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Objectives: Non-tuberculous mycobacteria (NTM) frequently colonize the airways of patients with bronchiectasis; however, there has been limited research into airway microbiota composition and predisposing factors for NTM detection during acute bronchiectasis exacerbations. Methods: This study enrolled 34 patients with bronchiectasis experiencing acute exacerbations. Metagenomic next-generation sequencing was used to detect microbiota in bronchoalveolar lavage fluid (BALF), and bioinformatics methods were used for the comparative analysis of meaningful microbiota in the BALF of patients with acute exacerbations of bronchiectasis. A correlation analysis was conducted to identify susceptibility factors for NTM in patients with bronchiectasis. Results: Compared with patients with community-acquired pneumonia, patients with bronchiectasis had higher detection rates of NTM (38.2%), Pseudomonas aeruginosa, and Haemophilus influenzae. Patients with NTM-positive bronchiectasis had lower body mass index and lipid profiles than patients who were NTM-negative. Metagenomic next-generation sequencing of BALF revealed patients who were NTM-positive had increased relative abundance of Rothia and other anaerobic genera compared with patients who were NTM-negative. Patients who were NTM-positive also showed higher levels of Streptococcus parasanguinis at the species level. Elevated Rothia mucilaginosa and S. parasanguinis correlated with decreased percentages of clusters of differentiation 3+ T lymphocytes and clusters of differentiation 3+ T-cell subgroups in peripheral blood. Conclusions: NTM colonization increases the risk of acute bronchiectasis exacerbations. Low body mass index, lipid levels, and isolation of R. mucilaginosa and S. parasanguinis in BALF are susceptibility factors for NTM colonization in patients with bronchiectasis.

(1) Background: In lung cancer, the use of small-molecule inhibitors, chemotherapy and immunotherapy has led to unprecedented survival benefits in selected patients. Considering most patients will experience a relapse within a short period of time due to single drug resistance, combination therapy is also particularly important to improve patient prognosis. Therefore, more robust biomarkers to predict responses to immunotherapy, targeted therapy, chemotherapy and rationally drug combination therapies may be helpful in clinical treatment choices. (2) Methods: We defined tumor-specific T cells (TSTs) and their features (TSTGs) by single-cell RNA sequencing. We applied LASSO regression to filter out the most survival-relevant TSTGs to form the Tumor-specific T cell score (TSTS). Immunological characteristics, enriched pathways, and mutation were evaluated in high- and low TSTS groups. (3) Results: We identified six clusters of T cells as TSTs in lung cancer, and four most robust genes from 9 feature genes expressed only on tumor-specific T cells were screened to construct a tumor-specific T cells score (TSTS). TSTS was positively correlated with immune infiltration and angiogenesis and negatively correlated with malignant cell proliferation. Moreover, potential vascular-immune crosstalk in lung cancer provides the theoretical basis for combined anti-angiogenic and immunotherapy. Noticeable, patients in high TSTS had better response to ICB and targeted therapy and patients in the low TSTS group often benefit from chemotherapy. (4) Conclusion: The proposed TSTS is a promising indicator to predict immunotherapy, targeted therapy and chemotherapy responses in lung cancer patients for helping clinical treatment choices.

Abstract Background The coronavirus disease 2019 (COVID-19) has induced a worldwide epidemiological event with a high infectivity and mortality. However, the predicting biomarkers and their potential mechanism in the progression of COVID-19 are not well known. Objective The aim of this study is to identify the candidate predictors of COVID-19 and investigate their underlying mechanism. Methods The retrospective study was conducted to identify the potential laboratory indicators with prognostic values of COVID-19 disease. Then, the prognostic nomogram was constructed to predict the overall survival of COVID-19 patients. Additionally, the scRNA-seq data of BALF and PBMCs from COVID-19 patients were downloaded to investigate the underlying mechanism of the most important prognostic indicators in lungs and peripherals, respectively. Results In total, 304 hospitalized adult COVID-19 patients in Wuhan Jinyintan Hospital were included in the retrospective study. CEA was the only laboratory indicator with significant difference in the univariate (P

Background: Cognitive impairment contributes significantly to negative health outcomes. This meta-analysis aimed to investigate the association between cognitive impairment and cardiovascular mortality in mature and older adults. Methods: PubMed, Web of Science, and Embase databases were searched until February 10, 2024, to identify the association between cognitive impairment and cardiovascular mortality in mature and older adults (aged 50 years and older) from the general population. The adjusted risk estimates from the included studies were extracted and pooled using a random effects model. Results: Ten studies were included in the meta-analysis, involving 16,765 participants. The pooled hazard ratio (HR) of cardiovascular mortality was 1.75 (95 % confidence interval [CI] 1.44–2.14; I2 = 48.2 %) for individuals with cognitive impairment compared to those without, even after adjusting for common confounding factors. Subgroup analysis revealed that the prognostic value of cognitive impairment may be influenced by the assessment tools used for measuring cognition. Additionally, cognitive impairment significantly predicted cardiovascular mortality in women (HR 2.40; 95 % CI 1.54–3.74; I2 = 45.4 %) but not in men (HR 1.49; 95 % CI 0.99–2.24; I2 = 44.8 %). Conclusions: Cognitive impairment is a significant predictor of cardiovascular mortality in mature and older adults from the general population. However, future studies are needed to evaluate the specific impact of cognitive impairment on different genders.

In a study conducted in a metro tunnel, acceleration and displacement sensors were strategically placed along steel rails, track beds, and tunnel walls to capture real-time dynamic responses during train operations. Data were analyzed in the time and frequency domains, focusing on vibration levels and one-third octave bands. The results indicated that peak vibration acceleration significantly decreases from steel rails to tunnel walls, with different vibration frequencies observed at various locations: steel rails (200 Hz–1400 Hz), track beds, and tunnel walls (70 Hz–400 Hz). Cracks notably increase peak acceleration, vibration levels, peak frequency, and steel rail displacement but do not alter the overall vibration trends. Tunnel wall responses show the highest sensitivity to cracks, with a 300% increase in peak frequency, followed by track beds (100%) and steel rails (70%). Vibration levels under one-third octave band processing increased by 12.4% for tunnel walls, 8.8% for track beds, and 2.2% for steel rails. Cracks also caused steel rails’ vertical and lateral displacement to rise by 112% and 53%, respectively. These findings provide valuable insights for vibration reduction and crack repair in long-term subway operations.

Detection of epidermal growth factor receptor (EGFR) is one real dilemma owing to the non-sufficient tissue for testing EGFR mutations in lung adenocarcinoma. A model for predicting EGFR mutations would be helpful for clinical decisions in those patients. A retrospective cohort of 1,196 patients diagnosed with lung adenocarcinoma was investigated between December 1, 2017, and December 31, 2019, in Renji Hospital, Shanghai, China. All patients were tested for EGFR mutations (amplification refractory mutation system, n=1,144; next-generation sequencing, n=52). Of 1,196 patients with lung adenocarcinoma, 944 met the inclusion criteria. A nomogram model was developed based on 567 patients and validated in 377 patients. Variables associated with EGFR mutations were age, sex, smoking history, lepidic predominant subtype, solid predominant subtype, mucinous adenocarcinoma, Ki67 expression, lobulation, solid texture in radiology, and pleural retraction. The nomogram based on the model performed well in the development group (c-index 0.789, 95% CI: 0.751-0.827), and the validation group (c-index 0.809, 95% CI: 0.771-0.847). At the probability cut-point of 0.7, the diagnostic efficiency was 82.7% in patients with NGS liquid biopsy. Decision curve analysis further confirmed the clinical usefulness of the nomogram, which showed that predicting the EGFR mutations probability applying this nomogram would be better than having all patients or none patients use this nomogram. A high probability group (>0.7) by nomogram model may suggest a high possibility of EGFR mutation, if tissue is limited, NGS-based ctDNA with liquid biopsy could be implemented effectively. [ABSTRACT FROM AUTHOR]

BackgroundUpper limb motor dysfunction caused by stroke greatly affects the daily life of patients, significantly reduces their quality of life, and places serious burdens on society. As an emerging rehabilitation training method, brain–computer interface (BCI)–based training can provide closed-loop rehabilitation and is currently being applied to the restoration of upper limb function following stroke. However, because of the differences in the type of experimental clinical research, the quality of the literature varies greatly, and debate around the efficacy of BCI for the rehabilitation of upper limb dysfunction after stroke has continued.ObjectiveWe aimed to provide medical evidence-based support for BCI in the treatment of upper limb dysfunction after stroke by conducting a meta-analysis of relevant clinical studies.MethodsThe search terms used to retrieve related articles included “brain-computer interface,” “stroke,” and “upper extremity.” A total of 13 randomized controlled trials involving 258 participants were retrieved from five databases (PubMed, Cochrane Library, Science Direct, MEDLINE, and Web of Science), and RevMan 5.3 was used for data analysis.ResultsThe total effect size for BCI training on upper limb motor function of post-stroke patients was 0.56 (95% CI: 0.29–0.83). Subgroup analysis indicated that the standard mean differences of BCI training on upper limb motor function of subacute stroke patients and chronic stroke patients were 1.10 (95% CI: 0.20–2.01) and 0.51 (95% CI: 0.09–0.92), respectively (p = 0.24).ConclusionBrain–computer interface training was shown to be effective in promoting upper limb motor function recovery in post-stroke patients, and the effect size was moderate.

Abstract Background Hepatitis C virus (HCV) infection is one of the leading causes of liver cancer, creating enormous economic and social burdens. The Chinese government recommends routine screening of inpatients for HCV before invasive procedures to prevent iatric infections. However, the diagnosis and treatment rates for HCV remain low. The aim of this study was to use available routine screening data to understand the HCV screening of inpatients in different regions of China. Methods Inpatient information and HCV screening results were collected from January 2016 to December 2016 at eight tertiary hospitals in different regions of China to compare the HCV-positivity of hospitalized patients among different regions and age groups. Results The HCV screening rate of inpatients was more than 50%. A total of 467,008 inpatients were enrolled in the study (51.20% were male), and the HCV antibody (anti-HCV) -positive rate was 0.88% (95% confidence interval [CI], 0.85–0.91%) among the total population. This rate was significantly higher among all males compared with all females (0.91% vs 0.85%). Moreover, the HCV antibody-positive rate increased with age and was highest for the 60–64-year age group. Notably, 90.14% (3722/4129) of the anti-HCV seropositive patients were 40 years of age or older. HCV screening for people over 40 years old is recommended. Conclusions This study highlights the key role of routine examination for HCV infection in hospitalized patients. Full use of inpatient screening results to manage HCV antibody-positive patients and a screening strategy targeting inpatients 40 years and older were found to be low-cost and effective, which will help to find the missing millions of yet unaware patients and also accelerate the elimination of HCV in China.

Nowadays, a huge number of shield-driven tunnels with noncircular cross sections are constructed in urban areas all around the world. However, the ground displacements associated with tunneling still form a difficult issue, especially for noncircular tunnels. In this study, an analytical solution is derived to estimate the ground displacements induced by the deformations of shallow noncircular tunnels in soft ground. First, a solution for the stresses and displacements around a deep tunnel in a full plane is formulated by imposing a specified convergence pattern over the cavity boundary. Subsequently, this solution is validated using finite element simulations in a case study of an elliptical tunnel with four different convergence patterns. Afterward, the solution in the full plane is extended to a half plane using the virtual image technique to estimate the ground displacements around shallow tunnels. The solution is also validated using finite element simulations.

Based on complex variable theory and conformal mapping method, the paper presents full plane elastic solutions around an unlined tunnel with arbitrary cross section in anisotropic soil. The solutions describe soil elastic solutions for assuming that the displacement vectors along the tunnel boundary are directed towards the center of the tunnel. Tunnels with different cross sections are used to illustrate the method and its correctness. An elliptical unlined tunnel case is discussed in detail in the paper. Using the image method, an approximate solution for predicting surface displacement and subsurface horizontal displacement around an unlined tunnel in anisotropic soil can be obtained. The results show anisotropic stiffness properties nn=Eh/Ev and mm=Gvh/Ev have a great effect on the displacement distribution patterns around an elliptical tunnel with certain shape.

The methodology of the existing displacement control is illustrated taking the shield of twin tunnels of Line 4 underpassing the upline tunnel of existing metro Line 1, for example. Vertical, horizontal, and convergence displacement of the existing tunnel is monitored and analyzed in detail in this paper. Shield parameters are predefined and adjusted based on the feedback of the displacement of Line 1. Short-term displacement of the existing tunnel is greatly influenced by the relative distance between the shield face and the existing tunnel and shield parameters. The shapes of horizontal and convergence displacement curves are similar. Line 1 is reinforced, and a new analysis method is firstly proposed for the design of reinforcement of the existing tunnel which is verified by the analytical methods derived from prior studies. The results show that the change of reinforcement stiffness has a greater effect on the normalized bending moment and the normalized shear force of the existing tunnel, and reinforcement of 25 rings on either side of the intersection point is the best choice in this case. The proposed model can be widely applicable for reinforcement design and safety check of the existing tunnel.

Background/Aims. It remains unclear whether tenofovir disoproxil fumarate- (TDF-) based combination therapy produces better outcomes than TDF monotherapy in chronic hepatitis B (CHB) patients. The aim of this study was to compare the efficacy of the two regimens by performing a meta-analysis. Methods. A comprehensive literature search was performed on the comparison of TDF-based combination therapy and monotherapy for CHB patients in the PubMed, Embase, Web of Science, and the Cochrane Libraries. Both dichotomous and continuous variables were extracted and pooled outcomes were expressed as risk ratio (RR) or standard mean difference (SMD). Results. Nine eligible studies (1089 subjects in total) were included in our analysis. The proportion of patients with undetectable HBV DNA at 24, 48, and 96 weeks were similar between the two comparable groups (62.5% versus 70.9%, P=0.086; 78.1% versus 83.7%, P=0.118; 86.4% versus 87.9%, P=0.626, resp.). HBV DNA reduction, rates of ALT normalization, hepatitis B e antigen (HBeAg) loss, and HBeAg seroconversion were also similar between the two groups. Conclusions. On the current data, TDF-based combination therapy seemed to be no better than those achieved by monotherapy. Further studies are needed to verify this comparison.

Hydraulic torque motors are one key component in electro-hydraulic servo valves that convert the electrical signal into mechanical motions. The systematic characteristics analysis of the hydraulic torque motor has not been found in the previous research, including the distribution of the electromagnetic field and torque output, and particularly the relationship between them. In addition, conventional studies of hydraulic torque motors generally assume an evenly distributed magnetic flux field and ignore the influence of special mechanical geometry in the air gaps, which may compromise the accuracy of analyzing the result and the high-precision motion control performance. Therefore, the objective of this study is to conduct a detailed analysis of the distribution of the magnetic field and torque output; the influence of limiting holes in the air gaps is considered to improve the accuracy of both numerical computation and analytical modeling. The structure and working principle of the torque motor are presented first. The magnetic field distribution in the air gaps and the magnetic saturation in the iron blocks are analyzed by using a numerical approach. Subsequently, the torque generation with respect to the current input and assembly errors is analyzed in detail. This shows that the influence of limiting holes on the magnetic field is consistent with that on torque generation. Following this, a novel modified equivalent magnetic circuit is proposed to formulate the torque output of the hydraulic torque motor analytically. The comparison among the modified equivalent magnetic circuit, the conventional modeling approach and the numerical computation is conducted, and it is found that the proposed method helps to improve the modeling accuracy by taking into account the effect of special geometry inside the air gaps.