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Abstract Objectives This study aimed to investigate the associations between changes in blood pressure (BP) and cerebral small vessel disease (CSVD). Methods This study included 401 participants in the magnetic resonance imaging (MRI) sub-study conducted between 2018 and 2020 as a part of the Multidomain Interventions to Delay Dementia and Disability in Rural China project. MRI markers of CSVD were assessed based on international criteria. Individualized linear regression models evaluated changes in BP by estimating the trend of blood pressure changes over time and fitting a straight line from 2014 to 2018. The data were analyzed using logistic and general linear regression models. Result The mean age of the participants was 64.48 ± 2.69 years, with 237 (59.1%) being females. Increases in systolic BP in later life were significantly associated with larger volumes of periventricular white matter hyperintensity (WMH), greater perivascular spaces in the basal ganglia (BG-PVS) burden, and the presence of deep lacunes and cerebral microbleeds. Additionally, increases in diastolic BP in later life were significantly associated with the presence of infratentorial and deep lacunes. Conclusions CSVDs are associated with increased exposure to elevated BP later in life.

Abstract Background Process-based teaching is a new education model. SPARK case database is a free medical imaging case database. This manuscript aimed to explore the application of the process-based teaching based on SPARK case database in the practice teaching of radiology in the musculoskeletal system. Methods 117 third year medical students were included. They were divided into Group A, B, C and D according to the curriculum arrangement. Group A and B attended the experimental class at the same time, A was the experimental group, B was the control group. Group C and D attended experimental classes at the same time, C was the experimental group, D was the control group. The experimental group used SPARK case database, while the control group used traditional teaching model for learning. The four groups of students were respectively tested after the theoretical class, before the experimental class, after the experimental class, and one week after the experimental class to compare the results. Finally, all students used SPARK case database to study, and were tested one month after the experimental class to compare their differences. Results The scores after the theoretical class of Group A and B were (100.0 ± 25.4), (101.0 ± 23.8)(t=-0.160, P > 0.05), Group C and D were (94.7 ± 23.7), (92.1 ± 18.6)(t = 0.467, P > 0.05). The scores of Group A and B before and after the experimental class and one week after the experimental class were respectively (84.1 ± 17.4), (72.1 ± 21.3)(t = 2.363, P 0.05), (89.7 ± 24.3), (66.6 ± 23.2)(t = 3.706, P 0.05), and Group C and D were (95.7 ± 20.3), (91.7 ± 23.0)(t = 0.699, P > 0.05). Conclusions The process-based teaching based on SPARK case database could improve the radiology practice ability of the musculoskeletal system of students.

Objectives: In this study, we aimed to evaluate the non-inferiority of a quadrivalent influenza vaccine (QIV) developed by Sinovac Biotech Co., Ltd. (Sinovac, Beijing, China) by comparing its immunogenicity and safety with a comparator QIV (Vaxigrip Tetra®) in a population aged 3 years and older in Chile and the Philippines. Methods: A phase 3, non-inferiority, double-blind, randomized controlled, multicenter clinical trial was conducted in the southern hemisphere (SH) 2023 influenza season. Participants aged ≥ 3 years old with stable health were randomized 1:1 to receive either Sinovac QIV or comparator QIV. The co-primary outcomes were immunological non-inferiority for Sinovac QIV versus the comparator against each strain contained in the vaccines in terms of seroconversion rates (SCRs) and geometric mean titers (GMTs) of hemagglutination inhibition (HI) antibodies 28 days after final vaccination. Results: A total of 2039 participants were vaccinated (1019 Sinovac QIV; 1020 comparator QIV). Sinovac QIV induced non-inferior immune responses to all four strains as compared to comparator QIV, with slightly higher GMTs than those of comparator QIV: GMT ratios (lower limit 95% confidence interval (CI)) were 1.8 (1.6) for A(H1N1), 1.4 (1.3) for A (H3N2), 1.3 (1.1) for B Victoria and 1.2 (1.1) for B Yamagata; observed seroconversion rate differences (lower limit 95% CI) were 9.6% (6.7) for A(H1N1), 7.0% (3.5) for A(H3N2), 2.4% (−0.03) for B Victoria and 6.8% (3.0) for B Yamagata. Adverse reactions were similar across the two groups and no vaccine-related serious adverse events were reported. Conclusions: The immunogenicity of Sinovac QIV was non-inferior to that of the comparator QIV in these populations aged 3 years and older, and safety was comparable.

Industrial water saving is an objective requirement for the high-quality development of the Yellow River Basin, as water resource is the largest rigid constraint. In this study, water resources input-output model, structural decomposition analysis (SDA) and structural path analysis (SPA) were constructed to decompose the driving factors of total water use in typical water-deficient provinces (Ningxia, Shanxi, and Henan) in China's Yellow River Basin, to calculate their water use at each production stage and identify their key water-saving pathways. The results were as follows: (i) Water intensity had the most obvious impact on total water saving, resulting in efficiency improvements of 81.39%, 9.21%, and 78.45% for each province, respectively. The next factor was the final demand structure, which suppressed total water-saving efforts by 24.23%, 11.52%, and 113.12% in the respective provinces. (ii) The key water-saving paths in the typical water-deficient provinces of the Yellow River Basin were primarily centered around Sector 1. (iii) Water intensity had a strong water-saving effect on the key paths in the three provinces, with contribution rates of 100.42%, 59.02%, and 42.34% for Ningxia, Henan, and Shanxi, respectively. Final demand also contributed to water-saving in the key paths of Shanxi and Henan, with contribution rates of 35.06% and 28.23%, respectively. However, it inhibited water-saving efforts in the key paths of Ningxia, reducing it by 8.64%. Policy measures should be tailored to local conditions.

An individual's likelihood of developing non-communicable diseases is often influenced by the types, intensities and duration of exposures at work. Job exposure matrices provide exposure estimates associated with different occupations. However, due to their time-consuming expert curation process, job exposure matrices currently cover only a subset of possible workplace exposures and may not be regularly updated. Scientific literature articles describing exposure studies provide important supporting evidence for developing and updating job exposure matrices, since they report on exposures in a variety of occupational scenarios. However, the constant growth of scientific literature is increasing the challenges of efficiently identifying relevant articles and important content within them. Natural language processing methods emulate the human process of reading and understanding texts, but in a fraction of the time. Such methods can increase the efficiency of both finding relevant documents and pinpointing specific information within them, which could streamline the process of developing and updating job exposure matrices. Named entity recognition is a fundamental natural language processing method for language understanding, which automatically identifies mentions of domain-specific concepts (named entities) in documents, e.g., exposures, occupations and job tasks. State-of-the-art machine learning models typically use evidence from an annotated corpus, i.e., a set of documents in which named entities are manually marked up (annotated) by experts, to learn how to detect named entities automatically in new documents. We have developed a novel annotated corpus of scientific articles to support machine learning based named entity recognition relevant to occupational substance exposures. Through incremental refinements to the annotation process, we demonstrate that expert annotators can attain high levels of agreement, and that the corpus can be used to train high-performance named entity recognition models. The corpus thus constitutes an important foundation for the wider development of natural language processing tools to support the study of occupational exposures.

Abstract Continuing studies imply that m6A RNA modification is involved in the development of cervical cancer (CC), but lack strong support on recurrence and diagnosis prediction. In this research, a comprehensive analysis of 33 m6A regulators was performed to fulfill them. Here, we performed diagnostic and prognosis models and identified key regulators, respectively. Then the CC patients were separated into two clusters in accordance with 33 regulators, and participants in the cluster 1 had a worse prognosis. Subsequently, the m6AScore was calculated to quantify the m6A modification pattern based on regulators and we found that patients in cluster 1 had higher m6AScore. Afterwards, immune microenvironment, cell infiltration, escape analyses and tumor burden mutation analyses were executed, and results showed that m6AScore was correlated with them, but to a limited extent. Interestingly, HLAs and immune checkpoint expression, and immunophenoscore in patients with high-m6AScores were significantly lower than those in the low-m6AScore group. These suggested the m6AScores might be used to predict the feasibility of immunotherapy in patients. Results provided a distinctive perspective on m6A modification and theoretical basis for CC diagnosis, prognosis, clinical treatment strategies, and potential mechanism exploration.

Objectives Hepatitis B virus (HBV) infection is a global public health threat, and couples of reproductive age comprise a key population in aiming to reduce both the vertical and horizontal transmission of HBV. We aimed to update knowledge on the seroepidemiology status of HBV in Guangdong, China among a large number of couples planning conception, and to identify high-risk subgroups.Design A cross-sectional study was performed in Guangdong, China from 2014 to 2017.Setting The data were collected from 641 642 couples (1 283 284 individuals) participating in the National Free Preconception Health Examination Project in Guangdong, China from 1 January 2014 to 31 December 2017. For each participant, sociodemographic data were obtained and a serum sample was tested for HBV infection status.Results 161 204 individuals (12.56%) were positive for hepatitis B surface antigen (HBsAg+), and 47 318 (3.69%) were positive for both HBsAg and hepatitis B e antigen (HBsAg+ and HBeAg+). There was a higher prevalence of HBsAg+ (12.77% vs 9.42%, p

During the COVID-19 pandemic, the importance of vaccinating children against SARS-CoV-2 was rapidly established. This study describes the safety of CoronaVac® in children and adolescents between 3- and 17-years-old in a multicenter study in Chile with two vaccine doses in a 4-week interval. For all participants, immediate adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were registered throughout the study. In the safety subgroup, AEs were recorded 28 days after each dose. COVID-19 surveillance was performed throughout the study. A total of 1139 individuals received the first and 1102 the second dose of CoronaVac®; 835 were in the safety subgroup. The first dose showed the highest number of AEs: up to 22.2% of participants reported any local and 17.1% systemic AE. AEs were more frequent in adolescents after the first dose, were transient, and mainly mild. Pain at the inoculation site was the most frequent AE for all ages. Fever was the most frequent systemic AE for 3–5 years old and headache in 6–17 years old. No SAEs or AESIs related to vaccination occurred. Most of the COVID-19 cases were mild and managed as outpatients. CoronaVac® was safe and well tolerated in children and adolescents, with different safety patterns according to age.

Revocation functionality and hierarchy key delegation are two necessary and crucial requirements to identity-based cryptosystems. Revocable hierarchical identity-based encryption (RHIBE) has attracted a lot of attention in recent years, many RHIBE schemes have been proposed but shown to be either insecure or bounded where they have to fix the maximum hierarchical depth of RHIBE at setup. In this paper, we propose a new unbounded RHIBE scheme with decryption key exposure resilience and with short public system parameters, and prove our RHIBE scheme to be adaptively secure. Our system model is scalable inherently to accommodate more levels of user adaptively with no adding workload or restarting the system. By carefully designing the hybrid games, we overcome the subtle obstacle in applying the dual system encryption methodology for the unbounded and revocable HIBE. To the best of our knowledge, this is the first construction of adaptively secure unbounded RHIBE scheme.

Background Antibiotic resistance is one of the world’s biggest public health issues, and the situation in China is particularly grave. The objective of this study is to investigate the antibiotics usage pattern among Chinese children and provide further insight in developing strategies for promoting public health education. Methods This is a cross-sectional study, in the study, participants are from 53,665 guardians of children aged 0–6 years, who were recruited with multistage stratified random cluster sampling in 2013/2014 from 46 community health centers in 14 provinces across China Mainland. Children’s guardians completed surveys on their previous experience on using antibiotics in treating diarrhea of their children without a prescription from any pediatrician. Odds ratios (ORs) and 95% confidential intervals (CIs) for the association between antibiotic use and its predictors were estimated using multilevel logistic regression models, with antibiotic rational use group as a reference group. Results The prevalence of antibiotic misuse among children with diarrhea in the eastern, middle and western areas of China and associations between antibiotic misuse and its predictors were studied. The average rate of antibiotic misuse is 35.12%. Multilevel logistic regression revealed that living in urban areas (OR = 0.79 (0.76, 0.83)), female children (OR = 0.92 (0.88, 0.96)), guardians having higher education (OR = 0.60 (0.55, 0.66)), being raised by parents (OR = 0.90 (0.85, 0.94)), guardians having basic health knowledge (OR = 0.82 (0.79, 0.86)) are protective factors and children’s age (1–3 years OR = 1.62 (1.54, 1.71)); 4–6 years OR = 1.90 (1.77, 2.03)) is a risk factor of antibiotic misuse among children aged 0–6 years with diarrhea in China. Conclusions Our findings confirmed that there has been a high rate of antibiotic misuse without a prescription in children with diarrhea in China, which requires considerable attention. Suitable regulations and interventions are needed to solve this problem.

Huperzine A is important in the treatment of Alzheimer's disease. There are major challenges for the mass production of huperzine A from plants due to the limited number of huperzine-A-producing plants, as well as the low content of huperzine A in these plants. Various endophytic fungi produce huperzine A. Colletotrichum gloeosporioides ES026 was previously isolated from a huperzine-A-producing plant Huperzia serrata, and this fungus also produces huperzine A. In this study, de novo RNA sequencing of C. gloeosporioides ES026 was carried out with an Illumina HiSeq2000. A total of 4,324,299,051 bp from 50,442,617 high-quality sequence reads of ES026 were obtained. These raw data were assembled into 24,998 unigenes, 40,536,684 residues and 19,790 genes. The majority of the unique sequences were assigned to corresponding putative functions based on BLAST searches of public databases. The molecular functions, biological processes and biochemical pathways of these unique sequences were determined using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) assignments. A gene encoding copper amine oxidase (CAO) (unigene 9322) was annotated for the conversion of cadaverine to 5-aminopentanal in the biosynthesis of huperzine A. This gene was also detected in the root, stem and leaf of H. serrata. Furthermore, a close relationship was observed between expression of the CAO gene (unigene 9322) and quantity of crude huperzine A extracted from ES026. Therefore, CAO might be involved in the biosynthesis of huperzine A and it most likely plays a key role in regulating the content of huperzine A in ES026.

S100A7 is highly expressed in squamous cell carcinomas (SCC) and is related to the terminal differentiation of keratinocytes. However, its characteristic and function in SCC is not very known. In this present study, we used immunohistochemistry to examine the expression of S100A7 in 452 SCC specimens, including the lung, esophagus, oral cavity, skin, cervix, bladder, and three SCC cell lines. We found that S100A7-positive staining showed significant heterogeneity in six types of SCC specimen and three SCC cell lines. Further examination found that S100A7-positive cells and its expression at mRNA and protein levels could be induced in HCC94, FaDu, and A-431 cells both in vitro and in vivo using immunohistochemistry, real-time PCR, and Western blotting. Notably, the upregulation of squamous differentiation markers, including keratin-4, keratin-13, TG-1, and involucrin, also accompanied S100A7 induction, and a similar staining pattern of S100A7 and keratin-13 was found in HCC94 cells both in vitro and in vivo. Further study revealed that the overexpression of S100A7 significantly increased proliferation and inhibited squamous differentiation in A-431 cells both in vitro and in vivo. Conversely, silencing S100A7 inhibited cell growth and survival and increased the expression of keratin-4, keratin-13, TG-1, and involucrin in HCC94 cells. Therefore, these results demonstrate that S100A7 displays heterogeneous and inducible characteristic in SCC and also provide novel evidence that S100A7 acts as a dual regulator in promoting proliferation and suppressing squamous differentiation of SCC.