Economic burden of pertussis in children: A single-center analysis in Hangzhou, China.

The "reemergence of pertussis" has elicited international concerns, occurring paradoxically amidst the expansion of immunization programs. This study was aimed to evaluate quantitatively the economic burden and identify the determinants that influence the cost associated with treating pertussis in Chinese children. We evaluated the economic burden by Chinese children diagnosed with pertussis at the Children's Hospital, Zhejiang University School of Medicine in 2022. Direct medical expenses and the utilization of medical resources attributed to pertussis were calculated. A generalized linear regression model was applied to analyze the determinants that were associated with the direct medical expenses among patients. Among the 1110 pertussis patients included in the study, 1060 were outpatients and 50 were inpatients. The average direct medical cost was ¥1878.70(i.e. $279.33). Living in urban areas (OR:1.27, p = .04), complications (OR:1.40, p < .001), hospitalization (OR:10.04, p < .001), and ≥ 3 medical visits (OR:3.71, p < .001) were associated with increased direct medical expenses. Having received four doses of the pertussis vaccine was associated with reduced direct medical expenses (OR:0.81, p = .04). This study underscores a substantial economic burden of pertussis in Hangzhou, with pronounced implications for patients residing in urban areas, experiencing complications, requiring hospitalization, having multiple medical consultations, or lacking comprehensive pertussis vaccination.

Leveraging spatial residual attention and temporal Markov networks for video action understanding.

The effective use of temporal relationships while extracting fertile spatial features is the key to video action understanding. Video action understanding is a challenging visual task because it generally necessitates not only the features of individual key frames but also the contextual understanding of the entire video and the relationships among key frames. Temporal relationships pose a challenge to video action understanding. However, existing 3D convolutional neural network approaches are limited, with a great deal of redundant spatial and temporal information. In this paper, we present a novel two-stream approach that incorporates Spatial Residual Attention and Temporal Markov (SRATM) to learn complementary features to achieve stronger video action understanding performance. Specifically, the proposed SRATM consists of spatial residual attention and temporal Markov. Firstly, the spatial residual attention network captures effective spatial feature representation. Further, the temporal Markov network enhances the model by learning the temporal relationships via conducting probabilistic logic calculation among frames in a video. Finally, we conduct extensive experiments on four video action datasets, namely, Something-Something-V1, Something-Something-V2, Diving48, and Mini-Kinetics, show that the proposed SRATM method achieves competitive results.

Blind Image Quality Assessment for Pathological Microscopic Image Under Screen and Immersion Scenarios.

The high-quality pathological microscopic images are essential for physicians or pathologists to make a correct diagnosis. Image quality assessment (IQA) can quantify the visual distortion degree of images and guide the imaging system to improve image quality, thus raising the quality of pathological microscopic images. Current IQA methods are not ideal for pathological microscopy images due to their specificity. In this paper, we present deep learning-based blind image quality assessment model with saliency block and patch block for pathological microscopic images. The saliency block and patch block can handle the local and global distortions, respectively. To better capture the area of interest of pathologists when viewing pathological images, the saliency block is fine-tuned by eye movement data of pathologists. The patch block can capture lots of global information strongly related to image quality via the interaction between different image patches from different positions. The performance of the developed model is validated by the home-made Pathological Microscopic Image Quality Database under Screen and Immersion Scenarios (PMIQD-SIS) and cross-validated by the five public datasets. The results of ablation experiments demonstrate the contribution of the added blocks. The dataset and the corresponding code are publicly available at: https://github.com/mikugyf/PMIQD-SIS.

Cost-effectiveness of various immunization schedules with inactivated Sabin strain polio vaccine in Hangzhou, China.

Background: It is necessary to select suitable inactivated poliovirus vaccine(IPV) and live, attenuated oral poliovirus vaccine (OPV) sequential immunization programs and configure the corresponding health resources. An economic evaluation was conducted on the sequential procedures of Sabin strain-based IPV (sIPV) and bivalent OPV (bOPV) with different doses to verify whether a cost-effectiveness target can be achieved. This study aimed to evaluate the cost-effectiveness of different sIPV immunization schedules, which would provide convincing evidence to further change the poliovirus vaccine (PV) immunization strategies in China. Methods: Five strategies were included in this analysis. Based on Strategy 0(S0), the incremental cost (IC), incremental effect (IE), and incremental cost-effectiveness ratio (ICER) of the four different strategies (S1/S2/S3/S4) were calculated based on the perspective of the society. Seven cost items were included in this study. Results of field investigations and expert consultations were used to calculate these costs. Results: The ICs of S1/S2/S3/S4 was Chinese Yuan (CNY) 30.77, 68.58, 103.82, and 219.82 million, respectively. The IE of vaccine-associated paralytic poliomyelitis (IEVAPP) cases of S1/S2/S3/S4 were 0.22, 0.22, 0.22, and 0.11, respectively, while the IE of disability-adjusted life-years (IEDALY) of S1/S2/S3/S4 were 8.98, 8.98, 8.98, and 4.49, respectively. The ICERVAPP of S1/S2/S3/S4 gradually increased to CNY 13.99, 31.17, 47.19, and 199.83 million/VAPP, respectively. The ICERDALY of S1/S2/S3/S4 also gradually increased to CNY 0.34, 0.76, 1.16, and 4.90 million/DALY, respectively. Conclusion: ICERVAPP and ICERDALY were substantially higher for S3 (four-sIPV) and S4 (replacement of self-funded sIPV based on one-sIPV-three-bOPV). Two-sIPV-two-bOPV had a cost-effectiveness advantage, whereas S2/S3/S4 had no cost-effectiveness advantage.

An investigation on trust in AI-enabled collaboration: Application of AI-Driven chatbot in accommodation-based sharing economy.

Several measures taken to control the spread of the COVID-19 pandemic have severely disrupted the accommodation sharing sector. This study attempts to find solutions to aid the recovery of the accommodation sharing sector via team efforts. Accordingly, we focus on the integration of artificial intelligence (AI) and collaboration. Despite the significant developments in AI technologies, there exists no research considering the application of AI in team collaboration. Utilizing the design science research method and collaboration engineering, we developed an AI-driven prototype system, AI-Driven, for collaboration process recommendation. Qualitative results show that the newly developed tool for collaboration process recommendation has achieved satisfactory performance. Furthermore, we investigated the antecedents and outcomes of trust in the AI-driven collaboration context. From a practical perspective, we propose several solutions to the challenges looming over the accommodation sharing sector according to collaboration deliverables. Furthermore, a system prototype was developed to facilitate collaboration process recommendation and provide procedural guidance.

Preliminary assessment of a portable Raman spectroscopy system for post-operative urinary stone analysis.

PURPOSE: We aimed to evaluate the reliability of a portable device that applies Raman spectroscopy at an excitation wavelength of 1064 nm for the post-operative analysis of urinary stone composition. MATERIALS AND METHODS: Urinary stone samples were obtained post-operatively from 300 patients. All samples were analyzed by the portable Raman spectroscopy system at an excitation wavelength of 1064 nm as well as by infrared spectroscopy (IR), and the results were compared. RESULTS: Both Raman spectroscopy and IR could detect multiple stone components, including calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate, uric acid, cystine, and magnesium ammonium phosphate hexahydrate. The results from 1064-nm Raman analysis matched those from IR analysis for 96.0% (288/300) of cases. Although IR detected multiple components within samples more often than Raman analysis (239 vs 131), the Raman analysis required less time to complete than IR data acquisition (5 min vs 30 min). CONCLUSIONS: These preliminary results indicate that 1064-nm Raman spectroscopy can be applied in a portable and automated analytical system for rapid detection of urinary stone composition in the post-operative clinical setting. TRIAL REGISTRATION: Chinese Clinical Trail Register ID: ChiCTR2000039810 (approved WHO primary register) http://www.chictr.org.cn/showproj.aspx?proj=63662 .

Construction land suitability assessment in rapid urbanizing cities for promoting the implementation of United Nations sustainable development goals: a case study of Nanchang, China.

Cities, the main place of human settlements, are required to offer high-quality environments to citizens. To achieve this, it is essential to overcome several mega challenges of urbanization, population growth, economic development, environmental deterioration, and climate change. Urban infrastructure construction is capable of enhancing economic growth and promoting urban sustainability, while it will lead to many environmental problems if the infrastructure construction is not properly planned and designed. To address this challenge, this study aims to understand how to ensure the construction land expansion sustainably in rapidly urbanizing cities. In particular, this study analyzed the suitability of construction land expansion in Nanchang, a rapid urbanizing city in China, from 1995 to 2015. The results indicate that the urban expansion speed from 1995 to 2005 was faster than that from 2005 to 2015. The construction land in Nanchang was expanding towards "all directions" and sprawled towards surrounding districts and counties from the original core areas. Nevertheless, about 70% of the Nanchang area was allowable construction area (highly suitable expansion, relatively suitable expansion, and basically suitable expansion areas), indicating that the abundant reserved land resources for urban construction. This study also identified multiple suitability expansion paths of construction land, providing a scientific guidance for the land use planning of Nanchang city. Overall, this study provides a reference to the understanding of the construction land expansion for the achievement of United Nations sustainable development goals. It can also promote the understanding of spatial territory planning and practically enhance the capabilities of land use planning and design.

Bamboo - An untapped plant resource for the phytoremediation of heavy metal contaminated soils.

Phytoremediation is a green technology used for the remediation of heavy metal soils. However, up to now, very few plants are known to be both hyperaccumulators and fast-growers. In contrast, some non-hyperaccumulators, which possess lower extraction capacities than hyperaccumulators, are fast-growing species with much higher total biomass yields and are potential alternative phytoremediators. Bamboo is a taxonomic group comprised of 1439 species that are mostly distributed in the tropics and subtropics. Although limited studies on bamboo for phytoremediation, recent studies have shown that some bamboo species have high ability to adapt to metalliferous environments and a high capacity to absorb heavy metals. Bamboo tissues in the rhizome and culm can accumulate a large amount of heavy metals that mainly accumulate in the cell wall, vacuole, and cytoplasm. Certain bamboo species such as moso bamboo, Phyllostachys praecox, have been shown to have a high endurance in metal contaminated soils, enabling a considerable uptake and accumulation of heavy metals. However, excessive concentrations of heavy metals may cause oxidative stress and damage bamboo plants. Therefore, several management strategies have been developed to improve the phytoremediation ability of bamboo species, including the selection of tolerant bamboo species, intercropping with hyperaccumulators, fertilization applications, and employment of chelate in soil. This review demonstrates that bamboo species, which have high biomass productivity, short rotation, and high economic value, can be used for phytoremediation. However, the mechanisms of heavy metal uptake, transport, sequestration, and detoxification of different bamboo species require urgent investigation.

Assessment of disease-drug-drug interaction between single-dose tocilizumab and oral contraceptives in women with active rheumatoid arthritis.

OBJECTIVES: The objective of this study was to evaluate the effect of a single intravenous dose of tocilizumab (TCZ) on pharmacokinetics (PK) of oral contraceptive (OC; norethindrone (NE) and ethinyl estradiol (EE)) and on sex hormone levels (progesterone (PG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH)) in subjects with active rheumatoid arthritis (RA) who were on stable doses of methotrexate. METHODS: This was an open-label, nonrandomized, multicenter, two-parallel group, one-sequence crossover study. In Group 1, Cycle 1 was a baseline cycle to determine the PK of OC and levels of sex hormones. At the start of Cycle 2, patients continued to receive OC and single TCZ dosing on Day 1. In Cycle 2, we determined the PK of OC and levels of sex hormones when OC and TCZ were combined. In Cycle 3, we determined the PK of OC and the levels of sex hormones after TCZ treatment was stopped. PK for EE and NE were analyzed serially on Day 7 when maximum TCZ effect on inflammation as indicated by C-reactiv protein (CRP) was expected. Hormone levels (PG, LH and FSH) were measured mid-cycle (cycle Days 12 - 16 and Day 21) during each cycle. Group 2 (healthy subjects) was studied to compare the levels of OC PK exposures with those in each cycle of Group 1 (RA subjects). RESULTS: Levels of PG, LH and FSH were not affected by the combination of TCZ/OC treatment in RA patients studied. No breakthrough bleeding was attributed to the initiation of TCZ treatment in subjects receiving OCs. PK exposures of EE and NE were similar between RA and healthy subjects at baseline and were not affected by single-dose TCZ. Administration of OC with or without a single dose of TCZ was well tolerated. CONCLUSIONS: Data from this study indicated that the PK and sex hormone levels were not affected in RA subjects who had active disease and were on a stable regimen of methotrexate.

Application of next-generation sequencing in clinical oncology to advance personalized treatment of cancer.

With the development and improvement of new sequencing technology, next-generation sequencing (NGS) has been applied increasingly in cancer genomics research over the past decade. More recently, NGS has been adopted in clinical oncology to advance personalized treatment of cancer. NGS is used to identify novel and rare cancer mutations, detect familial cancer mutation carriers, and provide molecular rationale for appropriate targeted therapy. Compared to traditional sequencing, NGS holds many advantages, such as the ability to fully sequence all types of mutations for a large number of genes (hundreds to thousands) in a single test at a relatively low cost. However, significant challenges, particularly with respect to the requirement for simpler assays, more flexible throughput, shorter turnaround time, and most importantly, easier data analysis and interpretation, will have to be overcome to translate NGS to the bedside of cancer patients. Overall, continuous dedication to apply NGS in clinical oncology practice will enable us to be one step closer to personalized medicine.

[Assessment of humic and fulvic acids in black soils using near-infrared reflectance spectroscopy].

The organic carbon content and optical densities of humic acids in black soils of China were predicted and assessed using near infrared spectroscopy technique. The contents of humic acid (HA) and fulvic acid (FA) in 136 black soil samples in China were analyzed and the NIR spectra were collected using a VECTOR/22 (Fourier transform infrared spectroscopy). Partial least squares (PLS) regression with cross validation was used to develop prediction models with reference data and soil NIRS spectra, and the model was validated using an independent set of samples. NIRS well predicted (HAC+FAC), HAC and FAC contents, with R2 = 0.92, 0.92 and 0.86, RPD = 3.66, 3.82 and 2.69, and high correlation coefficients between predicted and measured values (r = 0.90, 0.85 and 0.82). Predictions for the E4 values of HA and FA were also good (R2 = 0.85, 0.85; RPD = 2.88, 2.65; r = 0.92, 0.80). Predictions for optical densities of HA and FA at 665 nm (E6) was acceptable. Generally, NIRS showed a good potential to predict C content and optical densities of humic acid and fulvic acid in blacks soils and may reveal information on SOC quality.

Assessment of drug-drug interaction potential of enfuvirtide in human immunodeficiency virus type 1-infected patients.

INTRODUCTION: Enfuvirtide is the first drug to block human immunodeficiency virus type 1 (HIV-1) glycoprotein 41-mediated viral fusion to host cells. This study investigated whether enfuvirtide can influence the activities of cytochrome P450 (CYP) enzymes in HIV-1-infected patients. METHODS: An open-label, 1-sequence crossover study was conducted in 12 HIV-1-infected adults, by use of a 5-drug cocktail consisting of caffeine, chlorzoxazone, dapsone, debrisoquin (INN, debrisoquine), and mephenytoin to assess the activities of CYP1A2, CYP2E1, CYP3A4, CYP2D6, and CYP2C19, respectively. Dapsone was used to assess N-acetyltransferase activity. Patients received a single dose of the cocktail alone on day -15 and another together with enfuvirtide on day 6. Enfuvirtide (90 mg subcutaneously) was administered twice daily on days 1 to 7. Phenotypic index parameters were estimated and analyzed by ANOVA with factors subject and day (-15 and 6). RESULTS: The phenotypic index parameters, with and without enfuvirtide, for CYP3A4 (0.33 versus 0.34; 90% confidence interval [CI] for ratio of least squares means, 0.88-1.09), CYP2D6 (0.72 versus 0.71; 90% CI, 0.97-1.06), and N-acetyltransferase (0.35 versus 0.39; 90% CI, 0.82-0.98) were bioequivalent. The phenotypic index parameters, with and without enfuvirtide, for CYP1A2 (0.76 versus 0.81; 90% CI, 0.71-1.17), CYP2E1 (1.3 versus 1.2; 90% CI, 0.87-1.29), and CYP2C19 (93 versus 81.8; 90% CI, 0.98-1.28) were not bioequivalent but were not substantially different. CONCLUSIONS: Enfuvirtide had no clinically important effect on the metabolism of probe drugs mediated by CYP3A4, CYP2D6, or N-acetyltransferase and had little effect on the metabolism of drugs mediated by CYP1A2, CYP2E1, or CYP2C19. The potential for interactions between enfuvirtide and concomitantly administered drugs metabolized by the CYP enzymes tested in this study is low.

Quantitative assessment of the cell penetrating properties of RI-Tat-9: evidence for a cell type-specific barrier at the plasma membrane of epithelial cells.

Penetration of epithelial cells represents the rate-determining step for the absorption of many drugs and pharmaceutical macromolecules such as proteins and nucleic acid therapeutics. While the potential of using cell-penetrating peptides (CPPs) to facilitate absorption has been increasingly recognized, the mechanism of cell penetration and the uptake into certain cells have recently been called into question due to methodological artifacts. Therefore, the objective of this study was to quantitatively assess the ability of RI-Tat-9, a proteolytically stable CPP, to penetrate epithelial cell monolayers. The permeability of RI-Tat-9 with two epithelial cell lines, Madin-Darby canine kidney (MDCK) and Caco-2 cells, was comparable to the leakiness of the respective intact monolayers. Microscopic imaging showed that fluorescence-tagged RI-Tat-9 did not enter these cells, further supporting a paracellular transport mechanism. Although insufficient data were generated in these studies to generalize the observed phenomenon, the entry of RI-Tat-9 into nonepithelial T lymphocytic MT2 cells, possibly by endocytosis, suggested that a cell type-specific barrier might exist that controlled uptake of RI-Tat-9 by cells. Compared to that in MT2 and HeLa cells, the active uptake of the peptide into MDCK monolayers was much slower and showed no dependence of cell energy. Furthermore, the equilibrium binding of RI-Tat-9 to MDCK cells at 0 degrees C was indicative of an interaction with a nonspecific receptor. A correlation between binding density and concentration difference across a leaky separation barrier suggested that repulsion of free peptide molecules by bound peptide molecules at the MDCK monolayer surface may be significant at micromolar concentrations. The results of this study quantitatively show that Tat CPP uptake into two commonly used epithelial cell types is minimal and possibly cell type-specific. Implications for Tat CPP-assisted drug delivery are discussed.