To evaluate the prognostic utility of the canine-derived Veterinary Committee on Trauma score in cats suffering from high-rise syndrome and to compare it with the Animal Trauma Triage Score. To date, no trauma score has been developed exclusively from feline-derived data, and existing systems are adaptations or validations of scores originally created for other or mixed species. Retrospective observational study of 60 cats with high-rise syndrome. Recorded variables on admission were age, breed, sex, weight, body condition score, height of fall, clinicopathological variables, Animal Trauma Triage Score and Veterinary Committee on Trauma score. Mortality and length of hospital stay were also recorded. Univariate and multivariate statistical analyses as well as receiver operating characteristic curves were used to compare the different variables. Sixty cats were included. Eight cats (13%) did not survive to discharge. The receiver operating characteristic curves showed that the Animal Trauma Triage Score predicted mortality significantly better (AUC = 0.85, P < .001, 95% CI 0.76 to 0.95) than the Veterinary Committee on Trauma score (AUC = 0.709, P = .038, 95% CI 0.51 to 0.91). Requirement for vasopressor therapy (P = .008, OR 0.10, 95% CI 0.02 to 0.56), higher height of fall (P < .005, OR 3.69, 95% CI 1.49 to 9.10), serum lactate (P = .013, OR 1.57, 95% CI 1.09 to 2.25) and the Animal Trauma Triage Score (P = .006, OR 1.90, 95% CI 1.20 to 3.00) were associated with a worse outcome. In cats with high-rise syndrome, the Animal Trauma Triage Score demonstrates significantly superior prognostic performance compared with the canine-derived Veterinary Committee on Trauma score. Species-specific physiological differences may influence the applicability of trauma scoring systems in cats, supporting the need for further feline-specific validation of trauma scoring systems.
To address the inefficiency of conventional temperature rise tests for dry-type transformers in box substations, this study proposes a closed-loop "Standard-Experiment-Simulation-Optimization" methodology. An electromagnetic‑thermal coupled model was built, calibrated with field test data. The simulation revealed a saturated exponential growth pattern of hotspot temperature rise, verified experimentally. Based on this, additional thermocouples were placed beyond standard positions, enabling earlier and more accurate hotspot measurement. A predictive model using the first‑five‑hour data was derived to estimate steady‑state temperature, rise value, and required test duration. This approach reduces testing time and provides a reusable reference for improving hotspot detection accuracy.
To examine whether sleep quality mediates the relationship between perceived stress and blood pressure among older African American women (AAW). A cross-sectional analysis was conducted using baseline data from older AAW (aged 50-75) enrolled in the Resilience, Stress, and Ethnicity (RiSE) study. Perceived stress was assessed using the 10-item Perceived Stress Scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Blood pressure was measured three times and averaged to calculate mean systolic and diastolic blood pressure. Structural equation modeling was used to test mediation, adjusting for age, body mass index, and antihypertensive medication use. Among 158 women (mean age 63.0 ± 6.7 years), 57.6% were taking antihypertensive medications, mean systolic blood pressure was 129.5 ± 15.4 mmHg, and mean PSQI score was 7.6 ± 3.5, indicating poor sleep quality. Perceived stress was associated with poorer sleep quality (b = 0.21, p < .001), and poorer sleep quality was related to higher systolic blood pressure (b = 0.81, p = .037). Sleep quality significantly mediated the effect of stress on systolic blood pressure (b = 0.17, p = .049), with no direct effect observed (b = 0.10, p = .594). Sleep quality mediated the relationship between perceived stress and systolic blood pressure in older AAW. These findings support the role of sleep as a behavioral mechanism linking stress to cardiometabolic risk and suggest the importance of developing culturally tailored sleep interventions to mitigate the adverse cardiometabolic effects of stress in this high-risk population.
Understanding complex relations between neuronal activity and animal behavior is central question in neuroscience. Rapid advancements in Artificial Intelligence (AI) methods offer powerful tools to investigate highly non-linear mapping between motor cortex activity and body movements. Here, we developed a Generative Adversarial Network (GAN) that showed that detailed videos of behaving rats can be recreated from activity of just few selected neurons. This analysis also revealed that the predictability of behavior from neuronal activity (and vice versa) initially increases as a rat learns a new task. However, after the animal performance on the motor task achieves the required accuracy, then coupling between neuronal activity and behavior decreases, without degrading task performance. A plausible interpretation is that, as training progresses from Early to Mid training days, more neurons become engaged, forming a denser, broadly distributed representation, which then in the Late training days evolves into a sparse and more energy-efficient representation, with only a small subset of tuned neurons. Neuronal network simulations showed that such changes in coding strategy may be explained by neurons minimizing their energy use. Thus, our approach reveals a non-linear relationship between learning stages and neural-behavioral coupling, which is likely driven by energy efficiency.
This nationwide observational study investigated recent trends in pancreatic cancer (PC) incidence and surgical management in Japan. Annual data on PC incidence (2016-2021) and surgical procedures (2016-2023) were obtained from the Cancer Information Database and the National Database of Health Insurance Claims and Specific Health Checkups (NDB), respectively. Surgical procedures were categorized by type (distal pancreatectomy (DP, 2016-2023)/pancreatoduodenectomy (PD, 2020-2023)) and approach (open/laparoscopic). Crude and age-adjusted rates per 100 000 person-years were calculated. Temporal trends were evaluated using linear and Poisson regression to estimate annual risk ratios (RRs). Over the study period, the annual average PC incidence was 43 015, and the average number of PC surgery was 13 899. Age-adjusted PC incidence rates rose significantly among males, females, and both sexes (RR = 1.007, 1.016 and 1.011, respectively; p < 0.0001). A particularly notable rise was observed among females aged 10-29 years (RR range: 1.347-1.449; all p < 0.0009). DP rates increased significantly among males, females, and both sexes (RR = 1.033, 1.032, and 1.033, respectively; p < 0.0001), with marked increases among individuals aged 65-89 years for both sexes (RR range: 1.018-1.114; all p < 0.0012). PD volumes also rose during 2020-2023, although the limited analytic window precluded formal rate-based trend evaluation. In 2023, PD comprised 65.6% of PC surgeries (9444/14397), while DP comprised 34.4% (4953/14397). These nationwide findings highlight age- and sex-specific signals-notably an apparent rise among young women and increased DP use among older adults-that warrant further validation.
The food enzyme triacylglycerol lipase (triacylglycerol acylhydrolase, EC 3.1.1.3) is produced with the genetically modified Trichoderma reesei strain DP-Nzk118 by Genencor International B.V. The genetic modifications do not give rise to safety concerns. The food enzyme was considered free from viable cells of the production organism and its DNA. It is intended to be used in the processing of cereals and other grains for the production of distilled alcohol. Since residual amounts of food enzyme-total organic solids are removed in the food manufacturing process, dietary exposure estimation and toxicity testing were considered unnecessary. A search for the homology of the amino acid sequence of the triacylglycerol lipase to known allergens was made and no match was found. The Panel considered that a risk of allergic reactions upon dietary exposure to the food enzyme can be excluded when used for the production of distilled alcohol. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns under the intended conditions of use.
Background Learning disability registers in UK primary care support proactive care, but under-identification remains substantial. The 2019 NHS Long Term Plan introduced targets to increase enrolment. Aim To estimate prevalence and rates of new registration to learning disability registers among young people aged 14-24 years in England and examine changes following the introduction of national targets. Design and setting Population-based open cohort study using routinely collected primary care data from general practices in England contributing to the Clinical Practice Research Datalink (CPRD) Aurum database, 2015-2023. Method Young people aged 14-24 years who had been registered at least 6 months were included. Annual rates of new registration per 10,000 person-years at risk (PYAR) and recorded prevalence were calculated, stratified by age, sex, region, and year. Results Between 2015 and 2023, 11,776 young people were first recorded on a learning disability register. Rates of new registration increased in 2020-2021 across ages and sexes, peaking at 15.8 per 10,000 PYAR in males aged 14-17 years and 8.4 per 10,000 in females before returning to pre-2019 levels by 2023. Recorded prevalence remained low overall (0.03%-0.5%; 3.6-52.7 per 10,000) but increased among those aged 18-24 years, with eight-to-ten-fold rises between 2015 and 2023. Prevalence was higher in males (rate ratios 1.7-1.8, 95% confidence interval 1.6-1.9). Conclusion National targets coincided with a temporary rise in enrolment, but identification remains below expected prevalence. Sustained policy focus and systematic identification and coding by practices are needed to ensure equitable access to preventive care during the transition to adulthood.
Acute appendicitis is one of the most common general surgical diseases in children. The high misdiagnosis rate and high complication rate of appendicitis in the pediatric population have led to a more serious incidence of appendicitis in children. Therefore, for pediatric appendicitis, early accurate diagnosis and timely intervention are of vital importance. This cross-sectional study used data from the Global Burden of Disease (GBD) 2021 database to analyze the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year rate (ASDR) of appendicitis in children aged 0 to 14 years from 1990 to 2021. We calculated the average estimated annual percentage change (EAPC) using linear regression and analyzed the trends using the joinpoint analysis. The analysis was stratified by region, country, and Socioeconomic Development Index (SDI). We examined the associations of the EAPC with SDI and baseline rates. A total of 63,401,760 children were included. In 2021, the global number of incident cases of pediatric appendicitis was estimated at 2,193,019.79 (95% UI, 1,405,218.04 to 3,186,592.24), corresponding to a 24% increase (95% UI, 22% to 27%) from 1990. Concurrently, the number of deaths was 2,319.37 (95% UI, 1,728.04 to 2,876.17), reflecting a 68% decline (95% UI, 76% to 54%) over the same period. From 1990 to 2021, the growth of ASIR was not significant globally [EAPC = 0.05 (-0.08 to 0.17), p > 0.05], but there was a significant increase from 2001 to 2004 [APC = 3.28 (2.74 to 3.84), p < 0.05]. Additionally, ASMR [EAPC = -3.99 (-4.11 to -3.87), p < 0.05] and ASDR [EAPC = -3.77 (-3.84 to -3.69), p < 0.05] showed significant decreases. ASIR showed an increasing trend in the High-middle SDI region [EAPC = 1.05 (0.85 to 1.25), p < 0.05], while it decreased in the Low SDI region [EAPC = -0.45 (-0.53 to -0.37), p < 0.05]. ASMR showed the most significant decreasing trend in the High-middle SDI region [EAPC = -5.74 (-6.01 to -5.46), p < 0.05]. ASDR showed the most significant decreasing trend in the Middle SDI region [EAPC = -4.49 (-4.77 to -4.22), p < 0.05]. In 2021, across 21 regions and 204 countries worldwide, ASIR continued to increase along with the rise in SDI. However, ASMR and ASDR continuously decreased as SDI increased. Over the 32-year period, a positive correlation was observed between the EAPC of ASIR and SDI (Pearson correlation coefficient r = 0.27, p < 0.05), while a negative correlation was found between the EAPC of ASMR and SDI (Pearson correlation coefficient r = -0.30, p < 0.05). This study reveals that although the global number of incident cases of pediatric appendicitis has increased, both the ASMR and ASDR demonstrate significant declining trends. However, substantial disparities persist due to the uneven distribution of healthcare resources. Regions with high SDI should prioritize preventive measures to control the rising incidence, while low SDI regions must invest in healthcare resources to improve diagnosis, treatment, and reduce mortality rates. Countries can adapt targeted strategies implemented by nations that have successfully achieved substantial reductions in disease burden.
The present study evaluates the effect of borax as a cross-linker at different concentrations (0%, 1.32%, 2.61%, and 3.87%w/w) on the physicochemical properties of the films comprised of pectin, glycerol, and borax. The film-forming solutions were made by two distinct preparation methods: i. a heated system, at 85 °C, without stirring (thermal method, TM) and ii. a nonheated high-speed stirring system, 30,000 rpm (agitation method, AM). Films produced by both methods were compared to assess their structural, thermal, mechanical, and antimicrobial properties. Steady-state and real-time infrared spectroscopy (FTIR) indicated the formation of B-O-C moieties, with cross-linking efficiency favored under both higher pH and temperature. SEM images and mechanical analyses revealed that AM gave rise to markedly coherent and continuous films, whereas TM-derived films exhibited surface defects and breakpoints, particularly at higher borax concentrations. Thermal analyses (TGA/DTA) indicated that borax enhances the thermal stability of the films regardless of the preparation method. Increasing borax content, however, generally reduced tensile strength and elongation at break, suggesting a competitive balance between cross-linking and plasticization. The films did not display significant antibacterial effects, likely due to partial solubilization during diffusion-based assays. Overall, the results demonstrate that temperature and borax concentration in the film-forming solution play a key role toward pectin film properties.
This study tracked 47 high-altitude migrants to investigate the adaptive mechanisms of the brain to hypoxic environments. EEG and physiological indicators (SpO2, HCT, AAI) were recorded during the acute (7 days) and chronic (45 days) phases of high-altitude exposure. EEG complexity was assessed using multiscale entropy (MSE), and inter-regional brain coupling was also analyzed. Compared with the chronic phase, EEG complexity in the frontal, parietal, and occipital lobes was higher in the acute phase, whereas inter-regional brain coupling was stronger in the chronic phase. SpO2 decreased during the acute phase and then slowly recovered; HCT continued to rise; AAI showed a decelerating downward trend. Correlation analysis revealed that SpO2 was negatively correlated with fine-scale MSE, and HCT was negatively correlated with medium- to coarse-scale MSE. AAI was correlated only with occipital MSE during the acute phase. During the chronic phase, AAI was negatively correlated with MSE coupling across multiple brain regions but not with MSE itself. These findings suggest that hypoxia may increase fine-scale complexity by enhancing local neural interconnections, whereas elevated HCT reduces long-range interactions between distributed neural populations. The brain exhibits a compensatory pattern of "complexity reduction with enhanced inter-regional coupling" during hypoxic adaptation, which may represent an optimization of neural efficiency under sustained hypoxia.
As developmental science expands globally, its theories and methods must rise to the challenge. Children worldwide develop within caregiving ecologies that often differ from traditional family models. Understanding how infants adapt within these contexts reveals general principles of human development. Achieving this requires structural change: consensus-building, open methods, and theories grounded in the environments where most children actually grow up.
The oil and gas sector has experienced substantial growth in recent decades, leading to a significant increase in produced water containing hazardous pollutants that frequently surpass environmental standards and regulations. This study underscores the importance of developing sustainable and cost-effective treatment methods, particularly clay-based approaches that are renowned for their availability, affordability, and environmental sustainability. A bibliometric analysis was conducted to examine global trends in clay-based wastewater treatment from 1996 to 2025, using data from Web of Science and Scopus, which identified 1022 relevant publications. Visualization tools such as VOSviewer and SciVal were employed to map research networks and identify leading authors, institutions, countries, and key themes. The results demonstrate a considerable rise in scholarly articles on the use of clay-based materials for treating produced water, with China emerging as the foremost contributor. Keyword analysis revealed primary themes including adsorption, clay-based composites, and wastewater reuse, indicating a transition toward more sustainable water management practices. This study further emphasizes the vital role of clay-based technologies in achieving Sustainable Development Goal 6 by fostering water reuse and pollution reduction. It also highlights the necessity for continued research on produced water to diminish contamination levels and operational costs, offering valuable insights for researchers, policymakers, and industry stakeholders regarding material innovation, hybrid treatment systems, and techno-economic assessments to enhance scalability and efficiency.
Background and objective Knee arthroscopy has become an essential diagnostic and therapeutic tool in children and adolescents. However, data on temporal trends, indications, and surgical techniques in Spain remain limited. This study aimed to analyse the epidemiological and surgical evolution of knee arthroscopy in patients under 18 years of age between 1998 and 2023. Patients and methods This single-centre retrospective observational study including 416 patients under 18 years who underwent knee arthroscopy. Demographic, diagnostic, and surgical variables were collected. Descriptive statistics, the Kruskal-Wallis' test, the Cochran-Armitage trend test, and Spearman's correlation were used for analysis. Results The median age was 14 years, with a predominance of females (59%). The most frequent indications were meniscal tears (33%), anterior cruciate ligament (ACL) injury (22%), and osteochondral lesions (14%). Diagnostic arthroscopy (38%) and meniscectomy (27%) were the most common procedures, both showing a progressive decline since 2015, whereas meniscal repair and surgery for patellofemoral instability showed a slight increase. A sustained rise in arthroscopies was observed among adolescents over 11 years of age, with a gradual equalisation between sexes in recent years. Conclusion Paediatric knee arthroscopy has progressively increased over the last two decades, with meniscal, ACL, and osteochondral lesions being the most frequent indications. A trend towards meniscal preservation and reconstructive procedures is also evident, reflecting evolving clinical practice and patterns of sports participation.
Hypercapnic respiratory failure is a frequent and life-threatening condition in intensive care. While lung-protective ventilation is essential to limit ventilator-induced lung injury, it may aggravate hypercapnia, particularly in severely ill patients. Low-flow extracorporeal CO2 removal (ECCO2R) has therefore been proposed as an adjunct to facilitate CO2 clearance and support protective ventilation. When integrated into continuous renal replacement therapy (CRRT) platforms, ECCO2R offers a less invasive alternative to high-flow extracorporeal support. However, the effectiveness of CRRT-based ECCO2R operated at very low blood flows, particularly under regional citrate anticoagulation, remains insufficiently characterized. We conducted a retrospective analysis of invasively ventilated ICU patients with severe hypercapnic respiratory failure treated with low-flow ECCO2R integrated into a citrate-anticoagulated CRRT system. Arterial blood gas parameters and ventilatory settings were retrospectively extracted at baseline and 2, 12, and 48 h after ECCO2R initiation. In 11 patients, median PaCO2 decreased from 83.1 to 52.9 mmHg at 48 h, with a corresponding rise in pH from 7.21 to 7.33 (both p = 0.008). Tidal volume showed early pairwise changes, whereas overall ventilator settings and oxygenation remained unchanged. The system was feasible, required no systemic anticoagulation, and caused no coagulation-related complications. In invasively ventilated patients with severe hypercapnic respiratory failure, low-flow ECCO2R integrated into citrate-anticoagulated CRRT reduced PaCO2 and improved acidosis, without significant overall changes in ventilator settings. This first report of exclusive regional citrate anticoagulation in CRRT-based ECCO2R demonstrated feasibility and safety without coagulation complications. Despite a blood-flow limit of 200 ml/min, a statistically significant and clinically detectable reduction in PaCO2 was achieved.
Sexually transmitted infections (STIs) have continued to rise in the USA, and doxycycline postexposure prophylaxis (doxyPEP) has shown prevention efficacy for bacterial STIs. We sought to evaluate doxyPEP interest, use and its associated factors among a national sample of eligible users. Using national advertisements on a social networking application for men who have sex with men (MSM), we recruited participants to complete an anonymous cross-sectional online survey from 1 March to 30 April 2023. Analyses of doxyPEP user characteristics and factors associated with use were restricted to respondents assigned male sex at birth, residing in the USA and eligible for doxyPEP. Eligibility was defined as self-report of a bacterial STI in the past year following the US Centers for Disease Control and Prevention guidelines. A multivariate logistic regression model was used to evaluate the factors associated with doxyPEP use. Of 1428 respondents, only 9% reported ever using doxyPEP and 2.5% reported current use. Most respondents (88.3%) not currently on doxyPEP were interested in using it. Among the 471 eligible respondents included in the analysis, the median age was 37 years; the majority (93.6%) identified as cisgender MSM, 2.5% as transgender and 3.8% as non-binary. Most respondents were from the Southern United States (29.5%) and Western United States (37.6%). Among the eligible participants, 17.0% ever used doxyPEP. The majority received doxyPEP from their healthcare provider or STI clinic. Self-identifying as black race (adjusted OR (aOR) 3.08, 95% CI 1.31 to 7.16), reporting a higher number of sex partners (aOR 1.02, 95% CI 1.01 to 1.03), current pre-exposure prophylaxis use (aOR 3.61, 95% CI 1.55 to 9.74) and living with HIV (aOR 3.08, 95% CI 1.20 to 8.83) were associated with doxyPEP use in a multivariable model. A national online survey among cisgender MSM, transgender and non-binary persons showed high interest but low use of doxyPEP, which was expected as there were no national guidelines in place at the time. These findings provide baseline estimates to inform future monitoring of doxyPEP uptake.
Ulcerative colitis(UC) is a complex chronic inflammatory disease. It is characterized by a prolonged and persistent clinical course, accompanied by a rising tendency in the risk of colorectal cancer. The incidence of UC continues to rise, with a complex etiology and a lack of effective therapeutic agents. TCM has unique advantages in the prevention and treatment of UC, due to its multi-target regulation properties, multi-pathway action, mild side effects, and diverse pharmacological activities. Angelicae Sinensis Radix(AS) contains various active components, including angelica polysaccharides, volatile oils, and organic acids. These components can alleviate UC by a multi-target regulation mechanism, including the inhibition of NF-κB, NLRP3 inflammasome activation, the reduction of the expression of inflammatory factors such as TNF-α and IL-1β, the enhancement of antioxidant enzyme activity, and the up-regulation of tight junction proteins such as ZO-1 and Occludin. Such multi-pathway synergistic effects fully highlight the preventive and therapeutic advantages of TCM, demonstrating the potential application value of AS in the treatment of intestinal diseases. This review systematically elucidated the multidimensional anti-UC mechanisms of the core active ingredients of AS and discussed the translational value of colon-targeted delivery systems, providing effective evidence for clinical precision medication.
Iron deficiency (ID) affects up to 40% of pregnant women in the third trimester, even in highly resourced and iron-supplemented populations, with adverse consequences for maternal health and long-term offspring development. Psychological stress may compromise iron status through hypothalamic-pituitary-adrenocortical (HPA) axis dysregulation and inflammation, but no study has directly examined cortisol in relation to iron status across human pregnancy. This longitudinal study examined associations between HPA function and maternal iron status across pregnancy and tested whether IL-6 and CRP mediated the relationship between cortisol and ferritin across gestation. One hundred sixty-eight pregnant Black women with Medicaid insurance completed up to four laboratory assessments across pregnancy. Salivary cortisol was measured before and in response to the Trier Social Stress Test, yielding basal and reactive cortisol indices. Serum ferritin, IL-6, and CRP were collected at each visit. Trimester-specific regression models examined cortisol reactivity in relation to ferritin; linear mixed-effects models with moderated mediation tested whether basal cortisol predicted ferritin via inflammation. Higher cortisol reactivity was associated with lower ferritin specifically in the third trimester (std. β = -0.197, p = .004). Higher basal cortisol predicted a steeper IL-6 rise across gestation ( p = .002), and IL-6 was positively associated with ferritin (b = 0.236, p = .006), consistent with inflammatory iron sequestration. The indirect effect of basal cortisol on ferritin via IL-6 was statistically significant, and higher basal cortisol was negatively associated with cortisol reactivity in the third trimester. No pathway was observed through CRP. Greater cortisol reactivity predicted lower third-trimester ferritin, a pattern that suggests cumulative iron depletion, atypically sustained HPA reactivity in late pregnancy, or both. To our knowledge, this is the first prospective study linking cortisol reactivity to iron status across human pregnancy, identifying maternal stress physiology as a novel target for understanding and addressing gestational iron deficiency.
Blast injuries present a unique challenge in trauma care due to their complex pathophysiology and potential to cause multisystem damage. Unlike conventional trauma, explosions generate a combination of penetrating, blunt, thermal, and barotrauma injuries, requiring a multidisciplinary approach. The increasing prevalence of terrorist attacks, military conflicts, and industrial explosions has contributed to a global rise in blast-related casualties, affecting both military personnel and civilians.This chapter integrates clinical experience, current evidence, and established guidelines to provide a comprehensive framework for evaluating and managing blast injuries. Key areas discussed include the epidemiology, classification, injury mechanisms, and organ-specific impact of blast trauma, with a focus on neurotrauma, pulmonary injuries, cardiovascular compromise, auditory and ocular trauma, and musculoskeletal damage.Additionally, we present a pragmatic protocol for initial trauma bay management, emphasizing early recognition, timely interventions, and coordinated multidisciplinary care. Given the complexity of blast injuries, we advocate for the establishment of a research consortium to refine current management strategies and optimize patient outcomes. Through a deeper understanding of blast physics, injury patterns, and treatment approaches, clinicians can improve survival and long-term recovery for both military and civilian blast victims.
This study aimed to investigate the feasibility of inducing mental fatigue (MF) through nap deprivation, based on monitoring heart rate variability (HRV), cognitive performance, and subjective fatigue levels. Additionally, the intervention effect of caffeine oral tablets (COT) on MF was evaluated. This was an open-label, non-randomized, single-sequence crossover pilot study. The caffeine content in COT was quantified using high-performance liquid chromatography (HPLC). Ten healthy volunteers who habitually took naps were enrolled. Participants underwent nap deprivation to induce MF. Various parameters were collected at different time points, including the Karolinska Sleepiness Scale (KSS), Attention Network Task (ANT), and HRV metrics. Changes in each parameter before and after COT intervention were analyzed. Following nap deprivation, there was a significant increase in KSS scores for the control group compared to baseline measurements taken after 2 h of sleep deprivation (P < 0.01). No significant changes were observed in ANT performance; however, HRV exhibited variations influenced by circadian rhythms-showing increased volatility in time-domain parameters and differing trends in frequency-domain parameters without statistical significance. After administration of low-dose COT to experimental participants, KSS scores did not significantly rise; conversely, correct response rates (CR) on ANT improved significantly (P < 0.05), alongside notable changes in both time-domain and frequency-domain HRV parameters (P < 0.05). In this pilot study, the alignment between subjective and objective indices suggests that low-dose COT is associated with favorable changes in the MF state of volunteers following sleep deprivation. However, due to the small sample size and open-label design, these findings should be considered preliminary and warrant confirmation in larger, randomized controlled trials.
To characterize the longitudinal trajectories of body-mass-index-for-age Z-score(BAZ) from birth to 7-9 years and to explore their association with elevated blood pressure(EBP) in childhood. Based on the TAWS prospective cohort study in China, children living in Taicang were followed from 2013 to 2024. Length/height and weight of children were measured at 1, 3, 6, 8 months, and 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7-9 years of age. Blood pressure was measured in 2024 when children were 7-9 years old, and EBP was defined according to Chinese reference of screening for EBP among children. BAZ was calculated based on the World Health Organization child growth standards. Group-based trajectory modeling(GBTM) was applied to identify BAZ trajectories. Multivariate logistic regression was used to assess the association between BAZ trajectories groups and EBP, adjusting for potential confounders. Among the 1, 274 children included in this study, the prevalence of EBP was 20.6%. GBTM identified three distinct BAZ trajectories: low-decreasing(34.5%), moderate-stable(48.3%), and high-increasing(17.2%). After adjustment for child's gender, initial BAZ, and age at the last follow-up, children in the high-increasing BAZ group had an increased risk of EBP(OR=1.55, 95%CI 1.07-2.23, P=0.02) compared to those in the moderate-stable BAZ group, while the low-decreasing BAZ group showed no statistically significant association with EBP(OR=0.77, 95%CI 0.55-1.06, P=0.11). From 2.5 years old onwards, BAZ values in children with EBP were consistently higher than those with normal blood pressure(P<0.05). The high-increasing BAZ trajectory from birth to nine years is associated with an increased risk of EBP in children aged 7-9 years. The age of 2.5 years may represent a critical starting point for interventions aimed at controlling BAZ rise to mitigate future EBP.