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Land cover data are essential for modelling land surface processes in mountainous regions. Fine-resolution land cover products have provided unprecedented spatial detail of the land surface. The performance of land cover classification can be affected by various causes, propagating uncertainty through modelling. In this study, six openly accessible fine-resolution land cover data products for 2020, namely GlobeLand30, CLCD, GLC_FCS30, Esri land cover, WorldCover, and DynamicWorld, were cross-compared for consistency and accuracy in the Changbai Mountain Range. The study particularly highlighted the consistency and accuracy across various geomorphic types. The findings reveal that all the six data products exhibit an overall similarity in spatial patterns dominated by cropland and forest. Validation using a ground reference dataset revealed that WorldCover and GlobeLand30 provide the highest and lowest accuracy, respectively. Cropland and forest present considerable spatial consistencies among the data products and advanced accuracies. The middle-mountain regions with low landscape diversity and fragmentation showed the highest consistency and accuracy. Data products, however, are difficult to represent the distribution of grassland, wetland, and bare ground categories reliably due to limited consistency and accuracy. This study provides quantitative analysis for selecting appropriate land cover data products towards application implementations.

Introduction Previous studies have suggested that adolescents may smoke cigarettes to control weight, but relevant research is scarce in Chinese youth. This study was conducted to examine the associations of weight control related behaviors with cigarette smoking in Chinese students. Methods This was a secondary analysis of data for 24835 middle and high school students drawn from the 2022 Zhejiang Youth Risk Behavior Survey of China which collected self-reported information of cigarette smoking, weight control strategies and other health-related behaviors. Multivariable logistic regression models were used to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for the study associations. Results Overall, there were 998 (4.02%) current cigarette smokers in this wave of the Zhejiang YRBS (2022). Neither trying to control weight nor healthy weight control behavior of exercising was associated with current cigarette smoking (AOR=1.15; 95% CI: 0.97–1.37 and AOR=1.01; 95% CI: 0.85–1.20, respectively). Meanwhile, unhealthy weight control behaviors of taking laxatives (AOR=1.52; 95% CI: 1.03–2.26), taking diet pills (AOR=1.82; 95% CI: 1.26–2.62), dieting (AOR=1.24; 95% CI: 1.04–1.49), and fasting (AOR=1.81; 95% CI: 1.40–2.34) were significantly associated with increased odds of current cigarette smoking. Conclusions Screening and developing interventions for unhealthy weight control behaviors should be considered as part of smoking prevention programs among adolescents.

Although there have been tremendous improvements in the production and storage of platelets, platelet transfusion refractoriness (PTR) remains a serious clinical issue that may lead to various severe adverse events. The burden of supplying platelets is worsened by rising market demand and limited donor pools of compatible platelets. Antibodies against platelet antigens are known to activate platelets through FcγR-dependent or complement-activated channels, thereby rapidly eliminating foreign platelets. Recently, other mechanisms of platelet clearance have been reported. The current treatment strategy for PTR is to select appropriate and compatible platelets; however, this necessitates a sizable donor pool and technical assistance for costly testing. Consolidation of these mechanisms should be of critical significance in providing insight to establish novel therapeutics to target immunological platelet refractoriness. Therefore, the purposes of this review were to explore the modulation of the immune system over the activation and elimination of allogeneic platelets and to summarize the development of alternative approaches for treating and avoiding alloimmunization to human leukocyte antigen or human platelet antigen in PTR.

Information on the spatiotemporal distribution of human-caused wildfires on a national scale is crucial for developing susceptibility map and facilitating decision-making in fire risk management. In China, it is difficult to access a national dataset of wildfires based on ground records at a fine spatiotemporal scale for understanding fire regimes. This study explores the use of judgment documents as a potential alternative long-term key data source, considering human-caused wildfire events as criminal offense in certain cases. Judgment documents are readily accessible, regularly updated, and provide a diverse range of reliable information. To extract information on human-caused wildfires, we develop a rule-based approach for judgment documents. The results indicate the feasibility of the method, allowing for the effective extraction of specific information of event such as the start date and time, location, burn area, and ignition cause. A comparison reveals limited consistency in the spatiotemporal distributions between the novel data and conventional datasets. Notably, judgment documents provide richer attribute information and identify additional human-caused wildfires challenging to capture using conventional datasets. Despite inherent limitations, information sourced from judgment documents proves valuable data for characterizing national patterns of wildfire occurrence at a fine scale.

Abstract Background There is a broad pulse pressure (PP) and a high prevalence of carotid plaques in old adults. Previous studies have indicated that PP is strongly associated with carotid plaque formation. This study aimed to explore this association in old adults with uncontrolled hypertension. Methods 1371 hypertensive patients aged ≥ 60 years with uncontrolled hypertension were enrolled in a community-based screening in Hangzhou, China. Carotid plaques were assessed using ultrasonography. Logistic regression models were used to estimate the association between PP and carotid plaques by odds ratios (ORs) and 95% confidence intervals (CIs). Results Carotid plaques were detected in 639 (46.6%) of subjects. Multiple plaques were found in 408 (63.8%) and soft plaques in 218 (34.1%). Elevated PP was associated with a high prevalence of carotid plaques. After adjusting for traditional risk factors, compared to patients within the lowest tertile of PP, those within the highest tertiles had an increased risk of carotid plaques (OR 2.061, CI 1.547–2.745). For each 1-SD increase, the risk increased by 40.1% (OR 1.401, CI 1.237–1.587). There was a nonlinear association between PP and carotid plaques (P nonlinearity = 0.039). The risk increased rapidly after the predicted PP level reached around 60 mmHg. The associations were stronger among participants with multiple and soft plaques. Conclusions Our findings suggested that PP was independently associated with carotid plaques in old adults with uncontrolled hypertension who have an increased risk of atherosclerosis.

Abstract Elevated remnant cholesterol (RC) is considered a risk factor for atherosclerotic cardiovascular disease, but the evidence on this association applies to the Chinese population with hypertension is limited. We aimed to explore the association between RC levels and carotid plaque in old adults with hypertension. 8523 hypertensive patients aged ≥ 60 years with serum lipids and carotid ultrasonography data were included in this community-based screening. Fasting RC was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol (LDLC). The associations of RC levels with carotid plaque risk were evaluated using Logistic regression and restricted cubic spline models. Carotid plaque was screened in 4821 (56.56%) subjects. After multivariable-adjusted, RC was significantly related to carotid plaque [Odd ratio (OR)] = 1.043 per 0.1 mmol/L increase, 95% confidence interval (CI): 1.030–1.056). The highest versus the lowest quartile of RC was 1.928 (1.673–2.223) for carotid plaque. A nonlinear association was found between serum RC levels and the risk of carotid plaque (P for nonlinearity 0.78 mmol/L differentiated patients at a higher risk of carotid plaque compared to those at lower concentrations, regardless of whether LDLC was on target at 2.59 mmol/L. In old adults with hypertension, elevated RC was positively associated with carotid plaque, independent of LDLC and other conventional risk factors.

Abstract A reliable seizure detection or prediction device can potentially reduce the morbidity and mortality associated with epileptic seizures. Previous findings indicating alterations in cardiac activity during seizures suggest the usefulness of cardiac parameters for seizure detection or prediction. This study aims to examine available studies on seizure detection and prediction based on cardiac parameters using non‐invasive wearable devices. The Embase, PubMed, and Scopus databases were used to systematically search according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines. Human studies that evaluated seizure detection or prediction based on cardiac parameters collected using wearable devices were included. The QUADAS‐2 tool and proposed standards for validation for seizure detection devices were used for quality assessment. Twenty‐four articles were identified and included in the analysis. Twenty studies evaluated seizure detection algorithms, and four studies focused on seizure prediction. Most studies used either a wrist‐worn or chest‐worn device for data acquisition. Among the seizure detection studies, cardiac parameters utilized for the algorithms mainly included heart rate (HR) (n = 11) or a combination of HR and heart rate variability (HRV) (n = 6). HR‐based seizure detection studies collectively reported a sensitivity range of 56%‐100% and a false alarm rate (FAR) of 0.02‐8/h, with most studies performing retrospective validation of the algorithms. Three of the seizure prediction studies retrospectively validated multimodal algorithms, combining cardiac features with other physiological signals. Only one study prospectively validated their seizure prediction algorithm using HRV extracted from ECG data collected from a custom wearable device. These studies have demonstrated the feasibility of using cardiac parameters for seizure detection and prediction with wearable devices, with varying algorithmic performance. Many studies are in the proof‐of‐principle stage, and evidence for real‐time detection or prediction is currently limited. Future studies should prioritize further refinement of the algorithm performance with prospective validation using large‐scale longitudinal data. Plain Language Summary This systematic review highlights the potential use of wearable devices, like wristbands, for detecting and predicting seizures via the measurement of heart activity. By reviewing 24 articles, it was found that most studies focused on using heart rate and changes in heart rate for seizure detection. There was a lack of studies looking at seizure prediction. The results were promising but most studies were not conducted in real‐time. Therefore, more real‐time studies are needed to verify the usage of heart activity‐related wearable devices to detect seizures and even predict them, which will be beneficial to people with epilepsy.

Background: Influenza has many harmful effects on people with type 2 diabetes mellitus (T2DM), such as hyperglycemia and increasing incidence of cardiovascular and cerebrovascular diseases. Epidemiological evidence shows that influenza vaccinations can effectively prevent deterioration in T2DM patients. At present, there is a lack of nationwide studies on the vaccination status of influenza vaccines for patients with certain chronic diseases. This study aimed to evaluate the influenza vaccination status of T2DM patients in mainland China and the factors affecting their influenza vaccination. Methods: Data were sourced from PubMed, Embase, Web of Science, the China Biology Medicine Disc (CBMdisc), the China National Knowledge Infrastructure (CNKI), and the Wanfang Database. The keywords used in the literature search included “diabetes”, “diabetes mellitus”, “DM”, “diabetic”, “T2DM”, “influenza vaccine”, “flu vaccine”, “China”, and “Chinese”. A total of 249 articles were retrieved through the searches; 7 articles met the inclusion criteria. The fixed-effects model was used when heterogeneity was low and a random-effects model was used when the heterogeneity was high. Results: The influenza vaccination coverage rate was 1.46% in diabetic patients and 9.99% in elderly diabetic patients. The influenza vaccination rate of type 2 diabetes patients with a high education level is higher than that of patients with a low education level. (OR: 1.462 [1.123, 1.903]). Meanwhile, gender (OR: 1.076, 95%CI: 0.893–1.295), marriage (OR: 1.283; 95%CI: 0.931–1.766), and occupation (OR: 1.049; 95% CI: 4.422–2.606) have no significant impact on influenza vaccination in patients with type 2 diabetes. Conclusions: This study found that the coverage of influenza vaccination in patients with T2DM in Chinese mainland was low, and there were few relevant research articles. In China’s mainland areas, education background is an important factor affecting the influenza vaccination of T2DM patients. China should continue to improve the influenza vaccination rate of patients with type 2 diabetes.

BackgroundOvarian carcinoma (OC) is a prevalent gynecological malignancy associated with high recurrence rates and mortality, often diagnosed at advanced stages. Despite advances in immunotherapy, immune exhaustion remains a significant challenge in achieving optimal tumor control. However, the exploration of intratumoral heterogeneity of malignant epithelial cells and the ovarian cancer tumor microenvironment is still limited, hindering our comprehensive understanding of the disease.Materials and methodsUtilizing single-cell RNA sequencing (scRNA-seq), we comprehensively investigated the cellular composition across six ovarian cancer patients with omental metastasis. Our focus centered on analysis of the malignant epithelial cells. Employing CytoTRACE and slingshot pseudotime analyses, we identified critical subpopulations and explored associated transcription factors (TFs) influencing ovarian cancer progression. Furthermore, by integrating clinical factors from a large cohort of bulk RNA sequencing data, we have established a novel prognostic model to investigate the impact of the tumor immune microenvironment on ovarian cancer patients. Furthermore, we have investigated the condition of immunological exhaustion.ResultsOur study identified a distinct and highly proliferative subgroup of malignant epithelial cells, known as C2 TOP2A+ TCs. This subgroup primarily consisted of patients who hadn’t received neoadjuvant chemotherapy. Ovarian cancer patients with elevated TOP2A expression exhibited heightened sensitivity to neoadjuvant chemotherapy (NACT). Moreover, the transcription factor MYBL2 in this subgroup played a critical role in ovarian cancer development. Additionally, we developed an independent prognostic indicator, the TOP2A TCs Risk Score (TTRS), which revealed a correlation between the High TTRS Group and unfavorable outcomes. Furthermore, immune infiltration and drug sensitivity analyses demonstrated increased responsiveness to Paclitaxel, Cisplatin, and Gemcitabine in the Low TTRS Group.ConclusionThis research deepens our understanding of malignant epithelial cells in ovarian cancer and enhances our knowledge of the ovarian cancer immune microenvironment and immune exhaustion. We have revealed the heightened susceptibility of the C2 TOP2A+ TCs subgroup to neoadjuvant chemotherapy and emphasized the role of MYBL2 within the C2 subgroup in promoting the occurrence and progression of ovarian cancer. These insights provide valuable guidance for the management of ovarian cancer treatment.

Background Long-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.Objectives This study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter

Blood flow in arterioles have attracted considerable research attention due to their clinical implications. However, the fluid structure interaction between red blood cells and plasma in the blood poses formidable difficulty to the computational efforts. In this contribution, we seek to represent the red blood cells in the blood as a continuous non-Newtonian phase and construct a multi-phase model for the blood flow in microvessels. The methods are presented and validated using a channel with sudden expansion. And the resulting blood flow inside a stenosed microvessel is investigated at different inlet velocity amplitudes and hematocrits. It is show that the increase of both inlet velocity amplitude and inlet hematocrit leads to longer and thicker cell-rich layer downstream the stenosis. Besides, it is found that the maximum values of wall shear stress scales up with inlet velocity amplitudes and hematocrits. These results show the validity of the proposed computational model and provide helpful insights into blood flow behaviors inside stenosed vessels.

China’s energy transformation is at a critical stage, and virtual power plants are also in full swing. It is of great theoretical value and practical significance to identify whether virtual power plants can promote energy transformation. First, the concept of virtual power plant and energy transformation is defined, and the theoretical logic of interaction between virtual power plant and energy transformation is expounded. Then, the attribute model of the energy transition index is constructed from the attributes of energy system performance and energy transition maturity, and a double difference model is established. Finally, nine pilot provinces are taken as examples for empirical testing, and the results show that the implementation of virtual power plant pilot can promote energy transformation, but there are differences among provinces. The resource endowment and the degree of marketization and openness will have a differentiated effect on the promotion of energy transformation by virtual power plants.

Abstract Background In recent years, research on the pathogenesis of systemic lupus erythematosus (SLE) has made great progress. However, the prognosis of the disease remains poor, and high sensitivity and accurate biomarkers are particularly important for the early diagnosis of SLE. Methods SLE patient information was acquired from three Gene Expression Omnibus (GEO) databases and used for differential gene expression analysis, such as weighted gene coexpression network (WGCNA) and functional enrichment analysis. Subsequently, three algorithms, random forest (RF), support vector machine-recursive feature elimination (SVM-REF) and least absolute shrinkage and selection operation (LASSO), were used to analyze the above key genes. Furthermore, the expression levels of the final core genes in peripheral blood from SLE patients were confirmed by real-time quantitative polymerase chain reaction (RT-qPCR) assay. Results Five key genes (ABCB1, CD247, DSC1, KIR2DL3 and MX2) were found in this study. Moreover, these key genes had good reliability and validity, which were further confirmed by clinical samples from SLE patients. The receiver operating characteristic curves (ROC) of the five genes also revealed that they had critical roles in the pathogenesis of SLE. Conclusion In summary, five key genes were obtained and validated through machine-learning analysis, offering a new perspective for the molecular mechanism and potential therapeutic targets for SLE.

Abstract Background Dipeptidyl peptidase-4 inhibitors (DPP-4i) have become firmly established in treatment algorithms and national guidelines for improving glycemic control in type 2 diabetes mellitus (T2DM).To report the findings from a multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trial, which was designed to assess the efficacy and safety of a novel DPP-4 inhibitor fotagliptin in treatment-naive patients with T2DM. Methods Patients with T2DM were randomized to receive fotagliptin (n = 230), alogliptin (n = 113) or placebo (n = 115) at a 2:1:1 ratio for 24 weeks of double-blind treatment period, followed by an open-label treatment period, making up a total of 52 weeks. The primary efficacy endpoint was to determine the superiority of fotagliptin over placebo in the change of HbA1c from baseline to Week 24. All serious or significant adverse events were recorded. Results After 24 weeks, mean decreases in HbA1c from baseline were -0.70% for fotagliptin, -0.72% for alogliptin and -0.26% for placebo. Estimated mean treatment differences in HbA1c were -0.44% (95% confidence interval [CI]: -0.62% to -0.27%) for fotagliptin versus placebo, and -0.46% (95% CI: -0.67% to -0.26%) for alogliptin versus placebo, and 0.02% (95%CI: -0.16% to 0.19%; upper limit of 95%CI

ObjectiveTo analyze correlations of modifiable risks with all-cause deaths and cardiovascular disease (CVD) deaths in hypertension patients. MethodsComprehensive data of 2015 on 51 438 community hypertensive patients aged 35 – 85 years were extracted from the management information system of Essential Public Health Services and were linked to individual records of mortality in the datasets of death registry system up to February 28, 2021 in Hangzhou municipality, Zhejiang province. Cox proportional regression model was used to estimate hazard risks of all-cause and CVD deaths associated with modifiable risk factors of the mortalities. ResultsBy the end of study period, totally 2 365 all-cause and 842 CVD deaths were observed among the participants and the mortality ratios were 4.60% and 1.64%, respectively. Of the 51 438 hypertensives, 3 926 (7.63%), 20 392 (39.64%), 20 292 (39.45%), and 6 828 (13.28%) were assessed as having none, one, two, and three and more modifiable risk factors of CVD. The results of Cox proportional regression analysis showed that after adjusting for gender, age, living region, migration, and diabetes, the hypertensives being lack of good blood pressure control (systolic blood pressure [SBP] of ≥ 140 mmHg/diastolic blood pressure (DBP) of ≥ 90 mmHg at three measurements not in the same day) were at significantly increased risks of all-cause death (hazard risk [HR] = 1.39) and CVD death (HR = 1.52) compared to those under effective blood pressure control (SBP < 140 mmHg/DBP < 90 mmHg); the hypertensives being current smoker had significantly increased risks of all-cause death (HR = 1.21) and CVD death (HR = 1.24) contrasting to nonsmoking hypertensives; the hypertensives not having daily physical exercise were at significantly increased risks of all-cause death (HR = 1.52) and CVD death (HR = 1.73) in comparison to those reporting daily physical exercise; the results also revealed significantly increased risks of all-cause death (HR = 1.53, HR = 1.69, and HR = 1.97) and CVD death (HR = 2.32, HR = 2.35,and HR = 2.94) for the hypertensives with one, two, and three modifiable risk factors compared to those without any modifiable risk factor; while, the obese hepertensives had a significantly decreased risk of all-cause death (HR = 0.84) compared to the non-obese hypertensives. ConclusionThe risks of all-cause and CVD death increased with the number of modifiable risk factors among adult community hypertension patients.

Objective: This study aimed to understand the riding behaviors of electric bike (e-bike) users in Hangzhou after the “Regulations of Zhejiang Province on the Administration of Electric Bicycles”. Methods: The study consisted of two parts, including a questionnaire survey of local e-bike users in Shangcheng District and Jiande County in Hangzhou City, and a cross-sectional observational study of 16 intersections. Results: A total of 789 e-bike riders participated in the questionnaire survey, and the riding behavior of 99,407 e-bike users was observed. The main purpose of using e-bike was work and daily life, 46.0% of them used e-bikes more than 5 days a week, and 58.5% used e-bikes for less than 30 min each time. A vast majority (81.7%) of e-bike riders believe that the implementation of Zhejiang Regulations has significantly improved the safety level of e-bike riding in the region. The field survey found that the correct rates of helmet wearing by e-bike riders and passengers were 78.83% and 42.27%. The main violations were invalid/non-helmet wearing (21.17%), followed by carrying passengers and running red lights (7.94% and 4.26%). The rates of invalid/non-helmet wearing and running red lights were significantly higher during non-morning rush hour, weekends, and roads without separate non-motorized vehicle lanes than in other conditions (all P

Abstract Background With the safety of blood transfusion being a major public health concern, the development of a rapid, sensitive, specific, and cost-effective multiplex PCR assay for simultaneous detection of hepatitis B virus(HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and Treponema pallidum(T. pallidum) in blood is crucial. Methods Five primer pairs and probes were designed towards conserved regions of target genes and used to establish a one-step pentaplex real-time reverse transcription PCR(qRT-PCR) assay for simultaneous detection of HBV, HCV, HEV, T. pallidum, and RNase P(housekeeping gene), providing sample quality check. The clinical performance of the assay was further determined with 2400 blood samples from blood donors and patients in Zhejiang province, and compared the results with commercial singleplex qPCR and serological assays. Results The 95% limit of detection(LOD) of HBV, HCV, HEV, and T. pallidum were 7.11 copies/µL, 7.65 copies/µL, 8.45 copies/µL, and 9.06 copies/µL, respectively. Moreover, the assay has good specificity and precision. Compared to the singleplex qPCR assay, the novel assay for detecting HBV, HCV, HEV, and T. pallidum presented 100% clinical sensitivity, specificity, and consistency. Several discrepant results between serological and pentaplex qRT-PCR assays were found. Of 2400 blood samples, there were 2(0.08%) HBsAg positive samples, 3(0.13%) anti-HCV positive samples, 29(1.21%) IgM anti-HEV positive samples and 6(0.25%) anti-T. pallidum positive samples proven negative in nucleic acid detection. 1(0.04%) HBV DNA positive sample and 1(0.04%) HEV RNA positive sample were detected negative by serological testing. Conclusions The developed pentaplex qRT-PCR is the first assay on simultaneous, sensitive, specific, and reproducible detection of HBV, HCV, HEV, T. pallidum, and RNase P in a single tube. It could detect pathogens in blood during the window period of infection and is a good tool for effectively screening blood donors and early clinical diagnosis.

Drug resistance is currently one of the biggest challenges in cancer treatment. With the deepening understanding of drug resistance, various mechanisms have been revealed, including metabolic reprogramming and alterations of redox balance. Notably, metabolic reprogramming mediates the survival of tumor cells in harsh environments, thereby promoting the development of drug resistance. In addition, the changes during metabolic pattern shift trigger reactive oxygen species (ROS) production, which in turn regulates cellular metabolism, DNA repair, cell death, and drug metabolism in direct or indirect ways to influence the sensitivity of tumors to therapies. Therefore, the intersection of metabolism and ROS profoundly affects tumor drug resistance, and clarifying the entangled mechanisms may be beneficial for developing drugs and treatment methods to thwart drug resistance. In this review, we will summarize the regulatory mechanism of redox and metabolism on tumor drug resistance and highlight recent therapeutic strategies targeting metabolic–redox circuits, including dietary interventions, novel chemosynthetic drugs, drug combination regimens, and novel drug delivery systems.

IntroductionBoth conventional adenoma (AD) and serrated polyp (SP) were known precursor lesions of colorectal cancer (CRC). Modifiable lifestyle factors were significantly associated with CRC risk, but whether these factors were related to the risk of different precursors of CRC needed to be clarified. This study aimed to evaluate the risks of AD and SP caused by lifestyle factors and compare the risk differences between AD and SP.MethodsThe study population was from the CRC screening cohort in Hangzhou, China. A total of 458,457 eligible individuals volunteered to undergo initial screening including the fecal immunochemical test (FIT) and the CRC risk assessment. Finally, 13,993 participants who had undergone colonoscopy tests and had been diagnosed at designated hospitals were selected in this study. All participants were required to fill out a questionnaire during the initial screening for collecting their information. The generalized estimate equation (GEE) model was used to assess the association between lifestyle factors/dietary preferences and AD/SP.ResultsThe body mass index (BMI) and smoking were positively associated with the risks of only SP (BMI: OR = 1.50, 95%CI: 1.23–1.84; smoking: OR = 1.29, 95%CI: 1.07–1.55), only AD (BMI: OR = 1.53, 95%CI: 1.28–1.82; OR = 1.24, 95%CI: 1.11–1.39), and synchronous SP and AD (BMI: OR = 1.97, 95%CI: 1.40–2.75; smoking: OR = 1.53, 95%CI: 1.27–1.85). In the case-group comparison, smoking was more strongly associated with the risk of synchronous SP and AD than only AD. Alcohol drinking was positively associated with the risk of AD (OR = 1.28, 95%CI: 1.14–1.44), but no statistically significant difference was observed in risks in the case-group comparison. Furthermore, whole-grain intake was associated with a decreased risk of only AD (OR = 0.78, 95%CI: 0.65–0.93). However, white meat intake was positively associated with risks of only SP when compared with AD cases (OR = 1.60, 95%CI: 1.15–2.23).ConclusionThe current study identified common risk factors such as BMI and smoking as well as different risks of certain factors (e.g., alcohol drinking and whole-grain intake) for SP and AD. However, there were still some factors, especially diet-related factors, that have not been fully elucidated in their association with the two lesions. Further research is needed in future to confirm and develop prevention strategies for different lesions.

AbstractBackground High-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase (CK)-MB are the most commonly used biomarkers for the diagnosis and prognosis of acute myocardial infarction (AMI). Chronic kidney disease (CKD) often leads to elevated hs-cTnT levels in non-AMI patients. However, studies comparing the prognostic value of both hs-cTnT and CK-MB in patients with AMI and CKD are lacking.Methods We conducted a retrospective study on AMI patients diagnosed between January 2015 and October 2020. Patients were categorized based on renal function as normal or CKD. Peak hs-cTnT and CK-MB levels during hospitalization were collected, and their diagnostic value was evaluated using receiver operating characteristic (ROC) curves. The impact on in-hospital mortality was analyzed using multivariate logistic regression. The relationship between the hs-cTnT/CK-MB ratio and in-hospital death was examined using a restricted cubic spline (RCS) curve.Results The study included 5022 AMI patients, of whom 797 (15.9%) had CKD. The AUCs of Hs-cTnT and CK-MB were higher in the CKD group [0.842 (95% CI: 0.789–0.894) and 0.821 (95% CI: 0.760–0.882)] than in the normal renal function group [0.695 (95% CI: 0.604-0.790) and 0.708 (95% CI: 0.624-0.793)]. After full adjustment for all risk factors, hs-cTnT (OR, 2.82; 95% CI, 1.03–9.86; p = 0.038) and CK-MB (OR, 4.91; 95% CI, 1.54–14.68; p = 0.007) above the cutoff values were independent predictors of in-hospital mortality in patients with CKD. However, in patients with normal renal function, only CK-MB above the cutoff (OR, 2.45; 95% CI, 1.02–8.24; p = 0.046) was a predictor of in-hospital mortality, whereas hs-cTnT was not. There was an inverted V-shaped relationship between the hs-cTnT/CK-MB ratio and in-hospital mortality, with an inflection point of 19.61. The ratio within the second quartile (9.63-19.6) was an independent predictor of in-hospital mortality in patients with CKD (OR 5.3, 95% CI 1.66–16.86, p = 0.005).Conclusions Hs-cTnT independently predicted in-hospital mortality in AMI patients with CKD, whereas its predictive value was not observed in patients with normal renal function. CK-MB was an independent predictor of in-hospital mortality regardless of renal function. Moreover, the hs-cTnT/CK-MB ratio may aid in risk stratification of AMI patients with CKD.

In this study, an efficient cholesterol-lowering strain of Lactiplantibacillus plantarum 54–1 was screened and its degradation molecular mechanism was investigated. Furthermore, a novel practical MRS medium for screening cholesterol-lowering lactic acid bacteria (LAB) was developed based on ultrasound treatment. L. plantarum 54–1 was found to have the highest ability to eliminate cholesterol (340.69 ± 5.87 µg/mL). According to SEM and the count of viable LAB results, the morphology of LAB in the cholesterol-containing medium developed in this experiment was close to the normal (full and smooth), and it can grow normally. Metabolomics revealed that L. plantarum 54–1 initially converted a portion of cholesterol to 7α-hydroxy-cholesterol and then to the key metabolite taurine, via the phosphotransferase system. These metabolites were further transformed into L-alanine, L-lysine, N6-Acetyl-L-lysine, (R)-b-aminoisobutyric acid, and 2-oxoarginine, through glycine, serine, and threonine metabolism, citrate cycle, D-arginine and D-ornithine metabolism, lysine degradation, and pyruvate metabolism pathways. Prokaryotic reference transcriptomics found that this may be mainly regulated by the bsh, phnE, ptsP, B0667_RS04545, and B0667_RSRS12300 genes, which was further validated by qPCR. Furthermore, molecular docking results demonstrated that 8 differential metabolites might bind to another portion of cholesterol via PI-PI conjugation and hydrophobic interactions and lower cholesterol via co-sedimentation. This study has strategic implications for developing probiotic powder food that lowers cholesterol.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Metal selenides with controllable crystal structures and hierarchically porous architectures have recently attracted great attention as the advanced electrode materials for sodium‐ion batteries. In present study, hierarchically porous orthogonal CoSe2 (o‐CoSe2) and cubic CoSe2 (c‐CoSe2) spheres are prepared through a controllable selenization and subsequent annealing strategy. Both types of CoSe2 spheres exhibit superior electrochemical properties resulting from hierarchical architecture, which can alleviate of the structural strain, the accelerated electron transmission and shorten the diffusion pathway of Na+. As anode materials for SIBs, the o‐CoSe2 electrode delivers a higher rate capability of 244 mAh g−1 at 3000 mA g−1 and a better cyclability of 378 mAh g−1 after 100 cycles at 1000 mA g−1 compared to the c‐CoSe2. From detailed microstructure characterization and kinetics behavior analysis, it is revealed that the o‐CoSe2 spheres exhibits larger specific surface, optimized porous nature, higher pseudocapacitive contribution, and more powerful Na+‐ions mobility. Our studies can pave the way for rational design and development of selenides electrode materials in rechargeable batteries. [ABSTRACT FROM AUTHOR]

Abstract Background Health behaviours in the preconception period have the potential to impact on fertility and pregnancy outcomes, and the health of all women regardless of pregnancy intention. Public awareness of this is low and interventions that promote behaviour change have not been integrated into real-world settings. Aims were to explore women’s understandings of health and health behaviours and what supports are important to promote behaviour change in the preconception period. Methods This qualitative study is the first phase of a broader co-design project set in the state of Victoria, Australia. Over 3 months, a series of in-depth interviews were conducted with female participants who were intending to become pregnant in the next 2 years (n = 6) and participants who were not intending to become pregnant in the next 2 years (n = 6). Community advisors (n = 8) aged 18-45 years provided feedback throughout the process. Coding of transcripts from interviews and meetings was undertaken by two researchers before a deductive process identified themes mapped to the COM-B framework. Results Nine themes and eight sub-themes were identified. Participants had a holistic view of health with nutrition, physical activity and sleep being most valued. Social connections were considered as being important for overall health and wellbeing and for promoting health behaviours. The only difference between groups was that pregnancy was an additional motivator for women who were planning to become pregnant in the next 2 years. A range of health information is available from health professionals and other sources. Unlimited access to information was empowering but sometimes overwhelming. Being listened to and shared experiences were aspects of social connections that validated participants and guided them in their decision-making. Conclusions Women valued their health and had a holistic view that includes physical, mental and social dimensions. Women viewed social connections with others as an opportunity to be listened to and to gain support that empowers behaviour change. Future interventions to promote behaviour change in preconception women should consider the importance all women placed on social connections and leverage off existing resources to connect women.

Abstract Background Few studies examined socio-ecological factors and leisure time physical activities (LTPA) and rarely focused on self-regulation and social capital, which might play a significant role in impacting people’s physical activity behavior. This study aimed to examine the direct and indirect effects of individual level (perceived benefits, perceived barriers, and self-efficacy), interpersonal level (self-regulation), social level (social capital), and environmental level factors (perceived physical environment) on LTPA among older adults. Methods A cross-sectional study was conducted in 737 older adults from Sichuan, China. Structural equation modeling (SEM) analysis was used to examine the associations of individual, interpersonal, social, and environmental level factors with LTPA. Results The mean age of all participants was 71.22 (range, 60–97), and 56.1% of them were women. The SEM results showed that individual level variables (β = 0.32, ρ

Abstract The first branchial arch (BA1), which is derived from cranial neural crest (CNC) cells, gives rise to various orofacial tissues. Cre mice are widely used for the determination of CNC and exploration of gene functions in orofacial development. However, there is a lack of Cre mice specifically marked BA1’s cells. Pax2-Cre allele was previously generated and has been widely used in the field of inner ear development. Here, by compounding Pax2-Cre and R26R-mTmG mice, we found a specific expression pattern of Pax2 + cells that marked BA1’s mesenchymal cells and the BA1-derivatives. Compared to Pax2-Cre; R26R-mTmG allele, GFP+ cells were abundantly found both in BA1 and second branchial arch in Wnt1-Cre;R26R-mTmG mice. As BMP4 signaling is required for orofacial development, we over-activated Bmp4 by using Pax2-Cre; pMes-BMP4 strain. Interestingly, our results showed bilateral hyperplasia between the upper and lower teeth. We also compare the phenotypes of Wnt1-Cre; pMes-BMP4 and Pax2-Cre; pMes-BMP4 strains and found severe deformation of molar buds, palate, and maxilla-mandibular bony structures in Wnt1-Cre; pMes-BMP4 mice; however, the morphology of these orofacial organs were comparable between controls and Pax2-Cre; pMes-BMP4 mice except for bilateral hyperplastic tissues. We further explore the properties of the hyperplastic tissue and found it is not derived from Runx2 + cells but expresses Msx1, and probably caused by abnormal cell proliferation and altered expression pattern of p-Smad1/5/8. In sum, our findings suggest altering BMP4 signaling in BA1-specific cell lineage may lead to unique phenotypes in orofacial regions, further hinting that Pax2-Cre mice could be a new model for genetic manipulation of BA1-derived organogenesis in the orofacial region.

Myeloid-derived suppressor cells (MDSCs) are identified as a highly heterogeneous group of immature cells derived from bone marrow and play critical immunosuppressive functions in autoimmune diseases. Accumulating evidence indicates that the pathophysiology of autoimmune diseases was closely related to genetic mutations and epigenetic modifications, with the latter more common. Epigenetic modifications, which involve DNA methylation, covalent histone modification, and non-coding RNA-mediated regulation, refer to inheritable and potentially reversible changes in DNA and chromatin that regulate gene expression without altering the DNA sequence. Recently, numerous reports have shown that epigenetic modifications in MDSCs play important roles in the differentiation and development of MDSCs and their suppressive functions. The molecular mechanisms of differentiation and development of MDSCs and their regulatory roles in the initiation and progression of autoimmune diseases have been extensively studied, but the exact function of MDSCs remains controversial. Therefore, the biological and epigenetic regulation of MDSCs in autoimmune diseases still needs to be further characterized. This review provides a detailed summary of the current research on the regulatory roles of DNA methylation, histone modifications, and non-coding RNAs in the development and immunosuppressive activity of MDSCs, and further summarizes the distinct role of MDSCs in the pathogenesis of autoimmune diseases, in order to provide help for the diagnosis and treatment of diseases from the perspective of epigenetic regulation of MDSCs.

BackgroundChronic diseases and the associated risk factors are preventable with lifestyle changes such as eating a healthier diet and being more physically active. In Malaysia, the prevalence of chronic diseases, including diabetes, hypertension, and heart diseases, has risen. In the present study, we explore the potential of co-designing and implementing a digital wellness intervention to promote socially-driven health knowledge and practices in the workplace in Malaysia, drawing on social cognitive theory, social impact theory, and social influence theory. ObjectiveThis study aims to co-design and assess the feasibility of a socially-driven digital health intervention to promote healthy behavior and prevent chronic diseases in a workplace in Malaysia. MethodsThis study involves two phases: (i) identifying the barriers and facilitators to healthy behaviors at work and co-designing the intervention activities with the employees, (ii) implementing and evaluating the intervention’s feasibility. Phase 1 will involve qualitative data collection and analysis through semi-structured, in-depth interviews and co-design workshops with the employees, while Phase 2 will consist of a feasibility study employing quantitative measurements of health behaviors through accelerometers and questionnaires. ResultsThis study was funded in June 2021 and ethics approval for Phase 1 was obtained from the Monash University Human Research Ethics Committee in January 2022. As of August 2022, qualitative interviews with 12 employees have been completed and the data has been transcribed and analyzed. These results will be published in a future paper with results from all Phase 1 activities. ConclusionsThe study will help us to better understand the mechanisms through which digital technologies can promote socially-driven health knowledge and behaviors. This research will also result in a scalable wellness intervention that could be further tailored and expanded to other employers and social groups across the region. International Registered Report Identifier (IRRID)PRR1-10.2196/39238

Dairy-derived peptides and corn-derived peptides have been identified as essential ingredients for health promotion in the food industry. The hydrolysis based on lactic acid bacteria (LAB) protease system is one of the most popular methods to prepare bioactive peptides. The objectives of this paper are to develop antioxidant fermented milk and to obtain natural antioxidant peptides. In our study, LAB with antioxidant capacity were screened in vitro, and the corn fermented milk with antioxidant capacity was achieved by the traditional fermentation method. Fermented milk was purified by ultrafiltration and molecular sieve, and identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Our findings demonstrate that Limosilactobacillus fermentum L15 had a scavenging capacity of more than 80% of DPPH radicals, Trolox equivalent antioxidant capacity (TEAC) of 0.348 ± 0.005 mmol/L. Meanwhile, the peptide content of corn fermented milk prepared with L. fermentum L15 was 0.914 ± 0.009 mg/mL and TAEC of 0.781 ± 0.020 mmol/L. Particularly important, IGGIGTVPVGR and LTTVTPGSR isolated and extracted from fermented milk were found to have antioxidant capacity for the first time. The synthetic peptides IGGIGTVPVGR and LTTVTPGSR demonstrated a scavenging capacity of 70.07 ± 2.71% and 70.07 ± 2.77% for DPPH radicals and an antioxidant capacity of 0.62 ± 0.01 mmol/L and 0.64 ± 0.02 mmol/L Trolox equivalent, respectively. This research provides ideas and basis for the development and utilization of functional dairy products.

A novel photoelectric integration process (MPEC) was developed to degrade Amaranth. In the MPEC, the output voltage of the microbial fuel cells (MFCs) was used to assist the dual slant-placed electrodes thin-film photocatalytic (PC). With two MFCs connected in series, the MPEC process realized the highest decolorization efficiency. It is close to that of the external bias photoelectrocatalytic (PEC), and 7% higher than that of the self-generated electric field-assisted photoelectrocatalytic (SPEC). The feasibility of MPEC pre-treatment and MFC post-treatment of Amaranth was investigated. The results demonstrated that MPEC pre-treatment of Amaranth could improve its biodegradability. The higher MPEC decolorization efficiency indicated the stronger biodegradability of the obtained intermediates and the higher MFC output voltage. When the MPEC decolorization efficiency was gradually increased to 50%, the removal efficiencies of total Chemical Oxygen Demand (COD) by the MPEC and MFC increased; when the decolorization efficiency was increased above 50%, the removal efficiencies became stable. MPEC enhanced the biodegradability efficiently and was applicable to pre-treat textile wastewater. [ABSTRACT FROM AUTHOR]

Abstract The present study aimed to describe the blood pressure (BP) control rate and 10-years arteriosclerotic cardiovascular disease (ASCVD) risk estimation among community hypertensive patients. A total of 196,803 subjects were enrolled. The control rates calculated as the intensive (SBP < 130 mmHg and DBP < 80 mmHg) and standard (SBP < 140 mmHg and DBP < 90 mmHg) threshold. Multivariable logistic analysis was employed to assess the associations between cardiovascular factors and BP control. Sensitivity, specificity and Youden’s index were used to identify the ability of high risk of ASCVD estimation by different thresholds. The control rate was 16.34% and 50.25% by the intensive and standard threshold, respectively. Besides regular medication, the risk factors for BP control included older age, male, unhealthy lifestyle, obesity, dyslipidemia and abnormal FPG. 25.08% of subjects had high risk of 10-years ASCVD estimation. The sensitivity, specificity and Youden’s index of intensive threshold was 84.37%, 16.15% and 0.51%, and were significantly different from 50.55%, 50.42% and 0.98% of the standard threshold, respectively. Half of community hypertensive patients did not control BP, and nearly a quarter have high risk of 10-years ASCVD risk estimation. The intensive threshold resulted in a one-third reduction in the control rate compared to the standard threshold. No matter which threshold was used, a single BP control status seemed not a suitable indicator for identification of high risk of 10-years ASCVD risk estimation.

Aging is a complex multifactorial process that greatly affects animal health. Multi-omics analysis is widely applied in evolutionary biology and biomedical research. However, whether multi-omics can provide sufficient information to reveal comprehensive changes in aged non-human primates remains unclear. Here, we explored changes in host–microbe interactions with aging in Chinese rhesus macaques (Macaca mulatta lasiota, CRs) using multi-omics analysis. Results showed marked changes in the oral and gut microbiomes between young and aged CRs, including significantly reduced probiotic abundance and increased pathogenic bacterial abundance in aged CRs. Notably, the abundance of Lactobacillus, which can metabolize tryptophan to produce aryl hydrocarbon receptor (AhR) ligands, was decreased in aged CRs. Consistently, metabolomics detected a decrease in the plasma levels of AhR ligands. In addition, free fatty acid, acyl carnitine, heparin, 2-(4-hydroxyphenyl) propionic acid, and docosahexaenoic acid ethyl ester levels were increased in aged CRs, which may contribute to abnormal fatty acid metabolism and cardiovascular disease. Transcriptome analysis identified changes in the expression of genes associated with tryptophan metabolism and inflammation. In conclusion, many potential links among different omics were found, suggesting that aged CRs face multiple metabolic problems, immunological disorders, and oral and gut diseases. We determined that tryptophan metabolism is critical for the physiological health of aged CRs. Our findings demonstrate the value of multi-omics analyses in revealing host–microbe interactions in non-human primates and suggest that similar approaches could be applied in evolutionary and ecological research of other species.

The use and transformation of land by humans are the main cause of the increase in the concentration of carbon dioxide in the atmosphere. Using land-use data and socioeconomic statistics for 1995, 2000, 2005, 2010, 2015, and 2018, this study examines the carbon emissions from land use and their intensity in the entire Yangtze River Delta Region. We constructed a spatial correlation network of land-use carbon emissions by using a modified gravity model to analyze the characteristics of the spatial correlations and spillover effects of land-use carbon emissions. Results reveal that: (1) the spatial differences in land-use carbon emissions gradually increased, whereas those in land-use carbon emission intensity gradually narrowed from 1995 to 2018; (2) the high-degree centrality of Shanghai, Wuxi, and Suzhou indicated that they had always played leading roles in the network from 1995 to 2018. Moreover, Shanghai and Wuxi had large land-use carbon radiation ranges and together with Suzhou, Hangzhou, Changzhou, and Nanjing, exhibited above-average betweenness centrality from 1995 to 2018 and strong bridging capabilities across the entire network; (3) the land-use carbon emissions had obvious spatial correlations and spillover effects. Our results can provide a scientific basis from an urban agglomeration perspective for the transformation of China’s current economy into a low-carbon one, as well as the realization of regionally differentiated and coordinated emission reduction.

The number of viable lactic acid bacteria (LAB) is a key indicator of the quality of fermented milk. Currently, the combination of propidium monoazide (PMA) and qPCR has been applied in the quantification of viable bacteria in various matrices. In this research, the PMA-qPCR method was used to detect the number of viable bacteria of each LAB species in fermented milk. By analyzing pheS gene and 16S rRNA gene sequence similarities in five species of LAB, namely Lactobacillus delbrueckii subsp. bulgaricus, Lactiplantibacillus plantarum, Streptococcus thermophilus, Lactobacillus helveticus, and Lactococcus lactis subsp. lactis, the pheS gene resolved species identities better and was thus selected to design specific primers and probes. The pheS gene was cloned into the pUC19 vector and used to construct a standard curve for absolute quantification. Standard curves for quantification were constructed for each LAB species for serial dilutions between 1011 and 106 CFU/mL, with R2 > 0.99. The number of viable bacteria in the fermented milk detected by PMA-qPCR was significantly lower than that of qPCR (P < 0.05), indicating that PMA inhibited the amplification of DNA from dead cells. This was corroborated by the results from bacterial staining and plate count experiments. The proposed PMA-qPCR method provided rapid qualitative and quantitative determination of the number of viable bacteria for each LAB species in fermented milk within 3 h.

BackgroundImproving preconception health can benefit all women, their children, and their families regardless of their individual pregnancy intentions. Rapidly increasing access to information technology and online engagement have created opportunities to use digital health resources to engage with preconception women regarding lifestyle behaviors. ObjectiveThis study explores how preconception women engage with digital health resources and online platforms to inform the design and development of a digital health resource to support women to make positive behavior change for their preconception health. MethodsThis codesign research followed the Double Diamond process, which focuses on contextualization and explorative processes in phase 1 and ideation and development processes in phase 2. Phase 1 is reported on in this study and was undertaken via a series of 1-on-1 in-depth interviews with female participants (N=12) aged 18-45 years over 3 months. Interviews were designed to explore participants’ lived experiences in relation to their health and desired supports for healthy lifestyle behaviors. The first interview focused on participants’ perceptions of health and health behaviors, the second interview focused on social connections for health, and the third interview focused on digital health information and supports. Conversations from the first interview informed the development of the second interview, and conversations from the second interview informed the development of the third interview. Community advisors (N=8) met to provide feedback and advice to the researchers throughout the interview process. Qualitative analyses of transcripts from interviews were undertaken by 2 researchers before a deductive process identified themes mapped to the capability, opportunity, motivation, and behavior (COM-B) framework. ResultsIn total, 9 themes and 8 subthemes were identified from 124 codes. In relation to digital health resources, specifically, participants were already engaging with a range of digital health resources and had high expectations of these. Digital health resources needed to be easy to access, make women’s busy lives easier, be evidence based, and be reputable. Social connectedness was also highly important to our participants, with information and advice from peers with similar experiences being preferred over yet more online health information. Online communities facilitated these social interactions. Participants were open to the idea of chatbots and virtual assistants but acknowledged that they would not replace authentic social interactions. ConclusionsCodesigned digital health resources should be evidence based, reputable, and easy to access. Social connections were considered highly important to women, and designers of digital health resources should consider how they can increase opportunities for women to connect and learn from each other to promote health behaviors.

The function of the autoinducer-2 exporters (AI-2E) family transporter protein of Lactobacillus acidophilus is still unclear. The phylogenetic analysis was used to analyze the relationship between the AI-2E protein of the L. acidophilus CICC 6074 strain and other AI-2E family members. Escherichia coli KNabc strain was used to verify whether the protein has Na+ (Li+)/H+ antiporter activity. The AI-2E protein overexpression strain was constructed by using the pMG36e expression vector, and the overexpression efficiency was determined by real-time quantitative PCR. The vitality and AI-2 activity of L. acidophilus CICC 6074 strains were determined. The results showed that the AI-2E protein of Lactobacillus formed a single branch on the phylogenetic tree and was closer to the AI-2E family members whose function was AI-2 exporter group I. The expression of AI-2E protein in the E. coli KNabc strain did not recover the resistance of the bacteria to the saline environment. Overexpression of AI-2E protein in L. acidophilus CICC 6074 could promote the AI-2 secretion of L. acidophilus CICC 6074 strain and enhance their survival ability in intestinal juice.

Abstract Dental pulp can initiate its damage repair after an injury of the pulp–dentin complex by rearrangement of odontoblasts and formation of newly differentiated odontoblast-like cells. Connexin 43 (Cx43) is one of the gap junction proteins that participates in multiple tissue repair processes. However, the role of Cx43 in the repair of the dental pulp remains unclear. This study aimed to determine the function of Cx43 in the odontoblast arrangement patterns and odontoblastic differentiation. Human teeth for in vitro experiments were acquired, and a pulp injury model in Sprague-Dawley rats was used for in vivo analysis. The odontoblast arrangement pattern and the expression of Cx43 and dentin sialophosphoprotein (DSPP) were assessed. To investigate the function of Cx43 in odontoblastic differentiation, we overexpressed or inhibited Cx43. The results indicated that polarized odontoblasts were arranged along the pulp–dentin interface and had high levels of Cx43 expression in the healthy teeth; however, the odontoblast arrangement pattern was slightly changed concomitant to an increase in the Cx43 expression in the carious teeth. Regularly arranged odontoblast-like cells had high levels of the Cx43 expression during the formation of mature dentin, but the odontoblast-like cells were not regularly arranged beneath immature osteodentin in the pulp injury models. Subsequent in vitro experiments demonstrated that Cx43 is upregulated during odontoblastic differentiation of the dental pulp cells, and inhibition or overexpression of Cx43 influence the odontoblastic differentiation. Thus, Cx43 may be involved in the maintenance of odontoblast arrangement patterns, and influence the pulp repair outcomes by the regulation of odontoblastic differentiation.

Young people living in out-of-home care (OoHC) are widely considered to be one of the most vulnerable groups in the community. This article describes the evaluation and implementation study protocol of a healthy lifestyle programme developed to improve the eating and physical activity habits of young people living in residential OoHC. The study will employ a longitudinal multi-group pre-post process evaluation to assess our implementation strategy in the dissemination of HEALing Matters at the: 1) system-level; 2) organizational-level; 3) residential home-level; and 4) individual-level (N = approximately 60 residential homes [approximately 400–500 staff and 240 young people]). Implementation- and program-related outcomes will be assessed using self-report surveys, semi-structured interviews and focus groups, house audits and website usage data collected prior, during and after implementation. Results are expected to inform and help guide the further development and training of residential care staff’s understanding and application of health literacy.

BackgroundChronic hepatitis B virus (HBV) infection remains a major public health problem worldwide. Immune checkpoint molecules expressed on CD4+ T cells play critical roles in chronic HBV infection. However, their roles in chronic asymptomatic HBV carriers (ASCs) with hepatitis B e antigen (HBeAg)-negative remain unclear. In this study, we explored the role of immune checkpoint molecules expressed on CD4+ T cell subsets in chronic ASCs with HBeAg-negative.MethodsHuman peripheral blood mononuclear cells (PBMCs) from the ASCs with HBeAg-negative and healthy controls (HC) were isolated, and immune checkpoint molecules expressed on CD4+ T cell subsets and serum cytokines were detected by flow cytometry. Moreover, the mRNA expressions of immune checkpoint molecules were analyzed by a real-time quantitative PCR assay.ResultsIn comparison with HC, CD4+ T cells highly expressed LAG-3, TIM-3, and PD-1 in PBMCs from chronic ASCs with HBeAg-negative. Interestingly, the expressions of TIM-3 and PD-1 on circulating follicular helper T (Tfh) cells in ASCs were significantly high. Moreover, high expressions of LAG-3, TIM-3, and PD-1 were different among Treg, Th1, Th2, and Th17 cells. In addition, the expressions of TIM-3 and CTLA-4 mRNA in PBMCs from ASCs were significantly elevated. However, the frequency of CTLA-4+CD4+ T cell subsets in PBMCs from ASCs was not different from HC. The levels of six cytokines in serum from ASCs were not clearly different from HC.ConclusionImmune checkpoint molecules highly expressed on CD4+ T cell subsets indicated an important role in chronic ASCs with HBeAg-negative, which provided potential therapeutic targets in the pathogenesis of chronic HBV infection.

BackgroundBinge eating is a subjective loss of control while eating, which leads to the consumption of large amounts of food. It can cause significant emotional distress and is often accompanied by purging behaviors (eg, meal skipping, overexercising, or vomiting). ObjectiveThe aim of this study was to explore the potential of mobile sensing to detect indicators of binge-eating episodes, with a view toward informing the design of future context-aware mobile interventions. MethodsThis study was conducted in 2 stages. The first involved the development of the DeMMI (Detecting Mental health behaviors using Mobile Interactions) app. As part of this, we conducted a consultation session to explore whether the types of sensor data we were proposing to capture were useful and appropriate, as well as to gather feedback on some specific app features relating to self-reporting. The second stage involved conducting a 6-week period of data collection with 10 participants experiencing binge eating (logging both their mood and episodes of binge eating) and 10 comparison participants (logging only mood). An optional interview was conducted after the study, which discussed their experience using the app, and 8 participants (n=3, 38% binge eating and n=5, 63% comparisons) consented. ResultsThe findings showed unique differences in the types of sensor data that were triangulated with the individuals’ episodes (with nearby Bluetooth devices, screen and app use features, mobility features, and mood scores showing relevance). Participants had a largely positive opinion about the app, its unobtrusive role, and its ease of use. Interacting with the app increased participants’ awareness of and reflection on their mood and phone usage patterns. Moreover, they expressed no privacy concerns as these were alleviated by the study information sheet. ConclusionsThis study contributes a series of recommendations for future studies wishing to scale our approach and for the design of bespoke mobile interventions to support this population.

BackgroundPure red cell aplasia (PRCA) is one of the important complications in major ABO-incompatible allogeneic hematopoietic stem cell transplantation (HSCT). The established pathogenic factor of PRCA is the persistence of high anti-donor isohemagglutinins. As previously verified, the conditioning regimen and donor type were the factors associated with the development of PRCA in the small-sized studies. Currently, the prevalence, risk factors, and prognosis of PRCA are still worth studying to provide evidence.MethodsWe conducted a prospective nested case-control study to determine the prevalence, donor-related factors, and the outcomes of PRCA following major ABO-incompatible transplantation. A total of 469 patients who underwent ABO-incompatible grafts were observed.ResultsNone of the patients were diagnosed with PRCA with minor or bidirectional ABO-incompatible HSCT. Thirteen of the187 patients (7%; 95% confidence interval [CI], 3.9%–11.9%) developed PRCA following major ABO-incompatible HSCT. Eleven of the 13 patients with PRCA recovered entirely. Donor type was an independent factor associated with post-HSCT PRCA (odds ratio [OR]=0.030; 95% CI, 0.003–0.321; P=0.004). The cumulative incidence rates of post-HSCT PRCA in the context of major ABO-incompatible HSCT were 0.8%, 13.1%, and 27.2% for the haploidentical donor (HID), unrelated donor, and matched related donor, respectively. No significant influence of PRCA on transplantation outcomes was observed.In conclusion, post-HSCT PRCA is a rare and less threatening complication in major ABO-incompatible HSCT. The majority of patients with PRCA could recover. Additionally, HIDs for recipients may have a low risk of post-HSCT PRCA. This trial was registered at www.chictr.org.cn (#ChiCTR2000041412).

BackgroundPrimary hepatoid adenocarcinoma of the gallbladder is a relatively rare type of extrahepatic adenocarcinoma. The genetic changes involved in this type of adenocarcinoma were unexplained so far. We reported a rare case of primary hepatoid adenocarcinoma of gallbladder with Mab-21 domain containing 2 (MB21D2), polypeptide N-acetylgalactosaminyltransferase 12 (GALNT12), and AT-rich interaction domain 2 (ARID2) mutations, which was confirmed after surgical resection pathologically.Case SummaryA 69-year-old female with distention of hypogastrium and constipation received enema treatment, but ineffectively. No abnormalities were found on relevant physical examination. Then, the CT and MRI demonstrated a 3.3–4-cm soft tissue mass shadow in the neck of the gallbladder. The primary lesions consisted of two components: high-grade intraepithelial neoplasia of glands and hepatoid glands microscopically after laparoscope cholecystectomy. Immunohistochemical staining showed the sameness and difference of the two areas. Furthermore, tumor mutational burden (TMB) shows that the MB21D2, GALNT12, and ARID2 genes were mutated.ConclusionThis is the first report of primary hepatoid adenocarcinoma of the gallbladder with MB21D2, GALNT12, and ARID2 mutations. This will provide a theoretical basis for genetic changes in rare tumors.

Background. Quadratus lumborum block (QLB) has been used to reduce postoperative acute pain and opioid consumption. However, the efficacy of QLB on the quality of recovery (QoR) after gastrointestinal surgery has not been established. The aim of this study was to evaluate the ability of QLB to enhance the postoperative QoR in patients undergoing open gastrointestinal surgery. Methods. Eighty-four patients undergoing open gastrointestinal surgery were randomized to receive ultrasound-guided QLB with either 20 ml of 0.375% ropivacaine or saline. The primary outcome was the QoR-15 score at 24 h after surgery. The secondary outcomes were the postoperative pain intensity, opioid consumption, the incidence of nausea, vomiting, and chronic pain. Results. The global QoR-15 score at 24 h postoperatively was significantly higher in the QLB group than in the control group (mean difference: 16.9; 95% CI: 11.9–21.9). Additionally, the QoR-15 scores for five dimensions were significantly higher in the QLB group than in the control group. The cumulative oxycodone consumption was significantly lower in the QLB group during 0–6, 6–24, 0–24, 24–48, and 0–48 h postoperatively than in the control group. At rest or during coughing, the pain verbal rating scale scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than in the control group. The incidence of postoperative nausea was significantly different between the groups, but postoperative vomiting was not. Conclusion. Single-injection posteromedial QLB with ropivacaine enhanced the QoR at 48 h after surgery and improved analgesia during the early postoperative period in patients undergoing gastrointestinal surgery.

Background. Current guidelines recommend the use of potent antiplatelet agents in patients undergoing percutaneous coronary intervention (PCI) following an acute coronary syndrome (ACS). However, data about optimal platelet inhibition in severe renal insufficiency patients are scarce. The purpose of this study is to determine if ticagrelor is more effective than clopidogrel in patients with ACS and severe renal insufficiency treated with PCI. Methods. We retrospectively enrolled patients with ACS and severe renal insufficiency (eGFR ≤ 30 ml/min·1.73 m2 or dialysis) who underwent PCI at our hospital between January 2015 and March 2020. We used the adjusted Cox proportional hazards models to analyze the 1-year outcome endpoints, including the primary endpoint (the composite of cardiovascular death, recurrence of MI, or nonfatal ischemic stroke), death from any cause, and bleeding events (Bleeding Academic Research Consortium, BARC criteria). Results. A total of 276 patients with ACS and severe renal insufficiency who were treated with PCI with ticagrelor (n = 108) or clopidogrel (n = 168) were included in the study. After adjustment, there was no statistical difference in risk of the primary endpoint (HR, 0.78; 95% CI, 0.46–1.33; P=0.367) and death from any cause (HR, 0.86; 95% CI, 0.38–1.89; P=0.708) in the ticagrelor group against the clopidogrel group. However, the risk of total bleeding was significantly higher in the ticagrelor group (HR, 3.01; 95% CI, 1.81–5.62; P=0.01). Subgroup analysis according to the confounders did not identify any significant subgroup heterogeneity. Conclusion. Ticagrelor did not improve the major adverse cardiovascular events and all-cause mortality when compared to clopidogrel, but significantly increased the risk of bleeding in Chinese patients with ACS and severe renal insufficiency undergoing PCI.