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Abstract The aims of this study were to determine whether human umbilical cord mesenchymal stem cells (hucMSCs) modified by miRNA-25-3p (miR-25-3p) overexpression could promote venous endothelial cell proliferation and attenuate portal endothelial cell injury. HucMSCs and human umbilical vein endothelial cells (HUVEC) were isolated and cultured from human umbilical cord and characterized. Lentiviral vectors expressing miRNA-25-3p were transfected into hucMSCs and confirmed by PCR. We verified the effect of miR-25-3p-modified hucMSCs on HUVEC by cell co-culture and cell supernatant experiments. Subsequently, exosomes of miR-25-3p-modified hucMSCs were isolated from cell culture supernatants and characterized by WB, NTA and TEM. We verified the effects of miR-25-3p-modified exosomes derived from hucMSCs on HUVEC proliferation, migration, and angiogenesis by in vitro cellular function experiments. Meanwhile, we further examined the downstream target genes and signaling pathways potentially affected by miR-25-3p-modified hucMSC-derived exosomes in HUVEC. Finally, we established a rat portal vein venous thrombosis model by injecting CM-DiR-labeled hucMSCs intravenously into rats and examining the homing of cells in the portal vein by fluorescence microscopy. Histological and immunohistochemical experiments were used to examine the effects of miRNA-25-3p-modified hucMSCs on the proliferation and damage of portal vein endothelial cells. Primary hucMSCs and HUVECs were successfully isolated, cultured and characterized. Primary hucMSCs were modified with a lentiviral vector carrying miR-25-3p at MOI 80. Co-culture and cell supernatant intervention experiments showed that overexpression of miRNA-25-3p in hucMSCs enhanced HUVEC proliferation, migration and tube formation in vitro. We successfully isolated and characterized exosomes of miR-25-3p-modified hucMSCs, and exosome intervention experiments demonstrated that miR-25-3p-modified exosomes derived from hucMSCs similarly enhanced the proliferation, migration, and angiogenesis of HUVECs. Subsequent PCR and WB analyses indicated PTEN/KLF4/AKT/ERK1/2 as potential pathways of action. Analysis in a rat portal vein thrombosis model showed that miR-25-3p-modified hucMSCs could homing to damaged portal veins. Subsequent histological and immunohistochemical examinations demonstrated that intervention with miR-25-3p overexpression-modified hucMSCs significantly reduced damage and attenuated thrombosis in rat portal veins. The above findings indicate suggest that hucMSCs based on miR-25-3p modification may be a promising therapeutic approach for use in venous thrombotic diseases.

Research efforts on permanganate (Mn(VII)) combined with redox-mediator (RM), have received increasing attention due to their significant performance for bisphenol-A (BPA) removal. However, the mechanisms underpinning BPA degradation remain underexplored. Here we show the overlooked interactions between RM and BPA during permanganate oxidation by introducing an RM—N-hydroxyphthalimide (NHPI). We discovered that the concurrent generation of MnO2 and phthalimide-N-oxyl (PINO) radical significantly enhances BPA oxidation within the pH range of 5.0–6.0. The detection of radical cross-coupling products between PINO radicals and BPA or its derivatives corroborates the pivotal role of radical cross-coupling in BPA oxidation. Intriguingly, we observed the formation of an NHPI-BPA complex, which undergoes preferential oxidation by Mn(VII), marked by the emergence of an electron-rich domain in NHPI. These findings unveil the underlying mechanisms in the Mn(VII)/RM system and bridge the knowledge gap concerning BPA transformation via complexation. This research paves the way for further exploration into optimizing complexation sites and RM dosage, significantly enhancing the system's efficiency in water treatment applications.

Abstract Toxic metals are vital risk factors affecting serum ion balance; however, the effect of their co-exposure on serum ions and the underlying mechanism remain unclear. We assessed the correlations of single metal and mixed metals with serum ion levels, and the mediating effects of mineralocorticoids by investigating toxic metal concentrations in the blood, as well as the levels of representative mineralocorticoids, such as deoxycorticosterone (DOC), and serum ions in 471 participants from the Dongdagou–Xinglong cohort. In the single-exposure model, sodium and chloride levels were positively correlated with arsenic, selenium, cadmium, and lead levels and negatively correlated with zinc levels, whereas potassium and iron levels and the anion gap were positively correlated with zinc levels and negatively correlated with selenium, cadmium and lead levels (all P

Abstract Background and Aims Oncogenesis and tumor development have been related to oxidative stress (OS). The potential diagnostic utility of OS genes in hepatocellular carcinoma (HCC), however, remains uncertain. As a result, this work aimed to create a novel OS related‐genes signature that could be used to predict the survival of HCC patients and to screen OS related‐genes drugs that might be used for HCC treatment. Methods We used The Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database to acquire mRNA expression profiles and clinical data for this research and the GeneCards database to obtain OS related‐genes. Following that, biological functions from Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed on differentially expressed OS‐related genes (DEOSGs). Subsequently, the prognostic risk signature was constructed based on DEOSGs from the TCGA data that were screened by using univariate cox analysis, and the Least Absolute Shrinkage and Selection Operator (LASSO) regression, and multivariate cox analysis. At the same time, we developed a prognostic nomogram of HCC patients based on risk signature and clinical‐pathological characteristics. The GEO data was used for validation. We used the receiver operating characteristic (ROC) curve, calibration curves, and Kaplan–Meier (KM) survival curves to examine the prediction value of the risk signature and nomogram. Finally, we screened the differentially expressed OS genes related drugs. Results We were able to recognize 9 OS genes linked to HCC prognosis. In addition, the KM curve revealed a statistically significant difference in overall survival (OS) between the high‐risk and low‐risk groups. The area under the curve (AUC) shows the independent prognostic value of the risk signature model. Meanwhile, the ROC curves and calibration curves show the strong prognostic power of the nomogram. The top three drugs with negative ratings were ZM‐336372, lestaurtinib, and flunisolide, all of which inversely regulate different OS gene expressions. Conclusion Our findings indicate that OS related‐genes have a favorable prognostic value for HCC, which sheds new light on the relationship between oxidative stress and HCC, and suggests potential therapeutic strategies for HCC patients.

There is a bidirectional interactive relationship between heavy metals and intestinal microorganisms. Single exposure to common heavy metals (Cd, Cr, As, Pb, etc.) may cause intestinal microecological damage and related diseases by losing the diversity and relative abundance of intestinal microorganisms. However, heavy metals in the environment are usually mixed exposure and an overall toxic effect is presented. Published studies have suggested a synergistic effect between most heavy metals, so the impact of mixed exposure on intestinal microorganisms is expected to be more significant than that of single exposure. Intestinal microorganisms are the first line of defense against heavy metals entering the body, and can reduce inflammation and oxidation caused by heavy metals via changing protein synthesis, intestinal PH, enzyme activity, etc. At the same time, the colonization of oral probiotics in the intestinal tract has a significant detoxification effect on heavy metals entering the body through synergy with intestinal microorganisms, which can promote the elimination of heavy metals, reduce the production of oxides and inflammatory mediators, reverse the changes in the relative abundance of intestinal microorganisms, and then reduce the damage of heavy metals to intestinal microecology. Therefore, probiotics may have better prospects than traditional heavy metal antidotes. In the future, more in-depth research on the mechanism of bidirectional interactive relationship between heavy metals and intestinal microorganisms is needed to provide new ideas for clinical heavy metal detoxification.

Objective. Nonalcoholic fatty liver disease (NAFLD) is becoming more prevalent in the nonobese population. The aim of this study was to investigate the combined effects of metabolism-related mixtures on NAFLD subjects in nonobese populations using four statistical models. Study Design. This was a retrospective observational study. Methods. Our study included 904 nonobese patients who had taken part in the 2017-2018 National Health and Nutrition Examination Survey (NHANES). We used logistic regression models, Bayesian kernel machine regression (BKMR), and the weighted quantile sum (WQS) regression model to estimate the association between metabolism-related indicators and NAFLD in the nonobese population. Finally, we included several indicators to create nomograms to predict the risk of NAFLD occurrence in the nonobese population. Results. Among the 904 participants, 116 (12.83%) had NAFLD. The logistic regression model found that the waist-to-hip ratio (WHR), HDL-c, triglyceride (TG), and HbA1c were positively associated with the outcomes. The WQS regression model showed that the WQS index was significantly associated with the occurrence of NAFLD in the nonobese population (OR: 5.789, 95% CI: 3.933–8.520), and WHR, TC, and TG had the largest weight. The BKMR model’s WHR and TG increased from the 25th percentile to the 75th percentile (other metabolite exposure remained fixed at the 75th percentile) and the risk of developing NAFLD increased in the nonobese people. The significant predictors mentioned above were introduced to construct the nomogram. The calibration curve, DCA, and AUROC (0.796) (95% CI: 0.743–0.843) all indicated that the model had a good potential clinical performance. Conclusions. By comparing the results of the four models together, WHR and TG were identified as important factors associated with NAFLD in the nonobese population. Further research is warranted to investigate the risk factors and pathogeny of NAFLD in nonobese populations.

The gut-liver axis refers to the intimate relationship and rigorous interaction between the gut and the liver. The intestinal barrier’s integrity is critical for maintaining liver homeostasis. The liver operates as a second firewall in this interaction, limiting the movement of potentially dangerous compounds from the gut and, as a result, contributing in barrier management. An increasing amount of evidence shows that increased intestinal permeability and subsequent bacterial translocation play a role in liver damage development. The major pathogenic causes in cirrhotic individuals include poor intestinal permeability, nutrition, and intestinal flora dysbiosis. Portal hypertension promotes intestinal permeability and bacterial translocation in advanced liver disease, increasing liver damage. Bacterial dysbiosis is closely related to the development of cirrhosis and its related complications. This article describes the potential mechanisms of dysbiosis in liver cirrhosis and related complications, such as spontaneous bacterial peritonitis, hepatorenal syndrome, portal vein thrombosis, hepatic encephalopathy, and hepatocellular carcinoma, using dysbiosis of the intestinal flora as an entry point.

Abstract Increasing issues of hydrophobic membrane wetting occur in the membrane distillation (MD) process, stimulating the research on enhanced anti‐wetting methods for membrane materials. In recent years, surface structural construction (i.e., constructing reentrant‐like structures), surface chemical modification (i.e., coating organofluorides), and their combination have significantly improved the anti‐wetting properties of the hydrophobic membranes. Besides, these methods change the MD performance (i.e., increased/decreased vapor flux and increased salt rejection). This review first introduces the characterization parameters of wettability and the fundamental principles of membrane surface wetting. Then it summarizes the enhanced anti‐wetting methods, the related principles, and most importantly, the anti‐wetting properties of the resultant membranes. Next, the MD performance of hydrophobic membranes prepared by different enhanced anti‐wetting methods is discussed in desalinating different feeds. Finally, facile and reproducible strategies are aspired for the robust MD membrane in the future.

Background and aimsAdenocarcinoma is one of the most common pathological types of gastric cancer. The aims of this study were to develop and validate prognostic nomograms that could predict the probability of cancer-specific survival (CSS) for gastric adenocarcinoma (GAC) patients at 1, 3, and 5 years.MethodsIn total, 7747 patients with GAC diagnosed between 2010 and 2015, and 4591 patients diagnosed between 2004 and 2009 from the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. The 7747 patients were used as a prognostic cohort to explore GAC-related prognostic risk factors. Moreover, the 4591 patients were used for external validation. The prognostic cohort was also divided into a training and internal validation sets for construction and internal validation of the nomogram. CSS predictors were screened using least absolute shrinkage and selection operator regression analysis. A prognostic model was built using Cox hazard regression analysis and provided as static and dynamic network-based nomograms.ResultsThe primary site, tumor grade, surgery of the primary site, T stage, N stage, and M stage were determined to be independent prognostic factors for CSS and were subsequently included in construction of the nomogram. CSS was accurately estimated using the nomogram at 1, 3, and 5 years. The areas under the curve (AUCs) for the training group at 1, 3, and 5 years were 0.816, 0.853, and 0.863, respectively. Following internal validation, these values were 0.817, 0.851, and 0.861. Further, the AUC of the nomogram was much greater than that of American Joint Committee on Cancer (AJCC) or SEER staging. Moreover, the anticipated and actual CSS values were in good agreement based on decision curves and time-calibrated plots. Then, patients from the two subgroups were divided into high- and low-risk groups based on this nomogram. The survival rate of high-risk patients was considerably lower than that of low-risk patients, according to Kaplan–Meier (K-M) curves (p

Traditional mechanical bone drilling is prone to heat generation and debris accumulation which will cause tissue damage in orthopedic surgeries. Therefore, research on contactless laser bone drilling has become a mainstream trend in the development of bone surgery. This study presents a laser rapid drilling strategy for bone surgery with minimizing thermal osteonecrosis and debris based on the design of dynamic focusing and spreading droplet cooling. The laser drilled hole suffered from low temperature (Tmax = 46.2 ○C) under clinically accepted threshold of 47 ○C, presenting osteocyte-filled lacunas, visible Haversian canals and increased pullout strength when compared with that following mechanically drilling. An intact bone column without debris was extracted from a 4-mm-deep hole in vitro on a sheep tibia which provides a clean surgical method with increased drilling rate of 0.94 mm3/s. The criteria dimensionless We constant related to spreading droplets leading to effective heat transfer is determined as2.8 × 103 × Re-1/2 ≤ We ≤ 1.9 × 10-2 × Re7, yielding a high convective coefficient of 0.11 W/mm2·K for cooling. The comprehensive results of laser bone drilling proved the effectiveness of the presented technology and setup, which is significant in realizing rapid, debris-free orthopedic surgery.

As an ideal high-density storage unit, magnetic nanorings have become a research hotspot in recent years. We can both study the evolution of microscopic state of magnetization and acquire macroscopic magnetic properties by micromagnetic simulation, which has thus been widely used. However, traditional micromagnetism cannot simulate complex stress state. Due to the introduction of microelasticity theory, the phase field method for magnetic materials can be used to calculate the coupling effect of stress and magnetic field. However, the computing model usually needs to satisfy periodic boundary condition. In this paper, the phase field simulation combined with the finite element method is employed. By using user defined element, the evolution of magnetic domain structures of the double-hole nanorings has been studied. In different diameter of the holes and external magnetic field direction, we have found seven kinds of magnetic domain evolution mechanism. Among them, the twin-vortex evolution mechanism with high stability and low demagnetization interference characteristics of advantages, has good application prospect in magnetic random-access memory (MRAM) unit.

In this study, the impact test of two groups of reinforced concrete piers protected by closed-cell aluminum foam is carried out by using the ultrahigh drop hammer impact test system. The purpose of this study is to explore the impact resistance and protective performance of closed-cell aluminum foam under the impact load on the concrete bridge pier after replacing the ordinary reinforcement with stainless steel reinforcement. The study results show that the impact force is related to the overall stiffness of the specimen, as well as to the failure mode. When the impact velocity is less than 1.42 m/s, the closed-cell aluminum foam is in an elastic or yielding stage. The change rate of impact force (231 and 97.5, respectively), tip displacement (33.5 and 18, respectively), and ultrasonic damage rate of the concrete in the two groups of specimen is relatively small, while the change rate of the two groups of specimen remains approximately consistent. In addition, when the impact is greater than 1.42 m/s and the closed-cell aluminum foam is in the densification stage, the change rate of the impact force (increase from 231 to 819 and from 97.5 to 984.5), the tip displacement (increase from 33.5 to 67 and from 18 to 62), and ultrasonic damage rate of concrete are larger, which results in an increase in the dynamic response of the structure.

In the present study, in order to examine the impact performances of ordinary reinforced concrete bridge piers which have been replaced by stainless-steel bars of equal cross-sections under the protective condition of anticollision material, the impact dynamic responses of the ordinary reinforced concrete bridge piers, with replacements under the protection of closed-cell aluminum foam, were compared and analyzed using an ultrahigh drop hammer impact test system. The results showed that when the impact velocity was small (for example, less than 1.42 M/s), after the implementation of equal cross-sectional replacements, the closed-cell aluminum foam had been in an elastic or yield stage. During that stage, the impact forces of the stainless-steel reinforced concrete piers were larger than those of the ordinary reinforced concrete piers, and the relative ratios were stable at approximately 28 to 34%. In addition, the relative ratios of the displacements at the tops of the components were also found to be stable at approximately 22%, and the change rates of the concrete ultrasonic damages were approximately the same. However, when the impact forces had increased (for example, more than 1.67 m/s), the closed-cell aluminum foam entered a densification stage, and the peak impact force ratios decreased sharply. It was also observed that the relative peak displacement ratios at the tops of the components displayed increasing trends, and the change rates of the concrete ultrasonic damages had displayed major flux. Therefore, the replacement of the ordinary piers with stainless-steel bars had increased the possibility of shear failures.

The stress-induced magnetic domain switching in FeGa thin films is studied using phase-field method. In particular, the magnetic field is applied along the [110] direction and biaxial stresses are applied along [100] and [010]. A compressive pre-stress corresponds to a smaller coercive magnetic field while a tensile pre-stress corresponded to a larger coercive field. At the same time, it is also found that the transition between butterfly and square-like magnetostriction loops occurs at the critical opposite biaxial stress state. The two different evolutions correspond to two different mechanisms: one is that the single domain swings across a fan area back and forth; the other is that the single domain turns a clockwise circle. The results can be explained by the stress tuned anisotropy energy well.

Objective To evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease. Methods We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff. Findings The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days. Conclusion The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China.

An outbreak detection and response system, using time series moving percentile method based on historical data, in China has been used for identifying dengue fever outbreaks since 2008. For dengue fever outbreaks reported from 2009 to 2012, this system achieved a sensitivity of 100%, a specificity of 99.8% and a median time to detection of 3 days, which indicated that the system was a useful decision tool for dengue fever control and risk-management programs in China.

BACKGROUND: Acute lower respiratory infections (ALRIs) are an important cause of acute illnesses and mortality worldwide and in China. However, a large-scale study on the prevalence of viral infections across multiple provinces and seasons has not been previously reported from China. Here, we aimed to identify the viral etiologies associated with ALRIs from 22 Chinese provinces. METHODS AND FINDINGS: Active surveillance for hospitalized ALRI patients in 108 sentinel hospitals in 24 provinces of China was conducted from January 2009-September 2013. We enrolled hospitalized all-age patients with ALRI, and collected respiratory specimens, blood or serum collected for diagnostic testing for respiratory syncytial virus (RSV), human influenza virus, adenoviruses (ADV), human parainfluenza virus (PIV), human metapneumovirus (hMPV), human coronavirus (hCoV) and human bocavirus (hBoV). We included 28,369 ALRI patients from 81 (of the 108) sentinel hospitals in 22 (of the 24) provinces, and 10,387 (36.6%) were positive for at least one etiology. The most frequently detected virus was RSV (9.9%), followed by influenza (6.6%), PIV (4.8%), ADV (3.4%), hBoV (1.9), hMPV (1.5%) and hCoV (1.4%). Co-detections were found in 7.2% of patients. RSV was the most common etiology (17.0%) in young children aged

Each year there are approximately 390 million dengue infections worldwide. Weather variables have a significant impact on the transmission of Dengue Fever (DF), a mosquito borne viral disease. DF in mainland China is characterized as an imported disease. Hence it is necessary to explore the roles of imported cases, mosquito density and climate variability in dengue transmission in China. The study was to identify the relationship between dengue occurrence and possible risk factors and to develop a predicting model for dengue's control and prevention purpose.Three traditional suburbs and one district with an international airport in Guangzhou city were selected as the study areas. Autocorrelation and cross-correlation analysis were used to perform univariate analysis to identify possible risk factors, with relevant lagged effects, associated with local dengue cases. Principal component analysis (PCA) was applied to extract principal components and PCA score was used to represent the original variables to reduce multi-collinearity. Combining the univariate analysis and prior knowledge, time-series Poisson regression analysis was conducted to quantify the relationship between weather variables, Breteau Index, imported DF cases and the local dengue transmission in Guangzhou, China. The goodness-of-fit of the constructed model was determined by pseudo-R2, Akaike information criterion (AIC) and residual test. There were a total of 707 notified local DF cases from March 2006 to December 2012, with a seasonal distribution from August to November. There were a total of 65 notified imported DF cases from 20 countries, with forty-six cases (70.8%) imported from Southeast Asia. The model showed that local DF cases were positively associated with mosquito density, imported cases, temperature, precipitation, vapour pressure and minimum relative humidity, whilst being negatively associated with air pressure, with different time lags.Imported DF cases and mosquito density play a critical role in local DF transmission, together with weather variables. The establishment of an early warning system, using existing surveillance datasets will help to control and prevent dengue in Guangzhou, China.

We evaluated a novel strategy to improve the performance of outbreak detection algorithms, namely setting the alerting threshold separately in each region according to the disease incidence in that region. By using data on hand, foot and mouth disease in Shandong province, China, we evaluated the impact of disease incidence on the performance of outbreak detection algorithms (EARS-C1, C2 and C3). Compared to applying the same algorithm and threshold to the whole region, setting the optimal threshold in each region according to the level of disease incidence (i.e., high, middle, and low) enhanced sensitivity (C1: from 94.4% to 99.1%, C2: from 93.5% to 95.4%, C3: from 91.7% to 95.4%) and reduced the number of alert signals (the percentage of reduction is C1∶4.3%, C2∶11.9%, C3∶10.3%). Our findings illustrate a general method for improving the accuracy of detection algorithms that is potentially applicable broadly to other diseases and regions.

The field-dependent Young's modulus shows a promising application in the design and miniaturization of phononic crystals, tunable mechanical resonators, interdigital transducers, etc. With the multifield bulge-test instrument developed by our group, the electric field-tunable elastic modulus of ferroelectric films has been studied experimentally. A butterfly change in the Young's modulus of lead titanate zirconate (PZT) film under biaxial tensile stress state with electric field has been discovered for the first time. Based on the phase field model, an electromechanical coupling model is constructed, and a case of PZT ferroelectric film subjected to a vertical electric field and horizontal tensile strains is simulated. The numerical results show that the change in the Young's modulus is proportional to the variation of volume fraction of 90-deg domain switching under a pure tensile strain. It is the constraint of 90-deg domain switching by the electric field that contributes to the butterfly change in the elastic modulus. [ABSTRACT FROM AUTHOR]

Background: Syndromic surveillance has been widely used for the early warning of infectious disease outbreaks, especially in mass gatherings, but the collection of electronic data on symptoms in hospitals is one of the fundamental challenges that must be overcome during operating a syndromic surveillance system. The objective of our study is to describe and evaluate the implementation of a symptom-clicking-module (SCM) as a part of the enhanced hospital-based syndromic surveillance during the 41st World Exposition in Shanghai, China, 2010. Methods: The SCM, including 25 targeted symptoms, was embedded in the sentinels' Hospital Information Systems (HIS). The clinicians used SCM to record these information of all the visiting patients, and data were collated and transmitted automatically in daily batches. The symptoms were categorized into seven targeted syndromes using predefined criteria, and statistical algorithms were applied to detect temporal aberrations in the data series. Results: SCM was deployed successfully in each sentinel hospital and was operated during the 184-day surveillance period. A total of 1,730,797 patient encounters were recorded by SCM, and 6.1 % (105,352 visits) met the criteria of the seven targeted syndromes. Acute respiratory and gastrointestinal syndromes were reported most frequently, accounted for 92.1 % of reports in all syndromes, and the aggregated time-series presented an obvious day-of-week variation over the study period. In total, 191 aberration signals were triggered, and none of them were identified as outbreaks after verification and field investigation. Conclusions: SCM has acted as a practical tool for recording symptoms in the hospital-based enhanced syndromic surveillance system during the 41st World Exposition in Shanghai, in the context of without a preexisting electronic tool to collect syndromic data in the HIS of the sentinel hospitals. [ABSTRACT FROM AUTHOR]

Background: With the dramatic increase in international travel among Chinese people, the risk of malaria importation from malaria-endemic regions threatens the achievement of the malaria elimination goal of China. Methods: Epidemiological investigations of all imported malaria cases were conducted in nine provinces of China from 1 Nov, 2013 to 30 Oct, 2014. Plasmodium species, spatiotemporal distribution, clinical severity, preventive measures and infection history of the imported malaria cases were analysed using descriptive statistics. Results: A total of 1420 imported malaria cases were recorded during the study period, with P. falciparum (723 cases, 50.9 %) and P. vivax (629 cases, 44.3 %) being the two predominant species. Among them, 81.8 % of cases were in Chinese overseas labourers. The imported cases returned from 41 countries, mainly located in Africa (58.9 %) and Southeast Asia (39.4 %). About a quarter (25.5 %, 279/1094) of counties in the nine study provinces were affected by imported malaria cases. There were 112 cases (7.9 %) developing complicated malaria, including 12 deaths (case fatality rate: 0.8 %). Only 27.8 % of the imported cases had taken prophylactic anti-malarial drugs. While staying abroad, 27.7 % of the cases had experienced two or more episodes of malaria infection. The awareness of clinical manifestations and the capacity for malaria diagnosis were weak in private clinics and primary healthcare facilities. Conclusions: Imported malaria infections among Chinese labourers, returned from various countries, poses an increasing challenge to the malaria elimination programme in China. The risk of potential re-introduction of malaria into inland malaria-free areas of China should be urgently addressed. [ABSTRACT FROM AUTHOR]

Background: Dengue has been a notifiable disease in China since 1 September 1989. Cases have been reported each year during the past 25 years of dramatic socio-economic changes in China, and reached a historical high in 2014. This study describes the changing epidemiology of dengue in China during this period, to identify high-risk areas and seasons and to inform dengue prevention and control activities. Methods: We describe the incidence and distribution of dengue in mainland China using notifiable surveillance data from 1990-2014, which includes classification of imported and indigenous cases from 2005-2014. Results: From 1990-2014, 69,321 cases of dengue including 11 deaths were reported in mainland China, equating to 2.2 cases per one million residents. The highest number was recorded in 2014 (47,056 cases). The number of provinces affected has increased, from a median of three provinces per year (range: 1 to 5 provinces) during 1990-2000 to a median of 14.5 provinces per year (range: 5 to 26 provinces) during 2001-2014. During 2005-2014, imported cases were reported almost every month and 28 provinces (90.3%) were affected. However, 99.8% of indigenous cases occurred between July and November. The regions reporting indigenous cases have expanded from the coastal provinces of southern China and provinces adjacent to Southeast Asia to the central part of China. Dengue virus serotypes 1, 2, 3, and 4 were all detected from 2009-2014. Conclusions: In China, the area affected by dengue has expanded since 2000 and the incidence has increased steadily since 2012, for both imported and indigenous dengue. Surveillance and control strategies should be adjusted to account for these changes, and further research should explore the drivers of these trends. [ABSTRACT FROM AUTHOR]

Electromagnetic materials have been widely employed in micro-functional devices. Using multi-field nanoindentation technique, we have investigated the local deformation behavior of various electromagnetic materials in the form of bulk materials, foils, and thin films under electric or magnetic field. Based on dimensional analysis and experimental data, a field tunable scaling relationship among hardness, reduced contact elastic modulus, and indentation work has been found. Furthermore, a method to determine the hardness and reduced modulus of electromagnetic materials is proposed, which avoids the error from estimating the indentation contact area. This work is meaningful for the characterization of mechanical properties and design of devices made of electromagnetic materials. [ABSTRACT FROM AUTHOR]

Background: In China, the national malaria elimination programme has been operating since 2010. This study aimed to explore the epidemiological changes in patterns of malaria in China from intensified control to elimination stages. Methods: Data on nationwide malaria cases from 2004 to 2012 were extracted from the Chinese national malaria surveillance system. The secular trend, gender and age features, seasonality, and spatial distribution by Plasmodium species were analysed. Results: In total, 238,443 malaria cases were reported, and the proportion of Plasmodium falciparum increased drastically from <10% before 2010 to 55.2% in 2012. From 2004 to 2006, malaria showed a significantly increasing trend and with the highest incidence peak in 2006 (4.6/100,000), while from 2007 onwards, malaria decreased sharply to only 0.18/100,000 in 2012. Males and young age groups became the predominantly affected population. The areas affected by Plasmodium vivax malaria shrunk, while areas affected by P. falciparum malaria expanded from 294 counties in 2004 to 600 counties in 2012. Conclusions: This study demonstrated that malaria has decreased dramatically in the last five years, especially since the Chinese government launched a malaria elimination programme in 2010, and areas with reported falciparum malaria cases have expanded over recent years. These findings suggest that elimination efforts should be improved to meet these changes, so as to achieve the nationwide malaria elimination goal in China in 2020. [ABSTRACT FROM AUTHOR]

Many aberration detection algorithms are used in infectious disease surveillance systems to assist in the early detection of potential outbreaks. In this study, we explored a novel approach to adjusting aberration detection algorithms to account for the impact of seasonality inherent in some surveillance data. By using surveillance data for hand-foot-and-mouth disease in Shandong province, China, we evaluated the use of seasonally-adjusted alerting thresholds with three aberration detection methods (C1, C2, and C3). We found that the optimal thresholds of C1, C2, and C3 varied between the epidemic and non-epidemic seasons of hand-foot-and-mouth disease, and the application of seasonally adjusted thresholds improved the performance of outbreak detection by maintaining the same sensitivity and timeliness while decreasing by nearly half the false alert rate during the non-epidemic season. Our preliminary findings suggest a general approach to improving aberration detection for outbreaks of infectious disease with seasonally variable incidence. [ABSTRACT FROM AUTHOR]

Background Characterisation of the severity profile of human infections with influenza viruses of animal origin is a part of pandemic risk assessment, and an important part of the assessment of disease epidemiology. Our objective was to assess the clinical severity of human infections with avian influenza A H7N9 virus, which emerged in China in early 2013. Methods We obtained information about laboratory-confirmed cases of avian influenza A H7N9 virus infection reported as of May 28, 2013, from an integrated database built by the Chinese Center for Disease Control and Prevention. We estimated the risk of fatality, mechanical ventilation, and admission to the intensive care unit for patients who required hospital admission for medical reasons. We also used information about laboratory-confirmed cases detected through sentinel influenza-like illness surveillance to estimate the symptomatic case fatality risk. Findings Of 123 patients with laboratory-confirmed avian influenza A H7N9 virus infection who were admitted to hospital, 37 (30%) had died and 69 (56%) had recovered by May 28, 2013. After we accounted for incomplete data for 17 patients who were still in hospital, we estimated the fatality risk for all ages to be 36% (95% CI 26-45) on admission to hospital. Risks of mechanical ventilation or fatality (69%, 95% CI 60-77) and of admission to an intensive care unit, mechanical ventilation, or fatality (83%, 76-90) were high. With assumptions about coverage of the sentinel surveillance network and health-care-seeking behaviour for patients with influenza-like illness associated with influenza A H7N9 virus infection, and pro-rata extrapolation, we estimated that the symptomatic case fatality risk could be between 160 (63-460) and 2800 0000-9400) per 100 000 symptomatic cases. Interpretation Human infections with avian influenza A H7N9 virus seem to be less serious than has been previously reported. Many mild cases might already have occurred. Continued vigilance and sustained intensive control efforts are needed to minimise the risk of human infection. Funding Chinese Ministry of Science and Technology; Research Fund for the Control of Infectious Disease; Hong Kong University Grants Committee; China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases; Harvard Center for Communicable Disease Dynamics; US National Institute of Allergy and Infectious Disease; and the US National Institutes of Health. [ABSTRACT FROM AUTHOR]