Microstructural evolution during the progressive transformation-induced plasticity effect in a Fe-0.1C-5Mnmedium manganese steel

The microstructural evolution of a cold-rolled and intercritical annealed medium-Mn steel(Fe-0.10C-5Mn)was investigated during uniaxial tensile testing.In-situ observations under scanning electron microscopy,transmission electron microscopy,and X-ray diffraction analysis were conducted to characterize the progressive transformation-induced plasticity process and associated fracture initiation mechanisms.These findings were discussed with the local strain measurements via digital image correlation.The results indicated that Lüders band formation in the steel was limited to 1.5%strain,which was mainly due to the early-stage martensitic phase transformation of a very small amount of the less stable large-sized retained austenite(RA),which led to localized stress concentrations and strain hardening and further retardation of yielding.The small-sized RA exhibited high stability and progressively transformed into martensite and contributed to a stably extended Portevin-Le Chatelier effect.The volume fraction of RA gradually decreased from 26.8%to 8.2%prior to fracture.In the late deformation stage,fracture initiation primarily occurred at the austenite/martensite and ferrite/martensite interfaces and the ferrite phase.

Internal biliary diversion using appendix during liver transplantation for progressive familial intrahepatic cholestasis type 1:A case report

BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.

Systematic review of risk factors for progressive ischemic stroke

OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studies of progressive ischemic stroke. SEARCH STRATEGY： A computer-based, online, literature search of PubMed （1966/2007）, China Biological Medicine Database （CBM-disc, 1979/2007） and CNKI （www.cnki.net, 1979/2007） was performed to screen for related studies. DATA SELECTION： Cohort or case-controlled studies that focused on risk factors of progressive ischemic stroke were selected for review. Two reviewers independently extracted data and assessed study quality according to Cochrane Collaboration guidelines. Statistical analysis was performed using RevMan software. MAIN OUTCOME MEASUREMENT： Risk factors for progressive ischemic stroke. RESULTS： Using the inclusion criteria, 29/781 studies published in English and Chinese were initially reviewed, including 19 cohort studies and 10 case-control studies. Despite variations in determination of progressive ischemic stroke and the intervals between 2 evaluations, all studies described the diagnostic criteria for progressive ischemic stroke. Logistic analysis was employed in 20 of the studies. Meta-analysis of primary data in the related studies determined that the following factors that significantly correlated with progressive ischemic stroke： fever [risk ratio （RR） = 2.26, 95% confidence interval （CO： 1.20-4.26, P = 0.01; odds ratio （OR） = 2.85, 95% CI： 1.64-4.98, P 〈 0.01 ）]; diabetes （RR = 1.38, 95% CI： 1.18-1.61, P 〈 0.01 ; OR = 2.48, 95% Ch 1.93-3.19, P 〈 0.01 ）; coronary heart disease （RR = 1.22, 95% CI： 1.08-1.38, P 〈 0.01）; neuroimaging transformation （RR= 1.55, 95%CI： 1.34-1.80, P〈 0.01; OR= 2.29, 95% CI： 1.47-3.58, P〈 0.01）; and hyperglycemia （RR = 2.62, 95% CI： 1.86-3.68, P 〈 0.01 ; OR = 3.49, 95% CI： 1.92-6.35, P 〈 0.01）. CONCLUSION： Fever, diabetes, coronary heart disease, neuroimaging transformation, and hyperglycemia are important risk factors for progressive ischemic stroke. Interventions for these risk factors could effectively prevent occurrence of progressive ischemic stroke.

Systematic review and Meta-analysis comparing modified cross-linking and standard cross-linking for progressive keratoconus

AIM：To compare the effectiveness and safety between modified cross-linking（MC）and standard cross-linking（SC）in mild or moderate progressive keratoconus.METHODS：Eligible studies were retrieved from four electronic databases,including CENTRAL,Clinical Trials gov,Pup Med and OVID MEDLINE.We set post-surgical maximum K value（Kmax）as the primary outcome.In addition,uncorrected and corrected distant visual acuity（UDVA and UDVA）,spherical equivalent（SE）,endothelial cell density（ECD）,central cornea thickness（CCT）and depth of demarcation line（DDL）were Meta-analyzed as secondary outcomes.Mean differences for these outcomes were pooled through either a random-effect model or fixed-effect model according to data heterogeneity.RESULTS：Twenty-four comparative studies either on accelerated cross-linking（AC）compared with SC or on transepithelial cross-linking（TC）compared with SC were included and pooled for analysis.The results indicated that MC was significantly inferior to SC at delaying Kmax deterioration[AC vs SC 0.49（95%CI：0.04-0.94,I2=75%,P=0.03）;TC vs SC 1.15（95%CI：0.54-1.75,I2=50%,P=0.0002）].SE decreased significantly for SC when compared to AC[0.62（95%CI：0.38-0.86,I2=22%,P〈0.00001）].DDL of SC was more significantly deeper than that of TC[-133.49（95%CI：-145.94 to-121.04,I2=33%,P〈0.00001）].Other outcomes demonstrated comparable results between MC and SC.CONCLUSION：SC is more favorable at halting the progression of keratoconus,but visual acuity improvement showed comparable results between MCs and SC.

Pressure stimulated current in progressive failure process of combined coal-rock under uniaxial compression:Response and mechanism

Effective monitoring of the structural health of combined coal-rock under complex geological conditions by pressure stimulated currents(PSCs)has great potential for the understanding of dynamic disasters in underground engineering.To reveal the effect of this way,the uniaxial compression experiments with PSC monitoring were conducted on three types of coal-rock combination samples with different strength combinations.The mechanism explanation of PSCs are investigated by resistivity test,atomic force microscopy(AFM)and computed tomography(CT)methods,and a PSC flow model based on progressive failure process is proposed.The influence of strength combinations on PSCs in the progressive failure process are emphasized.The results show the PSC responses between rock part,coal part and the two components are different,which are affected by multi-scale fracture characteristics and electrical properties.As the rock strength decreases,the progressive failure process changes obviously with the influence range of interface constraint effect decreasing,resulting in the different responses of PSC strength and direction in different parts to fracture behaviors.The PSC flow model is initially validated by the relationship between the accumulated charges of different parts.The results are expected to provide a new reference and method for mining design and roadway quality assessment.

A Comparative Study on the Post-Buckling Behavior of Reinforced Thermoplastic Pipes(RTPs)Under External Pressure Considering Progressive Failure

The collapse pressure is a key parameter when RTPs are applied in harsh deep-water environments.To investigate the collapse of RTPs,numerical simulations and hydrostatic pressure tests are conducted.For the numerical simulations,the eigenvalue analysis and Riks analysis are combined,in which the Hashin failure criterion and fracture energy stiffness degradation model are used to simulate the progressive failure of composites,and the“infinite”boundary conditions are applied to eliminate the boundary effects.As for the hydrostatic pressure tests,RTP specimens were placed in a hydrostatic chamber after filled with water.It has been observed that the cross-section of the middle part collapses when it reaches the maximum pressure.The collapse pressure obtained from the numerical simulations agrees well with that in the experiment.Meanwhile,the applicability of NASA SP-8007 formula on the collapse pressure prediction was also discussed.It has a relatively greater difference because of the ignorance of the progressive failure of composites.For the parametric study,it is found that RTPs have much higher first-ply-failure pressure when the winding angles are between 50°and 70°.Besides,the effect of debonding and initial ovality,and the contribution of the liner and coating are also discussed.

Numerical analysis of downward progressive landslides in long natural slopes with sensitive clay

Landslides occurring in sensitive clay often result in widespread destruction,posing a significant risk to human lives and property due to the substantial decrease in undrained shear strength during deformation.Assessing the consequences of these landslides is challenging and necessitates robust numerical methods to comprehensively investigate their failure mechanisms.While studies have extensively explored upward progressive landslides in sensitive clays,understanding downward progressive cases remains limited.In this study,we utilised the nodal integration-based particle finite element method(NPFEM)with a nonlinear strain-softening model to analyse downward progressive landslides in sensitive clay on elongated slopes,induced by surcharge loads near the crest.We focused on elucidating the underlying failure mechanisms and evaluating the effects of different soil parameters and strainsoftening characteristics.The simulation results revealed the typical pattern for downward landslides,which typically start with a localised failure in proximity to the surcharge loads,followed by a combination of different types of failure mechanisms,including single flow slides,translational progressive landslides,progressive flow slides,and spread failures.Additionally,inclined shear bands occur within spread failures,often adopting distinctive ploughing patterns characterised by triangular shapes.The sensitive clay thickness at the base,the clay strength gradient,the sensitivity,and the softening rate significantly influence the failure mechanisms and the extent of diffused displacement.Remarkably,some of these effects mirror those observed in upward progressive landslides,underscoring the interconnectedness of these phenomena.This study contributes valuable insights into the complex dynamics of sensitive clay landslides,shedding light on the intricate interplay of factors governing their behaviour and progression.

Progressive Fault Accommodation for Time-delay Systems with Parametric Faults

The fault accommodation problem for time-delay system is studied in this paper. The progressive accommodation strategy based on the Newton-Raphson scheme is proposed to solve this problem. This accommodation scheme can significantly reduces the loss of performance and risk associated with system instability which results from the time-delay needed by fault accommodation algorithms to provide a solution. Simulation results are given to illustrate the efficiency of the provided method.

Effects of Comprehensive Rehabilitation on Patients with Progressive Multifocal Leukoencephalopathy Due to Systemic Lupus Erythematosus: A Case Report

Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.

Role of progressive muscle relaxation in preventing and alleviating of nausea and vomiting caused by chemotherapy among cancer patients: A protocol of systematic review

Background and aim:Progressive muscle relaxation(PMR)is one of the most common complementary and alternative therapies.Published systematic review unfolded that PMR has a positive impact on chemotherapy-induced nausea and vomiting among adult cancer patients.However,the pooled findings were not reliable and valid because included trials have poor quality.It must be noted is that additional studies with good quality have been published recently.So,we design this updated systematic review to comprehensively establish the efficacy of PMR for the of chemotherapy-induced nausea and vomiting among cancer patients.Methods:We will search PubMed,Cochrane Controlled Register of Trial(CENTRAL),Cumulative Index to Nursing and Allied Health Literature(CINAHL),China Biomedical Literature database(CBM),China National Knowledge Infrastructure(CNKI),and Wanfang data to capture all potential items.Data extraction sheet will be used to extract all essential information,the Cochrane risk of bias assessment tool will be utilized to appraise the risk of bias of eligible studies.Finally,a quantitative analysis will be performed if sufficient data were obtained.In contrast,a qualitative analysis will be used to summarize the results of all included studies.Ethics and dissemination:Ethics approval and patient written informed consent will not be required because all of the analyses in the present study will be performed based on data from published studies.We will submit our systematic review and network meta-analysis to a peer reviewed scientific journal for publication.

Effects of progressive muscle relaxation therapy on Maintenance hemodialysis patients:a systematic review and meta-analysis

Objective:This study aimed to evaluate the effects of progressive relaxation therapy on patients with maintenance hemodialysis.Methods:A literature search was performed using PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data from inception to July 2020.Randomized controlled trials on the use of progressive muscle relaxation therapy in maintenance hemodialysis patients were selected.The primary outcomes were the depression and anxiety.Secondary outcomes included fatigue and sleep.Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Results:A total of 8 studies,which comprised a total of 668 participants were included in the final meta-analysis.The results showed that progressive muscle relaxation therapy could reduce the depression of patients(MD=-5.11,95%CI:-6.74 to-3.48,P<0.001),reduce the anxiety(SMD=-1.27,95%CI:-1.73 to-0.82,P<0.001),relieve fatigue symptoms(MD=-0.87,95%CI:-1.20 to-0.53,P<0.001),improve the sleep quality(MD=-1.69,95%CI:-1.95 to-1.42,P<0.001).Conclusion:Progressive muscle relaxation therapy has positive effects on depression,anxiety,fatigue and sleep quality in patients with maintenance hemodialysis.While concurrent evidence is insufficient,and further studies of high quality are needed to strengthen the conclusion.

PAPS: Progressive Attention-Based Pan-sharpening

Pan-sharpening aims to seek high-resolution multispectral(HRMS) images from paired multispectral images of low resolution(LRMS) and panchromatic(PAN) images, the key to which is how to maximally integrate spatial and spectral information from PAN and LRMS images. Following the principle of gradual advance, this paper designs a novel network that contains two main logical functions, i.e., detail enhancement and progressive fusion, to solve the problem. More specifically, the detail enhancement module attempts to produce enhanced MS results with the same spatial sizes as corresponding PAN images, which are of higher quality than directly up-sampling LRMS images.Having a better MS base(enhanced MS) and its PAN, we progressively extract information from the PAN and enhanced MS images, expecting to capture pivotal and complementary information of the two modalities for the purpose of constructing the desired HRMS. Extensive experiments together with ablation studies on widely-used datasets are provided to verify the efficacy of our design, and demonstrate its superiority over other state-of-the-art methods both quantitatively and qualitatively. Our code has been released at https://github.com/JiaYN1/PAPS.

Global Dynamic Responses and Progressive Failure of Submerged Floating Tunnel Under Cable Breakage Conditions

The Submerged Floating Tunnel(SFT)relies on a tensioned mooring system for precise positioning.The sudden breakage of a single cable can trigger an immediate alteration in the constraint conditions of the tube,inducing a transient heave response within the structure along with a transient increase in cable tension experienced by adjacent cables.In more severe cases,this may even lead to a progressive failure culminating in the global destruction of the SFT.This study used ANSYS/AQWA to establish a numerical model of the entire length SFT for the hydrodynamic response analysis,and conducted a coupled calculation of the dynamic responses of the SFT-mooring line model based on Orca Flex to study the global dynamic responses of the SFT at the moment of cable breakage and the redistribution of cable internal forces.The most unfavorable position for SFT cable breakage was identified,the influence mechanism of cable breakage at different positions on the global dynamic response was revealed,and the progressive chain failure pattern caused by localized cable breakage are also clarified.

A progressive framework for rotary motion deblurring

The rotary motion deblurring is an inevitable procedure when the imaging seeker is mounted in the rotating missiles.Traditional rotary motion deblurring methods suffer from ringing artifacts and noise,especially for large blur extents.To solve the above problems,we propose a progressive rotary motion deblurring framework consisting of a coarse deblurring stage and a refinement stage.In the first stage,we design an adaptive blur extents factor(BE factor)to balance noise suppression and details reconstruction.And a novel deconvolution model is proposed based on BE factor.In the second stage,a triplescale deformable module CNN(TDM-CNN)is designed to reduce the ringing artifacts,which can exploit the 2D information of an image and adaptively adjust spatial sampling locations.To establish a standard evaluation benchmark,a real-world rotary motion blur dataset is proposed and released,which includes rotary blurred images and corresponding ground truth images with different blur angles.Experimental results demonstrate that the proposed method outperforms the state-of-the-art models on synthetic and real-world rotary motion blur datasets.The code and dataset are available at https://github.com/JinhuiQin/RotaryDeblurring.

Computational Analysis of Novel Extended Lindley Progressively Censored Data

A novel extended Lindley lifetime model that exhibits unimodal or decreasing density shapes as well as increasing,bathtub or unimodal-then-bathtub failure rates, named the Marshall-Olkin-Lindley (MOL) model is studied.In this research, using a progressive Type-II censored, various inferences of the MOL model parameters oflife are introduced. Utilizing the maximum likelihood method as a classical approach, the estimators of themodel parameters and various reliability measures are investigated. Against both symmetric and asymmetric lossfunctions, the Bayesian estimates are obtained using the Markov Chain Monte Carlo (MCMC) technique with theassumption of independent gamma priors. From the Fisher information data and the simulatedMarkovian chains,the approximate asymptotic interval and the highest posterior density interval, respectively, of each unknownparameter are calculated. Via an extensive simulated study, the usefulness of the various suggested strategies isassessedwith respect to some evaluationmetrics such as mean squared errors, mean relative absolute biases, averageconfidence lengths, and coverage percentages. Comparing the Bayesian estimations based on the asymmetric lossfunction to the traditional technique or the symmetric loss function-based Bayesian estimations, the analysisdemonstrates that asymmetric loss function-based Bayesian estimations are preferred. Finally, two data sets,representing vinyl chloride and repairable mechanical equipment items, have been investigated to support theapproaches proposed and show the superiority of the proposed model compared to the other fourteen lifetimemodels.

Effect of dietary with Zhibai dihuang pills and gonadotropinreleasing-hormone-analogue on girls with precocious and rapidly progressive puberty

BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.

Bayesian and Non-Bayesian Analysis for the Sine Generalized Linear Exponential Model under Progressively Censored Data

This article introduces a novel variant of the generalized linear exponential(GLE)distribution,known as the sine generalized linear exponential(SGLE)distribution.The SGLE distribution utilizes the sine transformation to enhance its capabilities.The updated distribution is very adaptable and may be efficiently used in the modeling of survival data and dependability issues.The suggested model incorporates a hazard rate function(HRF)that may display a rising,J-shaped,or bathtub form,depending on its unique characteristics.This model includes many well-known lifespan distributions as separate sub-models.The suggested model is accompanied with a range of statistical features.The model parameters are examined using the techniques of maximum likelihood and Bayesian estimation using progressively censored data.In order to evaluate the effectiveness of these techniques,we provide a set of simulated data for testing purposes.The relevance of the newly presented model is shown via two real-world dataset applications,highlighting its superiority over other respected similar models.

Effectiveness of aromatherapy with lavender compared to progressive muscle relaxation on anxiety and vital signs in patients under spinal anesthesia:A randomized clinical trial

Objective:This study aimed to determine the effectiveness of aromatherapy with lavender essential oil compared to progressive muscle relaxation(PMR)on anxiety and vital signs of patients under spinal anesthesia.Materials and Methods:This clinical trial was conducted on 120 spinal anesthesia candidates who were randomly assigned into three groups of 40 including control,PMR(Jacobsen group),and aromatherapy.The state-trait anxiety inventory was completed on surgery day and 15 min after the end of the intervention by the samples of all three groups,and at the same time as completing the questionnaire,vital signs were also measured and recorded.Results:The mean score of anxiety after intervention was lower than that before the intervention in the aromatherapy group(P<0.001).The mean score of anxiety in the aromatherapy group was significantly lower than that in the Jacobsen group(P<0.001).Moreover,data analysis showed a significant decrease in the mean arterial blood pressure scores of the PMR(P=008)and aromatherapy(P<0.001)groups and a statistically significant increase in the mean heart rate scores in the control group(P=0.002).Conclusion:The use of aromatherapy with lavender is more effective than PMR therapy in reducing the anxiety level of patients undergoing spinal anesthesia.Due to the high level of anxiety and its serious effects on the patient’s hemodynamics,aromatherapy with lavender can be used as an easy and cheap method to reduce anxiety in operation rooms.

The Importance of Stakeholder Engagement in Progressive Rehabilitation of Large-Scale Open Pit Mines—A Case Study of Lumwana Mine

Mining globally contributes to the growth of many economies of the world. Since its inception, the Zambian mining industry has contributed largely to the country’s economy. The various developments both in technology and knowledge have contributed to the scale at which mining is being done. Challenges in such a setting arise due to the socio-economic and environmental impacts of mining, which create multidimensional problems. The study investigated the importance of engaging stakeholders in progressive rehabilitation programs for large-scale open pit mines, using a case study of the Lumwana Mine and its host community, Manyama. A qualitative approach was used, and data was collected through one-on-one interviews. A combination of convenient and quota sampling was used to engage with host community leaders, professionals and academicians from various fields and institutions. Results showed that most participants had agreed that stakeholder engagement is important for progressive rehabilitation, but the challenge was that the host community and municipal council representatives were not aware of any progressive rehabilitation efforts at Lumwana Mine. This was attributed to a lack of stakeholder engagement and communication of mitigation progress activities by the Lumwana Mine. Results also revealed that the lack of environmental impact assessment regulations to compel companies to involve stakeholders throughout the entire life of the mine other than just at the pre-mining stage led to a lack of compliance and accountability in rehabilitation.

Association between tobacco exposure and bladder cancer recurrence:A systematic review and meta-analysis

BACKGROUND However,the connection between smoking and the prognosis of patients with bladder cancer remains unclear.AIM To determine whether smoking is linked to the recurrence and progression of bladder cancer.METHODS As of July 20,2022,relevant English-language research was identified by searching PubMed,the Web of Science,and the Cochrane Library.We pooled the available data from the included studies using a random effects model.Subgroup analysis and sensitivity analysis were also conducted.RESULTS A total of 12 studies were included in this meta-analysis.The combined analysis revealed that tobacco exposure was associated with a significantly greater recurrence rate than nonsmoking status[odd ratios(OR)=1.76,95%CI:1.84-2.93],and the progression of bladder cancer was significantly greater in smokers than in nonsmokers(OR=1.21,95%CI:1.02-1.44).Stratified analysis further revealed that current smokers were more likely to experience relapse than never-smokers were(OR=1.85,95%CI:1.11-3.07).Former smokers also had a greater risk of relapse than did never-smokers(OR=1.73,95%CI:1.09-2.73).Subgroup analysis indicated that non-Caucasians may be more susceptible to bladder cancer recurrence than Caucasians are(OR=2.13,95%CI:1.74-2.61).CONCLUSION This meta-analysis revealed that tobacco exposure may be a significant risk factor for both the recurrence and progression of bladder cancer.