Establishment and application of severity assessment system for patients with delayed encephalopathy caused by carbon monoxide poisoning.

OBJECTIVE: To identify the factors related to the severity of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and establishment of a clinical nomogram assessment model. METHODS: Clinical data of 200 patients with DEACMP admitted to the First Hospital of Yulin from January 2019 to December 2022 were retrospectively analyzed. The patients were classified into severe and non-severe groups according to the severity of the disease. Clinical data was collected from both groups. Logistic regression was applied to analyze the risk factors for disease severity of DEACMP patients. The risk prediction model of the nomogram was constructed by incorporating risk factors, and its effectiveness was verified. Model differentiation performance was evaluated using the Respondent Operating Characteristic (ROC) Curve. Model calibration curve was adopted for fitting the situation of evaluation. The consistency of the model was evaluated by Hosmer-Lemeshow (H-L) analysis. RESULT: Age, coma time out of exposure, creatine kinase (CK), caspase, and red blood cell distribution width (RDW) were the risk factors for the severe DEACMP. A nomogram prediction model was built based on the above indicators. The area under the curve (AUC) of the model in predicting severe DEACMP was 0.961 (95% CI: 0.934-0.988) and 0.929 (95% CI: 0.841-1) in the training and test sets, respectively. The H-L test showed good goodness of fit (χ2 = 4.468, P = 0.813). The calibration curve showed a good agreement between the predicted values of the nomogram and the actual observed values. CONCLUSION: Age, coma time out of exposure, CK, caspase, and RDW were significantly correlated with the severity of DEACMP patients. The nomogram prediction model incorporating the five indicators has certain clinical reference value for predicting the severe DEACMP and could be used as an accurate and rapid clinical assessment tool.

Nakagami statistics-based photoacoustic spectroscopy used for label-free assessment of bone tissue.

Quick identification of abnormal molecular metabolism of bone tissues is challenging. Photoacoustic (PA) spectroscopy techniques have great potential in molecular imaging. However, most of them are amplitude-dependent and easily affected by the light deposition, especially for bone tissues with high optical scattering. In this Letter, we propose a Nakagami statistics-based PA spectroscopy (NSPS) method for characterizing molecules in bone tissues. We indicate that the NSPS curve can intelligently identify changes in the content of molecules in bone tissues, with a high disturbance-resisting ability. The NSPS has remarkable potential for use in the early and rapid detection of bone diseases.

Research on Village Type Identification and Development Strategy under the Background of Rural Revitalization: A Case of Gaochun District in Nanjing, China.

In the context of rural revitalization, it is of great significance for the implementation of a Rural Revitalization Strategy to carry out the research on scientifically identifying village types and clarifying the differences and pluralistic trends within villages. Taking Gaochun District of Nanjing in China as an example, this paper constructs an index system of development level and reconstruction intensity from a dynamic and static perspective, uses the polygon area method to calculate the comprehensive score of each index, divides village types based on the combination of development level and reconstruction intensity, and then puts forward the differentiated development strategies of various villages. The results show that the identification method of village types based on combined features is multi-dimensional and comprehensive, and the recognition results are more in line with the objective reality. Villages in Gaochun district have a medium overall development level and high overall reconstruction intensity. There are a large number of low-value villages with development level and high-value villages with reconstruction intensity. According to the three-step strategy of village type identification, the list of characteristic villages, the location of villages and the characteristics of index combination, five village types were identified: the characteristic protection type, the urban-suburban integration type, the agglomeration and upgrading type, the improvement and development type, and the relocation and merger type.

Characterization of multi-biomarkers for bone health assessment based on photoacoustic physicochemical analysis method.

Photoacoustic (PA) techniques are potential alternatives to histopathology. The physicochemical spectrogram (PCS) generated by the PA measurement at multiple wavelengths can presents the morphology and chemical composition target at multi-biomarkers simultaneously. In this work, via multi-wavelength PA measurements performed on rabbit bone models, we investigated the feasibility of using PCSs for bone health assessment. A comprehensive analysis of the PCSs, termed PA physicochemical analysis (PAPCA), was conducted. The "slope" and "relative content" were used as the PAPCA-quantified parameters to characterize the changes in the physical and chemical properties of bone tissue, respectively. The findings are consistent well with the gold-standard imaging results. It demonstrated that the PAPCA can be used to characterize both the microstructure and content of multi-biomarkers which highly related with bone health. Considering the PA technique is noninvasive and radiation-free, it has great potential in the implementation and monitoring of bone diseases progression.

Rapid Assessment on Potential Risks of Schistosomiasis Transmission - 7 PLADs, China, 2019 and 2021.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Oncomelania hupensis(O. hupensis) and livestock are main infection sources of schistosomiasis. The schistosome infected O. hupensis and livestock's feces are important risk factors in the transmission of schistosomiasis. WHAT IS ADDED BY THIS REPORT?: The potential risks of schistosomiasis transmission remain prevalent, giving an early warning to local government with information on existing transmission risks. It is expected that the effectiveness and efficiency of schistosomiasis surveillance could be improved by conducting rapid risk assessment at the beginning of transmission season. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Rapid risk assessment is essential in early detection and the active monitoring of indicators of the transmission risks of schistosomiasis in endemic areas. This could work synergistically with surveillance system to minimize infections and prevent rebounds of endemic schistosomiasis outbreaks.

Cross-cultural adaptation and validation of the strategic learning assessment map for Chinese nursing organisation: A cross-sectional study.

AIM: To translate the Strategic Learning Assessment Map into Chinese and validate it in Chinese nursing organisations. BACKGROUND: Nursing is the largest occupational organisation in the health sector and its adaptation and innovation are important for the realisation of sustainable development goals. Organisational learning is critical in cultivating the adaptive and innovative abilities of organisations, but there is limited research on its measurement. Although the Strategic Learning Assessment Map is a widely acknowledged organisational measurement instrument, it has not yet been adapted and validated in China. DESIGN: A cross-sectional study design was used. METHODS: The Chinese version of the Strategic Learning Assessment Map was generated through forward-backward translation and was tested with a convenience sample of 2745 nurses from 7 administrative regions of mainland China. The internal consistency, content validity, structural validity and theoretical framework were examined. RESULTS: Results validated the theoretical framework and showed excellent content validity, convergent validity and fitness of the measurement model; only discriminant validity was not satisfactory. Cronbach's α values for the overall scale and its subscales ranged from 0.97 to 0.99. CONCLUSIONS: The Chinese version of the Strategic Learning Assessment Map is a reliable organisational learning instrument for Chinese nursing organisations.

Detection of collagen by multi-wavelength photoacoustic analysis as a biomarker for bone health assessment.

Collagen is an important biomarker of osteoporosis progression. Noninvasive, multispectral, photoacoustic (PA) techniques use pulsed laser light to induce PA signals to facilitate the visualization of chemical components that are strongly related to tissue health. In this study, the feasibility of multi-wavelength PA (MWPA) measurement of the collagen in bone, using the wavelength range of 1300-1800 nm, was investigated. First, the feasibility of this approach for detecting the collagen content of bone was demonstrated by means of numerical simulation. Then, ex vivo experiments were conducted on both animal and human bone specimens with different bone densities using the MWPA method. The relative collagen content was extracted and compared with the results of micro-computed tomography (micro-CT) and histology. The results showed that the "relative collagen content" parameter obtained using the MWPA approach correlated well with the bone volume ratio obtained from micro-CT images and histological analysis results. This study highlights the potential of the proposed PA technique for determining the collagen content of bones as a biomarker for bone health assessment.

Wavelet transform-based photoacoustic time-frequency spectral analysis for bone assessment.

In this study, we investigated the feasibility of using photoacoustic time-frequency spectral analysis (PA-TFSA) for evaluating the bone mineral density (BMD) and bone structure. Simulations and ex vivo experiments on bone samples with different BMDs and mean trabecular thickness (MTT) were conducted. All photoacoustic signals were processed using the wavelet transform-based PA-TFSA. The power-weighted mean frequency (PWMF) was evaluated to obtain the main frequency component at different times. The y-intercept, midband-fit, and slope of the linearly fitted curve of the PWMF over time were also quantified. The results show that the osteoporotic bone samples with lower BMD and thinner MTT have higher frequency components and lower acoustic frequency attenuation over time, thus higher y-intercept, midband-fit, and slope. The midband-fit and slope were found to be sensitive to the BMD; therefore, both parameters could be used to distinguish between osteoporotic and normal bones (p < 0.05).

A cone-beam computed tomographic study evaluating the efficacy of incisor movement with clear aligners: Assessment of incisor pure tipping, controlled tipping, translation, and torque.

INTRODUCTION: This retrospective clinical study aimed to evaluate the efficacy of different types of incisor movements with clear aligners in the sagittal plane. METHODS: Pretreatment and posttreatment cone-beam computed tomography (CBCT) scans were collected from 69 patients who underwent nonextraction treatment with clear aligners (Invisalign; Align Technology, San Jose, Calif). Integrated 3-dimensional models of the virtual incisor position (ClinCheck; Align Technology) and the posttreatment incisor position (from posttreatment CBCT scans) were superimposed over the pretreatment position (from pretreatment CBCT scans) using Mimics software (Materialise, Leuven, Belgium). On the basis of the location of the rotation center, incisors showing pure tipping (>10°), controlled tipping (>10°), translation (>1 mm), or torque (>10°) movements were selected. Efficacy was determined by comparing the predicted and achieved incisor movement, and differences with efficacy were analyzed using Kruskal-Wallis and Shapiro-Wilk tests (α = 0.05). RESULTS: In measurements for 231 incisors, the mean efficacy of incisor movements in the sagittal plane was 55.58%. The most and least predictable movements were pure tipping (72.48%) and torque (35.21%), respectively. Labial root movement was significantly more predictable than lingual root movement, and labial movement of the mandibular incisors was significantly easier than that of the maxillary incisors. The type of tooth movement achieved was different from the type designed. CONCLUSIONS: The efficacy of incisor movement in the sagittal plane using clear aligners varies with designed movement type, and labial root movement appears to be more accurate than the lingual root movement. The biomechanics of clear aligners remains to be further elucidated to achieve more predictable treatment results.

Contributions and achievements on schistosomiasis control and elimination in China by NIPD-CTDR.

Being a zoonotic parasitic disease, schistosomiasis was widely spread in 12 provinces of Southern China in the 1950s, severly harming human health and hindering economic development. The National Institute of Parasitic Diseases at the Chinese Center for Diseases Control and Prevention, and Chinese Center for Tropical Diseases Research (NIPD-CTDR), as the only professional institution focussing on parasitic diseases at the national level, has played an important role in schistosomiasis control in the country. In this article, we look back at the changes of schistosomiasis endemicity and the contribution of NIPD-CTDR to the national schistosomiasis control programme. We review NIPD-CTDR's activities, including field investigations, design of control strategies and measures, development of diagnostics and drugs, surveillance-response of endemic situation, and monitoring & evaluation of the programme. The NIPD-CTDR has mastered the transmission status of schistosomiasis, mapped the snail distribution, and explored strategies and measures suitable for different types of endemic areas in China. With a good understanding of the life cycle of Schistosoma japonicum and transmission patterns of the disease, advanced research carried out in the NIPD-CTDR based on genomics and modern technology has made it possible to explore highly efficient and soft therapeutic drugs and molluscicides, making it possible to develop new diagnostic tools and produce vaccine candidates. In the field, epidemiological studies, updated strategies and targeted intervention measures developed by scientists from the NIPD-CTDR have contributed significantly to the national schistosomiasis control programme. This all adds up to a strong foundation for eliminating schistosomiasis in China in the near future, and recommendations have been put forward how to reach this goal.

Functional Photoacoustic and Ultrasonic Assessment of Osteoporosis: A Clinical Feasibility Study.

Objective and Impact Statement. To study the feasibility of combined functional photoacoustic (PA) and quantitative ultrasound (US) for diagnosis of osteoporosis in vivo based on the detection of chemical and microarchitecture (BMA) information in calcaneus bone. Introduction. Clinically available X-ray or US technologies for the diagnosis of osteoporosis do not report important parameters such as chemical information and BMA. With unique advantages, including good sensitivity to molecular and metabolic properties, PA bone assessment techniques hold a great potential for clinical translation. Methods. By performing multiwavelength PA measurements, the chemical information in the human calcaneus bone, including mineral, lipid, oxygenated-hemoglobin, and deoxygenated-hemoglobin, were assessed. In parallel, by performing PA spectrum analysis, the BMA as an important bone physical property was quantified. An unpaired t-test and a two-way ANOVA test were conducted to compare the outcomes from the two subject groups. Results. Multiwavelength PA measurement is capable of assessing the relative contents of several chemical components in the trabecular bone in vivo, including both minerals and organic materials such as oxygenated-hemoglobin, deoxygenated-hemoglobin, and lipid, which are relevant to metabolic activities and bone health. In addition, PA measurements of BMA show good correlations (R2 up to 0.65) with DEXA. Both the chemical and microarchitectural measurements from PA techniques can differentiate the two subject groups. Conclusion. The results from this initial clinical study suggest that PA techniques, by providing additional chemical and microarchitecture information relevant to bone health, may lead to accurate and early diagnosis, as well as sensitive monitoring of the treatment of osteoporosis.

[Risk Assessment of Schistosomiasis Transmission by Catalytic Models Based on Antibody Positive Rates].

Objective: To evaluate the transmission risk and features of schistosomiasis by analyzing the data concerning positive rates of anti-schistosome antibody using catalytic models. Methods: Cross-sectional survey was conducted in seven villages with different endemicity of schistosomiasis in Jiangxi (Caohui, Xinhua, Jingtou villages), Anhui (Yuye, Tieguai, Longshang villages) and Hubei (Hebei village) Provinces in 2008. Serum samples were collected and indirect hemagglutination assay was performed to detect anti-schistosome antibodies in serum. Antibody positive rate was calculated and differences among villages and age groups as well as between genders were analyzed. Data of antibody positive rate based on age strata for each village were analyzed by two-stage catalytic model and reversible and two-stage compound catalytic model. Parameters of each model were estimated through the maximum likelihood method. Seroconversion rate and sero-negative conversion rate were estimated in the two-stage catalytic model. Seroconversion rate, seroreversion rate and sero-negative conversion rate were estimated in reversible and two-stage compound catalytic model. The fitting effect was evaluated through correlation analysis and chi-square tests. The best fitted models and parameters were used to analyze the transmission risk and characteristics of schistosomiasis. Results: A total of 6 428 individuals were examined with an average schistosomiasis antibody positive rate of 39.80%（2 485/6 428）. In terms of age, the peak of antibody positive rate in Caohui, Xinhua, Jingtou, Yuye, Tieguai, Longshang, and Hebei villages occurred in the age group of 46-50 （82.86%, 58/70）, 31-35 （60.78%, 31/51）, 31-35 （68.42%, 26/38）, 41-45（55.04%, 71/129）, 51-55 （62.38%, 63/101）, 56-60 （31.43%, 33/105）, and 16-20 （21.88%, 7/32） years old, respectively. In general, the antibody positive rate showed a trend of increase followed by a decrease with increasing age in each village. The best model for the data of Caohui, Xinhua and Jingtou and Yuye village was the two-stage catalytic model. The estimated seroconversion rate in these villages was 0.049 5, 0.044 0, 0.055 7, and 0.034 4 respectively, all higher than the corresponding sero-negative conversion rate of 0.005 9, 0.019 6, 0.015 5, and 0.017 8. The best model for the data of Longshang, Tieguai and Hebei villages was the reversible and two-stage compound model. The seroconversion rate in these villages was 0.062 9, 0.168 1, and 0.039 4 respectively, the seroreversion rate was 0.168 8, 0.121 1, and 0.152 2, and the sero-negative conversion rate was 0.001 7, 0.000 2, and 0.090 9. Conclusions: The catalytic model based on antibody positive rate by age strata could reflect the transmission rate and risk quantitatively and may provide guidance for making control strategies.

Bone assessment via thermal photo-acoustic measurements.

The feasibility of an innovative biomedical diagnostic technique, thermal photo-acoustic (TPA) measurement, for non-ionizing and non-invasive assessment of bone health is investigated. Unlike conventional photo-acoustic PA methods that are mostly focused on the measurement of absolute signal intensity, TPA targets the change in PA signal intensity as a function of the sample temperature, i.e., the temperature-dependent Grueneisen parameter that is closely relevant to the chemical and molecular properties in the sample. Based on the differentiation measurement, the results from TPA technique are less susceptible to the variations associated with sample and system, and could be quantified with improved accurately. Due to the fact that the PA signal intensity from organic components such as blood changes faster than that from non-organic mineral under the same modulation of temperature, TPA measurement is able to objectively evaluate bone mineral density (BMD) and its loss as a result of osteoporosis. In an experiment on well-established rat models of bone loss and preservation, PA measurements of rat tibia bones were conducted over a temperature range from 37°C to 44°C. The slope of PA signal intensity verses temperature was quantified for each specimen. The comparison among three groups of specimens with different BMD shows that bones with lower BMD have higher slopes, demonstrating the potential of the proposed TPA technique in future clinical management of osteoporosis.

[Assessment of effect and quality control for parasitological tests in national schistosomiasis surveillance sites].

OBJECTIVE: To understand the ability of pathogenic diagnosis for schistosomiasis japonica in the national surveillance sites and evaluate the effect of stool hatching method in the field, so as to provide the evidence for establishing a quality control system of pathogenic diagnosis of schistosomiasis in the surveillance sites. METHODS: The data pertaining to the parasitological diagnosis of the residents with positive serological tests were collected in 81 national surveillance sites of 12 provinces in 2011, and the effects of the Kato-Katz technique and stool hatching method were evaluated and compared. The incubation quality control samples made by the national schistosomiasis diagnosis reference laboratory were detected by both Kato-Katz technique and stool hatching method using the single-blind method, and the results were analyzed and compared for the coincidence rate, misdiagnosis rate and missing diagnosis rate in all the county laboratories in 2012. RESULTS: A total of 3 780 sero-positive residents were tested by using the Kato-Katz technique and stool hatching method in the 81 national surveillance sites in 2011, 127 persons were double egg-positive, 3 513 persons were double egg-negative, and the total coincidence rate was 96.30%. Totally 173 infected people were diagnosed by using the Kato-Katz technique and the positive detection rate was 4.58%; 221 infected people were diagnosed by using the stool hatching method and the positive detection rate was 5.85%. A total of 267 positive people were diagnosed by the Kato-Katz technique or the stool hatching method or both and the total positive detection rate was 7.06%, which was higher by 54.15% than that by using the single Kato-Katz technique (chi2 = 21.32, P < 0.01). In 2012, of 240 standard incubation quality control samples (160 positives, 80 negatives) detected by the technicians from the 80 surveillance sites, 105 samples were positive and 67 samples were negative, with a total coincidence rate of 71.67% (172/240) and a total missing diagnosis rate of 34.38% (55/160). Among them, the missing rate of the strong positive samples was 32.50% (26/80), the missing rate of the weakly positive samples was 36.25% (29/80), and the misdiagnosis rate of the negative samples was 16.25% (13/80). The detection rates of the incubation quality control samples were 61.11%, 80.00%, 77.08%, 90.48%, 58.33% and 59.26% in the surveillance sites of six provinces, including Anhui, Hubei, Hunan, Jiangsu, Jiangxi and Sichuan provinces, respectively, and a significant difference was found (chi2 = 14.27, P < 0.05). CONCLUSIONS: The detection efficiency of the stool hatching method is superior to that of the Kato-Katz technique in the field. However, the levels of the technical personnel for the stool hatching method are relatively low in most of the surveillance sites. Therefore, the technical training should be strengthened.

Tools to support policy decisions related to treatment strategies and surveillance of Schistosomiasis japonica towards elimination.

BACKGROUND: Appropriate diagnostics to monitor disease trends and assess the effectiveness and impact of interventions are essential for guiding treatment strategies at different thresholds of schistosomiasis transmission and for certifying elimination. Field validation of these assays is urgently needed before they can be adopted to support policy decisions of the national programme for control and elimination of schistosomiasis in P.R. China. We compared the efficacy and utility of different immunoassays in guiding control strategies and monitoring the endemic status of S. japonicum infections towards elimination. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional survey was conducted in seven villages with different transmission intensities settings to assess the performance and utility of three immunoassays, e.g., an indirect hemagglutination assay (IHA_JX), an enzyme linked immunosorbent assay (ELISA_SZ), and a dot immunogold filtration assay (DIGFA_SH). 6,248 individuals aged 6-65 years old who gave consent and supplied their stool and blood samples were included for data analysis. Results showed that ELISA_SZ performed significantly higher sensitivity (95.45%, 95%CI: 92.94-97.97%) than IHA_JX (87.59%, 95%CI: 83.51-91.49%) and DIGFA_SH (79.55%, 95%CI: 74.68-84.41%), especially in subgroups with very low infection intensity. The specificity of ELISA_SZ, IHA_JX, DIGFA_SH in 6-9 year olds with occasional exposure was nearly 90%. DIGFA_SH performed the highest screening efficacy for patients among three assays with overall positive predicative value of 13.07% (95%CI: 11.42-14.72%). We found a positive correlation of antibody positive rate of IHA_JX with results of stool examination in age strata (r = 0.70, P<0.001). Seropositivity of IHA_JX in children aged 6-9 years old showed an excellent correlation with prevalence of schistosome infection in the seven communities (r = 0.77, P<0.05). CONCLUSIONS/SIGNIFICANCE: Studies suggest that ELISA_SZ could be used to guide selective chemotherapy in moderate or low endemic regions. IHA_JX could be used to as a surveillance tool and for certifying elimination of schistosomiasis through monitoring children as a sentinel population.

[Evaluations of self-perceived orthodontic treatment need using 2 different scales in adolescents].

PURPOSE: To evaluate the self-perceived dental aesthetics through visualized analogue scale (VAS) and aesthetic component (AC) of index of orthodontic treatment (IOTN) among adolescents in Shanghai area. METHODS: The investigation was carried out among 302 students (148 boys and 144 girls) aged 11-13 years. Self-perception of the dental aesthetic appearance was evaluated through VAS and AC. Additionally, the objective dental aesthetics were scored by orthodontists using AC and the actual dental attractiveness satisfaction was determined by a simple question. The data was analyzed using SPSS11.0 software package for Spearman correlation analysis. RESULTS: Generally, no statistically significant sex differences were found in relation to the VAS score and SAC degree (P > 0.05). No correlation was found between actual dental attractiveness satisfaction and self-perceived AC grade (r = 0.04. P = 0.441). However, statistically significant, positive, strong correlations were found between the actual dental attractiveness satisfaction and VAS score (r = 0.80, P = 0.000). And meaningful relation between the AC and VAS score was found. CONCLUSIONS: VAS showed high ability to predict the self-perceived dental aesthetics and act as a simple and useful tool, which can be used in further investigations.