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Theology and philosophy are strange bedfellows: although they share many similar interests and constantly influence each other, their relationship is fraught with suspicion or even enmity. This problem is especially acute for those who want to harmonize their commitment to sola Scriptura with the use of philosophy in their theology. Drawing insights from Herman Bavinck’s Neo-Calvinist worldview, I argue that this apparent competition is mainly caused by the failure to recognize the organic unity between both disciplines. Without theology, all disciplines would be meaningless, but without philosophy, all disciplines would be unintelligible. Portraying the harmony between theology and philosophy depends on the success of locating the difference and relationship between the universality of theology and that of philosophy. Further, the organicity that suffuses all things and affirms the primacy of special revelation reflects the Neo-Calvinist belief in both sola scriptura and the sacredness of all vocations.

This article probes into Karl Barth's theology of nationhood set forth in Gottes Gnadenwahl, a volume on the doctrine of election published in November 1936. I will attend to his use of Hegelian terms and concepts to demonstrate his refutation of secularist and immanentist reinterpretations of the Christian doctrines of election and providence under the Enlightenment principle of historical progress by modern German thinkers, most notably Hegel. As Barth sees it, Hegel was largely at fault for having provided theological and philosophical justifications for the rise of Germany's mystical nationalism in the name of German Christianity. Using Hegelian language, Barth insists against Hegel that election is God's predetermination of human existence in Christo. Rather than negating nationhood altogether, Barth's repudiation of nationalism is intended to stress that nationhood is an external basis of the communion of the elect, and that the election of the community is the internal basis of nationhood.

Herman Bavinck's reception of the organic motif has become in recent years the central locus for discussing the means by which the unity of his thought may be recognised. This article provides a critical reading of Bavinck on Hegel on the locus of providence for the purpose of contributing to the ongoing discussion that identifies the unity of Bavinck's thought not in his confessional self in simple opposition against the philosophies of his day, but rather in characterising Bavinck as an eclectic, orthodox and modern theologian. To this end this essay moves in three steps. First, we provide an analysis that showcases the nuanced points of contact between Bavinck and Hegel on providence. Second, the essay homes in on the specific ways in which the two thinkers diverge on the Creator–creature relationship. Finally, we close the essay by sketching the salient dogmatic and philosophical implications of the preceding analysis.

At-risk alcohol consumption is the established most important risk factor for cirrhosis in people without HBV/HCV infection. We aimed to develop and validate a simple and non-invasive tool for triaging cirrhosis risk in at-risk alcohol drinkers without HBV/HCV infection. A large-sample size, cross-sectional study within the framework of a population-based Cancer Screening Program in Urban China (CanSPUC) was conducted. Data on the liver cancer screening in Henan province, China were used. At-risk alcohol drinkers were those who currently drink one or more alcohol units per week for at least six months. A total of 6,581 eligible participants enrolled from October 1, 2013 to December 31, 2016 were included into the derivation dataset, and 2,096 eligible participants enrolled from January 1, 2017 to October 31, 2018 were included into the external validation dataset, respectively. Using the derivation dataset, a 20-point scale risk score model was developed, based on sex, education background, dietary intake of vegetables, dietary intake of roughage, smoking index, length of secondhand smoke exposure, history of fatty liver, history of diabetes, and first-degree family history of liver cancer. The model showed excellent discrimination (AUC = 0.787; 95% CI, 0.7603–0.812) and calibration (Hosmer–Lemeshow test: P = 0.123) in the derivation dataset and an optimal cut-off value of 12 yield sensitivity of 61.3%, specificity of 82.7%. The model also had achieved similar performance in the external validation dataset. In conclusion, this model can be a practical tool to identify and triage population at high risk of cirrhosis in at-risk alcohol drinkers without HBV/HCV infection. Prevention Relevance: The risk model we developed will not only be used as a practical tool to triage high risk groups for liver cirrhosis, but also have implications for public health measures, such as guidelines for the prevention of liver cancer, in at-risk alcohol drinkers without HBV/HCV infection.

Supplementary Table from Development and Validation of a Noninvasive Risk Score Model for Liver Cirrhosis in At-Risk Alcohol Drinkers Without HBV/HCV Infection

Supplementary Data from Risk of Liver Cirrhosis in HBV/HCV-Infected Individuals with First-Degree Relatives Who Have Liver Cancer: Development and Validation of a Simple Model

Identification of high-risk population among hepatitis B virus (HBV)/hepatitis C virus (HCV)-infected individuals with first-degree relatives (FDR) who have liver cancer is important to implement precise intervention. A cross-sectional study was conducted under the framework of a population-based Cancer Screening Program in Urban China (CanSPUC), aimed to develop and validate a simple noninvasive model that could assess and stratify cirrhosis risk, in HBV/HCV-infected individuals with FDRs who have liver cancer. People who participated in liver cancer screening in Henan province were enrolled. Using the data set consisting of participants admitted from October 1, 2013, to December 31, 2016, a 24-point scale risk score model was developed through logistic regression, based on educational background, dietary habit, smoking index, cooking oil fume exposure, history of severe trauma, HBV/HCV infection status, history of diabetes, history of hyperlipidemia, and parent history of liver cancer. The model showed excellent discrimination with area under the receiver operator characteristic curve (AUROC) of 0.875 [95% confidence interval (CI), 0.853–0.896] and fair calibration with a Hosmer–Lemeshow test P = 0.106. The prevalence rates in the medium- and high-risk groups were 2.87 (95% CI, 1.94–4.25) and 47.57 (95% CI, 31.59–71.63) times of low-risk group, respectively. After internal validation, bias-corrected AUROC was 0.874 (95% CI, 0.873–0.875). In the external validation data set consisting of participants admitted from January 1, 2017, to October 31, 2018, the model had achieved similar discrimination, calibration, and risk stratification ability. In conclusion, the risk score model we developed can be a practical tool for the screening and prevention of liver cirrhosis among HBV/HCV-infected individuals with FDRs who have liver cancer.Prevention Relevance:We created a simple and noninvasive cirrhosis risk model for individuals infected by HBV/HCV who have FDRs with liver cancer. This model is useful not only for the prognosis of HBV/HCV infection, but also for the prevention of hepatocellular carcinoma.

PDF - 70K, Transition Probability of The Adjusted Models Between States at 1, 3, 5 and 10 Years With 95% CI.

Background: It is important to understand the natural history of cervical cancer, which has implications for cancer prevention and management. However, a dearth of studies on the long-term development of cervical cancer exists in China.Methods: We investigated the natural history of cervical cancer in Chinese women by creating a multistate model using 11 years of follow-up data from the Shanxi Province Cervical Cancer Screening Study I conducted from 1999 to 2010. In 1999, a total of 1,997 eligible women, ages 35 to 45 years, were enrolled in Xiangyuan County, Shanxi Province. Participants were followed up in 2005 and 2010, respectively.Results: The average time a subject spent in CIN1 before transiting into another state was 1.4693 years [95% confidence interval (CI): 1.1215–1.9251] and the average time a subject spent in CIN2 was 2.9822 years (95% CI: 1.9790–4.4938). A subject's transition probability from CIN1 to normal increased with time. However, the transition probability from CIN1 to CIN2 was relatively lower, with 3-, 5-, and 10-year transition probabilities of 0.1415, 0.1066, and 0.0437. Comparison of 5-year transition probabilities between CIN2 to normal/CIN1 and CIN2 to CIN3+ yielded a ratio of 2.74.Conclusions: Women with CIN1 had a substantial tendency for regression. Similarly, women with CIN2 had a higher probability of regression to normal/CIN1 than progression to CIN3+. Findings in this study may have significant implications for the development and evaluation of formal cervical cancer preventive strategies in China.Impact: This study may serve as a valuable reference to future research on other multistate cancer processes. Cancer Epidemiol Biomarkers Prev; 23(7); 1298–305. ©2014 AACR.

We aimed to determine participation in low-dose computed tomography (LDCT) of individuals with a family history of common cancers in a population-based screening program to provide timely evidence in high-risk populations in China. The analysis was conducted using data from the Cancer Screening Program in Urban China (CanSPUC), which recruited 282 377 participants aged 40 to 74 years from eight cities in the Henan province. Using the CanSPUC risk score system, 55 428 participants were evaluated to have high risk for lung cancer and were recommended for LDCT. We calculated the overall and group-specific participation rates using family history of common cancers and compared differences in participation rates between different groups. Odds ratios (ORs) and 95% confidence intervals were derived by multivariable logistic regression. Of the 55 428 participants, 22 260 underwent LDCT (participation rate, 40.16%). Family history of lung, esophageal, stomach, liver and colorectal cancer was associated with increased participation in LDCT screening. The odds of participants with a family history of one, two, three and four or more cancer cases undergoing LDCT screening were 1.9, 2.7, 2.8 and 3.5 times, respectively, than those without a family history of cancer. Compared to those without a history of cancer, participation in LDCT gradually increased as the number of cancer cases in the family increased (P .001). Our findings suggest that there is room for improvement in lung cancer screening given the relatively low participation rate. Lung cancer screening in populations with a family history of cancer may improve efficiency and cost-effectiveness; however, this requires further verification.

Bi2S3 capsules were developed as an X-ray contrast agent for gastrointestinal motility assessment based on X-ray, CT and spectral CT imaging in vivo. The X-ray attenuation ability of Bi2S3 makes it suitable for gastrointestinal motility evaluation.

IR820, an analog of FDA-approved indocyanine green, is a promising second near-infrared window (NIR-II) fluorescence probe with better NIR-II fluorescence stability and great clinical transformation potential. Moreover, its fluorescence can be further remarkably enhanced by the interaction with albumin. Therefore, it is significant to flexibly design IR820-albumin complex using endogenous or exogenetic albumin to meet the requirements of different biological applications. Herein, we show the rational synthesis of IR820-albumin complex for NIR-II fluorescence imaging-guided surgical treatment of tumors and gastrointestinal obstruction. We compared the NIR-II fluorescence imaging ability of IR820 pre-incubated with albumin or not to visualize tumors and the gastrointestinal tract

BACKGROUND Previous studies have shown that the likelihood of liver cancer recurrence scales proportionally with the hepatitis B surface antigen (HBsAg) intensity. The intensity assessment of HBsAg is traditionally performed manually based on an observation of the cytoplasm in stained immunohistochemistry (IHC) whole slide images (WSIs). However, the assessment process is time consuming and subjective, and depends heavily on the experience of the pathologist. To address these issues, the use of machine learning to provide objective results has been suggested as a potential solution. However, applying deep learning networks to perform supervised cytoplasmic segmentation is challenging due to the lack of clear boundaries in the cytoplasm, which makes it difficult to generate accurate and a large number of ground truth data for training. This presents a significant challenge for HBsAg intensity assessment. OBJECTIVE This study presents the first automatic approach to grade the HBsAg intensity from IHC stained WSIs. The proposed method combines supervised learning with unsupervised techniques to provide quantitative results without the need of detailed and comprehensive labeling of cytoplasmic boundaries. The HBsAg intensity assessment enables pathologists to objectively evaluate the relationship between HBsAg and liver cancer by eliminating the need for human intervention. METHODS A hierarchical nucleus-guided cytoplasm grading method is proposed for HBsAg intensity assessment. The proposed method comprises three sequential steps: nuclear instance segmentation, unsupervised cytoplasm region extraction, and HBsAg intensity grading. The output of the nuclear segmentation network is used to guide an unsupervised cytoplasm region extraction process. HBsAg intensity grading is then performed in the HSV color domain to obtain quantitative analysis results. The proposed method leverages the power of convolutional neural networks (CNNs) to facilitate the challenging task of unsupervised cytoplasm region extraction and enable the automatic HBsAg intensity assessment. RESULTS The feasibility of the proposed method is demonstrated using an NCKUH HBsAg intensity grading dataset consisting of 40 WSIs acquired from patients with clinically-diagnosed liver disease. The results show that a grading accuracy of 95% is obtained for the testing images. CONCLUSIONS The proposed method provides a novel automatic approach for assessing the HBsAg intensity from IHC stained images and visualizing the intensity assessment results in a user-friendly and intuitive manner. It thus provides a convenient and objective assessment tool to support pathologists in performing HBsAg intensity grading and analyzing the correlation between HBsAg and liver cancer.

The Mn-CDs-based contrast-enhanced magnetic resonance imaging provides a promising method for the non-invasive diagnosis of acute kidney injury, solving the problem of the potential nephrotoxicity of Gd-based contrast agents.

Krylov state complexity measures the spread of the wavefunction in the Krylov basis, a particular basis that is uniquely constructed using the Hamiltonian of a given physical system. Viewing each basis vector as one site, this basis naturally constitutes a one-dimensional chain, so that the state evolution can be mapped to a particle propagating on the chain, and its position is the Krylov state complexity. Based on this interpretation, we derive an Ehrenfest theorem for the Krylov complexity, which reveals its close relation to the spectrum. In particular, we find that the Krylov state complexity is directly driven by the properly normalized spectral form factor. This allows us to give an analytical expression for Krylov state complexity in random matrix theory. We also study the time evolution of the wavefunction in the Krylov basis. This provides the transition probability associated to the evolution of the initial state to the basis vector at a given site. For chaotic systems, including random matrix theories and the Sachdev-Ye-Kitaev model, we numerically observe a universal rise-slope-ramp-plateau behavior of the transition probability, with a long linear ramp. For the Gaussian unitary ensemble, we analytically explain this universal behavior for the sites located on the first half of the chain. The long linear ramp in the transition probability at each site leads to a peak in the Krylov complexity at late times. For non-chaotic systems, the transition probability shows a different behavior without the linear ramp. Our results clarify which features of the wave function time evolution in Krylov space characterize chaos., Comment: 46+16 pages, 19 figures, template changed, references added, typos fixed

Additional file 5: Table S1. qRT-PCR primer sequences

We develop solvable models of large-$N$ hybrid quantum circuits on qubits and fermions with long-range power-law interactions and continuous local monitoring, which provide analytical access to the entanglement phase diagram and error-correcting properties of many-body entangled non-equilibrium states generated by such dynamics. In one dimension, the long-range coupling is irrelevant for $\alpha>3/2$, where $\alpha$ is the power-law exponent, and the models exhibit a conventional measurement-induced phase transition between volume- and area-law entangled phases. For $1/2, Comment: 8+12 pages, 6 figures, v2 close to published version

The combination of high-resolution computed tomography (CT) and the real-time sensitive second near-infrared window (NIR-II) fluorescence bioimaging can provide complementary information for the diagnosis, progression and prognosis of gastrointestinal disorders. Ag

BACKGROUND Targeted therapy represents an effective modality for metastatic colorectal cancer (mCRC) with substantial health benefits. Targeted agents for mCRC have been approved for over a decade. However, little is known about their application in real-world clinical practice. OBJECTIVE We aimed to explore the uptake of targeted therapy and determine barriers and factors associated with initiating targeted therapy among Chinese mCRC patients. METHODS A cross-sectional, multi-center, hospital-based survey was conducted in China, from March 2020 to March 2021. mCRC patients who had finished at least one cycle of chemotherapy were enrolled from nineteen hospitals in fourteen cities through stratified, multistage cluster sampling. Descriptive analyses were used to report patients' characteristics, distribution on the timing and kinds of targeted agents first time used, and barriers against targeted therapy. Logistic regressions were conducted to assess the factors associated with initiating targeted therapy. RESULTS A total of 1,688 mCRC patients were included. Slightly over half the patients (51.6%, 871/1,688) have initiated the targeted therapy, of whom, 44.5% (388/871), 20.2% (176/871), and 35.2% (307/871) first initiated as the first-line, second-line, and third-line therapy, respectively. Bevacizumab was most frequently used (68.4%, 596/871). Unaffordable medical costs (41.6%, 340/817), not convinced that targeted therapy works (30.8%, 252/817) and fear of side effects (17.3%, 141/817) were the most reported barriers against targeted therapy. Patients treated in the general hospital, and with lower level of education, less annual family income, no medical insurance, poor health-related quality of life prior to the first treatment of mCRC, metastasis outside liver/lung or systemic metastasis, a duration of mCRC CONCLUSIONS This study highlights the limited uptake of targeted therapy, and frequent delayed treatment and misuse of targeted agents among mCRC patients in China. Reducing the costs, and interventional education on improving public awareness were recommended to facilitate the application of targeted therapy.

Esophageal cancer is a malignant tumor that seriously endangers human health. Compared with surgery alone, enhanced recovery after surgery (ERAS) has been widely used in clinical practice because it can improve perioperative care, minimize complications, and accelerate the recovery of esophageal cancer patients. However, there is a lack of data supporting the cost-effectiveness of ERAS.This retrospective cohort study included 968 esophageal cancer patients according to the pre-determined inclusion and exclusion criteria. Based on the Chinese expert consensus and guidelines, we improved the ERAS protocols consisting of 17 core measures. Subjects receiving60% of the ERAS optimization measures were classified as the ERAS group, while those receiving60% were classified as the pre-ERAS group. The demographic information, clinical and cost data of these patients were collected from the medical records. Based on the data distribution, the clinical effects and costs between the two groups were examined using the independent-sampleA total of 374 and 594 patients were included in the ERAS and pre-ERAS groups, respectively, and there were no significant differences in gender, American Society of Anesthesiologists (ASA) grade, tumor location, tumor stage, and other basic conditions between the two groups. The intraoperative blood loss, hospital stays, postoperative rehabilitation time, postoperative complications, and the number of secondary admissions within 30 days postoperatively of the ERAS group were lower than those of the pre-ERAS group (P0.05). Compared with the pre-ERAS group, participants in the ERAS group had lower direct medical cost, direct non-medical cost, and indirect cost (P0.05). Moreover, the cost-effectiveness ratio of the ERAS group (118,439.0 Yuan) was lower than that of the pre-ERAS group (143,369.0 Yuan) with respect to the cure rate.The study demonstrated that compared with pre-ERAS, the application of ERAS in esophageal cancer patients may accelerate postoperative rehabilitation, reduce the length of hospital stays and postoperative complications, and have better cost-effectiveness, highlighting the potential of ERAS to improve the quality of medical care.

A cluster randomized controlled trial of endoscopy-based screening for esophageal cancer (EC) and gastric cancer (GC) was conducted to evaluate the efficacy and feasibility of this strategy in a non-high-incidence rural area of China. The trial design and baseline findings are presented here.A total of 33 eligible villages in Luoshan County in Henan Province were assigned randomly to the intervention or control group in a 1:1 ratio by a computer-generated randomization list. Local residents aged 40 to 69 years were enrolled from the villages. Participants in the intervention group were risk-stratified with a questionnaire, and high-risk individuals were subsequently screened by endoscopy. The primary outcomes were EC and GC mortality. The secondary outcomes comprised the detection rate, stage distribution, and the treatment rate. In this study, baseline characteristics were assessed by a questionnaire. Multivariate logistic regression analysis was performed to explore factors associated with endoscopy compliance.Trial recruitment was completed in 2017, and ultimately, there were 12,475 and 11,442 participants allocated to the intervention (17 clusters) and the control group (16 clusters), respectively. We included 23,653 participants in the analysis, with 12,402 in the intervention group and 11,251 in the control group. A total of 6,286 (50.7%) participants in the intervention group were estimated as high-risk individuals, and 2,719 (43.3%) underwent endoscopy. Multivariate logistic regression analysis demonstrated that some factors including age, gender, education, personality and mental health, and upper gastrointestinal diseases or symptoms might affect endoscopy compliance. The detection rates for positive cases of EC and GC were 0.22% and 0.55%, respectively. The rates for esophageal and gastric precancerous lesions were 0.70% and 2.35%, respectively. The early detection rates for EC and GC were 50.0% and 33.3%, respectively. Additionally, the overall treatment rate for positive cases was 90.0%.The diagnostic yield of endoscopy-based screening for EC and GC was relatively low in a non-high-incidence rural area. The study may offer clues for the improvement of endoscopy compliance and the optimization of screening strategies for upper gastrointestinal cancer in non-high-incidence areas.Chinese Clinical Trial Registry ChiCTR-EOR-16008577.

It is great of significance to figure the time-trend of esophageal cancer (EC) and its current status for effective prevention and control, especially in EC high risk areas. As one of world-renowned high-risk areas, the epidemiology of EC in Henan has not been recently updated. Therefore, we aimed to depict the status quo of EC and analyze its time-trend in Henan.The EC data were extracted from the Henan Provincial Cancer registry database derived from the population based cancer registry system, which covered 30.51% of the whole population in Henan and were qualified according to national and international guidelines. The incidence and mortality of EC were estimated by area (rural/urban), gender, and age groups. The age-standardized rates (ASRs) were calculated according to the Segi's population. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to evaluate the time-trend of EC.As estimated, there were 29,913 new EC cases in Henan, 2018. The crude incidence and the age-standardized incidence rate by world standard population (ASIRW) was 27.43/10The EC incidence and mortality in Henan has exhibited a significant declining trend in past years. Nonetheless, the disease burden remains high, especially in males and rural areas. Therefore, the ongoing prevention and control strategies of EC should be maintained alongside the establishment of more effective strategies.

Henan province is an area with a serious disease burden of colorectal cancer (CRC) in China. Understanding the current incidence and mortality and the time-trend is critical to formulate and optimize prevention and control strategies for CRC. However, the current incidence and mortality and time-trend of CRC in Henan province, China have not been reported.CRC data was got from the Henan Provincial Central Cancer Registry of China in which the data was submitted from local cancer registries. Combined with the census data, the incidence, mortality, proportion, age-standardized rate by Chinese population (ASRC), age-standardized rate by world population (ASRW), and cumulative incidence and mortality (0-74 years old) of CRC by urban and rural population, gender, and age groups were estimated. The average annual percentage change (AAPC) and its 95% confidence interval (CI) of ASRC from 2010 to 2017 were analyzed.In 2017, it was estimated that there were 20,275 new cases and 10,046 deaths of CRC in Henan province. The crude incidence was 18.73/100,000, with an age-standardized incidence rate by Chinese population (ASIRC) of 13.97/100,000 and age-standardized mortality rate by world population (ASIRW) of 13.78/100,000. The cumulative incidence was 1.66%. The mortality rate was 9.28/100,000, with an age-standardized mortality rate by Chinese population (ASMRC) of 6.49/100,000 and an age-standardized mortality rate by world population (ASMRW) of 6.45/100,000. The cumulative mortality rate was 0.69%. The ASIRC and ASMRC were higher in urban areas (15.89/100,000, 7.19/100,000) than in rural areas (13.13/100,000, 6.20/100,000), and higher in males (15.53/100,000, 7.44/100,000) than in females (12.48/100,000, 5.66/100,000). The age-specific incidence reached the peak at age of 80-84, and the age-specific mortality reached the peak at age 85. From 2010 to 2017, the overall ASIRC and ASMRC showed a steady trend (P0.05), while an upward trend was observed in the mortality rate in urban males (AAPC =3.4, 95% CI: 0.2-6.7, P=0.040).The incidence and mortality of CRC were high in Henan province, and higher in urban areas and males. It is critical to strengthen the prevention and control of CRC, carry out targeted intervention, and promote screening and early diagnosis and treatment, particularly among urban areas and males.

Kuang-Ming Liao,1 Yi-Ju Chen,2 Chuan-Wei Shen,2 Shao-Kai Ou,2 Chung-Yu Chen2– 4 1Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan; 2School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; 3Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 4Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanCorrespondence: Chung-Yu Chen, School of Pharmacy, Kaohsiung Medical University, No. 100, Shihcyuan 1st Road, Sanmin District, Kaohsiung City, 80708, Taiwan, Tel +886-7-3121101 ext 2375, Fax +886-7-3210683, Email jk2975525@hotmail.comIntroduction: Chronic obstructive pulmonary disease (COPD) is a common disease and is preventable and treatable. A previous study showed that influenza virus infections were also associated with the risk of acute exacerbation in patients with COPD, and other studies showed that the influenza virus might increase the risk of stroke. However, studies on the influence of influenza infection among COPD patients are limited. In this study, we review the role of influenza infection in contributing to mortality, pneumonia, respiratory failure, COPD acute exacerbation, and ischemic stroke among COPD patients.Materials and Methods: We performed a population-based cohort study of COPD patients using data from Taiwan between January 1, 2011, and December 31, 2019. We excluded patients with lung cancer, lung transplantation and asthma. We also excluded patients who lacked COPD medication prescriptions and those treated with anti-influenza drugs without flu diagnosis records. Patients with missing or incomplete data were also excluded from the study cohort.Results: After 1:1 matching by age, sex, COPD duration, diagnosed years and comorbidities, we enrolled 10,855 cases and controls for further analysis. The risks of pneumonia, respiratory failure, COPD acute exacerbation, and ischemic stroke were 1.770 (95% CI=1.638– 1.860; P< 0.0001), 1.097 (95% CI=1.008– 1.194; P=0.0319), 1.338 (95% CI=1.248– 1.435; P< 0.0001), and 1.134 (95% CI=1.039– 1.239, P=0.0051), respectively, in the influenza infection group compared with COPD patients without influenza infection.Conclusion: Influenza infections are linked to an increased risk of ischemic stroke, pneumonia, respiratory failure, and COPD acute exacerbation among COPD patients. In conclusion, patients with COPD need to be closely monitored after having an influenza infection.Keywords: acute exacerbation, chronic obstructive pulmonary disease, influenza virus, pneumonia, stroke, respiratory failure

We study the effect of disorder on the spacetime supersymmetry that is proposed to emerge at the quantum critical point of pair density wave transition in (2+1)D Dirac semimetals and (3+1)D Weyl semimetals. In the (2+1)D Dirac semimetal, we consider three types of disorder, including random scalar potential, random vector potential and random mass potential, while the random mass disorder is absent in the (3+1)D Weyl semimetal. Via a systematic renormalization group analysis, we find that any type of weak random disorder is irrelevant due to the couplings between the disorder potential and the Yukawa vertex. The emergent supersymmetry is thus stable for weak random potentials. Our work will pave the way for exploration supersymmetry in realistic condensed matter systems.

Vaccine uptake rate is crucial for herd immunity. Medical care workers (MCWs) can serve as ambassadors of COVID-19 vaccine acceptance. This study aimed to assess MCWs' willingness to receive the COVID-19 vaccine, and to explore the factors affecting COVID-19 vaccination acceptance. A multicenter study among medical care workers was conducted in seven selected hospitals from seven geographical territories of China, and data were collected on sociodemographic characteristics, vaccine hesitancy, and health beliefs on COVID-19 vaccination among participants. Univariate and multivariate logistic regression models were performed to explore the correlations between individual factors and the acceptance of the COVID-19 vaccine. Among the 2681 subjects, 82.5% of the participants were willing to accept the COVID-19 vaccination. Multivariate regression analyses revealed that individuals with more cues to action about the vaccination, higher level of confidence about the vaccine, and higher level of trust in the recommendations of COVID-19 vaccine from the government and the healthcare system were more likely to get the COVID-19 vaccine. In contrast, subjects with higher level of perceived barriers and complacency were less likely to accept the COVID-19 vaccine. Overall, MCWs in China showed a high willingness to get the COVID-19 vaccine. The governmental recommendation is an important driver and lead of vaccination. Relevant institutions could increase MCWs' willingness to COVID-19 vaccines by increasing MCWs' perception of confidence about COVID-19 vaccines and cues to action through various strategies and channels. Meanwhile, it can also provide evidence in similar circumstances in the future to develop vaccine promotion strategies.

BACKGROUND The World Health Organization (WHO) put forward a global target to eliminate HCV by 2030. A better understanding of HCV knowledge, testing behaviours, and associated factors in general population is essential to meet the target. OBJECTIVE To assess HCV knowledge, self-reported HCV testing behaviours among Chinese general population. Additionally, we explored the characteristics of patients who had less knowledge, and who were less likely to be tested. METHODS The cross-sectional online survey of Chinese general population aged 15 years or older was conducted from November 2021 to January 2022. A brief 8-item HCV knowledge scale was used to evaluate HCV knowledge among those who had ever heard of HCV. Those scoring 0 points and who had never heard of HCV were categorized as having “Poor” knowledge, those scoring 1~4 points were categorized as having “Fair” knowledge, whereas those scoring above 4 points were categorized as having “Good” knowledge. Ordinal logistic regression analysis and binary logistic regression analysis were used to assess the associated factors with HCV knowledge level and the uptake of HCV testing, respectively. RESULTS A total of 812 valid questionnaires were included. Of these, 47.4% (385/812) had ever heard of HCV with a median HCV knowledge score of 6 (Q1, Q3: 2, 7). The proportions of participants who had “Poor”, “Fair” and “Good” knowledge were 59.1% (480/812), 11.2% (91/812) and 29.7% (241/812), respectively. A total of 31.8% (258/812) reported that they had ever tested HCV. The majority were tested for HCV because of blood donation (65.9%, 170/258). The most common reasons why participants did not test HCV were unaware of HCV (67.0%, 371/554). Participants who were less educated, who were located in West China and who currently drink alcohol had a low level of HCV knowledge. Participants with blood donation history and family history of HBV/HCV infection had a high level of HCV knowledge. Female, participants who were less educated, who were located in West China, who currently drink alcohol, and who had poor HCV knowledge had a low proportion of self-reported HCV testing. Participants who had a family history of HBV/HCV infection had a high proportion of self-reported HCV testing. CONCLUSIONS The general population has low HCV knowledge and testing rate in China. There is an urgent need to design and distribute education information to enhance HCV knowledge and testing rate. Scaling up screening is recommended in order to facilitate HCV testing and treatment. In addition, persons less educated, belonging to less-developed areas, who currently drink alcohol, and women are the subgroups that should be given priority to health education and testing behaviour intervention.

Objective To measure the prevalence of mental health symptoms and identify the associated factors among college students at the beginning of coronavirus disease 2019(COVID-19)outbreak in China. Methods We carried out a multi-center cross-sectional study via snowball sampling and convenience sampling of the college students in different areas of China.The rates of self-reported depression,anxiety,and stress and post-traumatic stress disorder(PTSD)were assessed via the 21-item Depression-Anxiety-Stress Scale(DASS-21)and the 6-item Impact of Event Scale-Revised(IES-6),respectively.Covariates included sociodemographic characteristics,health-related data,and information of the social environment.Data pertaining to mental health service seeking were also collected.Multivariate Logistic regression analyses were performed to identify the risk factors. Results A total of 3641 valid questionnaires were collected from college students.At the beginning of the COVID-19 outbreak,535(14.69%)students had negative emotions,among which 402(11.04%),381(10.49%),and 171(4.90%)students had the symptoms of depression,anxiety,and stress,respectively.Meanwhile,1245(34.19%)college students had PTSD.Among the risk factors identified,male gender was associated with a lower likelihood of reporting depression symptoms(

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BACKGROUND: Colorectal cancer (CRC) causes a substantial disease burden in China. Information on the medical expenditure of CRC patients is critical for decision-makers to allocate medical resources reasonably, however, relevant data is limited in China, especially advanced CRC. The aim of this survey was to quantify the out-of-pocket medical expenditure of advanced CRC and explore associated factors. METHODS: A nation-wide, multi-center, cross-sectional survey was conducted from March 2020 to March 2021. Nineteen hospitals in seven geographical regions were selected by multi-stage stratified sampling. For each eligible CRC patient with stage III or IV disease in the selected hospitals, the socio-demographics, clinical information, and range of out-of-pocket medical expenditure data were collected based on patients’ self-reporting or medical records. Multivariable logistic analysis was used to explore associated factors of medical expenditure. All statistical analyses were conducted using SAS 9.4. RESULTS: The mean age of the 4,428 advanced CRC patients included was 59.5±11.6 years, 59.6% were male, and 80.1% of patients were in stage III or IV at the time of diagnosis. Besides, 57.2% of patients had an annual household income of less than 50,000 Chinese Yuan (CNY), 40.9% of patients had an out-of-pocket medical expenditure of 50,000–99,999 CNY. As for the affordability of medical expenditure, 33.2% could afford 50,000–99,999 CNY. Multivariate analysis showed that patients who were in the southern [odds ratio (OR): 1.63, 95% confidence interval (CI): 1.31–2.03] and southwestern (OR: 1.55, 95% CI: 1.25–1.93), were in stage III at the time of diagnosis (OR: 1.33, 95% CI: 1.13–1.57), visited three or more hospitals (OR: 1.26, 95% CI: 1.04–1.52), had sought cross-regional health care (OR: 1.60, 95% CI: 1.40–1.83), used genetic testing (OR: 1.26, 95% CI: 1.10–1.45) and targeted drugs (OR: 2.12, 95% CI: 1.79–2.51) had higher out-of-pocket medical expenditure. CONCLUSIONS: Patients with advanced CRC had a high out-of-pocket medical expenditure. It is necessary to strengthen the prevention and control of CRC to reduce the disease burden; also, it is critical to deepen the reform of the medical system, increase proportion of medical insurance reimbursement, and remove barriers to cross-regional health care.

BACKGROUND: Biomarkers are a key tool in early detection, prognostication, survival, and predicting treatment response of colorectal cancer (CRC). However, little is known about biomarker testing for CRC patients in real-life clinical practice in China. This study aimed to address the usage of biomarker testing and analyze factors related to its acceptance among Chinese patients with advanced CRC. METHODS: A multicenter, cross-sectional, hospital-based clinical epidemiology study was conducted from March 2020 to March 2021. Nineteen hospitals were selected in seven geographical regions of China using stratified, multistage, nonrandomized cluster sampling. Data on demographics and clinical characteristics of each eligible CRC patient in stage III or IV diseases were recorded based on the patients’ self-reporting and/or medical records. In addition, information on whether biomarker testing [RAS, BRAF, and microsatellite instability (MSI)] was performed, the results and timing for performing biomarker testing, and the reasons for refusing biomarker testing were also recorded. Univariate and multivariate logistic regression were conducted to explore the potential factors of biomarker testing. RESULTS: A total of 4,526 patients were enrolled in the study, of whom 41.4%, 36.1%, and 28.2% underwent RAS, BRAF, and MSI testing, respectively. RAS, BRAF, and high-level MSI (MSI-high) mutation rates in Chinese patients with advanced CRC were 37.0%, 9.9%, and 8.1%, respectively. The logistic regression analysis revealed that the treating hospital, age at diagnosis, education, family income, tumor site, history of chemotherapy and radiotherapy, and metastases were dependent factors affecting the utilization of biomarker testing in advanced CRC in China (P

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers in China, and most CRC patients have already reached an advanced stage by the time of initial diagnosis. Due to the loss of health as a result of cancer, it has consequence on the treatment which may affect the psychophysical and social impairment of CRC patients. These indicators (psychophysical, function and social impairment) affect the health-related quality of life (HRQOL). There are limited studies that focus on advanced CRC patients in China. This study aimed to assess the HRQOL and its associated factors of advanced CRC patients in China. METHODS: This was a cross-sectional, nationwide, hospital-based, and multi-center survey. According to the traditional administrative district definition, we selected 19 hospitals in 7 regions by multi-stage stratified sampling in China. For each eligible CRC patient with stage III or IV in the selected hospitals, socio-demographics, clinical information, and HRQOL were collected based on patients’ self-reporting and/or medical records between March 2020 and March 2021. Patients completed the Functional Assessment of Cancer Therapy Colorectal (FACT-C) plus-traditional Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-9. RESULTS: A total of 4,589 CRC patients (mean age 60.1 years, including 2,730 males and 1,859 females) were included. The total score of HRQOL in population was 128.2±24.70. There were significant differences in the overall score of HRQOL in gender, education level, occupation, region, disease type, and disease stage (P

Microscopic speed limits that constrain the motion of matter, energy, and information abound in physics, from the "ultimate" speed limit set by light to Lieb-Robinson speed limits in quantum spin systems. In addition to these state-independent speed limits, systems can also be governed by emergent state-dependent speed limits indicating slow dynamics arising, for example, from slow low-energy quasiparticles. Here we describe a different kind of speed limit: a situation where complex information/entanglement spreads rapidly, in a fashion inconsistent with any speed limit, but where simple signals continue to obey an approximate speed limit. If we take the point of view that the motion of simple signals defines the local spacetime geometry of the universe, then the effects we describe show that spacetime locality can be compatible with a high degree of non-local interactions provided these are sufficiently chaotic. With this perspective, we sharpen a puzzle about black holes recently raised by Shor and propose a schematic resolution., 38 pages

In this paper, we consider two types of topological solitons in a generalized Born-Infeld-Higgs model. We explore the self-dual structure of the model and prove the existence of planar vortex solutions. Furthermore, we couple the system with the Einstein equations and study the cosmic strings problem over $\mathbb R^{1,1}\times S$, where $S$ is a Riemann surface. We prove the existence of cosmic string solutions when $S$ is noncompact. We also discuss the decay estimates for vortices and cosmic strings at infinity and show that the minimal energy is quantized and depends on the number of vortices and strings, respectively., Comment: 22 pages

Diverse oxygen generation strategies have been developed to overcome hypoxia in tumors for enhancing the therapeutic efficacy, but inevitably suffering from tedious synthesis process of oxygen generators in vitro before in vivo administration. Herein, we show direct injection of commercially and clinically used KMnO

Charge-4e superconductivity as a novel phase of matter remains elusive so far. Here, we show that charge-4e phase can arise as a vestigial order above the nematic superconducting transition temperature in time-reversal-invariant nematic superconductors. On the one hand, the nontrivial topological defect-nematic vortex-is energetically favored over the superconducting phase vortex when the nematic stiffness is less than the superfluid stiffness; consequently the charge-4e phase emerges by proliferation of nematic vortices upon increasing temperatures. On the other hand, the Ginzburg-Landau theory of the nematic superconductors has two distinct decoupling channels to either charge-4e orders or nematic orders; by analyzing the competition between the effective mass of the charge-4e order and the cubic potential of the nematic order, we find a sizable regime where the charge-4e order is favored. These two analyses consistently show that nematic superconductors can provide a promising route to realize charge-4e phases, which may apply to candidate nematic superconductors such as PbTaSe_{2} and twisted bilayer graphene.

We show that a class of $\mathcal{PT}$ symmetric non-Hermitian Hamiltonians realizing the Yang-Lee edge singularity exhibits an entanglement transition in the long-time steady state evolved under the Hamiltonian. Such a transition is induced by a level crossing triggered by the critical point associated with the Yang-Lee singularity and hence is first-order in nature. At the transition, the entanglement entropy of the steady state jumps discontinuously from a volume-law to an area-law scaling. We exemplify this mechanism using a one-dimensional transverse field Ising model with additional imaginary fields, as well as the spin-1 Blume-Capel model and the three-state Potts model. We further make a connection to the forced-measurement induced entanglement transition in a Floquet non-unitary circuit subject to continuous measurements followed by post-selections. Our results demonstrate a new mechanism for entanglement transitions in non-Hermitian systems harboring a critical point., Updated to published version

We construct Brownian Sachdev-Ye-Kitaev (SYK) chains subjected to continuous monitoring and explore possible entanglement phase transitions therein. We analytically derive the effective action in the large-N limit and show that an entanglement transition is caused by the symmetry breaking in the enlarged replica space. In the noninteracting case with SYK_{2} chains, the model features a continuous O(2) symmetry between two replicas and a transition corresponding to spontaneous breaking of that symmetry upon varying the measurement rate. In the symmetry broken phase at low measurement rate, the emergent replica criticality associated with the Goldstone mode leads to a log-scaling entanglement entropy that can be attributed to the free energy of vortices. In the symmetric phase at higher measurement rate, the entanglement entropy obeys area-law scaling. In the interacting case, the continuous O(2) symmetry is explicitly lowered to a discrete C_{4} symmetry, giving rise to volume-law entanglement entropy in the symmetry-broken phase due to the enhanced linear free energy cost of domain walls compared to vortices. The interacting transition is described by C_{4} symmetry breaking. We also verify the large-N critical exponents by numerically solving the Schwinger-Dyson equation.

The disease burden of lung cancer is high in Henan province, China, it is out of the utmost significance to figure the current epidemic status and temporal trend of lung cancer for effective prevention and control.The qualified data was obtained from the Henan Provincial Central Cancer Registry of China, covering 30.51% of the whole population. Incidence, mortality, proportions, and cumulative rates (among patients aged 0-74 years old) of lung cancer by areas, sex and age groups were estimated. The world Segi's standard population was applied to calculate the age-standardized rate. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to evaluate temporal trends from 2010 to 2018.In 2018, there were about 55,344 new cases of lung cancer in Henan province, with the crude incidence of 50.75/100,000, the age-standardized incidence rate by world standard (Segi's) population (ASIRW) of 37.14/100,000, and the cumulative rate of 4.57%. About 41,782 people died from lung cancer in 2018, with the crude mortality rate of 38.31/100,000, the age-standardized mortality rate by world standard (Segi's) population (ASMRW) of 27.09/100,000, and the cumulative rate of 3.22%. The age-specific incidence and mortality of lung cancer increased gradually as age increased and reached the peak at the age of 85+ years. The overall ASIRW (AAPC =0.3, P=0.531) and ASMRW (AAPC =-0.2, P=0.687) remained stable from 2010 to 2018, but decreased in urban areas from 2014 to 2018 (APC for ASIRW =-4.7, P=0.023; APC for ASMRW =-5.3, P=0.012). From 2010 to 2018, the incidence rate increased in the rural population aged 75+ years old (AAPC =4.2, P=0.023).The incidence and mortality rates of lung cancer significantly decreased in urban areas partly due to the Cancer Screening Program in Urban China. Nonetheless, the disease burden remains high, especially in males and elderly population. Comprehensive prevention and control programs, such as smoking cessation intervention, screening, early diagnosis and early treatment programs, need to be implemented to reduce the burden of lung cancer.