Objective: To compare the predictive performance of the seasonal autoregressive integrated moving average (SARIMA) model, the Prophet model, and the Bayesian structural time series (BSTS) model in forecasting the incidence of hand, foot, and mouth disease (HFMD) , so as to provide a basis for optimizing the early warning system of this disease. Methods: Weekly incidence data of HFMD in Longgang District, Shenzhen City from 2014 to 2024 were collected. The HFMD incidence data from 2014-2019 and 2023 were used as the training set to construct SARIMA, Prophet, and BSTS models, while the data from 2024 were used as the test set to compare and evaluate the predictive performance of the three models. The technique for order preference by similarity to ideal solution (TOPSIS) method was employed to calculate the C-value. This approach integrates multiple evaluation metrics, such as the mean absolute error (MAE), mean squared error (MSE), root mean squared error (RMSE), and symmetric mean absolute percentage error (SMAPE), to comprehensively assess model performance. Results: A total of 150 111 cases of HFMD were reported in Longgang District from 2014 to 2024, with an average annual incidence of 400.72/105. The weekly incidence fluctuated between 0 and 63.78/105, exhibiting a bimodal seasonal pattern characterized by a primary peak from May to July and a secondary peak from September to October. In the training set, all three models demonstrated a good fit to the bimodal epidemic trend of HFMD, with the BSTS model achieving the best fit. The BSTS model yielded performance metrics as follows: MAE=0.124, MSE=0.050, RMSE=0.223, SMAPE=0.021, and a C-value of 1.000. In the test set, all three models, including SARIMA, Prophet, and BSTS, performed well for short-term predictions (≤16 weeks), with the Prophet model showing relatively superior predictive performance. However, the prediction accuracy of all models declined as the forecast horizon extended. During the primary peak period (May-July), the Prophet model exhibited better predictive performance, whereas the BSTS model performed relatively better during the secondary peak period (September-October). Conclusions For the short-term forecasting of weekly HFMD incidence, the Prophet model outperformed both the SARIMA and BSTS models. During the primary peak period, the Prophet model demonstrated superior predictive performance, whereas the BSTS model exhibited better accuracy in forecasting the secondary peak period.

The three-dimensional (3D) printed bone tissue repair guide scaffold is considered a promising method for treating bone defect repair. In this experiment, chitosan (CS), sodium alginate (SA), and mineralized collagen (MC) were combined and 3D printed to form scaffolds. The experimental results showed that the printability of the scaffold was improved with the increase of chitosan concentration. Infrared spectroscopy analysis confirmed that the scaffold formed a cross-linked network through electrostatic interaction between chitosan and sodium alginate under acidic conditions, and X-ray diffraction results showed the presence of characteristic peaks of hydroxyapatite, indicating the incorporation of mineralized collagen into the scaffold system. In the in vitro collagen release experiments, a weakly alkaline environment was found to accelerate the release rate of collagen, and the release amount increased significantly with a lower concentration of chitosan. Cell experiments showed that scaffolds loaded with mineralized collagen could significantly promote cell proliferation activity and alkaline phosphatase expression. The subcutaneous implantation experiment further verified the biocompatibility of the material, and the implantation of printed scaffolds did not cause significant inflammatory reactions. Histological analysis showed no abnormal pathological changes in the surrounding tissues. Therefore, incorporating mineralized collagen into sodium alginate/chitosan scaffolds is believed to be a new tissue engineering and regeneration strategy for achieving enhanced osteogenic differentiation through the slow release of collagen.
Chitosan/chemistry* ; Alginates/chemistry* ; Tissue Scaffolds/chemistry* ; Printing, Three-Dimensional ; Osteogenesis ; Collagen/chemistry* ; Cell Differentiation ; Animals ; Tissue Engineering/methods* ; Cell Proliferation ; Biocompatible Materials ; Glucuronic Acid/chemistry* ; Hexuronic Acids/chemistry*

Objective To investigate the impact of noise isolation through the use of noise-cancelling headphones on the quality of postoperative recovery following esophageal or gastric endoscopic submucosal dissec-tion.Methods This is a prospective,parallel-group,randomized controlled clinical trial.Patients aged 18 years or older,regardless of gender and with ASA physical status Ⅰ-Ⅳ,who underwent elective esophageal or gastric endoscopic submucosal dissection under general anesthesia with endotracheal intubation from August 2023 to February 2024 were randomly assigned to either a control group or an observation group using a random number table.In the observation group,noise-cancelling headphones were used to reduce intraoperative noise intensity during general anesthesia,while the control group did not receive any noise isolation measures.The study recorded the average noise intensity during surgery and the proportion of intraoperative time with noise intensity≥70 dB.The primary outcome was the quality of recovery at 24 hours postoperatively,assessed using the 15-item Quality of Recovery Scale(QoR-15).Secondary outcomes included QoR-15 scores at 48 hours postoperatively,resting and movement-evoked pain scores measured by the Visual Analog Pain Scale(VAS)immediately after extubation,upon leaving the resuscitation room,and at 24 and 48 hours postoperatively,as well as analgesic drug consumption during surgery and within 48 hours postoperatively.Additionally,sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI)at 48 hours postoperatively.Results Compared with the control group,the observation group exhibited a significant increase in QoR-15 score at 24 hours post-surgery[(123.43±5.92)vs.(119.75±6.62),t=3.211,P=0.002].The resting VAS score[1(0,3)vs.2(2,3),Z=-3.755,P<0.001]and movement-evoked VAS score[2(1,3)vs.3(2,3),Z=-2.959,P=0.003]of the observation group immediately after extubation were significantly lower than those of control group.There was no significant difference in resting and movement-evoked VAS scores between the two groups when leaving the resuscitation room or at 24 and 48 hours after surgery(P>0.05).The intraoperative fentanyl consumption was significantly lower in the observation group compared to the control group[(0.23±0.05)vs.(0.27±0.06),t=3.515,P=0.01].There were no significant differences in remifentanil consumption during surgery or in the frequency of rescue analgesia with flurbiprofen axetil within 48 hours post-surgery(P>0.05).Postoperative PSQI scores were significantly lower in the observation group compared to the control group[(5.40±2.57)vs.(6.63±3.23),t=2.313,P=0.022].Conclusion The use of noise-cancelling headphones for intraoperative noise isolation is a safe and effective strategy that enhances postop-erative recovery quality,alleviates postoperative pain,and decreases the overall consumption of analgesic drugs in patients undergoing endoscopic submucosal dissection of esophageal and gastric lesions under general anesthesia.

Objective:To improve the isolation and culture method of seasonal influenza virus in embryonated chicken eggs (ECEs), and evaluate their isolation efficiency.Methods:We randomly selected 80 positive samples of H1N1 (H1N1pdm09) and seasonal H3N2 (H3N2snl) influenza virus nucleic acid, and inoculated them into the amniotic and urinary sac cavities of 10-day-old (traditional method) and 14-day-old (improved method) ECEs respectively to adapt the virus to the ECEs (E1-E2). Both method were used to inoculate 10-day-old urinary sac amplification virus (E2-E3), and the final virus isolation positive rates of the two method were compared; using fluorescence quantitative PCR method to detect viral nucleic acids in the improved amniotic and urinary sac cultures, and evaluate the viral proliferation at different inoculation sites; we analyzed the correlation between virus content and isolation positivity rate in the original specimen based on the CT value of nucleic acid testing and the final virus isolation positivity rate using the improved method.Results:The improved method obtained 42 strains of H1N1pdm09 strain, with a positive rate of 52.5% ( χ2=38.571, P<0.01); obtained 54 strains of H3N2snl strain, with a positive rate of 67.5% ( χ2=40.921, P<0.01). Significant differences were observed in the isolation efficiency of H1N1pdm09 samples when the improved method was applied to different inoculation sites of chicken embryos ( χ2=30.476, P<0.01), and similar differences were noted for H3N2snl samples ( χ2=4.928, P=0.026). There was no significant difference in the isolation rate of different CT value intervals of the original samples ( χH1N1pdm092=10.226, χH3N2snl2=3.764, P>0.05). Conclusions:The improved method of inoculating 14-day old ECEs adapted the virus, and the final number of strains obtained was significantly higher than the traditional method of inoculating 10 day old ECEs, which can significantly improve the positive isolation rate of H1N1pdm09 and H3N2snl influenza virus in ECEs. The amniotic cavity is more sensitive to H1N1pdm09 and H3N2snl influenza viruses, which helps the virus adapt in ECEs. There was no significant difference in the sample isolation rate and total positive rate of virus isolation among different CT value ranges, and further verification is needed.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

Objective To investigate the impact of noise isolation through the use of noise-cancelling headphones on the quality of postoperative recovery following esophageal or gastric endoscopic submucosal dissec-tion.Methods This is a prospective,parallel-group,randomized controlled clinical trial.Patients aged 18 years or older,regardless of gender and with ASA physical status Ⅰ-Ⅳ,who underwent elective esophageal or gastric endoscopic submucosal dissection under general anesthesia with endotracheal intubation from August 2023 to February 2024 were randomly assigned to either a control group or an observation group using a random number table.In the observation group,noise-cancelling headphones were used to reduce intraoperative noise intensity during general anesthesia,while the control group did not receive any noise isolation measures.The study recorded the average noise intensity during surgery and the proportion of intraoperative time with noise intensity≥70 dB.The primary outcome was the quality of recovery at 24 hours postoperatively,assessed using the 15-item Quality of Recovery Scale(QoR-15).Secondary outcomes included QoR-15 scores at 48 hours postoperatively,resting and movement-evoked pain scores measured by the Visual Analog Pain Scale(VAS)immediately after extubation,upon leaving the resuscitation room,and at 24 and 48 hours postoperatively,as well as analgesic drug consumption during surgery and within 48 hours postoperatively.Additionally,sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI)at 48 hours postoperatively.Results Compared with the control group,the observation group exhibited a significant increase in QoR-15 score at 24 hours post-surgery[(123.43±5.92)vs.(119.75±6.62),t=3.211,P=0.002].The resting VAS score[1(0,3)vs.2(2,3),Z=-3.755,P<0.001]and movement-evoked VAS score[2(1,3)vs.3(2,3),Z=-2.959,P=0.003]of the observation group immediately after extubation were significantly lower than those of control group.There was no significant difference in resting and movement-evoked VAS scores between the two groups when leaving the resuscitation room or at 24 and 48 hours after surgery(P>0.05).The intraoperative fentanyl consumption was significantly lower in the observation group compared to the control group[(0.23±0.05)vs.(0.27±0.06),t=3.515,P=0.01].There were no significant differences in remifentanil consumption during surgery or in the frequency of rescue analgesia with flurbiprofen axetil within 48 hours post-surgery(P>0.05).Postoperative PSQI scores were significantly lower in the observation group compared to the control group[(5.40±2.57)vs.(6.63±3.23),t=2.313,P=0.022].Conclusion The use of noise-cancelling headphones for intraoperative noise isolation is a safe and effective strategy that enhances postop-erative recovery quality,alleviates postoperative pain,and decreases the overall consumption of analgesic drugs in patients undergoing endoscopic submucosal dissection of esophageal and gastric lesions under general anesthesia.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

Objective:To improve the isolation and culture method of seasonal influenza virus in embryonated chicken eggs (ECEs), and evaluate their isolation efficiency.Methods:We randomly selected 80 positive samples of H1N1 (H1N1pdm09) and seasonal H3N2 (H3N2snl) influenza virus nucleic acid, and inoculated them into the amniotic and urinary sac cavities of 10-day-old (traditional method) and 14-day-old (improved method) ECEs respectively to adapt the virus to the ECEs (E1-E2). Both method were used to inoculate 10-day-old urinary sac amplification virus (E2-E3), and the final virus isolation positive rates of the two method were compared; using fluorescence quantitative PCR method to detect viral nucleic acids in the improved amniotic and urinary sac cultures, and evaluate the viral proliferation at different inoculation sites; we analyzed the correlation between virus content and isolation positivity rate in the original specimen based on the CT value of nucleic acid testing and the final virus isolation positivity rate using the improved method.Results:The improved method obtained 42 strains of H1N1pdm09 strain, with a positive rate of 52.5% ( χ2=38.571, P<0.01); obtained 54 strains of H3N2snl strain, with a positive rate of 67.5% ( χ2=40.921, P<0.01). Significant differences were observed in the isolation efficiency of H1N1pdm09 samples when the improved method was applied to different inoculation sites of chicken embryos ( χ2=30.476, P<0.01), and similar differences were noted for H3N2snl samples ( χ2=4.928, P=0.026). There was no significant difference in the isolation rate of different CT value intervals of the original samples ( χH1N1pdm092=10.226, χH3N2snl2=3.764, P>0.05). Conclusions:The improved method of inoculating 14-day old ECEs adapted the virus, and the final number of strains obtained was significantly higher than the traditional method of inoculating 10 day old ECEs, which can significantly improve the positive isolation rate of H1N1pdm09 and H3N2snl influenza virus in ECEs. The amniotic cavity is more sensitive to H1N1pdm09 and H3N2snl influenza viruses, which helps the virus adapt in ECEs. There was no significant difference in the sample isolation rate and total positive rate of virus isolation among different CT value ranges, and further verification is needed.

Objective:To explore the impact of whole blood organophosphate esters (OPEs) flame retardant exposure on thyroid function-related hormones in healthy older adults.Methods:In this panel study, five repeated population-based epidemiological surveys and biological sample collection were conducted from September 2018 to January 2019, with 76 healthy older adults aged 60-69 years in the Dianliu Community of Jinan, Shandong Province. Information on the sociodemographic characteristics, diet, and health status of the respondents was systematically gathered through questionnaires and physical examinations. Fasting venous blood was collected to determine the levels of OPEs, thyroid-stimulating hormone (TSH), triiodothyronine (T 3), and thyroxine (T 4). A linear mixed-effects model was used to analyze the impact of OPEs exposure on thyroid function-related hormones in healthy older adults. Results:Each of the 76 subjects participated in at least two follow-up visits, resulting in a total of 350 person visits. The age of the study participants was (65.07±2.76) years, with 38 participants of both sexes. A total of eight OPEs were included with a detection rate exceeding 50%, and the M ( Q 1, Q3) for ∑OPEs was 3.85 (2.33, 5.74) ng/ml, with alkyl-OPEs being the major type of OPEs with an M ( Q 1, Q3) of 1.27 (0.64, 2.50) ng/ml. The M ( Q 1, Q3) for TSH, T 3, and T 4 was 3.74 (2.55, 5.69) μIU/ml, 1.32 (1.10, 1.60) ng/ml, and 45.04 (36.96, 53.27) ng/ml, respectively. Linear mixed-effects model showed that TSH was significantly decreased by 9.93% (95% CI:-15.17%, -4.36%) and 11.14% (95% CI:-15.94%, -6.06%) in older adults for each quartile level increase in TnBP and TEHP exposures, respectively. Gender-stratified analysis indicated that TEHP exposure was negatively associated with TSH levels in male older adults, whereas a decrease in TSH levels among female older adults was associated with TnBP exposure. Conclusion:Exposure to whole blood OPEs is associated with decreased TSH levels among healthy older adults, with notable gender differences.

Objective:To explore the impact of whole blood organophosphate esters (OPEs) flame retardant exposure on thyroid function-related hormones in healthy older adults.Methods:In this panel study, five repeated population-based epidemiological surveys and biological sample collection were conducted from September 2018 to January 2019, with 76 healthy older adults aged 60-69 years in the Dianliu Community of Jinan, Shandong Province. Information on the sociodemographic characteristics, diet, and health status of the respondents was systematically gathered through questionnaires and physical examinations. Fasting venous blood was collected to determine the levels of OPEs, thyroid-stimulating hormone (TSH), triiodothyronine (T 3), and thyroxine (T 4). A linear mixed-effects model was used to analyze the impact of OPEs exposure on thyroid function-related hormones in healthy older adults. Results:Each of the 76 subjects participated in at least two follow-up visits, resulting in a total of 350 person visits. The age of the study participants was (65.07±2.76) years, with 38 participants of both sexes. A total of eight OPEs were included with a detection rate exceeding 50%, and the M ( Q 1, Q3) for ∑OPEs was 3.85 (2.33, 5.74) ng/ml, with alkyl-OPEs being the major type of OPEs with an M ( Q 1, Q3) of 1.27 (0.64, 2.50) ng/ml. The M ( Q 1, Q3) for TSH, T 3, and T 4 was 3.74 (2.55, 5.69) μIU/ml, 1.32 (1.10, 1.60) ng/ml, and 45.04 (36.96, 53.27) ng/ml, respectively. Linear mixed-effects model showed that TSH was significantly decreased by 9.93% (95% CI:-15.17%, -4.36%) and 11.14% (95% CI:-15.94%, -6.06%) in older adults for each quartile level increase in TnBP and TEHP exposures, respectively. Gender-stratified analysis indicated that TEHP exposure was negatively associated with TSH levels in male older adults, whereas a decrease in TSH levels among female older adults was associated with TnBP exposure. Conclusion:Exposure to whole blood OPEs is associated with decreased TSH levels among healthy older adults, with notable gender differences.