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Carboxymethyl pachymaran （CMP） is a carboxymethylated modification product of the water-insoluble polysaccharides from Poria cocos. It has many biological activities such as immune regulation, antibacterial, anti-inflammatory, anti-tumor, anti-oxidation, liver damage protection and intestinal flora regulation. It has a wide application prospect in functional food, active molecular carrier, medicine and other fields. In this paper, the research of CMP at home and abroad in recent years was focused, the biological activity, preparation, identification and application development of CMP were reviewed, and the future development direction of CMP was prospected.

Summary: Background: Since 1992, when recombinant hepatitis B vaccine was introduced in China, government health officials have used nationally representative serological surveys to monitor progress in prevention and control of hepatitis B. In 2020, we conducted the fourth seroepidemiological survey, which for the first time included medical evaluation of the clinical status of HBsAg positive subjects over the age of 15 and their medical management. We report survey results in comparison with the three previous surveys. Methods: Consistent with previous national surveys, the 2020 survey used a stratified, three-stage cluster random sampling method to select for evaluation 1-69-year-olds in 120 national disease surveillance points. Blood samples were tested for HBsAg, anti-HBV surface antigen (anti-HBs), and anti-HBV core antigen (anti-HBc) in the National Hepatitis Laboratory of the Institute for Viral Disease Control and Prevention of China CDC. HBsAg positive subjects aged ≥15-year were evaluated for evidence of liver disease, and through face-to-face questionnaire-based survey, we determined the healthcare management cascade of HBV-infected individuals. Findings: HBsAg prevalence in 1–69-year-olds was 5.86%; in children 1–4 years of age, seroprevalence was 0.30%; 75 million people were living with HBV nationwide. Among HBsAg-positive individuals 15 years and older, expert medical examination found that 78.03% were HBsAg carriers with no evidence of liver damage, 19.63% had chronic HBV with liver enzyme abnormalities, 0.84% had evidence of cirrhosis, and 0.15% had evidence of liver cancer. 59.78% of HBsAg + individuals were aware that they were positive before the survey, 30 million were unaware; 38.25% of those who knew they were positive (17 million) had medical indications for antiviral treatment, and 17.33% of these individuals (3 million) were being treated with antivirals. Interpretation: The decline in HBsAg prevalence in the general population, from 9.72% in 1992 to 5.86% in 2020, and in 1–4-year-olds from 9.67% in 1992 to 0.30% in 2020, shows progress that continues on track toward WHO targets for prevention of new infections. Implementation of acceptable strategies to identify infected individuals and offer long-term medical monitoring and management will be important to prevent complications from hepatitis B infection and for meeting WHO cascade-of-care targets. Funding: The study was funded by the Major Science and Technology Special Project of China’s 13th 5-Year Plan (grant no. 2017ZX10105015); Central finance-operation of public health emergency response mechanism of Chinese Center for Disease Control and Prevention (131031001000200001, 102393220020010000017).

Objective: This study aimed to improve the functional characteristics of Polygonati rhizoma （PR）. Methods: Using the freeze-dried fresh PR and nine-steam-nine-bask processing PR as control products, the study comprehensively compared and analyzed human sensory, electronic sensory, color, fluidity, dissolving ability, extract content, total polysaccharide content and total saponin content in PR powder modified by extrusion cooking. Results: Extrusion cooking effectively eliminated the bad taste and improved the color and fluidity of PR powder. Compared with the nine-steam-nine-bask processing, extrusion cooking significantly increased the total polysaccharide content and total saponin content, with increase rates of 49.27% and 69.10%, respectively. Conclusion: Extrusion cooking can effectively improve the functional characteristics of PR, and enhance the controllability and stability of processing quality.

The partial discharge （PD） of high-voltage cables and the accessories directly affects the insulation performance of power cables. Therefore， a PD detection method for high-voltage cables based on finite-difference time-domain （FDTD） modeling is proposed. First， the FDTD method and the theory of transfer function are introduced into the cable PD detection. Besides， the FDTD model of high-voltage cables is established， and the accuracy of the model is evaluated. Then， the original pulses used to excite PD events in the FDTD model of 11 kV XLPE （cross-linked polyethylene） cables are obtained， and the relevant steps of hybrid modeling for PD detection are elaborated. Finally， the finite element calculation results of the pulse injection test are analyzed to verify the effectiveness of the proposed method. The method， also applicable to the PD detection of EPR （ethylene propylene rubber） cables， paper-insulated cables， and other cables， helps to study the relationship between the PD signals and the excitation signals of PD sources.

In the context of rural revitalization and carbon peaking and carbon neutrality goals， a model of township micro-energy network is established. Firstly， the mathematical models of garbage power generation and biogas production from anaerobic digestion of sludge are built in view of the characteristics of energy in rural areas. An electric vehicle load prediction model is established considering the development of rural transportation industry and tourism. Secondly， the carbon emissions from farming， breeding， and purchased energy are modeled， and the carbon reduction from domestic waste treatment， biogas export， and electric vehicle are also considered to illustrate the carbon emission characteristics from production and living in rural areas. Finally， with the lowest energy cost and lowest carbon emission of the township micro-energy network as the objective functions， the multi-objective optimization problem is solved using the normal boundary intersection （NBI） and the TOPSIS. The optimal energy consumption decision of the township under the premise of economy and low carbon is obtained through specific cases. The role of energy equipment with rural characteristics is analyzed to provide a theoretical basis for promoting the construction of zero-carbon villages.

Glioblastoma multiforme (GBM) is a highly vascularized malignant brain tumor. Our previous study showed that prostate-specific membrane antigen (PSMA) promotes angiogenesis of GBM. However, the specific mechanism underlying GBM-induced PSMA upregulation remains unclear. In this study, we demonstrate that the GBM-secreted cytokine phosphoprotein 1 (SPP1) can regulate the expression of PSMA in human umbilical vein endothelial cells (HUVECs). Our mechanistic study further reveals that SPP1 regulates the expression of PSMA through the transcription factor HIF1α. Moreover, SPP1 promotes HUVEC migration and tube formation. In addition, HIF1α knockdown reduces the expression of PSMA in HUVECs and blocks the ability of SPP1 to promote HUVEC migration and tube formation. We further confirm that SPP1 is abundantly expressed in GBM, is associated with poor prognosis, and has high clinical diagnostic value with considerable sensitivity and specificity. Collectively, our findings identify that the GBM-secreted cytokine SPP1 upregulates PSMA expression in endothelial cells via the transcription factor HIF1α, providing insight into the angiogenic process and promising candidates for targeted GBM therapy.

Cage farming is an important means of aquacultural production, while its potential environmental pollution needs to be further investigated. In this study, Dongshan Bay was taken as an example to investigate whether long-term cage farming in a semi-closed bay would cause environmental pollution via vertical distribution assessment. The four sediment cores (YB1, YB2, B1, and B2) were collected from two cage farming areas. Total nitrogen (TN), total organic carbon (TOC), and total phosphorus (TP) were measured. The results showed a negative correlation between TN and TOC and the sediment depth at four sampling sites, and TP was also negatively correlated with the depth at three sites. The average TN (1,405.8, 1,413.8, 1,115.7, and 936.1 mgkg−1) and TP (1,206, 1,141.6, 1,064.6, and 932.8 mgkg−1) values of the four sites were markedly higher than the safety level, with the indexes STN, STP, FF, and ON of the four sites indicating moderate to severe pollution of nitrogen and phosphorus. Particularly, the YB1 and YB2 sites in the area with lower current speed have more severe pollution. The C/N ratio uncovered that the organic matter (OM) might mainly derived from the phytoplankton and nonfibrous plants as a result of excessive fish feed and feces. Collectively, the results indicated that long-term (more than 10 years) cage farming activity in a semi-closed bay such as Dongshan Bay had a negative impact on the environmental quality. Despite limitations in sample size and the absence of stable isotopic analyses, this study enhances our understanding of environmental changes and endogenous pollution risks in shallow marine aquaculture areas. Moreover, it suggests practical approaches such as implementing alternative farming and fallowing periods, should be conducted to mitigate the pollution.

High security and effectiveness are critical performance metrics in the data transmission process for satellite remote sensing images, medical images, and so on. Previously, the receiver could gain a high-quality cover image (lossy) after decryption in a separable manner to balance embedding capacity (EC) and security. Completely separable, reversible data hiding in encrypted image (SRDH-EI) algorithms are proposed to address this issue. In this study, the cover image was preprocessed at the sender’s end. The pre-embedded pixels and most significant bits (MSB) were compressed via two coding methods to reserve space. Additionally, the header data were embedded for marking. Finally, auxiliary data and secret data were embedded in a forward “Z” and reverse “Z” shape before and after encryption, respectively. The receiver could extract secret data and decrypt the cover image separately using the keys and markers. The experimental results demonstrate that the algorithm reached a high EC for remote sensing images by utilizing pixel correlation at multiple positions within the groups. The cover image could maintain its entropy during the data embedding process, ensuring security. The decrypted image could be recovered without distortion, furthermore, the receiver could achieve complete separability, so it has good application prospects for remote sensing images.

Remote epitaxy represents a promising method for the synthesis of thin films on lattice-mismatched substrates, but its atomic-scale mechanisms are still unclear. Here, the authors demonstrate the growth of exfoliatable GaSb films on graphene-terminated GaSb (001) via seeded lateral epitaxy, showing that pinhole defects in graphene serve as selective nucleation sites.

BackgroundHypoglycemia is the most common adverse consequence of treating diabetes, and is often due to suboptimal patient self-care. Behavioral interventions by health professionals and self-care education helps avoid recurrent hypoglycemic episodes by targeting problematic patient behaviors. This relies on time-consuming investigation of reasons behind the observed episodes, which involves manual interpretation of personal diabetes diaries and communication with patients. Therefore, there is a clear motivation to automate this process using a supervised machine learning paradigm. This manuscript presents a feasibility study of automatic identification of hypoglycemia causes.MethodsReasons for 1885 hypoglycemia events were labeled by 54 participants with type 1 diabetes over a 21 months period. A broad range of possible predictors were extracted describing a hypoglycemic episode and the subject’s general self-care from participants’ routinely collected data on the Glucollector, their diabetes management platform. Thereafter, the possible hypoglycemia reasons were categorized for two major analysis sections - statistical analysis of relationships between the data features of self-care and hypoglycemia reasons, and classification analysis investigating the design of an automated system to determine the reason for hypoglycemia.ResultsPhysical activity contributed to 45% of hypoglycemia reasons on the real world collected data. The statistical analysis provided a number of interpretable predictors of different hypoglycemia reasons based on self-care behaviors. The classification analysis showed the performance of a reasoning system in practical settings with different objectives under F1-score, recall and precision metrics.ConclusionThe data acquisition characterized the incidence distribution of the various hypoglycemia reasons. The analyses highlighted many interpretable predictors of the various hypoglycemia types. Also, the feasibility study presented a number of concerns valuable in the design of the decision support system for automatic hypoglycemia reason classification. Therefore, automating the identification of the causes of hypoglycemia may help objectively to target behavioral and therapeutic changes in patients' care.

Background and objectiveNeonatal jaundice is a common clinical disease in neonates. Pathologic jaundice is more harmful to neonates. There are a few studies on the biomarkers of pathologic jaundice and the correlation between gut microbiota and clinical indices. Therefore, we aimed to reveal the characteristics of gut microbiota in pathologic jaundice, provide potential biomarkers for the diagnosis of pathologic jaundice, and find the correlation between gut microbiota and clinical indices.MethodsFourteen neonates with physiologic jaundice were recruited into a control group (Group A). Additionally, 14 neonates with pathologic jaundice were recruited into a case group (Group B). The microbial communities were analyzed using 16S rDNA sequencing. LEfSe and the differences in the relative abundance of gut microbiota were used to identify different bacteria among the two groups. The ROC curve was used to assess effective biomarkers for pathologic jaundice. Spearman’s rank-sum correlation coefficient was used to evaluate the correlation between gut microbiota and clinical indices.ResultsThere were no differences in the total richness or diversity of gut microbiota between the two groups. At the phylum and genus levels, compared with the control group, Bacteroidetes (p = 0.002) and Braydrhizobium (p = 0.01) were significantly higher, while Actinobacteria (p = 0.003) and Bidfldobacterium (p = 0.016) were significantly lower in the case group. Bacteroidetes were valuable in differentiating pathologic jaundice from physiologic jaundice by the ROC curve, and the area under the ROC curve (AUC) value was 0.839 [95%CI (0.648–0.995)]. In the case group, Bacteroidetes were negatively associated with total bilirubin (TBIL) (p

Objective To explore the risk factors of pain in de novo Parkinson's disease (PD) patients. Methods A total of 129 de novo PD patients collected from The Affiliated Brain Hospital of Nanjing Medical University from October 2018 to September 2021 were included. According to the Item ⁃17 of the Unified Parkinson's Disease Rating Scale Ⅱ (UPDRSⅡ⁃17th), patients were classified as PD patients without pain (UPDRSⅡ⁃17th was 0, n = 88) and PD patients with pain (UPDRSⅡ⁃17th ≥ 2, n = 41）. Mini⁃ Mental State Examination (MMSE) and corrected Montreal Cognitive Assessment (corrected MoCA) were used to assess cognitive function. Meanwhile, Hamilton Depression Rating Scale ⁃24 Items (HAMD ⁃24) was used to assess the depression status and the UPDRSⅢ was used to assess the motor function. The modified version of Hoehn ⁃Yahr staging was used to assess disease severity. The related risk factors of pain in PD patients were analyzed by univariate and multivariate forward Logistic regression. Results The in of pain in PD patients was 31.78% (41/129). Compared with PD without pain group, PD with pain group had lower scores in MMSE (Z = ﹣2.389, P = 0.017) and corrected MoCA (Z = ﹣2.166, P = 0.030), but higher scores in HAMD-24 (Z = ﹣4.024, P = 0.000), UPDRS Ⅲ (Z = ﹣3.639, P = 0.000）and Hoehn-Yahr staging grading (Z = ﹣2.232, P = 0.026). Further analysis of the differences between 2 groups in 7 domains of HAMD-24 showed PD with pain group had higher scores of the anxiety/somatization (Z = ﹣3.707, P = 0.000), mental disorder (Z = ﹣2.519, P = 0.012), retardation symptom (Z = ﹣2.048, P = 0.041), sleep disturbances (Z = ﹣3.484, P = 0.000) and despair symptom (Z = ﹣3.069, P = 0.002) than PD without pain group. Logistic regression analysis showed long duration (OR = 1.354, 95%CI: 1.013-1.809; P = 0.041), high HAMD-24 score (OR = 1.095, 95%CI: 1.033-1.162; P = 0.002) and high UPDRS Ⅲ score (OR = 1.040, 95%CI: 1.001- 1.082; P = 0.046) were risk factors of pain in PD patients. Conclusions Pain in PD has a high incidence in de novo PD patients. Long duration, a depressed state and severe motor symptoms are main risk factors for the development of pain in PD patients.

A multimodal biometric authentication framework based on Index-of-Max (IoM) hashing, Alignment-Free Hashing (AFH), and feature-level fusion is proposed in this paper. This framework enjoys three major merits: 1) Biometric templates are secured by biometric template protection technology (i.e., IoM hashing), thus providing strong resistance to security and privacy invasion; 2) It flexibly adopts a variety of biometric feature representations (e.g., binary, and real-valued), thus generalizing to a wide range of biometric features for fusion; 3) Feature-level fusion, which has low template storage, low matching computational complexity, and low privacy risks, which can be accomplished without alignment via AFH. Specifically, the proposed framework works as a drag-and-drop model that can quickly adopt all popular biometric modalities with different feature distributions for feature-level fusion. The fused templates are produced using operators AND, OR and XOR in binary domain. To evaluate the proposed framework, benchmarking datasets from four widely deployed biometric modalities (i.e., FVC 2002 for fingerprint, LFW for face, CASIA-v3-Interval for iris, and UTFVP for finger-vein) are used. The experimental results presented in Table 5 suggest that the proposed framework can achieve state-of-the-art performance in most of the datasets while offering additional folds, such as template protection and generalization to variable features. Moreover, biometric template protection criteria (irreversibility, unlinkability, and revocability) are also analyzed. The results of the analysis indicate satisfaction in terms of the security and privacy of the templates generated from the proposed framework.

Objective To explore the advantage and feasibility of the program of training anesthesiologists that is based on the clinical postdoctoral program of Peking Union Medical College Hospital (PUMCH) with collaboration between general hospitals and specialized hospitals. Methods We analyzed the operational volume of the operation platform in PUMCH and the clinical characteristics of the specialized hospitals in Beijing, and built a collaborative standardized training base that combines general hospitals with specialized hospitals. Before and after the implementation of the collaborative training program, the number of training cases of each sub-specialty and the trainees' scores of the assessment of clinical abilities were compared. Results After implementation of the collaborative standardized training program, the number of training cases of pediatric anesthesia, obstetrics anesthesia, and cardiovascular surgery anesthesia were significantly increased (all P < 0.01) with the total number of clinical anesthetic cases unchanged. Meanwhile, the scores of medical knowledge and skills, communication and collaboration, and patient care of the trainees were significantly improved (all P < 0.05). Conclusion The collaborative standardized training program can optimize the disease resources and improve the core competency of trainees, and is feasible for standardized postdoctoral training of clinical anesthesiology.

In this paper, the aerodynamic characteristics of a vehicle model are analyzed through numerical simulation considering the fluid–structure interaction (FSI) effect, and the accuracy of the simulation method is verified by comparison with the wind tunnel experiment. Then, the wind-induced vibration of vehicles under time-varying crosswind is studied and applied to engineering problems, such as vehicle sideslip and roll. The results show that the deviation between the FSI simulation and wind tunnel test is less than 10%, proving that the numerical method is feasible. The FSI effect on the aerodynamic lift is obvious, and its influence mechanism is mainly due to the change in body position, which changes the topological structure of the shedding or separated vortex in the flow field. As for the aerodynamic lift, a big gap exists between the results of the numerical simulations with and without coupling; high-intensity side wind will seriously affect the vehicle stability, and the uncoupled numerical simulation decreases the accuracy of the vehicle design.

Introduction: Pulmonary arterial hypertension (PAH) specific drug therapy using bosentan has significantly improved quality of life and survival, although PAH is still an incurable disease. Recent studies suggest metformin may have additional treatment benefits in PAH. We therefore investigated in vitro pulmonary artery reactivity after combination therapy of bosentan and metformin in PAH patients as compared with bosentan monotherapy in a prospective, randomized study. Methods: Adult patients with PAH associated with congenital heart defects (PAH-CHD) were randomised to receive bosentan (initially at 62.5 mg twice daily for 4 weeks and then 125 mg twice daily) for 3 months with or without the combination treatment of metformin (500 mg twice daily). Vessel reactivity of isolated pulmonary arteries was examined using a wire myograph. Results: Phenylephrine (PE)-induced contractions of arteries in patients received combination therapy were significantly attenuated at concentrations of 3 × 10-7 M, 10-6 M and 3 × 10-6 M, compared to those received bosentan monotherapy. After denudation, PE-induced contractions at concentrations of 3 × 10-6 M and 10-5 M were significantly decreased in the combination therapy group. AMP-activated protein kinase (AMPK) inhibitor compound C abrogated the inhibitory effects of metformin on PE-induced contractility. AMPK and eNOS phosphorylation in the pulmonary arteries of patients treated with combination therapy was increased compared to monotherapy (P < 0.05). Conclusion: Adding metformin to bosentan therapy in patients with PAH-CHD decreased in vitro pulmonary artery contraction induced by PE, which is possibly related to increased AMPK phosphorylation.

Introduction The successful treatment of type 1 diabetes (T1D) requires those affected to employ insulin therapy to maintain their blood glucose levels as close to normal to avoid complications in the long-term. The Dose Adjustment For Normal Eating (DAFNE) intervention is a group education course designed to help adults with T1D develop and sustain the complex self-management skills needed to adjust insulin in everyday life. It leads to improved glucose levels in the short term (manifest by falls in glycated haemoglobin, HbA1c), reduced rates of hypoglycaemia and sustained improvements in quality of life but overall glucose levels remain well above national targets. The DAFNEplus intervention is a development of DAFNE designed to incorporate behavioural change techniques, technology and longer-term structured support from healthcare professionals (HCPs).Methods and analysis A pragmatic cluster randomised controlled trial in adults with T1D, delivered in diabetes centres in National Health Service secondary care hospitals in the UK. Centres will be randomised on a 1:1 basis to standard DAFNE or DAFNEplus. Primary clinical outcome is the change in HbA1c and the primary endpoint is HbA1c at 12 months, in those entering the trial with HbA1c >7.5% (58 mmol/mol), and HbA1c at 6 months is the secondary endpoint. Sample size is 662 participants (approximately 47 per centre); 92% power to detect a 0.5% difference in the primary outcome of HbA1c between treatment groups. The trial also measures rates of hypoglycaemia, psychological outcomes, an economic evaluation and process evaluation.Ethics and dissemination Ethics approval was granted by South West-Exeter Research Ethics Committee (REC ref: 18/SW/0100) on 14 May 2018. The results of the trial will be published in a National Institute for Health Research monograph and relevant high-impact journals.Trial registration number ISRCTN42908016.

Abstract Background The mortality rate due to severe sepsis is approximately 30–60%. Sepsis readily progresses to septic shock and multiple organ dysfunction, representing a significant problem in the pediatric intensive care unit (PICU). The aim of this study was to explore the value of plasma mitochondrial DNA (mtDNA) for early diagnosis and prognosis in children with sepsis. Methods A total of 123 children with sepsis who were hospitalized in the Hunan Children’s Hospital PICU from July 2013 to December 2014 were divided into the general sepsis group (n = 70) and severe sepsis group (n = 53) based on diagnostic standards. An additional 30 children with non-sepsis infection and 30 healthy children were randomly selected as a control group. Patients’ plasma was collected during admission to the PICU. A pediatric critical illness score (PCIS) was also calculated. The plasma mtDNA level was examined using real-time polymerase chain reaction technology, and other parameters including routine laboratory values; blood lactate, procalcitonin (PCT), and C-reactive protein (CRP) levels; and data on survival were collected and compared among the groups. Results The plasma mtDNA level in the sepsis group than that in the non-sepsis infection and healthy groups. The plasma mtDNA level was significantly higher in the severe sepsis than in the general sepsis group (p

Reconstruction, post-processing and visualization of images are important parts of magnetic resonance imaging (MRI). In this work, a new open source framework, namely Yet Another Pipeline (YAP), was proposed for reconstruction, post-processing and visualization of MR images. With YAP, researchers can build customized image-processing pipelines with ease. Compared with the existing open source frameworks, YAP has the following features: (1) it has an interface-based design, enabling function extension by plugin development; (2) it uses a script language with straightforward grammar, making it easy to build and modify customized pipelines; (3) it supports branches in the pipelines, facilitating pipeline building and debugging. YAP has been implemented on a commercial MRI system.

As an important process of UE initial access and uplink synchronization, the random access procedure is simplified and modified on the basis of LTE system in NB-IoT. Through the random access procedure in LTE system, a random access procedure based on competitive mode which is currently supported by NB-IoT is deeply analyzed and a conformance test platform based on TTCN-3 is built to verify the consistency of the random access procedure with the standard.