Global road traffic injury statistics: Challenges, mechanisms and solutions.

High-quality data are the foundation to monitor the progress and evaluate the effects of road traffic injury prevention measures. Unfortunately, official road traffic injury statistics delivered by governments worldwide, are often believed somewhat unreliable and invalid. We summarized the reported problems concerning the road traffic injury statistics through systematically searching and reviewing the literature. The problems include absence of regular data, under-reporting, low specificity, distorted cause spectrum of road traffic injury, inconsistency, inaccessibility, and delay of data release. We also explored the mechanisms behind the problematic data and proposed the solutions to the addressed challenges for road traffic statistics.

Osteoporotic Vertebral Fracture Prevalence in Elderly Chinese Men and Women: A Comparison of Endplate/Cortex Fracture-Based and Morphometrical Deformity-Based Methods.

This study aims to evaluate endplate/cortex fracture (ECF)-based method for detecting osteoporotic vertebral fracture (VF) in elderly Chinese population (age ≥ 65 years). The radiographs of 1954 elderly Chinese men (mean: 72.3 years) and 1953 elderly Chinese women (mean: 72.5 years) were evaluated according to Genant's morphometrical vertebral deformity (VD) severity criteria, as well as identified VF according to ECF without necessary requirement of VD. According to ECF, grade-1, -2, and -3 VF prevalence was 1.89%, 1.74%, and 2.25% in men, and 3.33%, 3.07%, and 5.89% in women, respectively. In men and women, 15.7% (35 of 223) and 34.5% (48 of 139) of vertebrae with VD grade-1 deformity were ECF(+, with fracture), respectively. In men and women, 89.7% (35 of 39) and 66.7% (48 of 72) of vertebrae with ECF grade-1 fracture had VD grade-1 deformity. For grade-1 change, ECF(+) subjects tended to have a lower BMD than the VD(+) subjects. In subjects with VD grade-2 deformity, those who were also EC (+) tended to have a lower BMD than those were ECF(-). In all grades, VD(-) and ECF(-) subjects tended to have highest BMD, whereas VD(+) and ECF(+) subjects tended to have lowest BMD. ECF may be more specific for assessing mild VF than the criteria based on vertebral deformity.

Left-turning vehicle-pedestrian conflicts at signalized intersections with traffic lights: Benefit or harm? A two-stage study.

PURPOSE: Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood. METHODS: A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. First, a cross-sectional study estimated the proportion of signalized intersections with conflicting left-turning vehicle-pedestrian traffic lights in Changsha city, China. Second, a natural experiment compared transportation efficiency and safety between intersections with and without conflicting left-turning vehicle-pedestrian traffic lights. Risky conflicts, where motor vehicles violated laws and failed to yield to pedestrians in crosswalk were used as a surrogate for transportation safety. The number of motor vehicles and pedestrians passing through the intersections per second and per meter were used to estimate transportation efficiency. Data were collected and analyzed in 2015 (from March to December). A search of online news from domestic media sources was also conducted to collect pedestrian injury data occurring at the intersections. RESULTS: About one-fourth (57/216) intersections had conflicting left-turning traffic lights (95% CI: 20.5%, 32.3%). Risky vehicle-pedestrian conflicts were more frequently observed at intersections with conflicting lights compared to those without (incidence rate ratio (IRR) = 3.13; pedestrians: IRR = 4.02), after adjusting for type of day (weekday vs. weekend), the time period of observation, and motor vehicles traffic flow. Intersections without conflicting vehicle-pedestrian traffic lights had similar transportation efficiency to those with conflicting lights after controlling for covariates (p > 0.05). The systematic review of news media reports yielded 10 left-turning vehicle-pedestrian crash events between 2011 and 2017, involving 11 moderate or severe pedestrian injuries and 3 fatal pedestrian injuries. CONCLUSION: Over one-fourth of road intersections in Changsha city, China have conflicting left-turning traffic lights. Conflicting traffic lights cannot improve transportation efficiency, but increase risky conflicts between vehicles and pedestrians.

Prevalence and risk factors of lumbar spondylolisthesis in elderly Chinese men and women.

OBJECTIVE: A screening survey for osteoporotic fractures in men and women in Hong Kong represents the first large-scale prospective population-based study on bone health in elderly (≥65 years) Chinese men and women. This study aims to identify the prevalence and potential risk factors of lumbar spondylolisthesis in these subjects. METHODS: The lateral lumbar radiographs of 1,994 male and 1,996 female patients were analysed using the Meyerding classification. RESULTS: Amongst the men, 380 (19.1%) had at least one spondylolisthesis and 43 (11.3%) had slips at two or more levels; 283 had anterolisthesis, 85 had retrolisthesis, whereas 12 subjects had both anterolisthesis and retrolisthesis. Amongst the women, 499 (25.0%) had at least one spondylolisthesis and 69 (13.8%) had slips at two or more levels; 459 had anterolisthesis, 34 had retrolisthesis, whereas 6 subjects had both anterolisthesis and retrolisthesis. Advanced age, short height, higher body mass index (BMI), higher bone mineral density (BMD) and degenerative arthritis are associated with spondylolisthesis. Lower Physical Activity Scale for the Elderly (PASE) score was associated with spondylolisthesis in men; higher body weight, angina and lower grip strength were associated with spondylolisthesis in women. CONCLUSION: The male/female ratio of lumbar spondylolisthesis prevalence was 1:1.3 in elderly Chinese. Men are more likely to have retrolisthesis. KEY POINTS: • The prevalence of spondylolisthesis is 19.1% in elderly Chinese men. • The prevalence of spondylolisthesis is 25.0% in elderly Chinese women. • Men are more likely to have retrolisthesis. • Anterolisthesis is most commonly seen at the L4/L5 level. • Retrolisthesis is most commonly seen at the L3/L4 level.

Improvement of Multilevel Memory Performance of MnTe Thin Films by Ta Doping.

The pressing need for data storage in the era of big data has driven the development of new storage technologies. As a prominent contender for next-generation memory, phase-change memory can effectively increase storage density through multilevel cell operation and can be applied to neuromorphic and in-memory computing. Herein, the structure and properties of Ta-doped MnTe thin films and their inherent correlations are systematically investigated. Amorphous MnTe thin films sequentially precipitated cubic MnTe2 and hexagonal Te phases with increasing temperature, causing resistance changes. Ta doping inhibited phase segregation in the films and improved their thermal stability in the amorphous state. A phase-change memory cell based on a Ta2.8%-MnTe thin film exhibited three stable resistive states with low resistive drift coefficients. The study findings reveal the possibility of regulating the two-step phase-change process in Ta-MnTe thin films, providing insight into the design of multilevel phase-change memory.

Effects of Vitamin A on Immune Responses and Vitamin A Metabolism in Broiler Chickens Challenged with Necrotic Enteritis.

Necrotic enteritis (NE) is an important enteric inflammatory disease of poultry, and the effects of vitamin A (VitA) on NE birds are largely unknown. The present study was conducted to investigate the effects of VitA on the immune responses and VitA metabolism of NE broilers as well as the underlying mechanisms. Using a 2 × 2 factorial arrangement, 336 1-day-old Ross 308 broiler chicks were randomly assigned to 4 groups with 7 replicates. Broilers in the control (Ctrl) group were fed a basal diet without extra VitA supplementation. Broilers in the VitA group were fed a basal diet supplemented with 12,000 IU/kg of VitA. Birds in NE and VitA + NE groups were fed corresponding diets and, in addition, co-infected with Eimeria spp. and Clostridium perfringens on days 14 to 20. Samples of the blood, jejunum, spleen and liver were obtained on day 28 for analysis, and meanwhile, lesion scores were also recorded. The results showed that NE challenge increased lesion score in the jejunum and decreased serum glucose, total glyceride, calcium, phosphorus and uric acid levels (p < 0.05). VitA supplementation reduced the levels of serum phosphorus, uric acid and alkaline phosphatase in NE-challenged birds and increased serum low-density lipoprotein content and the activity of aspartate aminotransferase and creatine kinase (p < 0.05). Compared with the Ctrl group, the VitA and NE groups had higher mRNA expression of interferon-γ in the jejunum (p < 0.05). NE challenge up-regulated mRNA expression of interleukin (IL)-13, transforming growth factor-ß4, aldehyde dehydrogenase (RALDH)-2 and RALDH-3 in the jejunum, while VitA supplementation increased jejunal IL-13 mRNA expression and hepatic VitA content, but down-regulated splenic IL-13 mRNA expression (p < 0.05). The VitA + NE group had higher serum prostaglandin E2 levels and the Ctrl group had higher splenic RALDH-3 mRNA expression than that of the other three groups (p < 0.05). NE challenge up-regulated jejunal retinoic acid receptor (RAR)-ß and retinoid X receptor (RXR)-α as well as splenic RAR-α and RAR-ß mRNA expression (p < 0.05). VitA supplementation up-regulated jejunal RAR-ß expression but down-regulated mRNA expression of RXR-α, RXR-γ, signal transducers and activators of transcription (STAT) 5 and STAT6 in the spleen (p < 0.05). Moreover, compared with the Ctrl group, the VitA and NE groups had down-regulated mRNA expression of jejunal and splenic Janus kinase (JAK) 1 (p < 0.05). In conclusion, NE challenge induced jejunal injury and expression of Th2 and Treg cell-related cytokines and enhanced RALDH and RAR/RXR mRNA expression, mainly in the jejunum of broilers. VitA supplementation did not alleviate jejunal injury or Th2 cell-related cytokine expression; however, it improved hepatic VitA deposition and inhibited the expression of RALDH-3, RXR and the JAK/STAT signaling pathway in the spleen of broilers. In short, the present study suggested the modulatory effects of vitamin A on the immune responses and vitamin A metabolism in broiler chickens challenged with necrotic enteritis.

A software program for automated compressive vertebral fracture detection on elderly women's lateral chest radiograph: Ofeye 1.0.

Background: Because osteoporotic vertebral fracture (OVF) on chest radiographs is commonly missed in radiological reports, we aimed to develop a software program which offers automated detection of compressive vertebral fracture (CVF) on lateral chest radiographs, and which emphasizes CVF detection specificity with a low false positivity rate. Methods: For model training, we retrieved 3,991 spine radiograph cases and 1,979 chest radiograph cases from 16 sources, with among them in total 1,404 cases had OVF. For model testing, we retrieved 542 chest radiograph cases and 162 spine radiograph cases from four independent clinics, with among them 215 cases had OVF. All cases were female subjects, and except for 31 training data cases which were spine trauma cases, all the remaining cases were post-menopausal women. Image data included DICOM (Digital Imaging and Communications in Medicine) format, hard film scanned PNG (Portable Network Graphics) format, DICOM exported PNG format, and PACS (Picture Archiving and Communication System) downloaded resolution reduced DICOM format. OVF classification included: minimal and mild grades with <20% or ≥20-25% vertebral height loss respectively, moderate grade with ≥25-40% vertebral height loss, severe grade with ≥40%-2/3 vertebral height loss, and collapsed grade with ≥2/3 vertebral height loss. The CVF detection base model was mainly composed of convolution layers that include convolution kernels of different sizes, pooling layers, up-sampling layers, feature merging layers, and residual modules. When the model loss function could not be further decreased with additional training, the model was considered to be optimal and termed 'base-model 1.0'. A user-friendly interface was also developed, with the synthesized software termed 'Ofeye 1.0'. Results: Counting cases and with minimal and mild OVFs included, base-model 1.0 demonstrated a specificity of 97.1%, a sensitivity of 86%, and an accuracy of 93.9% for the 704 testing cases. In total, 33 OVFs in 30 cases had a false negative reading, which constituted a false negative rate of 14.0% (30/215) by counting all OVF cases. Eighteen OVFs in 15 cases had OVFs of ≥ moderate grades missed, which constituted a false negative rate of 7.0% (15/215, i.e., sensitivity 93%) if only counting cases with ≥ moderate grade OVFs missed. False positive reading was recorded in 13 vertebrae in 13 cases (one vertebra in each case), which constituted a false positivity rate of 2.7% (13/489). These vertebrae with false positivity labeling could be readily differentiated from a true OVF by a human reader. The software Ofeye 1.0 allows 'batch processing', for example, 100 radiographs can be processed in a single operation. This software can be integrated into hospital PACS, or installed in a standalone personal computer. Conclusions: A user-friendly software program was developed for CVF detection on elderly women's lateral chest radiographs. It has an overall low false positivity rate, and for moderate and severe CVFs an acceptably low false negativity rate. The integration of this software into radiological practice is expected to improve osteoporosis management for elderly women.

Construction of an infectious Marek's disease virus bacterial artificial chromosome and characterization of protection induced in chickens.

Marek's disease virus (MDV) is a highly oncogenic alphaherpesvirus that induces rapid-onset T-cell lymphoma in poultry. The complete genome of the avirulent vaccine strain MDV-814 was cloned as an infectious bacterial artificial chromosome (BAC) using an 8.8-kb fragment containing the self-designed selective marker guanosine phosphoriboxyl transferase. The recombinant virus MDV-814-BAC was generated by co-transfection of a BAC transfer vector and MDV-814 total DNA, and was purified by eight rounds of selective passaging. The infectivity of the BAC DNA clone was validated by MDV reconstitution from chicken embryo fibroblasts transfected with MDV-BAC DNA, which was extracted from electroporated Escherichia coli DH10B cells. In vitro, the BAC-derived virus had similar biological characteristics and growth kinetics as the wild-type parental and recombinant viruses, and chickens immunized with BAC derivatives by various delivery mechanisms acquired protection against virulent MDV challenge. Construction of this MDV-BAC may aid the development of recombinant vaccines-containing multiple antigens.

Tris(dibenzoyl-methanido-κO,O')[(6S,8S)-(+)-7,7-dimethyl-3-(2-pyrid-yl)-5,6,7,8-tetra-hydro-6,8-methano-isoquinoline-κN,N']gadolinium(III).

In the title compound, [Gd(C(15)H(11)O(2))(3)(C(17)H(18)N(2))], the Gd(III) atom is coordinated by six O atoms from three ß-diketonate ligands and two N atoms from a chiral ligand L(S),(S)-(+)-7,7-dimethyl-3-(2-pyrid-yl)-5,6,7,8-tetra-hydro-6,8-methano-iso-quinoline, in a coordination geometry best described as distorted square-anti-prismatic.

Application of amplitude of low­frequency fluctuation to altered spontaneous neuronal activity in classical trigeminal neuralgia patients: A resting­state functional MRI study.

Recent studies have reported structural and functional abnormalities in multiple brain regions of classical trigeminal neuralgia (CTN) patients. Differences in spontaneous neuronal activity between CTN patients and healthy subjects, however, remain unknown. The aim of the present study was to investigate alterations in brain activity by application of amplitude of low frequency fluctuation (ALFF), thus analyzing the correlation between durations of spontaneous pain intensity and ALFF values in CTN patients. A total of 28 CTN patients (male, n=12; female, n=16) and 28 healthy controls (HCs; male, n=12; female, n=16) matched for age and sex were enrolled. All subjects underwent resting­state functional magnetic resonance imaging and changes in spontaneous brain activity were investigated using an ALFF method. Receiver operating characteristic (ROC) curve analysis was applied to differentiate ALFF values of CTN patients from HCs. Altered ALFF values and clinical manifestations were evaluated using Pearson's correlation analysis. ALFF values of the bilateral inferior cerebellum, bilateral fusiform gyrus, right precentral gyrus, left inferior temporal gyrus, right superior cerebellum, left inferior occipital gyrus and right superior occipital gyrus were significantly higher in CTN patients when compared to HCs. ROC curve analysis of each brain revealed a near­perfect AUC accuracy. Pearson's correlation analysis revealed the visual analog scale of the right eye to be positively correlated with both left inferior temporal and occipital gyral findings, while episode duration likewise was positively associated with left inferior temporal gyral findings. CTN patients exhibited abnormal spontaneous activity in multiple brain regions closely related to pain regulation and perception, while VAS and CTN episode duration were positively correlated with ALFF signal values in some brain regions. The present findings provide further insight into the pathological mechanisms underlying CTN.

[Diagnostic value of protein tyrosine phosphatase-2beta antibody (IA-2betaA) in type 1 diabetes].

OBJECTIVE: To explore the prevalence and clinical features of protein tyrosine phosphatase-2beta antibody (IA-2betaA) in type 1 diabetes (T1DM). METHODS: Four hundred and one T1DM patients and 200 healthy controls were screened for glutamic acid carboxylase antibody (GADA), islet cell antigen-2 (IA-2A), IA-2betaA by radioligand assay. The clinical features of the patients positive in different antibodies were analyzed. RESULTS: Thirty-five of the 401 T1DM patients were positive in IA-2betaA with a positivity rate of 8.7%, significantly higher than that of the normal controls (1.0%, 2/100, P < 0.05). Out of the 35 cases with IA-2betaA positivity, 16 (45.7%) were positive in IA-2A. Among the 401 T1DM patients, IA-2betaA titer was not correlated with IA-2A titer (r = 0.021, P = 0.780). The IA-2betaA positive rate of the age group of 0-9 years was 62.8%, significantly higher than that of the age group > 10 years (19.7%, chi2 = 31.41, P < 0.001); and the IA-2A positive rate of the age group of 0-9 years was 20.0%, significantly higher than that of the age group > 10 years (7.6%, chi2 = 6.11, P < 0.05). GADA was not significantly correlated with age. The age and onset age of the patients positive only in IA-2betaA were 35.5 and 34.0 years respectively, both significantly higher than those of the patients positive only in IA-2A (24.2 and 21.6 years respectively, both P < 0.05). CONCLUSION: Higher in child-onset T1DM, the prevalence of IA-2betaA positivity decreases with age. IA-2betaA is a practical parameter for identifying autoimmune diabetes.

Osteoporotic vertebral endplate and cortex fractures: A pictorial review.

Despite years' research, the radiographic criteria for osteoporotic vertebral fracture and its grading remain debated. The importance of identifying vertebral endplate/cortex fracture (ECF) is being recognised; however, evaluation of osteoporotic ECF requires training and experience. This article aims to serve as a teaching material for radiologists/physicians or researchers to evaluate osteoporotic ECF. Emphasis is particularly dedicated to identifying ECF that may not be associated with apparent vertebral body collapse. We suggest a combined approach based on standardised radiologic evaluation by experts and morphometry measurement is the most appropriate approach to detect and classify osteoporotic vertebral fractures. THE TRANSLATIONAL POTENTIAL: A good understanding of radiologic anatomy of vertebrae and fracture signs of endplate/cortex are essential for spine fragility fracture assessment.

A New Entrance Technique for C2 Pedicle Screw Placement and the Use in Patients With Atlantoaxial Instability.

STUDY DESIGN: A prospective study and a technique note. OBJECTIVES: To introduce a new entrance technique for C2 pedicle screw placement and to measure the related linear and angular parameters about the entrance point on computed tomography (CT) images. The safety of this technique for patients with atlantoaxial instability was also evaluated. BACKGROUND DATA: Although earlier studies have introduced different methods for C2 pedicle screw placement, the entry points and the angular parameters may be variable. Few studies have established a fixed entry point on the basis of the anatomic structure of C2 for pedicle screw placement. METHODS: A total of 60 dry C2 vertebrae were obtained for anatomic measurement in the study. The posterior bilateral nutrient foramens of C2 lamina were selected as the entry points for pedicle screw placement. The foramens were marked with needles and then the vertebrae underwent CT scan. The axial and sagittal planes of C2 pedicles were harvested and 4 linear and 2 angular parameters about the entry point were determined. After that, we used the entrance technique on 31 patients with atlantoaxial instability in a prospective study. CT of the cervical spine was performed to evaluate the safety of the entrance technique. RESULTS: The nutrient foramens exist in 97% of the left lamina and 93% of the right lamina of the C2 vertebra. The overall mean distance from the entry point (nutrient foramen) to the superior border of lamina (PSD), to the inferior border of lamina (PID), to the medial border of the pedicle (PMD), and the length of pedicle screw trajectory (PL, transit the pedicle center) were 3.32±0.63, 8.33±1.21, 6.85±1.00, and 24.47±1.51, respectively. The averaged transverse angle (α) on the axial plane and the superior angle (ß) on the sagittal plane were 19.83±3.83 and 30.12±6.02 degrees, respectively. Then, 31 patients underwent bilateral C2 pedicle screw fixation without screw violation into the spinal canal or vertebral artery injury by the new entrance technique. The overall mean angles α and ß and the length of the pedicle screw were 17.52±3.81 and 34.29±4.18 degrees and 25.85±2.06 mm, respectively. No statistical differences were found in these 3 parameters between the dry C2 vertebrae and the C2 vertebrae of patients who underwent the surgery (P>0.05). CONCLUSIONS: Using the posterior bilateral nutrient foramens of the C2 lamina as the entry point is a helpful intraoperative landmark for C2 pedicle screw placement.

Interleukin-27 is differentially associated with HIV viral load and CD4+ T cell counts in therapy-naïve HIV-mono-infected and HIV/HCV-co-infected Chinese.

Human Immunodeficiency Virus (HIV) infection and the resultant Acquired Immunodeficiency Syndrome (AIDS) epidemic are major global health challenges; hepatitis C virus (HCV) co-infection has made the HIV/AIDS epidemic even worse. Interleukin-27 (IL-27), a cytokine which inhibits HIV and HCV replication in vitro, associates with HIV infection and HIV/HCV co-infection in clinical settings. However, the impact of HIV and HCV viral loads on plasma IL-27 expression levels has not been well characterized. In this study, 155 antiretroviral therapy-naïve Chinese were recruited. Among them 80 were HIV- and HCV-negative healthy controls, 45 were HIV-mono-infected and 30 were HIV/HCV-co-infected. Plasma level HIV, HCV, IL-27 and CD4+ number were counted and their correlation, regression relationships were explored. We show that: plasma IL-27 level was significantly upregulated in HIV-mono-infected and HIV/HCV-co-infected Chinese; HIV viral load was negatively correlated with IL-27 titer in HIV-mono-infected subjects whereas the relationship was opposite in HIV/HCV-co-infected subjects; and the relationships between HIV viral loads, IL-27 titers and CD4+ T cell counts in the HIV mono-infection and HIV/HCV co-infection groups were dramatically different. Overall, our results suggest that IL-27 differs in treatment-naïve groups with HIV mono-infections and HIV/HCV co-infections, thereby providing critical information to be considered when caring and treating those with HIV mono-infection and HIV/HCV co-infection.

A large desmoids-type fibromatosis in left deep buttock and thigh.

Desmoid-type fibromatosis (DF) is a rare intermediately and locally aggressive tumor that occurs predominantly between puberty and 40 years, with female having higher incidence than male. This report describes a 48-year-old man with biopsy-proven DF in left intermuscular spatium of buttock and thigh. The mass had a wide longitudinal distribution from femoral neck level to popliteal fossa and measured about 40 cm. Plain CT showed a partially ill-defined mass with an irregular contour, with a density similar or slightly higher than skeletal muscle. On MR images, the tumor showed uneven signal in both T(1)WI and T(2)WI, mainly hyperintense to skeletal muscle and with stripe or patch-like markedly low signal. After contrast injection, the mass showed heterogeneous enhancement.

[Construction of Marek's disease virus serotype 814 strain as an infectious bacterial artificial chromosome].

The aim of this study was to construct the complete genome of Marek's disease virus serotype 814 strain as an infectious bacterial artificial chromosome (BAC). Using self-designed selection marker Eco-gpt (1.3 kb) and BAC vector pBeloBAC11 (7.5 kb), we constructed the transfer plasmid pUAB-gpt-BAC11. The plasmid pUAB-gpt-BAC11 and MDV total-DNA were cotransfected into secondary CEFs; we put the virus-containing cells in selection medium for eight rounds and obtained purified recombinant viruses. Recombinant viral genomes were extracted and electroporated into E. coli, BAC clones were identified by restriction enzyme digestion and PCR analysis. Finally, we obtained 38 BAC clones, DNA from various MDV-1 BACs was transfected into CEFs, and recombinant virus was reconstituted by transfection of MDV-BAC2 DNA. We successfully cloned the complete genome of MDV-1814 strain as an infectious bacterial artificial chromosome. With these cloned genomes, a revolutionary MDV-DNA engineering platform utilizing RED/ET recombination system was constructed successfully, which can help the understanding of MDV gene functions and promote the using of MDV as a vector for expressing foreign genes. In addition, it opens the possibility to generate novel MDV-1 vaccines based on the BACs.