AIM: To screen and analyze the influencing factors of myopia among primary and secondary school students and establish a predictive model to provide ideas for the prevention and control measures of myopia among children and adolescents.METHODS:A total of 1 759 primary and secondary school students from 2 primary schools, 2 junior high schools, 2 senior high schools and 1 vocational high school in the urban area of Qingdao were sampled by means of stratified cluster sampling in September 2023. Vision screening and a questionnaire survey on influencing factors were carried out based on machine learning algorithms. The screening and determination were mainly conducted in accordance with the Standard Logarithmic Visual Acuity Chart(GB/T11533-2011)and the Specifications for Screening Myopia in Children and Adolescents. The influencing factors of myopia were analyzed and a prediction model was developed based on the machine learning algorithms LASSO in combination with XGBoost, and visualization was achieved through an interactive Nomogram. Statistical analysis was performed using R statistical software version 4.3.3.RESULTS:The screening prevalence of myopia among primary and secondary school students in the urban area of Qingdao was 70.61%(1 242 cases). The optimal predictive variables for screening were grade, gender, whether parents were myopic, daily indoor sedentary time, appropriate distance between eyes and books during reading and writing, daily sleep time, distance between eyes and TV screen when watching TV/playing video games exceeding 3 meters, the playground during breaks, total duration of tutorial classes, how often eyes are rested during near work, daily computer usage time, and average daily homework time after school, totaling 12 influencing factors. The AUCs of the training set and test set were 0.770(95%CI:0.751-0.789)and 0.732(95%CI:0.714-0.750), respectively.CONCLUSION: A machine learning-based prediction model was developed and validated to predict the risk of myopia onset in primary and secondary school students, accompanied by effective visualization techniques.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

The xylitol dehydrogenase(XDH)is a crucial enzyme involved in the xylose utilization in pentose-catabolizing yeasts and fungi.In addition to producing xylulose,XDH can also be employed to develop a biosensor for monitoring xylitol concentration.In this study,the gene encoding the thermophilic fungus Talaromyces emersonii XDH(TeXDH)was heterologously expressed in Escherichia coli BL21(DE3)at 16 ℃ in the soluble form.Recombinant TeXDH with high purity was purified by using a Ni-NTA affinity column.Size-exclusion chromatography and SDS-PAGE analysis demonstrated that the puri-fied recombinant TeXDH exists as a native trimer with a molecular mass of approximately 116 kD,and is composed of three identical subunits,each with a molecular weight of around 39 kD.The TeXDH strictly preferred NAD+as a coenzyme to NADP+.The optimal temperature and pH of the TeXDH were 40 ℃and 10.0,respectively.After EDTA treatment,the enzyme activity of TeXDH decreased to 43.26％of the initial enzyme activity,while the divalent metal ions Mg2+or Ca2+could recover the enzyme activity of TeXDH,reaching 103.32％and 110.69％of the initial enzyme activity,respectively,making them the optimal divalent metal ion cofactors for TeXDH enzyme.However,the divalent metal ions of Mn2+,Ni2+,Cu2+,Zn2+,Co2+,and Cd2+significantly inhibited the activity of TeXDH.ICP-MS and molecular doc-king studies revealed that 1 mol/L of TeXDH bound 2 mol/L Zn2+ions and 1 mol/L Mg2+ion.Further-more,TeXDH exhibited a high specificity for xylitol,laying the foundation for the development of future xylitol biosensors.

The xylitol dehydrogenase(XDH)is a crucial enzyme involved in the xylose utilization in pentose-catabolizing yeasts and fungi.In addition to producing xylulose,XDH can also be employed to develop a biosensor for monitoring xylitol concentration.In this study,the gene encoding the thermophilic fungus Talaromyces emersonii XDH(TeXDH)was heterologously expressed in Escherichia coli BL21(DE3)at 16 ℃ in the soluble form.Recombinant TeXDH with high purity was purified by using a Ni-NTA affinity column.Size-exclusion chromatography and SDS-PAGE analysis demonstrated that the puri-fied recombinant TeXDH exists as a native trimer with a molecular mass of approximately 116 kD,and is composed of three identical subunits,each with a molecular weight of around 39 kD.The TeXDH strictly preferred NAD+as a coenzyme to NADP+.The optimal temperature and pH of the TeXDH were 40 ℃and 10.0,respectively.After EDTA treatment,the enzyme activity of TeXDH decreased to 43.26％of the initial enzyme activity,while the divalent metal ions Mg2+or Ca2+could recover the enzyme activity of TeXDH,reaching 103.32％and 110.69％of the initial enzyme activity,respectively,making them the optimal divalent metal ion cofactors for TeXDH enzyme.However,the divalent metal ions of Mn2+,Ni2+,Cu2+,Zn2+,Co2+,and Cd2+significantly inhibited the activity of TeXDH.ICP-MS and molecular doc-king studies revealed that 1 mol/L of TeXDH bound 2 mol/L Zn2+ions and 1 mol/L Mg2+ion.Further-more,TeXDH exhibited a high specificity for xylitol,laying the foundation for the development of future xylitol biosensors.

Objective To develop a systematic and scientific assessment-adaptation-evaluation framework for wheelchair cushions.Methods A mixed-methods approach integrating literature review,qualitative interviews and Delphi expert consultation was employed.First,27 relevant studies were identified through systematic literature searches,comprehensively synthesizing wheelchair cushion types,performance indicators,key assessment/adaptation elements and evalua-tion methods.Second,semi-structured interviews were conducted with 24 wheelchair users and six assistive tech-nology specialists.Interview transcripts were analyzed using Colaizzi's phenomenological analysis to extract themes and deeply explore user needs and practitioner experiences.Based on the literature and interview find-ings,the research team developed a preliminary protocol comprising an assessment form,an adaptation process table and an effectiveness evaluation form.Finally,20 multidisciplinary experts participated in a two-round Del-phi consultation.Experts rated the importance of items using a 5-point Likert scale.Consensus was analyzed us-ing Kendall's W coefficient and the coefficient of variation(CV),supplemented by mean importance scores and full-score frequency to refine the protocol.Results The consultation demonstrated excellent expert engagement(100%response rate)and strong authority(Cr=0.90).The finalized protocol comprised of an assessment form(four primary domains/21 secondary items),an ad-aptation protocol(two primary domains/eight secondary items)and an evaluation form(two primary domains/15 secondary items).Statistical analysis revealed Kendall's W=0.20(P<0.05),mean importance scores of(4.48±0.72),CV=(0.15±0.05),and full-score frequency of(60.80±16.39)%,indicating acceptable consensus.Conclusion The assessment-adaptation-evaluation method for wheelchair cushions constructed in this study is scientific,comprehensive and operable,and can provide a standardized tool for clinical personalized adaptation.Future studies should enhance the applicability of the method in diverse clinical settings.

Objective To develop a systematic and scientific assessment-adaptation-evaluation framework for wheelchair cushions.Methods A mixed-methods approach integrating literature review,qualitative interviews and Delphi expert consultation was employed.First,27 relevant studies were identified through systematic literature searches,comprehensively synthesizing wheelchair cushion types,performance indicators,key assessment/adaptation elements and evalua-tion methods.Second,semi-structured interviews were conducted with 24 wheelchair users and six assistive tech-nology specialists.Interview transcripts were analyzed using Colaizzi's phenomenological analysis to extract themes and deeply explore user needs and practitioner experiences.Based on the literature and interview find-ings,the research team developed a preliminary protocol comprising an assessment form,an adaptation process table and an effectiveness evaluation form.Finally,20 multidisciplinary experts participated in a two-round Del-phi consultation.Experts rated the importance of items using a 5-point Likert scale.Consensus was analyzed us-ing Kendall's W coefficient and the coefficient of variation(CV),supplemented by mean importance scores and full-score frequency to refine the protocol.Results The consultation demonstrated excellent expert engagement(100%response rate)and strong authority(Cr=0.90).The finalized protocol comprised of an assessment form(four primary domains/21 secondary items),an ad-aptation protocol(two primary domains/eight secondary items)and an evaluation form(two primary domains/15 secondary items).Statistical analysis revealed Kendall's W=0.20(P<0.05),mean importance scores of(4.48±0.72),CV=(0.15±0.05),and full-score frequency of(60.80±16.39)%,indicating acceptable consensus.Conclusion The assessment-adaptation-evaluation method for wheelchair cushions constructed in this study is scientific,comprehensive and operable,and can provide a standardized tool for clinical personalized adaptation.Future studies should enhance the applicability of the method in diverse clinical settings.

Objective To explore the efficacy and safety of recombinant human anti-severe acute respiratory syn-drome coronavirus 2(anti-SARS-CoV-2)monoclonal antibody injection(F61 injection)in the treatment of patients with coronavirus disease 2019(COVID-19)combined with renal damage.Methods Patients with COVID-19 and renal damage who visited the PLA General Hospital from January to February 2023 were selected.Subjects were randomly divided into two groups.Control group was treated with conventional anti-COVID-19 therapy,while trial group was treated with conventional anti-COVID-19 therapy combined with F61 injection.A 15-day follow-up was conducted after drug administration.Clinical symptoms,laboratory tests,electrocardiogram,and chest CT of pa-tients were performed to analyze the efficacy and safety of F61 injection.Results Twelve subjects(7 in trial group and 5 in control group)were included in study.Neither group had any clinical progression or death cases.The ave-rage time for negative conversion of nucleic acid of SARS-CoV-2 in control group and trial group were 3.2 days and 1.57 days(P=0.046),respectively.The scores of COVID-19 related target symptom in the trial group on the 3rd and 5th day after medication were both lower than those of the control group(both P＜0.05).According to the clinical staging and World Health Organization 10-point graded disease progression scale,both groups of subjects improved but didn't show statistical differences(P＞0.05).For safety,trial group didn't present any infusion-re-lated adverse event.Subjects in both groups demonstrated varying degrees of elevated blood glucose,elevated urine glucose,elevated urobilinogen,positive urine casts,and cardiac arrhythmia,but the differences were not statistica-lly significant(all P＞0.05).Conclusion F61 injection has initially demonstrated safety and clinical benefit in trea-ting patients with COVID-19 combined with renal damage.As the domestically produced drug,it has good clinical accessibility and may provide more options for clinical practice.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective:To analyze the epidemiological characteristics of norovirus (NoV) acute gastroenteritis (AGE) outbreaks caused by GII.17[P17] variant in China, 2022.Methods:Information and specimens of AGE outbreaks between January and December 2022 were collected. NoV RNA was detected in all specimens by real-time RT-PCR. The viral genome of the positive specimens were amplified, sequenced and analyzed.Results:Between January and December 2022, 360 AGE outbreaks were reported cumulatively, of which 266 outbreaks successfully obtained genotype results. GII.17 [P17] was one of the main genotypes and detected in 34 outbreaks (12.78%, 34/266), with the highest number of outbreaks detected in spring (6 outbreaks in March and 7 outbreaks in May), mainly in childcare facilities and primary schools (61.76%, 21/34). According to the result of NoV genotype analysis in different age groups, 14 strains of GII.17 [P17] in this study belonged to Cluster III b and SC III branch of Cluster III (Kawasaki308) in the capsid region and polymerase region, respectively, and both belonged to the same cluster as the variant strain (GZ41621 strain) that caused the NoV AGE outbreaks in China during the 2014/15 season. Compared to reference strains of Cluster I, Cluster II and Cluster III a, Cluster III b was provided with 22 amino acid mutations in VP1. The main amino acid changes in the subgroup of Cluster III b including the virus strains isolated in this study were at T294I and Q299R of antigen epitope A, an insertion mutation occurred at antigen epitope D, H353Q at the site I of the human histo-blood group antigen receptor binding site. The selection pressure analysis detected a large number of negative selection sites, indicating that negative selection plays an important role in the evolution of VP1 genes.Conclusions:GII.17 [P17] was one of the primary genotypes responsible for NoV diarrhea outbreaks in China in 2022. Phylogenetic analysis had revealed that it still belonged to the same cluster as the novel GII.17 [P17] variant (strain GZ41621) that caused NoV epidemics in China during the 2014/15 season, exhibiting minor amino acid variations at the potential epitope.