Virtual calibration for in vivo measurement of Pb-210 activity in the skull using BOMAB, MIRD, and MIDA phantoms.

The counting efficiency calibration for in vivo measurement is crucial to derive the activity of radionuclides residing inside a monitored subject. Recently, virtual calibration based on computational phantoms has become popular, yet some key questions remain unresolved. Here, we focus on the in vivo measurement of Pb-210 in the skull and systematically examine how virtual calibration compares to those using physical phantoms and how the variety of computational phantoms affects the derived counting efficiency. It is found that the virtually calibrated efficiency based on the MIDA phantom, which characterizes the highest anatomical fidelity, shows reasonable consistency with the experimental counterpart, with a relative bias of approximately 10%. However, in comparison to the case based on the MIDA phantom, those based on the BOMAB and MIRD phantoms show larger deviation, demonstrating underestimations on the counting efficiency by 51% and 42%, respectively. This finding underscores the critical role of computational phantoms in the virtual calibration. This study contributes to the development of techniques for assessing lung cancer risk resulting from chronic radon exposure through in vivo measurement of skeletal Pb-210 activity.

Summary of best evidence for self-management in postoperative osteoporotic fracture patients.

Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors. OBJECTIVE: To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms. METHODS: Based on the "6 S" pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence. RESULTS: Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted. CONCLUSION: The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.

Examining the factors influencing postpartum musculoskeletal pain: a thorough analysis of risk factors and pain assessment indices.

BACKGROUND: Musculoskeletal disorders after childbirth are common, but current studies often have a narrow focus, concentrating on particular areas and neglecting a thorough evaluation of pain locations and overall severity. This research aimed to determine the occurrence, spread, severity, and root causes of musculoskeletal discomfort in females during the 6-8 week period after giving birth, focusing on investigating the link between pain and posture. METHODS: This study collected data from 432 postpartum women, 6-8 weeks post-delivery, focusing on ten posture angles captured photographically and analysed using Exbody software. Participants also filled out structured questionnaires on pregnancy history, the Short Form McGill Pain Questionnaire (SF-MPQ) scores, physical activity patterns, and involvement in household and neonatal care tasks. RESULTS: In our research, 49.8% of the respondents experienced pain after childbirth in different regions of their bodies. Utilising SF-MPQ, the mean Pain Rating Index was 7.35 (SD = 5.93) and Present Pain Intensity and Visual Analog Scale was 3.13 (SD = 2.09). Among the evaluated postural angles, only the Q-angle exhibited a noteworthy correlation with knee discomfort. Individuals with less involvement in household and newborn care tasks had a significantly lower occurrence of postpartum pain, with a decrease of 76% (OR = 0.243, p = 0.001). Similarly, those who shared these responsibilities had a 53% decreased likelihood (OR = 0.468, p = 0.008) of experiencing postpartum pain. CONCLUSION: Many postpartum women experience moderate-intensity pain in various body regions. Pain's correlation with posture was limited. Reducing physical strain during infant care notably decreased postpartum pain, underscoring the need for holistic support for postpartum women.

Evolution and interaction relationship of "eco-economy" dual grid pattern in Lingwu City, Ningxia, China.

Strengthening ecological network construction is an important measure to improve urban ecological environment and protect biodiversity. With Lingwu City of Ningxia as an example, based on remote sensing and social and economic data, we comprehensively analyzed the "double network" (ecological network and social and economic landscape) pattern and their relationship by using morphological spatial pattern analysis, Linkage Mapper, and improved gravity model. The results showed that land use/cover changed dramatically from 2000 to 2020 in Lingwu City. The area of sandy land and grassland decreased sharply, that of forest and construction land increased, and industrial zones expanded rapidly. The connectivity and stability of "dual network" were improved. The intensive areas of human activities were distributed in urban area, oasis agricultural areas, and Ningdong energy industrial zone. The ecological source areas and ecological corridors were mainly distributed in the middle of the nature reserve, while some extended to the other three functional areas. The transportation corridor presented an "H" pattern that was dense in oasis agricultural area and Ningdong energy industrial zone, and connected between the two regions. The "double network" were centered around their respective functional area spaces and had interwoven distributions. The trend of the "double network" changed from conflict to coordinated situation, with obvious zoning and interaction in space. The oasis agricultural area and Ningdong energy industrial area destroyed the eco-logy in the early stage and improved that in the later stage. In the future, it is necessary to strengthen the coordination between ecological protection and social and economic development, which could improve ecological quality by combining measures such as improving the quality of ecological sources and corridors, constructing ecological nodes, and repairing ecological disturbance points.

A Review of Recent Advances in Vital Signals Monitoring of Sports and Health via Flexible Wearable Sensors.

In recent years, vital signals monitoring in sports and health have been considered the research focus in the field of wearable sensing technologies. Typical signals include bioelectrical signals, biophysical signals, and biochemical signals, which have applications in the fields of athletic training, medical diagnosis and prevention, and rehabilitation. In particular, since the COVID-19 pandemic, there has been a dramatic increase in real-time interest in personal health. This has created an urgent need for flexible, wearable, portable, and real-time monitoring sensors to remotely monitor these signals in response to health management. To this end, the paper reviews recent advances in flexible wearable sensors for monitoring vital signals in sports and health. More precisely, emerging wearable devices and systems for health and exercise-related vital signals (e.g., ECG, EEG, EMG, inertia, body movements, heart rate, blood, sweat, and interstitial fluid) are reviewed first. Then, the paper creatively presents multidimensional and multimodal wearable sensors and systems. The paper also summarizes the current challenges and limitations and future directions of wearable sensors for vital typical signal detection. Through the review, the paper finds that these signals can be effectively monitored and used for health management (e.g., disease prediction) thanks to advanced manufacturing, flexible electronics, IoT, and artificial intelligence algorithms; however, wearable sensors and systems with multidimensional and multimodal are more compliant.

Emerging and Legacy Per- and Polyfluoroalkyl Substances in an Elderly Population in Jinan, China: The Exposure Level, Short-Term Variation, and Intake Assessment.

Human exposure to per- and polyfluoroalkyl substances (PFASs) has gained worldwide attention due to their widespread presence in the environment and adverse health effects, but the exposure assessment in the elderly is still lacking. This study aimed to assess exposures to 3 emerging PFASs (chlorinated polyfluoroalkyl ether sulfonic acids, Cl-PFESAs) and 15 legacy PFASs. The temporal variability of internal exposures and intake amounts of these PFASs were evaluated among a population of 76 healthy elderly adults (age: 60-69) in Jinan, China over 5 consecutive months. Fifteen PFASs were detected in whole blood with the mean total concentration (ΣPFAS) at 20.1 ng/mL (range: 5.0-135.9 ng/mL) dominated by perfluorooctanoic acid (PFOA) (9.0 ng/mL), perfluorooctanesulfonic acid (PFOS) (5.3 ng/mL), and 6:2 Cl-PFESA (1.6 ng/mL). Across the 5 month assessment period, significant variation was only observed for short-chain (C4-C7) perfluoroalkyl carboxylic acids, and their variations ranged from 53 to 334%. The median intake of PFOA and PFOS was estimated to be 1.46 and 0.92 ng/kg bw/day, respectively. Regression analysis showed that dietary ingestion, especially fish, was likely an important exposure pathway for PFASs among the elderly adults. Various pathways (e.g., dietary, water, air, and dust) should thus be considered to fully understand human exposure to PFASs.

COVID-19 distributes socially in China: A Bayesian spatial analysis.

PURPOSE: The ongoing coronavirus disease 2019 (COVID-19) epidemic increasingly threatens the public health security worldwide. We aimed to identify high-risk areas of COVID-19 and understand how socioeconomic factors are associated with the spatial distribution of COVID-19 in China, which may help other countries control the epidemic. METHODS: We analyzed the data of COVID-19 cases from 30 provinces in mainland China (outside of Hubei) from 16 January 2020 to 31 March 2020, considering the data of demographic, economic, health, and transportation factors. Global autocorrelation analysis and Bayesian spatial models were used to present the spatial pattern of COVID-19 and explore the relationship between COVID-19 risk and various factors. RESULTS: Global Moran's I statistics of COVID-19 incidences was 0.31 (P<0.05). The areas with a high risk of COVID-19 were mainly located in the provinces around Hubei and the provinces with a high level of economic development. The relative risk of two socioeconomic factors, the per capita consumption expenditure of households and the proportion of the migrating population from Hubei, were 1.887 [95% confidence interval (CI): 1.469~2.399] and 1.099 (95% CI: 1.053~1.148), respectively. The two factors explained up to 78.2% out of 99.7% of structured spatial variations. CONCLUSION: Our results suggested that COVID-19 risk was positively associated with the level of economic development and population movements. Blocking population movement and reducing local exposures are effective in preventing the local transmission of COVID-19.

Cost-Effectiveness of Conbercept vs. Ranibizumab for Age-Related Macular Degeneration, Diabetic Macular Edema, and Pathological Myopia: Population-Based Cohort Study and Markov Model.

Background: With the advent of aging society of China, fundus diseases related to pathological neovascularization, including age-related macular degeneration (AMD), diabetic macular edema (DME), and pathological myopia (PM), have become an increasingly serious medical and health problems. As effective drugs of the treatment, conbercept and ranibizumab have been commonly used and covered by the national basic medical insurance in China. However, the pharmacoeconomic evaluation of conbercept vs. ranibizumab for DME and PM remains lacking. This study would assess the cost-effectiveness of conbercept and ranibizumab for the treatment of AMD, DME, and PM from the perspective of Chinese payers. Methods: A Markov chain model was constructed based on the visual conditions of the patient indicated by the number of letters in best corrected visual acuity (BCVA). We conducted models based on real-world scenario to calculate the cost per the quality-adjusted life-year (QALY) gained. A 1-year cycle length and a 10-year simulation treatment were applied and the number of injections of conbercept and ranibizumab was assumed to the average number within 10 years. Transition probabilities, costs, utility data, and other parameters were obtained from literature searches. A 3.5% discounting rate was applied for both the costs and utilities. Results: The incremental cost-effectiveness ratios (ICERs) were more favorable for conbercept than ranibizumab in treatment of AMD, DME, and PM, with associated ICER of 66,669 renminbi (RMB), -258,813 RMB, and -373,185 RMB per QALY gained. Compared with ranibizumab, the incremental effectiveness of conbercept in treatment of AMD, DME, and PM was -0.665 QALYs, 0.215 QALYs, and 0.029 QALYs, respectively. The sensitivity analysis showed the same findings, although the ICER is sensitive to the costs of this program. Conclusion: Under the current Chinese healthcare setting, conbercept is suitable and cost-effective in treatment of AMD, DME, and PM compared with ranibizumab.

Comorbid Depressive and Anxiety Symptoms and Their Correlates Among 93,078 Multiethnic Adults in Southwest China.

Background: Depressive symptoms and anxiety symptoms commonly coexist and severely increases the disease burden worldwide. Little is known about the patterns and correlates of comorbid depressive and anxiety symptoms among the multiethnic populations of China. Methods: This population-based study investigated the comprehensive associations of comorbid depressive and anxiety symptoms with lifestyles, stressful life events, chronic diseases, and physical and mental well-being among 93,078 participants (37,193 men, 55,885 women) aged 30-79 years across seven ethnic groups in Southwest China. Multivariable logistic regression models were used to estimate associations. Results: Overall, 2.9% (2.1% in men and 3.5% in women) participants had comorbid depressive and anxiety symptoms; there was considerable heterogeneity among multiethnic populations. Participants with chronic diseases were more likely to have comorbidity than those without them; people with rheumatic heart disease reported the highest risk, with an odds ratio (OR) of 6.25 and 95% confidence interval (CI) of 4.06-9.62. Having experienced 3 or more stressful life events (OR, 8.43, 95% CI: 7.27-9.77), very poor self-rated health status (OR, 33.60, 95%CI: 25.16-44.87), and very unsatisfied life (OR, 33.30, 95% CI: 23.73-46.74) had strong positive associations with comorbid depressive symptoms and anxiety symptoms, with a dose-response relationship (P < 0.05). High frequency of physical activity had negative associations. All the associations were stronger than depressive symptoms alone or anxiety symptoms alone. Conclusions: Our findings emphasize the need to focus on the vulnerable ethnic groups with comorbid depressive and anxiety symptoms, ultimate for help early prevention and improvement of health equity in the underdevelopment and high urbanization areas.

Disclosing the future food security risk of China based on crop production and water scarcity under diverse socioeconomic and climate scenarios.

Climate change and human development may lead to a serious crisis in food security in China, especially in areas with both water shortages and large grain production. Thus, the quantitative evaluation of future food security risk considering water scarcity is increasingly important. Here, we combined water scarcity and crop production data under different scenarios of representative concentration pathways (RCPs) and shared socioeconomic pathways (SSPs), incorporating demographic, food habit and water resource factors, to develop a new framework for measuring China's food security risk. The results show that the water scarcity and crop production-water crisis (CPWC) of China would both be aggravated during the 21st century. In particular, northern China might face more serious water scarcity than southern China and has a higher contribution rate to the national crop production-water crisis. Food scarcity in China might occur at some point in the 21st century under all SSP scenarios, except SSP1 (sustainability development pathway). The next 40 years could be the most critical period for ensuring China's food security. Moreover, by comparing the RCP2.6 and RCP6.0 scenarios, we also find that higher food production does not represent lower food security risk. The food security risk of the RCP26 scenario with higher food production was significantly higher than that of the RCP6.0 scenario at the same SSP because higher grain production comes from water shortage areas. From the perspective of societal development scenarios, SSP1 provided better results for both the risk of food security and water security in the 21st century. Our findings therefore provide useful information for a comprehensive understanding of long-term food security and water security of China.

The accuracy of the pediatric assessment triangle in assessing triage of critically ill patients in emergency pediatric department.

BACKGROUND: The Pediatric Assessment Triangle (PAT) is a rapid evaluation tool that establishes a child's clinical status and his or her category of illness in order to direct initial management priorities. However, only few studies have examined its accuracy in assessing triage of critically ill patients in the emergency pediatric department (EPD) in China. OBJECTIVE: To quantitatively validate the accuracy in assessing critically ill medical children and nurses' acceptance of PAT in the EPD. METHODS: This is a prospective observational study performed at The First People's Hospital of Kunshan from January to May 2019. Ill children arriving to the EPD were assessed by trained nurses with the PAT and Pediatric early warning score (PEWS) at the same time. The five-level triage system used as the gold standard for comparing the accuracy of PAT was tracked following the triage. PEWS was compared with PAT in terms of assessment time and the degree of nurse' acceptance. RESULTS: A total of 1608 subjects were included in this study, of whom 74 were critically ill. The AUROCC to screen out the critical children evaluated by PAT was 0.963. When the cut-off value of PAT score was 1, its sensitivity, specificity, PPV and NPV were 93.24%, 99.15%, 84.15% and 99.67%, respectively. The maximum value of the YI of PAT scored with 1 was 0.924. For the different categories of diseases, PAT had a better performance in assessing non-respiratory critical diseases (vs. respiratory critical diseases), with values of AUROCC of 0.986 vs 0.930, YI of 0.969 vs 0.858, respectively. For the different age of sick children, PAT had a better performance in assessing critical diseases in children aged 1 to 36 months (vs. 3 to 14 years), with values of AUROCC of 0.978 and 0.899, YI of 0.952 and 0.797, respectively. The assessment time of PAT was 13.81 ± 6.41 s, while PEWS score was 37.24 ± 10.29 s (t = 17.27, p < 0.001). The VAS scores of nurses' acceptance of PAT and PEWS were 9.27 ± 0.87 and 8.57 ± 1.52, respectively. CONCLUSIONS: PAT can be used as a rapid and effective assessment tool in emergency triage in China. When a child's PAT score is 1 or more, the child's condition is critical and priority treatment should be arranged.

[Spatial Distribution Pattern and Influencing Factors of Industrial Pollution Emissions in Yangtze River Economic Belt].

The development of Yangtze River economic belt emphasizes the strategy of "no large-scale development, joint efforts in large-scale protection". The restoration of the Yangtze River environment has become an important part of the development of the region. Therefore, it is important to explore the spatial distribution of industrial pollution emissions and its influencing factors in the Yangtze River economic belt. Using industrial SO2, wastewater, and soot emission data from 102 cities in the Yangtze River economic belt, from 2013 to 2017, this study analyzes the spatial distribution of industrial pollution emissions in the Yangtze River economic belt. This was achieved using spatial autocorrelation analysis and Getis-Ord Gi* methods, and by adopting the logarithmic mean Divisia index model to decompose the influencing factors of industrial pollution emissions in the Yangtze River economic belt. The results show that from 2013 to 2017, the emissions of industrial SO2, wastewater, and soot in the Yangtze River economic belt exhibited a downward trend, with a decrease in the number of high-emission cities and an increase in the number of low-emission cities. The spatial correlation of industrial pollutants increased with time, and technological improvements had the most significant inhibitory effect, making it the most important factor affecting industrial pollution emissions in the Yangtze River economic belt.

Microfluidic Assessment of Drug Effects on Physical Properties of Androgen Sensitive and Non-Sensitive Prostate Cancer Cells.

The identification and treatment of androgen-independent prostate cancer are both challenging and significant. In this work, high-throughput deformability cytometry was employed to assess the effects of two anti-cancer drugs, docetaxel and enzalutamide, on androgen-sensitive prostate cancer cells (LNCaP) and androgen-independent prostate cancer cells (PC-3), respectively. The quantified results show that PC-3 and LNCaP present not only different intrinsic physical properties but also different physical responses to the same anti-cancer drug. PC-3 cells possess greater stiffness and a smaller size than LNCaP cells. As the docetaxel concentration increases, PC-3 cells present an increase in stiffness and size, but LNCaP cells only present an increase in stiffness. As the enzalutamide concentration increases, PC-3 cells present no physical changes but LNCaP cells present changes in both cell size and deformation. These results demonstrated that cellular physical properties quantified by the deformability cytometry are effective indicators for identifying the androgen-independent prostate cancer cells from androgen-sensitive prostate cancer cells and evaluating drug effects on these two types of prostate cancer.

Distribution behavior and risk assessment of emerging perfluoroalkyl acids in multiple environmental media at Luoma Lake, East China.

Perfluoroalkyl acids (PFAAs) are ubiquitous in various environments. This has caused great public concern, particularly in the shallow freshwater lake region, where the lake, rivers, and estuaries form a highly interconnected continuum. However, little is known about the environmental behaviors of PFAAs in the continuum. For the first time, a high-resolution monitoring framework covering the river-estuary-lake continuum of Luoma Lake was built, and the concentrations, sources, and environmental fates of PFAAs were identified and analyzed. The results revealed that the total concentration of PFAAs was at a moderate level in the water and at a high level in the sediment compared to global levels respectively. Perfluorooctanesulfonate (PFOS) was the most abundant PFAA in the continuum. In particular, the ∑PFAA concentration in the particle phase was much higher than that in the sediment phase. Distinct spatial heterogeneities were observed in the behaviors of distribution and the multiphase fate of PFAAs in the continuum, mainly driven by the turbulent mixing during transport, dilution of lake water, and spatial differences of hydrodynamic features and sedimentary properties among the sub-regions. Interestingly, the pH of the sediment and water had significant effects on the water-sediment portioning of PFAAs in contrasting ways. Furthermore, based on the composition of the sediments, four possible migration paths for PFAAs were deduced and the main sources of PFAAs were identified as sewage, domestic, and industrial effluents using the positive matrix factorization model. During the human health assessment, no risk was found under the median exposure scenario; however, under the high exposure scenario, PFAAs posed uncertain risks to human health, which cannot be ignored. This study provides basic information for simulating the fate and transport of PFAAs in the continuum and is significant for developing cost-effective control and remediation strategies in the near future.

High-Quality Genome Resource of the Pathogen of Diaporthe (Phomopsis) phragmitis Causing Kiwifruit Soft Rot.

Diaporthe spp. are critical plant pathogens that cause wood cankers, wilt, dieback, and fruit rot in a wide variety of economic plant hosts and are regarded as one of the most acute threats faced by the kiwifruit industry worldwide. Diaporthe phragmitis NJD1 is a highly pathogenic isolate of soft rot of kiwifruit. Here, we present a high-quality genome-wide sequence of D. phragmitis NJD1 that was assembled into 28 contigs containing a total size of 58.33 Mb and N50 length of 3.55 Mb. These results lay a solid foundation for understanding host-pathogen interaction and improving disease management strategies.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

First line nucleos(t)ide analog monotherapy is more cost-effective than combination strategies in hepatitis B e antigen-positive chronic hepatitis B patients in China.

BACKGROUND: Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed "functional cure," based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective. METHODS: A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively. RESULTS: In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA - PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results. CONCLUSION: Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

Assessment of a new arbidol derivative against herpes simplex virus II in human cervical epithelial cells and in BALB/c mice.

As one of the highly contagious forms, herpes simplex virus type 2 (HSV-2) commonly caused severe genital diseases and closely referred to the HIV infection. The lack of effective vaccines and drug-resistance proclaimed the preoccupation for alternative antiviral agents against HSV-2. Molecules bearing indole nucleus presented diverse biological properties involving antiviral and anti-inflammatory activities. In this study, one of the indole molecules, arbidol derivative (ARD) was designed and synthesized prior to the evaluation of its anti-HSV-2 activity. Our data showed that the ARD effectively suppressed HSV-2-induced cytopathic effects and the generation of progeny virus, with 50% effective concentrations of 3.386 and 1.717 µg/mL, respectively. The results of the time-course assay suggested that the ARD operated in a dual antiviral way by interfering virus entry and impairing the earlier period of viral cycle during viral DNA synthesis. The ARD-mediated HSV-2 inhibition was partially attained by blocking NF-κB pathways and down-regulating the expressions of several inflammatory cytokines. Furthermore, in vivo studies showed that oral administration of ARD protected BALB/c mice from intravaginal HSV-2 challenge by alleviating serious vulval lesions and histopathological changes in the target organs. Besides, the treatment with ARD also made the levels of viral protein, NF-κB protein and inflammatory cytokines lower, in consistent with the in-vitro studies. Collectively, ARD unveiled therapeutic potential for the prevention and treatment of HSV-2 infections.

Improving people's access to community-based back pain treatment through an inclusive design approach.

Back pain is a very common health problem and affects people across the world. This study applies an Inclusive Design approach to a community-based back pain service to understand the challenges, in relation to patients' capabilities, that can affect their access to the service. It consisted of three steps: i) online surveys and interviews with physiotherapists and collected patients' personal online care stories to gather insight into their experiences within the back pain care journeys; ii) estimated services' demands made on patients when they access the service and identified the related challenges and iii) proposed recommendations that could address the challenges for patients to access the service. The study suggests an Inclusive Design approach could help identify capability-related challenges such as vision and memory which could affect people's access to back pain treatment. In addition, the application of the approach also uncovered some non-capability-related challenges.

Environmental legacy and catchment erosion modulate sediment records of trace metals in alpine lakes of southwest China.

Sediment records are widely used to infer impact of atmospheric metal deposition in alpine lakes, however, the legacy effect and catchment erosion of historical pollutants could potentially affect metal influx into lakes. Here, we collect data (including six trace metals and three lithogenic elements) from well-dated sediment cores of seven alpine lakes in southeast Tibet, which is adjacent to southwest China. This area has a documented history of preindustrial pollution. Metals such as cadmium (Cd), zinc (Zn) and arsenic (As) are found at relatively low concentrations until a clear increase is observed after 1950s across lakes. This result is consistent with accelerating atmospheric metal deposition due to socio-economic development in the region. We observe no synchronous trend across lakes in the changes of lead (Pb), copper (Cu) and silver (Ag), which show no significant increase after ∼1950 over the last two centuries in most of the study lakes. The historical trends of 206Pb/207Pb ratio reflect an important source of anthropogenic Pb associated with preindustrial mining and smelting in this study region, suggesting a substantial impact of legacy contamination from ancient mines. Furthermore, the temporal variations in these six anthropogenic metals are largely accounted for by terrigenous elements (e.g. aluminum (Al) and titanium (Ti)) in most of the study lakes, and to a lesser degree by sediment grain sizes and organic matter content, suggesting a significant role of catchment erosion in modulating sediment metal signals. In all, this study highlights the legacy effect of historical pollutants may have enhanced the forcing of catchment erosion in modulating the sediment signals of anthropogenic deposition in southeast Tibet.

Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin.

OBJECTIVE: This study aimed to identify the local levels of vulnerability among patients with Type-II diabetes (T2DM) in Tianjin. The study was aimed at curbing the rise of T2DM in cities. METHODS: 229 participants living with T2DM were purposively sampled from hospitals in Tianjin. Collected data were coded and analysed following well-established thematic analysis principles. RESULTS: Twelve themes involving 29 factors were associated with diabetes patients' vulnerability: 1. Financial constraints (Low Income, Unemployment, No Medical Insurance/Low ratio reimbursement); 2. Severity of disease (Appearance of symptoms, complications, co-morbidities, high BMI, poor disease control); 3. Health literacy (No/Low/Wrong knowledge of health literacy); 4. Health beliefs (Perceived diabetes indifferently, Passively Acquire Health Knowledge, Distrust of primary health services); 5. Medical environment (Needs not met by Medical Services); 6. Life restrictions (Daily Life, Occupational Restriction); 7. Lifestyle change (Adhering to traditional or unhealthy diet, Lack of exercise, Low-quality sleep); 8. Time poverty (Healthcare-seeking behaviours were limited by work, Healthcare-seeking behaviours were limited by family issues); 9. Mental Condition (Negative emotions towards diabetes, Negative emotions towards life); 10. Levels of Support (Lack of community support, Lack of support from Friends and Family, Lack of Social Support); 11. Social integration (Low Degree of Integration, Belief in Suffering Alone); 12. Experience of transitions (Diet, Dwelling Environment). CONCLUSION: Based on our findings, specific interventions targeting individual patients, family, community and society are needed to improve diabetes control, as well as patients' mental health care and general living conditions.