Assessment of Dynamic Cerebral Autoregulation During Long-Term Exposure to High Altitude in Normal Subjects by Ultrasonography.

PURPOSE: To evaluate changes in dynamic cerebral autoregulation (CA) during short-term and long-term exposure to high altitude with ultrasonography, and also study the sex differences in the response of CA to altitude. METHODS: We assessed the differences in dynamic CA and measured with Doppler ultrasound of the bilateral internal carotid artery (ICA), vertebral artery (VA), and middle cerebral artery (MCA) and the values of basic information within 48 hours and at 2 years after arrival at Tibet in 65 healthy Han young Chinese volunteers, meanwhile, we compared the resistance index (RI) and pulsatility index (PI) of the right MCA at inhale oxygen 8 minutes when a newcomer with 2 years after arrival at Tibet. RESULTS: With 2 years of altitude exposure, the SaO2 of all subjects was above 90%, the mean PEF, DAP, and HR values decreased, HGB increased compared within 48 hours in same-gender groups. Comparisons of cerebral hemodynamics between before 2 years and after 2 years within male and female groups, the mean RI and PI values of bilateral MCA after 2 years were significantly higher than before 2 years, at the same time, the mean RI and PI values of bilateral ICA were significant differences (P < .05) between male groups, with regard to female groups, showed that the mean RI and PI values of bilateral VA were significant differences (P < .05). Comparisons of Right MCA hemodynamics between after oxygen uptake 8 minutes and 2 years, the mean RI and PI values were no significant difference within male and female groups (P > .05). CONCLUSIONS: Acute mountain sickness could result from an alteration of dynamic autoregulation of cerebral blood flow, but the impaired autoregulation may be corrected with the extension of time, furthermore, the response of CA to altitude in males and females are different.

Clinical and economic comparison of laparoscopic versus open hepatectomy for primary hepatolithiasis: a propensity score-matched cohort study.

BACKGROUND: It is unclear whether laparoscopic hepatectomy (LH) for hepatolithiasis confers better clinical benefit and lower hospital costs than open hepatectomy (OH). This study aim to evaluate the clinical and economic value of LH versus OH. METHODS: Patients undergoing OH or LH for primary hepatolithiasis at Yijishan Hospital of Wannan Medical College between 2015 and 2022 were divided into OH group and LH group. Propensity score matching (PSM) was used to balance the baseline data. Deviation-based cost modelling and weighted average median cost (WAMC) were used to assess and compare the economic value. RESULTS: A total of 853 patients were identified. After exclusions, 403 patients with primary hepatolithiasis underwent anatomical hepatectomy (OH n=143; LH n=260). PSM resulted in 2 groups of 100 patients each. Although LH required a longer median operation duration compared with OH (285.0 versus 240.0 min, respectively, P<0.001), LH patients had fewer wound infections, fewer pre-discharge overall complications (26 versus 43%, respectively, P=0.009), and shorter median postoperative hospital stays (8.0 versus 12.0 days, respectively, P<0.001). No differences were found in blood loss, major complications, stone clearance, and mortality between the two matched groups. However, the median overall hospital cost of LH was significantly higher than that of OH (CNY¥52,196.1 versus 45,349.5, respectively, P=0.007). Although LH patients had shorter median postoperative hospital stays and fewer complications than OH patients, the WAMC was still higher for the LH group than for the OH group with an increase of CNY¥9,755.2 per patient undergoing LH. CONCLUSION: The overall clinical benefit of LH for hepatolithiasis is comparable or even superior to that of OH, but with an economic disadvantage. There is a need to effectively reduce the hospital costs of LH and the gap between costs and diagnosis-related group reimbursement to promote its adoption.

Imaging assessment of conjunctival goblet cells in dry eye disease.

Dry eye disease (DED) is a widespread, multifactorial, and chronic disorder of the ocular surface with disruption of tear film homeostasis as its core trait. Conjunctival goblet cells (CGCs) are specialised secretory cells found in the conjunctival epithelium that participate in tear film formation by secreting mucin. Changes in both the structure and function of CGCs are hallmarks of DED, and imaging assessment of CGCs is important for the diagnosis, classification, and severity evaluation of DED. Existing imaging methods include conjunctival biopsy, conjunctival impression cytology and in vivo confocal microscopy, which can be used to assess the morphology, distribution, and density of the CGCs. Recently, moxifloxacin-based fluorescence microscopy has emerged as a novel technique that enables efficient, non-invasive and in vivo imaging of CGCs. This article presents a comprehensive overview of both the structure and function of CGCs and their alterations in the context of DED, as well as current methods of CGCs imaging assessment. Additionally, potential directions for the visual evaluation of CGCs are discussed.

Genetic and environmental influence on alcohol intent and alcohol sips among U.S. children-Effects across sex, race, and ethnicity.

INTRODUCTION: Alcohol intent (the susceptibility to initiating alcohol use) and alcohol sips (the initiation of alcohol) in youth are a multifactorial puzzle with many components. This research aims to examine the connection between genetic and environmental factors across sex, race and ethnicity. METHODS: Data was obtained from the twin hub of the Adolescent Brain Cognitive Development (ABCD) study at baseline (2016-2018). Variance component models were conducted to dissect the additive genetic (A), common (C) and unique environmental (E) effects on alcohol traits. The proportion of the total alcohol phenotypic variation attributable to additive genetic factors is reported as heritability (h2). RESULTS: The sample (n = 1,772) included an approximately equal male-female distribution. The 886 same-sex twin pairs were 60.4% dizygotic (DZ), 39.6% monozygotic (MZ), 65.4% non-Hispanic Whites, 13.9% non-Hispanic Blacks, 10.8% of Hispanics with a mean age of 121.2 months. Overall, genetic predisposition was moderate for alcohol intent (h2 = 28%, p = .006) and low for alcohol initiation (h2 = 4%, p = 0.83). Hispanics (h2 = 53%, p < .0001) and Blacks (h2 = 48%, p < .0001) demonstrated higher alcohol intent due to additive genetic factors than Whites (h2 = 34%, p < .0001). Common environmental factors explained more variation in alcohol sips in females (c2 = 63%, p = .001) than in males (c2 = 55%, p = .003). Unique environmental factors largely attributed to alcohol intent, while common environmental factors explained the substantial variation in alcohol initiation. CONCLUSION: Sex and racial/ethnic disparities in genetic and environmental risk factors for susceptibility to alcohol initiation can lead to significant health disparities. Certain populations may be at greater risk for alcohol use due to their genetic and ecological factors at an early age.

Assessment of mental health status among Chinese nursing staff in the intensive care unit: a network analysis.

Backgrounds: Nursing is the key group to provide healthcare services, and it is easy for nursing staff to develop mental health problems. Aims: The study aimed to evaluate prevalence of psychological symptoms in nurses working in an intensive care unit (ICU) and the inter-relationship of associations of psychological symptoms using network analysis. Methods: This study is a cross-sectional design study. The Chinese version of the Symptom Check List-90 (SCL-90) was used to measure the psychological status of ICU nurses. The network structure of psychological symptoms was characterised, and indices of 'Expected influence' were used to identify symptoms central to the network. Network stability was examined using a case-dropping bootstrap procedure. Results: Multiple logistic regression analysis found those who had worked more than 15 years were less likely to experience positive psychological symptoms, whereas nurses working in emergency ICU and other ICUs, nurses working in departments with over 16 beds were more likely to develop psychological symptoms. In addition, 'Anxiety', 'Mental degeneration' and 'Depression' were central symptoms in the network. Conclusions: ICU nurses reported a high level of psychological symptoms, which may affect the quality of their work and worsen public health problems.

3D Off-Lattice Coarse-Grained Monte Carlo Simulations for Nucleation of Alkaline Aluminosilicate Gels.

This work presents a 3D off-lattice coarse-grained Monte Carlo (CGMC) approach to simulate the nucleation of alkaline aluminosilicate gels, their nanostructure particle size, and their pore size distribution. In this model, four monomer species are coarse-grained with different particle sizes. The novelty is extending the previous on-lattice approach from White et al. (2012 and 2020) by implementing a full off-lattice numerical implementation to consider tetrahedral geometrical constraints when aggregating the particles into clusters. Aggregation of the dissolved silicate and aluminate monomers was simulated until reaching the equilibrium condition of 16.46% and 17.04% in particle number, respectively. The cluster size formation was analyzed as a function of iteration step evolution. The obtained equilibrated nano-structure was digitized to obtain the pore size distribution and this was compared with the on-lattice CGMC and measurement results from White et al. The observed difference highlighted the importance of the developed off-lattice CGMC approach to better describe the nanostructure of aluminosilicate gels.

Assessment of the Benefits of Targeted Interventions for Pandemic Control in China Based on Machine Learning Method and Web Service for COVID-19 Policy Simulation.

Taking the Chinese city of Xiamen as an example, simulation and quantitative analysis were performed on the transmissions of the Coronavirus Disease 2019 (COVID-19) and the influence of intervention combinations to assist policymakers in the preparation of targeted response measures. A machine learning model was built to estimate the effectiveness of interventions and simulate transmission in different scenarios. The comparison was conducted between simulated and real cases in Xiamen. A web interface with adjustable parameters, including choice of intervention measures, intervention weights, vaccination, and viral variants, was designed for users to run the simulation. The total case number was set as the outcome. The cumulative number was 4,614,641 without restrictions and 78 under the strictest intervention set. Simulation with the parameters closest to the real situation of the Xiamen outbreak was performed to verify the accuracy and reliability of the model. The simulation model generated a duration of 52 days before the daily cases dropped to zero and the final cumulative case number of 200, which were 25 more days and 36 fewer cases than the real situation, respectively. Targeted interventions could benefit the prevention and control of COVID-19 outbreak while safeguarding public health and mitigating impacts on people's livelihood.

[Chinese medicine dispensing granules: history, status quo, and development prospect in "post-pilot era"].

Chinese medicine dispensing granules, the result of the efforts to transform Chinese medicinal decoction pieces in China, features portability and ease of storage. Thus, it is destined to be an indispensible dosage form in the modernization drive of Chinese medicine. The Announcement on Ending the Pilot Project of Chinese Medicine Dispensing Granules was released in February 2021 and relevant regulations went into force in November 2021, which marks the a new journey for the development of Chinese medicine dispensing granules and the beginning of the "post-pilot era". However, it faces the challenges in quality and standard. This study reviewed the history of Chinese medicine dispensing granules, analyzed the technical progress, market, and main problems in development, and proposed suggestions and prospects for its development in the "post-pilot era", which is expected to serve as a reference for its industry development and rational use.

[Risk prediction for deep venous thrombosis after total knee arthroplasty based on modified Caprini risk assessment model:a confirmatory study].

OBJECTIVE: To investigate the effectiveness of modified Caprini risk assessment model(Caprini MRAM) in predicting the risk of deep venous thrombosis (DVT) after total knee arthroplasty (TKA). METHODS: A case-control study was used to collect 43 patients with DVT after TKA in lower limb department of Sichuan Orthopedic Hospital from January 2016 to November 2020 in the positive group, and 172 patients without DVT after TKA in the same period according to the 1∶4 ratio between positive and control group were selected in the control group. Caprini MRAM was used to score and grade the risk of DVT. The clinical data, score and risk classification of the two groups were compared. The relationship between the risk of DVT in the patients after TKA and the risk factors in the risk ckassification and assessment of Caprini MRAM was analyzed by multivariate logistic regression model. RESULTS: The average score of caprini in DVT group was significantly higher than that in control group[(8.11±2.91) vs(4.07±2.12), P<0.001];DVT group was mainly at medium and high risk group(66.67%), while the control group was mainly at low risk (77.33%). There was a significant difference between the two groups in risk classification composition (P<0.001). BMI≥30 kg/m2, lower extremity edema (<1 month), severe pulmonary disease (<1 month), acute myocardial infarction (<1 month), bed rest (> 2 h), history of superficial or deep vein or pulmonary embolism and family history of thrombosis were the main risk factors for DVT in patients after TKA(all P<0.05). Preoperative D-dimer elevation (OR=4.380), BMI≥30 kg/m2(OR=2.518), lower extremity edema(<1 month)(OR=7.652), acute myocardial infarction (<1 month) (OR=1.994), bed rest (> 72 h)(OR=3.897), history of superficial or deep vein or pulmonary embolism (OR=13.517) and family history of blood embolism (OR=6.551) were independent risk factors for DVT in patients after TKA (all P<0.05). The risk of DVT was 13.457 and 2.739 times higher in high and moderate risk TKA patients with Caprini MRAM classification, respectively. CONCLUSION: Caprini MRAM can be used to predict the risk of DVT in patients after TKA, especially for patients with high risk.

Novel ensemble intelligence methodologies for rockburst assessment in complex and variable environments.

Rockburst is a severe geological hazard that restricts deep mine operations and tunnel constructions. To overcome the shortcomings of widely used algorithms in rockburst prediction, this study investigates the ensemble trees, i.e., random forest (RF), extremely randomized tree (ET), adaptive boosting machine (AdaBoost), gradient boosting machine, extreme gradient boosting machine (XGBoost), light gradient boosting machine, and category gradient boosting machine, for rockburst estimation based on 314 real rockburst cases. Additionally, Bayesian optimization is utilized to optimize these ensemble trees. To improve performance, three combination strategies, voting, bagging, and stacking, are adopted to combine multiple models according to training accuracy. ET and XGBoost receive the best capabilities (85.71% testing accuracy) in single models, and except for AdaBoost, six ensemble trees have high accuracy and can effectively foretell strong rockburst to prevent large-scale underground disasters. The combination models generated by voting, bagging, and stacking perform better than single models, and the voting 2 model that combines XGBoost, ET, and RF with simple soft voting, is the most outstanding (88.89% testing accuracy). The performed sensitivity analysis confirms that the voting 2 model has better robustness than single models and has remarkable adaptation and superiority when input parameters vary or miss, and it has more power to deal with complex and variable engineering environments. Eventually, the rockburst cases in Sanshandao Gold Mine, China, were investigated, and these data verify the practicability of voting 2 in field rockburst prediction.

A novel multiple subdivision-based algorithm for quantitative assessment of retinal vascular tortuosity.

Vascular tortuosity as an indicator of retinal vascular morphological changes can be quantitatively analyzed and used as a biomarker for the early diagnosis of relevant disease such as diabetes. While various methods have been proposed to evaluate retinal vascular tortuosity, the main obstacle limiting their clinical application is the poor consistency compared with the experts' evaluation. In this research, we proposed to apply a multiple subdivision-based algorithm for the vessel segment vascular tortuosity analysis combining with a learning curve function of vessel curvature inflection point number, emphasizing the human assessment nature focusing not only global but also on local vascular features. Our algorithm achieved high correlation coefficients of 0.931 for arteries and 0.925 for veins compared with clinical grading of extracted retinal vessels. For the prognostic performance against experts' prediction in retinal fundus images from diabetic patients, the area under the receiver operating characteristic curve reached 0.968, indicating a good consistency with experts' predication in full retinal vascular network evaluation.

Rapid expansion of human impact on natural land in South America since 1985.

Across South America, the expansion of commodity land uses has underpinned substantial economic development at the expense of natural land cover and associated ecosystem services. Here, we show that such human impact on the continent's land surface, specifically land use conversion and natural land cover modification, expanded by 268 million hectares (Mha), or 60%, from 1985 to 2018. By 2018, 713 Mha, or 40%, of the South American landmass was impacted by human activity. Since 1985, the area of natural tree cover decreased by 16%, and pasture, cropland, and plantation land uses increased by 23, 160, and 288%, respectively. A substantial area of disturbed natural land cover, totaling 55 Mha, had no discernable land use, representing land that is degraded in terms of ecosystem function but not economically productive. These results illustrate the extent of ongoing human appropriation of natural ecosystems in South America, which intensifies threats to ecosystem-scale functions.

Risk assessment of insect pest expansion in alpine ecosystems under climate change.

BACKGROUND: Growth in insect pest populations poses a significant threat to ecosystem functions and services, societal development, and food security in alpine regions under climate change. Risk assessments are important prioritization tools for pest management, which must be used to study insect pest expansion in alpine ecosystems under global warming. We used species distribution modeling to simulate the current and future distribution probabilities of 58 insect pest species in the Qinghai Province, China, based on a comprehensive field investigation. Subsequently, general linear modeling was used to explore the relationship between the distribution probability of these species and the damage caused by them. Finally, we assessed the ecological risk of insect pest expansion across different alpine ecosystems under climate change. RESULTS: Climate change could increase the distribution probabilities of insect pest species across different alpine ecosystems. However, the presence of insect pest species may not correspond to the damage occurrence in alpine ecosystems based on percent leaf loss, amount of stunting, and seedling death of their host species. Significant positive relationships between distribution probability and damage occurrence were found for several of the examined insect pest species. Insect pest expansion is likely to increase extensively in alpine ecosystems under increasing carbon dioxide (CO2 ) emission scenarios. CONCLUSION: The relationships between distribution probability and damage occurrence should be considered in species distribution modeling for risk assessment of insect pest expansion under climate change. Our study could improve the effectiveness of risk assessment of insect pest expansion under changing climate conditions. © 2021 Society of Chemical Industry.

In vivo safety assessment, biodistribution and toxicology of polyvinyl alcohol microneedles with 160-day uninterruptedly applications in mice.

Dissolving microneedles (DMNs) are widely used in drug delivery systems since they are based on one-step application, which is simple and convenient for patients, especially for the patients such as diabetes who need daily or long-term self-administration. In general, the matrix materials of DMNs are water-soluble materials that can release the encapsulated drugs gradually by dissolving in the skin without generating sharp needle waste. However, the matrix materials of DMNs will also leave in the skin after application. Thus, it is vital to evaluate whether the matrix material of DMNs dissolved in the skin will cause health risks such as toxicity to the body or some skin-related complications to patients who frequent or long-term administration. In this work, PVA, as one of the typical matrix materials of DMNs, was selected to prepare the DMNs to research the safety of PVA-based MNs to the body after being dissolved in the skin. Briefly, in a 160 - days trial, the healthy mice were daily administrated by PVA MNs. The results showed that PVA materials mainly accumulated in the skin tissues of mice after dissolving and the concentration of PVA in the insertion sites gradually decreased and was almost undetectable at 6 days after administration. The observation of general conditions, blood hematological analysis and histological examinations of the mice demonstrated that the PVA-based MNs do not cause appreciable toxicity to the healthy mice after daily insertion in a 160 - days trial. Altogether, these results encourage further studies of PVA MNs for biomedical applications and support translation of PVA-based DMNs from pre-clinical development into clinical trials.

Evaluation of the disability assessment Longshi scale: A multicenter study.

OBJECTIVE: We investigated factors affecting the disability assessment Longshi scale, and differences between the Longshi and Barthel scales, as well as modified Rankin scale (mRS), to determine whether the Longshi scale is superior to the other scales. METHODS: This cross-sectional study included 721 participants with disability. We performed the t-test, analysis of variance, Pearson's correlation test, and multiple linear regression to analyze group differences and define explanatory variables. RESULTS: The Longshi scale had a strong positive correlation with the Barthel scale (r = 0.868) but a weak negative correlation with the mRS (r = -0.185). Scores obtained among seven study hospitals in two provinces of southeast China were significantly different (F = 8.034). Social activities of participants with disability can be positively predicted using the Longshi (ß = 0.251) and Barthel scales (ß = 0.276). However, age has a weak negative correlation with the Longshi scale (r = -0.163). CONCLUSION: Training did not cause significant variations in assessment using the Longshi scale. However, the results differed among different regions. The Longshi scale showed a strong correlation with the Barthel scale but a weak correlation with the mRS. Assessment time was shorter using the Longshi scale and the scale can be used to predict the social activities of individuals with disability.

Assessment of biological functions for C3A cells interacting with adverse environments of liver failure plasma.

BACKGROUND: For its better differentiated hepatocyte phenotype, C3A cell line has been utilized in bioartificial liver system. However, up to now, there are only a few of studies working at the metabolic alternations of C3A cells under the culture conditions with liver failure plasma, which mainly focus on carbohydrate metabolism, total protein synthesis and ureagenesis. In this study, we investigated the effects of acute liver failure plasma on the growth and biological functions of C3A cells, especially on CYP450 enzymes. METHODS: C3A cells were treated with fresh DMEM medium containing 10% FBS, fresh DMEM medium containing 10% normal plasma and acute liver failure plasma, respectively. After incubation, the C3A cells were assessed for cell viabilities, lactate dehydrogenase leakage, gene transcription, protein levels, albumin secretion, ammonia metabolism and CYP450 enzyme activities. RESULTS: Cell viabilities decreased 15%, and lactate dehydrogenase leakage had 1.3-fold elevation in acute liver failure plasma group. Gene transcription exhibited up-regulation, down-regulation or stability for different hepatic genes. In contrast, protein expression levels for several CYP450 enzymes kept constant, while the CYP450 enzyme activities decreased or remained stable. Albumin secretion reduced about 48%, and ammonia accumulation increased approximately 41%. CONCLUSIONS: C3A cells cultured with acute liver failure plasma showed mild inhibition of cell viabilities, reduction of albumin secretion, and increase of ammonia accumulation. Furthermore, CYP450 enzymes demonstrated various alterations on gene transcription, protein expression and enzyme activities.

Growing burden of alcoholic liver disease in China: A review.

Explosive economic growth and increasing social openness in China over the last 30 years have significantly boosted alcohol consumption, and consequently, the incidence of alcoholic liver disease (ALD) in China has increased. Because the epidemiologic and clinical features of ALD in the Chinese population may differ from those of the Caucasian population, this review describes the epidemiology, pathogenesis, genetic polymorphisms, diagnosis, and treatment of ALD in the Chinese population. This updated knowledge of ALD in China provides information needed for a global understanding of ALD and may help in the development of useful strategies for reducing the global ALD burden.

Micro-/Macroscopically Synergetic Control of Switchable 2D/3D Photothermal Water Purification Enabled by Robust, Portable, and Cost-Effective Cellulose Papers.

Solar energy, as a renewable and sustainable resource, is considered to be a promising candidate for solving the water shortage through an interfacial solar-to-thermal conversion. Despite tremendous advances are achieved, it is still challenging for limited size, high-cost, and complicated fabrication protocols. More importantly, a favorable 2D/3D structure transformation to adapt to diverse conditions is considered to be very important. Inspired by the transformers with changeable geometries, herein, a large-area polypyrrole chemically functionalized cellulose paper (PPyP) with tunable microstructures and macroscopic geometries is developed via an in situ controlled oxypolymerization reaction. The resulted PPyP enables tunable 2D interfacial solar vaporization and even adapt itself to realization of 3D structures transformation for high-efficient water evaporation of up to 2.99 kg m-2 h-1 under 1 sun via an alternative kirigami/origami approach. Significantly, the PPyP can realize a switchable transformation between 2D and 3D structures to adapt diverse environments, demonstrating significant potentials in environmentally adaptable water purification.

Applying Benefit-Cost Analysis to Air Pollution Control in the Indian Power Sector.

Air pollution is a persistent and well-established public health problem in India: emissions from coal-fired power plants have been associated with over 80,000 premature deaths in 2015. Premature deaths could rise by four to five times this number by 2050 without additional pollution controls. We site a model 500 MW coal-fired electricity generating unit at eight locations in India and examine the benefits and costs of retrofitting the plant with a flue-gas desulfurization unit to reduce sulfur dioxide emissions. We quantify the mortality benefits associated with the reduction in sulfates (fine particles) and value these benefits using estimates of the value per statistical life transferred to India from high income countries. The net benefits of scrubbing vary widely by location, reflecting differences in the size of the exposed population. They are highest at locations in the densely populated north of India, which are also among the poorest states in the country.

Retraction Note to: An assessment of transgenomics as a tool for gene discovery in Populus euphratica Oliv.

This article (Zhou et al. 2018) has been retracted by the authors because the sequence BIBAC 002A111F06 was incorrectly assigned to the wrong bacterial species. The BIBAC 002A111F06 sequence (GenBank Accession KC129717) reported in the paper was attributed to Populus euphratica Oliv. The BLAST search of this KC129717 sequence against the nr database at NCBI showed that it has very high similarity to a genomic sequence from the gram-negative bacteria Stenotrophomonas maltophilia. The bacterium associates with Populus euphratica Oliv. and DNA isolated from Populus euphratica Oliv. for the construction of the BIBAC clone library inlcuded DNA from Stenotrophomonas maltophilia. Therefore, the phenotype of the transgenic Arabidopsis line carrying the KC129717 sequence cannot be attributed to genes from Populus euphratica Oliv. The authors apologize for the confusion and misinterpretation of our data resulting from the incorrect sequence assignment. All authors agree to this retraction.