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ObjectivesTo understand the sex difference in age at adiposity rebound (AR), integrate the prevalence of early AR (EAR), and provide a quantitative association between early age at AR and overweight/obesity.MethodsLiterature review was conducted in different databases, including the Web of Science, PubMed, EMBASE, Wiley, Chinese National Knowledge Infrastructure, and ScienceDirect databases up to August 2021. Studies that reported data related to AR were considered for inclusion. Pooled effect sizes and their respective 95% confidence intervals (CIs) were calculated using random effects models, depending on the size of heterogeneity. Heterogeneity was tested by using the I2 statistics.Results28 studies with a combined sample size of 106,397 people were included in the final meta-analysis. Girls had a significantly earlier age of AR than boys (mean difference = 3.38 months; 95% CI 2.14–4.63). The overall prevalence of EAR was 40% (95% CI 31% to 50%), and the prevalence in girls was 5% higher than that in boys based on the definition of age at AR < 5.0–5.1 years. The overall pooled prevalence of EAR showed an increasing trend by child’s birth year [1934–1973]: 29% (95% CI 22% to 37%), 1991–2001: 35% (95% CI 26% to 44%), and 2002–2009: 52% (95% CI 40–63%). Early age at AR (age at AR < 5.0–5.1 years) was associated with a significantly increased risk of overweight/obesity (OR = 5.07; 95% CI 3.60–7.12), overweight (OR = 3.10; 95% CI 1.69–5.70), and obesity (OR = 6.97; 95% CI 4.32–11.26) from the preschool period to adulthood.ConclusionsThe overall prevalence of EAR is increasing, and girls experience AR earlier than boys. The early age at AR in children may be an early and effective marker of obesity.

[This corrects the article DOI: 10.1371/journal.pone.0242523.].

Sulfonamides are widely used to treat infectious diseases during pregnancy. However, the safety of maternal exposure to sulfonamides is controversial. This study aims to systematically review the available studies and examine the effect of maternal sulfonamides use on adverse pregnancy outcomes. We searched PubMed, Science Direct, Web of Science, ClinicalTrials.gov, CNKI and Wanfang Database (in Chinese). The meta-analysis used random effects model or fixed effects model to obtain the total odds ratio (OR) for each outcome through Stata11.0 software. Study on the relationship between sulfonamide exposure during pregnancy and adverse pregnancy outcomes. The study design covered randomized controlled trials, cohort studies and case-control studies. The study protocol was registered in PROSPERO with protocol number CRD42020178687. A total of 10 studies, and 1096350 participants were included for systematic review. Maternal exposure to sulfonamides was found to be possibly associated with increased risk of congenital malformations (OR = 1.21, 95% CI 1.07-1.37). The use of sulfonamides in the first trimester of pregnancy and during the entire pregnancy might be associated with congenital malformations. Maternal exposure to sulfonamides may be associated with offspring' s congenital malformations. Prescription of sulfonamides for pregnant women is suggested to be carefully censored.

Vascular covered stents play a significant therapeutic role in cardiovascular diseases. However, the poor compliance and biological inertness of commercial materials cause post-implantation complications. Silk fibroin (SF), as a biomaterial, possesses satisfactory hemocompatibility and tissue compatibility. In this study, we developed a silk film for use in covered stents by employing a layer-by-layer self-assembly strategy with regenerated SF on silk braiding fabric. We investigated the effects on the mechanical properties of the silk films in detail, which were closely correlated with fabric parameters and layer-by-layer self-assembly. The results showed that there was a significant relationship between these factors and both the compliance and mechanical strength. The 1 × 2/90°/100/SF 6 film exhibited excellent mechanical properties. Notably, compliance reached 2.6%/100 mmHg, matching that of the human saphenous vein. Thus, this strategy shows promise in developing a novel covered stent, with biocompatible and comprehensive mechanical properties, and significant potential for clinical applications.

Artificial neural networks (ANN) which include deep learning neural networks (DNN) have problems such as the local minimal problem of Back propagation neural network (BPNN), the unstable problem of Radial basis function neural network (RBFNN) and the limited maximum precision problem of Convolutional neural network (CNN). Performance (training speed, precision, etc.) of BPNN, RBFNN and CNN are expected to be improved. Main works are as follows: Firstly, based on existing BPNN and RBFNN, Wavelet neural network (WNN) is implemented in order to get better performance for further improving CNN. WNN adopts the network structure of BPNN in order to get faster training speed. WNN adopts the wavelet function as an activation function, whose form is similar to the radial basis function of RBFNN, in order to solve the local minimum problem. Secondly, WNN-based Convolutional wavelet neural network (CWNN) method is proposed, in which the fully connected layers (FCL) of CNN is replaced by WNN. Thirdly, comparative simulations based on MNIST and CIFAR-10 datasets among the discussed methods of BPNN, RBFNN, CNN and CWNN are implemented and analyzed. Fourthly, the wavelet-based Convolutional Neural Network (WCNN) is proposed, where the wavelet transformation is adopted as the activation function in Convolutional Pool Neural Network (CPNN) of CNN. Fifthly, simulations based on CWNN are implemented and analyzed on the MNIST dataset. Effects are as follows: Firstly, WNN can solve the problems of BPNN and RBFNN and have better performance. Secondly, the proposed CWNN can reduce the mean square error and the error rate of CNN, which means CWNN has better maximum precision than CNN. Thirdly, the proposed WCNN can reduce the mean square error and the error rate of CWNN, which means WCNN has better maximum precision than CWNN.

This study analyzes the transient axial force of a centrifugal pump under variable operating conditions using wavelet analysis and a novel technique called windowed multi-resolution dynamic mode decomposition (wmrDMD). Numerically simulating the sampled time series allows the reconstruction of the impeller’s axial force information, providing validation for this innovative data-driven analysis technique. The comparison between the reconstructed results and the original axial force data demonstrates a remarkable agreement, as all data points exhibit error values below 2.49%. The wmrDMD technique systematically decomposes the impeller’s axial force field into dynamically significant modes across various time scales. Removing the mean flow field in this study resolves the transient motion of the impeller’s axial force, facilitating the identification of positions with high-frequency axial force oscillations and fluctuations in intensity amplitude. The high-frequency axial force of the impeller exhibits stable periodic variations within the operating range of 1.0nr-1.0Qr, whereas the changes are insignificant within the range of 0.4nr-0.4Qr. However, within the operating range of 1.0nr-0.4Qr, both the position and intensity amplitude of the axial force exhibit significant variations without a stable trend. Furthermore, cross-wavelet and wavelet coherence analyses reveal that within the operating range of 0.4nr-0.4Qr, the axial forces on the front and rear cover plates show the strongest correlation at the periodic scale. Within the operating range of 1.0nr-1.0Qr, the next highest correlation is observed, whereas the correlation is lowest within the 1.0nr-0.4Qr operating range.

This study looks into the parameters that affect the heat transfer coefficient (h2) on the wet surfaces of vertical tube indirect evaporative coolers (VTIEC). An experimental platform was used to investigate the impact of secondary-to-primary airflow ratios (AFR) and spray water density on the HTC. The findings show that raising the primary air temperature drop, expanding the outside dry-bulb and wet-bulb temperature differences, and decreasing the air-to-water ratio improve heat transmission. The HTC of the wet sides ranged from 34.79 to 924.5 W/(m2·°C) throughout testing. To achieve optimal performance, aim for a spray water density of 2.07 to 3.46 m3/(m2·h), an AFR of 0.5 to 0.6, and a primary air temperature drop of at least 6 °C. These factors help keep the h2 above 350 W/(m2·°C).

Hospitalised, unwell patients have vital signs such as heart rate (HR), oxygen saturation (SpO2) and temperature measured multiple times a day to detect clinical deterioration and monitor health trajectories. Advancements in contact-free (ambient) sensors (AS) to measure vital signs can help mitigate risks due to skin injury and infection transmission seen in conventional hospital equipment. This prospective, observational clinical study aims to validate vital sign measurements from a multi-channel AS compared to conventional equipment in three cohorts: patients in a hospital ward, patients at home within a Hospital-at-Home service, and healthy volunteers. Data analysis of 571 paired measurements from 29 participants indicates that heart rate measurements via AS were accurate, though they lacked precision, with the clinical agreement range between 6.38 and 6.49 beats per minute. Temperature and oxygen saturation measurements showed less agreement when compared with the reference standard. In conclusion, ambient sensors show promising utility in measuring vital signs, with this study amongst the first of its kind to utilise this in measuring vital signs in hospitalised patient cohorts in both ward and home environments.

Although X-rays are not recommended for routine diagnosis of osteoarthritis (OA), clinicians and patients often use or expect X-rays. We evaluated whether: (i) a radiographic diagnosis and explanation of knee OA influences patient beliefs about management, compared to a clinical diagnosis and explanation that does not involve X-rays; and (ii) showing the patient their X-ray images when explaining radiographic report findings influences beliefs, compared to not showing X-ray images. This was a 3-arm randomised controlled trial conducted between May 23, 2024 and May 28, 2024 as a single exposure (no follow-up) online survey. A total of 617 people aged ≥45 years, with and without chronic knee pain, were recruited from the Australian-wide community. Participants were presented with a hypothetical scenario where their knee was painful for 6 months and they had made an appointment with a general practitioner (primary care physician). Participants were randomly allocated to one of 3 groups where they watched a 2-min video of the general practitioner providing them with either: (i) clinical explanation of knee OA (no X-rays); (ii) radiographic explanation (not showing X-ray images); or (iii) radiographic explanation (showing X-ray images). Primary comparisons were: (i) clinical explanation (no X-rays) versus radiographic explanation (showing X-ray images); and (ii) radiographic explanation (not showing X-ray images) versus radiographic explanation (showing X-ray images). Primary outcomes were perceived (i) necessity of joint replacement surgery; and (ii) helpfulness of exercise and physical activity, both measured on 11-point numeric rating scales (NRS) ranging 0 to 10. Compared to clinical explanation (no X-rays), those who received radiographic explanation (showing X-ray images) believed surgery was more necessary (mean 3.3 [standard deviation: 2.7] versus 4.5 [2.7], respectively; mean difference 1.1 [Bonferroni-adjusted 95% confidence interval: 0.5, 1.8]), but there were no differences in beliefs about the helpfulness of exercise and physical activity (mean 7.9 [standard deviation: 1.9] versus 7.5 [2.2], respectively; mean difference -0.4 [Bonferroni-adjusted 95% confidence interval: -0.9, 0.1]). There were no differences in beliefs between radiographic explanation with and without showing X-ray images (for beliefs about necessity of surgery: mean 4.5 [standard deviation: 2.7] versus 3.9 [2.6], respectively; mean difference 0.5 [Bonferroni-adjusted 95% confidence interval: -0.1, 1.2]; for beliefs about helpfulness of exercise and physical activity: mean 7.5 [standard deviation: 2.2] versus 7.7 [2.0], respectively; mean difference -0.2 [Bonferroni-adjusted 95% confidence interval: -0.7, 0.3]). Limitations of our study included the fact that participants were responding to a hypothetical scenario, and so findings may not necessarily translate to real-world clinical situations, and that it is unclear whether effects would impact subsequent OA management behaviours. An X-ray-based diagnosis and explanation of knee OA may have potentially undesirable effects on people's beliefs about management. ACTRN12624000622505.

Background This study investigates the current mental health status among children and adolescents in Jiangsu Province by analyzing symptoms of depression, anxiety, and stress using standardized psychological scales. Machine learning models were utilized to identify key influencing variables and predict mental health outcomes, aiming to establish a rapid psychological well-being assessment framework for this population. Objective A cross-sectional survey was conducted via random cluster sampling across 98 counties (cities/districts) in Jiangsu Province, enrolling 141,725 students (47,502 primary, 47,274 junior high, 11,619 vocational high school students, and 35,330 senior high ). The study focused on prevalent mental health disorders and associated risk factors. Methods Depression, anxiety, and stress scores served as dependent variables, with 57 socio-demographic and behavioral factors as independent variables. Five supervised machine learning models (Decision Tree, Naive Bayes, Random Forest, K-Nearest Neighbors (KNN), and XGBoost) were implemented using R software. Model performance was evaluated using accuracy, precision, recall, F1 Score and Area Under the ROC Curve (AUC). Feature importance analysis was conducted to identify key predictors. Results The study revealed significant mental health disparities: depression (14.9%), anxiety (25.5%), and stress (10.9%) prevalences showed clear gender and regional gradients. Females exhibited higher rates across all conditions ( p  < 0.05), and urban areas had elevated risks compared to suburban regions. Mental health deterioration escalated with educational stages (e.g., depression from 9.2% in primary to 21.2% in senior high; χ² trend = 2274.55, p  < 0.05). The XGBoost model demonstrated optimal predictive performance (AUC: depression = 0.799, anxiety = 0.770, stress = 0.762), outperforming other models. Feature importance analysis consistently identified bullying duration, age, and drinking history as top risk factors across both Gain and SHAP methods, while SHAP values additionally emphasized modifiable lifestyle factors (e.g., breakfast frequency) and demographic variables (e.g., gender). Conclusions This study identifies bullying, age, and alcohol consumption history as key mental health risk factors among Jiangsu’s children and adolescents. These findings emphasize the need for school-based anti-bullying programs, age-specific mental health counseling, and healthy lifestyle education (including alcohol refusal). Lifestyle behaviors like daily breakfast intake should be integrated into dietary interventions for mental health promotion. Urban-rural and gender disparities necessitate targeted support for urban adolescent females, while educational stage differences highlight the criticality of early prevention.