An Empirical Study of the Socratic Method in Nongraded English Teaching in Senior High School Under the Background of the New National College Entrance Examination

With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.

Scientific Advances and Weather Services of the China Meteorological Administration’s National Forecasting Systems during the Beijing 2022 Winter Olympics

Since the Beijing 2022 Winter Olympics was the first Winter Olympics in history held in continental winter monsoon climate conditions across complex terrain areas,there is a deficiency of relevant research,operational techniques,and experience.This made providing meteorological services for this event particularly challenging.The China Meteorological Administration(CMA)Earth System Modeling and Prediction Centre,achieved breakthroughs in research on short-and medium-term deterministic and ensemble numerical predictions.Several key technologies crucial for precise winter weather services during the Winter Olympics were developed.A comprehensive framework,known as the Operational System for High-Precision Weather Forecasting for the Winter Olympics,was established.Some of these advancements represent the highest level of capabilities currently available in China.The meteorological service provided to the Beijing 2022 Games also exceeded previous Winter Olympic Games in both variety and quality.This included achievements such as the“100-meter level,minute level”downscaled spatiotemporal resolution and forecasts spanning 1 to 15 days.Around 30 new technologies and over 60 kinds of products that align with the requirements of the Winter Olympics Organizing Committee were developed,and many of these techniques have since been integrated into the CMA’s operational national forecasting systems.These accomplishments were facilitated by a dedicated weather forecasting and research initiative,in conjunction with the preexisting real-time operational forecasting systems of the CMA.This program represents one of the five subprograms of the WMO’s high-impact weather forecasting demonstration project(SMART2022),and continues to play an important role in their Regional Association(RA)II Research Development Project(Hangzhou RDP).Therefore,the research accomplishments and meteorological service experiences from this program will be carried forward into forthcoming highimpact weather forecasting activities.This article provides an overview and assessment of this program and the operational national forecasting systems.

慢性心力衰竭病人6 min步行试验与代谢当量的相关性

目的:探讨慢性心力衰竭(CHF)病人6 min步行距离(6MWD)与代谢当量(MET)的相关性。方法:纳入符合射血分数降低标准的CHF病人60例,进行心肺运动试验(CPET)与2次6 min步行试验(6MWT)。采集2次6MWD、峰值摄氧量(VO_(2)peak)、无氧阈下代谢当量(METs-AT)、血氧饱和度(SpO_(2))、心率等数据,采用线性回归分析建立6MWD与METs-AT之间的回归方程模型。结果:正式6MWT中6MWD、VO_(2)peak、METs均较预行6MWT显著提高,分别增加5.02%、7.83%及8.61%,差异有统计学意义(P<0.05),2次6MWT过程中,病人的心率、Borg评分、SpO_(2)变化趋势基本一致;正式6MWD与METs-AT相关存在线性关系(r=0.78),方程式中决定系数R2和常量均具有统计学差异(P<0.05);试验过程中未出现严重不良事件。结论:正式6MWT结果可作为评估运动耐量的准确测量指标,根据6MWT建立回归模型推导METs-AT适用于CHF病人的评估。

Ecological correlates of sport and exercise participation among Thai adolescents:A hierarchical examination of a cross-sectional population survey

Background:Understanding factors influencing adolescents’ sport/exercise participation(S/EP) is vital to developing effective interventions,but currently,evidence from less developed countries is limited.The purpose of this study was to examine correlates of S/EP across individual,interpersonal,and environmental levels in a nationally representative sample of Thai adolescents.Methods:Data from 4617 Thai adolescents aged 14-17 years old were obtained from recruited schools across Thailand.Data on S/EP(outcome variable),and psychosocial,home,and community environment covariates were collected from individual adolescents using the Thailand Physical Activity Children Survey,Student Questionnaire.School environmental data were collected at the school level using a School Built Environment Audit.Hierarchical regressions taking into account school clustering effects were applied for data analysis.Results:At the individual level,age and body mass index were independently and strongly correlated with S/EP.Adolescents with high preference for physical activity(PA)(odd ratio(OR)=1.71,p <0.001) and at least a moderate level of self-efficacy(OR=1.33,p=0.001) were more likely to have high S/EP.At the interpersonal level,adolescents whose parents joined their sports/exercise at least 1-2 times/week(OR=1.36,p=0.003) received>3 types of parental support(OR=1.43,p=0.005) and who received siblings’(OR=1.26,p=0.004) and friends’(OR=1.99,p <0.001) support had a greater chance of high S/EP.At the environmental level,adolescents’ S/EP was greater when there were at least 3-4 pieces of home sport/exercise equipment(OR=2.77,p=0.003),grass areas at school(OR=1.56,p <0.001),and at least 1-2 PA facilities in the community(OR=1.30,p=0.009).Conclusion:Multiple factors at different levels within an ecological framework influencing Thai adolescents’ S/EP were generally similar to those found in developed countries,despite some differences.For those interested in promoting and supporting Thai adolescents’ engagement in sports/exercise,further exploration of the influence of self-efficacy and attitude toward PA is required at the individual level;parental and peer support at the interpersonal level;and home sport equipment,school grass areas,and neighborhood PA facilities at the environment level.

Shadow Extraction and Elimination of Moving Vehicles for Tracking Vehicles

Shadow extraction and elimination is essential for intelligent transportation systems(ITS)in vehicle tracking application.The shadow is the source of error for vehicle detection,which causes misclassification of vehicles and a high false alarm rate in the research of vehicle counting,vehicle detection,vehicle tracking,and classification.Most of the existing research is on shadow extraction of moving vehicles in high intensity and on standard datasets,but the process of extracting shadows from moving vehicles in low light of real scenes is difficult.The real scenes of vehicles dataset are generated by self on the Vadodara–Mumbai highway during periods of poor illumination for shadow extraction of moving vehicles to address the above problem.This paper offers a robust shadow extraction of moving vehicles and its elimination for vehicle tracking.The method is distributed into two phases:In the first phase,we extract foreground regions using a mixture of Gaussian model,and then in the second phase,with the help of the Gamma correction,intensity ratio,negative transformation,and a combination of Gaussian filters,we locate and remove the shadow region from the foreground areas.Compared to the outcomes proposed method with outcomes of an existing method,the suggested method achieves an average true negative rate of above 90%,a shadow detection rate SDR(η%),and a shadow discrimination rate SDR(ξ%)of 80%.Hence,the suggested method is more appropriate for moving shadow detection in real scenes.

细菌分裂调控Min系统的功能、机制及应用研究进展

细菌分裂过程及其调控机制是生物学研究中的根本问题。大多数细菌采用“二分裂”方式分裂,分裂过程主要包括染色体复制和分离、FtsZ组装成Z环、细胞内隔膜形成与子细胞形成等关键步骤。Min系统是Z环组装的主要调控系统之一,由FtsZ抑制蛋白MinC、膜结合的ATP酶MinD和结构拓扑因子MinE组成。早期研究大多聚焦在Min系统的细胞分裂调控功能,然而Min系统还作为细胞内部重要的自组装调控系统参与多种细胞代谢生理过程与细胞表型,具有应用开发潜力。本文首先简要概述Min系统的主要类型、结构特征和摆动模型,随后从细胞分裂、细胞运动性、细菌粘附性与致病性、细胞代谢生理过程等方面总结Min系统的生物学功能,最后介绍Min系统在细胞形态工程、抗菌制剂开发和合成生物学应用等方面的应用潜力。

Characterisation of Human-Wildlife Conflicts around the Kahuzi-Biega National Park, Eastern Democratic Republic of Congo

The history of mankind contains so many illustrations of well-classified and violent struggles against various animals over crop production in agricultural fields, attacks on human life or competition in order to have access to certain natural resources. The aim of this study is to characterise the human-wildlife conflicts that occur around the KBNP, especially with regard to primates. Surveys were carried out in 260 households selected using the snowball method. The results showed that human-wildlife conflicts around the KBNP are characterised by the destruction of crops in riparian fields by monkeys, chimpanzees and gorillas, the destruction of houses, physical attacks and zoonoses. Despite the conservation and protection measures for wildlife and local populations put in place by the Park’s managers, conflicts between local populations and the Park’s wild animals are still visible. These conflicts lead to the detention of wild animals by local people roaming in the villages and to poaching on the Park’s boundaries. The weakness of the community management policy on the part of the park managers and the resentment of the indigenous peoples towards the restriction of their access to natural resources are the major constraints on the sustainable management of conflicts between the local populations and the wild animals in the KBNP. The strategies for the sustainable resolution of human-wildlife conflicts around the KBNP must be geared towards and integrated into a community conservation approach.

Resurgence of measles virus infection in an eliminated country, Sri Lanka

Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.

The Association of Mercury and ALT with Obesity in Korean Adults Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years(KNHANES 2005,2008-2017)

The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.

Evaluating the Impacts of Human Activities on Diversity, Abundance, and Distribution of Large Mammals in Nimule National Park, South Sudan

Globally, human activities have a significant impact on the diversity, abundance, and distribution of large mammals in Protected Areas (PAs). These disturbances increase human pressure on biodiversity and species habitats, highlighting the need for conservation. This study aimed to assess the abundance and distribution of large mammals in different habitat types within Nimule National Park (NNP) and understand the impacts of human activities on them. Data on the abundance and distribution of large mammals and their respective habitat types were collected through line transect surveys. Human activity signs were observed and recorded along the transect lines. To estimate the impacts of human activities on the diversity, abundance, and distribution of large mammal species, as well as to identify any significant differences between them and their habitat types, the study utilized the Kruskal Wallis test, Polynomial multiple regressions, and diversity indices. The findings from the Shannon-Weiner and Simpson indices indicated that large mammal species were more diverse inside the park (H’ = 1.136;D = 0.570) compared to the buffer zone (H’ = 0.413;D = 0.171), with 85% (443 out of 510 samples) recorded within Nimule National Park. The species abundance showed a semi-balanced status (0.58). The diversity results among different habitat types revealed that large mammals were more diverse and highly distributed in both open woodlands (244) and dense woodlands (192), while riverine vegetation had the lowest diversity (8). Statistical tests demonstrated a highly significant difference at a 99% confidence interval (p-value = 0.01) between habitat types and identified species of large mammals. Additionally, the results highlighted the high abundance of Uganda kob (274), baboons (141), and warthog (57) across most habitat types, accounting for at least 75% of their distribution. The most prevalent human activities observed were cattle footprints (27%) and cattle dung (14%). Human footprints and tree cutting combined accounted for 9%, indicating the practice of livestock grazing, poaching, encroachment, and fuelwood collection by local communities. However, these activities did not appear to significantly impact the diversity, abundance, and distribution of large mammals in Nimule National Park. Therefore, it is crucial to foster shared responsibilities and engage relevant stakeholders in the management and conservation of large wildlife species. Regular community awareness programs should be implemented to cultivate a sense of ownership. Moreover, it is recommended that a comprehensive survey be conducted on the population status of all mammal species in Nimule National Park, including its surrounding Buffer Zone. Monitoring the impact of human activities on their behavior and habitats using satellite images should also be carried out at least every five to ten years.

Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 days.Methods:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were compiled.Univariate analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical associations.Results:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were available.Univariate and multivariable analysis exhibited similar results.For LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant associations.For hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant associations.Conclusion:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data.Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

Nationalist Trends in the Transformation of New Zealand’s Maori Language Policy

Language is an important carrier of human culture and a specific method for communication between humans.It is one of the most important symbols of human identity and flags of dividing group identity.At present,in the modern national state,the government is paying more attention to language policy and being more and more prudent to it.In the process of making and implementing language policy,the government must take into account a range of factors such as the country’s national history,politics,culture,economy,and relations between different social groups.From the mid-nineteenth century,when New Zealand became a British colony,until the mid-twentieth century,the Maori people were inspired to defend their rights and respect for themselves by the rise of Maori nationalist ideology and Maori political radicalism in a struggle that lasted more than 100 years.Until 1994,there were more than 800 kohanga reo,early childhood institutions that established Maori language instruction independent of the school system,and the nationalism drives to revitalize the Maori national language was at its peak.The process of revolution on Maori language policies in New Zealand reflects a trend of nationalist thoughts from Maori becoming more deep.Exploring the process of change in New Zealand’s Maori language policy will help to develop the study of the social history of indigenous peoples during the colonial period and will contribute to the study of the development of colonized countries and regions in the post-colonial period.The change in New Zealand’s Maori language policy has provided an important example of the preservation and revitalization of the indigenous languages of the world’s former colonies,which is of great significance for the preservation of linguistic and cultural diversity.

National Social Investment Programmes in Nigeria:A Descriptive Analysis of the Socio-Economic Contributions of N-Power Programme in Benue State

This study analysed the socio-economic contributions of N-Power programme amongst the beneficiaries of the scheme in Benue State.Prior to the introduction of N-Power programme,successive administrations in Nigeria have made concerted efforts towards improving the standard of living of the citizenry through the execution of various welfare or social intervention programmes,but not much successes were recorded.Learning from the mistakes of the past regimes,and by way of deliberate state policy,the Buhari’s government initiated a multi-pronged social investment policy,one of which is the N-power programme that came onboard in 2016,which also doubles as the subject of this study.To achieve the goal of this study,a combination of desktop research and survey design was employed.Questionnaires were administered to 390 respondents through a combination of stratified and random sampling techniques.The results of the survey were matched with that of the secondary data obtained through online websites and other related sources.The result indicated that N-Power made positive contributions to the socio-economic life of the beneficiaries in Benue State:specifically,the scheme contributed in poverty eradication,employment generation,skills acquisitions and capacity building.However,some aspect of our findings revealed that the programme has a number of challenges such as:inadequate cash support,delay in monthly cash transfer to beneficiaries,distance participants had to move to their work stations,absence of posting in N-Teach scheme,and lack of adequate working tools amongst others.To salvage this problem the paper recommended the following solutions:expansion of the scheme to cover N-Teach and other aspects,increment in the monthly cash transfer to cushion the high rate of inflation,support for the participants/beneficiaries in transportation and logistics,enrolment of more youth into the various schemes,proper monitoring and evaluation of the implementation of the schemes amongst others.

Exploring the Reasons for Changes in National Reading Behaviour from the Perspective of Media Environmentalism

In this paper, through the perspective of Merowitz’s media environmentalism, following the research path of media-scene-behaviour, and based on the results of the national reading survey released by the China Press and Publication Research Institute in the past ten years (2013-2022), we analyse the characteristics of national reading behaviours, explore the reasons for the changes in national reading behaviour in terms of technology, media, and scenarios. It also discusses the future trend of national reading behaviour and the promotion of national reading activities, and puts forward certain countermeasures from the government, schools and the society to make joint efforts to promote national reading.

National Image Construction from the Perspective of Multimodal Metaphor-A Case Study of the Opening Ceremony of the Beijing Winter Olympics

The national image is a comprehensive concept with a distinct political feature,including the international image presented to the outside world,and also encompassing the national identity of the people.With the development of globalization,international cultural communication has become a crucial part of shaping the national image,and the opening ceremony of the Beijing Winter Olympics has become an important opportunity for China to showcase its national image to the world in the post-pandemic era.Based on Forceville’s multimodal metaphor theory,this paper examines the metaphorical phenomena contained in the performance and their functions,effects,and purposes in the construction of the national image.It is found that there are many scenes,images,and narratives in the opening ceremony,including war metaphor,competition metaphor,personification metaphor,and other conceptual metaphors.The focus of this paper is on multimodal metaphor in a broad sense,mainly encompassing auditory and visual modes.Through the use of these multimodal metaphors,the opening ceremony of the Winter Olympics builds an image of a vibrant,peace-loving,and responsible country,which not only demonstrates China’s cultural self-confidence,but also expresses the Chinese people’s beautiful vision for the early reunification of the motherland.

Progress in neurorehabilitation research and the support by the National Natural Science Foundation of China from 2010 to 2022

The National Natural Science Foundation of China is one of the major funding agencies for neuro rehabilitation research in China.This study reviews the frontier directions and achievements in the field of neurorehabilitation in China and wo rldwide.We used data from the Web of Science Core Collection(WoSCC) database to analyze the publications and data provided by the National Natural Science Foundation of China to analyze funding information.In addition,the prospects for neurorehabilitation research in China are discussed.From 2010 to 2022,a total of 74,220 publications in neurorehabilitation were identified,with there being an overall upward tendency.During this period,the National Natural Science Foundation of China has funded 476 research projects with a total funding of 192.38 million RMB to support neuro rehabilitation research in China.With the support of the National Natural Science Foundation of China,China has made some achievements in neurorehabilitation research.Research related to neurorehabilitation is believed to be making steady and significant progress in China.

Impact of index admission cholecystectomy vs interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey

BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.

Examining the Experiences and Challenges of Haze-Fog Governance in China

With the rapid development of industrialisation and urbanisation, China is facing the challenge of severe HF (Haze-Fog) pollution. This essay compares the advantages and disadvantages of China’s HF management and summarizes the important lessons China can teach the rest of the world about applying this tactic. China’s capabilities in the digital economy, National Innovation Demonstration Zones, and urban innovation systems are examined in this article, along with its shortcomings in information mechanisms and pollution sources. This essay also summarizes China’s achievements, particularly regarding local autonomy. The essay goes on to say, however, that China is probably going to be under more pressure to manage HF in the future, both in terms of long-term solutions and the economy.

Link between irritable bowel syndrome,depression,and colorectal cancer risk in young patients:Age-matched nationwide populationbased study

BACKGROUND There exists a link between irritable bowel syndrome(IBS)and depression.Similarly,chronic depression is known to increase the risk of cancer in general.In this population-based analysis,we investigated the prevalence and the odds of colorectal cancer(CRC)in young-depressed patients with IBS.AIM To investigate the relationship between IBS and CRC in young,depressed patients using a nationally representative United States inpatient sample.METHODS The 2019 National Inpatient Sample was used to identify young(18-44 years)patients admitted with comorbid depression in the presence vs absence of IBS using relevant International Classification of Diseases,Tenth Revision,Clinical Modification codes.Primary endpoint was the prevalence and odds of CRC in age matched(1:1)youngdepressed cohort hospitalized with IBS(IBS+)vs without IBS(IBS-).Multivariable regression analysis was performed adjusting for potential confounders.RESULTS Age-matched(1:1)young-depressed IBS+(83.9%females,median age 36 years)and IBS-(65.8%females,median age 36 years)cohorts consisted of 14370 patients in each group.IBS+cohort had higher rates of hypertension,uncomplicated diabetes,hyperlipidemia,obesity,peripheral vascular disease,chronic obstructive pulmonary disease,hypothyroidism,prior stroke,prior venous thromboembolism,anxiety,bipolar disorder,and borderline personality disorder(P<0.005)vs the IBS-cohort.However,prior myocardial infarction,acquired immunodeficiency syndrome,dementia,smoking,alcohol abuse,and drug abuse(P<0.005)are high in IBS-cohort.The rate of CRC was comparable in both cohorts[IBS+n=25(0.17%)vs IBS-n=35(0.24%)].Compared to the IBS-cohort,the odds ratio(OR)of developing CRC was not significantly higher[OR 0.71,95%confidence interval(CI)0.23-2.25)]in IBS+cohort.Also,adjusting for baseline sociodemographic and hospital characteristics and relevant comorbidities,the OR was found to be non-significant(OR 0.89,95%CI 0.21-3.83).CONCLUSION This nationwide propensity-matched analysis revealed comparable prevalence and risk of CRC in youngdepressed patients with vs without IBS.Future large-scale prospective studies are needed to evaluate the long-term effects of depression and its treatment on CRC risk and outcomes in IBS patients.