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The Huagang Formation of the central inverted structural tectonic belt structure A in the Xihu Depression has abundant hydrocarbon resources. This is an important area for exploration and development in the East China Sea Basin (ECSB). Due to the high drilling costs in offshore basins and limited drilling in Structure A, the mechanism of hydrocarbon accumulation is complex, and the laws and processes of hydrocarbon accumulation in structure A are still unclear. To clarify the hydrocarbon accumulation process in the Huagang Formation of structure A, this study used thin section observation, scanning electron microscopy, natural gas carbon isotopes, fluid inclusions, and micro thermometry. Combined with structural evolution and burial history, the origin and source of natural gas, hydrocarbon accumulation periods, and processes were systematically analyzed. The research shows that the sandstone reservoir in the Huagang Formation has satisfactory reservoir, trapping, and preservation conditions; the primary hydrocarbon accumulation period was the Longjing Movement. Therefore, early natural gas filling existed before the Longjing Movement. Based on the evolutionary and fluid potential characteristics of the top tectonic peak of the Pinghu Formation, the natural gas generated in the early stage of structure A is stored in the paleo-structural high point of the Pinghu Formation (paleo convergence area). In the early stage of the Longjing Movement, natural gas migrated from the paleo convergence area of the Pinghu Formation to the current tectonic high point and accumulated in the trap. Therefore, three different “convergence ahead of accumulation” reservoir formation models were developed. These reservoir formation models are critical for guiding the exploration of a series of large traps, including structure A and its surrounding structures, and they have important reference significance for natural gas exploration in other basins.

Abstract Parkinson’s disease (PD) exhibits heterogeneity in terms of symptoms and prognosis, likely due to diverse neuroanatomical alterations. This study employs a contrastive deep learning approach to analyze Magnetic Resonance Imaging (MRI) data from 932 PD patients and 366 controls, aiming to disentangle PD-specific neuroanatomical alterations. The results reveal that these neuroanatomical alterations in PD are correlated with individual differences in dopamine transporter binding deficit, neurodegeneration biomarkers, and clinical severity and progression. The correlation with clinical severity is verified in an external cohort. Notably, certain proteins in the cerebrospinal fluid are strongly associated with PD-specific features, particularly those involved in the immune function. The most notable neuroanatomical alterations are observed in both subcortical and temporal regions. Our findings provide deeper insights into the patterns of brain atrophy in PD and potential underlying molecular mechanisms, paving the way for earlier patient stratification and the development of treatments to slow down neurodegeneration.

Many developing countries use tax reform as a strategy to support national or regional development. China's tax reform of the Hainan Free Trade Port in 2025 serves this purpose. The reform replaces the existing VAT, consumption tax, vehicle purchase tax, urban maintenance and construction tax, and education fee (''four taxes and one fee'') with a sales tax. Previous studies of tax structure reform have rarely addressed the economic impact of such a transition, and few sales tax studies have discussed the issue of optimal tax rates. To study the economic effects of the introduction of sales tax and to find the optimal tax rate, this paper uses the computable general equilibrium (CGE) model to conduct simulation analyses. It is found that the sales tax rate should be 17.16 % to keep the fiscal revenue of Hainan Province more or less unchanged after the ‘four taxes and one fee’ are simplified into sales tax. The total economic volume and sales tax rate show an inverted ‘U’ type relationship, the optimal sales tax rate is about 9.79 %, and the tax rate of GDP, investment, employment growth of 3.82 %, 0.35 %, 3.41 %, respectively, the manufacturing industry and other industries in most of the different degrees of growth. Therefore, we suggest that the average sales tax rate of Hainan Free Trade Port should be around 9.79 %.

Background: This study aims to clarify the N6-methyladenosine (m6A) modification of LINC01006, which is involved in migration, invasion and proliferation of non-small cell lung cancer (NSCLC). Materials and methods: LINC01006 and METTL3 expressions were analyzed in TCGA-LUAD cohort. Colony formation assay, wound-healing assay and transwell assay were performed to evaluate the ability of colony formation, migration and invasion. Q-PCR and western blot analysis determined gene expressions. M6A-RNA immunoprecipitation and m6A quantification assay were used to evaluate m6A modification. qChIP assay was used to validate transcriptional target. Luciferase assay validated the miRNA targets and transcriptional targets. In-situ xenograft model were included to evaluate tumor proliferation in vivo. Results: LINC01006 and METTL3 expressions were elevated in NSCLC cells and tissues. LINC01006 promoted the migration and invasion of NSCLC via epithelial – mesenchymal transition (EMT). The expression of LINC01006 was positively correlated to the expression of METTL3. METTL3 promoted tumor formation and proliferation in the in-situ xenograft model of NSCLC. The expression of LINC01006 was increased by METTL3 via m6A modification. c-MYC directly induced METTL3. Both c-MYC and LINC01006 were commonly targeted by miR-34a/b/c and miR-2682, and thereby c-MYC/METTL3/LINC01006 formed a positive feedback loop through miRNA targets in NSCLC. Conclusions: LINC01006 is an oncogenic lncRNA, which induces migration, invasion and proliferation of NSCLC. METTL3 increases LINC01006 expression through stabilizing LINC01006 mRNA. c-MYC, as a transcription factor, activates METTL3, which results in an elevated level of LINC01006. c-MYC, METTL3 and LINC01006 form a positive feedback loop through multiple miRNA targets in NSCLC.

Early screening for Mild Cognitive Impairment (MCI) is crucial in delaying cognitive deterioration and treating dementia. Conventional neuropsychological tests, commonly used for MCI detection, often lack ecological validity due to their simplistic and quiet testing environments. To address this gap, our study developed an immersive VR supermarket cognitive assessment program (IVRSCAP), simulating daily cognitive activities to enhance the ecological validity of MCI detection. This program involved elderly participants from Chengdu Second People’s Hospital and various communities, comprising both MCI patients (N=301) and healthy elderly individuals (N=1027). They engaged in the VR supermarket cognitive test, generating complex datasets including User Behavior Data, Tested Cognitive Dimension Game Data, Trajectory Data, and Regional Data. To analyze this data, we introduced an adaptive ensemble learning method for imbalanced samples. Our study’s primary contribution is demonstrating the superior performance of this algorithm in classifying MCI and healthy groups based on their performance in IVRSCAP. Comparative analysis confirmed its efficacy over traditional imbalanced sample processing methods and classic ensemble learning voting algorithms, significantly outperforming in metrics such as recall, F1-score, AUC, and G-mean. Our findings advocate the combined use of IVRSCAP and our algorithm as a technologically advanced, ecologically valid approach for enhancing early MCI detection strategies. This aligns with our broader aim of integrating realistic simulations with advanced computational techniques to improve diagnostic accuracy and treatment efficacy in cognitive health assessments.

Abstract Aspirin and its active metabolite salicylate have emerged as promising agents for the chemoprevention of colorectal cancer (CRC). Moreover, aspirin suppresses the progression of established CRCs. However, the underlying molecular mechanisms are not completely understood. Here we found that salicylate induces the expression of the miR-34a and miR-34b/c genes, which encode tumor suppressive microRNAs, in a p53-independent manner. Salicylate activated AMPK, thereby activating NRF2, which directly induced miR-34a/b/c expression via ARE motifs. In addition, salicylate suppressed c-MYC, a known repressor of NRF2-mediated transactivation, via activating AMPK. The suppression of c-MYC by salicylate was necessary for NRF2-mediated activation of miR-34a/b/c. Inactivation of miR-34a/b/c largely abrogated the inhibitory effects of salicylate on migration, invasion and metastasis formation by CRC cells. In the future, aspirin and its derivates may be used therapeutically to activate miR-34a and miR-34b/c in tumors that have lost p53.

HfNbTaTiZr high-entropy alloy has wide application prospects as a biomedical material, and the use of laser additive manufacturing can solve the forming problems faced by the alloy. In view of the characteristics of the one-time forming of additive manufacturing methods, it is necessary to develop non-mechanical processing modification methods. In this paper, deep cryogenic treatment (DCT) is first applied to the modification of a HEA with BCC structure, then the post-processing method of DCT is combined with laser melting deposition (LMD) technology to successfully realize the coordinated improvement of forming and strength–ductility synergistic improvement in lightweight Hf0.25NbTa0.25TiZr alloy. The final tensile strength of the alloy after DCT treatment is 25% higher than that of the as-cast alloy and 11% higher than that of the as-deposited alloy, and the elongation is increased by 48% and 10%, respectively. In addition, DCT also achieves induced phase transition without additional deformation.

Abstract Establishing financial models or economic models to describe economic phenomena in real life has become a heated discussion in society at present. From a mathematical point of view, the exploration on dynamics of financial models or economic models is a valuable work. In this study, we build a new delayed finance model and explore the dynamical behavior containing existence and uniqueness, boundedness of solution, Hopf bifurcation, and Hopf bifurcation control of the considered delayed finance model. By virtue of fixed point theorem, we prove the existence and uniqueness of the solution to the considered delayed finance model. Applying a suitable function, we obtain the boundedness of the solutions for the considered delayed finance model. Taking advantage of the stability criterion and bifurcation argument of delayed differential equation, we establish a delay-independent condition ensuring the stability and generation of Hopf bifurcation of the involved delayed finance model. Exploiting hybrid controller including state feedback and parameter perturbation, we efficaciously adjust the stability region and the time of occurrence of Hopf bifurcation of the involved delayed finance model. The study manifests that time delay is a fundamental parameter in controlling stability region and the time of onset of Hopf bifurcation of the involved delayed finance model. To examine the soundness of established key results, computer simulation figures are concretely displayed. The derived conclusions of this study are perfectly new and has momentous theoretical value in economical operation.

With economic and social development, the transport sector is growing rapidly, leading to a surge in energy consumption and environmental degradation. New Energy Vehicles (NEVs) are regarded as an important tool to alleviate energy and environmental issues, but the market share of NEVs in China is low, and how to increase the market share of NEVs is an urgent issue. This study constructs an evolutionary game model between local governments and automakers to explore the evolutionary stable strategy (ESS) of both under different combinations of subsidy and carbon tax, aiming to find rational policies to promote the development of the NEVs. Considering the possible delay effect of the game process, a time-delayed differential equation is established to analyze the effects of random time delay on the stability of the system. Finally, a numerical simulation is carried out to obtain the following conclusions: constant subsidy and carbon tax policy is not conducive to the proliferation of NEVs, variable subsidy and carbon tax policy is effective in the short term, and variable subsidy and constant carbon tax policy is effective in the long term; strengthening the entry of carbon tax can help to develop the NEVs industry; the initial value will affect the evolution of system under constant policy; excessive time delay can cause the system to lose its original stability.

Abstract Background Head and neck squamous cell carcinoma (HNSCC) are the most common cancers in the head and neck. Therapeutic response-related genes (TRRGs) are closely associated with carcinogenesis and prognosis in HNSCC. However, the clinical value and prognostic significance of TRRGs are still unclear. We aimed to construct a prognostic risk model to predict therapy response and prognosis in TRRGs-defined subgroups of HNSCC. Methods The multiomics data and clinical information of HNSCC patients were downloaded from The Cancer Genome Atlas (TCGA). The profile data GSE65858 and GSE67614 chip was downloaded from public functional genomics data Gene Expression Omnibus (GEO). Based on TCGA-HNSC database, patients were divided into a remission group and a non-remission group according to therapy response, and differentially expressed TRRGs between those two groups were screened. Using Cox regression analysis and Least absolute shrinkage and selection operator (LASSO) analysis, candidate TRRGs that can predict the prognosis of HNSCC were identified and used to construct a TRRGs-based signature and a prognostic nomogram. Result A total of 1896 differentially expressed TRRGs were screened, including 1530 upregulated genes and 366 downregulated genes. Then, 206 differently expressed TRRGs that was significantly associated with the survival were chosen using univariate Cox regression analysis. Finally, a total of 20 candidate TRRGs genes were identified by LASSO analysis to establish a signature for risk prediction, and the risk score of each patient was calculated. Patients were divided into a high-risk group (Risk-H) and a low-risk group (Risk-L) based on the risk score. Results showed that the Risk-L patients had better overall survival (OS) than Risk-H patients. Receiver operating characteristic (ROC) curve analysis revealed great predictive performance for 1-, 3-, and 5-year OS in TCGA-HNSC and GEO databases. Moreover, for patients treated with post-operative radiotherapy, Risk-L patients had longer OS and lower recurrence than Risk-H patients. The nomogram involves risk score and other clinical factors had good performance in predicting survival probability. Conclusions The proposed risk prognostic signature and Nomogram based on TRRGs are novel promising tools for predicting therapy response and overall survival in HNSCC patients.

Abstract The Underwater Internet of Things (UIoT) has emerged as one of the prominent technologies in the development of future ocean monitoring systems, where mobile edge elements (such as autonomous underwater vehicles (AUVs)) provide a promising method for the data collection from sensor nodes. However, as an important part of the UIoT, underwater wireless sensor networks (UWSNs) are severely affected by the underwater dynamic environment. For instance, node locations change continuously, which significantly increases the difficulty of data collection. To solve this problem, the concept of an inevitable communication space (ICS) is proposed. The ICS is calculated by analyzing the variation in the position of nodes and the communication range. Furthermore, an ICS-based dynamic data collection algorithm (ICS-DDCA) for UIoT is proposed to collect underwater data. This method utilizes the ICS instead of the initial location of the node for data collection to further improve the performance of the algorithm and shorten the data collection time. The simulation results demonstrate that compared with the energy-efficient data collection over AUV-assisted (EEDA) and data collection algorithms based on probabilistic neighborhood (PNCS-GHA), ICS-DDCA can effectively reduce the collection time, while ensuring the full completion of data collection.

A two-step brazing process was successfully employed to join MgF2 ceramic and TA15 alloy using eutectic Ag28% (in mass fraction) Cu alloy and Bi2O3B2O3ZnO (BBZ) glass as fillers, by introducing a 100 μm thick GH4169 interlayer. Multiscale characterization revealed that interdiffusion and reaction occurred at the joint interfaces. As a result, a reliable joint system consisting of TA15/TiCu/TiCu2Al/Ag(s,s) + Cu(s,s)/TiCu2Al/TiCu Ni + Ag-rich layer/GH4169/nano-oxide layer/glass/Mg3(BO3)F3+MgO + MgF2 reaction layer/MgF2 was formed. The GH4169-interlayer exhibited adaptive compatibility though its interaction with AgCu and BBZ glass fillers, effectively accommodating strong interface bonding and thermal mismatch stress between TA15 and MgF2 substrates. It shows an excellent shear strength (32 MPa, at room temperature) as well as thermal cycling stability without any cracking or spallation observed after the 20 thermal shock cycles between room temperature and 300 °C. It provides valuable insights into designing highly reliable ceramic/metal joints that demonstrate superior stability and adaptability in specific applications.

BackgroundPatients with Parkinson’s disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions.ObjectiveDespite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition.MethodsA total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites.ResultsParkinson’s disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients.ConclusionBiceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.

Abstract Objective To explore the factors correlated with excessive daytime sleepiness (EDS) in patients with Parkinson's disease (PD). Methods A total of 239 PD patients were divided into two groups based on the presence of EDS (Epworth Sleepiness Scale score≥10) (PD‐EDS vs. PD‐non‐EDS). Participants underwent an extensive assessment to determine demographic features, disease severity, polysomnography characteristics, and nonmotor symptoms. Results Of the 239 patients, 56 patients (23.4%) were classified as having PD combined with EDS. Binary logistic regression analysis showed that fatigue (Fatigue Severity Scale [FSS] score ≥4) (odds ratio [OR] [95% CI] = 4.897 [2.376–10.095], p

ObjectiveThe aim of this study was to explore the influential mechanism of the relationship between sleep quality and activities of daily living (ADL) in patients with Parkinson’s disease (PD), we hypothesized disease severity as a mediator and assumed the mediating process was regulated by cognition.Methods194 individuals with PD (95 women and 99 men) were enrolled in study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality of PD patients. Patients’ ADL, disease severity and cognition were measured by the Unified Parkinson’s Disease Rating Scale-II (UPDRSII), Hoehn-Yahr (H-Y) Scale, and Mini-Mental State Examination (MMSE). We investigated the mediating role of disease severity and the moderating effect of cognition on the association between sleep quality and ADL in PD patients.ResultsThe score of UPDRSII was positively correlated with the score of PSQI and H-Y stage, while the score of MMSE was negatively correlated with the score of H-Y stage and UPDRSII. Sleep quality predicts disease severity, and disease severity predicts ADL. Disease severity mediated the relationship between sleep quality and ADL, and the mediating effect was 0.179. Cognition alone did not affect ADL, but the interaction between disease severity and cognition was significantly affected ADL, confirming the moderating effect of cognition in PD patients.ConclusionDisease severity mediated the association between sleep quality and ADL, good cognition significantly reduced disease severity’s mediating influence on the relationship between sleep quality and ADL. Our study indicated a close relationship between ADL and sleep and cognition in PD, and also provided new insights into the overall management of PD and a better quality of life of PD patients.

Abstract. Background:. Studies suggest seasonal fluctuations of symptoms in Parkinson's disease (PD) patients in Western countries. However, the association between seasonal change and variation in nonmotor symptoms (NMS) in Chinese PD patients is unclear. Here, we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China. Methods:. We studied 1005 PD patients between April 2008 and October 2020. Patients were classified into four seasons according to the 24 Chinese solar terms, based on assessment date. We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity. Results:. Among the 1005 patients studied, the mean age was 64.2 ± 9.7 years and 569 (56.6%) of them were men. Relative to the summer group, patients assessed during winter had higher Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT) scores (P = 0.045). The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer (P = 0.009). Among patients who completed polysomnography during the same period (n = 135), compared with summer follow-ups, we observed a higher percentage of NREMS1 in winter and spring follow-ups (P = 0.042, P = 0.011), a higher NREMS1 time in spring follow-ups (P = 0.0024), a lower NREMS2 time in winter follow-ups (P = 0.007), and a higher percentage of phasic rapid eye movement (REM)-sleep without atonia in autumn and winter follow-ups (P = 0.026 and P = 0.020, respectively). In a subset of patients with PD and REM sleep behavior disorder (RBD; n = 182), those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1 (dream-related sub-score) than those visited during summer (P = 0.034, P = 0.020). We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis. Conclusions:. PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter, and less sleep disturbance than those in spring and winter, suggesting that seasonal change and NMS fluctuation are related, especially in patients with early stage PD.

Abstract Genome-wide association studies (GWASs) have identified numerous susceptibility loci for Parkinson’s disease (PD), but its genetic architecture remains underexplored in populations of non-European ancestry. To identify genetic variants associated with PD in the Chinese population, we performed a GWAS using whole-genome sequencing (WGS) in 1,972 cases and 2,478 controls, and a replication study in a total of 8209 cases and 9454 controls. We identified one new risk variant rs61204179 (P combined = 1.47 × 10−9) with low allele frequency, four previously reported risk variants (NUCKS1/RAB29-rs11557080, SNCA-rs356182, FYN-rs997368, and VPS13C-rs2251086), as well as three risk variants in LRRK2 coding region (A419V, R1628P, and G2385R) with genome-wide significance (P

Background and Purpose Deep venous thrombosis (DVT) makes spontaneous intracerebral hemorrhage (ICH) treatment more challenging. We aimed to determine the predictive ability of D-dimer combination with albumin for DVT in spontaneous ICH. Methods Spontaneous ICH patients were retrospectively included. Univariate and multivariate logistic regression analyses were performed. The restricted cubic spline (RCS) curve was adopted. Multivariate logistic regression analysis was further conducted to assess the predictive powers of D-dimer and albumin in different models. Besides, the incremental predictive ability of D-dimer combination with albumin was evaluated with areas under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination index (IDI). Results D-dimer was significantly higher, while albumin was considerably lower in the DVT group than in the non-DVT group [D-dimer, 0.47 (0.29, 1.08) versus 0.98 (0.48, 2.49), P

Preeclampsia (PE) is a severe placenta-related pregnancy disease that has been associated with maternal systemic inflammation and immune system disorders. However, the distribution and functional changes in immune cells of the maternal–placental interface have not been well characterized. Herein, cytometry by time-of-flight mass spectrometry (CyTOF) was used to investigate the immune atlas at the decidua, which was obtained from four PE patients and four healthy controls. Six superclusters were identified, namely, T cells, B cells, natural killer (NK) cells, monocytes, granulocytes, and others. B cells were significantly decreased in the PE group, among which the reduction in CD27+CD38+ regulatory B cell (Breg)-like cells may stimulate immune activation in PE. The significantly increased migration of B cells could be linked to the significantly overexpressed chemokine C-X-C receptor 5 (CXCR5) in the PE group, which may result in the production of excessive autoantibodies and the pathogenesis of PE. A subset of T cells, CD11c+CD8+ T cells, was significantly decreased in PE and might lead to sustained immune activation in PE patients. NK cells were ultimately separated into four subsets. The significant reduction in a novel subset of NK cells (CD56-CD49a-CD38+) in PE might have led to the failure to suppress inflammation at the maternal–fetal interface during PE progression. Moreover, the expression levels of functional markers were significantly altered in the PE group, which also inferred that shifts in the decidual immune state contributed to the development of PE and might serve as potential treatment targets. This is a worthy attempt to elaborate the differences in the phenotype and function of CD45+ immune cells in the decidua between PE and healthy pregnancies by CyTOF, which contributes to understand the pathogenesis of PE, and the altered cell subsets and markers may inspire the immune modulatory therapy for PE.

As activated hepatic stellate cells and liver sinusoidal endothelial cells express high levels of integrin α v β3, Turaga et al. present a strategy for treatment of chronic liver disease using their rationally designed protein (ProAgio) which targets integrin α v β3. They find that ProAgio –mediated apoptosis of these disease-associated cells reverses liver fibrosis and ameliorates intrahepatic vascular resistance in a mouse model

ABSTRACT Importance Acute necrotizing encephalopathy (ANE) is a rare disease with high mortality. Plasma exchange (PLEX) has recently been reported to treat ANE of childhood (ANEC), but its efficacy is uncertain. Objective This study aimed to investigate the effectiveness of PLEX on ANEC. Methods A retrospective study was conducted in four pediatric intensive care units from December 2014 to December 2020. All patients who were diagnosed with ANEC were included; however, these patients were excluded if their length of stay was less than 24 h. Participants were classified into PLEX and non‐PLEX groups. Results Twenty‐nine patients with ANEC were identified, 10 in the PLEX group and 19 in the non‐PLEX group. In the PLEX group, C‐reactive protein, procalcitonin, alanine aminotransferase, and aspartate aminotransaminase levels were significantly lower after 3 days of treatment than before treatment (13.1 vs. 8.0, P = 0.043; 9.8 vs. 1.5, P = 0.028; 133.4 vs. 31.9, P = 0.028; 282.4 vs. 50.5, P = 0.046, respectively). Nine patients (31.0%, 9/29) died at discharge, and a significantly difference was found between the PLEX group and non‐PLEX group [0 vs. 47.4% (9/19), P = 0.011]. The median follow‐up period was 27 months, and three patients were lost to follow‐up. Thirteen patients (50.0%, 13/26) died at the last follow‐up, comprising three (33.3%, 3/9) in the PLEX group and ten (58.8%, 10/17) in the non‐PLEX group, but there was no significant difference between the two groups (P = 0.411). Three patients (10.3%, 3/29) fully recovered. Interpretation PLEX may reduce serum C‐reactive protein and procalcitonin levels and improve liver function in the short term. PLEX may improve the prognosis of ANEC, and further studies are needed.

Abstract Background New therapies are urgently needed for Alzheimer’s disease (AD). Sodium oligomannate (GV-971) is a marine-derived oligosaccharide with a novel proposed mechanism of action. The first phase 3 clinical trial of GV-971 has been completed in China. Methods We conducted a phase 3, double-blind, placebo-controlled trial in participants with mild-to-moderate AD to assess GV-971 efficacy and safety. Participants were randomized to placebo or GV-971 (900 mg) for 36 weeks. The primary outcome was the drug-placebo difference in change from baseline on the 12-item cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog12). Secondary endpoints were drug-placebo differences on the Clinician’s Interview-Based Impression of Change with caregiver input (CIBIC+), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale, and Neuropsychiatric Inventory (NPI). Safety and tolerability were monitored. Results A total of 818 participants were randomized: 408 to GV-971 and 410 to placebo. A significant drug-placebo difference on the ADAS-Cog12 favoring GV-971 was present at each measurement time point, measurable at the week 4 visit and continuing throughout the trial. The difference between the groups in change from baseline was − 2.15 points (95% confidence interval, − 3.07 to − 1.23; p

To solve the problem of the low segmentation accuracy of lung nodule CT images using U-Net, an improved method for segmentation of lung nodules by U-Net was proposed. Initially, the dense network connection and sawtooth expanded convolution design was added to the feature extraction part, and a local residual design was adopted in the upsampling process. Finally, the effectiveness of the proposed algorithm was evaluated using the LIDC-IDRI lung nodule public dataset. The results showed that the improved algorithm had 7.03%, 14.05%, and 10.43% higher performance than the U-Net segmentation algorithm under the three loss functions of DC, MIOU, and SE, and the accuracy was 2.45% higher compared with that of U-Net. Thus, the proposed method had an effective network structure.

Background & Aims: Pancreatic ductal adenocarcinoma (PDAC) is resistant to most therapeutics owing to dense fibrotic stroma orchestrated by cancer-associated pancreatic stellate cells (CAPaSC). CAPaSC also support cancer cell growth, metastasis, and resistance to apoptosis. Currently, there is no effective therapy for PDAC that specifically targets CAPaSC. We previously reported a rationally designed protein, ProAgio, that targets integrin αvβ3 at a novel site and induces apoptosis in integrin αvβ3-expressing cells. Because both CAPaSC and angiogenic endothelial cells express high levels of integrin αvβ3, we aimed to analyze the effects of ProAgio in PDAC tumor. Methods: Expression of integrin αvβ3 was examined in both patient tissue and cultured cells. The effects of ProAgio on CAPaSC were analyzed using an apoptosis assay kit. The effects of ProAgio in PDAC tumor were studied in 3 murine tumor models: subcutaneous xenograft, genetic engineered (KrasG12D; p53R172H; Pdx1-Cre, GEM-KPC) mice, and an orthotopic KrasG12D; p53R172H; Pdx1-Cre (KPC) model. Results: ProAgio induces apoptosis in CAPaSC. ProAgio treatment significantly prolonged survival of a genetically engineered mouse–KPC and orthotopic KPC mice alone or in combination with gemcitabine (Gem). ProAgio specifically induced apoptosis in CAPaSC, resorbed collagen, and opened collapsed tumor vessels without an increase in angiogenesis in PDAC tumor, enabling drug delivery into the tumor. ProAgio decreased intratumoral insulin-like growth factor 1 levels as a result of depletion of CAPaSC and consequently decreased cytidine deaminase, a Gem metabolism enzyme in cancer cells, and thereby reduced resistance to Gem-induced apoptosis. Conclusions: Our study suggests that ProAgio is an effective PDAC treatment agent because it specifically depletes CAPaSC and eliminates tumor angiogenesis, thereby enhancing drug delivery and Gem efficacy in PDAC tumors.

Candida albicans is the most frequent fungal species responsible for vulvovaginal candidiasis (VVC), which exhibits distinct genetic diversity that is linked with the clinical phenotype. This study aimed to assess the genotypes and clinical characteristics of different C. albicans isolates from VVC patients. Based on multilocus sequence typing (MLST), clade 1 was identified as the largest C. albicans group, which appeared most frequently in recurrent VVC and treatment failure cases. Further study of antifungal susceptibility demonstrated that MLST clade 1 strains presented significantly higher drug resistance ability than non-clade 1 strains, which result from the overexpression of MDR1. The mRNA and protein expression levels of virulence-related genes were also significantly higher in clade 1 isolates than in non-clade 1 isolates. Proteomic analysis indicated that the protein stabilization pathway was significantly enriched in clade 1 strains and that RPS4 was a central regulator of proteins involved in stress resistance, adherence, and DNA repair, which all contribute to the resistance and virulence of MLST clade 1 strains. This study was the first attempt to compare the correlation mechanisms between C. albicans MLST clade 1 and non-clade 1 strains and the clinical phenotype, which is of great significance for VVC classification and treatment.

Abstract Background Soft-tissue metastasis (STM) is a relatively rare, but not exceptional, manifestation of lung cancer. The purpose of this study was to evaluate the imaging features of STM from lung cancer using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and assess the impact of STM detected at baseline PET/CT on patient survival. Methods Out of 4543 patients with lung cancer who underwent 18F-FDG PET/CT in our hospital between January 2013 and September 2018, 85 were diagnosed with STM (78 at baseline PET/CT and 7 at restaging PET/CT) and included in the imaging study. We conducted a comparative survival analysis between patients with stage 4 lung cancer with and without STM at baseline PET/CT (n = 78 in each group) and performed univariate and multivariate analyses to investigate the factors affecting the prognosis of lung cancer. Results A total of 219 lesions were identified by 18F-FDG PET/CT: 215 were detected by PET and 139 by CT. Muscle STM were primarily found in the hip and upper limb muscle, whereas subcutaneous STM were mainly distributed in the chest, abdomen, and back. In 68 patients, STM were found incidentally during routine 18F-FDG PET/CT staging. Isolated STM were detected in 6 patients, whose tumor staging and treatment were affected by PET/CT findings. There were no significant differences in the 1-, 3-, and 5-year survival rates between patients with and without STM at baseline PET/CT. Brain and adrenal metastases, but not STM, were associated with poor prognosis of stage 4 lung cancer. Conclusions We described the PET/CT imaging characteristics of STM from lung cancer, and confirmed that PET/CT can detect unsuspected STM to change the staging and treatment of some patients. Our analysis indicates that STM is not a useful prognostic indicator for patients with advanced lung cancer, while brain and adrenal metastases portend a poor prognosis.

Abstract Background The aseptic meningitis caused by varicella zoster virus (VZV) reactivation was less described in the literature, most of which were detected by means of polymerase chain reaction. The authors presented 4 adult immunocompetent patients with acute aseptic meningitis with VZV infection diagnosed by next-generation sequencing (NGS). Case presentation Four patients were admitted to the hospital with headache and fever between March 2018 and August 2019. The median ages were 37 years (range 22–52 years). The median symptoms onset to clinic time was 3.5 days (range 3–6 days). Two patients had signs of meningeal irritation. Rash occurred after the meningitis symptoms in 1 patient (time from meningitis symptoms to rash, 2 days). No other sign or symptom was reported. The brain Magnetic resonance imaging and electroencephalography were normal in all patients. Cerebrospinal fluid (CSF) samples were obtained at a median of 4 days (range 3–7 days) from the meningitis symptoms onset. Opening pressure of lumbar puncture after admission were high in these cases (median 256 mm H2O; range 165–400 mm H2O). White blood cell counts and protein levels were significantly elevated in CSF samples (median 317 × 10^6/L, range 147–478 × 10^6/L; median 1.41 g/L, range 0.57–1.79 g/L). The cytology of CSF demonstrated a lymphocytic pleocytosis, and most multinuclear cells. The culture of CSF was negative for all 4 cases, while T-cell spot test was positive for 2 cases, who were administrated with anti-tuberculosis treatment for suspicious tuberculous meningitis. NGS of CSF (the Vision Medical Research Institute) detected specific sequences of VZV in the 4 cases within 72 h after admission. The inappropriate treatment were stopped while acyclovir were continued intravenously for 10–14 days. All patients recovered completely. Conclusions VZV is an infectious agent that causes aseptic meningitis in immunocompetent adults and could not be accompanied by skin manifestations. The NGS of CSF is a rapid detection for the identification and differentiation of meningitis in patients, which is of great importance for providing the rapid and accurate diagnosis and the targeted antimicrobial therapy for central nervous system infection.

Preeclampsia (PE) is a serious disease during pregnancy that affects approximately eight million mothers and infants worldwide each year and is closely related to abnormal trophoblast function. However, research on placental trophoblast functional abnormalities is insufficient, and the etiology of PE is unclear. Here, we report that the expression of transgelin-2 (TAGLN2) was downregulated in the placenta of patients with PE. In addition, a lack of TAGLN2 significantly reduced the ability of trophoblasts to migrate, invade and fuse. A co-immunoprecipitation (Co-IP) and microscale thermophoresis analysis showed that TAGLN2 bound directly to E-cadherin. A decrease in TAGLN2 expression led to a reduction in cleavage of the E-cadherin extracellular domain, thereby regulating the function of trophoblasts. In addition, we found that a reduction in soluble E-cadherin may also have an effect on blood vessel formation in the placenta, which is necessary for normal placental development. What’s more, the in vivo mouse model provided additional evidence of TAGLN2 involvement in the development of PE. By injecting pregnant mice with Ad-TAGLN2, we successfully generated a human PE-like syndrome that resulted in high blood pressure and some adverse pregnancy outcomes. Overall, the association between TAGLN2 and PE gives a new insight into PE diagnosis and treatment.

This paper describes a method for determining the initiation and unstable toughness of fully graded concrete of arbitrary specimen size. The method first predicts the initiation and peak loads of concrete specimens of any size, as well as crack length-to-height ratios based on the fracture test results of concrete specimens with limited sizes or crack length-to-height ratios. Then, combined with the fracture extreme theory, the fracture toughness of concrete with varying size or crack length-to-height ratios is determined. Finally, in order to verify the applicability of the method, it is used to calculate the fracture toughness of small aggregate concrete and fully graded concrete with different sizes or crack length-to-height ratios, and its prediction accuracy is evaluated through indices such as mean absolute percentage error, root mean square error and reliability index a15. The results show that the proposed method can meet the needs of practical engineering applications and can provide theoretical basis for the optimization of the fracture test method of fully graded concrete and the determination of fracture parameters in crack stability or propagation analysis.

Mutations in leucine-rich repeat kinase 2 gene (LRRK2) are the most frequent genetic factors contributing to Parkinson's disease (PD). G2385R-LRRK2 increases the risk for PD susceptibility in the Chinese population. However, the pathological role of G2385R-LRRK2 is not clear. In this study, we investigate the roles of G2385R-LRRK2 in neurodegeneration underlying PD pathogenesis using cell biology and pharmacology approaches. We demonstrated that expression of G2385R-LRRK2-induced neurotoxicity in human neuroblastoma SH-SY5Y and mouse primary neurons. G2385R-LRRK2 increased mitochondrial ROS, activates caspase-3/7, and increased PARP cleavage, resulting in neurotoxicity. Treatment with curcumin (an antioxidant) significantly protected against G2385R-LRRK2-induced neurodegeneration by reducing mitochondrial ROS, caspase-3/7 activation, and PARP cleavage. We also found that the cellular environmental stressor, H2O2 significantly promotes both WT-LRRK2- and G2385R-LRRK2-induced neurotoxicity by increasing mitochondrial ROS, caspase-3/7 activation, and PARP cleavage, while curcumin attenuated this combined neurotoxicity. These findings not only provide a novel understanding of G2385R roles in neurodegeneration and environment interaction but also provide a pharmacological approach for intervention for G2385R-LRRK2-linked PD.

Acetaldehyde is regarded as an important flavor compound in alcoholic beverages. With the advantages of rapidity, low cost and high sensitivity, fluorescent probe could be used as a new tool for the detection of acetaldehyde. Here, an effective fluorescence sensing method based on fluorescent probe N1 (FPN1) was established in this study. The function of FPN1 relies on the nucleophile substitution reaction and photoinduced electron transfer (PET), resulting in a fluorescence increase. Remarkably, the pretreatment background removal method (BRM) was successfully applied for removal of the interference of pyruvate and acetal. The linearity range (LR), limit of detection (LOD) and recovery of the fluorescence sensing method with BRM were 0.0053–200 mg/L, 0.0016 mg/L and 94.02–108.12%, respectively, which showed a broader detection range and better performance on sensitivity compared with the traditional quantitation using gas chromatography (GC). Furthermore, successful application of the method in real samples indicated the advantages of low-cost and rapidity for small-scale detection while assuring the accuracy, which provides a new strategy for the detection of acetaldehyde concentration in alcoholic beverages.

(1) Background: The degradation products of ribonucleic acid (RNA)are widely used in the food and pharmaceutical industry for their flavoring and nutritional enhancement functions. Yeast is the main source for commercial RNA production, and an efficient strain is the key to reducing production costs; (2) Methods: A mutant Saccharomyces pastorianus G03H8 with a high RNA yield was developed via ARTP mutagenesis and fed-batch fermentation was applied to optimize production capacity. Genome sequencing analysis was used to reveal the underlying mechanism of higher RNA production genetic differences in the preferred mutant; (3) Results: Compared with the highest RNA content of the mutant strain, G03H8 increased by 40% compared with the parental strain G03 after response surface model optimization. Meanwhile, in fed-batch fermentation, G03H8′s dry cell weight (DCW) reached 60.58 g/L in 5 L fermenter by molasses flowing and RNA production reached up to 3.58 g/L. Genome sequencing showed that the ribosome biogenesis, yeast meiosis, RNA transport, and longevity regulating pathway were closely related to the metabolism of high RNA production; (4) Conclusion: S. pastorianus G03H8 was developed for RNA production and had the potential to greatly reduce the cost of RNA production and shorten the fermentation cycle. This work lays the foundation for efficient RNA content using S. pastorianus.

This paper presents a novel linear mathematical model for integrated cell formation and task scheduling in the cellular manufacturing system (CMS). It is suitable for the dual-resource constrained setting, such as garment process, component assembly, and electronics manufacturing. The model can handle the manufacturing project composing of some tasks with precedence constraints. It provides a method to assign the multi-skilled workers to appropriate machines. The workers are allowed to move among the machines such that the processing time of tasks might be reduced. A hybrid simulated annealing (HSA) is proposed to minimize the makespan of manufacturing project in the CMS. The approach combines the priority rule based heuristic algorithm (PRBHA) and revised forward recursion algorithm (RFRA) with conventional simulated annealing (SA). The result of extensive numerical experiments shows that the proposed HSA outperforms the conventional SA accurately and efficiently.

Underwater acoustic sensor network (UASN) has become one of the enabling technologies for the development of future ocean observation systems (OOSs). However, the UASN could be severely damaged because of the harsh environment that causes the simultaneous failure of many sensor nodes, thus leading to the partition of the network into multiple disconnected segments. In this paper, we studied the crucial issue to reestablish the network connectivity with the least quantity of employed relay nodes. To achieve a clear understanding of the issue, we present its integer nonlinear programming formulation, which is generally NP-hard. So, with the aim of solving the problem efficiently, an original heuristic scheme is proposed in this paper. Two fundamental algorithms are integrated into the scheme, namely, alternating tree construction and Fermat-point selection (ATCFS) as a whole. The results of extensive simulation experiment have confirmed that the ATCFS can solve this problem simply and effectively.

Abstract Background Rasagiline is a monoamine oxidase-B inhibitor used for Parkinson’s disease (PD) treatment, but its effectiveness on Chinese patients is unclear. This study aimed to evaluate the efficacy and safety of rasagiline monotherapy in Chinese patients with early PD. Methods A 26-weeks, randomized, double-blind, placebo-controlled study has been performed at 15 sites in China and enrolled outpatients (≥35 years old) with idiopathic PD without a history of using any dopaminergic drugs. Participants were randomized 1:1 to receive rasagiline 1 mg once daily or placebo. The primary endpoint was the change of the Unified Parkinson’s Disease Rating Scale (UPDRS) total score from baseline to 26 weeks treatment. Secondary endpoints included changes in UPDRS subscale scores from part I to III. Health status was assessed with the PD Questionnaire (PDQ)-39 and EuroQol-Five-Dimension (EQ-5D) questionnaire. Safety profile was collected until 30 weeks after randomization. Results A total of 130 patients (n = 65/group) were recruited, and 127 (rasagiline, n = 64; placebo, n = 63) were included in the full analysis set. Baseline characteristics were comparable between the two groups. The decrease in the mean UPDRS total score was greater in the rasagiline group than in the placebo group (− 3.18 ± 0.95 vs. − 0.18 ± 0.98, P = 0.025), and the mean UPDRS part I non-motor symptoms score (− 0.54 ± 0.15 vs. -0.08 ± 0.15, P = 0.003) were significantly decreased in the rasagiline group compared with placebo treated patients. An improvement trend was observed in the active treatment group for the subscales evaluation with parts II and III, while the difference to placebo was not statistically significant. Life quality assessed by the EQ-5D visual analog scale improved in the rasagiline group but worsened in placebo treated patients. The overall incidence of treatment-emergent adverse events (AEs) was slightly lower in the rasagiline group (41.5%) than in the placebo group (46.2%). Conclusions Rasagiline is effective, safe, and well tolerated as monotherapy for the treatment of Chinese PD patients. Trial registration Clinicaltrials.gov: NCT01556165. Registered 13 Mar 2012.

Ever since SARS-CoV-2 began infecting people by the end of 2019, of whom some developed severe pneumonia (about 5%), which could be fatal (case fatality ~3.5%), the extent and speed of the COVID-19 outbreak has been phenomenal. Within 2.5 months (by March 18, 2020) over 191,127 COVID-19 patients have been identified in 161 countries. By then, over 700 pediatric patients were confirmed to have COVID-19 in China, with only about 58 diagnosed elsewhere. By now, there are thousands of children and adolescents infected. Chinese pediatricians would like to share their experience on how these patients were managed in China and the key recommendations that had guided them in meeting the evolving challenges. A group of experts were summoned by the Chinese Pediatric Society and Editorial Board of Chinese Journal of Pediatrics to extract informative data from a survey on confirmed COVID-19 pediatric patients in China. Consensus on diagnosis, management, and prevention of pediatric COVID-19 were drawn up based on the analysis of such data plus insights gained from the past SARS and MERS coronavirus outbreaks. Relevant cumulating experiences from physicians managing adult patients, expedited reports on clinical and scientific COVID-19 and SARS-CoV-2 data, and the National Health Committee guidelines on COVID-19 management were integrated into this proposal.

The goal of this paper provides better understanding of the effect of sodium gluconate (SG) on ordinary Portland cement (OPC) hydration behavior. Pastes’ performances of ordinary Portland cement, including setting time at 20°C and 35°C curing temperature, mechanical strength, fluidity, and zeta potential are studied. Furthermore, the effects of SG on cement hydration behaviors are investigated by the means of isothermal calorimetry measurements, X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The results show that SG is difficult to maintain significant retarding effect at the temperature of 35°C compared to that at the temperature of 20°C. SG is able to reduce the cement cumulative hydration heat and delay the occurrence time of heat evolution peak in a certain extent, but it has little impact on reducing the cement evolution rate peak. The effects of SG on mechanical properties and dispersion properties of cement depend on its dosages. Specifically, the positive effect occurs when the addition dosage is less than 0.15% (i.e., by cement weight), but the negative effect emerges if the addition dosages exceed this limitation. Similarly, SG plays different roles on cement hydration at different hydration periods. It inhibits the hydration of C3S and the formation of portlandite (CH) at the early hydration period. On the contrary, it promotes the C3S hydration when hydration time is beyond 1 d. Meanwhile, SG also plays different roles on cement hydration at different dosage additions. Specifically, SG promotes ettringite (AFt) formation at the dosage less than 0.06%, but it inhibits AFt formation at the dosage more than 0.06%.

Due to the complex structure and stress distribution of dam galleries, cracks often appear during the construction, operation and maintenance periods of dams. This paper proposes a method to determine the real strength and fracture parameters of gallery concrete, considering environmental temperature and humidity. The strength and fracture tests were carried out for gallery concrete at various ages and under different curing temperature and humidity conditions. The influence of curing conditions on the mechanical properties of gallery concrete was quantitatively analyzed. The prediction equations of the strength and fracture parameters of gallery concrete under arbitrary temperature and humidity were established. Based on the measured temperature and humidity data, the real mechanical parameters of gallery concrete were predicted. The research results show that the influence of environmental conditions on mechanical parameters cannot be neglected, as this can result in a strength reduction of up to 33.81%. The proposed equations can be used to predict the mechanical parameters of gallery concrete, subject to real environmental conditions, which can help to correct a maximum deviation of 54.62% on parameters calculated using actual ages. The proposed method can provide a scientific basis for the cracking risk analysis and safety assessment of the gallery structure under actual conditions.

Abstract Background The use of adjunct rasagiline in levodopa-treated patients with Parkinson’s disease and motor fluctuations is supported by findings from large-scale clinical studies. This study is to investigate the efficacy and safety of adjunct rasagiline in Chinese patients with Parkinson’s disease, as a product registration study. Methods This 16-week, randomized, double-blind, parallel-group, multicenter, placebo-controlled study of rasagiline 1 mg/day included levodopa-treated patients with Parkinson’s disease and motor fluctuations. The primary efficacy endpoint was mean change from baseline in total daily OFF time over 16 weeks. Secondary endpoints were Clinical Global Impressions – Improvement (CGI-I), and change in Unified Parkinson’s Disease Rating Scale (UPDRS) Activities of daily living (ADL) and Motor scores. Patient well-being (EQ-5D), and the frequency of adverse events were also assessed. Results In total, 324 levodopa-treated patients were randomized to rasagiline 1 mg/day (n = 165) or placebo (n = 159). Over 16 weeks, rasagiline statistically significantly reduced the mean [95% confidence interval] total daily OFF time versus placebo (− 0.5 h [− 0.92, − 0.07]; p = 0.023). There were also statistically significant improvements versus placebo in CGI-I (− 0.4 points [− 0.61, − 0.22]; p

Flavor stability is important for beer quality and extensive efforts have been undertaken to improve this. In our previous work, we proved a concept whereby metabolic engineering lager yeast with increased cellular nicotinamide adenine dinucleotide hydride (NADH) availability could enhance the flavor stability of beer. However, the method for breeding non-genetically modified strains with higher NADH levels remains unsolved. In the current study, we reported a novel approach to develop such strains based on atmospheric and room temperature plasma (ARTP) mutagenesis coupled with 2,4-dinitrophenol (DNP) selection. As a result, we obtained a serial of strains with higher NADH levels as well as improved flavor stability. For screening an optimal strain with industrial application potential, we examined the other fermentation characteristics of the mutants and ultimately obtained the optimal strain, YDR-63. The overall fermentation performance of the strain YDR-63 in pilot-scale fermentation was similar to that of the parental strain YJ-002, but the acetaldehyde production was decreased by 53.7% and the resistance staling value of beer was improved by 99.8%. The forced beer aging assay further demonstrated that the favor stability was indeed improved as the contents of 5-hydroxymethylfurfural in YDR-63 was less than that in YJ-002 and the sensory notes of staling was weaker in YDR-63. We also employed this novel approach to another industrial strain, M14, and succeeded in improving its flavor stability. All the findings demonstrated the efficiency and versatility of this new approach in developing strains with improved flavor stability for the beer industry.

Aiming at optimizing properties of alumina-spinel refractory castables, coarse corundum particles were replaced partially with the particles of a novel porous multi-component CMA (CaO-MgO-Al2O3) aggregate in the same size. Properties including the bulk density, apparent porosity, strength, slag corrosion resistance, thermal shock resistance and thermal fatigue resistance of alumina-spinel refractory castables containing CMA aggregates were evaluated contrastively. The results demonstrated that the incorporation of CMA aggregates can significantly improve thermal shock resistance and thermal fatigue resistance of castables, although companying with slight decrease in the bulk density and strength. Moreover, slag penetration resistance of castables can also be enhanced by CMA aggregates with appropriate particle size. The influence of CMA aggregates on properties of alumina-spinel refractory castables depended strongly on their particle size.

This paper compares the evaluation standards of new and old green buildings, and studies the existing evaluation system of Expressway Green Service area, this paper expounds the relationship between the existing Green Service area evaluation system and the new and old green building standards, and finally, combining the new green building evaluation standards and the actual evaluation work, advances the new Green Service Area Evaluation Index, it will guide the revision of the relevant policy standard of the current Green Service area.

Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of EQClinic with larger numbers will ascertain learning gains and application in health professional training. Developing a standard model for the assessment of non-verbal behaviour in tele-consultations and providing students with more valuable evaluation and suggestions are part of our future work.