Qinzhou University

The optimal management of unruptured brain arteriovenous malformations (AVMs) remains controversial, as the risk-benefit balance between interventional treatment and conservative management is unclear. While ARUBA (A Randomized Trial of Unruptured Brain AVMs) favored conservative management in the short term, methodologic limitations and limited follow-up have left uncertainty regarding long-term outcomes. To evaluate the association between interventional treatment and hemorrhage-free survival, compared with conservative management, in patients with unruptured AVMs. This cohort study used a target trial emulation approach based on data from the Multimodality Treatment for Brain Arteriovenous Malformation in Mainland China (MATCH) registry, a nationwide, multicenter prospective collaboration conducted from August 1, 2011, to December 31, 2021. Patients with unruptured AVMs at baseline were included. Data analyses were conducted from January 24 to April 6, 2025. Interventional treatment (microsurgical resection, stereotactic radiosurgery, endovascular embolization, or combinations thereof) initiated within 6 months of diagnosis vs conservative management (observation and medical therapy). The primary outcome was 5-year hemorrhage-free survival, defined as survival without AVM-related hemorrhage or death. The secondary outcome was 10-year hemorrhage-free survival. Hazard ratios (HRs) and risk differences were estimated using inverse probability of censoring-weighted survival analyses following a clone-censor-weight approach. Among the 1770 patients included in the analysis (median age, 26.2 [IQR, 16.5-37.6] years; 1059 [59.8%] male), the estimated 5-year hemorrhage-free survival was 96.23% (95% CI, 93.95%-97.65%) for the interventional treatment group and 89.00% (95% CI, 86.37%-91.24%) for the conservative management group, yielding a risk difference of 7.23% (95% CI, 4.78%-9.91%) and an HR for hemorrhage of 0.44 (95% CI, 0.33-0.57). At 10 years, the risk difference was 8.37% (95% CI, 2.68%-15.70%) and the HR was 0.56 (95% CI, 0.42-0.69). Subgroup analyses indicated that the benefit of the intervention was not observed in patients with high-grade AVMs or diffuse nidus, for whom outcomes were similar to those of patients with conservative management. Only microsurgical resection was consistently associated with reduced hemorrhage risk in sensitivity analyses. In this nationwide cohort study using target trial emulation, interventional treatment of unruptured AVMs was associated with improved hemorrhage-free survival at 5 and 10 years. These findings support individualized decision-making in the management of unruptured AVMs and demonstrate how target trial emulation can inform clinical questions where randomized clinical trials are not feasible.

Objective: In order to solve the problem that there is no conclusive report of the dissociation constant of tofacitinib citrate, the dissociation constant of tofacitinib citrate was determined for the first time by using the model algorithm of different dissociation constants of ultraviolet spectroscopy. It provides an important reference for the analysis and design of the drug form. Methods: The characteristic absorption wavelengths of tofacitinib citrate were obtained by scanning the pH gradient solutions of different tofacitinib citrate by ultraviolet spectroscopy, and the dissociation constant of tofacitinib citrate was calculated according to the logarithmic value of the absorbance ratio of the molecular tofacitinib citrate and the ionized tofacitinib citrate and the data of pH calculation. At the same time, the

Adjuvant therapy may improve survival of patients with hepatocellular carcinoma (HCC) after curative resection. This study compared safety and efficacy outcomes between patients at high risk of recurrence who received different types of adjuvant therapy or no such therapy after hepatic resection for HCC. Recurrence-free survival (RFS), overall survival, and adverse events were compared among patients who received adjuvant immune checkpoint inhibitors (ICIs) alone, ICIs with tyrosine kinase inhibitors (TKIs), or no adjuvant therapy between 13 March 2019 and 19 March 2022. This study was registered on ClinicalTrials.gov (NCT05221398). Of the 517 patients in final analysis, 432 (83.6%) received no adjuvant therapy, 53 (10.2%) received ICIs alone, and 32 (6.2%) received adjuvant ICIs and TKIs. During median follow-up of 34.0months (IQR 27.8 to 41.6months), RFS was significantly longer among patients who received either type of adjuvant therapy (25.2months, 95%CI 16.4-34.0) than among those who received none (16.1months, 95%CI 12.9-19.4), and this difference remained significant after propensity score matching (HR 0.52, 95%CI 0.35-0.76, P = 0.004). Overall survival was unaffected by either type of adjuvant therapy, while significant difference was observed between patients who received adjuvant therapy or not after propensity score matching (HR 0.31, 95%CI 0.17-0.59, P = 0.005). The rate of grade 3 or 4 adverse events was similar between the two types of adjuvant therapy. ICIs alone or with TKIs may improve RFS of patients at high risk of HCC recurrence after curative resection.

ObjectivesThis study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support.MethodA cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms.ResultBoth the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect.ConclusionThe mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

The purpose of this study was to explore the effect of night-shift work on the risk of hypertension for improving workers' health. A total of 10,038 Chinese participants were constituted in the cross-sectional study. Logistic regression and restricted cubic spline were used to estimate the effect of night shift on hypertension. There were higher odds of having hypertension in any night-shift workers (odds ratio [OR], 1.16 [95% confidence interval, 1.03-1.30]) when compared with day workers. Having 5 to 10 night shifts per month were significantly more likely to be hypertensive (OR, 1.19 [95% confidence interval, 1.03-1.38]). The OR for hypertension increased as the number of night shifts increased as the result of the restricted cubic spline. Our results support the hypothesis that night shift is associated with an elevated risk of hypertension.

OPINION article Front. Psychol., 07 September 2022Sec. Educational Psychology https://doi.org/10.3389/fpsyg.2022.958104

IntroductionPretreatment drug resistance (PDR) is becoming an obstacle to the success of ART. This study investigated the prevalence of PDR and the transmission clusters (TCs) of drug resistance mutations (DRMs) in two cities where drug abuse used to be high to describe the local HIV-1 transmission dynamics.MethodsPlasma samples were obtained from 1,027 ART-naïve patients in Guangxi. Viral subtypes and DRMs were identified. Transmission network and related factors were also determined.ResultsA total of 1,025 eligible sequences were obtained from Qinzhou (65.8%) and Baise (34.2%) cities. The predominant HIV-1 genotype was CRF08_BC (45.0%), followed by CRF01_AE (40.9%). The overall prevalence of PDR was 8.3%, and resistance to NNRTI was the most common. Putative links with at least one other sequence were found in 543/1,025 (53.0%) sequences, forming 111 clusters (2–143 individuals). The most prevalent shared DRMs included V106I (45.35%), V179D (15.1%), and V179E (15.1%). Clusters related to shared DRMs were more frequent and larger in CRF08_BC. The prevalence of shared DRMs increased with time, while the proportion of PDR gradually decreased. Age > 50 years was associated with clustering. Subtype CRF08_BC was more likely to have DRMs, PDR propagation, and DRM sharing.ConclusionPDR prevalence is moderate in this region. The association between PDR and subtype CRF08_BC suggested that DRMs spreading from injection drug users (IDUs) to heterosexuals (HETs) might be the major source of PDR in this region. Our findings highlight the significance of continuous surveillance of PDR.

With the increase of marine industry in the Beibu Gulf, data clustering has become an important task of intelligent ocean. Partition clustering methods are suitable for marine data. However, traditional K-means algorithm is not suitable for large scale data. Focusing on the characteristics of oceanic big data, we propose a clustering method based on incremental K-means (IKM) algorithm. First, a vector model is adopted to represent data sets, and the calculation model for mean values and centres is used to initialise arbitrary numbers of data points. Second, the input data vectors are iteratively calculated in an incremental vector form. Finally, by applying incremental vector and distance model, the large-scale data are clustered according to convergence condition. Experiments show that the algorithm can increase the clustering efficiency, reduce time and space complexity, and lower the missing data rate.