Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China

High-resolution ultrasonography was used to analyze the nerve cross-sectional area （CSA） of the median nerve at 7 sites： the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm （where the nerve enters the pronator teres muscle）, 4 cm proximal to the tip of the medial epicondyle, and mid-humerus （mid-point between elbow crease and axilla） in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Correlation between current and cross-sectional area of parallel fixed-movable dual electrodes in ESC

Electroslag casting with parallel fixed-movable dual electrodes is a new method for achieving better quality of castings in complex mold cavities.In this work,a mathematical model,y=kx^2+(k+1)x,was established to describe the ideal correlation between the current ratio(y)and the cross-sectional area ratio(x)of the dual electrodes,where k is the filling ratio.Investigation was conducted on the electroslag casting process with dual electrodes of various cross-sectional areas,but at a constant k value.The experimental results indicated that the ideal correlation was obtained at the stable casting stage,and the fitting results were consistent with the experimental results at certain k values.The experimental findings show that better castings can be obtained when the current ratio is greater than 1.536 and the cross-sectional area ratio is greater than 0.5.

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

BACKGROUND Acromioclavicular joint(ACJ)space narrowing has been considered to be an important diagnostic image parameter of ACJ osteoarthritis(ACJO).However,the morphology of the ACJ space is irregular because of osteophyte formation,subchondral irregularity,capsular distention,sclerosis,and erosion.Therefore,we created the ACJ cross-sectional area(ACJCSA)as a new diagnostic image parameter to assess the irregular morphologic changes of the ACJ.AIM To hypothesize that the ACJCSA is a new diagnostic image parameter for ACJO.METHODS ACJ samples were obtained from 35 patients with ACJO and 30 healthy individuals who underwent shoulder magnetic resonance(S-MR)imaging that revealed no evidence of ACJO.Oblique coronal,T2-weighted,fat-suppressed SMR images were acquired at the ACJ level from the two groups.We measured the ACJCSA and the ACJ space width(ACJSW)at the ACJ on the S-MR images using our imaging analysis program.The ACJCSA was measured as the cross-sectional area of the ACJ.The ACJSW was measured as the narrowest point between the acromion and the clavicle.RESULTS The average ACJCSA was 39.88±10.60 mm;in the normal group and 18.80±5.13 mm;in the ACJO group.The mean ACJSW was 3.51±0.58 mm in the normal group and 2.02±0.48 mm in the ACJO group.ACJO individuals had significantly lower ACJCSA and ACJSW than the healthy individuals.Receiver operating characteristic curve analyses demonstrated that the most suitable ACJCSA cutoff score was 26.14 mm^(2),with 91.4%sensitivity and 90.0%specificity.CONCLUSION The optimal ACJSW cutoff score was 2.37 mm,with 88.6%sensitivity and 96.7%specificity.Even though both the ACJCSA and ACJSW were significantly associated with ACJO,the ACJCSA was a more sensitive diagnostic image parameter.

Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects

BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.

Aerodynamic effects on a railway tunnel with partially changed cross-sectional area

The present study numerically explored the aerodynamic performance of a novel railway tunnel with a partially reduced cross-section.The impact of the reduction rate of the tunnel cross-section on wave transmissions was analyzed based on the three-dimensional,unsteady,compressible,and RNG k-εturbulence model.The results highlight that the reduction rate(S)most affects pressure configurations at the middle tunnel segment,followed by the enlarged segments near access,and finally the exit.The strength of the newly generated compression wave at the tunnel junction where the cross-section abruptly changes increases exponentially with the decrease of the cross-sectional area.The maximum peak-to-peak pressureΔP on the tunnel and train surface for non-uniform tunnels is reduced by 10.7%and 13.8%,respectively,compared with those of equivalent uniform tunnels.Overall,the economic analysis suggests that the aerodynamic performance of the developed tunnel prototype surpasses those conventional tunnels based on the same excavated volume.

Optimization Design of the Multi-Layer Cross-Sectional Layout of An Umbilical Based on the GA-GLM

Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components directly affects manufacturing,operation and storage performances of the umbilical.For the multi-layer cross-sectional layout design of the umbilical,a quantifiable multi-objective optimization model is established according to the operation and storage requirements.Considering the manufacturing factors,the multi-layering strategy based on contact point identification is introduced for a great number of functional components.Then,the GA-GLM global optimization algorithm is proposed combining the genetic algorithm and the generalized multiplier method,and the selection operator of the genetic algorithm is improved based on the steepest descent method.Genetic algorithm is used to find the optimal solution in the global space,which can converge from any initial layout to the feasible layout solution.The feasible layout solution is taken as the initial value of the generalized multiplier method for fast and accurate solution.Finally,taking umbilicals with a great number of components as examples,the results show that the cross-sectional performance of the umbilical obtained by optimization algorithm is better and the solution efficiency is higher.Meanwhile,the multi-layering strategy is effective and feasible.The design method proposed in this paper can quickly obtain the optimal multi-layer cross-sectional layout,which replaces the manual design,and provides useful reference and guidance for the umbilical industry.

Association between triglyceride-glucose index and colorectal polyps:A retrospective cross-sectional study

BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.

Association between Residential Greenness and Cardiometabolic Risk Factors among Adults in Rural Xinjiang Uygur Autonomous Region,China:A Cross-Sectional Study

Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.

Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic:A multicenter cross-sectional study

BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.

Patterns of Infertility and Abortion in Saudi Arabia: A Cross-Sectional Study

Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.

A Cross-Sectional Study on The Prevalence of Anemia in Maintenance Hemodialysis and Peritoneal Dialysis Patients and Its Related Factors

Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.

Endoscopy demand among county people in southeast China:A cross-sectional study

Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.

Knowledge,attitude,and practice of patients living with inflammatory bowel disease:A cross-sectional study

BACKGROUND Patients with inflammatory bowel diseases(IBDs)generally have poor knowledge,attitude,and practice of their disease,while the data from China are lacking.AIM To address this knowledge disparity among Chinese patients with IBD.METHODS This web-based,cross-sectional study was conducted on a cohort of IBD patients who visited the Second Affiliated Hospital of Wenzhou Medical University between December 2022 and February 2023.Their socio-demographic information and the knowledge,attitude,and practice scores were collected and estimated using a self-designed questionnaire.Pearson’s correlation analysis was used to determine the pairwise correlations among knowledge,attitude,and practice scores.A multivariate logistic regression analysis was further performed to determine the independent factors associated with their knowledge,attitude,and practice scores.RESULTS A total of 353 patients(224 males)with IBD completed the questionnaires.The mean knowledge,attitude,and practice scores were 10.05±3.46(possible range:0-14),41.58±5.23(possible range:0-56),44.20±7.39(possible range:0-56),respectively,indicating good knowledge,positive attitude,and proactive practice toward IBD.Pearson’s correlation analysis showed that the knowledge score had significant positive correlations with the attitude score(r=0.371,P<0.001)and practice score(r=0.100,P<0.001).The attitude score had a significant positive correlation with the practice score(r=0.452,P<0.001).Moreover,multivariate logistic regression analysis showed that aged 30-40 years[odds ratio(OR)=4.06,95%confidence interval(CI):1.04-15.82,P=0.043],middle school education(OR=3.98,95%CI:1.29-12.33,P=0.017),high school/technical secondary school education(OR=14.06,95%CI:3.92-50.38,P<0.001),and junior college/bachelor’s degree and above education(OR=15.20,95%CI:4.15-55.650,P<0.001)were independently associated with good knowledge.The higher knowledge score was independently associated with a positive attitude(OR=1.23,95%CI:1.11-1.36,P<0.001).The higher attitude score was independently associated with proactive practice(OR=1.20,95%CI:1.11-1.30,P<0.001).CONCLUSION Chinese patients with IBD might have good knowledge,a positive attitude,and proactive practice toward their disease.However,a small number of specific items require education.

Exercise, Depression, and Anxiety in Young People: A Cross-Sectional Survey

Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.

Ecological-Based Mining:A Coal-Water-Thermal Collaborative Paradigm in Ecologically Fragile Areas in Western China

A substantial reduction in groundwater level,exacerbated by coal mining activities,is intensifying water scarcity in western China’s ecologically fragile coal mining areas.China’s national strategic goal of achieving a carbon peak and carbon neutrality has made eco-friendly mining that prioritizes the protection and efficient use of water resources essential.Based on the resource characteristics of mine water and heat hazards,an intensive coal-water-thermal collaborative co-mining paradigm for the duration of the mining process is proposed.An integrated system for the production,supply,and storage of mining companion resources is achieved through technologies such as roof water inrush prevention and control,hydrothermal quality improvement,and deep-injection geological storage.An active preventive and control system achieved by adjusting the mining technology and a passive system centered on multiobjective drainage and grouting treatment are suggested,in accordance with the original geological characteristics and dynamic process of water inrush.By implementing advanced multi-objective drainage,specifically designed to address the“skylight-type”water inrush mode in the Yulin mining area of Shaanxi Province,a substantial reduction of 50%in water drillings and inflow was achieved,leading to stabilized water conditions that effectively ensure subsequent safe coal mining.An integrated-energy complementary model that incorporates the clean production concept of heat utilization is also proposed.The findings indicate a potential saving of 8419 t of standard coal by using water and air heat as an alternative heating source for the Xiaojihan coalmine,resulting in an impressive energy conservation of 50.2%and a notable 24.2%reduction in carbon emissions.The ultra-deep sustained water injection of 100 m^(3)·h^(-1)in a single well would not rupture the formation or cause water leakage,and 7.87×10^(5)t of mine water could be effectively stored in the Liujiagou Formation,presenting a viable method for mine-water management in the Ordos Basin and providing insights for green and low-carbon mining.

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.

Determinants of internet addiction among medical students in Casablanca: a cross-sectional study

Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.

Research on the Relationship Between Environmental and Economic Coupling Systems in Bohai Bay Area Based on a Vector Autoregression(VAR)Model

This study analyzed the impact of land-based contaminants and tertiary industrial structure on economic development in the selected Bohai Bay area,China.Based on panel data spanning 2011-2020,a vector autoregressive(VAR)model is used to analyze and forecast the short-run and long-run relationships between three industrial structures,pollutant discharge,and economic development.The results showed that the environmental index had a long-term cointegration relationship with the industrial structure economic index.Per capital chemical oxygen demand(PCOD)and per capita ammonia nitrogen(PNH_(3)N)had a positive impact on delta per capita GDP(dPGDP),while per capita solid waste(PSW),the secondary industry rate(SIR)and delta tertiary industry(dTIR)had a negative impact on dPGDP.The VAR model under this coupling system had stability and credibility.The impulse response results showed that the short-term effect of the coupling system on dPGDP was basically consistent with the Granger causality test results.In addition,variance decomposition was used in this study to predict the long-term impact of the coupling system in the next ten periods(i.e.,ten years).It was found that dTIR had a great impact on dPGDP,with a contribution rate as high as 74.35%in the tenth period,followed by the contribution rate of PCOD up to 3.94%,while the long-term contribution rates of PSW,SIR and PNH3N were all less than 1%.The results show that the government should support the development of the tertiary industry to maintain the vitality of economic development and prevent environmental deterioration.