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Abstract Background Several studies have demonstrated the population-level effectiveness of oral PrEP in reducing the risk of HIV infection. However, oral PrEP utilization among MSM in China remains below 1%. While existing literature has primarily focused on oral PrEP preference and willingness, there is limited exploration of the underlying factors contributing to oral PrEP cessation in China. This study aims to fill this gap by investigating the factors associated with oral PrEP cessation among MSM in China. Methods Assisted by MSM community organizations, we collected 6,535 electronic questionnaires from 31 regions across China, excluding Taiwan, Hong Kong, and Macau. The questionnaire focused on investigating MSM's awareness, willingness, usage, and cessation of oral PrEP. Additionally, 40 participants were randomly chosen for key informant interviews. These qualitative interviews aimed to explore the reasons influencing MSM discontinuing oral PrEP. Results We eventually enrolled 6535 participants. Among the 685 participants who had used oral PrEP, 19.70% (135/685) ceased oral PrEP. The results indicated that individuals spending > ¥1000 on a bottle of PrEP (aOR = 2.999, 95% CI: 1.886–4.771) were more likely to cease oral PrEP compared to those spending ≤ ¥1000. Conversely, individuals opting for on-demand PrEP (aOR = 0.307, 95% CI: 0.194–0.485) and those using both daily and on-demand PrEP (aOR = 0.114, 95% CI: 0.058–0.226) were less likely to cease PrEP compared to those using daily PrEP. The qualitative analysis uncovered eight themes influencing oral PrEP cessation: (i) High cost and low adherence; (ii) Sexual inactivity; (iii) Lack of knowledge about PrEP; (iv) Trust in current prevention strategies; (v) Poor quality of medical service and counseling; (vi) PrEP stigma; (vii) Partner and relationship factors; (viii) Access challenges. Conclusions The cessation of oral PrEP among MSM in China is associated with various factors, including the cost of oral PrEP medication, regimens, individual perception of HIV risk, stigma, and the quality of medical services. It is recommended to provide appropriate regimens for eligible MSM and develop tailored combinations of strategies to enhance PrEP awareness and acceptance among individuals, medical staff, and the MSM community. The findings from this study can support the refinement of HIV interventions among MSM in China, contributing to efforts to reduce the burden of HIV in this population.

Prussian blue analogues (PBAs) are considered as promising cathode materials for capacitive deionization (CDI) technology due to their 3D open‐frame structure and tunable redox active sites. However, the inevitably high content of [Fe(CN)6] vacancies in the crystal structure results in a low salt adsorption capacity (SAC) and poor recycling performance. Herein, a high‐salt nano‐reaction system is established by mechanochemical ball milling, enabling the preparation of a variety of highly crystallized PBAs (metal hexacyanoferrate, MHCF‐B‐170, M = Ni, Co, or Cu) with low vacancies (0.05–0.06 per formula unit). The reduction of vacancies in the PBAs lattice not only strengthens the conductivity and promotes the rapid transfer of electrons, but also reduces the migration energy barrier and accelerates the fast and reversible diffusion of Na+ ions. The structural characterization method and theoretical simulation demonstrates the excellent reversibility and crystal structure stability of MHCF‐B‐170 during the CDI process. Impressively, the NiHCF‐B‐170 exhibits excellent CDI performance, characterized by an exceptionally high SAC of up to 101.4 mg g−1 at 1.2 V, and demonstrates remarkable cycle stability with no significant degradation observed even after 100 cycles. This PBAs with low Fe(CN)6 vacancies are expected to be a competitive candidate material for CDI electrodes.

Abstract Background Although the association between ambient temperature and mortality of respiratory diseases was numerously documented, the association between various ambient temperature levels and respiratory emergency department (ED) visits has not been well studied. A recent investigation of the association between respiratory ED visits and various levels of ambient temperature was conducted in Beijing, China. Methods Daily meteorological data, air pollution data, and respiratory ED visits data from 2017 to 2018 were collected in Beijing. The relationship between ambient temperature and respiratory ED visits was explored using a distributed lagged nonlinear model (DLNM). Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of ambient temperature on respiratory ED visits across China. Results The single-day lag risk for extreme cold peaked at a relative risk (RR) of 1.048 [95% confidence interval (CI): 1.009, 1.088] at a lag of 21 days, with a long lag effect. As for the single-day lag risk for extreme hot, a short lag effect was shown at a lag of 7 days with an RR of 1.076 (95% CI: 1.038, 1.114). The cumulative lagged effects of both hot and cold effects peaked at lag 0–21 days, with a cumulative risk of the onset of 3.690 (95% CI: 2.133, 6.382) and 1.641 (95% CI: 1.284, 2.098), respectively, with stronger impact on the hot. Additionally, the elderly were more sensitive to ambient temperature. The males were more susceptible to hot weather than the females. A longer cold temperature lag effect was found in females. Compared with the meta-analysis, a pooled effect of ambient temperature was consistent in general. In the subgroup analysis, a significant difference was found by gender. Conclusions Temperature level, age-specific, and gender-specific effects between ambient temperature and the number of ED visits provide information on early warning measures for the prevention and control of respiratory diseases.

Abstract Introduction Few studies focused on the Pre-Exposure Prophylaxis (PrEP) -related aspects, and the applicability of prior evidence to young men who have sex with men (YMSM) students was unknown. This study aimed to assess the awareness, willingness, uptake, and adherence (AWUA) to PrEP among YMSM students in China and to explore the associated factors with these stages. Methods A cross-sectional survey with a sizable sample of 1151 was conducted among YMSM students aged 16 and above, who self-identified as men who have sex with men(MSM) and resided in mainland China between October 20 and December 20, 2021. The chi-square test and Fisher’s exact test were used for univariate analysis, followed by multivariable logistic regression analysis of influencing factors at all levels. Results According to the cascade analysis approach, 88.71% of the participants were aware of PrEP, among which 66.7% expressed willingness to use it. Among those who were willing to use PrEP, only 13.80% took it, and of those who took it, 44.68% adhered to it. The students taking PrEP were those with higher education (OR = 4.239, 95% CI: 1.334–13.467), residence in pilot cities (OR = 2.791, 95% CI: 1.498–5.198), residence in high-risk areas (OR = 5.082, 95% CI: 2.224–11.612), engagement in multi-person sexual behavior (OR = 2.186, 95% CI: 1.236–3.867), and substance use (OR = 1.908, 95% CI: 1.167–3.118). Furtherly, students with higher adherence to PrEP were likely to have receptive sexual behaviors (OR = 8.702, 95% CI: 2.070-36.592), absence of substance use (OR = 4.468, 95% CI: 1.371–14.561), and uptake of PrEP through daily oral route. (OR = 7.065, 95% CI: 1.699–29.371). Conclusion YMSM students exhibit distinct patterns of “high awareness, low willingness, low uptake, and low adherence” to PrEP. Strategies for reduction in the acquisition of HIV prioritizing the current features of utilizing PrEP were urgently warranted.

Abstract Prussian blue analogs (PBAs) are considered as one of the most potential electrode materials in capacitive deionization (CDI) due to their unique 3D framework structure. However, their practical applications suffer from low desalination capacity and poor cyclic stability. Here, an entropy engineering strategy is proposed that incorporates high‐entropy (HE) concept into PBAs to address the unfavorable multistage phase transitions during CDI desalination. By introducing five or more metals, which share N coordination site, high‐entropy hexacyanoferrate (HE‐HCF) is constructed, thereby increasing the configurational entropy of the system to above 1.5R and placing it into the high‐entropy category. As a result, the developed HE‐HCF demonstrates remarkable cycling performance, with a capacity retention rate of over 97% after undergoing 350 ultralong‐life cycles of adsorption/desorption. Additionally, it exhibits a high desalination capacity of 77.24 mg g−1 at 1.2 V. Structural characterization and theoretical calculation reveal that high configurational entropy not only helps to restrain phase transition and strengthen structural stability, but also optimizes Na+ ions diffusion path and energy barrier, accelerates reaction kinetics and thus improves performance. This research introduces a new approach for designing electrodes with high performance, low cost, and long‐lasting durability for capacitive deionization applications.

Men who have sex with men (MSM) are at a high risk of HIV infection and should be offered effective preventive measures, such as pre-exposure prophylaxis (PrEP). However, PrEP uptake among eligible MSM was not as high as desired. Diverse research findings on how risky sexual behaviors affect PrEP uptake highlight the necessity for a comprehensive investigation. Understanding the interconnectedness of different sexual behaviors is crucial for evaluating their impact on PrEP uptake among eligible MSM.Using a proportional sampling method, we recruited 5877 MSM aged 16 years and above in mainland China according to PrEP eligibility criteria. Through latent class analysis (LCA), three distinct sexual behavior patterns were identified among eligible MSM. Demographic variances and PrEP uptake among the three distinct sexual behavior patterns were examined using chi-squared tests and multinomial logistic regression.LCA revealed three patterns: low-risk (4,815 MSM), medium-risk (516 MSM), and high-risk (546 MSM). MSM aged 25 years or older with a monthly income of ≥¥8,000 were more likely to be in the medium-risk group. Those from areas with high HIV prevalence and engaging as ''top'' in anal sex were more likely to be in the medium- and high-risk groups. The medium- and high-risk groups had a higher willingness, uptake, and adherence rates for PrEP than the low-risk group.LCA is effective in identifying diverse sexual behavior patterns among MSM, aiding targeted interventions to enhance PrEP uptake. Addressing demographic variations and tailoring interventions for specific risk groups are crucial for promoting PrEP dissemination and reducing HIV infection risk in eligible MSM.

Suaeda glauca Bunge produces dimorphic seeds on the same plant, with brown seeds displaying non-dormant characteristics and black seeds exhibiting intermediate physiological dormancy traits. Previous studies have shown that black seeds have a very low germination rate under natural conditions, but exogenous GA3 effectively enhanced the germination rate of black seeds. However, the physiological and molecular mechanisms underlying the effects of GA3 on S. glauca black seeds are still unclear. In this study, transcriptomic profiles of seeds at different germination stages with and without GA3 treatment were analyzed and compared, and the TTF, H2O2, O2–, starch, and soluble sugar contents of the corresponding seed samples were determined. The results indicated that exogenous GA3 treatment significantly increased seed vigor, H2O2, and O2– contents but decreased starch and soluble sugar contents of S. glauca black seeds during seed dormancy release. RNA-seq results showed that a total of 1136 DEGs were identified in three comparison groups and were involved mainly in plant hormone signal transduction, diterpenoid biosynthesis, flavonoid biosynthesis, phenylpropanoid biosynthesis, and carbohydrate metabolism pathway. Among them, the DEGs related to diterpenoid biosynthesis (SgGA3ox1, SgKAO and SgGA2ox8) and ABA signal transduction (SgPP2Cs) could play important roles during seed dormancy release. Most genes involved in phenylpropanoid biosynthesis were activated under GA3 treatment conditions, especially many SgPER genes encoding peroxidase. In addition, exogenous GA3 treatment also significantly enhanced the expression of genes involved in flavonoid synthesis, which might be beneficial to seed dormancy release. In accordance with the decline in starch and soluble sugar contents, 15 genes involved in carbohydrate metabolism were significantly up-regulated during GA3-induced dormancy release, such as SgBAM, SgHXK2, and SgAGLU, etc. In a word, exogenous GA3 effectively increased the germination rate and seed vigor of S. glauca black seeds by mediating the metabolic process or signal transduction of plant hormones, phenylpropanoid and flavonoid biosynthesis, and carbohydrate metabolism processes. Our results provide novel insights into the transcriptional regulation mechanism of exogenous GA3 on the dormancy release of S. glauca black seeds. The candidate genes identified in this study may be further studied and used to enrich our knowledge of seed dormancy and germination.

Traditional drilling methods often face difficulty meeting the demand for efficient and accurate coring under complex geological conditions. Cordless coring is an advanced technology that uses hydraulic lifting to carry out coring, which can achieve automation and automated and intelligent drilling operations. In this research, a new type of hydraulic lifting cordless coring drilling tool is designed. Moreover, a numerical simulation model of the fluid flow in the annulus between the spearhead and spool of the cordless coring drilling tool was established. Orthogonal simulation tests are carried out, and according to the orthogonal test data, a numerical prediction model of the spool annulus fluid field based on the Backpropagation Neural Network (BP neural network) is established. The prediction of the flow rate of the drilling fluid and the spool back-pressure ratio was obtained when the structural parameters of the spearhead and the spool annulus were different. A multi-objective optimization of the annulus flow structure of the cordless core drilling tool has been carried out. The optimization objectives include deciding the back pressure ratio of the spool overcoming the spring and the flow rate of the drilling fluid. According to the established nonlinear optimization model and based on the improved Non-dominated Sorting Genetic Algorithm II (NSGA-II) multi-objective optimization algorithm, it is verified that the convergence speed and diversity of the improved algorithm are better than those before the improvement. The simulation and experimental validation are carried out. It is verified that the flow rate of drilling fluid increased by 33.56% after optimization, and the force ratio was lowered by 5.825%. Finally, based on the simulation and optimization results, the φ96 cordless core drilling tool was manufactured on a trial basis, and on-site concrete drilling, coring, and hydraulic lifting operations were conducted for smooth coring and lifting. This study could provide an important scientific basis and technical support for the application and development of hydraulic lifting cordless coring technology.

Foreign objects such as balloons and nests often lead to widespread power outages by coming into contact with transmission lines. The manual detection of these is labor-intensive work. Automatic foreign object detection on transmission lines is a crucial task for power safety and is becoming the mainstream method, but the lack of datasets is a restriction. In this paper, we propose an advanced model termed YOLOv8 Network with Bidirectional Feature Pyramid Network (YOLOv8_BiFPN) to detect foreign objects on power transmission lines. Firstly, we add a weighted cross-scale connection structure to the detection head of the YOLOv8 network. The structure is bidirectional. It provides interaction between low-level and high-level features, and allows information to spread across feature maps of different scales. Secondly, in comparison to the traditional concatenation and shortcut operations, our method integrates information between different scale features through weighted settings. Moreover, we created a dataset of Foreign Object detection on Transmission Lines from a Drone-view (FOTL_Drone). It consists of 1495 annotated images with six types of foreign object. To our knowledge, FOTL_Drone stands out as the most comprehensive dataset in the field of foreign object detection on transmission lines, which encompasses a wide array of geographic features and diverse types of foreign object. Experimental results showcase that YOLOv8_BiFPN achieves an average precision of 90.2% and an mAP@.50 of 0.896 across various categories of foreign objects, surpassing other models.

Objectives To assess the association between ambient temperature and diurnal temperature range (DTR) on emergency admissions for hyperventilation syndrome (HVS).Design Distributed lag non-linear model design was used with a lag time to 5 days.Setting Emergency admission data used were from the Beijing Red Cross Emergency Centre (2017–2018).Participants and exposure Cases were those with emergency visits to the Beijing Emergency Center during the period 2017–2018 and who were given the primary outcome indicator defined as HVS according to the International Classification of Diseases, 10th edition code F45.303. Ambient temperature and DTR were used as exposure factors with adjustments for relative humidity, wind speed, precipitation, seasonality long-term trend and day of the week.Main outcome measure We used the minimum emergency visits temperature as a reference to indicate the relative risk with 95% CI of exposure–response for the risk of HVS visits at different temperatures.Results A u-shape was described between ambient temperature and HVS visits, with a minimum risk at 12°C. Moderate heat (23°C) at lag (0–3) days, extreme heat at lag 0 days, had greatest relative risks on HVS visits, with 2.021 (95% CI 1.101 to 3.71) and 1.995 (95% CI 1.016 to 3.915), respectively. A stronger association between HVS visits and temperature was found in women and aged ≤44 years. Notably, the relationship between DTR and HVS visits appeared a reverse u-shaped. Low DTR (4°C) effect appeared at lag (0–1) days with 0.589 (95% CI 0.395 to 0.878), lasting until lag (0–3) days with 0.535 (95% CI 0.319 to 0.897) and was associated with a reduced risk of HVS visits in women and those aged ≤44 years.Conclusions Ambient temperature and DTR were associated with HVS visits, appearing a differentiation in gender and age groups. Timely prevention strategies during high temperatures and control mild changes in temperature might reduce the risk of HVS.

High-voltage electropulse boring (EPB) is a new drilling method with great potential for drilling and industrialization. The existing high-voltage electropulse boring damage model based on PFC2D does not calibrate the parameters of the rock used in the rock-breaking test, so it is impossible to ensure that the simulated model is consistent with the mechanical properties of the rock in the actual rock-breaking test. The parameters of natural rock were calibrated based on the data results of indoor uniaxial compression and Brazilian splitting tests. Based on the calibrated micro parameters, a geometric model consistent with the size of the high-voltage EPB test was established, and the EPB process was simulated. The simulation results indicated that the shear failure mainly occurred in the process of high-voltage EPB, accompanied by a certain amount of tensile failure. Then, the EPB test was carried out with the high-voltage EPB test system, and an irregular broken hole with a diameter of 60 mm and a depth of 22.5 mm was obtained. The breaking effect was visualized by point cloud software. The results of the EPB rock-breaking test verified the effectiveness of the calibrated parameters. Finally, the influence of the fractures on the rock-breaking effect of high-voltage EPB was studied through the geometric model established with the calibrated parameters. The results showed that the existence of fractures would reduce the energy consumption in the rock-breaking process, and the crushing area tended to develop in the direction of fractures.

CFRP/Ti stacks have attracted considerable attention over the past decades as a promising alternative to individual fibrous composites and metallic alloys due to their improved properties and enhanced structural functions. Mechanical drilling is a compulsory but challenging process to shape these compound stacks to desired dimensions and target quality. Despite a large volume of studies already addressing the conventional twist drilling of CFRP/Ti stacks, a comprehensive understanding of their fundamental drilling mechanisms is still lacking. The present paper aims to report the state-of-the-art advances achieved in the fields of CFRP/Ti machining. Aspects including chip removal, damage formation, mechanical/thermal effects, influences of process conditions, hole quality attributes, and tool wear mechanisms are carefully reviewed. An emphasis is placed on the discussion of the interface drilling behaviors as well as the impacts of different drilling sequence strategies on the machining outputs of CFRP/Ti stacks. The current research limitations and future research perspectives are pointed out. The review paper could provide technical guidance for both scientific and industrial communities to achieve the damage-free drilling of CFRP/Ti stacks.

Abstract Background Analysis of the relationship between chromosomal structural variation (synteny breaks) and 3D-chromatin architectural changes among closely related species has the potential to reveal causes and correlates between chromosomal change and chromatin remodeling. Of note, contrary to extensive studies in animal species, the pace and pattern of chromatin architectural changes following the speciation of plants remain unexplored; moreover, there is little exploration of the occurrence of synteny breaks in the context of multiple genome topological hierarchies within the same model species. Results Here we used Hi-C and epigenomic analyses to characterize and compare the profiles of hierarchical chromatin architectural features in representative species of the cotton tribe (Gossypieae), including Gossypium arboreum, Gossypium raimondii, and Gossypioides kirkii, which differ with respect to chromosome rearrangements. We found that (i) overall chromatin architectural territories were preserved in Gossypioides and Gossypium, which was reflected in their similar intra-chromosomal contact patterns and spatial chromosomal distributions; (ii) the non-random preferential occurrence of synteny breaks in A compartment significantly associate with the B-to-A compartment switch in syntenic blocks flanking synteny breaks; (iii) synteny changes co-localize with open-chromatin boundaries of topologically associating domains, while TAD stabilization has a greater influence on regulating orthologous expression divergence than do rearrangements; and (iv) rearranged chromosome segments largely maintain ancestral in-cis interactions. Conclusions Our findings provide insights into the non-random occurrence of epigenomic remodeling relative to the genomic landscape and its evolutionary and functional connections to alterations of hierarchical chromatin architecture, on a known evolutionary timescale.

SGLT-2 inhibitors, such as empagliflozin, have been shown to reduce the occurrence of cardiovascular events and delay the progression of atherosclerosis. However, its role in atherosclerotic calcification remains unclear. In this research, ApoE−/− mice were fed with western diet and empagliflozin was added to the drinking water for 24 weeks. Empagliflozin treatment significantly alleviated arterial calcification assessed by alizarin red and von kossa staining in aortic roots and reduced the lipid levels, while had little effect on body weight and blood glucose levels in ApoE−/− mice. In vitro studies, empagliflozin significantly inhibits calcification of primary vascular smooth muscle cells (VSMCs) and aortic rings induced by osteogenic media (OM) or inorganic phosphorus (Pi). RNA sequencing of VSMCs cultured in OM with or without empagliflozin showed that empagliflozin negatively regulated the osteogenic differentiation of VSMCs. And further studies confirmed that empagliflozin significantly inhibited osteogenic differentiation of VSMCs via qRT-PCR. Our study demonstrates that empagliflozin alleviates atherosclerotic calcification by inhibiting osteogenic differentiation of VSMCs, which addressed a critical need for the discovery of a drug-based therapeutic approach in the treatment of atherosclerotic calcification.

Abstract Background Acute and early HIV (AEH) infection is characterized by a high viral load and infectivity. Approximately 50% of cases of HIV-1 transmission occur during AEH. Understanding sexual behaviour trajectories would be useful for predicting changes in the risk of HIV acquisition. However, few studies have investigated sexual behaviour trajectories and their association with AEH acquisition. This study identified behaviour trajectories among men who have sex with men (MSM), determined the risk of AEH infection, and compared risk factors between different behaviour trajectories. Methods The study was based on an ongoing prospective open cohort of voluntary HIV counselling and testing (VHCT) among MSM in Tianjin, China. From 2011 to 2019, 1974 MSM were recruited. Group-based trajectory modelling (GBTM) was used to identify behaviour trajectories by constructing a sexual risk behaviour score. Logistic regression and generalized estimating equation (GEE) were used to compare the risk of AEH infection and risk factors for different behaviour trajectories. All data analyses were performed using SAS 9.4. Results The incidence of AEH infection was 1.76/100 person-years, with 64 AEH infections documented in 3633 person-years of follow-up. Three sexual behaviour trajectories were identified: CL (consistently low risk, 35.46%), CH (consistently high risk, 42.71%) and HTL (high to low risk, 21.83%). MSM in the HTL and CH groups had higher AEH infection rates than MSM in the CL group (6.73%, 3.08% and 1.28%, respectively), with ORs of 5.54 (2.60, 11.82) and 2.44 (1.14, 5.25), respectively. MSM aged 30–50 years old and MSM who underwent HIV testing in the last year were more likely to be in the CH group and HTL group. In addition, the HTL group was characterized by a lower likelihood of local registration and a higher likelihood of working as a MSW. Conclusion MSM in the CH group and the HTL group had a higher risk of AEH infection. In the future, VHCT should be performed more often among younger MSM, and HIV counselling should be given the same priority as HIV testing. In addition, VHCT combined with PrEP may have a better preventive impact on MSM with a high risk of AEH infection.

Key points Long-term survivors of HSCT recipients demonstrated longitudinal recovery in QoL which can be quantified with both SF-36 and FACT-BMT forms Recipients of HID-HSCT reported higher performance of QoL in both mental and physical dimensions. History of acute GVHD or CMV reactivation significantly was associated with inferior QoL. The SF-36 and FACT-BMT forms demonstrated different performance in the quantification of QoL recovery and combination of both may improve QoL evaluation system

Objectives To evaluate the safety and efficacy of high-dose amoxicillin-proton pump inhibitor dual therapy, and to provide a new eradication regimen as a first-line option for patients with H. pylori infection. Methods A total of 971 H. pylori positive patients who received initial treatment were recruited from March to August 2020, and randomly divided into treatment group and control group. The treatment group received of 20 mg esomeprazole four times daily and 750 mg amoxicillin four times daily for 14 days. Control group received of 220 mg bismuth potassium citrate twice daily, 20 mg esomeprazole twice daily, 1000 mg amoxicillin twice daily and 250 mg clarithromycin capsule twice daily for 14 days. Four weeks after the end of treatment, the urea breath test was reviewed to detect whether H. pylori was eradicated. Results There were no statistical differences in age, gender, the total clinical symptom scores before and after initial treatment, the compliance, and the degree of remission of symptoms before and after initial treatment between the two groups. The eradication rates of H. pylori between dual therapy and quadruple therapy were 88.31% and 85.26% (p=.158) by intention-to-treat (ITT) analysis, 88.66% and 85.44% (p=.186) by modified intention-to-treat (mITT) analysis, and 91.63% and 90.60% (p=.116) by PP analysis, respectively. Adverse events in dual therapy group were significantly lower than quadruple therapy group (13.3% vs. 28.2% (p

ObjectivesExposure to air pollution has been linked to an increased risk of premature mortality. However, the acute effects of air pollution on the risk of non-accidental mortality have not been extensively researched in developing countries, and the findings thus far have been inconsistent. Therefore, this study aimed to examine the association between short-term exposure to six pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and non-accidental mortality in Beijing, China.MethodsDaily data on non-accidental deaths were gathered from 1 January 2017 to 31 December 2018. Air pollution data for the same period were collected from 35 fixed-site air quality monitoring stations in Beijing. Generalized additive models (GAM) based on Poisson regression were used to investigate the association between non-accidental mortality in emergency department visits and the daily average levels of air pollutants.ResultsThere were 8,676 non-accidental deaths recorded during 2017–2018. After sensitivity analysis, short-term exposure to air pollutants, particularly gaseous pollutants, was linked to non-accidental mortality. Specifically, for every 10 μg/m3 increase (5 μg/m3 in SO2, 0.5 mg/m3 in CO) of SO2 (lag 04), NO2 (lag 04), O3 (lag 05), and CO (lag 04), the relative risk (RR) values were 1.054 (95% CI: 1.009, 1.100), 1.038 (95% CI: 1.013, 1.063), 1.032 (95% CI: 1.011, 1.054), and 1.034 (95% CI: 1.004, 1.066), respectively. In terms of causes of death, short-term exposure to NO2, SO2, and O3 increased the risk of circulatory mortality. Further stratified analysis revealed that the stronger associations were presented in females for O3 while in males for CO. People aged 65 and over were strongly associated with ambient air pollution.ConclusionsOur study showed that ambient air pollutants were associated with non-accidental mortality. Our findings suggested that efforts to control gaseous pollution should be stepped up, and vulnerable groups should be the focus of health protection education.

Abstract Background Although men who have sex with men (MSM) and male sex workers (MSWs) both represent the high-risk groups for the transmission of HIV/AIDS and syphilis, the comparison between them have not yet been well studied in China. We aimed to evaluate the prevalence of HIV among MSM and MSW, and then identify the difference of risk factors of HIV infection. Methods A snowball sampling was employed to recruit patrons attending the Tianjin bathhouse from March 2011 to October 2018. A questionnaire covering sociodemographic characteristics, sexual behaviors, HIV-related and HIV awareness was completed by 5166 patrons from all parts of China. Bivariate analyses were done using the Chi-square test to investigate the association between factors and HIV infection among MSM and MSWs. Subsequently, we studied the different impact of risk factors on HIV infections among the two groups using multiple logistic regression with the adjusted odds ratio (aOR) being derived. Results From 2011 to 2018, 235 MSWs and 4931 MSM were included into our study. HIV prevalence among the MSWs was 17.8% (95%CI: 13.2% ~ 23.4%) while 6.5% (95%CI: 5.8% ~ 7.2%) for MSM (P

Compared with traditional deepwater drilling, riserless mud recovery (RMR) drilling technology has the advantages of improving drilling efficiency, reducing risks, and minimizing environmental effects. Therefore, RMR drilling technology has been widely applied in recent years. This study primarily investigates the relationships among reverse torque, vibration, and input parameters of mud pumps in riserless mud recovery drilling. Firstly, the operating principle and the structure of the mud pump module are analyzed, and an analytical model for the reverse torque and the vibration of the mud pump is established. Secondly, relevant data are derived from theoretical calculations and experiments, and the relationships among the reverse torque, vibration, and input parameters of the mud pump are analyzed using ANSYS (Version 2020 R1) software. Furthermore, the SVR (support vector regression) algorithm is employed to predict and analyze the amplitude of the mud pump’s vibration. Finally, the conclusions are drawn based on the findings of the relationships among the reverse torque, vibration, and input parameters of the mud pump. The findings show that the reverse torque of the mud pump increases approximately linearly with an increase in rotational speed, and the vibration of the mud pump increases and then decreases with an increase in rotational speed. The predicted values obtained through the prediction algorithm closely match the actual values. The findings provide a valuable reference for the application of RMR technology.

Abstracts Background In recent years, HIV testing has become one of the effective strategies to reduce the risk of the infection. Frequent quarterly HIV testing can be cost effective. Therefore, an in-depth study of factors related to the testing behavior of men who have sex with men (MSM) were analyzed to optimize intervention strategies. Methods From March 2011 to October 2018, the project was implemented in a Tianjin (China) bathhouse, and 5165 MSM were surveyed using snowball sampling. Factors related to HIV testing behavior were analyzed by ordinal logistic regression analysis after grouping according to testing frequency, and comprehensive analysis was performed. Results The multivariate logistic analysis showed that 6 variables including young MSM (OR = 0.67, 95% CI: 0.49–0.92, p = 0.01), low-educated MSM (OR = 0.60, 95% CI: 0.48–0.77, p

BackgroundMost studies have focused on the relationship between ambient temperature and stroke mortality, but studies on the relationship between ambient temperature and stroke occurrence are still limited and inconsistent.ObjectiveThis study aimed to analyze the effect of ambient temperature and other environmental factors on emergency stroke visits in Beijing.MethodsOur study utilized stroke visit data from the Beijing Red Cross Emergency Medical Center during 2017–2018, and applied a generalized additive model (GAM) as well as a distributed lag non-linear model (DLNM), respectively, regarding the direct, lagged, and cumulative effects of ambient temperature alone and with correction for other environmental factors on stroke occurrence.ResultsWith a total of 26,984 emergency stroke patients in 2017–2018, both cold and hot effects were observed and weakened after correction for other environmental factors. Compared to the reference temperature, in the multi-factor model, extreme cold (−10°C) reached a maximum relative risk (RR) of 1.20 [95% Confidence Interval (CI): 1.09, 1.32] at lag 14 days, and extreme hot (30°C) had a maximum RR of 1.07 (95% CI: 1.04, 1.11) at lag 6 days. The cumulative effect of extreme cold reached a maximum of 2.02 (95% CI: 1.11, 3.67) at lag 0–14 days, whereas the cumulative effect of extreme hot temperature is greatest at lag 0–10 days, but no statistically significant effect was found. In addition, ischemic stroke patients, the elderly, and males were more susceptible to the effects of cold temperature.ConclusionsThere is a non-linear relationship between ambient temperature and stroke occurrence, with cold temperature having a greater and longer-lasting impact than hot temperature.

Background The HIV epidemic in key populations such as men who have sex with men (MSM) is a public health issue of worldwide concern. China has seen an increase in newly diagnosed HIV infections through male–male sexual contact in the past decade. In a long-term cohort, how the complex behaviour pattern of MSM changed and the association with the HIV risk are unclear at present.Methods This study was conducted from October 2011 to December 2019 in Tianjin. MSM were recruited by snowball sampling through online and offline ways. Demographic and sexual behavioural data were collected for analysis. Three indicators (condom use in last anal sex, frequency of condom use during anal sex and the number of sexual partners) were used to define the behaviour change. Participants with zero, one, and two or three risk indicators were categorised into behaviour types of ‘protective’, ‘moderate’, and ‘fragile’, respectively. Change in behaviour type between baseline and each visit was considered. Time-varying Cox models were performed to evaluate HIV infection risk.Results Of 2029 MSM included in the study, 127 were new HIV diagnoses. The overall incidence rate was 3.36 per 100 person-years. The percentage of ‘protective’ and ‘moderate’ behaviour types had a conspicuous growth trend as the follow-up. Furthermore, the HIV incidence rate in each visit among different behaviour transition types showed a general downward trend as the number of total follow-up times increased. Individuals who remained in ‘fragile’ (adjusted HR (aHR): 25.86, 95% CI: 6.92 to 96.57) or changed from ‘protective’ to ‘moderate’ (aHR: 4.79, 95% CI: 1.18 to 19.47), ‘protective’ to ‘fragile’ (aHR: 23.03, 95% CI: 6.02 to 88.13), and ‘moderate’ to ‘fragile’ (aHR: 25.48, 95% CI: 6.79 to 95.40) between baseline and the last follow-up had a higher HIV risk. Gained risk indicators were associated with the increase of HIV risk (gained one indicator, aHR: 2.67, 95% CI: 1.68 to 4.24; gained two or three indicators, aHR: 4.99, 95% CI: 3.00 to 8.31) while losing just one risk indicator could halve the risk (aHR: 0.43, 95% CI: 0.21 to 0.90).Conclusions Among MSM in Tianjin, it is necessary to get timely behaviour change for those with high-incidence behaviour patterns while sustaining for those with low-incidence patterns.Trial registration number Chinese Clinical Trials Registry (ChiCTR2000039500).

The NAC (NAM, ATAF1/2 and CUC2) transcription factors are ubiquitously distributed in plants and play critical roles in the construction of plant organs and abiotic stress response. In this study, we described the cloning of a Suaeda liaotungensis K. NAC transcription factor gene SlNAC4, which contained 1450 bp, coding a 331 amino acid. We found that SlNAC4 was highly expressed in stems of S. liaotungensis, and the expression of SlNAC4 was considerably up-regulated after salt, drought, and ABA treatments. Transcription analysis and subcellular localization demonstrated that the SlNAC4 protein was located both in the nucleus and cytoplasm, and contained a C-terminal transcriptional activator. The SlNAC4 overexpression Arabidopsis lines significantly enhanced the tolerance to salt and drought treatment and displayed obviously increased activity of antioxidant enzymes under salt and drought stress. Additionally, transgenic plants overexpressing SlNAC4 had a significantly higher level of physiological indices. Interestingly, SlNAC4 promoted the expression of ABA metabolism-related genes including AtABA1, AtABA3, AtNCED3, AtAAO3, but inhibited the expression of AtCYP707A3 in overexpression lines. Using a yeast one-hybrid (Y1H) assay, we identified that the SlNAC4 transcription factor could bind to the promoters of those ABA metabolism-related genes. These results indicate that overexpression of SlNAC4 in plants enhances the tolerance to salt and drought stress by regulating ABA metabolism.

Riserless mud-recovery (RMR) drilling technology was widely applied in recent years. Compared with traditional deepwater drilling, RMR drilling can improve drilling efficiency, reduce risks, and minimize environmental effects. This paper focuses primarily on the stability of a mud-return circulation system in an RMR system. First, various factors that affect the stability of a mud-return circulation system are analyzed. An analytical model for the skid-and-mud-return line is established. Second, relevant data are derived from theoretical calculations and experiments. ABAQUS software is used to analyze the effects of each factor on the stability of the mud-return circulation system. The influencing patterns of each factor on the stability of the mud-return circulation system are summarized. Furthermore, the stability of the system under different operating conditions is analyzed based on the coupling of multiple factors. The support vector regression with derivative significance weight analysis (SVR-DWSA) algorithm is employed to perform a weight analysis of the effect on the system’s stability. Finally, based on the research findings on the stability of the mud-return circulation system, relevant conclusions and recommendations are drawn. The results of this study provide valuable references for the application of RMR technology.

Abstract Background Polyploidy has played a prominent role in the evolution of plants and many other eukaryotic lineages. However, how polyploid genomes adapt to the abrupt presence of two or more sets of chromosomes via genome regulation remains poorly understood. Here, we analyzed genome-wide histone modification and gene expression profiles in relation to domestication and ploidy transition in the A and B subgenomes of polyploid wheat. Results We found that epigenetic modification patterns by two typical euchromatin histone markers, H3K4me3 and H3K27me3, for the great majority of homoeologous triad genes in A and B subgenomes were highly conserved between wild and domesticated tetraploid wheats and remained stable in the process of ploidy transitions from hexaploid to extracted tetraploid and then back to resynthesized hexaploid. However, a subset of genes was differentially modified during tetraploid and hexaploid wheat domestication and in response to ploidy transitions, and these genes were enriched for particular gene ontology (GO) terms. The extracted tetraploid wheat manifested higher overall histone modification levels than its hexaploid donor, and which were reversible and restored to normal levels in the resynthesized hexaploid. Further, while H3K4me3 marks were distally distributed along each chromosome and significantly correlated with subgenome expression as expected, H3K27me3 marks showed only a weak distal bias and did not show a significant correlation with gene expression. Conclusions Our results reveal overall high stability of histone modification patterns in the A and B subgenomes of polyploid wheat during domestication and in the process of ploidy transitions. However, modification levels of a subset of functionally relevant genes in the A and B genomes were trans-regulated by the D genome in hexaploid wheat.

Wind energy is a type of clean energy that can address global energy shortages and environmental issues. Wind turbine blades are a critical component in capturing wind energy. Carbon fiber composites have been widely recognized for their excellent overall performance in large-scale wind turbine blades. However, in China, the wide application of carbon fiber composites in wind turbine blades still faces many problems and challenges. This paper examines the current state of carbon fiber composites for wind turbine blades and the geographical distribution characteristics of wind resources in China. The economic revenues from increasing the length of wind turbine blades in four typical wind farms, including offshore wind farms, are compared. Using a mathematical model, the energy efficiency of carbon fiber composites in the application of large wind turbine blades is evaluated from the aspects of cost, embedded energy, and carbon footprint. Further, the current relationship between supply and demand for the industrial structure of carbon fiber in China is revealed. The manufacturing technologies for carbon fiber composite wind turbine blades are analyzed, and corresponding countermeasures are proposed. Finally, the incentive policy for applying carbon fiber composites to wind turbine blades is explained, and the development prospects are explored. In this paper, the economics and energy efficiency of the application of carbon fiber composite materials in large wind turbine blades are analyzed and comprehensively evaluated by using mathematical models, which will provide a valuable reference for China’s wind turbine blade industry.

The systemic immunity-inflammation index (SII) is a novel inflammatory marker, and aberrant blood lipid levels are linked to inflammation. This study aimed to look at the probable link between SII and hyperlipidemia. The current cross-sectional investigation was carried out among people with complete SII and hyperlipidemia data from the 2015–2020 National Health and Nutrition Examination Survey (NHANES). SII was computed by dividing the platelet count × the neutrophil count/the lymphocyte count. The National Cholesterol Education Program standards were used to define hyperlipidemia. The nonlinear association between SII and hyperlipidemia was described using fitted smoothing curves and threshold effect analyses. A total of 6117 US adults were included in our study. A substantial positive correlation between SII and hyperlipidemia was found [1.03 (1.01, 1.05)] in a multivariate linear regression analysis. Age, sex, body mass index, smoking status, hypertension, and diabetes were not significantly correlated with this positive connection, according to subgroup analysis and interaction testing (p for interaction > 0.05). Additionally, we discovered a non-linear association between SII and hyperlipidemia with an inflection point of 479.15 using a two-segment linear regression model. Our findings suggest a significant association between SII levels and hyperlipidemia. More large-scale prospective studies are needed to investigate the role of SII in hyperlipidemia.

Riserless Mud Recovery (RMR) technology, as an emerging and efficient drilling method, is advantageous to reduce the shallow flow hazards and the number of casings. The wave current effect is one of the reasons limiting the application of RMR technology in deep and ultra-deep water, and fewer quantitative and qualitative analyses of the effect of the current are made on the stability of conductors. This paper investigates the influence of the overturning moment generated by the continuous subsea internal wave flow and the soil resistance to the conductor. The numerical simulation software ABAQUS is used to study the effects of sea state recurrence period, seabed soil properties, conductor material, driving depth in the mud, and conductor wellhead height on the stability of the conductor, and the influence weights of the factors affecting the stability of the conductor are analyzed using the weight analysis algorithm of extreme learning machine-mean impact value (ELM-MIV). Finally, the qualitative and quantitative analyses affecting the stability of the conductor are carried out, which provide reference values for the application of the RMR technology.

The function of vehicle powertrains (including hybrid powertrains) is to transmit power from the power source (engine or electric machine) to driving wheels. The planetary gear train (PGT) is a core structure of mechanisms of powertrains. The detection of topological symmetry is helpful for improving the efficiency of mechanism design. In this paper, we present a fully automatic and reliable method for detecting symmetry of plane kinematic chains and extend this method to symmetry detection and the topological design of mechanisms of powertrains. First, the topological model and adjacency matrix are introduced to represent various kinds of plane kinematic chains. Then, the moment matrix of the kinematic chain is established to obtain link groups, based on which we propose an algorithm to generate the unique numerical code of each link and precisely detect the symmetry. Our method is applied to synthesize different kinds of plane kinematic chains and mechanisms, which can improve the design efficiency of mechanisms of powertrains and other mechanical devices.

It is necessary to develop new drilling and breaking technology for hard rock construction. However, the process of high-voltage electro-pulse (HVEP) rock-breaking is complex, and the selection of electro-pulse boring (EPB) process parameters lacks a theoretical basis. Firstly, the RLC model, TV-RLC model, and TV-CRLC model are established based on the characteristics of the HVEP circuit to predict the EPB dynamic discharge curve. Secondly, the parameters are identified by the Particle Swarm Optimization Genetic Algorithm (PSO-GA). Finally, due to the nonlinear and complex time-varying characteristics of the discharge circuit, the discharge circuit prediction models based on Bayesian fusion and current residual normalization fusion method are proposed, and the optimal weight of these three models is determined. Compared with the single models for EPB current prediction, the average relative error reduction rates based on Bayesian fusion and current residual normalization fusion methods are 25.5% and 9.5%, respectively. In this paper, the discharge circuit prediction model based on Bayesian fusion is established, which improves the prediction accuracy and reliability of the model, and it guides the selection of process parameters and the design of pulse power supply and electrode bits.

Background: Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. Methods: Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. Results: A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02–1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30–1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. Conclusions: This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.

Nuclear factor erythroid 2-related factor 2 (NRF2) functions as a transcription factor and regulates a wide array of antioxidant and stress-responsive genes. NRF2 has been widely implicated in different types of cancers, but only limited studies concerning the relationship between NRF2 expression and tumour invasion or prognosis in lung cancer. Therefore, we conducted a meta-analysis to determine the prognostic value of NRF2 in patients with non-small cell lung cancer (NSCLC). The relationship between NRF2 expression in NSCLC patients and clinicopathological features was also investigated. Overall survival (OS) and treatment response rate were evaluated using STATA software. Twenty eligible articles with 2530 lung cancer patients were included in this meta-analysis. The results revealed that high expression level of NRF2 was associated with pathologic distant metastasis (odds ratio (OR) = 2.64, 95% confidence interval (CI) 1.62-4.31; P < 0.001), lymph node metastasis (OR = 2.14, 95% CI: 1.53-3.00; P < 0.001), and tumour node metastasis (TNM) stage (OR = 1.95, 95% CI: 1.52-2.49, P < 0.001). High NRF2 expression was associated with low treatment response rate in platinum-based chemotherapy (HR = 0.11, 95% CI 0.02-0.51; P = 0.005). High expression level of NRF2 is predictive for poor overall survival rate (HR = 1.86, 95% CI 1.44-2.41, P < 0.001) and poor progression-free survival (PFS) (HR = 2.27, 95% CI 1.26-4.09, P = 0.006). Compared to patients with a low level of NRF2 expression, patients with high NRF2 expression levels were associated with worse OS and PFS when given the chemotherapy or EGFR-TKI. Together, our meta-analysis results suggest that NRF2 can act as a potential indicator of NSCLC tumour aggressiveness and help the prognosis and design of a better treatment strategy for NSCLC patients.

Numerous communications and power towers are distributed around urban districts. To ensure the safety of tower and mast structures, an effective measurement is to establish a simple structural health monitoring (SHM) system for each tower structure to obtain continuous deformation data of all structures. However, there is little research focusing on evaluating the condition of tower and mast structures monitored within one cluster using deformation monitoring data. To address this issue, a condition assessment approach combining principal component analysis (PCA) with cross-validation is proposed in this study. The PCA-based method is applied to mitigate the influence of environmental temperature and speed load on the horizontal displacement monitoring data, and novelty detection based on cross-validation is adopted to evaluate the condition of all the tower and mast structures monitored within one cluster. Finally, the effectiveness of the proposed method is demonstrated using monitoring data obtained from actual tower and mast structures.

Abstract Background Diabetes is a chronic disease, and it could affect both health and quality of life (QOL). A lot of studies have reported some predictors of QOL of type 2 diabetes patients. While their results were not completely consistent. So the aim of our study was finding out the related factors (including characteristics related to the disease, life styles and mental health factors) of QOL of type 2 diabetes patients. Methods We searched Cochrane library, EmBase, PubMed and CNKI databases for published studies that evaluated the related factors of QOL of type 2 diabetes patients by using a proper statistic method and had effect sizes (OR or β) and 95% confidence intervals from January 1st 2000 to May 31st 2016. Any study types were acceptable, and we excluded the reviews, letters, editorials and pooled analyses. The data were analyzed using STATA software (Version 12.0; Stata Corporation). Effect sizes and 95% confidence intervals were calculated to evaluate the relationship between these factors and QOL. Results Eighteen studies were included into our systematic review and meta-analysis, totaling 57,109 type 2 diabetes patients. Do more physical exercises (The pooled ORs ranged from 0.635 to 0.825 for different scales, less than 1.00), glucose check more frequently [pooled OR (95%CI): 0.175 (0.041, 0.756)] were associated with a better QOL. Presence of complications (The pooled ORs ranged from 1.462 to 3.038 for different scales, more than 1.00), presence of hypertension [pooled OR (95%CI): 1.389 (1.173, 1644)], longer duration of diabetes [pooled OR (95%CI): 1.865 (1.088, 3.197)], diet with more red meat [pooled OR (95%CI): 2.085 (1.063, 4.089)] and depression (The pooled ORs ranged from 3.003 to 11.473 for different scales, higher than 1.00) were associated with a worse QOL. Conclusion The results of this study show that physical exercise, glucose check frequently, complications, hypertension, duration of diabetes, diet with more red meat, and depression were associated with the QOL of type 2 diabetes patients.

Abstract Background Currently, resistance to tyrosine kinase inhibitors, such as gefitinib, has become a major obstacle in improving the clinical outcome of patients with metastatic and advanced-stage esophageal squamous cell carcinoma (ESCC). While cell behavior can be modulated by long non-coding RNAs (lncRNAs), the roles of lncRNAs within extracellular vesicles (exosomes) are largely unknown. Therefore, we investigated the involvement and regulatory functions of potential lncRNAs enclosed in exosomes during formation of chemoresistance in human ESCC. Methods Gefitinib-resistant cell lines were established by continuously grafting TE1 and KYSE-450 cells into gefitinib-containing culture medium. LncRNA microarray assay followed by RT-qPCR were used to verify the differential expression of lncRNA Prostate Androgen-Regulated Transcript 1 (PART1) between gefitinib resistant and parental cell lines. RNA fluorescence in situ hybridization (FISH) was used to investigate whether extracellular PART1 could be incorporated into exosomes and transmitted to recipient cells. Subsequently, a series of in vitro assays and a xenograft tumor model were used to observe the functions of lncRNA PART1 in ESCC cells. A signal transduction reporter array, bioinformatics analysis, western blotting, and immunofluorescence were carried out to verify the regulation of PART1 and its downstream Bcl-2 signaling pathway. Results lncRNA PART1 was upregulated in gefitinib-resistant cells when compared to parental ESCC cells. It was found that STAT1 can bind to the promoter region of lncRNA PART1, resulting in its activation. Knockdown of lncRNA PART1 potently promoted the gefitinib-induced cell death, while elevated PART1 promoted gefitinib resistance by competitively binding to miR-129 to facilitate Bcl-2 expression in ESCC cells. In addition, extracellular PART1 could be incorporated into exosomes and transmitted to sensitive cells, thus disseminating gefitinib resistance. Clinically, high levels of serum lncRNA PART1 in exosome were associated with poor response to gefitinib treatment in ESCC patients. Conclusions LncRNA PART1 promotes gefitinib resistance by regulating miR-129/Bcl-2 pathway, and may serve as a therapeutic target for ESCC patients.

ObjectivesCapitation policy, a new medical insurance settlement method implemented on 1 January 2014 in Tianjin, China, aimed to control unreasonable increases in medical costs. The goal of the current study was to evaluate the impact of capitation on outpatient expenses among patients with diabetes mellitus and provide scientific evidence for health policy-makers.DesignA natural experiment.SettingThe medical insurance database of Tianjin from 1 January 2010 to 31 December 2014.ParticipantsIn total, 35 529 records were included, comprising 9646 records in the pilot group (4907 records in 2014 and 4739 records in 2013) and 25 883 records in the control group (9814 records in 2014 and 16 069 records in 2013).Main outcome measuresThe outcome variables included annual total outpatient expenses, drug expenses, examination expenses, treatment expenses and other expenses.ResultsCapitation produced an increase in total outpatient expenses of ¥1993.76 (95% CI, ¥1643.74 to ¥2343.77) in the pilot group relative to the control group. There was also an increase in drug expenses of ¥1904.30 (95% CI, ¥1578.63 to ¥2229.96) after the implementation of capitation. An increase in examination expenses of ¥44.90 (95% CI, ¥19.11 to ¥70.68) was found in the pilot group versus the control group. Capitation also produced an increase in treatment expenses of ¥3.55 (95% CI, ¥1.01 to ¥6.09) and an increase in other expenses of ¥43.46 (95% CI, ¥26.81 to ¥60.11) in the pilot group versus the control group.ConclusionCompared with those who participated in the ‘control’ policy, outpatient expenses of patients enrolled in capitation increased significantly. The increases were due to the actual needs of patients, changes in drug directories, and the autonomy and independence of hospitals. It is necessary for the government, policy-makers, hospitals, doctors, patients and supervisory agencies to improve the capitation policy.

BACKGROUND AND OBJECTIVE:Most previous studies adopted single traditional time series models to predict incidences of malaria. A single model cannot effectively capture all the properties of the data structure. However, a stacking architecture can solve this problem by combining distinct algorithms and models. This study compares the performance of traditional time series models and deep learning algorithms in malaria case prediction and explores the application value of stacking methods in the field of infectious disease prediction. METHODS:The ARIMA, STL+ARIMA, BP-ANN and LSTM network models were separately applied in simulations using malaria data and meteorological data in Yunnan Province from 2011 to 2017. We compared the predictive performance of each model through evaluation measures: RMSE, MASE, MAD. In addition, gradient-boosting regression trees (GBRTs) were used to combine the above four models. We also determined whether stacking structure improved the model prediction performance. RESULTS:The root mean square errors (RMSEs) of the four sub-models were 13.176, 14.543, 9.571 and 7.208; the mean absolute scaled errors (MASEs) were 0.469, 0.472, 0.296 and 0.266 and the mean absolute deviation (MAD) were 6.403, 7.658, 5.871 and 5.691. After using the stacking architecture combined with the above four models, the RMSE, MASE and MAD values of the ensemble model decreased to 6.810, 0.224 and 4.625, respectively. CONCLUSIONS:A novel ensemble model based on the robustness of structured prediction and model combination through stacking was developed. The findings suggest that the predictive performance of the final model is superior to that of the other four sub-models, indicating that stacking architecture may have significant implications in infectious disease prediction.

Electropulse rock breaking has wide application prospects in hard rock drilling and ore breaking. At present, there are no suitable physical mathematical models that describe electropulse boring (EPB) processes under confining pressures. In this paper, a high-voltage electropulse breakdown damage model is established for granite, which includes three submodels. It considers electric field distortions inside the rock, and an electric field distribution coefficient is introduced in the electro-breakdown model. A shock-wave model is also constructed and solved. To simulate the heterogeneity of rocks, EPB rock breaking in deep environments is simulated using the two-dimensional Particle Flow Code (PFC2D) program. The solved shock wave is loaded into the model, and confining pressure is applied by the particle servo method. An artificial viscous boundary is used in the numerical simulation model. Using this approach, a complete numerical simulation of electropulse granite breaking is achieved. Breakdown strength and the influences of physical and mechanical parameters on it are also obtained. Time-varying waveforms of electrical parameters are obtained, and the effect of confining pressure on EPB is also described.

ABSTRACT PURPOSE: To investigate the effect of curcumin on visfatin and zinc-α2-glycoprotein (ZAG) expression levels in rats with non-alcoholic fatty liver disease (NAFLD). METHODS: Fifty-six male rats were randomly divided into a control group (n=16) and model group (n=40) and were fed on a normal diet or a high-fat diet, respectively. Equal volumes of sodium carboxymethyl cellulose (CMC) were intragastrically administered to the control group for 4 weeks. At the end of the 12th week, visfatin and ZAG protein expression levels were examined by immunohistochemistry. Visfatin mRNA levels were measured by semi-quantitative reverse transcription polymerase chain reaction. RESULTS: Compared with the control group, the model group showed significantly increased expression of visfatin in liver tissue (P < 0.01) and significantly decreased expression of ZAG (P < 0.01). These effects were ameliorated by curcumin treatment. CONCLUSIONS: Visfatin and zinc-α2-glycoprotein may be involved in the pathogenesis of NAFLD. Treatment of NAFLD in rats by curcumin may be mediated by the decrease of visfatin and the increase of non-alcoholic fatty liver disease.

ObjectivesWe investigated the association between occupational noise exposure and the risk of elevated blood pressure and hypertension by stage in young adults.MethodsWe utilized 124,286 young adults (18-40 years) from the Project ELEFANT study. We categorized occupational noise exposure as high (75 dBA noise exposure for more than 4 hours per day) or low, and measured blood pressure (mmHg) and categorized participants by hypertension stage (normal, elevated, Stage 1, Stage 2). We applied adjusted logistic regression models to identify associations with hypertension risk, and we further examined the noise-BMI, noise-gender, and noise-residence interactions on hypertension risk in separate models.ResultsHigh occupational noise exposure was associated with increases in blood pressure among participants with elevated blood pressure (Estimate = 0.23, 95% CI: 1.09, 1.46, p = 0.0009), in Stage 1 hypertension (Estimate = 0.15, 95% CI: 1.06, 1.25, p = 0.0008), and in Stage 2 hypertension (Estimate = 0.41 95% CI: 1.31, 1.73, p

BackgroundThe menstrual cycle is regulated by reproductive hormones such as estrogen which has been implicated in the pathogenesis of hypertension and is associated with obesity. However, to date there has scant study of hypertension in relation to menstrual characteristics and abnormalities. We hypothesize that adverse menstrual characteristics are associated with an increase the prevalence of hypertension and that this relationship is exacerbated by obesity.MethodsOur study leverages 178,205 healthy female participants (mean age = 29) in a population-based cross-sectional study in Tianjin, China. Menstrual characteristics including menstrual cycle length and regularity, menstrual bleeding length, menstrual blood loss and dysmenorrhea were assessed by self-reported questionnaires, and hypertension was diagnosed by physician. Multiple logistic regression models were used to assess the relationships between menstrual characteristics and hypertension.ResultsNormal length menstrual cycle (OR = 1.21, 95% CI: 1.03-1.41), oligomenorrhea (OR = 1.54, 95% CI: 1.12-2.07), irregular cycle (OR = 1.54, 95% CI: 1.22-1.93), and light menstrual blood loss (OR = 1.36, 95% CI: 1.06-1.72) were associated with hypertension among women who are overweight or obese, but not among women who are normal weight. Longer menstrual bleeding duration (OR = 1.44, 95% CI: 1.24-1.67) and dysmenorrhea were associated with increased prevalence of hypertension (OR = 1.20, 95% CI: 1.14-1.41) in all young women.ConclusionsThe prevalence of hypertension is higher among women with menstrual abnormalities, and this association is modified by overweight and obesity.

This paper presents a resonance-based wireless power transfer (R-WPT) system using two multi-layer multi-turn inductor coils on the transmission side and a third coil on the receiver side. We theoretically characterized and optimized the system in terms of quality factor (Q factor) of the coils and power transfer efficiency (PTE). In our R-WPT prototype, the alternating currents (AC) were simultaneously applied to two transmitter coils, which, in turn, transferred power wirelessly to the secondary coil with a 3-mm radius on the receiving end. Owing to the optimization of the inductive coils, all of the coils achieved the highest Q-factor and PTE at the resonance frequency of 2.9 MHz, and the transfer distance could be extended up to 30 mm. The results show that the PTE was greater than 74% at a separation distance of 5 mm and about 38.7% at 20 mm. This is distinctly higher than that of its 2 and 3-coil counterparts using only one driving coil.

The authors wish to make the following corrections to this paper [...]

The authors wish to make the following corrections to this paper [...]

High-voltage electro pulse boring (EPB) has the advantages of high rock-breaking efficiency and good wall quality, and is a new and efficient potential method of rock breaking. The EPB process is defined as random because it is affected by many factors. At present, there is no suitable physical and mathematical model to describe the process and results of rock breakage in EPB, and the conclusions reached regarding rock-breakage mechanisms are not uniform. In this study, a complete damage model of high voltage EPB in granite is established, which includes a shock wave model and a damage model of high voltage EPB in granite. The damage model is based on the Particle Flow Code two-dimensional program. Use of a damage model of EPB accommodates the complete process of high voltage EPB, from discharge to production of a shock wave, and so rock-breaking via electro pulse can be simulated and calculated. The time-varying waveforms of shock waves with different electrical parameters are simulated and calculated on the basis of the model. Different shock wave forms are loaded into the surface and internal rock in the damage geometric model of EPB granite. Then, the breakage process of the rock surface and internally, and the mechanism of rock breakage using EPB are analyzed. This study provides a scientific basis for the quantitative expression and prediction of rock fragmentation in EPB in order to improve the drilling efficiency and reduction of energy loss in the process of EPB.

As the exploration and drilling of oil, natural gas and geothermal wells are expanding continuously, research into high-efficiency rock drilling technology is imperative. High-voltage electro pulse boring (EPB) has the advantages of high rock breaking efficiency and good wall quality, and is a new and efficient potential method of rock breaking. The design of electrode drill bits and the selection of drilling process parameters are the main obstacles restricting the commercialization of EPB. Accordingly, it is necessary to determine the influences on high-voltage EPB. In this study, based on the equivalent circuit of high-voltage electro pulse breakdown, a mathematical model of high-voltage electro pulse discharge in rock is established. Meanwhile, a numerical simulation model of high-voltage EPB of hard granite is established based on a coaxial cylindrical electrode structure, which is often used for electrode drill bits. The simulation analysis software Comsol Multiphysics (Comsol Multiphysics®5.3a, COMSOL Co., Ltd., Stockholm, Sweden) is used to study the influences of granite composition, electrode spacing and electrode shape on the high-voltage EPB process. In addition, the influences of electrical parameters on high-voltage EPB are calculated according to a model of high-voltage electro pulse discharge in rock. Finally, it is demonstrated that high-voltage EPB is influenced by granite composition, electrical parameters, electrode spacing, and electrode shape, and the relationships between these factors are obtained. This study is of guiding significance for improving rock breaking efficiency, reducing energy loss, designing electrode drill bits and selecting drilling process parameters.

OBJECTIVES: Based on the important changes in South Africa since 2009 and the Antiretroviral Treatment Guideline 2013 recommendations, we explored the cost-effectiveness of different strategy combinations according to the South African HIV-infected mothers' prompt treatments and different feeding patterns. STUDY DESIGN: A decision analytic model was applied to simulate cohorts of 10,000 HIV-infected pregnant women to compare the cost-effectiveness of two different HIV strategy combinations: (1) Women were tested and treated promptly at any time during pregnancy (Promptly treated cohort). (2) Women did not get testing or treatment until after delivery and appropriate standard treatments were offered as a remedy (Remedy cohort). Replacement feeding or exclusive breastfeeding was assigned in both strategies. Outcome measures included the number of infant HIV cases averted, the cost per infant HIV case averted, and the cost per life year (LY) saved from the interventions. One-way and multivariate sensitivity analyses were performed to estimate the uncertainty ranges of all outcomes. RESULTS: The remedy strategy does not particularly cost-effective. Compared with the untreated baseline cohort which leads to 1127 infected infants, 698 (61.93%) and 110 (9.76%) of pediatric HIV cases are averted in the promptly treated cohort and remedy cohort respectively, with incremental cost-effectiveness of $68.51 and $118.33 per LY, respectively. With or without the antenatal testing and treatments, breastfeeding is less cost-effective ($193.26 per LY) than replacement feeding ($134.88 per LY), without considering the impact of willingness to pay. CONCLUSION: Compared with the prompt treatments, remedy in labor or during the postnatal period is less cost-effective. Antenatal HIV testing and prompt treatments and avoiding breastfeeding are the best strategies. Although encouraging mothers to practice replacement feeding in South Africa is far from easy and the advantages of breastfeeding can not be ignored, we still suggest choosing replacement feeding as far as possible.