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The disposal of agricultural waste ash is a great ecological challenge. This study analyzed the basic properties of corn straw ash and soybean straw ash, encompassing the identification of key oxides, the assessment of particle size distribution, and the performance of thermogravimetric analysis. This study also evaluated the potential of corn straw ash and soybean straw ash to replace cement in mortar and concrete through laboratory tests. The findings indicated that the strength activity index of corn straw ash was higher than soybean straw ash. Furthermore, when these ashes were used as cement replacements, the compressive strength of concrete decreased. Notably, concrete containing corn straw ash exhibited greater strength than concrete with the same substitution amount of soybean straw ash. Specifically, at a 5% substitution level, the compressive strengths of corn straw ash concrete and soybean straw ash concrete were 31.5 and 30.5 MPa, respectively. Additionally, soybean straw ash concrete demonstrated superior resistance to water penetration compared to corn straw ash concrete. Both corn straw ash and soybean straw ash exhibited the potential to enhance the early crack resistance of concrete.

Subway tunneling construction in shallow buried karst region is a common challenge. Survey boreholes and cross-hole seismic CT data showed that 29 karst caves exist at elevation of −17 m to −37 m in Si–He section of the Wuxi Metro Line 4, which are consisted of 18 filled caves and 11 empty caves and constitute substantial dangers to the stability and quality of metro construction projects. Based on their size, position, and type of filling, we divided these shallow karst caves into four types. Aimed at exploring the instability of the tunnel after excavation, numerical analyses have been developed by using the Finite difference method. Both the effects of the distance between tunnel and karst caves and the effects of the filling of the cavities on the overall stability of the rock mass around the tunnel have been investigated. According to the design criteria, safety distance between tunnel and karst caves was determined. The monitoring data of tunnel during excavation proved the rationality and accuracy of the analysis results. The research results can provide technical reference for the design and construction of other proposed tunnels that are located in the regions of shallow buried karst in Jiangsu Province.

Long non-coding RNA (lncRNA) PMS2L2 has been reported to participate in endotoxin-induced inflammatory responses. As these types of responses can promote osteoarthritis (OA), it was of interest to ascertain if PMS2L2 may be involved in OA. To explore any potential participation of PMS2L2 in OA, synovial fluid was extracted from both OA patients and healthy controls (n = 62 each) and PMS2L2 expression of each sample determined by RT-qPCR. In addition, as miR-34a has a potential binding site on PMS2L2, hypothetical interactions between PMS2L2 and miR-34a in chondrocytes were analyzed by performing over-expression experiments. Furthermore, the role of PMS2L2 and miR-34a in the regulation of chondrocyte proliferation was analyzed using CCK-8 and BrdU assays. The results showed that PMS2L2 expression in OA patient synovial fluid was lower compared to that in control group fluid, and the extent of this reduction was related to disease stage. In in vitro studies, it was seen that endotoxin treatment of chondrocytes led to decreased PMS2L2 expression. It was found that PMS2L2 over-expression caused increased miR-34a expression in OA patient chondrocytes but not in cells from healthy controls. In contrast, miR-34a over-expression in either cell population did not affect PMS2L2 expression. Lastly, over-expression of both PMS2L2 and miR-34a led to inhibited chondrocyte proliferation. Of note, a combined over-expression of PMS2L2 and miR-34a resulted in stronger effects on proliferation compared to that from either single over-expression. Based on the findings that PMS2L2 is down-regulated during ongoing states of OA, and that changes in PMS2L2 expression can lead to increases in chondrocyte expression of miR-34a – resulting in inhibition of chondrocyte proliferation in OA. From these findings, one may conclude that finding means to regulate PMS2L2 could be a promising new target in the development of regimens for the treatment of OA.

In recent years, the unloading of excavation engineering activities such as foundation pits and tunnels has caused excessive lateral deformation of cohesive soil, which result in more and more engineering accidents. At present, the inclinometer is often used to monitor the horizontal displacement of the soil around the foundation pit. However, due to the special engineering properties of soft soil, the inclinometer cannot be driven to deform with the soft soil during monitoring. The effect of monitoring is often unsatisfactory and inaccurate to reflect the true deformation. Therefore, it is necessary to strengthen the research of lateral deformation monitoring technology of soil in the construction of excavation unloading engineering. In this paper, based on the directional characteristics of the deformation of magnetic minerals under loading, the magnetic fabric test is used to study the magnetic anisotropy of the cohesive soil sample after unconfined compression test and then to compare with the results of the confined one. The paper then discusses the mathematical relationship between the main magnetic susceptibility value and the strain as the consequence of the analysis of the influence of the axial stress and the moisture content of soil on the magnetic anisotropy under unconfined compression. Finally, the feasibility of the calculation of the law of force and the deformation from the magnetic anisotropy of the cohesive soil is explored. The research results show that the deformation of the cohesive soil under force has good consistency with its orientation of magnetic mineral. This understanding has important theoretical significance and practical application value for effectively monitoring the deformation of soft soil around unloading projects in soft soil areas.

Abstract Background Necrotizing enterocolitis (NEC) is the leading cause of death among preterm infants born at

BackgroundAbnormal accumulation of macrophages in the colon cancer (CC) contribute to its progression. miR-183-5p has been confirmed as an oncogene in CC and this article explores the effect and mechanism of exosomal miR-183-5p enriched by M2-polarized tumor-associated macrophages (TAM) on CC cells.MethodsThe human macrophage THP1 was induced to M2 polarization through IL-4 and IL-13 treatment. Exosomes in THP1 were isolated through ultracentrifugation, and the miR-183-5p expression in macrophages and exosomes was verified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The miR-183-5p inhibitors and mimics were applied to down-regulate and upregulate miR-183-5p in macrophages, respectively. Meanwhile, CC cell lines LoVo and SW480 were treated with the macrophage conditioned medium and exosomes, respectively. CC cells’ proliferation, invasion, and apoptosis were tested by the cell counting kit-8 (CCK-8) assay, colony formation assay, flow cytometry (FCM), Transwell assay, and xenograft assay, respectively. The profiles of thioesterase superfamily member 4 (THEM4), Akt, and NF-κB were compared by Western blotting (WB).ResultsThe miR-183-5p level in M2-TAM and M2-TAM-derived exosomes was significantly increased. Meanwhile, M2-TAM and M2-TAM-derived exosomes significantly facilitated CC cell proliferation and invasion and dampened apoptosis. Overexpression of miR-183-5p in M2-TAM aggravated M2-TAM-mediated promotive effects on CC cells, with down-regulating miR-183-5p reversed M2-TAM-mediated tumor-promotive effects. Mechanically, miR-183-5p targeted THEM4 and inhibited its mRNA and protein expression. Overexpressing THEM4 abated miR-183-5p-mediated carcinogenic effects and inactivates Akt and NF-κB pathways in CC cells. Overall, this article elaborated that exosomal miR-183-5p shuttled by M2-TAM mediated Akt/NF-κB pathway to accelerate CC progression through targeting THEM4.

A large underground transportation hub is located on the west side of the Nanjing Youth Olympic Center, which is close to the embankment of the Yangtze River. The near-surface primarily comprises newly deposited soft soil of considerable thickness; the lower part is a riverbed-phase sandy soil containing two confined aquifers. The foundation pit requires deep excavation and has unusual shapes of “pit in pit” and “pit leaning pit.” For the convenience and safety of excavation, the piezometric head of the upper confined aquifer, where the pit bottom is located, reached 1 m below the bottom plane through precipitation, while that of the lower confined aquifer also dewatered down to a safe water level to avoid an uplift problem. After considering the engineering geological conditions, the function and shape of the foundation pits, we divided the soil layers of the foundation pits into two areas (the NW area and the SE area) and proposed the support scheme correspondingly. The numerical simulation results and completed construction safely verified the feasibility of the support scheme.

A deep foundation pit constructed for an underground transportation hub was excavated near the Yangtze River. Among the strata, there are two confined aquifers, between which lies an aquiclude that is partially missing. To guarantee the safety of pit excavation, the piezometric head of the upper confined aquifer, where the pit bottom is located, should be 1 m below the pit bottom, while that of the lower confined aquifer should be dewatered down to a safe water level to avoid uplift problem. The Yangtze River levee is notably close to the pit, and its deformation caused by dewatering should be controlled. A pumping test was performed to obtain the hydraulic conductivity of the upper confined aquifer. The average value of the hydraulic conductivity obtained from analytical calculation is 20.45 m/d, which is larger than the values from numerical simulation (horizontal hydraulic conductivity KH = 16 m/d and vertical hydraulic conductivity KV = 8 m/d). The difference between KH and KV indicates the anisotropy of the aquifer. Two dewatering schemes were designed for the construction and simulated by the numerical models for comparison purposes. The results show that though the first scheme could meet the dewatering requirements, the largest accumulated settlement and differential settlement would be 94.64 mm and 3.3‰, respectively, greatly exceeding the limited values. Meanwhile, the second scheme, in which the bottoms of the waterproof curtains in ramp B and the river side of ramp A are installed at a deeper elevation of −28 m above sea level, and 27 recharge wells are set along the levee, can control the deformation of the levee significantly. Keywords: Deep foundation pit, Parameter calculation, Dewatering schemes, Numerical simulation

A conveyance water shield tunnel under the Yangtze River, which was designed for the Jiangsu Changshu Power Plant Co., Ltd., was damaged due to water leakage and submersion. In order to complete the engineering, the shield tunnel should be repaired, and the connection between the shield and standpipes should be completed. Therefore, a deep excavation recovery program was designed. According to the excavation design, the distance between the axes of the two tunnels is only 20.8 m, but the depth of excavation reaches 15.1 m. Because of the small distance between the deep excavation and the adjacent west line tunnel, the new excavation in the east line tunnel might have large effects on the west line tunnel, and the environmental effects on the west tunnel due to the excavation should be evaluated. Simulations using 3D and 2D finite element methods were performed. The variations in the loads and lateral deformations on the retaining structures due to earth pressure differences outside and inside the foundation pit were analyzed in detail. The environmental effects on the west line tunnel due to deep excavation were evaluated. The 2D and 3D numerical simulation results were compared. The numerical simulation results agree with practical engineering and are applicable and reliable.

Building deformations are not only closely related to the distance from the building to metro-station excavation but also related to the relative positions of the building and metro-station excavation. Building deformations can be predicted using ground surface settlement profiles. Based on typical geological parameters of Nanjing metro-station excavation, ground surface settlements were numerically simulated by auxiliary planes perpendicular and parallel to the excavation and by angled auxiliary planes at the excavation corner. Results show that the ground surface settlement profiles in auxiliary planes are closely related to the relative positions of the auxiliary planes and the metro-station excavation. Partitioning of ground surface settlements was proposed according to the three types of ground surface settlement profiles; furthermore, bending deformation and torsional deformation regularities of surrounding buildings were analyzed, and an estimation method for building settlements was developed. Finally, field-monitored settlement data of 21 buildings in different zones were compared with the estimated settlement data, and the application of the settlement estimation method to different types of foundations was analyzed. The results of this study can serve as reference for metro-station deep excavation construction and protection of surrounding buildings.

China has abundant straw resources; however, the utilization of straw waste resource remains challenging. In this work, corn straw fiber and corn straw ash were applied to concrete as raw material after pretreatment. Through mechanical and thermal conductivity tests, it was concluded that the tensile strength of the corn straw fiber was 160.5 MPa after alkali treatment. The corn straw fiber and corn straw powder did not enhance the compressive strength of concrete. Compared with original concrete, the thermal conductivity of concrete added with 1.5% corn straw powder decreased by 25.9%, and the thermal conductivity of concrete with 5% corn straw ash was reduced by only 5.2%. Through thermogravimetric analysis of the concrete, it was found that the internal weakly bound water and strongly bound water will be lost in the range 100 °C to 160 °C, Ca(OH)2 will decompose from 420 °C to 500 °C, and CaCO3 will decompose approximately at 800 °C. It is recommended that corn straw powder and corn straw ash can be added at 1.5% and 5% concentrations to ensure that the mechanical properties can meet the engineering requirements and achieve good insulation performance. [ABSTRACT FROM AUTHOR]

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Abstract Background Describing the transmission dynamics of infectious diseases across different regions is crucial for effective disease surveillance. The multivariate time series (MTS) model has been widely adopted for constructing cross-regional infectious disease transmission networks due to its strengths in interpretability and predictive performance. Nevertheless, the assumption of constant parameters frequently disregards the dynamic shifts in disease transmission rates, thereby compromising the accuracy of early warnings. This study investigated the applicability of time-varying MTS models in multi-regional infectious disease monitoring and explored strategies for model selection. Methods This study focused on two prominent time-varying MTS models: the time-varying parameter-stochastic volatility-vector autoregression (TVP-SV-VAR) model and the time-varying VAR model using the generalized additive framework (tvvarGAM), and intended to explore and verify their applicable conditions for the surveillance of infectious diseases. For the first time, this study proposed the time delay coefficient and spatial sparsity indicators for model selection. These indicators quantify the temporal lags and spatial distribution of infectious disease data, respectively. Simulation study adopted from real-world infectious disease surveillance was carried out to compare model performances under various scenarios of spatio-temporal variation as well as random volatility. Meanwhile, we illustrated how the modelling process could help the surveillance of infectious diseases with an application to the influenza-like case in Sichuan Province, China. Results When the spatio-temporal variation was small (time delay coefficient: 0.1–0.2, spatial sparsity:0.1–0.3), the TVP-SV-VAR model was superior with smaller fitting residuals and standard errors of parameter estimation than those of the tvvarGAM model. In contrast, the tvvarGAM model was preferable when the spatio-temporal variation increased (time delay coefficient: 0.2–0.3, spatial sparsity: 0.6–0.9). Conclusion This study emphasized the importance of considering spatio-temporal variations when selecting appropriate models for infectious disease surveillance. By incorporating our novel indicators—the time delay coefficient and spatial sparsity—into the model selection process, the study could enhance the accuracy and effectiveness of infectious disease monitoring efforts. This approach was not only valuable in the context of this study, but also has broader implications for improving time-varying MTS analyses in various applications.

Abstract Novel phase of nano materials that break the traditional structural constraints are highly desirable, particularly in the field of mechanocatalysis, offering versatile applications ranging from energy to medical diagnosis and treatment. In this work, a distinct layered barium dititanate (BaTi2O5) nanocrystals using a pH‐modulated hydrothermal method is successfully synthesized. These nanocrystals exhibit outstanding hydrogen generation capability (1160 µmol g−1 h−1 in pure water) and demonstrate remarkable performance in organic dye degradation using ultrasonication. The crystal structure of this newly discovered BaTi2O5 phase, is determined by a combination of synchrotron Powder Diffraction refinement and X‐ray adsorption techniques, including X‐ray Absorption Near Edge Structure (XANES) and Extended X‐ray Absorption Fine Structure (EXAFS). Density Functional Theory calculations revealed that the newly‐discovered BaTi2O5 phase demonstrates dipole moments along the z‐axis, distributed in an antiparallel direction within a single unit cell. These inherent dipoles induce a surface polarization and a ferroelectric‐flexoelectric response under mechanical stimuli when the materials go to nano dimension. With a band alignment well‐suitable for hydrogen and reactive oxygen species generation, this BaTi2O5 phase demonstrates promising potential for Mechanocatalysis. The discovery of this distinct phase not only enriches the material candidates for mechanocatalysis but also provides valuable insights.

Abstract Background There is a significant increase in the number of SARS-CoV-2 reinfection reports in various countries. However, the trend of reinfection rate over time is not clear. Methods We searched PubMed, Web of Science, Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang for cohort studies, case-control studies, and cross-sectional studies up to March 16, 2023, to conduct a meta-analysis of global SARS-CoV-2 reinfection rate. Subgroup analyses were performed for age, country, study type, and study population, and time-varying reinfection rates of SARS-CoV-2 were estimated using meta-regression. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Joanna Briggs Institute critical appraisal tool. Result A total of 55 studies involving 111,846 cases of SARS-CoV-2 reinfection were included. The pooled SARS-CoV-2 reinfection rate was 0.94% (95% CI: 0.65 -1.35%). In the subgroup analyses, there were statistically significant differences in the pooled reinfection rates by reinfection variant, and study type (P

This study investigates the use of treated sewage water (TSW) as a substitute for fresh tap water (FTW) in concrete production using calcium sulfoaluminate (CSA) cement. The research addresses concerns about freshwater scarcity and emphasizes CSA cement's rapid setting properties, crucial for emergency constructions like military airfield recovery. The focus is on the early-age properties of CSA paste mixed with TSW, with assessments conducted at 4 h, 1 day, and 3 days post-mixing. Key parameters, including slump, setting times, and hardened characteristics, were evaluated. TSW contained significant metal concentrations and a high pH, with total dissolved solids exceeding FTW by 67 %, yet all parameters remained within acceptable limits. Analytical techniques identified ettringite (AFt) as a primary hydration product, while ye'elimite (C4A3Š) was present as a component of the unhydrated clinker in the CSA cement. Simulations showed improved stability in the TSW-CSA interface compared to FTW, although early hydration was slower, likely due to delayed C4A3Š hydration and increased AFt formation. Initially, CSA/TSW pastes presented a refined microstructure, which altered by 3 days. Despite a 14 % faster final setting time, compressive strength was 21 % lower at 4 h. These findings highlight TSW's potential as a sustainable alternative in CSA cement mixing, necessitating further research for long-term performance evaluation.

BiFeO3 (BFO), Mn-doped-BFO (BFMO), Ti-doped-BFO (BFTO), and (Mn,Ti)-codoped-BFO (BFMTO) thin films are fabricated on the Pt/TiO2/SiO2/Si substrates via a sol–gel method combined with spin-coating and the subsequent layer-by-layer annealing technique. Compared with BFO film, the BFMTO film exhibits the lowest leakage current density ([Formula: see text][Formula: see text]A/cm2@290[Formula: see text]kV/cm). Notably, the polarization–electric field (P–E) loop of BFMTO film exhibits a positive displacement along the x-axis due to the existence of internal bias electric field, which is in agreement with the results of the PFM phase and amplitude curves. Especially, a very prominent inverse piezoelectric constant of [Formula: see text][Formula: see text]pm/V was obtained, which overcomes other related thin films. The internal bias electric field of BFMTO film can be caused by the different work functions of the thin film and the bottom electrode, accumulation of oxygen vacancies and the formation of defect dipoles. Besides, the internal bias electric field of BFMTO film has a good stability at the same electric field after experiencing the test cycle from low electric field to high electric field (400–1900[Formula: see text]kV/cm). These results indicate that self-polarized BFMTO film can be integrated to devices without additional polarization process, and have a wide range of application in microelectromechanical systems.

BackgroundMultiple investigations and scholarly articles have presented compelling evidence indicating that tertiary lymphoid structures (TLS) play a pivotal role in inhibiting and controlling the advancement of tumors. While there is an abundance of information highlighting the importance of TLS in different cancer types, their prognostic significance specifically in hepatocellular carcinoma (HCC) cancers remains unclear. Thus, this meta-analysis aimed to explore the prognostic relevance of TLS in HCC.MethodsWe conducted a thorough search across four databases, namely Web of Science, PubMed, Embase, and the Cochrane Library, to identify pertinent studies. The search utilized the keywords “tertiary lymphoid structures” and “hepatocellular carcinoma.” The primary outcomes of interest encompassed overall survival (OS), recurrence-free survival (RFS), early recurrence, and late recurrence. The statistical effect size for these measures was expressed in terms of hazard ratios (HR).ResultsSix studies were incorporated into the analysis. Among them, four studies, encompassing 6 datasets and involving 1490 patients, and three studies, comprising 5 datasets and involving 656 patients, respectively, investigated the correlation between intratumoral and peritumoral TLSs and the prognosis in HCC patients. The meta-analysis revealed that the presence of intratumoral TLSs is linked to longer RFS and reduced early recurrence (HR, 0.60; 95% CI, 0.50–0.67; p

Abstract Background The role of mitochondrial dynamics, encompassing fission, fusion, and mitophagy, in cancer progression has been extensively studied. However, the specific impact of mitochondrial dynamics on hepatocellular carcinoma (HCC) is still under investigation. Methods In this study, mitochondrial dynamic genes were obtained from the MitoCarta 3.0 database, and gene expression data were collected from The Cancer Genome Atlas (TCGA) database. Based on the expression of these dynamic genes and differentially expressed genes (DEGs), patients were stratified into two clusters. Subsequently, a prognostic model was constructed using univariate COX regression and the least absolute shrinkage and selection operator (LASSO) regression, and the prognostic signature was evaluated. We analyzed the interaction between these model genes and dynamic genes to identify hub genes and reveal mitochondrial status. Furthermore, we assessed immune infiltration, tumor mutational burden (TMB), tumor stemness indices (TSI), and the response to immune checkpoint block (ICB) therapy using the TIDE algorithm and risk scores. Additionally, transmission electron microscopy (TEM), hematoxylin-eosin (H&E) staining, immunohistochemistry (IHC), western blotting (WB), and immunofluorescence (IF) were conducted to afford detailed visualization of the morphology of the mitochondria and the expression patterns of fission-associated proteins. Results Patients in Cluster 2 exhibited heightened mitochondrial fission and had a worse prognosis. The up-regulated dynamic genes in Cluster 2 were identified as fission genes. GO/KEGG analyses reconfirmed the connection of Cluster 2 to augmented mitochondrial fission activities. Subsequently, a ten-gene prognostic signature based on the differentially expressed genes between the two clusters was generated, with all ten genes being up-regulated in the high-risk group. Moreover, the potential links between these ten signature genes and mitochondrial dynamics were explored, suggesting their involvement in mediating mitochondrial fission through interaction with MTFR2. Further investigation revealed that the high-risk group had an unfavorable prognosis, with a higher mutation frequency of TP53, increased immune checkpoint expression, a higher TIS score, and a lower TIDE score. The mitochondrial imbalance characterized by increased fission and upregulated MTFR2 and DNM1L expression was substantiated in both HCC specimens and cell lines. Conclusions In conclusion, we developed a novel MTFR2-related prognostic signature comprising ten mitochondrial dynamics genes. These genes play crucial roles in mitochondrial fission and have the potential to serve as important predictors and therapeutic targets for HCC.

With the rapid development of modern industries, the high-temperature piezoelectric sensors that can work in extreme environments are in great demand. In this work, langasite (La3Ga5SiO[Formula: see text], LGS), as a high-temperature piezoelectric crystal with stable electro-elastic performance, is used as core element, and air and porous Al2O3 are selected as backing layers respectively to prepare two kinds of high-temperature acoustic emission (AE) sensors. The detection sensitivities at 25–500∘C are analyzed by the ball falling test and Hsu–Nielsen experiment. Under the condition of 25–500∘C, the received amplitude signals by both sensors are maintained above 90[Formula: see text]dB stimulated by the ZrO2 ceramic ball dropping. In the Hsu–Nielsen experiment, as the temperature rising from 25∘C to 500∘C, the signal amplitude of sensor with air backing layer decays from 447[Formula: see text]mV to 365[Formula: see text]mV, while the signal amplitude varies from 270[Formula: see text]mV to 203[Formula: see text]mV for the sensor with porous Al2O3 backing layer. Significantly, compared with the bandwidth of the air-backing sensor (37–183[Formula: see text]kHz), the sensor with porous Al2O3 backing layer broadens bandwidth to 28–273[Formula: see text]kHz. These results show that both these AE sensors have strong and stable response ability to AE signals at high-temperature of 500∘C. Therefore, piezoelectric AE sensor based on LGS has great potential application in the field of high-temperature structural health monitoring.

Ultra-long single-crystalline orthorhombic Al4O4C nanowires (NWs) were synthesized via annealing a mixture of Ta, Al, and graphite powders at 1500 °C for 1 h in a flowing argon atmosphere based on the vapor-liquid-solid (VSL) mechanism. The molten Al-Ta droplets formed by adding Ta resulted in its growth along the [101] direction. Therefore, highly crystalline Al4O4C NWs possessed rough surfaces, a high aspect ratio (∼2200) with diameters ranging from 100 nm to 500 nm and lengths up to hundreds of micrometers (660 μm). They exhibited a decreased bandgap of 2.63 eV and broad emission bands in yellow/near-infrared light region under the excitation of 532 nm, which was originated by Ar doping and surficial defects. Furthermore, the single nanowire electrode devices were fabricated using the FIB-SEM technique to accurately measure the electrical and mechanical properties. Al4O4C NWs possessed the intrinsic resistivity of 202.61 Ω·m, Young's modulus of 93.89 ± 13.34 GPa, and yield strength of 4.08 ± 0.51 GPa, and therefore it is potential for nanodevice applications.

BackgroundHand, foot and mouth disease (HFMD) is a public health concern that threatens the health of children. Accurately forecasting of HFMD cases multiple days ahead and early detection of peaks in the number of cases followed by timely response are essential for HFMD prevention and control. However, many studies mainly predict future one-day incidence, which reduces the flexibility of prevention and control.MethodsWe collected the daily number of HFMD cases among children aged 0-14 years in Chengdu from 2011 to 2017, as well as meteorological and air pollutant data for the same period. The LSTM, Seq2Seq, Seq2Seq-Luong and Seq2Seq-Shih models were used to perform multi-step prediction of HFMD through multi-input multi-output. We evaluated the models in terms of overall prediction performance, the time delay and intensity of detection peaks.ResultsFrom 2011 to 2017, HFMD in Chengdu showed seasonal trends that were consistent with temperature, air pressure, rainfall, relative humidity, and PM10. The Seq2Seq-Shih model achieved the best performance, with RMSE, sMAPE and PCC values of 13.943~22.192, 17.880~27.937, and 0.887~0.705 for the 2-day to 15-day predictions, respectively. Meanwhile, the Seq2Seq-Shih model is able to detect peaks in the next 15 days with a smaller time delay.ConclusionsThe deep learning Seq2Seq-Shih model achieves the best performance in overall and peak prediction, and is applicable to HFMD multi-step prediction based on environmental factors.