inpatient data from a county-level medical institution in Nanjing. Drug utilization behavior of medical institutions of 88 most commonly used policy-related drugs (by generic name, including bid-winning and bid-non-winning brands) was analyzed, and the substitution of bid-winning brands for brand-name drugs after policy intervention was evaluated.

RESULTS

After policy intervention, 43.18% of policy-related drugs realized the substitution of bid-winning brands for bid-non-winning brands (6.82% of complete substitution, 36.36% of partial substitution). Meanwhile, 40.90% of policy-related drugs failed to realize brand substitution. Multiple factors affected brand substitution, including: (1) Policy effect: brand substitution was more obvious after the intervention of the first and third round of NCDP. (2) Drug market competition: the greater the price reduction of bid-non-winning brands, the more the drugs for the same indication, the more likely that medical institutions keep using the same brands as they did before policy intervention. (3) Previous drug utilization of medical institutions: brand substitution was more obvious in drugs with large number of prescriptions and weak preference for brand-name drugs.

CONCLUSION

The NCDP policy promoted the substitution of bid-winning brands for bid-non-winning brands. However, the NCDP policy remained to be further implemented in county-level medical institutions. Policy implememtation efforts, drug market competition and drug utilization of medical institutions would affect the implementation of the NCDP policy.

Investigating and analyzing the current situation and factors influencing chronic neck, shoulder, and lumbar back pain among medical personnel after the epidemic

BACKGROUND

Chronic shoulder and neck pain is one of the most common chronic occupational disorders, with an average incidence rate of 48.5%, severely affecting patients' quality of life and ability to work. According to epidemiological research, the prevalence of chronic neck, shoulder, and low back pain in adults over the age of 45 ranges from 40 to 80%. According to reports, medical staff have a higher incidence rate than other populations, and there is a positive correlation between the grade of the medical institution and the incidence rate, making medical staff a priority group for the prevention of chronic neck, shoulder, and low back pain. By the end of 2022, China has been fully opened to epidemic prevention and control, the total number of patients in domestic hospitals has increased significantly, and resulting in medical personnel shoulting great pressure, which seriously affects the physical and mental health of medical personnel. The aim of this study was to explore the risk factors of chronic neck, shoulder and lumbar back pain in medical staff. To provide guidelines for medical staff to improve cervical and lumbar subacute pain and reduce the emergence of spinal lesions.

METHODS

From January to February 2023, 602 staff members of a third-grade hospital in Zunyi City were studied by Questionnaire star. Univariate and multivariate Logistic regression were used to analyze the independent risk factors of chronic neck, shoulder and lumbar back pain in medical staff, with stepwise regression utilized to choose the optimum model. The model was selected using Akaike's information criterion (AIC) and the Hosmer-Lemeshow goodness-of-fit test.

RESULTS

A total of 602 medical staff were polled, and the findings revealed that 588 cases of chronic neck, shoulder, and low back pain of varied severity had occurred in the previous 1 to 2 years, with a 97.7% incidence rate; logistic regression analysis revealed that anxiety level, frequency of bending over in the previous 1 to 2 years, whether related preventive measures were taken at work, gender, positive senior title, daily ambulation time, and whether the department they worked in organized independent influencing factors.

CONCLUSION

The incidence of chronic neck, shoulder, and lumbar back pain among medical staff is high; its influencing factors are different and have not been systematically identified. Hospitals should take effective measures tailored to local conditions to improve the physical and mental health of medical staff.

Release characteristics and risk assessment of volatile sulfur compounds in municipal wastewater treatment plants

In recent years, the malodorous gases generated by sewage treatment plants have gradually received widespread attention due to their sensory stimulation and health hazards. The emission concentration, sensory evaluation and health risk assessment of volatile sulfur compounds (VSCs) were all explored in two municipal wastewater treatment plants (WWTPs) with oxidation ditch and anaerobic/oxic treatment process, respectively. The VSCs concentration showed the highest amount in the primary treatment unit in both the two WWTPs (73.3% in Plant A and 93.0% in Plant B), while the H2S took the main role in the composition of VSCs. However, H2S took a larger percentage in Plant A (84.5% ∼ 87.0%) rather than Plant B (61.2% ∼ 83.5%), which may be due to the different operating conditions and sludge properties in different treatment process. Besides, H2S also gained the first rank in the sensory evaluation and health risk assessment, which may cause considerable sensory irritation and health risk to workers and surrounding residents. Furthermore, the influencing factor analyses of VSCs emission showed that the temperature of water and air, ORP of sludge made the greatest effect on VSCs release. This study provides theoretical and data support for the research of VSCs emission control in WWTPs.

Contributing factors related to abnormal uterine bleeding in perimenopausal women: a case-control study

Abnormal uterine bleeding (AUB) during the menopausal transition results in reproductive endocrine disorders and both physiological and pathological changes, substantially impacting women's health. This study aimed to investigate the factors influencing AUB in perimenopausal women. Between April 2021 and June 2022, 120 perimenopausal women with AUB in the menopausal transition, diagnosed and treated at the Gynaecology Department of Kunming Tongren Hospital, were included in the case group. Concurrently, women undergoing routine health examinations at the same hospital were randomly selected as the control group. Univariate and multivariate logistic regression analyses identified factors related to AUB. The univariate analysis revealed significant associations (P < 0.05) between AUB and several factors, including age, body mass index (BMI), age at menarche, gravidity, and intrauterine device (IUD) placement in perimenopausal women. The multivariate regression analysis indicated that the independent risk factors for AUB include benign endometrial lesions (odds ratio [OR] 5.243, 95% confidence interval [CI] 3.082-9.458, P < 0.001), endometrial thickness ≥ 10 mm (OR 1.573, 95% CI 0.984-3.287, P < 0.001), age ≥ 50 years (OR 2.045, 95% CI 1.035-4.762, P = 0.001), BMI ≥ 25 kg/m2 (OR 2.436, 95% CI 1.43-4.86, P = 0.002), and IUD placement (OR 2.458, 95% CI 1.253-4.406, P < 0.001). Abnormal uterine bleeding during the menopausal transition is associated with several factors, including age, BMI, and IUD placement, highlighting the importance of early screening for these risk factors in the diagnosis and treatment of AUB.

[Related factors and equity of health status among floating population in China based on geographic information system analysis]

OBJECTIVE

To understand the health status, influencing factors and spatial distribution of the Chinese floating population and to evaluate the health equity of the floating population.

METHODS

All the data were collected from the 2017 Migrant Population Dynamic Monitoring Survey in China, binary Logistic regression was used to analyze the factors that might affect the health of the floating population, and the concentration index method was used to evaluate the health equity of the floating population. Spatial autocorrelation analyses the spatial aggregation of health status and health equity.

RESULTS

The unhealthy rate of the floating population in China was 2.71%. Age and gender show a statistically significant impact on self-rated health; that is, as age increases, the self-rated health of the migrant population gradually deteriorates, and women are more likely to think that they are unhealthy. Fairness analysis shows that the concentration index of the floating population is 0.021 7, the urban household registration floating population is 0.021 6, and the rural household registration floating population is 0.021 9. It is shown that the fairness of the health status of the floating population is biased towards the high-income class, and the rural household registration floating population' s health unfairness is greater than that of the urban household registration migration population. Moreover, Moran' s i=0.211 for self-rated health and Moran' s i=0.291 for the unhealthy rate indicate that self-rated health has a spatial aggregation trend. Moran' s i=0.136 showed the characteristics of spatial clustering, and the two-week prevalence fairness of the floating population was mainly in the northern and southeastern coastal areas.

CONCLUSION

In general, the health status of the floating population in China is relatively good. The main influencing factors of health included gender and age. The central tendency of health inequity is reflected in the southeast coastal and northern regions, which are characterized by poverty. Attention to spatial aggregation is not only helpful to analyze the reasons of floating population, but also to study the health differences between different regions and health-related factors, to improve the overall health level of the whole population.

Study on the geographic distribution and influencing factors of Dai settlements in Yunnan based on geodetector

The Dai people are primarily found in Yunnan Province, China, and have a long heritage there. The latest national census reports that Yunnan is home to 1,259,000 individuals of the Dai ethnic group. This study focuses on 3504 Dai settlements in Yunnan, identified through county records. Using the ArcGIS spatial analysis platform, we first evaluated their settlements' spatial distribution patterns using metrics like the nearest neighbor index and geographic concentration index. Then, we applied geodetector to investigate the underlying mechanisms of their distribution. The results reveal that: (1) Dai settlements in Yunnan Province generally have a cohesive spatial distribution; at the provincial level, however, there is an uneven distribution pattern, with many densely populated areas and a pattern of "two cores, one belt, one area, and two points"; (2) The Dai settlements predominantly occupy the third gradient of the vertical zonation, with Dai gathering settlements primarily found in the Lancang, Ayeyarwaddy, and Red River basins. Conversely, Dai mixed settlements are mainly situated in the Lancang, Red, and Nu River basins; (3) Analysis via geodetector indicates that ethnocultural factors are the most significant in determining the spatial distribution of the Dai settlements, followed by socio-economic and natural factors; (4) The distribution of settlements is significantly influenced by the proportion of the Dai population within these settlements. Dai gathering settlements are typically located on flat slopes with elevations ranging from 500 to 1000 m and slopes of 0°-5°. Meanwhile, Dai mixed settlements are found on gentle slopes with elevations of 1000-2000 m and slopes of 5°-15°. The study reveals that the location of Dai settlements is strongly influenced by environmental considerations and has a significant explanation from similar origins.

A pathway study of factors influencing quality of fertility life

BACKGROUD

To investigate the factors influencing fertility quality of life in infertile men, constructing a structural equation model of the factors influencing fertility quality of life in infertile men, and to provide suggested measures for improving fertility quality of life in infertile men.

METHODS

It is a Observational study. Infertile men (n = 250) attending a fertility centre in a hospital in Xinjiang, matched 1:2 men with no obvious male factor in the control group (n = 500).The Quality of Fertility Life Scale, the Social Support Scale, the Fertility Stress Scale and the Positive Attention Awareness Scale were used to conduct the survey. The model was constructed by applying the maximum likelihood estimation method in Mplus 8.3 software, to explore the factors influencing the quality of reproductive life of infertile men through path analyses. Differences between the case and control groups were statistically significant (P < 0.05) in terms of total fertility quality of life scores, core entry dimensions, affective responses, physical and mental relationships, selective treatment dimensions, and treatment tolerance.

RESULTS

Past medical history, history of exposure to hazardous environments, health insurance reimbursement, social support, fertility stress, and mindfulness are important factors affecting the quality of fertility life of infertile men.

CONCLUSION

The quality of fertility life of infertile men is not optimistic. By improving the level of mindfulness, fertility stress, and social support, we propose appropriate measures to improve the quality of fertility life of infertile men. These measures can improve their confidence in clinical diagnosis and infertility treatment, enabling them to cope positively with these challenges.

Analysing influencing factors and correlation paths of learning burnout among secondary vocational students in the context of social media: An integrated ISM-MICMAC approach

By analysing the factors influencing secondary vocational students' learning burnout in the context of social media, this study unearthed the underlying causes of learning burnout. It also determined the correlation paths among the factors influencing learning burnout, providing references for educational and pedagogical improvement. This contributes to preventing secondary vocational students' learning burnout and enhancing learning efficiency in secondary vocational schools. Combined with previous research results and a theoretical basis, this study identifies 10 influencing factors employing the Delphi method, and uses Interpretative Structural Modelling (ISM) and Matrice d' Impacts Croisés Multiplication Appliqués à un Classement (MICMAC) to elucidate the relationship between influencing factors of learning burnout among secondary vocational students in the context of social media. This study also constructs a corresponding mechanism model and subsequently proposes prevention and improvement strategies. The results show that the overdevelopment of social media, as driving factors, has the greatest impact on secondary vocational students' learning burnout. Simultaneously, it takes the lead in addressing cognitive bias among students, decreased self-control, and low learning efficiency, factors that contribute to learning burnout. This is particularly beneficial in alleviating the degree of learning burnout among secondary vocational students in the context of social media and improves overall learning outcomes for these students. The hierarchical structure and correlation paths identified in this study offer robust invaluable guidance for developing a scientific program to address the problem of learning burnout among this demographic. This includes implementing related educational practises, thereby reducing the unpredictability of the practical applications.

The awareness rate of knowledge of chronic diseases and influencing factors among 4790 adults in anhui province: An online survey using WeChat

Objective

To investigate public awareness about core information regarding chronic diseases and identify factors influencing that awareness among Anhui Province residents, provide a scientific basis for policy-making, and formulate corresponding intervention measures.

Methods

From March to April 2021, 12 provincial-level representative counties and districts of Anhui province in the China Adult Chronic Disease and Nutrition Surveillance were selected as survey sites, and 4790 residents were recruited for the survey using stratified multi-stage cluster random sampling. Basic details about the study participants were collected and their awareness of core information about major chronic diseases was measured through an online survey using WeChat.

Results

In 2021, the awareness rate of core information about chronic diseases among residents of Anhui Province was 54.93%. Multivariate logistic regression analysis showed that a higher awareness rate was associated with the following factors: non-housework occupations (agriculture, forestry, animal husbandry, and fishery: OR = 1.309, commercial services and production and transportation: OR = 1.450, institutions, and professional and technical personnel: OR = 1.461), a high education level (high school/junior high school/technical school OR = 1.357, college and above OR = 2.133), and residence in the southern and northern Anhui areas (southern Anhui OR = 1.282, northern Anhui OR = 1.431); whereas in rural areas (by district and country) (OR = 0.863), the awareness rate was low (all P < 0.05).

Conclusions

The awareness rate of core information about chronic diseases among residents of Anhui, China, is low. It is necessary to strengthen awareness about chronic disease prevention and management by targeting specific groups of people in this region.

Spatial distribution and influencing factors of rural tourism: A case study of Henan Province

Rural tourism is a powerful way to revitalize the countryside, and its spatial pattern is crucial for sustainable development. This paper analyzes the spatial distribution of rural tourism characteristic villages in Henan Province by taking 723 villages as the research object and using the nearest neighbor index, kernel density analysis, and spatial autocorrelation. It investigates the influencing factors utilizing the optimal parameters-based geographical detector (OPGD) model. The results show that, firstly, the overall spatial distribution of the rural tourism characteristic villages in Henan Province is characterized by aggregation and unbalanced distribution, and the overall spatial distribution density demonstrates the aggregation characteristics of "four cores and one belt". Secondly, the rural tourism characteristic villages can be divided into four primary categories, agricultural industry, rural culture, and featured villages and towns. The spatial distributions of the four main categories are all clustered. Thirdly, the primary factors affecting the differences in the spatial distribution of the rural tourism characteristic villages are the topographic features, economic development level, tourism market potential, traffic capacity, and relevant policies, among which the critical factor is the number of A-class scenic spots in the tourism market potential. To promote the optimisation of the spatial pattern of rural tourism, it is necessary to strengthen resource integration. Furthermore, it is important to conduct in-depth exploration of more factors in order to provide comprehensive guidance for the sustainable development of rural tourism.

The influencing factors of hearing protection device usage among noise-exposed workers in Guangdong Province: a structural equation modeling-based survey

BACKGROUND

There are numerous complex barriers and facilitators to continuously wearing hearing protection devices (HPDs) for noise-exposed workers. Therefore, the present study aimed to investigate the relationship between HPD wearing behavior and hearing protection knowledge and attitude, HPD wearing comfort, and work-related factors.

METHOD

A cross-sectional study was conducted with 524 noise-exposed workers in manufacturing enterprises in Guangdong Province, China. Data were collected on hearing protection knowledge and attitudes, HPD wearing comfort and behavior, and work-related factors through a questionnaire. Using structural equation modeling (SEM), we tested the association among the study variables.

RESULTS

Among the total workers, 69.47% wore HPD continuously, and the attitudes of hearing protection (26.17 ± 2.958) and total HPD wearing comfort (60.13 ± 8.924) were satisfactory, while hearing protection knowledge (3.54 ± 1.552) was not enough. SEM revealed that hearing protection knowledge had direct effects on attitudes (β = 0.333, p < 0.01) and HPD wearing behavior (β = 0.239, p < 0.01), and the direct effect of total HPD wearing comfort on behavior was β = 0.157 (p < 0.01). The direct effect also existed between work shifts and behavior (β=-0.107, p < 0.05). Indirect relationships mainly existed between other work-related factors, hearing protection attitudes, and HPD wearing behavior through knowledge. Meanwhile, work operation had a direct and negative effect on attitudes (β=-0.146, p < 0.05), and it can also indirectly and positively affect attitudes through knowledge (β = 0.08, p < 0.05).

CONCLUSION

The behavior of wearing HPD was influenced by hearing protection knowledge, comfort in wearing HPD, and work-related factors. The results showed that to improve the compliance of noise-exposed workers wearing HPD continuously when exposed to noise, the HPD wearing comfort and work-related factors must be taken into consideration. In addition, we evaluated HPD wearing comfort in physical and functional dimensions, and this study initially verified the availability of the questionnaire scale of HPD wearing comfort.

Digital transformation of the agricultural industry: Behavioral decision-making, influencing factors, and simulation practices in the Yunnan highlands

Motivating the agricultural industry to engage in digital transformation is a challenge academically and socially. It is of great significance to study the choice of digital transformation mode of agricultural industrial organization and analyze its driving factors for promoting the sustainable development of agricultural industrial organization. This study adopts a bilateral evolutionary game to construct a decision-making model for behavioral decision-making during the digital transformation of the agricultural industry. The contingent-actual logical framework and multiple case studies of Yunnan highland agriculture are used to explore the impact of various factors on behavioral decision-making during the digital transformation of the agricultural industry. Additionally, a simulation analysis is used to verify the validity of the bilateral evolutionary game model. The results demonstrate that: (1) When the agricultural industry chooses "active transformation," behavioral decision-making during the digital transformation of the agricultural industry reaches a Nash equilibrium; (2) transformation costs, industry revenue, and reward and penalty mechanisms are the main driving factors for whether or not the agricultural industry chooses to actively engage in digital transformation; and (3) the probability of active digital transformation increases when agricultural industry organizations obtain higher returns at lower costs. Simultaneously, the higher the government's incentives, the greater the enthusiasm. However, when the penalty is excessive, the digital transformation takes the shape of either passive transformation or forced active transformation. Subsequently, it is necessary to improve the digital transformation planning of the agricultural industry, strengthen this field's cooperation mechanism, and formulate a reasonable reward and penalty system for digital transformation.

Factors influencing periprosthetic bone mineral density in total knee arthroplasty: a systematic review

INTRODUCTION

Following total knee arthroplasty (TKA), there is a significant decline in periprosthetic bone mineral density (BMD), potentially resulting in complications such as prosthetic loosening, periprosthetic fracture, and influencing the postoperative recovery. The objective of this study was to summarize the factors influencing periprosthetic BMD in TKA from existing studies.

METHODS

A comprehensive systematic search was performed in 4 databases: Pubmed, Embase, Web of Science, and Cochrane Library. The last search was carried out on October 12, 2023. We used the keywords ''total knee arthroplasty'', ''bone mineral density'' and each of them combined with ''tibia'' and ''femur'' to identify all relevant articles reporting about potential impact factors influencing the periprosthetic BMD in patients after TKA.

RESULTS

Out of 1391 articles, 22 published from 2001 to 2023 were included in this systematic review. Following eligibility screening, six significant categories affecting periprosthetic BMD were recognized: prosthesis type, design of stem, coating, body weight, cement, and peg distance.

CONCLUSION

Mobile-bearing prostheses, modular polyethylene design, short stems, cruciform stems, avoidance of bone cement, higher body mass index, titanium nitride coating, and a smaller medial peg distance could potentially benefit periprosthetic BMD. Comprehensive consideration of diverse factors influencing periprosthetic BMD before surgery and collaboration with post-operative drug therapy are essential.

TRIAL REGISTRY

The PROSPERO registration number is CRD42023472030.

Distribution, seasonal variation and influencing factors of total dissolved inorganic arsenic in the middle and lower reaches of the Yellow River

The concentrations of dissolved arsenate in natural water has an important impact on human health. The distributions, seasonal variation and major influencing factors of total dissolved inorganic arsenic (TDIAs) were studied in the Yellow River. The concentrations of TDIAs in the middle and lower reaches of the Yellow River ranged from 4.3 to 42.4 nmol/L, which met the standards for drinking water of WHO. The seasonal variation of TDIAs concentration in the middle and lower reaches of the Yellow River was highest in summer, followed by autumn and winter, and lowest in spring. The influencing factors of TDIAs concentration in the middle and lower reaches of the Yellow River mainly include the hydrological conditions, topographical variation, the adsorption and desorption of suspended particulate matter (SPM) and the intervention of human activities. The absorption of TDIAs by phytoplankton in the Xiaolangdi Reservoir (XLD) is an important factor affecting its distributions and seasonal variation. The annual flux of TDIAs transported from the Yellow River into the Bohai Sea ranged from 1.1 × 105 to 4.5 × 105 mol from 2016 to 2018, which is lower than the flux in 1985 and 2009. The carcinogenic risks (CR) of TDIAs for children and adults were all within acceptable levels (<10-6).

Global burden of self-harm and interpersonal violence and influencing factors study 1990-2019: analysis of the global burden of disease study

INTRODUCTION

Widespread concern exists in today's world regarding self-harm and interpersonal violence. This study to analyze the changes in temporal trends and spatial patterns of risk factors and burdens of self-harm and interpersonal violence using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

METHODS

Temporal trends in self-harm and interpersonal violence were initially summarized using the estimated annual percentage change (EAPC). Data were compiled and visualized to delineate changes in disease burden and factors influencing self-harm and interpersonal violence from 1990 to 2019, stratified by gender, age and GBD region.

RESULTS

In 2019, the DALY rates of self-harm were 424.7(95% UI 383.25, 466.93). Over the period from 1999 to 2019, self-harm exhibited an overall decreasing trend, with the EAPC of -1.5351 (95% CI -1.6194, -1.4507), -2.0205 (95% CI -2.166, -1.8740) and -2.0605 (95% CI -2.2089, -1.9119), respectively. In contrast, the incidence rate of interpersonal violence was significantly higher than self-harm, with a rate of 413.44 (95% UI 329.88, 502.37) per 100,000 population. Mortality and DALYs of interpersonal violence were lower than those of self-harm, at 5.22 (95% UI 4.87, 5.63) and 342.43 (95% UI 316.61, 371.55). Disease burden of self-harm and interpersonal violence varied by gender, age groups and region. Specific risk factors showed that alcohol use, high temperature and drug use were the main risk factors for self-harm, while alcohol use, intimate partner violence and high temperature were associated with interpersonal violence. Low temperature was a common protective factor for both self-harm and interpersonal violence. The burden of self-harm and interpersonal violence was attributed to different factors influences in different SDI regions.

CONCLUSIONS

The study explored temporal trends and spatial distribution of the global disease burden of self-harm and interpersonal violence, emphasizing the significant impact of factors such as alcohol use, temperature, and drug use on disease burden. Further research and policy actions are needed to interpret recent changes of disease burden of self-harm and interpersonal violence, and dedicated efforts should be implemented to devise evidence-based interventions and policies to curtail risk factors and protect high-risk groups.

Spatial-temporal differentiation and influencing factors of carbon emission trajectory in Chinese cities - A case study of 247 prefecture-level cities

Cities, where human energy activities and greenhouse gas emissions are concentrated, contribute significantly to alleviating the impacts of global climate change. Utilizing the China Carbon Emissions Accounting Database (CEADs) to provide carbon dioxide emission inventories for urban areas in China at the prefecture level, this study closely examines the historical evolution trajectories of carbon emissions across 247 urban units from 2005 to 2019. The logarithmic cubic function model was employed to simulate these trajectories, evaluating urban emission peaks and classifying the different carbon emission trajectories. Further, the Geographical and Temporal Weighted Regression model was employed to explore spatiotemporal traits and essential variables that impact the variations in carbon emissions among four identified trajectory types. Our results showed that Chinese urban carbon emission trajectories can be classified into four categories: a) peaking emissions, b) fluctuating growth, c) continuous growth, and d) passive decline. Specifically, 43 cities, primarily in North China, proactively attained their emission peak post-2010, driven by the reduction in secondary industry and energy intensity. 90 cities, largely industrial hubs in the southeast coast and inland, reached an emission plateau around 2015, exhibiting fluctuating growth due to dependencies on secondary industries. 101 cities, predominantly located in western and central regions, demonstrated a clear upward trend in carbon emissions, propelled by rapid urbanization and heavy industry-oriented economic development. Lastly, 13 cities, typically in the northeastern and southwestern regions, experienced a passive decline in carbon emissions, attributable to resource depletion or economic downturns. It is evident that China's city-level carbon peaking has demonstrated some effectiveness, yet considerable progress is still required.

Hydroxychloroquine-induced pigmentation in rheumatic diseases: prevalence, clinical features and influencing factors

OBJECTIVE

To describe the clinical features of Chinese patients with hydroxychloroquine (HCQ)-induced pigmentation and analyze the potential risk factors associated with HCQ-induced pigmentation.

METHODS

A cross-sectional study was conducted over a duration of 7 months, during which patients who had received HCQ treatment for >6 months were included. Data was collected through a structured questionnaire that encompassed demographic and geographic characteristics, information on HCQ and concomitant medication usage, sun exposure characteristics, and hyperpigmentation-related characteristics. Univariate and multivariate analyses were employed to calculate the statistical association between HCQ-induced pigmentation and multiple variables.

RESULTS

Out of 316 patients, 83 (26.3%) patients presented hyperpigmentation during HCQ treatment. Hyperpigmentation presented after a median duration of HCQ treatment of 12 months (interquartile range, 6.0 months-30.0 months) with a median cumulative dose of 108 g of HCQ (interquartile range, 36-288 g). The most frequently affected sites of pigmentation were the face (60.2%), lower limbs (36.1%), and hands (20.5%). There was a linear decrease in the incidence of pigmentation with increasing daily sun exposure time (p= 0.030). In the multivariate analysis, variables (cumulative HCQ dose and daily sun exposure time) were included in the final models. The results revealed an independent correlation between HCQ-induced pigmentation and daily sun exposure exceeding 1 h (OR: 0.431; 95%CI: 0.208-0.892; p= 0.023).

CONCLUSIONS

The occurrence of HCQ-induced pigmentation is not uncommon, with an incidence rate of 26.3%. Daily sun exposure time exhibited a protective effect against HCQ-induced pigmentation.

Study of factors affecting the remediation of contaminated soil through pneumatic fracturing and soil vapor extraction

In low-permeability soils, the effectiveness of soil vapor extraction (SVE) is often constrained, resulting in increased time and operational expenses. In this study, pneumatic fracturing and the SVE were combined to remediate low-permeability clay contaminated with ammonia gas. The soil parameters, pneumatic fracturing parameters, extraction mode, and other influencing factors were investigated via laboratory testing. The results indicated that: (1) Pneumatically induced fracturing disrupts soil structure, forming cracks and providing new pathways for ammonium gas migration; (2) the soil crack area exhibits a quadratic function relationship with both the fracturing pressure and frequency, and the soil crack area increases with higher pneumatic frequencies, leading to a faster pneumatic pressure decline; (3) a denser network of pathways emerges within the soil due to the reduced distance between the two pneumatic fracturing points, consequently enhancing soil permeability and increasing pollutant elimination efficiency; (4) the ammonium gas removal efficiency gradually increases with an increase in the extracted vapor flow rate, but there is an optimal extraction flow rate (9 L/min); (5) continuous extraction combined with gas injection effectively ameliorates the issue of prolonged fluctuations in ammonium gas concentration during the later stages of extraction. (6) Fracturing and extraction reduce the moisture content of the surrounding soil. The results demonstrated the feasibility and superiority of pneumatic pre-fracturing extraction in low-permeability soils.

Identification, influencing factors and outcomes of time delays in the management pathway of diabetic foot: A systematic review

OBJECTIVE

A systematic review was conducted to evaluate the time delays in the management of diabetic foot and explore influencing factors of these delays and potential outcomes.

METHODS

The researchers searched several electronic databases (Pubmed, Web of Science, Cochrane Library, EMbase, CNKI, WanFang, CBM and VIP) for English and Chinese studies that examined time delays in the management pathway of diabetic foot. Two authors independently screened and extracted data, and assessed the quality of the included studies using the Newcastle-Ottawa Scale and the Agency for Health Research and Quality checklist. Due to heterogeneity among the studies, descriptive analysis was performed.

RESULTS

The review included 28 articles, comprising 20 cohort studies and 8 cross-sectional studies, that met the inclusion criteria. Among these, 14 were deemed of high quality. The median times from symptom onset to primary health care or specialist care varied from 3 to 46.69 days. The median delay in referral by primary care specialists ranged from 7 to 31 days, and subsequent median times to definitive treatment ranged from 6.2 to 56 days. Multiple complex factors were found to contribute to these delays, including patient demographics (older age, lower education level and income level) and poor patient health-seeking behaviors (inaccurate self-treatment, incorrect recognition and interpretation of symptoms), inaccurate assessment or initial treatment by health primary professionals, complex referral pathways and clinical characteristics of diabetic foot (number of foot ulcers, Wagner grade scale, and hemoglobin A1c index). Negative outcomes associated with these delays included increased risk of major amputation and mortality, decreased wound healing rate, prolonged hospital stay, and increased hospital costs.

CONCLUSIONS

Time delays in the diabetic foot management pathway were both common and serious, contributing to negative health outcomes for patients with diabetic foot. Many complex factors related to patient's poor patient health-seeking behaviors, health system, and clinical characteristics of diabetic foot are responsible for these delays. Therefore, it is necessary to develop new strategies for standard referral practices and strengthen patient awareness of seeking care.

A cross-sectional study on turnover intention of nurses in eastern China

BACKGROUND

This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors.

METHODS

A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021.

RESULTS

The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons.

CONCLUSION

Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.

A Novel Method for the Measurement of Retinal Arteriolar Bifurcation

INTRODUCTION

The purpose of this research was to develop protocols for evaluating the bifurcation parameters of retinal arteriole and establish a reference range of normal values.

METHODS

In this retrospective study, we measured a total of 1314 retinal arteriolar bifurcations from 100 fundus photographs. We selected 200 from these bifurcations for testing inter-measurer and inter-method agreement. Additionally, we calculated the normal reference range for retinal arteriolar bifurcation parameters and analyzed the effects of gender, age, and anatomical features on retinal arteriolar bifurcation.

RESULTS

The measurement method proposed in this study has demonstrated nearly perfect consistency among different measurers, with interclass correlation coefficient (ICC) for all bifurcation parameters of retinal arteriole exceeding 0.95. Among healthy individuals, the retinal arteriolar caliber was narrowest in young adults and increased in children, teenagers, and the elderly; retinal arteriolar caliber was greater in females than in males; and the diameter of the inferior temporal branch exceeded that of the superior temporal branch. The angle between the two branches of retinal arteriolar bifurcation was also greater in females than in males. When using the center of the optic disc as a reference point, the angle between the two branches of the retinal arteriole at the proximal or distal ends increased. In contrast, the estimated optimum theoretical values of retinal arteriolar bifurcation were not affected by these factors.

CONCLUSIONS

The method for the measurement of retinal arteriolar bifurcation in this study was highly accurate and reproducible. The diameter and branching angle of the retinal arteriolar bifurcation were more susceptible to the influence of gender, age, and anatomical features. In comparison, the estimated optimum theoretical values of retinal arteriolar bifurcation were relatively stable. Video available for this article.

Inequality characteristics and influencing factors of CO2 emissions per capita in Jiangsu Province, China

Analyzing the inequality characteristics and influencing factors of CO2 emissions per capita (CEPC) is conducive to balancing regional development and CO2 emissions reduction. This study applied the Gini coefficient and Theil index to investigate the CEPC inequalities during 2005-2017 at the county level in Jiangsu Province, China. Considering the spatial spillover and interaction effects, the factors influencing CEPC were analyzed by a hierarchical spatial autoregressive model. The results showed that the inequalities in CEPC first increased and then decreased at the inter-regional, and inter-county levels. The spatial pattern of CEPC was stable, and there was a significantly positive spatial autocorrelation of CEPC at the county level. The High-High type counties were mainly located in Sunan (southern Jiangsu). The spatial interaction effects of the CEPC between the prefecture and county levels indicated that governments at the prefecture level should integrate their county governments to reduce the CEPC. Moreover, carbon intensity, GDP per capita, land urbanization, and industrial structure play an important role in reducing CEPC. Our findings provide a scientific basis for formulating reasonable and effective carbon emission reduction policies.

Occurrence, source apportionment, and ecological risk of legacy and emerging per- and poly-fluoroalkyl substances (PFASs) in the Dahei river basin of a typical arid region in China

Per- and poly-fluoroalkyl substances (PFASs) are artificial chemicals with broad commercial and industrial applications. Many studies about PFASs have been conducted in densely industrial and populated regions. However, fewer studies have focused on the PFASs' status in a typical arid region. Here, we investigated 30 legacy and emerging PFASs in surface water from the mainstream and tributaries of the Dahei River. Our results revealed that total PFASs concentrations (∑30PFASs) in water ranged from 3.13 to 289.1 ng/L (mean: 25.40 ng/L). Perfluorooctanoic acid (PFOA) had the highest mean concentration of 2.44 ng/L with a 100% detection frequency (DF), followed by perfluorohexanoic acid (PFHxA) (mean concentration: 1.34 ng/L, DF: 59.26%). Also, perfluorohexane sulfonate (DF: 44.44%), perfluorobutane sulfonate (DF: 88.89%), and perfluorooctane sulfonate (PFOS) (DF: 92.59%) had mean concentrations of 12.94, 2.00, and 1.05 ng/L, respectively. Source apportionment through ratio analysis and principal component analysis-multiple linear regression analysis showed that treated or untreated sewage, aqueous film-forming foam, degradation of precursors, and fluoropolymer production were the primary sources. The PFOS alternatives were more prevalent than those of PFOA. Conductivity, total phosphorus, and chlorophyll a positively correlated with Σ30PFASs and total perfluoroalkane sulfonates concentrations. Furthermore, ecological risk assessment showed that more attention should be paid to perfluorooctadecanoic acid, perfluorohexadecanoic acid, perfluorooctane sulfonate, perfluorohexane sulfonate, and (6:2 and 6:2/8:2) polyfluoroalkyl phosphate mono- and di-esters. The mass load of PFASs to the Yellow River was 1.28 kg/year due to the low annual runoff in the Dahei River in the arid region. This study provides baseline data for PFASs in the Dahei River that can aid in the development of effective management strategies for controlling PFASs pollution in typical arid regions in China.

Review of fruits flavor deterioration in postharvest storage: Odorants, formation mechanism and quality control

Fruits flavor deterioration is extremely likely to occur during post-harvest storage, which not only damages quality but also seriously affects its market value. This work focuses on the study of fruits deterioration odorants during storage by describing their chemical compositions (i.e., alcohols, aldehydes, acids, and sulfur-containing compounds). Besides, the specific flavor deterioration mechanisms (i.e., fermentation metabolism, lipid oxidation, and amino acid degradation) inducing by factors (temperature, oxygen, microorganisms, ethylene) are summarized. Moreover, quality control strategies to mitigate fruits flavor deterioration by physical (temperature control, hypobaric treatment, UV-C, CA) and chemical (1-MCP, MT, NO, MeJA) techniques are also proposed. This review will provide useful references for fruits flavor control technologies development.

Using fs/QCA to explore the influencing factors of urban green infrastructure development and its combinational drivers: the case of the Yangtze River Delta region of China

High levels of urban green infrastructure (UGI) development can help mitigate the climate, biodiversity, and habitat crises faced by cities and support the achievement of sustainable urban development. Based on the relevant data of 41 cities in the Yangtze River Delta region obtained from 2011 to 2020, this study measured the development level of natural and geographic conditions, economic development, urban construction, social and cultural development, and eco-environment quality and urban green infrastructure (UGI); evaluated the development trend of UGI in the region during the 12th Five-Year Plan and 13th Five-Year Plan by using entropy TOPSIS; and used fs/QCA to explain the high-level development path of each city toward the achievement of a green infrastructure. The results showed that (1) the development level of UGI in the Yangtze River Delta region decreases from southeast to northwest, and gradually decreases from Shanghai, Hangzhou, and other central cities. (2) There were several different configurations of high levels and non-high levels of UGI development drivers across regions, confirming the existence of multiple causality and asymmetry indices in the drivers of UGI. (3) During the "12th Five-Year Plan" and the "13th Five-Year Plan" period, the conditions needed to achieve a high level of UGI gradually became stricter, expanding from nature-social culture and urban construction-eco-environmental drivers to nature-urban construction, nature-social culture-eco-environmental, urban construction-economy-social culture-eco-environmental drivers. Research findings can provide greater guidance and implications for future sustainable urban development.

Co-benefits and influencing factors exploration of air pollution and carbon reduction in China: Based on marginal abatement costs

This study addresses the pressing need for cost-effective emission reduction strategies that maximize co-benefits in terms of air pollution and carbon emissions. Our research contributes to the literature by accurately measuring these co-benefits, thereby facilitating their prompt realization in different regions. We employ an input-output framework that integrates carbon emissions and air pollution, allowing us to calculate marginal abatement costs using the shadow price of undesired output. Through this approach, we quantify the co-benefits and analyze the factors influencing them at both spatiotemporal and factor levels using spatial kernel density and geographical detectors. Our findings reveal several key insights: (1) under joint emission reduction efforts, we observe average annual reduction rates of 6.46% for marginal pollution and 6.10% for carbon reduction costs. Importantly, we document an increase in co-benefits from 0.50 to 0.86, characterized by an initial fluctuation followed by a linear increase. (2) the marginal cost difference for carbon emission and pollution reduction in western China was 179.45 and 155.08 respectively, compared to 321.51 and 124.70 in the Northeast, highlighting the crucial role of regional differences in shaping co-benefit outcomes. (3) we identify a negative spatial spillover effect between provinces, which diminishes over time, leading to heterogeneous effects when local provincial co-benefits exceed a threshold of 0.9. (4) during the adjustment period, we find that the industrial structure exerts significant single and interactive effects on co-benefits. Additionally, we highlight the critical role of environmental governance investment and government intervention as drivers of co-benefits in the current era. By offering the quantification of co-benefits under the marginal abatement costs, our study provides valuable scientific insights for planning and implementing effective synergy strategies.

Knowledge, Attitude, and Uptake of Human Papillomavirus (HPV) Vaccination among Chinese Female Adults: A National Cross-sectional Web-Based Survey Based on a Large E-commerce Platform

BACKGROUND

Human papillomavirus (HPV) vaccination is a promising step toward cervical cancer elimination. This study was conducted to investigate the knowledge, attitude, and HPV vaccine uptake among female adults in mainland China based on a large e-commerce platform.

METHODS

We conducted a cross-sectional online survey of female adults between March 4 to April 20, 2022. The survey consisted of sociodemographic information, related knowledge, vaccination uptake, and attitudes toward vaccination. We included women aged 18-45 years in the final analysis. Logistic regressions were conducted to explore influencing factors associated with related knowledge, HPV vaccination uptake, and willingness to be vaccinated.

RESULTS

In total, 3,572 female adults (34 years, IQR 30-39) were included in the analysis. The majority of the participants were highly educated (78.7%) with a high monthly family income (79.0%). The median HPV knowledge score was 8.25 out of 11. More than 75% of respondents were unvaccinated, while 95.8% of unvaccinated female adults are willing to be vaccinated. Variables such as age, insurance, vaccination history, and whether one had heard of the HPV vaccine influence HPV vaccination practice (all p-values < 0.05). The main barriers to vaccination were vaccine inaccessibility and the high cost of the vaccine.

CONCLUSION

The findings of our study highlight a moderate knowledge level, poor vaccination rate, and strong willingness to be vaccinated among Chinese female adults who were better educated and wealthier. Targeted health education and practical support should be provided in the future, to reduce gaps between vaccine uptake and vaccine acceptance.

Aetiology of bioethanol related burn accidents: A qualitative study

BACKGROUND

Since insight into the motivation of behaviour in bioethanol related burn accidents is lacking, this study aimed to qualitatively examine influencing factors in bioethanol related burn accidents. In order to identify target points for effective burn prevention.

METHODS

Patients previously admitted with bioethanol related acute non-intentional burn injury to the three Dutch burn centres were eligible. One interviewer conducted fourteen semi-structured interviews. Interviews were transcribed and coded by two independent researchers. Conclusions were drawn based on generalised statements on the concerned topics.

RESULTS

Four overall themes in influencing factors were found, namely 1) motivation; including non-designated use and impaired judgement, 2) knowledge and education; including unknown product and properties and information overload, 3) risk perception; including poor recognisability of risks and preferred trial and error and 4) thresholds; including easy availability and unclear liability.

CONCLUSION

Trust in consumers may be over-estimated, as proper use cannot be expected. To prevent future bioethanol related burn incidents, thresholds for obtaining and using bioethanol should be increased, safe alternatives to ignite open fires and wood stoves should be provided and knowledge and warnings should be improved.

Recent advances in microplastic removal from drinking water by coagulation: Removal mechanisms and influencing factors

Microplastics (MPs) are emerging contaminants that are widely detected in drinking water and pose a potential risk to humans. Therefore, the MP removal from drinking water is a critical challenge. Recent studies have shown that MPs can be removed by coagulation. However, the coagulation removal of MPs from drinking water remains inadequately understood. Herein, the efficiency, mechanisms, and influencing factors of coagulation for removing MPs from drinking water are critically reviewed. First, the efficiency of MP removal by coagulation in drinking water treatment plants (DWTPs) and laboratories was comprehensively summarized, which indicated that coagulation plays an important role in MP removal from drinking water. The difference in removal effectiveness between the DWTPs and laboratory was mainly due to variations in treatment conditions and limitations of the detection techniques. Several dominant coagulation mechanisms for removing MPs and their research methods are thoroughly discussed. Charge neutralization is more relevant for small-sized MPs, whereas large-sized MPs are more dependent on adsorption bridging and sweeping. Furthermore, the factors influencing the efficiency of MP removal were jointly analyzed using meta-analysis and a random forest model. The meta-analysis was used to quantify the individual effects of each factor on coagulation removal efficiency by performing subgroup analysis. The random forest model quantified the relative importance of the influencing factors on removal efficiency, the results of which were ordered as follows: MPs shape > Coagulant type > Coagulant dosage > MPs concentration > MPs size > MPs type > pH. Finally, knowledge gaps and potential future directions are proposed. This review assists in the understanding of the coagulation removal of MPs, and provides novel insight into the challenges posed by MPs in drinking water.

Microalgal-bacterial consortia for the treatment of livestock wastewater: Removal of pollutants, interaction mechanisms, influencing factors, and prospects for application

The livestock sector is responsible for a significant amount of wastewater globally. The microalgal-bacterial consortium (MBC) treatment has gained increasing attention as it is able to eliminate pollutants to yield value-added microalgal products. This review offers a critical discussion of the source of pollutants from livestock wastewater and the environmental impact of these pollutants. It also discusses the interactions between microalgae and bacteria in treatment systems and natural habitats in detail. The effects on MBC on the removal of various pollutants (conventional and emerging) are highlighted, focusing specifically on analysis of the removal mechanisms. Notably, the various influencing factors are classified into internal, external, and operating factors, and the mutual feedback relationships between them and the target (removal efficiency and biomass) have been thoroughly analysed. Finally, a wastewater recycling treatment model based on MBC is proposed for the construction of a green livestock farm, and the application value of various microalgal products has been analysed. The overall aim was to indicate that the use of MBC can provide cost-effective and eco-friendly approaches for the treatment of livestock wastewater, thereby advancing the path toward a promising microalgal-bacterial-based technology.

Exploring the medical decision-making patterns and influencing factors among the general Chinese public: a binary logistic regression analysis

OBJECTIVE

With the ongoing evolution of the healthcare system and shifts in cultural paradigms, there is a pressing need to delve into the medical decision-making behaviors of general Chinese public and understand their underlying motivations. This research seeks to elucidate the prevailing tendencies in these decision-making processes and to empirically validate the pivotal factors that shape their choices, offering valuable insights for healthcare policymakers and institutions.

METHOD

A comprehensive survey was administered to 2,696 Chinese residents to examine their medical decision-making patterns. These patterns were classified into two primary categories: Unilateral Decision-making (Doctor-dominant, Family-centric, and Patient-driven subtypes) and Collaborative Decision-making (Doctor-led, Doctor-Patient, Patient-Family, and Doctor-Patient-Family subtypes). Binary logistic regression analysis was employed to empirically pinpoint the significant factors influencing these decision-making frameworks.

RESULTS

The study's analysis reveals distinct preferences in medical decision-making among Chinese residents. In the Collaborative Decision-making category, chosen by 70.81% of participants, the subtypes are as follows: Doctor-led (29.90%), Doctor-Patient (13.54%), Patient-Family (2.93%), and Doctor-Patient-Family (24.44%). The Unilateral Decision-making, preferred by 29.19%, includes Doctor-dominant (23.22%), Family-centric (1.74%), and Patient-driven (4.23%) models. The preference for Collaborative Decision-making is associated with higher educational levels, specific marital statuses (particularly married but childless), and choices of rural residents' basic medical insurance or occupational basic medical insurance. In contrast, Unilateral Decision-making correlates with males, individuals with religious beliefs, certain occupational roles (like civil servants), and holders of commercial or publicly funded medical insurance.

CONCLUSION

This study elucidates the complex interplay of socio-cultural and individual determinants shaping medical decision-making in China. The findings reveal a marked inclination towards collaborative models, closely linked to educational level, marital status, and specific insurance types, reflecting an evolving trend towards participatory healthcare. Simultaneously, the persistence of unilateral models, influenced by gender, religious beliefs, and occupational roles, highlights the heterogeneity within Chinese healthcare preferences. These insights are crucial for policymakers and healthcare practitioners, underscoring the need for adaptable, culturally attuned healthcare frameworks that cater to this diversity, thereby enhancing patient engagement and healthcare efficacy.

[Influencing factors of traumatic arthritis after ankle fracture surgery and construction of risk prediction model]

OBJECTIVE

To explore risk factors of post-operative traumatic arthritis in patients with ankle fracture,and to establish risk prediction model.

METHODS

Totally 550 patients with ankle fracture treated from May 2020 to May 2022 were selected as research objects and divided into modeling group (385 patients) and verification group (165 patients) according to 7:3. In modeling group,patients were classified as occurrence group (112 patients) and non-occurrence group (273 patients) according to whether traumatic arthritis occurred after opertaion. Age,body mass index(BMI),gender,smoking history,diabetes history,injury type,fracture type,operation time,manual labor,open injury,osteoporosis,poor reduction,postoperative weight-bearing time,vascular injury,and surgical method were recorded; risk factors of traumatic arthritis in ankle fracture patients were analyzed by single factor and multi factor logistic regression analyses; R software was used to build the prediction model of line graph;receiver operating characteristic (ROC) curve and calibration graph were applied to verify the discrimination and consistency of the model.

RESULTS

One hundred and twelve of 385 patients with ankle fracture were developed to post-operative traumatic arthritis,and 275 did not. Univariate analysis showed that there were significant differences in age,BMI,fracture type,operation time,physical labor aboveⅡ,open injury,osteoporosis and poor reduction between two groups (P<0.05). Multivariate Logistic regression analysis showed that age (OR=2.887),BMI (OR=4.042),fracture type (OR=4.244),operation time (OR=2.665),physical labor above gradeⅡ(OR=5.099),osteoporosis (OR=10.219),and poor reduction (OR=3.112) were independent risk factors for traumatic arthritis after ankle fracture (P<0.05). Based on the above risk factors,an nomogram model was established to predict the risk of postoperative traumatic arthritis in ankle fracture patients,and internal and external verification was conducted. The results showed calibration curve of modeling group and verification group showed a good fit between correction curve and ideal curve,indicating that the predicted risk of postoperative traumatic arthritis by the model was basically consistent with actual risk. Area runder ROC curve analysis results showed 0.867[(95%CI(0.826,0.908)] and 0.882 [95%CI(0.827,0.938)],respectively,indicating that the prediction model had good prediction ability.

CONCLUSION

Age,BMI,fracture type,operation time,physical labor above gradeⅡ,osteoporosis and poor reduction are all risk factors for post-operative traumatic arthritis in patients with ankle fracture. The prediction model based on the above risk factors could effectively evaluate risk of post-operative traumatic arthritis in patients with ankle fracture.

[Prevalence and Influencing Factors of Isolated Diastolic Hypertension in Tibetan Population in Tibet]

Objective

To investigate the prevalence and influencing factors of isolated diastolic hypertension (IDH) in the Tibetan population in Tibet and to provide some evidence for the prevention and control of hypertension and other related diseases in high-altitude areas.

Methods

A multistage stratified whole-group random sampling method was used to enroll participants from Ngari Prefecture, Nagqu City, Shannan City, and Lhasa City, Tibet. A total of 3918 native Tibetans with complete data were enrolled in the survey between June 2020 and August 2023. The participants were aged from 18 to 80. The demographic data, life habits, and chronic disease prevalence of the participants were collected. Fasting venous blood samples were collected to perform the routine blood tests and blood biochemistry tests. The prevalence of IDH in subgroups with different characteristics was analyzed and the influencing factors were analyzed by multivariate logistic regression, accordingly. The predictive value of influencing factors on the prevalence of IDH was analyzed by the receiver operating characteristic (ROC) curve and the findings were compared with those of the previous prediction models for IDH.

Results

The prevalence of hypertension in the participants was 33.7% (n=1321), among which, 395 had IDH, accounting for 29.9% of the hypertensive patients. The results of multivariate regression showed that age, heart rate, body mass index, waist circumference, hemoglobin, and low-density lipoprotein cholesterol were associated with risks of developing IDH (P<0.05). The area under the ROC curve (AUC) was 0.71, which indicated improved accuracy for predicting the risks for IDH in comparison with previous predictive models for IDH. Among the influencing factors, BMI showed the best predictive value for IDH risks.

Conclusion

The prevalence of IDH is high among Tibetans in Tibet, suggesting the necessity for rational allocation of health resources in accordance. Compared with the previous IDH prediction models, the model proposed in this study is more suited for the Tibetan population. Targeted interventions should be carried out for the high-risk populations, such as young and middle-aged adults and populations suffering from overweight/obesity, central obesity, high-altitude polycythemia, and dyslipidemia, so as to effectively control the occurrence and development of IDH.

Nutrient allocation patterns of Picea crassifolia on the eastern margin of the Qinghai-Tibet Plateau

It can provide a basis for decision making for the conservation and sustainable use of forest ecosystems in mountains to understand the stoichiometric properties and nutrient allocation strategies of major tree species. However, the plant nutrient allocation strategies under different environmental gradients in forest systems of arid and semi-arid mountains are not fully understand. Therefore, three typical regions in the Qilian Mountains on the eastern edge of the Qinghai-Tibet Plateau were selected based on precipitation and temperature gradients, and the stoichiometric characteristics and nutrient allocation strategies of Qinghai spruce (Picea crassifolia) of the dominant tree species under different environmental gradients were investigated. The results showed that (1) the stoichiometric characteristics of plant tissues were different in the three regions. (2) The importance of each tissue in the plant nutrient allocation varied in different regions, showing that the plant roots are more important in the warm-wet region, while the plant leaves, branches and trunks are more important in the transition and hot-dry regions. (3) The influencing factors affecting plant nutrient allocation strategies were inconsistent across regions, which showed that plant nutrient allocation strategies in the warm-wet and transition region were mainly influenced by soil factors, while they were more influenced by climatic factors in the hot-dry region. The patterns of plant nutrient allocation strategies and drivers under different environmental gradients could help us better understand the ecological adaptation mechanism and physiological adjustment mechanism of forest ecosystem in mountains.

Dietary knowledge-attitude-practice status in hemodialysis patients: a latent profile analysis

BACKGROUND

Hemodialysis patients require a reasonable dietary intake to manage their disease progression effectively. However, there is limited research on these patients' overall dietary knowledge, attitude, and practice (KAP) status. This study aimed to investigate the dietary KAP status and latent profiles in hemodialysis patients and identify sociodemographic and disease-related factors associated with these profiles and dietary practice.

METHODS

A multicenter cross-sectional study involving 425 hemodialysis patients was conducted. A dietary KAP questionnaire in hemodialysis patients was used to evaluate the dietary KAP of the patients. A structural equation model was employed to analyze the correlations between dietary knowledge, attitude, and practice. Multiple linear regression analysis was used to identify factors associated with dietary practice scores. Latent profile analysis was conducted to determine the latent profiles of dietary KAP, and binary logistic regression was used to explore the sociodemographic and disease-related characteristics associated with each KAP profile in hemodialysis patients.

RESULTS

The normalized average scores for dietary knowledge, attitude, and practice in hemodialysis patients were 0.58, 0.82, and 0.58, respectively. The structural equation model revealed significant positive correlations between dietary knowledge and attitude, and attitude and practice. Attitude played an indirect effect between knowledge and practice. Gender, cerebrovascular disease, and dietary attitude scores were identified as independent influencing factors for dietary practice scores. Two dietary KAP profiles were developed: a profile with general knowledge and attitude but low practice (40.2%) and a profile with general knowledge and attitude and high practice (59.8%). Binary logistic regression analysis indicated gender and monthly income per household significantly predicted membership in each KAP profile.

CONCLUSIONS

The dietary practice of hemodialysis patients requires improvement. It is necessary to develop more individualized dietary interventions for these patients. Further exploration is needed to understand the motivation of patients to change their dietary behavior.