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Manganese (Mn) is a crucial trace element that actively participates in a diverse array of physiological processes. Mn is maintained at appropriate levels in the body by absorption and excretion by the body. Dysregulation of Mn homeostasis can lead to a variety of diseases, especially the accumulation of Mn in the brain, resulting in toxic side effects. We reviewed the metabolism and distribution of Mn at multiple levels, including organ, cellular, and sub-cell levels. Mitochondria are the main sites of Mn metabolism and energy conversion in cells. Enhanced Mn superoxide dismutase activity reduces mitochondrial oxidative stress and inhibits cancer development. In addition, Mn enhances anticancer immune responses through the cGAS-STING pathway. We introduced various delivery vectors for Mn delivery to cancer sites for Mn supplementation and anti-cancer immunity. This review aims to provide new research perspectives for the application of Mn in the prevention and treatment of human diseases, especially by enhancing anticancer immune responses to inhibit cancer progression.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and/or hyperactivity-impulsivity, accompanied by deficits in executive function (EF). However, how the two core symptoms of ADHD are affected by EF deficits remains unclear. 649 children with ADHD were recruited. Data were collected from ADHD rating scales, the Behavior Rating Inventory of EF (BRIEF), and other demographic questionnaires. Regression and path analyses were conducted to explore how deficits in cool and hot EF influence different ADHD core symptoms. Latent class analysis and logistic regression were employed to further examine whether classification of ADHD subtypes is associated with specific EF deficits. EF deficits significantly predicted the severity of ADHD core symptoms, with cool EF being a greater predictor of inattention and hot EF having a more significant effect on hyperactivity/impulsivity. Moreover, person-centered analyses revealed higher EF deficits in subtypes of ADHD with more severe symptoms, and both cool and hot EF deficits could predict the classification of ADHD subtypes. Our findings identify distinct roles for cool and hot EF deficits in the two core symptoms of ADHD, which provide scientific support for the development of ADHD diagnostic tools and personalized intervention from the perspective of specific EF deficits.
An actively controllable cascaded proton acceleration driven by a separate 0.8 picosecond (ps) laser is demonstrated in proof-of-principle experiments. MeV protons, initially driven by a femtosecond laser, are further accelerated and focused into a dot structure by an electromagnetic pulse (EMP) on the solenoid, which can be tuned into a ring structure by increasing the ps laser energy. An electrodynamics model is carried out to explain the experimental results and show that the dot-structured proton beam is formed when the outer part of the incident proton beam is optimally focused by the EMP force on the solenoid; otherwise, it is overfocused into a ring structure by a larger EMP. Such a separately controlled mechanism allows precise tuning of the proton beam structures for various applications, such as edge-enhanced proton radiography, proton therapy and pre-injection in traditional accelerators.
Seed chemical composition and oxidation after long-term storage may affect seed longevity, seed germination and seedling normality after planting. By screening the entire USDA cultivated peanut germplasm collection for fatty acid composition, we identified the -01 inventory of accession PI 268941 with the following characteristics: (a) two distinct seed fatty acid profiles (high oleate 78.9% and normal oleate 48.19%); (b) two FAD2B genotypes (with and without a functional point mutation of 435DelT within the FAD2B gene); and (c) uniform plant morphology and seed-coat color. This inventory had been stored at −18°C within the same sealed aluminum bag for 30 years and was acquired to investigate the relationship between seed chemical composition and seed performance after planting using individual seed analysis. Our results indicated that (1) the spontaneous point-functional mutation 435T deletion of FAD2B within the accession led to the high and normal oleate seeds; (2) additional unidentified compounds observed during analysis may be due to a higher oxidation rate in normal oleate seeds than in high oleate seeds; (3) the high oleate seeds had significantly higher rates of seed germination and seedling normality than the normal oleate seeds; and (4) the seedling performance highly and significantly correlated with fatty acid composition and extra peaks. Our results suggest that high oleic acid significantly extends the viability of long-term stored peanut seeds. The information revealed in this study will be useful for germplasm preservation as well as the selection of seeds for planting and agricultural production based on seed fatty acid composition and storage length.
In response to the auxiliary requirements for the treatment and prevention of lumbar diseases, based on the biomechanical characteristics of the human waist, a novel unpowered rigid-flexible coupling waist exoskeleton with multiple degrees of freedom and its human-exoskeleton parallel wearable equivalent research prototype are proposed, further focusing on the encompassing kinematic compatibility and dynamic load-bearing effectiveness of the biomimetic coordination, an in-depth analysis is performed on the multi-body dynamic dimensional synthesis and its methodological research. Initially, based on the rigid-flexible coupling characteristics and experimental biomechanical data of the lumbar region in the sagittal plane, an accurate multi-body system dynamics model of the research prototype, which incorporates the rigid-flexible coupling characteristics, is systematically constructed. Subsequently, to effectively quantify the biomimetic coordination of the exoskeleton, a novel comprehensive optimization index, termed biomimetic load-bearing comfort, is proposed. Finally, by utilizing this index, the exoskeleton is optimized in dimension by employing a thorough combination of multi-dimensional spatial search algorithm and compression factor particle swarm algorithm. The simulation results validate the correctness and effectiveness of both the dynamic dimensional synthesis and its methodology. Furthermore, the study also reveals that the optimized exoskeleton’s passive working mode showcases favorable biomimetic coordination. These results are crucial for progressing the research on the biomimetic load-bearing capacities of other exoskeletons.
Due to the effects of tolerance, design, and manufacturing deviations, there are clearances in the revolute joints of mechanical arms. These clearances can easily lead to system impacts and vibrations, resulting in a decrease in dynamic performance and affecting the trajectory tracking accuracy of the end effector. The existing dynamic models of mechanisms with clearance in revolute joints lack comprehensiveness, universality, and systematicity, and have not addressed the impact of joint reaction forces within clearance revolute joints on the system. The impact collision problem of the revolute joints with clearance was systematically, accurately, and comprehensively modeled and simulated in this study based on multibody dynamics theory. Based on Hertz’s elastic theory, the LuGre friction model, and joint reaction forces, this paper constructs constraint and mechanical models of revolute joints with clearance based on the theory of multibody dynamics. To facilitate multibody dynamics analysis, the collision impact direction matrix is proposed and used for the first time to transform the mechanical model of revolute joints with clearance into external forces. The dynamic models of mobile parallel and double serial manipulators are then constructed. Through numerical simulations on different clearance amounts, tracking trajectories, and load parameters, the impact of revolute joint clearances on system dynamic performance is analyzed. The engineering significance of this research in dynamic analysis of mobile parallel manipulators under imperfect revolute joint conditions is also discussed.
Clinical high risk for psychosis (CHR) is often managed with antipsychotic medications, but their effects on neurocognitive performance and clinical outcomes remain insufficiently explored. This study investigates the association between aripiprazole and olanzapine use and cognitive and clinical outcomes in CHR individuals, compared to those receiving no antipsychotic treatment.
Methods
A retrospective analysis was conducted on 127 participants from the Shanghai At Risk for Psychosis (SHARP) cohort, categorized into three groups: aripiprazole, olanzapine, and no antipsychotic treatment. Neurocognitive performance was evaluated using the MATRICS Consensus Cognitive Battery (MCCB), while clinical symptoms were assessed through the Structured Interview for Prodromal Syndromes (SIPS) at baseline, 8 weeks, and one year.
Results
The non-medicated group demonstrated greater improvements in cognitive performance, clinical symptoms, and functional outcomes compared to the medicated groups. Among the antipsychotic groups, aripiprazole was associated with better visual learning outcomes than olanzapine. Improvements in neurocognition correlated significantly with clinical symptom relief and overall functional gains at follow-up assessments.
Conclusions
These findings suggest potential associations between antipsychotic use and cognitive outcomes in CHR populations while recognizing that observed differences may reflect baseline illness severity rather than medication effects alone. Aripiprazole may offer specific advantages over olanzapine, underscoring the importance of individualized risk-benefit evaluations in treatment planning. Randomized controlled trials are needed to establish causality.
Hospital-acquired pneumonia (HAP) represents one of the most common nosocomial infections in intensive care units (ICUs), accounting for 25% of all hospital-acquired infections. While oral care is recommended as a preventive measure, the relationship between standardized oral care practices and HAP incidence remains incompletely characterized.
Objective:
To evaluate the association between oral care practice compliance and HAP incidence in ICU patients, and to identify specific aspects of oral care delivery that influence outcomes.
Methods:
We conducted a prospective mixed-methods observational cohort study from May 2021 across seven ICUs in a tertiary hospital in China. The study utilized a two-phase approach: (1) systematic assessment of oral care implementation through structured observation of nursing staff (n = 58), and (2) prospective evaluation of HAP outcomes in patients (n = 142). Primary outcomes included oral care compliance metrics and HAP incidence. HAP was defined according to standardized clinical criteria and confirmed by two independent physicians.
Results:
Among 142 unique patients, 63 (44.37%) received oral care orders. The oral care completion rate was 61.93%, and the qualification rate was 54.13%. In our analysis, HAP (including both ventilator-associated pneumonia [VAP] and non-ventilator hospital-acquired pneumonia [NVHAP]) occurred in 15/63 (23.81%) patients receiving oral care and 22/79 (27.85%) patients without oral care. Multivariate analysis revealed that incomplete oral care (adjusted OR 2.47, [95% CI, 1.15–4.45], P = 0.009), non-qualified care techniques (adjusted OR 3.17, [95% CI, 1.45–6.35], P = 0.002), and inadequate item qualification (adjusted OR 3.33, [95% CI, 1.47–6.55], P = 0.001) were independently associated with increased HAP risk, after adjusting for confounders. Stratified analysis showed similar associations in both VAP and NVHAP subgroups.
Conclusion:
Our investigation demonstrated that suboptimal oral care practices were associated with increased HAP risk in ICU patients. Implementation of evidence-based standardized protocols and improved adherence strategies may help reduce HAP incidence.
Oasis communities across Central Asia were key to the emergence and maintenance of the ancient Silk Roads that spanned Eurasia from the late second century BC, yet our understanding of early interaction networks in this region is limited. Multi-isotopic analysis of human teeth from the Zaghunluq Cemetery, southern Xinjiang (sixth century BC to first century AD) now suggests that oasis communities established intricate exchange networks, forming strong ties with other nearby oases and mountain pastoralists and weak ties, facilitated through in migration, with more distant regions. These diverse connections, the authors argue, made possible cultural exchange across the challenging geography of eastern Central Asia.
Viscous fingering, a classic hydrodynamic instability, is governed by the the competition between destabilising viscosity ratios and stabilising surface tension or thermal diffusion. We show that the channel confinement can induce ‘diffusion’-like stabilising effects on viscous fingering even in the absence of interfacial tension and thermal diffusion, when a clear oil invades the mixture of the same oil and non-colloidal particles. The key lies in the generation of long-range dipolar disturbance flows by highly confined particles that form a monolayer inside a Hele-Shaw cell. We develop a coarse-grained model whose results correctly predict universal fingering dynamics that is independent of particle concentrations. This new mechanism offers insights into manipulating and harnessing collective motion in non-equilibrium systems.
We sought to assess the degree to which environmental risk factors affect CHD prevalence using a case–control study.
Methods:
A hospital-based study was conducted by collecting data from outpatients between January 2016 and January 2021, which included 31 CHD cases and 72 controls from eastern China. Risk ratios were estimated using univariate and multivariate logistic regression models and mediating effect analysis.
Results:
Residential characteristics (usage of cement flooring, odds ratio = 17.04[1.954–148.574], P = 0.01; musty smell, odds ratio = 3.105[1.198–8.051], P = 0.02) and indoor total volatile organic compound levels of participants’ room (odds ratio = 31.846[8.187–123.872, P < 0.001), benzene level (odds ratio = 7.370[2.289–23.726], P = 0.001) increased the risk of CHDs in offspring. And folic acid plays a masking effect, which mitigates the affection of the total volatile organic compound (indirect effect = -0.072[−0.138,-0.033]) and formaldehyde (indirect effect = −0.109[-0.381,-0.006]) levels on the incidence of CHDs. While food intake including milk (odds ratio = 0.396[0.16–0.977], P = 0.044), sea fish (odds ratio = 0.273[0.086–0.867], P = 0.028), and wheat (odds ratio = 0.390[0.154–0.990], P = 0.048) were all protective factors for the occurrence of CHDs. Factors including women reproductive history (history of conception control, odds ratio = 2.648[1.062–6.603], P = 0.037; history of threatened abortion, odds ratio = 2.632[1.005–6.894], P = 0.049; history of dysmenorrhoea (odds ratio = 2.720[1.075–6.878], P = 0.035); sleep status (napping habit during daytime, odds ratio = 0.856[0.355–2.063], P = 0.047; poor sleep quality, odds ratio = 3.180[1.037–9.754], P = 0.043); and work status (working time > 40h weekly, odds ratio = 2.882[1.172–7.086], P = 0.021) also influenced the CHDs incidence to differing degrees.
Conclusion:
Diet habits, nutrients intake, psychological status of pregnant women, and residential air quality were associated with fetal CHDs. Indoor total volatile organic compound content was significantly correlated with CHDs risk, and folic acid may serve as a masking factor that reduce the harmful effects of air pollutants.
Spherical robots face significant challenges in motion control on non-horizontal terrains, such as slopes, due to their unique spherical structure. This paper systematically investigates the motion stability of spherical robots on inclined surfaces through modeling, control algorithm design, and experimental validation. Precise Equilibrium Modeling: Using the virtual displacement method, the precise equilibrium equation for spherical robots on slopes is derived, addressing the issue of insufficient accuracy in describing the actual center of gravity in existing studies. Control Algorithm Design: For known slope conditions, a Backstepping Control (BSC) algorithm is designed, demonstrating excellent tracking performance. For unknown slope conditions, an Adaptive Backstepping Control (ABSC) algorithm is proposed, which significantly reduces tracking errors and enhances system robustness through parameter adaptation. Simulation and Physical Validation: Simulations confirm the effectiveness of the algorithms: BSC achieves high-precision control under known slopes, while ABSC exhibits strong adaptability under unknown slopes. Physical experiments validate the stability of the algorithms in a $5^\circ$ slope environment, demonstrating reliable performance across different control angles.
As a novel type of catalytic Janus micromotor (JM), a double-bubble-powered Janus micromotor has a distinct propulsion mechanism that is closely associated with the bubble coalescence in viscous liquids and corresponding flow physics. Based on high-speed camera and microscopic observation, we provide the first experimental results of the coalescence of two microbubbles near a JM. By performing experiments with a wide range of Ohnesorge numbers, we identify a universal scaling law of bubble coalescence, which shows a cross-over at dimensionless time $\tilde{t}$ = 1 from an inertially limited viscous regime with linear scaling to an inertial regime with 1/2 scaling. Due to the confinement from the nearby solid JM, we observe asymmetric neck growth and find the combined effect of the surface tension and viscosity. The bubble coalescence and detachment can result in a high propulsion speed of ∼0.25 m s−1 for the JM. We further characterise two contributions to the JM’s displacement propelled by the coalescing bubble: the counteraction from the liquid due to bubble deformation and the momentum transfer during bubble detachment. Our findings provide a better understanding of the flow dynamics and transport mechanism in micro- and nano-scale devices like the swimming microrobot and bubble-powered microrocket.
This study presents a novel investigation into the vortex dynamics of flow around a near-wall rectangular cylinder based on direct numerical simulation at $Re=1000$, marking the first in-depth exploration of these phenomena. By varying aspect ratios ($L/D = 5$, $10$, $15$) and gap ratios ($G/D = 0.1$, $0.3$, $0.9$), the study reveals the vortex dynamics influenced by the near-wall effect, considering the incoming laminar boundary layer flow. Both $L/D$ and $G/D$ significantly influence vortex dynamics, leading to behaviours not observed in previous bluff body flows. As $G/D$ increases, the streamwise scale of the upper leading edge (ULE) recirculation grows, delaying flow reattachment. At smaller $G/D$, lower leading edge (LLE) recirculation is suppressed, with upper Kelvin–Helmholtz vortices merging to form the ULE vortex, followed by instability, differing from conventional flow dynamics. Larger $G/D$ promotes the formation of an LLE shear layer. An intriguing finding at $L/D = 5$ and $G/D = 0.1$ is the backward flow of fluid from the downstream region to the upper side of the cylinder. At $G/D = 0.3$, double-trailing-edge vortices emerge for larger $L/D$, with two distinct flow behaviours associated with two interactions between gap flow and wall recirculation. These interactions lead to different multiple flow separations. For $G/D = 0.9$, the secondary vortex (SV) from the plate wall induces the formation of a tertiary vortex from the lower side of the cylinder. Double-SVs are observed at $L/D = 5$. Frequency locking is observed in most cases, but is suppressed at $L/D = 10$ and $G/D = 0.9$, where competing shedding modes lead to two distinct evolutions of the SV.
In this study, the propagation behaviour of detonation waves in a channel filled with stratified media is analysed using a detailed chemical reaction model. Two symmetrical layers of non-reactive gas are introduced near the upper and lower walls to encapsulate a stoichiometric premixed H2–air mixture. The effects of gas temperature and molecular weight of the non-reactive layers on the detonation wave’s propagation mode and velocity are examined thoroughly. The results reveal that as the non-reactive gas temperature increases, the detonation wave front transitions from a ‘convex’ to a ‘concave’ shape, accompanied by an increase in wave velocity. Notably, the concave wave front comprises detached shocks, oblique shocks and detonation waves, with the overall wave system propagating at a velocity exceeding the theoretical Chapman–Jouguet speed, indicating the emergence of a strong detonation wave. Furthermore, when the molecular weight of non-reactive layers varies, the results qualitatively align with those obtained from temperature variations. To elucidate the formation mechanism of different detonation wave front shapes, a dimensionless parameter $\eta$ (defined as a function of the specific heat ratio and sound speed) is proposed. This parameter unifies the effects of temperature and molecular weight, confirming that the specific heat ratio and sound speed of non-reactive layers are the primary factors governing the detonation wave propagation mode. Additionally, considering the effect of mixture inhomogeneity on the detonation reaction zone, the stream tube contraction theory is proposed, successfully explaining why strong detonation waves form in stratified mixtures. Numerical results show good agreement with theoretical predictions, validating the proposed model.
The relationship between emotional symptoms and cognitive impairments in major depressive disorder (MDD) is key to understanding cognitive dysfunction and optimizing recovery strategies. This study investigates the relationship between subjective and objective cognitive functions and emotional symptoms in MDD and evaluates their contributions to social functioning recovery.
Methods
The Prospective Cohort Study of Depression in China (PROUD) involved 1,376 MDD patients, who underwent 8 weeks of antidepressant monotherapy with assessments at baseline, week 8, and week 52. Measures included the Hamilton Depression Rating Scale (HAMD-17), Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), Chinese Brief Cognitive Test (C-BCT), Perceived Deficits Questionnaire for Depression-5 (PDQ-D5), and Sheehan Disability Scale (SDS). Cross-lagged panel modeling (CLPM) was used to analyze temporal relationships.
Results
Depressive symptoms and cognitive measures demonstrated significant improvement over 8 weeks (p < 0.001). Baseline subjective cognitive dysfunction predicted depressive symptoms at week 8 (HAMD-17: β = 0.190, 95% CI: 0.108–0.271; QIDS-SR16: β = 0.217, 95% CI: 0.126–0.308). Meanwhile, baseline depressive symptoms (QIDS-SR16) also predicted subsequent subjective cognitive dysfunction (β = 0.090, 95% CI: 0.003-0.177). Recovery of social functioning was driven by improvements in depressive symptoms (β = 0.384, p < 0.0001) and subjective cognition (β = 0.551, p < 0.0001), with subjective cognition contributing more substantially (R2 = 0.196 vs. 0.075).
Conclusions
Subjective cognitive dysfunction is more strongly associated with depressive symptoms and plays a significant role in social functioning recovery, highlighting the need for targeted interventions addressing subjective cognitive deficits in MDD.
Ice shelves affect the stability of ice sheets by supporting the mass balance of ice upstream of the grounding line. Marine ice, formed from supercooled water freezing at the base of ice shelves, contributes to mass gain and affects ice dynamics. Direct measurements of marine ice thickness are rare due to the challenges of borehole drilling. Here we assume hydrostatic equilibrium to estimate marine ice distribution beneath the Amery Ice Shelf (AIS) using meteoric ice-thickness data obtained from radio-echo sounding collected during the Chinese National Antarctic Research Expedition between 2015 and 2019. This is the first mapping of marine ice beneath the AIS in nearly 20 years. Our new estimates of marine ice along two longitudinal bands beneath the northwest AIS are spatially consistent with earlier work but thicker. We also find a marine ice layer exceeding 30 m of thickness in the central ice shelf and patchy refreezing downstream of the grounding line. Thickness differences from prior results may indicate time-variation in basal melting and freezing patterns driven by polynya activity and coastal water intrusions masses under the ice shelf, highlighting that those changes in ice–ocean interaction are impacting ice-shelf stability.
Porcine small intestinal epithelial cell line (IPEC-J2) is a good research model exploring the impact of feed additives on intestinal epithelial cells. Monobutyrin (MB), as a derivative of butyric acid (BA), overcomes the shortcomings of BA. MB can maintain intestinal barrier function in animals, but its underlying regulatory mechanism is unknown. Thus, we used IPEC-J2 cells as the research object. We were using real-time fluorescence quantitative PCR, western blot, immunofluorescence, and transcriptomics technology to explore the effect of MB on the barrier function of IPEC-J2 cells and its regulatory mechanism. The results found that MB treatment could cause IPEC-J2 cells to occur a response to hypoxia at the transcriptional level, thereby increasing the expression of hypoxia-inducible factor 1 and phospho-extracellular signal-regulated kinase 1/2 protein and improving the expression of tight junction proteins. Therefore, MB can alleviate the activation of the NF-κB signaling pathway. In addition, MB mitigates the damage to cell transmembrane glycoproteins, microvilli, and tight junctions caused by lipopolysaccharides (LPS) stimulation, thus resisting the effects of LPS. As a dietary supplement, MB has good application prospects in maintaining the intestinal epithelial barrier function of animals.
We aimed to validate in-body bioelectrical impedance analysis (BIA) measures with dual-energy X-ray absorptiometry (DXA) as reference and describe the body composition (BC) profiling of Tibetan adults.
Design:
This cross-sectional study included 855 participants (391 men and 464 women). Correlation and Bland–Altman analyses were performed for method agreement of in-body BIA and DXA. BC were described by obesity and metabolic status.
Setting:
In-body BIA and DXA have not been employed to characterise the BC of the Tibetan population living in the Qinghai–Tibet Plateau.
Participants:
A total of 855 Tibetan adults, including 391 men and 464 women, were enrolled in the study.
Results:
Concordance correlation coefficient for total fat mass (FM) and total lean mass (LM) between in-body BIA and DXA were 0·91 and 0·89. The bias of in-body BIA for percentages of total FM and total LM was 0·91 % (2·46 %) and –1·74 % (–2·80 %) compared with DXA, respectively. Absolute limits of agreement were wider for total FM in obese men and women and for total LM in overweight men than their counterparts. Gradience in the distribution of total and regional FM content was observed across different BMI categories and its combinations with waist circumference and metabolic status.
Conclusions:
In-body BIA and DXA provided overall good agreement at the group level in Tibetan adults, but the agreement was inferior in participants being overweight or obese.
Multimorbidity, especially physical–mental multimorbidity, is an emerging global health challenge. However, the characteristics and patterns of physical–mental multimorbidity based on the diagnosis of mental disorders in Chinese adults remain unclear.
Methods
A cross-sectional study was conducted from November 2004 to April 2005 among 13,358 adults (ages 18–65years) residing in Liaoning Province, China, to evaluate the occurrence of physical–mental multimorbidity. Mental disorders were assessed using the Composite International Diagnostic Interview (version 1.0) with reference to the Diagnostic and Statistical Manual of Mental Disorders (3rd Edition Revised), while physical diseases were self-reported. Physical–mental multimorbidity was assessed based on a list of 16 physical and mental morbidities with prevalence ≥1% and was defined as the presence of one mental disorder and one physical disease. The chi-square test was used to calculate differences in the prevalence and comorbidity of different diseases between the sexes. A matrix heat map was generated of the absolute number of comorbidities for each disease. To identify complex associations and potential disease clustering patterns, a network analysis was performed, constructing a network to explore the relationships within and between various mental disorders and physical diseases.
Results
Physical–mental multimorbidity was confirmed in 3.7% (498) of the participants, with a higher prevalence among women (4.2%, 282) than men (3.3%, 216). The top three diseases with the highest comorbidity rate and average number of comorbidities were dysphoric mood (86.3%; 2.86), social anxiety disorder (77.8%; 2.78) and major depressive disorder (77.1%; 2.53). A physical–mental multimorbidity network was visually divided into mental and physical domains. Additionally, four distinct multimorbidity patterns were identified: ‘Affective-addiction’, ‘Anxiety’, ‘Cardiometabolic’ and ‘Gastro-musculoskeletal-respiratory’, with the digestive-respiratory-musculoskeletal pattern being the most common among the total sample. The affective-addiction pattern was more prevalent in men and rural populations. The cardiometabolic pattern was more common in urban populations.
Conclusions
The physical–mental multimorbidity network structure and the four patterns identified in this study align with previous research, though we observed notable differences in the proportion of these patterns. These variations highlight the importance of tailored interventions that address specific multimorbidity patterns while maintaining broader applicability to diverse populations.