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The aim of this study was to evaluate the hypotensive effect and optimal protocol of inspiratory muscle resistance training (IMST). Randomized controlled trials using IMST to lower blood pressure (BP) were retrieved from 12 databases as of July 2022. A meta‐analysis of BP and heart rate variability (HRV) was performed and a trial sequence analysis was performed using trial sequential analysis (TSA) software. Twelve articles (n = 386 participants) from five countries were included, with a mean quality score of 5.83. IMST achieved significant results in reducing systolic, diastolic, and mean arterial pressure (−7.93 [−12.08, −3.78]; −3.80 [−6.08, −1.53]; −4.90 [−13.76, 3.96]). Furthermore, TSA has shown that the findings for systolic and diastolic BP are conclusive. Finally, considerable variation remained between studies when analyzing HRV. The overall hypotensive effect of IMST was demonstrated by the TSA and was well tolerated in different populations. Of these, two interventions, high resistance or low resistance combined with slow breathing, showed the best efficacy under an 8‐week exercise intervention. In addition, the process of lowering BP by modulating sympathetic vagal activity has not been further confirmed in this study. Future long‐term interventions, especially those over 3 months, are needed to observe the prolonged antihypertensive effects and modulatory mechanisms; controlling for variables such as respiratory rate and executing more rigorous studies to further explore antihypertensive options. [ABSTRACT FROM AUTHOR]

Background: Functional dyspepsia (FD) as a type of disorders of brain-gut interaction (DBGI), patient self-reporting of its symptoms becomes an important component of clinical outcome assessment. We performed a systematic review using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines to identify the best available patient-reported outcome measure (PROM) of FD. Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched four databases with no date limit, looking for previously confirmed PROMs for evaluating FD symptoms. An overall rating was then assigned based upon COSMIN guidelines, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the level of evidence for psychometric properties of included PROMs. Results: Thirty articles covering outcome indicators of 24 patient reports were included. The Leuven Postprandial Distress Scale (LPDS) showed adequate content validity and moderate quality evidence of adequate internal consistency to generate an A recommendation. Conclusion: LPDS is currently the most recommended PROM for patient self-reported FD symptoms. However, it fails to assess two important areas of cross-cultural validity/ measurement invariance and measurement error. Future research can be continuously improved on this basis. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a poor prognosis; nearly 80% patients have regional or distant metastasis when diagnosed. Tumor microenvironment (TME) alteration and epithelial-to-mesenchymal transition (EMT) have been reported to play a key role in cancer metastasis. However, the correlation between TME and EMT was poorly studied in PDAC. This study aims to explore the correlation between EMT markers and TME alteration, mainly including macrophage polarization and PD-L1 expression change, in primary and metastatic PDAC tissues by immunohistochemistry. The results indicated that macrophage polarization was found in metastases with the number of M1 macrophages (CD86+) decreased and M2 (CD163+) increased, though PD-L1 expression did not have a significant alteration. Compared to primary tumors, E-cadherin was significantly lower, while snail was higher, while no difference was found with N-cadherin and ZEB1. Correlation analysis indicated that snail, but not ZEB1, E-cadherin, or N-cadherin, was highly correlated with macrophage polarization. To conclude, the number of CD86+ M1 macrophages was increased while CD163+ M2 macrophages decreased in metastases, with no significant alteration of PD-L1 expression compared to primary tumors. EMT markers—Snail and E-cadherin—but not ZEB1 or N-cadherin, were found to be higher/lower in metastases, which mean that EMT played an important role in PDAC metastasis. Further analysis indicated that snail was highly correlated with M1 to M2 macrophage polarization, which prompted that EMT may be one reason for macrophage polarization induced TME alteration in PDAC metastasis. [ABSTRACT FROM AUTHOR]

Real-time and online screening techniques for single load effect signal monitoring are one of the key issues in smart structure monitoring. In this paper, an online signal sifting framework called online recursive empirical mode decomposition (EMD) is proposed. The framework is based on an improved EMD that optimizes the boundary effect by using extreme value recursion and eigensystem realization algorithm (ERA) extension, and combines the intrinsic mode functions (IMFs) correlation coefficient and adaptive filtering to select IMFs for signal reconstruction to achieve the sifting purpose. When applied to simulated signals, the method satisfies the requirements of signal sifting in an online environment with high adaptivity, low parameter sensitivity and good robustness. The method was applied to the dynamic strain data collected by the health monitoring system of Daishan Second Bridge to achieve real-time online sifting of strain signals caused by traffic loads, which provided the basis for subsequent data analysis applications and confirmed the value of the application in a real bridge health monitoring system. [ABSTRACT FROM AUTHOR]

The incidence of pancreatic ductal adenocarcinoma (PDAC) has been on the rise in recent years; however, its clinical diagnosis and treatment remain challenging. Although surgical resection remains the only chance for long-term patient survival, the likelihood of initial resectability is no higher than 20%. Neoadjuvant therapy (NAT) in PDAC aims to transform the proportion of inoperable PDACs into operable cases and reduce the likelihood of recurrence to improve overall survival. Ongoing phase 3 clinical trial aims to validate the role of NAT in PDAC therapy, including prolongation of survival, increased R0 resection, and a higher proportion of negative lymph nodes. Controversies surrounding the role of NAT in PDAC treatment include applicability to different stages of PDAC, chemotherapy regimens, radiation, duration of treatment, and assessment of effect. This review aims to summarize the current progress and controversies of NAT in PDAC. [ABSTRACT FROM AUTHOR]

Chrysolaminarin, a kind of water-soluble bioactive β-glucan produced by certain microalgae, is a potential candidate for food/pharmaceutical applications. This study identified a marine microalga Isochrysis zhangjiangensis, in which chrysolaminarin production was investigated via nutrient (nitrogen, phosphorus, or sulfur) deprivations (-N, -P, or -S conditions) along with an increase in light intensity. A characterization of the antioxidant activities of the chrysolaminarin produced under each condition was also conducted. The results showed that nutrient deprivation caused a significant increase in chrysolaminarin accumulation, though this was accompanied by diminished biomass production and photosynthetic activity. -S was the best strategy to induce chrysolaminarin accumulation. An increase in light intensity from 80 (LL) to 150 (HL) µE·m−2·s−1 further enhanced chrysolaminarin production. Compared with -N, -S caused more suitable stress and reduced carbon allocation toward neutral lipid production, which enabled a higher chrysolaminarin accumulation capacity. The highest chrysolaminarin content and concentration reached 41.7% of dry weight (%DW) and 632.2 mg/L, respectively, under HL-S, with a corresponding productivity of 155.1 mg/L/day achieved, which exceeds most of the photoautotrophic microalgae previously reported. The chrysolaminarin produced under HL-N (Iz-N) had a relatively competitive hydroxyl radical scavenging activity at low concentrations, while the chrysolaminarin produced under HL-S (Iz-S) exhibited an overall better activity, comparable to the commercial yeast β-glucan, demonstrating I. zhangjiangensis as a promising bioactive chrysolaminarin producer from CO2. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has imposed tremendous impacts on the tourism industry worldwide. The tourism sector can take advantage of the new technology (e.g. virtual tourism), to respond to the challenges. This study aims to investigate factors influencing people's acceptability in using virtual tourism during the pandemic in China and explore how virtual tourism can aid the recovery of tourism industry during and after the pandemic. We explore this through a mixed-methods approach. Our results show that the use of virtual tourism can be partially explained by the theory of planned behaviour. Virtual tourism has a strong influence on people's on-site destination choices and can be used as an effective marketing tool to promote destinations and a platform to sell souvenirs and products. Virtual tourism can be an entertainment activity to bring immersed experience to people without being actually in the destinations, and thus reinforce stay-at-home order and help contain COVID-19. Even after the pandemic is over, people still show willingness to use virtual tourism for diverse purposes. The qualitative data also suggest virtual tourism can help promote sustainable tourism by reducing unnecessary greenhouse gas emissions from transportation and enhance 'virtual accessibility' especially for the elderly and disabled with limited mobility. [ABSTRACT FROM AUTHOR]

Sox9 has been previously characterized as a transcription factor responsible for the extracellular matrix production during liver fibrosis. However, the deregulation and functional role of hepatocyte Sox9 in the progression of liver fibrosis remains elusive. Here, we found a significant increase of Sox9 in the hepatocytes isolated from CCl4-induced fibrotic liver and showed that antisense oligoribonucleotides depletion of Sox9 was sufficient to attenuate CCl4-induced liver fibrosis. Notably, the increase of Sox9 in hepatocyte was associated with the upregulation of long noncoding RNA H19 in both in vitro and in vivo systems. Mechanistic studies revealed that Sox9 induced H19 by binding to a conserved promoter region of H19. In vitro , hepatocyte injury triggered the increase of Sox9/H19 axis, whereas silence of H19 greatly alleviated the H2O2-induced hepatocyte apoptosis, suggesting that H19 functions as a downstream effector of Sox9 signaling and is involved in hepatocyte apoptosis. In animal experiments, inhibition of H19 alleviated the activation of hepatic stellate cells and reduced the extent of liver fibrosis, whereas ectopic expression of H19 abolished the inhibitory effects of Sox9 depletion on liver fibrosis, suggesting that the profibrotic effect of hepatocyte Sox9 depends on H19. Finally, we investigated the clinical relevance of Sox9/H19 axis to liver fibrosis and identified the increase of Sox9/H19 axis in liver cirrhosis patients. In conclusion, our findings link Sox9/H19 axis to the intrinsic mechanisms of hepatocyte apoptosis and may represent a hitherto unknown paradigm in hepatocyte injury associated with the progression of liver fibrosis. [ABSTRACT FROM AUTHOR]

In this paper, the features and possible causes of sea surface temperature (SST) biases over the Northwest Pacific are investigated based on a mixed-layer heat budget analysis in 21 coupled general circulation models (CGCMs) from phase 5 of the Coupled Model Inter-comparison Project (CMIP5). Most CMIP5 models show cold SST biases throughout the year over the Northwest Pacific. The largest biases appear during summer, and the smallest biases occur during winter. These cold SST biases are seen at the basin scale and are mainly located in the inner region of the low and mid-latitudes. According to the mixed-layer heat budget analysis, overestimation of upward net sea surface heat fluxes associated with atmospheric processes are primarily responsible for the cold SST biases. Among the different components of surface heat fluxes, overestimated upward latent heat fluxes induced by the excessively strong surface winds contribute the most to the cold SST biases during the spring, autumn, and winter seasons. Conversely, during the summer, overestimated upward latent heat fluxes and underestimated downward solar radiations at the sea surface are equally important. Further analysis suggests that the overly strong surface winds over the Northwest Pacific during winter and spring are associated with excessive precipitation over the Maritime Continent region, whereas those occurring during summer and autumn are associated with the excessive northward extension of the intertropical convergence zone (ITCZ). The excessive precipitation over the Maritime Continent region and the biases in the simulated ITCZ induce anomalous northeasterlies, which are in favor of enhancing low-level winds over the North Pacific. The enhanced surface wind increases the sea surface evaporation, which contributes to the excessive upward latent heat fluxes. Thus, the SST over the Northwest Pacific cools. [ABSTRACT FROM AUTHOR]