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Background: The burden of nonalcoholic fatty liver disease (NAFLD) is growing in patients with chronic hepatitis B (CHB). NAFLD is typically associated with obesity, however, it is increasingly being identified in non-obese patients. This study aimed to investigate disease severity and antiviral response in non-obese patients with CHB with NAFLD (CHB + NAFLD). Methods: A total of 809 patients with CHB + NAFLD were prospectively recruited and followed up for 3 years. NAFLD was diagnosed by transient elastography and defined as controlled attenuation parameter ≥248 dB/m, in the absence of excessive alcohol intake. Obesity status was defined by the Asian body mass index (BMI) cutoff of 25 kg/m2. Metabolic abnormality was defined by the presence of dyslipidemia, hypertension or diabetes. Fibrosis staging was defined according to the EASL-ALEH guidelines, with fibrosis progression defined as ≥1-stage increment. Results: In the total cohort (median age 40 years, 59.0% antiviral-treated), 33.3% were non-obese. Non-obese patients were less metabolically abnormal than obese patients (60.2% vs 72.0%, P = 0.003). After 3-year follow up, the rate of fibrosis progression was comparable between non-obese and obese patients (17.5% vs 21.9% in the total cohort, P = 0.145; 15.7% vs 14.6% in antiviral-treated cohort with persistent viral suppression, P = 0.795). No significant differences in virological and biochemical responses were observed between non-obese and obese patients (P >0.05 for all). Conclusion: Approximately one third of CHB + NAFLD patients were non-obese. Non-obese patients, while less metabolically abnormal, had a similar risk for fibrosis progression as obese patients. Obesity status did not impact the efficiency of antiviral therapy.

Abstract Background People with chronic hepatitis B (CHB) commonly experience social and self-stigma. This study sought to understand the impacts of CHB-related stigma and a functional cure on stigma. Methods Adults with CHB with a wide range of age and education were recruited from 5 countries and participated in 90-minute qualitative, semi-structured interviews to explore concepts related to CHB-associated stigma and its impact. Participants answered open-ended concept-elicitation questions regarding their experience of social and self-stigma, and the potential impact of reduced CHB-related stigma. Results Sixty-three participants aged 25 to 71 years (15 from the United States and 12 each from China, Germany, Italy, and Japan) reported emotional, lifestyle, and social impacts of living with CHB, including prejudice, marginalization, and negative relationship and work experiences. Self-stigma led to low self-esteem, concealment of CHB status, and social withdrawal. Most participants stated a functional cure for hepatitis B would reduce self-stigma. Conclusions CHB-related social and self-stigma are widely prevalent and affect many aspects of life. A functional cure for hepatitis B may reduce social and self-stigma and substantially improve the health-related quality of life of people with CHB. Incorporating stigma into guidelines along with infectivity considerations may broaden the patient groups who should receive treatment.

Dabie Banda virus (DBV), a tick-borne pathogen, was first identified in China in 2009 and causes profound symptoms including fever, leukopenia, thrombocytopenia and multi-organ dysfunction, which is known as severe fever with thrombocytopenia syndrome (SFTS). In the last decade, global incidence and mortality of SFTS increased significantly, especially in East Asia. Though previous studies provide understandings of clinical and immunological characteristics of SFTS development, comprehensive insight of antiviral immunity response is still lacking. Here, we intensively discuss the antiviral immune response after DBV infection by integrating previous ex- and in-vivo studies, including innate and adaptive immune responses, anti-viral immune responses and long-term immune characters. A comprehensive overview of potential immune targets for clinical trials is provided as well. However, development of novel strategies for improving the prognosis of the disease remains on challenge. The current review may shed light on the establishment of immunological interventions for the critical disease SFTS.

Background & aims: With a drastic increase in the number of chronic hepatitis B (CHB) patients with coexisting nonalcoholic fatty liver disease (NAFLD), there is an urgent need to evaluate antiviral treatment effects in this special population. Methods: CHB patients with hepatic steatosis (CHB + HS) were prospectively recruited with followed-up of 3 years. HS and liver fibrosis were assessed by transient elastography. HS was defined as controlled attenuation parameter (CAP) ≥248 dB/m, and fibrosis progression was defined with ≥1-stage fibrosis increment. Multivariate and propensity score matching (PSM) analysis were used to evaluate antiviral therapy effects on fibrosis progression. Results: In total 212 recruited CHB + HS patients (median age 36 years, median ALT 59 U/L), 49.1% (104/212) received antiviral therapy and 50.9% (108/212) did not. Among patients with antiviral therapy, rates of serum HBV DNA undetectable, HBeAg and HBsAg loss, and ALT normalization at year 3 were 88.5%, 31.0%, 8.7% and 70.2%, respectively. Patients with mild-moderate HS didn't differ patients with severe HS regarding biochemical and virological responses. Antiviral therapy was independently associated with a lower risk of fibrosis progression among the entire cohort (odds ratio 0.473, 95% CI 0.245–0.911, P = 0.025). This finding was further verified by PSM analysis. When stratified by the severity of HS, the antiviral therapy benefits in reducing fibrosis progression were mainly seen in patients with mild-moderate HS. Conclusions: Among CHB + HS patients, long-term antiviral treatment effectively inhibits HBV replication and reduces fibrosis progression. Our findings have implications for the optimal management of this population.

Two previously undescribed plant sterols, namely anemhupehins D (1) and E (2), and one undescribed chromone derivative, namely anemhupehin F (3), have been isolated from the aerial parts of Anemone hupehensis. Their structures were elucidated by extensive spectroscopic data analyses and computational methods. All compounds were investigated for their anti-inflammatory and antibacterial activities. Compounds 1 and 2 showed inhibitory activity against NO production with IC 50 values of 4.4 and 16.2 μ M, respectively. All compounds had no antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa at the concentration of 128 μ g/mL. [Display omitted] • Three unknown metabolites have been obtained from Anemone hupehensis. • The structures were established by means of spectroscopic methods. • Two compounds showed inhibitory activity against NO production. [ABSTRACT FROM AUTHOR]

Physiologically based pharmacokinetic/toxicokinetic (PBPK/PBTK) models are designed to elucidate the mechanism of chemical compound action in organisms based on the physiological, biochemical, anatomical, and thermodynamic properties of organisms. After nearly a century of research and practice, good results have been achieved in the fields of medicine, environmental science, and ecology. However, there is currently a lack of a more systematic review of progress in the main research directions of PBPK models, especially a more comprehensive understanding of the application in aquatic environmental research. In this review, a total of 3974 articles related to PBPK models from 1996 to 24 March 2024 were collected. Then, the main research areas of the PBPK model were categorized based on the keyword co-occurrence maps and cluster maps obtained by CiteSpace. The results showed that research related to medicine is the main application area of PBPK. Four major research directions included in the medical field were "drug assessment", "cross-species prediction", "drug–drug interactions", and "pediatrics and pregnancy drug development", in which "drug assessment" accounted for 55% of the total publication volume. In addition, bibliometric analyses indicated a rapid growth trend in the application in the field of environmental research, especially in predicting the residual levels in organisms and revealing the relationship between internal and external exposure. Despite facing the limitation of insufficient species-specific parameters, the PBPK model is still an effective tool for improving the understanding of chemical–biological effectiveness and will provide a theoretical basis for accurately assessing potential risks to ecosystems and human health. The combination with the quantitative structure–activity relationship model, Bayesian method, and machine learning technology are potential solutions to the previous research gaps. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between medication literacy and blood pressure control among hypertensive patients. Background: Blood pressure control is a challenge for global health systems. Medication literacy is essential for medication self‐management in hypertensive patients and a basis for managers to develop comprehensive intervention strategies for hypertension medication use. Design: A cross‐sectional observational study was conducted. Methods: A total of 378 hypertensive patients was selected by convenience sampling from two tertiary hospitals and four community health service centres from December 2021 to January 2022 in Changsha, China. Associations between medication literacy and blood pressure control were identified with chi‐square, independent samples t‐tests and logistic regression analyses. Results: The average medication literacy score of the hypertensive patients investigated was low. Over a third of patients had uncontrolled blood pressure. Logistic regression analysis showed that medication literacy was an influencing factor for blood pressure control rate in hypertensive patients. Conclusions: Medication literacy and blood pressure control among hypertensive patients was poor. Medication literacy was a facilitator of blood pressure control so improving medication literacy may be of value to improve blood pressure control in hypertensive patients. Summary statement: What is already known about this topic? Medication literacy is essential for medication self‐management in hypertensive patientsThe association between medication literacy and blood pressure control in hypertensive patients is unclear. What this paper adds? Medication literacy and blood pressure control rates among hypertensive patients were poor and in need of urgent improvement.Medication literacy was a facilitator of blood pressure control in hypertensive patients. The implications of this paper: Clinical nurses may enhance hypertension management by improving medication literacy.Findings provide a base for implementing medication literacy intervention strategies and promoting blood pressure management. [ABSTRACT FROM AUTHOR]

CO2 fixation plays a key role to make biobased production cost competitive. Here, we use 3-hydroxypropionic acid (3-HP) to showcase how CO2 fixation enables approaching theoretical-yield production. Using genome-scale metabolic models to calculate the production envelope, we demonstrate that the provision of bicarbonate, formed from CO2, restricts previous attempts for high yield production of 3-HP. We thus develop multiple strategies for bicarbonate uptake, including the identification of Sul1 as a potential bicarbonate transporter, domain swapping of malonyl-CoA reductase, identification of Esbp6 as a potential 3-HP exporter, and deletion of Uga1 to prevent 3-HP degradation. The combined rational engineering increases 3-HP production from 0.14 g/L to 11.25 g/L in shake flask using 20 g/L glucose, approaching the maximum theoretical yield with concurrent biomass formation. The engineered yeast forms the basis for commercialization of bio-acrylic acid, while our CO2 fixation strategies pave the way for CO2 being used as the sole carbon source. CO2 fixation plays an important role to make bioproduction cost competitive. Here, the authors take 3-hydroxypropionic acid as an example to showcase how to achieve high carbon yield production through increasing the accessible bicarbonate, minimizing native CO2 release and avoiding carbon waste. [ABSTRACT FROM AUTHOR]

A 2-D airfoil shape optimization in transonic low-Reynolds number regime is conducted. A Navier–Stokes flow solver with a transition model (k-ω SST γ-Reθ) is used to evaluate the fitness function. Single-point and multi-point formulations of the optimization results are compared. In addition, the effects of Mach number and angles of attack on aerodynamic characteristics of the optimized airfoils are investigated under low Reynolds number (Re = 17,000) and high-subsonic-flow ( M a , ∞ = 0.6 − 0.9) conditions. The results show that the corresponding drag divergence Mach number curves of the conventional airfoil present almost a parallel shifting at the entire Mach number range. By contrast, the unconventional airfoil starts showing a significant drag reduction when Mach number is greater than 0.75. Besides, the maximum lift-to-drag ratio is highly influenced by the Mach number because of the formation, movement, type, and strength of a shock wave. In addition, the distinguishing difference in the conclusion between two airfoils is that the lift fluctuation of the conventional airfoil amplifies with the increase of the Mach number. However, the unconventional airfoil shows an opposite trend. [ABSTRACT FROM AUTHOR]

Currently, tire wear particles (TWPs), a typical type of black microplastics (MPs), are frequently overlooked as the major source of MPs in aquatic environments. TWPs are widely distributed and exhibit complex environmental behaviors. However, how natural forces affect the aging and release behavior of TWPs at the nano(micro)scale remains inadequately explored. This study systematically investigated the aging behavior and mechanism of TWPs under the action of simulated natural light and high-temperature in both dry and wet environments, as well as the effect of aging treatment on the released leachate. The findings demonstrated that aging treatment significantly altered the physicochemical properties of TWPs, including chain scission and surface oxidation, and facilitated the release of heavy metals and organic additives in the meantime. In particular, the leaching concentration of Zn exhibited a positive linear relationship with exposure time. In the thermal-aging process, the oxidation of TWPs was primarily caused by superoxide anion (O 2 •- ). During the photo-aging exposure, TWPs exhibited heightened electron-donating capacity, resulting in the formation of more O 2 •- and singlet oxygen ( 1 O 2 ) to attack TWPs. Moreover, the analysis of leachate produced under light and high-temperature conditions suggested that heavy metals exerted low ecological risks in water. Nonetheless, the photo-aging process enhanced the toxicity of released leachate to L929 cells, which could be attributed to highly toxic additive transformation products (such as HMMM-411 and 6PPD-Q) and more heavy metals. These findings shed light on the fate of TWPs and the ecological risks posed by aged TWPs in aquatic environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Indigenous chickens are very important to households for income and protein. However, their performance is usually poor, especially under small-scale farmer management, despite their potential to perform better. The performance of these chickens can be improved by selective breeding. However, for this to be a success, there is a need to understand the phenotypic and production characteristics of these chickens fully. Hence, this study aimed to characterize the phenotypes of these chickens and their production system among small-scale farmers., Method: A structured questionnaire was administered to 177 small-scale farmers. A total of 538 chickens whose mean weight was 1.66 kg were individually phenotyped in Luapula, Muchinga, and Northern provinces of Zambia., Results: Ownership of the indigenous chickens was dominated by females (65.37%), with most (64.31%) having attained primary education. Most housed their chickens in family houses (42.03%). All the farmers let their chickens scavenge for their feed, with 45.58% of them providing basic supplementation. Most (84.10%) farmers bought their breed stock from within their community and had a mean flock size of 12.5 chickens/household, which they mostly (78.09%) kept as free-range. The majority (77.39%) practiced culling, with low productivity being the most common reason for culling (84.45%). Only 59.01% of farmers practiced selective breeding, while 86.22% practiced uncontrolled mating. The age at first mating for cocks and hens was 6.8 months and 6.34 months, respectively, with 6.73 months being the age at first egg. It takes 15.43 days to reach a mean clutch size of 13 eggs. The hatchability and mortality at 8 weeks were 83.44% and 67.57%, respectively. All chickens were sold as live chickens, and the majority (51.59%) of the farmers sold their chickens within the community at 7.23 months. Diseases and predators were the most common challenges affecting farmers in the study area. Consultations with veterinarians, vaccinations, and deworming were uncommon while treating sick chickens mostly using ethnoveterinary medicines was common. The most common qualitative traits were brown (27.88%) and mixed (26.77%) plumage color, white skins (91.45%) and shanks (48.70%), single comb type (91.08%), red earlobe (55.76%), and orange eyes (78.07%). All linear body measurements positively and significantly correlated with the body weight averaging 1.66kgs, an indicator that selection for any of them would result in a corresponding increase in body weight. Principal Component Analysis extracted two components with 69.38% of the total variation., Discussion: The diversity in phenotypes of these chickens and their production systems indicate huge potential for improvement by implementing breeding programs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liswaniso, Mwambilwa, Odubote, Tyasi, Mweni, Sun, Xu and Qin.)

Introduction: Depression is a major global health problem, with high prevalence rates of depressive symptoms observed among the elderly population in China, particularly exacerbating in rural areas. Due to a lack of professional mental health training and inadequate psychotherapy capacity within primary medical staff, rural elderly individuals grappling with depressive symptoms often encounter challenges in receiving timely diagnosis and treatment. In this landscape, the modified behavioural activation treatment (MBAT) emerges as a promising approach due to its practicality, ease of therapist training and application, patient acceptability, and broad applicability. However, existing evidence for MBAT mainly hails from developed countries, leaving a gap in its adaptation and implementation within rural China. This study aims to develop an MBAT training programme for primary medical staff to manage depressive symptoms among rural elderly and evaluate its effectiveness., Methods and Analysis: A cluster randomised controlled trial will be conducted in 10 randomly selected township hospitals in Lengshuijiang and Lianyuan, Hunan Province. We aim to recruit 150 participants, with 5 township hospitals selected for each group, each consisting of 15 participants. The intervention group will implement the MBAT training programme, while the control group will receive usual care training programme. Depressive symptoms, psychosocial functioning, quality of life and satisfaction will be measured at baseline, immediately post-intervention, and at 3 and 6 months post-intervention. Effectiveness will be assessed using linear or generalised linear mixed models., Ethics and Dissemination: This study has obtained approval from the Institutional Review Board of the Third Xiangya Hospital, Centre South University (No.: 2022-S261). Results will be disseminated through publication in international peer-reviewed journals and presentations at national and international conferences., Trial Registration Number: ChiCTR2300074544., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Research Question: Does frozen embryo transfer (FET) increase the risk of allergic diseases in offspring?, Design: This study followed up 653 singleton children: 166 born through FET and 487 born through natural conception. Demographic characteristics, perinatal information and allergic diseases of children and their parents were collected through clinical medical systems and questionnaires. Among these 653 children, allergen-specific immunoglobulin E (IgE) testing was performed using peripheral blood samples collected from 207 children: 145 in the FET group and 62 in the natural conception group. The prevalence of allergic diseases and positive rates of allergen-specific IgE testing were compared between the two groups with adjustments for confounding factors., Results: The prevalence of food allergy was significantly higher in children born through FET compared with children born through natural conception (adjusted OR = 3.154, 95% CI 1.895-5.250; P < 0.001). In addition, positive rates of food allergen sensitization were higher in children in the FET group compared with children in the natural conception group (adjusted OR = 5.769, 95% CI 2.859-11.751, P < 0.001). Children in the FET group had a higher positive sensitization rate to at least one allergen compared with children in the natural conception group (adjusted OR = 3.127, 95% CI 1.640-5.961, P < 0.001). No association was observed between FET and other allergic diseases, including asthma (P = 0.136), atopic dermatitis (P = 0.130) and allergic rhinitis (P = 0.922). Allergen sensitization IgE testing indicated no differences between the two groups in terms of positive sensitization rates of other common allergens, including animal and insect allergens (P = 0.627), inhaled outdoor allergens (P = 0.915) and inhaled outdoor allergens (P = 0.544)., Conclusion: This study suggests that children born through FET have increased risk of developing food allergy in early childhood., (Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Objectives: To explore the rules of acupoint selection in the treatment of metabolic-associated fatty liver disease (MAFLD) with acupuncture and moxibustion by using data mining technology., Methods: The clinical research literature on acupuncture treatment of MAFLD was collected from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database and China Biology Medicine from their inception to November 20, 2022. According to our inclusion and exclusion criteria, the literature was independently screened and re-screened by two research members, and the screened results were checked, followed by establishing an acupoint prescription database using Excel 2019. Descriptive statistics of acupoints applied frequency, involved meridians, locations and specific acupoints were perpormed. Then, SPSS Modeler18.0 software was used to conduct analysis about association rules, and the SPSS Statistics 26.0 software was used to perform cluster analysis on high-frequency acupoints, exploring the characteristics and rules of acupoint selection and combination in the treatment of MAFLD., Results: Totally, 178 papers were collected, containing 130 acupoints, with a total application frequency of 1 305. The top five acupoints are Zusanli (ST36), Fenglong (ST40), Ganshu (BL18), Taichong (LR3) and Sanyinjiao (SP6). The commonly involved meridians are the Stomach Meridian of Foot Yangming, Bladder Meridian of Foot Taiyang, and Spleen Meridian of Foot Taiyin. The employed acupoints are mostly located in the lower limbs and abdomen, and the five Shu acupoints and crossing acupoints are in the majority. The association rule analysis of high frequency acupoints indicated that of the 16 qualified acupoint groups, the top 5 with close correlation degrees are ST36 and ST40, ST36 and LR3, ST36 and SP6, ST40 and LR3 and ST36, ST36 and SP6 and ST40. Further, 3 effective clusters were obtained by cluster analysis., Conclusions: Acupuncture and moxibustion treatment of MAFLD follows the therapeutic principles of soothing the liver, invigorating the spleen, tonifying the kidney, and resolving phlegm and removing dampness. The core acupoint group is ST36, ST40 and LR3, and the combination of acupoints is based on syndrome differentiation. These results may provide a useful reference for clinical practice.

CO 2 fixation plays a key role to make biobased production cost competitive. Here, we use 3-hydroxypropionic acid (3-HP) to showcase how CO 2 fixation enables approaching theoretical-yield production. Using genome-scale metabolic models to calculate the production envelope, we demonstrate that the provision of bicarbonate, formed from CO 2 , restricts previous attempts for high yield production of 3-HP. We thus develop multiple strategies for bicarbonate uptake, including the identification of Sul1 as a potential bicarbonate transporter, domain swapping of malonyl-CoA reductase, identification of Esbp6 as a potential 3-HP exporter, and deletion of Uga1 to prevent 3-HP degradation. The combined rational engineering increases 3-HP production from 0.14 g/L to 11.25 g/L in shake flask using 20 g/L glucose, approaching the maximum theoretical yield with concurrent biomass formation. The engineered yeast forms the basis for commercialization of bio-acrylic acid, while our CO 2 fixation strategies pave the way for CO 2 being used as the sole carbon source., (© 2024. The Author(s).)

The operation and maintenance of railway signal systems create a significant and complex quantity of text data about faults. Aiming at the problems of fuzzy entity boundaries and low accuracy of entity recognition in the field of railway signal equipment faults, this paper provides a method for entity recognition of railway signal equipment fault information based on RoBERTa-wwm and deep learning integration. First, the model utilizes the RoBERTa-wwm pretrained language model to get the word vector of text sequences. Second, a parallel network consisting of a BiLSTM and a CNN is constructed to obtain the context feature information and the local attention information, respectively. Third, the feature vectors output from BiLSTM and CNN are combined and fed into MHA, focusing on extracting key feature information and mining the connection between different features. Finally, the label sequences with constraint relationships are outputted in CRF to complete the entity recognition task. The experimental analysis is carried out with fault text of railway signal equipment in the past ten years, and the experimental results show that the model has a higher evaluation index compared with the traditional model on this dataset, in which the precision, recall and F 1 value are 93.25%, 92.45%, and 92.85%, respectively.