Voluntary wheel running ameliorated the deleterious effects of high-fat diet on glucose metabolism,gut microbiota and microbial-associated metabolites

Exercise training is critical for the early prevention and treatment of obesity and diabetes mellitus.However,the mechanism with gut microbiota and fecal metabolites underlying the effects of voluntary wheel running on high-fat diet induced abnormal glucose metabolism has not been fully elaborated.C57BL/6 male mice were randomly assigned to 4 groups according to diets(fed with normal chow diet or high-fat diet)and running paradigm(housed in static cage or with voluntary running wheel).An integrative 16S rDNA sequencing and metabolites profiling was synchronously performed to characterize the effects of voluntary wheel running on gut microbiota and metabolites.It showed that voluntary wheel running prevented the detrimental effects of high-fat feeding on glucose metabolism 16S rDNA sequencing showed remarkable changes in Rikenella and Marvinbryantia genera.Metabolic profiling indicated multiple altered metabolites,which were enriched in secondary bile acid biosynthesis signaling.In conclusion,our study indicated that voluntary wheel running significantly improved glucose metabolism and counteracted the deleterious effects of high-fat feeding on body weight and glucose intolerance.We further found that voluntary wheel running could integratively program gut microbiota composition and fecal metabolites changes,and may regulate muricholic acid metabolism and secondary bile acid biosynthesis in high-fat fed mice.

Influence of pier height on the safety of trains running on high-speed railway bridges during earthquakes

Sudden earthquakes pose a threat to the running safety of trains on high-speed railway bridges,and the stiffness of piers is one of the factors affecting the dynamic response of train-track-bridge system.In this paper,a experiment of a train running on a high-speed railway bridge is performed based on a dynamic experiment system,and the corresponding numerical model is established.The reliability of the numerical model is verified by experiments.Then,the experiment and numerical data are analyzed to reveal the pier height effects on the running safety of trains on bridges.The results show that when the pier height changes,the frequency of the bridge below the 30 m pier height changes greater;the increase of pier height causes the transverse fundamental frequency of the bridge close to that of the train,and the shaking angle and lateral displacement of the train are the largest for bridge with 50 m pier,which increases the risk of derailment;with the pier height increases from 8 m to 50 m,the derailment coefficient obtained by numerical simulations increases by 75% on average,and the spectral intensity obtained by experiments increases by 120% on average,two indicators exhibit logarithmic variation.

Acute effect of foot strike patterns on in vivo tibiotalar and subtalar joint kinematics during barefoot running

Background:Foot kinematics,such as excessive eversion and malalignment of the hindfoot,are believed to be associated with running-related injuries.The maj ority of studies to date show that different foot strike patterns influence these specific foot and ankle kinematics.However,technical deficiencies in traditional motion capture approaches limit knowledge of in vivo joint kinematics with respect to rearfoot and forefoot strike patterns(RFS and FFS,respectively).This study uses a high-speed dual fluoroscopic imaging system(DFIS)to determine the effects of different foot strike patterns on 3D in vivo tibiotalar and subtalar joints kinematics.Methods:Fifteen healthy male recreational runners underwent foot computed tomography scanning for the construction of 3-dimensional models.A high-speed DFIS(100 Hz)was used to collect 6 degrees of freedom kinematics for participants’tibiotalar and subtalar joints when they adopted RFS and FFS in barefoot condition.Results:Compared with RFS,FFS exhibited greater internal rotation at 0%-20%of the stance phase in the tibiotalar joint.The peak internal rotation angle of the tibiotalar joint under FFS was greater than under RFS(p<0.001,Cohen’s d=0.92).RFS showed more dorsiflexion at 0%-20%of the stance phase in the tibiotalar joint than FFS.RFS also presented a larger anterior translation(p<0.001,Cohen’s d=1.28)in the subtalar joint at i nitial contact than FFS.Conclusion:Running with acute barefoot FFS increases the internal rotation of the tibiotalar joint in the early stance.The use of high-speed DFIS to quantify the movement of the tibiotalar and subtalar joint was critical to revealing the effects of RF S and FFS during running.

Enhancement of motor functional recovery in thoracic spinal cord injury: voluntary wheel running versus forced treadmill exercise

Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.

A novel refined dynamic model of high-speed maglev train-bridge coupled system for random vibration and running safety assessment

Running safety assessment and tracking irregularity parametric sensitivity analysis of high-speed maglev train-bridge system are of great concern,especially need perfect refinement models in which all properties can be well characterized based on various stochastic excitations.A three-dimensional refined spatial random vibration analysis model of high-speed maglev train-bridge coupled system is established in this paper,in which multi-source uncertainty excitation can be considered simultaneously,and the probability density evolution method(PDEM)is adopted to reveal the system-specific uncertainty dynamic characteristic.The motion equation of the maglev vehicle model is composed of multi-rigid bodies with a total 210-degrees of freedom for each vehicle,and a refined electromagnetic force-air gap model is used to account for the interaction and coupling effect between the moving train and track beam bridges,which are directly established by using finite element method.The model is proven to be applicable by comparing with Monte Carlo simulation.By applying the proposed stochastic framework to the high maglev line,the random dynamic responses of maglev vehicles running on the bridges are studied for running safety and stability assessment.Moreover,the effects of track irregularity wavelength range under different amplitude and running speeds on the coupled system are investigated.The results show that the augmentation of train speed will move backward the sensitive wavelength interval,and track irregularity amplitude influences the response remarkably in the sensitive interval.

SmartMicro Grid Energy System Management Based on Optimum Running Cost for Rural Communities in Rwanda

The governmental electric utility and the private sector are joining hands to meet the target of electrifying all households by 2024.However,the aforementioned goal is challenged by households that are scattered in remote areas.So far,Solar Home Systems(SHS)have mostly been applied to increase electricity access in rural areas.SHSs have continuous constraints to meet electricity demands and cannot run income-generating activities.The current research presents the feasibility study of electrifying Remera village with the smart microgrid as a case study.The renewable energy resources available in Remera are the key sources of electricity in that village.The generation capacity is estimated based on the load profile.The microgrid configurations are simulated with HOMER,and the genetic algorithm is used to analyze the optimum cost.By analyzing the impact of operation and maintenance costs,the results show that the absence of subsidies increases the levelized cost of electricity(COE)five times greater than the electricity price from the public utility.The microgrid made up of PV,diesel generator,and batteries proved to be the most viable solution and ensured continuous power supply to customers.By considering the subsidies,COE reaches 0.186$/kWh,a competitive price with electricity from public utilities in Rwanda.

Review of Research on English Translation of Chinese Running Sentences

In order to convey complete meanings,there is a phenomenon in Chinese of using multiple running sentences.Xu Jingning(2023,p.66)states,“In communication,a complete expression of meaning often requires more than one clause,which is common in human languages.”Domestic research on running sentences includes discussions on defining the concept and structural features of running sentences,sentence properties,sentence pattern classifications and their criteria,as well as issues related to translating running sentences into English.This article primarily focuses on scholarly research into the English translation of running sentences in China,highlighting recent achievements and identifying existing issues in the study of running sentence translation.However,by reviewing literature on the translation of running sentences,it is found that current research in the academic community on non-core running sentences is limited.Therefore,this paper proposes relevant strategies to address this issue.

Safety of the express freight train running over a long-span bridge

Purpose-Express freight transportation is in rapid development currently.Owing to the higher speed of express freight train,the deformation of the bridge deck worsens the railway line condition under the action of wind and train moving load when the train runs over a long-span bridge.Besides,the blunt car body of vehicle has poor aerodynamic characteristics,bringing a greater challenge on the running stability in the crosswind.Design/methodology/approach-In this study,the aerodynamic force coefficients of express freight vehicles on the bridge are measured by scale model wind tunnel test.The dynamic model of the train-long-span steel truss bridge coupling system is established,and the dynamic response as well as the running safety of vehicle are evaluated.Findings-The results show that wind speed has a significant influence on running safety,which is mainly reflected in the over-limitation of wheel unloading rate.The wind speed limit decreases with train speed,and it reduces to 18.83 m/s when the train speed is 160 km/h.Originality/value-This study deepens the theoretical understanding of the interaction between vehicles and bridges and proposes new methods for analyzing similar engineering problems.It also provides a new theoretical basis for the safety assessment of express freight trains.

基于RUN-XGBoost算法的土石坝渗流预测模型

针对传统土石坝渗流预测模型存在局部最优、抗干扰性差和预测精度低等问题,通过RUN算法优化XGBoost算法得到RUN-XGBoost算法,构建了RUN-XGBoost模型以获得更优的土石坝渗流预测结果。该模型在种群初始化时采用RUN算法对XGBoost算法的3个主要参数进行改进,使预测结果有较高的有效性;通过自动寻找最优参数增进算法的整体收敛速度和预测精度,同时引入随机解,使算法能够排除局部最小值并继续搜索,从而获得全局最优结果。工程实例验证结果表明,RUN-XGBoost模型具有简洁、高效、预测精度高、鲁棒性强等优点。

Does orthotics use improve comfort,speed,and injury rate during running?A randomised control trial

BACKGROUND Running is a hugely popular sport.Unfortunately,running-related injury(RRI)rates are high,particularly amongst amateur and recreational runners.Finding ways to reduce RRI rates and maximise comfort and performance for runners is important.Evidence regarding whether orthotics can successfully improve these parameters is limited and contradicting.Further research is required to provide runners with clearer guidance on the usefulness of orthotics.AIM To investigate the effect of Aetrex Orthotics on comfort,speed and RRI rates during recreational running.METHODS One hundred and six recreational runners were recruited on a voluntary basis via running clubs and social media pages and randomised into either the intervention or control group.Participants in the intervention group ran with Aetrex L700 Speed Orthotics inserted in their usual running shoes,whilst participants in the control group ran in their usual running shoes with no orthotics.The study ran for an 8-wk period.Participants provided data relating to running comfort,distance,and time during weeks 3-6.Participants provided data relating to any RRIs they sustained during all 8 wks.Running distance and time were used to calculate running speed in miles per hour(mph).For each outcome variable,95%confidence intervals and P values were calculated to assess the statistical significance between the groups.For comfort and speed data,univariate multi-level analysis was performed,and for outcome variables with significant between group differences,multi-level multivariate analysis was performed to evaluate any confounding effects of gender and age.RESULTS Ninety-four participants were included in the final analysis(drop-out rate=11%).Comfort and speed from 940 runs and 978 injury data reports were analysed.Participants who ran with orthotics reported,on average,speeds 0.30 mph faster(P=0.20)and comfort scores 1.27 points higher(P≤0.001)than participants who ran with no orthotics.They were also 2.22 times less likely to sustain an injury(P=0.08)than participants who ran with no orthotics.However,findings were only significant for comfort and not for speed or injury rates.Age and gender were found to be significant predictors of comfort.However,the improvements in comfort reported by participants who ran with orthotics were still significant after adjusting for age and gender.CONCLUSION This study found orthotics to improve comfort and speed and prevent RRIs whilst running.However,these findings were only statistically significant for comfort.

Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

Free running period affected by network structures of suprachiasmatic nucleus neurons exposed to constant light

Exposed to the natural light-dark cycle,24 h rhythms exist in behavioral and physiological processes of living beings.Interestingly,under constant darkness or constant light,living beings can maintain a robust endogenous rhythm with a free running period(FRP)close to 24 h.In mammals,the circadian rhythm is coordinated by a master clock located in the suprachiasmatic nucleus(SCN)of the brain,which is composed of about twenty thousand self-oscillating neurons.These SCN neurons form a heterogenous network to output a robust rhythm.Thus far,the exact network topology of the SCN neurons is unknown.In this article,we examine the effect of the SCN network structure on the FRP when exposed to constant light by a Poincare model.Four typical network structures are considered,including a nearest-neighbor coupled network,a Newman-Watts small world network,an Erd¨os-Renyi random network and a Barabasi-Albert(BA)scale free network.The results show that the FRP is longest in the BA network,because the BA network is characterized by the most heterogeneous structure among these four types of networks.These findings are not affected by the average node degree of the SCN network or the value of relaxation rate of the SCN neuronal oscillators.Our findings contribute to the understanding of how the network structure of the SCN neurons influences the FRP.

Long-term outcomes after endoscopic removal of malignant colorectal polyps:Results from a 10-year cohort

BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020.Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were invest-igated.Event rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were performed.Potential risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were enrolled.The proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,respectively.Tumor differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,respectively.Residual tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection.Univariate analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance examinations.Adverse outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance only.CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy needs improvement.Long-term adverse outcome rates might be higher than previously reported,irrespective of whether secondary surgery was performed.

Pile Running in Layered Soils

This paper presents a case study on incidents of offshore pile running in layered soils.The study provides a detailed description of the seabed soil data,pile driving records,and field surveillance video observations.Three-dimensional large deformation finite element(LDFE)analyses were conducted to retrospectively analyze the incidents,considering the remoulding of seabed soil and degradation of the pile-soil interface in the LDFE modeling.By comparing the field observations with the LDFE analysis,the mechanism of pile running was discussed,with a focus on investigating the pile penetration resistance in each layer.The study revealed that pile running in layered soils primarily resulted from a significant reduction in pile base resistance when transitioning from a strong layer to an adjacent weak layer.To further investigate the pile running mechanism in layered soils,a parametric study on the strength variation of adjacent soil layers and its influence on pile base resistance was conducted.Lastly,a simplified prediction model of pile base resistance,suitable for assessing the risk of pile running in layered soils,was proposed.

RUN和FYVE结构域蛋白1在胰腺癌中的表达特征及功能作用

目的探究RUN和FYVE结构域蛋白1(RUFY1)在胰腺癌中的表达特征及功能作用。方法通过分析癌症基因组图谱、临床蛋白质组肿瘤分析协作组、基因表达综合数据库等,探究RUFY1在胰腺癌中mRNA、蛋白的表达水平以及与胰腺癌患者预后关系。采用免疫组织化学染色比对胰腺癌患者肿瘤组织与正常胰腺组织中RUFY1蛋白表达水平。在胰腺癌细胞系中敲低RUFY1,并通过肿瘤成球、CCK-8、克隆形成实验验证RUFY1在胰腺癌细胞系中发挥的功能与作用。联合CTRP和PRISM等数据库探究RUFY1与部分抗肿瘤药物敏感性的关系。结果通过分析公共数据库发现,与正常胰腺组织相比,胰腺癌肿瘤组织中RUFY1 mRNA和蛋白表达水平显著升高(P<0.05,P<0.01);RUFY1的高表达与胰腺癌患者的预后呈显著负相关(P<0.05)。免疫组织化学染色结果表明,相较于癌旁组织,RUFY1蛋白表达水平在胰腺癌肿瘤组织中升高。肿瘤成球、CCK-8、克隆形成实验结果显示RUFY1敲低会显著抑制胰腺癌细胞系的增殖功能(P<0.01)。由CTRP和PRISM数据库分析得出,低RUFY1表达的患者对PD318088(P<0.01)、RITA(P<0.01)、selumetinib(P<0.05)、AZD8931(P<0.01)等药物更加敏感。结论RUFY1 mRNA及蛋白水平在胰腺癌肿瘤组织中升高,RUFY1的高表达与胰腺癌患者的预后呈负相关,敲低RUFY1可抑制胰腺癌细胞系的增殖能力,RUFY1有望成为用来预测临床用药治疗敏感性的靶点。

Long-Term Performance and Microstructural Characterization of Dam Concrete in the Three Gorges Project

This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled from the Three Gorges Dam.The mechanical properties of the laboratory dam concrete,whether cured in natural or standard environments,continued to improve over time.Furthermore,the laboratory dam concrete exhibited good resistance to diffusion and a refined microstructure after 17 years.However,curing and long-term exposure to the local natural environment reduced the frost resistance.Microstructural analyses of the laboratory concrete samples demonstrated that moderate-heat cement and fine fly ash(FA)particles were almost fully hydrated to form compact micro structures consisting of large quantities of homogeneous calcium(alumino)silicate hydrate(C-(A)-S-H)gels and a few crystals.No obvious interfacial transition zones were observed in the microstructure owing to the longterm pozzolanic reaction.This dense and homogenous microstructure was the crucial reason for the excellent long-term performance of the dam concrete.A high FA volume also played a significant role in the microstructural densification and performance growth of dam concrete at a later age.The concrete drilled from the dam surface exhibited a loose microstructure with higher microporosity,indicating that concrete directly exposed to the actual service environment suffered degradation caused by water and wind attacks.In this study,both macro-performance and microstructural analyses revealed that the application of moderate-heat cement and FA resulted in a dense and homogenous microstructure,which ensured the excellent long-term performance of concrete from the Three Gorges Dam after 17 years.Long-term exposure to an actual service environment may lead to microstructural degradation of the concrete surface.Therefore,the retained long-term dam concrete samples need to be further researched to better understand its microstructural evolution and development of its properties.

Soil bacterial and fungal communities resilience to long-term nitrogen addition in subtropical forests in China

Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.

Long-term thinning decreases the contribution of heterotrophic respiration to soil respiration in subalpine plantations

Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.

Optimism,Social Support,and Caregiving Burden among the Long-Term Caregivers:The Mediating Effect of Psychological Resilience

Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such as work fatigue,heavy workloads,and inadequate support.These issues can impact job satisfaction,mental health,and care quality,leading to staff turnover.This study examines how optimism,social support,and psychological resilience relate to caregiving burden,aiming to understand their effects on caregivers’well-being and performance to enhance the quality of long-term care services.Methods:The participants were 542 long-term care workers.Descriptive statistics,t-tests,one-way ANOVA,and hierarchical regression were used for data analysis.Results:(1)Optimism and social support were significantly and positively correlated with psychological resilience and significantly and negatively associated with caregiving burden.(2)Regarding differences in optimism,social support,psychological resilience,and caregiving burden among long-term care workers,females scored significantly higher than males in“social support;”married workers scored significantly higher than unmarried workers in“optimism,”“social support,”and“psychological resilience”;workers aged 45–65 scored significantly higher than those aged 25–45 in“optimism”;workers aged 25–45 scored significantly higher than those aged 45–65 in“caregiving burden”;social workers scored significantly higher than nursing staff in“optimism.”(3)Psychological resilience partially mediated the relationship between social support and caregiving burden concerning explanatory and predictive power.Conclusions:These findings suggest that optimism,social support,and psychological resilience are essential factors in reducing the caregiving burden among long-term care workers.The study highlights the importance of promoting psychological resilience and providing social support to alleviate the burden of caregiving.

Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there have been no specific studies on predicting long-term survival after TIPS placement.AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.METHODS A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS implantation.Through univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after TIPS.Consequently,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)level.Furthermore,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing models.RESULTS The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement.The NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation cohorts.Additionally,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients and guide follow-up management after TIPS implantation.