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Abstract Background Diabetes is associated with high morbidity, mortality and quality-of-life impairment in patients. In China, the number of people suffering from diabetes ranks first in the world. Gansu Province is located in northwest China and is an economically underdeveloped region of China. By analyzing the level of health service utilization of people with diabetes in Gansu Province, the degree of equity in health service utilization and its influencing factors were studied to provide scientific data to support the promotion of health equity for people with diabetes and the introduction of relevant policies by relevant authorities. Methods A sample of 282 people with diabetes who were 15 years old and above was chosen by multi-stage stratified sampling method. A structured questionnaire survey was conducted via face-to-face interviews. Random forest and logistic regression analysis were used to demonstrate the effects of the explanatory variables on health seeking behaviors from predisposing, enabling and need variables. The concentration index was used to indicate the equity of health service utilization across households of different economic levels. Results The outpatient rate for the diabetic population surveyed was 92.91%, with 99.87% of urban patients, higher than the 90.39% of rural patients. The average number of hospital days per person was 3.18 days, with 5.03 days per person in urban areas, which was higher than the 2.51 days per person in rural areas. The study showed that the factors most likely to influence patients to seek outpatient services were frequency of taking diabetic medication, whether or not they were contracted to a household doctor, and living environment; the top three factors most likely to influence patients with diabetes to seek inpatient services were number of non-communicable chronic disease, self-assessment of health status, medical insurance. The concentration index for outpatient service utilization and inpatient service utilization were − 0.241 and 0.107, respectively, indicating that outpatient services were concentrated on patients at lower income levels and patients at higher income levels tended to favor inpatient services. Conclusion This study found that the low level of health care resources available to people with diabetes, whose health status is suboptimal, makes it difficult to meet their health needs. Patients' health conditions, comorbidities of people with diabetes, and the level of protection were still important factors that hindered the use of health services. It is necessary to promote the rational use of health services by diabetic patients and further improve the corresponding policies to achieve the goal of chronic disease prevention and control in “Health China 2030”.

ABSTRACT: Heat stress (HS) can result in sudden death and is one of the most stressful and costly events in chicken. Currently, biomarkers used clinically to detect heat stress state in chickens are not optimal, especially for living ones. Analysis of changes in serum proteins of heat-stressed chickens can help to identify some novel convenient biomarkers for this. Twenty-four chickens were exposed to HS at 42°C ± 1°C with a relative humidity of 65% for continuous 5 h in a single day, and 10 birds were used as controls (Con). During HS, 15 dead chickens were categorized as heat stress death group (HSD), and 9 surviving ones served as heat stress survivor group (HSS). Label-free quantitative proteomics (LFQP) was used to analyze differentially expressed proteins (DEPs) in serum of tested animals. Candidate proteins associated with HS were validated by enzyme-linked immunosorbent assay (ELISA). Diagnostic value of candidate biomarkers was assessed using receiver operating characteristic (ROC) curve analysis. Source of the selected proteins was analyzed in liver tissues with immunohistochemistry and in cell culture supernatant of primary chicken hepatocytes (PCH) using ELISA. In this study, compared to Con, LFQP identified 123 and 53 significantly different serum proteins in HSD and HSS, respectively. Bioinformatics analysis showed that XDH, POSTN, and HSP90 were potential HS biomarkers in tested chickens, which was similar with results from serum ELISAs and immunohistochemistry in liver tissues. The ROC values of 0.793, 0.752, and 0.779 for XDH, POSTN, and HSP90, respectively, permitted the distinction of heat-stressed chickens from the control. Levels of 3 proteins above in the cell culture supernatant of PCH showed an increasing trend as HS time increased. Therefore, considering that mean concentration of POSTN in serum was higher than that of HSP90, XDH, and POSTN may be optimal biomarkers in serum for detecting HS level in chickens, and mainly secreted from hepatocytes. The former indicates that heat-stressed chickens are in a damaged state, and the latter implies that chickens can repair heat stress damage.

Ethylenediamine bisborane (EDAB), as a hydrogen storage material, is one of the most promising possible candidates. This work reports the effects of pressure on the structural, mechanical, electronic, and vibrational behaviors of EDAB using density functional theory calculations. The predicted lattice parameters, bulk modulus B0 and its first pressure derivative B′ are in accord with available experimental data. From the unit-cell constants as a function of pressure, crystal EDAB is found to present an anisotropic compressibility. The calculated elastic properties show that the ambient phase EDAB is mechanical unstable at 3 GPa. Furthermore, the discontinuous behavior was found in the pressure dependence of crystal and electronic structure, suggesting a structural transformation occurred around 3 GPa. Finally, vibrational spectra are reported together with their infrared active modes assignment. The NH and BH stretching modes soften under compression, indicating the strengthening of hydrogen bonding, which leads to the occurrence of pressure-induced structural transformation.

Abstract Background Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic. Methods A cross-sectional study was conducted from February to June 2020. Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China). Descriptive statistics and t-tests were used to analyze the data. Statistical significance was set at p

Despite many studies on the immune characteristics of Coronavirus disease 2019 (COVID-19) patients in the progression stage, a detailed understanding of pertinent immune cells in recovered patients is lacking. We performed single-cell RNA sequencing on samples from recovered COVID-19 patients and healthy controls. We created a comprehensive immune landscape with more than 260,000 peripheral blood mononuclear cells (PBMCs) from 41 samples by integrating our dataset with previously reported datasets, which included samples collected between 27 and 47 days after symptom onset. According to our large-scale single-cell analysis, recovered patients, who had severe symptoms (severe/critical recovered), still exhibited peripheral immune disorders 1–2 months after symptom onset. Specifically, in these severe/critical recovered patients, human leukocyte antigen (HLA) class II and antigen processing pathways were downregulated in both CD14 monocytes and dendritic cells compared to healthy controls, while the proportion of CD14 monocytes increased. These may lead to the downregulation of T-cell differentiation pathways in memory T cells. However, in the mild/moderate recovered patients, the proportion of plasmacytoid dendritic cells increased compared to healthy controls, accompanied by the upregulation of HLA-DRA and HLA-DRB1 in both CD14 monocytes and dendritic cells. In addition, T-cell differentiation regulation and memory T cell–related genes FOS, JUN, CD69, CXCR4, and CD83 were upregulated in the mild/moderate recovered patients. Further, the immunoglobulin heavy chain V3-21 (IGHV3-21) gene segment was preferred in B-cell immune repertoires in severe/critical recovered patients. Collectively, we provide a large-scale single-cell atlas of the peripheral immune response in recovered COVID-19 patients.

Nanostructured Cu–Ni alloys have become the focus of public attention due to their better corrosion resistance and high hardness in experimental measurements. First-principles calculation based on the density functional theory (DFT) has been confirmed as an effective tool and used to illustrate the mechanical properties of these alloys. In this paper, the DFT has been employed to calculate the mechanical properties of Cu–Ni alloys, including bulk modulus, shear modulus, Young’s modulus, anisotropic index, Poisson’s ratio, average velocity, and B/G. We find that the Ni-rich Cu–Ni alloys have relatively higher mechanical parameters, and the Cu-rich alloys have smaller mechanical parameters, which is consistent with previous experiments. This provides an idea for us to design alloys to improve alloy strength.

Wild aquatic birds are the primary natural reservoir of influenza A viruses (IAVs), although a small number of viruses can spill over to mammals and circulate. The focus of IAV infection in mammals was largely limited to humans and swine variants, until the emergence of H3N2 canine influenza viruses (CIVs), which provides new perspective for interspecies transmission of the virus. In this study, we captured 54 canine-adaptive signatures in H3N2 CIVs through entropy computation, which were largely concentrated in the interaction region of polymerase proteins on ribonucleoprotein complex. The receiver operating characteristic curves of these sites showed >95% accuracy in distinguishing between the hosts. Nine of the 54 canine-adaptive signatures were shared in avian–human/equine or equine–canine (PB2-82; PB1-361; PA-277; HA-81, 111, 172, 196, 222, 489), suggesting their involvement in canine adaptation. Furthermore, we found that IAVs can establish persistent transmission in lower mammals with greater ease compared to higher mammals, and 25 common adaptation signatures of H3 IAVs were observed in diverse avian–mammals comparison. There were few human-like residues in H3N2 CIVs, which suggested a low risk of human infection. Our study highlights the necessity of identifying and monitoring the emerging adaptive mutations in companion animals by enhanced surveillance and provides a basis for mammal adaptation of avian influenza viruses.

Blended learning (BL) reform is one of the vital methods to improve the teaching quality of institutions in the intelligent education era. However, institutions are always faced with many obstacles (instructors’ reluctance/inability to change, etc.) in conducting the reform. What is worse, very few studies have reported the design and effect of such a transformation. This study designed an intervention of institutional BL reform by making a unified deployment based on Graham et al.’s BL adoption framework: identifying strategy, structure, and support issues at three developmental stages. More than 900 courses (involving more than 14,000 students and more than 2000 instructors) within S university were taken as a sample. A quasi-experiment was designed to investigate the effect of the intervention on S university’s BL course transformation, students’ learning, instructors’ professional development, etc. Course logs, responses to students’ course evaluation forms, and instructors’ questionnaires were collected and analyzed. Results indicated that S university systematically conducted the BL transformation and gradually reached the mature implementation stage within 7 years. This study contributes to the literature by reporting a best practice of BL institutional adoption. Three implications, relating to strategy, structure, and support, were drawn to shed light for other institutions in moving forward on BL adoption.

Carbon dots (CDs) have various attractive properties and potential applications, but there is much less attention paid to their phosphorescent phenomenon and mechanism. Herein, we prepared a kind of highly efficient CD-based phosphorescent material by a subtle design method that incorporated N-doped CDs (NCDs) into composite matrices (the melting recrystallization urea and biuret from the heating urea) by a one-pot heating treatment for the mixture of urea and NCDs. Through systematic investigation, C-N bonds on the surface of the NCDs can create new energy level structures, and for the first time, evidence that shows they are the origin of phosphorescence is presented. Composite matrices play a dual role to suppress the vibrational dissipation of long-lived triplets by combining the rigidity of the melting recrystallization urea and hydrogen bonding between biuret and NCDs, which have obvious advantages over a single-component matrix. The results show the obtained materials have an ultralong phosphorescent lifetime of 1.06 s under 280 nm excitation and a high phosphorescent quantum yield of 7% under 360 nm excitation in air, which are the highest values recorded for the CD-based materials. These CD-based room-temperature phosphorescent materials have also shown potential in white light-emitting diodes and data security. [ABSTRACT FROM AUTHOR]

BackgroundAnnual vaccination is the most effective prevention of influenza infection. Up to now, a series of studies have demonstrated the role of genetic variants in regulating the antibody response to influenza vaccine. However, among the Chinese population, the relationship between genetic factors and the responsiveness to influenza vaccination has not been clarified through genome-wide association study (GWAS).MethodA total of 1,968 healthy volunteers of Chinese descent were recruited and 1,582 of them were available for the subsequent two-stage analysis. In the discovery stage, according to our inclusion criteria, 123 of 1,582 subjects were selected as group 1 and received whole-genome sequencing to identify potential variants and genes. In the verification stage, 29 candidate variants identified by GWAS were selected for further validation in 481 subjects in group 2. Besides, we also analyzed nine variants from previously published reports in our study.ResultsMultivariate logistic regression analysis showed that compared with the TT genotype of ZBTB46 rs2281929, the TC + CC genotype was associated with a lower risk of low responsiveness to influenza vaccination adjusted for gender and age (Group 2: P = 7.75E-05, OR = 0.466, 95%CI = 0.319–0.680; Combined group: P = 1.18E-06, OR = 0.423, 95%CI = 0.299–0.599). In the combined group, IQGAP2 rs2455230 GC + CC genotype was correlated with a lower risk of low responsiveness to influenza vaccination compared with the GG genotype (P = 8.90E-04, OR = 0.535, 95%CI = 0.370–0.774), but the difference was not statistically significant in group 2 (P = 0.008). The antibody fold rises of subjects with ZBTB46 rs2281929 TT genotype against H1N1, H3N2,and B were all significantly lower than that of subjects with TC + CC genotype (P < 0.001). Compared with IQGAP2 rs2455230 GC + CC carriers, GG carriers had lower antibody fold rises to H1N1 (P = 0.001) and B (P = 0.032). The GG genotype of rs2455230 tended to be correlated with lower antibody fold rises (P = 0.096) against H3N2, but the difference was not statistically significant. No correlation was found between nine SNPs from previously published reports and the serological response to influenza vaccine in our study.ConclusionOur study identified two novel candidate missense variants, ZBTB46 rs2281929 and IQGAP2 rs2455230, were associated with the immune response to influenza vaccination among the Chinese population. Identifying these variants will provide more evidence for future research and improve the individualized influenza vaccination program.

In recent years, food safety issues have drawn growing concerns from society. In order to efficiently detect and prevent food safety problems and trace the accountability, building a reliable traceability system is indispensable. It is especially essential to accurately record, share, and trace the specific data within the whole food supply chain, including the process of production, processing, warehousing, transportation, and retail. The traditional traceability systems have issues, such as data invisibility, tampering, and sensitive information disclosure. The blockchain is a promising technology for the food safety traceability system because of the characteristics, such as the irreversible time vector, smart contract, and consensus algorithm. This paper proposes a food safety traceability system based on the blockchain and the EPC Information Services and develops a prototype system. The management architecture of on-chain & off-chain data is proposed as well, through which the traceability system can alleviate the data explosion issue of the blockchain for the Internet of Things. Furthermore, the enterprise-level smart contract is designed to prevent data tampering and sensitive information disclosure during information interaction among participants. The prototype system was implemented based on the Ethereum. According to the test results, the average time of information query response is around 2 ms, while the amount of on-chain data and query counts are 1 GB and 1000 times/s, respectively.

The water vapor-related microphysical processes (WVRMPs) in cloud microphysics schemes are crucial to the formation and dissipation of clouds, which have a significant impact on the quantitative precipitation forecasting of numerical weather prediction models. In this study, a well physics-based parallel-split transition approach (PSTA) to compute the WVRMPs from the same temperature and humidity state is developed and compared with the original sequential-update transition approach (SUTA) in a double-moment cloud microphysics scheme. Case study and batch experiments were carried out to investigate their different impacts on the clouds and precipitation simulated by the Global/Regional Assimilation and Prediction System (GRAPES) regional 3 km high-resolution model of the China Meteorological Administration (CMA), named CMA-MESO. The results show that the PSTA experiment tends to simulate a narrower and more concentrated precipitation area with a higher-intensity center compared to those of the SUTA experiment, which is more consistent with the observations. In the cold region, the net transition rates of WVRMPs from the PSTA experiment with more ice-phase hydrometeors are higher than those from the SUTA experiment. While in the warm region, the condensation and evaporation rates with violent fluctuation simulated by the SUTA are significantly larger than those from the PSTA experiment, resulting in less precipitation. The batch experiments indicate that the equitable threat scores (ETSs) of 24-h precipitation simulated by the PSTA are just slightly better than those of the SUTA, yet its ETSs of 48-h precipitation have been systematically improved for all magnitude levels against the SUTA. It is demonstrated that more attention should be paid to the reasonable treatments of the WVRMPs in developing cloud microphysics schemes.

Pomegranate peel extract (PPE), which is abundant in polyphenols, holds immerse prospects for the treatment of airway infection. In this study, water and ethanol of 30%, 50%, and 80% were used to prepare PPE. A total of 18 phenols belonging to 8 categories of polyphenols were identified in PPE by HPLC-MS/MS. The PPE from the four extraction solvents possessed different antioxidant, antibacterial, and anti-inflammatory activities. Principal component analysis revealed that though total flavonoids (TFs), total polyphenols (TPs), and total tannins (TTs) were responsible for the reducing power of PPE, only TFs contributed to the effect of PPE in inhibiting lipid membrane peroxidation. TPs, TTs, and punicalagin were positively correlated with the antibacterial strength against S. aureus while TTs alone contributed to the inhibition of methicillin-resistant S. aureus, implying the crucial role of TT in suppressing bacteria. Meanwhile, TTs was associated with the prevention of IL-6 release. The PPE with higher contents of TPs, TTs, and punicalagin had a weaker capacity to decrease nitric oxide secretion. PPE of 30% ethanol gained the highest integrated score due to its stronger antioxidant, antibacterial, and anti-inflammatory activities. It is a suitable candidate for the therapy of respiratory tract infection.

Although several cross-sectional studies have shown an association of metabolic syndrome (MetS) with nodular thyroid disease, related prospective studies are scarce. This study investigated the association of MetS with thyroid nodule (TN) incidence in Chinese adults, and explored whether the development of or recovery from MetS is associated with changes in the risk of developing TNs. A total of 4,749 Chinese aged 18–65 years were involved in this 6-year prospective study. The association of MetS with TN prevalence was examined. TN-free individuals at baseline (n = 3,133) were further examined. TN incidence rates in groups with different MetS statuses (MetS-free, MetS-developed, MetS-recovery and MetS-chronic) were analyzed. Of all participants, 18.21 and 31.65% had MetS and TNs, respectively. MetS patients had a higher TN prevalence than the non-MetS group (31.08 vs. 19.81% in males, p < 0.01; 59.52 vs. 39.59% in females, p < 0.01). Sex, age and MetS were independent risk factors for TNs. At a median follow up of 5.94 years, the MetS-chronic group (4.37/100 person-years) had a higher risk of TNs (adjusted incidence rate ratio [IRR] = 1.288 [95% CI 1.014–1.636]) compared with the MetS-free group (2.72/100 person-years) in the whole cohort. In males, the MetS-chronic group (3.76/100 person-years) had a higher risk of TNs (adjusted IRR = 1.367 [95% CI 1.017–1.835]) compared with the MetS-free group (2.31/100 person-years). In females, the risk of TNs was significantly higher in the MetS-chronic (6.44/100 person-years) and MetS-developed (6.31/100 person-years) groups compared with the MetS-free group (3.23/100 person-years).

Abstract SLC10A1 codes for the sodium-taurocholate cotransporting polypeptide (NTCP), which is a hepatocellular transporter for bile acids (BAs) and the receptor for hepatitis B and D viruses. NTCP is also a target of multiple drugs. We aimed to evaluate the medical consequences of the loss of function mutation p.Ser267Phe in SLC10A1. We identified eight individuals with homozygous p.Ser267Phe mutation in SLC10A1 and followed up for 8–90 months. We compared their total serum BAs and 6 species of BAs with 170 wild-type and 107 heterozygous healthy individuals. We performed in-depth medical examinations and exome sequencing in the homozygous individuals. All homozygous individuals had persistent hypercholanemia (P = 5.8 × 10–29). Exome sequencing excluded the involvement of other BA metabolism-associated genes in the hypercholanemia. Although asymptomatic, all individuals had low vitamin D levels. Of six adults that were subjected to bone mineral density analysis, three presented with osteoporosis/osteopenia. Sex hormones and blood lipids were deviated in all subjects. Homozygosity of p.Ser267Phe in SLC10A1 is associated with asymptomatic hypercholanemia. Individuals with homozygous p.Ser267Phe in SLC10A1 are prone to vitamin D deficiency, deviated sex hormones and blood lipids. Surveillance of these parameters may also be needed in patients treated with drugs targeting NTCP.

The accurate identification of the human brain tumor boundary and the complete resection of the tumor are two essential factors for the removal of the glioma tumor in brain surgery. We present a visible resonance Raman (VRR) spectroscopy technique for differentiating the brain tumor margin and glioma grading. Eighty-seven VRR spectra from twenty-one human brain specimens of four types of brain tissues, including the control, glioma grade II, III, and IV tissues, were observed. This study focuses on observing the characteristics of new biomarkers and their changes in the four types of brain tissue. We found that two new RR peaks at 1129 cm−1 and 1338 cm−1 associated with molecular vibrational bonds in four types of brain tissues are significantly different in peak intensities of VRR spectra. These two resonance enhanced peaks may arise from lactic acid/phosphatidic acid and adenosine triphosphate (ATP)/nicotinamide adenine dinucleotide, respectively. We found that lactic acid and ATP concentrations vary with glioma gratings. The higher the grade of malignancy, the more the increase in lactic acid and ATP concentrations. These two RR peaks may be considered as new molecular biomarkers and used to evaluate glioma grades and identify the margin of gliomas from the control tissues. The metabolic process of lactic acid and ATP in glioma cells based on the VRR spectral changes may reveal the Warburg hypothesis.