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Infected pancreatic necrosis (IPN) is a highly morbid complication of acute necrotising pancreatitis (ANP). Since there is evidence of early-onset immunosuppression in acute pancreatitis, immune enhancement may be a therapeutic option. This trial aimed to evaluate whether early immune-enhancing Thymosin alpha 1 (Tα1) treatment reduces the incidence of IPN in patients with predicted severe ANP.We conducted a multicentre, double-blind, randomised, placebo-controlled trial involving ANP patients with an Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 8 and a computed tomography (CT) severity score ≥ 5 admitted within 7 days of the advent of symptoms. Enrolled patients were assigned to receive a subcutaneous injection of Tα1 1.6 mg every 12 h for the first 7 days and 1.6 mg once a day for the subsequent 7 days or matching placebos (normal saline). The primary outcome was the development of IPN during the index admission.A total of 508 patients were randomised, of whom 254 were assigned to receive Tα1 and 254 placebo. The vast majority of the participants required admission to the intensive care unit (ICU) (479/508, 94.3%). During the index admission, 40/254(15.7%) patients in the Tα1 group developed IPN compared with 46/254 patients (18.1%) in the placebo group (difference -2.4% [95% CI - 7.4 to 5.1%]; p = 0.48). The results were similar across four predefined subgroups. There was no difference in other major complications, including new-onset organ failure (10.6% vs. 15%), bleeding (6.3% vs. 3.5%), and gastrointestinal fistula (2% vs. 2.4%).The immune-enhancing Tα1 treatment of patients with predicted severe ANP did not reduce the incidence of IPN during the index admission.

Dementia is an urgent public health problem worldwide, and the determination of the contribution of pain to cognitive decline or dementia is significant for the prevention of dementia.To comprehensively explore the contribution of pain to subsequent cognitive decline or dementia and analyze possible influencing factors.Systematic review and meta-analysis of cohort studies.We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, China National Knowledge Internet, WANFANG DATA and VIP for cohort studies from database inception to January 21, 2022. Random-effects meta-analysis was used to pool odds ratios (ORs) and 95% confidence intervals (CIs) of incident cognitive decline or dementia among patients with pain. Subgroup analyses and meta-regression were used to explore the sources of heterogeneity.A total of 35 cohort studies containing 1,122,503 participants were included. As a whole, pain (OR = 1.24; 95% CI = 1.17-1.31) was a risk factor for subsequent cognitive decline or dementia; headache, migraine, tension-type headache, widespread pain, and irritable bowel syndrome, but not burning mouth syndrome, were also risk factors. Pain increased the risk of all-cause dementia (OR = 1.26; 95% CI = 1.18-1.35), Alzheimer's disease (OR = 1.28; 95% CI = 1.12-1.47), and vascular dementia (OR = 1.31; 95% CI = 1.06-1.62). Pain interference (OR = 1.42; 95% CI = 1.16-1.74) was associated with an increased risk of cognitive decline or dementia, while pain intensity was not. Pooled results from studies with sample sizes less than 2000 or with relatively low quality showed that pain did not increase the risk of cognitive decline or dementia. There was no statistically significant increase in the risk of cognitive decline or dementia in people with pain aged ≥75 years.Our results demonstrated that pain increased the risk of subsequent cognitive decline or dementia. Sample size, study methodological quality, types of pain, pain severity (pain interference), and age composition of the study population may affect the relationship between pain and cognitive decline or dementia.PROSPERO (CRD42022316406).

It is very important to study public library services available to migrant workers, which have the potential to enrich public library services and promote social equity. After analyzing the present situation and characteristics of migrant workers in China, this article takes the services for migrant workers offered by Hangzhou Public Library as an example and explores the best ways to service migrant workers in public libraries, including how to further break down the obstacles to service, how to expand the mode of service, and how to make a greater effort to optimize the growth environment of migrant workers and promote their integration into urban cultural life in the future.

IntroductionThe high incidence of unsafe anaesthetic care leads to adverse events and increases the burden on patient safety. An important reason for unsafe anaesthesia care is the lack of non-technical skills (NTS), which are defined as personal cognitive, social or interpersonal skills, among anaesthetists. The anaesthetists’ NTS (ANTS) behavioural marker system has been widely used to evaluate and improve anaesthetists’ behavioural performance to ensure patient safety. This protocol describes a planned systematic review aiming to determine the validity and reliability of the ANTS behavioural marker system and its application as a tool for the training and assessment of ANTS and for improving patient safety.Methods and analysisThis systematic review follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. Studies that applied the ANTS behavioural marker system in a meaningful way, including using the ANTS behavioural marker system to guide data collection, analysis, coding, measurement, and/or reporting, which have been published in peer-reviewed journals, will be eligible. A citation search strategy will be employed. We will search Scopus and Web of Science for publications from 2002 to May 2022, which cite the three original ANTS behavioural marker system publications by Fletcheret al. We will also search the references of the relevant reviews for additional eligible studies. For each study, two authors will independently screen papers to determine eligibility and will extract the data. The quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. A framework analysis approach that consists of five steps—familiarisation, identifying a thematic data extraction framework, indexing, charting, mapping and interpretation—will be used to synthesise and report the data.Ethics and disseminationEthics approval is not required for this study. The findings will be disseminated primarily through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42022297773.

BACKGROUND&AIMSInfected pancreatic necrosis (IPN) is a highly morbid complication of acute pancreatitis (AP). Since there is evidence of immunosuppression in the early phase of AP, immune enhancement using Thymosin alpha 1 (Tα1), which stimulates both innate and adaptive immunity, may be a therapeutic strategy to prevent IPN. Our aim was to assess the efficacy of early Tα1 treatment on the development of IPN.METHODSWe conducted a multicenter, randomized, double-blind, placebo-controlled trial in patients with predicted severe acute necrotizing pancreatitis (ANP). ANP patients with an APACHE II score≥8 admitted within seven days of the advent of symptoms were considered eligible. Enrolled patients were assigned to receive a subcutaneous injection of Tα1 1.6 mg, every 12 hours for the first 7 days and 1.6 mg once a day for the subsequent 7 days or matching placebo (normal saline). The primary outcome was the development of IPN during the index admission.RESULTSFrom Mar 2017 through Dec 2020, 508 patients were randomized at 16 hospitals, of whom 254 were assigned to receive Tα1 and 254 placebo. During the index admission, 40/254 (15.7%) patients in the Tα1 group developed IPN compared with 46/254 patients (18.1%) in the placebo group (difference -2.4% [95%CI -7.4% to 5.0%]; p=0.47). The results were similar in four predefined subgroups. There was no difference in other major complications, including new-onset organ failure (10.6% vs. 15.0%; p=0.15), bleeding (6.3% vs. 3.5%; p=0.15), and gastrointestinal fistula (2.0% vs. 2.4%; p=0.75) during the index admission.CONCLUSIONSThe immune-enhancing Tα1 treatment of patients with predicted severe ANP did not reduce the incidence of IPN during the index admission.Trial registrationClinicaltrials.gov registry: NCT02473406.

Urinary incontinence (UI) is prevalent among women, including young women (18–30 years old). This article aims to explore the prevalence of UI, as well as toileting behaviors and other factors that are associated with UI, in female college students in central China. We used convenience sampling to recruit 1000 students from five institutions of higher education. We distributed pencil-and-paper questionnaires to obtain demographic, environmental, and general health information, including whether UI was present or not, and information regarding toileting behaviors used by the respondents. Most students, n = 929, responded to the questionnaire. Their ages ranged from 18 to 26 years old (average: 20.5 ± 1.6); 23.6% of these respondents reported UI, 52.7% often/always worried about public toilet cleanliness, and 25.3% often/always delayed emptying their bladder when they were busy. Respondents who were between 21 and 26 years old had a lower probability of UI (odds ratio [OR] = 0.867 and 95% confidence interval [CI] = 0.771–0.975) than younger respondents (18–21 years old). Respondents who reported constipation (OR = 2.395, 95% CI = 1.494–3.839), drank alcohol (OR = 1.763, 95% CI = 1.114–2.792), often/always delayed urination (OR = 1.738, 95% CI = 1.306–2.313), and/or often/always strained to urinate (OR = 1.433, 95% CI = 1.111–1.849) had greater odds of having UI than respondents who did not have constipation or engage in these behaviors. UI is prevalent in young Chinese women who are attending college. These women should be asked and given culturally appropriate information about UI and associated factors that include toileting behaviors.

Surveillance performance is studied in this paper for a wireless eavesdropping system, where a full-duplex legitimate monitor eavesdrops a suspicious link efficiently with the artificial noise (AN) assistance. Different from the existing work, the suspicious receiver is assumed to be capable of detecting the presence of AN. Once such receiver detects the AN, the suspicious user will stop transmission, which degrades the surveillance performance. Hence, to improve the surveillance performance, AN should be transmitted covertly with a low detection probability. Under these assumptions, an optimization problem is formulated to maximize the eavesdropping non-outage probability under a covert constraint. Based on the detection ability at the suspicious receiver, a novel scheme is proposed to solve the optimization problem using an iterative search. Moreover, we investigate the impact of both the suspicious and the jamming links uncertainties on the covert surveillance performance. Simulations are performed to verify the analyses. We show that the suspicious link uncertainty enhances the surveillance performance, while the jamming link uncertainty can degrade the surveillance performance.

Ischemia reperfusion-induced acute kidney injury (IR-induced AKI) is a life-threatening disease with many complications. Mitofusin 2 (Mfn2) ubiquitination is related to AKI. But the underlying molecular mechanisms remain unknown. This study aimed to probe the mechanism of Mfn2 ubiquitination in IR-induced AKI development. In IR-induced AKI mouse models, orbital blood and urine were collected for assessing kidney function. The kidney injury, ultrastructure of mitochondria, and histopathology in mice were evaluated after injection of G5, an ubiquitination inhibitor. Oxygen glucose deprivation/reoxygenation (OGD/R) models were established in HK-2 cells, and the mitochondria were extracted. Cell viability, apoptosis, oxidative stress, inflammatory reaction, mitochondrial membrane potential, and ATP production were measured. Mfn2 ubiquitination in mouse and cell models was evaluated. si-SIRT3 and pcDNA3.1-SIRT3 were transfected into cell models. Consequently, kidney function in mice was impaired by IR-induced AKI. Mfn2 ubiquitination and degradation promoted IR-induced AKI. OGD/R induced renal tubular epithelial cell injury and disrupted mitochondrial dynamics and functions through promoting Mfn2 ubiquitination. SIRT3 knockdown led to Mfn2 ubiquitination by binding to UBC; while its overexpression alleviated tubular epithelial cell injury. Briefly, SIRT3 mediates Mfn2 ubiquitination to relieve IR-induced AKI. This investigation may offer new insights for the treatment of IR-induced AKI injury.

This paper studies digital beam forming (DBF) methods based on phased array. First of all, the basic principle of DBF is introduced, and the signal direction is controlled through realizing DBF. Secondly, different beam forming methods and their limitations and applications are analyzed. Through the comparison and analysis of different parameters, it is proper to adopt linear constrained minimum variance beam forming method in practical application. Finally, the beam width and zero depth of different parameter beam forming methods are analyzed by simulation.

For the system of multiple types of EOS (Earth Observing Satellites), it is a vital issue to assure that each type of payloads carried by the group of EOS can be used efficiently and reasonably for in astronautics fields. Currently, most of researches on configuration of satellite and payloads focus on the scheduling for launched satellites. However, the assignments of payloads for un-launched satellites are bit researched, which are the same crucial as the scheduling of tasks. Moreover, the current models of satellite resources scheduling lack of more general characteristics. Referring the idea about roles-based access control (RBAC) of information system, this paper brings forward a model based on role-mining of RBAC to improve the generality and foresight of the method of assignments of satellite-payload. By this way, the assignment of satellite-payload can be mapped onto the problem of role-mining. A novel method will be introduced, based on the idea of biclique-combination in graph theory and evoluti...