This study aimed to examine the associations among the International Classification of Functioning, Disability, and Health (ICF) core sets relevant to chronic ischemic heart disease (CIHD) using the least absolute shrinkage and selection operator (LASSO) model based on the ICF core sets scale in Chinese patients. This was a prospective study of 120 patients with CIHD selected from January 2013 to June 2014 at the Fada Institute of Forensic Medicine & Science (Beijing, China). Functioning was qualified using the ICF core sets checklist for CIHD (Chinese version). The variables of core set categories of the ICF assessment scale for CIHD were entered into the LASSO model for mining dependencies among those variables. Graphical modeling was applied using LASSO generalized linear models. “Muscle endurance functions”, “sensations associated with cardiovascular and respiratory functions”, “blood vessel functions”, and “heart functions” were the most injured in CIHD status. “Recreation and leisure” and “intimate relationships” were the most affected in CIHD status. “General social support services, systems, and policies” and “acquaintances, peers, colleagues, neighbors, and community members” were important for the outcome of functional status of the CIHD patient. “Economic self-sufficiency” and “family relationships” of the CIHD patient were not undermined in most cases. Graphical modeling can be used to describe associations between different areas of functioning in CIHD patients. The results suggest that these associations could be used as basis to improve rehabilitation and provide a deeper understanding of functioning in Chinese CIHD patients.

Crashes involving vulnerable road users (VRUs) are types of traffic accidents which take up a large proportion and cause lots of casualties. With methods of statistics and accident reconstruction, this research investigates 378 actual traffic collisions between vehicles and VRUs in China in 2021 to obtain human, vehicle, and road factors that affect the injury severity. The paper focuses on risky behaviors of VRUs and typical scenarios such as non-use of the crosswalk, violation of traffic lights, stepping into the motorway, and riding against traffic. Then, based on the Bayesian General Ordinal Logit model, influencing factors of injury severity in 168 VRU accidents are analyzed. Results demonstrate that the probability of death in an accident will rise when the motorist is middle-aged and the VRU is an e-bicycle rider; the probability of death in an accident will greatly decrease when the VRU bears minor responsibility. Therefore, middle-aged motorists and e-bicycle riders should strengthen safety consciousness and compliance with regulations to prevent accident and reduce injury for VRUs. In addition, helmet-wearing will help to reduce riders’ injuries. This research may provide ideas for intelligent vehicles to avoid collisions with risky VRUs.

Rationale: Individuals diagnosed with neurofibromatosis type I (NF1) commonly present with neurofibromas, and a subset may progress to develop malignant peripheral nerve sheath tumors (MPNST) during their lifetime. Diagnosing and treating MPNST, typically linked to NF1, poses challenges for clinicians due to its histopathological complexity. Patient concerns: A 25-year-old male presented with postprandial discomfort and vomiting, subsequently developing left mid-abdominal pain. Diagnoses: The patient was admitted to the hospital, where a low-density retroperitoneal mass was detected via computed tomography (CT). Histopathological examination revealed spindle-shaped tumor cells characterized by abundant cytoplasm and highly pigmented nuclei, demonstrating pathological nuclear division. The tumor cells exhibited partial cytoplasmic positive for S-100 and focal cytoplasmic positive for cytokeratin (CK) and desmin, as determined by immunohistochemical staining. Genetic analysis of blood and extracted tissues identified an NF1 missense mutation. Prior research corroborated the pathological diagnosis of MPNST exhibiting both epithelial and myogenic differentiation. Interventions: A retroperitoneal mass excision was conducted, revealing a mass located in the retroperitoneal omental sac. Outcomes: Approximately 5 hours after surgery, the patient’s blood pressure exhibited a gradual decline. An emergency laparotomy was conducted. Approximately 3000 mL of blood was identified in the upper abdominal cavity. The patient’s blood pressure consistently declined and ultimately resulted in death after 2 days. Lessons: It is crucial to assess the potential for heterogeneous differentiation in MPNST during pathological diagnosis. In the treatment of MPNST with heterogeneous differentiation, particularly in cases with significant tumor bulk, surgeons must anticipate potential hemorrhagic complications and adopt a cautious approach to surgical intervention.