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Abstract Purpose The essence of this scholarly work was to carefully outline the key factors intensifying the virulence and protracted contagion of COVID-19, particularly among individuals afflicted with hematologic malignancies (HM), in an epoch predominantly governed by the Omicron variant. Methods Adults with HM diagnosed with COVID-19 from November 2022 to February 2023 were monitored in this retrospective study. Patient blood samples yielded biochemical data, and COVID-19 was confirmed through RNA or antigen testing. The factors affecting severity and infection duration were examined using both univariate and multivariate logistic regression analyses. For calculating the overall survival probabilities, the Kaplan–Meier product limit approach was employed. Results In the examined cohort, 133 individuals diagnosed with HM and concomitantly infected with COVID-19 were scrutinized. Of the participants, 29.3% (39 patients) were classified as Severe/Critical, while the other 70.7% (94 patients) were categorized as Non-severe. A significant difference was observed in vaccination status: 61.7% of patients in the Non-severe group had received at least a two-dose vaccine regimen, whereas 61.5% of the Severe/Critical group had either minimal or only one dose of vaccination. The data analysis revealed that elevated C-reactive protein levels (≥ 100 mg/L) significantly raised the risk of severe/critical conditions in HM patients with COVID-19, as determined by advanced multivariate logistic regression. The odds ratio was 3.415 with a 95% confidence interval of 1.294–9.012 (p = 0.013). Patients who continued to have positive nucleic acid tests and ongoing symptoms beyond 30 days were categorized as having a persistent infection, whereas those who achieved infection control within this timeframe were categorized as having infection recovery. Of the HM cohort, 11 did not survive beyond 30 days after diagnosis. The results from a competing risk model revealed that increased interleukin-6 levels (HR: 2.626, 95% CI: 1.361–5.075; p = 0.004) was significantly associated with persistent infection. Conversely, receiving more than two vaccine doses (HR: 0.366, 95% CI: 0.158–0.846; p = 0.019), and having high IgG levels (≥ 1000 mg/dl) (HR: 0.364, 95% CI: 0.167–0.791; p = 0.011), were associated with infection recovery. There was a notable disparity in survival rates between patients with persistent infections and infection recovery, with those in the non-persistent group demonstrating superior survival outcomes (P

Abstract The optimal treatment endpoints and duration of continuous therapy for multicentric Castleman disease (MCD) remain controversial. We retrospectively analyzed data from 123 patients with Human Herpesvirus (HHV)-8 negative MCD. We demonstrated that continuous therapy significantly enhanced progression-free survival (PFS) in patients who achieved an optimal response after initial treatment. These findings underscore the critical role of continuous therapy in HHV-8 negative MCD. Further studies with larger cohorts are required to validate these findings.

Currently, the study of analytical solutions for the seismic stability of slopes under anchorage conditions is one of the hottest subjects in engineering. In this paper, an analytical solution for the seismic safety of the three-dimensional (3D) two-stage rock slope reinforced with prestressed anchor cables governed by the nonlinear Hoek–Brown criterion was deduced, in which the analyses of seismicity were performed by the latest modified pseudo-dynamic method. This method supplements the consideration of the damping effect of the rock medium on seismic waves, which is more in line with the real seismic situation. A mathematical geometric model was developed for calculating the external forces work and internal energy dissipation acting on 3D rotating rock masses reinforced with prestressed anchor cables, in which the seismic work rate was calculated using a new layer-by-layer superposition summation method. The analytical solution of the safety factor could be collated as an explicit function of several variables, and then, the optimal value was obtained by the Particle Swarm Optimization (PSO) algorithm. To corroborate the accuracy of new analytical solutions, the results were contrasted with those of the pertinent literature. The results of the two comparisons were very close. Ultimately, the sensitivity analyses and coupling effects of seismic pseudo-dynamic factors and prestressing anchorage factors were carried out. It was found that even small seismic intensities had a large effect on the stability of rock slopes with developed joints. Increasing the number of steps and prestressing anchors can effectively improve the stability of rock slopes under seismic effects. The conclusions have significant implications for the anchorage design of the 3D two-stage rock slope as seismic events occur.

Abstract Objectives: To evaluate various diet quality indices and to estimate their associations with major non-communicable diseases (NCD) (i.e. diabetes mellitus (DM) and myocardial infarction (MI)) and risk for overweight (OW). Design: Four dietary diversity indices (namely, count index (Count), dietary diversity score index, berry index (BI) and entropy index (EI)) and three Chinese dietary guideline-based indices (namely, China healthy diet index, Chinese food pagoda score and diet quality divergence index) were employed to evaluate Chinese diet quality. DM, MI and OW were used as diet-related health indicators. Logit regressions were employed to unveil the associations between diet quality indices and NCD and risk for OW. The relationships between diet quality indices and daily energy intakes were checked with ordinary least squares linear regressions. Setting: Four recent waves (2004, 2006, 2009, 2011) of longitudinal individual data from China Health and Nutrition Survey. Participants: Chinese adults (aged 18–64 years) from twelve provinces were included in the analysis (n 30 350). Results: Count, BI, and EI were positively associated with higher OW risk and daily energy intakes. As dietary guideline-based indices got better, people were exposed to lower DM and OW risks and got lower daily energy intakes. Finally, dietary guideline-based indices properly revealed the expected relationships that high-quality diets would reduce NCD and risk for OW, while high diversity indices were usually correlated with over-nutrition and high risks. Conclusions: Increasing diversity of the diet does not necessarily improve the nutrition and health. Dietary guideline-based indices are more robust than dietary diversity indices; thus, they should be highly recommended when evaluating diet quality.

Abstract Objectives In order to explore the impact of pegylated liposomal doxorubicin (PLD) dose intensity on survival outcomes of newly diagnosed elderly patients with diffuse large B‐cell lymphoma (DLBCL), we performed a retrospective study to compare the efficacy and adverse effects of RCEOP (70 mg/m2), RCdOP (20–30 mg/m2) and RCDOP (30–45 mg/m2). The optimal PLD dose of patients with different clinical characteristics of subgroups was explored to provide a clue for the selection of clinical PLD dose. Methods A total of 335 DLBCL patients (60–85 years old) who were newly diagnosed and completed at least four cycles of RCE(D)OP were selected. The patients were mainly divided into RCEOP (126 cases) (epirubicin 70 mg/m2), RCdOP (151 cases) (PLD 20–30 mg/m2) and RCdOP (58 cases) (PLD 30–45 mg/m2). The effects of different doses of PLD on clinical efficacy, cardiotoxicity and prognosis of patients were retrospectively analyzed. Subgroup analysis was performed to compare the clinical characteristics of different subgroups. Results Our study showed that PLD and epirubicin had similar efficacy (overall survival (OS) p = 0.776; progression‐free survival (PFS) p = 0.959). RCDOP (30–45 mg/m2 PLD) group had a higher complete remission (CR) rate of 75.9% compared with RCdOP (20–30 mg/m2 PLD) group (P D vs. d = 0.018). In the overall population, there was no significant difference in survival between RCDOP and RCdOP groups (OS P D vs. d = 0.661; PFS P D vs. d = 0.212). In patients with underlying cardiovascular diseases, the PFS of the RCDOP group was significantly better than the RCdOP group (p = 0.043). Meanwhile, patients in the RCDOP group tended to have a better prognosis than those in the RCEOP group (OS: RCDOP vs. RCEOP p = 0.054, PFS: RCDOP vs. RCEOP p = 0.053). There was no significant difference in the incidence of cardiotoxicity and other adverse events among the three groups. For the low‐risk (age‐adjusted‐International Prognostic Index = 0/1) old patients without cardiovascular disease, RCdOP was considered a better strategy in OS (p = 0.020). Conclusion In the general population, the CR rate in the RCDOP group was significantly higher than that in the RCdOP group (p = 0.018). For elderly DLBCL patients with cardiovascular disease, the effect benefit brought by the PLD dose was more obvious, and the PFS of the RCDOP group was significantly better than that of the RCdOP group (p = 0.043). Full dose of PLD is an efficient alternative in the treatment of patients with preexisting cardiovascular diseases.

In this study, the graded hierarchical hexagonal honeycomb (GHHH) integrating gradient design and hierarchical design was fabricated using the 3D-printing technique, and its in-plane elastic properties were investigated theoretically, experimentally, and numerically. Theoretical solutions were developed based on the Euler beam theory to predict the effective elastic modulus and Poisson’s ratio of GHHH, and theoretical values were in good agreement with the experimental and numerical results. The effect of gradient design and hierarchical design on the in-plane elastic properties of GHHH was also analyzed and compared. Results showed that the hierarchical design has a more significant effect on Poisson’s ratio and adjusting the internal forces of GHHH compared with the gradient design. In addition, it was found that GHHH exhibited higher stiffness compared with regular hexagonal honeycomb (RHH), graded hexagonal honeycomb (GHH), and vertex-based hierarchical hexagonal honeycomb (VHHH) under the constraint of the same relative density, respectively. Specifically, the effective elastic modulus of GHHH can be enhanced by 119.82% compared to that of RHH. This research will help to reveal the effect of integrating hierarchical design and gradient design on the in-plane elastic properties of honeycombs.

Background Acute myeloid leukemia (AML) with t(8;21) is generally associated with a favorable clinical course. Loss of sex chromosome (LOS) are frequently observed in t (8;21) AML, but the prognostic value of LOS remains uncertain.Methods A total of 73 patients with AML with t(8;21) were studied and divided into t(8;21) with LOS group (n = 36) and t(8;21) alone group (n = 37). The patients with t(8;21) AML with ACAs other than LOS were excluded. The clinical characteristics of these two groups were compared, and the prognostic value of LOS was evaluated based on disease-free survival (DFS) and overall survival (OS).Results The clinical characteristics (except for gender) were found to have no significant difference between these two groups, and the male patients tended to account for a larger proportion in the former group (P = .001). The OS of the t(8;21) AML with LOS group was significantly longer than that of the t(8;21) AML alone group (P = .005). While not obvious, the patients with LOS seemed to have longer DFS (P = .061). The multivariable analysis also showed LOS to be an independent favorable prognostic factor of t(8;21) AML (P = .022).Conclusions Our results suggested that LOS could be associated with a favorable prognosis in t(8;21) AML patients without other ACAs, and for this subtype of AML, longer DFS and a satisfactory and stable survival can be achieved with high-dose cytarabine (HDAC) consolidation treatment.

BackgroundDiffuse large B-cell lymphoma (DLBCL) is a kind of highly heterogeneous non-Hodgkin lymphoma, both in clinical and genetic terms. DLBCL is admittedly categorized into six subtypes by genetics, which contain MCD, BN2, EZB, N1, ST2, and A53. Dyslipidemia is relevant to a multitude of solid tumors and has recently been reported to be associated with hematologic malignancies. We aim to present a retrospective study investigating dyslipidemia in DLBCL based on the molecular subtypes.ResultsThis study concluded that 259 patients with newly diagnosed DLBCL and their biopsy specimens were available for molecular typing. Results show that the incidence of dyslipidemia (87.0%, p

The study of analytical solutions for the bearing capacity of reinforced soil foundations is a very important topic in engineering mathematics. Existing evaluations of the foundation-bearing capacity on reinforced soils are based on dry conditions, while many foundations are located on unsaturated soils in real engineering. In this paper, a new formula for the bearing capacity of reinforced strip footings on unsaturated soils is presented. Two sliding failure mechanisms are constructed based on the position of the reinforcement layer relative to the sliding surface. The distribution of apparent cohesion in the depth direction is calculated by considering the effect of matrix suction. By additionally considering the work conducted by the reinforcement and the contribution of the apparent cohesion, the bearing capacity formula is obtained using the upper bound theorem of limit analysis. The bearing capacity solution is obtained by adopting the sequential quadratic programming (SQP) algorithm. Comparing the results under two failure mechanisms, the optimal bearing capacity and the optimal embedment depth of reinforcement are obtained. The results of this paper are consistent with those of the existing literature. Finally, the effects of reinforcement embedment depth, effective internal friction angle, uniform load, and unsaturated soil parameters on the optimal bearing capacity are investigated through parametric analysis. This paper provides useful recommendations for the engineering application of reinforced strip footings on unsaturated soils.

The evaluation of the bearing capacity of strip footings generally assumes that the soil is either dry or fully saturated, which contradicts the actual condition in nature where the soil is often in a partially saturated state. Furthermore, infiltration has a significant impact on the shear strength of the soil. Following the upper bound theory of the limit analysis, this article provides a theoretical framework for assessing the bearing capacity under transient flow with linear variation in infiltration intensity for the first time. Firstly, the closed form of suction stress under linear transient infiltration is derived using Laplace transform and introduced into the Mohr–Coulomb criterion. A discrete failure mechanism with fewer variables and higher accuracy is provided to ensure kinematic admissibility. The upper bound solution for bearing capacity is obtained by solving the power balance equation. The present results are compared with results from the published literature and the finite element, confirming the validity and superiority of the theoretical framework provided. A parametric analysis is also conducted on three hypothetical soil types (fine sand, silt, and clay), and the results show that unsaturated transient infiltration has a positive influence on increasing the foundation bearing capacity. The magnitude of the influence is comprehensively controlled by factors such as soil type, saturated hydraulic conductivity, infiltration intensity, infiltration time, and water table depth. The increase in bearing capacity due to unsaturated transient infiltration can be incorporated into Terzaghi’s equation as a separate component presented in tabular form for engineering design purposes.

Abstract Peripheral T-cell lymphoma(PTCL) is a group of lymphoproliferative tumors originated from post-thymic T cells or mature natural killer (NK) cells. It shows highly aggressive clinical behaviour, resistance to conventional chemotherapy, and a poor prognosis. Although a few prognostic models of PTCL have been established in retrospective studies, some high-risk patients still can not be screened out. Therefor we retrospectively studied 347 newly diagnosed PTCL patients and assessed the prognostic role of lymphocyte-monocyte ratio (LMR) and platelet-monocyte ratio (PMR) in the complete response (CR) and survival of PTCL patients. Patients with LMR ≤ 1.68 and PMR ≤ 300 achieved a lower CR rate and a poor survival. In multivariate analysis, LMR ≤ 1.68 (HR = 1.751, 95% CI 1.158–2.647, p

In engineering mathematics, the unsaturated nature of soil has a significant impact on the seismic bearing capacity solution. However, it has generally been neglected in the published literature to date. Based on the kinematic approach of limit analysis, the present study proposes a method for calculating the bearing capacity of shallow strip footings located in unsaturated soils, taking four common types of soils as examples. The modified pseudo-dynamic (MPD) approach is used to calculate the seismic forces varying with time and space, and the layerwise summation method is used to derive the power generated by the seismic forces. In the calculation of internal energy dissipation, this paper introduces the effective stress based on the suction stress to derive the cohesion expression at different depths. The analytical formula of bearing capacity is obtained by the principle of virtual work, and its value is optimized by the Sequential Quadratic Programming (SQP) algorithm. In order to verify the validity of the proposed method, the present results are compared with the solutions published so far and a good agreement is obtained. Finally, a parametric study is performed to investigate the influence of different types of parameters on the bearing capacity.

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. Hemorrhagic pneumonia (adjusted HR 2.316, 95% CI 1.140–4.705; P = 0.020) was an independent risk factor of 30-day mortality in hematological patients with SM bacteremia. Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin (PCT). Multivariate analysis showed that neutropenia, high levels of PCT, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Neutropenia, high level of PCT and prior tigecycline therapy within 1 month were significant independent predictors of hemorrhagic pneumonia in hematologic patients with SM bacteremia. Due to no effective antibiotics to prevent hemorrhagic pneumonia, prophylaxis of SM infection and its progression to hemorrhagic pneumonia is particularly important.

Acute myeloid leukemia (AML) is a highly heterogeneous hematopoietic malignancy that strongly correlates with poor clinical outcomes. Ferroptosis is an iron-dependent, non-apoptotic form of regulated cell death which plays an important role in various human cancers. Nevertheless, the prognostic significance and functions of ferroptosis-related genes (FRGs) in AML have not received sufficient attention. The aim of this article was to evaluate the association between FRGs levels and AML prognosis using publicly available RNA-sequencing datasets. The univariate Cox regression analysis identified 20 FRGs that correlate with patient overall survival. The LASSO Cox regression model was used to construct a prognostic 12-gene risk model using a TCGA cohort, and internal and external validation proved the signature efficient. The 12-FRGs signature was then used to assign patients into high- and low-risk groups, with the former exhibiting markedly reduced overall survival, compared to the low-risk group. ROC curve analysis verified the predictive ability of the risk model. Functional analysis showed that immune status and drug sensitivity differed between the 2 risk groups. In summary, FRGs is a promising candidate biomarker and therapeutic target for AML.

Most of the published literature regarding bearing capacity are often focused on linear and associative soils. Concerning the intrinsic strength nonlinearity in dilatancy soils, this study investigates the problem of the seismic bearing capacity in the framework of the kinematic theorem of limit analysis. The conventional linear Mohr–Coulomb criterion is substituted with a nonlinear power law criterion to depict the nonlinearity of the soil strength. The non-associative feature of soil materials is considered by defining a nonlinear dilatancy coefficient. A generalized tangential technique is accordingly introduced to linearize the strength envelope for making the nonlinear criterion tractable in the analysis. A non-symmetrical translational failure mechanism that is comprised of several rigid wedges is used to characterize the failure of the foundation at the limit state. Moreover, the seismic action is considered by the classic pseudo-static method. Based upon the energy equilibrium theory of the upper-bound limit analysis, new analytical solutions are derived from the work-balanced equation with nonlinearity and dilatancy. This rigorous upper-bound solution is formulated as a multivariate optimization problem and is readily addressed by sequential quadratic programming (SQP). To verify the reliability of the new expressions, the present results are compared with already posted solutions and the original pseudo-dynamic solutions. The comparative results show a good agreement with previous works, and the correctness and rationality of the new analytical solutions are validated. The detailed parametric study reveals that, in the non-associative flow soils, the ultimate bearing capacity is significantly decreased with a reduction in the dilatancy coefficient. Particularly in the linear condition, namely m = 1, the larger the internal friction angle is, the more obvious the influence of the non-associative feature on the bearing capacity is.

MYD88/CD79B-mutated (MCD) genotype is a genetic subgroup of diffuse large B-cell lymphoma (DLBCL) with the co-occurrence of MYD88 L265P and CD79B mutations. MCD genotype is characterized by poor prognosis and extranodal involvement especially in immune-privileged sites. MCD model is dominated by activated B-cell (ABC)-like subtype of DLBCLs. It is generally accepted that the pathogenesis of MCD DLBCL mainly includes chronic active B-cell receptor (BCR) signaling and oncogenic MYD88 mutations, which drives pathological nuclear factor kappa B (NF-κB) activation in MCD lymphoid malignancies. CD79B and MYD88 L265P mutations are frequently and contemporaneously founded in B-cell malignancies. The collaboration of the two mutations may explain the unique biology of MCD. Meanwhile, standard immunochemotherapy combine with different targeted therapies worth further study to improve the prognosis of MCD, according to genetic, phenotypic, and clinical features of MCD type. In this review, we systematically described mechanism, clinical characteristics, and targeted therapy of MCD DLBCL.

Land finance is a special land financing mode in China under the nationalization of urban land since 1954. The policy authorizes local governments to collect fiscal revenue from land grant premiums and land taxes. As China is experiencing the social and economic transformation, heavily replying on land finance starts causing financial sustainable problems. Based on the spatial panel data of 30 provinces in China in the last two decades, we analyzed the spatial-temporal evolution of land finance. We found that the spatial variation of land finance declined during the period of study and decreased from east to west. The results revealed that land finance had significant positive spatial autocorrelation and robust spatial clustering characteristics. In addition, the spatial distribution of land finance was consistent with the population-based Hu Line. We also assessed land finance risks via a four-dimensional risk matrix through spatial panel regression (SPR). The spatial spillover effects suggested that there is inter-provincial imitation and collaboration but no competition. Our forecast indicates that most provinces will be at a relatively low risk level in the next decade except some southwest provinces. Based on the findings, we highlight the policy implications to mitigate risks and maintain sustainable land finance.

Seismic events are an active factor in causing slope instability, and the existing pseudo-dynamic method ignores some practical engineering conditions. In this paper, the seismic stability of three-dimensional (3D) two-step slopes is evaluated utilizing the modified pseudo-dynamic method based on the kinematical approach of limit analysis, in which the nonlinear characteristics of soil are considered using the generalized tangent technique. A 3D horn-like rotational failure mechanism is established to solve internal energy dissipation and external force work, in which the seismic work is considered in addition to the soil weight work and obtained by the layer-wise summation method. Based on the force-increase technique, the analytical expression for the safety factor (FS) of 3D two-step slopes is derived more readily. To verify the reliability of the new expression, the present results are compared with already posted solutions and the original pseudo-dynamic solutions. Ultimately, the sensitivity discussions are carried out to investigate the impacts of various factors on slope stability. This has some significance for the design and safety of 3D two-step slopes.

Steel-concrete composite beam has been widely applied in civil engineering, and the concrete during operation may crack due to the large shear force at the wet joint. A new concrete panel shear key with the boss is designed to strengthen the shear capacity of the wet joint part. Three different configurations of specimens are tested to study the shear capacity of the wet joint. These specimens include plain concrete specimens with shear keys, specimens with reinforcement and no shear key, and specimens with both shear keys and reinforcements. An experimental study is designed and conducted to verify the shear capacity of each specimen. The experimental results show that the ultimate shear capacity of the new wet joint structure is 73% higher than the conventional one. Meanwhile, the shear capacity of the new wet joint structure is theoretically predicted, and the finite element models are established to demonstrate the effectiveness of the experiment and the good performance of the new wet joint design.

The primary aim of the present retrospective study was to investigate lipid profiles and kinetics in acute promyelocytic leukemia (APL) patients. We analyzed 402 newly diagnosed APL patients and 201 non-APL patients with acute myeloid leukemia (as control). Incidence of hypertriglyceridemia in APL patients and non-APL patients was 55.82% and 28.4% (p = 0.0003). The initial levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were higher in APL patients than in control (all p < 0.0001). In APL patients, triglyceride levels were significantly increased during induction treatment with all-trans retinoic acid and arsenic. Multivariable analysis showed that age, being overweight (body mass index ≥25) and APL were independent risk factors for hypertriglyceridemia in all patients before treatment. High triglyceride levels were not significantly associated with disease-free survival or overall survival in the APL patients. In summary, in the current study triglyceride levels were significantly elevated in APL patients before treatment, and they increased during induction treatment, but there were no significant corresponding effects on survival.

Currently, coronavirus disease 2019 (COVID-19) has become the most severe infectious disease affecting the world, which has spread around the world to more than 200 countries in 2020. Until the number of COVID-19 vaccines is insufficient, nucleic acid testing is considered as an effective way to screen virus carriers and control the spread of the virus. Considering that the medical resources and infection rates are different across various countries and regions, if all infected areas adopt the traditional individual nucleic acid testing method, the workload will be heavy and time-consuming. Therefore, this will not lead to the control of the pandemic. After Wuhan completed a citywide nucleic acid testing in May 2020, China basically controlled the spread of COVID-19 and entered the post-epidemic period. Since then, although some cities in China, such as Qingdao, Xinjiang, Beijing, and Dalian, have experienced a local epidemic resurgence, the pandemic was quickly suppressed through wide-scale pooled nucleic acid testing methods. Combined with the successful experience of mass nucleic acid testing in China, this study introduces two main pooled testing methods used in two cities with a population of more than ten million people, Wuhan’s “five-in-one” and Qingdao’s “ten-in-one” rapid pooled testing methods. This study proposes an improved method for optimising the second round of “ten-in-one” pooled testing, known as “the pentagram mini-pooled testing method”, which speeds up the testing process (as a result of reducing the numbers of testing by 40%) and significantly reduces the cost. Qingdao’s optimised “ten-in-one” pooled testing method quickly screens out the infections by running fewer testing samples. This study also mathematically examines the probabilistic principles and applicability conditions for pooled testing of COVID-19. Herein, the study theoretically determines the optimal number of samples that could successfully be combined into a pool under different infection rates. Then, it quantitatively discusses the applicability and principles for choosing the pooled testing instead of individual testing. Overall, this research offers a reference for other countries with different infection rates to help them in implementing the mass testing for COVID-19 to reduce the spread of coronavirus.

Bridge deformation consists of cross-section rotation and deflection, which are crucial parameters for bridge capacity evaluation and damage detection. The maximum value of deflection usually happens at mid-span while for rotation it happens at two-ends. Therefore, compared with deflection, rotation is more convenient for in-situ measurement since the bridge pier can be the reference point. In this study, a high-precision inclinometer for bridge rotation measurement was conceptualized, designed, and validated. The proposed inclinometer converted the small rotation of bridge section into the deformation of an elastomer. Strain gauges were then utilized to measure the elastomer deformation and thus the bridge rotation can be obtained. The dimensions and modulus of the elastomer were designed and chosen based on the theoretical analysis. Characteristics of the inclinometer were calibrated in lab and in-situ experiments at an in-service bridge were conducted to validate its feasibility and robustness. Test results showed that the proposed inclinometer had excellent performance in resolution and accuracy, which indicate its great potential for future bridge health monitoring.

Gut microbiota has been implicated in the pathogenesis of many autoimmune diseases. This is still an area of active research given that the role of gut microbiota on the primary immune thrombocytopenia (ITP) remains unclear. In this study, fecal samples of 30 untreated adult primary ITP patients and 29 healthy controls (HCs) were used to investigate the gut microbial community and metabolite profiles. Our results show that fecal bacteria such as Blautia, Streptococcus, and Lactobacillus are enriched, whereas bacteria such as Bacteroides are depleted in ITP patients. Notably, fecal metabolites such as fatty acyls and glycerophospholipids are enriched and strongly correlate with discrepant gut microbiota. Furthermore, combinations of Weissella and Streptococcus anginosus, or Cer (t18:0/16:0), Cer (d18:1/17:0), and 13-hydroxyoctadecanoic acid could provide good diagnostic markers for ITP. Moreover, a strong negative correlation was found between platelet count and altered gut microbiota such as S. anginosus and gut metabolites such as Cer (t18:0/16:0) in ITP. In conclusion, dysbiosis of both gut microbiota and metabolome develops in ITP patients compared to HCs. Several ITP-altered gut bacteria and metabolites can be diagnostic biomarkers for ITP, and are highly correlated with platelet count, suggesting that they may also play a role in ITP pathogenesis.

BACKGROUND Haemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterised by activation of the mononuclear phagocytic system, and often leads to progressive multiple organ failure. The diagnosis of HLH is made late by most physicians. METHODS To confirm the diagnosis of acquired HLH made in a single-institution series of adult patients with HLH-04 criteria, we applied the HScore and evaluated prognostic factors associated with clinical outcome. RESULTS A total of 174 patients with a median age of 51 years (range 17–90) were included. Male/female ratio was 111/63. In 92/174 (52.9%) patients, there were potential haematological diseases (4 acute leukaemia, 1 thrombotic thrombocytopenic purpura, 3 Hodgkin’s lymphoma [HL], 17 B-cell non-Hodgkin’s lymphoma [NHL], 67 T-cell NHL including 22 natural killer / T-cell NHL [NK/t-cell NHL). Six (3.4%) patients had autoimmune disease and 76 (43.7%) undiagnosed underlying disease. There were 44 (25.3%) patients with Epstein-Barr virus infection, 11 (6.3%) with cytomegalovirus, 1 (0.5%) syphilis, 9 (5.2%) hepatitis B virus and 3 (1.7%) human immunodeficiency virus. More than 95% of patients had hyperferritinaemia, high lactate dehydrogenase, fever and low albumin, whereas 89.1% of patients had bone marrow phagocytosis. By the HScore, 4/174 patients had a >50% and 16/174 patients had a >90% probability of not having HLH. All 174 patients fulfilled more than five of the HLH-04 diagnostic criteria, but 16 of them had a low probability of HLH by the HScore. In a multivariate analysis, lymphopenia and hypofibrinogenaemia were independent prognostic factors for death. CONCLUSION In our study, viral infection was not an independent prognostic factor. NK/T-cell -NHL was associated with worse prognosis compared with B-cell NHL and T-cell NHL (p = 0.036) and similar to other aetiologies.

There is an increasing demand for feed as the industrialization of hog production in China. Land scarcity limits China's ability to continue increasing its hog production without feed imports, particularly soybean, and the feed markets are increasingly integrated into the global market. This study performs an analysis of price transmission between the hog price in China and feed prices, specifically domestic maize price and international soybean price, from January 2000 to April 2014. We identified a long-term stable equilibrium relationship between the three markets. However, further analyses show that there is no significant Granger causality between hog and feed market, and the long-run equilibrium partially results from Granger causality between the international soybean market and domestic maize market. This suggests that the domestic hog market has been distorted by different policies. The results also indicate that the efficiency of price transmission is very low and it takes about 11 months to correct one-half of any long-run disequilibrium for the hog market in China. Therefore, to stabilize hog price in China, only market intervention to regulate the maize and soybean markets would be insufficient and comprehensive measures need to be taken into account such as hog production modernization, agricultural insurance, epidemic surveillance etc.

BACKGROUND:In China, the combination of homoharringtonine, cytarabine, and G-CSF (HAG) has been extensively applied for treatment of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). METHODS:We performed a meta-analysis of 2,314 patients (AML, n = 1754; MDS, n = 560) to determine the overall safety and efficacy of this regimen. RESULTS:The complete response (CR) rate of AML patients (53%) was significantly higher than that of MDS/transformed-AML patients (45%; P = 0.007). The CR rate of patients with newly diagnosed AML (62%) was significantly higher than in patients with relapsed/refractory AML (50%; P = 0.001). There were no significant difference in CR rates between elderly AML patients (54%) and all AML patients (P = 0.721). When compared with non-HAG regimens for AML/MDS induction therapy, the CR rate of patients treated with HAG was significantly higher than in treated with intensive chemotherapy (P = 0.000). No significant differences in CR rates were observed between patients treated with HAG and those treated with CAG (cytarabine, aclarubicin, G-CSF) regimens (P = 0.073). HAG regimen was well tolerated, with early death (ED) in 2%, grade IV myelosurrpression in 52% and infection in 50%. Reports of ED and rates of myelosuppression were reduced as compared with intensive chemotherapy (P = 0.000 and P = 0.000, respectively). CONCLUSION:The HAG regimen is an effective and safe regimen for the treatment of AML and MDS, and appears to be more effective and better tolerated than intensive chemotherapy. Future randomized controlled trials and further meta-analyses are strongly needed to confirm its efficacy and safety, especially in comparison with intensive chemotherapy.

Abstract Background Although economic reforms have brought significant benefits, including improved health care to many Chinese people, accessibility to improved care has not been distributed evenly throughout Chinese society. Also, the effects of the uneven distribution of improved healthcare are not clearly understood. Evidence suggests that mortality is an indicator for evaluating accessibility to improved health care services. We constructed spatially smoothed risk maps for gender-specific adult mortality in an area of southern China comprising both urban and rural areas and identified ecological factors of gender-specific mortality across societies. Results The study analyzed the data of the Hechi Prefecture in southern in China. An average of 124,204 people lived in the area during the study period (2002–2004). Individual level data for 2002–2004 were grouped using identical rectangular cells (regular lattice) of 0.25 km2. Poisson regression was fitted to the group level data to identify gender-specific ecological factors of adult (ages 15– Conclusion We found a disparity in mortality rates between rural and urban areas in the study area in southern China, especially for adult men. There were also differences in mortality rates between poorer and wealthy populations in both rural and urban areas, which may in part reflect differences in health care quality. Spatial influences upon adult male versus adult female mortality difference underscore the need for more research on gender-related influences on adult mortality in China.

Background: Light-chain proximal tubulopathy (LCPT) is a rare disease characterized by the accumulation of monoclonal light chains within proximal tubular cells. This study aimed to investigate the clinical characteristics of LCPT from a single Chinese nephrology referral center. Methods: Patients with kidney biopsy-proven isolated LCPT between 2016 and 2022 at Peking University First Hospital were retrospectively included. Clinical data, kidney pathological type, treatment, and prognosis were analyzed. Results: Nineteen patients were enrolled, the mean age at diagnosis was 57±11 and the sex ratio was 6/13 (female/male). Mean proteinuria was 2.44±1.89g/24hr and the mean estimated glomerular filtration rate (eGFR) at the point of biopsy was 59.640±27.449ml/min/1.73 m². κ-restriction (84%) was dominant among LCPTs. An abnormal free light chain ratio was observed in 86% of the patients. Proximal tubulopathy with cytoplasmic inclusions accounted for the majority (53%), followed by tubulopathy associated with interstitial inflammation reaction (26%), proximal tubulopathy without cytoplasmic inclusions (16%), and proximal tubulopathy with lysosomal indigestion/constipation (5%). One patient presented with acute kidney injury and 16 patients presented with chronic kidney disease. Regarding follow-up, patients received bortezomib-based or R-CHOP chemotherapy or supportive treatment only. The mean follow-up time was 22±16months, and the mean eGFR was 63.098±27.439ml/min/1.73 m² at the end of follow-up. These patients showed improved or stable kidney function. Conclusions: This is the first case series report of LCPT in four different pathological types in northern China. Clone-targeted chemotherapy may help preserve the kidney function in these patients. [ABSTRACT FROM AUTHOR]

Context: Cardio-cerebrovascular events are severe complications of diabetes. Objective: We aim to compare the incident risk of cardio-cerebrovascular events in maturity onset diabetes of the young (MODY), type 1 diabetes, and type 2 diabetes. Methods: Type 1 diabetes, type 2 diabetes, and MODY were diagnosed by whole exome sequencing. The primary endpoint was the occurrence of the first major adverse cardiovascular event (MACE), including acute myocardial infarction, heart failure, stroke, unstable angina pectoris, and cardio-cerebrovascular-related mortality. Cox proportional hazards models were applied and adjusted to calculate hazard ratios (HRs) and 95% CIs for the incident risk of MACE in type 1 diabetes, type 2 diabetes, MODY, and MODY subgroups compared with people without diabetes (control group). Results: Type 1 diabetes, type 2 diabetes, and MODY accounted for 2.7%, 68.1%, and 11.4% of 26 198 participants with diabetes from UK Biobank. During a median follow-up of 13 years, 1028 MACEs occurred in the control group, contrasting with 70 events in patients with type 1 diabetes (HR 2.15, 95% CI 1.69-2.74, P < .05), 5020 events in patients with type 2 diabetes (HR 7.02, 95% CI 6.56-7.51, P < .05), and 717 events in MODY (HR 5.79, 95% CI 5.26-6.37, P < .05). The hazard of MACE in HNF1B-MODY was highest among MODY subgroups (HR 11.00, 95% CI 5.47-22.00, P = 1.5 × 10-11). Conclusion: MODY diagnosed by genetic analysis represents higher prevalence than the clinical diagnosis in UK Biobank. The risk of incident cardio-cerebrovascular events in MODY ranks between type 1 diabetes and type 2 diabetes. [ABSTRACT FROM AUTHOR]