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Abstract Dietary intake of live microbes may benefit human health, but less is known about the role in insulin resistance. This study was developed with the goal of evaluating potential relationships between IR and dietary live microbes. The National Health and Nutrition Examination Survey (NHANES) dataset was leveraged to collect data from 6,333 subjects 18 + years of age. The Sanders system for the classification of dietary live microbe intake (containing Low ( 107 CFU/g) levels of live microbes) was then used to separate these patients into three groups (low, medium, or high). Fasting blood glucose and insulin levels were used to approximate IR based on the homeostasis model of insulin resistance (HOMA-IR). Weighted linear regressions were used to assess the relationship between IR and live microbe intake. After fully adjusting for confounding factors, subjects in the groups exhibiting medium and high levels of live microbe intake exhibited HOMA-IR scores that were below those of subjects in the low group. The relationship between live microbe intake and HOMA-IR scores was also potentially impacted by ethnicity. In summary, a negative correlation was detected between dietary live microbe intake and HOMA-IR values.

Abstract Incomplete radiofrequency ablation (IRFA) triggers mild protective autophagy in residual tumor cells and results in an immunosuppressive microenvironment. This accelerates the recurrence of residual tumors and causes resistance to anti-PD-1/PDL1 therapy, which bringing a great clinical challenge in residual tumors immunotherapy. Mild autophagy activation can promote cancer cell survival while further amplification of autophagy contributes to immunogenic cell death (ICD). To this regard, we constructed active targeting zeolitic imidazolate framework-8 (ZIF-8) nanoparticles (NPs) loaded with STF62247 or both STF62247 and BMS202, namely STF62247@ZIF-8/PEG-FA (SZP) or STF62247-BMS202@ZIF-8/PEG-FA (SBZP) NPs. We found that SZP NPs inhibited proliferation and stimulated apoptosis of residual tumor cells exposed to sublethal heat stress in an autophagy-dependent manner. Further results discovered that SZP NPs could amplify autophagy in residual tumor cells and evoke their ICD, which dramatically boosted the maturation of dendritic cells (DCs). Through vaccination experiments, we found for the first time that vaccination with heat + SZP treatment could efficiently suppress the growth of new tumors and establish long-term immunological memory. Furthermore, SBZP NPs could remarkably promote the ICD of residual tumor cells, obviously activate the anti-tumor immune microenvironment, and significantly inhibit the growth of residual tumors. Thus, amplified autophagy coupled with anti-PD-1/PDL1 therapy is potentially a novel strategy for treating residual tumors after IRFA. Graphical Abstract

BackgroundThis study aimed to determine the roles of interleukin (IL)-17, TAO kinase 1 (TAOK1), and NOD-like receptor protein 3 (NLRP3) in cardiomyocyte pyroptosis and proliferation.MethodsThe IL-17-treated H9C2 cells were used as in vitro heart failure (HF) models. These cells were subjected to TAOK1 overexpression or knockdown and treated with BMS-986299 (NLRP3 inflammasome agonist), MCC950 (NLRP3 inflammasome inhibitor), or verteporfin (Yes-associated protein [YAP] inhibitor). Thereafter, their pyroptosis, proliferative capacity, and gene and protein expression levels were detected. Doxorubicin-induced HF rats were used as in vivo models and subjected to TAOK1 overexpression. Thereafter, their myocardial pathology, NLRP3 inflammasome-mediated pyroptosis, and YAP/TEAD pathway function were evaluated.ResultsIL-17 treatment increased the pyroptosis and decreased the proliferative capacity of H9C2 cells. Additionally, IL-17 treatment inducedto the activation of the NLRP3 inflammasomes and inhibition of the YAP/TEAD pathway in the H9C2 cells. Moreover, the IL-17-mediated effects on the H9C2 cells were alleviated by TAOK1 overexpression and augmented by TAOK1 knockdown. Furthermore, treatment with BMS-986299 or verteporfin affected the pyroptosis, proliferative capacity, and NLRP3 inflammasome activation of the H9C2 cells independently of TAOK1 expression. In the doxorubicin-induced HF rat model, TAOK1 overexpression mitigated myocardial injury, suppressed NLRP3 inflammasome pathway activation, and restored the YAP/TEAD pathway activity.ConclusionTAOK1 played a crucial role in regulating IL-17-mediated increase in the pyroptosis and decrease in the proliferation of cardiomyocytes by regulating the activities of the NLRP3 inflammasomes and the YAP/TEAD pathway.

The accurate perception of external environment information through the robot foot is crucial for the mobile robot to evaluate its ability to traverse terrain. Adequate foot-end contact signals can provide robust support for robot motion control and decision-making processes. The shape and uncertain rotation of the wheel-legged robot foot end represent a significant challenge to sensing the robot foot-end contact state, which current foot-end sensing schemes cannot solve. This paper presents a sensing method for the tire stress field of wheel-legged robots. A finite element analysis was conducted to study the deformation characteristics of the foot-end tire under force. Based on this analysis, a heuristic contact position estimator was designed that utilizes symmetrical deformation characteristics. Strain sensors, arranged in an array, extract the deformation information on the inner surface of the tire at a frequency of 200 Hz. The contact position estimator reduces the dimensionality of the data and fits the eigenvalues to the estimated contact position. Using support vector regression, the force estimator utilizes the estimated contact position and sensor signal to estimate the normal reaction force, designated as FZ. The sensing system is capable of detecting the contact position on the wheel circumference (with a root mean square error of 1.150°), as well as the normal force of 160 N on the Z axis (with a root mean square error of 6.04%). To validate the efficacy of the sensor detection method, a series of randomized and repeated experiments were conducted on a self-constructed test platform. This novel approach offers a promising avenue for perceiving contact states in wheel-legged robots.

Abstract This study aimed to assess the impact of adjuvant external beam radiotherapy (EBRT) on the survival of patients with locally invasive papillary thyroid carcinoma. This retrospective study used data from the Surveillance, Epidemiology, and End Results database for the diagnosis of papillary thyroid carcinoma, using Cox models to screen for adverse prognostic factors. The prognostic value of using adjuvant external beam radiotherapy in papillary thyroid carcinoma was further evaluated, based on the competing risk model and propensity score matching. Based on the competitive risk model, the sub-distribution hazard ratio (SHR) of the multivariate analysis of patients receiving EBRT alone versus those receiving radioiodine-131 alone was 9.301 (95% CI 5.99–14.44) (P

AbstractBackground Given its progressive deterioration in the clinical course, noninvasive assessment and risk stratification for the severity of renal fibrosis in chronic kidney disease (CKD) are required. We aimed to develop and validate an end-to-end multilayer perceptron (MLP) model for assessing renal fibrosis in CKD patients based on real-time two-dimensional shear wave elastography (2D-SWE) and clinical variables.Methods From April 2019 to December 2021, a total of 162 patients with CKD who underwent a kidney biopsy and 2D-SWE examination were included in this single-center, cross-sectional, and prospective clinical study. 2D-SWE was performed to measure the right renal cortex stiffness, and the corresponding elastic values were recorded. Patients were categorized into two groups according to their histopathological results: mild and moderate-severe renal fibrosis. The patients were randomly divided into a training cohort (n = 114) or a test cohort (n = 48). The MLP classifier using a machine learning algorithm was used to construct a diagnostic model incorporating elastic values with clinical features. Discrimination, calibration, and clinical utility were used to appraise the performance of the established MLP model in the training and test sets, respectively.Results The developed MLP model demonstrated good calibration and discrimination in both the training [area under the receiver operating characteristic curve (AUC) = 0.93; 95% confidence interval (CI) = 0.88 to 0.98] and test cohorts [AUC = 0.86; 95% CI = 0.75 to 0.97]. A decision curve analysis and a clinical impact curve also showed that the MLP model had a positive clinical impact and relatively few negative effects.Conclusions The proposed MLP model exhibited the satisfactory performance in identifying the individualized risk of moderate-severe renal fibrosis in patients with CKD, which is potentially helpful for clinical management and treatment decision-making.

Background Knowledge gaps remain in how gender‐related socioeconomic inequality affects sex disparities in cardiovascular diseases (CVD) prevention and outcome. Methods and Results Based on a nationwide population cohort, we enrolled 3 737 036 residents aged 35 to 75 years (2014–2021). Age‐standardized sex differences and the effect of gender‐related socioeconomic inequality (Gender Inequality Index) on sex disparities were explored in 9 CVD prevention indicators. Compared with men, women had seemingly better primary prevention (aspirin usage: relative risk [RR], 1.24 [95% CI, 1.18–1.31] and statin usage: RR, 1.48 [95% CI, 1.39–1.57]); however, women's status became insignificant or even worse when adjusted for metabolic factors. In secondary prevention, the sex disparities in usage of aspirin (RR, 0.65 [95% CI, 0.63–0.68]) and statin (RR, 0.63 [95% CI, 0.61–0.66]) were explicitly larger than disparities in usage of angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (RR, 0.88 [95% CI, 0.84–0.91]) or β blockers (RR, 0.67 [95% CI, 0.63–0.71]). Nevertheless, women had better hypertension awareness (RR, 1.09 [95% CI, 1.09–1.10]), similar hypertension control (RR, 1.01 [95% CI, 1.00–1.02]), and lower CVD mortality (hazard ratio, 0.46 [95% CI, 0.45–0.47]). Heterogeneities of sex disparities existed across all subgroups. Significant correlations existed between regional Gender Inequality Index values and sex disparities in usage of angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (Spearman correlation coefficient, r=−0.57, P=0.0013), hypertension control (r=−0.62, P=0.0007), and CVD mortality (r=0.45, P=0.014), which remained significant after adjusting for economic factors. Conclusions Notable sex disparities remain in CVD prevention and outcomes, with large subgroup heterogeneities. Gendered socioeconomic factors could reinforce such disparities. A sex‐specific perspective factoring in socioeconomic disadvantages could facilitate more targeted prevention policy making.

Background: Increased leisure-time physical activity (LTPA) is linked with decreased mortality risk, while also with increased left ventricular mass, which may induce left ventricular hypertrophy (LVH). We investigated whether LVH modifies the association between higher LTPA and lower mortality risk in population at high cardiovascular risk. Methods: In a prospective national cohort, we used the left ventricular mass/body surface area (LVM/BSA) method to define LVH. Baseline LTPA was self-reported and divided into: low (

Abstract Aims We aimed to demonstrate the distribution of alcohol use disorder (AUD) in China and assess its association with quality of life and mortality. Methods We studied 367 120 men aged 35–75 years from 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project. At baseline, AUD was assessed by alcohol use disorders identification test score, and EQ-5D-3L questionnaire was used to measure the quality of life. Mortality data was collected via National Mortality Surveillance System and Vital Registration. Mixed models were fitted to assess the associations of AUD with quality of life, and Cox proportional hazard models were fitted for the associations with all-cause and cause-specific mortality. Results We identified 39 163 men with AUD, which accounted for 10.7% of male participants and 25.8% of male drinkers. In the multivariable analysis, male drinkers who were aged 45–54 years, with higher education level, currently smoking, obese, with diagnosed hypertension, and without diagnosed cardiovascular diseases had higher rates of AUD. Male drinkers with AUD were less likely to have optimal QOL compared with those without AUD (OR: 0.63, 95% CI: 0.61–0.65, P

Abstract Background Healthy lifestyle behaviours are effective means to reduce the burden of diseases. This study was aimed to fill the knowledge gaps on the distribution, associated factors, and potential health benefits on mortality of four healthy lifestyle behaviours in China. Methods During 2015–2019, participants aged 35–75 years from 31 provinces were recruited by the China PEACE Million Persons Project. Four healthy lifestyle behaviours were investigated in our study, including non-smoking, none or moderate alcohol use, sufficient leisure time physical activity (LTPA), and healthy diet. Results Among 903,499 participants, 74.1% were non-smokers, 96.0% had none or moderate alcohol use, 23.6% had sufficient LTPA, 11.1% had healthy diet, and only 2.8% had all the four healthy lifestyle behaviours. The adherence varied across seven regions; the highest median of county-level adherence to all the four healthy lifestyle behaviours was in North China (3.3%) while the lowest in the Southwest (0.8%) (p

A series of hybridized charged membrane materials containing carboxyl and silyl groups were prepared via the epoxy ring-opening reaction and sol–gel methods using 3-glycidoxypropyltrimethoxysilane (WD-60) and polyethylene glycol 6000 (PEG-6000) as raw materials and DMF as a solvent. Scanning electron microscopy (SEM), fourier transform infrared spectroscopy (FTIR), and thermal gravimetric analyzer/differential scanning calorimetry (TGA/DSC) analysis showed that the heat resistance of the polymerized materials could reach over 300 °C after hybridization. A comparison of the results of heavy metal lead and copper ions’ adsorption tests on the materials at different times, temperatures, pHs, and concentrations showed that the hybridized membrane materials have good adsorption effects on heavy metals and better adsorption effects on lead ions. The maximum capacity obtained from optimized conditions for Cu2+ and Pb2+ ions were 0.331 and 5.012 mmol/g. The experiments proved that this material is indeed a new environmentally friendly, energy-saving, high-efficiency material. Moreover, their adsorptions for Cu2+ and Pb2+ ions will be evaluated as a model for the separation and recovery of heavy metal ions from wastewater.

Abstract Background Systemic studies of association of genome-wide DNA methylated sites with cardiovascular disease (CVD) in prospective cohorts are lacking. Our aim was to identify DNA methylation sites associated with the risk of CVD and further investigate their potential predictive value in CVD development for high-risk subjects. Methods We performed an epigenome-wide association study (EWAS) to identify CpGs related to CVD development in a Chinese population.We adopted a nested case–control design based on data from China PEACE Million Persons Project. A total of 83 cases who developed CVD events during follow-up and 83 controls who were matched with cases by age, sex, BMI, ethnicity, medications treatment and behavior risk factors were included in the discovery stage. Genome-wide DNA methylation from whole blood was detected using Infinium Human Methylation EPIC Beadchip (850 K). For significant CpGs [FDR(false discovery rate)

BackgroundMicrovascular invasion (MVI) is an independent risk factor for postoperative recurrence of hepatocellular carcinoma (HCC). To perform a meta-analysis to investigate the diagnostic performance of radiomics for the preoperative evaluation of MVI in HCC and the effect of potential factors.Materials and MethodsA systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies focusing on the preoperative evaluation of MVI in HCC with radiomics methods. Data extraction and quality assessment of the retrieved studies were performed. Statistical analysis included data pooling, heterogeneity testing and forest plot construction. Meta-regression and subgroup analyses were performed to reveal the effect of potential explanatory factors [design, combination of clinical factors, imaging modality, number of participants, and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) applicability risk] on the diagnostic performance.ResultsTwenty-two studies with 4,129 patients focusing on radiomics for the preoperative prediction of MVI in HCC were included. The pooled sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were 84% (95% CI: 81, 87), 83% (95% CI: 78, 87) and 0.90 (95% CI: 0.87, 0.92). Substantial heterogeneity was observed among the studies (I²=94%, 95% CI: 88, 99). Meta-regression showed that all investigative covariates contributed to the heterogeneity in the sensitivity analysis (P < 0.05). Combined clinical factors, MRI, CT and number of participants contributed to the heterogeneity in the specificity analysis (P < 0.05). Subgroup analysis showed that the pooled sensitivity, specificity and AUC estimates were similar among studies with CT or MRI.ConclusionRadiomics is a promising noninvasive method that has high preoperative diagnostic performance for MVI status. Radiomics based on CT and MRI had a comparable predictive performance for MVI in HCC. Prospective, large-scale and multicenter studies with radiomics methods will improve the diagnostic power for MVI in the future.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259363, identifier CRD42021259363.

Background: Physical activity (PA) is an important component of secondary prevention after myocardial infarction (MI). The mortality risk of MI survivors varies at different post-MI periods, yet the time-varying effect of total PA is unclear. We aimed to investigate the association between different volumes and patterns of total PA and mortality at different post-MI periods. Methods: Using data from the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project, we divided the screened MI survivors into within-1-year and beyond-1-year groups based on the duration between their baseline interview and MI onset. Total PA was divided into insufficient (4500 MET minutes/week) volumes; leisure (≥50%) and non-leisure (>50%) patterns. Data on mortality were derived from the National Mortality Surveillance System and Vital Registration of the Chinese Center for Disease Control and Prevention. Cox proportional hazard models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline regression analyses were performed to examine the dose-response association between PA and mortality. Results: During the follow-up (median 3.7 years) of the 20,653 post-MI patients, 751 patients died. In the within-1-year group, moderate (HR: 0.59, 95% CI: 0.40 to 0.88) and high (0.63, 0.45 to 0.88) volumes and both patterns (leisure: 0.52, 0.29 to 0.94; non-leisure: 0.64, 0.46 to 0.88) of PA were all associated with significantly lower risk of mortality, compared with insufficient PA. In the beyond-1-year group, the association was observed in high volume (0.69, 0.56 to 0.86) and both patterns (leisure: 0.64, 0.48 to 0.87; non-leisure: 0.79, 0.65 to 0.97). A non-linear relationship between PA and mortality was found in the within-1-year group (p for non-linearity

BackgroundLipid-lowering therapy (LLT) is one of the key strategies for reducing the atherosclerotic cardiovascular disease (ASCVD) burden. However, little is known about the percentage of people in need of different LLT regimens to achieve optimal targets of low-density lipoprotein cholesterol (LDL-C), and the corresponding cost and benefit.MethodsWe conducted a simulation study based on the data from the nationwide China PEACE MPP population cohort (2015–2020), from which we included 2,904,914 participants aged 35–75 years from all the 31 provinces in mainland China. Participants were grouped based on their 10-year ASCVD risks, then entered into a Monte Carlo model which was used to perform LLT intensification simulation scenarios to achieve corresponding LDL-C goals in each risk stratification.ResultsAfter standardizing age and sex, the proportions of participants included at low, moderate, high, and very-high risk were 70.8%, 15.6%, 11.5%, and 2.1%, respectively. People who failed to achieve the corresponding LDL-C goals −8.1% at low risk, 19.6% at moderate risk, 53.2% at high risk, and 93.6% at very-high risk (either not achieving the goal or not receiving LLT)—would be in need of the LLT intensification simulation. After the use of atorvastatin 20 mg was simulated, over 99% of the population at low or moderate risk could achieve the LDL-C goals; while 11.3% at high and 24.5% at very-high risk would still require additional non-statin therapy. After the additional use of ezetimibe, there were still 4.8% at high risk and 11.3% at very-high risk in need of evolocumab; and 99% of these two groups could achieve the LDL-C goals after the use of evolocumab. Such LLT intensification with statin, ezetimibe, and evolocumab would annually cost $2.4 billion, $4.2 billion, and $24.5 billion, respectively, and prevent 264,170, 18,390, and 17,045 cardiovascular events, respectively.ConclusionsModerate-intensity statin therapy is pivotal for the attainment of optimal LDL-C goals in China, and around 10–25% of high- or very-high-risk patients would require additional non-statin agents. There is an opportunity to reduce the rising ASCVD burden in China by optimizing LLT.

ObjectivesWe aimed to assess the dose–response association between weight gain from young to middle adulthood and odds of metabolic syndrome, across body mass index (BMI) categories at young adulthood.MethodsBased on a national population-based screening project, middle-aged (35–64 years) participants who recalled weight at age 25 years and received standardized measurements were included. Multivariable adjusted restricted cubic splines and logistic regression models were applied.ResultsIn total, 437,849 participants were included (62.1% women, 52.0 ± 7.6 years). Larger weight gains from young to middle adulthood were associated with higher odds of metabolic syndrome at middle adulthood, with odds of 2.01 (1.98–2.05), 1.93 (1.92–1.94), and 1.67 (1.64–1.7) per 5-kg weight gain across participants who were underweight, normal-weight, and overweight/obese at young adulthood, respectively. After further adjusting for current BMI, larger weight gains still correlated with higher odds of metabolic syndrome among underweight and normal-weight participants, while an inverted U-shaped association was observed in overweight/obese participants.ConclusionsWeight maintenance from young to middle adulthood could be effective to mitigate metabolic syndrome burden, especially among underweight and normal-weight people. Historical weight gain confers varied information about metabolic syndrome risk independent of attained BMI across BMI categories at young adulthood.

Abstract MicroRNAs(miRNAs) are maladjusted in multifarious malignant tumor and can be considered as both carcinogens and tumor‐inhibiting factor. In the present study, we analyzed the miRNAs expression profiles and clinical information of 481 patients with head and neck squamous cell carcinoma (HNSCC) through the TCGA dataset to identify the prognostic miRNAs signature. A total of 114 significantly differentially expressed miRNAs (SDEMs) were identified, consisting of 60 up‐adjusted and 54 down‐adjusted miRNAs. The Kaplan‐Meier survival method identified the prognostic function of 2 miRNAs (miR‐4652‐5p and miR‐99a‐3P). Univariate and multivariate Cox regression analyses indicated that the 2 miRNAs were significant prognostic elements of HNSCC. Furthermore, bioinformatic analysis was conducted by means of 4 online gene predicted toolkits to recognize the target genes, and enrichment analysis was performed on the target genes by DAVID. The outcomes depicted that target genes were correlated with calcium, as well as cell proliferation, circadian entrainment, EGFR, PI3K‐Akt‐mTOR, and P53 signaling pathways. Finally, the PPI network was conducted in view of STRING database and Cytoscape. Eight hub genes were identified by CytoHubba and MCODE app, respectively, CBL, SKP1, H2AFX, HGF, POLR2F, UBE2I, VAMP2, and GNAI2 genes. As a result, we identified 2 miRNAs signatures, 8 hub genes, and significant signaling pathways for estimating the prognosis of HNSCC. In order to further explore the molecular mechanism of HNSCC occurrence and development, more comprehensive basic and clinical studies are needed.

We develop a new process for the preparation of synergistic antifouling functional coatings on gold surfaces via a “grafting to” approach. The strategy includes a synthetic step of polymer brushes that consist of poly (ethylene glycol) (PEG) and zwitterionic side chains via a typical reversible-addition fragmentation chain transfer (RAFT) polymerization process, and a subsequent deposition of the polymer brushes onto a gold substrate. The presence of PEG and zwitterion chains on these polymer brush-coated gold surfaces has been proved to have a synergistic effect on the final antifouling property of the coating. PEG chains lower the electrostatic repulsion between zwitterionic polymer chains and increase their graft density on gold surfaces, while zwitterionic polymer effectively improves the antifouling property that is offered by PEG chains alone. Protein adsorption and cell attachment assays tests are conducted to confirm that this copolymer layer on gold surface has a pronounced resistance against proteins such as Bovine serum albumin and Lysozyme. Importantly, the antifouling property can be systematically adjusted by varying the molar ratio of PEG to zwitterionic chains in the final coating copolymer. Keywords: Grafting to, PEG-co-zwitterionic polymer, Synergistic effect, Antifouling coating

Functional matrix membranes formed by blending hydrophilic polymers with polysulfone (PSF) can provide functional surfaces with ameliorative hydrophilicity and possess excellent antifouling resistance over a wide range of applications. Zwitterionic polymers have better antifouling properties, but their homopolymers should not be used directly because of their poor mechanical properties and strong water absorption. To solve these problems, a living radical polymerization process was used to prepare P(4VPx-r-SBMAy) copolymers comprising of zwitterion side chains and hydrophobic 4-vinylpyridine (4VP). The modified PSF membranes were then constructed by adding different ratios of P(4VPx-r-SBMAy) via phase inversion/immersion precipitation technique. The presence of 4VP and zwitterion chains of copolymer was verified by 1H nuclear magnetic resonance (NMR) and Fourier transform infrared (FTIR) analyses, and the successful surface functionalization was further confirmed with atomic force microscopy (AFM), scanning electron microscopy (SEM) and water contact angle measurement. Protein adsorption, bacterium adhesion and cell attachment assays showed that the functional PSF membrane surfaces exhibited superior hydrophilicity and antifouling performance.

The vibration energy distribution pattern usually changes with the rotating machine’s health state and is a good indicator for intelligent fault diagnosis (IFD). The existing initial features such as RMS are less effective in revealing the vibration energy distribution pattern, and the frequency spectrum cannot provide a rich and hierarchical description of the vibration energy distribution pattern. Addressing this issue, we proposed a multi-scale frequency energy distribution (MSFED) feature for the IFD of rotating machines. The MSFED feature can reveal the vibration energy distribution patterns in the frequency domain in a multi-scale manner, and its one-dimensional vector and two-dimensional map formats make it usable for most IFD models. Experimental validation on the gearbox and bearing datasets verified that the MSFED feature achieved the highest diagnostic accuracy among commonly used initial features, in typical fault diagnosis scenarios except for the variable-load scenario. Furthermore, the separability and transferability of the MSFED feature were evaluated by distance-based metrics, and the results were in agreement with the features’ diagnostic performance. This work provides an important reference for the IFD of rotating machines, not only proposing a novel MSFED feature but also opening a new avenue for model-independent methods of the initial quality evaluation.

The peripheral surface of the grinding wheel can grind the rail according to the envelope of the contour of the rail surface, thus a fuller and smoother rail surface can be obtained. Specifically, a better grinding effect can be obtained in that the end face of the grinding wheel deviates from the longitudinal section of the rail at a certain angle. Based on the traditional grinding technology theory, the mathematical models of the peripheral grinding parameters (kinematic contact arc length, wheel-rail grinding contact area, and maximum undeformed chip thickness) and the grinding force are established, in which the angle exists between the grinding wheel end face and the rail longitudinal section. The main influence of grinding wheel circumferential speed, grinding wheel kinematic speed, and the deflection angle of the grinding wheel end face on the grinding parameters and the force are analyzed. The result shows that: when there is angle θ in the models, the ratios of peripheral grinding parameters between up-grinding and down-grinding varies monotonically with the increase in vm, and their maximum variation range is about 12%, vs has the greatest influence on the peripheral grinding parameters, and the maximum variation range of the ratios is about 20% when the vs is 10 m/s. With the increase in the grinding width, Fa’ cannot be ignored and will increase gradually with the increase in angle θ. The analysis and conclusion have guiding significance for the structural design, grinding control strategy, and experimental research regarding rail curved surface grinding equipment.

Objectives Patients admitted to hospital with acute myocardial infarction (AMI) have considerable variability in in-hospital risks, resulting in higher demands on healthcare resources. Simple risk-assessment tools are important for the identification of patients with higher risk to inform clinical decisions. However, few risk assessment tools have been built that are suitable for populations with AMI in China. We aim to develop and validate a risk prediction model, and further build a risk scoring system.Design Data from a nationally representative retrospective study was used to develop the model. Patients from a prospective study and another nationally representative retrospective study were both used for external validation.Setting 161 nationally representative hospitals, and 53 and 157 other hospitals were involved in the above three studies, respectively.Participants 8010 patients hospitalised for AMI were included as development sample, and 4485 and 11 223 other patients were included as validation samples in their corresponding studies.Primary and secondary outcome measures The in-hospital major adverse cardiovascular events (MACE) was defined as death from any cause, recurrent AMI, or ischaemic stroke.Results The proportion of in-hospital MACE was 11.7%, 8.8% and 11.4% among the development sample and two external-validation samples, respectively. Nine predictors (ie, age, sex, left ventricular ejection fraction, Killip class, systolic blood pressure, creatinine, white blood cell count, heart rate and blood glucose) were independently associated with in-hospital MACE. The model performed well on both discrimination and calibration capability, with areas under the Receiver Operating Characteristic Curve (ROC) curve of 0.85, 0.74 and 0.80, and calibration slopes of 0.98, 0.84 and 0.97 in the development sample and two external validation samples, respectively. A point-based risk scoring system was built with good discrimination and reclassification ability.Conclusions A prediction model using readily available clinical parameters was developed and externally validated to estimate risks of in-hospital MACE among patients with AMI, thereby better informing decision-making in improving clinical care.

Objectives To develop a model of in-hospital mortality using medical record front page (MRFP) data and assess its validity in case-mix standardisation by comparison with a model developed using the complete medical record data.Design A nationally representative retrospective study.Setting Representative hospitals in China, covering 161 hospitals in modelling cohort and 156 hospitals in validation cohort.Participants Representative patients admitted for acute myocardial infarction. 8370 patients in modelling cohort and 9704 patients in validation cohort.Primary outcome measures In-hospital mortality, which was defined explicitly as death that occurred during hospitalisation, and the hospital-level risk standardised mortality rate (RSMR).Results A total of 14 variables were included in the model predicting in-hospital mortality based on MRFP data, with the area under receiver operating characteristic curve of 0.78 among modelling cohort and 0.79 among validation cohort. The median of absolute difference between the hospital RSMR predicted by hierarchical generalised linear models established based on MRFP data and complete medical record data, which was built as ‘reference model’, was 0.08% (10th and 90th percentiles: −1.8% and 1.6%). In the regression model comparing the RSMR between two models, the slope and intercept of the regression equation is 0.90 and 0.007 in modelling cohort, while 0.85 and 0.010 in validation cohort, which indicated that the evaluation capability from two models were very similar.Conclusions The models based on MRFP data showed good discrimination and calibration capability, as well as similar risk prediction effect in comparison with the model based on complete medical record data, which proved that MRFP data could be suitable for risk adjustment in hospital performance measurement.

The present study aimed to investigate anti-diabetic activities of a flavonoid-rich extract from Wisteria sinensis (WS-FRE). In vitro, WS-FRE significantly promote the translocation of GLUT4 (Glucose transporter 4) to the plasma membrane. Mechanisms analysis revealed that WS-FRE enhanced glucose uptake via activation of Akt and GLUT4. In vivo, 4-week treatment of WS-FRE alleviated the typical symptoms including hyperglycemia, glucose intolerance, hyperinsulinemia and dyslipidemia. Histopathological examinations revealed that WS-FRE relieved hepatic steatosis, adipocyte hypertrophy and pancreatic islet lesion to a certain extent in diabetic mice. Western blot analysis indicated that WS-FRE resulted in the suppression of IRS-1 serine phosphorylation and an elevation of PI3K p85, Akt phosphorylation and GLUT4 expression in insulin target tissues, which contributes to improving insulin sensitivity in peripheral tissues and thereby ameliorating glucose metabolism in diabetic mice. Diverse anti-diabetic effects of WS-FRE may be attributed to regulation of GLUT4, IRS-1 serine phosphorylation, PI3K phosphorylation and Akt phosphorylation.

Laryngeal cancer is a prevalent malignancy of the head and neck with a high rate of mortality. Corilagin, a natural gallic acid derivative, was isolated from PhmLlanthi Fructus, a “drug homologous food”, and its in vitro and in vivo activity were investigated. Results of our study demonstrate that corilagin has significant anti-laryngeal cancer activity in vitro and in vivo. It was observed that corilagin inhibits proliferation and migration of cancerous laryngeal cells Hep-2 and TU212 in a concentration-dependent manner and inhibits growth of transplanted tumors in nude mice without apparent signs of toxicity. The anti-cancer effects of corilagin may be attributed to the inhibition of human laryngeal cancer proliferation by activation of mitochondrial apoptotic and endoplasmic reticulum stress signaling pathways and inhibition of Akt and STAT3 pathways.

Background Characterizing and assessing the prevalence, awareness, and treatment patterns of patients with isolated diastolic hypertension (IDH) can generate new knowledge and highlight opportunities to improve their care. Methods and Results We used data from the China PEACE (Patient‐centered Evaluative Assessment of Cardiac Events) Million Persons Project, which screened 2 351 035 participants aged 35 to 75 years between 2014 and 2018. IDH was defined as systolic and diastolic blood pressure of 28 kg/m2, consumed alcohol, had diabetes mellitus, and prior cardiovascular events were more likely to have IDH (all P28 kg/m2, higher income, diabetes mellitus, prior cardiovascular events, and Central or Eastern region (all P

Semantic segmentation of remote sensing images (RSI) plays a significant role in urban management and land cover classification. Due to the richer spatial information in the RSI, existing convolutional neural network (CNN)-based methods cannot segment images accurately and lose some edge information of objects. In addition, recent studies have shown that leveraging additional 3D geometric data with 2D appearance is beneficial to distinguish the pixels’ category. However, most of them require height maps as additional inputs, which severely limits their applications. To alleviate the above issues, we propose a height aware-multi path parallel network (HA-MPPNet). Our proposed MPPNet first obtains multi-level semantic features while maintaining the spatial resolution in each path for preserving detailed image information. Afterward, gated high-low level feature fusion is utilized to complement the lack of low-level semantics. Then, we designed the height feature decode branch to learn the height features under the supervision of digital surface model (DSM) images and used the learned embeddings to improve semantic context by height feature guide propagation. Note that our module does not need a DSM image as additional input after training and is end-to-end. Our method outperformed other state-of-the-art methods for semantic segmentation on publicly available remote sensing image datasets.

Davidone C is a newly discovered flavonoid compound purified from the ethyl acetate-soluble fraction of Sophora davidii (Franch.) Skeels. This study explored the anti-tumor activity of davidone C on hepatocellular carcinoma HepG2 and Bel-7402 cells and its mechanism through MTT method, morphological observation, flow cytometry and Western blotting. The results showed that davidone C significantly inhibited the proliferation of HepG2 and Bel-7402 cells in a time- and dose-dependent manner. The morphological changes of apoptotic cells can be observed under an inverted microscope, such as cell floating, chromosome condensation, apoptotic bodies, and other phenomena. The expressions of Bax, cleaved caspase-9, cleaved caspase-3 and cleaved PARP increased with the increase of dosage while Bcl-2 decreased, suggesting that the apoptotic mechanism might be related to the mitochondrial apoptotic pathway. Moreover, davidone C administration can down-regulate the expression of Grp78, and simultaneously up-regulate the expression of caspase-7 and caspase-12, indicating that the apoptotic mechanism might be related to the ERS pathway. In addition, davidone C can down-regulate the expression of p62, and simultaneously up-regulate the expression of LC3-I and LC3-II with a quantitative dependence, suggesting that the mechanism of apoptosis may be related to the autophagy signal pathway. All these results showed davidone C has potential effects on hepatocellular carcinoma.

Background Heart failure (HF) is an emerging epidemic in China and accounts for significant healthcare resource utilization in the inpatient setting. To create evidence‐based, life‐saving, and cost‐saving hospitalization systems, the first step is to characterize the contemporary national landscape of inpatient HF care. Methods and Results In the China PEACE 5r‐HF study (China Patient‐centered evaluative Assessment of Cardiac Events Retrospective Study of Heart Failure), we used 2‐stage random sampling to create a nationally representative cohort of 10 004 admissions for HF from 189 hospitals in 2015 in China. Data on patient characteristics, management, and outcomes were obtained through centralized medical record abstraction. The median age of the cohort was 73 years (interquartile range, 65–80), and 48.9% were women. More than half (56.2%) of the patients were hospitalized in rural areas. Prevalence of ejection fraction ≥50%, 40% to 50%, and

The objective of this study was to evaluate the feasibility of using the dry matter intake of first 2 h after feeding (DMI-2h), body weight (BW), and milk yield to estimate daily DMI in mid and late lactating dairy cows with fed ration three times per day. Our dataset included 2840 individual observations from 76 cows enrolled in two studies, of which 2259 observations served as development dataset (DDS) from 54 cows and 581 observations acted as the validation dataset (VDS) from 22 cows. The descriptive statistics of these variables were 26.0 ± 2.77 kg/day (mean ± standard deviation) of DMI, 14.9 ± 3.68 kg/day of DMI-2h, 35.0 ± 5.48 kg/day of milk yield, and 636 ± 82.6 kg/day of BW in DDS and 23.2 ± 4.72 kg/day of DMI, 12.6 ± 4.08 kg/day of DMI-2h, 30.4 ± 5.85 kg/day of milk yield, and 597 ± 63.7 kg/day of BW in VDS, respectively. A multiple regression analysis was conducted using the REG procedure of SAS to develop the forecasting models for DMI. The proposed prediction equation was: DMI (kg/day) = 8.499 + 0.2725 × DMI-2h (kg/day) + 0.2132 × Milk yield (kg/day) + 0.0095 × BW (kg/day) (R2 = 0.46, mean bias = 0 kg/day, RMSPE = 1.26 kg/day). Moreover, when compared with the prediction equation for DMI in Nutrient Requirements of Dairy Cattle (2001) using the independent dataset (VDS), our proposed model shows higher R2 (0.22 vs. 0.07) and smaller mean bias (−0.10 vs. 1.52 kg/day) and RMSPE (1.77 vs. 2.34 kg/day). Overall, we constructed a feasible forecasting model with better precision and accuracy in predicting daily DMI of dairy cows in mid and late lactation when fed ration three times per day.

Red light (RL) can stimulate plant defense against foliar diseases; however, its role in activation of systemic defense against root diseases remains unclear. Here, the effect of RL on root knot nematode Meloidogyne incognita (RKN) infestation was investigated in watermelon plants (Citrullus lanatus L.). Plants were exposed to 200 μmol m-2 s-1 photosynthetic photon flux density RL at the canopy level for 21 days using light-emitting photodiodes. The results showed that RL significantly suppressed gall formation and nematode development, which was closely associated with the RL-induced attenuation of oxidative stress in roots. Gene expression analysis showed that RL caused a transient upregulation of PR1 and WRKY70 transcripts at 7 days post inoculation in RKN-infected plants. Further investigation revealed that RL-induced systemic defense against RKN was attributed to increased jasmonic acid (JA) and salicylic acid (SA) content, and transcript levels of their biosynthetic genes in roots. Interestingly, while malondialdehyde content decreased, H2O2 accumulation increased in RL-treated RKN-plants, indicating a potential signaling role of H2O2 in mediating RL-induced systemic defense. Furthermore, analysis of enzymatic and non-enzymatic antidoxidants revealed that RL-induced enhanced defense agaist RKN was also attributed to increased activities of antioxidant enzymes as well as redox homeostasis. Taken together, these findings suggest that RL could enhance systemic resistance against RKN, which is mediated by a coordinated regulation of JA- and SA-dependent signaling, antioxidants, and redox homeostasis in watermelon plants.

The longitudinal–torsional ultrasonic vibration machining process is popular for machining hard and brittle materials. A longitudinal–torsional ultrasonic vibration system with diagonal slits was designed for the ultrasonic vibration machining process based on the principle of acoustics propagation in this study. Four uniform diagonal slits were cut off on the horn cylinder to transform the longitudinal ultrasonic vibration into a longitudinal–torsional composite motion. A finite element analysis was used to optimize the mechanical structure of the vibration system. Dynamic characteristics of the vibration system were numerically studied, and the relationship of diagonal slits versus the resonance frequency and amplitudes of longitudinal–torsional vibration was analyzed, so that the longitudinal–torsional output amplitude can be optimized by rational choice of structure parameters of diagonal slits. Moreover, the movement locus of the system output end was obtained by utilizing the Origin software, which was proved to be elliptical, and the accuracy of the finite element model was confirmed by comparing numerically and experimentally determined resonant characteristics. In addition, the verification of longitudinal–torsional ultrasonic vibration was proved for the designed ultrasonic vibration system.

Gear failure is the main cause of machine malfunction. Therefore, it has become increasingly important to detect gear failure to ensure the normal operation of a machine. Here, we propose a gear damage detection and localization approach by studying the vibration signal of an individual gear tooth and support vector machines. Generally, it is difficult to detect a small gear failure in the total vibration signal. The waveform of an individual gear tooth was studied to investigate the vibration features of a gear in more detail. The characteristics of damaged and normal teeth were investigated by analyzing their individual waveform. Besides, the feature parameters were also extracted from both the time and frequency domains of the waveform to investigate the characteristics of each gear tooth. The difference between the damaged and normal teeth was detected by the waveform and feature parameters. Additionally, the condition of each gear tooth was diagnosed by support vector machines using the extracted feature parameters. The method was used to analyze the results of cyclic fatigue experiments. The conditions of most of the gear teeth were correctly classified, validating the proposed method.

Poly(dimethylsiloxane) (PDMS) surface modification via gradient-induced transport of embedded amphiphilic molecules is a novel, easy, flexible, and environmentally friendly approach for reducing protein adsorption on PDMS in microfluidic applications. To better understand the processing and the potential use in the viability-sensitive applications such as manipulation and culturing of primary neural cells, we systematically investigate how embedded molecules interact with a PDMS matrix and its surface in aqueous environments by studying the wetting angle over time under various processing conditions, including water exposure time, water exposure temperature, curing master materials, in addition to comparing different embedded amphiphilic molecules. The results indicate that the water exposure time clearly plays an important role in the surface properties. Our interpretation is that molecular rearrangement of the surface-embedded molecules improves surface coverage in the short term; while over a longer period, the transport of molecules embedded in the bulk enhance its coverage. However, this improvement finally terminates when molecules transported from the bulk to the surface are not sufficient to replace the molecules leaching into the water.

Zwitterionic polymers are suitable for replacing poly(ethylene glycol) (PEG) polymers because of their better antifouling properties, but zwitterionic polymers have poor mechanical properties, strong water absorption, and their homopolymers should not be used directly. To solve these problems, a reversible-addition fragmentation chain transfer (RAFT) polymerization process was used to prepare copolymers comprised of zwitterionic side chains that were attached to an ITO glass substrate using spin-casting. The presence of 4-vinylpyridine (4VP) and zwitterion chains on these polymer-coated ITO surfaces was confirmed using 1H NMR, FTIR, and GPC analyses, with successful surface functionalization confirmed using water contact angle, X-ray photoelectron spectroscopy (XPS), and atomic force microscopy (AFM) studies. Changes in water contact angles and C/O ratios (XPS) analysis demonstrated that the functionalization of these polymers with β-propiolactone resulted in hydrophilic mixed 4VP/zwitterionic polymers. Protein adsorption and cell attachment assays were used to optimize the ratio of the zwitterionic component to maximize the antifouling properties of the polymer brush surface. This work demonstrated that the antifouling surface coatings could be readily prepared using a “P4VP-modified” method, that is, the functionality of P4VP to modify the prepared zwitterionic polymer. We believe these materials are likely to be useful for the preparation of biomaterials for biosensing and diagnostic applications.

BackgroundChina is experiencing a marked increase in ST‐segment elevation myocardial infarction hospitalizations, with 30% occurring among women and higher risk of in‐hospital death in relatively younger age groups (12 hours between symptom onset and admission time in 2001, since 2006 delays in presentation were comparable between women and men. Fewer women without contraindications received evidence‐based therapies than men, including reperfusion (57.5% versus 44.2%), early aspirin (88.8% versus 85.9%), and clopidogrel (56.9% versus 52.5%, P

OBJECTIVE:The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. METHODS:The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. RESULTS:Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. CONCLUSIONS:The findings suggested food environment disparities did exist in different cities of China.

The paper describes an evolution game model of travel mode choice to determine whether transportation policies would have the desired effect. The model is first expressed as a two-stage sequential game in the extensive form based on the similarity between evolution game theory and the travel mode choice process. Second, backward induction is used to solve for Nash equilibrium of the game based on the Folk Theorem. Third, the sensitivity analysis suggests that a payoff reduction of travel by any mode will result in a rising proportion of inhabitants travelling by that mode and falling proportions of inhabitants travelling by other modes. Finally, the model is applied to Beijing inhabitants’ travel mode choices during morning peak hours and draws the conclusion that the proportion of inhabitants travelling by rail would increase when traffic congestion is more severe. This confirms that fast construction of the urban rail transit would be an effective means of alleviating traffic congestion. The model may be a useful tool for policy makers for analyzing the complex influence of travel mode choice processes on transport policies and transport construction projects.

OBJECTIVE: This study was designed to investigate the impact of body mass index (BMI) on short- and long-term outcomes after initial revascularization with coronary artery bypass graft (CABG) surgery. METHODS: 4916 Chinese who consecutively underwent isolated, primary CABG at the Cardiovascular Institute of Fuwai Hospital from January 1, 1999 to December 31, 2005 were included in this study. They were classified based on BMI as follows: underweight: 32 kg/m2. Short (in-hospital) and long-term (5-years) major post-operative complications and mortalities were compared among various BMI groups after initial revascularization. RESULTS: Multiple regression analysis of five years follow-up of clinical end points indicated that various BMI groups were not associated with significant differences in 5 years mortality and MACCE, however, old age, smoking, hypertension, myocardial infarction and heart failure were the risk factor for the mortality. CONCLUSIONS: In this large-scale study with long term follow-up after primary CABG in an exclusively ethnic Chinese population, we found that different BMI groups were not significantly associated with 5-years mortality and MACCE, however, old age, smoking, hypertension, myocardial infarction and heart failure were the risk factors of post-operative mortality, and old age, hypertension and heart failure increased the rate of MACCE.

Breast cancer metastasis suppressor 1 (BRMS1) was originally identified as an active metastasis suppressor in human breast cancer. Loss of BRMS1 expression correlates with tumor progression, and BRMS1 suppresses several steps required for tumor metastasis. However, the role of BRMS1 in hepatocellular carcinoma (HCC) remains elusive. In this study, we found that the expression level of BRMS1 was significantly down-regulated in HCC tissues. Expression of BRMS1 in SK-Hep1 cells did not affect cell growth under normal culture conditions, but sensitized cells to apoptosis induced by serum deprivation or anoikis. Consistently, knockdown of endogenous BRMS1 expression in Hep3B cells suppressed cell apoptosis. We identified that BRMS1 suppresses osteopontin (OPN) expression in HCC cells and that there is a negative correlation between BRMS1 and OPN mRNA expression in HCC tissues. Moreover, knockdown of endogenous OPN expression reversed the anti-apoptosis effect achieved by knockdown of BRMS1. Taken together, our results show that BRMS1 sensitizes HCC cells to apoptosis through suppressing OPN expression, suggesting a potential role of BRMS1 in regulating HCC apoptosis and metastasis.