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Fan Li,1– 3,* Zhengjian Wang,4,* Yinan Cao,1– 3 Boliang Pei,1– 3 Xinyu Luo,1– 3 Jin Liu,1– 3 Peng Ge,1– 3 Yalan Luo,1– 3 Shurong Ma,1,3 Hailong Chen1– 3 1Department of General Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, People’s Republic of China; 2Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, 116011, People’s Republic of China; 3Laboratory of Integrative Medicine, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, People’s Republic of China; 4Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shurong Ma; Hailong Chen, Department of General Surgery, the First Affiliated Hospital of Dalian Medical University, Zhongshan Road 222, Dalian, Liaoning, 116011, People’s Republic of China, Tel +86-411-83635963, Fax +86-411-83622844, Email shurongma94@163.com; chenhailong@dmu.edu.cnAbstract: The pathogenesis of severe acute pancreatitis-associated acute lung injury (SAP-ALI), which is the leading cause of mortality among hospitalized patients in the intensive care unit, remains incompletely elucidated. The intestinal mucosal immune barrier is a crucial component of the intestinal epithelial barrier, and its aberrant activation contributes to the induction of sustained pro-inflammatory immune responses, paradoxical intercellular communication, and bacterial translocation. In this review, we firstly provide a comprehensive overview of the composition of the intestinal mucosal immune barrier and its pivotal roles in the pathogenesis of SAP-ALI. Secondly, the mechanisms of its crosstalk with gut microbiota, which is called gut-lung axis, and its effect on SAP-ALI were summarized. Finally, a number of drugs that could enhance the intestinal mucosal immune barrier and exhibit potential anti-SAP-ALI activities were presented, including probiotics, glutamine, enteral nutrition, and traditional Chinese medicine (TCM). The aim is to offer a theoretical framework based on the perspective of the intestinal mucosal immune barrier to protect against SAP-ALI.Keywords: severe acute pancreatitis-associated acute lung injury, intestinal mucosal immune barrier, gut microbiota, gut-lung axis, migration of immune cells

Tao Luo,1 Yile Wang,1 Hailin Tang,1 Fei Zhou,2 Ying Chen,3 Bing Pei,4 Jinke Wang1 1State Key Laboratory of Bioelectronics, Southeast University, Nanjing, 210096, People’s Republic of China; 2School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, 521041, People’s Republic of China; 3School of Medical Technology, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 4Department of Clinical Laboratory, the Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, Jiangsu, 223800, People’s Republic of ChinaCorrespondence: Jinke Wang, State Key Laboratory of Bioelectronics, Southeast University, Nanjing, 210096, People’s Republic of China, Email wangjinke@seu.edu.cnBackground: The inflammatory diseases pose a great threat to human health. Variant anti-inflammatory agents have been therefore developed. However, the current anti-inflammatory drugs are still challenged by low response and side effects. There remain great unmet treatments to inflammatory diseases.Methods: In this work, we fabricate a recombinant adeno-associated virus (rAAV), rAAV-DMP-miR533, by packaging a DNA molecule DMP-miR533 into AAV, in which DMP is a NF-κB-activatable promoter composed of a NF-κB decoy and a minimal promoter and miR533 codes an artificial microRNA targeting NF-κB RELA. We evaluate the in vitro and in vivo anti-inflammatory effect of the virus with inflammatory cells and the mice of three typical inflammatory diseases including the dextran sulphate sodium-induced acute colitis, imiquimod-induced psoriasis, and collagen-induced arthritis.Results: We found that rAAV-DMP-miR533 had marked anti-inflammatory effect in both cells and mice. In addition, rAAV-DMP-miR533 showed biosafety in mice.Conclusion: This study thus provides a promising gene therapy to variant inflammatory diseases by directly targeting NF-κB, an established hub regulator of inflammation.Keywords: NF-κB, inflammation, therapy, AAV, microRNA

Jingyu Xu,1,* Zhenbiao Guan,2,* Xiaowei Wang,1,* Dazhi Sun,1 Yongjin Li,1 Bei Pei,1 Ye Lu,1 Liangxi Yuan,3 Xuan Zhang1 1Department of Traditional Chinese Medicine, Changzheng Hospital, Naval Medical University, Shanghai 200003, People’s Republic of China; 2Department of Respiration, Changhai Hospital, Naval Medical University, Shanghai 200433, People’s Republic of China; 3Department of Vascular Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liangxi YuanDepartment of Vascular Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, People’s Republic of ChinaEmail yuanlx116@163.comXuan ZhangDepartment of Traditional Chinese Medicine, Changzheng Hospital, Naval Medical University, Shanghai 200003, People’s Republic of ChinaEmail zhangx@smmu.edu.cnBackground and Objective: Neurotoxicity is a common side effect of oxaliplatin; the effect of current drugs such as methylcobalamin and gabapentine is not obvious. Astragaloside IV (AS-IV) is an important active ingredient of Astragali Radix, which can protect the nervous system and inhibit tumor growth to a certain extent. However, whether AS-IV can reduce oxaliplatin neurotoxicity and its molecular mechanism remain unclear.Methods: The network pharmacology method was used to determine the collective targets of AS-IV and oxaliplatin neurotoxicity. The model of neurotoxicity was established by intraperitoneal injection of oxaliplatin in rats. Bodyweight, mechanical withdrawal threshold (MWT), cold allodynia, and nerve conduction velocity (NCV) were examined, pathological changes were observed by hematoxylin-eosin staining, number of Nissl bodies were assessed by Nissl staining, the key collective targets were measured by spectrophotometry and immunohistochemistry.Results: Through network pharmacological analysis, 25 collective targets of AS-IV and oxaliplatin neurotoxicity were identified, mainly related to inflammation and oxidative stress. AS-IV could increase body weight, elevate MWT, and reduce cold allodynia of model rats, it also raised NCV. Neuropathology was improved and the number of Nissl bodies was increased by AS-IV administration. It reduced TNF-α, IL-6, and IL-1β in the spinal cord of model rats to inhibit inflammation; it also decreased MDA, raised SOD, CAT, and GSH-Px in the spinal cord of model rats to block oxidative stress.Conclusion: AS-IV improves oxaliplatin neurotoxicity by regulating neuroinflammation and oxidative stress; the results can provide a new perspective for the potential treatment strategy of oxaliplatin neurotoxicity.Keywords: network pharmacology, astragaloside IV, oxaliplatin neurotoxicity, neuroinflammation, oxidative stress

Youwen Zhang, Deyin Tong, Daobiao Che, Bing Pei, Xiaodong Xia, Gaofeng Yuan, Xin Jin Department of Hospital Pharmacy, The First Hospital of Suqian, Suqian, People’s Republic of China Abstract: The roles of ginsenoside compound K (CK) in inhibiting tumor have been widely recognized in recent years. However, low water solubility and significant P-gp efflux have restricted its application. In this study, CK ascorbyl palmitate (AP)/d-α-tocopheryl polyethylene glycol 1000 succinate monoester (TPGS) mixed micelles were prepared as a delivery system to increase the absorption and targeted antitumor effect of CK. Consequently, the solubility of CK increased from 35.2±4.3 to 1,463.2±153.3 µg/mL. Furthermore, in an in vitro A549 cell model, CK AP/TPGS mixed micelles significantly inhibited cell growth, induced G0/G1 phase cell cycle arrest, induced cell apoptosis, and inhibited cell migration compared to free CK, all indicating that the developed micellar delivery system could increase the antitumor effect of CK in vitro. Both in vitro cellular fluorescence uptake and in vivo near-infrared imaging studies indicated that AP/TPGS mixed micelles can promote cellular uptake and enhance tumor targeting. Moreover, studies in the A549 lung cancer xenograft mouse model showed that CK AP/TPGS mixed micelles are an efficient tumor-targeted drug delivery system with an effective antitumor effect. Western blot analysis further confirmed that the marked antitumor effect in vivo could likely be due to apoptosis promotion and P-gp efflux inhibition. Therefore, these findings suggest that the AP/TPGS mixed micellar delivery system could be an efficient delivery strategy for enhanced tumor targeting and antitumor effects. Keywords: ginsenoside CK, ascorbyl palmitate, TPGS, mixed micelles, anti-tumor therapy

Meiwen Yu,1,* Kan Wu,1,* Bing Pei,2 Degang Yang,2 Qiulin Wang,1 Hongsheng Wang,1 Jianping Shen,1 Liangbing Yan,1 Guochen Zhang1 1Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for STD and Leprosy Control, China CDC, Nanjing, People's Republic of China; 2Department of Infectious Diseases, Shanghai Skin Disease Hospital, Shanghai, People's Republic of China *These authors contributed equally to this work Abstract: The reported number of registered leprosy patients worldwide declined with the introduction of multidrug therapy. However, the emergence of rifampicin resistance in leprosy patients engenders difficulties for an individual patient, and its dissemination could pose a threat to leprosy control. This study reports an elderly patient who was diagnosed with rifampicin-resistant lepromatous leprosy. This case indicates that inadequate treatment and poor compliance may eventually result in rifampicin resistance in Mycobacterium leprae and clinical relapse. Keywords: leprosy, rifampicin, drug resistance, elderly patient

Summary: While videolaryngoscopy has resulted in better overall success rates of tracheal intubation, airway assessment is still an important prerequisite for safe airway management. This study aimed to create an artificial intelligence model to identify difficult videolaryngoscopy using a neural network. Baseline characteristics, medical history, bedside examination and seven facial images were included as predictor variables. ResNet‐18 was introduced to recognise images and extract features. Different machine learning algorithms were utilised to develop predictive models. A videolaryngoscopy view of Cormack‐Lehane grade of 1 or 2 was classified as 'non‐difficult', while grade 3 or 4 was classified as 'difficult'. A total of 5849 patients were included, of whom 5335 had non‐difficult and 514 had difficult videolaryngoscopy. The facial model (only including facial images) using the Light Gradient Boosting Machine algorithm showed the highest area under the curve (95%CI) of 0.779 (0.733–0.825) with a sensitivity (95%CI) of 0.757 (0.650–0.845) and specificity (95%CI) of 0.721 (0.626–0.794) in the test set. Compared with bedside examination and multivariate scores (El‐Ganzouri and Wilson), the facial model had significantly higher predictive performance (p < 0.001). Artificial intelligence‐based facial analysis is a feasible technique for predicting difficulty during videolaryngoscopy, and the model developed using neural networks has higher predictive performance than traditional methods. [ABSTRACT FROM AUTHOR]

The rapid development of informatization and digitalization in public security business has generated a large amount of law enforcement case data in public security work. However, due to various types of text and large amount of information, front-line police officers often face problems such as low reading efficiency and difficulty in aggregating information in the process of reading case files. In order to further utilize the law enforcement case text, it is necessary to conduct intelligent analysis and knowledge extraction. However, due to the professionalism, data sensitivity, confidentiality of public security professional law enforcement case text, as well as the requirements of public security data going out of the network, only a small number of learning training samples can be obtained, and the traditional deep learning model has unsatisfactory extraction effect. Therefore, this paper proposes to build a large language model in vertical fields with fewer resources and data, and realize the adaptation of the model to the public security profession. The model uses knowledge editing technology MEMIT (mess-editing memory in a transformer), low-resource fine-tuning technology LoRA (low-rank adaptation), and prompt templates to improve the model??s understanding of public security knowledge such as police terminology and common sense. Moreover, in order to further improve the knowledge extraction effect of the model, a small sample law enforcement case text data extraction process is designed to better integrate the professional knowledge related to the case in the model. Experimental results show that the accuracy of the public security professional vertical field large language model integrated with the extraction process in various knowledge extraction tasks is significantly improved compared with the traditional methods, which helps front-line police officers quickly, objectively and accurately analyze law enforcement case text, dig out potential case information, and support the intelligent development of public security work.

Abstract Background Memory and attention are important for daily functioning, and their function deteriorates due to aging. However, fruit and vegetable consumption are one of the protective factors against deterioration in memory and attention. This systematic review of randomized controlled trials (RCTs) aims to identify the effects of fruit and vegetable consumption on memory and attention. Methods We conducted a systematic search in EBSCOhost, ProQuest, PubMed, Embase, and Web of Science from inception up to 06/09/2022. The inclusion criteria were peer-reviewed articles, fruit and vegetable intake measured using randomized controlled trials, and the outcome measures that showed the results of memory and attention scores. Two researchers independently extracted articles that met the selection criteria and evaluated the quality of each study. Results There were 70 articles identified from the databases, of which 13 articles met the inclusion criteria and were included in this systematic review. There were 493 participants in total. The results show that consumption of fruit and vegetable intake improved memory and attention in longitudinal studies (10 to 12 weeks). Children showed improvement in immediate recall after supplementation with blueberries. Older adults required a higher dose of fruit and vegetable intake consumption to achieve significant improvement compared with children and younger adults. Furthermore, the effect of fruits and vegetables on memory showed better immediate memory recall than delayed recall. Conclusion This systematic review showed that there is an improvement in memory and attention with fruit and vegetable intake consumption. Hence, awareness of fruit and vegetable intake consumption is important to maintain cognitive health.

Background As the recognition of psychological factors in chronic illness management grows, this study examined the interplay of psychological traits – grit, self-efficacy, resilience, and nature-relatedness – and their collective impact on the Quality of Life (QoL) among patients with rheumatoid arthritis (RA) in Malaysia.Methods A cross-sectional study was conducted among 222 patients with RA at a private hospital in Malaysia. Utilizing validated scales, including the Connor-Davidson Resilience Scale, Short Grit Scale, Nature Relatedness Scale, and Arthritis Self Efficacy Scale, data were collected. Pearson Product-moment Correlation analyses assessed the relationships between variables, and a multiple mediation analysis explored the mediating effects of resilience, grit, and self-efficacy on the relationship between nature-relatedness and QoL.Findings Of the 222 participants (86% female, mean age = 56.03, S.D. = 13.42), the analysis revealed a significant mediating role of resilience in the relationship between nature-relatedness and QoL among RA patients (b = −.117, SE = .042, 95% BCa CI [−.208, –.046]). Although grit and self-efficacy positively correlated with QoL, they did not serve as significant mediators in the nature-relatedness – QoL relationship. This highlights the pivotal role of building a sense of resiliency among patients with RA.Interpretation Individuals with RA are not only resilient in terms of their psychological traits such as grit, self-efficacy, and general resilience but also exhibit resilience in their connection and interaction with the natural environment (nature-relatedness). This holistic concept recognizes that fostering resilience in both psychological aspects and the context of one's environment is crucial for promoting overall well-being, particularly in the management of chronic illnesses like RA. It emphasizes the interconnectedness of psychological factors and environmental engagement in contributing to an individual's ability to cope and thrive despite health challenges.

Abstract Nanoscale polymeric thin films are widely used in diverse modern applications, where a satisfactory mechanical performance is a requirement to their full functionality. The mechanical response of polymer films is strongly affected by the size effects under nanoconfinement; however, the mechanism of such response in terms of molecular configurations and chain conformations has yet to be determined. In this work, we reveal the conformational origin of the stiffening behavior of crosslinked polymeric nanofilms via coarse-grained molecular dynamics and tailored experiments. We find that the biaxial modulus changes follow the alteration of polymer conformations, decoupled from size and thickness. We propose a theory to quantitatively link the elastic properties of the polymers to the distribution of their chain end-to-end distances, predicting a stiffening effect on uncoiled chains. Finally, we use such insight to obtain several PDMS nano-films of the same thickness but with a variability of two orders of magnitudes in their moduli.

In order to analyze the lubrication characteristics of the planetary gear transmission of shield main drive reducers, a simulation model of splash lubrication of the single-stage planetary gear train is established using the moving particle semi-implicit (MPS) method. By comparing the distribution of lubricating oil particles, velocity field, pressure field, the number of lubricating oil particles in the meshing area of gear teeth and the churning resistance moment produced by each rotating part during the planetary gear train movement under different working conditions, the influence of input speed, initial oil level height and oil temperature on the system lubrication effect and churning loss power are studied. The results show that the oil particle velocity and pressure increase with the increase of the input speed and oil level, and the low speed and oil level height will lead to the uneven distribution of oil particles in the reducer. The number of particles in the meshing zone between planetary gears, sun gears and inner gear rings decreases with the increase of input speed and oil temperature, and decreases with the decrease of oil level height. The meshing area of sun gears is the risk area of poor lubrication. The power loss of the system is most significantly affected by the input speed, and increases exponentially with the increase of the speed, while the influence of oil level height and oil temperature is relatively small. In each working condition, the churning loss power generated by the three planetary gears takes the largest proportion in the total churning loss power.

Background Breast cancer is a common clinical malignant tumor, which seriously affects the health of women. Although the current targeted therapy system for breast cancer is well established, the difference in clinical efficacy between double-target therapy and single-target therapy remains unclear.Objective To explore the effects of different neoadjuvant chemotherapy regimens on the immune indicators and tumor microenvironment in HER2-positive breast cancer patients.Methods A total of 92 patients with HER-2-positive breast cancer admitted to Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University from September 2017 to September 2021 were collected and randomly divided into the study group (trastuzumab+patuzumab+docetaxel therapy, n=46) and the control group (trastuzumab+docetaxel therapy, n=46) . The clinical efficiency rate and control rate, the changes of inflammatory factors levels and immunological indicators were compared between the two groups.Results The clinical efficiency rate and control rate after treatment of the study group were higher than those of the control group (P

Understanding how bullying leads to eating disorders can help develop effective intervention strategies. This phenomenological study examines the relationship between bullying and coping strategies Malaysian adolescents diagnosed with eating disorders use. Using the snowball sampling technique, 12 Kuala Lumpur participants, six females and six males aged 10 to 19, responded to interview questions based on the literature reviews, theories, and a published questionnaire. By using thematic analysis, the researcher found out that all 12 participants with EDs were bullied about their weight or size. Most of the bullying and teasing were verbal or via online platforms. The findings suggest that bullying can be a significant cause of the development of eating disorders among adolescents in Malaysia. Proper coping strategies can be essential in overcoming the trauma of being bullied and treating eating disorders.

Divorce has been a significant societal issue since antiquity, warranting careful scholarly attention. The evolution of divorce systems from ancient times to the present day mirrors broader societal, ideological, and marital transformations. This paper presents an analytical exploration of the social implications of ancient divorce legislation through the lens of four historical divorce models. By assembling a corpus of ancient divorce texts and employing the vector space model for data representation, this study leverages the TF-IDF algorithm for keyword extraction. Subsequently, it utilizes a keyword co-occurrence network to scrutinize pivotal elements within the ancient divorce systems. Furthermore, the study employs the Latent Dirichlet Allocation (LDA) model to investigate the thematic evolution of these systems. Analysis of the corpus reveals that the term “separation” appears 513 times, underscoring its prevalence. The keyword co-occurrence network exhibits a point degree centrality of 0.523, indicating significant interconnectivity. The principal legal term, “shall,” occurs 68 times, reflecting its normative importance. Notably, the study identifies subtle variations in legal stipulations across different dynasties, primarily concerning changes in the grounds and moral considerations for divorce. These historical divorce systems were profoundly influenced by the dynamics of marital relationships, as well as patriarchal, familial, and societal constraints. This historical perspective offers valuable insights for contemporary marital law implementations, suggesting a nuanced understanding of divorce’s legal and social dimensions.

This study aimed to investigate the effects of gastric cancer interstitial fluid (GCIF) on tumors and explore the possible mechanism of Xiaotan Sanjie decoction (XTSJ) on treatment of gastric cancer from the view of regulating microRNA-21 (miR-21) expression. The GCIF was extracted and identified by measuring the levels of interleukin-8 (IL-8), intercellular adhesion molecule 1 (ICAM-1) and miR-21. The effects of GCIF on the proliferation of SGC-7901 cells and tumor growing were assessed by cell counting kit-8 (CCK-8) assay and subcutaneously transplanted tumor-bearing nude mice model, respectively. Additionally, inhibition effect of XTSJ decoction on proliferation of SGC-7901 cells intervened by GCIF were assessed in vitro and anti-cancer effect of it was further assessed using orthotopic transplanted tumor-bearing nude mice model. The concentration of SGC-7901 gastric cancer cells were dependent on the concentration of the added GCIF. After 72 hours of continuous culture, the interstitial fluid had an obvious proliferative effect on the SGC-7901 tumor cells, which was the most significant in the high concentration group. XTSJ decoction could inhibit the growth-promoting effect (P < 0.01) of GCIF on gastric cancer cells. Intervention of the GCIF might promote the growth (P < 0.05) of the subcutaneously transplanted tumors in nude mice and decrease the net weight of the tumor-bearing nude mice (P < 0.05) after tumor removal. The GCIF was able to up-regulate the expression (P < 0.001) of miR-21 in the subcutaneously transplanted tumors. XTSJ decoction could downregulate the expression (P < 0.05) of miR-21 in SGC-7901 orthotopically transplanted tumors. XTSJ decoction can inhibit the multiplicative effect of GCIF on gastric cancer cells, growth of gastric tumor and promotion effect of GCIF on tumors, probably due to the down-regulating miR-21 expression in tumor tissues. [ABSTRACT FROM AUTHOR]

As the core components of metro vehicles, the reliability of metro gearboxes determines the reliability of the whole train. The operation process of subway includes start-up, continuity, high-speed and short circuit conditions. In short circuit conditions, the box body has the maximum stress and the lowest reliability. According to the test requirements of national standard “Railway applications—Rolling stock equipment—Shock and vibration tests”, the reliability analysis of metro gearboxes in abnormal condition (condition 1) and short circuit condition (condition 2) occurring in actual operation is carried out. Thus, the influence of casting tolerance, material parameters and input torque uncertainties on the maximum equivalent stress and maximum deformation of the box body are considered. The CCD experimental design method is used to calculate the sample and fit the response surface, and the static reliability is obtained combined with Monte Carlo sampling. On this basis, combined with the order statistic theory, the reliability of the box with the number of loads is obtained. The results show that the reliability of the box body is still very high and meets the design requirements after 100 thousand loads under the two working conditions. According to the time-dependent reliability diagram, although the mean value of stress in working condition 2 is smaller than that in working condition 1, the variance is larger than that in working condition 1, which leads to the reliability decline rate of working condition 2 is greater than that in working condition 1. Therefore, the dispersion of stress should be reduced to increase the reliability during operation.

The notion of extended X-factor contribution has been proposed and evaluated recently as a tool to identify system capacity constraints based on machine group utilization and raw processing time. This provides a great convenience for factory-floor managers examining system capacity issues by using only local- or machine-level information. The purpose of this study is twofold: to study fundamental properties of the extended X-factor contribution measure augmented with availability, and to use this new measure to investigate resource allocation for optimizing mean cycle time. The availability-adjusted X-factor was first introduced in the context of local cycle time and its relation to allocation of personnel in individual machine groups. The availability-adjusted X-factor contribution measure developed and evaluated in the current study differs from the previous measure by its ability to identify capacity-constraining machines in the entire system. The measure presented herein is a more accurate indicator of capacity constraints than the extended X-factor contribution measures. With an objective to minimize cycle time or maximize throughput by properly allocating available resources, the results presented herein clearly demonstrate the effectiveness of this new measure to identify capacity-constraining machines. This study also uses availability as a decision variable for mean cycle time optimization. [ABSTRACT FROM AUTHOR]

Abstract Aims Right ventricular pacing (RVP) dependence could impair left ventricular ejection fraction (LVEF). This study aimed to illuminate the relationship between RVP proportion and LVEF, as well as disclosing independent predictors of RVP dependence. Methods and results Patients indicated for permanent pacemaker implantation were included (2016–2020). The ventricular pacing lead was placed in right ventricular apex or septum. Pacing mode programming followed universal standard. Electrocardiographic, echocardiographic, and serological parameters were collected. RVP dependence was defined according to its influence on LVEF. This study was of case–control design. Included patients were matched by potentially confounding factors through propensity score matching. A total of 1183 patients were included, and the mean duration of follow‐up was 24 months. Percentage of RVP 120 ms (OR = 2.46, 95% CI: 1.42–4.27), QTc interval > 470 ms (OR = 2.01, 95% CI: 1.33–3.05), and pulmonary artery systolic pressure (PASP) > 40 mmHg (OR = 1.93, 95% CI: 1.46–2.56) were proved to predict RVP dependence. Conclusions High RVP percentage (>80%) indicating RVP dependence significantly correlates with poor prognosis of cardiac function. High degree/complete AVB, AF, ischaemic aetiology, PCI history, HRmax 120 ms, QTc interval > 470 ms, and PASP > 40 mmHg were verified as independent risk factors of RVP dependence.

In the present study, the effects of Humulus scandens extract on growth performance, antioxidant responses and intestinal microflora of Yellow River carp (Cyprinus carpio) were investigated. 240 carps were assigned to four treatments received diets supplemented with 0 (control), 0.5, 1 and 2 g/kg Humulus scandens extract for 8 weeks. At end of the trial, the final body weight, specific growth rate (SGR) and intestinal body index of the 1.0 g/kg and 2.0 g/kg group were significantly higher than those of the control group (P

Abstract Background The COVID-19 pandemic has resulted in a global health emergency and lock-down measures to curb the uncontrolled transmission chain. Vaccination is an effective measure against COVID-19 infections. In Malaysia amidst the national immunisation programme (NIP) which started in February 2021, there were rising concerns regarding the prevalence of vaccine hesitancy and refusal, and therefore, vaccine uptake among Malaysians. Although there are many quantitative studies on COVID-19 vaccination, the subjective experience of individuals was understudied. This study aims to explore the lived experiences of Malaysians regarding vaccine hesitancy and refusal, and facilitating factors that could enhance vaccine acceptance and uptake. Methods This qualitative study employed the hermeneutic phenomenological study design. Purposive sampling strategies were used to recruit Malaysians that had direct experiences with friends, family members and their community who were hesitating or refusing to accept the COVID-19 vaccines. A semi-structured interview guide was developed based on the expert knowledge of the investigators and existing literature on the topic. A series of focus group interviews (FGIs) was conducted online facilitated by a multidisciplinary team of experts. The group interviews were transcribed verbatim and analysed. Results Fifty-nine participants took part in seven FGIs. We found that “incongruence” was the overall thematic meaning that connected all the 3 main themes. These themes comprise firstly, the incongruence between the aims and implementation of the National Immunization Program which highlighted the gap between realities and needs on the ground. Secondly, the incongruence between Trust and Mistrust revealed a trust deficit in the government, COVID-19 news, and younger people’s preference to follow the examples of local vaccination “heroes”. Thirdly, the incongruence in communication showed the populace’s mixed views regarding official media and local social media. Conclusions This study provided rich details on the complex picture of the COVID-19 immunization program in Malaysia and its impact on vaccine hesitancy and refusal. The inter-related and incongruent factors explained the operational difficulty and complexity of the NIP and the design of an effective health communication campaign. Identified gaps such as logistical implementation and communication strategies should be noted by policymakers in implementing mitigation plans.

In order to study the transportation efficiency of the aggregate device of coal cleaning machine, taking a certain type of coal cleaning machine as the research object, establishing the mechanical model of interaction between particles and blades, obtaining the relationship between force and speed.Based on the Archard wear theory and discrete element method, Coupling model of screw and coal was established by EDEM.Analyzing the transportation capacity of screw by controlling variable, the influence of coal particle size and rotating speed on the wear depth of screw was studied.The results show that increasing the rotating speed can improve the coal transportation efficiency in terms of speed control, but too fast speed will cause particles to fly out along the radial direction.The wear depth of the screw decreases first and then increases with speed changing in from 20 r/min to 65 r/min.When speed is increased from 35 r/min to 50 r/min, the efficiency improvement effect is the most significant.,the torque of screw is relatively small at the same time.In conclusion, the best range of screw speed is 35 r/min～ 50 r/min.In addition, the screw wear is serious when transporting large coal particles compared with small particles.Therefore, in practical application, the transportation of large coal should be carried out at low screw speed.Based on the above conclusion, in this paper, an optimal mathematical model is established to minimize the driving torque, obtaining the optimal structure and dynamic parameters of the screw, and proving the correctness of optimization process by simulation test.It provides a theoretical reference for improving the transportation efficiency of the coal cleaning machine, reducing the energy consumption of the equipment and prolonging the service life of the equipment.

Objectives: This systematic review aims to identify influencing factors of medication adherence behavior in patients with end-stage renal disease (ESRD), with a special interest in patient-related factors based on the World Health Organization adherence model. Materials and Methods: Primary electronic databases comprising PubMed, Scopus, Web of Science, Embase and Cochrane Library, as well as ProQuest (Health and Medical), ProQuest (Psychology), and EBSCOHost (APA PsychARTICLES) were used to search for literature on patient-related factors in medication adherence, from inception till August 31, 2021. Results: 479 articles were identified and six articles meeting eligibility criteria were reviewed and remained in this systematic review. The present review found that despite different tools being used to measure ESRD's perception of medication's necessity and beliefs, there was a profound association between perception and beliefs with medication adherence behavior. There is a positive relationship between knowledge, belief, educational level, ethnicity, female, and medication adherence behavior. Mixed finding was reported between perception, age, and medication adherence behavior. However, there were no studies on patients' attitudes and medication adherence behavior as suggested in the WHO adherence model. Conclusion: Only a limited number of patient-related factors were available for evaluation in the current systematic review. Additional research is needed to advance the understanding of medication adherence behavior affected by patient-related factors on the medication and illness. However, the findings must be taken with caution because of the limited studies included in this review.

Most studies reporting prevalence of obesity use actual weight and height measurements. Self-reported weight and height have been used in epidemiological studies as they have been shown to be reliable, convenient, and inexpensive alternatives to actual measurements. However, the accuracy of self-reported weight and height might vary in different regions because of the difference in health awareness and social influences. This study aims to determine the accuracy and reliability of self-reported weight and height compared to actual measured weight and height among adults in Malaysia. This was a cross-sectional study conducted at the community level during blood pressure screening campaigns. Participants self-reported their weight and height in a questionnaire survey. Their weight and height were validated using measurements by researchers on the same setting. Body mass index (BMI) was defined as underweight (

Improving energy efficiency and optimizing energy structure is the key to achieving the “dual carbon” goal and high-quality development. This paper calculates the energy efficiency of 30 provinces in China between 2000 and 2017 using the DEA method. The study found that in China, the energy efficiency is higher in East China than in West China, in South China than in North China, and in the coastal areas than in the interior. Moreover, the efficiency gap between clean fuel and fossil fuel is widening. Taking total power consumption as energy input and measuring carbon emissions using regional grid base line emission factor can accurately measure China’s clean energy efficiency. The conclusions of the study provide important references for promoting China’s energy transformation and the development of the green economy.

Depression, anxiety, and stress are ranked among the top mental health concerns faced by university students in recent times perpetuated by the proliferation of digitalization. Thus, this study was performed to assess the relationship between depression, anxiety, stress, and satisfaction with life, with interpersonal needs (perceived burdensomeness and thwarted belongingness) as moderators. A cross-sectional study using a convenient sampling method was conducted among 430 Malaysian private university students (Mean aged= 20.73 years; SD = 1.26 years). A self-administered questionnaire comprising the Depression, Anxiety and Stress Scale (DASS-21), Satisfaction with Life Scale, and Interpersonal Needs Questionnaire were used. Students who experienced lower depression and anxiety reported higher satisfaction with life under the influence of low perceived burdensomeness. Perceived burdensomeness, when coupled with depression (β = 0.76, p < 0.01) and anxiety (β = 0.79, p < 0.01), contributed 15.8% of variance in satisfaction with life. Students who experienced stress reported higher satisfaction with life under the influence of high thwarted belongingness (β = 0.73, p < 0.01), contributing 17.3% of the variance in satisfaction with life. For university students who experienced depression and anxiety symptoms, mental health practitioners may need to be cognizant of how to support students' education and management of their perceived burdensomeness perceptions.

Abstract Backgrounds Inflammation underlies the mechanism of different kinds of heart disease. Cytoplasmic membrane localized N‐terminal fragment of gasdermin‐D (GSDMD‐N) could induce inflammatory injury to cardiomyocyte. However, effects and dynamic changes of GSDMD during the process of lipopolysaccharide (LPS) related inflammatory stress induced cardiomyocyte injury are barely elucidated to date. In this study, LPS related cardiomyocyte injury was investigated based on potential interaction of GSDMD‐N induced mitochondrial injury and mitophagy mediated mitochondria quality control. Methods HL‐1 cardiomyocytes were treated with LPS and Nigericin to induce inflammatory stress. The dual‐fluorescence‐labelled GSDMD expressed HL‐1 cardiomyocytes were constructed to study the translocation of GSDMD. The mitochondrial membrane potential (MMP) was measured by JC‐1 staining. Mitophagy and autophagic flux were recorded by transmission electron microscopy and fluorescent image. Results GSDMD‐N showed a time‐dependent pattern of translocation from mitochondria to cytoplasmic membrane under LPS and Nigericin induced inflammatory stress in HL‐1 cardiomyocytes. GSDMD‐N preferred to localize to mitochondria to permeablize its membrane and dissipate the MMP. This effect couldn't be reversed by cyclosporine‐A (mPTP inhibitor), indicating GSDMD‐N pores as alternative mechanism underlying MMP regulation, in addition to mitochondrial permeability transition pore (mPTP). Moreover, the combination between GSDMD‐N and autophagy related Microtubule Associated Protein 1 Light Chain 3 Beta (LC3B) was verified by co‐immunoprecipitation. Besides, mitophagy alleviating GSDMD‐N induced mitochondrial injury was proved by pre‐treatment of autophagy antagonist or agonist in GSDMD‐knock out or GSDMD‐overexpression cells. A time‐dependent pattern of GSDMD translocation and mitochondrial GSDMD targeted mitophagy were verified. Conclusion Herein, our study confirmed a crosstalk between GSDMD‐N induced mitochondrial injury and mitophagy mediated mitochondria quality control during LPS related inflammation induced cardiomyocyte injury, which potentially facilitating the development of therapeutic target to myocardial inflammatory disease. Our findings support pharmaceutical intervention on enhancing autophagy or inhibiting GSDMD as potential target for inflammatory heart disease treatment.

BackgroundBlood glucose disorders are prevalent in heart failure, while the influence of the gut microbiota on this process remains unclear. Here, we used heart failure model mice and fecal microbiota transplantation (FMT) mice to evaluate the effect of the gut microbiota on the regulation of blood glucose during heart failure.MethodsThoracic aortic constriction (TAC) surgery was performed in a heart failure model, while an antibiotic cocktail was used to eliminate the microbiota to establish a germ-free (GF) model. Blood glucose, insulin, and glucagon levels were measured, and an intraperitoneal glucose tolerance test (IPGTT) was performed. 16S rRNA sequencing and metabolomics were used to evaluate the changes in gut microbiota structure and metabolism induced by TAC. Another group of FMT mice was established to observe the effect of the gut microbiota on host metabolism.ResultsAfter microbiota clearance, the glucagon concentration, the homeostasis model assessment for insulin resistance (HOMA-IR), and the area under the curve (AUC) of the IPGTT were decreased significantly in the TAC germ-free (TAC-GF) group in the third month as compared to the other groups. 16S rRNA sequencing indicated that TAC surgery affected the gut microbiota structure, and fecal metabolomics suggested that noradrenaline and adrenaline levels were higher in the TAC group than in the sham group. The FMT mice transplanted with the feces of the TAC (FMT-TAC) mice displayed a higher AUC of IPGTT, accompanied by a higher glucagon level, insulin level, and HOMA-IR than those of the mice in the other groups. The serum metabolomics of the FMT-TAC group showed that noradrenaline levels were significantly higher than those of the FMT-sham group.ConclusionThe gut microbiota and its metabolism were altered during heart failure, which increased blood glucose and glucagon in the host.