BACKGROUND: Post-stroke disability diminishes the physical activity (PA) level of survivors, potentially affecting their long-term prognosis. This study endeavors to explore the correlation between daily PA level and the all-cause mortality in patients with a history of stoke in the United States. METHODS: Data of stroke survivors were sourced from the National Health and Nutritional Examination Survey (NHANES) 2007-2018. The population was stratified into three groups based on their PA level. Kaplan-Meier method with log-rank tests for significance was used for survival analysis. Weighted Cox proportional hazards regression models were employed to estimate the hazard ratios (HRs) for all-cause mortality. Subgroup analysis was conducted to strengthen the results. RESULTS: A total of 1395 participants were recruited, comprising 679 males and 716 females, with a median age of 68 years. Based on their PA levels, 779 individuals were classified as inactive, 156 as insufficiently active, and 460 as sufficiently active. Following a median observation period of 59 months, there were 476 recorded deaths, with 349, 47, and 80 cases in the three respective groups. Compared to the inactive group, the HRs and 95% confidence intervals (CIs) for all-cause mortality in participants who were insufficiently active and sufficiently active were 0.58 (0.40, 0.84) and 0.47 (0.33, 0.67), respectively. The Kaplan-Meier curve revealed a significant difference in overall survival between the three groups, as confirmed by the log-rank test (P < 0.0001). Subgroup analysis further validated our results and demonstrated that the protective impact of PA on stroke prognosis varies according to distinct characteristics. CONCLUSIONS The results indicate that increased levels of PA are associated with a protective effect on long-term mortality among stroke survivors. Further prospective longitudinal studies are necessary to elucidate the optional PA level and special exercise guideline targeting this population.
Humans ; Male ; Female ; Aged ; Exercise ; Middle Aged ; Nutrition Surveys ; Stroke/mortality* ; United States/epidemiology* ; Survivors/statistics & numerical data* ; Aged, 80 and over ; Mortality

Adolescence is defined as a population ranging from ten to nineteen years old. Permanent teeth in adolescents are of critical significance as they are actively involved in mastication, contribute to aesthetic appearance, play a role in pronunciation, and are integral to the growth and development of the stomatognathic system. Specifically, permanent teeth in adolescents comprise those with incomplete root development and those with complete root development but unstable gingival margin positions. However, the prevalence of permanent tooth defects among adolescents remains high, primarily due to their insufficient awareness of oral health care and poor compliance with preventive measures. Therefore, it is very important to emphasize the necessity for timely and appropriate restoration of permanent tooth defects in adolescents. Given the distinct physiological characteristics of adolescent permanent teeth compared with mature permanent teeth, interim restoration approaches are required. The field of adolescent permanent tooth restoration is an interdisciplinary area, involving both prosthodontics and pediatric dentistry. Currently, a comprehensive and standardized principle for the selection of restoration indications is lacking, which poses challenges for clinicians in making optimal treatment decisions. Therefore, this article aims to comprehensively summarize the clinical dilemmas associated with the restoration of adolescent permanent teeth, and propose a set of principles for the selection of restoration methods and materials, aiming to offer practical clinical guidelines for dentists when dealing with permanent tooth defects in adolescent patients. In particular, because of the different restoration dilemmas of anterior and posterior permanent teeth, a variety of interim restoration methods, their applicable conditions, advantages, and disadvantages are introduced respectively. Additionally, it provides an in-depth discussion of different interim restoration materials, including direct restoration materials like light-cured composite resin and dual-cured temporary crown resin, as well as indirect restoration materials such as polymeric porcelain and CAD/CAM resin-matrix ceramics. The goal of this research is to provide a foundation for the development of evidence-based restoration plans in clinical practice and to contribute to the establishment of future standards in the field of adolescent permanent tooth restoration. This will enhance the quality of dental care for adolescents and promote better oral health outcomes in this population.
Humans ; Adolescent ; Dentition, Permanent ; Dental Restoration, Permanent/methods* ; Child

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Objective To investigate the effect of autophagy activation on cell proliferation in human umbilical vein endothelial cells(HUVECs).Methods HUVECs were treated with rapamycin(Rapa).Western blot assay was performed to examine the expression of protein of microtubule associated protein 1 light chain 3(LC3),Beclin 1 and unc-51-like kinase 1(ULK1).Autophagosomes were detected by transmission electron microscopy(TEM),and autophagy fluorescence was detected by monodansylcadaverine staining(MDC)assay.The effect of autophagy activation on cell proliferation was assessed by CCK-8 assay and EdU assay.Vascular formation experiments were used to detect vasculogenic ability.Results After Rapa treatment,LC3,Beclin1 and ULK1 expressions were en-hanced,while the green autophagy fluorescence expression in the experimental group was stronger than that in the control group,and autophagosomes were visible by TEM;CCK-8 and EdU results showed that compared with the control group,the cell proliferation ability was weakened and tubes formation ability was reduced after the activation of autophagy in experimental cells.Conclusion Rapa upregulates autophagy activity in HUVECs to inhibit cell proliferation under certain time.

Objective To compare the clinical efficacy between a direct aspiration first-pass technique(ADAPT)and stent-retriever thrombectomy(SRT)in the treatment for acute ischemic stroke(AIS)caused by intracranial atherosclerotic stenosis related large vessel occlusion(ICAS-LVO).Methods We retrospectively included patients with AIS caused by ICAS-LVO who received endovascular treatment in The First Affiliated Hospital of Xi'an Jiaotong University or The Second Affiliated Hospital of Shaanxi University of Chinese Medicine between January 2020 and January 2023.They were divided into ADAPT group and SRT group according to the first-selected device for thrombectomy.We compared the baseline data,test and examination results,operation process,clinical prognosis and follow-up data of the two groups.Results A total of 117 patients were recruited,including 48 patients in the ADAPT group and 69 patients in the SRT group.There was no significant difference in the baseline data between the two groups.The success rate of both the first-time thrombectomy(P=0.014)and the first-selected device of thrombectomy(P＜0.001)was significantly higher in the SRT group than in the ADAPT group.Meanwhile,the incidence of iatrogenic dissection(P＜0.001)and vasospasm(P=0.003)was significantly lower in the SRT group than in the ADAPT group.The proportion of patients for whom the device of thrombectomy was changed for remedial treatment in the ADAPT group was significantly higher than that in the SRT group(P＜0.001).However,the two groups did not differ significantly in the rate of successful vascular recanalization,incidence of symptomatic/asymptomatic intracranial hemorrhage or the rate of 90-day favorable prognosis.Conclusion For patients with AIS caused by ICAS-LVO of MCA,SRT has a higher rate of immediate successful vascular recanalization with a lower rate of secondary vascular injury compared with ADAPT,but the two techniques have similar efficacy on the 90-day prognosis.

Glioblastoma (GBM) is one of the most threatening diseases of the central nervous system, and the prognosis has not improved despite the constant updating of therapeutic approaches. However, the introduction of tumor treating fields (TTFields) has changed the treatment of newly diagnosed and recurrent GBM. TTFields is a novel non-invasive therapy for the treatment of tumors using mid-frequency and low-intensity alternating electric fields, which is important for the treatment of central nervous system diseases such as GBM. TTFields has fewer side effects and greater local efficacy than traditional treatment modalities. In addition, the combination of chemotherapeutic drugs and radiotherapy with TTFields has shown significant advantages and may become one of the future clinical treatment strategies. Despite the potential of TTFields in the treatment of GBM, a number of limitations remain, including issues of device dependency, discomfort during use and tolerability in some patients. Therefore, the use of TTFields needs to be further optimized to maximize their therapeutic potential in patients with GBM and to provide more effective treatment options for patients.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Objective To investigate the effect of intravertebral labor analgesia nursing intervened by anesthesia nurse on labor analgesia and delivery outcome.Methods Two hundreds cases of parturients who received intravertebral labor analgesia in The First Affiliated Hospital of Kunming Medical University from July to December 2022 were selected as research objects and randomly divided into observation group and control group by drawing lots,with 100 cases in each group.The control group was given routine nursing by midwives,and the observation group was given anesthesia nursing by an anesthesia nurse.The degree of labor pain,the outcome of labor,the incidence of anesthesia-related complications,and the satisfaction of labor analgesia nursing were compared between the two groups.Results The degree of labor pain in the observation group was significantly lower than that in the control group(P<0.05).The duration of labor in the observation group was longer than that in the control group(P<0.05).The incidence of anesthesia-related complications in the observation group was significantly lower than that in the control group(P<0.05).The satisfaction of parturient analgesic care in the observation group was higher than that in the control group(P<0.05).Conclusion Labor analgesia care intervened by anesthesia nurses can effectively reduce labor pain,shorten the labor process,reduce the incidence of anesthesia-related complications,improve the satisfaction of labor analgesia nursing,and provide a safe,comfortable,and effective labor process for women,which is worthy of clinical promotion.