Quality control, safety assessment and preparation approaches of low molecular weight heparin.

Low Molecular Weight Heparins (LMWHs) are well-established for use in the prevention and treatment of thrombotic diseases, and as a substitute for unfractionated heparin (UFH) due to their predictable pharmacokinetics and subcutaneous bioavailability. LMWHs are produced by various depolymerization methods from UFH, resulting in heterogeneous compounds with similar biochemical and pharmacological properties. However, the delicate supply chain of UFH and potential contamination from animal sources require new manufacturing approaches for LMWHs. Various LMWH preparation methods are emerging, such as chemical synthesis, enzymatic or chemical depolymerization and chemoenzymatic synthesis. To establish the sameness of active ingredients in both innovator and generic LMWH products, the Food and Drug Administration has implemented a stringent scientific method of equivalence based on physicochemical properties, heparin source material and depolymerization techniques, disaccharide composition and oligosaccharide mapping, biological and biochemical properties, and in vivo pharmacodynamic profiles. In this review, we discuss currently available LMWHs, potential manufacturing methods, and recent progress for manufacturing quality control of these LMWHs.

Zinc Oxide Nanoparticles Alleviate Salt Stress in Cotton (Gossypium hirsutum L.) by Adjusting Na+/K+ Ratio and Antioxidative Ability.

Soil salinization poses a threat to the sustainability of agricultural production and has become a global issue. Cotton is an important cash crop and plays an important role in economic development. Salt stress has been harming the yield and quality of many crops, including cotton, for many years. In recent years, soil salinization has been increasing. It is crucial to study the mechanism of cotton salt tolerance and explore diversified materials and methods to alleviate the salt stress of cotton for the development of the cotton industry. Nanoparticles (NPs) are an effective means to alleviate salt stress. In this study, zinc oxide NPs (ZnO NPs) were sprayed on cotton leaves with the aim of investigating the intrinsic mechanism of NPs to alleviate salt stress in cotton. The results show that the foliar spraying of ZnO NPs significantly alleviated the negative effects of salt stress on hydroponic cotton seedlings, including the improvement of above-ground and root dry and fresh weight, leaf area, seedling height, and stem diameter. In addition, ZnO NPs can significantly improve the salt-induced oxidative stress by reducing the levels of MDA, H2O2, and O2- and increasing the activities of major antioxidant enzymes, such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT). Furthermore, RNA-seq showed that the foliar spraying of ZnO NPs could induce the expressions of CNGC, NHX2, AHA3, HAK17, and other genes, and reduce the expression of SKOR, combined with the CBL-CIPK pathway, which alleviated the toxic effect of excessive Na+ and reduced the loss of excessive K+ so that the Na+/K+ ratio was stabilized. In summary, our results indicate that the foliar application of ZnO NPs can alleviate high salt stress in cotton by adjusting the Na+/K+ ratio and regulating antioxidative ability. This provides a new strategy for alleviating the salt stress of cotton and other crops, which is conducive to the development of agriculture.

Robust Representation Learning for Power System Short-Term Voltage Stability Assessment Under Diverse Data Loss Conditions.

With the help of neural network-based representation learning, significant progress has been recently made in data-driven online dynamic stability assessment (DSA) of complex electric power systems. However, without sufficient attention to diverse data loss conditions in practice, the existing data-driven DSA solutions' performance could be largely degraded due to practical defective input data. To address this problem, this work develops a robust representation learning approach to enhance DSA performance against multiple input data loss conditions in practice. Specifically, focusing on the short-term voltage stability (SVS) issue, an ensemble representation learning scheme (ERLS) is carefully designed to achieve data loss-tolerant online SVS assessment: 1) based on an efficient data masking technique, various missing data conditions are handled and augmented in a unified manner for lossy learning dataset preparation; 2) the emerging spatial-temporal graph convolutional network (STGCN) is leveraged to derive multiple diversified base learners with strong capability in SVS feature learning and representation; and 3) with massive SVS scenarios deeply grouped into a number of clusters, these STGCN-enabled base learners are distinctly assembled for each cluster via multilinear regression (MLR) to realize ensemble SVS assessment. Such a divide-and-conquer ensemble strategy results in highly robust SVS assessment performance when faced with various severe data loss conditions. Numerical tests on the benchmark Nordic test system illustrate the efficacy of the proposed approach.

Optimizing the fuel economy of hydrostatic power-split system in continuously variable tractor transmission.

The aim of this study is to enhance the fuel economy of a continuously variable tractor transmission by analyzing its energy and fuel consumption. First, we present the principle of a self-developed tractor transmission based on power splitting and examine its parasitic power characteristics. Next, we construct a mathematical model of the hydraulic system, mechanical system, and entire transmission, calibrating the model to ensure the accuracy of subsequent results. We then perform a systematic analysis of the energy and fuel consumption of the tractor transmission. Finally, we optimize the transmission through design and power matching, investigating the impact of changes in parameters and control strategies on the fuel economy of the transmission. The results indicate that fuel consumption can be reduced by 2%-14% through parameter optimization and by an additional 0%-20% through appropriate power matching.

Investigation on stability and controller design for singular bio-economic systems with stochastic fluctuations.

In this paper, the finite-time stability and control of a kind of singular bio-economic systems with stochastic fluctuations are investigated. When economic profit is no longer a constant but a variable, the system shows distinct dynamic behavior. First, a singular system is proposed to describe the bio-economic system with stochastic fluctuation. Then a singular stochastic T-S fuzzy model is established based on T-S fuzzy system theory. Second, a sufficient condition is proposed to satisfy finite-time stochastic stability of bio-economic system. On this basis, a fuzzy state feedback controller is designed which can make corresponding closed-loop singular stochastic bio-economic system admissible in finite-time, and the states of the system can be driven to a bounded range through the management of the open resource. Finally, the validity of the results is verified through the numerical simulation.

Modality alignment contrastive learning for severity assessment of COVID-19 from lung ultrasound and clinical information.

The outbreak of COVID-19 around the world has caused great pressure to the health care system, and many efforts have been devoted to artificial intelligence (AI)-based analysis of CT and chest X-ray images to help alleviate the shortage of radiologists and improve the diagnosis efficiency. However, only a few works focus on AI-based lung ultrasound (LUS) analysis in spite of its significant role in COVID-19. In this work, we aim to propose a novel method for severity assessment of COVID-19 patients from LUS and clinical information. Great challenges exist regarding the heterogeneous data, multi-modality information, and highly nonlinear mapping. To overcome these challenges, we first propose a dual-level supervised multiple instance learning module (DSA-MIL) to effectively combine the zone-level representations into patient-level representations. Then a novel modality alignment contrastive learning module (MA-CLR) is presented to combine representations of the two modalities, LUS and clinical information, by matching the two spaces while keeping the discriminative features. To train the nonlinear mapping, a staged representation transfer (SRT) strategy is introduced to maximumly leverage the semantic and discriminative information from the training data. We trained the model with LUS data of 233 patients, and validated it with 80 patients. Our method can effectively combine the two modalities and achieve accuracy of 75.0% for 4-level patient severity assessment, and 87.5% for the binary severe/non-severe identification. Besides, our method also provides interpretation of the severity assessment by grading each of the lung zone (with accuracy of 85.28%) and identifying the pathological patterns of each lung zone. Our method has a great potential in real clinical practice for COVID-19 patients, especially for pregnant women and children, in aspects of progress monitoring, prognosis stratification, and patient management.

Determination and Safety Assessment of Residual Spirotetramat and Its Metabolites in Amaranth (Amaranthus tricolor) and Soil by Liquid Chromatography Triple-Quadrupole Tandem Mass Spectrometry.

With the purpose of guaranteeing the safe use of spirotetramat and preventing its potential health threats to consumers, a QuEChERS extraction method coupled with LC triple-quadrupole tandem MS was applied in this study to determine residual spirotetramat metabolites in different tissues of amaranth (Amaranthus tricolor) and in soil. The results indicate that the spirotetramat degraded into different types of metabolites that were located in different tissues of amaranth and in soil. B-keto, B-glu, and B-enol were the three most representative degradation products in the leaf of amaranth, and B-glu and B-enol were the two major degradation products found in the stem of amaranth; however, only B-enol was detected in the root of amaranth. B-keto and B-mono were the two products detected in the soil in which the amaranth grew. The cytotoxicity results demonstrate that spirotetramat and its metabolite B-enol inhibited cellular growth, and the toxicity of spirotetramat and its metabolite B-enol exceeded than that of the metabolites B-keto, B-mono, and B-glu. This investigation is of great significance to the safe use of spirotetramat in agriculture.

A New Approach to Organization and Implementation of Military Medical Treatment in Response to Military Reform and Modern Warfare in the Chinese Army.

BACKGROUND: Recent system reforms within the People's Liberation Army (PLA) have led to establishment of 5 theatre commands and a general joint logistics command. These reforms have presented new challenges to the organization and implementation of medical services. The medical service of the PLA must keep pace with these reforms by applying innovative theories to establish appropriate organizational guidelines and structures. The medical service must also adapt to the modern and future eras of information warfare. METHODS: We review the existing structure and features of the military medical service of the PLA, highlighting issues related to ongoing reform within the PLA and the characteristics of modern and future information warfare. Reflection on current rules for medical evacuation and treatment of war-related injuries were made, and related organizational and structural innovations were proposed. FINDINGS: Recent reforms and the characteristics of modern information warfare have rendered the current medical service and medical evacuation system of the PLA inefficient. The scale of the echelon configuration should be adjusted to establish a more focused, effective, and intelligent medical service. Resource allocation and general joint logistics should be optimized to establish a new well-rounded, three-dimensional medical evacuation system, and the "stabilize before healing" rule should be applied at all levels of the medical service. These changes should help to create a modern, effective, and responsive medical service within the PLA. DISCUSSION: This article explores how the military medical service of the PLA could adapt to system reform in order to implement efficient treatment of war injuries, reduce mortality and morbidity rates, and maintain combat readiness in the modern era of information warfare.

Utility of Real-Time Shear Wave Elastography in the Assessment of Testicular Torsion.

Real-time shear-wave elastography (SWE) is a newly developed method which can obtain the stiffness of tissues and organs based on tracking of shear wave propagation through a structure. Several studies have demonstrated its potential in the differentiation between diseased and normal tissue in clinical practices, however the applicability to testicular disease has not been well elucidated. We investigated the feasibility and reproducibility of SWE in the detection of testicular torsion. This prospective study comprised 15 patients with complete testicular torsion. Results obtained from SWE along with conventional gray-scale and color Doppler sonography and post-operative pathology were compared. The results revealed that (i) the size of injured testis was increased and the twisted testis parenchyma was heterogeneous. The blood flow signals in injured testis were barely visible or absent; (ii) The Young's modulus, including Emean, Emax, Emin and SD values in the border area of torsional testis were higher than those of normal testis (Emean, 78.07±9.01 kPa vs 22.0±5.10 kPa; Emax, 94.07±6.53 kPa vs 27.87±5.78 kPa; Emin, 60.73±7.84 kPa vs 18.90±4.39 kPa; SD, 7.67±0.60 kPa vs 2.30±0.36 kPa, [P<0.05]); The Emax and SD values in the central area of the torsional testis were higher than the corresponding area of the normal testis (Emax, 8.23±0.30 kPa vs 3.97±0.95 kPa; SD, 1.5±0.26 kPa vs 0.67±0.35 kPa,[P<0.05]) and Emin values was lower than those of normal testicles (0.93±0.51 kPa vs 1.6±0.36 kPa; [P<0.05]); (iii) The Young's modulus measurement between two physicians showed good agreement. The pathological findings were accordance with SWE measurement. SWE is a non-invasive, convenient and high reproducible method and may serve as an important alternative tool in the diagnosis and monitoring the progression of the acute scrotums, in additional to conventional Doppler sonography.

Calcium-deficiency assessment and biomarker identification by an integrated urinary metabonomics analysis.

BACKGROUND: Calcium deficiency is a global public-health problem. Although the initial stage of calcium deficiency can lead to metabolic alterations or potential pathological changes, calcium deficiency is difficult to diagnose accurately. Moreover, the details of the molecular mechanism of calcium deficiency remain somewhat elusive. To accurately assess and provide appropriate nutritional intervention, we carried out a global analysis of metabolic alterations in response to calcium deficiency. METHODS: The metabolic alterations associated with calcium deficiency were first investigated in a rat model, using urinary metabonomics based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry and multivariate statistical analysis. Correlations between dietary calcium intake and the biomarkers identified from the rat model were further analyzed to confirm the potential application of these biomarkers in humans. RESULTS: Urinary metabolic-profiling analysis could preliminarily distinguish between calcium-deficient and non-deficient rats after a 2-week low-calcium diet. We established an integrated metabonomics strategy for identifying reliable biomarkers of calcium deficiency using a time-course analysis of discriminating metabolites in a low-calcium diet experiment, repeating the low-calcium diet experiment and performing a calcium-supplement experiment. In total, 27 biomarkers were identified, including glycine, oxoglutaric acid, pyrophosphoric acid, sebacic acid, pseudouridine, indoxyl sulfate, taurine, and phenylacetylglycine. The integrated urinary metabonomics analysis, which combined biomarkers with regular trends of change (types A, B, and C), could accurately assess calcium-deficient rats at different stages and clarify the dynamic pathophysiological changes and molecular mechanism of calcium deficiency in detail. Significant correlations between calcium intake and two biomarkers, pseudouridine (Pearson correlation, r = 0.53, P = 0.0001) and citrate (Pearson correlation, r = -0.43, P = 0.001), were further confirmed in 70 women. CONCLUSIONS: To our knowledge, this is the first report of reliable biomarkers of calcium deficiency, which were identified using an integrated strategy. The identified biomarkers give new insights into the pathophysiological changes and molecular mechanisms of calcium deficiency. The correlations between calcium intake and two of the biomarkers provide a rationale or potential for further assessment and elucidation of the metabolic responses of calcium deficiency in humans.

Spectacle acceptance among secondary school students in rural China: the Xichang Pediatric Refractive Error Study (X-PRES)--report 5.

PURPOSE: To assess determinants of spectacle acceptance and use among rural Chinese children. METHODS: Children with uncorrected acuity < or = 6/12 in either eye and whose presenting vision could be improved > or = 2 lines with refraction were identified from a school-based sample of 1892 students. Information on obtaining glasses and the benefits of spectacles was provided to children, families, and teachers. Purchase of new spectacles and reasons for nonpurchase were assessed by direct inspection and interview 3 months later. RESULTS: Among 674 (35.6%) children requiring spectacles (mean age, 14.7 +/- 0.8 years), 597 (88.6%) were followed up. Among 339 children with no glasses at baseline, 30.7% purchased spectacles, whereas 43.2% of 258 children with inaccurate glasses replaced them. Most (70%) subjects paid US$13 to $26. Among children with bilateral vision < or = 6/18, 45.6% bought glasses. In multivariate models, presenting vision < 6/12 (P < 0.009), refractive error < -2.0 D (P < 0.001), and amount willing to pay for glasses (P = 0.01) were predictors of purchase. Reasons for nonpurchase included satisfaction with current vision (78% of those with glasses at baseline, 49% of those without), concerns over price or parental refusal (18%), and fear glasses would weaken the eyes (13%). Only 26% of children stated that they usually wore their new glasses. CONCLUSIONS: Many families in rural China will pay for glasses, though spectacle acceptance was < 50%, even among children with poor vision. Acceptance could be improved by price reduction, education showing that glasses will not harm the eyes, and parent-focused interventions.

Capillary high performance liquid chromatography coupled with electrospray ionization mass spectrometry for rapid analysis of pinane monoterpene glycosides in Cortex Moutan.

In this study, a rapid and reliable assay has been developed for quantification of pinane monoterpene glycosides in cortex Moutan; it is based on capillary high performance liquid chromatography coupled with electrospray ionization mass spectrometry (capillary HPLC-ESI MS). This method utilizes capillary HPLC for the separation of seven pinane monoterpene glycosides in a methanol extract of the botanical sample followed by negative ion electrospray ionization and single ion monitoring (SIM). The compounds of interest in the sample were unambiguously identified on the basis of information about retention time and quasi-molecular ions ([M-H](-)) or adduct ions ([M+HCOO](-)). Validation parameters of the method were established. The linearity range was 1.01-105.5 microg/mL with the square of correlation coefficients lying in the range of 0.9965-0.9997, limits of detection were on the fmol level, the average recoveries varied between 91.8 and 101.0%, and good precision values (RSD, 1.2-4.91%) for peak area were obtained. After validation, the applicability of the method for determination of these pinane monoterpene glycosides in cortex Moutan has been demonstrated.