Objective To validate the efficacy of the prediction model for difficulty of peroral endoscopic myotomy (POEM) through an independent cohort. Methods A total of 617 patients with achalasia who underwent POEM at the Endoscopy Center of Zhongshan Hospital, Fudan University from January 2021 to December 2023 were included. The general data of patients were collected, and the predictive value of the prediction model for POEM difficulty in the validation cohort was estimated. The stratified analysis was undergone according to the difficulty risk scores. Results In 617 consecutive patients, technical difficulty was observed in 90 cases (14.6%). The predictive model demonstrated moderate discriminatory capacity with an area under the receiver operating characteristic curve (AUC) of 0.711 (95%CI 0.643-0.780). Patients were stratified into three risk categories according to the difficulty risk scores: low-risk (＜0.1), medium-risk (0.1-0.25), and high-risk (≥0.25). The corresponding technical difficulty rates were 7.3%, 16.9%, and 51.6%, respectively. Conclusion The prediction model for POEM difficulty built by our center shows good stability and discrimination, and has good clinical application value.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Objective:To investigate the level of occupational health literacy (OHL) among workers in the electronic manufacturing industry, analyze the influencing factors, and provide a scientific basis for occupational health promotion work.Methods:From July to September 2022, a stratified cluster random sampling method was adopted, and 870 workers from 20 large, medium, small and micro electronic manufacturing enterprises in Guangdong Province were selected as the research subjects. The OHL level of workers was investigated by using the "Personal Questionnaire for Monitoring and Surveying Occupational Health Literacy of National Key Populations", and the influencing factors were analyzed by binary logistic regression.Results:The OHL level of workers in electronic manufacturing industry was 36.09% (314/870). The OHL levels in the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, healthy work methods and behaviors, and basic skills of occupational health protection were 39.08% (340/870), 78.97% (687/870), 56.55% (492/870), and 22.41% (195/870), respectively. logistic regression analysis showed that junior high school, senior high school/vocational high school/technical secondary school education, and average monthly income of 5000-6999 yuan and ≥7000 yuan were protective factors for high OHL levels among workers ( P<0.05) . Conclusion:The OHL level of workers in the electronic manufacturing industry is relatively low, and the promotion and intervention of OHL should be actively carried out to effectively improve the health literacy level of workers, focusing on workers with low education and low income.

Objective To evaluate the efficacy rebound of congenital auricle deformation after noninvasive cor-rection of EarWell and study the environmental factors that may affect the occurrence of the disease.Methods ① A total of 86 children diagnosed with congenital auricle deformation in the First Hospital of Jilin University were se-lected as the treatment group(treated with EarWell),and the rebound after treatment was compared among differ-ent age groups(group A:3-7 days,31 ears,group B:8-42 days,59 ears,group C:＞42 days,33ears).② 77 chil-dren with normal auricle with similar age were selected as the control group,and the relevant information of the two groups of children was collected by questionnaire survey to analyze the risk factors that may affect the occurrence of the disease.Results ① A total of 13.0％of deformed ears developed rebound,with about 81.3％occurring within three months after the end of treatment.The rebound rate of group C was higher than those of groups A and B(P＜0.001),and there was no significant difference between groups A and B(P＞0.05).② Compared with the con-trol group,the parents in the treatment group were older at birth,the incidence of smoking of the father,abortion of the mother,hypertension and anemia of pregnancy was higher,and the incidence of folic acid supplementation and cesarean section of the mother was lower(P＜0.05).Multivariate logistic regression model analysis showed that paternal age(OR=1.58,P=0.003),hypertension during pregnancy(OR=4.39,P=0.004),and anemia during pregnancy(OR=3.72,P=0.005)were independent risk factors for congenital auricle deformation.Folic acid sup-plementation for mothers(OR=0.44,P=0.049)and cesarean section(OR=0.35,P=0.008)were the protective factors.Conclusion The rebound of congenital auricular deformation after non-invasive correction mostly occurred within three months after treatment,and the rebound rate of deformed ear with children of age greater than 42 days was higher.Moreover,its occurrence may be related to the age of the father,whether the mother regularly supple-ments folic acid,the mode of production,whether have hypertension or anemia during pregnancy.

Objective:To explore the relationship between mindfulness, optimism, and subjective well-being in post-lung transplantation patients, so as to provide a basis for nursing staff to improve patients' subjective well-being.Methods:This study was a cross-sectional survey. Convenience sampling was used to select 205 post-lung transplantation patients admitted to the First Affiliated Hospital of Guangzhou Medical University from October 2022 to November 2023 for the study. General Information Questionnaire, World Health Organization-Five Well-Being Scale, Mindful Attention Awareness Scale (MAAS) and Life Orientation Test-R (LOT-R) were used to investigate the study participants. Pearson correlation was used to analyze the correlation between subjective well-being and mindfulness and optimism in patients after lung transplantation. AMOS 24.0 software was used to construct a mediating model to analyze the path relationship between mindfulness, optimism and subjective well-being.Results:A total of 205 questionnaires were distributed and 202 valid questionnaires were recovered, with an effective recovery rate of 98.54% (202/205). In 202 patients after lung transplantation, the WHO-5 Well-Being Scale total score, MAAS total score, and LOT-R score were (16.31±4.73), (56.75±9.44), and (18.49±3.85), respectively. Lung transplantation patients' subjective well-being was positively correlated with mindfulness and optimism ( r=0.570, 0.600, both P<0.01). Optimism partially mediated the relationship between mindfulness and subjective well-being, with an effect value of 0.290 and an effect proportion of 52.35% (0.290/0.554) . Conclusions:Mindfulness and optimism are both positively correlated with subjective well-being in post-lung transplantation patients, and mindfulness could also influence subjective well-being through the mediating effect of optimism. Healthcare professionals should fully explore and cultivate positive psychological resources, such as mindfulness, in lung transplant patients, by increasing optimism as the target of intervention, which in turn improves patients' subjective well-being.

Objective To evaluate the efficacy rebound of congenital auricle deformation after noninvasive cor-rection of EarWell and study the environmental factors that may affect the occurrence of the disease.Methods ① A total of 86 children diagnosed with congenital auricle deformation in the First Hospital of Jilin University were se-lected as the treatment group(treated with EarWell),and the rebound after treatment was compared among differ-ent age groups(group A:3-7 days,31 ears,group B:8-42 days,59 ears,group C:＞42 days,33ears).② 77 chil-dren with normal auricle with similar age were selected as the control group,and the relevant information of the two groups of children was collected by questionnaire survey to analyze the risk factors that may affect the occurrence of the disease.Results ① A total of 13.0％of deformed ears developed rebound,with about 81.3％occurring within three months after the end of treatment.The rebound rate of group C was higher than those of groups A and B(P＜0.001),and there was no significant difference between groups A and B(P＞0.05).② Compared with the con-trol group,the parents in the treatment group were older at birth,the incidence of smoking of the father,abortion of the mother,hypertension and anemia of pregnancy was higher,and the incidence of folic acid supplementation and cesarean section of the mother was lower(P＜0.05).Multivariate logistic regression model analysis showed that paternal age(OR=1.58,P=0.003),hypertension during pregnancy(OR=4.39,P=0.004),and anemia during pregnancy(OR=3.72,P=0.005)were independent risk factors for congenital auricle deformation.Folic acid sup-plementation for mothers(OR=0.44,P=0.049)and cesarean section(OR=0.35,P=0.008)were the protective factors.Conclusion The rebound of congenital auricular deformation after non-invasive correction mostly occurred within three months after treatment,and the rebound rate of deformed ear with children of age greater than 42 days was higher.Moreover,its occurrence may be related to the age of the father,whether the mother regularly supple-ments folic acid,the mode of production,whether have hypertension or anemia during pregnancy.

Objective:To investigate the level of occupational health literacy (OHL) among workers in the electronic manufacturing industry, analyze the influencing factors, and provide a scientific basis for occupational health promotion work.Methods:From July to September 2022, a stratified cluster random sampling method was adopted, and 870 workers from 20 large, medium, small and micro electronic manufacturing enterprises in Guangdong Province were selected as the research subjects. The OHL level of workers was investigated by using the "Personal Questionnaire for Monitoring and Surveying Occupational Health Literacy of National Key Populations", and the influencing factors were analyzed by binary logistic regression.Results:The OHL level of workers in electronic manufacturing industry was 36.09% (314/870). The OHL levels in the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, healthy work methods and behaviors, and basic skills of occupational health protection were 39.08% (340/870), 78.97% (687/870), 56.55% (492/870), and 22.41% (195/870), respectively. logistic regression analysis showed that junior high school, senior high school/vocational high school/technical secondary school education, and average monthly income of 5000-6999 yuan and ≥7000 yuan were protective factors for high OHL levels among workers ( P<0.05) . Conclusion:The OHL level of workers in the electronic manufacturing industry is relatively low, and the promotion and intervention of OHL should be actively carried out to effectively improve the health literacy level of workers, focusing on workers with low education and low income.