Risk of infection with arboviruses in a healthy population in Pakistan based on seroprevalence.

Infectious diseases caused by arboviruses are a public health concern in Pakistan. However, the studies on data prevalence and threats posed by arboviruses are limited. This study investigated the seroprevalence of arboviruses in a healthy population in Pakistan, including severe fever with thrombocytopenia syndrome virus (SFTSV), Crimean-Congo hemorrhagic fever virus (CCHFV), Tamdy virus (TAMV), and Karshi virus (KSIV) based on a newly established luciferase immunoprecipitation system (LIPS) assays, and Zika virus (ZIKV) by enzyme-linked immunosorbent assays (ELISA). Neutralizing activities against these arboviruses were further examined from the antibody positive samples. The results showed that the seroprevalence of SFTSV, CCHFV, TAMV, KSIV, and ZIKV was 17.37%, 7.58%, 4.41%, 1.10%, and 6.48%, respectively, and neutralizing to SFTSV (1.79%), CCHFV (2.62%), and ZIKV (0.69%) were identified, as well as to the SFTSV-related Guertu virus (GTV, 0.83%). Risk factors associated with the incidence of exposure and levels of antibody response were analyzed. Moreover, co-exposure to different arboviruses was demonstrated, as thirty-seven individuals were having antibodies against multiple viruses and thirteen showed neutralizing activity. Males, individuals aged ≤40 years, and outdoor workers had high risk of exposure to arboviruses. All these results reveal the substantial risks of infection with arboviruses in Pakistan, and indicate the threat from co-exposure to multiple arboviruses. The findings raise the need for further epidemiologic investigation in expanded regions and populations and the necessity to improve health surveillance in Pakistan.

A retrospective cohort study of Paxlovid efficacy depending on treatment time in hospitalized COVID-19 patients.

Paxlovid, a SARS-CoV-2 antiviral, not only prevents severe illness but also curtails viral shedding, lowering transmission risks from treated patients. By fitting a mathematical model of within-host Omicron viral dynamics to electronic health records data from 208 hospitalized patients in Hong Kong, we estimate that Paxlovid can inhibit over 90% of viral replication. However, its effectiveness critically depends on the timing of treatment. If treatment is initiated three days after symptoms first appear, we estimate a 17% chance of a post-treatment viral rebound and a 12% (95% CI: 0-16%) reduction in overall infectiousness for non-rebound cases. Earlier treatment significantly elevates the risk of rebound without further reducing infectiousness, whereas starting beyond five days reduces its efficacy in curbing peak viral shedding. Among the 104 patients who received Paxlovid, 62% began treatment within an optimal three-to-five-day day window after symptoms appeared. Our findings indicate that broader global access to Paxlovid, coupled with appropriately timed treatment, can mitigate the severity and transmission of SARS-Cov-2.

Piezocatalytically-induced controllable mineralization scaffold with bone-like microenvironment to achieve endogenous bone regeneration.

Orderly hierarchical structure with balanced mechanical, chemical, and electrical properties is the basis of the natural bone microenvironment. Inspired by nature, we developed a piezocatalytically-induced controlled mineralization strategy using piezoelectric polymer poly-L-lactic acid (PLLA) fibers with ordered micro-nano structures to prepare biomimetic tissue engineering scaffolds with a bone-like microenvironment (pcm-PLLA), in which PLLA-mediated piezoelectric catalysis promoted the in-situ polymerization of dopamine and subsequently regulated the controllable growth of hydroxyapatite crystals on the fiber surface. PLLA fibers, as analogs of mineralized collagen fibers, were arranged in an oriented manner, and ultimately formed a bone-like interconnected pore structure; in addition, they also provided bone-like piezoelectric properties. The uniformly sized HA nanocrystals formed by controlled mineralization provided a bone-like mechanical strength and chemical environment. The pcm-PLLA scaffold could rapidly recruit endogenous stem cells, and promote their osteogenic differentiation by activating cell membrane calcium channels and PI3K signaling pathways through ultrasound-responsive piezoelectric signals. In addition, the scaffold also provided a suitable microenvironment to promote macrophage M2 polarization and angiogenesis, thereby enhancing bone regeneration in skull defects of rats. The proposed piezocatalytically-induced controllable mineralization strategy provides a new idea for the development of tissue engineering scaffolds that can be implemented for multimodal physical stimulation therapy.

Minor envelope proteins from GP2a to GP4 contribute to the spread pattern and yield of type 2 PRRSV in MARC-145 cells.

In China, porcine reproductive and respiratory syndrome virus (PRRSV) vaccines are widely used. These vaccines, which contain inactivated and live attenuated vaccines (LAVs), are produced by MARC-145 cells derived from the monkey kidney cell line. However, some PRRSV strains in MARC-145 cells have a low yield. Here, we used two type 2 PRRSV strains (CH-1R and HuN4) to identify the genes responsible for virus yield in MARC-145 cells. Our findings indicate that the two viruses have different spread patterns, which ultimately determine their yield. By replacing the viral envelope genes with a reverse genetics system, we discovered that the minor envelope proteins, from GP2a to GP4, play a crucial role in determining the spread pattern and yield of type 2 PRRSV in MARC-145 cells. The cell-free transmission pattern of type 2 PRRSV appears to be more efficient than the cell-to-cell transmission pattern. Overall, these findings suggest that GP2a to GP4 contributes to the spread pattern and yield of type 2 PRRSV.

Exploring functional genes' correlation with (S)-equol concentration and new daidzein racemase identification.

With its estrogenic activity, (S)-equol plays an important role in maintaining host health and preventing estrogen-related diseases. Exclusive production occurs through the transformation of soy isoflavones by intestinal bacteria, but the reasons for variations in (S)-equol production among different individuals and species remain unclear. Here, fecal samples from humans, pigs, chickens, mice, and rats were used as research objects. The concentrations of (S)-equol, along with the genetic homology and evolutionary relationships of (S)-equol production-related genes [daidzein reductase (DZNR), daidzein racemase (DDRC), dihydrodaidzein reductase (DHDR), tetrahydrodaidzein reductase (THDR)], were analyzed. Additionally, in vitro functional verification of the newly identified DDRC gene was conducted. It was found that approximately 40% of human samples contained (S)-equol, whereas 100% of samples from other species contained (S)-equol. However, there were significant variations in (S)-equol content among the different species: rats > pigs > chickens > mice > humans. The distributions of the four genes displayed species-specific patterns. High detection rates across various species were exhibited by DHDR, THDR, and DDRC. In contrast, substantial variations in detection rates among different species and individuals were observed with respect to DZNR. It appears that various types of DZNR may be associated with different concentrations of (S)-equol, which potentially correspond to the regulatory role during (S)-equol synthesis. This enhances our understanding of individual variations in (S)-equol production and their connection with functional genes in vitro. Moreover, the newly identified DDRC exhibits higher potential for (S)-equol synthesis compared to the known DDRC, providing valuable resources for advancing in vitro (S)-equol production. IMPORTANCE: (S)-equol ((S)-EQ) plays a crucial role in maintaining human health, along with its known capacity to prevent and treat various diseases, including cardiovascular diseases, metabolic syndromes, osteoporosis, diabetes, brain-related diseases, high blood pressure, hyperlipidemia, obesity, and inflammation. However, factors affecting individual variations in (S)-EQ production and the underlying regulatory mechanisms remain elusive. This study examines the association between functional genes and (S)-EQ production, highlighting a potential correlation between the DZNR gene and (S)-EQ content. Various types of DZNR may be linked to the regulation of (S)-EQ synthesis. Furthermore, the identification of a new DDRC gene offers promising prospects for enhancing in vitro (S)-EQ production.

Genome-wide characterization and comparison of endogenous retroviruses among 3 duck reference genomes.

Endogenous retroviruses (ERV) are viral genomes integrated into the host genome and can be stably inherited. Although ERV sequences have been reported in some avian species' genome, the duck endogenous retroviruses (DERV) genome has yet to be quantified. This study aimed to identify ERV sequences and characterize genes near ERVs in the duck genome by utilizing LTRhavest and LTRdigest tools to forecast the duck genome and analyze the distribution of ERV copies. The results revealed 1,607, 2,031, and 1,908 full-length ERV copies in the Pekin duck (ZJU1.0), Mallard (CAU_wild_1.0), and Shaoxing duck (CAU_laying_1.0) genomes, respectively, with average lengths of 7,046, 7,027, and 6,945 bp. ERVs are mainly distributed on the 1, 2, and sex chromosomes. Phylogenetic analysis demonstrated the presence of Betaretrovirus in 3 duck genomes, whereas Alpharetrovirus was exclusively identified in the Shaoxing duck genome. Through screening, 596, 315, and 343 genes adjacent to ERV were identified in 3 duck genomes, respectively, and their functions of ERV neighboring genes were predicted. Functional enrichment analysis of ERV-adjacent genes revealed enrichment for Focal adhesion, Calcium signaling pathway, and Adherens junction in 3 duck genomes. The overlapped genes were highly expressed in 8 tissues (brain, fat, heart, kidney, liver, lung, skin, and spleen) of 8-wk-old Mallard, revealing their important expression in different tissues. Our study provides a new perspective for understanding the quantity and function of DERVs, and may also provide important clues for regulating nearby genes and affecting the traits of organisms.

Identification of candidate genes affecting the tibia quality in Nonghua duck.

The skeleton is a vital organ providing structural support in poultry. Weakness in bone structure can lead to deformities, osteoporosis, cage fatigue, and fractures, resulting in economic losses. Research has substantiated that genetic factors play a significant role in influencing bone quality. The discovery of genetic markers associated with bone quality holds paramount importance for enhancing genetic traits related to the skeletal system in poultry. This study analyzed nine phenotypic indicators of tibia quality in 120-day-old ducks. The phenotypic correlation revealed a high correlation among diameter, Perimeter, and weight (0.69-0.78), and a strong correlation was observed between toughness and breaking strength (0.62). Then, we conducted a genome-wide association analysis of the phenotypic indicators to elucidate the genetic basis of tibial quality in Nonghua ducks. Among the 11 candidate genes that were annotated, TAPT1, BST1, and STIM2 were related to the diameter indicator, ZNF652, IGF2BP1, CASK, and GREB1L were associated with the weight and toughness indicators. RFX8, GLP1R, and DNAAF5 were identified for ash, calcium, and phosphorus content, respectively. Finally, KEGG and GO analysis for annotated genes were performed. STIM2 and BST1 were enriched into the Calcium signalling pathway and Niacin and nicotinamide metabolic pathway, which may be key candidate genes affecting bone quality phenotypes. Gene expression analysis of the candidate genes, such as STIM2, BST1, TAPT1, and CASK showed higher expression levels in bones compared to other tissues. The obtained results can contribute to new insights into tibial quality and provide new genetic biomarkers that can be employed in duck breeding.

Strategies to Improve the Output Performance of Triboelectric Nanogenerators.

Triboelectric nanogenerators (TENGs) can collect and convert random mechanical energy into electric energy, with remarkable advantages including broadly available materials, straightforward preparation, and multiple applications. Over the years, researchers have made substantial advancements in the theoretical and practical aspects of TENG. Nevertheless, the pivotal challenge in realizing full applications of TENG lies in ensuring that the generated output meets the specific application requirements. Consequently, substantial research is dedicated to exploring methods and mechanisms for enhancing the output performance of TENG devices. This review aims to comprehensively examine the influencing factors and corresponding improvement strategies of the output performance based on the contact electrification mechanism and operational principles that underlie TENG technology. This review primarily delves into five key areas of improvement: materials selection, surface modification, component adjustments, structural optimization, and electrode enhancements. These aspects are crucial in tailoring TENG devices to meet the desired performance metrics for various applications.

Combustion properties and pollutant analysis of coal-blended bio-heavy oil fuel.

Excessive carbon-dioxide emissions drive global climate change and environmental challenges. Integrating renewable biomass fuels with coal in power units is crucial for achieving low-carbon emission reductions. Coal blending with bio-heavy oil enhances the combustion calorific value of the fuel, improves combustion characteristics, and decreases pollutant emissions. This study found that bio-heavy oil with low sulfur (0.073%), low nitrogen (0.18%), low ash, and high oxygen (11.005%) content exhibits excellent fuel performance, which can be attributed to the abundant oxygen-containing functional groups (such as C[double bond, length as m-dash]O) in the alcohols, aldehydes, and ketones present in bio-heavy oil. Additionally, the residual moisture in coal-blended bio-heavy oil reduces the fuel's calorific value. The calorific value increases with a higher proportion of blended bio-heavy oil (28.1, 28.9, 32.1, 34.7, 40.6 MJ kg-1). Experiments on combustion flame shooting reveal that the combustion time of bio-heavy oils is significantly shorter than that of coal. As the proportion of blended bio-heavy oil increases, the flame height increases. Coal blending with bio-heavy oil involves three stages: water evaporation, volatile-matter decomposition, fixed-carbon combustion and mineral decomposition. This advances the combustion process and improves coal's ignition performance. Furthermore, the amount of gaseous pollutants (sulfur dioxide and nitrogen dioxide) in coal mixed with bio-heavy oil is relatively low, which is in alignment with the green environmental protection guidelines. The blending of coal with biomass fuel holds significant practical and strategic importance for developing high-efficiency, low-carbon, coal power units.

Critical fractions in reclaimed water responsible for membrane fouling: Isolation, fouling characteristics, quantitative and qualitative variations in practical application.

Considering the different fouling characteristics between model foulants and organic components in real reclaimed water, it is of great importance to identify the critical foulants responsible for membrane fouling. This study identified and isolated the fraction with molecular weight (MW) > 100 kDa as the critical foulant in secondary effluent by MW cut-off membrane of 100 kDa with high efficiency. This fraction accounted for 92.2% membrane fouling of raw water, including 28.7%, 29.7% and 33.8% fouling contribution by subfractions with MW between 100-300, 300-500 and > 500 kDa. Specifically, the critical fraction with MW > 100 kDa were mainly distributed in two parts: < 0.22 µm and > 0.45 µm, corresponding to 41.9% and 56.9% fouling contribution of this fraction. Furthermore, both total organic carbon (TOC) and fouling potential of fraction with MW > 100 kDa were monitored, presenting about threefold increase from September to January in next year. Membrane fouling contribution of this critical fraction in raw secondary effluent were mainly distributed in 85∼95% throughout the 5 months, demonstrating its predominant fouling propensity. Moreover, the TOC concentration of fraction with MW > 100 kDa presented distinct positive correlation with the fouling potential of raw secondary effluent (R2 = 0.947), which was promising to be a surrogate for predicting membrane fouling in practical application.

Public Health Impact of Paxlovid as Treatment for COVID-19, United States.

We evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizations and save US $56.95 billion (95% CI US $2.62-$122.63 billion). In a higher transmission scenario (effective reproduction number of 3), the benefits increase, potentially preventing 0.85 million (95% CI 0.36-1.38 million) hospitalizations and saving US $170.17 billion (95% CI US $60.49-$286.14 billion). Our findings suggest that timely and widespread use of Paxlovid could be an effective and economical approach to mitigate the effects of COVID-19.

Epidemiological surveys revealed the risk of TAMV spill-over from ticks to hosts.

BACKGROUND: Tick-borne viral diseases have become an increasingly important public health concern. Tamdy virus (TAMV) is a tick-borne virus of the genus Orthonairovirus in the family Nairoviridae. While some studies have suggested that TAMV is a pathogen associated with human febrile illness, its epidemiology and the risk of TAMV spill-over remain poorly understood. METHODS: Ticks were collected in Xinjiang, China, and grouped into pools. RT-PCR assays were used to detect TAMV RNA in these pools. The seroprevalence of TAMV was investigated using Immunofluorescence assays, Western blotting, and Luciferase immunoprecipitation system (LIPS) assays. RESULTS: TAMV RNA was detected in 17 out of 363 tick pools, resulting in a minimum infection rate (MIR) of 4.7%. Hyalomma asiaticum and Dermacentor nuttalli were identified as major tick vectors of TAMV. Phylogenetic analysis demonstrated that TAMV strains from Xinjiang are closely related to strains from other countries. Seroprevalence studies showed that TAMV exposure has been occurring in Xinjiang since at least 2006. Antibody responses to TAMV were detected in 1.1% (26/2296) of animals, including domestic animals and wild rodents. The seropositivity rates were as follows: sheep (1.7%), dog (2.3%), Marmota monax (0.8%), Meriones meridianus (3.5%). CONCLUSIONS: The research findings reveal that TAMV can be transmitted by ticks to various animal species, posing a significant public health risk. The wide distribution of TAMV and its tick vectors emphasise the importance of early preparedness and control measures. This study highlights the necessity for maintaining vigilance in addressing emerging zoonotic diseases transmitted by ticks.

Nowcasting and Forecasting Seasonal Influenza Epidemics - China, 2022-2023.

Background: Seasonal influenza resurged in China in February 2023, causing a large number of hospitalizations. While influenza epidemics occurred across China during the coronavirus disease 2019 (COVID-19) pandemic, the relaxation of COVID-19 containment measures in December 2022 may have contributed to the spread of acute respiratory infections in winter 2022/2023. Methods: Using a mathematical model incorporating influenza activity as measured by influenza-like illness (ILI) data for northern and southern regions of China, we reconstructed the seasonal influenza incidence from October 2015 to September 2019 before the COVID-19 pandemic. Using this trained model, we predicted influenza activities in northern and southern China from March to September 2023. Results: We estimated the effective reproduction number R e as 1.08 [95% confidence interval ( CI): 0.51, 1.65] in northern China and 1.10 (95% CI: 0.55, 1.67) in southern China at the start of the 2022-2023 influenza season. We estimated the infection attack rate of this influenza wave as 18.51% (95% CI: 0.00%, 37.78%) in northern China and 28.30% (95% CI: 14.77%, 41.82%) in southern China. Conclusions: The 2023 spring wave of seasonal influenza in China spread until July 2023 and infected a substantial number of people.

Application of prone position ventilation in ventilation strategies for patients with COVID-19.

BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) have been shown to die mainly due to disease-induced acute respiratory distress syndrome (ARDS). Prone position ventilation (PPV) is an important ventilation strategy in the management of patients with ARDS. OBJECTIVE: To investigate the application of PPV in ventilation strategies for patients with COVID-19. METHODS: Three hundred patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Shanxi Bethune Hospital from January 2020 to June 2021 were retrospectively collected. Based on body position and conscious state, all patients were divided into three groups: intubation prone position group (n= 110), awake prone position group (n= 90) and supine position group (n= 100); The acute physiology and chronic health evaluation II (APACHE-II) scores, blood gas indicators, complications and other relevant clinical indicators were compared among the three groups. One-way ANOVA was used to compare means between multiple groups for quantitative information that conformed to a normal distribution. Repeated measures ANOVA was used for repeated measures data. Component comparisons were made using the Kruskal-Wallis H rank sum test for non-normally distributed quantitative data. RESULTS: One-way repeated-measures ANOVA main effect analysis showed different effects of different treatments on PaO2 in patients with COVID-19 (F treatment = 256.231, P< 0.05), with the order of awake prone position group > intubation prone position group > supine position group. The effects of the three different treatments on P/F in patients with COVID-19 (F treatment = 311.661, P< 0.05), with the order of awake prone position group > supine position group > intubation prone position group; Moreover, the three treatments had different effects on APACHE II scores in patients with COVID-19 (F treatment = 201.342, P< 0.05), with the order of intubation prone position group > supine position group > awake prone position group. CONCLUSION: Intubation prone position and awake prone position can improve lung function to some extent in patients with COVID-19, and should be applied as early as possible in patients with COVID-19-induced ARDS.

Mitigation of respiratory syncytial virus epidemics by RSVpreF vaccines after the COVID-19 pandemic in the UK: a modelling study.

BACKGROUND: The RSVpreF vaccines have breakthrough progress. The respiratory syncytial virus (RSV) vaccine for older adults from GlaxoSmithKline was the first RSV vaccine approved by the US Food and Drug Administration (FDA) in early May 2023, followed by the subsequent FDA approval of Pfizer's RSV vaccines for older adults and pregnant women. We aimed to estimate the public health impact of the potential population-level administrations of the RSVpreF vaccine in the UK. METHODS: In this modelling study, we used national census and contact survey data to construct an individual-based mathematical model, with interpersonal connections characterising household structure, social settings, and age-specific contact patterns. We considered both within-host viral-load dynamics and between-host RSV transmission. We modelled the coverages of RSV vaccines for older people (age ≥60 years) and pregnant women, using influenza vaccination data from the 2018-19 season. We explored a range of possible transmissibility and estimated the health burden averted by RSVpreF vaccine over a 300-day period as compared with the control scenario without vaccines. FINDINGS: In a low-transmission scenario (Re=1·2), RSVpreF would avert a total population of 2·35 (95% credible interval [CrI] 1·24-3·77) million infections, 12.80 (95% CrI 8·60-17·06) thousand hospital admissions, and 0·93 (95% CrI 0·69-1·25) thousand deaths, with 1·82 (1·41-2·33) million infections, 12·44 (8·50-16·38) thousand hospital admissions, and 0·93 (0·67-1·23) thousand deaths averted for people aged 60 years and older. In a high-transmission scenario (Re=2·0), RSVpreF would avert 2·01 (1·37-2·68) million infections, 14·67 (10·05-18·33) thousand hospital admissions, and 1·12 (0·80-1·35) thousand deaths. The majority averted would still be among older adults. INTERPRETATION: Our mathematical models will help improve the vaccine schedules of RSVpreF. Future work will address several limitations when data become available, including the incorporation of population immunity, potential vaccine hesitancy, and other factors affecting vaccine uptake and effectiveness. FUNDING: Government of the Hong Kong Special Administrative Region, the European Research Council, and Ministry of Science and Technology of the People's Republic of China.

Identifying Phage Sequences From Metagenomic Data Using Deep Neural Network With Word Embedding and Attention Mechanism.

Phages are the functional viruses that infect bacteria and they play important roles in microbial communities and ecosystems. Phage research has attracted great attention due to the wide applications of phage therapy in treating bacterial infection in recent years. Metagenomics sequencing technique can sequence microbial communities directly from an environmental sample. Identifying phage sequences from metagenomic data is a vital step in the downstream of phage analysis. However, the existing methods for phage identification suffer from some limitations in the utilization of the phage feature for prediction, and therefore their prediction performance still need to be improved further. In this article, we propose a novel deep neural network (called MetaPhaPred) for identifying phages from metagenomic data. In MetaPhaPred, we first use a word embedding technique to encode the metagenomic sequences into word vectors, extracting the latent feature vectors of DNA words. Then, we design a deep neural network with a convolutional neural network (CNN) to capture the feature maps in sequences, and with a bi-directional long short-term memory network (Bi-LSTM) to capture the long-term dependencies between features from both forward and backward directions. The feature map consists of a set of feature patterns, each of which is the weighted feature extracted by a convolution filter with convolution kernels in the CNN slide along the input feature vectors. Next, an attention mechanism is used to enhance contributions of important features. Experimental results on both simulated and real metagenomic data with different lengths demonstrate the superiority of the proposed MetaPhaPred over the state-of-the-art methods in identifying phage sequences.

The public health impact of Paxlovid COVID-19 treatment in the United States.

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario Re∼1.2 treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% CrI: 1.69, 71.15) thousand deaths averted, and US$52.16 (95% CrI: 2.62, 122.63) billion reduction in health- and treatment-related costs. Rapid and broad use of the antiviral Paxlovid could substantially reduce COVID-19 morbidity and mortality, while averting socioeconomic hardship.

Investigation and analysis of high risk factors of falls in hospitalised patients after vascular surgery.

AIM: To analyse the risk factors for falls in vascular patients and methods to mitigate fall risk in hospitalised patients receiving vascular surgery. DESIGN: This study is a multicentre, retrospective study. METHODS: A total of 112 inpatients that underwent vascular surgery in five hospitals in Shanxi Province from April 2018 to April 2022 were selected. They were divided into two groups according to whether they had fallen or not; 56 patients who fell were taken as the observation group and 56 patients who did not fall were taken as the control group. The risk factors of falls were analysed by univariate and logistic regression. RESULTS: There was no significant difference between the observation and the control groups in male patients and the incidence of falls without family members. In the observation group, the percentage of patients aged ≥65 years old, with a history of falls and/or fractures, long-term medications and a history of osteoporosis was higher than in the control group and showed a statistically significant difference. Multivariate logistic regression analysis showed that advanced age, a history of falls and fractures, long-term medications and a history of osteoporosis were independent risk factors for falls, and the differences were statistically significant. CONCLUSION: Older age, a history of falls and/or fractures, continuous medication for more than 3 months and a history of osteoporosis are the risk factors for falls in hospitalised patients undergoing vascular surgery.

A critical review of enzymes immobilized on chitosan composites: characterization and applications.

Enzymes with industrial significance are typically used in biological processes. However, instability, high sensitivity, and impractical recovery are the major drawbacks of enzymes in practical applications. In recent years, the immobilization technology has attracted wide attention to overcoming these restrictions and improving the efficiency of enzyme applications. Chitosan (CS) is a unique functional substance with biocompatibility, biodegradability, non-toxicity, and antibacterial properties. Chitosan composites are anticipated to be widely used in the near future for a variety of purposes, including as supports for enzyme immobilization, because of their advantages. Therefor this review explores the effects of the chitosan's structure, molecular weight, degree of deacetylation on the enzyme immobilized, effect of key factors, and the enzymes immobilized on chitosan based composites for numerous applications, including the fields of biosensor, biomedical science, food industry, environmental protection, and industrial production. Moreover, this study carefully investigates the advantages and disadvantages of using these composites as well as their potential in the future.

Estimate of COVID-19 Deaths, China, December 2022-February 2023.

China announced a slight easing of its zero-COVID rules on November 11, 2022, and then a major relaxation on December 7, 2022. We estimate that the ensuing wave of SARS-CoV-2 infections caused 1.41 million deaths in China during December 2022-February 2023, substantially higher than that reported through official channels.