Risk prediction model based on machine learning for predicting miscarriage among pregnant patients with immune abnormalities.

Introduction: It is known that patients with immune-abnormal co-pregnancies are at a higher risk of adverse pregnancy outcomes. Traditional pregnancy risk management systems have poor prediction abilities for adverse pregnancy outcomes in such patients, with many limitations in clinical application. In this study, we will use machine learning to screen high-risk factors for miscarriage and develop a miscarriage risk prediction model for patients with immune-abnormal pregnancies. This model aims to provide an adjunctive tool for the clinical identification of patients at high risk of miscarriage and to allow for active intervention to reduce adverse pregnancy outcomes. Methods: Patients with immune-abnormal pregnancies attending Sichuan Provincial People's Hospital were collected through electronic medical records (EMR). The data were divided into a training set and a test set in an 8:2 ratio. Comparisons were made to evaluate the performance of traditional pregnancy risk assessment tools for clinical applications. This analysis involved assessing the cost-benefit of clinical treatment, evaluating the model's performance, and determining its economic value. Data sampling methods, feature screening, and machine learning algorithms were utilized to develop predictive models. These models were internally validated using 10-fold cross-validation for the training set and externally validated using bootstrapping for the test set. Model performance was assessed by the area under the characteristic curve (AUC). Based on the best parameters, a predictive model for miscarriage risk was developed, and the SHapley additive expansion (SHAP) method was used to assess the best model feature contribution. Results: A total of 565 patients were included in this study on machine learning-based models for predicting the risk of miscarriage in patients with immune-abnormal pregnancies. Twenty-eight risk warning models were developed, and the predictive model constructed using XGBoost demonstrated the best performance with an AUC of 0.9209. The SHAP analysis of the best model highlighted the total number of medications, as well as the use of aspirin and low molecular weight heparin, as significant influencing factors. The implementation of the pregnancy risk scoring rules resulted in accuracy, precision, and F1 scores of 0.3009, 0.1663, and 0.2852, respectively. The economic evaluation showed a saving of ¥7,485,865.7 due to the model. Conclusion: The predictive model developed in this study performed well in estimating the risk of miscarriage in patients with immune-abnormal pregnancies. The findings of the model interpretation identified the total number of medications and the use of other medications during pregnancy as key factors in the early warning model for miscarriage risk. This provides an important basis for early risk assessment and intervention in immune-abnormal pregnancies. The predictive model developed in this study demonstrated better risk prediction performance than the Pregnancy Risk Management System (PRMS) and also demonstrated economic value. Therefore, miscarriage risk prediction in patients with immune-abnormal pregnancies may be the most cost-effective management method.

Quality assessment of paediatric education and research in southwest China: A cross-sectional study.

Currently, there is a limited analysis of medical education research both domestically and internationally. To enhance, improve the quality of medical education, this study conducted a quantitative analysis of teaching project data from an affiliated hospital during the period 2016-2022. The results indicated that a total of 133 teaching projects were initiated during this period, with an average age of project leaders being 42.73±6.45 years. Regarding professional ranks and titles, municipal-level project leaders had a high concentration of seniors (48.15%), while at the university-level, most project leaders held the title of deputy seniors (58.82%). At the university-level, project leaders were mainly distributed between deputy senior titles (37.08%) and intermediate titles (38.20%). In terms of research content, nearly half of the studies (46.62%) focused on teaching methods and models. Further regression analysis revealed that professional ranks and titles were an independent factor influencing the project level (P<0. 05). These findings suggest the need for improvement in medical education research, including addressing the uneven distribution of research topics, enhancing the research capacity of junior and mid-career medical education teachers, and improving the dissemination of research results.

Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation.

BACKGROUND: Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance (IR). However, the link between two of the most prevalent bowel disorders, chronic diarrhea and constipation, and the triglyceride glucose (TyG) index, a marker of IR, has not yet been investigated. AIM: To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation. METHODS: This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010. TyG was used as an exposure variable, with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables. A demographic investigation based on TyG quartile subgroups was performed. The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG, chronic diarrhea, and constipation. Subgroup analyses were performed to examine the stability of any potential associations. RESULTS: In the chosen sample, chronic diarrhea had a prevalence of 8.00%, while chronic constipation had a prevalence of 8.04%. In multiple logistic regression, a more prominent positive association was found between TyG and chronic diarrhea, particularly in model 1 (OR = 1.45; 95%CI: 1.17-1.79, P = 0.0007) and model 2 (OR = 1.40; 95%CI: 1.12-1.76, P = 0.0033). No definite association was observed between the TyG levels and chronic constipation. The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63 (OR = 1.89; 95%CI: 1.05-3.41, P = 0.0344), and another positive association with chronic constipation when it was greater than 8.2 (OR = 1.74; 95%CI: 1.02-2.95, P = 0.0415). The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations. CONCLUSION: Higher TyG levels were positively associated with abnormal bowel health.

Dust detection and cleanliness assessment based on S-YOLOv5s for NPP reactor containment wall-climbing cleaning robot.

NPP reactor containment dust can easily turn into radioactive dust, endangering staff health and the environment. However, the nuclear reactor containment wall-climbing cleaning robot cleans blindly without the ability to clean the dust in a timely and thoroughly. In this paper, ShuffleNetV2-YOLOv5s (S-YOLOv5s) model is proposed to solve the problem of wall-climbing robots unable to detect different categories of dust in time. The use of ShuffleNetV2 in the backbone of the network not only ensures a large number of characterized channels and a large network capacity, but also reduces the complexity of the model; SIoU is chosen for the loss function to improve the model accuracy. Then, planar cleaning index (PCI) is proposed by combining the results of S-YOLOv5s to evaluate whether the wall-climbing cleaning robot cleans thoroughly. Compared to other methods, PCI considers amount and area occupation of different classes of dust. The dust data set is collected to train the designed model, and the model size is reduced to 14 % of the original model, and the FPS is 7.313 higher than the original model. Especially when compared with the state-of-the-art lightweight methods, our model has smaller model size and higher recognition speed. Experimental results have shown that our dust detection and cleanliness assessment method can be used on a wall-climbing cleaning robot to clean dust in time and thoroughly.

Prokaryotic taxonomy and functional diversity assessment of different sequencing platform in a hyper-arid Gobi soil in Xinjiang Turpan Basin, China.

Turpan Basin located in the eastern Xinjiang is a typical arid inland basin with extremely scarce water resources and a fragile ecosystem. Prokaryotic communities with unique genetic and physiological modifications can survive and function in such harsh environments, offering diverse microbial resources. However, numerous microbes can enter the viable but non-culturable state because of drought stress in the desert soil. In this work, next generation sequencing (NGS) technology based on DNA nanoball sequencing platform (DNBSEQ-G400) and sequencing-by-synthesis platform (NovaSeq 6000) were applied to analyze the prokaryotic diversity in three hyper-arid Gobi soils from Flaming Mountain, Toksun, and Kumtag. The comparison between two platforms indicated that DNBSEQ-G400 had better repeatability and could better reflect the prokaryotic community of this hyper-arid region. The diversity analysis based on DNBSEQ-G400 identified a total of 36 bacterial phyla, including Pseudomonadota, Bacteroidota, Bacillota, Actinomycetota, Methanobacteriota, Acidobacteriota, Nitrososphaerota, and Planctomycetota. The environmental factors, including soluble salt, available potassium, total nitrogen, and organic matter, were positively correlated with the abundance of most prokaryote. In addition, the prokaryotic community assembly in hyper-arid soil was well described by neutral-based models, indicating that the community assembly was mainly controlled by stochastic processes. Finally, the phylogenetic analysis of Actinomycetota proved that such extremophiles played an important role in the ecosystems they colonize. Overall, our result provides a reference for choosing the appropriate sequencing platform and a perspective for the utilization of soil microbial resources from hyper-arid regions.

Clinical value of anterior segment optical coherence tomography­assisted Wuerzburg bleb classification system for bleb assessment following trabeculectomy.

The Wuerzburg bleb classification system (WBCS) is an established tool for evaluating filtering blebs, while anterior segment optical coherence tomography (ASOCT) provides detailed information on inner bleb structure. The present study aimed to investigate the clinical value of ASOCT-assisted WBCS following trabeculectomy (TRAB). The present prospective, observational study included eyes that underwent TRAB. Bleb assessments using the WBCS were based on the image acquired by ASOCT. The WBCS scores were assessed at postoperative week 2 and postoperative month (POM) 1, 2, 3, 6 and 12. The surgical outcomes at 1 year were determined as success or failure. Spearman's analysis explored the correlation of WBCS scores with intraocular pressure (IOP) and surgical outcome. A total of 32 eyes from 32 patients were included in the present study. The WBCS total score significantly correlated with IOP at POM 1, 2, 3, 6 and 12 (P<0.05). For single parameters, microcysts demonstrated a good correlation with IOP at POM 1, 2, 3, 6 and 12 (P<0.05). The WBCS total score correlated well with surgical outcome at POM 2, 3, 6 and 12 (P≤0.005). Microcysts, vascularity and encapsulation significantly correlated with surgical outcomes (P<0.05). The results of the present study suggest that ASOCT-assisted WBCS is a simple and effective measurement system for blebs after TRAB in clinical practice, which correlates well with IOP and surgical outcomes. Blebs with a higher WBCS total score and microcysts score in the early postoperative period, such as at POM 2 and 3, are less likely to have surgical failure in the long term.

Multiplex Assessment of Serum Chemokines CCL2, CCL5, CXCL1, CXCL10, and CXCL13 Following Traumatic Brain Injury.

Chemokines may promote neuroinflammation following traumatic brain injury (TBI), thereby exacerbating secondary injury. This study was designed to investigate the contributions of chemokines (CCL2, CCL5, CXCL1, CXCL10, and CXCL13) to TBI severity and clinical outcome. Peripheral blood was drawn from 92 TBI patients on admission, and 40 controls were recruited. Serum concentrations of CCL2, CCL5, CXCL1, CXCL10, and CXCL13 on admission were measured by ELISA. Preoperative clinical severity was evaluated using the Glasgow Coma Scale (GCS), and clinical outcome at 90 days post-TBI was evaluated using the Glasgow Outcome Scale (GOS). The associations were evaluated by calculating Spearman's correlation coefficients. A binary logistic regression model was used to identify clinicodemographic factors influencing outcome, and ROC curves were constructed. Serum concentrations of CCL2, CCL5, CXCL1, CXCL10, and CXCL13 were elevated significantly after TBI and negatively correlated with GCS and GOS scores except CCL5. CCL2 may be considered as an independent predictor to predict severity and outcome. Moreover, combination of GCS score, CCL2, and CXCL10 can be a better assessment prognosis of moderate and severe TBI.

Clinical and economic burdens of recurrence following nephrectomy for intermediate high- or high-risk renal cell carcinoma: A retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data.

BACKGROUND: Renal cell carcinoma (RCC) is associated with a high risk of recurrence. Although RCC has been shown to impose a substantial burden on patients, little is known about the incremental clinical and economic burden attributable to disease recurrence. With recent advances in the RCC-therapeutic landscape, including adjuvant therapies, it is important to quantify the clinical and economic burden associated with RCC recurrence to better evaluate the potential impact of treatment in this patient population. OBJECTIVE: To quantify the incremental clinical and economic burden associated with disease recurrence among patients with intermediate high-risk and high-risk RCC postnephrectomy. METHODS: Data from the Surveillance, Epidemiology, and End Results-Medicare database (2007-2016) were used to identify patients with newly diagnosed, intermediate high-risk or high-risk RCC following nephrectomy. Patients with a diagnosis of metastatic disease or repeat nephrectomy or initiating a systemic treatment for advanced RCC were grouped as the recurrence cohort; patients without evidence of recurrence were grouped as the cohort without recurrence. Health care resource utilization (HRU), health care costs (2019 US dollars), and overall survival (OS) were compared between cohorts with and without recurrence, adjusting for demographic and clinical characteristics. RESULTS: A total of 269 patients with recurrence and 374 patients without recurrence were analyzed. Mean age was 75.2 and 75.7 years (P = 0.383), respectively, and 64.7% and 57.8% (P = 0.076) of patients were male, respectively. Median follow-up duration was 17 and 28 months, respectively. Patients with recurrence had a significantly shorter OS relative to patients without recurrence (adjusted hazard ratio = 6.00; 95% CI = 4.24-8.48; P < 0.001). Additionally, compared with patients without recurrence, patients with recurrence had significantly more inpatient admissions (0.16 vs 0.04 admissions per person-month [PM]; adjusted incidence rate ratio [aIRR] = 3.88; 95% CI = 3.12-4.81), outpatient visits (3.06 vs 1.77 visits per PM; aIRR = 1.68; 95% CI = 1.56-1.81), emergency department visits (0.10 vs 0.05 visits per PM; aIRR = 2.11; 95% CI = 1.66-2.68), and days hospitalized (1.40 vs 0.35 days per PM; aIRR = 6.73; 95% CI = 4.95-9.15) per patient per month (all P < 0.001). Adjusted mean monthly health care costs per patient were significantly higher among patients with recurrence vs patients without recurrence (differences of all-cause total costs, total medical costs, and pharmacy cost per month: $6,320, $4,924, and $1,387; all P < 0.001). CONCLUSIONS: RCC recurrence is associated with a significant increase in mortality, HRU, and health care costs, highlighting the substantial unmet need in patients with intermediate high-risk and high-risk RCC postnephrectomy when adjuvant therapies are not widely available. DISCLOSURES: Dr Sundaram is an employee of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., and holds stock in AbbVie, Abbott, Johnson & Johnson, Bristol Myers Squibb, and Merck & Co., Inc. Dr Bhattacharya is an employee of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., and holds stock in Merck & Co., Inc. Dr Adejoro and Dr Rogerio were employees of Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc. at the time of study conduct. Dr Adejoro holds stock in Johnson & Johnson. Dr Song, Dr Zhang, Mr Carley, and Dr Signorovitch are employees of Analysis Group, Inc., a consulting firm that received funding from Merck & Co., Inc. for the conduct of this research. Ms Zhu was an employee of Analysis Group, Inc. at the time of study conduct. Dr Haas is a Professor of Medicine at the Perelman School of Medicine, University of Pennsylvania and also serves on the advisory board for Aveo, Calithera and Exelixis, Co. Financial support for this study was provided by Merck & Co., Inc. The study sponsor was involved in the design and conduct of the study; collection, management, analysis, interpretation of data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Financial Crisis in Management Stress: From the Perspective of Crisis Anxiety of Others.

The crisis anxiety of others is a phenomenon that goes hand in hand with the spread of the occupational health pandemic. It is becoming increasingly important to better understand its emergence process, especially in the era of greater uncertainty. This study aims to examine the impact of the external financial crisis on managerial stress among financial employees. The sample consists of 347 senior managers and financial employees from companies in China. The empirical analysis shows that external financial crises have significant effects on anxiety levels, especially external corporate crisis, debt crisis and growth crisis both have mediating effect on the relationship between anxiety level and pressure management and the relationship between external financial crisis and pressure management. This study explores the rules for the emergence of anxiety among corporate managers and expands the scope of environmental factors that need to be discussed in the study of corporate financial management. This study provides theoretical implications for the psychological study of Financial Management and practical implications for corporate financial management.

Recover the food-energy-water nexus from COVID-19 under Sustainable Development Goals acceleration actions.

The interwoven relationship between food, energy, and water (FEW) is described as the FEW nexus. The COVID-19 pandemic has interrupted the FEW nexus and impeded the progress of FEW-related Sustainable Development Goals (SDGs) (SDG 2: Zero Hunger; 6: Clean Water and Sanitation; 7: Affordable and Clean Energy). We aim to find solutions to recover the FEW nexus from COVID-19. First, we discussed the challenges faced by FEW amid COVID-19. Second, we observed responses of the FEW nexus under COVID-19's interference. Finally, we proposed the solutions that guide the FEW nexus in recovery from the pandemic by mining 164 FEW-related SDG Acceleration Actions. The key solutions include 1) building or upgrading FEW facilities and infrastructure, 2) improving nature's contribution to the FEW nexus, 3) developing digital technologies, 4) innovating the source and production of FEW, and 5) promoting community production and transforming the lifestyle. Our work highlights the importance of feasible and accelerated actions that recover the FEW nexus in the post-pandemic era.

Factors That Shape Women's Physical Activity: Development of the Reasons to Participate in Physical Activity Scale (RPPAS).

(1) Background: Obesity could deepen women's susceptibility to COVID-19 infections and deaths. While physical activity has the potential to improve women's physical and psychological resilience to the pandemic, there is a dearth of research on factors that motivate women's participation in physical activity. Thus, to bridge the research gap, this study aims to identify factors that motivate women's participation in physical activity. (2) Methods: An online survey on motivations for physical activity was developed and distributed to the participants. A total of 108 women offered complete answers (N = 108, 18-33 years old, Mage = 20.34 ± 2.42 years). Participants selected factors that promote their physical activity from a list of 34 factors from the Reasons to Participate in Physical Activity Scale (RPPAS) developed in this study. (3) Results: Exploratory factor analysis revealed that factors that motivate women's participation in physical activity are: enjoyment and gratification, consideration for other activities (i.e., exergaming), health benefits, networking opportunities, and appearance and performance. Multiple linear regression analyses indicate that only consideration for appearance and performance was significantly associated with participants' physical activity levels after controlling for compounding factors. (4) Conclusions: The findings of this study underscore the importance of appearance and performance in shaping women's participation in physical activity. Furthermore, the results also emphasize the need for a nuanced understanding of factors that influence women's physical activity levels. Future research could investigate how to leverage these motivators in tailored health interventions that aim to improve women's physical activity.

Levels of urinary metabolites of benzene compounds, trichloroethylene, and polycyclic aromatic hydrocarbons and their correlations with socioeconomic, demographic, dietary factors among pregnant women in six cities of China.

Maternal exposure to benzene and related compounds, trichloroethylene, and polycyclic aromatic hydrocarbons has been suggested as risk factors for reproductive and developmental problem. In different countries and groups, there are differences in socioeconomic circumstances, consumer products, dietary habits, lifestyles, and so on, resulting in different exposure risks from these chemicals. This study investigated the correlation between their metabolite concentrations and socioeconomic, demographic, and dietary factors to explore the possible exposure source of the concerned pollutants in pregnant women. We conducted biological monitoring to assess the exposure of these chemicals using urine samples from 590 to 639 pregnant women during 2nd or 3rd trimester of pregnancy in six cities of China. Socioeconomic and demographic characteristics and dietary habits were collected from questionnaires. The detection rate was over 74% of the urine samples for all metabolites. Compared with the Fourth National Report on Human Exposure to Environmental Chemical concentrations for females (FNRHEEC, the US Centers for Disease Control and Prevention), the metabolite concentrations of benzene compounds and trichloroethylene, excluding MA reported here, were higher. Principal component analysis results showed that SBMA and MHA could be proxy of the principal sources of metabolites for benzene compounds. The concentrations of SBMA and MA were higher in Fuzhou and Wuhan, respectively. The concentration of DCVMA was higher in Shenzhen, Xi'an, and Nanning, and the concentration of PGA was higher in Fuzhou, Wuhan, and Xi'an. Also, the 1-OHPG concentration in Wuhan is higher than that in Fuzhou and Shenzhen. Unhealthy dietary habits, using cosmetics and indoor exposure, contacting chemical solvent during pregnancy were associated with increased benzene compounds, trichloroethylene, and PAH exposure. There were significant positive associations between 1-OHPG level and maternal BMI, low education status, and cooking without a range hood. Pregnant women in China may be at a greater risk of exposure to most of the target compounds than US females, and their exposure levels varied in different regions. Some adverse environmental and behavioral factors may increase the exposure of environmental toxins, which can urge people to take measures to reduce the health risk to pregnant women during pregnancy.

Transmissive-detected laser speckle contrast imaging for blood flow monitoring in thick tissue: from Monte Carlo simulation to experimental demonstration.

Laser speckle contrast imaging (LSCI) is a powerful tool to monitor blood flow distribution and has been widely used in studies of microcirculation, both for animal and clinical applications. Conventionally, LSCI usually works on reflective-detected mode. However, it could provide promising temporal and spatial resolution for in vivo applications only with the assistance of various tissue windows, otherwise, the overlarge superficial static speckle would extremely limit its contrast and resolution. Here, we systematically investigated the capability of transmissive-detected LSCI (TR-LSCI) for blood flow monitoring in thick tissue. Using Monte Carlo simulation, we theoretically compared the performance of transmissive and reflective detection. It was found that the reflective-detected mode was better when the target layer was at the very surface, but the imaging quality would rapidly decrease with imaging depth, while the transmissive-detected mode could obtain a much stronger signal-to-background ratio (SBR) for thick tissue. We further proved by tissue phantom, animal, and human experiments that in a certain thickness of tissue, TR-LSCI showed remarkably better performance for thick-tissue imaging, and the imaging quality would be further improved if the use of longer wavelengths of near-infrared light. Therefore, both theoretical and experimental results demonstrate that TR-LSCI is capable of obtaining thick-tissue blood flow information and holds great potential in the field of microcirculation research.

IL-27 signalling promotes adipocyte thermogenesis and energy expenditure.

Thermogenesis in brown and beige adipose tissue has important roles in maintaining body temperature and countering the development of metabolic disorders such as obesity and type 2 diabetes1,2. Although much is known about commitment and activation of brown and beige adipose tissue, its multiple and abundant immunological factors have not been well characterized3-6. Here we define a critical role of IL-27-IL-27Rα signalling in improving thermogenesis, protecting against diet-induced obesity and ameliorating insulin resistance. Mechanistic studies demonstrate that IL-27 directly targets adipocytes, activating p38 MAPK-PGC-1α signalling and stimulating the production of UCP1. Notably, therapeutic administration of IL-27 ameliorated metabolic morbidities in well-established mouse models of obesity. Consistently, individuals with obesity show significantly decreased levels of serum IL-27, which can be restored after bariatric surgery. Collectively, these findings show that IL-27 has an important role in orchestrating metabolic programs, and is a highly promising target for anti-obesity immunotherapy.

[Spatio-temporal Distribution Characteristic and Risk Assessment of Heavy Metals in Soils Around Centralized Drinking Water Sources in Wuhan].

In the present study, the spatio-temporal distribution characteristics of heavy metals (Cd, Hg, As, Pb, Cr, Cu, Ni, and Zn) in soil around 19 centralized drinking water sources in Wuhan were investigated. Single-factor and comprehensive pollution indexes were used to determine soil pollution levels. The potential ecological hazard index was employed to evaluate soil potential ecological risks. The correlation and cluster analysis were conducted to identify pollution sources. The results showed that higher concentrations of heavy metals were present in soil from centralized drinking water source located in core area than suburb area of Wuhan. The concentrations of heavy metals in soil from centralized drinking water sources near the Yangtze River were higher than that in the sites near the tributaries of the Yangtze River. The average single potential ecological risk index of Hg, As, Pb, Cr, Cu, Ni, and Zn were lower than 40, which suggests a slight potential ecological risk. The average single potential ecological risk index of Cd was 80-160, which indicates a high potential ecological risk. The average comprehensive potential ecological risk index of heavy metals in soil around centralized drinking water sources in Wuhan was 142.12, which corresponded to a slight potential ecological risk. The correlation analysis showed that the sources of Cu, Pb, and Cr were similar and came from transport. The sources of Ni, As, Cr, and Cu were similar and could be attributed to metallurgical industries. The sources of Zn, Hg, and Cr were similar and could be related to antiseptic and catalytic industries. The long-term monitoring of Wuhan Dijiao and Baishazhou waterworks indicated that the concentrations of heavy metals around centralized drinking water sources in Wuhan were markedly decreased after 2017 and that ecological risk may be further reduced in the future.

Age-Related Disease Burden in China, 1997-2017: Findings From the Global Burden of Disease Study.

Background: The population is aging much faster in China than other low- and middle-income countries. With the accelerated aging of the population, incidence and disease burden of age-related diseases have also continued to increase. Exploring the burden of age-related diseases is crucial for early disease prevention, assessing the extent of population aging, and achieving the goal of healthy aging. Methods: We used the dataset from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), and selected data on incidence, prevalence, and disease burden in China, in 1997, 2007, and 2017. We classified age-related diseases, which were defined as diseases in which the incidence rate increased quadratically with age in the adult population. Additionally, we described the changes in age-related diseases during the study period by different GBD categories. It also measured changes in the age-related disease burden in our study period, including disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD). Finally, we compared the differences in the age-related disease burdens for men and women. Results: Among the 293 diseases listed in the GBD study, 69 in 2017, 78 in 1997 and 72 in 2007 were identified as age-related diseases. More than half of the age-related diseases belonged to non-communicable diseases (NCDs) in our study period. The rate of age-standardized age-related disease burden decreased between 1997 and 2017. DALYs decreased by 24.89% for non-age-related diseases and by 50.15% in age-related diseases from 1997 to 2017. The age-related disease burden of men was higher than that of women; we found a decreasing trend, with -46.23% in men and -54.90% in women. Conclusions: Comparing characteristics of the aging population in China and the world, we found that China does not have the typical disease characteristics of aging society. Currently, China faces the dual threat of NCDs and communicable diseases, and NCDs account for the vast majority of the age-related disease burden. Our health systems should focus on disease prevention and early detection among the entire population, instead of treatment. Further studies should focus on reducing the duration and severity of morbidity in later life.

Non-invasive assessment of early and acute myocarditis in a rat model using cardiac magnetic resonance tissue tracking analysis of myocardial strain.

BACKGROUND: Myocardial strain analysis can provide diagnostic and prognostic information for myocarditis. The aim of the present study was to assess early and acute myocarditis in a rat model using cardiac magnetic resonance tissue tracking (CMR-TT) for myocardial strain analysis. We compared the strain's findings with the histological and immunohistochemical results. METHODS: Experimental autoimmune myocarditis (EAM) was induced by footpad injections of porcine cardiac myosin. The rats were examined by 7.0T preclinical CMR at day 14 (n=15) and day 21 (n=16) after EAM induction and the two control groups (each n=15) were also examined at day 14 and day 21, respectively. Using CMR-TT, we found a global peak systolic radial strain (ErrSAX) and a circumferential strain (EccSAX) from the short-axis cine views and a radial strain (ErrLAX) and a longitudinal strain (EllLAX) from the long-axis cine views, which were calculated by dedicated TT software. Subsequently, histological and immunohistochemical evaluations were performed. RESULTS: EllLAX significantly decreased in early myocarditis compared with the control (-23.40%±1.48% vs. -22.02%±0.81%, P<0.05). ErrSAX, EccSAX, ErrLAX, and EllLAX values significantly reduced in acute myocarditis compared with the controls (ErrSAX: 34.27%±9.80% vs. 49.76%±4.97%, EccSAX: -18.98%±3.69% vs. -24.13±1.23, ErrLAX: 33.21%±10.24% vs. 49.59%±5.69%, and EllLAX: -17.75%±3.58% vs. -23.39%±1.48%; P<0.001, respectively). The receiver operating characteristic curve showed that myocardial strain analysis had a good diagnostic performance in early and acute myocarditis. The pathological evaluation revealed that inflammatory lesions began to appear in early myocarditis and peaked in acute myocarditis. CONCLUSIONS: The CMR-TT strain analysis allowed accurate and reliable evaluation of early and acute myocarditis in a rat model, and has the potential to serve as a diagnostic indicator for the assessment of myocardial dysfunction in myocarditis.

Assessment of patient-based real-time quality control algorithm performance on different types of analytical error.

BACKGROUND: Patient-based real-time quality control (PBRTQC) has gained attention because of its potential to detect analytical errors in situations wherein internal quality control is less effective. Multiple PBRTQC algorithms have been proposed. However, there is a lack of comprehensive comparison of the performance of PBRTQC algorithms on different types of analytical errors. Thus, a comparative study was conducted. METHODS: The performance of six different PBRTQC algorithms was evaluated on three types of analytical errors using 906,552 test results for outpatient serum sodium, chloride, alanine aminotransferase, and creatinine at the Department of Laboratory Medicine at Zhongshan Hospital, Fudan University in 2019. The performance results were compared and assessed. RESULTS: The moving average, moving median, exponentially weighted moving average, and moving quartiles performed similarly for effectively detecting constant errors (CE) and proportional errors (PE) but not random errors (RE). The moving sum of positive patients and moving standard deviation could detect RE for serum sodium and chlorides but performed poorly on detecting the CE and PE. CONCLUSIONS: This study demonstrated the importance of assessing the potential source of error of a particular analyte and the corresponding type of analytical error before choosing a quality control algorithm for implementation.

An Optimal Pollution Control Model for Environmental Protection Cooperation between Developing and Developed Countries.

With the continuous increase in greenhouse gas emissions in the world and the United States announcing withdrawal from the Paris Agreement, the conflicts between environmental protection and economic growth of developing and developed countries have become increasingly challenging. In this paper, following the principle of "common but differentiated responsibilities" specified in the Kyoto Protocol and the Paris Agreement, we develop an optimal pollution control model based on a dynamic system for both developing and developed countries. We analyze how different perspectives of the developing and developed countries affect their investments in pollution control and how to determine their responsibilities based on the principle of common but differentiated responsibilities. Our aim is to obtain a stable equilibrium mechanism to maximize the social welfare between the developing and developed countries and explore the optimal pollution control and economic growth path. Our results show that it is optimal for the developed countries to help developing countries with pollution control in their initial stage of economic growth. Once the developing countries reach a certain economic development level, they can contribute more to pollution control, while the developed countries can reduce their environmental investment. We show that by following this optimal path, the developing and developed countries can effectively control environment pollution without significant loss of social welfare.

Global diastolic strain rate for the assessment of left ventricular diastolic dysfunction in young peritoneal dialysis patients: a case control study.

BACKGROUND: Left ventricular (LV) myocardial longitudinal diastolic strain rate measured by two-dimensional speckle tracking imaging (2D-STI) was proved to have a better correlation with the LV diastolic function. We aimed to use this sensitive tool to predict LV myocardial diastolic dysfunction in young peritoneal dialysis (PD) patients with preserved LV ejection fraction (LVEF). METHODS: We enrolled 30 PD patients aged ≤60 with LVEF ≥54% and classified as normal LV diastolic function by conventional echocardiography, and 30 age- and sex-matched healthy people as the control group. The left atrial maximum volume index (LAVI), LV mass index (LVMI), LVEF, LV posterior wall thickness (LVPWT), interventricular septal thickness (IVST), peak velocity of tricuspid regurgitation (TR), peak early diastolic velocity/late diastolic velocity (by Pulsed Doppler) (E/A) and E/peak velocity of the early diastolic wave (by Pulsed-wave tissue Doppler) (E/e') were recorded by conventional echocardiographic. Next, the average LV global longitudinal systolic strain (GLS avg) and the average LV global longitudinal diastolic strain rate (DSr avg) during early diastole (DSrE avg), late diastole (DSrA avg) and isovolumic relaxation period (DSrIVR avg) were obtained from 2D-STI. Combined them with E, the new noninvasive indexes (E/DSrE avg., E/DSrA avg. and E/DSrIVR avg) were derived. RESULTS: The PD group 's LVEF, E/e', TR and LAVI were in the normal range compared with the controls, and only e' (p < 0.001) was decreased. The LVMI (p < 0.001), LVPWT (p < 0.001), IVST (p < 0.001) increased while E/A (p < 0.001) decreased. The GLS avg. (p = 0.008) was significantly decreased in PD patients compared with the controls. DSrA avg. (p = 0.006) and E/DSrE avg. (p = 0.006) were increased, while DSrE avg. (p < 0.001), DSrIVR avg. (p = 0.017) and E/DSrA avg. (p < 0.001) decreased. After the multivariable regression analysis, the correlation between DSrE and the conventional parameters including LVPWT (p < 0.001), E/A (p < 0.001) still remained significant. CONCLUSIONS: Young PD patients with preserved LVEF already exhibited myocardial diastolic dysfunction. Global diastolic strain rate indexes were valuable parameters to evaluate diastolic dysfunction. Additionally, LVPWT was highly correlated with DSrE, such parameter should be taken into account for predicting the early LV diastolic dysfunction in clinical practice.