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Abstract Aim To explore the feasibility and effectiveness of an alternating shift pattern in two-hour segments in the state of emergency management of public health events. Methods A cross-sectional research design was conducted in our study. The nursing staff working in the admission ward of suspected or confirmed patients with COVID-19 in December 2022 were selected as subjects by the whole-group sampling method. We adopted a shift pattern of alternating shifts every two-hour in the isolation wards. The vital signs parameters were captured by uniformly wearing the multi-signs sensing devices, and the questionnaires collected the symptoms. Results Sixty-seven female participants, with a mean age of 33.09 ± 5.96 years, were included in this study. Measurements of body temperature (T), blood oxygen saturation (SpO2), respiratory rate (RR), and heart rate (HR) while wearing personal protective equipment (PPE) all remained within normal limits. None of the nurses reported sweating, dizziness, blurred vision, palpitations, or dyspnea. Statistical analysis showed significant differences between the critical care group and the non-critical care group in terms of age (P = 0.041), working duration (P = 0.036), and the total number of entries into isolation areas for nursing care (rounds) (P = 0.007). However, there were no statistically significant differences in vital signs based on age, work duration, or body mass index (BMI). The data indicated a notable increase in body temperature compared to other vital sign parameters with increasing work time while wearing PPE. Body temperature approached the upper limit when working close to 2 h long. Conclusions The alternating shift pattern in two-hour segments can effectively maintain the physical well-being of nurses wearing PPE without increasing the burden on nursing staff or the wastage of protective materials. This approach is recommended for addressing similar public health events in the future.

Summary: Increasing cohort studies have examined the link between mitochondrial DNA copy number (mtDNA-CN) and cardiovascular disease (CVD), with inconsistent findings. We searched PubMed, EMBASE, and Web of Science up to July 11, 2023 and used a random-effects model to calculate summary hazard ratios (HRs) and 95% confidence intervals (CIs). This systematic review and meta-analysis included 8 articles encompassing 29 studies with 646,398 participants. Individuals with the lowest mtDNA-CN had a summary HR of 1.27 (95% CI 1.02–1.59) for CVD, 1.18 (95% CI 0.92–1.50) for coronary heart disease (CHD), 1.10 (95% CI 0.89–1.37) for stroke, and 1.30 (95% CI 1.07–1.56) for heart failure (HF). Decreased mtDNA-CN is linked to an increased risk of CVD and HF but not CHD and stroke. These findings suggest mtDNA-CN from leukocytes may be a potential early biomarker for CVD. However, more prospective studies with long follow-up are needed.

IntroductionAcinetobacter baumannii (AB) is rising as a human pathogen of critical priority worldwide as it is the leading cause of opportunistic infections in healthcare settings and carbapenem-resistant AB is listed as a “super bacterium” or “priority pathogen for drug resistance” by the World Health Organization.MethodsClinical isolates of A. baumannii were collected and tested for antimicrobial susceptibility. Among them, carbapenem-resistant and carbapenem-sensitive A. baumannii were subjected to prokaryotic transcriptome sequencing. The change of sRNA and mRNA expression was analyzed by bioinformatics and validated by quantitative reverse transcription-PCR.ResultsA total of 687 clinical isolates were collected, of which 336 strains of A. baumannii were resistant to carbapenem. Five hundred and six differentially expressed genes and nineteen differentially expressed sRNA candidates were discovered through transcriptomic profile analysis between carbapenem-resistant isolates and carbapenem-sensitive isolates. Possible binding sites were predicted through software for sRNA21 and adeK, sRNA27 and pgaC, sRNA29 and adeB, sRNA36 and katG, indicating a possible targeting relationship. A negative correlation was shown between sRNA21 and adeK (r = -0.581, P = 0.007), sRNA27 and pgaC (r = -0.612, P = 0.004), sRNA29 and adeB (r = -0.516, P = 0.020).DiscussionThis study preliminarily screened differentially expressed mRNA and sRNA in carbapenem-resistant A. baumannii, and explored possible targeting relationships, which will help further reveal the resistance mechanism and provide a theoretical basis for the development of drugs targeting sRNA for the prevention and treatment of carbapenem-resistant A. baumannii infection.

Abstract Background This study used a bidirectional 2-sample Mendelian randomization study to investigate the potential causal links between mtDNA copy number and cardiometabolic disease (obesity, hypertension, hyperlipidaemia, type 2 diabetes [T2DM], coronary artery disease [CAD], stroke, ischemic stroke, and heart failure). Methods Genetic associations with mtDNA copy number were obtained from a genome-wide association study (GWAS) summary statistics from the UK biobank (n = 395,718) and cardio-metabolic disease were from largest available GWAS summary statistics. Inverse variance weighting (IVW) was conducted, with weighted median, MR-Egger, and MR-PRESSO as sensitivity analyses. We repeated this in the opposite direction using instruments for cardio-metabolic disease. Results Genetically predicted mtDNA copy number was not associated with risk of obesity (P = 0.148), hypertension (P = 0.515), dyslipidemia (P = 0.684), T2DM (P = 0.631), CAD (P = 0.199), stroke (P = 0.314), ischemic stroke (P = 0.633), and heart failure (P = 0.708). Regarding the reverse directions, we only found that genetically predicted dyslipidemia was associated with decreased levels of mtDNA copy number in the IVW analysis (β= − 0.060, 95% CI − 0.044 to − 0.076; P = 2.416e−14) and there was suggestive of evidence for a potential causal association between CAD and mtDNA copy number (β= − 0.021, 95% CI − 0.003 to − 0.039; P = 0.025). Sensitivity and replication analyses showed the stable findings. Conclusions Findings of this Mendelian randomization study did not support a causal effect of mtDNA copy number in the development of cardiometabolic disease, but found dyslipidemia and CAD can lead to reduced mtDNA copy number. These findings have implications for mtDNA copy number as a biomarker of dyslipidemia and CAD in clinical practice.

Abstract Background Alzheimer’s disease (AD) is the most prevalent neurodegenerative and remains incurable. Aluminum is a potent neurotoxin associated with AD. The main pathological features of AD are extracellular amyloid-β protein deposition and intracellular hyperphosphorylated Tau protein. A body of evidence suggest that oxidative stress and autophagy are involved in the pathogenesis of AD. Andrographis paniculata (AP) is a native plant with anti-inflammatory, anti-oxidative stress, and regulation of autophagy properties. AP significantly alleviated cognitive impairments, reduced Aβ deposition and has neuroprotective effect. However, its effects on aluminum-induced AD model have not been studied much. In this study, we investigated whether AP protect against aluminum-induced neurotoxicity through regulation of p62-Kelch-like ECH-associated protein 1(Keap1)-Nuclear factor E2 related factor 2 (Nrf2) pathway and activation autophagy in vivo and in vitro. Methods UPLC-ESI-qTOF-MS/MS was used to identify the chemical constituents of AP ethanol extract. The mice with cognitive deficit were established by injecting aluminum chloride and D-galactose, and treated with either AP extract (200, 400, or 600 mg/kg/d) or andrographolide (2 mg/kg/2d).The spatial memory ability was detected by Morris water maze, HE staining were used to detect in brain tissue,Oxidative stress indexs and SOD activity in both serum and brain tissue were detected by kit.The expression of p62-Nrf2 pathway proteins were measured via western blotting. Furthermore, the neurotoxicity model was induced by aluminum maltolate (700 µM) in PC12 cells. Following AP and andrographolide treatment, the cell viability was detected. The relevant mRNA and protein expressions were detected in cells transfected with the p62 siRNA. Results The main active components of AP included andrographolide, neoandrographolide and deoxyandrographolide as identified. AP and andrographolide significantly improved the spatial memory ability of mice, attenuated pathological changes of hippocampal cells, reduced the level of malondialdehyde, and increased superoxide dismutase activity in serum or brain tissue as compared to model control. In addition, the Nrf2, p62 and LC3B-II proteins expression were increased, and p-Tau and Keap1 proteins were decreased in the hippocampus after AP and andrographolide treatment.Furthermore, AP increased aluminum maltolate-induced cell viability in PC12 cells. Silencing p62 could reverse the upregulation expression of Nrf2 and downregulation of Keap1 and Tau proteins induced by AP in aluminum maltolate-treated cells. Conclusions AP had neuroprotective effects against aluminum -induced cognitive dysfunction or cytotoxicity, which was involved in the activation of the p62-keap1-Nrf2 pathway and may develop as therapeutic drugs for the treatment of AD. However, this study has certain limitations, further optimize the protocol or model and study the molecular mechanism of AP improving AD.

Infantile Malignant Osteopetrosis (IMO) is a rare, severe autosomal recessive form of osteopetrosis. Here, the peripheral blood mononuclear cells (PBMCs) extracted from a patient with IMO carrying a compound heterozygous mutation in T cell immune regulator 1, ATPase H + transporting V0 subunit a3 (TCIRG1) gene (c.242delC; c.1114C > T) were successfully reprogrammed using Sendai virus encoding the four Yamanaka factors. The generated hiPSCs, IMO-hiPSCs, displayed typical embryonic stem cell-like morphology and were verified by expression of pluripotency markers such as OCT4, SOX2, NANOG, TRA-1–60 and SSEA4, as well as in vivo and in vitro differentiation into derivatives of three germ layers.

Abstract The assembled camshaft is a novel manufacturing product which connects the cam and the mandrel by tube hydroforming (THF) technology after they are processed separately. However, in the process of THF, the structure of the cam-bores has a crucial influence on the connection strength of the assembled camshafts. Therefore, three kinds of cam-bores with circular structure, isometric-trilateral profile and logarithmic spiral profile are selected for hydroforming with a hollow mandrel (tube) in this study. The finite-element-analysis is carried out by ABAQUS software, the variations of (residual) contact pressure and contact area under different structures are obtained, and the torsional angle variations after assembly are measured. Further, the connection strength of the assembled camshaft under three structures is discussed. The results show that the evaluation of connection strength of the assembled camshaft is affected by many factors, including contact pressure, maximum residual contact pressure, axial and circular residual contact pressure, contact area and its rate, residual contact area percentage and torsional angle. Through the comprehensive analysis of various factors, the torsional angle of the camshaft with circular structure is the largest, i.e. poor connection strength. By contrast, the torsional strength of the camshaft with isometric-trilateral profile is the largest, namely, the best connection strength.

ObjectivesTo conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and insoluble fiber intake and risk of all causes, cardiovascular disease (CVD), and cancer mortality and quantitatively assess the dose–response relation.MethodsEligible studies were identified by searching PubMed, Embase and Web of science before August 2023. Random effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CI) and restricted cubic splines to model the linear/non-linear association.ResultsThe summary RR for all-cause, CVD and cancer mortality of dietary fiber was 0.90 (95% CI: 0.86,0.93), 0.87 (0.84,0.91), 0.91 (0.88,0.93), respectively. Significant association was observed for all-cause and CVD mortality with fruit, vegetable cereal and soluble fiber intake and cancer mortality with cereal fiber intake. No significant association was found for insoluble fiber, vegetable or fruit fiber intake and cancer mortality. Dose-response analysis showed a significant non-linear relation of dietary fiber intake with all-cause mortality, and linear relation for others.ConclusionsHigher dietary fiber including different type and food sources of fiber intake were associated with lower risk of mortality. Our findings provide more comprehensive evidence on dietary fiber intake with mortality.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier: CRD42022338837.

BackgroundHealthcare workers were at high risk of psychological problems during the COVID-19 pandemic, but it remains not well-investigated in the post-pandemic era of COVID-19, with regular epidemic prevention and control embedded in burdened healthcare work. This study aimed to investigate the prevalence and potential risk factors of the symptoms of depression and anxiety among healthcare workers at a tertiary hospital in Shenzhen.MethodOur cross-sectional study was conducted among 21- to 64-year-old healthcare workers in December 2021 at a tertiary hospital in Shenzhen, using a simple random sampling strategy. A wide range of socio-demographic characteristics, individual information, and psychological condition of the subjects were extracted. Healthcare workers' psychological conditions were tested with the Center for Epidemiologic Studies Depression (CESD-10), General Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Work-Family Conflict Scale (WFCS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and 17-item of Maslach's Burnout Inventory-Human Services Survey (MBI-HSS-17). Data were collected based on these questionnaires. Descriptive statistics were used to assess the difference between healthcare workers with depressive and anxiety symptoms among different groups. Hierarchical logistic regression analyses were conducted to investigate the association between focused variables and mental health outcomes.ResultsA total of 245 healthcare workers were enrolled. The proportion of depressive symptoms, anxiety symptoms and their co-occurrence were 34.7, 59.6, and 33.1%, respectively. Logistic regression showed that for the three outcomes, no history of receiving psychological help and self-rated good or higher health were protective factors, whereas more severe insomnia and job burnout were risk factors. Junior or lower job title and higher psychological resilience were related to a lower prevalence of depressive symptoms, while relatively longer working hours and larger work-family conflict were positively associated with the anxiety symptoms. Psychological resilience was inversely associated with the co-occurrence of depressive and anxiety symptoms.ConclusionsOur study revealed a high proportion of psychological problems and proved that several similar factors which were significant during the pandemic were also associated with the symptoms of depression and anxiety among healthcare workers in the post-pandemic era of COVID-19. These results provide scientific evidence for psychological interventions for healthcare workers.

The contact state of a seamless internal threaded copper tube and an aluminium foil fin not only affects the heat transfer efficiency of a tube–fin heat exchanger but also seriously affects its service life. In this study, hydraulic expansion technology was used to connect the copper tube with an internal thread with a 7 mm diameter to the fin of the heat exchanger. The influence of the expansion pressure and pressure holding time on the contact state was analysed through experiments and finite element simulation, and the variation law of the two on the contact state was obtained. The contact state was characterised by the contact gap and contact area. In order to obtain the specific contact area value, a new method of measuring the contact area was developed to reveal the variation in contact area between the copper tube and the fin after expansion. The results show that the contact gap decreases with an increase in expansion pressure, while the pressure holding time remains the same. The contact area increases with an increase in expansion pressure, and the rate of increase slows. When the expansion pressure is 18 MPa, the average contact gap is approximately 0.018 mm. When the expansion pressure reaches 16 MPa, the contact area ratio is 91.0%. When the expansion pressure increases to 18 MPa, the contact area ratio only increases by approximately 0.6%. Compared with the influence of the expansion pressure on the increase in contact area, the influence of the pressure holding time on the contact area is lower.

We aimed to assess the association between fasting plasma glucose (FPG) change trajectory and incident hypertension among Chinese population. This cohort study included 11,791 adults aged 18–80 years without hypertension at first entry and who completed at least four follow-ups between 2009 and 2016. Logistic regression was used to estimate odds ratios (ORs) and 95% CIs for the association between FPG change trajectory and probability of hypertension. During a median follow-up of 5.10 years (total person– years 61,887.76), hypertension developed in 2177 participants. After adjusting for baseline potential confounders, the probability of hypertension increased with the increasing FPG change trajectory (adjusted OR (aOR) 1.22, 95% CI 1.07–1.40), bell-shape trajectory (aOR 1.15, 95% CI 1.02–1.30) and other-shape trajectory (aOR 1.13, 95% CI 1.02–1.25) which showed a higher variability of FPG compared to the decreasing group. In addition, the increasing FPG change trajectory was associated with a higher probability of hypertension compared with the decreasing group regardless of age and BMI bu t was only significant in males and in those with normal FPG at baseline. Our study indicates that the increasing FPG change trajectory determines the highest risk of hypertension, demonstrating the importance of maintaining low and stable levels of FPG, especially in males and in those with normal FPG.

Objective: To investigate the immunomodulatory effects of artesunate in the immunologic non-responders (INRs) in people living with HIV (PLWH), and suggest new adjuvant strategies for HIV treatment in INRs. Methods: A total of 197 INRs receiving antiretroviral therapy (ART) for at least 24 months from eight medical centers in China were enrolled. Artesunate tablets at different dosages were administered based on the conventional antiviral treatment regimen for 48 weeks. We evaluated immunological parameters at the baseline and during the follow-up period. Results: There were significant increases in CD4+ T cell counts and CD45RA+ T cell counts in the ART + high-dose artesunate group after 24 and 48 weeks of treatment (P < 0.05). The recovery level of CD8+CD38+ T cell counts after 24 and 48 weeks was significantly lower in ART + low-dose artesunate group than ART + high-dose artesunate group (Padj = 0.007 and P = 0.002, respectively). The level of CD4+Ki67+/CD4+, early apoptosis cell counts/CD4+ and early apoptosis cell counts/CD8+ in ART + high-dose artesunate group were significantly recovered during duration (P < 0.05). There were no significant differences in the level of CD4+CD25+T cell counts and CD4+CD38+T cell counts among the three groups after 24 and 48 weeks of treatment (P > 0.05). Conclusions: High-dose artesunate could benefit INRs in terms of CD4+ T cell counts by enhancing the functional recovery of the thymus and decreasing the level of immune activation and apoptosis. This study was registered at the Chinese Clinical Trial Registry with DOL number as CHiCTR1800015289.

Abstract Sand flux is the key factor to determine the migration of sand dunes and the erosion to the surrounding environment. There are crescent-shaped sand dunes of various scales in the desert, and there are significant differences in spatial wind field and sand flux among them. However, due to the difficulty of monitoring, it is difficult to continuously observe the spatial wind field and sand flux around the larger crescentic dunes. On the basis of the Reynolds-Average Navier–Stokes (RA-NS) equation and the stress and sand flux model, the distribution of wind field and sand flux of a circular dune with a height of 4.2 m and a length of about 100 m during the four evolutionary periods of the evolution into a crescentic dune was simulated in this study. By comparing with the measured results, we verified that the closer to the leeward side, the more the simulated values of the velocity in wind field and sand flux were in line with the measured results. In order to further analyze the influence of the height of dune and other relevant parameters on sand flux, we simulated the influence on wind field and sand flux by changing the air viscosity and wind velocity of upper boundary. We found that the air viscosity mainly affected the amount of deposited sand on the leeward side of sand dune, while the increase of wind velocity would undoubtedly increase the sand flux of the whole sand dune. In addition, the simulation results also showed that the influence of changes in height of dune on the turbulent intensity of leeward side was very significant, and the turbulent intensity increased with the height of dune. The height changes of tall dunes gradually affected the transport of sand caused by wind flow behind the leeward side because that the rotation of the wind flow would form new vortexes at the large pores behind the leeward side, which would increase the turbulent energy in space and thus would increase the distance of migration of the lifting sand. While the low sand dunes could not form extra small vortexes at the bottom of the leeward side, so the wind velocity was small and the eddy currents behind the leeward side were more stable. The simulation results indicated that wind velocity was not the only reason for increasing the amount of sand flux, and the fluctuation of wind flow caused by turbulence could also stimulate the movement of sand particles on the ground.

Abstract Background Epidemiological studies have suggested that adiponectin is associated with the development of insulin resistance and type 2 diabetes. This study first examined the effect of purified anthocyanins, a group of dietary flavonoids, on serum adiponectin in patients with prediabetes and newly diagnosed diabetes. Methods A total of 160 patients with prediabetes (n = 90) or newly diagnosed diabetes (n = 70) were randomly assigned to either the anthocyanins group or the placebo group for 12 weeks of intervention. Serum adiponectin, a set of biomarkers related to glucolipid metabolism, anthropometric parameters, dietary intake and physical activity were measured before and after intervention. Results Anthocyanins increased serum adiponectin compared with placebo (net change 0.46 µg/mL, 95% CI [0.03, 0.90], p = 0.038) in the subjects with newly diagnosed diabetes. No significant difference in the change in adiponectin was observed between the two groups either in the overall subjects (0.02 µg/mL [− 0.32, 0.36], p = 0.906) or in prediabetes (− 0.35 µg/mL [− 0.85, 0.16], p = 0.174). Anthocyanins also decreased fasting glucose (− 0.5 mmol/L [− 1, − 0.04], p = 0.035) in the subjects with newly diagnosed diabetes, but no such change was observed in those with prediabetes. Conclusions Anthocyanins supplementation for 12 weeks improved serum adiponectin and fasting glucose in patients with newly diagnosed diabetes, but not in patients with prediabetes. Trial registration ClinicalTrials.gov, NCT02689765. Registered on 6 February 2016, https://clinicaltrials.gov/ct2/show/NCT02689765 .

Abstract Background The discordance of the low-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with alterative lipid parameters may explain the inconsistent association of CIMT with the LDL-C/HDL-C ratio. Therefore, this study aimed to explore the associations between LDL-C/HDL-C ratio discordance with alternative lipid parameters and elevated carotid intima-media thickness (CIMT) risk in a large cohort in Beijing, China. Methods In total, 13,612 adults who didn’t have elevated CIMT at baseline and who participated in at least one follow-up of annual examination between 2009 and 2016 were included in this cohort study. A multivariable Cox regression model was utilized to evaluate the associations of discordance of the LDL-C/HDL-C ratio with TC, TGs, LDL-C and HDL-C with elevated CIMT risk. Results During 37,999 person-years of follow-up, 2004 individuals (1274 men and 730 women) developed elevated CIMT. Among individuals with normal TC and TGs, 16.6 and 15.2% individuals had a discordantly high LDL-C/HDL-C ratio, respectively, and the risk of elevated CIMT increased by 1.54 (95% CI 1.33, 1.77) and 1.53 (95% CI 1.33, 1.76), respectively, comparing to individuals with a concordantly low LDL-C/HDL-C ratio. A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with LDL-C and HDL-C (P

Background: A meta-analysis was performed to evaluate the effect of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or standard care as control.Methods: A systematic literature search up to June 2021 was performed and nine studies selected 785 pediatric subjects on the day of surgery at the start of the study; 390 of them were using smartphone interventions, 192 were control, and 203 were using oral midazolam. They were reporting relationships between the effects of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or control. The mean difference (MD) with its 95% CIs was calculated to assess the effect of smartphone interventions on the anxiety of the pediatric subjects at induction on the day of surgery compared to oral midazolam or control using the continuous method with a fixed or a random-effects model.Results: Smartphone interventions in pediatric subjects were significantly related to lower anxiety at induction on the day of surgery (MD, −19.74; 95% CI, −29.87 to −9.61, p < 0.001) compared to control and significantly related to lower anxiety at induction on the day of surgery (MD, −7.81; 95% CI, −14.49 to −1.14, p = 0.02) compared to oral midazolam.Conclusion: Smartphone interventions in pediatric subjects on the day of surgery may have lower anxiety at induction compared to control and oral midazolam. Further studies are needed to confirm these findings.

Tigecycline serves as one of the last-resort antibiotics to treat severe infections caused by carbapenem-resistant Enterobacterales. Recently, a novel plasmid-mediated resistance-nodulation-division (RND)-type efflux pump gene cluster, TmexCD1-ToprJ1, and its variants, TmexCD2-ToprJ2 and TmexCD3-ToprJ3, encoding tetracyclines and tigecycline resistance, were revealed. In this study, we reported three TmexCD2-ToprJ2-harboring Klebsiella species strains, collected from two teaching tertiary hospitals in China, including one K. quasipneumoniae, one K. variicola, and one K. michiganensis. The three strains were characterized by antimicrobial susceptibility testing (AST), conjugation assay, WGS, and bioinformatics analysis. AST showed that K. variicola and K. quasipneumoniae strains were resistant to tigecycline with MIC values of 4μg/ml, whereas the K. michiganensis was susceptible to tigecycline with an MIC value of 1μg/ml. The TmexCD2-ToprJ2 clusters were located on three similar IncHI1B plasmids, of which two co-harbored the metallo-β-lactamase gene blaNDM-1. Conjugation experiments showed that all three plasmids were capable of self-transfer via conjugation. Our results showed, for the first time, that this novel plasmid-mediated tigecycline resistance mechanism TmexCD2-ToprJ2 has spread into different Klebsiella species, and clinical susceptibility testing may fail to detect. The co-occurrence of blaNDM-1 and TmexCD2-ToprJ2 in the same plasmid is of particular public health concern as the convergence of “mosaic” plasmids can confer both tigecycline and carbapenem resistance. Its further spread into other clinical high-risk Klebsiella clones will likely exacerbate the antimicrobial resistance crisis. A close monitoring of the dissemination of TmexCD-ToprJ encoding resistance should be considered.

Objectives Plasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease. This study aimed to assess the relationship of dietary antioxidant vitamins intake with tHcy levels in middle-aged and older adults with hypertension.Design A cross-sectional study.Setting The survey was conducted in the Nanshan district of Shenzhen.Participants A total of 1465 middle-aged and older adults with hypertension were included between July and September of 2013.Measurements Hyperhomocysteinaemia (HHcy) was defined as tHcy ≥15 µmol/L. Some dietary antioxidant vitamins (vitamin C (VC) and vitamin E (VE), carotenes, retinol, lutein) intake was estimated using the Food Frequency Questionnaire. Sociodemographic and potential covariates were evaluated through questionnaires, anthropometric measurements and blood tests. The association between dietary intakes of antioxidant vitamins and tHcy concentration were evaluated by multiple linear regression analyses after napierian logarithm transformed. Multiple logistic regression models were further used to determine ORs and 95% CIs.Results The β (95% CIs) of VC intake and tHcy was −0.050 (−0.084 to –0.016). Compared with the lowest quartile in the fully adjusted model, the ORs (95% CIs) for HHcy levels across quartiles of dietary VC intake were 0.82 (0.57 to 1.16), 0.49 (0.33 to 0.74) and 0.40 (0.22 to 0.74) (p for trend=0.001). The β (95% CIs) of retinol intake and tHcy was −0.021 (−0.041 to –0.002) and the ORs (95% CIs) in the third quartile of retinol intake was 0.61 (0.42 to 0.86), while the effect for the highest quartile was not significant (p for trend=0.951). No significant association was observed between dietary VE, carotenes and lutein intake and HHcy.Conclusions A linear inverse association between dietary VC intake and HHcy prevalence, and an L-shaped association between dietary retinol intake and HHcy prevalence were found in Chinese middle-aged and older adults with hypertension.

Due to the complex and changeable working environment of assembled camshafts using tube hydroforming (THF) technology, the manifestations of failure, the causes of failure and the preventive measures for these failures are a major concern. Therefore, in view of this new connection technology for assembled camshafts, it is important to put forward a prediction and evaluation method of failure for hydraulic expanding assembled camshafts. In this study, an isometric-trilateral profile cam was used to complete the hydroforming connection with the hollow shaft (tube) under different hydraulic pressures. Orthogonal torsion experiment and laser measurement experiment were performed. Finite element analysis was carried out using ABAQUS 6.14 software, and relevant research data were obtained. A more accurate BP neural network model was constructed to predict the main failure factors of assembled camshafts. The failure manifestations of assembled camshafts are displayed by the experiment from the microscopic perspective. The causes of failure are analyzed by using the minimum cut set in the failure Tree (FT) theory. The effect of basic causes on the subsystems is analyzed, and the weight distribution of the main events in the FT is given. Finally, the specific measures to prevent failure are proposed from a macro perspective. The research is of great significance to study the failures of assembled camshafts in service to further the production, manufacturing, failure prevention, faults monitoring and performance improvement of assembled camshafts in the engine industry.

Objective: This study aims to investigate the effect of optimized ultrafiltration on perioperative electrolytes, acid–base balance, and pulmonary function during cardiopulmonary bypass (CPB) in infants with low body weight (under 10 kg), using traditional balanced ultrafiltration and modified ultrafiltration.Methods: A total of 30 children who underwent surgical correction for congenital heart disease in Changzhou Children's Hospital between January 2018 and December 2019 were randomly divided into two groups. In the treatment group, ultrafiltration pre-treatment was carried out with blood-containing priming fluid prior to CPB. Balanced ultrafiltration was performed during the operation, and optimized and modified ultrafiltration were conducted before closing and extubation. In the control group, traditional balanced ultrafiltration was used during the operation, and a modified ultrafiltration combination was used before closing and extubation. Indexes such as blood gas analysis and electrolytes were measured perioperatively, and pulmonary function was observed.Results: No deaths were reported in either group. The ventilator-assisted breathing time was shorter in the treatment group than in the control group (P < 0.05). The indexes of the treatment group were closer than those of the control group to the optimal physiological values. The concentrations of potassium ion (K+), lactate (Lac), and blood glucose (Glu) decreased, and there was significant difference between the two groups (P < 0.05) at the end of CPB. Hemoglobin (Hb) and hematocrit (HCT) in the treatment group increased (P < 0.01). Alveolar-arterial differences for oxygen (A-aDO2) and respiratory index (RI) increased significantly in both groups after operation. Children in the treatment group began to recover lung function earlier than children in the control group. Both A-aDO2 and RI were lower in the treatment group than in the control group at each time point after operation (P < 0.05).Conclusion: Optimizing and modifying the traditional ultrafiltration combination method can effectively shorten the ultrafiltration time, reduce the adverse impacts of the ultrafiltration technique, and improve the lung function of infants after operation.

As a high expansion strength corresponds to a high heat transfer efficiency, this study investigated the expansion strength of an air-conditioning heat exchanger jointed by hydraulic expansion. A device that would be reliable and adaptable to different types of tubes and fins was designed and developed for testing hydraulic expansion. The device was used to perform a non-pulsating hydraulic expansion experiment on samples comprising tubes and fins to determine the hydraulic pressure range. The expansion strength was tested by performing tensile tests to evaluate the pull-out force at different bulging zones of the same sample with the selected hydraulic pressure. A series of pulsating hydraulic expansion experiments were performed on the joints of tubes and fins with different pulsating amplitudes and frequencies. Tensile tests were performed on the pulsating hydraulic expansion samples to study the influence of the pulsation parameters on the pull-out force. When the amplitude was fixed, an increase in frequency led to uniform expansion in the exchanger. This indicates that joint expansion in tubes and fins results in a more reliable heat exchanger performance.

The MTHFR gene encodes methylenetetrahydrofolate reductase required for the metabolism of homocysteine (Hcy) – a previously reported independent risk factor for ischemic stroke (IS). In this study, we first aimed to clarify the association between DNA methylation levels in the MTHFR promoter and the risk of IS, followed by the analysis of potential interactions between environmental factors and DNA methylation levels that affect IS risk. We recruited 164 patients with hypertension and IS (case group) and 345 age-matched and sex-matched patients with hypertension only (control group). Demographic and clinical information was obtained using questionnaires, and blood samples were collected for biochemical analyses. Fluorescence quantitative methylation-specific PCR (qMSP) was used to detect MTHFR promoter methylation levels. A logistic regression analysis was performed to determine the relationship between environmental factors, MTHFR promoter methylation levels, and IS risk. We finally generated a receiver operating characteristic curve to determine whether MTHFR promoter methylation levels can predict IS. The mean MTHFR methylation levels in the case group (8.10 ± 6.14) were significantly lower than those in the control group (17.44 ± 3.16; p < 0.05). MTHFR promoter methylation levels were also lower in patients with plasma Hcy levels ≥15 μmol/L (10.65 ± 4.05) than in those with Hcy levels

Background. Conflicting findings have been reported regarding the sex-specific association between serum uric acid (SUA) level and type 2 diabetes mellitus (T2DM) risk, and no study has explored the association between the change in hyperuricemia status and T2DM risk. The study was aimed at exploring the sex-specific association of baseline SUA and changes in hyperuricemia status with T2DM risk. Methods. We included 37,296 eligible adults without T2DM at the first examination who attended the baseline examination and at least one follow-up annual examination. Cox and logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs) with their 95% confidence intervals (CIs) for T2DM risk associated with baseline SUA and the change in hyperuricemia status, respectively. Results. During a median follow-up of 3.09 years, of 37,296 eligible adults, 2,263 developed T2DM. Compared with the first SUA quartile, higher quartiles were associated with an increased risk of T2DM in women (HR 1.78, 95% CI 1.17-2.71 for Q3 and 1.93, 1.27-2.93 for Q4; Ptrend

Hyponatremia is the most common electrolyte disorder in hospitals. Many medical illnesses, including congestive heart failure, liver failure, renal failure and pneumonia, may be associated with hyponatremia. In addition, hyponatremia in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) was first reported in 1993. The evidence suggests that severe hyponatremia is associated with increased morbidity and mortality in human immunodeficiency virus (HIV)/AIDS patients; however, the incidence of hyponatremic syndrome in HIV/AIDS patients remains very high in clinical practice, as almost 40% of HIV/AIDS inpatients in Xinjiang, a developing region of China, are hyponatremic. A method for identifying the pathogenesis and therapeutic treatments for hyponatremia in HIV/AIDS patients is needed. This review focuses on the clinical and pathophysiological aspects of hyponatremia and highlights the causes, presentation and treatment recommendations for hyponatremic patients with HIV/AIDS.

Nb-doped ZnO thin films were fabricated on glass substrates by using co-sputtering with direct-current and radio frequency magnetron sputtering. The structures, optical and electrical performances of Nb-doped ZnO thin films were investigated. The results showed that all thin films have (0 0 2) c-axis preferential orientation. The minimum resistivity of 2.12×10−3Ωcm and the maximum carrier concentration of 2.39×1019cm−3 were obtained at the direct-current sputtering power of 10W, respectively. Nb-doped ZnO thin films have also shown high average transmittance of 89.6%, and lower surface roughness of 2.74nm. Meanwhile, a distinct absorption edge in the ultraviolet range of 300–400nm was observed in absorbance, the optical band gap of Nb-doped ZnO thin films illustrates an increased tendency with increasing Nb concentration.

Abstract Background The treatment failure and reinfection rates among syphilis patients are high, and relevant studies in China are limited. The aim of this study was to detect the rates of treatment failure and reinfection after syphilis treatment and to explore the potential associated factors. Methods We conducted a longitudinal cohort study in a sexually transmitted disease clinic, the Department of Dermatology and Venereology in Nanshan Center for Chronic Disease Control. Serological testing was performed at baseline and throughout the 2-year follow-up for syphilis patients. To identify potential predictors of treatment outcomes, multivariate logistics analyses were utilized to compare the demographic and clinical characteristics of patients with serological failure/reinfection to those with serological cure/serofast. Results From June 2011 to June 2016, a total of 1133 patients were screened for syphilis. Among the 770 patients who completed the 2-year follow-up, 510 first-diagnosed patients were included in the final analysis. Multivariate logistics analysis revealed the stage of syphilis (secondary syphilis VS. primary syphilis: adjusted odds ratio, 3.50; 95% confidence interval, 1.11-15.47; p = 0.04), HIV status (positive VS. negative: adjusted odds ratio, 3.06; 95% confidence interval, 1.15-8.04; p = 0.02) and frequency of condom use (always use VS. never use: adjusted odds ratio, 0.28; 95% confidence interval 0.08-0.75; p = 0.02) were significantly associated with the serological outcome. Conclusions The clinical implications of our findings suggest that it is very important to perform regular clinical and serologic evaluations after treatment. Health counseling and safety education on sex activity should be intensified among HIV-infected patients and secondary syphilis patients after treatment.

Objective: To investigate the incidence and trends in colorectal cancer (CRC) among Asian American populations in the United States. Methods: CRC incidence data from 1994 through 2013 were obtained from 13 Surveillance, Epidemiology, and End Results registries. SEER*Stat and IBM SPSS Statistics were used. Results: The age-adjusted incidence of CRC among Asian Americans decreased from 45.6 per 100,000 in 1994 to 33.0 per 100,000 in 2013, with the annual percent change being −1.8% (P

OBJECTIVES: Cystathionine β-synthase is a major enzyme in the metabolism of plasma homocysteine. Hyperhomocysteinemia is positively associated with hypertension and stroke. The present study was performed to examine the possible effects of Cystathionine β-synthase promoter methylation on the development of hypertension and stroke. METHODS: Using quantitative methylation-specific PCR, we determined the Cystathionine β-synthase methylation levels in 218 healthy individuals and 132 and 243 age- and gender-matched stroke and hypertensive patients, respectively. The relative changes in Cystathionine β-synthase promoter methylation were analyzed using the 2–ΔΔCt method. The percent of the methylated reference of Cystathionine β-synthase was used to represent the Cystathionine β-synthase promoter methylation levels. RESULTS: In this study, the Cystathionine β-synthase promoter methylation levels of hypertensive and stroke participants were both higher than that of the healthy individuals (median percentages of the methylated reference were 50.61%, 38.05% and 30.53%, respectively, all p

Immunodeficient mice reconstituted with human immune tissues and cells (humanized mice) are relevant and robust models for the study of HIV-1 infection, immunopathogenesis, and therapy. In this study, we performed a comprehensive comparison of human immune reconstitution and HIV-1 infection, immunopathogenesis and therapy between immunodeficient NOD/Rag2−/−/γc−/− (NRG) mice transplanted with human HSCs (NRG-hu HSC) and mice transplanted with HSCs and thymus fragments (NRG-hu Thy/HSC) from the same donors. We found that similar human lymphoid and myeloid lineages were reconstituted in NRG-hu HSC and NRG-hu Thy/HSC mice, with human T cells more predominantly reconstituted in NRG-hu Thy/HSC mice, while NRG-hu HSC mice supported more human B cells and myeloid cells reconstitution. HIV-1 replicated similarly and induced similar T cell depletion, immune activation, and dysfunction in NRG-hu HSC and NRG-hu Thy/HSC mice. Moreover, combined antiretroviral therapy (cART) inhibited HIV-1 replication efficiently with similar persistent HIV-1 reservoirs in both models. Finally, we found that blocking type-I interferon signaling under cART treatment transiently activated HIV-1 reservoirs, enhanced T cell recovery and reduced HIV-1 reservoirs in both HIV-1 infected NRG-hu HSC and NRG-hu Thy/HSC mice. In summary, we report that NRG-hu Thy/HSC and NRG-hu HSC mice support similar HIV-1 infection and similar HIV-1 immunopathology; and HIV-1 replication responds similarly to cART and IFNAR blockade therapies. The NRG-hu HSC mouse model reconstituted with human HSC only is sufficient for the study of HIV-1 infection, pathogenesis, and therapy.

Pattern classifications have become important tools for fault diagnosis in nuclear power plants (NPP). However, it is often difficult to obtain training data under fault conditions to train a supervised classification model. By contrast, normal plant operating data can be easily made available through increased deployment of supervisory, control, and data acquisition systems. Such data can also be used to train classification models to improve the performance of fault diagnosis scheme. In this paper, a fault diagnosis scheme based on semisupervised classification (SSC) scheme is developed. In this scheme, new measurements collected from the plant are integrated with data observed under fault conditions to train the SSC models. The trained models are subsequently applied to new measurements for fault diagnosis. In comparison with supervised classifiers, the proposed scheme requires significantly fewer data collected under fault conditions to train the classifier. The developed scheme has been validated using different fault scenarios on a desktop NPP simulator as well as on a physical NPP simulator using a graph-based SSC algorithm. All the considered faults have been successfully diagnosed. The results have demonstrated that SSC is a promising tool for fault diagnosis in NPPs.

OBJECTIVES: The aim of this study was to compare the expression levels of serum miRNAs in diabetic retinopathy and type 2 diabetes mellitus. METHODS: Serum miRNA expression profiles from diabetic retinopathy cases (type 2 diabetes mellitus patients with diabetic retinopathy) and type 2 diabetes mellitus controls (type 2 diabetes mellitus patients without diabetic retinopathy) were examined by miRNA-specific microarray analysis. Quantitative real-time polymerase chain reaction was used to validate the significantly differentially expressed serum miRNAs from the microarray analysis of 45 diabetic retinopathy cases and 45 age-, sex-, body mass index- and duration-of-diabetes-matched type 2 diabetes mellitus controls. The relative changes in serum miRNA expression levels were analyzed using the 2-ΔΔCt method. RESULTS: A total of 5 diabetic retinopathy cases and 5 type 2 diabetes mellitus controls were included in the miRNA-specific microarray analysis. The serum levels of miR-3939 and miR-1910-3p differed significantly between the two groups in the screening stage; however, quantitative real-time polymerase chain reaction did not reveal significant differences in miRNA expression for 45 diabetic retinopathy cases and their matched type 2 diabetes mellitus controls. CONCLUSION: Our findings indicate that miR-3939 and miR-1910-3p may not play important roles in the development of diabetic retinopathy; however, studies with a larger sample size are needed to confirm our findings.