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Abstract Background Since May 7 2022, mpox has been endemic in many countries which has attracted the attention of health authorities in various countries and made control decisions, in which vaccination is the mainstream strategy. However, the shortage of vaccine doses and the reduction of protective efficacy have led to unresolved issues such as vaccine allocation decisions and evaluation of transmission scale. Methods We developed an epidemiological model to describe the prevalence of the mpox virus in New York City and calibrated the model to match surveillance data from May 19 to November 3, 2022. Finally, we adjusted the model to simulate and compare several scenarios of non-vaccination and pre-pandemic vaccination. Results Relative to the status quo, if vaccination is not carried out, the number of new infections increases to about 385%, and the transmission time will be extended to about 350%, while if vaccinated before the epidemic, the number of new infections decreases to 94.2-96%. Conclusions The mpox outbreak in New York City may be linked to the Pride event. However, with current vaccine coverage, there will be no more large-scale outbreaks of mpox, even if there is another similar activity. For areas with limited vaccines, priority is given to high-risk groups in the age group [34–45] years as soon as possible.

BackgroundObservational studies have found that vascular endothelial growth factor (VEGF) levels are associated with the risk of cardiovascular disease. However, it remains unclear whether VEGF levels have a causal effect on the risk of atrial fibrillation.MethodsA two-sample Mendelian randomization (MR) study was conducted to explore the causal relationship between VEGF levels and the risk of atrial fibrillation. Genetic variants associated with VEGF [VEGF-A, VEGF-C, VEGF-D, VEGF receptor−2 (VEGFR-2), VEGFR-3] and atrial fibrillation (atrial fibrillation, atrial fibrillation and flutter) were used as instrumental variables. Data on genetic variants were obtained from published genome-wide association studies (GWAS) or the IEU Open GWAS project. Inverse-variance weighted (IVW) analysis was used as the primary basis for the results, and sensitivity analyses were used to reduce bias. Causal relationships were expressed as odds ratio (OR) with 95% confidence interval (CI), and a P-value of

The World Health Organization (WHO) 2017 classifications for neuroendocrine neoplasms (NENs) subdivided grade 3 pancreatic neuroendocrine neoplasms (pNENs) into G3 well-differentiated pancreatic neuroendocrine tumors (G3 pNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (pNECs), according to the mitotic count, Ki-67 index, and cell differentiation. As a new category, G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice. Therefore, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

AimsA strategy based on therapeutic drug monitoring and population pharmacokinetic (popPK) models would likely increase the rate of clinical remission (CR) after infliximab (IFX) induction in patients with Crohn’s disease (CD). This study aimed to evaluate the relationship between early IFX levels and antibodies to infliximab (ATI) and CR at week 14 and simulate the probability of attaining the identified exposure target.MethodsPatients with CD (n = 140) treated with IFX were enrolled to develop the popPK model. Of these, 43 moderate-to-severe patients with CD were followed up at week 14. Simulations were performed on patients with different dosage regimens and covariates.ResultsIFX levels >20.08 μg/mL at week 2, >18.44 μg/mL at week 6, and >3.08 μg/mL at week 14 were linked to CR. A one-compartment model fit the data best. The covariates influencing clearance were fat free mass, albumin and ATI levels. To achieve IFX levels >20.08 μg/mL at week 2, ≥400 mg IFX was predicted to be required in over 50% patients with 45–70 kg and 35–45 g/L albumin, except for patients with 70 kg and 30 g/L albumin.ConclusionIFX levels >20.08 μg/mL at week 2 and absence of ATI at week 14 are associated with CR. Optimising IFX induction dosing will be critical to achieve the target of early IFX levels associated with CR.

BackgroundAdalimumab induces the production of anti-drug antibodies (ADA) that may lead to reduced drug concentration and loss-of-response, posing significant clinical challenges. However, traditional immunoassays have limitations in terms of sensitivity and drug-tolerance, hindering the insights of ADA response.MethodsHerein, we developed an integrated immunoassay platform combining the electrochemiluminescence immunoassay with immunomagnetic separation strategy. A longitudinal cohort study involving 49 patients with ankylosing spondylitis was carried out to analyze the dynamic profiles of ADA and to investigate the impact of ADA on adalimumab pharmacokinetics using a population pharmacokinetic model. Additionally, cross-sectional data from 12 patients were collected to validate the correlation between ADA levels and disease relapse.ResultsThe ADA assay demonstrated high sensitivity (0.4 ng/mL) and drug-tolerance (100 μg/mL), while the neutralizing antibodies (NAB) assay showed a sensitivity of 100 ng/mL and drug-tolerance of 20 μg/mL. Analysis of the longitudinal cohort revealed that a majority of patients (44/49, 90%) developed persistent ADA within the first 24 weeks of treatment. ADA levels tended to plateau over time after an initial increase during the early immune response phase. Further, nearly all of the tested patients (26/27, 96%) were classified as NAB positive, with a strong correlation between ADA levels and neutralization capacity (R2 = 0.83, P < 0.001). Population pharmacokinetic modeling revealed a significant positive association between model-estimated individual clearance and observed ADA levels. Higher ADA levels were associated with adalimumab clearance and disease relapse in a cross-sectional cohort, suggesting a promising ADA threshold of 10 for potential clinical application. Moreover, the IgG class was the primary contributor to ADA against adalimumab and the apparent affinity exhibited an increasing trend over time, indicating a T-cell dependent mechanism for ADA elicitation by adalimumab.ConclusionIn summary, this integrated immunoassay platform shows promise for in-depth analysis of ADA against biologics, offering fresh insights into immunogenicity and its clinical implications.

Boehmeria is a taxonomically challenging group within the nettle family (Urticaceae). The polyphyly of the genus has been proposed by previous studies with respect to five genera (Debregeasia, Cypholophus, Sarcochlamys, Archiboehmeria, and Astrothalamus). Extensive homoplasy of morphological characters has made generic delimitation problematic. Previous studies in other plant groups suggest that plastome structural variations have the potential to provide characters useful in reconstructing evolutionary relationships. We aimed to test this across Boehmeria and its allied genera by mapping plastome structural variations onto a resolved strongly supported phylogeny. In doing so, we expanded the sampling of the plastome to include Cypholophus, Sarcochlamys, Archiboehmeria, and Astrothalamus for the first time. The results of our phylogenomic analyses provide strong support for Sarcochlamys as being more closely related to Leucosyke puya than to Boehmeria and for the clustering of Boehmeria s.l. into four subclades. The sizes of the plastomes in Boehmeria s.l. ranged from 142,627 bp to 170,958 bp. The plastomes recovered a typical quadripartite structure comprising 127~146 genes. We observe several obvious structural variations across the taxa such as gene loss and multiple gene duplication, inverted repeat (IR) contraction and wide expansions, and inversions. Moreover, we recover a trend for these variations that the early clades were relatively conserved in evolution, whereas the later diverging clades were variable. We propose that the structural variations documented may be linked to the adaptation of Boehmeria s.l. to a wide range of habitats, from moist broadleaf forests in Asia to xeric shrublands and deserts in Africa. This study confirms that variation in plastome gene loss/duplication, IR contraction/expansion, and inversions can provide evidence useful for the reconstruction of evolutionary relationships.

Abstract Purpose This study aims to evaluate the effectiveness of mitigation strategies and analyze the impact of human behavior on the transmission of Mpox. The results can provide guidance to public health authorities on comprehensive prevention and control for the new Mpox virus strain in the Democratic Republic of Congo as of December 2023. Methods We develop a two-layer Watts-Strogatz network model. The basic reproduction number is calculated using the next-generation matrix approach. Markov chain Monte Carlo (MCMC) optimization algorithm is used to fit Mpox cases in Canada into the network model. Numerical simulations are used to assess the impact of mitigation strategies and human behavior on the final epidemic size. Results Our results show that the contact transmission rate of low-risk groups and susceptible humans increases when the contact transmission rate of high-risk groups and susceptible humans is controlled as the Mpox epidemic spreads. The contact transmission rate of high-risk groups after May 18, 2022, is approximately 20% lower than that before May 18, 2022. Our findings indicate a positive correlation between the basic reproduction number and the level of heterogeneity in human contacts, with the basic reproduction number estimated at 2.3475 (95% CI: 0.0749–6.9084). Reducing the average number of sexual contacts to two per week effectively reduces the reproduction number to below one. Conclusion We need to pay attention to the re-emergence of the epidemics caused by low-risk groups when an outbreak dominated by high-risk groups is under control. Numerical simulations show that reducing the average number of sexual contacts to two per week is effective in slowing down the rapid spread of the epidemic. Our findings offer guidance for the public health authorities of the Democratic Republic of Congo in developing effective mitigation strategies.

Abstract Background Obesity is increasingly recognized as a grave public health concern globally. It is associated with prevalent diseases including coronary heart disease, fatty liver, type 2 diabetes, and dyslipidemia. Prior research has identified demographic, socioeconomic, lifestyle, and genetic factors as contributors to obesity. Nevertheless, the influence of occupational risk factors on obesity among workers remains under-explored. Investigating risk factors specific to steelworkers is crucial for early detection, prediction, and effective intervention, thereby safeguarding their health. Methods This research utilized a cohort study examining health impacts on workers in an iron and steel company in Hebei Province, China. The study involved 5469 participants. By univariate analysis, multifactor analysis, and review of relevant literature, predictor variables were found. Three predictive models—XG Boost, Support Vector Machine (SVM), and Random Forest (RF)—were employed. Results Univariate analysis and cox proportional hazard regression modeling identified age, gender, smoking and drinking habits, dietary score, physical activity, shift work, exposure to high temperatures, occupational stress, and carbon monoxide exposure as key factors in the development of obesity in steelworkers. Test results indicated accuracies of 0.819, 0.868, and 0.872 for XG Boost, SVM, and RF respectively. Precision rates were 0.571, 0.696, and 0.765, while recall rates were 0.333, 0.592, and 0.481. The models achieved AUCs of 0.849, 0.908, and 0.912, with Brier scores of 0.128, 0.105, and 0.104, log losses of 0.409, 0.349, and 0.345, and calibration-in-the-large of 0.058, 0.054, and 0.051, respectively. Among these, the Random Forest model demonstrated superior performance. Conclusions The research indicates that obesity in steelworkers results from a combination of occupational and lifestyle factors. Of the models tested, the Random Forest model exhibited superior predictive ability, highlighting its significant practical application.

Stachys yingzuijieensis, a new species from western Hunan, China, is described and illustrated. Molecular phylogenetic analyses based on three nuclear ribosomal DNA loci (ETS, ITS and 5S-NTS) recovered S. yingzuijieensis within the Stachys clade and as a sister group of S. arrecta. The two species can be easily distinguished by the morphology of lamina, corolla and nutlet. A key to all species of Stachydeae from China is also provided.

The dynamics of two-plant competitive models have been widely studied, while the effect of chemical heterogeneity on competitive plants is rarely explored. In this study, a model that explicitly incorporates light and total phosphorus in the system is formulated to characterize the impacts of limited carbon and phosphorus on the dynamics of the two-plant competition system. The dissipativity, existence and stability of boundary equilibria and coexistence equilibrium are proved, when the two plants compete for light equally. Our simulations indicate that, with equal competition for light ($ b_{12} = b_{21} $) and a fixed total phosphorus in the system ($ T $), plants can coexist with moderate light intensity ($ K $). A higher $ K $ tends to favor the plant with a lower phosphorus loss rate ($ d_1 $ vs $ d_2 $). When $ K $ is held constant, a moderate level of $ T $ leads to the dominance of the plant with a lower phosphorus loss rate ($ d_1 $ vs $ d_2 $). At high $ T $ levels, both plants can coexist. Moreover, our numerical analysis also shows that, when the competition for light is not equal, the low level of total phosphorus in the system may lead the model to be unstable and have more types of bistability compared with the two-dimensional Lotka-Volterra competition model.

Abstract Background Chronic obstructive pulmonary disease (COPD) represents a prevalent ailment, progressively surging within the ranks of coal mine laborers. The current study endeavors to elucidate the effects of dust exposure and smoking on COPD incidence amongst coal mine workers, while concurrently devising preventive strategies for this affliction. Method A nested case–control study was conducted encompassing 1,416 participants aged ≥ 18 years, spanning the duration from (2017–2018) until 2020. A meticulous matching process yielded a cohort of 708 COPD patients, each paired with a control subject, forming a harmonious 1:1 ratio. Multiple logistic regression analysis was employed to scrutinize the associations between smoking, dust exposure with COPD among coal workers. Results The COPD prevalence within the cohort of coal workers under investigation amounted to 22.66%, with an accompanying incidence density of 0.09/person-year. Following meticulous adjustment for confounding variables, it was discerned that cumulative dust exposure within the range of 47.19 ~ (OR: 1.90, 95% CI: 1.05, 3.44), 101.27 ~ (OR: 1.99, 95% CI: 1.17, 3.39), as well as smoking indices of 72 ~ (OR: 1.85, 95% CI: 1.19, 2.88), 145 ~ (OR: 1.74, 95% CI: 1.17, 2.61), 310 ~ (OR: 1.85, 95% CI: 1.23, 2.77) engender an escalated vulnerability to COPD among coal workers. Furthermore, interaction analysis discerned an absence of both multiplicative and additive interactions between dust exposure, smoking, and COPD occurrence amidst coal workers. Conclusion Dust exposure and smoking were unequivocally identified as precipitating risk factors for COPD incidence within the population of coal workers, albeit devoid of any discernible interaction between these two causal agents.

Abstract We aimed to explore excessive daytime sleepiness (EDS) and correlates of clinical characteristics by using cross‐sectional and longitudinal analyses from the Parkinson's Progression Markers Initiative database. Four hundred twenty‐three patients with Parkinson's disease (PD; EDS: non‐EDS = 357:66) and 195 healthy controls (HCs; EDS: nEDS = 171:24) were enrolled in our study at baseline. Multiple linear and linear mixed‐effects models were used to research the relationships between EDS/daytime sleepiness severity and clinical characteristics. Relationships between the change rates of clinical characteristics and daytime sleepiness severity were further investigated through multiple linear regression models. Mediating effect analysis was used to determine whether autonomic dysfunction was the mediator between cognition assessments and daytime sleepiness severity. Patients with PD with EDS and greater daytime sleepiness severity presented faster cognitive decline, high possibility for rapid eye movement sleep behavior disorder, autonomic dysfunction, depression, and anxiety from cross‐sectional and longitudinal analyses. Furthermore, HC individuals with EDS showed a higher striatal binding ratio of the right putamen, right striatum, and mean striatum. Autonomic dysfunction may act as a mediator between PD and cognitive decline. In early PD, EDS and daytime sleepiness severity were related to several clinical variables, suggesting that EDS might play an essential role in regulating PD progression.

Abstract Background The global incidence of nonalcoholic fatty liver disease (NAFLD) is rapidly escalating, positioning it as a principal public health challenge with significant implications for population well-being. Given its status as a cornerstone of China's economic structure, the steel industry employs a substantial workforce, consequently bringing associated health issues under increasing scrutiny. Establishing a risk assessment model for NAFLD within steelworkers aids in disease risk stratification among this demographic, thereby facilitating early intervention measures to protect the health of this significant populace. Methods Use of cross-sectional studies. A total of 3328 steelworkers who underwent occupational health evaluations between January and September 2017 were included in this study. Hepatic steatosis was uniformly diagnosed via abdominal ultrasound. Influential factors were pinpointed using chi-square (χ2) tests and unconditional logistic regression analysis, with model inclusion variables identified by pertinent literature. Assessment models encompassing logistic regression, random forest, and XGBoost were constructed, and their effectiveness was juxtaposed in terms of accuracy, area under the curve (AUC), and F1 score. Subsequently, a scoring system for NAFLD risk was established, premised on the optimal model. Results The findings indicated that sex, overweight, obesity, hyperuricemia, dyslipidemia, occupational dust exposure, and ALT serve as risk factors for NAFLD in steelworkers, with corresponding odds ratios (OR, 95% confidence interval (CI)) of 0.672 (0.487–0.928), 4.971 (3.981–6.207), 16.887 (12.99–21.953), 2.124 (1.77–2.548), 2.315 (1.63–3.288), 1.254 (1.014–1.551), and 3.629 (2.705–4.869), respectively. The sensitivity of the three models was reported as 0.607, 0.680 and 0.564, respectively, while the precision was 0.708, 0.643, and 0.701, respectively. The AUC measurements were 0.839, 0.839, and 0.832, and the Brier scores were 0.150, 0.153, and 0.155, respectively. The F1 score results were 0.654, 0.661, and 0.625, with log loss measures at 0.460, 0.661, and 0.564, respectively. R 2 values were reported as 0.789, 0.771, and 0.778, respectively. Performance was comparable across all three models, with no significant differences observed. The NAFLD risk score system exhibited exceptional risk detection capabilities with an established cutoff value of 86. Conclusions The study identified sex, BMI, dyslipidemia, hyperuricemia, occupational dust exposure, and ALT as significant risk factors for NAFLD among steelworkers. The traditional logistic regression model proved equally effective as the random forest and XGBoost models in assessing NAFLD risk. The optimal cutoff value for risk assessment was determined to be 86. This study provides clinicians with a visually accessible risk stratification approach to gauge the propensity for NAFLD in steelworkers, thereby aiding early identification and intervention among those at risk.

Pulmonary infection is highly prevalent in patients with acute myocardial infarction undergoing percutaneous coronary intervention. However, the potential mechanism is not well characterized. Myocardial ischemia-reperfusion injury (MIRI) induces acute lung injury (ALI) related to pulmonary infection and inflammation. Recent studies have shown that pyroptosis mediates ALI in several human respiratory diseases. It is not known whether MIRI induces pyroptosis in the lungs. Furthermore, ticagrelor is a clinically approved anti-platelet drug that reduces ALI and inhibits the expression levels of several pyroptosis-associated proteins, but the effects of ticagrelor on MIRI-induced ALI have not been reported. Therefore, we investigated whether ticagrelor alleviated ALI in the rat MIRI model, and its effects on pyroptosis in the lungs. Sprague-Dawley rats were randomly divided into four groups: control, MIRI, MIRI plus low ticagrelor (30 mg/kg), and MIRI plus high ticagrelor (100 mg/kg). Hematoxylin and Eosin (HE) staining was performed on the lung sections, and the HE scores were calculated to determine the extent of lung pathology. The wet-to-dry ratio of the lung tissues were also determined. The expression levels of pyroptosis-related proteins such as NLRP3, ASC, and Cleaved caspase-1 were estimated in the lung tissues using the western blot. ELISA was used to estimate the IL-1β levels in the lungs. Immunohistochemistry was performed to determine the levels of MPO-positive neutrophils as well as the total NLRP3-positive and Cleaved caspase-1-positive areas in the lung tissues. The lung tissues from the MIRI group rats showed significantly higher HE score, wet-to-dry ratio, and the MPO-positive area compared to the control group, but these effects were attenuated by pre-treatment with ticagrelor. Furthermore, lung tissues of the MIRI group rats showed significantly higher expression levels of pyroptosis-associated proteins, including NLRP3 (2.1-fold, P < 0.05), ASC (3.0-fold, P < 0.01), and Cleaved caspase-1 (9.0-fold, P < 0.01). Pre-treatment with the high-dose of ticagrelor suppressed MIRI-induced upregulation of NLRP3 (0.46-fold, P < 0.05), ASC (0.64-fold, P < 0.01), and Cleaved caspase-1 (0.80-fold, P < 0.01). Immunohistochemistry results also confirmed that pre-treatment with ticagrelor suppressed MIRI-induced upregulation of pyroptosis in the lungs. In summary, our data demonstrated that MIRI induced ALI and upregulated pyroptosis in the rat lung tissues. Pre-treatment with ticagrelor attenuated these effects.

Against the backdrop of globalization, interpreting, a translation communicative activity in a verbal way, plays an increasingly important role in international communications and exchanges. In response to this world pattern, the Chinese government attaches great importance to the interpreting industry. However, due to the national condition of uneven regional development, the English interpreting level across China is also unbalanced. Confronting this circumstance, previous research only stagnates at the level of recognizing the problem, but very few studies have attempted to solve the problem. Thus, the current study aims to figure out the regional interpreting level in mainland China by establishing and utilizing an innovative indicator system based on statistics and geography technologies. Based on the literature review and empirical questionnaire survey from different stakeholders, the study proposes an indicator system containing 3 first-level factors and 7 second-level factors to measure regional English interpreting levels. The weight of each indicator and scoring method is laid down based on factor analysis and interval marking. In addition, putting the innovative indicator system into practice, a total of 38 groups of regional data are collected to rank the regional interpreting level across China. Integrating with GIS and statistical techniques, the result visually shows that the English interpreting level across China is uneven at present: higher in the southern and eastern parts of China compared to that of northern and western China, which is unfriendly to sustainable development in the future. Facing this reality, a following-up analysis has been made for offering explanations of the results and suggestions for regional interpreting sustainable development.

ABSTRACTIn order to end the AIDS epidemic by 2030 that was put forward by the Joint United Nations Programme on HIV/AIDS in 2014, China needs to take more effective measures to achieve the three 90% goals (90-90-90). We establish a compartmental model to study the dynamics of HIV transmission with control strategies. The analytical results show the existence and stability of the disease-free equilibrium and endemic equilibrium. An optimal control model is constructed to evaluate the impacts of control measures. The simulation results show that the optimal control strategy proposed in this work can eradicate AIDS by 2030. The cost-effectiveness analysis indicates that the cost of the control strategy that combines screening for latent individuals and enhancing education for unaware infected individuals is the lowest. Our findings can provide guidance for public health authorities on effective mitigation strategies to achieve the goals proposed by the United Nations Program on HIV/AIDS.

Background: Acute graft- versus -host disease (aGVHD) is a major complication following hematopoietic stem cell transplantation (HSCT). Objective: This study aimed to explore the risk factors for the incidence of aGVHD in patients post-HSCT. Design: This was a retrospective study. Methods: A total of 407 patients were enrolled. The patients’ data were recorded from the medical records. The exposure of cyclosporine was estimated based on a population pharmacokinetics model. The occurrence of aGVHD was clinically graded and staged in severity from grades I to IV. A proportional odds model that estimated the cumulative probabilities of aGVHD was used to analyze the data using a nonlinear mixed-effects model. Then, the model parameters and plausibility were evaluated by bootstrap and visual predictive checks. Results: The typical probabilities were 18.9% and 17.9% for grade II and grades III–IV, respectively. The incidence of grade II and grade III–IV aGVHD for human leukocyte antigen (HLA) haplo sibling donor patients was higher than that for HLA-matched donor patients. The incidence of grade II and grade III–IV aGVHD decreased with increasing early cyclosporine trough concentration; however, cyclosporine exposure was not associated with the incidence of aGVHD. Conclusion: HLA matching and early cyclosporine trough concentration were important factors for the occurrence of aGVHD.

Abstract Background Many studies have shown that occupational exposure to indium and its compounds could induce lung disease. Although animal toxicological studies and human epidemiological studies suggest indium exposure may cause lung injury, inflammation, pulmonary fibrosis, emphysema, pulmonary alveolar proteinosis, and even lung cancer, related data collected from humans is currently limited and confined to single workplaces, and the early effects of exposure on the lungs are not well understood. Objectives This study combined population studies and animal experiments to examine the links of indium with pulmonary injury, as well as its mechanism of action. A cross-sectional epidemiological study of indium-exposed workers from China was conducted to evaluate associations between occupational indium exposure and serum biomarkers of early effect. This study also compares and analyzes the causal perspectives of changes in human serum biomarkers induced by indium compound exposure and indium exposure-related rat lung pathobiology, and discusses possible avenues for their recognition and prevention. Methods This is a study of 57 exposed (at least 6 h per day for one year) workers from an indium ingot production plant, and 63 controls. Indium concentration in serum, urine, and airborne as exposure indices were measured by inductively coupled plasma-mass spectrometry. Sixteen serum biomarkers of pulmonary injury, inflammation, and oxidative stress were measured using ELISA. The associations between serum indium and 16 serum biomarkers were analyzed to explore the mechanism of action of indium on pulmonary injury in indium-exposed workers. Animal experiments were conducted to measure inflammatory factors levels in bronchoalveolar lavage fluid (BALF) and lung tissue protein expressions in rats. Four different forms of indium compound-exposed rat models were established (intratracheal instillation twice per week, 8 week exposure, 8 week recovery). Model I: 0, 1.2, 3, and 6 mg/kg bw indium tin oxide group; Model II: 0, 1.2, 3, and 6 mg/kg bw indium oxide (In2O3) group; Model III: 0, 0.523, 1.046, and 2.614 mg/kg bw indium sulfate (In2(SO4)3) group; Model IV: 0, 0.065, 0.65, and 1.3 mg/kg bw indium trichloride (InCl3) group. Lung pathological changes were assessed by hematoxylin & eosin, periodic acid Schiff, and Masson’s staining, transmission electron microscopy, and the protein changes were determined by immunohistochemistry. Results In the production workshop, the airborne indium concentration was 78.4 μg/m3. The levels of serum indium and urine indium in indium-exposed workers were 39.3 μg/L and 11.0 ng/g creatinine. Increased lung damage markers, oxidative stress markers, and inflammation markers were found in indium-exposed workers. Serum indium levels were statistically and positively associated with the serum levels of SP-A, IL-1β, IL-6 in indium-exposed workers. Among them, SP-A showed a duration-response pattern. The results of animal experiments showed that, with an increase in dosage, indium exposure significantly increased the levels of serum indium and lung indium, as well as the BALF levels of IL‑1β, IL‑6, IL‑10, and TNF‑α and up-regulated the protein expression of SP-A, SP-D, KL-6, GM-CSF, NF-κB p65, and HO-1 in all rat models groups. TEM revealed that In2(SO4)3 and InCl3 are soluble and that no particles were found in lung tissue, in contrast to the non-soluble compounds (ITO and In2O3). No PAS-staining positive substance was found in the lung tissue of In2(SO4)3 and InCl3 exposure groups, whereas ITO and In2O3 rat models supported findings of pulmonary alveolar proteinosis and interstitial fibrosis seen in human indium lung disease. ITO and InCl3 can accelerate interstitial fibrosis. Findings from our in vivo studies demonstrated that intra-alveolar accumulation of surfactant (immunohistochemistry) and characteristic cholesterol clefts granulomas of indium lung disease (PAS staining) were triggered by a specific form of indium (ITO and In2O3). Conclusions In indium-exposed workers, biomarker findings indicated lung damage, oxidative stress and an inflammatory response. In rat models of the four forms of indium encountered in a workplace, the biomarkers response to all compounds overall corresponded to that in humans. In addition, pulmonary alveolar proteinosis was found following exposure to indium tin oxide and indium oxide in the rat models, and interstitial fibrosis was found following exposure to indium tin oxide and indium trichloride, supporting previous report of human disease. Serum SP-A levels were positively associated with indium exposure and may be considered a potential biomarker of exposure and effect in exposed workers.

Abstract Background Gastric cancer has a high incidence and mortality rate. Angiogenesis is necessary for tumor infiltration and metastasis and affects patient prognosis. YKL-39 has monocyte chemotactic activity and pro-angiogenic activity in some tumors. In this study, we investigated the relationship between YKL-39 and tumor-associated macrophages and microangiogenesis in gastric cancer to determine its potential as a prognostic biomarker. Materials and methods A total of 119 patients with gastric cancer who had undergone gastrectomy at the 940th Hospital of the Joint Security Force between 2014 and 2018 were included in this study. We assayed the protein expression of YKL-39, CD68, and CD34 by immunohistochemistry in tissues of 119 patients with gastric cancer, as well as the intracellular expression of YKL-39 and CD68 by immunofluorescence. Data were analyzed with SPSS Statistics 25.0 to explore the impact of expression of YKL-39, CD68, and CD34 in gastric cancer patients and the relationship among them. Results Our results show that YKL-39 was expressed in both the nucleus and cytoplasm of gastric cancer cells and tumor mesenchyme. YKL-39 protein expression was associated with the depth of tumor infiltration, lymph node metastasis, and TNM stage; CD68 protein expression was associated with lymph node metastasis and TNM stage; CD34 protein expression was not associated with clinicopathological characteristics. Expression of YKL-39 was positively correlated with CD68 and CD34 (p

We study the global dynamics of large amplitude classical solutions to a system of balance laws, derived from a chemotaxis model with logarithmic sensitivity, subject to time-dependent boundary conditions. The model is supplemented with $ H^2 $ initial data and unmatched boundary conditions at the endpoints of a one-dimensional interval. Under suitable assumptions on the boundary data, it is shown that classical solutions exist globally in time. Time asymptotically, the differences between the solutions and their corresponding boundary data converge to zero, as time goes to infinity. No smallness restrictions on the magnitude of the initial perturbations is imposed. Numerical simulations are carried out to explore some topics that are not covered by the analytical results.

ABSTRACT: Objectives: Because of the spread of the Omicron variant, many countries have experienced COVID-19 case numbers unseen since the start of the pandemic. We aimed to compare the epidemiological characteristics of Omicron with previous variants and different strains of influenza to provide context for public health responses. Methods: We developed transmission models for SARS-CoV-2 variants and influenza, in which transmission, death, and vaccination rates were taken to be time-varying. We fit our model based on publicly available data in South Africa, the United States, and Canada. We used this model to evaluate the relative transmissibility and mortality of Omicron compared with previous variants and influenza. Results: We found that Omicron is more transmissible and less fatal than both seasonal and 2009 H1N1 influenza and the Delta variant; these characteristics make Omicron epidemiologically more similar to influenza than it is to Delta. We estimate that as of February 7, 2022, booster doses have prevented 4.29×107 and 1.14×106 Omicron infections in the United States and Canada, respectively. Conclusion: Our findings indicate that the high infectivity of Omicron will keep COVID-19 endemic, similar to influenza. However, because of Omicron's lower fatality rate, our work suggests that human populations living with SARS-CoV-2 are most likely.

This study aimed to assess the association of postoperative platelet counts with early and late outcomes after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively evaluated 892 patients with TBAD who underwent TEVAR from a prospectively maintained database. Postoperative nadir platelet counts were evaluated as a continuous variable, and a categorical variable (thrombocytopenia), which was defined as platelet count≤ the lowest 10% percentile (108 × 109/l). Multivariable logistic regression analyses were conducted to assess the impact of postoperative thrombocytopenia on early outcomes, and multivariable cox regression analyses on long-term mortality. Patients with postoperative thrombocytopenia experienced significantly higher rates of postoperative mortality, prolonged intensive care unit stay, death, stroke, limb ischemia, mesenteric ischemia, acute kidney injury (AKI), and puncture-related hematoma (P

The COVID-19 pandemic has presented a unique opportunity for the advancement of online education, as billions of students from 190 countries have been compelled to take classes remotely. The degree of satisfaction is considered one of the major factors in determining the quality of online educational programs. As a result, many empirical studies have been conducted on the level of satisfaction with online education over the last two decades. However, few studies have synthesized previous findings from similar research questions. Therefore, to reinforce statistical power, the study aimed to conduct a meta-analysis to examine satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak. A total of 52 studies in English were screened from six academic electronic databases, yielding 57 effect sizes using Comprehensive Meta-Analysis (CMA) software. The results showed that the prevalence of satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak was 59.5, 75.3, and 70.7%, respectively, with a significant difference between the satisfaction rates of students and those of their faculty and parents. Besides, we conducted a moderator analysis that found that (1) a significantly higher number of students in the pre-pandemic era in countries with developed digital infrastructure and emergency online learning environments were less satisfied with online education than their counterparts in the post-pandemic era, in countries with developing digital infrastructure, and in non-emergency online learning environments. Additionally, a significantly higher proportion of adult education learners reported being satisfied with online education compared to K-12 and university students. (2) The faculty in the non-emergency situation reported almost double the satisfaction rate of their counterparts in the emergency circumstance. With fewer satisfied remote learning students, efforts could be made by providing well-designed online lessons via faculty and strengthening digital infrastructure via governments to improve student satisfaction.

Background and aimsSurgical site infection is a common complication after surgery. Periprocedural antibiotics are necessary to prescribe for preventing or treating infections. The present study aimed to explore the effect of intravenous antibiotics on gut microbiota and menaquinone biosynthesis in patients, especially in elderly patients undergoing cardiac surgery.MethodsA total of 388 fecal samples were collected from 154 cardiac surgery patients. The V3–V4 hypervariable region of the bacterial 16S rRNA gene was amplified and sequenced on a MiSeq PE300. The gut microbiota diversity of samples was analyzed in terms of α- and β-diversity at the OTU level. The different groups were classified according to antibiotics in combinations and single antibiotics. PICRUSt2 was used for preliminary prediction of the gut microbiota function for menaquinone biosynthesis.ResultsThe intravenously administered antibiotics which are excreted via bile represents the main antibiotics that could disturb the gut microbiota’s composition in cardiac surgery patients, especially for elderly patients. The effect of antibiotics on gut microbiota is produced after antibiotics treatments over one week. The recovery of gut microbiota to the state of pre-antibiotics may require over two weeks of antibiotics withdrawal. Sex factor doesn’t represent as an influencer in gut microbiota composition. Long-term use of cefoperazone-sulbactam may affect coagulation function.ConclusionsThe composition of the gut microbiota had a significant change post-intravenous antibiotics treatment in cardiac surgery patients. The richness and diversity of gut microbiota are increased in elderly patients.

Contact tracing is an important tool to contain the spread of many airborne diseases. We develop an approximated pairwise model to investigate the impact of non-Markovian awareness process among infectious individuals represented by pairwise endemic models. We derive the basic reproduction number and the final epidemic size, which are dependent on the tracing rate and the distribution of awareness process. The model analysis provides the threshold of contact tracing rate. When the contact tracing rate is greater than the threshold, the basic reproduction number will be less than one, then the epidemic will eventually die out. The analysis further shows that, higher variance in the awareness process generates smaller basic reproduction number, lower tracing threshold, and larger final epidemic size, when the mean awareness period is fixed. Extensive numerical analysis show the comprehensive effects of tracing rates and non-Markovian awareness processes on human behavior and the transmissibility ability of epidemic. It turns out that large tracing rates and high variances in awareness process lead to obvious reductions in contacts between susceptible and infectious individuals, so as to curb the transmission of infectious diseases. Moreover, contact tracing is more effective in reducing the number of infected individuals and the contacts between susceptible and infected individuals when the awareness process has a larger variance.

Abstract Background The impact of thrombocytopenia on infection in patients with ST-elevation myocardial infarction (STEMI) remains poorly understood. Aims To evaluate the association between thrombocytopenia and infection in patients with STEMI. Methods Patients diagnosed with STEMI were identified from January 2010 to June 2016. The primary endpoint was in-hospital infection, and major adverse clinical events (MACE) and all-cause death were considered as secondary endpoints. Results A total of 1401 STEMI patients were enrolled and divided into two groups according to the presence (n = 186) or absence (n = 1215) of thrombocytopenia. The prevalence of in-hospital infection was significantly higher in the thrombocytopenic group (30.6% (57/186) vs. 16.2% (197/1215), p

ObjectivesThe aim of this study was to determine whether neurofifilament light (NfL) could reflect motor decline and compare the predictive values of cerebrospinal fluid (CSF) and serum NfL in individuals with PD.MethodsCSF/serum samples were collected from patients with PD and healthy controls (HCs) with motor assessments at baseline and after three years of follow-up from the Parkinson’s Progression Markers Initiative (PPMI). Multiple linear regression models and linear mixed-effects models were used to investigate the associations of motor assessments with baseline and longitudinal CSF/serum NfL. Associations between the change rates of motor assessments and CSF/serum NfL were further investigated via multiple linear regression models. Mediating effect analysis was used to research whether CSF alpha-synuclein (α-syn) acts as the mediator between NfL and motor assessments.ResultsWe found patients with PD had higher baseline CSF/serum NfL levels than HCs. Both baseline CSF/serum NfLs and their change rates predicted measurable motor decline in PD assessed by different motor scores. Baseline serum NfL and its rate of change were strongly associated with CSF NfL levels in patients with PD (P < 0.001). Besides, there were also significant differences in CSF/serum NfL levels and predicted values of motor decline between men and women with PD. Mediating effect analysis showed CSF α-syn mediated the effect of CSF NfL on total Unified Parkinson’s Disease Rating Scale (UPDRS) scores and UPDRSIII with 30.6 and 20.2% mediation, respectively.ConclusionOur results indicated that NfL, especially serum NfL concentration, could serve as an easily accessible biomarker to monitor the severity and progression of motor decline in individuals with PD, especially in men with PD. Besides, CSF α-syn acts as a mediator between NfL and motor progression.

Objectives: The ongoing COVID-19 pandemic expanded its geographic distribution through the movement of humans and caused subsequent local outbreaks. Hence, it is essential to investigate how human mobility and travel ban affect the transmission and spatial spread while minimizing the impact on social activities and national economics. Methods: We developed a mobility network model for spatial epidemics, explicitly taking into account time-varying inter-province and inner-province population flows, spatial heterogeneity in terms of disease transmission, as well as the impact of media reports. The model is applied to study the epidemic of the dynamic network of 30 provinces of mainland China. The model was calibrated using the publicly available incidence and movement data. Results: We estimated that the second outbreak occurred approximately on February 24, 2020, and the cumulative number of cases as of March 15, 2020, increased by 290.1% (95% CI: (255.3%, 324.9%)) without a travel ban in mainland China (excluding Hubei and Tibet). We found that intra-province travel contributes more to the increase of cumulative number of cases than inter-province travel. Conclusion: Our quantitative and qualitative research results suggest that the strict travel ban has successfully prevented a severe secondary outbreak in mainland China, which provides solutions for many countries and regions experiencing secondary outbreaks of COVID-19.

Abstract. Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Although exogenous D-serine has been applied as a neural regulatory intervention in many studies, the role played by D-serine in hippocampal injuries caused by lead exposure remains poorly understood. Rat models of chronic lead exposure were established through the administration of 0.05% lead acetate for 8 weeks. Simultaneously, rats were administered 30 or 60 mg/kg D-serine, intraperitoneally, twice a day. Our results showed that D-serine treatment shortened the escape latency from the Morris water maze, increased the number of times that mice crossed the original platform location, and alleviated the pathological damage experienced by hippocampal neurons in response to lead exposure. Although D-serine administration did not increase the expression levels of the N-methyl-D-aspartate receptor subtype 2B (NR2B) in the hippocampi of lead-exposed rats, 60 mg/kg D-serine treatment restored the expression levels of NR2A, which are reduced by lead exposure. These findings suggested that D-serine can alleviate learning and memory impairments induced by lead exposure and that the underlying mechanism is associated with the increased expression of NR2A in the hippocampus. This study was approved by the Animal Ethics Committee of North China University of Science and Technology, China (approval No. LX2018155) on December 21, 2018.

Aims: The aims of the study were to 1) establish a population pharmacokinetic (Pop-PK) model for busulfan in Chinese pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) and then estimate busulfan exposure and 2) explore the association between busulfan exposure and clinical outcomes.Methods: A total of 128 patients with 467 busulfan concentrations were obtained for Pop-PK modeling using nonlinear mixed effect model (NONMEM) software. Sixty-three patients who received the 16-dose busulfan conditioning regimen were enrolled to explore the correlations between clinical outcomes and the busulfan area under the concentration–time curve (AUC) using the Cox proportional hazards regression model, Kaplan–Meier method and logistic regression.Results: The typical values for clearance (CL) and distribution volume (V) of busulfan were 7.71 L h−1 and 42.4 L, respectively. The allometric normal fat mass (NFM) and maturation function (Fmat) can be used to describe the variability in CL, and the fat-free mass (FFM) can be used to describe the variability in V. Patients with AUCs of 950–1,600 µM × min had 83.7% (95% CI: 73.3–95.5) event-free survival (EFS) compared with 55.0% (95% CI: 37.0–81.8) for patients with low or high exposure (p = 0.024). The logistic regression analysis results showed no association between transplant-related toxicities and the busulfan AUC (p > 0.05).Conclusions: The variability in busulfan CL was related to the NFM and Fmat, while busulfan V was related to the FFM. Preliminary analysis results suggested that a busulfan AUC of 950–1,600 µM × min was associated with better EFS in children receiving the 16-dose busulfan regimen.

BackgroundInfection during hospitalization is a serious complication among patients who suffered from acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI); however, there are no suitable and accurate means to assess risk. This study aimed to develop and validate a simple scoring system to predict post-AMI infection in such patients.MethodsAll patients with ST-segment elevation myocardial infarction (STEMI) undergoing PCI consecutively enrolled from January 2010 to May 2016 were served as derivation cohort, and those from June 2016 to May 2018 as validation cohort, respectively. The primary endpoint was post-AMI infection during hospitalization, and all-cause death and major adverse cardiovascular events (MACE) were considered as secondary endpoints. The simplified risk model was established using logistic regression. The area under the receiver operating curve and calibration of predicted and observed infection risk were calculated.ResultsA 24-point risk score was developed, with infection risk ranging from 0.7 to 99.6% for patients with the lowest and highest score. Seven variables including age, Killip classification, insulin use, white blood cell count, serum albumin, diuretic use, and transfemoral approach were included. This model achieved the same high discrimination in the development and validation cohort (C-statistic:0.851) and revealed adequate calibration in both datasets. The incidences of post-AMI infection increased steadily across risk score groups in both development (1.3, 5.1, 26.3, and 69.1%; P < 0.001) and validation (1.8, 5.9, 27.2, and 79.2%; P < 0.001) cohort. Moreover, the risk score demonstrated good performance for infection, in-hospital all-cause death, and MACE among these patients, as well as in patients with the non-ST-elevation acute coronary syndrome.ConclusionThis present risk score established a simple bedside tool to estimate the risk of developing infection and other in-hospital outcomes in patients with STEMI undergoing PCI. Clinicians can use this risk score to evaluate the infection risk and subsequently make evidence-based decisions.

IntroductionHigh-intensity interval training (HIIT) is an emerging method of cardiac rehabilitation, which is more and more popular in recent years. Research into the effect of HIIT on peak oxygen uptake (VO2 peak) and myocardial fibrosis among patients with myocardial infarction (MI) is lacking. Here, we describe the rationale along with the protocol for a clinical trial to test the following hypotheses: (1) compared with the control group, VO2 peak will be increased in both the moderate-intensity continuous training (MICT) and HIIT groups and (2) compared with the control group, myocardial fibrosis due to MI will be improved by HIIT and MICT.Methods and AnalysisThis is a single-center, randomized controlled clinical trial. In total, 180 patients with MI are to be recruited for this study. VO2 peak will be tested by cardiopulmonary exercise testing (CPET) and myocardial fibrosis will be evaluated by cardiac MR. A variety of blood and psychometric tests and also the peripheral arterial tonometry, reactive hyperemia index for microvascular endothelial function, and microvascular blockage or digital vasomotor response are included.Ethics and DisseminationThe ethics committee of the Guangdong Provincial People's Hospital has authorized this mechanistic clinical research. Peer-reviewed articles and conference presentations will be used to disseminate the findings.Trial Registration NumberNCT04863677.

This study aimed at exploring the concentration‐effect relationship of adalimumab and early adalimumab and anti‐adalimumab antibody (AAA) levels in predicting primary nonresponse in a real‐world pilot cohort of patients with ankylosing spondylitis. Thirty‐one patients were included. The Ankylosing Spondylitis Disease Activity Score improved with increasing adalimumab trough level at week 12 and reached a major improvement with levels between 8 and 12 μg/mL. Moreover, weeks 4 and 2 adalimumab levels below 4.28 and 3.37 μg/mL were predictive of primary nonresponse (area under the curve (AUC) = 0.89, 0.88; P = 0.0003, P = 0.034, respectively). Week 4 AAA signal‐to‐noise levels were significantly higher among primary nonresponders, and the cutoff for primary nonresponse prediction was above 5.31 (AUC = 0.81; P = 0.004). Adalimumab trough levels in a range of 8–12 μg/mL are optimum to reach major improvement, and lower adalimumab with higher AAA levels at the early stage (week 4) predict primary nonresponse by supporting proactive monitoring to optimize adalimumab therapy.

Abstract Background Prophylactic vaccines are critical in preventing hand, foot, and mouth disease (HFMD) primarily caused by human enterovirus 71 (EV71) infection. Children aged less than 5 years are especially susceptible to EV71 infections. In addition to the development of vaccines containing the inactivated virus, those containing virus-like particles (VLPs) with repeated antigens also constitute an effective preventive strategy for EV71 infections, with safety and productivity advantages. We previously developed a fusion protein composed with truncated peptides of the EV71 capsid protein, which assembled into spherical particles. This study aimed to assess the immunoprotective effects of this fusion protein as a vaccine candidate in a mouse model of EV71 infection. Methods To evaluate the protective effect of fusion protein vaccine candidate, neonatal mice born by immunized female mice, as well as normal neonatal mice immunized twice were infected with EV71 virus. Whereafter, the survival rates, clinical scores and viral loads were measured. Results The high dosage and booster immunization helped induce specific serum antibodies with high neutralization titers, which were transferred to neonatal mice, thereby facilitating effective resistance towards EV71 infection. An active immune response was also observed in neonatal mice which generated following immunization. Conclusions The present results suggest that this fusion protein is a suitable vaccine candidate in treating EV71 infections.

Cobaltosic oxide has been used as catalysts in dehydrogenation for tail chlorine due to the advantages of low price and security. The Co3O4/ZSM-5 was synthesized by the volume impregnation method. The catalytic dehydrogenation performance of Co3O4/ZSM-5 was investigated, the catalytic reaction of hydrogen with oxygen and chlorine was carried out in a fixed-bed, and the mixed reactant gases were prepared according to the composition and content of tail chlorine in industry: Cl2(65%-80%), N2(6-16%), O2(8%-10%) and H2(1.5%-4%). The catalytic efficiency and stability of Co3O4/ZSM-5 in dehydrogenation for tail chlorine were better than that of Co3O4. After the calcination on 300°C, the Co3O4/ZSM-5 with 1 %wt. Co3O4 shown excellent catalytic performance at 50°C, and the average conversion of hydrogen can reach up to 99.59%.

Na0.67Ni0.33Mn0.67O2 is a prospective layered cathode material for sodium-ion batteries owing to its low cost, ease of synthesis, and high specific capacity. However, due to direct contact with electrolytes during the cycling process, the cyclic stability is not satisfied. To address this issue, magnesium oxide (MgO) surface modification was performed in this study to improve the material’s cycling properties. MgO layers of various thicknesses were successfully coated onto the cathode, and their electrochemical performances were thoroughly investigated. Among the as-prepared samples, the 2 wt% MgO-coated sample demonstrated the best rate capability and cycling stability. It had an initial reversible discharge capacity of 105 mAh g−1 in the voltage range from 2.0 to 4.5 V at 0.2 C with a high cycle retention of 81.5%. Electrochemical impedance spectroscopy (EIS) results showed that the 2 wt% MgO-coated electrode had the highest conductivity due to the smaller charge transfer resistance (Rct) value. All the test results show that the MgO modification improves the electrochemical properties of Na0.67Ni0.33Mn0.67O2 cathode material. This research could lead to the development of a promising strategy for improving the electrochemical performance of next-generation sodium-ion batteries.

Aims: The monocyte to high-density lipoprotein ratio (MHR), a novel marker of inflammation and cardiovascular events, has recently been found to facilitate the diagnosis of acute aortic dissection. This study aimed to assess the association of preoperative MHR with in-hospital and long-term mortality after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection (TBAD).Methods: We retrospectively evaluated 637 patients with acute TBAD who underwent TEVAR from a prospectively maintained database. Multivariable logistic and cox regression analyses were conducted to assess the relationship between preoperative MHR and in-hospital as well as long-term mortality. For clinical use, MHR was modeled as a continuous variable and a categorical variable with the optimal cutoff evaluated by receiver operator characteristic curve for long-term mortality. Propensity score matching was used to diminish baseline differences and subgroups analyses were conducted to assess the robustness of the results.Results: Twenty-one (3.3%) patients died during hospitalization and 52 deaths (8.4%) were documented after a median follow-up of 48.1 months. The optimal cutoff value was 1.13 selected according to the receiver operator characteristic curve (sensitivity 78.8%; specificity 58.9%). Multivariate analyses showed that MHR was independently associated with either in-hospital death [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.16-3.85, P = 0.015] or long-term mortality [hazard ratio (HR) 1.78, 95% CI 1.31-2.41, P < 0.001). As a categorical variable, MHR > 1.13 remained an independent predictor of in-hospital death (OR 4.53, 95% CI 1.44-14.30, P = 0.010) and long-term mortality (HR 4.16, 95% CI 2.13-8.10, P < 0.001). Propensity score analyses demonstrated similar results for both in-hospital death and long-term mortality. The association was further confirmed by subgroup analyses.Conclusions: MHR might be useful for identifying patients at high risk of in-hospital and long-term mortality, which could be integrated into risk stratification strategies for acute TBAD patients undergoing TEVAR.

The working condition of a centrifugal pump as a turbine (PAT) is often unsteady. The rotating speed of a PAT constantly varies as the flow and load change, resulting in transient hydrodynamic behaviors between different working conditions. During the transition, the PAT undergoes a severe change in performance and complicated internal flow structures. In previous work, the fixed rotating speed of a PAT was mostly considered using computational fluid dynamics. To investigate the transient behavior of a PAT, relevant simulation tools are developed to depict transient flow conditions, and the corresponding transient speed of the impeller is calculated. Both large and small fluctuation transitions are simulated for the practical application of the PAT. The simulated results are first verified by experiments. The results show that the rotating speed significantly affects the performance and stability of the PAT. The rapid increment in flow rate and rotating speed lead to large energy dissipation in the internal flow field of the PAT. The range of high efficiency of the PAT expands and migrates to the high flow rate range. The efficiency in the transition condition started a cyclic growth after the flow reached 60 m3/h, and it reached a peak at around 80 m3/h, which was about 5% lower than the calculated value in a quasi-steady state. In the range of high rotating speeds, the rotating speed of the impeller and the operational stability are sensitive to flow fluctuation. The internal flow fields during transition conditions are analyzed as well. The obtained results can be utilized as a reference for studying the hydrodynamic characteristics and stability of fluid machinery in the transition under transient flow conditions.

In this study, we performed electric pulse treatment (EPT) on the cold-rolled pure copper sheets. And the effects of the current density of EPT on the microstructure and mechanical properties of the cold-rolled pure copper sheets were investigated. It has been found that the change in the current density of EPT has a remarkable influence on the surface temperature, microstructure, strength, plasticity and microhardness of the samples. Compared with the untreated sample, the elongation after fracture increased by about 3.2 times at a current density of 200 A mm ^−2 , whereas the ultimate tensile strength decreased by only 38.0%. Microstructures indicate that the electric pulse can induce rapid recrystallization in cold-rolled pure copper sheets within a short time, while reducing the dislocation density, weakening the rolling textures and increasing microstructure uniformity, thereby improving the plasticity of the material. Therefore, the present research has the potential to provide an effective alternative way to the traditional heat treatment of copper sheets and strips.

Background: Peripheral arterial disease (PAD) can severely compromise limb vitality and function. Angiogenesis plays an important role in healing of ischemic lesions. Radiolabeled RGD (Arg-Gly-Asp) peptides specifically targeting αvβ3 integrin are promising tracers for imaging angiogenesis. In this study, we investigated the application of a one-step labeled RGD in evaluation of angiogenesis and therapy response in a mouse model of hindlimb ischemia (HI) by positron emission tomography (PET). Methods: HI was induced by ablation of the femoral artery in mice. PET imaging using 18F-AlF-NOTA-PRGD2 (18F-PRGD2) tracer was performed at day 0 (pre-surgery) and days 3, 7, 14, and 21 after surgery to evaluate hindlimb angiogenesis longitudinally and noninvasively. The control peptide RAD (Arg-Ala-Asp) labeled with a similar procedure and a block agent were used to confirm the specific binding of 18F-PRGD2 to αvβ3 integrin. Ex vivo CD31 staining was performed to detect angiogenesis. In addition, the angiogenic therapy response was monitored with 18F-PRGD2 tracer and immunofluorescence staining to confirm the imaging data. Results: The successful establishment of HI model was confirmed by ultrasound imaging and laser doppler perfusion imaging (LDPI). Specific binding of 18F-PRGD2 to αvβ3 integrin was validated by minimal tracer uptake of the control peptide RAD and significant decrease of tracer accumulation when a block agent was added. Local accumulation of 18F-RRGD2 in ischemic hindlimb was detected as early as 3 days and reached a peak at 7 days after surgery. The temporal change of focal tracer uptake was positively correlated with the pattern of vascular density. Moreover, vascular endothelial growth factor (VEGF) treatment increased the tracer uptake and enhanced angiogenesis, which is consistent with integrin β3 expression. Conclusions: PET imaging of a one-step labeled tracer 18F-PRGD2 targeted to αvβ3integrin allows longitudinal monitoring of ischemia-induced angiogenesis and noninvasive assessment of VEGF treatment response in a mouse model of hindlimb ischemia. The simple synthesis procedure and in vivo performance of this PET tracer enables the feasibility of future clinical translation in ischemic cardiovascular diseases.

Background: Infections increase the risk of poor outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). However, predicting patients at a high risk of developing infection remains unclear. Moreover, the value of N-terminal probrain natriuretic peptide (NT-proBNP) for predicting infection is still unknown. Thus, we aimed to assess the relationship between NT-proBNP and the following development of infection, and clinical adverse outcomes in patients with STEMI undergoing PCI.Methods: STEMI patients undergoing PCI were consecutively enrolled from January 2010 to July 2016 and divided into groups according to baseline NT-proBNP levels: tertiles T1 (

Backgrounds: Emerging evidence suggests that stress hyperglycemia ratio (SHR), an index of relative stress hyperglycemia, is of great prognostic value in acute myocardial infarction (AMI), but current evidence is limited in elderly patients. In this study, we aimed to assess whether SHR is associated with in-hospital outcomes in elderly patients with AMI.Methods: In this retrospective study, patients who were aged over 75 years and diagnosed with AMI were consecutively enrolled from 2015, January 1st to 2019, December 31th. Admission blood glucose and glycosylated hemoglobin (HbA1C) during the index hospitalization were used to calculate SHR. Restricted quadratic splines, receiver-operating curves, and logistic regression were performed to evaluate the association between SHR and in-hospital outcomes, including in-hospital all-cause death and in-hospital major adverse cardiac and cerebrovascular events (MACCEs) defined as a composite of all-cause death, cardiogenic shock, reinfarction, mechanical complications of MI, stroke, and major bleeding.Results: A total of 341 subjects were included in this study. Higher SHR levels were observed in patients who had MACCEs (n = 69) or death (n = 44) during hospitalization. Compared with a SHR value below 1.25, a high SHR was independently associated with in-hospital MACCEs (odds ratio [OR]: 2.945, 95% confidence interval [CI]: 1.626–5.334, P < 0.001) and all-cause death (OR: 2.871 95% CI: 1.428–5.772, P = 0.003) in univariate and multivariate logisitic analysis. This relationship increased with SHR levels based on a non-linear dose-response curve. In contrast, admission glucose was only associated with clinical outcomes in univariate analysis. In subgroup analysis, high SHR was significantly predictive of worse in-hospital clinical outcomes in non-diabetic patients (MACCEs: 2.716 [1.281–5.762], P = 0.009; all-cause death: 2.394 [1.040–5.507], P = 0.040), but the association was not significant in diabetic patients.Conclusion: SHR might serve as a simple and independent indicator of adverse in-hospital outcomes in elderly patients with AMI, especially in non-diabetic population.

The transition metal oxide, such as iron oxide and Fe2O3/Al2O3 is cheap and industrialized that are widely used to catalyze the reaction of chlorine and oxygen with hydrogen in mixture gas to remove hydrogen from tail chlorine at low temperature. The reaction gas was prepared by the same composition with industrial tail chlorine, namely Cl2 (65% ~ 80%), O2 (8% ~ 10%), N2 (6% ~16%) and H2 (1.5% ~ 4%). In this experiment, the fixed bed reactor and iron oxide or Fe2O3/Al2O3 were used as the reaction device and catalysts, respectively. The optimum conversion rate of hydrogen was 84.11% when the reaction temperature was at 70 °C with 3%wt. Fe2O3/Al2O3 and the calcination temperature was 500 °C. The results showed that the catalytic performance of Fe2O3/Al2O3 is superior to Fe2O3. The selectivity of the reaction of hydrogen and chloride was higher than that of hydrogen and oxygen. We also characterized the catalysts with XRD, XPS, SEM and N2 adsorption-desorption and the results showed that the iron oxide was dispersive uniformly on the support surface.

With the introduction of the global brain science program, the brain science and cognitive science are listed as one of the important research areas in China, the goal of which is to understand the function of the brain. In the human brain plan, the neurodegeneration and neurodevelopment in diseases and aging are one of the key areas of concern. However, lead is an environmental heavy metal neurotoxin, which can cause neurodegenerative diseases and affect brain health. At present, the mechanism of the lead-induced nervous system damage mainly focuses on the damage of lead to neurons, while the researches related to the repair of damaged nerve cells induced by the lead exposure have not been reported. The Transcriptome sequencing technology is direct detection of transcripts by the deep sequencing technology, which can more accurately measure the expression of transcripts, and is an inevitable link between genomic genetic information and the proteome of biological functions. In addition, the regulation of the transcription level is the most important regulation mode of organisms. Based on the characteristics of neurogenesis for nerve repair, the current study applied transcriptional sequencing technology to screen the differentially expressed genes in the choroid plexus of rats and to explore the changes in the expression of neurotrophic factors regulating neurogenesis in the choroid plexus of the lead-exposed rats. The results showed that the differentially expressed genes on choroid plexus of the lead exposed rats were related to neurogenesis. In the process of neurogenesis, the expression of nutritive and growth-promoting factors IGF1, EGFr, IGF1r, EGFr1, VEGFα , and TGFβ2 decreased, which suggested that these cytokines may be involved in the process of lead exposure neurogenesis, which needs further experimental verification. The findings of this study provide a new target for the mechanism research and prevention and control measures of brain nerve injury caused by the lead exposure.

Background: Post-acute myocardial infarction (post-AMI) infection is an infrequent but important and serious complication in patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Predicting its occurrence is essential for future prevention. However, little is known about the prediction of post-AMI infection in such patients to date. This study aims to develop and validate a new risk score based on risk factors for early prediction of infection in STEMI patients undergoing PCI.Methods: This prospective, multi-center and observational study assesses the predictive value of risk score for post-AMI infection among a cohort of patients hospitalized due to STEMI. The STEMI patients undergoing PCI enrolled between January 1st 2010 and May 31st 2016 were served as a development cohort while those enrolled from June 1st 2016 to May 31st 2018 were served as validation cohort. The primary endpoint was post-AMI infection during hospitalization, defined as infection requiring antibiotics (reflecting the clinical influence of infection compatible with the necessity for additional treatment), and all-cause death and major adverse cardiovascular events (MACE) including all-cause death, recurrent myocardial infarction, target vessel revascularization, and stroke were considered as secondary endpoints. The risk score model based on risk factors was established using stepwise logistic regression, and will be validated in other centers and external patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).Results: This study will provide evidence on prognostic property, reliability of scoring, comparative performance, and suitability of the novel model for screening purpose in order to be recommended for clinical practice.Discussion: Our study is designed to develop and validate a clinical risk score for predicting infection in participants with STEMI who have undergone PCI. This simple tool may therefore improve evaluation of post-AMI infection and enhance future researches into the best practices to prevent or reduce infection in such patients.Clinical Trial Registration:www.chictr.org.cn, identifier: ChiCTR1900028278.

Background: Uncommonly high rates of pneumonia in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) have been observed during recent years. Inspiratory muscle training (IMT) could reduce pneumonia in patients undergoing coronary artery bypass grafting and other cardiac surgeries. The relationship between IMT and AMI is unknown. Here, we describe the feasibility and potential benefit of IMT in patients at high risk for pneumonia with AMI who have undergone primary PCI.Methods: Our study is a prospective, randomized, controlled, single-center clinical trial. A total of 60 participants will be randomized into an IMT group and control group with 30 participants in each group. Participants in the IMT group will undergo training for 15 min per session, twice a day, from 12 to 24 h after primary PCI, until 30 days post-randomization; usual care will be provided for the control group. The primary endpoint is the change in inspiratory muscle strength, the secondary endpoint included feasibility, pneumonia, major adverse cardiovascular events, length of stay, pulmonary function tests measure, and quality of life.Discussion: Our study is designed to evaluate the feasibility of IMT and its effectiveness in improving inspiratory muscle strength in participants with AMI who have undergone primary PCI.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04491760.

Aims: Very few of the risk scores to predict infection in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) have been validated, and reports on their differences. We aimed to validate and compare the discriminatory value of different risk scores for infection.Methods: A total of 2,260 eligible patients with STEMI undergoing PCI from January 2010 to May 2018 were enrolled. Six risk scores were investigated: age, serum creatinine, or glomerular filtration rate, and ejection fraction (ACEF or AGEF) score; Canada Acute Coronary Syndrome (CACS) risk score; CHADS2 score; Global Registry for Acute Coronary Events (GRACE) score; and Mehran score conceived for contrast induced nephropathy. The primary endpoint was infection during hospitalization.Results: Except CHADS2 score (AUC, 0.682; 95%CI, 0.652–0.712), the other risk scores showed good discrimination for predicting infection. All risk scores but CACS risk score (calibration slope, 0.77; 95%CI, 0.18–1.35) showed best calibration for infection. The risks scores also showed good discrimination for in-hospital major adverse clinical events (MACE) (AUC range, 0.700–0.786), except for CHADS2 score. All six risk scores showed best calibration for in-hospital MACE. Subgroup analysis demonstrated similar results.Conclusions: The ACEF, AGEF, CACS, GRACE, and Mehran scores showed a good discrimination and calibration for predicting infection and MACE.

The COVID-19 outbreak has caused two waves and spread to more than 90% of Canada's provinces since it was first reported more than a year ago. During the COVID-19 epidemic, Canadian provinces have implemented many Non-Pharmaceutical Interventions (NPIs). However, the spread of the COVID-19 epidemic continues due to the complex dynamics of human mobility. We develop a meta-population network model to study the transmission dynamics of COVID-19. The model takes into account the heterogeneity of mitigation strategies in different provinces of Canada, such as the timing of implementing NPIs, the human mobility in retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residences due to work and recreation. To determine which activity is most closely related to the dynamics of COVID-19, we use the cross-correlation analysis to find that the positive correlation is the highest between the mobility data of parks and the weekly number of confirmed COVID-19 from February 15 to December 13, 2020. The average effective reproduction numbers in nine Canadian provinces are all greater than one during the time period, and NPIs have little impact on the dynamics of COVID-19 epidemics in Ontario and Saskatchewan. After November 20, 2020, the average infection probability in Alberta became the highest since the start of the COVID-19 epidemic in Canada. We also observe that human activities around residences do not contribute much to the spread of the COVID-19 epidemic. The simulation results indicate that social distancing and constricting human mobility is effective in mitigating COVID-19 transmission in Canada. Our findings can provide guidance for public health authorities in projecting the effectiveness of future NPIs.