[Analysis on vaccination willingness and related factors of influenza, pneumonia, and herpes zoster vaccine among people over 50 years old in Minhang district of Shanghai].

Objective: To determine the knowledge of influenza, pneumonia, herpes zoster and related vaccines, willingness to vaccinate under multiple payment scenarios, and corresponding risk factors among people over 50 years old in Minhang District of Shanghai. Methods: A total of 1 672 respondents aged 50-69 from 13 communities/towns in Minhang district of Shanghai were included in this study using a stratified random sampling strategy on December 2020. The knowledge of influenza, pneumonia, herpes zoster and vaccines was investigated using a questionnaire, and the differences in the willingness under multiple payment scenarios were determined using chi-square test. The consistency in the willingness under multiple payment scenarios was compared using Cohen's Kappa and the risk factors of the willingness was determined using ordinal logistic regression. Results: The average age of 1 672 respondents was (60.48±5.96) years old, including 777 (46.47%) males and 895 (53.53%) females. A total of 1 350 subjects (80.74%) had local household registration in Shanghai. The proportion of the willingness to vaccinate for themselves, spouses, and parents under any payment scenario was determined to be 80.6% (influenza vaccine), 81.5% (pneumonia vaccine), and 74.0% (herpes zoster vaccine). The willingness to vaccinate against influenza and pneumonia under multiple payment scenarios remained stable (Kappa value ≥0.6), while that against herpes zoster infection was inconsistent (Kappa value ≤0.35). Logistic regression analysis showed that respondents who had higher knowledge of influenza and influenza vaccine [OR (95%CI): 1.111 (1.054-1.170), 1.182 (1.126-1.240), respectively], aged 50-59 [1.305 (1.085-1.531)] and local household registration in Shanghai [1.372 (1.079-1.721)] had higher willingness to vaccinate against influenza, while males had lower willingness [0.733 (0.551-0.910)]. Respondents who had higher knowledge of pneumonia and pneumonia vaccine [OR (95%CI): 1.837 (1.152-2.517), 2.217 (1.541-2.893), respectively] had higher willingness to receive pneumonia vaccine. Respondents aged 50-59 [1.327 (1.059-1.537)] and with local household registration in Shanghai [2.497 (1.417-4.400)] were more likely to be vaccinated against herpes zoster, while those with middle school degree or below [0.664 (0.396-0.992)] and high school degree [0.559 (0.324-0.964)] were less likely to be vaccinated. Conclusion: Among people aged over 50 years old in Minhang district of Shanghai, the willingness to vaccinate for themselves, spouses, and parents against influenza, pneumonia and herpes zoster infection is quite different under multiple payment scenarios, especially for herpes zoster vaccine.

The effect of dispatch of national medical teams to Wuhan on its control and prevention of COVID-19.

OBJECTIVES: As a unique prevention and control measure, the dispatch of national medical teams to Wuhan has played a key role in protecting Wuhan against COVID-19. This study aimed to quantitatively evaluate the effect of this key measure in reducing infections and fatalities. STUDY DESIGN: A scenario analysis is used in this study, where the forming of scenarios is on the basis of the stages of medical to Wuhan. We divided the evaluation into 4 scenarios: Scenario Ⅰ-no dispatch, Scenario Ⅱ-dispatch of 4599 medical staff, Scenario Ⅲ-dispatch of 16,000 staff, and Scenario Ⅳ-dispatch of 32,000 staff. METHODS: The extended Susceptible-Exposed-Infectious-Recovered-Death model was adopted to quantify the effect of the dispatch of national medical teams to Wuhan on COVID-19 prevention and control. RESULTS: The dispatch dramatically cuts the channels for the transmission of the virus and succeeds in raising the cure rates while reducing the fatality rates. If there were no dispatch at all, a cumulative total of 158,881 confirmed cases, 18,700 fatalities and a fatality rate of 11.77% would have occurred in Wuhan, which are 3.2 times, 4.8 times and 1.5 times the real figures respectively. The dispatch has avoided 108,541 confirmed cases and 14,831 fatalities in this city. CONCLUSIONS: The proven successful measure provides valuable experience and enlightenment to international cooperation on prevention and control of COVID-19, as well as a similar outbreak of new emerging infectious diseases.

Deep learning risk assessment models for predicting progression of radiographic medial joint space loss over a 48-MONTH follow-up period.

OBJECTIVE: To develop and evaluate deep learning (DL) risk assessment models for predicting the progression of radiographic medial joint space loss using baseline knee X-rays. METHODS: Knees from the Osteoarthritis Initiative without and with progression of radiographic joint space loss (defined as ≥ 0.7 mm decrease in medial joint space width measurement between baseline and 48-month follow-up X-rays) were randomly stratified into training (1400 knees) and hold-out testing (400 knees) datasets. A DL network was trained to predict the progression of radiographic joint space loss using the baseline knee X-rays. An artificial neural network was used to develop a traditional model for predicting progression utilizing demographic and radiographic risk factors. A combined joint training model was developed using a DL network to extract information from baseline knee X-rays as a feature vector, which was further concatenated with the risk factor data vector. Area under the curve (AUC) analysis was performed using the hold-out test dataset to evaluate model performance. RESULTS: The traditional model had an AUC of 0.660 (61.5% sensitivity and 64.0% specificity) for predicting progression. The DL model had an AUC of 0.799 (78.0% sensitivity and 75.5% specificity), which was significantly higher (P < 0.001) than the traditional model. The combined model had an AUC of 0.863 (80.5% sensitivity and specificity), which was significantly higher than the DL (P = 0.015) and traditional (P < 0.001) models. CONCLUSION: DL models using baseline knee X-rays had higher diagnostic performance for predicting the progression of radiographic joint space loss than the traditional model using demographic and radiographic risk factors.

[Application of preoperative three-dimensional image reconstruction in the treatment of ureteropelvic junction obstruction].

OBJECTIVE: To investigate the value of preoperative three-dimensional image reconstruction in the treatment of ureteropelvic junction obstruction (UPJO). METHODS: We reviewed data on 40 patients (22 male cases, and 18 female cases) diagnosed with UPJO in Peking University First Hospital from May 2017 to April 2019. The median age was 26.5 years (IQR 23.25-38.75) years. There were 11 patients complicated with ectopic vessels, 14 patients with kidney stones, 3 patients with horseshoe kidney, and 6 patients with obstruction after pyeloplasty. All the patients underwent preoperative enhanced CT scan, and the CT data were reconstructed into three-dimensional image models. The obstruction position of ureteropelvic junction and the relationship between ureteropelvic junction and blood vessels and organs were observed by three-dimensional models to assist planning surgery. Thirty-seven patients underwent laparoscopic pyeloplasty (including 3 cases combined with pyelolithotomy with flexible cystoscope, 1 case combined with pyelolithotomy by sun-style cystoscope, 1 case with laparoscopic ureter resection and anastomosis, 3 cases of laparoscopic pyeloplasty of horseshoe kidney), 2 patients underwent laparoscopic ventral onlay lingual mucosal graft ureteroplasty, and 1 patient underwent robot-assisted laparoscopic pyeloplasty. RESULTS: Three-dimensional CT image clearly showed the relationship between the obstruction of ureteropelvic junction and blood vessels and organs after three-dimensional reconstruction. The type, diameter, position and direction of the ectopic vessels could be observed clearly before operation according to the three-dimensional reconstruction model, and the number, size, location and shape of renal calculi or other masses, the number of involved renal calyces and the anatomical distribution in the renal pelvis and calyces could be also evaluated preoperatively. After comprehensive analysis of the above information, individualized operation plans were performed on the patients, all the 40 cases were successfully completed with the surgery without any transfer to open surgery. The average operative time was (129.91±37.90) min (range: 75 to 273), the average blood loss was (48.1±78.0) mL (range: 10 to 400), the average hospitality was (5.04±1.99) d (range: 2 to 10), and the average postoperative drainage time was (3.8±1.4) d (range: 2 to 8). CONCLUSION: The preoperative three-dimensional image reconstruction has a high clinical value in the treatment of ureteropelvic junction obstruction, and it is of great help to assist surgery planning and is worthy of further clinical promotion and application.

[Evaluating the impact of preoperative anemia on the prognosis of upper tract urothelial carcinoma following radical nephroureterectomy: A single-center retrospective study of 686 patients].

OBJECTIVE: To identify the effect of preoperative anemia on the prognosis of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy. METHODS: Clinicopathological and prognosis data on 686 patients with UTUC who underwent RNU at Peking University First Hospital between January 2000 and December 2013 were retrospectively analyzed. Preoperative anemia was defined as hemoglobin <130 g/L in men and <120 g/L in women based on the World Health Organization classification. The Kaplan-Meier method with log-rank test was applied to estimate the effect of anemia on survival. The associations of clinicopathologic features with overall survival and cancer-specific survival were evaluated using univariate and multivariate Cox regression models. RESULTS: There were 303(44.2%, 303/686) male and 383(55.8%, 383/686) female patients, and the median age was 68 years (interquartile range: 60-74 years). In all, 320 (46.6%, 320/686) patients were anemic before surgery. The median follow-up duration was 47 months. In all, 160 (23.3%) patients died, 141 (20.6%) died of cancer and 19 (2.7%) died of other disease or accidents. Preoperative anemia was associated with gender (P=0.002), age (P<0.001), lymph node positive (P=0.026), increased tumor grade (P=0.018), concomitant carcinoma in situ (P=0.038), tumor necrosis (P=0.007) and poor renal function (P<0.001). In univariate analysis, overall mortality was correlated with pre-operative anemia (P<0.001), gender (P=0.009), hydronephrosis (P=0.024), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture(P<0.001), sarcomatoid differentiation (P=0.013), history of ureteroscope (P=0.033) and tumor hemorrhage (P<0.001); cancer-specific mortality was correlated with preoperative anemia (P=0.001), gender (P=0.001), hydronephrosis (P=0.043), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture (P<0.001), sarcomatoid differentiation (P=0.016), history of ureteroscope (P=0.028) and tumor hemorrhage (P=0.003). A multivariate Cox proportional hazards model indicated that preoperative anemia was an independent prognositic predictor for overall mortality (P<0.001, HR=1.861) and cancer-specific mortality (P=0.003, HR=1.688). CONCLUSION: The preoperative anemia is an independent risk factor for cancer-specific survival and overall survival. Hemoglobin levels should be considered during patient counseling and in decision-making for further therapy.

EFFECTS OF EXENDIN-4 ON ENDOPLASMIC RETICULUM STRESS-MEDIATED INSULIN RESISTANCE IN 3T3-L1 ADIPOCYTES.

OBJECTIVE: Endoplasmic reticulum stress (ERS) is suspected as an important factor in the initiation of insulin resistance. AIM: To explore the effects of exendin-4 (Ex-4) on the endoplasmic reticulum stress (ERS)-mediated insulin resistance in 3T3-L1 adipocytes. In our study, 3T3-L1 adipocytes were pre-treated with ERS inhibitors tauroursodeoxycholic acid (TUDCA), Ex-4 and an ERS inducer tunicamycin (TM) then induced insulin resistance. Glucose consumption of the adipocytes was measured. Western blots determined the protein levels of ERS markers and insulin signaling pathway. RESULTS: TM treatment reduced insulin-stimulated glucose consumption by 19.7% in 3T3-L1 adipocytes. This repression was blunted by 24h pre-treatment with TUDCA or Ex-4. Ex-4 augmented insulin-stimulated glucose consumption in adipocytes by 14.9%. Western blotting showed that TM treatment significantly increased the ER stress markers including p-IRE, p-JNK, p-PERK, p-eIF2a and ATF6 expression, whereas 24h pre-treatment of adipocytes with TUDCA or Ex-4 alleviated the ER stress. Ex-4 alleviates ERS-induced insulin resistance by upregulating the expression of phosphorylated Akt. CONCLUSION: ERs mediates insulin resistance in 3T3-L1 adipocytes, and exendin-4 significantly improves this insulin resistance.

All-polymer fiber-optic pH sensor.

A novel all-polymer fiber-optic pH sensor using a UV-cured pH-sensitive hydrogel, poly(ethylene glycol) diacrylate (PEGDA), coated on a polymer fiber Bragg grating was developed. The PEGDA increased in volume according to the pH value of the surrounding fluid, which subsequently induced a lateral stress in the polymer fiber Bragg grating. The proposed pH sensor exhibits a pH sensitivity of up to -0.41 nm/pH and a fast response time of 30 s.

The intrapapillary capillary loop (IPCL) changes in superficial esophageal lesions.

The aims of this study were to investigate intrapapillary capillary loops (IPCLs) of superficial esophageal lesions changes in different types classified by the Japan Esophageal Society classification. The calibers, areas, and densities of IPCLs were detected in 34 cases of esophageal lesions using immunohistochemical analysis. Statistically significant differences in calibers, areas, and densities of IPCLs were observed between type A, type B1/B2, and type B3 area (P < 0.001). In conclusion, the results of this observation showed the Japan Esophageal Society classification of IPCL would help endoscopists to diagnose the type and the invasion depth of lesion in esophagus, and decide the treatment strategy.

[Prognostic factors of patients with T2N0M0 upper tract urothelial carcinoma: a single-center retrospective study of 235 patients].

OBJECTIVE: To evaluate the impacts of the prognostic factors of T2N0M0 upper tract urothelial carcinoma (UTUC) for Chinese patients. METHODS: A retrospective study was conducted including 235 patients who were diagnosed with T2N0M0 UTUC in our hospital and received radical nephroureterectomy (RNU) or partial ureterectomy during January 2000 and December 2013. The 3 and 5-year cancer-specific survival rates and bladder recurrence-free survival rates of all the patients were valued using Kaplan-Meier method, and the survival curves with statistical significance between the two were compared using the Log-rank test. Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model. RESULTS: A total of 235 patients were included in this study, including 95 (40.4%) male patients and 140 (59.6%) female patients. The mean age was 66.73±10.49 years.The median follow-up time was 53 (rang: 3-142) months, and during the follow-up, 74 (31.5%) patients died of UTUC after a median of 35 months,and 96 (40.9%) patients developed intravesical recurrence after a median of 19.5 months. The 3 and 5-year cancer-specific survival rates of all the patients were 89.1% and 85.9%, respectively; the bladder recurrence-free survival rates were 85.5% and 80.2%, respectively. The independent prognostic factors of cancer-specific mortality were tumor age elder than 55 years (HR=3.138, 95%CI: 1.348-7.306, P=0.008) and diameter larger than 5 cm (HR=3.320, 95%CI: 1.882-5.857, P<0.001). The independent prognostic factors of bladder recurrence-free survival were ureter tumor (HR=1.757, 95%CI: 1.159-2.664, P=0.008) and lower tumor grade (HR=1.760, 95% CI: 1.151-2.692, P=0.009). CONCLUSION: T2N0M0 UTUC has a better cancer-specific survival. The intravesical recurrence was equivalent to non-muscle invasive UTUC but earlier. The tumor diameter larger than 5 cm and the patient age elder than 55 years were independently associated with cancer-specific mortality; the primary tumor located in ureter and lower tumor grade were more likely to develop intravesical recurrence.

[MicroRNA-205 targeted Krüppel-like factor 12 and regulated MDA-MB-468 cells apoptosis in basal-like breast carcinoma].

OBJECTIVE: To identify basal-like breast carcinoma (BLBC)-specific microRNA (miRs) and its target gene and to investigate the distinct biological function. METHOD: Krüppel-like factor 12 (KLF12) 3'-UTR was constructed and luciferase reporter assay was performed for target gene. Expression levels of miR including its target genes were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR), Western blot and immunohistochemistry (IHC). Further functional analyses were conducted which included apoptosis. RESULTS: Luciferase assay showed miR-205 directly targets KLF12 through binding its 3'-UTR (P=0.001 6). QRT-PCR revealed that miR-205 expression levels were exclusively lower in MDA-MB-468 cell lines (P=0.00 7) and BLBC tumor tissues (P=0.007 4; n=3), but KLF12 were highly expressed in MDA-MB-468 cell lines (P=0.003 9); knock-up of miR-205 expression by transfection with its mimics in MDA-MB-468 cells substantially increased miR-205 expression level (P=0.000) and reduced KLF12 expression level (P=0.038). Western blot displayed that KLF12 expression levels were higher in tumor tissues when compared with normal breast tissues (P=0.008 3; n=9). Knock-up of miR-205 expression by transfection with its mimics promoted MDA-MB-468 cells apoptosis (P=0.006 1). CONCLUSIONS: Our results suggest that miR-205 is a miR specific for BLBC which exerts tumor suppression role through negative regulated proto-oncogene KLF12 and promote cell apoptosis. MiR-205 and KLF12 may provide potential diagnosis molecular biomarker and possible new approach for the treatment for BLBC.

Broadband photonic microwave phase shifter based on controlling two RF modulation sidebands via a Fourier-domain optical processor.

An all-optical photonic microwave phase shifter that can realize a continuous 360° phase shift over a wide frequency range is presented. It is based on the new concept of controlling the amplitude and phase of the two RF modulation sidebands via a Fourier-domain optical processor. The operating frequency range of the phase shifter is largely increased compared to the previously reported Fourier-domain optical processor based phase shifter that uses only one RF modulation sideband. This is due to the extension of the lower RF operating frequency by designing the amplitude and phase of one of the RF modulation sidebands while the other sideband is designed to realize the required RF signal phase shift. The two-sideband amplitude-and-phase-control based photonic microwave phase shifter has a simple structure as it only requires a single laser source, a phase modulator, a Fourier-domain optical processor and a single photodetector. Investigation on the bandwidth limitation problem in the conventional Fourier-domain optical processor based phase shifter is presented. Comparisons between the measured phase shifter output RF amplitude and phase responses with theory, which show excellent agreement, are also presented for the first time. Experimental results demonstrate the full -180° to + 180° phase shift with little RF signal amplitude variation of less than 3 dB and with a phase deviation of less than 4° over a 7.5 GHz to 26.5 GHz frequency range, and the phase shifter exhibits a long term stable performance.

Mode-multiplexed transmission over conventional graded-index multimode fibers.

We present experimental results for combined mode-multiplexed and wavelength multiplexed transmission over conventional graded-index multimode fibers. We use mode-selective photonic lanterns as mode couplers to precisely excite a subset of the modes of the multimode fiber and additionally to compensate for the differential group delay between the excited modes. Spatial mode filters are added to suppress undesired higher order modes. We transmit 30-Gbaud QPSK signals over 60 WDM channels, 3 spatial modes, and 2 polarizations, reaching a distance of 310 km based on a 44.3 km long span. We also report about transmission experiments over 6 spatial modes for a 17-km single-span experiment. The results indicate that multimode fibers support scalable mode-division multiplexing approaches, where modes can be added over time if desired. Also the results indicate that mode-multiplexed transmission distance over 300 km are possible in conventional multimode fibers.

Irradiation of 850-nm laser light changes the neural activities in rat primary visual cortex.

Although infrared laser was proven to be an alternative approach for neural stimulation, there is very little known about the neural response to infrared laser irradiation in visual cortex. This study is to investigate the effect of near-infrared laser irradiation on neural activities at the cortex level. A 850-nm pigtailed diode laser was applied to stimulate the rat primary visual cortex while the horizontal black and white stripe pattern was used as standard visual stimulation to evoke visual-evoked potential (VEP). Both amplitude and latency of VEP P100 was measured with or without infrared pulse stimulation applied in rat primary visual cortex. Paired t test and one-way analysis of variance were used to evaluate the impact of infrared irradiation and its pulse width on the amplitudes and latencies of P100, respectively. The results from our preliminary study revealed that, the pulsed near-infrared laser depressed the VEP amplitude and shortened the latency of P100; with the increment of pulse width of infrared irradiation, further decline of VEP amplitude and much shortened latency of P100 were observed. The present work suggests that near-infrared laser irradiation can alter the neural activities in primary visual cortex transiently, and could provide a novel contactless artificial neural stimulus to brain cortex with high spatial selectivity.

Increases in Future AR Count and Size: Overview of the ARTMIP Tier 2 CMIP5/6 Experiment.

The Atmospheric River (AR) Tracking Method Intercomparison Project (ARTMIP) is a community effort to systematically assess how the uncertainties from AR detectors (ARDTs) impact our scientific understanding of ARs. This study describes the ARTMIP Tier 2 experimental design and initial results using the Coupled Model Intercomparison Project (CMIP) Phases 5 and 6 multi-model ensembles. We show that AR statistics from a given ARDT in CMIP5/6 historical simulations compare remarkably well with the MERRA-2 reanalysis. In CMIP5/6 future simulations, most ARDTs project a global increase in AR frequency, counts, and sizes, especially along the western coastlines of the Pacific and Atlantic oceans. We find that the choice of ARDT is the dominant contributor to the uncertainty in projected AR frequency when compared with model choice. These results imply that new projects investigating future changes in ARs should explicitly consider ARDT uncertainty as a core part of the experimental design.

[Voxel-based morphometry study of the brain structures in patients with congenital hereditary hearing loss].

Objective: To analyze the physiological basics for changes of cerebral functions in patients with congenital hereditary hearing loss (CHHL), by using voxel-based morphometry (VBM). Methods: From June 2016 to June 2017, we recruited volunteers from Yangzhou Special Education School and CHHL patients from the Department of Otorhinolaryngology, Subei People's Hospital as a case group with a total of 14 cases (8 males and 6 females), with an average age from 10 to 18 (13.13 ± 0.39). At the same time,patients with no ear diseases were recruited as a control group, a total of 23 cases (10 males and 13 females), with an average age from 10 to18 (13.50 ± 0.49). Brain scanning with resting state functional magnetic resonance imaging was performed on all subjects, and 3D T1WI was collected and processed by the analyzing software. Two sample t-tests were conducted with alphasim correction at the threshold level of P<0.001. Different morphologies of cerebral cortex were identified between patients with CHHL and their normal controls retrospectively. Results: Compared to their normal controls, patients with CHHL had no significant difference in terms of brain volume, gray matter volume, white matter volume, and cerebrospinal fluid volume ((1 397.53±103.98)cm(3) vs. (1 439.45±128.84)cm(3), (765.19±60.27)cm(3) vs. (800.139±77.64)cm(3), (392.89±40.38)cm(3) vs. (414.54±49.22)cm(3), (314.17±25.81)cm(3) vs. (296.47±51.42)cm(3), all P>0.05). However, compared to their normal controls, patients with CHHL had significantly increased (P<0.001) gray matter in the following cerebral gyri: right temporal pole: middle temporal gyrus, right inferior temporal gyrus, left middle occipital gyrus, right inferior parietal gyrus, and left middle frontal gyrus, left superior occipital gyrus, right superior frontal gyrus, and left superior frontal gyrus. Furthermore, compared to their normal controls, patients with CHHL had significantly decreased (P<0.001) gray matter in the following cerebral gyri: left parahippocampal gyrus, right fusiform gyrus, right middle frontal gyrus, left inferior temporal gyrus, right middle occipital gyrus, left insula, right inferior frontal gyrus, left precentral gyrus, and right superior parietal gyrus. Conclusions: Patients with CHHL show global changes in cerebral cortex not limited to auditory associated cerebral areas. This suggests that adaptable reshaping of global brain structures and functions has occurred in patients with CHHL.

Retrograde signaling by a mtDNA-encoded non-coding RNA preserves mitochondrial bioenergetics.

Alveolar epithelial type II (AETII) cells are important for lung epithelium maintenance and function. We demonstrate that AETII cells from mouse lungs exposed to cigarette smoke (CS) increase the levels of the mitochondria-encoded non-coding RNA, mito-RNA-805, generated by the control region of the mitochondrial genome. The protective effects of mito-ncR-805 are associated with positive regulation of mitochondrial energy metabolism, and respiration. Levels of mito-ncR-805 do not relate to steady-state transcription or replication of the mitochondrial genome. Instead, CS-exposure causes the redistribution of mito-ncR-805 from mitochondria to the nucleus, which correlated with the increased expression of nuclear-encoded genes involved in mitochondrial function. These studies reveal an unrecognized mitochondria stress associated retrograde signaling, and put forward the idea that mito-ncRNA-805 represents a subtype of small non coding RNAs that are regulated in a tissue- or cell-type specific manner to protect cells under physiological stress.