BACKGROUND: High temperatures are known to be associated with an increased risk of self-harm, but the influence of demographic changes and country-level indicators on the burden of heat-related self-harm remains unclear. This study examined the key factors driving changes in self-harm mortality linked to high temperatures and explored their impact at the country level. METHODS: This is an ecological study that analyzes data from the 2021 Global Burden of Disease (GBD) study, the World Bank, and the Climate Research Unit (CRU) were analyzed. Decomposition analyses were used to identify key factors driving changes in high temperature-related self-harm mortality between 1990 and 2021. A panel data model assessed the impact of national indicators on heat-related self-harm mortality. RESULTS: In 2021, 14,885 deaths globally were attributed to heat-related self-harm, a 41.94% increase from 1990, with low-middle SDI regions accounting for 47.84% of these deaths. While the global death rate from heat-related self-harm declined slightly over this period, South Asia and low-middle SDI regions contributed most to the decline. However, population aging exacerbated mortality rates. Demographic and meteorological factors were also linked to heat-related self-harm. CONCLUSION The global decline in heat-related self-harm mortality is largely driven by reductions in females, low-middle SDI regions, and South Asia. However, population aging and growth in these regions have added to the mortality burden, slowing the overall decline. Factors such as population density are also associated with heat-related self-harm. Targeted measures are needed to mitigate heat-induced self-harm more effectively in future.
Humans ; Self-Injurious Behavior/etiology* ; Hot Temperature/adverse effects* ; Global Health/statistics & numerical data* ; Female ; Male ; Adult ; Middle Aged ; Aged ; Young Adult ; Adolescent

Objective:To explore the core categories of postpartum functional assessment based on the international classifica-tion of functioning,disability and health(ICF)and its brief version.Method:Using the method of evidence-based medicine,through literature search,the concepts contained in the literature indicators were extracted,linked with ICF,and referred to the relevant literature and WHO ICF checklist to develop the postpartum functional assessment scale for women.A total of 300 patients were investi-gated and evaluated clinically,and the frequency of each ICF item was counted.The items with dysfunction frequency rank≥30%were taken as the first ICF core set of postpartum function for women.Questionnaires were distributed to medical staff to count the ICF items that medical staff thought were closely related to wom-en's postpartum function,and more than 50%of the items were used as the second stage ICF item pool.The results of the two periods were integrated to construct the core category set of postpartum functional assessment for women based on ICF.In addition,the items with more than 50%dysfunction and 100%dysfunction were further selected as the brief version of the core category set for postpartum functional assessment of women.Result:A core category set of 63 items was initially constructed based on the ICF for postpartum functional as-sessment of women,including 27 physical function items,10 body structure items,15 activity and participa-tion items,and 11 environmental factors items.In addition,a brief version of the 43-item core set of function-al assessments for postpartum women was constructed,including 16 items in the physical function part,9 items in the body structure part,9 items in the activity and participation part,and 9 items in the environmen-tal factors part.Conclusion:Based on the ICF,this study preliminarily discusses the core categories of postpartum functional assessment and its brief version,so as to provide some guidance for clinical postpartum examination,function-al assessment and rehabilitation treatment of women.

Objective:To explore the core categories of postpartum functional assessment based on the international classifica-tion of functioning,disability and health(ICF)and its brief version.Method:Using the method of evidence-based medicine,through literature search,the concepts contained in the literature indicators were extracted,linked with ICF,and referred to the relevant literature and WHO ICF checklist to develop the postpartum functional assessment scale for women.A total of 300 patients were investi-gated and evaluated clinically,and the frequency of each ICF item was counted.The items with dysfunction frequency rank≥30%were taken as the first ICF core set of postpartum function for women.Questionnaires were distributed to medical staff to count the ICF items that medical staff thought were closely related to wom-en's postpartum function,and more than 50%of the items were used as the second stage ICF item pool.The results of the two periods were integrated to construct the core category set of postpartum functional assessment for women based on ICF.In addition,the items with more than 50%dysfunction and 100%dysfunction were further selected as the brief version of the core category set for postpartum functional assessment of women.Result:A core category set of 63 items was initially constructed based on the ICF for postpartum functional as-sessment of women,including 27 physical function items,10 body structure items,15 activity and participa-tion items,and 11 environmental factors items.In addition,a brief version of the 43-item core set of function-al assessments for postpartum women was constructed,including 16 items in the physical function part,9 items in the body structure part,9 items in the activity and participation part,and 9 items in the environmen-tal factors part.Conclusion:Based on the ICF,this study preliminarily discusses the core categories of postpartum functional assessment and its brief version,so as to provide some guidance for clinical postpartum examination,function-al assessment and rehabilitation treatment of women.

Objective To investigate the epidemiological characteristics and influencing factors of Femoral Artery Compression-Related Skin Complications Around the Puncture Site(FACR-SCAPS)in patients with primary hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE).Methods A multicenter cross-sectional study was conducted using convenience sampling.A total of 1 573 HCC patients who underwent TACE between April 2023 and October 2024 were recruited from interventional radiology departments,oncology units,and specialized centers across 10 hospitals in Beijing,Tianjin,Shandong,Hebei,Qinghai,and Inner Mongolia.Descriptive statistics,univariate analysis,and multivariate logistic regression were used to explore the epidemiological characteristics and influencing factors of FACR-SCAPS in this population.Results Among the 1 573 primary HCC patients undergoing TACE interventional therapy,FACR-SCAPS occurred in 28.99％(456/1 573),with a total of 476 complication instances recorded(30.26 per 100 patients).Patients with a single complication accounted for 96.93％,whereas those with multiple complications constituted 3.07％.The most prevalent types of complications were skin erythema,skin ecchymosis,and hard lumps formation,collectively accounting for 96.49％of all complications.Hematoma,blisters,and rupture complications collectively accounted for only 4.61％.Logistic regression analysis revealed that peak diastolic blood pressure during compression(OR=1.024,95％CI:1.013-1.035,P＜0.001),use of rotary compression hemostasis devices(OR=3.220,95％CI:2.120-4.891,P＜0.001),elevated PT-INR(OR=19.630,95％CI:6.039-63.810,P＜0.001),and anticoagulant use within the last three months(OR=1.909,95％CI:1.064-3.427,P=0.030)were significant influencing factors associated with FACR-SCAPS post-TACE.Conclusion FACR-SCAPS is commonly seen among primary HCC patients after TACE,its risk factors include peak diastolic blood pressure during compression,use of rotary compression devices,elevated PT-INR,and recent anticoagulant use.

Objective:To explore the effects of transcutaneous electrical nerve stimulation(TENS)on knee joint pain,func-tion,muscle strength and gait in patients with knee fracture surgery.Method:Forty patients with knee fractures were divided into the control group and the experimental group,with 20 cases in each group.Strength training,joint mobilization techniques,neuromuscular electrical stimula-tion,and routine rehabilitation training were provided to the control group.The experimental group was given the same routine rehabilitation program,except the TENS intervention instead of neuromuscular electrical stimu-lation.For six weeks,each treatment was given once daily over five days.All the patients were evaluated by Visual analogue score(VAS),American hospital for special surgery knee score(HSS-KS),isometric muscle strength test and 3-D gait analysis before and after treatment.Result:There was no significant difference between the two groups in each evaluation scores before treatment(P＞0.05).HSS-KS score,peak torque per bodyweight of knee extensors and flexors under 60°/s and 180°/s,and gait parameters in both groups were significantly improved after 6 weeks of treatment,compared to those before treatment(P＜0.05).Meanwhile,the experimental group were significantly better than the control group in terms of the VAS score and HSS-KS score,peak torque/body weight(PT/BW)at 60°/s and 180°/s of knee extensors,and subparts of gait parameters(P＜0.05).Conclusion:In patients with knee fractures surgery,TENS can significantly minimize the pain,improve knee function and gait pattern,and strengthen the absolute force of knee extensors.

Objective:To explore the effects of transcutaneous electrical nerve stimulation(TENS)on knee joint pain,func-tion,muscle strength and gait in patients with knee fracture surgery.Method:Forty patients with knee fractures were divided into the control group and the experimental group,with 20 cases in each group.Strength training,joint mobilization techniques,neuromuscular electrical stimula-tion,and routine rehabilitation training were provided to the control group.The experimental group was given the same routine rehabilitation program,except the TENS intervention instead of neuromuscular electrical stimu-lation.For six weeks,each treatment was given once daily over five days.All the patients were evaluated by Visual analogue score(VAS),American hospital for special surgery knee score(HSS-KS),isometric muscle strength test and 3-D gait analysis before and after treatment.Result:There was no significant difference between the two groups in each evaluation scores before treatment(P＞0.05).HSS-KS score,peak torque per bodyweight of knee extensors and flexors under 60°/s and 180°/s,and gait parameters in both groups were significantly improved after 6 weeks of treatment,compared to those before treatment(P＜0.05).Meanwhile,the experimental group were significantly better than the control group in terms of the VAS score and HSS-KS score,peak torque/body weight(PT/BW)at 60°/s and 180°/s of knee extensors,and subparts of gait parameters(P＜0.05).Conclusion:In patients with knee fractures surgery,TENS can significantly minimize the pain,improve knee function and gait pattern,and strengthen the absolute force of knee extensors.

Objective:To predict the short-term postoperative recurrence status of patients with refractory temporal lobe epilepsy (TLE) by analyzing preoperative 18F-FDG PET images and patients′ clinical characteristics based on deep residual neural network (ResNet). Methods:Retrospective analysis was conducted on preoperative 18F-FDG PET images and clinical data of 220 patients with refractory TLE (132 males and 88 females, age 23.0(20.0, 30.2) years)) in the First Affiliated Hospital of Jinan University between January 2014 and June 2020. ResNet was used to perform high-throughput feature extraction on preprocessed PET images and clinical features, and to perform a postoperative recurrence prediction task for differentiating patients with TLE. The predictive performance of ResNet model was evaluated by ROC curve analysis, and the AUC was compared with that of classical Cox proportional risk model using Delong test. Results:Based on PET images combined with clinical feature training, AUCs of the ResNet in predicting 12-, 24-, and 36-month postoperative recurrence were 0.895±0.073, 0.861±0.058 and 0.754±0.111, respectively, which were 0.717±0.093, 0.697±0.081 and 0.645±0.087 for Cox proportional hazards model respectively ( z values: -3.00, -2.98, -1.09, P values: 0.011, 0.018, 0.310). The ResNet showed best predictive effect for recurrence events within 12 months after surgery. Conclusion:The ResNet model is expected to be used in clinical practice for postoperative follow-up of patients with TLE, helping for risk stratification and individualized management of postoperative patients.

ObjectiveTo explore the effect of home exercise on pain, function and quality of life after operation for rotator cuff injury. MethodsFrom June, 2023 to June, 2024, 45 patients after operation for rotator cuff injury were selected from Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University and Xuzhou Central Hospital, and randomly divided into conventional group (n = 15), home-based group (n = 15) and combined group (n = 15). The conventional group received an eight-week routine rehabilitation program in hospital, the home-based group received an eight-week home exercise prescription training, and the combined group first received four weeks of routine rehabilitation in hospital, and followed by four weeks of home exercise prescription training. They were assessed with Visual Analogue Scale for pain (VAS), University of California at Los Angeles shoulder rating scale (UCLA), Constant-Murley Score (CMS), range of motion (ROM) of shoulder, and the Short-form of Health Survey-36 (SF-36) before treatment, and four and eight weeks after treatment. ResultsVAS scores decreased in all the three groups four and eight weeks after treatment (Z > 2.964, P < 0.001), which was the most in the home-based group four weeks after treatment (|Z| > 2.531, P < 0.05). The main effect of time was significant in scores of UCLA, CMS, and physical health and mental health of SF-36 (F > 498.102, P < 0.001), which improved after treatment (P < 0.001). The main effect of group was significant in score of mental health of SF-36 (F = 7.408, P = 0.002), which was the most in the home-based group four and eight weeks after treatment (P < 0.01). The interaction was significant in score of physical health of SF-36 (F = 10.138, P < 0.001), which was the least in the home-based group four weeks after treatment (P < 0.05). The main effect of time was significant in every direction of ROM, which improved after treatment (P < 0.001). The interaction was significant in ROM of abduction and external rotation (F > 4.059, P < 0.01), and almost significant in ROM of flexion (F = 2.412, P = 0.055). However, ROM of flexion was less in the home-based group than in the combined group four weeks after treatment (P = 0.047), which was less in the home-based group than in the conventional group eight weeks after treatment (P = 0.042); ROM of abduction was the least in the home-based group four weeks after treatment (P < 0.01), which was less in the home-based group than in the combined group eight weeks after treatment (P = 0.046); ROM of external rotation was less in the home-based group than in the combined group four weeks after treatment (P = 0.022). ConclusionHome exercise is effective on pain, function and quality of life in patients after operation for rotator cuff injury. There are benefits with both home exercise and institution-based rehabilitation, and almost the same in a whole eight weeks after treatment.

Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.

Objective:To explore the effect of enriched environment on pain sensitivity, anxiety- and depressive-like behavior in selective nerve injury(SNI) rats model and its potential mechanism.Methods:A total of 36 male clean grade SD rats aged 6-8 weeks were randomly divided into three groups( n=12 in each group): sham operation+ standard environment group (sham group), SNI+ standard environment group (standard environment group), SNI+ enriched environment group (enriched environment group). The rat model of neuropathic pain was established by SNI.The rats in the enriched enviroment group were placed in an enriched enviroment 7 days before operation until 21 days after operation.The paw withdraw threshold(PWT) and paw withdraw latency (PWL) were performed to assess hyperalgesia.The open field test, elevated plus maze test, novelty suppressed feeding test and forced swimming test were used to assess anxiety and depression like behavior.The expressions of cAMP response element binding protein (CREB), p-CREB, brain-derived neurotrophic factor (BDNF), postsynaptic density-95 (PSD-95) and neuroligin 2 (NLGN2) were detected by Western blot.The expression of CREB and BDNF in contralateral ACC were measured by immunofluorescence.GraphPad prism 8.0 and SPSS 23.0 were used for data analysis.One way ANOVA was used for inter group comparison, repeated measurement ANOVA was used to analyze PWT and PWL results, and Tukey test was used for pairwise comparison. Results:(1) In PWT and PWL experiments, the interaction effect between group and time, group main effect and time main effect of PWT were significant ( F=13.4, 39.6, 369.6, all P<0.05), and the interaction effect between group and time, group main effect and time main effect of PWL were significant ( F=3.8, 10.3, 58.8, all P<0.05). Compared with sham group, PWT((8.0±3.5) g, (2.4±1.4) g, (2.3±1.1) g, (2.2±1.6) g, (1.6±0.5) g) and PWL((8.6±1.3) s, (7.3±1.5) s, (7.9±1.0) s, (6.6±1.1) s, (7.7±1.4) s) in standard environment group decreased at each time point (all P<0.05). (2) Compared with sham group, the number of entrying into the central area (1.3±1.7), the time of entrying into the central area((1.6±1.3) s), the proportion of entering open arms ((8.0±7.8) %) and the proportion of time in the open arms ((1.3±1.2) %) all significantly decreased in standard environment group ( t=4.585, 5.423, 4.682, 5.202, all P<0.05). The eating latency ((365.2±94.4) s) and immobility time ((127.6±24.3) s) dramatically increased ( t=6.008, 14.290, both P<0.05). The number and time of entrying into central area of enriched environment group were both higher than those of standard environment group(both P<0.05), while the eating latency and immobility time of enriched environment group were both lower than those of standard environment group(both P<0.05). (3) Compared with sham group(CREB: (1.6±0.2), (0.8±0.5); BDNF: (0.8±0.5), (1.0±0.4)), the expression of CREB ((1.8±0.1), (1.5±0.2)), BDNF ((0.9±0.6), (1.4±0.3)) in spinal cord and ACC of standard environment group increased (spinal: t=3.283, 4.989; ACC: t=5.502, 4.257, all P<0.05). The expression of PSD-95 ((1.6±0.2), (1.0±0.2) and NLGN2 ((1.5±0.5), (1.1±0.2)) also increased in ACC of standard enviroment group ( t=4.257, 2.214, both P<0.05). Compared with standard environment group, the expression of CREB (1.3±0.3), BDNF (0.7±0.4), PSD-95(1.0±0.3) and NLGN2(1.1±0.4) in spinal cord of enriched environment group decreased ( t=5.007, 2.166, 2.358, 2.322, all P<0.05). The expression of PSD-95(1.2±0.3) and NLGN2(1.1±0.2) also decreased in ACC of enriched environment group ( t=2.674, 2.944, both P<0.05). However, the expression of p-CREB (1.7±0.6) and BDNF (2.4±0.2) increased in ACC ( t=4.180, 7.610, P<0.05). Conclusion:Enriched environment can improve neuropathic pain and anxiety- and depressive-like behavior in SNI rats, which may be related to the change of synaptic plasticity in spinal cord and ACC.