Global, regional, and national time trends in incidence for tuberculosis, 1990-2019: An age-period-cohort analysis for the Global Burden of Disease 2019 study.

BACKGROUND: Tuberculosis (TB) represents a significant global health concern, being the leading cause of mortality from a single infectious agent worldwide. The investigation of TB incidence and epidemiological trends is critical for evaluating the effectiveness of control strategies and identifying ongoing challenges. OBJECTIVES: This study presents the trend in TB incidence across 204 countries and regions over a 30-year period. METHODS: The study utilises data sourced from the Global Burden of Disease (GBD) database. The age cohort model and gender subgroup analysis were employed to estimate the net drift (overall annual percentage change), local drift (age annual percentage change), longitudinal age curve (expected age ratio), and cycle and cohort effect (relative risk of cycle and birth cohort) of TB incidence from 1990 to 2019. This approach facilitates the examination and differentiation of age, period, and cohort effects in TB incidence trends, potentially identifying disparities in TB prevention across different countries. RESULTS: Over the past three decades, a general downward trend in TB incidence has been observed in most countries. However, in 15 of the 204 countries, the overall incidence rate is still on the rise (net drift ≥0.0 %) or stagnant decline (≥-0.5 %). From 1990 to 2019, the net drift of tuberculosis mortality ranged from -2.2 % [95 % confidence interval (CI): -2.33, -2.05] in high Socio-demographic Index (SDI) countries to -1.7 % [95 % CI: -1.81, -1.62] in low SDI countries. In some below-average SDI countries,men in the birth cohort are at a disadvantage and at risk of deterioration, necessitating comprehensive TB prevention and treatment. CONCLUSIONS: While the global incidence of TB has declined, adverse period and cohort effects have been identified in numerous countries, raising questions about the adequacy of TB healthcare provision across all age groups. Furthermore, this study reveals gender disparities in TB incidence.

Assessment of the Role of Artificial Intelligence in the Association Between Time of Day and Colonoscopy Quality.

Importance: Time of day was associated with a decline in adenoma detection during colonoscopy. Artificial intelligence (AI) systems are effective in improving the adenoma detection rate (ADR), but the performance of AI during different times of the day remains unknown. Objective: To validate whether the assistance of an AI system could overcome the time-related decline in ADR during colonoscopy. Design, Setting, and Participants: This cohort study is a secondary analysis of 2 prospective randomized controlled trials (RCT) from Renmin Hospital of Wuhan University. Consecutive patients undergoing colonoscopy were randomly assigned to either the AI-assisted group or unassisted group from June 18, 2019, to September 6, 2019, and July 1, 2020, to October 15, 2020. The ADR of early and late colonoscopy sessions per half day were compared before and after the intervention of the AI system. Data were analyzed from March to June 2022. Exposure: Conventional colonoscopy or AI-assisted colonoscopy. Main Outcomes and Measures: Adenoma detection rate. Results: A total of 1780 patients (mean [SD] age, 48.61 [13.35] years, 837 [47.02%] women) were enrolled. A total of 1041 procedures (58.48%) were performed in early sessions, with 357 randomized into the unassisted group (34.29%) and 684 into the AI group (65.71%). A total of 739 procedures (41.52%) were performed in late sessions, with 263 randomized into the unassisted group (35.59%) and 476 into the AI group (64.41%). In the unassisted group, the ADR in early sessions was significantly higher compared with that of late sessions (13.73% vs 5.70%; P = .005; OR, 2.42; 95% CI, 1.31-4.47). After the intervention of the AI system, as expected, no statistically significant difference was found (22.95% vs 22.06%, P = .78; OR, 0.96; 95% CI; 0.71-1.29). Furthermore, the AI systems showed better assistance ability on ADR in late sessions compared with early sessions (odds ratio, 3.81; 95% CI, 2.10-6.91 vs 1.60; 95% CI, 1.10-2.34). Conclusions and Relevance: In this cohort study, AI systems showed higher assistance ability in late sessions per half day, which suggests the potential to maintain high quality and homogeneity of colonoscopies and further improve endoscopist performance in large screening programs and centers with high workloads.

Benefit-Risk Assessment of Dietary Patterns by Bioavailable Metals, Gut Microbes, and Their Interaction for Human Health.

The high-carbohydrate, low-fat, low-protein (HC-LFP) and low-carbohydrate, high-fat, high-protein (LC-HFP) diets are the main dietary patterns worldwide. The influence of dietary patterns on bioavailable metals, gut microbes, and their interaction is still unknown. A biomimetic digestive tract with full functions is constructed to transform the diets into chyme, and the gut microbes are cultured with the corresponding chyme. The diet species-specificity in bioavailable metal content and the positive and negative correlations between bioavailable metals and microbial reproductions are disclosed. The safe dosage and maximum consumption are 369.5 and 858.6 g/d and 268.6 and 3119.0 g/d for LC-HFP and HC-LFP, respectively. When replacing HC-LFP with LC-HFP for 21 days, the bioavailability of Fe and Cr is increased 83.2% and 268.4%, respectively; the reproductions of harmful and benefical microbes are significantly increased and decreased. The prevalences of obesity, inflammation, septicemia, and cancer are increased, and then the risk of dietary pattern shift is disclosed.

Self-Healing Performance Assessment of Bacterial-Based Concrete Using Machine Learning Approaches.

Bacterial-based self-healing concrete (BSHC) is a well-known healing technology which has been investigated for a few decades for its excellent crack healing capacity. Nevertheless, considered as costly and time-consuming, the healing performance (HP) of concrete with various types of bacteria can be designed and evaluated only in laboratory environments. Employing machine learning (ML) models for predicting the HP of BSHC is inspired by practical applications using concrete mechanical properties. The HP of BSHC can be predicted to save the time and cost of laboratory tests, bacteria selection and healing mechanisms adoption. In this paper, three types of BSHC, including ureolytic bacterial healing concrete (UBHC), aerobic bacterial healing concrete (ABHC) and nitrifying bacterial healing concrete (NBHC), and ML models with five kinds of algorithms consisting of the support vector regression (SVR), decision tree regression (DTR), deep neural network (DNN), gradient boosting regression (GBR) and random forest (RF) are established. Most importantly, 22 influencing factors are first employed as variables in the ML models to predict the HP of BSHC. A total of 797 sets of BSHC tests available in the open literature between 2000 and 2021 are collected to verify the ML models. The grid search algorithm (GSA) is also utilised for tuning parameters of the algorithms. Moreover, the coefficient of determination (R2) and root mean square error (RMSE) are applied to evaluate the prediction ability, including the prediction performance and accuracy of the ML models. The results exhibit that the GBR model has better prediction ability (R2GBR = 0.956, RMSEGBR = 6.756%) than other ML models. Finally, the influence of the variables on the HP is investigated by employing the sensitivity analysis in the GBR model.

Benefit-risk assessment of metal bioavailability in edible fungi by biomimetic whole digestive tracts with digestion, metabolism, and absorption functions.

As worldwide edible fungi, Lentinula edodes and Agaricus bisporus accumulate both essential and harmful metals. Metal bioavailability is important for metal benefit-risk assessment. A full functional model of digestive tracts (including digestion, metabolism, and absorption) is established. Under the digestive tract functions, the bioaccessible and bioavailable metals are released from edible fungi and absorbed by intestinal tract, respectively. Based on bioavailable metal contents in the intestine, safe dosage and maximum consumption are 43.52 g/d and 248.7 g/d for Agaricus bisporu, 20.59/328.9 g/d (for males/ female) and 132.9 g/d for Lentinus edodes; V, Co, Ni, Cu, Zn, Se, Cr, Cd and Pb in Agaricus bisporus and Lentinula edodes are absorbed mainly in the large intestine; Fe is mainly absorbed in small intestine; edible fungi species-specificity in metal bioavailability is observed for As and Mn, which are mainly absorbed by small and large intestine for Agaricus bisporus and Lentinus edodes, respectively; and then metal toxicity on small and large intestine is disclosed. Metal benefit-risk is assessed by the content of monolayer liposome-extracted metal in the chyme from small and large intestine, which is controlled by the gastrointestinal functions, metal and edible fungi species.

Is there a causal relationship between oil prices and tourist arrivals?

This application note investigates the causal relationship between oil price and tourist arrivals to further explain the impact of oil price volatility on tourism-related economic activities. The analysis itself considers the time domain, frequency domain and information theory domain perspectives. Data relating to US and nine European countries are exploited in this paper with causality tests which include time domain, frequency domain, and Convergent Cross Mapping (CCM). The CCM approach is nonparametric and therefore not restricted by assumptions. We contribute to existing research through the successful and introductory application of an advanced method, and via the uncovering of significant causal links from oil prices to tourist arrivals.

Incidence and outcomes of acute respiratory distress syndrome in intensive care units of mainland China: a multicentre prospective longitudinal study.

OBJECTIVES: To evaluate the incidence and mortality of acute respiratory distress syndrome (ARDS) in medical/respiratory intensive care units (MICUs/RICUs) to assess ventilation management and the use of adjunct therapy in routine clinical practice for patients fulfilling the Berlin definition of ARDS in mainland China. METHODS: This was a multicentre prospective longitudinal study. Patients who met the Berlin definition of ARDS were included. Baseline data and data on ventilator management and the use of adjunct therapy were collected. RESULTS: Of the 18,793 patients admitted to participating ICUs during the study timeframe, 672 patients fulfilled the Berlin ARDS criteria and 527 patients were included in the analysis. The most common predisposing factor for ARDS in 402 (77.0) patients was pneumonia. The prevalence rates were 9.7% (51/527) for mild ARDS, 47.4% (250/527) for moderate ARDS, and 42.9% (226/527) for severe ARDS. In total, 400 (75.9%) patients were managed with invasive mechanical ventilation during their ICU stays. All ARDS patients received a tidal volume of 6.8 (5.8-7.9) mL/kg of their predicted body weight and a positive end-expository pressure (PEEP) of 8 (6-12) cmH2O. Recruitment manoeuvres (RMs) and prone positioning were used in 61 (15.3%) and 85 (16.1%) ventilated patients, respectively. Life-sustaining care was withdrawn from 92 (17.5%) patients. When these patients were included in the mortality analysis, 244 (46.3%) ARDS patients (16 (31.4%) with mild ARDS, 101 (40.4%) with moderate ARDS, and 127 (56.2%) with severe ARDS) died in the hospital. CONCLUSIONS: Among the 18 ICUs in mainland China, the incidence of ARDS was low. The rates of mortality and withdrawal of life-sustaining care were high. The recommended lung protective strategy was followed with a high degree of compliance, but the implementation of adjunct treatment was lacking. These findings indicate the potential for improvement in the management of patients with ARDS in China. TRIAL REGISTRATION: Clinicaltrials.gov NCT02975908 . Registered on 29 November 2016-retrospectively registered.

Biexciton Condensation in Electron-Hole-Doped Hubbard Bilayers: A Sign-Problem-Free Quantum Monte Carlo Study.

The bilayer Hubbard model with electron-hole doping is an ideal platform to study excitonic orders due to suppressed recombination via spatial separation of electrons and holes. However, suffering from the sign problem, previous quantum Monte Carlo studies could not arrive at an unequivocal conclusion regarding the presence of phases with clear signatures of excitonic condensation in bilayer Hubbard models. Here, we develop a determinant quantum Monte Carlo algorithm for the bilayer Hubbard model that is sign-problem-free for equal and opposite doping in the two layers and study excitonic order and charge and spin density modulations as a function of chemical potential difference between the two layers, on-site Coulomb repulsion, and interlayer interaction. In the intermediate coupling regime and in proximity to the SU(4)-symmetric point, we find a biexcitonic condensate phase at finite electron-hole doping, as well as a competing (π,π) charge density wave state. We extract the Berezinskii-Kosterlitz-Thouless transition temperature from superfluid density and a finite-size scaling analysis of the correlation functions and explain our results in terms of an effective biexcitonic hard-core boson model.

A shape-memory and spiral light-emitting device for precise multisite stimulation of nerve bundles.

We previously demonstrated that for long-term spastic limb paralysis, transferring the seventh cervical nerve (C7) from the nonparalyzed side to the paralyzed side results in increase of 17.7 in Fugl-Meyer score. One strategy for further improvement in voluntary arm movement is selective activation of five target muscles innervated by C7 during recovery process. In this study, we develop an implantable multisite optogenetic stimulation device (MOSD) based on shape-memory polymer. Two-site stimulation of sciatic nerve bundles by MOSD induces precise extension or flexion movements of the ankle joint, while eight-site stimulation of C7 nerve bundles induce selective limb movement. Long-term implant of MOSD to mice with severed and anastomosed C7 nerve is proven to be both safe and effective. Our work opens up the possibility for multisite nerve bundle stimulation to induce highly-selective activations of limb muscles, which could inspire further applications in neurosurgery and neuroscience research.

Toward a functional near-infrared spectroscopy-based monitoring of pain assessment for nonverbal patients.

Pain diagnosis for nonverbal patients represents a challenge in clinical settings. Neuroimaging methods, such as functional magnetic resonance imaging and functional near-infrared spectroscopy (fNIRS), have shown promising results to assess neuronal function in response to nociception and pain. Recent studies suggest that neuroimaging in conjunction with machine learning models can be used to predict different cognitive tasks. The aim of this study is to expand previous studies by exploring the classification of fNIRS signals (oxyhaemoglobin) according to temperature level (cold and hot) and corresponding pain intensity (low and high) using machine learning models. Toward this aim, we used the quantitative sensory testing to determine pain threshold and pain tolerance to cold and heat in 18 healthy subjects (three females), mean age±standard deviation (31.9±5.5). The classification model is based on the bag-of-words approach, a histogram representation used in document classification based on the frequencies of extracted words and adapted for time series; two learning algorithms were used separately, K-nearest neighbor (K-NN) and support vector machines (SVM). A comparison between two sets of fNIRS channels was also made in the classification task, all 24 channels and 8 channels from the somatosensory region defined as our region of interest (RoI). The results showed that K-NN obtained slightly better results (92.08%) than SVM (91.25%) using the 24 channels; however, the performance slightly dropped using only channels from the RoI with K-NN (91.53%) and SVM (90.83%). These results indicate potential applications of fNIRS in the development of a physiologically based diagnosis of human pain that would benefit vulnerable patients who cannot self-report pain.

Multi-Level Assessment of Fracture Calluses in Rats Subjected to Low-Magnitude High-Frequency Vibration with Different Rest Periods.

The aim of this study was to investigate the influences of low-magnitude high-frequency vibration (LMHFV) with different rest period regimes (vibrational loading per day [with or without the loading divided into bouts]; or vibrational loading for 7 day followed by 7 day rest [with or without the loading divided into bouts]) on bone healing at multi-levels. Transverse fractures of rat bilateral tibias were established using a Kirschner wire inserted for fixation. The animals were randomly assigned to five groups (n = 7 for each group): four for vibrational groups by LMHFV with different rest period regimes and one for fractured model without mechanical loading. The macromechanical properties of the fractured tibias and the nanomechanical properties of the calluses were investigated through three-point bending and nanoindentation tests, respectively. Atomic force microscopy (AFM) was performed to analyze the nanostructure of the calluses. Micro-computed tomography (micro-CT) scanning was conducted to evaluate the microarchitecture of the calluses. The serum concentration of osteocalcin (OG) and tartrate-resistant acid phosphatase 5b (TRAP5b) were measured to assess the bone formation and resorption rates, respectively. Significantly higher values of failure load and elastic modulus were observed in DL (vibrational loading for 15 min per day) and DLR (vibrational loading per day in which three bouts of 5 min of vibration were separated by 4 h) than FBC (fractured model without mechanical loading) at macro-level (P < 0.05). The results of nanoindentation test showed the highest values of indentation modulus and hardness in DLR (significantly higher than FBC; P < 0.05); besides, higher value of hardness was also observed in DL (significantly higher than FBC; P < 0.05). Though AFM imaging showed no significant differences in grain sizes between the vibrational groups and FBC, roughness of DLR showed the highest value, i.e. it was significantly higher than that in FBC (P < 0.05). For microarchitectural parameters obtained from micro-CT imaging, tissue mineral density (TMD) of DLR and VL7 (vibrational loading for 7 day followed by a 7-day rest, 15 min per day during vibrational periods) were significantly higher than that in FBC (P < 0.05), but no significant differences in other parameters were observed between vibrational groups and FBC. There were no significant differences of OG between vibrational groups and FBC; however, FBC showed significantly higher TRAP5b concentration than all vibrational groups (P < 0.05). The results show that LMHFV with different rest period regimes not only altered the macro- and nano-level bone mechanical properties but also influenced the TMD of calluses and nano-level spatial arrangement (roughness) significantly. The most significant effect of LMHFV with different rest period regimes was observed in DLR, which indicated that both osteogenic accumulation and cellular resensitization can be satisfied under this regimen. Hence, the DLR group demonstrated a great potential in clinical applications.

In vitro assessment of the bioaccessibility of fatty acids and tocopherol from soybean oil body emulsions stabilized with ι-carrageenan.

The present investigation aimed to expand the knowledge of the in vitro bioaccessibility of fatty acids and tocopherol from natural soybean oil body emulsions stabilized with different concentrations of ι-carrageenan. Several physicochemical parameters including proteolysis of the interfacial layer, interfacial composition, and microstructure were evaluated with regard to their impact on the bioaccessibility of fatty acids and tocopherol. Results from simulated human digestion in vitro indicated that the bioaccessibility of total fatty acids and tocopherol decreased (62.7-8.3 and 59.7-19.4%, respectively) with the increasing concentration of ι-carrageenan. During the in vitro digestion procedure, ι-carrageenan affected physicochemical properties of the emulsions, thereby controlling the release of fatty acids and tocopherol. These results suggested that soybean oil body emulsions stabilized with ι-carrageenan could provide natural emulsions in foods that were digested at a relatively slow rate, the important physiological consequence of which might be increasing satiety.

[Research on investing methods and mold cooling methods of the self-made investment for pure titanium castings].

OBJECTIVE: To observe the influence of different investing methods and mold cooling methods on pure titanium castings invested in the self-made investment, and to provide theoretic base for the development for the investment. METHODS: The influence of investing methods (one-step investing method and two-step investing method) on castability and crown fit of titanium castings were investigated, and the influence of cooling methods on reaction layers, mechanical properties and crown fit of titanium castings were investigated. RESULTS: Both the investing methods exhibited good castability, but only the titanium full crowns by one-step investing method showed clinically acceptable fit. Although the quenching group showed thinner reaction layer(100 microm), lower strength and similar elongation rate, the titanium castings by bench cooling showed clinically acceptable full crown fit with 115 microm thick reaction layer as cast. CONCLUSION: The one-step investing method and the bench cooling are recommended for the self-made investment.