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The spread of the novel coronavirus pneumonia epidemic proves that mankind is a community of shared destiny. A community with a shared future for mankind is built on the ethical foundation of love, and at the same time, it is necessary to establish a sense of community and build a community of responsibility. China's responsibilities and actions in the epidemic have allowed the world to improve its understanding of a community with a shared future for mankind.

ImportanceTransvaginal mesh (TVM) can increase the durability of vaginal surgical procedures for pelvic organ prolapse (POP) and may be indicated in certain situations despite concerns about mesh-related complications. In addition, the expense of commercial mesh kits has limited their use. The effectiveness, safety, and cost of a self-cut mesh procedure compared with a commercial mesh-kit procedure for the surgical treatment of women with POP is unclear.ObjectiveTo assess the 1-year effectiveness and safety of self-cut titanium-coated polypropylene mesh compared with a precut commercial mesh kit for the transvaginal surgical treatment of women with severe symptomatic POP.Design, Setting, and ParticipantsThis multicenter randomized noninferiority clinical trial was conducted at 11 hospitals in 8 provinces of China. A total of 336 women with symptomatic stage 3 to 4 POP were enrolled between January 22, 2018, and November 11, 2019, with follow-up through December 11, 2020.InterventionsParticipants were randomized to receive a TVM procedure using either self-cut mesh (self-cut mesh group) or a precut commercial mesh kit (mesh-kit group), both of which used the same titanium-coated polypropylene mesh.Main Outcomes and MeasuresThe primary outcome measure was composite surgical success at 1 year, which was defined as the absence of vaginal bulge symptoms, no additional retreatment for POP, and no vaginal prolapse at or beyond the hymen. Secondary outcomes included symptom-specific pelvic floor function and quality-of-life measures as well as perioperative complications, including mesh-related complications and hospitalization costs. Complications were categorized using the Clavien-Dindo system (with grade 1 indicating any deviation from the normal postoperative course but not requiring grade 2-4 interventions; grade 2, need for pharmacological treatment, blood transfusion, and/or total parenteral nutrition; grade 3, the need for surgical, endoscopic, and/or interventional radiological procedures; and grade 4, life threatening).ResultsAmong 336 female participants (mean [SD] age, 63.3 [5.9] years; all of Chinese ethnicity), 169 patients were randomized to the self-cut mesh group, and 167 were randomized to the mesh-kit group. Three patients were unavailable for follow-up after 1 year. In the intention-to-treat analysis, 162 women (95.9%) in the self-cut mesh group had outcomes that met the definition of surgical success; this result was noninferior to the surgical success rate observed in the mesh-kit group (146 women [87.4%]; risk difference, 8.5%; 95% CI, 2.2%-14.3%; P = .006). The frequency of Clavien-Dindo grade 1 to 3 perioperative complications was not significant between groups (12 of 166 women [7.2%] in the self-cut mesh group vs 20 of 161 women [12.4%] in the mesh-kit group; P = .14). Vaginal mesh exposure rates in women examined at 1 year were similar (4 women [2.4%] in the self-cut mesh group vs 8 women [4.8%] in the mesh-kit group; P = .23). Median (IQR) total hospitalization costs were $3663.00 ($3258.90-$4495.10) in the self-cut mesh group vs $6144.00 ($5434.90-$7160.20) in the mesh-kit group (P Conclusions and RelevanceIn this clinical trial, the composite surgical success rate of a self-cut mesh procedure was noninferior to that of a commercial mesh-kit procedure using the same titanium-coated polypropylene mesh and reduced hospitalization expenses by 40.4%. These findings suggest that the use of self-cut mesh procedures may be advantageous for the surgical treatment of some women with severe POP, particularly those in countries with low and middle income.Trial RegistrationClinicalTrials.gov identifier: NCT03283124

Compared with traditional filter paper, a high-purity cellulose membrane prepared via a green pathway was used to enhance detection performance for cadmium ions. In this work, a simple, rapid, and ...

Background Pelvic organ prolapse (POP) is a common health problem and has significant negative effects on a woman’s quality of life. The transvaginal mesh procedure is a durable reconstructive surgery, but the mesh kits are expensive for underdeveloped countries. Our previous case-series study showed that the use of self-cut mesh had a good success rate (91.8% at 1-year follow-up) and low complication rate. This trial is designed to compare a self-cut titanium-coated polypropylene mesh procedure with a mesh kit for the treatment of symptomatic stage III–IV anterior or apical prolapse in terms of efficacy, safety and cost-effectiveness. Methods The trial is a randomized controlled multicenter non-inferiority trial. The primary outcome measure is the composite success rate at 1-year follow-up. The secondary outcomes are anatomic outcomes of each vaginal segment (anterior, posterior and apical) using the POP-Q score, subjective improvement of quality of life according to questionnaires, intraoperative parameters, complications and costs. Analysis will be performed according to the intention-to-treat principle. Based on a comparable success rate of 90% and 10% as the margin (β = 0.2 and one-sided α = 0.025), about 312 patients in total from 11 centers will be recruited including 10% dropout. The aims of the research are to demonstrate whether the self-cut mesh procedure is non-inferior to the mesh-kit procedure and to investigate the performance of titanium-coated mesh for vaginal prolapse repair. Discussion This multicenter non-inferiority trial will evaluate whether the efficacy and safety of self-cut mesh is non-inferior to mesh kits in women with severe symptomatic stage III–IV anterior or apical prolapse. If we are able to show that the self-cut mesh procedure is non-inferior to the mesh-kit procedure in success rates, then the self-cut mesh procedure may be more cost-effective. Trial registration ClinicalTrials.gov, NCT03283124. Registered on 17 January 2018.

Crystal plane regulation, defect engineering, and element doping can effectively solve the problems of large band gaps, poor light absorption, and fast recombination of BiOCl. In this work, iodine-doped BiOCl (I/BiOCl) nanowafers with abundant (110) crystal planes and oxygen vacancies (OV) were prepared by a simple hydrothermal method and assessed for pollutant photodegradation. I/BiOCl with a molar ratio of I to Cl of 0.6 (I

High-purity cellulose membranes prepared via a green pathway were used to attempt to enhance their performance of glucose detection compared with that of traditional filter paper. In this work, cellulose-based strips (CBS) for the low concentration of glucose detection have been designed based on a fast, sensitive, and easy enzyme colorimetric assay from porous and high-purity cellulose membranes (CM). Different from the traditional paper-based sensors that were made of commercially available filter paper, the cellulose-based membranes matrix was fabricated by a "green" route in that cellulose was dissolved in an aqueous NaOH/urea solution, and then modified by the sodium periodate oxidation method to immobilize the glucose oxidase (GOX) and horseradish peroxidase (HRP) with Schiff-base reaction. The structure and properties of CM and CBS were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray mapping (EDS), Fourier-transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), etc. SEM images showed a porous, interpenetrating structure of CM, which benefited the enzyme immobilization and enzymatic reaction. When glucose solution was dropped onto the CBS, the color change from colorless to blue was only 5 min. The limit of detection (LOD) is 0.45 mM in the linear range of glucose from 1 to 11 mM. Moreover, the CBS had also been successfully used for glucose determination in real urine samples, and the color changes can be easily recorded by a simple camera to achieve the semiquantitative detection of glucose. This work provided a new design strategy for the cellulose-based functional materials which could be applied in biosensors, drug carriers, and biomedicine.

In this work, cobalt oxyhydroxide (CoOOH) nanoflakes/cellulose composite membranes (CCM) were fabricated by a simple one-step method and green route without further treatment. The CoOOH nanoflakes were synthesized in the high-purity cellulose membranes (CM) matrix that expected to enhance its detection performance of ascorbic acid in comparison to the traditional paper-based sensors that were made of commercially available filter paper. The structure and properties of CM and CCM were characterized by SEM, EDS, FT-IR, XRD and XPS, etc. The combination mechanism between nanoflakes and cellulose was well analyzed and discussed by various characterizations and experiments. When the CCM was immersed into the ascorbic acid (AA) solution, the color changing from colorless to blue was observed only in 2 min. Furthermore, the CCM can be used for AA determination in real samples.

Background: Transvaginal mesh can increase the durability of surgery for pelvic organ prolapse. However, commercial mesh kits can be expensive. We assessed the efficacy of a much cheaper self-cut titanium-coated polypropylene mesh with a mesh-kit for treating symptomatic pelvic organ prolapse. Methods: We conducted a multicenter, randomized, non-inferiority trial. Patients were randomized to either self-cut mesh or commercial mesh-kit. Patients with symptomatic stage III-IV pelvic organ prolapse were enrolled at 11 centers between January 2018 and November 2019. The primary outcome measure was composite success at one year defined by absence of vaginal bulge symptoms, and no additional re-treatment for POP, and no vaginal prolapse at or beyond the hymen. Secondary outcomes included symptom-specific pelvic floor function and quality of life measures, complications and costs. Findings: A total of 336 participants were randomized. In the intention-to-treat analysis, 95∙9% (162/169) met the definition of surgical success in the self-cut group, which was noninferior to the 87∙4% (146/167) surgical success in the mesh-kit group (risk difference, 8∙5 [95%CI 2∙2 to 14∙3]). The frequency of Clavien-Dindo grade I-III complications were not significant between groups (12 [7∙2%] vs 20 [12∙4%], P=0∙14). Vaginal mesh exposure rates in women examined within 1 year [self-cut group 4/169 (2∙4%) vs mesh-kit group 8/167 (4∙8%)] were similar (P=0∙23). Interpretation: This trial demonstrated that composite surgical success of a self-cut mesh procedure was non-inferior to a commercial mesh-kit procedure using the same mesh. The use of self-cut mesh was effective and safe, while reducing the hospitalization expense by approximately 40%. Clinical Trial Registration Details: Clinicaltrials.gov, NCT03283124. Funding Information: Chinese Academy of Medical Science Initiative for Innovative Medicine(CAMS-2017-12M-1-002). Medstron Medical(shanghai) Co. Ltd, the agent of Tiloop® products in China, provided monetary support for this research including interim meeting and third party (LinkDoc Beijing company) EDC system. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The study was approved by the Institutional Review Board of Peking Union Medical College Hospital (JS-1278).

Indoor thermal environment significantly affects human health and comfort. Although several studies have investigated this aspect in numerous buildings, a gap exists with regard to the hospital waiting areas and the thermal comfort of pregnant women. Therefore, this study assessed the ambient conditions in the waiting areas of obstetric departments in four Guangzhou hospitals during summer and winter and conducted a questionnaire survey on pregnant women and males & non-pregnant female patients in the waiting areas to analyze the differences in their thermal sensation. A total of 2594 questionnaire responses were collected during the survey period, including 1477 and 1117 responses during summer and winter, respectively. Further, the predicted mean vote (PMV) model was applied to evaluate the thermal comfort and differences in the thermal sensation between pregnant women and escorts. The results indicated that the PMV model could not accurately predict the thermal comfort of the subjects and overestimated their thermal sensation. Additionally, the acceptable operative temperature ranges in the obstetric waiting areas were 23.8–28.6 °C and 18.5–23.5 °C, and acceptable standard effective temperature ranges were 21.0–27.9 °C and 19.0–25.8 °C during summer and winter, respectively. Further, the neutral temperature of pregnant women was lower than that of the males & non-pregnant female patients. The results of this study can guide the indoor thermal environments in the hospitals for the improved comfort of pregnant women, which in turn, will benefit their health as well as that of their babies.

The human microbiota is an aggregate of microorganisms residing in the human body, mostly in the gastrointestinal tract (GIT). Our gut microbiota evolves with us and plays a pivotal role in human health and disease. In recent years, the microbiota has gained increasing attention due to its impact on host metabolism, physiology, and immune system development, but also because the perturbation of the microbiota may result in a number of diseases. The gut microbiota may be linked to malignancies such as gastric cancer and colorectal cancer. It may also be linked to disorders such as nonalcoholic fatty liver disease (NAFLD); obesity and diabetes, which are characterized as “lifestyle diseases” of the industrialized world; coronary heart disease; and neurological disorders. Although the revolution in molecular technologies has provided us with the necessary tools to study the gut microbiota more accurately, we need to elucidate the relationships between the gut microbiota and several human pathologies more precisely, as understanding the impact that the microbiota plays in various diseases is fundamental for the development of novel therapeutic strategies. Therefore, the aim of this review is to provide the reader with an updated overview of the importance of the gut microbiota for human health and the potential to manipulate gut microbial composition for purposes such as the treatment of antibiotic-resistant Clostridium difficile (C. difficile) infections. The concept of altering the gut community by microbial intervention in an effort to improve health is currently in its infancy. However, the therapeutic implications appear to be very great. Thus, the removal of harmful organisms and the enrichment of beneficial microbes may protect our health, and such efforts will pave the way for the development of more rational treatment options in the future.

Additional file 1. SPIRIT Checklist: Recommended items to address in a clinical trial protocol and related documents.

Buildings now incorporate increasing levels of renewable energy to the point where net zero energy buildings (NetZEBs) and net zero energy clusters (NetZECs) have the potential to become widely used. Information exchange among stakeholders is essential to enable energy sharing among buildings that form a NetZECs. However, traditional, centralised energy management usually places emphasis on the supply side and does not address data exchange among individual stakeholders. This paper proposes an information sharing strategy based on linked data for improved management of NetZEBs and NetZECs. This strategy systematically integrates stakeholders' engagement by using energy performance indicators as information carriers and linked data as engagement channels. A case study proves the advantages of the developed strategy for improving the energy balance at individual building level, building cluster level, and community level. It is found that the strategy could help achieve NetZEBs and NetZECs through empowering stakeholders' interaction and information sharing.

Centralised district cooling system equipped with ice storage has substantial advantages in comprehensive energy utilization and cost effectiveness. It facilitates cutting peak and filling valley of power load and helps saving energy costs by using the peak-valley electricity price. Despite such advantages, energy performance of ice-storage district cooling systems is still a controversial topic, especially there is a lack of effective evaluation methods and relevant evaluation standards in China. Therefore, this paper establishes a thorough index system to evaluate energy performance of ice-storage district cooling system. The index system covers all aspects of ice-storage district cooling systems, including the gradual evaluation of each process from equipment, via subsystem to whole system. Afterwards, the index system is used to analyse a real case, focusing on the eight most important energy performance indexes. The results show that the index system can adapt well to the evaluation requirements, help to find energy performance problems and facilitate to improve energy efficiency. In view of existing insufficiency, further efforts are needed to make in formulating reasonable benchmarks of such energy performance indexes.

A large amount of building energy consumption data has been accumulated nowadays. Such data can help to find problems in building energy efficiency and put forward suggestions for imporvements. However, the present situation is that a big amount of data has been mothballed and its value has not been fully exploited. In this paper, clustering method is used to analyse the energy consumption data of 784 public buildings in Guangzhou. The method combines K-means algorithm and Euclidean distance for similarity measure, aiming to classify the time-series data of energy consumption. The analysis results identify well the energy consumption trends of these buildings. Three clusters of buildings with incresing energy consumption trends are taken as key target for energy conservation and four clusters of buildings with downward energy consumption trends are treated as example buildings for experience learning. A further analysis of the clusters finds the characteristics of each group, this helps understand better the patterns of building energy consumption. The clustering analysis facilitates more effective diagnosis in energy efficiency and also supports policy making regarding building energy conservation.

The prediction of energy consumption is important for the efficient operation of building air-conditioning systems. Most predicted models are based on historical energy consumption data and the factors influencing air conditioning systems, including weather, time of day, and previous consumption. However, the traditional prediction models, such as the Autoregressive Integrated Moving Average (ARIMA) time series model and back propagation (BP) neural network model, show large errors in their prediction of the energy consumption of air-conditioning systems. To achieve better prediction, the Long Short-Term Memory (LSTM) model of deep learning is adopted in this study based on an air-conditioning system of a University Library in Guangzhou. The results demonstrate that the LSTM model can produce more reliable predictions. The daily energy consumption forecast reduced by 11.2 % compared to that of the Autoregressive Moving Average model (MAPE). The hourly energy consumption forecast reduced by 16.31 %. In addition, compared with the BP neural network model, the MAPE’s daily energy consumption prediction reduced by 49 % and the hourly energy consumption prediction reduced by 36.61 %.

In this study, a new two-dimensional model of CPRF was developed in TRNSYS. Its accuracy was validated by a full-scale experiment. The effects of key parameters of CPRF coupled with solar water heating system on indoor temperature was analyzed. The single factor analysis revealed that reducing tube pitch and solidification temperature, increasing PCM layer thickness and solar collector area could increase indoor temperature. The orthogonal test analysis indicated that tube pitch has the greatest impact on the average indoor temperature. The CPRF heating system coupled to solar energy and an electric boiler operating on valley electricity (CSSEBV) was proposed to ensure stable heating. It was optimized by GENOPT. The optimal parameters are that the tube pitch is 0.28 m, the PCM layer thickness is 0.02 m, the solar collector area is 12.5 m2 and the operating time of the electric boiler is 2h. The economy, energy saving property and environmental benefits of four systems were also compared and analyzed.

Both immunosuppressants and antibiotics (ABX) are indispensable for transplant patients. However, the former increases the risk of new-onset diabetes, whereas the latter impacts intestinal microbiota (IM). It is still unclear whether and how the interaction between immunosuppressants and ABX alters the IM and thus leads to glucose metabolism disorders. This study examined the alterations of glucose and lipid metabolism and IM in mice exposed to tacrolimus (TAC) with or without ABX. We found that ABX further aggravated TAC-induced glucose tolerance and increased insulin secretion. Combined treatment resulted in exacerbated lipid accumulation in the liver. TAC-altered microbial community was further amplified by ABX administration, as characterized by reductions in phylum Firmicutes, family Lachnospiraceae, and genus Coprococcus. Analyses based on the metagenomic profiles revealed that ABX augmented the effect of TAC on microbial metabolic function mostly related to lipid metabolism. The altered components of gut microbiome and predicted microbial functional profiles showed significant correlation with hepatic lipid accumulation and glucose disorders. In conclusion, ABX aggravated the effect of TAC on the microbiome and its metabolic capacities, which might contribute to hepatic lipid accumulation and glucose disorders. These findings suggest that the ABX-altered microbiome can amplify the diabetogenic effect of TAC and could be a novel therapeutic target for patients.

Due to energy crisis and phenomenon of global warming, green buildings have been undergoing vigorous development in China, and people are paying increasing attention to the actual operational effect of green buildings rather than the design. In this paper, 12 high-star green buildings (3 LEED Gold buildings, 1 operation Two-Star building, 1 operation Three-Star building, 1 design Two-Star building, and 6 design Three-Star buildings) in the cold region and hot summer and warm winter region (HSWW region) were taken as the research objects to evaluate their indoor thermal comfort. First, from December 2016 to March 2018, this paper conducted a continuous collection of indoor objective thermal environment data of green buildings to obtain the actual thermal environment distribution, and proposed new indexes to evaluate indoor thermal environment of green buildings, namely, OTCD (Over Thermal Comfort Distance) and OTCP (Over Thermal Comfort Percentage). It was found that indoor temperature and humidity of most buildings didn't reach the standard. The new evaluation indexes clearly showed the percentage of the indoor temperature and humidity of each green building away from the comfort zone under different standards in mathematical form, which is convenient for comparison. Second, a questionnaire survey on people's subjective satisfaction of indoor thermal comfort in green buildings was carried out at the same time, wherein 1400 valid questionnaires were recovered. Based on the different evaluation results of subjective and objective thermal comfort, the operative comfort temperature/humidity and thermal/humid comfort zone of different building climate zones were obtained by cluster and linear regression analysis. The results showed that there are differences between thermal/humid comfort zone of different building climate zones and it is helpful for the research on thermal comfort of green buildings in China and the development of relevant codes.

Increasing evidence suggests a role of intestinal dysbiosis in obesity and non-alcoholic fatty liver disease (NAFLD). But it remains unknown in nonobese NAFLD. This prospective, cross-sectional study sought to characterize differences in fecal microbiota between nonobese adult individuals with and without NAFLD and their potential association with metabolic markers of disease progression. A total of 126 nonobese subjects were enrolled: 43 NAFLD and 83 healthy controls (HC). The microbial community was profiled by denaturing gradient gel electrophoresis and examined by 454 pyrosequencing of the 16S ribosomal RNA V3 region. Lower diversity and a phylum-level change in the fecal microbiome were found in NAFLD. Compared with HC, patients had 20% more phylum Bacteroidetes (p = 0.005) and 24% less Firmicutes (p = 0.002). Within Firmicutes, four families and their 8 genera, which were short-chain fatty acids-producing and 7α-dehydroxylating bacteria, were significantly decreased. Moreover, Gram-negative (G−) bacteria were prevalent in NAFLD (p = 0.008). Furthermore, a significant correlation with metabolic markers was revealed for disturbed microbiota in NAFLD. This novel study indicated that intestinal dysbiosis was associated with nonobese NAFLD and might increase the risk of NAFLD progression.

Objective To explore the expressions and functions of miR-155, miR-125b-5p, miR-210, and their target proteins, in vascular endothelial cells in oxidative stress. Methods Human umbilical vein endothelial cells (HUVECs) were isolated and cultured; the expression of endothelial cell factor VIII related antigen was detected by immunofluorescence staining; and the expression of CD31 was detected and identified by flow cytometry. The oxidative stress model of vascular endothelial cells was established by preeclampsia serum and hydrogen peroxide (H2O2) treatment. The treated HUVECs were divided into 4 groups: normal pregnancy serum group, preeclampsia serum group, 0 μmol/L H2O2 group and 100 μmol/L H2O2 group. The levels of miR-155, miR-125b-5p, and miR-210 were tested by real-time quantitative PCR within 24 hours after modeling. The expression of Smad4 protein was detected by Western blotting and immunofluorescence staining. Cell apoptosis was detected by flow cytometry combined with annexin V-FITC/PI staining. Results Compared with 0 μmol/L H2O2 group, miR-125b-5p significantly decreased in 100 μmol/L H2O2 group, while Smad4 protein significantly increased. In addition, 100 μmol/L H2O2 treatment promoted cell apoptosis and necrosis. Compared with normal pregnancy serum group, the apoptosis and necrosis were significantly enhanced in preeclampsia serum group, but there were no significant differences in miR-125b-5p and Smad4 between the groups. Conclusion High level of H2O2 up-regulates Smad4 protein expression and inhibits miR-125b-5p expression.

A cascade of two slabs of dissimilar structurally chiral materials can function as a spectral hole filter for normally incident, circularly polarized light, provided (i) both have the same structural handedness and (ii) their constitutive parameters and thickness satisfy two matching conditions. When the total thickness of the cascade is relatively small, a narrow spectral hole is found in the reflection spectrum of co-handed light. Conversely, an ultranarrow spectral hole is found in the transmission spectrum of cross-handed light, when the total thickness of the cascade is relatively large.

In order to improve the storage efficiency of Hadoop Distributed File System (HDFS) and its load balancing ability, this paper presented a distributed storage method based on information dispersal algorithm (IDA). The method used IDA to encode files to blocks, and stored the blocks in the cluster by the improved data placement strategy. The results and analysis of the experiments show that the method improves the storage efficiency and load balancing ability.

Analyzed some shortages of the existing one-time password (OTP) authentication schemes, a new OTP authentication scheme is designed. This scheme used the SM2 cryptographic algorithm and Hash function to ensure data transmission security, provided the mutual authentication between client and server, resisted different kinds of attacks, and protected the user's identity information effectively. Analysis showed that compared with the existing schemes, the new designed scheme had higher security, small system overhead and easy to implement.

A first stage of a SHA-less 12-bit 200 MSps pipeline analog-to-digital converter (ADC) is designed in this paper. A high speed and high precision comparator is designed in order to reduce the transmission delay of the comparator. RC network of the multiplying digital-to-analog converter (MDAC) and Sub-ADC should be strict matched in order to reduce the sampling errors between the two path. The prototype circuit, implemented in SMIC 130nm 1P5M CMOS process under 1.2V power supply with a 94MHz input signal and 200MHz sampling clock, demonstrates a SNDR of 82.7dB, a SNR of 72.6dB, and a ENOB of 11.83 bit.