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Abstract Objective The objective of this study was to investigate the potential association between the inflammatory burden index (IBI) and the prevalence of chronic inflammatory airway diseases (CIAD), as well as mortality rates among individuals diagnosed with CIAD. Methods Participants were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2010. The IBI was calculated using the formula: IBI = C-reactive protein * neutrophils / lymphocytes. CIAD comprised self-reported asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Mortality outcomes, including all-cause and respiratory disease mortality, were determined through linked data from the National Death Index (NDI) up to December 2019. Results A total of 27,495 adults were included. IBI was divided into quartiles, with the lowest quartile as the reference group. After adjusting for confounding variables, a positive correlation was observed between higher IBI and increased prevalence of total CIAD (OR = 1.383 [1.215–1.575]), asthma (OR = 1.267 [1.096–1.465]), chronic bronchitis (OR = 1.568 [1.263–1.946]), and COPD (OR = 1.907 [1.311–2.774]). Over a median follow-up of 12.33 [9.92-16.00] years, there were 1221 deaths from all causes and 220 deaths from respiratory disease among 4499 patients with CIAD. Following multivariate adjustments, the fourth quartile was significantly associated with increased risk of all-cause mortality (HR = 2.227 [1.714–2.893]) and respiratory disease mortality (HR = 2.748 [1.383–5.459]) compared to the first quartile of IBI in CIAD participants. Moreover, variable importance analysis using a random survival forest model demonstrated the significance of IBI in predicting mortality from both all-cause and respiratory diseases. Conclusion IBI exhibited an association with the prevalence of CIAD, with higher IBI levels correlating with elevated all-cause and respiratory disease mortality among individuals with CIAD.

BackgroundCadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The neurotoxicity of cadmium received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, little is known about the relationship between cadmium and sleep. This study aimed to examine the relationship between blood cadmium concentrations and sleep-related disorders in US adults.MethodsThis cross-sectional study used data on blood cadmium and sleep from the 2005–2008 and 2015–2020 National Health and Nutrition Examination Survey (NHANES). Weighted multiple regression, generalized weighted modeling, and weighted restricted cubic splines (RCS) were utilized to investigate the association between blood cadmium and sleep outcomes (sleep duration, trouble sleeping, symptoms of obstructive sleep apnea (OSA) and daytime sleepiness). Furthermore, subgroup analyses were conducted to investigate any differences in the associations between age, gender, ethnicity, education level, marital status, smoking status, alcohol consumption, diabetes mellitus (DM), cardiovascular disease (CVD) and hypertension groups.ResultsIn 19,152 participants, the median blood cadmium concentration was 0.48 (IQR: 0.28, 0.82)μg/L. Compared with the lowest reference quartile, participants in the higher quartile had a significantly higher risk of insufficient sleeping (0.05).ConclusionInsufficient sleep, symptoms of OSA, trouble sleeping and daytime sleepiness were found to have a positive association with the blood cadmium concentration in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.

Background: Prolonged sitting and reduced physical activity lead to low energy expenditures. However, little is known about the joint impact of daily sitting time and physical activity on body fat distribution. We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults. Methods: This was a cross-sectional analysis of U.S. nationally representative data from the National Health and Nutrition Examination Survey 2011–2018 among adults aged 20 years or older. Daily sitting time and leisure-time physical activity (LTPA) were self-reported using the Global Physical Activity Questionnaire. Body fat (total and trunk fat percentage) was determined via dual X-ray absorptiometry. Results: Among 10,808 adults, about 54.6% spent 6 h/day or more sitting; more than one-half reported no LTPA (inactive) or less than 150 min/week LTPA (insufficiently active) with only 43.3% reported 150 min/week or more LTPA (active) in the past week. After fully adjusting for sociodemographic data, lifestyle behaviors, and chronic conditions, prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes. When stratifying by LTPA, the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insufficiently active. In the joint analyses, inactive/insufficiently active adults who reported sitting more than 8 h/day had the highest total (female: 3.99% (95% confidence interval (95%CI): 3.09%–4.88%); male: 3.79% (95%CI: 2.75%–4.82%)) and trunk body fat percentages (female: 4.21% (95%CI: 3.09%–5.32%); male: 4.07% (95%CI: 2.95%–5.19%)) when compared with those who were active and sitting less than 4 h/day. Conclusion: Prolonged daily sitting time was associated with increased body fat among U.S. adults. The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Abstract Background Smoke exposure is a prevalent and well-documented risk factor for various diseases across different organ systems. Serum neurofilament light chain (sNfL) has emerged as a promising biomarker for a multitude of nervous system disorders. However, there is a notable paucity of research exploring the associations between smoke exposure and sNfL levels. Methods We conducted a comprehensive analysis of the National Health and Nutrition Examination Survey (NHANES) cross-sectional data spanning the years 2013 to 2014. Serum cotinine levels were classified into the following three groups: < 0.05, 0.05–2.99, and ≥ 3 ng/ml. Multiple linear regression models were employed to assess the relationships between serum cotinine levels and sNfL levels. Additionally, we utilized restricted cubic spline analyses to elucidate the potential nonlinear relationship between serum cotinine and sNfL levels. Results A total of 2053 participants were included in our present research. Among these individuals, the mean age was 47.04 ± 15.32 years, and males accounted for 48.2% of the total study population. After adjusting the full model, serum cotinine was positively correlated with sNfl in the second group (β = 0.08, 95%CI 0.01–0.15) and in the highest concentration of serum cotinine (β = 0.10, 95%CI 0.01–0.19) compared to the group with the lowest serum cotinine concentrations. Current smokers, in comparison to non-smokers, exhibited a trend toward elevated sNfL levels (β = 0.07, 95%CI 0.01–0.13). Furthermore, subgroup analyses revealed interactions between serum cotinine levels and different age groups (P for interaction = 0.001) and gender stratification (P for interaction = 0.015) on sNfL levels. Conclusion The study suggested that serum cotinine was significantly and positively associated with sNfl levels in adult participants. Furthermore, current smokers tend to exhibit elevated sNfL levels. This research sheds light on the potential implications of smoke exposure on neurological function impairment and underscores the importance of further exploration in this area.

As escalating environmental pressures threaten the world’s beaches, understanding the driving factors influencing their geomorphological changes is of critical global importance. This study focuses on the morphological changes of Sigeng beach adjacent to Changhua River Mouth in Hainan Island, China through decadal monitoring of shoreline and profile topography and tries to illuminate the natural and anthropogenic factors that drove geomorphological changes. The results showed that Sigeng beach undergone significant changes between 2008 and 2024, with notable accretion at the northernmost and southernmost and general erosion at other sections. The shoreline change rates ranged between -18.4 m/yr and 13.0 m/yr, with the average rate of -1.9 m/yr, indicating overall erosion. The net longshore sediment transport (LST) rates along Sigeng beach was estimated through the combination of the cross-shore (profile) and longshore (shoreline) changes. The overall direction of net LST along the beach were southward, except for the northern section where the direction was northward due to the diffraction of NE waves by the long sand spit at the northernmost. The net LST rates at each profile varied from 0.8×104 m3/yr to 3.5×104 m3/yr. The main factors controlling Sigeng beach evolution, including seasonal wave action and reduction in fluvial sediment load, followed by sand spit and coastal structures, typhoon events, aeolian transport, and sea level rise, were discussed. Subsequently, adaptive protection measures, including beach nourishment, accompanied with groin system or multiple detached breakwaters were proposed to combat with beach erosion. The analysis presented in this study is helpful to understand the morphodynamics and to predict the future change of beaches.

Automatic seizure detection plays a crucial role in epilepsy diagnosis and treatment. Traditional machine learning based automatic seizure detection requires additional feature engineering and finding the optimal hand-crafted features is a challenging issue. Therefore, a novel end-to-end deep learning model that combines attention mechanism, temporal convolutional network(TCN), and bidirectional gated recurrent unit (BiGRU) is proposed for seizure detection in this work. Our model only requires filtering of the raw electroencephalogram(EEG) signals to remove artifacts, without the need for time-consuming feature extraction. Post-processing procedures including moving-average filtering, thresholding, and the collar technique are then applied to enhance the model’s performance. Experiments were conducted on the CHB-MIT dataset and the SH-SDU dataset. In patient-specific experiments, our model achieved average accuracies of 98.77% on the CHB-MIT dataset and 93.61% on the SH-SDU dataset. In cross-patient experiments, average accuracies of 93.78% and 91.37% were obtained, respectively. The total time required for the model to process 1-hour EEG signals is only 5.33s. These outstanding results indicate that our model achieves high accuracy and real-time performance in seizure detection tasks and could provide reference for clinical seizure diagnosis.

Abstract Acute pulmonary embolism (APE) is a potentially fatal disease. Early risk stratification is essential to determining appropriate treatment. We aimed to investigate the predictive value of the Naples Prognostic Score (NPS) for 30-day all-cause mortality in patients with APE. In this retrospective analysis, 325 hospitalized patients with APE were divided into Groups 0 (n = 131), 1 (n = 153), and 2 (n = 41) according to the NPS. The primary outcome event was all-cause mortality during 30 days of follow-up from the day of admission. The correlation between NPS, clinical features, and outcomes in each group was evaluated. The patients were divided into two groups, survivor (n = 294) and nonsurvivor (n = 31), according to their prognosis. The results of the comparison between the three NPS groups revealed that patients with older age, faster heart rate, lower systolic blood pressure, low albumin and total cholesterol levels, high neutrophil to lymphocyte ratio (NLR), low lymphocyte-to-monocyte ratio (LMR), right heart dilatation, heart failure, malignancy, and lower extremity venous thrombosis had significantly higher 30-day all-cause mortality (P

Abstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain. Methods In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD. Results The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70–0.86, P

Abstract Owing to its unique geometry, the kagome lattice hosts various many-body quantum states including frustrated magnetism, superconductivity, and charge-density waves (CDWs). In this work, using inelastic X-ray scattering, we discover a dynamic short-range $$\sqrt{3}\times \sqrt{3}\times 2$$ 3 × 3 × 2 CDW that is dominant in the kagome metal ScV6Sn6 above T CDW ≈ 91 K, competing with the $$\sqrt{3}\times \sqrt{3}\times 3$$ 3 × 3 × 3 CDW that orders below T CDW. The competing CDW instabilities lead to an unusual CDW formation process, with the most pronounced phonon softening and the static CDW occurring at different wavevectors. First-principles calculations indicate that the $$\sqrt{3}\times \sqrt{3}\times 2$$ 3 × 3 × 2 CDW is energetically favored, while a wavevector-dependent electron-phonon coupling (EPC) promotes the $$\sqrt{3}\times \sqrt{3}\times 3$$ 3 × 3 × 3 CDW as the ground state, and leads to enhanced electron scattering above T CDW. These findings underscore EPC-driven correlated many-body physics in ScV6Sn6 and motivate studies of emergent quantum phases in the strong EPC regime.

Abstract Background and Aims The relationship between oral contraceptive pill (OCP) and suicidal ideation remains unclear. This study aims to estimate the prevalence of suicidal ideation among US women and evaluate their associates overall and according to OCP use status. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005−2012 were used to calculate the prevalence and associates of suicidal ideation in women using OCP. Suicidal ideation was assessed using the Patient Health Questionnaire‐9. Overall and OCP‐specific weighted prevalence of suicidal ideation were estimated. Multivariable logistic regressions were used to investigate overall and OCP‐specific associates. Results The prevalence of suicidal ideation was 3.6% with no evident disparity between OCP groups, suggesting that OCP use is not associated with increased prevalence of suicidal ideation. Smoking was inversely associated with suicidal ideation in the former users of OCP. In the overall population, the prevalence of suicidal ideation was greater in those who were: Black or Hispanic, smoking, taking antidepressants, those with lower educational attainment, and women with low and middle income. Conclusion Our findings suggest that OCP use was not associated with increased prevalence of suicidal ideation. Unique associates were identified among different OCP groups.

In this work, a four-port directional filter (DF) with a broad passband and low reflection is proposed at the W-band, which comprises three unit filters at 92, 95, and 97 GHz, cascaded in series. Each unit consists of two microstrip lines in the top circuit layer for signal input and output, two pairs of apertures in the middle ground layer for directional coupling, and one square loop in the bottom layer as a selective resonator. By sweeping the working frequencies of the three units and optimizing the phase delays between them, the proposed filter achieves a 3-dB bandwidth as broad as 16%, an insertion loss of 2.5 dB at 95 GHz, and an out-of-band rejection of −28 and −23 dB at 80 and 110 GHz, respectively. The corresponding reflection attenuation is larger than 9.6 dB from 60 to 105 GHz. To verify our design, a prototype is fabricated and characterized, and its experimental data are consistent with the simulation. This work significantly expands the bandwidth of DFs and may find many applications in frequency division multiplexing and high-gain wireless systems.

Chronic Pseudomonas aeruginosa (PA) infection significantly contributes to morbidity and mortality in bronchiectasis patients. Initiating antibiotics early may lead to the eradication of PA. Here we outline the design of a trial (ERASE; NCT06093191) assessing the efficacy and safety of inhaled tobramycin, alone or with oral ciprofloxacin, in bronchiectasis patients with a new isolation of PA. This multicentre, 2×2 factorial randomised, double-blind, placebo-controlled, parallel-group trial includes a 2-week screening period, a 12-week treatment phase (with a combination of ciprofloxacin or a placebo at initial 2 weeks) and a 24-week follow-up. 364 adults with bronchiectasis and a new PA isolation will be randomly assigned to one of four groups: placebo (inhaled saline and ciprofloxacin placebo twice daily), ciprofloxacin alone (750 mg ciprofloxacin and inhaled saline twice daily), inhaled tobramycin alone (inhaled 300 mg tobramycin and ciprofloxacin placebo twice daily) or a combination of both drugs (inhaled 300 mg tobramycin and 750 mg ciprofloxacin twice daily). The primary objective of this study is to assess the proportion of patients successfully eradicating PA in each group by the end of the study. Efficacy will be evaluated based on the eradication rate of PA at other time points (12, 24 and 36 weeks), the occurrence of exacerbations and hospitalisations, time to first pulmonary exacerbations, patient-reported outcomes, symptom measures, pulmonary function tests and the cost of hospitalisations. To date no randomised trial has evaluated the benefit of different PA eradication strategies in bronchiectasis patients. The ERASE trial will therefore generate crucial data to inform future clinical guidelines.

At the dawn of of Artificial General Intelligence (AGI), the emergence of large language models such as ChatGPT show promise in revolutionizing healthcare by improving patient care, expanding medical access, and optimizing clinical processes. However, their integration into healthcare systems requires careful consideration of potential risks, such as inaccurate medical advice, patient privacy violations, the creation of falsified documents or images, overreliance on AGI in medical education, and the perpetuation of biases. It is crucial to implement proper oversight and regulation to address these risks, ensuring the safe and effective incorporation of AGI technologies into healthcare systems. By acknowledging and mitigating these challenges, AGI can be harnessed to enhance patient care, medical knowledge, and healthcare processes, ultimately benefiting society as a whole.

DesignUltra-processed foods (UPFs) have become a pressing global health concern, prompting investigations into their potential association with low muscle mass in adults.MethodsThis cross-sectional study analyzed data from 10,255 adults aged 20−59 years who participated in the National Health and Nutritional Examination Survey (NHANES) during cycles spanning from 2011 to 2018. The primary outcome, low muscle mass, was assessed using the Foundation for the National Institutes of Health (FNIH) definition, employing restricted cubic splines and weighted multivariate regression for analysis. Sensitivity analysis incorporated three other prevalent definitions to explore optimal cut points for muscle quality in the context of sarcopenia.ResultsThe weighted prevalence of low muscle mass was 7.65%. Comparing the percentage of UPFs calories intake between individuals with normal and low muscle mass, the values were found to be similar (55.70 vs. 54.62%). Significantly linear associations were observed between UPFs consumption and low muscle mass (P for non-linear = 0.7915, P for total = 0.0117). Upon full adjustment for potential confounding factors, participants with the highest UPFs intake exhibited a 60% increased risk of low muscle mass (OR = 1.60, 95% CI: 1.13 to 2.26, P for trend = 0.003) and a decrease in ALM/BMI (β = −0.0176, 95% CI: −0.0274 to −0.0077, P for trend = 0.003). Sensitivity analysis confirmed the consistency of these associations, except for the International Working Group on Sarcopenia (IWGS) definition, where the observed association between the highest quartiles of UPFs (%Kcal) and low muscle mass did not attain statistical significance (OR = 1.35, 95% CI: 0.97 to 1.87, P for trend = 0.082).ConclusionOur study underscores a significant linear association between higher UPFs consumption and an elevated risk of low muscle mass in adults. These findings emphasize the potential adverse impact of UPFs on muscle health and emphasize the need to address UPFs consumption as a modifiable risk factor in the context of sarcopenia.

Pulmonary fibrosis is a fatal lung disease affecting approximately 5 million people worldwide, with a 5-year survival rate of less than 50%. Currently, the only available treatments are palliative care and lung transplantation, as there is no curative drug for this condition. The disease involves the excessive synthesis of the extracellular matrix (ECM) due to alveolar epithelial cell damage, leading to scarring and stiffening of the lung tissue and ultimately causing respiratory failure. Although multiple factors contribute to the disease, the exact causes remain unclear. The mechanical properties of lung tissue, including elasticity, viscoelasticity, and surface tension, are not only affected by fibrosis but also contribute to its progression. This paper reviews the alteration in these mechanical properties as pulmonary fibrosis progresses and how cells in the lung, including alveolar epithelial cells, fibroblasts, and macrophages, respond to these changes, contributing to disease exacerbation. Furthermore, it highlights the importance of developing advanced in vitro models, based on hydrogels and 3D bioprinting, which can accurately replicate the mechanical and structural properties of fibrotic lungs and are conducive to studying the effects of mechanical stimuli on cellular responses. This review aims to summarize the current understanding of the interaction between the progression of pulmonary fibrosis and the alterations in mechanical properties, which could aid in the development of novel therapeutic strategies for the disease.

Springback error is a major obstacle in L-bending sheets via cold working. Although thermal processing can effectively reduce the springback phenomenon, it is challenging to heat the sheet globally due to the influence of working conditions. Therefore, this study applied local induction heating to reduce the springback of 45 steel sheets and investigated the effects of bending parameters on springback behavior. Initially, a thermodynamic coupling model and a static model were created utilizing the VOCE hardening model and the von Mises yield criterion in the ANSYS workbench 2022 R2 software. The springback behavior and stress distribution of the sheets were then investigated under different temperatures (room temperature and 800 °C) and bending angles (15°, 30°, 45°, 60°, 75°, and 90°). Simultaneously, the experiments were performed to investigate springback behavior and guarantee the accuracy of the model. The results indicate that the springback reached a minimum value at the 45° bending angle at room temperature while increasing with the increasing bending angle under 800 °C local heating. The springback under local heating can be decreased by 75.2% and the error of the bending angle can improve by 2–7° compared with samples processed in room temperature.

Abstract Background Circular RNAs (circRNAs) play a significant role in some diseases by acting as transcription templates. Therefore, analyzing the interaction mechanism between circRNA and RNA-binding proteins (RBPs) has far-reaching implications for the prevention and treatment of diseases. Existing models for circRNA-RBP identification usually adopt convolution neural network (CNN), recurrent neural network (RNN), or their variants as feature extractors. Most of them have drawbacks such as poor parallelism, insufficient stability, and inability to capture long-term dependencies. Methods In this paper, we propose a new method completely using the self-attention mechanism to capture deep semantic features of RNA sequences. On this basis, we construct a CircSSNN model for the cirRNA-RBP identification. The proposed model constructs a feature scheme by fusing circRNA sequence representations with statistical distributions, static local contexts, and dynamic global contexts. With a stable and efficient network architecture, the distance between any two positions in a sequence is reduced to a constant, so CircSSNN can quickly capture the long-term dependencies and extract the deep semantic features. Results Experiments on 37 circRNA datasets show that the proposed model has overall advantages in stability, parallelism, and prediction performance. Keeping the network structure and hyperparameters unchanged, we directly apply the CircSSNN to linRNA datasets. The favorable results show that CircSSNN can be transformed simply and efficiently without task-oriented tuning. Conclusions In conclusion, CircSSNN can serve as an appealing circRNA-RBP identification tool with good identification performance, excellent scalability, and wide application scope without the need for task-oriented fine-tuning of parameters, which is expected to reduce the professional threshold required for hyperparameter tuning in bioinformatics analysis.

Obtaining high-quality Pt coatings remains a challenging task. Here, explosive welding was attempted to prepare Pt coatings on a steel plate, and the complex interfacial phenomena of the achieved Pt/Fe joints as well as the governing mechanisms were carefully investigated by multi-scale microstructure analyses and smoothed particles hydrodynamics simulations. The results demonstrated that the self-development explosive welding was a suitable method for preparing Pt coatings, featuring a desirable undulating metallurgical interface. Two types of transition regions, namely the isolated zones and continuous layers, were formed at the wave interface, and their formation mechanisms were revealed. Besides, special attention was given to the frequent formed elliptic void in the isolated transition regions, and its formation mechanism was found to be combined actions of excessive shear instability and rapid cooling process. The multi-area EBSD analyses revealed diverse grain structures near the interface, such as formation of columnar grains in isolated transition region and small equiaxed grains in continuous melting layer. These grain characteristics provide strong supports for the interface formation mechanisms developed in this paper. Thus, this work enables to provide a new perspective for Pt coating preparation and improve the understanding of explosive welding process behavior.

Objective: This study was to evaluate the prognostic value of the Naples prognostic score (NPS) in adult patients with asthma. Methods: Data on 44 601 participants from the 1999–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. The NPS was calculated based on serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), and participants were divided into 3 groups. Self-administered questionnaires were used to collect information on asthma, and mortality was identified using the National Death Index through December 31, 2019. Multiple logistic regressions were used to analyze the relationship between NPS and its components and the prevalence of asthma. Kaplan-Meier survival analysis, Cox proportional regressions, and the random survival forest (RSF) were used to assess the significance of NPS and its components in predicting all-cause and cause-specific (cardiovascular, cancer, and respiratory diseases) mortality in asthma patients. Results: The mean age of the participants was 47.59 ± 0.18 years, and 48.47% were male. The prevalence of asthma was 13.11%. The participants were categorized into 3 groups: 8306 (18.6%) participants were in group 0 (NPS 0), 30 842 (69.2%) were in group 1 (NPS 1 or 2), and 5453 (11.2%) were in group 2 (NPS 3 or 4). Compared to the reference group, participants in group 2 had a higher prevalence of asthma (odds ratio [OR] = 1.40 [1.24–1.56]). Participants with asthma in group 2 had a significantly increased risk of all-cause mortality (hazard ratio [HR] = 2.42 [1.67–3.50]), cardiovascular mortality (HR = 2.68 [1.50–4.79]), cancer mortality (HR = 2.10 [1.00–4.45]), and respiratory disease mortality (HR = 3.00 [1.18–7.65]) compared to those with asthma in group 0. The RSF showed that NPS had the highest value in predicting all-cause mortality in adults with asthma, compared to its components. Conclusions: The results of this study indicate that the NPS is a powerful prognostic indicator for outcomes in asthma patients.

Abstract In this paper, a three‐dimensional simulation model of the engine cylinder is established using commercial simulation software AVL‐Fire, and the accuracy of the model is verified with experimental results. The effects of diesel/biodiesel/n‐butanol blends on diesel engine performance, and combustion and emissions characteristics were investigated by performing simulation operations on the model. The combustion process in the cylinder was simulated for 0%, 5%, 10%, 15%, and 20% of n‐butanol in the fuel mixture. The results showed that at 75% load, the brake thermal efficiency of D95N5, D90N10, D85N15, and D80N20 engines increased by 0.84%, 1.68%, 2.48%, and 3.19%, respectively, and soot emissions decreased by 2.76%, 5.52%, 8.25%, and 10.96%, respectively, compared with D100. However, the brake power of the engine was reduced, the brake ratio fuel consumption increased, and NOx emission increased. In addition, at all loads, soot and CO emissions decrease as the percentage of n‐butanol in the fuel mixture increases.

We perform systematic first-principles calculations on the electronic structure of n -type magnetic semiconductor Ba(Zn $_{1-x}$ Co _x ) _2 As _2 with the facilitation of HSE06 hybrid functional. Supercells are used to consider the doping of Co atoms, and the first-principles band structures are unfolded for clarity. Based on the calculation results, magnetic states are preferred by individual Co atoms doped in Ba(Zn $_{1-x}$ Co _x ) _2 As _2 at diluted limit, and carriers are originated mainly from situations where only one Co atom exists in the nearest neighbor Zn sites out of certain doped Co atoms. The origination of carriers can be explained by the density of states and the unfolded band structure, where it is found that the scattering effects from single Co atom is small but quite large when more Co atoms are located at adjacent Zn sites. The large scattering effects of two adjacent Co atoms will alter the band structures near the Fermi-level. Carriers in Ba(Zn $_{1-x}$ Co _x ) _2 As _2 mainly originate from the As-4p orbitals, with partial contributions from the Co-3d orbitals. Our work provides new insights into the origin of the n -type carriers in magnetic semiconductors and will inspire the development of new magnetic semiconducting systems.

Abstract The combination of magnetic symmetries and electronic band topology provides a promising route for realizing topologically nontrivial quasiparticles, and the manipulation of magnetic structures may enable the switching between topological phases, with the potential for achieving functional physical properties. Here, we report measurements of the electrical resistivity of EuCd2As2 under pressure, which show an intriguing insulating dome at pressures between p c1 ~ 1.0 GPa and p c2 ~ 2.0 GPa, situated between two regimes with metallic transport. The insulating state can be fully suppressed by a small magnetic field, leading to a colossal negative magnetoresistance on the order of 105%, accessible via a modest field of ~ 0.2 T. First-principles calculations reveal that the dramatic evolution of the resistivity under pressure can be attributed to consecutive transitions of EuCd2As2 from a magnetic topological insulator to a trivial insulator, and then to a Weyl semimetal, with the latter resulting from a pressure-induced change in the magnetic ground state. Similarly, the colossal magnetoresistance results from a field-induced polarization of the magnetic moments, transforming EuCd2As2 from a trivial insulator to a Weyl semimetal. These findings underscore weak exchange couplings and weak magnetic anisotropy as ingredients for discovering tunable magnetic topological materials with desirable functionalities.

Abstract Background Considering the considerable prevalence of allergic disease in the general population, an urgent need exists for inactivated SARS-CoV-2 vaccines that can be safely administered to those subjects. Methods This retrospective cohort study including 1926 participants who received inactivated SARS-CoV-2 vaccines, compared their local and systemic reactions in 7 days after each dose of inactivated SARS-CoV-2 vaccine, and anti–SARS-CoV-2 IgG after vaccination in all participants. Results Pain at the injection site within seven days after the first injection was the most commonly reported local reaction, occurring in 31.0% of the patients with allergic disease and 18.9% in the control group, respectively (P

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan–Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up.

Abstract The electronic property and magnetic susceptibility of Ce3Pd3Bi4 were systemically investigated from 18 to 290 K for varying values of cell volume using dynamic mean-field theory coupled with density functional theory. By extrapolating to zero temperature, the ground state of Ce3Pd3Bi4 at ambient pressure is found to be a correlated semimetal due to insufficient hybridization. Upon applying pressure, the hybridization strength increases and a crossover to the Kondo insulator is observed at finite temperatures. The characteristic temperature signaling the formation of Kondo singlet, as well as the characteristic temperature associated with f-electron delocalization–localization change, simultaneously vanishes around a critical volume of 0.992 V 0, suggesting that such metal–insulator transition is possibly associated with a quantum critical point. Finally, Wilson’s loop calculations indicate that the Kondo insulating side is topologically trivial, thus a topological transition also occurs across the quantum critical point.

Cotinine, the primary metabolite of nicotine, can be utilized as a marker for active smoking and as an indicator of exposure to secondhand smoke. However, the direct relationship between dietary flavonoid intake and serum cotinine levels remains a subject of ongoing investigation. In this study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 and 2017–2018 to assess the association between dietary flavonoid intake and serum cotinine levels in adults through multiple linear regression analysis. A weighted quantile sum (WQS) regression model was used to assess the association of the mixture of six dietary flavonoids with serum cotinine levels in adults, which could represent the overall effect of the mixture of six dietary flavonoids. We also conducted stratified analyses by smoke status to explore multiple linear regression associations between different flavonoid intake and serum cotinine levels. A total of 14,962 adults were included in the study. Compared to the group with the lowest dietary flavonoid intake, total flavonoid intake in the second (β = −0.29 [−0.44, −0.14]), third (β = −0.41 [−0.58, −0.24]), and highest groups (β = −0.32 [−0.49, −0.16]) was inversely related to the levels of serum cotinine after adjusting the full model. An RCS model showed that when the total dietary flavonoid intake was less than 99.61 mg/day, there was a negative linear association between dietary flavonoid intake and the serum cotinine. The WQS regression model also showed that the intake of a mixture of six dietary flavonoids was significantly negatively correlated with serum cotinine levels (β = −0.54 [−0.61, −0.46], p

Objective To investigate the risk factors of pulmonary embolism in patients with lung cancer and develop and validate a novel nomogram scoring system-based prediction model. Method We retrospectively analyzed the clinical data and laboratory characteristics of 900 patients with lung cancer who were treated, including patients with lung cancer without pulmonary embolism (LC) and patients with lung cancer with pulmonary embolism (LC + PE). The patients were randomly divided into derivation and internal validation groups in a 7:3 ratio. Using logistic regression analysis, a diagnostic model of the nomogram scoring system was developed by incorporating selected variables in the derivation group and validated in the internal and external validation groups (n = 108). Result Seven variables (adenocarcinoma, stage III-IV LC, indwelling central venous catheter, chemotherapy, and the levels of serum albumin, hemoglobin, and D-dimer) were identified as valuable parameters for developing the novel nomogram diagnostic model for differentiating patients with LC and LC + PE. The scoring system demonstrated good diagnostic performance in the derivation (area under the curve [AUC]; 95% confidence interval [CI], 0.918; 0.893, 0.943; sensitivity, 88.5%; specificity, 80.5%), internal validation (AUC; 95% CI, 0.921; 0.884, 0.958; sensitivity, 90.5%; specificity, 80.4%), and external validation (AUC; 95% CI, 0.929; 0.875, 0.983; sensitivity; 85.0%; specificity; 87.5%) groups. Conclusion In this study, we constructed and validated a nomogram scoring system based on 7 clinical parameters. The scoring system exhibits good accuracy and discrimination between patients with LC and LC + PE and can effectively predict the risk of PE in patients with LC.

We introduce an efficient training framework for constructing machine learning-based emulators and demonstrate its capability by training an artificial neural network to predict the time evolution of quantum wave packets propagating through a potential landscape. This approach is based on the idea of knowledge distillation and uses elements of curriculum learning. It works by constructing a set of simple, but rich-in-physics training examples (a curriculum). These examples are used by the emulator to learn the general rules describing the time evolution of a quantum system (knowledge distillation). We show that this emulator is capable of learning the rules of quantum dynamics from a curriculum of simple training examples (wave packet interacting with a single rectangular potential barrier), and subsequently generalizes this knowledge to solve more challenging cases (propagation through an arbitrarily complex potential landscape). Furthermore, we demonstrate, that using this framework we can not only make high-fidelity predictions, but we can also learn new facts about the underlying physical system, detect symmetries, and measure relative importance of the contributing physical processes.

Abstract To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.

Coastal erosion vulnerability assessment is widely used to assess the loss degree of coastal zone caused by erosion, and plays an important role in coastal natural resources protection, planning, management and decision-making. Based on the natural and social characteristics of the east coast of Qiongdong and the coastal erosion vulnerability index (CVI) method, this study selected 8 assessment indicators, such as shoreline change rate (U1). The Delphi method and the entropy weight method were used to calculate the comprehensive index weight, combined with CVI method and geographic information system (GIS) technology, to quantitatively evaluate the temporal and spatial distribution characteristics of typical coastal erosion vulnerability such as coral reefs in the east of Hainan Island. The study area was divided into 5 grades: very low (31%), low (10%), moderate (28%), high (24%) and high vulnerability (7%), and the overall performance was moderate erosion vulnerability. The research showed that the interannual downward rate erosion of beach (U3) and the rate of change of the isobath (U2) of the beach were the main controlling factors affecting the vulnerability of coastal erosion in the study area, and the coastal dynamic factor had a greater impact than the other two factors. As a natural barrier, the coral reefs in the study area had good wave absorption and energy reduction, and the coral reef coasts showed low coastal erosion vulnerability, due to the complex hydrodynamic characteristics, estuary coasts is the most vulnerable areas. The verification results of the ROC-AUC method showed that the accuracy of erosion vulnerability was 68.9%, which provided an important reference for the ecological restoration of tropical coral reef biological coasts and the development and management of the Hainan Qiongdong coastal zone.

Background: Sleep affects health. Sleep habits differ between population subgroups and may also differ between weekdays and weekends; however, these patterns are rarely described at the population level. Purpose: To investigate age and racial/ethnic differences in sleep duration and timing between weekdays (workdays) and weekends (non-workdays). Methods: A cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey among adolescents (16-19 years) and adults (≥20 years). Results: Data on 10069 individuals were analyzed (51% female), including 959 adolescents and 9110 adults. The hours per night of sleep were shorter during weekdays (7.6, 95%CI: 7.6 to 7.7) than on weekends (8.3, 95% CI: 8.3 to 8.2). Females slept shorter hours than males on weekdays (7.7 [95%CI, 7.7 to 7.8] vs. 7.5 [95%CI, 7.4 to 7.5]) and on weekends (8.5, [95%CI, 8.4 to 8.5] vs. 8.2 [95% CI, 8.1 to 8.2]). Non-Hispanic blacks (7.4, 95% CI: 7.4 to 7.5) reported the shortest weekdays sleep. With respect to sleep timing, comparing to weekdays, males reported 30-min delayed weekends bedtime (23:30 [IQR, 22:30-00:30] vs. 23:00 [IQR, 22:00-00:00]), whereas both sexes reported 1.5-hour delayed weekends wake-up time (male: 07:30 [IQR, 06:30-09:00] vs. 06:00 [IQR, 05:30-07:30]; female: 08:00 [IQR, 06:30-09:00] vs. 06:30 [IQR, 05:30-07:30]). The delayed weekend bedtime and wake-up times were observed in all racial/ethnic groups. Conclusions: In the US population, sleep habits differed between weekdays and weekends. Shorter sleep hours and delayed sleep timing were noted and more apparent among racial/ethnic minorities of both sexes.

Objective To explore the diagnostic value of liquid-based cytology (LBC) of bronchoalveolar lavage fluid (BALF) combined with bronchial brushing (BB). Methods One hundred patients with pulmonary masses or nodules found by chest computed tomography (CT) or X-ray before bronchoscopy or other diagnostic biopsy examinations were selected consecutively for this retrospective study. BALF and BB were performed for all patients. After conventional smear via BB, we mixed the BALF and BB samples in a prepared thin-layer bottle. Results The sensitivity of LBC of BALF combined with BB was noticeably higher than that of BB alone in the total sample group (65.15% vs. 32.84%, respectively). Similarly, in both the bronchoscopically visible group and invisible group, a higher sensitivity for LBC of BALF with BB vs BB alone (68.89% vs. 39.13%, respectively; 57.14% vs. 19.05%, respectively) was observed. Additionally, the negative predictive value of LBC of BALF with BB was higher than that with BB alone (58.56% vs. 42.31%; 61.29% vs. 44.73%; 53.47% vs. 37.83%; total sample vs visible vs invisible groups, respectively). Conclusion Regardless of whether lesions or nodules are bronchoscopically visible or invisible, LBC of BALF combined with BB may increase the diagnostic value over BB alone in lung cancer diagnosis.

DesignThere is a strong correlation between dietary intake and allergic diseases. Ultra-processed foods (UPFs) are gradually becoming dominant worldwide and causing health problems for children and adults. We hope to determine whether links exist between UPFs and allergic symptoms.MethodsWe investigated data from 2,736 children (16–19 years) and 4,256 adults (≥20 years) from the National Health and Nutritional Examination Survey (NHANES) 2005–2006. The associations between the mean UPFs contribution to total energy intake and all allergic symptoms (IgE, current asthma, allergy, rash, sneeze, wheeze, eczema, and hay fever) were estimated by weighted multivariate logistic regression.ResultsLogistic regression analysis showed UFPs were negatively associated with IgE levels in children. Those with higher quartiles had a reduced risk from 16% (OR, 0.84, 95%CI, 0.55 to 1.28) to 34% (OR, 0.66, 95%CI, 0.49 to 0.89), p for trend = 0.006. UPFs were also positively related to current asthma in children with an increased risk of 11% (OR, 1.11, 95%CI, 0.79 to 1.56) to 76% (OR, 1.76, 95%CI, 1.10 to 2.82), p for trend = 0.0393. UPFs were also associated with eczema in girls. But there was no association observed between UPFs and allergic symptoms in adults.ConclusionOur results suggested that UPFs assessed by the NOVA system were associated with IgE, current asthma in children, and eczema in girls. These results further support the need to test the association of modern dietary patterns with allergic symptoms.

Phosgene (COCl2) gas is a chemical intermediate of high-volume production with numerous industrial applications worldwide. Due to its high toxicity, accidental exposure to phosgene leads to various chemical injuries, primarily resulting in chemical-induced lung injury due to inhalation. Initially, the illness is mild and presents as coughing, chest tightness, and wheezing; however, within a few hours, symptoms progress to chronic respiratory depression, refractory pulmonary edema, dyspnea, and hypoxemia, which may contribute to acute respiratory distress syndrome or even death in severe cases. Despite rapid advances in medicine, effective treatments for phosgene-inhaled poisoning are lacking. Elucidating the pathophysiology and pathogenesis of acute inhalation toxicity caused by phosgene is necessary for the development of appropriate therapeutics. In this review, we discuss extant literature on relevant mechanisms and therapeutic strategies to highlight novel ideas for the treatment of phosgene-induced acute lung injury.

Abstract Background This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases at the start of the pandemic in China. Methods In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included. Demographic data, symptoms, laboratory values, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Results 58 patients were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12·9 ± 4·4 vs 8·3 ± 4·7; P = 0·0011), duration of viral shedding (15·7 ± 6·7 vs 11·8 ± 5·0; P = 0·0183), and hospital stay (20·7 ± 1·2 vs 14·4 ± 4·3; P = 0·0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1·28, 95%CI 1·06–1·54, per 0·1 × 109/L reduced; P = 0·007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0·14, 95%CI 0·02–0·80; P = 0·0275). Conclusions The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. However, this study was carried out right after the start of the pandemic with small sample size. Further prospective studies are warranted to confirm these findings. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029839 . Registered 15 February 2020 - Retrospectively registered.

The mechanism of the delocalization transition of 4f electrons in closely-packed Ce metal has been debated. Here, the authors present photoemission evidence for bandwidth-controlled Mott delocalization in a previously unreported structural phase of thin epitaxial Ce films obtained by thermal annealing.

Owing to the specific topological states in nodal-line semimetals, novel topological superconductivity is expected to emerge in these systems. In this Letter, we demonstrate that La_{3}Pt_{3}Bi_{4} is a topologically nontrivial nodal-ring semimetal protected by the gliding-mirror symmetry using first-principles calculations. Meanwhile, we discover bulk superconductivity with a transition temperature of ∼1.1 K and an upper critical field of ∼0.41 T by means of resistivity, susceptibility, and specific heat measurements. These findings demonstrate that La_{3}Pt_{3}Bi_{4} provides a material platform for studying novel superconductivity in the nodal-ring system.

Perturbation of the microbiome has numerous associations with the phenotypes and progression in chronic airways disease. However, the differences in the nasal microbiome in asthma and allergic rhinitis (AR) have not been defined. We examined whether the nasal microbiome would vary among different comorbidities in asthma and AR and that those differences may be associated with the severity of asthma. Nasal lavage fluid was collected from 110 participants, including 20 healthy controls, 30 subjects with AR, 30 subjects with asthma and 30 subjects with combined asthma + AR. The Asthma Control Questionnaire (ACQ-7) was used to evaluate asthma control status. Using 16S rRNA bacterial gene sequencing, we analyzed nasal microbiome in patients with asthma, AR, combined asthma + AR, and healthy controls. Bacterial diversity was analyzed in corresponding with α diversity indices (Chao and Shannon index). Compared with healthy controls, the Chao index tended to be lower in subjects with AR (P = 0.001), asthma (P = 0.001), and combined asthma + AR (P = 0.001) when compared with healthy controls. Furthermore, the Shannon index was significantly lower in subjects with asthma (P = 0.013) and comorbid asthma with AR (P = 0.004) than the control subjects. Disparity in the structure and composition of nasal bacteria were also observed among the four groups. Furthermore, patients with combined asthma + AR and isolated asthma were divided into two groups according to the level of disease control: partially or well-controlled and uncontrolled asthma. The mean relative abundance observed in the groups mentioned the genera of Pseudoflavonifractor were dominated in patients with well and partially controlled disease, in both isolated asthma and combined asthma + AR. In subjects with uncontrolled asthma and combined asthma + AR, a lower evenness and richness (Shannon index, P = 0.040) was observed in nasal microbiome composition. Importantly, lower evenness and richness in the nasal microbiome may be associated with poor disease control in combined asthma + AR. This study showed the upper airway microbiome is associated with airway inflammation disorders and the level of asthma control.

BackgroundThe comprehensive impacts of diverse breathing air volumes and preexisting immunity on the host susceptibility to and transmission of COVID-19 at various pandemic stages have not been investigated.MethodsWe classified the US weekly COVID-19 data into 0–4, 5–11, 12–17, 18–64, and 65+ age groups and applied the odds ratio (OR) of incidence between one age group and the 18–64 age group to delineate the transmissibility change.ResultsThe changes of incidence ORs between May, 2020 and November, 2021 were 0.22–0.66 (0–4 years), 0.20–1.34 (5–11 years), 0.39–1.04 (12–17 years), and 0.82–0.73 (65+ years). The changes could be explained by age-specific preexisting immunity including previous infection and vaccination, as well as volumes of breathing air. At the early pandemic, the ratio that 0–4-year children exhaled one-fifth of air and discharge a similar ratio of viruses was closely associated with incidence OR between two age groups. While, after a rollout of pandemic and vaccination, the much less increased preexisting immunity in children resulted in rapidly increased OR of incidence. The ARIMA model predicted the largest increase of relative transmissibility in 6 coming months in 5–11-year children.ConclusionsThe volume of breathing air may be a notable factor contributing to the infectivity of COVID-19 among different age groups of patients. This factor and the varied preexisting greatly shape the transmission of COVID-19 at different periods of pandemic among different age groups of people.

Under the dual effects of global climate change and intensive human development activities, vulnerability to coastal erosion in bay areas is becoming increasingly serious. This study focuses on 15 counties and districts along the coast of the Pearl River Estuary (PRE) Great Bay Area and selects 12 evaluation indices from five perspectives for analysis, including coastal characteristics, hydrodynamic forces, economics, population and coastal reconstruction. The analytic hierarchy process (AHP) method, Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method, independent weight method, Jenks natural breaks method (Jenks), exposure-sensitivity-adaptation (ESA) model and obstacle degree method are used in conjunction with the above indices to construct a coastal erosion vulnerability evaluation system for the PRE. The results show that coastal erosion vulnerability in the PRE is low in the eastern hilly area and high in the central and western delta areas. Coastal characteristics, coastal lowlands and protection capability are the main controlling elements of erosion. The PRE experienced an era of rapid economic development from 1980 to 2010, and coastal erosion vulnerability gradually increased, with a cost of ecological environment destruction. Then, an era of coastal zone ecological restoration supported by policy protection occurred from 2010 to 2020. Compared with three major bay areas with similar developed economies worldwide, the PRE is characterized by comparatively late but rapid economic development. Notably, the development and utilization efficiency of coastal zones is very high, the duration of damage to the ecological environment is short, and the effects of ecological repair and restoration are obvious. The results of this study provide a reference for economic development and ecological restoration in the bay areas of China and provide scientific guidance for coastal zone development, management and planning.

Summary: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures.

Introduction The study aimed to establish and internally validate a nomogram to predict successful smoking cessation in a Chinese outpatient population. Methods A total of 278 participants were included, and data were collected from March 2016 to December 2018. Predictors for successful smoking cessation were evaluated by 3-month sustained abstinence rates. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables for the model to predict successful smoking cessation, and multivariable logistic regression analysis was performed to establish a novel predictive model. The discriminatory ability, calibration, and clinical usefulness of the nomogram were determined by the concordance index (C-index), calibration plot, and decision curve analysis, respectively. Internal validation with bootstrapping was performed. Results The nomogram included living with a smoker or experiencing workplace smoking, number of outpatient department visits, reason for quitting tobacco, and varenicline use. The nomogram demonstrated valuable predictive performance, with a C-index of 0.816 and good calibration. A high C-index of 0.804 was reached with interval validation. Decision curve analysis revealed that the nomogram for predicting successful smoking cessation was clinically significant when intervention was conducted at a successful cessation of smoking possibility threshold of 19%. Conclusions This novel nomogram for successful smoking cessation can be conveniently used to predict successful cessation of smoking in outpatients.

Global climate change-induced sea-level rise and storm wave intensification, along with the large population densities and high-intensity human development activities in coastal areas, have caused serious burden and damage to China’s coasts, led to the rapid growth of artificial shorelines development, and formed a “new Great Wall” of reinforced concrete against the laws of nature. After the last ice age, transgression formed the different features of China’s coast. Depending on the types of geological and landform features, coasts are divided into 36 evaluation units, and 10 indicators are selected from natural aspects (including tectonics, geomorphology, sediment, and storms) and aspects of social economy (population, GDP, Gross Domestic Product), and cloud model theory is used to build a coastal erosion vulnerability evaluation index system in China. The results show that high grade (V), high-middle grade (IV), middle grade (III), low-middle grade (II), and low grade (I) coastal erosion vulnerability degrees account for 5.56, 13.89, 41.67, 33.33, and 5.56% of the Chinese coastlines, respectively. The coastal erosion vulnerability of the subsidence zone is significantly higher than that of the uplift zone. Reverse cloud model and analytic hierarchy process calculation show that the main factors that control coastal erosion vulnerability since the transgression after the last ice age are geological structure, topography and lithological features, and in recent years, the decrease in sea sediment loads and increase in reclamation engineering. Mainland China must live with the basic situation of coastal erosion, and this study shows that the index system and method of cloud modeling are suitable for the evaluation of the coastal erosion vulnerability of the Chinese mainland. This study provides a scientific basis for the adaptive management of coastal erosion, coastal disaster assessment and the overall planning of land and sea.

Noncoding RNAs play an important role in the pathogenesis of pulmonary arterial hypertension (PAH). In this study, we investigated the roles of hsa_circ_0016070, miR-942, and CCND1 in PAH. circRNA microarray was used to search circRNAs involved in PAH, whereas real-time PCR and western blot analysis were performed to detect miR-942 and CCND1 expression in different groups. In addition, the effect of miR-942 on CCND1 expression, as well as the effect of hsa_circ_0016070 on the expression of miR-942 and CCND1, was also studied using real-time PCR and western blot analysis. Moreover, MTT assay and flow cytometry were used to detect the effect of hsa _circ_0016070 on cell proliferation and cell cycle. According to the results of circRNA microarray analysis, hsa _circ_0016070 was identified to be associated with the risk of PAH in chronic obstructive pulmonary disease (COPD) patients. The miR-942 level in the COPD(+) PAH(+) group was much lower than that in the COPD(+) PAH(−) group, while the CCND1 level in the COPD(+) PAH(+) group was much higher. CCND1 was identified as a candidate target gene of miR-942, and the luciferase assay showed that the luciferase activity of wild-type CCND1 3′ UTR was inhibited by miR-942 mimics. In addition, hsa _circ_0016070 reduced miR-942 expression and enhanced CCND1 expression. Furthermore, hsa _circ_0016070 evidently increased cell viability and decreased the number of cells arrested in the G1/G0 phase. In summary, the results of this study suggested that hsa_circ_0016070 was associated with vascular remodeling in PAH by promoting the proliferation of pulmonary artery smooth muscle cells (PASMCs) via the miR-942/CCND1. Accordingly, has_circ_0016070 might be used as a novel biomarker in the diagnosis and treatment of PAH. Keywords: hsa _circ_0016070, PAH, smooth muscle, miR-942, CCND1

Alveolar epithelial cells (AECs) play a role in chemically induced acute lung injury (CALI). However, the mechanisms that induce alveolar epithelial type 2 cells (AEC2s) to proliferate, exit the cell cycle, and transdifferentiate into alveolar epithelial type 1 cells (AEC1s) are unclear. Here, we investigated the epithelial cell types and states in a phosgene-induced CALI rat model. Single-cell RNA-sequencing of bronchoalveolar lavage fluid (BALF) samples from phosgene-induced CALI rat models (Gas) and normal controls (NC) was performed. From the NC and Gas BALF samples, 37,245 and 29,853 high-quality cells were extracted, respectively. All cell types and states were identified and divided into 23 clusters; three cell types were identified: macrophages, epithelial cells, and macrophage proliferating cells. From NC and Gas samples, 1315 and 1756 epithelial cells were extracted, respectively, and divided into 11 clusters. The number of AEC1s decreased considerably following phosgene inhalation. A unique SOX9-positive AEC2 cell type that expanded considerably in the CALI state was identified. This progenitor cell type may develop into alveolar cells, indicating its stem cell differentiation potential. We present a single-cell genome-scale transcription map that can help uncover disease-associated cytologic signatures for understanding biological changes and regeneration of lung tissues during CALI.

Although alectinib is a well-tolerated and highly effective inhibitor of a second-generation anaplastic lymphoma kinase, special attention should be paid to the possibility of potentially severe and fatal adverse events such as interstitial pneumonia. We report a case of a patient with advanced non-small cell lung cancer treated with alectinib who developed immunohistochemically positive anaplastic lymphoma kinase (ALK(IHC +)) . However, due to the rapid emergence of drug-induced interstitial lung disease, alectinib treatment was halted. Once the interstitial lung disease had been successfully treated, we reluctantly chose crizotinib as a second-line treatment for ALK + NSCLC in this patient as he refused all other available treatments. Contrary to expectation, crizotinib performed well both in terms of its safety and efficacy. Our results suggest that crizotinib may provide a promising therapy option for patients with ALK + NSCLC accompanied by alectinib-induced interstitial lung disease. To our knowledge, this is a rare report of successful treatment of ALK + NSCLC with crizotinib after alectinib-induced interstitial lung disease.

Different from the rigid separation of biological tissue by scalpel, medical waterjet technology utilizes the impact kinetic energy of high-speed waterjet to instantly destroy the surface of biological tissue to achieve better clinical separation effect. Since the gelatin samples are transparent biomaterials, they were taken as the only substitute for soft tissue in experimental studies and observation in the current studies of medical waterjet separation technology, but the mechanical behavioural difference between the two has not been reported. To verify the adaptability of gelatin as a substitute of soft tissue under the impact of high-speed waterjet. Firstly, the dynamic process of impact was described through the energy balance equation. Then, based on the principle of altering a single variable, the difference of damage depth between 8 wt. %, 10 wt. %, and 12 wt. % gelatin samples and porcine liver tissue under various impact pressure, impact distance, and waterjet speed of motion (as opposed to flow velocity) was compared. The results show that the gelatin sample replicates the damage behaviour of porcine liver samples under the specific waterjet impact conditions, and the direction of the waterjet hydraulic power optimisation of the two materials is also consistent: however, due to the different sampling sites and anisotropy of porcine liver samples, the mechanical response of soft tissue under high-speed waterjet impact cannot be fully expressed by gelatin samples. The experimental results can provide support for the further study of medical waterjet separation technology.