Analyzing the factors influencing speeding behavior based on quasi-induced exposure and random parameter logit model with heterogeneity in means.

INTRODUCTION: Speeding behavior is a major threat to road traffic safety, which can increase crash risks and result in severe injury outcomes. Although several studies have been conducted to analyze speeding crashes and relevant influential factors, the heterogeneity of variables has not been fully explored. Based on the traffic crash data extracted from the Crash Report Sampling System, the study aims to identify the factors that influence speeding driving with the consideration of variable heterogeneity. METHOD: Quasi-induced exposure technique is adopted to identify the disparities in the propensities of speeding for various driving cohorts. The random parameter logit model with heterogeneity in means is employed to examine the factors impacting speeding behavior. RESULTS: Results indicate that: (a) driving cohorts such as young drivers, male drivers, passenger cars, and pickups appear to have higher propensities of engaging in speeding driving; (b) the propensity of speeding is higher when the driver is drinking, distracted, changing lanes, negotiating a curve, driving in lighted condition, and on curved roads; and (c) the random parameter logit model with heterogeneity in means has better performance as opposed to that without heterogeneity in means. CONCLUSIONS: Speeding behavior can be influenced by various factors in terms of driver-vehicle characteristics, physical condition, driving actions, and environmental conditions. PRACTICAL APPLICATIONS: The findings could serve to develop effective countermeasures to reduce speeding behavior and improve traffic safety.

Analysis of the climatic trends and heat stress periods for ruminants rearing in Bangladesh.

The production of ruminant livestock is greatly impacted by climate change, as it is anticipated to jeopardise food security due to the increasing heat stress experienced by the animals, which can be measured using the Temperature Humidity Index (THI). The objective of our study was to analyze climatic patterns, identify influential variables and evaluate heat stress episodes through the utilization of the THI to establish a rearing system for ruminants in Bangladesh. The THI value was determined by analyzing meteorological station data spanning from 1995 to 2022 across various climatic zones in Bangladesh. The Mann-Kendall evaluation was used to analyze the THI patterns throughout the study. Our findings indicated that heat stress problems are expected to occur in Bangladesh when THI for ruminant rearing exceeds 74, particularly from February to December. The severity of heat stress in THIruminant 71-90 varied significantly, ranging from normal to extremely severe. We observed that June (90) was the hottest month in the west central region, while January (71) was the coldest in the northwest area. When examining the impact of climatic factors on the THI, we found that air temperature has the highest influence, while relative humidity had the second-highest influence on THI in all areas of Bangladesh. Sunlight length and wind speed influenced the yearly THI marginally but not seasonally. Our findings highlighted a seasonal threat associated with heat stress in the climatic conditions of Bangladesh. It is essential to identify heat stress in ruminants, especially considering the continuing global warming issue. Our results recommend the implementation of heat stress mitigation strategies for ruminant farmers in Bangladesh.

Spatial distribution and influencing factors of CDC health resources in China: a study based on panel data from 2016-2021.

Background: Measuring the development of Chinese centers for disease control and prevention only by analyzing human resources for health seems incomplete. Moreover, previous studies have focused more on the quantitative changes in healthcare resources and ignored its determinants. Therefore, this study aimed to analyze the allocation of healthcare resources in Chinese centers for disease control and prevention from the perspective of population and spatial distribution, and to further explore the characteristics and influencing factors of the spatial distribution of healthcare resources. Methods: Disease control personnel density, disease control and prevention centers density, and health expenditures density were used to represent human, physical, and financial resources for health, respectively. First, health resources were analyzed descriptively. Then, spatial autocorrelation was used to analyze the spatial distribution characteristics of healthcare resources. Finally, we used spatial econometric modeling to explore the influencing factors of healthcare resources. Results: The global Moran index for disease control and prevention centers density decreased from 1.3164 to 0.2662 (p < 0.01), while the global Moran index for disease control personnel density increased from 0.4782 to 0.5067 (p < 0.01), while the global Moran index for health expenditures density was statistically significant only in 2016 (p < 0.1). All three types of healthcare resources showed spatial aggregation. Population density and urbanization have a negative impact on the disease control and prevention centers density. There are direct and indirect effects of disease control personnel density and health expenditures density. Population density and urbanization had significant negative effects on local disease control personnel density. Urbanization has an indirect effect on health expenditures density. Conclusion: There were obvious differences in the spatial distribution of healthcare resources in Chinese centers for disease control and prevention. Social, economic and policy factors can affect healthcare resources. The government should consider the rational allocation of healthcare resources at the macro level.

Hidden blood loss and the influential factors after minimally invasive treatment of posterior pelvic ring injury with sacroiliac screw.

BACKGROUND: To analyze the perioperative bleeding and hidden blood loss (HBL) of sacroiliac screw minimally invasive treatment of pelvic posterior ring injury and explore the influential factors of HBL after operation for providing reference for clinical treatment. METHOD: A retrospective analysis was conducted on data from 369 patients with posterior pelvic ring injuries treated with sacroiliac screws internal fixation at our hospital from January 2015 to January 2022. The research was registered in the Chinese Clinical Trial Registry in July 2022 (ChiCTR2200061866). The total blood loss (TBL) and HBL of patients were counted, and the factors such as gender, age, and surgical duration were statistically analyzed. The influential factors of HBL were analyzed by multiple linear regression. RESULTS: The TBL was 417.96 ± 98.05 ml, of which the visible blood loss (VBL) was 37.00 ± 9.0 ml and the HBL was 380.96 ± 68.8 ml. The HBL accounted for 91.14 ± 7.36% of the TBL. Gender, surgical duration, fixed position, and fixed depth had significant effects on the HBL (P < 0.05). CONCLUSIONS: The HBL was the main cause of anemia after minimally invasive treatment of posterior pelvic ring injury with a sacroiliac screw. Gender, surgical duration, fixed position, and fixed depth were closely related to the occurrence of HBL. In clinical treatment, we should consider these influential factors and take effective measures to reduce the impact of HBL on patients.

Hidden blood loss and its influencing factors after cement augmentation for vertebral metastasis.

Introduction: Few studies have focused on the risk factors for hidden blood loss (HBL) during cement augmentation surgery for pathologic vertebral compression fraction (PVCFs). Method: From January 2014 to December 2020, the clinical data of 169 PVCF patients (283 levels) who underwent cement augmentation were retrospectively analysed. HBL was calculated according to the linear Gross formula using the patient's average Hct during the perioperative course and PBV. Multivariate linear regression analysis was performed to evaluate the independent factors associated with HBL. Results: The mean HBL was 448.2 ± 267.2 ml, corresponding to 10.8% ± 6.2% of the patient blood volume (PBV). There were significant differences between pre- and postoperative haematocrit (Hct) (P < 0.001) and Hb (P < 0.001), and 132 patients developed anaemia postoperatively, while 79 patients had anaemia preoperatively (P < 0.001). Multivariate linear regression revealed that bone lesion quality (p = 0.028), number of PVCFs (p = 0.002), amount of bone cement (p = 0.027), bone cement leakage (p = 0.001), and percentage of vertebral height loss (VHL) (p = 0.011) were independent risk factors for HBL. Conclusion: In conclusion, patients with lytic vertebral destruction, larger amounts of bone cement, greater amounts of bone cement leakage, more PVCF(s), and greater percentages of VHL may be more prone to HBL.

Contribution of Particulates to Airborne Disease Transmission and Severity: A Review.

The emergence of coronavirus disease 2019 (COVID-19) has catalyzed great interest in the spread of airborne pathogens. Airborne infectious diseases are classified into viral, bacterial, and fungal infections. Environmental factors can elevate their transmission and lethality. Air pollution has been reported as the leading environmental cause of disease and premature death worldwide. Notably, ambient particulates of various components and sizes are harmful pollutants. There are two prominent health effects of particles in the atmosphere: (1) particulate matter (PM) penetrates the respiratory tract and adversely affects health, such as heart and respiratory diseases; and (2) bioaerosols of particles act as a medium for the spread of pathogens in the air. Particulates contribute to the occurrence of infectious diseases by increasing vulnerability to infection through inhalation and spreading disease through interactions with airborne pathogens. Here, we focus on the synergistic effects of airborne particulates on infectious disease. We outline the concepts and characteristics of bioaerosols, from their generation to transformation and circulation on Earth. Considering that microorganisms coexist with other particulates as bioaerosols, we investigate studies examining respiratory infections associated with airborne PM. Furthermore, we discuss four factors (meteorological, biological, physical, and chemical) that may impact the influence of PM on the survival of contagious pathogens in the atmosphere. Our review highlights the significant role of particulates in supporting the transmission of infectious aerosols and emphasizes the need for further research in this area.

Characterization and childhood exposure assessment of toxic heavy metals in household dust under true living conditions from 10 China cities.

Health hazards caused by metal exposure in household dust are concerning environmental health problems. Exposure to toxic metals in household dust imposes unclear but solid health risks, especially for children. In this multicenter cross-sectional study, a total of 250 household dust samples were collected from ten stratified cities in China (Panjin, Shijiazhuang, Qingdao, Lanzhou, Luoyang, Ningbo, Xi'an, Wuxi, Mianyang, Shenzhen) between April 2018 and March 2019. Questionnaire was conducted to gather information on individuals' living environment and health status in real-life situations. Multivariate logistic regression and principal component analysis were conducted to identify risk factors and determine the sources of metals in household dust. The median concentration of five metals in household dust from 10 cities ranged from 0.03 to 73.18 µg/g. Among the five heavy metals, only chromium in household dust of Mianyang was observed significantly both higher in the cold season and from the downwind households. Mercury, cadmium, and chromium were higher in the third-tier cities, with levels of 0.08, 0.30 and 97.28 µg/g, respectively. There were two sources with a contribution rate of 38.3 % and 25.8 %, respectively. Potential risk factors for increased metal concentration include long residence time, close to the motorway, decoration within five years, and purchase of new furniture within one year. Under both moderate and high exposure scenarios, chromium showed the highest level of exposure with 6.77 × 10-4 and 2.28 × 10-3 mg·kg-1·d-1, and arsenic imposed the highest lifetime carcinogenic risk at 1.67 × 10-4 and 3.17 × 10-4, respectively. The finding highlighted the priority to minimize childhood exposure of arsenic from household dust.

Uranium removal in groundwater by Priestia sp. isolated from uranium-contaminated mining soil.

Priestia sp. WW1 was isolated from a uranium-contaminated mining soil and identified. The uranium removal characteristics and mechanism of Priestia sp. WW1 were investigated. The results showed that the removal efficiency of uranium decreased with the increase of initial uranium concentration. When the uranium initial concentration was 5 mg/L, the uranium removal efficiency achieved 92.1%. The increase of temperature could promote the uranium removal. Carbon source could affect the removal rate of uranium, which was the fastest when the methanol was used as carbon source. The solution pH had significant effect on the uranium removal efficiency, which reached the maximum under solution pH 5.0. The experimental results and FTIR as well as XPS demonstrated that Priestia sp. WW1 could remove uranium via both adsorption and reduction. The common chloride ions, sulfate ions, Mn(II) and Cu(II) enhanced the uranium removal, while Fe(III) depressed the uranium removal. The Priestia sp. WW1 could effectively remove the uranium in the actual mining groundwater, and the increase of initial biomass could improve the removal efficiency of uranium in the actual mining groundwater. This study provided a promising bacterium for uranium remediation in the groundwater.

Predicting delirium and the effects of medications in hospitalized COVID-19 patients using machine learning: A retrospective study within the Korean Multidisciplinary Cohort for Delirium Prevention (KoMCoDe).

Objective: Delirium is commonly reported from the inpatients with Coronavirus disease 2019 (COVID-19) infection. As delirium is closely associated with adverse clinical outcomes, prediction and prevention of delirium is critical. We developed a machine learning (ML) model to predict delirium in hospitalized patients with COVID-19 and to identify modifiable factors to prevent delirium. Methods: The data set (n = 878) from four medical centers was constructed. Total of 78 predictors were included such as demographic characteristics, vital signs, laboratory results and medication, and the primary outcome was delirium occurrence during hospitalization. For analysis, the extreme gradient boosting (XGBoost) algorithm was applied, and the most influential factors were selected by recursive feature elimination. Among the indicators of performance for ML model, the area under the curve of the receiver operating characteristic (AUROC) curve was selected as the evaluation metric. Results: Regarding the performance of developed delirium prediction model, the accuracy, precision, recall, F1 score, and the AUROC were calculated (0.944, 0.581, 0.421, 0.485, 0.873, respectively). The influential factors of delirium in this model included were mechanical ventilation, medication (antipsychotics, sedatives, ambroxol, piperacillin/tazobactam, acetaminophen, ceftriaxone, and propacetamol), and sodium ion concentration (all p < 0.05). Conclusions: We developed and internally validated an ML model to predict delirium in COVID-19 inpatients. The model identified modifiable factors associated with the development of delirium and could be clinically useful for the prediction and prevention of delirium in COVID-19 inpatients.

Assessing the price levels of medical service and influential factors: evidence from China.

BACKGROUND: Medical service prices play a crucial role in cost containment in China. This study aimed to assess the change in medical service price levels at the macro level and the relationship with relevant macroeconomic factors. METHODS: Data from the 2022 China Statistics Yearbook, the 2022 China Health Statistics Yearbook, and the 2020 China National Health Accounts Report were used. Time trends of health price levels, utilization, and health expenditure were examined. A time-series regression model was employed to measure the impact of service utilization and medical service prices on total medical service expenditure growth from 2000 to 2021. The Johansen cointegration test was conducted to test the cointegrating relationship between medical service price levels and total medical service expenditure, average wage of employees and CPI. The Granger causality test was performed to observe the direction of causality. RESULTS: Descriptive analyses showed consistent growth in utilization and medical service price levels from 2000 to 2021. The time-series model indicated that medical service expenditure was influenced by the rise in inpatient admissions and price levels of medical service and medicine. The Johansen cointegration test identified a long-term equilibrium relationship between medical service price levels and total medical service expenditure, average wage and CPI. The change in medical service price levels was the Granger cause of the change in medical service expenditure, but it had no impact on average wage and CPI. However, the change in medical service price levels was influenced by these three macroeconomic factors. CONCLUSIONS: The growth of medical service expenditure in China was driven by inpatient use and price level. There was a long-term equilibrium relationship between medical service price levels and relevant macroeconomic factors. However, medical service price levels only affected medical service expenditure and have no impact on average wage and CPI. It is necessary to improve the value transmission mechanism of medical service prices.

Analysis of influential factors for purchasing quantity changes in the procurement varieties of the first batch of drug centralized procurement / 中国药房

OBJECTIVE To investigate the factors influencing the changes in purchasing quantity in the procurement varieties of the first batch of volume-based drug centralized procurement （hereinafter referred to as centralized procurement）. METHODS Using 25 procurement varieties of the “4+7” policy as research objects， the changes in purchasing quantity of procurement varieties were analyzed before and after the implementation of the “4+7” pilot， renewal and expansion policies. The influential factors were determined from the three levels of drugs， medical institutions and regions； and the multiple linear regression model was used to analyze the influential factors for the changes in the purchasing quantity of procurement varieties. RESULTS Before and after the implementation of the “4+7” pilot， renewal and expansion policies， the purchasing quantity increased by 52.1， －0.2， 85.8 ten thousand DDDs on average， compared with base period. During pilot， renewal and expansion period， DDDc decrease in procurement varieties was positively correlated with the increase in purchasing quantity （P＜0.01）. During the pilot and renewal period， the number of absolutely alternative varieties was positively correlated with the increase in purchasing quantity （P＜0.1）. During the pilot and expansion period， the number of alternative varieties to a certain extent was negatively correlated with the increase in purchasing quantity （P＜0.05）. During the renewal period， the increment of purchasing quantity in tertiary hospitals was smaller than that of primary medical institutions （P＜0.05）. CONCLUSIONS There is a relationship between the decline of DDDc and the changes in the purchasing quantity， that is， the more the drug price dropped， the more the purchasing quantity increased. The number of alternative varieties for centralized procurement will affect the changes in their purchasing quantity， but it is not always stable. With the implementation of the policy， the volume of primary medical institutions gradually exceeds that of tertiary institutions， indicating that the consumption of centralized purchased varieties is transferred to the primary medical institutions， and centralized procurement has promoted the implementation of the hierarchical diagnosis and treatment system.

Development and influential factor analysis of pharmacy outpatient departments in 714 Chinese tertiary healthcare institutions / 中国药房

OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics， the management of the pharmacy outpatient departments， and the construction of the pharmacist team for Logistic and linear regression analysis， with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey， with 714 tertiary hospitals. Among the tertiary hospitals， 377 （52.80%） had established pharmacy outpatient departments， including 321 grade-A tertiary hospitals， 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments， covering 19 specialized fields， with the highest proportion found in the cardiovascular field （including anticoagulation） at 16.45%. Tertiary hospitals in North China， Central China， East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status （P＝0.010） and the annual outpatient volume of the hospital （P＝0.008）， although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital （P＝0.042） and the number of pharmacists engaged in clinical pharmacy work （P＝0.004）. The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients， in order to meet the requirements of medical practice and patient care.

Understanding cross-data dynamics of individual and social/environmental factors through a public health lens: explainable machine learning approaches.

Introduction: The rising prevalence of obesity has become a public health concern, requiring efficient and comprehensive prevention strategies. Methods: This study innovatively investigated the combined influence of individual and social/environmental factors on obesity within the urban landscape of Seoul, by employing advanced machine learning approaches. We collected 'Community Health Surveys' and credit card usage data to represent individual factors. In parallel, we utilized 'Seoul Open Data' to encapsulate social/environmental factors contributing to obesity. A Random Forest model was used to predict obesity based on individual factors. The model was further subjected to Shapley Additive Explanations (SHAP) algorithms to determine each factor's relative importance in obesity prediction. For social/environmental factors, we used the Geographically Weighted Least Absolute Shrinkage and Selection Operator (GWLASSO) to calculate the regression coefficients. Results: The Random Forest model predicted obesity with an accuracy of >90%. The SHAP revealed diverse influential individual obesity-related factors in each Gu district, although 'self-awareness of obesity', 'weight control experience', and 'high blood pressure experience' were among the top five influential factors across all Gu districts. The GWLASSO indicated variations in regression coefficients between social/environmental factors across different districts. Conclusion: Our findings provide valuable insights for designing targeted obesity prevention programs that integrate different individual and social/environmental factors within the context of urban design, even within the same city. This study enhances the efficient development and application of explainable machine learning in devising urban health strategies. We recommend that each autonomous district consider these differential influential factors in designing their budget plans to tackle obesity effectively.

Airborne transmission of common swine viruses.

The transmission of viral aerosols poses a vulnerable aspect in the biosecurity measures aimed at preventing and controlling swine virus in pig production. Consequently, comprehending and mitigating the spread of aerosols holds paramount significance for the overall well-being of pig populations. This paper offers a comprehensive review of transmission characteristics, influential factors and preventive strategies of common swine viral aerosols. Firstly, certain viruses such as foot-and-mouth disease virus (FMDV), porcine reproductive and respiratory syndrome virus (PRRSV), influenza A viruses (IAV), porcine epidemic diarrhea virus (PEDV) and pseudorabies virus (PRV) have the potential to be transmitted over long distances (exceeding 150 m) through aerosols, thereby posing a substantial risk primarily to inter-farm transmission. Additionally, other viruses like classical swine fever virus (CSFV) and African swine fever virus (ASFV) can be transmitted over short distances (ranging from 0 to 150 m) through aerosols, posing a threat primarily to intra-farm transmission. Secondly, various significant factors, including aerosol particle sizes, viral strains, the host sensitivity to viruses, weather conditions, geographical conditions, as well as environmental conditions, exert a considerable influence on the transmission of viral aerosols. Researches on these factors serve as a foundation for the development of strategies to combat viral aerosol transmission in pig farms. Finally, we propose several preventive and control strategies that can be implemented in pig farms, primarily encompassing the implementation of early warning models, viral aerosol detection, and air pretreatment. This comprehensive review aims to provide a valuable reference for the formulation of efficient measures targeted at mitigating the transmission of viral aerosols among swine populations.

Effects of the source of information and knowledge of dengue fever on the mosquito control behavior of residents of border areas of Yunnan, China.

BACKGROUND: Strengthening the mosquito control measures undertaken by residents of an area where dengue fever is present can significantly decrease the spread of this disease. The aim of this study was to explore the effects of the source of information and knowledge of dengue fever on the mosquito control behavior of residents of areas at high risk of this disease to determine effective ways of enhancing this behavior. METHODS: A survey was conducted via face-to-face interviews or questionnaires between March and May 2021 in three regions of the province of Yunnan, China. The survey included basic information about the respondents, the source(s) of their dengue fever information, the level of their dengue fever knowledge, and the measures they had implemented to control mosquitoes. Principal component analysis was used to extract the main components of the sources of information. Correlation analysis and structural equation analysis were used to explore the impact of the sources of information and residents' dengue fever knowledge on their mosquito control behavior. RESULTS: Publicity achieved through mass media, including official WeChat accounts, magazines/newspapers, poster leaflets, television/radio and the Internet, had a direct effect on dengue fever knowledge and mosquito control behavior, and indirectly affected mosquito control behavior through dengue fever knowledge. Organized publicity campaigns, including information provided by medical staff and through community publicity, had a direct effect on dengue fever knowledge and indirectly affected mosquito control behavior through dengue fever knowledge. The residents' level of dengue fever knowledge had a significant, positive, direct effect on their mosquito control behavior. CONCLUSIONS: Mosquito control is an important measure for the prevention and control of outbreaks of dengue fever. An effective source of information can improve the level of dengue fever knowledge among residents and thus enhance their mosquito control behavior.

An Age-Stratified Cross-Sectional Study of Physical Activity and Exercise Adherence of Stroke Survivors in Rural Regions.

Objective: To describe the Physical Activity and Exercise (PAE) adherence of stroke survivors in rural regions, additionally, to analyze the influential factors through age stratification. Methods: This is a cross-sectional study. Totally, 596 stroke patients (65.70±10.76 years) from three rural regions were selected, PAE scale was used for measuring compliance. The influential factors among different age groups were explored separately. This study adheres to the EQUATOR checklist, SROBE. Results: Only 17.8% (106) of participants regularly participated in PAE. Altogether, 42.45% were classified as a young-middle age group, and the rest 57.55% were in the old age group. Positive attitudes and better PAE-relevant knowledge were protective factors for adherence in the young and middle-aged group (OR=0.683; 95% CI 0.173~0.588 and OR=0.939; 95% CI 0.013~0.114), as well as in the old group (OR=0.704; 95% CI 0.193~0.534 and OR=0.929; 95% CI 0.035~0.118); having no home rehabilitation equipment was a strong risk factor for younger patients (OR=16.078; 95% CI 1.235~4.320); however, without hemiplegia can positively affect their adherence (OR=0.891; 95% CI 0.045~0.229). In addition, the presence of a spouse can lead to a better compliance among old patients (OR=0.436; 95% CI -0.496~-0.165). Conclusion: It is necessary to improve the knowledge of physical activity in rural stroke patients of all ages. It is of great significance to install home rehabilitation equipment to promote exercise for young and middle-aged stroke patients. While for the old stroke patients, we strongly suggest focusing on the role of spouses, which would be more useful in low-income regions.

A study of factors influencing long-term glycemic variability in patients with type 2 diabetes: a structural equation modeling approach.

Aim: The present study aims to utilize structural equation modeling (SEM) to investigate the factors impacting long-term glycemic variability among patients afflicted with type 2 diabetes. Method: The present investigation is a retrospective cohort study that involved the collection of data on patients with type 2 diabetes mellitus who received care at a hospital located in Chengdu, Sichuan Province, over a period spanning from January 1, 2013, to October 30, 2022. Inclusion criteria required patients to have had at least three laboratory test results available. Pertinent patient-related information encompassing general demographic characteristics and biochemical indicators was gathered. Variability in the dataset was defined by standard deviation (SD) and coefficient of variation (CV), with glycosylated hemoglobin variation also considering variability score (HVS). Linear regression analysis was employed to establish the structural equation models for statistically significant influences on long-term glycemic variability. Structural equation modeling was employed to analyze effects and pathways. Results: Diabetes outpatient special disease management, uric acid variability, mean triglyceride levels, mean total cholesterol levels, total cholesterol variability, LDL variability, baseline glycated hemoglobin, and recent glycated hemoglobin were identified as significant factors influencing long-term glycemic variability. The overall fit of the structural equation model was found to be satisfactory and it was able to capture the relationship between outpatient special disease management, biochemical indicators, and glycated hemoglobin variability. According to the total effect statistics, baseline glycated hemoglobin and total cholesterol levels exhibited the strongest impact on glycated hemoglobin variability. Conclusion: The factors that have a significant impact on the variation of glycosylated hemoglobin include glycosylated hemoglobin itself, lipids, uric acid, and outpatient special disease management for diabetes. The identification and management of these associated factors can potentially mitigate long-term glycemic variability, thereby delaying the onset of complications and enhancing patients' quality of life.

Factors associated with lymphedema self-management behaviours among breast cancer survivors: A cross-sectional study.

AIMS AND OBJECTIVES: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self-management behaviours among Chinese breast cancer survivors. BACKGROUND: Breast cancer-related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self-management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self-management behaviours can help to develop targeted intervention programs. DESIGN: A multicentre cross-sectional study. METHODS: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self-reported questionnaires were used to measure socio-demographic characteristics, disease-and treatment-related characteristics, lymphedema self-management behaviours, lymphedema knowledge, illness perception, self-efficacy, self-regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. RESULTS: Breast cancer survivors reported moderate level of lymphedema self-management behaviours. Promotion of lymph reflux management was ranked the least performed self-management behaviours, while the affected limb protection management ranked the most. 36.2% of self-management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self-efficacy, emotional illness representation and social support. CONCLUSIONS: Lymphedema self-management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self-management varied with different socio-demographic characteristics, along with different levels of knowledge, self-efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self-management behaviours. RELEVANCE TO CLINICAL PRACTICE: This study addressed that breast cancer survivors' lymphedema self-management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self-management performance and adherence.

Construction of response surface model for photoacoustic-based H2S measurement system and significance analysis of multiple influential factors.

Herein we first introduce the relationship between the photoacoustic (PA) signals' intensity of hydrogen sulfide (H2S) versus multiple parameters of optical path conditions, following by the construction of response surface method (RSM)-based models of the PA signals' intensity versus the distance l1 from the laser head to the convex lens, the distance l2 from the convex lens to the PA cell (PAC), and the distance l3 from the geometric center line of the light beam to the acoustic sensor. After that, we perform the significance analysis. The results show that the RSM model with a third-order configuration is relatively preferred. The distances l1, l2 and l3 all have significant influences on the PA signals' intensity. Additionally, we ameliorated the performance of the full third-order model by removing the non-significant terms.

Comparison of injury severity between E-bikes-related and other two-wheelers-related accidents: Based on an accident dataset.

This study aims to compare the accident injury severity of e-bikes with that of other types of two-wheelers based on accident data and to analyze the factors influencing them. Using 1015 police accident records from Zhangjiakou City in 2020 and 2021, the accident injury severity of e-bikes was firstly compared with that of other two-wheelers based on five levels of accident injury severity classified according to the records. Two ordered Probit regression models were secondly used to compare the factors influencing the accident injury severity of e-bikes with that of other two-wheelers and the magnitude of their effects. At the same time, the contributions of each influential factor to the degree of accident injury of two-wheelers were estimated with the assistance of classification trees. Results show that e-bikes are closer to bicycles than motorcycles in terms of injury severities and the factors influencing them, in which the factors "accident configuration," "division of responsibility for the accident," and "collision with a heavy vehicle or four-wheeled vehicle" are significant. Based on the findings, potential measures are suggested to reduce e-bike accident casualties, such as improving rider education, ensuring speed limit enforcement, promoting safety equipment wearing, and making road design friendly to non-motorized and elderly riders. The results of this study can provide an essential reference for traffic management and rider education measures on e-bikes.