Cervical cancer prevention in China: where are we now, and what's next?

Cervical cancer(CC) epidemiology CC, the fourth most frequently diagnosed malignancy in women worldwide, is a major global health challenge, particularly in low-resource regions. Approximately 88.1% of the 604,000 CC new cases occurred in low-and middle-income countries in 2020, and more than 90% of the 342,000 CC deaths occurred in low-and middle-income countries in 2020~1.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.

Unlocking the potential-vitamin D in prostate cancer prevention

Prostate cancer poses a significant health challenge globally,demanding proactive prevention strategies.This editorial explores the emerging role of vitamin D in prostate cancer prevention.While traditionally associated with bone health,vitamin D is increasingly recognized for its broader impact on immune function,cellular signaling,and cancer prevention.Epidemiological studies suggest an intriguing link between vitamin D deficiency and elevated prostate cancer risk,particularly in regions with limited sunlight exposure.Mechanistically,vitamin D regulates cellular processes,inhibiting unchecked cancer cell growth and bols-tering immune surveillance.Personalized prevention strategies,considering individual factors,are deemed essential for harnessing the full potential of vitamin D.To unlock this potential,the future calls for robust research,public awareness campaigns,dietary improvements,and vigilant medical guidance.Collaborative efforts are poised to pave the way toward a future where vitamin D stands as a sentinel in prostate cancer prevention,ushering in hope and improved health for men worldwide.

Navigating nephrotoxic waters:A comprehensive overview of contrast-induced acute kidney injury prevention

Contrast-induced acute kidney injury(CI-AKI)is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality.Its pathophysiology,although not well-established,revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney.Critically ill patients,as well as those with pre-existing renal disease and cardiovascular comorbidities,are more susceptible to CI-AKI.Despite the continuous research in the field of CI-AKI prevention,clinical practice is based mostly on periprocedural hydration.In this review,all the investigated methods of prevention are presented,with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

Not in Control,but Liable?Attributing Human Responsibility for Fully Automated Vehicle Accidents

Human agency has become increasingly limited in complex systems with increasingly automated decision-making capabilities.For instance,human occupants are passengers and do not have direct vehicle control in fully automated cars(i.e.,driverless cars).An interesting question is whether users are responsible for the accidents of these cars.Normative ethical and legal analyses frequently argue that individuals should not bear responsibility for harm beyond their control.Here,we consider human judgment of responsibility for accidents involving fully automated cars through three studies with seven experiments(N=2668).We compared the responsibility attributed to the occupants in three conditions:an owner in his private fully automated car,a passenger in a driverless robotaxi,and a passenger in a conventional taxi,where none of these three occupants have direct vehicle control over the involved vehicles that cause identical pedestrian injury.In contrast to normative analyses,we show that the occupants of driverless cars(private cars and robotaxis)are attributed more responsibility than conventional taxi passengers.This dilemma is robust across different contexts(e.g.,participants from China vs the Republic of Korea,participants with first-vs third-person perspectives,and occupant presence vs absence).Furthermore,we observe that this is not due to the perception that these occupants have greater control over driving but because they are more expected to foresee the potential consequences of using driverless cars.Our findings suggest that when driverless vehicles(private cars and taxis)cause harm,their users may face more social pressure,which public discourse and legal regulations should manage appropriately.

Beyond dentistry:could prevention and screening for neurodegenerative diseases start in the dental office?

The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a disease.Considering the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.

Physical activity with or without dietary intervention for the prevention of cardiovascular diseases

We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.

Community-based prevention and treatment of cardiovascular diseases

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.

Stem cell transplantation in cerebrovascular accidents:A global bibliometric analysis(2000-2023)

BACKGROUND Cerebrovascular accident(CVA)is a major global contributor to death and disability.As part of its medical management,researchers have recognized the importance of promising neuroprotective strategies,where stem cell transplantation(SCT)is thought to confer advantages via trophic and neuroprotective effects.AIM To evaluate the current state of research on SCT in patients with CVA,assess key trends and highlight literature gaps.METHODS PubMed was screened for SCT in CVA-related articles in October 2023,for each country during the period between 2000 and 2023.Using the World Bank data,total population and gross domestic product were collected for comparison.VOSviewer_1.6.19 was used to create the VOS figure using the results of the same query.Graphs and tables were obtained using Microsoft Office Excel.RESULTS A total of 6923 studies were identified on SCT in CVA,making 0.03%of all published studies worldwide.Approximately,68%were conducted in high-income countries,with a significant focus on mesenchymal stem cells.The journal“Stroke”featured the largest share of these articles,with mesenchymal SCT having the highest rate of inclusion,followed by hematopoietic SCT.Over time,there has been a noticeable shift from in vitro studies,which assess stem cell proliferation and neurogenesis,to in vivo studies aimed at evaluating efficacy and safety.Additionally,the number of reviews increased along this approach.CONCLUSION This bibliometric analysis provides a comprehensive guide for physicians and researchers in the field through an objective overview of research activity,and highlights both current trends and gaps.Having a potential therapeutic role in CVA,more research is needed in the future to focus on different aspects of SCT,aiming to reach a better treatment strategy and improve life quality in patients.

Exploring the Factors Associated with 12-Month Non-Return to Work among Motorcyclists Involved in Road Accidents

Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.

Practice of Infection Prevention and Control Strategies in Risk Departments during the COVID-19 Epidemic

Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.

Transient Analysis of a Reactor Coolant Pump Rotor Seizure Nuclear Accident

The reactor coolant pump(RCP)rotor seizure accident is defined as a short-time seizure of the RCP rotor.This event typically leads to an abrupt flow decrease in the corresponding loop and an ensuing reactor and turbine trip.The significant reduction of core coolant flow while the reactor is being operated at full load can have very negative consequences.This potentially dangerous event is typically characterized by a complex transient behavior in terms of flow conditions and energy transformation,which need to be analyzed and understood.This study constructed transient flow and rotational speed mathematical models under various degrees of rotor seizure using the test data collected from a dedicated transient rotor seizure test system.Then,bidirectional fluid-solid coupling simulations were conducted to investigate the flow evolution mechanism.It is found that the influence of the impeller structure size and transient braking acceleration on the unsteady head(Hu)is dominant in rotor seizure accident events.Moreover,the present results also show that the rotational acceleration additional head(Hu1)is much higher than the instantaneous head(Hu2).

Comprehensive approach to esophageal variceal bleeding:From prevention to treatment

Esophageal variceal bleeding is a severe complication often associated with portal hypertension,commonly due to liver cirrhosis.Prevention and treatment of this condition are critical for patient outcomes.Preventive strategies focus on reducing portal hypertension to prevent varices from developing or enlarging.Primary prophylaxis involves the use of non-selective beta-blockers,such as propranolol or nadolol,which lower portal pressure by decreasing cardiac output and thereby reducing blood flow to the varices.Endoscopic variceal ligation(EVL)may also be employed as primary prophylaxis to prevent initial bleeding episodes.Once bleeding occurs,immediate treatment is essential.Initial management includes hemodynamic stabilization followed by pharmacological therapy with vasoactive drugs such as octreotide or terlipressin to control bleeding.Endoscopic intervention is the cornerstone of treatment,with techniques such as EVL or sclerotherapy applied to directly manage the bleeding varices.In cases where bleeding is refractory to endoscopic treatment,transjugular intrahepatic portosystemic shunt may be considered to effectively reduce portal pressure.Long-term management after an acute bleeding episode involves secondary prophylaxis using betablockers and repeated EVL sessions to prevent rebleeding,complemented by monitoring and managing liver function to address the underlying disease.In light of new scientific evidence,including the findings of the study by Peng et al,this editorial aims to review available strategies for the prevention and treatment of esophageal varices.

A STAMP-Game model for accident analysis in oil and gas industry

Accidents in engineered systems are usually generated by complex socio-technical factors.It is beneficial to investigate the increasing complexity and coupling of these factors from the perspective of system safety.Based on system and control theories,System-Theoretic Accident Model and Processes(STAMP)is a widely recognized approach for accident analysis.In this paper,we propose a STAMP-Game model to analyze accidents in oil and gas storage and transportation systems.Stakeholders in accident analysis by STAMP can be regarded as players of a game.Game theory can,thus,be adopted in accident analysis to depict the competition and cooperation between stakeholders.Subsequently,we established a game model to study the strategies of both supervisory and supervised entities.The obtained results demonstrate that the proposed game model allows for identifying the effectiveness deficiency of the supervisory entity,and the safety and protection altitudes of the supervised entity.The STAMP-Game model can generate quantitative parameters for supporting the behavior and strategy selections of the supervisory and supervised entities.The quantitative data obtained can be used to guide the safety improvement,to reduce the costs of safety regulation violation and accident risk.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Uncertainty and sensitivity analysis of in-vessel phenomena under severe accident mitigation strategy based on ISAA-SAUP program

The phenomenology involved in severe accidents in nuclear reactors is highly complex.Currently,integrated analysis programs used for severe accident analysis heavily rely on custom empirical parameters,which introduce considerable uncertainty.Therefore,in recent years,the field of severe accidents has shifted its focus toward applying uncertainty analysis methods to quantify uncertainty in safety assessment programs,known as“best estimate plus uncertainty(BEPU).”This approach aids in enhancing our comprehension of these programs and their further development and improvement.This study concentrates on a third-generation pressurized water reactor equipped with advanced active and passive mitigation strategies.Through an Integrated Severe Accident Analysis Program(ISAA),numerical modeling and uncertainty analysis were conducted on severe accidents resulting from large break loss of coolant accidents.Seventeen uncertainty parameters of the ISAA program were meticulously screened.Using Wilks'formula,the developed uncertainty program code,SAUP,was employed to carry out Latin hypercube sampling,while ISAA was employed to execute batch calculations.Statistical analysis was then conducted on two figures of merit,namely hydrogen generation and the release of fission products within the pressure vessel.Uncertainty calculations revealed that hydrogen production and the fraction of fission product released exhibited a normal distribution,ranging from 182.784 to 330.664 kg and from 15.6 to 84.3%,respectively.The ratio of hydrogen production to reactor thermal power fell within the range of 0.0578–0.105.A sensitivity analysis was performed for uncertain input parameters,revealing significant correlations between the failure temperature of the cladding oxide layer,maximum melt flow rate,size of the particulate debris,and porosity of the debris with both hydrogen generation and the release of fission products.

Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension

Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related contraindications.With recent advances in precision medicine,precise drug treatment provides better treatment efficacy.Data sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May 2022.Information on clinical trials was obtained from https://clinicaltrials.gov/and http://www.chictr.org.cn/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs.According to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and others.All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.Conclusions:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.

Assessing the Variability of Extreme Weather Events and Its Influence on Marine Accidents along the Northern Coast of Tanzania

The marine accidents are among the main components of the Zanzibar Disaster Management Policy (2011) and the Zanzibar Blue Economy Policy (2020). These policies aimed to institute legal frame works and procedures for reducing both the frequency of marine accidents and their associated fatalities. These fatalities include deaths, permanent disabilities and loss of properties which may result into increased poverty levels as per the sustainable development goal one (SDG1) which stipulates on ending the poverty in all its forms everywhere. Thus, in the way to support these Government efforts, the influence of climate and weather on marine accidents along Zanzibar and Pemba Channels was investigated. The study used the 10 years (2013-2022) records of daily rainfall and hourly wind speed acquired from Tanzania Meteorological Authority (TMA) (for the observation stations of Zanzibar, Pemba, Dares Salaam and Tanga), and the significant wave heights data, which was freely downloaded from Globally Forecasting System (GFS-World model of 13 km resolution). The marine accident records were collected from TASAC and Zanzibar Maritime Authority (ZMA), and the anecdotal information was collected from heads of quay and boat captains in different areas of Zanzibar. The Mann Kendal test, was used to determine the slopes and trends direction of used weather parameters, while the Pearson correlations analysis and t-tests were used to understand the significance of the underlying relationship between the weather and marine accidents. The paired t-test was used to evaluate the extent to which weather parameters affect the marine accidents. Results revealed that the variability of extreme weather events (rainfall, ocean waves and wind speed) was seen to be among the key factors for most of the recorded marine accidents. For instance, in Pemba high rainfall showed an increasing trend of extreme rainfall events, while Zanzibar has shown a decreasing trend of these events. As for extreme wind events, results show that Dar es Salaam and Tanga had an increasing trend, while Zanzibar and Pemba had shown a decreasing trend. As for the monthly variability of frequencies of extreme rainfall events, March to May (MAM) season was shown to have the highest frequencies over all stations with the peaks at Zanzibar and Pemba. On the other hand, high frequency of extreme wind speed was observed from May to September with peaks in June to July, and the highest strength was observed during 09:00 to 15:00 GMT. Moreover, results revealed an increasing trend of marine accidents caused by bad weather except during November. Also, results showed that bad weather conditions contributed to 48 (32%) of all 150 recorded accidents. Further results revealed significant correlation between the extreme wind and marine accidents, with the highest strong correlation of r = 0.71 (at p ≤ 0.007) and r = 0.75 (at p ≤ 0.009) at Tanga and Pemba, indicating the occurrence of more marine accidents at the Pemba channel. Indeed, strong correlation of r = 0.6 between extreme rainfall events and marine accidents was shown in Pemba, while the correlations between extremely significant wave heights and marine accidents were r = 0.41 (at p ≤ 0.006) and r = 0.34 (p ≤ 0.0006) for Pemba and Zanzibar Channel, respectively. In conclusion, the study has shown high influence between marine accidents and bad weather events with more impacts in Pemba and Zanzibar. Thus, the study calls for more work to be undertaken to raise the awareness on marine accidents as a way to alleviate the poverty and enhance the sustainable blue economy.

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Conceptual Strategy for Mitigating the Risk of Hydrogen as an Internal Hazard in Case of Severe Accidents at Nuclear Power Plant Considering Existing Risks and Uncertainties Associated with the Use of Traditional Strategies

Hydrogen challenge mitigation stands as one of the main objectives in the management of severe accidents at Nuclear Power Plants (NPPs). Key strategies for hydrogen control include atmospheric inertization and hydrogen removal with Passive Autocatalytic Recombiners (PARs) being a commonly accepted approach. However, an examination of PAR operation specificity reveals potential inefficiencies and reliability issues in certain severe accident scenarios. Moreover, during the in-vessel stage of severe accident development, in some severe accident scenarios PARs can unexpectedly become a source of hydrogen detonation. The effectiveness of hydrogen removal systems depends on various factors, including the chosen strategies, severe accident scenarios, reactor building design, and other influencing factors. Consequently, a comprehensive hydrogen mitigation strategy must effectively incorporate a combination of strategies rather than be based on one strategy, taking into consideration the probabilistic risks and uncertainties associated with the implementation of PARs or other traditional methods. In response to these considerations, within the framework of this research it has been suggested a conceptual strategy to mitigate the hydrogen challenge during the in-vessel stage of severe accident development.