Search Results (19,293)

This narrative review explores the interconnected relationship between quality of life (QoL) and satisfaction with nursing care (SNC) among cancer patients, recognizing that cancer’s burden extends beyond survival and significantly affects physical, psychological, and social well-being. A non-systematic search of PubMed, CINAHL, Scopus, and Google Scholar (2000–2025) identified relevant literature using keywords related to oncology nursing, QoL, SNC and patient satisfaction. Inclusion criteria encompassed peer-reviewed studies (quantitative, qualitative, and reviews) involving adult cancer populations and validated assessment instruments. Pediatric and non-nursing studies were excluded. Both QoL and SNC are critical outcomes in cancer care. QoL is an individual’s subjective perception and SNC reflects the patient’s subjective evaluation of how well nursing services align with their expectations, encompassing empathy, competence, and responsiveness. Research consistently demonstrates a strong positive association between high SNC and superior QoL outcomes, particularly through effective pain and symptom management, reducing psychological distress, and fostering patient empowerment. This relationship, however, is moderated by factors such as the patient’s disease stage, the type of care (hospital vs. palliative/home care), and organizational deficits like high nurse workload, which can undermine the delivery of high-quality care. Ultimately, ethical nursing practices are crucial for translating professional duty into positive patient experiences that are favorably linked with both SNC and QoL outcomes for cancer patients. Full article

Subjective grip strength and subjective walking speed may reflect actual grip strength and walking speed, respectively, in older adults. We examined whether pre-frailty could be identified using subjective motor ability. This cross-sectional observational study included 367 community-dwelling older adults who participated in physical fitness sessions in 2023. Frailty status was assessed using the revised Japanese Cardiovascular Health Study (J-CHS) criteria. A modified J-CHS classification was constructed by replacing the grip strength and walking speed components of the revised J-CHS criteria with subjective grip strength and subjective walking speed, respectively. Physical function was compared between the robust and pre-frail groups using analysis of covariance. Agreement between the revised J-CHS criteria and the modified J-CHS classification using the “disagree only” threshold was 79.0%, with a weighted kappa coefficient of 0.692. Subjective grip strength showed moderate discriminative performance for identifying objective low grip strength, whereas subjective walking speed showed lower discriminative performance for identifying objective slow walking speed. Comparisons of physical function revealed significantly lower physical function in the pre-frail group than in the robust group for both classifications. These findings suggest that subjective motor ability may help screen for pre-frailty in community-dwelling older adults. Full article

Background/Objectives: Obstructivesleep apnea (OSA) is one of the most widespread forms of sleep disease, affecting over 936 million adults globally. The health consequences of obstructive sleep apnea (OSA) are well documented; however, it remains largely underdiagnosed because the current gold-standard diagnostic method, polysomnography (PSG), is often costly, time-consuming, and unavailable in many healthcare settings. To address these challenges, this study presents a novel explainable deep learning (DL) framework for automated multi-class OSA severity classification using single-lead electrocardiogram (ECG) signals. Methods: The proposed framework integrates a hybrid CNN–BiLSTM architecture with explainable artificial intelligence (XAI) techniques to generate clinically meaningful predictions and explanations across four OSA severity classes: Normal, Mild, Moderate, and Severe. The framework was evaluated using the publicly available PhysioNet Apnea-ECG dataset (70 recordings) together with an institutional ECG dataset (150 recordings), resulting in a combined cohort of 220 recordings. Results: The proposed framework achieved an overall classification accuracy of 94.7%, with sensitivity and specificity values of 92.3% and 96.1%, respectively. Furthermore, the proposed model consistently outperformed conventional machine learning algorithms, including Support Vector Machine (SVM), Random Forest, and XGBoost, by 5.5%, 4.2%, and 2.9%, respectively. To enhance transparency and clinical trust, SHAP (SHapley Additive exPlanations) was employed to identify the most influential physiological predictors driving model decisions. Heart rate variability features, particularly RMSSD and pNN50, emerged as the strongest indicators of OSA severity. Moreover, computational efficiency analysis revealed that the model required only 0.23 s to process a 60 s ECG epoch on a standard computing platform, supporting its suitability for real-time deployment. Conclusions: The findings demonstrate that explainable deep learning applied to ECG signals can provide accurate, interpretable, and computationally efficient assessment of OSA severity. The proposed framework may support OSA screening, clinical triage, and early intervention, particularly in resource-constrained healthcare environments. Full article

Developmental and/or epileptic encephalopathy with spike-wave activation in sleep (D/EE-SWAS), previously described as continuous spike-wave during slow-wave sleep (CSWS) or electrical status epilepticus in sleep (ESES), is a childhood-onset disorder characterized by cognitive, language, behavioral, and/or motor regression or stagnation associated with marked activation of epileptiform discharges during non-rapid eye movement sleep. Three themes are central to the evolving understanding of D/EE-SWAS. First, it is a network disorder in which thalamocortical dysfunction, impaired sleep-dependent synaptic homeostasis, and potentially neuroinflammatory mechanisms contribute to neurodevelopmental deterioration. Second, increasing recognition of its genetic and structural heterogeneity is reshaping diagnostic evaluation. Monogenic etiologies are identified in up to one-third of cases, with a higher yield in the developmental and epileptic encephalopathy subtype, supporting early genomic testing alongside prolonged sleep EEG, MRI, and serial neuropsychological assessment. Third, treatment remains empiric and constrained by limited comparative evidence. Corticosteroids retain the strongest evidence base for cognitive improvement, although the overall certainty of this evidence remains low to moderate. Benzodiazepines are commonly used alternatives, and epilepsy surgery can provide substantial benefit in appropriately selected patients with focal structural abnormalities. Emerging etiology-directed therapies, including L-serine for selected GRIN loss-of-function variants and primidone for TRPM3-related disease, illustrate a broader transition from syndrome-based to precision management. However, no pharmacological therapy is specifically approved for D/EE-SWAS, long-term neurodevelopmental morbidity remains common, and adequately powered trials using standardized EEG and neurocognitive outcomes are urgently needed. Full article

Postural assessment is fundamental for the diagnosis and monitoring of musculoskeletal disorders. While single-camera structured light systems exist, they often lack the capability for simultaneous full-body capture, potentially leading to motion artifacts and incomplete analysis of the postural chain. This technical note utilizes a dual-camera architecture to explore the clinical feasibility and identify postural correlations in a healthy male sample. A cross-sectional exploratory study was conducted on 44 healthy male subjects (age 25–65 years). Posture was assessed using a Spine3D system equipped with two Time-of-Flight (ToF) cameras for instantaneous, radiation-free acquisition. Descriptive statistics and a Pearson correlation analysis (with FDR correction) were calculated for 38 postural parameters. Data normality was verified, and effect sizes were interpreted according to standard thresholds. The analysis identified that approximately 21% (148 out of 703 possible pairs) of correlations were statistically significant (p_FDR < 0.05). Among the most clinically meaningful were a strong positive correlation between cervical and lumbar lordosis (r = +0.666) and a moderate negative correlation between cervical lordosis depth and craniovertebral angle (r = −0.465), indicating that a more pronounced cervical curve is associated with a more protruded head posture. The dual-camera structured light system demonstrated potential clinical utility for a global and rapid postural assessment. The data confirm the close interdependence between various body segments, emphasizing the importance of a holistic approach. However, as an exploratory technical note, future rigorous studies are needed to establish reliability and validate these findings against radiographic gold standards. Full article

Heavy metal contamination poses significant ecological and public health concerns due to its persistence, toxicity, and bioaccumulative potential of toxic metals, threatening environmental quality and sustainable development. This study evaluated the distribution, pollution status, health risks, and sources of heavy metals in soils from industrial, agricultural, and residential areas of Rivers State, Nigeria, using Inductively Coupled Plasma–Mass Spectrometry (ICP-MS). Elevated concentrations of As, Mn, Se, Zn, and Co were detected across the study locations. Arsenic recorded the highest concentration in the Trans-Amadi industrial area (366.8 mg/kg), while Mn and Zn reached maximum concentrations of 1312 mg/kg and 327.9 mg/kg in Woji and Egi, respectively, exceeding the DPR limits for soil HMs. Pollution indices, including contamination factor, geo-accumulation index, enrichment factor, pollution load index, and Nemerow Integrated Pollution Index, revealed moderate to severe contamination, with the industrial zone exhibiting a NIPI value of 12.5. Health risk assessment identified ingestion as the dominant exposure pathway. Hazard quotient values for As (9.15) in the children category exceeded USEPA-acceptable limits, indicating potential non-carcinogenic risks. Carcinogenic risk assessment identified arsenic as the principal carcinogenic contaminant, with ingestion-derived Incremental Lifetime Cancer Risk (ILCR) values in the industrial area exceeding the USEPA maximum acceptable lifetime cancer risk threshold (1 × 10⁻⁴), particularly among children, whereas the carcinogenic risks associated with the other investigated metals generally remained within acceptable or tolerable limits. Source identification indicated that industrial emissions, vehicular activities, waste disposal, and agricultural practices were the primary contributors to heavy metal accumulation. These findings provide critical scientific evidence for targeted remediation, pollution prevention, and informed health-risk environmental management to protect soil quality, ecosystem integrity, and public health. The study supports evidence-based policies that advance sustainable land management, environmental protection, and progress in Rivers State, Nigeria. Full article

Background/Objectives: Post-radiation sarcomas (PRS) are secondary malignancies occurring years after radiotherapy. Due to low incidence, evidence on prognostic factors and management is limited. Methods: MEDLINE, Embase, and the Cochrane Library were searched from January 1960 to January 2026. Eligible studies included observational cohorts reporting outcomes of histologically confirmed PRS. We excluded case reports, case series with fewer than ten patients, reviews, editorials, and studies without survival or recurrence outcomes. Two authors independently screened studies, extracted data, and assessed risk of bias. Hazard ratios (HRs) and 95% confidence intervals were extracted or calculated. The primary outcome was overall survival. Heterogeneity was assessed using the I² statistic. This study was registered with PROSPERO (CRD42023457401). Results: The search identified 4222 records, of which 28 studies comprising 2438 patients were eligible for analysis. Most patients were female (2008, 83.3%), reflecting a predominance of breast radiation-associated angiosarcoma. Older age, larger tumor size, higher histological grade, and positive surgical margins were consistently associated with worse overall survival. Complete (R0) resection was associated with improved survival (pooled HR < 1.0), as was treatment in specialized sarcoma centers. Chemotherapy and additional radiotherapy were not associated with improved overall survival. Substantial heterogeneity was observed (I² > 50% for several analyses). Overall risk of bias was moderate. Conclusions: PRS share key prognostic determinants with sporadic sarcomas. Complete surgical resection and management in specialized sarcoma centers are the most important factors associated with improved outcomes. These findings support centralized care and highlight the need for prospective research to improve risk stratification and management of PRS. Full article

Background: Radiographic differentiation of odontogenic cysts remains challenging due to overlapping imaging features and limited specificity of conventional assessment. Radiomics offers a quantitative approach to extract imaging biomarkers that may improve non-invasive lesion characterization. Accurate differentiation among cyst subtypes is clinically relevant, as different odontogenic cysts may warrant different management and follow-up strategies. Methods: This study included 63 patients with histopathologically confirmed odontogenic cysts (odontogenic keratocyst [OKC], n = 33; radicular cyst [RC], n = 12; dentigerous cyst [DC], n = 10; odontogenic cyst, not otherwise specified [OC-NOS], n = 8). Panoramic radiographs were manually segmented to define cyst and anatomical regions of interest. Radiomic features were extracted using three groups: agnostic texture features, morphological/intensity descriptors, and perilesional features. Classification was performed using logistic regression with leave-one-out cross-validation. Pairwise and four-class classification analyses were conducted, and feature importance was evaluated. Results: Radiomic features demonstrated significant differences between cyst and anatomical regions, with approximately 60% of features remaining significant after correction. Pairwise classification performance varied across lesion types, achieving the highest balanced accuracy for DC vs. OC-NOS (0.838) and OKC vs. OC-NOS (0.752), while comparisons involving OKC vs. RC (0.602) and OKC vs. DC (0.644) were less discriminative. Texture-based features, particularly NGTDM-derived metrics, were among the most informative. The integration of morphological and perilesional features improved performance: four-class balanced accuracy increased from 0.416 with texture-only features to 0.487 with the combined feature set (p = 0.002). Conclusions: Radiomics-based analysis of panoramic radiographs enables moderate but preliminary differentiation of odontogenic cysts, with performance comparable to prior studies. The inclusion of perilesional and spatial features enhances classification, highlighting the importance of contextual information. Despite these advances, substantial overlap between cyst types persists, underscoring the need for multimodal diagnostic approaches and further validation in larger cohorts. Full article

Background/Objectives: Prolonged sedentary behavior is associated with adverse cardiometabolic risk, but the acute metabolic effects of interrupting sitting remain incompletely quantified in apparently healthy populations. The objective was to evaluate the acute effects of interrupting prolonged sitting on glucose, insulin and lipid metabolism and to identify potential protocol-level moderators. Methods: We conducted a three-level meta-analysis of randomized crossover trials comparing structured sitting interruptions with uninterrupted sitting in apparently healthy participants, an approach used to account for the statistical dependency among multiple effect sizes reported within individual studies. PubMed, Embase, Web of Science, Scopus and Cochrane Library were searched from inception through March 2026. Standardized mean differences (Hedges’ g) were calculated using random-effects models with robust variance estimation. Subgroup analyses and meta-regression examined interruption modality, intensity, frequency and duration. Certainty of evidence was assessed using GRADE. Results: The evidence base comprised 25 publications representing 23 independent cohorts; primary outcome analyses included 23 cohorts (135 effect sizes). Sitting interruption produced small but significant reductions in glucose (g = −0.28, 95% CI −0.49 to −0.08; PI −1.15 to 0.59) and insulin (g = −0.22, 95% CI −0.36 to −0.07; PI −0.51 to 0.07). No significant effect was observed for triglycerides (g = −0.04, 95% CI −0.14 to 0.07), whereas the exploratory estimates for non-esterified fatty acids (NEFA) and C-peptide were inconclusive. Subgroup analyses did not identify any statistically significant moderators of glucose, insulin or triglyceride responses; all subgroup estimates drawn from fewer than five independent cohorts are exploratory and hypothesis-generating. Meta-regression identified no statistically significant linear moderators. Certainty of evidence was low for all three primary outcomes (glucose, insulin and triglycerides) and very low for the exploratory outcomes (NEFA and C-peptide). Conclusions: Interrupting prolonged sitting may produce modest acute improvements in glucose and insulin responses in apparently healthy participants but does not reliably affect triglyceride metabolism. Given the low certainty of the current evidence, sitting interruption may be considered a low-burden adjunctive behavior for reducing uninterrupted sitting time. However, the current evidence primarily supports the hypothesis that interrupting prolonged sitting is a promising behavioral strategy rather than an evidence-based clinical recommendation, and its metabolic effects require confirmation in adequately powered, higher-quality trials. Full article

Background: T-cell redirecting therapies (TCRTs), including CAR T-cell therapies and bispecific antibodies, have transformed treatment for relapsed/refractory multiple myeloma (MM), yet real-world adoption remains limited by awareness and access barriers across patients, caregivers, and physicians. Methods: We conducted a cross-sectional study (June–September 2025) using IRB-approved REDCap surveys distributed to patients with MM (via MyChart), caregivers of TCRT recipients (via email), and community physicians (via email). Surveys assessed TCRT familiarity, perceived barriers, and access challenges. The primary objective was to compare TCRT utilization across racial groups among previously treated patients. Results: A total of 428 respondents participated (346 patients, 51 caregivers, 31 physicians). Among patients, 18% were Black. Overall, 26% were unfamiliar with TCRT, with higher unawareness among Black patients (32% vs. 25%) and those with ≤high school education (42% vs. 23%). Higher education was associated with twice the odds of TCRT utilization (p = 0.05). Among patients reporting prior MM treatment, TCRT utilization was similar across racial groups (39% Black vs. 38% non-Black). Among patients reporting TCRT receipt, Black patients more frequently reported receiving therapy through clinical trials compared with non-Black patients (44% vs. 34%). Among caregivers, 53% reported effects on mental/emotional wellness, 61% moderate-to-high stress during treatment, and 33% provided >40 h/week of care during month one. Among physicians, 71% referred patients for TCRT, but 48% reported <25% of referrals resulted in treatment. Patient hesitancy was the most cited referral barrier. Conclusions: Awareness gaps disproportionately affect Black patients and those with lower education. Caregivers experience substantial emotional and time burden. Patient hesitancy remains the primary barrier to TCRT referrals. Clinical trials may serve as an alternative access pathway for some patients. Multi-level interventions targeting education, caregiver support, and care coordination are needed to improve equitable TCRT access. Full article

Background: Shear wave elastography (SWE) and myotonometry are commonly used to assess muscle stiffness, but they reflect different aspects of tissue mechanics. SWE allows layer-specific evaluation, whereas myotonometry captures the response of a broader tissue complex. The contribution of individual layers to MyotonPRO-derived stiffness remains unclear. This study examined the relationship between MyotonPRO stiffness and layer-specific SWE measurements in the tibialis anterior muscle. Methods: In this cross-sectional study, 56 healthy adults were evaluated. Muscle stiffness was assessed using MyotonPRO and SWE across three regions of interest: superficial tissues including skin, subcutaneous tissue, and deep fascia (ROI 1); muscle tissue excluding fascia (ROI 2); and a composite region including all tissues from the skin surface to a depth of 2 cm (ROI 3). Relationships were analyzed using Spearman correlation, multiple linear regression, and Bland–Altman analysis. Results: Moderate but consistent correlations were observed between MyotonPRO stiffness and SWE values in ROI 2 (ρ = 0.516, p < 0.001) and ROI 3 (ρ = 0.550, p < 0.001), whereas no significant association was found in ROI 1. SWE values in ROI 2 and ROI 3 were significant predictors of MyotonPRO stiffness, explaining 38% of the variance. Bland–Altman analysis demonstrated moderate agreement with a systematic bias toward higher MyotonPRO values. Conclusions: MyotonPRO-derived stiffness reflects a composite mechanical response of muscle and surrounding tissues, with the strongest associations observed in regions encompassing both muscle and fascia. These findings highlight the importance of tissue composition and ROI selection in stiffness assessment and may facilitate more accurate interpretation of MyotonPRO measurements in musculoskeletal diagnostics and rehabilitation. Full article

Background: Carbapenem-resistant Acinetobacter baumannii is a critical priority pathogen of the Acinetobacter calcoaceticus-Acinetobacter baumannii Complex (Acb Complex) characterized by extensive multidrug resistance, leading to increased reliance on last-line polymyxins and widespread use of cationic disinfectants in healthcare settings. However, shared membrane-targeting mechanisms raise concerns regarding potential cross-resistance between disinfectants, polymyxins, and cationic antimicrobial peptides. Methods: A diverse panel of clinical A. baumannii isolates from Australia (n = 9), Pakistan (n = 15), and Switzerland (n = 3), and standard strains (n = 3), including polymyxin-resistant laboratory and clinical mutant strains (n = 4), was used. Minimum inhibitory concentrations (MICs) of polymyxin B, colistin, three cationic disinfectants (polyquaternium-1; PQ-1), polyhexamethylene biguanide (PHMB), and chlorhexidine (CHX), and four Antimicrobial peptides (AMPS: LL-37, melimine, Mel4, and lactoferricin) were determined using broth microdilution. Correlations between MICs were assessed using Spearman analysis, and differences between polymyxin-resistant and -susceptible isolates were analyzed statistically. Results: Most isolates were susceptible to polymyxins. The MIC data confirmed that one mutant strain, A. baumannii 19606 (R), and three clinical isolates displayed high-level polymyxin B and colistin resistance. PQ-1 exhibited the greatest antibacterial activity among disinfectants, while LL-37 showed the lowest and most consistent MICs among AMPs; lactoferricin was largely inactive. Within this exploratory strain collection, polymyxin-resistant isolates exhibited lower MICs to PQ-1 and PHMB, indicating collateral susceptibility. Correlation analysis revealed significant negative correlations between polymyxin susceptibility and disinfectant MICs (colistin–PQ-1 (r = −0.67 and p = 0.0001), colistin–PHMB (r = −0.44 and p = 0.05), and polymyxin B–PHMB (r = −0.48 and p = 0.005), whereas no consistent correlation was observed between polymyxins and AMPs, including LL-37. A moderate positive correlation was identified between colistin and Mel4 activity (r = 0.45 and p = 0.05). Conclusions: These findings indicate diverse susceptibility patterns of A. baumannii to cationic antimicrobials. Within this exploratory strain collection, polymyxin resistance was not associated with reduced susceptibility to disinfectants or most antimicrobial peptides and was instead associated with lower MICs to certain disinfectants. No evidence of cross-resistance between polymyxins and LL-37 was observed under the conditions tested, suggesting that polymyxin resistance does not necessarily confer reduced in vitro susceptibility to this host defense peptide. Given the small number of polymyxin-resistant isolates, these findings should be considered hypothesis-generating and require confirmation in larger collections of genetically characterized strains. Further mechanistic studies are needed to determine the biological basis and generalizability of these observed susceptibility patterns. Full article

In this study, we introduce a rational, surfactant-free synthetic strategy for the scalable preparation of relatively uniform spherical mesoporous silica with moderate-to-high surface area particles (MSPs), engineered specifically as advanced heterogeneous catalytic supports. Leveraging Ostwald ripening as the core morphogenetic driver—rather than conventional organic structure-directing agents—our approach improves process simplicity and reduces reliance on organic templates. Precise pH modulation to 8.0 using biocompatible organic acids enables controlled silica dissolution–reprecipitation kinetics, yielding MSPs with good spherical morphology, a relatively narrow particle-size distribution, a specific surface area of up to 484 m²/g, and uniform mesopores centered at approximately 3.02 nm. A systematic pH-screening study reveals a distinct structural transition: at pH < 7.5, incomplete condensation and suppressed ripening yield polydisperse aggregates with disordered worm-like porosity; at pH > 8.5, accelerated silicate dissolution induces particle coalescence and partial mesostructural degradation. Critically, pore ordering, channel dimensionality, surface area, and particle morphology are all systematically influenced by pH, establishing it as a key synthetic parameter for hierarchical textural programming. This study compares the methoxychlor (MXC) removal efficiency of polyhedral Bi₂WO₆ and Bi₂WO₆/MSP under identical irradiation conditions to assess MSPs’ catalytic impact. The enhanced photocatalytic performance is mainly associated with the improved dispersion of Bi₂WO₆ and enhanced interfacial contact between Bi₂WO₆ and the silica support. Considering the substantial decrease in surface area and pore volume after Bi₂WO₆ loading, the role of MSP is discussed primarily as an interfacial support rather than as a fully open mesoporous transport network in the final composite. Full article

Landslides and collapses seriously threaten the safety of residents in Xiangtan County, Hunan Province, southern China. Local human engineering activities, dominated by slope cutting for housing construction, create steep artificial free faces, greatly weakening slope stability and becoming the key anthropogenic driver aggravating geological hazard risks, while targeted quantitative susceptibility assessment for residential slope units is still lacking for precise disaster prevention. To fill this gap and support proactive geohazard mitigation, this study selects Xiangtan County as the research object. A total of 166 landslide and collapse hazard points and 869 moderately and highly susceptible residential slope units were collected, and 12 conditioning factors, such as relative height difference, average slope and engineering rock mass group, were subsequently screened. Three hybrid intelligence models, namely PSO-BP, PSO-RF and PSO-SVM, were established to map residential slope unit susceptibility across the whole study area. The ROC-AUC and Kappa coefficient were adopted to quantify and compare the predictive performance of each model, and the Jenks natural breakpoint method combined with field survey data was used to classify all 7257 residential slope units into three susceptibility grades. The evaluation results show that the PSO-RF model performs best with an AUC of 0.913 and a Kappa coefficient of 0.64, representing strong predictive reliability. Under this optimal model, moderate-susceptibility units account for 12.94% (939 units) and high-susceptibility units account for 0.69% (50 units), both of which are concentrated in the southwest, southeast and partially northern zones of the county where intensive human slope-cutting activities prevail. This research provides a feasible technical framework for identifying high-risk residential slopes and delivers clear data support for local geohazard risk control and disaster reduction. In summary, the PSO-RF hybrid model is proven suitable for fine-scale susceptibility assessment of residential slopes in hilly regions with frequent small-sized slope failures. Full article

As the primary substitutes for traditional brominated flame retardants, organophosphate esters (OPEs) are widely employed in industrial manufacturing and consumer products, and they have been detected in most rivers across China. The Zhuozhang River, a major tributary of the Haihe River, is situated in a region characterized by intensive anthropogenic activities and water scarcity. Nevertheless, research on OPE contamination and its associated environmental impacts in the Zhuozhang River basin remains limited. To address this knowledge gap, this study investigated the occurrence, sources, and ecological risks of 12 OPEs in water samples collected from representative sites, including major reservoirs, upstream river sections, main river channels, and wastewater treatment plants. The results showed that tris(2-chloroethyl) phosphate (TCEP) and triethyl phosphate (TEP) were the dominant compounds by mass, with concentrations ranging from 1108 to 1977 ng/L and 202 to 238 ng/L in the mainstream. Ecological risk assessment using the RQ method revealed that EHDPP and TDCIPP fall into the moderate-risk category. The positive matrix factorization (PMF) model was applied to explore the sources of OPEs. The results show that plastic-related industries most likely serve as the dominant contributors to OPE contamination. Full article