Impact of Exercise on Depression in Older Adults:Potential Benefits,Risks,and Appropriate Application Strategies

As the global elderly population increases,depression within this group has become a significant public health concern.Although exercise has been recognized for its potential to improve depression in the elderly,the benefits,risks,and implementation strategies remain contentious.This review attempts to examine the impact of exercise on depression in older adults,including potential benefits,risks,and suggestions for application.Our analysis highlights the benefits of aerobic and resistance training,which can significantly alleviate depressive symptoms and enhance overall quality of life.Despite these benefits,the review acknowledges the complexity of the exercise-depression interaction in the elderly,necessitating personalized exercise regimens.Potential risks,such as muscle and joint pain,are pointed out,emphasizing the importance of tailored,supervised exercise programs.The review calls for future research to focus on identifying the most effective types of exercise and regimens for this population,considering factors such as age,gender,and existing health conditions.Lastly,it advocates for the inclusion of exercise in comprehensive treatment plans for depression in older adults,viewing it as a promising step toward achieving holistic mental health care in a growing demographic.

Risk Factors for Geo-Helminthiasis in Children Aged 6 - 36 Months in a Rural Health District in Cameroon

Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.

美国、欧盟和我国监管部门对药品获益-风险沟通管理与实践的研究

更加安全地用药在于每个人的持续意识和警惕,对药品的获益-风险信息沟通是这一过程的重要支撑。国外对药品获益-风险沟通的探索起步相对较早。查阅美国、欧盟药品监督管理部门网站发现,美国和欧盟已形成了较为完善的沟通管理与实践体系,制定了策略计划和指南,以多种工具和途径向医疗专业人员、患者、公众沟通,主要内容包括药品法定信息、新的风险信息、潜在安全信号等。我国相关立法中已涉及到药品获益-风险,但相关指南与具体实施细则尚且缺乏,循证沟通研究与沟通工具相对不足。可以借鉴其他国家经验,加强法规落实,构建沟通体系,发展科学证据,评估沟通成效,完善沟通工具,减少信息壁垒,最终支持患者和医疗专业人员能够做出关于药物治疗的明智决策。

纳秒脉冲等离子体处理玉米中单端孢霉烯族毒素的风险-受益评估

评估纳秒脉冲等离子体处理玉米中单端孢霉烯族毒素(trichothecenes,TCT)的风险与受益,是制定食品安全相关政策的重要依据。文中采用纳秒脉冲等离子体放电对玉米中的TCT进行不同时间的减毒处理,计算玉米中TCT降解率与脂肪酸消减率;并参考BRAFO模型,对等离子体处理后玉米中TCT与脂肪酸进行定性的风险-受益评估。结果表明,纳秒脉冲等离子体处理能显著降低玉米中的TCT含量,随处理时间的延长,TCT降解率逐渐升高,处理10minT-2毒素、HT-2毒素、雪腐镰刀菌烯醇(nivalenol,NIV)、脱氧雪腐镰刀菌烯醇(deoxynivalenol,DON)可降解39.5%、34.9%、69.67%、54.62%。虽然经等离子体减毒处理后的玉米中各类脂肪酸含量有所降低,但结合我国居民日常膳食中经玉米摄入的各类脂肪酸含量以及居民膳食脂肪酸推荐量分析可得,等离子体处理对玉米中各类脂肪酸含量影响极低,其影响低于膳食营养素参考摄入量的0.05%。因此脂肪酸含量变化值及其变化可能带来的健康影响可以忽略。这表明纳秒脉冲等离子体处理能显著减少玉米中的TCT含量,将有效降低TCT对人群的健康风险,受益明显大于风险。

The Benefit Risk Assessment of Consumption of Marine Species Based on Benefit-Risk Analysis for Foods(BRAFO)-tiered Approach

Objective To assess the net health effect caused by the consumption of specific marine species based on Benefit-Risk Analysis for Foods （BRAFO）-tiered approach. Methods Twenty species were collected from the Zhoushan Archipelago, China. Concentrations of n-3 long-chain polyunsaturated fatty acids, methyl mercury （MeHg）, and dioxin-like compounds （DLCs） in the samples were analyzed for benefit risk assessment based on BRAFO-tiered approach. Results Based on the BRAFO-tiered approach, reference scenario （no intake） and alternative scenario （intake of specific species of 200 g/week） were determined. The exposure to MeHg/DLCs via alternative scenario of all studied species did not exceed provisional tolerable weekly/monthly intake. However, the adult population with high DLCs exposure in China would significantly exceed the upper limit of DLCs via an additional alternative scenario of some species such as Auxis thazard. The results of deterministic computation showed that alternative scenario of all studied species generated clear net beneficial effects on death prevention and child IQ gain. Conclusion The alternative scenario of all studied species could be recommended to population with average DLCs exposure, and the reference scenario of species with relatively high DLCs concentration could be recommended to population exposed to high DLCs.

COVID-19患者使用G-CSF的安全性

2019新冠病毒病(COVID-19)被定义为由SARS-CoV-2感染引起的疾病,短时间内就造成了全球大流行,其关键免疫病理特征包括淋巴细胞减少、中性粒细胞增多以及细胞因子风暴和肺等实质器官的免疫损伤等。COVID-19的临床表现因人而异,但最常见、最严重的症状一般是呼吸系统疾病相关的表现,肺是病毒的主要靶器官。COVID-19的一个显著特征是促炎细胞因子(包括GCSF)升高,而G-CSF可能会引发过度炎症反应,也许会使部分患者病情加重,故COVID-19是否要应用G-CSF治疗,目前颇有争议,还需要临床医生根据每个病人的具体情况评估使用G-CSF的有效性和安全性。

基于多准则决策的替格瑞洛联合替罗非班治疗急性冠脉综合征的风险-效益评价

目的基于多准则决策(MCDM)模型评价替格瑞洛联合替罗非班治疗急性冠脉综合征(ACS)的风险与效益。方法选取2019年12月~2022年2月于秦皇岛市第一医院就诊的ACS患者(n=136)为研究对象;根据随机数字表法,分为A组(n=68,替格瑞洛+替罗非班)和B组(n=68,替格瑞洛)。建立治疗ACS的MCDM模型。结果治疗后,与B组相比,A组患者的左室射血分数(LVEF)、活化部分凝血活酶时间(APTT)以及总有效率更大(均P<0.01),左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)、D-二聚体(D-D)、纤维蛋白原(FIB)、基质金属蛋白酶-9(MMP-9)、髓过氧化物酶(MPO)、主要不良心血管事件(MACE)(均P<0.01)以及不良反应(ADR)发生率(P<0.05)更小。Meta分析结果发现,与B组相比,A组疗效更显著,对改善心功能、凝血功能以及炎性反应更有优势,MACE以及ADR发生概率显著降低。计算结果显示,A组效益高且风险低,效益-风险总值为65,B组为53,且A组100%优于B组。结论对于ACS患者的治疗,替格瑞洛联合替罗非班效果较好,可显著改善凝血以及心功能,减轻炎性反应,并降低MACE以及ADR发生概率。

国外药品获益-风险评价方法概述与启示

目的进一步了解国外有关药品获益-风险评价方法,比较优劣势,为我国相关工作提供参考。方法查阅国外有关药品获益-风险评价方法的文献和其他公开资料,对相关方法进行对比分析。结果梳理出国外研究理论上适用于监管决策的7种定性评价方法和18种定量方法,并搜集相关案例进行适应性研究,并提出促进我国药品获益-风险评价方法的相关建议。结论部分方法适用性较强,建议我国明确药品获益-风险评价框架;在定性评价框架下开发使用定量评价方法;明确获益-风险的比较标准;构建全面的数据采集网络。

Co-Benefits and Risks of Implementation of Forestry Activities for Climate Change Mitigation in India

Implementation of forestry activities as a climate change mitigation option is likely to result in a range of outcomes in addition to carbon sequestration and these include changes with respect to environmental, social and economic aspects. These impacts to the extent when positive are deemed “co-benefit” and if adverse and uncertain, imply risk. It is important to recognize that implementation of forestry mitigation activities can have varied environmental, socio-economic co-benefits and/or risks. Further, there is no general agreement on attribution of co-benefits and risks to specific forestry mitigation activities. An overarching risk to mitigation potential that could be realised by implementation of forestry activities is climate change. But, overall, forestry mitigation activities also contribute to the sustainable development agenda. Maximizing co-benefits of forestry mitigation measures can increase efficiency in achieving the objectives of other international agreements.

Benefit-Risk Assessment for PD-1/PD-L1 Inhibitors in the Treatment of Non-Small Cell Lung Cancer

Objective To explore the benefits and risks of PD-1/PD-L1 inhibitors Atezolizumab and Nivolumab in the treatment of non-squamous non-small cell lung cancer and provide some references for clinicians.Methods Based on the data results of relevant studies published by ClinicalTrical.gov in the US clinical trial database and foreign peer-reviewed journals,the internationally recognized multi-criteria decision analysis(MCDA)model was used to assess the benefit and risk of PD-1/PD-L1 inhibitors for non-squamous non-small lung cancer comprehensively.Finally,a sensitivity analysis was performed to test the sensitivity of the weight to the evaluation.Results and Conclusion The benefit-risk evaluation result of Atezolizumab for the treatment of non-squamous non-small cell lung cancer is better than that of Nivolumab.Specifically,Atezolizumab has more benefits than Nivolumab with a lower risk.The results of MCDA model in drug benefit and risk evaluation are easy to understand.However,the selection of indicators in the model and the degree of data acquisition are limited.The evaluation results of the MCDA model should be comprehensively viewed with other evaluations to make decisions objectively.

United States Healthcare Data Breaches: Insights for NIST SP 800-66 Revision 2 from a Review of the NIST SP 800-66 Revision 1

Healthcare security and privacy breaches are occurring in the United States (US), and increased substantially during the pandemic. This paper reviews the National Institute of Standards and Technology (NIST) publication base as an effective solution. The NIST Special Publication 800-66 Revision 1 was an essential standard in US healthcare, which was withdrawn in February 2024 and superseded by SP 800-66 Revision 2. This review investigates the academic papers concerning the application of the NIST SP 800-66 Revision 1 standard in the US healthcare literature. A systematic review method was used in this study to determine current knowledge gaps of the SP 800-66 Revision 1. Some limitations were employed in the search to enforce validity. A total of eleven articles were found eligible for the study. Consequently, this study suggests the necessity for additional academic papers pertaining to SP 800-66 Revision 2 in the US healthcare literature. In turn, it will enhance awareness of safeguarding electronic protected health information (ePHI), help to mitigate potential future risks, and eventually reduce breaches.

Study on Environmental Risk and Economic Benefits of Rotation Systems in Farmland of Erhai Lake Basin

This study was designed to find out an optimised planting system of reducing non-point （source） pollution by analyzing the reasons and the factors of influence non-point pollution in farmland of Erhai Lake basin. The results showed that incomes, residual nitrogen in soil, and the loss of nitrogen in surface water in rice-garlic system were higher than those in rice-fava bean system. There were positive correlations between the nitrogen loss of farmland, nitrogen inputs, residual nitrogen in soil, and incomes of farmland. Economic benefits and environment benefits are both appropriate, if the area of rice-garlic system would be reduced to 53% and the area of rice-fava bean system increased to 36% of total cropping area in the investigated watershed. Adjustment of planting structure and introduction of reasonable rotation systems is considered an effective measure of controlling agricultural non-point pollution in watersheds of Erhai Lake.

Screening for pancreatic cancer in familial high-risk individuals: A systematic review

AIM:To analyze the benefits and harms of pancreatic cancer screening in familial high-risk individuals(HRIs).METHODS:Studies were identified by searching PubMed,EBSCO,ClinicalTrials.gov and the Cochrane database from database inception to June 2014.We also obtained papers from the reference lists of pertinent studies and systematic reviews.Englishlanguage trials and observational studies were searched.The key words used as search terms were "screening" and "surveillance".Cost-effectiveness,diagnostic rate,survival rate,mortality and adverse events were the outcomes of interest.Age,sex,lifestyle and other confounding factors were also considered.However,anticipating only a few of these studies,we also included observational studies with or without control groups.We also included studies concerning the anxiety associated with pancreatic cancer risk and other psychological changes in familial HRIs.We extracted details on study design,objectives,population characteristics,inclusion criteria,year of enrollment,method of screening,adjusted and unadjusted mortality,cost-effectiveness and adverse events from the included studies.Studies were assessed using the Reporting of Observational studies in Epidemiology(STROBE) checklist.RESULTS:Sixteen studies on pancreatic cancer screening were included.Five studies included control groups,nine were observational studies without control groups,and the other two studies investigated the worry associated with pancreatic cancer risk.We found that pancreatic cancer screening resulted in a high curative resection rate(60%vs 25%,P = 0.011),longer median survival time(14.5 mo vs 4 mo,P < 0.001),and higher 3-year survival rate(20%vs 15.0%,P =0.624).We also found that familial HRIs had a higher diagnostic rate of pancreatic tumors than controls(34%vs 7.2%,P< 0.001).In patients who underwent regular physical examinations,more stage I pancreatic cancers were observed(19%vs 2.6%,P= 0.001).In addition,endoscopic ultrasonography,which was the main means of detection,diagnosed 64.3%of pancreatic cancers.In comparison,endoscopic retrograde cannulation of the pancreas,magnetic resonance imaging,and computed tomography diagnosed 28.6%,42.9%,and21.4%,respectively.For mass lesions,instant surgery was recommended because of the beneficial effects of post-operative chemotherapy.However,in patients with intraductal papillary mucinous neoplasms,we did not find a significant difference in outcome between surgery and follow-up without treatment.Moreover,pancreatic cancer screening in familial HRIs had a greater perceived risk of pancreatic cancer(P< 0.0001),higher levels of anxiety regarding pancreatic cancer(P< 0.0001),and increased economic burden.CONCLUSION:Pancreatic cancer screening in familial HRIs is associated with a higher detection rate and longer survival,although screening may influence psychological function and increase the economic burden.

超声引导下腹股沟上髂筋膜阻滞在股前外侧皮瓣移植手术中的风险-效益评价

目的 基于多准则决策模型评价超声引导下腹股沟上髂筋膜阻滞在股前外侧皮瓣移植手术中的风险-效益。方法 选取2018年12月—2020年9月于苏州大学附属无锡九院行股前外侧皮瓣移植手术的患者98例,采用随机数字表法分为对照组和观察组,每组49例。对照组行全身麻醉,观察组于全身麻醉诱导前20 min行腹股沟上髂筋膜阻滞。对比两组患者一般资料、手术情况、术中麻醉药物用量、术后视觉模拟评分法(VAS)评分、麻醉恢复室(PACU)停留时间、术后镇痛泵按压次数、术后镇痛满意度评分及术后住院时间,并对比两组不良发反应发生情况。建立超声引导下腹股沟上髂筋膜阻滞在股前外侧皮瓣移植手术中的效益与风险多准则决策(MCDM)分析模型,采用RevMan5.3软件合并数据,得出各效益指标和风险指标效应值,采用Hiview3软件计算出两组的效益值、风险值和效益-风险总值,改变效益-风险中一级指标的权重来并评价模型的灵敏度。结果 与对照组比较,观察组术中舒芬太尼和丙泊酚用量显著降低,术后4、8、12 h的静息VAS评分明显降低,PACU停留时间、术后镇痛泵按压次数及术后住院时间明显减少,术后不良反应发生率明显降低,术后镇痛满意度评分明显增加(均P<0.05)。与对照组比较,观察组的效益高、风险低,当效益和风险都重要时,观察组、对照组的效益-风险总值分别为71、58,且观察组100%优于对照组,MCDM评价模型的稳定性较好。结论 与传统全身麻醉相比,超声引导下腹股沟上髂筋膜阻滞在股前外侧皮瓣移植手术中的获益高于风险,且效益-风险更优,可用于股前外侧皮瓣移植手术镇痛。

Benefit allocation model of distributed photovoltaic power generation vehicle shed and energy storage charging pile based on integrated weighting-Shapley method

In this study,to develop a benefit-allocation model,in-depth analysis of a distributed photovoltaic-powergeneration carport and energy-storage charging-pile project was performed;the model was developed using Shapley integrated-empowerment benefit-distribution method.First,through literature survey and expert interview to identify the risk factors at various stages of the project,a dynamic risk-factor indicator system is developed.Second,to obtain a more meaningful risk-calculation result,the subjective and objective weights are combined,the weights of the risk factors at each stage are determined by the expert scoring method and entropy weight method,and the interest distribution model based on multi-dimensional risk factors is established.Finally,an example is used to verify the rationality of the method for the benefit distribution of the charging-pile project.The results of the example indicate that the limitations of the Shapley method can be reasonably avoided,and the applicability of the model for the benefit distribution of the charging-pile project is verified.

Risk Assessment and Service Benefit Evaluation of Forestry Meteorological Disasters in Guangxi

In order to strengthen the construction of forestry meteorological service capacity and improve the quality of forestry meteorological services,the national forestry meteorological disaster risk survey and service benefit assessment were carried out from November 2016 to May2017. A total of 196 risk sites in Guangxi were collected by means of questionnaire survey,expert evaluation and field survey. The results showed that fire,pest and wind hazards are the main types of risk points in Guangxi. The survey showed that there were 77 monitoring stations around the disaster risk sites belonging to the Forestry Sector,which mainly monitor fire hazards,while other disasters had no monitoring point yet. Early warning facilities were still constantly improving. The meteorological disasters that affecting forestry production were drought,gale,and heavy rainfall,and the main meteorological hazard factors were temperature,wind speed,and precipitation. Forest fire prevention,forestry resources development and utilization,forestation and tending demand for meteorological services were relatively large. It was hoped that forestry meteorological service products would be obtained through telephone,SMS and early warning systems. In addition,experts objectivly evaluated the contribution rate of meteorological services in Guangxi. The contribution rate of forest meteorological services in the whole region was8. 41%. The scale of Guangxi's total forestry output value was 31. 478 billion yuan in 2016. According to the calculation of this value,the service benefit value had reached 2. 647 billion yuan. In conclusion,strengthening the cooperation in forestry meteorological monitoring,technology development,and emergency response,and further improving forestry meteorological services and effective reducing forestry disaster losses are the top priorities of the meteorological department.

Activity of the Fungicide JS399-19 Against Fusarium Head Blight of Wheat and the Risk of Resistance

This report reviews the characteristics of JS399-19, a novel cyanoacrylate fungicide. JS399-19 strongly inhibits the mycelial growth of the fungal plant pathogens of the genus Fusarium and exhibits great potential in controlling Fusarium head blight （FHB） on wheat and other cereals. The mode of action of JS399-19 is evidently different from that of benzimidazole （for example, carbendazim） and other sort of fungicides, making it a possible replacement for carbendazim in China to manage carbendazim-resistant subpopulations of Fusarium graminearum and F. asiaticum. JS399-t9 has excellent protective and curative activity against these pathogens. Incorrect use of this fungicide, however, is likely to select for resistance. Among JS399-19-resistant mutants of F. asiaticum induced in the laboratory, the resistant level of mutants was high and the phenotype of resistance against JS399-19 was conferred by a major gene by genetic analysis. The fitness of laboratory-induced JS399-19-resistant mutants of F. asiaticum was nearly equal to that of their parents. JS399-19 lacks cross resistance with other sort fungicides. To control FHB with JS399-19 and to delay the development of the fungicide-resistance, farmers should use tank mixtures containing JS399-19 and carbendazim, metconazole, tebuconazole, or prothioconazole.

复苏时家属在场“风险-收益”与自信度量表的汉化和信效度检验

目的:引进、汉化复苏时家属在场“风险-收益”与自信度量表,并对其进行跨文化调试及信效度检验。方法:获取原量表作者授权,遵循Brislin量表翻译原则,对该量表进行正向翻译、综合、回译和文化调适,形成中文版复苏时家属在场“风险-收益”与自信度量表。2022年7月—10月采用目的抽样法对394名医护人员进行调查,评价中文版量表的信效度。结果:形成的中文版量表由复苏时家属在场“风险-收益”分量表和自信度分量表组成,共38个条目。家属在场“风险-收益”分量表的Cronbach’sα系数为0.840,重测信度为0.891;家属在场自信度分量表的Cronbach’sα系数为0.970,重测信度为0.951。经探索性因子分析,“风险-收益”分量表提取4个公因子,累计方差贡献率为69.708%;自信度分量表提取2个公因子,累计方差贡献率为75.401%。结论:中文版复苏时家属在场“风险-收益”与自信度量表具有较好的信效度,可以用于测量医护人员对复苏时家属在场“风险-收益”感知以及实施自信度。

Risk Assessment M ode of Sale-Leaseback——Based on Fuzzy Analytic Hierarchy Process

Sale-leaseback is paid special focus on for its great application in China in recent years.By giving a detailed analysis,an analysis of the features of sale-leaseback and a study of the risks of it are given in this paper.Then a quantitative analysis of commercial real estate sale-leaseback is carried out.The scientific theoretical analysis is provided in this paper for risk assessment in commercial real estate sale-leaseback mode in China.An effective approach is put forward for sale-leaseback project evaluation and prevention of risk.A useful means is given to supervise commerciai real estate sale-leaseback mode for relevant departments and a certain contribution is made to a further sound development of commercial real estate sale-leaseback mode.

医疗技术评估与决策中风险-获益分析方法的伦理反思

将经济学领域常用的风险-获益分析方法应用在医疗技术领域,为医疗技术评估与决策提供借鉴和指导。然而,从伦理学角度对这一方法进行审视,会发现存在诸多难以定义和应对的困境。按照其属性划分,这些困境大致可以划分为风险-获益分析本身的伦理问题和根据风险-获益分析作出决策所产生的伦理问题两条脉络。对于风险-获益分析中伦理问题的探讨并不是为了束缚医疗技术的应用,而是着眼于技术长期发展与更好地服务人类的目的,尊重人之为人的价值和人与人的平等。