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The wettability mechanism of soil–water interfaces is of significant importance in geotechnical engineering. However, the effect of different contact angles on unsaturated sand soil behavior has been less understood. In this study, the wetting behavior of nano water droplets on various silica substrates is investigated using molecular dynamics. Seventeen groups of simulation systems with different interaction potential energies ($\varepsilon _{\mathrm{Si}} = 0.008$, 0.04, 0.2, 0.4, 0.6, 0.8, 1, 2 kcal/mol) and temperatures ($T = 273$, 298, 323, 353 K) are conducted. The results show that the contact angles varies intensively with interaction potential energies from 108.5° to 18.1°, which indicates a transition from hydrophobic to hydrophilic and wettability enhancement along with the increase of interaction potential energy. Simulation results also show that contact angles increase with the increase of temperature, whatever the hydrophobic or hydrophilic of the silica surface. Such phenomena are interpreted from the perspective of microstructure, along with the performance of macrostructure. In addition, results show that the contact angles are independent of the thickness and width (length) of silica substrate.

A highly efficient, transition-metal- and light-free approach to polyheterocycles via regioselective cascade radical cyclization is developed. The redox-neutral protocol has a broad substrate scope with good functional group tolerance and probably undergoes a SET process, which is initiated by catalytic amounts of quinone in combination with 2.0 equiv. of Cs2CO3.

Abstract Expressway networks are continuously developing and emergency rescue demand is increasing proportionately. The location of expressway emergency rescue nodes needs refinement to meet changing requirements. In this study, the expressway was modeled as an expressway network. The differences in the origin destination (OD) distribution matrices for working days and major holidays were used as the bases for determining the need for temporary emergency rescue nodes. Overlapping and non-overlapping community detection algorithms were used to extract the distribution characteristics of OD during both day categories. These distributions were used to determine permanent and temporary emergency rescue sites. In this study, we considered the differences in traffic volume, distance, and impact of four vehicle types on traffic accidents to select the location of emergency rescue nodes, and allocate emergency resources. An emergency rescue node selection model for an expressway network was established based on spatio-temporal characteristics. The results based on a regional example determined that 22 permanent and 25 temporary emergency rescue nodes were appropriate. The average rescue time for traffic accidents during working days and major holidays compared to the P-center location model, was reduced by approximately 27.08% and 6.70%, respectively. The coefficient of variation of emergency rescue time was reduced by approximately 28.22% and 21.41%, respectively. The results indicated that the model satisfied the expressway emergency rescue demand requirements, and improved the rationality of the rescue center node layout.

The aim of this study was to investigate the global epidemiological trends in the incidence and deaths of acute respiratory infections (ARIs), encompassing both upper respiratory infections (URIs) and lower respiratory infections (LRIs), from 1990 to 2021. Using data from the Global Burden of Disease study 2021 (GBD 2021), we utilized the average annual percentage change (AAPC) to examine the trends in the age-standardized incidence rate and deaths rate (ASIR and ASDRs) of URIs and LRIs. In 2021, the global ASIR of URIs and LRIs were 166,770.73 (95 % UI: 148,098.16–189,487.93) per 100,000 and 4283.61 (95 % UI: 4057.03–4524.89) per 100,000, respectively. The highest ASIR of URIs occurred in high-sociodemographic index (SDI) regions (232744.64, 95 % UI: 206887.07–261694.81) per 100,000, whereas LRIs occurred in low-SDI regions (9261.1, 95 % UI: 8741.61–9820.86) per 100,000. In 2021, the global ASDRs of URIs and LRIs were 0.28 (95 % UI: 0.09–0.61) per 100,000 and 28.67 (95 % UI: 25.92–31.07) per 100,000, respectively. The highest ASDRs of both URIs and LRIs were observed in low-SDI regions, with 1.1 (95 % UI: 0.08–2.78) per 100,000 and 70.68 (95 % UI: 62.56–78.62) per 100,000, respectively. From 1990 to 2021, the global ASIR for URIs and LRIs decreased, with AAPCs of −0.17 % (95 % CI: 0.17 % to −0.16 %) and −1.28 % (95 % CI: −1.37 % to −1.22 %), respectively. The global ASDRs also decreased (−3.39 % for URIs; −2.46 % for LRIs). However, during the COVID-19 pandemic, the ASIR of URIs increased in many countries, especially in high-SDI regions (rate difference before and during the COVID-19 pandemic in ASIR was 2210.19 per 100,000.) and low-SDI regions (rate difference in ASIR: 111.26 per 100,000). The global incidence and deaths related to ARIs have decreased over the past 32 years. However, it remains a significant public health concern, particularly due to the notable incidence of URIs in high SDI regions and the deaths associated with both URIs and LRIs in low SDI regions. Furthermore, an increase in the incidence of URIs was observed in both high- and low-SDI regions during the COVID-19 pandemic, highlighting the need for increased attention.

In the post-COVID-19 pandemic era, influenza virus infections continuously lead to a global disease burden. Evaluating vaccine effectiveness against influenza infection is crucial to inform vaccine design and vaccination strategy. In this study, we recruited 1120 patients with influenza-like illness (ILI) who attended fever clinics of 4 sentinel hospitals in the Ili Kazakh Autonomous Prefecture, Xinjiang Uygur Autonomous Region, China, from January 1 to April 7, 2024. Using a test-negative design, we estimated influenza vaccine effectiveness (VE) of 54.7% (95% CrI: 23.7, 73.1) against medical-attended influenza infection, with 62.3% (95% CrI: 29.3, 79.8) against influenza A, and 51.2% (95% CrI: 28.7, 83.0) against influenza B. Despite the moderate VE estimated in this study, influenza vaccination remains the most important approach to prevent influenza at the community level.

To study the vehicle–bridge interaction (VBI) of highway bridges under seismic excitation, a vehicle–bridge couple analysis method based on Ansys is proposed. The 1/2 vehicle model and space beam element model were established to analyze the VBI response of Lanzhou Xiaoshagou bridge. The self-excited excitation of the system is represented by road surface irregularity randomness, while the external excitation is represented by an earthquake. The impact of seismic types, seismic direction, seismic intensity, vehicle speed, and road surface irregularity on the bridge vibration under the vehicle–bridge coupling during an earthquake is thoroughly analyzed. The results reveal that the type of earthquake significantly influences the dynamic response of the bridge, showing a minimum difference of 31.4%. The intensity of the earthquake is positively correlated with the dynamic response of the bridge. Longitudinal and vertical earthquakes have a more noticeable effect on the bridge’s vertical vibration compared to lateral earthquakes. The ratio of the bridge response under vertical or longitudinal seismic excitation to the response of lateral earthquakes ranges from 1.50 to 26.61. Vehicle speed, road irregularity grade, and randomness have a negligible impact on the dynamic response of vehicle–bridge interaction under an earthquake, accounting for less than 3%. These findings indicate that the analysis of earthquake-bridge vibration can simplify the VBI analysis for continuous rigid frame composite box girder bridges with corrugated steel webs under seismic conditions.

Objective. Periodontitis is a chronic inflammatory disease that causes loss of periodontal support tissue. Our objective was to investigate the mechanism by which METTL3-mediated N6-methyladenosine modification regulates the osteogenic differentiation through lncRNA in periodontal mesenchymal stem cells in patients with periodontitis (pPDLSCs). Material and Methods. We carried out a series of experiments, including methylated RNA immunoprecipitation-PCR, quantitative real-time polymerase chain reaction, and western blotting. The expressions of alkaline phosphatase (ALP), Runx2, Col1, Runx2 protein level, ALP staining, and Alizarin red staining were used to demonstrate the degree of osteogenic differentiation. Results. We found that METTL3 was the most significantly differentially expressed methylation-related enzyme in pPDLSCs and promoted osteogenic differentiation of pPDLSCs. METTL3 regulated the stability and expression of lncRNA CUTALP, while lncRNA CUTALP promoted osteogenic differentiation of pPDLSCs by inhibiting miR-30b-3p. At different time points of osteogenic differentiation, lncRNA CUTALP expression was positively correlated with Runx2, while miR-30b-3p showed the opposite pattern. The attenuated osteogenic differentiation induced by METTL3 knockdown was recovered by lncRNA CUTALP overexpression. The attenuated osteogenic differentiation induced by lncRNA CUTALP knockdown could be reversed by the miR-30b-3p inhibitor. Conclusions. In summary, METTL3/lncRNA CUTALP/miR-30b-3p/Runx2 is a regulatory network in the osteogenic differentiation of pPDLSCs.

Abstract This study was designed to explore the effects of exosomal miR‐421 secreted by cancer‐associated fibroblasts (CAFs) on pancreatic cancer (PC) progression and the mechanisms involved. CAFs and exosomes (exos) were isolated and identified. PC cells were treated with CAF‐derived exos (CAF‐exos). Western blotting and quantitative polymerase chain reaction (qPCR) were used to measure miR‐421, sirtuin‐3 (SIRT3), and hypoxia duciblefactors‐1 alpha (HIF‐1α) levels. Cell counting kit‐8 (CCK‐8), wound‐healing, and transwell migration assays were used to measure proliferation, migration, and invasion abilities of the cells. Dual‐luciferase assay and RNA immunoprecipitation (RIP) experiment analyzed the relationship between miR‐421 and SIRT3. Chromatin immunoprecipitation (f)‐verified H3K9Ac enrichment in the HIF‐1α promoter region. In vivo tumorigenesis experiments were performed to further explore the effects of exosomal miR‐421 from CAFs on PC. CAFs and exos were successfully isolated. CAF‐exo‐treated PC cells highly expressed miR‐421 and had increased cell proliferation, migration, and invasion abilities. Knocking down miR‐421 increased the expression of SIRT3. SIRT3 is a target of miR‐421, and inhibiting the expression of SIRT3 reversed the negative effects of miR‐421 knockdown on PC cell. Knocking down miR‐421 in CAF‐exo inhibited the expression of HIF‐1α in PC cells. Moreover, SIRT3‐mediated HIF‐1α expression by regulating H3K9Ac. HIF‐1α overexpression reversed the inhibiting effects of SIRT3 overexpression on PC progression and counteracted the inhibiting effects of miR‐421 knockdown on glycolysis. Moreover, in vivo tumorigenesis experiments showed that knocking down miR‐421 attenuated CAF‐exo induced tumor growth. Exosomal miR‐421 from CAFs promoted PC progression by regulating the SIRT3/H3K9Ac/HIF‐1α axis. This study provided insights into the molecular mechanism of PC.

Abstract Traditional triboelectric tactile sensors based on solid–solid interface have illustrated promising application prospects through optimization approach. However, the poor sensitivity and reliability caused by hard contact-electrification still poses challenges for the practical applications. In this work, a liquid–solid interface ferrofluid-based triboelectric tactile sensor (FTTS) with ultrahigh sensitivity is proposed. Relying on the fluidity and magnetism of ferrofluid, the topography of microstructure can be flexibly adjusted by directly employing ferrofluid as triboelectric material and controlling the position of outward magnet. To date, an ultrahigh sensitivity of 21.48 kPa−1 for the triboelectric sensors can be achieved due to the high spike microstructure, low Young’s modulus of ferrofluid and efficient solid–liquid interface contact-electrification. The detection limit of FTTS of 1.25 Pa with a wide detection range to 390 kPa was also obtained. In addition, the oleophobic property between ferrofluid and poly-tetra-fluoro-ethylene triboelectric layer can greatly reduce the wear and tear, resulting in the great improvement of stability. Finally, a strategy for personalized password lock with high security level has been demonstrated, illustrating a great perspective for practical application in smart home, artificial intelligence, Internet of things, etc.

The existence of giant karst cave can cause collapse and water inrush hazards during the excavation of the karst tunnel, causing serious economic losses. In this paper, based on the FEA software MIDAS, a numerical simulation model for the backfilling of a large karst cave through a large cross-section tunnel was established. The distribution characteristics and change rules of the displacement field, stress field, horizontal support stress, and plastic zone of the tunnel surrounding rock and backfill were explored. The first stage of tunnel excavation leads to a sharp increase in the displacement of the tunnel’s surrounding rock and the deterioration of the plastic zone, which should be strengthened and monitored. The tunnel arch, waist, and wall footing areas were prone to stress concentration. The two layers of horizontal support force show a certain regularity, showing a sharp increase and a gradually smooth growth trend. Meanwhile, the site monitoring results for arch settlement and horizontal convergence of the mega cavern tunnel were analyzed. The results show that the numerical calculation results were in good agreement with the values of site monitoring data. The average errors of final crown settlement and horizontal convergence were 8.6% and 15.9%, respectively, which verified the correctness of the numerical modeling method. This project can provide reliable experience for the construction of similar large cavern tunnels.

Patients with type 2 diabetes mellitus (T2DM) often have cognitive impairment and structural brain abnormalities. The magnetic resonance imaging (MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function, and can therefore also be used to reflect whole-brain structural changes related to T2DM. A total of 136 participants (64 men and 72 women, aged 55–86 years) were recruited for our study between January 2014 and December 2016. All participants underwent MRI and Mini-Mental State Examination assessment (including 42 healthy control, 38 T2DM without cognitive impairment, 26 with cognitive impairment but without T2DM, and 30 T2DM with cognitive impairment participants). The total and sub-category brain atrophy and lesion index scores in patients with T2DM with cognitive impairment were higher than those in healthy controls. Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2DM patients with cognitive impairment and patients with T2DM and cognitive impairment. After adjusting for age, the brain atrophy and lesion index retained its capacity to identify patients with T2DM with cognitive impairment. These findings suggest that the brain atrophy and lesion index, based on T1-weighted and T2-weighted imaging, is of clinical value for identifying patients with T2DM and cognitive impairment. Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2DM that is complicated by cognitive impairment. This study was approved by the Medical Ethics Committee of University of South China (approval No. USC20131109003) on November 9, 2013, and was retrospectively registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900024150) on June 27, 2019.

Abstract Background School closure is a common mitigation strategy during severe influenza epidemics and pandemics. However, the effectiveness of this strategy remains controversial. In this study, we aimed to explore the effectiveness of school closure on seasonal influenza epidemics in provincial-level administrative divisions (PLADs) with varying urbanization rates in China. Methods This study analyzed influenza surveillance data between 2010 and 2019 provided by the Chinese National Influenza Center. Taking into consideration the climate, this study included a region with 3 adjacent PLADs in Northern China and another region with 4 adjacent PLADs in Southern China. The effect of school closure on influenza transmission was evaluated by the reduction of the effective reproductive number of seasonal influenza during school winter breaks compared with that before school winter breaks. An age-structured Susceptible-Infected-Recovered-Susceptible (SIRS) model was built to model influenza transmission in different levels of urbanization. Parameters were determined using the surveillance data via robust Bayesian method. Results Between 2010 and 2019, in the less urbanized provinces: Hebei, Zhejiang, Jiangsu and Anhui, during school winter breaks, the effective reproductive number of seasonal influenza epidemics reduced 14.6% [95% confidential interval (CI): 6.2–22.9%], 9.6% (95% CI: 2.5–16.6%), 7.3% (95% CI: 0.1–14.4%) and 8.2% (95% CI: 1.1–15.3%) respectively. However, in the highly urbanized cities: Beijing, Tianjin and Shanghai, it reduced only 5.2% (95% CI: -0.7–11.2%), 4.1% (95% CI: -0.9–9.1%) and 3.9% (95% CI: -1.6–9.4%) respectively. In China, urbanization is associated with decreased proportion of children and increased social contact. According to the SIRS model, both factors could reduce the impact of school closure on seasonal influenza epidemics, and the proportion of children in the population is thought to be the dominant influencing factor. Conclusions Effectiveness of school closure on the epidemics varies with the age structure in the population and social contact patterns. School closure should be recommended in the low urbanized regions in China in the influenza seasons. Graphical abstract

The aim of this study is to identify brain structures involved in the individual difference of nicotine susceptibility in rats with longitudinal magnetic resonance imaging (MRI). Adult male Sprague-Dawley rats were subjected to intermittent intraperitoneal nicotine injection for 14 days using a mini-osmotic pump, followed by forced withdrawal for 14 days. Somatic withdrawal behavioral signs test was performed on day 0, 15, and 29 to quantify nicotine dependence. Correlation analyses between the withdrawal behavior score and structural MRI indices on day 1 (baseline scan) revealed that the severity of nicotine dependence was negatively correlated with the gray matter (GM) volumes in bilateral prelimbic cortex/left granular insular cortex and the white matter volume in bilateral thalamus, but positively correlated with the GM volumes in right hippocampal CA1/left thalamus. It is proposed that the aforementioned structural indices may be used as biomarkers for nicotine susceptibility, predicting the risk of nicotine dependence before individuals are exposed to nicotine.

Biological sex may play a large role in cigarette use and cessation outcomes and neuroimaging studies have demonstrated that cigarette smoking is associated with sex-related differences in brain structure and function. However, less is known about sex-specific alterations in spontaneous brain activity in cigarette smokers. In this study, we investigated the sex-related effects of cigarette smoking on local spontaneous brain activity using regional homogeneity (ReHo) based on resting-state fMRI. Fifty-six smokers (24 females) and sixty-three (25 females) healthy non-smoking controls were recruited. Whole-brain voxelwise 2-way analysis of covariance of ReHo was performed to detect brain regions with sex-dependent alterations on the spontaneous brain activity. Compared to non-smokers, smokers exhibited significant ReHo differences in several brain regions, including the right medial orbitofrontal cortex extended to the ventral striatum/amygdala/parahippocampus, left precuneus, and bilateral cerebellum crus. Smoking and sex interaction analysis revealed that male smokers showed significantly lower ReHo in the right ventral striatum, left cerebellum crus1, and left fusiform gyrus compared to male non-smokers, whereas there are no significant differences between female smokers and non-smokers. Furthermore, the ReHo within the left cerebellum crus1 was negatively correlated with craving scores in male smokers but not in female smokers. Such sex-dependent differences in spontaneous brain activity lays a foundation for further understanding the neural pathophysiology of sex-specific effects of nicotine addiction and promoting more effective health management of quitting smoking.

Metabolic homoeostasis in adipose tissue plays a major role in obesity-related insulin resistance (IR). Regulatory T (Treg) cells have been recorded to regulate metabolic homoeostasis in adipose tissue. However, their specific mechanism is not yet known. This review aims to present the role of Treg cells and other immune cells in obesity-associated IR, focusing on the balance of numbers and functions of Treg cells and other immune cells as well as the crucial role of their interactions in maintaining adipose tissue homoeostasis. Th1 cells, Th17 cells, CD8+ T cells, and pro-inflammatory macrophages mediate the occurrence of obesity and IR by antagonizing Treg cells, while anti-inflammatory dendritic cells, eosinophils and type 2 innate lymphoid cells (ILC2s) regulate the metabolic homoeostasis of adipose tissue by promoting the proliferation and differentiation of Treg cells. γ δ T cells and invariant natural killer T (iNKT) cells have complex effects on Treg cells, and their roles in obesity-associated IR are controversial. The balance of Treg cells and other immune cells can help maintain the metabolic homoeostasis of adipose tissue. Further research needs to explore more specific molecular mechanisms, thus providing more precise directions for the treatment of obesity with IR.

Abstract Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of sudden cardiac death worldwide. Researchers have found significant pathophysiological differences between females and males and clinically significant sex differences related to medical services. However, conflicting results exist and there is no uniform agreement regarding sex differences in survival and prognosis after OHCA. Therefore, we investigated the relationship between the prognosis of OHCA and sex factors. Methods We comprehensively searched the PubMed, Embase, and Cochrane databases and obtained a total of 1042 articles, from which 33 studies were selected for inclusion. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Results The meta-analysis included 1,268,664 patients. Compared with males, females were older (69.7 years vs. 65.4 years, p

Objective To evaluate the joint effects of cerebral small vessel disease (CSVD)-related imaging biomarkers in patients of type 2 diabetes mellitus (T2DM) with cognitive impairment. Methods This study is a retrospective cohort study. A total of 227 participants (115 patients with T2DM and 112 healthy control subjects) were enrolled in this study. Cognitive function assessments were evaluated using the Mini-Mental State Examination and the Montreal Cognitive Assessment. The burden of CSVD markers, including the lacunes, white matter hyperintensities (WMH), cerebral microbleeds (CMBs), and enlarged perivascular spaces (PVS), was identified by magnetic resonance imaging and evaluated using small vessel disease (SVD) scores (0–4). The subjects were divided into two groups based on the results of the cognitive function assessments. The synergy index was used to estimate the biological interactions between T2DM and lacunes. Results There was a significant correlation between T2DM and cognitive impairment (p < 0.001, χ2 test). In patients with diabetes, cognitive impairment was significantly associated with both the presence of lacunes (p < 0.01, χ2 test) and increased total SVD burden scores (p < 0.01, χ2 test). Regarding CMBs, only the existence of lobar CMBs was correlated with cognitive impairment (p < 0.05, χ2 test). The joint effect tended to be larger than the independent effects of T2DM and lacunes on cognitive impairment (adjusted odds ratio [OR]: 7.084, 95% CI [2.836–17.698]; synergy index: 10.018, 95% CI [0.344–291.414]). Conclusions T2DM and the presence of lacunes are significantly correlated with cognitive impairment. There was a joint effect of T2DM and lacunes on cognitive impairment.

Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment in many domains. There are several pieces of evidence that changes in neuronal neuropathies and metabolism have been observed in T2DM. Structural and functional MRI shows that abnormal connections and synchronization occur in T2DM brain circuits and related networks. Neuroplasticity and energy metabolism appear to be principal effector systems, which may be related to amyloid beta (Aβ) deposition, although there is no unified explanation that includes the complex etiology of T2DM with cognitive impairment. Herein, we assume that cognitive impairment in diabetes may lead to abnormalities in neuroplasticity and energy metabolism in the brain, and those reflected to MRI structural connectivity and functional connectivity, respectively.

In order to further understand the instability mechanism and geohazard causation when the main sliding path of the slope body is parallel to the path of the bridge, the corresponding bridge-landslide parallel system is constructed for shaking table tests. This paper summarizes the combination forms of bridge-landslide model under different position and focused on the slope body located above the bridge deck. Firstly, based on the shaking table test results of El Centro (1940), the failure behavior of bridge-landslide parallel system was evaluated, and the changes of acceleration and deformation of bridge pile were subsequently analyzed. Then, the interaction bridge structure and sliding body were explained by the spectral features. The main conclusions are as follows. First, in the model test, the landslide belongs to the thrust-type landslide. Due to the barrier function of the bridge, the main failure site of landslide occurs in the middle and trailing edge of slope body. At the same time, the acceleration value of earthquake waves is 0.3 g, which is the key to this variation. Second, the acceleration response of the measuring points on the bridge pile and landslide increases with the increase of ground elevation. If the slope structure is damaged severely, the deformation response of weak interlayer is inconsistent with the surrounding soil structure. Third, with the increase of excitation power, the dominant frequency of bridge-landslide parallel system gradually transitions from low to high frequency rate, and the interaction of the parallel system weakens the influence of river direction on frequency. Finally, under the same working condition, the dynamic response of the measuring points has obvious regularity with the change of situation. But the response of the same points is not regular due to the different earthquake excitation intensity.

Calcified aortic valve disease (CAVD) is the most common valvular cardiovascular disease with increasing incidence and mortality. The primary treatment for CAVD is surgical or transcatheter aortic valve replacement and there remains a lack of effective drug treatment. Recently, lipoprotein (a) (Lp(a)) has been considered to play a crucial role in CAVD pathophysiology. Multiple studies have shown that Lp(a) represents an independent risk factor for CAVD. Moreover, Lp(a) mediates the occurrence and development of CAVD by affecting aortic valve endothelial dysfunction, indirectly promoting foam cell formation through oxidized phospholipids (OxPL), inflammation, oxidative stress, and directly promotes valve calcification. However, there is a lack of clinical trials with Lp(a) reduction as a primary endpoint. This review aims to explore the relationship and mechanism between Lp(a) and CAVD, and focuses on the current drugs that can be used as potential therapeutic targets for CAVD.

Abstract Background An efficient surface cleaning strategy would first target cleaning to surfaces that make large contributions to the risk of infections. Methods In this study, we used data from the literature about methicillin-resistant Staphylococcus aureus (MRSA) and developed an ordinary differential equations based mathematical model to quantify the impact of contact heterogeneity on MRSA transmission in a hypothetical 6-bed intensive care unit (ICU). The susceptible patients are divided into two types, these who are cared by the same nurse as the MRSA infected patient (Type 1) and these who are not (Type 2). Results The results showed that the mean MRSA concentration on three kinds of susceptible patient nearby surfaces was significantly linearly associated with the hand-touch frequency (p

Personal protective behaviors of healthcare workers (HCWs) and dynamic changes in them are known to play a major role in the hospital transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, 1,499 HCWs in Chinese hospitals completed an online survey about their knowledge on SARS-CoV-2 transmission and their personal protective behaviors before and after coronavirus disease 2019 (COVID-19) vaccination. Of all the respondents, 89% were vaccinated at the time of the survey and 96% believed that the vaccine was effective or highly effective. Further, 88% of the vaccinated HCWs expressed that they would get revaccinated if the vaccination failed. Compared with HCWs with a lower education level, those with a higher education level had less fear of being infected with SARS-CoV-2 and reported a lower negative impact of the pandemic on how they treated patients. Physicians and nurses were willing to believe that short-range airborne and long-range fomite are possible transmission routes. HCWs with a higher education level had a better knowledge of COVID-19 but worse personal protective behaviors. The fact that HCWs with a longer work experience had worse personal protective behaviors showed that HCWs gradually relax their personal protective behaviors over time. Moreover, vaccination reduced the negative effects of the COVID-19 pandemic on how the HCWs treated patients. Importantly, the survey revealed that after vaccination, HCWs in China did not relax their personal protective behaviors, and it may bring a low potential risk for following waves of variant virus (e.g., delta).

By the end of February 2021, COVID-19 had spread to over 230 countries, with more than 100 million confirmed cases and 2.5 million deaths. To control infection spread with the least disruption to economic and societal activities, it is crucial to implement the various interventions effectively. In this study, we developed an agent-based SEIR model, using real demographic and geographic data from Hong Kong, to analyse the efficiency of various intervention strategies in preventing infection by the SARS-CoV-2 virus. Close contact route including short-range airborne is considered as the main transmission routes for COVID-19 spread. Contact tracing is not that useful if all other interventions have been fully deployed. The number of infected individuals could be halved if people reduced their close contact rate by 25%. For reducing transmission, students should be prioritized for vaccination rather than retired older people and preschool aged children. Home isolation, and taking the nucleic acid test (NAT) as soon as possible after symptom onset, are much more effective interventions than wearing masks in public places. Temperature screening in public places only disrupted the infection spread by a small amount when other interventions have been fully implemented. Our results may be useful for other highly populated cities, when choosing their intervention strategies to prevent outbreaks of COVID-19 and similar diseases.

As past studies of self-control and Internet addiction showed mixed results, this meta-analysis of 83 primary studies with 80,681 participants determined whether (a) these students with less self-control had greater Internet addiction, and (b) age, culture, gender, Internet addiction measures, or year moderated these relations. We used a random-effects meta-analysis of Pearson product-moment coefficients r with Fisher’s z-transformation and tested for moderation with the homogeneity tests. The results showed a positive link between impulsivity and Internet addiction (r = 0.371, 95% CI = [0.311, 0.427]) and a negative link between restraint and Internet addiction (r = −0.362, 95% CI = [−0.414, −0.307]). The moderation analysis indicated that the correlation between impulsivity indicators and greater Internet addiction was stronger among undergraduates (18–22 years old) than among adolescents (10–17 years old). Furthermore, the negative link between a restraint indicator and Internet addiction was greater (a) among students in East Asia than those in Western Europe/North America, (b) among males than females and (c) when using the Internet addiction measures GPIUS or IAT rather than CIAS. Hence, these results indicate a negative link between self-control and Internet addiction, and this link is moderated by age, culture, gender, and Internet addiction measure.

Long-term therapy with levodopa (L-DOPA) in patients with Parkinson’s disease (PD) often triggers motor complications termed as L-DOPA-induced dyskinesia (LID). However, few studies have explored the pathogenesis of LID from the perspective of neuroanatomy. This study aimed to investigate macroscopic structural changes in a rat model of LID and the underlying histological mechanisms. First, we established the hemiparkinsonism rat model through stereotaxic injection of 6-hydroxydopamine (6-OHDA) into the right medial forebrain bundle, followed by administration of saline (PD) or L-DOPA to induce LID. Magnetic resonance imaging (MRI) and behavioral evaluations were performed at different time points. Histological analysis was conducted to assess the correlations between MRI signal changes and cellular contributors. Voxel-based morphometry (VBM) analysis revealed progressive bilateral volume reduction in the cortical and subcortical areas in PD rats compared with the sham rats. These changes were partially reversed by chronic L-DOPA administration; moreover, there was a significant volume increase mainly in the dorsolateral striatum, substantia nigra, and piriform cortex of the lesioned side compared with that of PD rats. At the striatal cellular level, glial fibrillary acidic protein-positive (GFAP+) astrocytes were significantly increased in the lesioned dorsolateral striatum of PD rats compared with the intact side and the sham group. Prolonged L-DOPA treatment further increased GFAP levels. Neither 6-OHDA damage nor L-DOPA treatment influenced the striatal expression of vascular endothelial growth factor (VEGF). Additionally, there was a considerable increase in synapse-associated proteins (SYP, PSD95, and SAP97) in the lesioned striatum of LID rats relative to the PD rats. Golgi-Cox staining analysis of the dendritic spine morphology revealed an increased density of dendritic spines after chronic L-DOPA treatment. Taken together, our findings suggest that striatal volume changes in LID rats involve astrocyte activation, enrichment of synaptic ultrastructure and signaling proteins in the ipsilateral striatum. Meanwhile, the data highlight the enormous potential of structural MRI, especially VBM analysis, in determining the morphological phenotype of rodent models of LID.

Background Understanding the transmission source, pattern, and mechanism of infectious diseases is essential for targeted prevention and control. Though it has been studied for many years, the detailed transmission patterns and drivers for the seasonal influenza epidemics in China remain elusive. Methods In this study, utilizing a suite of epidemiological and genetic approaches, we analyzed the updated province-level weekly influenza surveillance, sequence, climate, and demographic data between 1 April 2010 and 31 March 2018 from continental China, to characterize detailed transmission patterns and explore the potential initiating region and drivers of the seasonal influenza epidemics in China. Results An annual cycle for influenza A(H1N1)pdm09 and B and a semi-annual cycle for influenza A(H3N2) were confirmed. Overall, the seasonal influenza A(H3N2) virus caused more infection in China and dominated the summer season in the south. The summer season epidemics in southern China were likely initiated in the “Lingnan” region, which includes the three most southern provinces of Hainan, Guangxi, and Guangdong. Additionally, the regions in the south play more important seeding roles in maintaining the circulation of seasonal influenza in China. Though intense human mobility plays a role in the province-level transmission of influenza epidemics on a temporal scale, climate factors drive the spread of influenza epidemics on both the spatial and temporal scales. Conclusion The surveillance of seasonal influenza in the south, especially the “Lingnan” region in the summer, should be strengthened. More broadly, both the socioeconomic and climate factors contribute to the transmission of seasonal influenza in China. The patterns and mechanisms revealed in this study shed light on the precise forecasting, prevention, and control of seasonal influenza in China and worldwide.

Tree peony (Paeonia ostii) is an important ornamental plant with high oil and medical values and is widely distributed in China. In order to explore the effects of sucrose treatment on the growth of the P. ostii seeds and identify key genes involved in sucrose metabolism and transport during the early development of the P. ostii seeds, the comparative transcriptome sequencing of the P. ostii seed coats and endosperms at 50 days after flowering (DAF) with and without sucrose supply were conducted using Illumina HiSeq platform. A total of 97,976 unigenes were obtained and annotated with seven public function protein databases. There were 22,779, 22,632, 16,700, and 36,233 differentially expressed genes (DEGs) identified in the four comparisons, respectively. A total of 77 DEGs associated with the sucrose metabolism and transporter were identified in this study. Among them, sucrose transporter protein (SUT) and sweet sugar transporter (SWEET) were predicted to participate in sucrose transport from seed coat to embryo, and invertase (INV) was identified to be involved in sucrose degradation. In addition, sucrose synthase (SUS) and sucrose phosphate synthase (SPS) related to sucrose synthesis were highly expressed in seeds with sucrose supply. Finally, nine differentially expressed genes were selected randomly to analyze their expression levels using qRT-PCR, which were consistent with the transcriptome sequencing results. Above all, these results and analyses provide valuable gene resources and directions for further studying the effects of sucrose supply on the molecular mechanism of the sucrose metabolism and transporter during the development of P. ostii seeds.

To study the dynamic response and spectrum characteristics of the three-dimensional crossing tunnel under the action of seismic load, we established a 1/50 downscale model based on a typical of the oblique overlapped tunnel and conducted a series of shaking table tests. Through examining the recorded dynamic responses (acceleration and dynamic strain measured at different locations in model tunnels), we found that the seismic response of the crown was the largest at the central section, and the invert of the tunnels was exactly opposite to the crown, which presented a “parabolic” distribution, and we inferred that the damage within the model may be mainly concentrated on the crown of the tunnels. Additionally, the dynamic strain showed obvious nonlinear and nonstationary characteristics under the action of different degrees of seismic intensities. Different from a single tunnel, the acceleration superposition effect appears in the cross section of two tunnels because of the spatial effect of overlapping tunnels, resulting in the obvious seismic response in the cross section. Meanwhile, we also found that the 1st dominant frequency (0.1–6.26 Hz) seismic wave played a leading role in the process of tunnel slope failure. Furthermore, the analysis of the acceleration response spectrum also showed that the surrounding rock mass has an amplification effect on low-frequency seismic waves. These results help us better understand the features of the dynamic responses and also provide evidence to reinforce the overlapped tunnels against earthquakes.

This paper presents the seismic dynamic response and spectrum characteristics of an orthogonal overlapped tunnel by shaking table tests. First, a prototype of the engineering and shaking table test device, which was used to design details of the experiment, was developed. Then, the sensors used in the test were selected, and the measurement points were arranged. Subsequently, the Wenchuan seismic wave with horizontal direction in different peak ground accelerations was inputted into the model, followed by a short analysis of the seismic response of the overlapped tunnel in the shaking table test as well as the distribution of the peak acceleration. Throughout the studies, the model exhibited obvious deformation stages during the seismic wave loading process, which can be divided into elastic, plastic, plastic enhancement, and failure stage. In particular, the time- and frequency-domain characteristics of the key parts of the tunnel were discussed in detail by using the continuous wavelet transform (CWT) based on the Morlet wavelet as the basis function. We found that the acceleration response was more intense within 25–60 s after the seismic wave was inputted. Furthermore, owing to “the superposition effect,” the seismic response at the crown of the under-crossing tunnel was stronger than that at the invert of the upper-span tunnel. The low and medium frequencies in the transformation of small scales (5–20) significantly affected the overlapped tunnel. These results elucidate the seismic dynamic response of the overlapped tunnel and provide guidance for the design of stabilizing structures for reinforcing tunnels against earthquakes.

To explore the staged catastrophic evolution mechanism and failure process of bedding rock landslides under construction disturbance and rainfall conditions, we selected water content, displacement, strain, and soil stress as the study objects and carried out a model test. Combining the test phenomena, the following conclusions are drawn: first, bedding rock landslides have experienced three different stages of initial, constant velocity, and accelerated deformation affected by construction and rainfall factors. Then, the mode of bedding rock landslides is both sliding and traction sliding compound sliding mode. Finally, in the initial and constant deformation stages, the stress and strain values in the soil both increase slightly. In the accelerated deformation stage, the horizontal and vertical deformation at the slope foot increases sharply. Meanwhile, the strain value increases greatly, the stress decreases, and the stress in the slope increases significantly. Therefore, stress, strain, and displacement can be used as early warning indicators for staged disasters of bedding rock landslides.

To explore the optimal seismic performance of multianchor pile, we carried out a series of shaking table tests. Based on the special form of multianchor piles’ reinforcement, we put forward the optimal design scheme of using EPS foam as damping layers and energy-dissipation springs for improving the self-coordinating devices of anchor head. By measuring acceleration and dynamic soil-pressure response under different intensities of vibration, we analyzed the correlation between acceleration caused by seismic wave action and damage characterized by time-domain and spectral characteristics of dynamic soil-pressure. We discuss in detail the relationship between frequency and specific period of dynamic soil-pressure and acceleration. We then used the SPECTR program to calculate the energy spectrum. Under the reciprocating action of seismic waves of different intensities, our slope model showed the continuous effect of spatial coupling deformation leading to regional damage and failure. Furthermore, the spatial distribution for amplitude of acceleration and dynamic soil-pressure showed the outstanding response of lateral amplitude of pile structures without optimization. The energy-spectrum distribution of acceleration seismic input was orderly, while the dynamic soil-pressure distribution of piles was disordered. Low-frequency (≤10 Hz) seismic waves have a great influence on these structures. The difference of acceleration hysteresis along the elevations was mainly caused by the propagation stage after the main earthquake. The correlation between dynamic soil-pressure and acceleration response in each group before the pile occurred in the same earthquake area was very weak, showing a low correlation. The optimization effect of optimized structures is related to the position of the shock-absorbing layer. Under high acceleration, multianchor piles easily cause bulge failures or shear failures at the positions of sliding surfaces. These results are helpful for improvements to reliably optimize designs in pile structure dynamic parameters.

The electronic structure of GaSe/silicane (GaSe/SiH) van der Waals (vdW) heterostructure in response to a vertical electric field and strain was studied via first-principle calculations. The heterostructure had indirect band gap characteristics in the range [−1.0, −0.4] V/Å and direct band gap features in the range [−0.3, 0.2] V/Å. Furthermore, a type-II to type-I band alignment transition appeared at −0.7 and −0.3 V/Å. Additionally, the GaSe/SiH vdW heterostructure had a type-II band alignment under strain, but an indirect to direct band gap semiconductor transition occurred at −3%. These results indicated that the GaSe/SiH vdW heterostructure may have applications in novel nanoelectronic and optoelectronic devices.

To clarify the feasibility of BFRP (basalt fiber reinforced plastics) anchors instead of steel anchors in the seismic application of slopes under different vibration strengths, a series of shaking table tests were carried out to strengthen the slope using BFRP anchors and steel anchors, respectively. By studying the dynamic response recorded in the slope model and the observed experimental phenomena, the acceleration dynamic response and displacement spectrum dynamic response of the two slope models were analyzed. The test results show that the deformation stage of the slope reinforced by the two types of anchors is basically the same during the test, that is, elastic, plastic (potential sliding surface and plastic strengthening), and failure stages, respectively. The slope is in the elastic stage before the 0.2 g seismic wave, and it gradually enters the plastic stage after the 0.4 g seismic wave. However, the peak acceleration and displacement of the slope reinforced by steel anchors are greater than those of the slope reinforced by BFRP anchors under the same working conditions of seismic waves. In addition, we found that the acceleration response spectrum distribution curve of each measuring point in the short period has an obvious amplification effect along the elevation, and its predominant period has a forward migration phenomenon with the increase of the height of the measuring point, which also indicates that the higher frequency seismic wave has a greater impact on the top of the slope. The BFRP anchors, as a kind of flexible structure supporting slope, can effectively reduce the impact of seismic waves on the slope and attenuate seismic waves to a certain extent compared with steel anchors. Furthermore, the BFRP anchors can be deformed in coordination with the slope, which can improve the overall working performance of the slope, especially limit the dynamic response of the middle and lower slopes. These results can provide a theoretical guide for the seismic design of BFRP anchors for high slopes.

Potential earthquake-induced damage to overlapped tunnels probably occurs during the operation and maintenance of mountain tunnel engineering, especially in the seismically active zone. This study investigated the dynamic response and the failure characteristics of the parallel overlapped tunnel under seismic loadings by employing shaking table tests. The failure mode of the parallel overlapped tunnels was analyzed through macroscopic test phenomena. The dynamic responses of the surrounding rock and tunnel lining were evaluated by acceleration and dynamic strain, respectively. In particular, wavelet packets were used to investigate the spectrum characteristics of the tunnel structure in depth. The failure process of the model can be divided into three stages. The upper-span and the under-crossing tunnels showed different failure characteristics. Additionally, the lining damage on the outer surface of the tunnel mainly occurred on the right side arch waist and the left side wall, whereas the lining damage on the inner surface of the tunnel mainly appeared on the crown and invert. Wavelet packet energy results showed that the energy characteristic distributions of the upper-span and the under-crossing tunnels were not consistent. Specifically, the energy eigenvalues of the crown of the upper-span tunnel and the invert of the under-crossing tunnel were the largest, which should be considered to be the weak parts in the seismic design.

Converging lines of evidence indicates that smoking and internet gaming disorder (IGD) affect spontaneous brain activity, respectively. However, little is known about whether these two factors work together on the human brain. In this study, we investigated the interaction between smoking and IGD on local spontaneous brain activity using amplitude of low-frequency fluctuation (ALFF) based on resting-state fMRI (rs-fMRI). Forty-six cigarette smokers, 38 IGD individuals, 34 participants with both IGD and cigarette smoking (IGD-Smoking), and 60 healthy individuals involved in the study. Voxel-wise analysis of covariance of ALFF revealed that there were significant interactions between IGD by smoking in the right medial pre-frontal cortex (MPFC)/ventral striatum, bilateral cerebellar, and visual-related regions as well as the left temporal gyrus. In the right MPFC/ventral striatum and left temporal gyrus, ALFF in smoking group was significantly higher than healthy group while there were no significant ALFF differences between IGD-Smoking group and IGD group. While in the bilateral cerebellar and visual-related regions, ALFF in the smoking group was significantly lower than healthy group while ALFF in IGD-Smoking group did not show significant difference with IGD group. In addition, in the smoking group, ALFF of the right MPFC/ventral striatum was associated positively with anxiety and depression scores while the ALFF value in the smoking group had a trend toward negative correlation with SDS scores in the bilateral cerebellar and visual-related regions. The ALFF value in the smoking group was associated positively with anxiety score in the left temporal gyrus. These findings indicate that smoking and IGD interacted with each other in the human brain. Our results, in terms of spontaneous brain activity, may imply the fact that IGD people are more tended to get smoking. Moreover, it is possible to predict that smokers may be more easily to get internet addiction than healthy people.

An enriched environment (EE) provides multi-dimensional stimuli to the brain. EE exposure for days to months induces functional and structural neuroplasticity. In this study, manganese-enhanced magnetic resonance imaging (MEMRI) was used to map the accumulative whole-brain activities associated with a 7-day EE exposure in freely-moving adult male mice, followed by c-Fos immunochemical assessments. Relative to the mice residing in a standard environment (SE), the mice subjected to EE treatment had significantly enhanced regional MEMRI signal intensities in the prefrontal cortex, somatosensory cortices, basal ganglia, amygdala, motor thalamus, lateral hypothalamus, ventral hippocampus and midbrain dopaminergic areas at the end of the 7-day exposure, likely attributing to enhanced Mn2+ uptake/transport associated with brain activities at both the regional and macroscale network levels. Some of, but not all, the brain regions in the EE-treated mice showing enhanced MEMRI signal intensity had accompanying increases in c-Fos expression. The EE-treated mice were also found to have significantly increased overall amount of food consumption, decreased body weight gain and upregulated tyrosine hydroxylase (TH) expression in the midbrain dopaminergic areas. Taken together, these results demonstrated that the 7-day EE exposure was associated with elevated cumulative activities in the nigrostriatal, mesolimbic and corticostriatal circuits underpinning reward, motivation, cognition, motor control and appetite regulation. Such accumulative activities might have served as the substrate of EE-related neuroplasticity and the beneficial effects of EE treatment on neurological/psychiatric conditions including drug addiction, Parkinson’s disease and eating disorder.

Objective. The goal is to increase the precision of radiation delivery during radiotherapy by tracking the movements of the tumor and other surrounding normal tissues due to respiratory and other body motions. Introduction. This work presents the recent advancement of X-ray-induced radiation acoustic imaging (xRAI) technology and the evaluation of its feasibility for real-time monitoring of geometric and morphological misalignments of the X-ray field with respect to the target tissue by combining xRAI with established ultrasound (US) imaging, thereby improving radiotherapy tumor eradication and limiting treatment side effects. Methods. An integrated xRAI and B-mode US dual-modality system was established based on a clinic-ready research US platform. The performance of this dual-modality imaging system was evaluated via experiments on phantoms and ex vivo and in vivo rabbit liver models. Results. This system can alternatively switch between the xRAI and the US modes, with spatial resolutions of 1.1 mm and 0.37 mm, respectively. 300 times signal averaging was required for xRAI to reach a satisfactory signal-to-noise ratio, and a frame rate of 1.1 Hz was achieved with a clinical linear accelerator. The US imaging frame rate was 22 Hz, which is sufficient for real-time monitoring of the displacement of the target due to internal body motion. Conclusion. Our developed xRAI, in combination with US imaging, allows for mapping of the dose deposition in biological samples in vivo, in real-time, during radiotherapy. Impact Statement. The US-based image-guided radiotherapy system presented in this work holds great potential for personalized cancer treatment and better outcomes.

Static stability margin is a critical parameter in flight control design. The feasible range of it must cover the uncertainty through the flight. To reasonably identify the feasible range of static stability margin in advance, an approach based on guardian maps is proposed for flight control of hypersonic flight vehicles with input saturation. First, the model of hypersonic flight vehicle (HFV) is established as a parametric plant. Then, flying quality requirements for the closed-loop system are formulated as inequality constraints using guardian maps. Moreover, by using linear matrix inequality, the saturation of elevators is taken into account in the integrated control of attitude control. The prescribed minimum of static stability margin that ensures the flying quality of hypersonic flight vehicles with input saturation is obtained. Furthermore, from the prospective of integrated control, it is shown that the feasible range of static stability margin can be enlarged by changing aerodynamic characteristics. The effectiveness of the proposed approach is validated by numerical simulation.

Objective: The objective was to evaluate the application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in the left atrial appendage occlusion. Methods: A total of 53 patients with persistent atrial fibrillation hospitalized from January 2015 to February 2019 were selected. Transesophageal echocardiography and cardiac computed tomography angiography were performed simultaneously before operation, and three-dimensional reconstruction of the left atrial appendage model was performed based on the cardiac computed tomography angiography findings. The morphology and size of the left atrial appendage were displayed by the left atrial appendage angiography during the operation. Results: Cardiac computed tomography angiography revealed filling defects in the left atrial appendage in four patients, whereas transesophageal echocardiography revealed thrombosis in two patients of the four patients. According to the cardiac computed tomography angiography results, the morphology of the left atrial appendage was classified into chicken wing–like, cauliflower-like, wind vane–like, and cactus-like. The diameters and depths of the left atrial appendage measured by cardiac computed tomography angiography and three-dimensional reconstruction model were found to be the greatest, and the orifice sizes and depths of the left atrial appendage measured by the left atrial appendage angiography were the smallest. Conclusion: Transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model can evaluate the morphology and size of the left atrial appendage. The cardiac computed tomography angiography and three-dimensional reconstruction model could demonstrate the internal structure of the left atrial appendage more clearly.

Abstract Background Current evidence regarding the efficacy of ethanol locks in preventing catheter-related bloodstream infection (CRBI) is inconclusive. Methods Electronic databases, including PubMed, Web of Science, Embase, and the Cochrane Library (until April 2018),were systematically searched for relevant studies. Two reviewers independently screened the retrieved records and identified RCTs that met the inclusion criteria. Relevant data were extracted for pooled analyses using Review Manager 5.3 software. Subgroup analysis was performed according to the study quality, duration of the ethanol lock, disease type and CRBI definition. Eggs’ method was applied to detect publication bias. Sensitivity analysis was conducted to check the stability of the meta-analysis results. Results Ten RCTs involving 2760 patients were included in the analysis. The overall pooled result indicated that ethanol locks significantly reduced the incidence of CRBI (RR 0.66, 95% CI 0.51–0.86). Subgroup analysis suggested that an ethanol lock significantly decreased the incidence of CRBI in patients with hematological diseases (RR 0.50, 95% CI 0.31–0.80). An ethanol lock significantly reduced the incidence of CRBI in a2-hour ethanol lock group (RR 0.49, 95% CI 0.33–0.73). The meta-analysis showed that an ethanol lock significantly reduced the incidence of CRBI according to analysis of high-(RR 0.66, 95% CI 0.47–0.94) or low-(RR 0.66, 95% CI 0.46–0.95) quality studies. Meta-analysis of studies with a strict CRBI definition showed that an ethanol lock can significantly prevent CRBI (RR 0.61, 95% CI 0.42–0.89). The results of sensitivity analysis suggested that the pooled result was stable. Meta-analysis of adverse events showed that an ethanol lock did not increase the incidence of thrombosis (RR 1.05, 95% CI 0.51–2.18) or mortality (RR 0.99, 95% CI 0.90–1.08) but did result in increased nausea (RR 1.54, 95% CI 1.01–2.35), dizziness (RR 4.21, 95% CI 2.40–7.39),elevated blushing rates (RR 3.27, 95% CI 2.05–5.22) and altered taste rates (RR 2.61, 95% CI 1.93–3.54). Conclusions An ethanol lock may play a role in the prevention of CRBI, especially in immunocompromised patients with hematological diseases.

In order to estimate the state-of-charge (SoC) for all cells in the battery pack, this paper proposed an average cell model to represent every cell in the pack. The average cell model consisted of a basic model and a bias function. First, the parameter identification of the basic model was conducted, and the inconsistencies between cells were calibrated by the uncertainties of the basic model parameters. Second, artificial neural networks were used to construct the response surface approximate model of the bias function. In order to make the average cell model more adaptable to different working conditions, a novel bias function considering the polarization voltage and the temperature was proposed to correct the basic model, and it was compared with other bias functions. Then, the extended Kalman filtering algorithm was used for SoC estimation based on the corrected model. Finally, a case study with six lithium-ion battery cells was performed for the verification and evaluation of the proposed method. The results indicated that the average model corrected by the proposed bias function showed good adaptability to different working conditions, and the maximum absolute SoC estimate errors of all cells in the battery pack were less than 2% at 25°C, and 3.5%at 10 °C or 40 °C.

The components in traditional human–machine interaction (HMI) systems are relatively independent, distributed and low-integrated, and the wearing experience is poor when the system adopts wearable electronics for intelligent control. The continuous and stable operation of every part always poses challenges for energy supply. In this work, a triboelectric technology-based all-in-one self-powered HMI system for wireless remote telemetry and the control of intelligent cars is proposed. The dual-network crosslinking hydrogel was synthesized and wrapped with functional layers to fabricate a stretchable fibrous triboelectric nanogenerator (SF-TENG) and a supercapacitor (SF-SC), respectively. A self-charging power unit containing woven SF-TENGs, SF-SCs, and a power management circuit was exploited to harvest mechanical energy from the human body and provided power for the whole system. A smart glove designed with five SF-TENGs on the dorsum of five fingers acts as a gesture sensor to generate signal permutations. The signals were processed by the microcontroller and then wirelessly transmitted to the intelligent car for remote telemetry and control. This work is of paramount potential for the application of various terminal devices in self-powered HMI systems with high integration for wearable electronics.

Abstract Corneal endothelial cells (CECs) are very important for the maintenance of corneal transparency. However, in vitro, CECs display limited proliferation and loss of phenotype via endothelial to mesenchymal transformation (EMT) and cellular senescence. In this study, we demonstrate that continuous supplementary nutrition using a perfusion culture bioreactor and three-dimensional (3D) spheroid culture can be used to improve CEC expansion in culture and to construct a tissue-engineered CEC layer. Compared with static culture, perfusion-derived CECs exhibited an increased proliferative ability as well as formed close cell-cell contact junctions and numerous surface microvilli. We also demonstrated that the CEC spheroid culture significantly down-regulated gene expression of the proliferation marker Ki67 and EMT-related markers Vimentin and α-SMA, whereas the gene expression level of the CEC marker ATP1A1 was significantly up-regulated. Furthermore, use of the perfusion system in conjunction with a spheroid culture on decellularized corneal scaffolds and collagen sheets promoted the generation of CEC monolayers as well as neo-synthesized ECM formation. This study also confirmed that a CEC spheroid culture on a curved collagen sheet with controlled physiological intraocular pressure could generate a CEC monolayer. Thus, our results show that the use of a perfusion system and 3D spheroid culture can promote CEC expansion and the construction of tissue-engineered corneal endothelial layers in vitro.

Background/Aims: Hirschsprung's disease (HSCR), known as aganglionosis, is an infrequent congenital gut motility disorder characterized by absence of enteric neurons. In this study, we focus on the role of the intronic miR-215 and its host gene isoleucyl-tRNA synthetase 2 (IARS2) in the pathogenesis of HSCR. Methods: Quantitative real time PCR and Western blot were used to detect the miRNA, mRNAs, and proteins levels. The dual-luciferase reporter gene assay confirmed the direct regulation of the specific mRNA and miRNAs in cell lines. Transwell assays, CCK8 assay, and flow cytometry were used to measure cell function of the human 293T and SH-SY5Y cells. Results: Expression levels of miR-215 in HSCR patient colon tissues were outstandingly lower than controls, which was positively correlated with expression of the host gene IARS2 and negatively correlated with predicted target gene: sialic acid binding Ig-like lectin 8 (SIGLEC-8). The loss of miR-215 inhibited cell migration and proliferation, which was consistent with the reduction of IARS2. The dual-luciferase reporter gene assay confirmed that miR-215 resulted in the inhibition of SIGLEC-8 by directly binding to the 3'-UTR of SIGLEC-8. Moreover, knocking-down SIGLEC-8 rescued the extent of suppressed cell migration and proliferation that resulted from the diminishment of miR-215. Conclusions: Our findings indicate that miR-215 acts in concert with the host gene IARS2 to affect neuron migration and proliferation through the target gene SIGLEC-8. We infer that the IARS2-miR-215-SIGLEC-8 pathway may play a crucial role in the pathogenesis of HSCR.

Insula plays an essential role in maintaining the addiction to cigarette smoking and smoking-related alterations on the insular volume and density have been reported in smokers. However, less is known about the effects of chronic cigarette smoking on the insular cortical thickness. In this study, we explored the region-specific changes of insular cortical thickness in heavy smokers and their relations with smoking-related variables. 37 heavy smokers (29 males, mean age 47.19 ± 7.22 years) and 37 non-smoking healthy controls (29 males, mean age 46.95 ± 8.45 years) participated in the study. Subregional insular cortical thickness was evaluated and compared between the two groups. Correlation analysis was performed to investigate relationships between the insular cortical thickness and clinical characteristics in heavy smokers. There was no statistical difference on the cortical thickness in the left insula (p = 0.536) between the two groups while heavy smokers had a slightly thinner cortical thickness in the right insula (p = 0.048). In addition, heavy smokers showed a greater cortical thinning in the anterior (p = 0.0084) and superior (p = 0.0054) segment of the circular sulcus of the right insula as well as the inferior (p = 0.012) segment of the circular sulcus of the left insula. Moreover, the cortical thickness of the superior segment of the circular sulcus of the left insula was correlated negatively with nicotine severity (r = −0.423; p = 0.009) and the longer cigarette exposure was associated with the cortical thinning in the long insular gyrus and central sulcus of the right insula (r = −0.475; p = 0.003). Our findings indicate that chronic cigarette use is associated with region-specific insular thinning, which has the potential to improve our understanding of the specific roles of insular subregions in nicotine addiction.

In this paper, we reviewed the long-term survival outcomes, safety, and quality-of-life of androgen-deprivation therapy (ADT) alone versus combined with radiation therapy (RT) or chemotherapy for locally advanced and metastatic prostate cancer (PCa). A literature search was performed using OvidSP. Randomized controlled trials (RCTs) that met the following criteria were included: including locally advanced or metastatic PCa, comparing ADT alone versus combined with any treatment method and reporting quantitative data of disease control or survival outcomes. Finally, eight RCTs met the inclusion criteria. Among these, three compared ADT versus ADT plus RT (n = 2344) and one compared ADT versus ADT plus docetaxel-estramustine (n = 413) in locally advanced PCa; two compared ADT versus ADT plus docetaxel (n = 1175) and two compared ADT versus ADT plus estramustine (n = 114) in metastatic PCa. For locally advanced PCa, the addition of RT to long-term ADT can improve the outcomes of survival and tumor control with fully acceptable adverse effects. Specially, the pooled odds ratio (OR) of overall survival (OS) was 1.43 (95% confidence interval 1.20-1.71) when compared ADT plus RT with ADT alone (P < 0.0001). For metastatic hormonally sensitive PCa, the concurrent use of docetaxel plus ADT was effective and safe (pooled OR of OS: 1.29 [1.01-1.65]: P = 0.04). In all, long-term ADT plus RT and long-term ADT plus docetaxel should be considered as proper treatment option in locally advanced and metastatic hormonally sensitive PCa, respectively. The major limitation for the paper was that only eight RCTs were available.

This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P < 0.001), pain scores during the procedure (P < 0.001) and at 24 h postoperatively (P < 0.001), bleeding (P = 0.001), infection (P = 0.034), and satisfaction with penile appearance (P < 0.001) in the SR group were superior to those in the DS group. After two postoperative weeks, the percentage of patients with edema in the SR group (P = 0.029) was higher but no differences were found at 4 weeks (P = 0.185) between the two groups. In conclusions, the no-flip SR method was found to be superior to the DS method for its short operation time (

This paper investigates the relationship between teacher efficacy and socio-demographic factors, work engagement, and social support among Chinese special education school teachers. The sample comprised 1,027 special education school teachers in mainland China. The Teachers’ Sense of Efficacy Scale, the Multi-Dimensional Scale of Perceived Social Support, and the Utrecht Work Engagement Scale were used for data collection. Correlation analysis revealed that social support, work engagement, and teacher efficacy were significantly correlated with each other. Additionally, gender, years of experience, and monthly salary were significant predictors of teacher efficacy. Furthermore, structural equation modeling analysis showed that social support exerted its indirect effect on teacher efficacy through the mediation of work engagement. The findings of this study provide a new perspective on the complex association between social support and teacher efficacy. The explanations and limitations of these findings are discussed.

Purpose —This study focuses on the establishment and evolution of the school curriculum administrative system in China. Design/Approach/Methods —Based on policy papers and documents, this paper explores changes of the concept, tradition and practices of curriculum administration in China. Findings —The curriculum administration since 1949 has developed from an “excessively centralized curriculum administration” model to a “sharing-based curriculum administration”. China's three-level curriculum administrative system, comprising a national-, local-, and school-level curriculum administration framework, is explained and analyzed. Originality/Value —This is a comprehensive scholarly review of historical changes in school curriculum administration in China. This paper also provides provocative suggestions for future development of school curriculum administration in the Chinese context.

This meta-analysis examines the association between teacher support and students' academic emotions [both positive academic emotions (PAEs) and negative academic emotions (NAEs)] and explores how student characteristics moderate these relationships. We identified 65 primary studies with 58,368 students. The results provided strong evidence linking teacher support and students' academic emotions. Furthermore, students' culture, age, and gender moderated these links. The correlation between teacher support and PAEs was stronger for Western European and American students than for East Asian students, while the correlation between teacher support and NAEs was stronger for East Asian students than for Western European and American students. Also, the correlation between teacher support and PAEs was strong among university students and weaker among middle school students, compared to other students. The correlation between teacher support and NAEs was stronger for middle school students and for female students, compared to other students.