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Importance: Acupoint autohemotherapy (AA), a therapeutic technique involving the subcutaneous injection of autologous blood into acupoints, has been empirically validated as safe and effective for treating asthma by alleviating symptoms and decreasing acute attacks, though its mechanism is not well understood. Objective: The role of heme oxygenase-1 (HO-1) in AA-induced suppression of asthmatic airway inflammation is examined. Methods: Twenty rats were assigned randomly to four groups, namely the Control, OVA, OVA + AA, and (OVA + Snpp) + AA. Rats in the OVA + AA and (OVA + Snpp) + AA received autologous blood injections into acupoints (BL13 and BL23) following OVA challenge. Rats in the (OVA + Snpp) + AA were concurrently subjected to intraperitoneal injections of Snpp, a inhibitor of HO-1. Airway inflammation was evaluated through HE staining, while the concentrations of cytokines in BALF were quantified using ELISA. The mRNA and protein levels of RORγt (Th17-specific transcription factor), Foxp3 (Treg-specific transcription factor), and HO-1 in lung tissue were assessed through qRT-PCR and WB. Results: HE staining indicated that airway inflammation was alleviated in the OVA + AA. The OVA + AA displayed significantly lower counts of total cells and eosinophils in the BALF compared to both the OVA and (OVA + Snpp) + AA. The ELISA demonstrated a significant decrease in levels of pro-inflamatory cytokines (IL-4, IL-17A), and an increase in levels of anti-inflamatory cytokines (IFN-γ, IL-10), in the OVA + AA when compared to both OVA and (OVA + Snpp) + AA. The qRT-PCR and WB analyses revealed an upregulation of HO-1 and Foxp3 expression, and a downregulation of RORγt expression, in the OVA + AA when compared to OVA and (OVA + Snpp) + AA. Conclusions and Relevance: The involvement of HO-1 in the underlying mechanism responsible for the anti-inflammatory effects of AA is evident. [ABSTRACT FROM AUTHOR]

Background: In colorectal cancer (CRC), tumor deposits (TD) have been used to guide the N staging only in node-negative patients. It remains unknown about the prognostic value of TD in combination with positive lymph node ratio (LNR) in stage III CRC. Patients and methods: The authors analyzed data from 31 139 eligible patients diagnosed with stage III CRC, including 30 230 from the Surveillance, Epidemiology, and End Results (SEER) database as a training set and 909 from two Chinese hospitals as a validation set. The associations of TD and LNR with cancer-specific survival (CSS) and overall survival (OS) were evaluated using the Kaplan-Meier method and Cox regression models. Results: Both TD-positive and high LNR (value =0.4) were associated with worse CSS in the training [multivariable hazard ratio (HR), 1.50; 95% CI: 1.43-1.58 and HR, 1.74; 95% CI: 1.62-1.86, respectively] and validation sets (HR, 1.90; 95% CI: 1.41-2.54 and HR, 2.01; 95% CI: 1.29-3.15, respectively). Compared to patients with TD-negative and low LNR (value <0.4), those with TDpositive and high LNR had a 4.09-fold risk of CRC-specific death in the training set (HR, 4.09; 95% CI: 3.54-4.72) and 4.60-fold risk in the validation set (HR, 4.60; 95% CI: 2.88-7.35). Patients with TD-positive/H-LNR CRC on the right side had the worst prognosis (P <0.001). The combined variable of TD and LNR contributed the most to CSS prediction in the training (24.26%) and validation (32.31%) sets. A nomogram including TD and LNR showed satisfactory discriminative ability, and calibration curves indicated favorable consistency in both the training and validation sets. Conclusions: TD and LNR represent independent prognostic predictors for stage III CRC. A combination of TD and LNR could be used to identify those at high-risk of CRC deaths. [ABSTRACT FROM AUTHOR]

Background: The high incidence of early recurrence after liver resection (LR) for hepatocellular carcinoma (HCC) is the main obstacle in achieving good long-term survival outcomes. The aim of the present study is to develop a prognostic model in predicting the risk of very early (1-year) recurrence. Material and methods: Consecutive patients who underwent LR for HCC with curative intent at multicenters in China were enrolled in this study. The VERM-pre (the Preoperative Very Early Recurrence Model of HCC) with good performance was derived and validated by internal and external cohorts retrospectively and by another two-center cohort prospectively. Results: Seven thousand four hundred one patients were enrolled and divided randomly into three cohorts. Eight variables (tumor diameter, tumor number, macrovascular invasion, satellite nodule, alpha-fetoprotein, level of HBV-DNA, γ-GT, and prothrombin time) were identified as independent risk factors for recurrence-free survival on univariate and multivariate analyses. The VERM-pre model was developed which showed a high capacity of discrimination (C-index: 0.722; AUROC at 1-year: 0.722)) and was validated comprehensively by the internal, external, and prospective cohorts, retrospectively. Calibration plots showed satisfactory fitting of probability of early HCC recurrence in the cohorts. Three risk strata were derived to have significantly different recurrence-free survival rates (low-risk: 80.4-85.4%; intermediate-risk: 59.7-64.8%; high-risk: 32.6-42.6%). In the prospective validation cohort, the swimming plot illustrated consistent outcomes with the beginning predictive score. Conclusion: The VERM-pre model accurately predicted the 1-year recurrence rates of HCC after LR with curative intent. The model was retrospectively and prospectively validated and then developed as the online tool. [ABSTRACT FROM AUTHOR]

Background: To assess the burden and change in incidence, death, and disability-adjusted life years (DALYs) for all-cause-specific injuries among children and adolescents in 204 countries and territories between 1990 and 2019. Materials and methods: Data were extracted from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019). Global, regional, and country-level age-standardized rate (per 100 000) of incidence (ASRI), mortality (ASRM), and DALYs (ASRD) with 95% uncertainty interval (95% UI) of injuries were estimated by age, sex, socio-demographic index (SDI), and all-cause-specific injuries from 1990 to 2019. Results: Overall, the ASRI, ASRM, and ASRD of injury were 9006.18 (95% UI: 7459.74-10 918.04), 23.04 (20.00-26.50), and 2020.19 (1759.47-2318.64) among children and adolescents worldwide in 2019, respectively. All the above indicators showed a downward trend from1990 to 2019. In level 2 cause of injury, both the global transport injury and unintentional injury declined during the study years, while self-harm and interpersonal violence-related injury showed an increasing trend. High SDI regions had higher ASRI of injuries, but low SDI regions had higher ASRM and ASRD of injuries globally in 2019. Males had a higher burden of injuries than those in females. The ASRI of injuries is higher in adolescents aged 15-19 years, whereas the mortality and DALYs rate are higher among children under 5 years old. Moreover, adolescents aged 15-19 years and individuals living in Central Asia, Middle East, and Africa had higher ASRI, ASRM, and ASRD of injuries owing to self-harm and interpersonal violence. Generally, falls and road traffic injuries are the leading cause of injury among the population aged 0-19 years worldwide, but self-harm, interpersonal violence, and conflict and terrorism are also leading types of injuries in some regions, particularly in Low-Income Countries and Middle-Income Countries. Conclusions: Injury remains a major global public health problem among children and adolescents, although its burden at the worldwide level showed a decreasing trend from 1990 to 2019. Of concern, the burden of injuries caused by transport injuries, and unintentional injuries has shown a downward trend in most countries, while the burden caused by self-harm and interpersonal violence has shown an upward trend in most countries. These findings suggest that more targeted and specific strategies to prevent the burden of injuries should be reoriented, and our study provides important findings for decision-makers and healthcare providers to reduce injury burden among children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic related limb osteomyelitis (PTRLO) is a complex bone infection. Currently, there are no available microbial data on a national scale that can guide appropriate antibiotic selection, and explore the dynamic changes in dominant pathogens over time. This study aimed to conduct a comprehensive epidemiological analysis of PTRLO in China. Methods: The study was approved by the Institutional Research Board (IRB), and 3526 PTRLO patients were identified from 212 394 traumatic limb fracture patients at 21 hospitals between 1 January 2008 and 31 December 2017. A retrospective analysis was conducted to investigate the epidemiology of PTRLO, including changes in infection rate (IR), pathogens, infection risk factors and antibiotic resistance and sensitivity. Results: The IR of PTRLO increased gradually from 0.93 to 2.16% (Z = 14.392, P<0.001). Monomicrobial infection (82.6%) was significantly higher than polymicrobial infection (17.4%) (P< 0.001). The IR of Gram-positive (GP) and Gram-negative (GN) pathogens showed a significant increase from the lowest 0.41% to the highest 1.15% (GP) or 1.62% (GN), respectively. However, the longitudinal trend of GP vs. GN's composition did not show any significance (Z= ± 1.1918, P>0.05). The most prevalent GP strains were Methicillin-sensitive Staphylococcus aureus (MSSA) (17.03%), Methicillin-resistant Staphylococcus aureus (MRSA) (10.46%), E. faecalis (5.19%) and S. epidermidis (4.87%). In contrast, the dominant strains GN strains were Pseudomonas Aeruginosa (10.92%), E. cloacae (10.34%), E. coli (9.47%), Acinetobacter Baumannii (7.92%) and Klebsiella Pneumoniae (3.33%). In general, the high-risk factors for polymicrobial infection include opened-fracture (odds ratio, 2.223), hypoproteinemia (odds ratio, 2.328), and multiple fractures (odds ratio, 1.465). It is important to note that the antibiotics resistance and sensitivity analysis of the pathogens may be influenced by complications or comorbidities. Conclusions: This study provides the latest data of PTRLO in China and offers trustworthy guidelines for clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical safety and efficacy of Lianhuaqingwen (LHQW) capsules in patients with high-risk common type COVID-19 pneumonia. Methods: A retrospective multicenter study on 383 high-risk common type COVID-19 pneumonia cases was conducted. Patients were categorized as the standard treatment (SDT) group (n=168) and the LHQW+SDT group (n=215). The primary endpoint was the rate of symptom (fever, fatigue, coughing) recovery and the secondary endpoints included the time to symptom recovery, the proportion of patients with improvement in chest CT images, the proportion of patients with clinical cure, the timing and rate of negative conversion of SARS-CoV-2 RNA assay. Results: The recovery rate was significantly higher in the LHQW+SDT group as compared with the SDT group (89.7% vs. 72.0%, P<0.01). The combined use of LHQW+SDT also showed shorter time for symptom recovery, as well as shorter time for individual symptom of fever, fatigue and coughing recovery than use of SDT alone. A higher proportion of patients in the LHQW+SDT group with improvements in chest CT images and clinical cure (77.7% vs. 57.1%, P<0.01) but the proportion of patients deteriorating to severe cases (1% vs. 25%, P<0.01) in this group was significant lower than those in the SDT group. No significant difference in negative conversion rate of viral assay results was observed (76.8% vs. 75.0%, P>0.05). No serious adverse events were reported. Conclusions: LHQW capsules could be recommended to ameliorate clinical symptoms and reduce the rate of deteriorating to severe cases for high-risk common type COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

Background: Renal tumour can invade the venous system and ~4-10% patients with renal tumour had venous thrombus. Although the feasibility of robot-assisted laparoscopic inferior vena cava thrombectomy (RAL-IVCT) in patients with inferior vena cava (IVC) thrombus has been validated, the wide application is still a challenge due to the complexity of IVC control. The objective was to describe our novel cephalic IVC non-clamping technique and to compare the outcomes versus standard RAL-IVCT. Materials and methods: A prospective single-centre cohort containing 30 patients with level II-III IVC thrombus was established since August 2020. Fifteen patients underwent cephalic IVC non-clamping approach and 15 patients received standard RAL-IVCT. The authors decided the surgical technique according to the echocardiographic assessment of the right heart and IVC. Results: The non-clamping group had less operative time (median 148 versus 185 min, P = 0.04), and lower Clavien-grade II complication rate (26.7% versus 80.0%, P = 0.003). The median intraoperative blood loss were 400 ml [interquartile range (IQR) 275-615 mL] and 800 ml (IQR 350-1300 ml), respectively (P = 0.05). The most common complication in standard RAL-IVCT group was liver dysfunction. No gas embolism, hypercapnia or tumour thrombus dislodgment occurred in non-clamping group. After a median follow-up of 17.0 months (IQR 13.5-18.5 months) and 15.5 months (IQR 13.0-17.0 months), two patients (16.7%) in the non-clamping group and 3 patients (20.0%) in the standard RAL-IVCT group died (hazard ratio 0.59, 95% CI 0.10-3.54, P = 0.55). Conclusions: The cephalic IVC non-clamping technique can be performed safely with acceptable surgical outcomes and short-term oncologic outcomes in patients with level II-III IVC thrombus. Compared with standard procedure, it had less operative time and lower complication rate. [ABSTRACT FROM AUTHOR]

Background: In 2018, only one third of girls and boys completed the 2-dose series of the human papillomavirus vaccine by their 13th birthday, the target for on-time vaccination. The study objective was to identify key patient, provider and practice-level factors associated with on-time vaccination in the primary care setting. Methods: We examined data from 20 primary care pediatric practices (89 providers) in St. Louis including: the percentage of eligible patients with on-time vaccination assessed from medical records; providers' knowledge, attitudes and behaviors regarding on-time vaccination assessed with a survey; and practice-level strategies used to optimize vaccine delivery assessed with a 19-item vaccine delivery system score (VDSS). Factors that increased on-time vaccination were identified using logistic regression, controlling for clustering within providers. Results: Completion of on-time vaccination occurred in 1347/3125 (43.10%) of patients (95% confidence interval [CI], 41.36%-44.86%) and varied among practices (7.39% -64.24%) and among providers (2.63%-82.50%). Independent predictors for higher completion of on-time vaccination included more frequent use by providers of the announcement style for vaccine recommendation (odds ratio [OR] 1.18, 95% CI, 1.04, 1.35), higher provider self-efficacy to deliver the vaccine according to guideline recommendations if parents were hesitant (OR 1.21, 95% CI, 1.05, 1.40), and higher VDSS (OR 1.20, 95% CI, 1.10, 1.31). Conclusions: Provider and practice-level factors were identified that may represent modifiable targets for improvement in on-time vaccine uptake. Future research is needed to test interventions built on these findings. [ABSTRACT FROM AUTHOR]

Bone marrow mesenchymal stem cell (BMMSC) is reported to promote spinal cord injury (SCI) recovery via secreting exosomes to deliver RNAs, proteins, lipids, etc. The present study aimed to investigate the effect of microRNA 137 (miR-137)-overexpressing BMMSC exosomes on SCI rats. BMMSCs were extracted from Sprague-Dawley (SD) rat hind leg bone marrow, and then BMMSC-secreted exosomes were collected. MiR-137 mimic and negative control (NC) mimic were transfected into BMMSCs, and then the corresponding exosomes were collected. Subsequently, SD rats were treated with sham operation + phosphate-buffered saline (PBS), SCI operation + PBS, SCI operation + NC mimic BMMSC exosomes, or SCI operation + miR-137-overexpressing BMMSC exosomes. MiR-137 was downregulated in the spinal cord tissue of SCI rats compared to sham rats. Furthermore, BMMSC exosome injection elevated the Basso, Beattie, and Bresnahan (BBB) scores and neuronal viability and reduced tissue injury and proinflammatory cytokine expression in the spinal cord tissue of SCI rats compared to PBS treatment. Subsequently, miR-137-overexpressing BMMSC exosome injection improved the BBB score and neuron viability, and decreased tissue injury as well as proinflammatory cytokine expression in SCI rats compared to NC-overexpressing BMMSC exosomes. Additionally, miR-137-overexpressing BMMSC exosomes also diminished neuronal apoptosis in the spinal cord tissue of SCI rats compared to NC-overexpressing BMMSC exosomes. In conclusion, miR-137-overexpressing BMMSC exosomes reduce tissue injury and inflammation while improving locomotor capacity and neuronal viability in SCI rats. These findings suggest that miR-137-overexpressing BMMSC exosomes may serve as a treatment option for SCI recovery. [ABSTRACT FROM AUTHOR]

The efficient development of shale gas, an important unconventional oil and gas resource, can alleviate the current severe energy situation. However, shale gas usually has low porosity and permeability, and natural fractures are densely distributed, which has a great impact on the accurate prediction and efficient development of shale gas geological reserves. Moreover, complex fracture network will be formed in shale reservoir during hydraulic fracturing, and gel breaking and invasion of fracturing fluid will cause reservoir damage, which will affect the subsequent development of shale gas. Therefore, in this study, the behavior of fracture initiation and propagation in shale hydraulic fracturing was explored by finite element method, and the pollution and damage of fracturing fluid to the surrounding strata were analyzed experimentally. It is found that: (1) The shale reservoir is extremely high in strength and brittleness, and its elastic modulus and tensile strength are 12.54 GPa and 6.9 MPa, respectively. At the same time, the porosity and permeability of shale reservoirs are extremely poor, with the permeability of only 0.15 mD. Therefore, it is imperative to develop shale oil and gas resources by hydraulic fracturing. (2) The crack propagation is extremely fast at the beginning of hydraulic fracturing, and will gradually slow down as the fracturing continues. Moreover, after a long hydraulic fracturing operation, the hydraulic fractures will eventually continue to expand and extend along the direction of the maximum horizontal principal stress. (3) During fracturing operation, the invasion of fracturing fluid and its pollution to reservoir will weaken with the increase of additive concentration. When the concentration of carboxymethyl cellulose in fracturing fluid increases from 5 g/cm³ to 40 g/cm³, the invasion range of fracturing fluid will decrease from 3.825 m to 0.989 m. The research can provide ideas and technical support for the formulation optimization of fracturing fluid and the exploration of shale gas recovery enhancement measures. [ABSTRACT FROM AUTHOR]

Tight reservoirs have complex rock mineral composition and pore structure, which lead to extremely complex reservoir permeability stress sensitivity in the process of developing oil and gas resources. Quantitative evaluation of the effect of stress on reservoir permeability has important reference value for formulating reasonable development strategies. In this paper, taking the deep tight sandstone in L Oilfield as an example, the variation law of stress sensitivity of tight sandstone under saturated formation water condition was measured by overburden pressure porosimeter. The research shows that the acoustic and dynamic mechanical parameters of the samples after water saturation tend to increase, and the increments are: Vp, 12.3%; Vs, 1.5%; Young's modulus, 9.9%; Poisson's ratio, 40%. The values of mechanical parameters were increased in triaxial conditions compared with those in uniaxial conditions. When the core contains a certain number of micro-fractures, the fracture permeability accounts for most of the core permeability; when the stress increases, the fractures close, resulting in a significant decrease in permeability. When the fracture is basically closed and the effective stress continues to increase, the fracture permeability will not change much; however, it will cause deformation of the matrix pores of the rock skeleton, and the matrix permeability will decrease. Therefore, when the effective stress reaches a certain level, the change of rock permeability tends to be stable. The flow pressure decreases during the elastic-plastic deformation process, and the permeability of the sample is difficult to return to the initial state during the pressure recovery process, resulting in irreversible core damage. The change of the stress sensitivity coefficient with the initial value of permeability conforms to the linear function distribution. In low-permeability reservoirs, the better the development of rock fractures, the greater the porosity and permeability of the reservoir, but in contrast, fractures are easier to seal than matrix pores, so fractures play a leading role in the stress sensitivity of rock. [ABSTRACT FROM AUTHOR]

Background: Cough is often the most prominent and intractable symptom reported by patients with asthma, but few studies have explored the characteristics of patients with asthma and with chronic cough (CC) in a real-world setting. Methods: In a prospective cohort study, patients ages ≥ 18 years with stable asthma were consecutively recruited at the West China Hospital, Sichuan University. The patients were classified as having asthma with CC (the CC group) or asthma with non-CC (the non-CC group) after 3 months of optimized asthma therapy according to standard guidelines. Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to assess asthma exacerbations. Results: Of 323 patients with asthma, 127 patients were assigned to the CC group and 196 patients were assigned to the non-CC group. The participants with CC were older and had more airflow obstruction; worse asthma control and quality of life; increased airway inflammation; upper respiratory tract infection as a trigger; and more comorbidities, such as psychological dysfunction, rhinitis, chronic obstructive pulmonary disease, and bronchiectasis. They reported greater work productivity loss and daily activity impairment, and increased moderate-to-severe exacerbations. Conclusion: The participants with asthma and with CC had a significant disease burden, with increased exacerbations, health-care utilization, and impaired work productivity and daily activity. These observations indicated potential clinical implications in patients with asthma and with CC, and call for more attention to this aspect of asthma. [ABSTRACT FROM AUTHOR]

During online learning, complicated environmental perception factors influence the cognitive engagement of students, which is an influencing variable of learning motivation, learning outcomes, and other classroom effect indicators. In this study, the research hypotheses on the influences of the environmental perception of online learning (including students' self-factors, teacher factors, peer factors, and technological factors) on individual cognitive engagement (deep engagement and superficial engagement) were proposed. The mediating effect of the influences of self-efficacy on individual cognitive engagement under the online learning model was estimated. Results demonstrate that the Cronbach's α of the questionnaire used in the study is 0.891 and the KMO is 0.841. These outcomes reflect that this questionnaire has very good reliability and validity. In the online learning environment, students' self-factors, peer factors, and technological factors can promote individual cognitive engagement significantly. Furthermore, self-efficacy develops a mediating effect in the significantly positive promotion of environmental perception on individual cognitive engagement. Cognitive engagement also changes with the duration of online learning (F=4.530, p=0.005). Moreover, the influences of majors on cognitive engagement are significant at the 0.05 level (F=2.188, p=0.047). Conclusions have important references to comprehend the influences of different environmental perception factors on individual cognitive engagement in the process of online learning and disclose how self-efficacy influences individual cognitive engagement. [ABSTRACT FROM AUTHOR]

The demand analysis method of maritime emergency resources is the key technology to promote a reasonable emergency resource allocation during maritime emergency management. It is widely used to improve the efficiency of maritime emergency rescue and reduce the loss of maritime accidents. However, it requires a scientific and effective method of the demand analysis of maritime emergency resources. This paper aims to analyze the underlying modeling paradigms and to assess the extent to which the demand analysis methods of maritime emergency resources can meet the requirements. Focusing on the demand analysis methods, this paper provides a broad overview of the current literature on maritime emergency resources of the last decades, by considering the models' purposes, theoretical frameworks, factors, and outputs. The results indicate that the existing methods can be classified into three concepts: the linear regression theory, Back Propagation (BP) Neural Network, and Case-based Reasoning (CBR) technology. Combined with the characteristics of China's maritime emergency management field, the interaction between theoretical framework and applications is not sufficiently understood and thus needs to be further studied. Being familiar with knowledge gaps acts as a catalyst for further research on scientific and efficient demand analysis methods of maritime emergency resources in various navigation conditions. [ABSTRACT FROM AUTHOR]

Background: Vertebral fractures in elderly patients contribute to huge economic and social burden and seriously low quality of life. This study aims to identify the associated risk factors for vertebral fractures in the non-institutionalized old American population. Methods: A total of 31034 people from National Health and Nutrition Examination Survey (NHANES) during 2005--2010were included. Therein, 108 individuals with exact history of vertebral fractures were enrolled from a series of 4268 people (aged between 65 and 85 years old). The related demographic and laboratory examination data were collected. Further, univariate and multivariate analysis were applied to identify the related risk factors of vertebral fractures in the elderly. A nomogram risk prediction model was constructed and internally validated through the boot strapping method. Results: Univariate analysis indicated these factors, age (χ² = 5.75, p = 0.017), smoking (χ² = 4.46, p = 0.035), and combined with osteoporosis (χ² = 41.26, p < 0.001) were statistically different between the vertebral fracture group and no-vertebral fracture group. In multivariate analysis, the parameters of smoking (OR = 1.620, 95% CI: 1.080-2.440, p = 0.021), combined with osteoporosis (OR = 3.370, 95% CI: 2.220-5.110, p < 0.001), and the serum K (OR = 0.360, 95% CI: 0.230-0.560, p < 0.001) were screened as the independent risk factors for vertebral fractures in the elderly. The nomogram demonstrated a favorable level of discrimination with the area under the curve was 0.71. The calibration curves exhibited satisfactory agreement between the actual observation and nomogram prediction. Conclusion: The nomogram (including osteoporosis, smoking, and serum K) was capable of predicting vertebral fracture and has certain auxiliary value in clinical applications. [ABSTRACT FROM AUTHOR]

Background: Symptomatic asthma and rhinitis negatively impact patients' work productivity and activity. However, little is known about the potential interaction effect of both asthma and rhinitis control on work productivity and activity impairment. Objective: This study aimed to explore whether there are interaction effects of asthma and rhinitis control on work productivity and activity impairment in patients with asthma and with rhinitis. Methods: A total of 206 adult patients were prospectively recruited and were divided into four groups: both poorly controlled (BPC) n = 53), poorly controlled asthma (PCA) with controlled rhinitis (CR) (n = 38), well controlled asthma with uncontrolled rhinitis (n = 43), and both well controlled (BWC) (n = 72) based on the symptom control status of asthma and rhinitis. Work productivity loss and activity impairment, asthma control, and rhinitis control were assessed by using work productivity and activity impairment questionnaire: general health, the asthma control test, and the rhinitis control assessment test, respectively. General linear regression models were used to study the contribution of asthma control, rhinitis control, and the interaction effect on work productivity and activity impairment. Results: Work productivity loss was most frequently reported in patients in the BPC group. Compared with the patients in the BWC group, the patients in the PCA-CR group had significantly higher activity impairment and worse asthma-related quality of life (both p< 0.001). There were significant interaction effects of asthma and rhinitis control, which accounted for the increase in presenteeism, work productivity loss, and activity impairment (all p< 0.001). Although differences in absenteeism were not significant among the groups, there was a significant interaction effect of control levels accounted for absenteeism (p=0.035). Conclusion: Distinct interaction effects of asthma and rhinitis control reflected a link between upper and lower airways, which indicated that rhinitis control and the interaction effects of asthma and rhinitis control cannot be neglected during asthma management. [ABSTRACT FROM AUTHOR]

The Cap of porcine circovirus type 2 (PCV2) can be assembled into virus like particles (VLPs) in vitro that have multiple loops located on the particle surface. This would make it a good vehicle for displaying exogenous proteins or epitopes. We derived two epitopes, epitope B (EpB, S37HIQLIYNL45) and epitope 7 (Ep7, Q196WGRL200) from Gp5 of the highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV). We replaced the core region of Loop CD (L75PPGGGSN82) and the carboxyl terminus (K222DPPL226) of PCV2 Cap, respectively, to construct a bi-epitope chimeric PCV2 Cap. Its immunogenicity and protective effects were evaluated as one PRRSV subunit vaccine. The chimeric PCV2 Cap was soluble, efficiently expressed in an Escherichia coli expression system, and could be self-assembled into chimeric virus like particles (cVLPs) with a diameter of 12-15 nm. Western blotting confirmed that the cVLPs could be specifically recognized by anti-PCV2, anti-EpB and anti-Ep7 antibodies. The cVLPs vaccine could alleviate the clinical symptoms and reduce the viral loads after HP-PRRSV challenge in 100-120 days old pigs. These data suggest that the cVLPs vaccine could provide pigs with partial protection against homologous PRRSV strains, and it provides a new design for additional PRRSV subunit vaccines. [ABSTRACT FROM AUTHOR]