Search Results (92)

Background/Objective: This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). Methods: In this retrospective cohort study using the 2011–2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status. Frail patients were then classified according to malnutrition and anemia status. Frailty was determined using the revised risk analysis index (RAI-rev). Our primary outcomes were extended length of stay (LOS), non-routine discharge (NRD), 30-day adverse events (AE), and 30-day mortality. For each outcome, we fitted four nested multivariable logistic regression models (RAI-rev + anemia + malnutrition, RAI-rev + anemia, RAI-rev + malnutrition, and RAI-rev alone) and compared the incremental discrimination of each model using receiver operating characteristic (ROC) analysis. Results: Of 3639 patients, 460 were frail alone, 266 were frail + anemic, 37 were frail + malnourished, 121 were frail + anemic + malnourished, and 2755 were not frail. RAI-rev (aOR: 1.84, 95% CI: 1.45–2.35), anemia (aOR: 1.84, 95% CI: 1.45–2.35), and malnourishment (aOR: 2.34, 95% CI: 1.69–3.24) were independent predictors of extended LOS. RAI-rev (aOR: 1.07, 95% CI: 1.04–1.11) and anemia (aOR: 2.09, 95% CI: 1.66–2.61) were associated with an increased risk of 30-day AEs. RAI-rev and malnutrition were independent predictors of NRD (RAI-rev: aOR: 1.11, 95% CI: 1.06–1.16; Malnutrition: aOR: 1.57, 95% CI: 1.08–2.29) and 30-day mortality (RAI-rev: aOR: 1.10, 95% CI: 1.04–1.17; Malnutrition: aOR: 3.79, 95% CI: 1.24–11.60). Based on ROC analysis, RAI-rev + anemic + malnourished was a superior predictor of LOS and 30-day AEs (both p < 0.001). Compared to RAI-rev, RAI-rev + anemic superiorly predicted LOS and 30-day AEs, and RAI-rev + malnutrition superiorly predicted LOS (all p < 0.001). Conclusions: Our results reveal RAI-rev combined with malnutrition and anemia superiorly predicts 30-day AEs and LOS in postoperative ASD patients. Future studies should investigate the feasibility and efficacy of these models for perioperative risk stratification and optimized recovery planning to improve outcomes for ASD patients. Full article

Background and Objectives: Neonatal respiratory distress syndrome (NRDS), resulting from a deficiency of pulmonary surfactant (PS), can cause alveoli to collapse. Glucocorticoids reduce inflammation and are effective in reducing pulmonary swelling. This study aims to assess the effectiveness of the combination of PS and budesonide in the management of NRDS. Materials and Methods: Publications between 21 May and 24 November were screened through PubMed, Cochrane and Embase. Data analysis was performed on RevMan 5.3 software. Subgroup analysis was performed to evaluate the routes of administrations. Results: The use of budesonide along with pulmonary surfactant for treating NRDS revealed the following results: (1) a reduced duration of invasive mechanical ventilation (standardized mean difference (SMD) = −1.06, 95% confidence interval (CI) = −1.55 to −0.56, p < 0.0001); (2) reduced rate of bronchopulmonary dysplasia (BPD) occurrence (relative risk (RR) = 0.72, 95% CI = 0.60 to 0.86, p = 0.0003); (3) reduced duration for hospital admittance (SMD = −0.38, 95% CI = −0.64 to −0.11, p = 0.005). The occurrence of complications, i.e., sepsis, pneumothorax, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), rate of mortality, hyperglycemia and intraventricular hemorrhage (IVH), was not significantly different among the intervention and comparison group except for patent ductus arteriosus (PDA) and pulmonary hemorrhage, with their incidence being higher in the control group (p = 0.002 and p = 0.05, respectively). Conclusions: The combination of pulmonary surfactant and budesonide decreases the occurrence of BPD, duration of mechanical ventilation, length of hospital stay and risk of pulmonary hemorrhage and PDA. It does not increase the risk of complications and death and is clinically safe. Full article

Background/Objectives: The tumor microenvironment (TME) plays a critical role in cancer progression by shaping immune responses and influencing patient outcomes. We hypothesized that the relative proximity of specific immune cell pairs to cancer cells within the TME could help predict their pro- or anti-tumor functions and reflect clinically relevant immune dynamics. Methods: We analyzed imaging mass cytometry (IMC) data from lung adenocarcinoma (LUAD) and triple-negative breast cancer (TNBC) cohorts. For each immune cell pair, we calculated a relative distance (RD) score, which quantifies the spatial difference in proximity to cancer cells. We assessed the prognostic and predictive significance of these RD-scores by comparing them with conventional features such as cell fractions, densities, and individual cell distances. To account for variations in cell abundance, we also derived normalized RD-scores (NRD-scores). Results: RD-scores were more strongly associated with overall patient survival than standard immunological metrics. Among all immune cell pairs, the RD-score comparing the proximity of B cells to that of intermediate monocytes showed the most significant association with improved survival. In TNBC, RD-scores also improved the distinction between responders and non-responders to immunochemotherapy and chemotherapy. Normalized RD-scores reinforced these findings by minimizing the influence of cell density and further highlighting the importance of immune cell spatial relationships. Conclusions: RD-scores offer a spatially informed biomarker that outperforms traditional metrics in predicting survival and treatment response. This approach provides a new perspective on immune cell behavior in the TME and has potential utility in guiding personalized cancer therapies and patient stratification. Full article

Aspergillus flavus can produce aflatoxins, posing a threat of contamination to peanuts. To mitigate this issue, the use of biocontrol isolates, which do not produce aflatoxins (AF⁻), has been considered to reduce aflatoxin levels. In this study, we evaluated five different AF⁻ isolates belonging to different vegetative compatibility groups, all of which exhibited varying degrees of deletion in aflatoxin biosynthesis gene clusters. One isolate that exhibited poor competitive ability against toxigenic A. flavus was eliminated, and the remaining four isolates were formulated as biocontrol agents and applied to a peanut field in Tai’an, Shandong, as a combination. Three months after application, the soil aflatoxin content was reduced from 0.62 ± 0.01 to 0.19 ± 0.03 μg/kg (inhibition rate: 69.35%). Among filamentous fungi in the soil, the proportion of AF⁻ isolates increased from 0% to 4.33%. Using SSR-specific primers, the microbial agents were recovered. We discovered that among the four AF⁻ isolates, CA04 had a lower colonization rate compared to the other three (only 12.00% of the total AF⁻ population), suggesting that the absence of sclerotia may result in poor reversibility and weaker dispersal ability. We utilized Illumina sequencing to investigate the changes in soil fungal ecology. The results showed a reduction in the population density of harmful fungi, such as Fusarium spp. (66.18%) and Plectosphaerella spp. (79.90%), but an increase in the density of Nothopassalora personata. This is the first study on the dispersal distance and soil fungal community structure following the application of AF⁻ agents in peanut fields in China. Full article

Background: Chronic mitral regurgitation (MR) is categorized into primary and secondary MR (SMR). While primary MR arises from structural abnormalities of the mitral valve apparatus, SMR is a consequence of cardiac remodeling, typically due to heart failure or atrial fibrillation. Management strategies differ significantly, with primary MR requiring direct valvular intervention and SMR necessitating a comprehensive approach incorporating guideline-directed medical therapy (GDMT), revascularization, and resynchronization strategies. The MitraClip, a transcatheter edge-to-edge repair (TEER) device, has emerged as a recommended intervention for symptomatic severe SMR despite optimal GDMT. Objectives: This study aims to evaluate national trends in MitraClip placements in the U.S. from 2016 to 2021 and to assess 90-day readmission events following the procedure. Additionally, we analyze patient and socioeconomic factors associated with heart failure readmissions post-MitraClip placement to optimize patient selection criteria. Methods: The study utilized data from the National Inpatient Sample (NIS) for the years 2016–2021 and the National Readmissions Database (NRD) for 2021. Patients who underwent MitraClip placement were identified using ICD-10 code 02UG3JZ. We stratified the population based on demographics, hospital resource utilization, and comorbidities. Index admissions were classified based on the presence or absence of heart failure remissions within 90 days post-procedure. Statistical analyses, including ANOVA and logistic regression, were conducted to identify factors associated with readmissions. Results: MitraClip utilization demonstrated a rising trend from 2016 to 2021, with total annual procedures increasing from 869 to 2488. Mean patient age remained stable at 76–79 years, with a nearly equal sex distribution. In-hospital mortality remained low (1–3%) throughout the study period. A steady increase in hospital charges was observed, alongside a decline in the mean length of stay. Analysis of 4918 index admissions for MitraClip placement in 2021 identified 780 total readmissions within 90 days, with 206 (26.4%) attributed to heart failure. Factors significantly associated with increased risk of heart failure readmissions included atrial fibrillation (OR 3.77, CI 1.82–4.23), pulmonary hypertension (OR 3.96, CI 1.49–5.55), and chronic lung disease (OR 1.91, CI 1.32–2.77). Conclusions: The increasing adoption of MitraClip underscores its growing role in managing SMR. However, heart failure readmissions remain a significant concern. Identifying high-risk patient profiles can refine selection criteria and enhance post-procedural management strategies to improve clinical outcomes. Further research is needed to optimize patient selection and refine risk stratification for MitraClip interventions. Full article

Background: Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for severe aortic stenosis in high- and intermediate-risk patients, with expanding indications for lower-risk populations. However, post-procedural complications, such as stroke, conduction disturbances, and heart failure readmissions, remain concerns. The aim of our study is to analyze the national trends in TAVR procedures, in-hospital outcomes, major readmission causes, and the association of risk factors for readmissions following TAVR. Methods: We analyzed NIS data (2018–2022) to assess TAVR utilization trends, patient demographics, and in-hospital outcomes. The NRD (2021–2022) was used to evaluate 60-day readmission rates for stroke, complete heart block, and heart failure. Multivariate regression models were employed to identify risk factors having significant association with major readmission causes. Results: TAVR utilization increased from 10,788 cases in 2018 to 17,784 in 2022, with a concurrent decrease in in-hospital mortality (1.33% to 0.90%) and length of stay (3.88 to 2.97 days). Of 123,376 TAVR index admissions in 2021, 28,654 patients had 66,100 readmission events (53.57%) in the 60 days following discharge. Heart failure (17,566 cases, 26.57% of readmissions) was the most common readmission cause, followed by complete heart block (1760 cases, 2.66% of readmissions) and stroke (284 cases, 0.42% of readmissions). Predictors of post-TAVR stroke included uncontrolled hypertension (OR 2.29, p < 0.001) and chronic heart failure (OR 2.73, p < 0.001). Left bundle branch block (LBBB) was strongly associated with complete heart block (OR 12.89, p < 0.001) and heart failure readmissions (OR 7.65, p < 0.001). Conclusions: TAVR utilization has increased with improving perioperative outcomes, but post-TAVR readmissions remain significant, particularly for heart failure, stroke, and conduction disturbances. Pre-procedural uncontrolled hypertension, hyperlipidemia, congestive heart failure, and atrial fibrillation were risk factors with significant association with stroke in the 60 days following TAVR. The presence of documented pre-procedural LBB, RBB, as well as BFB were risk factors with significant association with complete heart block following TAVR placements. Pre-procedural LBB, RBB, BFB, and atrial fibrillation were risk factors having significant association with heart failure readmissions in the 60 days following TAVR. Full article

Background/Objectives: Primary spondylodiscitis (SD) cases surging in incidence globally remain a diagnostic and therapeutic challenge for physicians. The effect of lesion location on outcomes remains unclear. This study aims to assess the 90-day all-cause readmission rate in patients suffering from spondylodiscitis in different regions of the spine, with a secondary objective of comparing in-hospital mortality rates. Methods: Utilizing the 2020 Nationwide Readmissions Database (NRD), USA, adult patients (>18 years) were selected by diagnosis with ICD-10 codes for primary spondylodiscitis. Patients were categorized by localization into eight groups, excluding multifocal patients. Comparative analysis and logistic regressions were performed. Results: Among 5547 patients, lumbar SD was most prevalent, followed by thoracic and lumbo-sacral regions. Cervical SD had the lowest readmission rate (31.3%) and lower odds versus lumbar SD (adjusted OR = 0.73; p = 0.007). Other regions showed no significant differences. In-hospital mortality varied by location. The sacral region, renal failure, and advanced age were the strongest mortality predictors. Conclusions: While the incidence of spondylodiscitis varies by location on the spine, we found no significant differences in readmission rates across regions. However, there were substantial differences in in-hospital mortality rates. Comorbidities, particularly renal failure and advanced age, appear to outweigh spinal localization as risk factors for mortality and readmission. Full article

This study, for the first time in Italy, analyses by WGS a Streptococcus agalactiae strain isolated from a non-pregnant adult affected by Meningitis and without common risk factors. The S. agalactiae strain was classified as a serotype II (SS2), sequence type ST569. Molecular characterization evidenced the presence of resistance genes to tetracycline and macrolide (tet(M) and mre(A)) and several virulence genes coding for adhesion and immune evasion factors (bca, cps family, neu family, scpB, gbs family, pil family and hylB), toxins (cfa/cfb, cyl family), pro-inflammatory factors (lepA), and two homologous genes that contributed to bacterial escape from the host immune system (lmb, luxS). SNP analysis showed 18 different alleles, with 9 missense SNP mutations related to genes involved in cellular metabolism (dhaS, ftsE, ligA, nrdD and secA), virulence (bgrR and galE) and antimicrobial resistance (glpK and mutL). SNPs in glpK and mutL genes might reduce susceptibility to drugs. The SNP analysis highlighted the presence of mutations conferring pathogenicity to the strain. The evidence in this study could explain the development of Meningitis in a healthy patient. This case highlights the importance of using molecular methods to characterize the complete genome of a bacterial species that could seriously affect human health. Full article

Background: Heart transplantation (Htx) remains the definitive therapy for patients with end-stage heart failure. Despite advancements in mechanical circulatory support (MCS), immunosuppressive strategies, and organ allocation policies, donor availability remains a major limitation. This study analyzes the trends in Htx in the United States between 2016 and 2022, focusing on demographic shifts, mortality trends, and 30-day readmission patterns. Methods: We utilized the National Inpatient Sample (NIS) from 2016 to 2022 and the National Readmissions Database (NRD) for 2021 to identify Htx admissions using ICD-10 PCS code O2YA0Z0. Patient characteristics, mortality rates, and readmission patterns were analyzed using ANOVA and multivariate logistic regression, with statistical significance defined as p < 0.05. Results: The total number of Htx procedures increased from 641 in 2016 to 773 in 2022. The mean age of transplant recipients remained between 45 and 50 years, with no significant differences across years. Racial and socioeconomic disparities persisted, with approximately 60% of transplants occurring in White patients and 21–26% of recipients belonging to the lowest income quartile. All-cause in-hospital mortality remained stable at 4–7%. The 30-day readmission rate in 2021 was 57.7%, with heart failure, transplant rejection, and infections being the leading causes. Peripheral vascular disease (PVD) was the only comorbidity significantly associated with higher 30-day readmission risk (OR: 1.815, 95% CI: 1.477–2.230). Conclusions: Htx utilization has increased over time, driven by improvements in donor allocation and perioperative management. However, racial and socioeconomic disparities remain, and readmission rates continue to be high. Future efforts should focus on optimizing post-transplant care and addressing disparities to improve long-term outcomes. Full article

Soil active nitrogen (N) fractions are essential for plant growth and nutrient cycling in terrestrial ecosystems. While previous studies have primarily focused on the impact of vegetation restoration on soil active nitrogen in karst ecosystems, the role of microclimate variation in rocky desertification areas has not been well explored. This study investigates soil active nitrogen fractions and key biotic and abiotic factors across four grades of rocky desertification—non-rocky desertification (NRD), light rocky desertification (LRD), moderate rocky desertification (MRD), and intense rocky desertification (IRD)—within two distinct microclimates: a dry-hot valley and a humid monsoon zone in the karst region of Guizhou Province, China. We evaluate soil organic carbon (SOC), total nitrogen (TN), total phosphorus (TP), soil nitrate nitrogen (NO₃⁻-N), ammonium nitrogen (NH₄⁺-N), microbial biomass nitrogen (MBN), soluble organic nitrogen (SON), and plant diversity. Results showed that SOC, TN, and TP were significantly higher in IRD areas. Soil NO₃⁻-N, MBN, and SON initially decreased before increasing, with consistent MBN growth in the dry-hot valley. NH₄⁺-N did not differ significantly under NRD but was higher in the dry-hot valley under LRD, MRD, and IRD. The dry-hot valley had higher MBN and SON across most desertification grades. Microclimate significantly influenced soil active N, with higher levels in the dry-hot valley under LRD and MRD conditions. Plant diversity and regeneration varied markedly between the microclimates. In the dry-hot valley, Artemisia dominated herbaceous regeneration, especially in MRD areas. Conversely, the humid monsoon zone showed more diverse regeneration, with Artemisia and Bidens prevalent in MRD and NRD grades. Despite declining plant diversity with desertification, the humid monsoon zone displayed greater resilience. These findings highlight the role of microclimate in influencing soil nitrogen dynamics and plant regeneration across rocky desertification gradients, offering insights for restoration strategies in karst ecosystems. Full article

Background: Upper Gastrointestinal Bleed (UGIB) is a common and potentially life-threatening condition with an annual incidence of 80–150 per 100,000 individuals and a mortality rate of 2–10%. Esophagogastroduodenoscopy (EGD) is the gold standard for both diagnosis and treatment, but post-discharge outcomes, including readmissions, remain underexplored. Methods: This study utilized the 2021 National Readmission Database (NRD) to analyze 30-day readmission rates following EGD for UGIB. Adult patients (≥18 years) admitted for UGIB and undergoing EGD were included; those who died during the index hospitalization were excluded. Demographic, clinical, and socioeconomic factors associated with readmission were examined using multivariate logistic regression. Results: Among 34,257 patients admitted for UGIB and undergoing EGD, 11,088 (32.4%) were readmitted within 30 days, with 5423 (49%) due to recurrent UGIB. Readmitted patients had a higher mean age (68.46 vs. 67.63 years) and greater prevalence of cirrhosis (16.71% vs. 13.84%). Hospital resource utilization was significantly higher among readmissions, with increased total hospital charges (USD 82,544.82 vs. USD 61,521.17) and longer hospital stays (5.38 vs. 4.97 days). Mortality was lower among readmitted patients (1.46% vs. 3.53%). Multivariate analysis identified cirrhosis (OR 7.20, 95% CI: 6.45–8.02), untreated H. pylori infection (OR 3.43, 95% CI: 2.15–4.30), atrial fibrillation (OR 1.52, 95% CI: 1.36–1.69), and chronic antithrombotic therapy (OR 1.63, 95% CI: 1.41–1.89) as significant predictors of recurrent UGIB readmission. Lower socioeconomic status was also associated with increased readmission risk (OR 1.15, 95% CI: 1.05–1.25). Conclusions: Readmission following EGD for UGIB is common and driven primarily by recurrent bleeding. Cirrhosis, untreated H. pylori infection, atrial fibrillation, and chronic anticoagulation therapy are key risk factors. These findings highlight the need for targeted interventions, including improved post-discharge management and optimization of anticoagulation strategies, to reduce readmission rates and improve patient outcomes. Full article

Background: Diabetes insipidus affects heart failure outcomes through its impact on volume status and electrolyte imbalance. However, previous data on its impact on heart failure hospitalizations are limited. This study aimed to evaluate the prognostic implications of diabetes insipidus in patients admitted with heart failure. We utilized the United States National Readmissions Database (NRD) from the years 2016 to 2021. Methods: Adult patients hospitalized with a primary diagnosis of heart failure were stratified based on the presence of diabetes insipidus. Propensity matching was used to balance the baseline characteristics. Multivariable logistic regression was used to estimate the association of heart failure with diabetes insipidus on clinical outcomes, complications, 30-day readmissions, and healthcare utilization. Results: Among 5,946,749 heart failure hospitalizations, 2846 (0.04%) had a secondary diagnosis of diabetes insipidus. Compared with matched control, patients with heart failure and diabetes insipidus had significantly higher in-hospital mortality (odds ratio [OR] 5.77 [95% CI, 4.78–6.97], p < 0.001). Patients with heart failure and diabetes insipidus were also associated with increased odds of acute kidney injury (OR 2.11 [95% CI, 1.86–2.39], p < 0.001), hypernatremia (OR 4.98 [95% CI, 1.86–2.39], p < 0.001), cardiogenic shock (OR 1.69 [95% CI, 1.32–2.15], p < 0.001), and cerebral edema (OR 22.28 [95% CI, 14.74–33.69], p < 0.001) compared with the matched controls. No difference was found in the all-cause readmission (OR 0.89 [95% CI, 0.76–1.04], p = 0.14), but patients with diabetes insipidus had a lower risk of heart failure readmissions (OR 0.47 [95% CI, 0.33–0.66], p < 0.001) and a higher risk of non-cardiac readmissions (OR 2.21 [95% CI, 1.48–3.9], p < 0.001). Conclusions: Diabetes insipidus was associated with worse outcomes in patients with primary heart failure hospitalizations, which was likely secondary to the risk of excessive diuresis. Full article

Theoretically, regions with rich natural resources often tend to develop resource-based industries more intensively, resulting in resource-dependent land development. China’s resource-dependent cities exhibit certain exceptions. Natural resource dependence (NRD) plays a relatively positive role in the total factor productivity change (TFPCH) in these cities, primarily attributable to their relatively mature technological efficiency. However, while such positive impacts exist, their overall effect remains limited. Many resource-based cities in China still face challenges in achieving sustainable growth. This raises a key question: why have some resource-based cities failed to achieve sustainable development? In order to explore the root cause of this problem, this paper systematically analyses the impact of resource dependence on TFPCH, and its governance mechanism based on the balanced panel data of 112 resource cities in China from 2003 to 2021, using the Super-SBM-DEA-Malmquist index method in the first stage, and the OLS model in the second stage. The main findings of this paper are as follows: First, NRD has a significantly positive impact on TFPCH, especially in growing and regenerating cities. The empirical results further validate the applicability of the resource blessing theory in China. Second, government regulation has a dampening effect on TFPCH in resource cities, which suggests that in the future development of resource cities, government intervention should be moderately reduced, and more emphasis should be placed on stimulating the city’s own autonomous mobility and endogenous development drive. Third, heterogeneity analyses show that this promotional effect is mainly realized through the improvement of technical efficiency. Fourth, the analysis of the moderation effect shows that research and development (R&D) intensity plays a positively moderating role in the sustainable development of resource-based cities. Through a stepwise approach, this paper reveals why resource-based cities cannot achieve sustainable development. The level of R&D in some resource-based cities remains relatively low, while it is the key factor for the applicability of the resource blessing (RB) hypothesis in China’s resource city. The findings not only provide new perspectives for theoretical research, but also important policy recommendations for the sustainable governance of land use in resource-based cities worldwide. Full article

Background/Objectives: Spondylodiscitis (SD) is a challenging and multifaceted condition with increasing incidences globally. Mental health disorders (MHDs) are well recognized for their negative impacts on outcomes. To our knowledge, the effects of MHDs on SD have not been studied. This study aims to assess the incidence of MHDs in patients hospitalized for SD, and their impact on 90-day all-cause readmission rates using the Nationwide Readmission Database (NRD). Methods: A retrospective analysis using the 2020 NRD was performed. Adult patients were selected by primary ICD-10 codes for SD. MHDs were defined by ICD-10 F-codes. Demographic and clinical data were extracted, and readmissions were identified using VisitLinks. Patients were stratified based on MHD presence, with statistical analyses conducted to identify independent risk factors for readmission. Results: Of a total of 6139 patients, 3771 (61.4%) had an MHD. The overall 90-day readmission rate was 35%, with MHD patients experiencing a significantly higher rate (36.1%). Substance-related disorders, particularly opioid (OR 1.187, p = 0.019) and alcohol use disorders (OR 1.310, p = 0.020), were independently associated with increased readmission risk. Although common, depression, anxiety, schizophrenia, and personality disorders were not significant predictors. Conclusions: MHDs are prevalent among SD patients and are associated with an increased risk of hospital readmission, particularly in those with substance-related disorders. Integrating mental health interventions into SD management may improve patient outcomes. This study is limited by the use of an administrative database, which may lead to potential under-reporting of clinical variables. Future research may explore targeted interventions to optimize care for this high-risk population. Full article

The decomposition-based multi-objective optimization algorithm MOEA/D (multi-objective evolutionary algorithm based on decomposition) introduces the concept of neighborhood, where each sub-problem requires optimization through solutions within its neighborhood. Due to the comparison being only with solutions in the neighborhood, the obtained set of solutions is not sufficiently diverse, leading to poorer convergence properties. In order to adequately acquire a high-quality set of solutions, this algorithm requires a large number of population iterations, which in turn results in relatively low computational efficiency. To address this issue, this paper proposes an algorithm termed MOEA/D-NRD, which is based on neighborhood region domination in the MOEA/D framework. In the improved algorithm, domination relationships are determined by comparing offspring solutions against neighborhood ideal points and neighborhood worst points. By selecting appropriate solution sets within these comparison regions, the solution sets can approach the ideal points more and faster, thereby accelerating population convergence and enhancing the computational efficiency of the algorithm. Full article