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Physical performance in hemodialysis patients declines and serves as a cardiovascular disease (CVD) incidence and mortality predictor. However, lower extremity function's role remains unclear. This study aimed to quantify the association between lower extremity function and CVD risk in hemodialysis patients. This was a multicenter cross‐sectional study enrolling 868 participants (532 males, 336 females) from seven hemodialysis centers in Shanghai, China. Patients were divided into three groups per lower extremity function, evaluated by short physical performance battery (SPPB) scores: 0–6, 7–9, and 10–12. Upper extremity function was quantified through grip strength assessment. CVD risk was assessed using the Framingham Risk Score. Approximately 35% of hemodialysis patients had impaired lower extremity function (SPPB score < 10). Participants with high SPPB scores had stronger handgrip and lower Framingham CVD risk scores than those with low and moderate SPPB scores (p < 0.05). After adjusting clinical confounders, SPPB was independently associated with CVD risk, as a categorized variable (odds ratio: 0.577, 95% confidence interval [CI]: 0.388–0.857, p = 0.006) and as a continuous variable (odds ratio: 0.858, 95% CI: 0.772–0.953, p = 0.004). An SPPB score < 10 predicted an increased CVD risk (area under curve: 0.649, 95% CI: 0.599–0.699, p < 0.001). Causality between physical performance and CVD risk was not considered. Some upper limb results may not be generalizable to peritoneal dialysis and kidney transplant patients. Lower extremity function was significantly associated with CVD risk in hemodialysis patients. Further studies are needed to explore the long‐term relationship between lower extremity function and CVD risk. [ABSTRACT FROM AUTHOR]

Background Lack of evaluations of the dietary phosphorus and dialysis phosphorus removal in daily clinical practice are common obstacles to assessing phosphorus balance and controlling phosphorus in hemodialysis patients. We aimed to investigate whether individualized therapy using a phosphorus balance calculator improves phosphorus control. Methods A randomized, open-label, multicenter, 4-week clinical trial was conducted. A total of 119 maintenance hemodialysis patients aged 18–85 years old and with serum phosphorus level >1.45 mmol/L from three university teaching hospitals in Shanghai were enrolled. Patients were randomized in a 1:1 ratio to individualized therapy (n  = 60) or conventional therapy (n  = 59). The primary outcome was the serum phosphorus concentration after 4-week treatment. Secondary outcomes included the serum calcium and parathyroid hormone (PTH) concentrations, changes in serum phosphorus, calcium and PTH concentrations, and the proportion of patients achieving target ranges of serum phosphorus, calcium and PTH after 4-week treatment. Results Among 119 randomized participants [mean age 62 years; 68 male (57%)], 116 completed the trial. Using the phosphorus balance calculator, the individualized group achieved a better phosphorus balance state and significantly reduced serum phosphorus (1.62 ± 0.45 mmol/L versus 1.85 ± 0.45 mmol/L, P  = .006), increased the proportions of patients achieving target serum phosphorus range (41% versus 18%, P  = .006) and had greater adjusted mean difference in change in serum phosphorus over the 4 weeks (−0.47 versus −0.23 mmol/L, P  = .010) when compared with conventional therapy. No significant changes were observed in serum calcium and PTH levels, the proportion of patients achieving target serum calcium or PTH levels, or the adjusted mean difference of serum calcium and PTH levels over the treatment period. Conclusion Phosphorus balance calculator was proved to improve serum phosphorus control in patients undergoing maintenance hemodialysis, offering a new tool for managing hyperphosphatemia. [ABSTRACT FROM AUTHOR]

Background: CaIMR is proposed as a novel angiographic index designed to assess microcirculation without the need for pressure wires or hyperemic agents. We aimed to investigate the impact of caIMR on predicting clinical outcomes in STEMI patients. Methods: One hundred and forty patients with STEMI who received PCI in Putuo Hospital of Shanghai from October 2021 to September 2022 were categorized into CMD and non–CMD groups according to the caIMR value. The baseline information, patient‐related examinations, and the occurrence of MACE at the 12‐month follow‐up were collected to investigate risk factors in patients with STEMI. Results: We divided 140 patients with STEMI enrolled into two groups according to caIMR results, including 61 patients diagnosed with CMD and 79 patients diagnosed with non–CMD. A total of 21 MACE occurred during the 1 year of follow‐up. Compared with non–CMD group, patients with CMD showed a significantly higher risk of MACE. A multivariate Cox regression model was conducted for the patients, and it was found thatcaIMR was a significant predictor of prognosis in STEMI patients (HR: 8.921). Patients with CMD were divided into culprit vascular CMD and non‐culprit vascular CMD, and the result found that culprit vascular CMD was associated with the incidence of MACE (OR: 4.75) and heart failure (OR: 7.50). Conclusion: CaIMR is a strong predictor of clinical outcomes and can provide an objective risk stratification for patients with STEMI. There is a strong correlation among leukocyte index, the use of furosemide, Killips classification, and clinical outcomes. [ABSTRACT FROM AUTHOR]

Organosulfates (OSs) are ubiquitous aerosol components, which has seen intense research over years. However, spatial and diurnal variations in OS formation in polluted atmospheres remain poorly understood. In this study, 130 OS species were quantified (or semi-quantified) in ambient fine particulate matter (PM 2.5) collected in urban and suburban Shanghai (East China) in the summer of 2021. Isoprene- and monoterpene-derived OSs were dominant OS groups (averaging 51 % and 19 % of total quantified OSs, respectively), likely indicating a large biogenic contribution to OS formation in summer. Most OSs peaked during daytime, while monoterpene-derived nitrooxy-OSs (NOS m) increased during nighttime. Accordingly, OSs were largely produced via daytime formation processes, rather than nighttime chemistry, except for NOS m. Additionally, although OS formation in the urban and suburban areas exhibited similar diurnal variations, the average concentrations of biogenic and anthropogenic OSs decreased significantly from the urban site to the suburban site. Furthermore, we concretized daytime OS formation based on the interactions among OSs, ultraviolet (UV), ozone (O 3), and sulfate (SO 42-). Indeed, the concentrations of most OSs were significantly correlated with the values of UV[O 3 ][SO 42- ] during daytime in both urban and suburban Shanghai. In particular, the correlation between major OSs and UV[O 3 ][SO 42- ] was stronger than the correlation of major OSs with O 3 and SO 42- ; moreover, there was no significant correlation between major OSs and UV. Thus, higher urban OS events were attributed to the enhanced photochemical processes and sulfate level in the urban area. Overall, this study provides field evidence for the influence of photochemical processes and anthropogenic sulfate on OS formation and has important implications for the mitigation of organic particulate pollution. [ABSTRACT FROM AUTHOR]

Background Sarcopenia is a clinical condition that is common in patients with chronic kidney disease (CKD), especially in those on dialysis. However, the relatively complicated diagnostic procedure limits its use in clinical situations. In this study we aimed to establish a simplified tool for the diagnosis of sarcopenia in patients on hemodialysis (HD). Methods Overall, 757 eligible patients from seven HD centers in Shanghai and Suzhou, China, were recruited from 2020 to 2021. The cross-sectional data were analyzed. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Among them, 511 consecutive patients (77 with and 434 without sarcopenia) from five centers were included in the training set for the establishment of a diagnostic nomogram. Ten investigative parameters including clinical characteristics, body measurements and physical performance were used to derive the diagnostic nomogram. A total of 246 consecutive patients (47 with and 199 without sarcopenia) were included for validation of the diagnostic model. Results The average age of the enrolled patients was 60.4 ± 12.1 years, 59.8% were males and 90.5% received dialysis using an arteriovenous fistula. Overall, the sarcopenia rate was 16.4%. The training and validation sets showed no significant differences in sarcopenia rate (15.1% and 19.1%, respectively; P  = .160). The nomogram derived from the training set for sarcopenia, which was based on only four features—age, sex, body weight and grip strength—achieved high C-indexes of 0.929 [95% confidence interval (CI) 0.904–0.953] and 0.955 (95% CI 0.931–0.979) in the training and external sets, respectively, and had a well-fitted calibration curve. The cut-off value was 0.725, with a sensitivity of 0.909 and a specificity of 0.816. The nomogram accurately diagnosed sarcopenia with fewer variables and more simplified diagnostic procedures. Conclusions The nomogram had a good diagnostic capability for sarcopenia in patients on HD and may be a convenient tool for clinical use. [ABSTRACT FROM AUTHOR]

Background: Though controversial for its various disadvantages, involuntary admission (IA) is necessary in providing mental health care for patients suffering from schizophrenia in China. This article examines the IA rate in a representative sample, and under which circumstances are these patients more likely to be admitted involuntarily. Methods: Adult patients consecutively admitted to two typical hospitals in Shanghai between 2013 and 2014 with a diagnosis of ICD-10 schizophrenia were included. 2167 patients were included in this study. Sociodemographic and clinical data, as well as personal information of psychiatrists who made risk assessment, were collected. The whole sample was divided into voluntary and involuntary admission groups. Group comparisons were performed with SPSS 17.0, using one-way ANOVA, Wilcoxon rank sum test, Chi-squares and Logistic regression. Results: Among 2167 inpatients, the majority (2003, 92.4%) were involuntarily admitted. Clinical features, including age of patients (p < 0.001, OR = 1.037), lacking of insight (p < 0.001, OR = 3.691), were statistically significant for IA. Psychiatrist's age (p < 0.001, OR = 1.042) was independently associated with IA. However, risk behaviors had dramatically affected patients' admission status, of which the strongest predictor of IA was noncompliance with treatment (p < 0.001, OR = 3.597). The areas under the curve of the ROC and accuracy for the regression model were 0.815 and 0.927, respectively. Conclusion: IA patients account for a major proportion of all those hospitalized with schizophrenia in China. Insights and risk behaviors contributed the most reasons for admission status of patients. This research shed light on necessity of further qualitative studies learning detailed evaluation processes of IA and high-quality interventional studies aiming to limit the performance of IA among patients with schizophrenia. [ABSTRACT FROM AUTHOR]

purpose of this study is to observe the correlation between high sensitivity C-reactive protein (hs-CRP) and metabolic syndrome (MetS) in hemodialysis patients, determine its optimal cut-off point value, and compare the diagnostic ability of different inflammatory markers for MetS. Methods: This cross-sectional study finally included 860 long-term hemodialysis patients (male 524, average age 61.5 years) from seven dialysis centers in Shanghai, China. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS, including high waist circumference, elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced HDL cholesterol. Serum hs-CRP was determined by the immunonephelometric assay. The association with MetS was observed according to the quartile of inflammatory markers, and then the optimal cut-off point value of the hs-CRP was determined by ROC analysis. Results: The overall prevalence of MetS was 55.1% (46.6% in males and 68.5% in females). In the final logistic regression model, there was a significant, graded positive association between hs-CRP and MetS (p for trend = 0.010). The traditional inflammatory markers leukocytes, neutrophils, lymphocytes, monocytes and neutrophil-to-lymphocyte ratio (NLR) were not associated with MetS. The results of the ROC analysis showed that the optimal cut point value of hs-CRP for the diagnosis of MetS was 1.58 mg/L. In the components of MetS and hs-CRP was significantly positively associated with high waist circumference, elevated TG and low HDL (p < 0.05). Conclusion: The increase in hs-CRP concentration is significantly associated with the risk of MetS, and the diagnostic ability of hs-CRP for MetS is better than traditional inflammatory markers. [ABSTRACT FROM AUTHOR]

The separation between a corporate headquarters and its registered address is no longer a rare phenomenon, which not only exerts an important socioeconomic impact but also leads to deviations from reality in the conclusions of many studies that use the registered address as the location of corporate headquarters. We take Chinese A-share listed companies as an example to investigate the interprovincial separation between headquarters and registered addresses and its formation process and use a logistic model to analyze the impact of company attributes on the interprovincial separation between headquarters and registered addresses. The results show that the companies with separate headquarters and registered addresses account for approximately one-third of all listed companies; 177 companies have their headquarters and registered addresses in different provinces. These companies are usually headquartered in economically developed cities (such as Beijing and Shanghai), while their registered addresses are mainly located in general cities. Inconsistent interprovincial migration between headquarters and registered addresses is the main reason for the interprovincial separation of the two. The logistic model demonstrates that industry, organizational form, city level of the registered address, special treatment, and restructuring exert varying degrees of influence on the interprovincial separation between headquarters and registered addresses. [ABSTRACT FROM AUTHOR]

Candida tropicalis is the leading cause of non-C. albicans candidemia in tropical Asia and Latin America. We evaluated isolates from 344 patients with an initial episode of C. tropicalis candidemia. We found that 58 (16.9%) patients were infected by fluconazole-nonsusceptible (FNS) C. tropicalis with cross resistance to itraconazole, voriconazole, and posaconazole; 55.2% (32/58) of patients were azole-naive. Multilocus sequence typing analysis revealed FNS isolates were genetically closely related, but we did not see time- or place-clustering. Among the diploid sequence types (DSTs), we noted DST225, which has been reported from fruit in Taiwan and hospitals in Beijing, China, as well as DST376 and DST505-7, which also were reported from hospitals in Shanghai, China. Our findings suggest cross-boundary expansion of FNS C. tropicalis and highlight the importance of active surveillance of clinical isolates to detect dissemination of this pathogen and explore potential sources in the community. [ABSTRACT FROM AUTHOR]

The combined usage of high-resolution satellite images and thermal infrared (TIR) data helps understanding the thermal effect of urban fabric properties and the mechanism of urban heat island (UHI) formation. In this study, three typical urban functional zones (UFZs) of downtown Shanghai were chosen for quantifying the relationship between fine-scale urban fabric properties and their thermal effect. Nine land surfaces and 146 aggregated land parcels extracted from a QuickBird image (dated 14 April 2014) were used to characterize urban fabric properties. The thermal effect was deduced from land surface temperature (LST), intra-UHI intensity, blackbody flux density (BBFD) and blackbody flux (BBF). The net BBF was retrieved from the Landsat 8 TIR band 10 dated 13 August 2013, and 28 May 2014. The products were resampled to fine resolution using a geospatial sharpening approach and further validated. The results show that: (1) On the UFZ level, there is a significant thermal differential among land surfaces. Water, well-vegetated land, high-rises with light color and high-rises with glass curtain walls exhibited relatively low LST, UHI intensity and BBFD. In contrast, mobile homes with light steel roofs, low buildings with bituminous roofs, asphalt roads and composite material pavements showed inverse trends for LST, UHI intensity, and BBFD; (2) It was found that parcel-based per ha net BBF, which offsets the "size-effect" among parcels, is more reasonable and comparable when quantifying excess surface flux emitted by the parcels; (3) When examining the relationship between parcel-level land surfaces and per ha BBF, a partial least squares (PLS) regression model showed that buildings and asphalt roads are major contributors to parcel-based per ha BBF, followed by other impervious surfaces. In contrast, vegetated land and water contribute with a much lower per ha net BBF to parcel warming. [ABSTRACT FROM AUTHOR]

This article addresses the linked topics of internal migration and occupational discrimination against migrants. The data, collected from 21 manufacturing companies in Shanghai, indicate that migrants are a heterogeneous group in terms of their origins. Migrants from rural areas are the least well-educated. In contrast, migrants from other cities in China have attained significantly higher education than local workers in Shanghai. Much of the literature compares the occupations of rural migrants and local residents; urban migrants are often neglected. By examining occupational patterns for rural migrants, urban migrants and local workers, this study adds to the literature through a full assessment of occupational inequalities. Such inequalities reflect both market forces (rewards for differing productivity) and institutional factors (rewards on grounds of residential status). [ABSTRACT FROM PUBLISHER]

Background: To retrospectively review the incidence, treatment efficacy, we followed up newly diagnosed chronic myelogenous leukemia (CML) patients residing in Shanghai during 2001-2006. Methods: All eligible cases were reviewed with the data of efficacy responses as well as overall survival (OS) and progression-free survival (PFS) time. Results: A total of 615 cases entered the study. CML mainly afflicted those aged 40-60 years old and was slightly more frequent in males than females. More than 85% of the patients were in chronic phase (CP) when diagnosed. All patients were divided into four groups based on the main regimens - hydroxyurea, interferon alpha (IFN-a), imatinib, and hemopoietic stem cell transplantation (HSCT). With the median follow-up of 18 months, imatinib treatment induced 92.2% complete hematologic responses, and 64.3% complete cytogenetic responses among CML-CP patients. Overall the therapeutic efficacy in the imatinib group was higher than that in the hydroxyurea or IFN-α group. Meanwhile, in the imatinib group, all response rates of patients in CP were significantly greater than that in accelerated or blastic crisis phase. The patients treated with imatinib also showed the most promising results regarding OS and PFS. Patients receiving HSCT decreased markedly in number with the introduction of imatinib. Conclusions: The number of new patients arising in Shanghai increased from 2001 to 2006. There were still patients receiving hydroxyurea and IFN-α. As the first-line regime for CML, imatinib was less administered in Shanghai before, but has received considerable development and great responses since 2003. [ABSTRACT FROM AUTHOR]

It has been documented widely that temporary migrants in Chinese cities are subject to labour market discrimination and urban labour markets are segmented across institutional barriers including the hukou system. Continued economic reform and policies, committed to more equal treatment of migrants and local dwellers, will generate greater competition between migrants and local workers. This article assesses whether the urban labour markets for migrants and local workers have remained segmented by examining the existence, and the extent, of wage discrimination against migrants. Our data, collected during recent fieldwork in Shanghai, revealed that migrants from rural and urban origins differed in their educational attainment and skills. We then compared wage patterns for rural migrants, urban migrants and local workers in Shanghai separately. These wage differentials reflected both market forces (rewards to differing productivity) and institutional factors (rezoards to residence status or hukou), indicating that discrimination in the labour market still exists. [ABSTRACT FROM AUTHOR]

Background: Renal anemia is one of the most important complications in patients on maintenance hemodialysis (MHD). Telehealth-based dialysis registration systems have the advantage of real-time monitoring and have gradually been applied to the management of chronic diseases.Objective: The objective of our study was to evaluate the impact of a telehealth-based dialysis registration system on patients on MHD in terms of renal anemia control.Methods: The Red China project aimed to develop a dialysis registration system based on the WeChat mobile platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, and baseline creatinine levels were recorded using this system. In addition, the hemoglobin and hematocrit levels were recorded monthly. The platform then generated a hemoglobin and hematocrit statistics report for each hemodialysis center monthly, including the detection rate, target rate, and distribution of hemoglobin and released it to physicians via the WeChat mobile phone app. The physicians were then able to treat the individual's anemia appropriately by changing the doses of erythropoiesis-stimulating agents or iron use on the basis of this report. We analyzed the demographic and baseline laboratory parameters, detection rate, target rate, and average level and distribution of hemoglobin 28 months after the launch of the project.Results: A total of 8392 patients on MHD from 28 hemodialysis centers in Shanghai were enrolled from June 2015 to October 2017. The detection rate of hemoglobin increased from 54.18% to 73.61% (P<.001), the target rate of hemoglobin increased from 47.55% to 56.07% (P<.001), and the mean level of hemoglobin increased from 10.83 (SD 1. 60) g/dL to 11.07 (SD 1.60) g/dL (P<.001). In addition, the proportion of patients with hemoglobin levels ≥11 g/dL but <13 g/dL increased from 40.40% to 47.48%.Conclusions: This telehealth-based dialysis registration system can provide timely reporting of the anemia status in patients on MHD, which may improve the awareness of anemia and the attention to and compliance with anemia monitoring. [ABSTRACT FROM AUTHOR]

Background: Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive sarcomas that typically carry a dismal prognosis. Given the insensitivity of these tumors to traditional chemotherapy and the absence of effective targeted drugs, new therapeutic strategies are urgently needed. Photothermal therapy (PTT) including near- infrared laser at the third biowindow (NIR-III) has demonstrated significant potential in cancer theranostics due to its minimally invasive nature and excellent therapeutic outcomes. However, the passive utilization of photothermal agents (PTAs) with poor target specificity and biocompatibility substantially hinders the clinical translation and application of this method. Methods: We evaluated the efficiency, safety, and underlying mechanisms of NIR-III without PTAs in the treatment of MPNSTs. The photothermal performance and tissue penetration capability of the NIR-III laser were evaluated in human MPNST cell lines using CCK-8, Calcein-AM and propidium iodide (PI) staining, and Annexin V-FITC/PI assays. The tumor xenografted mice model was used for evaluating the efficacy and biosafety of NIR-III photothermal ablation. Finally, the underlying mechanisms of NIR- III treatment, explored by whole-transcriptome sequencing, are further verified by RT-qPCR. Results: We found that although the NIR-III photothermal treatment efficiency varied among individuals, which was possibly influenced by different endoplasmic reticulum stress responses, the expected antineoplastic effect was ultimately achieved after adjustment of the power density and radiation duration. Conclusions: The present study provides an intriguing noninvasive therapy for MPNSTs that accelerates the clinical translation of PTT while avoiding the biocompatibility issues arising from PTAs. Funding: This work was supported by grants from National Natural Science Foundation of China (82102344; 82172228); Shanghai Rising Star Program supported by Science and Technology Commission of Shanghai Municipality (20QA1405600); Natural Science Foundation of Shanghai (22ZR1422300); Science and Technology Commission of Shanghai Municipality (19JC1413) ; "Chenguang Program" supported by Shanghai Education Development Foundation (SHEDF) (19CG18); Shanghai Municipal Key Clinical Specialty (shslczdzk00901); Innovative research team of high-level local universities in Shanghai (SSMU-ZDCX20180700). [ABSTRACT FROM AUTHOR]