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Abstract Background The increasing prevalence of multimorbidity has created a serious global public health problem in aging populations. Certain multimorbidity patterns across different age ranges and their association with health status remain unclear. The main aim of this study is to identify multimorbidity patterns discrepancies and associated health status between younger-old and oldest-old. Methods The Ethics Committee of Nanjing Medical University approved the study protocol (No.2019–473). Convenience sampling method was used to recruit older adults aged ≥ 60 years with multimorbidity from July to December 2021 from 38 Landsea long-term care facilities in China. The multimorbidity patterns were analyzed using network analysis and two-step cluster analysis. One-Way ANOVA was utilized to explore their association with health status including body function, activity of daily living, and social participation. A Sankey diagram visualized the flow of health status within different multimorbidity patterns. This study is reported following the STROBE guidelines. Results A total of 214 younger-old (60–84 years) and 173 oldest-old (≥ 85 years) were included. Leading coexisting diseases were cardiovascular disease (CD), metabolic and endocrine disease (MED), neurological disease (ND), and orthopedic disease (OD). Cluster 1 (53, 24.8%) of CD-ND (50, 94.3%; 31, 58.8%), cluster 2 (39, 18.2%) of MED-ND-CD (39, 100%; 39, 100%; 37, 94.9%), cluster 3 (37, 17.3%) of OD-CD-MED-ND (37, 100%; 33, 89.2%; 27, 73.0%; 16, 43.2%), and cluster 4 (34, 15.9%) of CD-MED (34, 100%; 34, 100%) were identified in the younger-old. In the oldest-old, the primary multimorbidity patterns were: cluster 1 (33, 19.1%) of CD-respiratory disease-digestive disease-urogenital disease (CD-RD-DSD-UD) (32, 97.0%; 9, 27.3%; 8, 24.2%; 7, 21.2%), cluster 2 (42, 24.3%) of ND-CD-MED (42, 100%; 35, 83.3%; 14, 33.3%), cluster 3 (28, 16.2%) of OD-CD-MED (28, 100%; 25, 89.3%; 18, 64.3%), and cluster 4 (35, 20.2%) of CD-MED (35, 100%; 35, 100%). Younger-old with CD-ND or MED-ND-CD, and oldest-old with ND-CD-MED have worse health status compared with other multimorbidity patterns (e.g., CD-MED and OD-CD-MED). Conclusion Discrepancies in common patterns of multimorbidity across age groups suggest that caregivers in long-term care facilities should consider changes in multimorbidity patterns with ageing when developing prevention plans for individualized management. Neurological disease concurrent with other diseases was the major determinant of health status, especially for the oldest-old. Interventions targeting multimorbidity need to be focused, yet generic. It is essential to assess complex needs and health outcomes that arise from different multimorbidity patterns and manage them through an interdisciplinary approach and consider their priorities to gain high-quality primary care for older adults living in long-term care facilities.

Ticks are primary vectors for many tick-borne pathogens (TBPs) and pose a serious threat to veterinary and public health. Information on the presence of TBPs in Chinese Milu deer (Elaphurus davidianus) is limited. In this study, a total of 102 Chinese Milu deer blood samples were examined for Anaplasma spp., Theileria spp., Babesia spp., Rickettsia spp., and Borrelia spp., and three TBPs were identified: Anaplasma phagocytophilum (48; 47.1 %), Candidatus Anaplasma boleense (47; 46.1%), and Theileria capreoli (8; 7.8 %). Genetic and phylogenetic analysis of the 16S rRNA and 18S rRNA confirmed their identity with corresponding TBPs. To our knowledge, this is the first report on Candidatus A. boleense and T. capreoli detection in Chinese Milu deer. A high prevalence of A. phagocytophilum with veterinary and medical significance was identified in endangered Chinese Milu deer, which could act as potential zoonotic reservoirs. The identification of the TBPs in Chinese Milu deer provides useful information for the prevention and control of tick-borne diseases.

Background Photodynamic therapy (PDT) has been strongly recommended as an excellent alternative treatment for Bowen disease (BD). However, reported data on 5-aminolaevulinic acid-mediated PDT (ALA-PDT) with red-light irradiation are limited and the long-term effectiveness remains to be determined, especially in dark-skinned populations. Objectives We aimed to review routine clinical practice in the field of BD treatment with ALA-PDT over an extended study period (2011–2021), calculate the overall clearance rate, and explore and evaluate factors that might affect the effectiveness of therapy in a real-world setting. Methods The medical records of patients with BD who received ALA-PDT with red-light irradiation between February 2011 and June 2021 were reviewed and summarized. Univariate and multivariate analyses of clinically relevant variables that may affect treatment outcomes were conducted to identify risk predictors. Results The overall clearance rate of 122 BD lesions was 89.3% with a median follow-up time of 36 months. The correlation between the effectiveness and fluorescence intensity of pre-PDT or PDT sessions was statistically significant after eliminating the interference of confounding factors. All recurrences occurred in the first 2 years following ALA-PDT. Conclusions ALA-PDT is an effective treatment for BD in patients with darker-coloured skin. Well-executed operations and effective pretreatment are the determinants of effectiveness. Fluorescence intensity of pre-PDT appeared to be a significant predictor of final effectiveness. In addition, 2 years of follow-up is necessary following ALA-PDT. [ABSTRACT FROM AUTHOR]

A highly graphitized carbon on a silicon monoxide (SiO) surface coating at low temperature, based on polymer precursor π⁻π stacking, was developed. A novel conductive and electrochemically stable carbon coating was rationally designed to modify the SiO anode materials by controlling the sintering of a conductive polymer, a pyrene-based homopolymer poly (1-pyrenemethyl methacrylate; PPy), which achieved high graphitization of the carbon layers at a low temperature and avoided silicon carbide formation and possible SiO material transformation. When evaluated as the anode of a lithium-ion battery (LIB), the carbon-coated SiO composite delivered a high discharge capacity of 2058.6 mAh/g at 0.05 C of the first formation cycle with an initial Coulombic efficiency (ICE) of 62.2%. After 50 cycles at 0.1 C, this electrode capacity was 1090.2 mAh/g (~82% capacity retention, relative to the capacity of the second cycle at 0.1 °C rate), and a specific capacity of 514.7 mAh/g was attained at 0.3 C after 500 cycles. Furthermore, the coin-type full cell composed of the carbon coated SiO composite anode and the Li[Ni0.5Co0.2Mn0.3O₂] cathode attained excellent cycling performance. The results show the potential applications for using a π⁻π stacking polymer precursor to generate a highly graphitize coating for next-generation high-energy-density LIBs.

A highly graphitized carbon on a silicon monoxide (SiO) surface coating at low temperature, based on polymer precursor π⁻π stacking, was developed. A novel conductive and electrochemically stable carbon coating was rationally designed to modify the SiO anode materials by controlling the sintering of a conductive polymer, a pyrene-based homopolymer poly (1-pyrenemethyl methacrylate; PPy), which achieved high graphitization of the carbon layers at a low temperature and avoided silicon carbide formation and possible SiO material transformation. When evaluated as the anode of a lithium-ion battery (LIB), the carbon-coated SiO composite delivered a high discharge capacity of 2058.6 mAh/g at 0.05 C of the first formation cycle with an initial Coulombic efficiency (ICE) of 62.2%. After 50 cycles at 0.1 C, this electrode capacity was 1090.2 mAh/g (~82% capacity retention, relative to the capacity of the second cycle at 0.1 °C rate), and a specific capacity of 514.7 mAh/g was attained at 0.3 C after 500 cycles. Furthermore, the coin-type full cell composed of the carbon coated SiO composite anode and the Li[Ni0.5Co0.2Mn0.3O₂] cathode attained excellent cycling performance. The results show the potential applications for using a π⁻π stacking polymer precursor to generate a highly graphitize coating for next-generation high-energy-density LIBs.

Abstract Premature ovarian failure (POF) is one of the common disorders found in women leading to 1% female infertility. Clinical features of POF are hypoestrogenism or estrogen deficiency, increased gonadotropin level, and, most importantly, amenorrhea. With the development of regenerative medicine, human mesenchymal stem cell (hMSC) therapy brings new prospects for POF. This study aimed to describe the types of MSCs currently available for POF therapy, their biological characteristics, and their mechanism of action. It reviewed the latest findings on POF to provide the theoretical basis for further investigation and clinical therapy.

Medicago ruthenica is an important perennial forage with multiple characteristics of resistance. In this study, we sequenced and characterized the complete chloroplast genome of M. ruthenica ‘Taihang’, which is 124, 254 bp in length. A total of 108 genes were identified, including 74 protein-coding, 30 tRNA, and four rRNA genes. Phylogenetic analysis based on 27 chloroplast genomes showed that M. ruthenica ‘Taihang’ has a close relationship with M. ruthenica from Qinghai Province, China. The data are useful in better understanding the genetic diversity and stress resistance of Medicago and contribute to the phylogenetic study of Trifolieae.

Deploying the dynamic wireless power transfer (DWPT) equipment at intersections can improve the transportation efficiency and decrease the energy consumption. It can easily turn the disadvantages of waiting time for red phase into the advantages of charging benefits for electric vehicles (EVs). This study develops a multiobjective speed planning model with differentiated charging strategy to optimize the EV's trajectory at signalized intersections with DWPT. To mitigate the negative impact of DWPT, the proposed model is divided into charging priority driving (C-eco-driving) mode and time priority driving (T-eco-driving) mode for connected and automated electric vehicles (CAEVs) to apply different scenarios. Meanwhile, a widely applied car-following model, i.e., the Intelligent Driver Model (IDM), has been calibrated with the ground-truth dataset to meet the intersection characteristic for EVs in mixed traffic. The efficiency and robustness of two eco-driving modes were validated in single-vehicle and mixed traffic based on MATLAB simulation. For single vehicle, the electricity benefits of the C-eco-driving mode and T-eco-driving mode increase about 0.0867kWh and 0.0532kWh, respectively. T-eco-driving mode reduces 2.5s of travel time. For mixed traffic, the C-eco-driving mode provides more charging benefits about 51~73% than no-control strategy. In contrast, the T-eco-driving mode provides significant time benefits of 2.6s and slight electricity benefits of 12~30% than no-control strategy. The increment of market penetration rate and wireless charging length can significantly improve the charging benefits. When charging length has the same value, the closer the DWPT facilities to the intersection, the more obvious the charging benefits., Author(s): Lan Yang [1]; Mengjie Han (corresponding author) [1]; Shan Fang [1]; Guoyuan Wu [2]; He Sheng [1]; Heng Wei [3]; Xiangmo Zhao [1] 1. Introduction EVs have been recognized [...]

Background: Obesity is an independent risk factor for cardiovascular disease. We investigated whether and to what extent visceral obesity-related indices were associated with coronary collateralization (CC) in chronic total occlusion (CTO) patients.Methods: This retrospective cohort study involved 1,008 consecutive patients with CTO who underwent CTO-percutaneous coronary artery intervention (PCI). CC was graded according to the Rentrop scoring system. Data on demographic and clinical characteristics were collected by cardiovascular doctors. Logistic regression, receiver operating characteristic (ROC) curve and Kaplan-Meier analyses were performed to assess the predictive value of visceral obesity-related indices for CC.Results: Overall, 1,008 inpatients were assigned to the poor CC group (n = 592) and good CC group (n = 416). In multivariate-adjusted logistic regression analyses, all visceral obesity-related indices (P-value < 0.001) were significantly associated with CC. After ROC analysis and the Delong test, the Chinese visceral adiposity index (CVAI) had the largest area under the curve (AUC) of 0.741 (0.711–0.771). Further analysis revealed that CVAI quartile remained a risk factor for poor CC in all groups, CVAI was associated with a 1.018-fold higher risk of poor CC (OR = 1.018, 95% CI: 1.014–1.021, P < 0.001). Individuals in the top CVAI quartile group had the highest risk of poor CC (OR = 10.657, 95% CI: 6.492–17.493, P < 0.001). Subgroup analyses showed similar results, and CVAI quartile remained a risk factor for poor CC. Moreover, increased CVAI predicted poor prognosis in CTO patients.Conclusion: In summary, this study indicated that all the increased visceral obesity-related indices were significantly associated with increased poor CC risk. After adjusting for potential risks, CVAI had the best performance for estimating CC and predicting prognosis in CTO patients.

Bothriochloa ischaemum (Linn.) 1936 is a high-quality perennial forage in Loess Plateau of China. In this study, we sequenced and characterized the complete chloroplast genome of B. ischaemum, which was a circular DNA of 138,316 bp in length, including a large single copy (LSC) region of 80,226 bp, a small single copy (SSC) region of 12,526 bp, and the circular DNA was separated by a pair of identical inverted repeat regions (IRs) of 22,782 bp each. A total of 134 genes were identified, including 87 protein-coding genes, 39 tRNA genes, and eight rRNA genes. Phylogenetic tree showed that B. ischaemum was closer to B. decipiens and B. alta, genus Bothriochloa was closely related to genus Pseudanthistiria. Our findings will be helpful for better understanding of genetic diversity of Bothriochloa plants.

Many studies have simulated traffic behavior at signalized intersections using various Car-Following (CF) models. However, the performance of which CF Model is superior at signalized intersections has not been thoroughly analyzed and evaluated. In this study, two novel Artificial Neural Network (ANN) CF models, the Convolutional Neural Network--Long Short-term Memory (CNN-LSTM) and the Convolution-LSTM (Conv-LSTM)--are first applied to predict CF behaviors at signalized intersections. Both models can extract spatial and temporal information to address the long-term dependency problem more effectively. Based on the filtered NGSIM dataset, we conduct a comparative empirical study of three conventional CF models and five ANN CF models. The dataset is divided into two categories based on the characteristics of CF behavior at signalized intersections: continuous and discontinuous. The experiments demonstrated that ANN CF models outperformed conventional CF models when the output was the velocity in two categories of traffic flow but only failed to do so when the output was acceleration in discontinuous traffic flow. The proposed models were capable of accurately predicting acceleration, but the traffic fluctuations also existed as time passed. Additionally, it was discovered that while the ANN CF model is preferable for traffic flow simulation, the conventional CF model still cannot be ignored for discontinuous traffic flow simulation, particularly when acceleration is required., Author(s): Lan Yang [1]; Shan Fang (corresponding author) [1]; Guoyuan Wu [2]; He Sheng [1]; Zhigang Xu [1]; Mengxiao Zhang [1]; Xiangmo Zhao [1] 1. Introduction With the development of [...]

In order to track the research progress of AEB-related technologies, this paper makes a systematic analysis and research on the impact factors, key technologies, and effect evaluation of AEB. First, the paper deeply analyzes the three levels of factors affecting the performance of AEB, which are vehicle factors, driver factors, and environmental factors. Second, the paper deeply studies the technical status of the three subsystems of environment perception, decision-making, and control execution. Particularly, the performance of Mazda, Honda, NHTSA, Berkeley, and Seungwuk Moon are compared and analyzed based on MATLAB. Third, the paper summarizes the current AEB virtual test methods, closed field test methods, and its test sites. Three classic evaluation methods in the world, including the AEB test evaluation standards of ENCAP, IIHS, and i-Vista are analyzed. Finally, the paper prospects the specific research directions, including the protection of vulnerable road users, target detection method, collision avoidance strategy, complex scenarios application, and application of emerging technologies., Author(s): Lan Yang [1]; Yipeng Yang (corresponding author) [1]; Guoyuan Wu (corresponding author) [2]; Xiangmo Zhao [1]; Shan Fang [1]; Xishun Liao [2]; Runmin Wang [1]; Mengxiao Zhang [1] 1. [...]

ObjectivesA combined equation based on white cell count (WCC) and total bilirubin (TB) was assessed for its ability to predict adverse clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI).DesignA single-centre, prospective cohort study.SettingThe First Affiliated Hospital of Xinjiang Medical University.MethodA total of 615 patients with STEMI postprimary PCI were enrolled. WCC and TB were collected at admission. Logistic regression was used to determine the combined equation. The primary endpoints were in-hospital mortality and major adverse cardiovascular events (MACE), which composed of cardiac death, cardiac shock, malignant arrhythmia (ventricular tachycardia, ventricular fibrillation), severe cardiac insufficiency, non-fatal myocardial infarction, angina pectoris readmission, severe cardiac insufficiency (cardiac III–IV level), stent restenosis and target vessels revascularisation during the hospitalisation and 36 months follow-up period.Result77 patients occurred in MACE during the hospitalisation (17 in-hospital mortality). WCC and TB were taken as an independent variables to make a category of logistic regression analysis of in-hospital MACE, the logistic regression model was: logit (P)=−8.00+0.265 WCC+0.077 TB, the combination of WCC and TB was more valuable on evaluating the in-hospital mortality (area under the curve 0.804, 95% CI 0.678 to 0.929, p