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Improper domestic food handling in rural areas of China is an important public health issue leading to foodborne illness. However, the underlying factors responsible for poor domestic food hygiene practices have not been comprehensively studied. Here, a cross-sectional study was conducted in Anhui Province, China between 2015 - 2016, using a questionnaire to collect data from 819 respondents, selected using multistage cluster random sampling techniques. Multivariate logistic regression analysis was then used to assess the demographic factors associated with improper food handling. Results showed that 525 (64.1%) of respondents used improper food handling techniques. The factors associated with improper food handling included gender, age, education, income, and occupation. Males (vs. females), adults aged ≥ 50 years (vs. those aged 18 - 30 years), individuals with primary school education or lower (vs. individuals with a bachelor’s degree or higher), individuals with annual incomes of < 4,387 USD (vs. income ≥ 13,161 USD), and workers (vs. other occupation groups) were more likely to report inappropriate food handling practices in rural areas. The results obtained from the present work may provide the basis for training in domestic food safety hygiene/handling practices in rural areas of China in order to reduce the incidence of foodborne illnesses.

Ganodermataceae is one of the main families of macrofungi since species in the family are both ecologically and economically important. The double-walled basidiospores with ornamented endospore walls are the characteristic features of Ganodermataceae. It is a large and complex family; although many studies have focused on Ganodermataceae, the global diversity, geographic distribution, taxonomy and molecular phylogeny of Ganodermataceae still remained incompletely understood. In this work, taxonomic and phylogenetic studies on worldwide species of Ganodermataceae were carried out by morphological examination and molecular phylogenetic analyses inferred from six gene loci including the internal transcribed spacer regions (ITS), the large subunit of nuclear ribosomal RNA gene (nLSU), the second largest subunit of RNA polymerase II gene (rpb2), the translation elongation factor 1-αgene (tef1), the small subunit mitochondrial rRNA gene (mtSSU) and the small subunit nuclear ribosomal RNA gene (nSSU). A total of 1 382 sequences were used in the phylogenetic analyses, of which 817 were newly generated, including 132 sequences of ITS, 139 sequences of nLSU, 83 sequences of rpb2, 124 sequences of tef1, 150 sequences of mtSSU and 189 sequences of nSSU. The combined six-gene dataset included sequences from 391 specimens representing 146 taxa from Ganodermataceae. Based on morphological and phylogenetic analyses, 14 genera were confirmed in Ganodermataceae: Amauroderma, Amaurodermellus, Cristataspora, Foraminispora, Furtadoella, Ganoderma, Haddowia, Humphreya, Magoderna, Neoganoderma, Sanguinoderma, Sinoganoderma, Tomophagus and Trachydermella. Among these genera, Neoganoderma gen. nov. is proposed for Ganoderma neurosporum; Sinoganoderma gen. nov. is proposed for Ganoderma shandongense; Furtadoella gen. nov. is proposed to include taxa previously belonging to Furtadoa since Furtadoa is a homonym of a plant genus in the Araceae; Trachydermella gen. nov. is proposed to include Trachyderma tsunodae since Trachyderma is a homonym of a lichen genus in the Pannariaceae. Twenty-three new species, viz., Ganoderma acaciicola, G. acontextum, G. alpinum, G. bubalinomarginatum, G. castaneum, G. chuxiongense, G. cocoicola, G. fallax, G. guangxiense, G. puerense, G. subangustisporum, G. subellipsoideum, G. subflexipes, G. sublobatum, G. tongshanense, G. yunlingense, Haddowia macropora, Sanguinoderma guangdongense, Sa. infundibulare, Sa. longistipitum, Sa. melanocarpum, Sa. microsporum and Sa. tricolor are described. In addition, another 33 known species are also described in detail for comparison. Scanning electron micrographs of basidiospores of 10 genera in Ganodermataceae are provided. A key to the accepted genera of Ganodermataceae and keys to the accepted species of Ganoderma, Haddowia, Humphreya, Magoderna, Sanguinoderma and Tomophagus are also provided. In total, 278 species are accepted as members of Ganodermataceae including 59 species distributed in China.

The availability of nitrogen (N) and phosphorus (P) is crucial for maintaining coral-dinoflagellate symbiosis, whereas excess nutrients and skewed N:P ratios are often associated with coral reef decline. It is thus essential to understand the general patterns of species-specific as well as dose-dependent responses of corals to elevated nutrient concentrations and skewed N:P ratios. Here, we found that the impacts of nutrient enrichment on the corals Acropora millepora and Platygyra crosslandi from Weizhou Island, South China Sea, were highly dependent on nutrient dose, N:P ratios, and coral species. Moderate nutrient enrichment (N: 19-140 µmol l-1 and P: 0.5-1.5 µmol l-1) did not lead to bleaching of either coral species, but their metabolic processes (calcification, nutrient uptake, and dinitrogen fixation) were affected. More depleted δ13C and lower dinitrogen fixation rates of A. millepora than of P. crosslandi indicated that A. millepora was more vulnerable to the disturbance of nutrient enrichment. However, N:P ratios (±SD) as high as 106 ± 10 decreased the photosynthetic efficiency and nutrient uptake rates of P. crosslandi, indicating that this species may be vulnerable to high N:P ratios, although it was one of the dominant coral assemblages at Weizhou Island. The results provide an important basis for understanding coral reef degradation triggered by nutrients and a suggestion that coastal management should focus not only on the concentrations but also on the ratios of nutrients.

In urban areas, due to the limited underground space, tunnels are being built close to or underneath existing buried foundations. As a result, it is essential to understand the effect of tunnelling on nearby structures and buried foundations. Tunnel-structure interaction problems have been widely investigated via numerical and physical modelling as well as with field monitoring. However, the use of protective measures, such as protective walls, to reduce the effect of tunnelling on structures have received much less research attention. Protective measures are often very costly and designed in an overly conservative way. A better understanding of tunnel, soil, piled structure and protective wall interaction (TSPPWI) problems would enable more efficient and cost-effective protective measures to be adopted. In general, this thesis involves the study of three main areas, with centrifuge models developed to study each area: (1) greenfield tunnelling in sand, (2) effect of tunnelling on piled structures, and (3) the use of protective walls to protect buildings from tunnelling induced damage. The centrifuge models focus on the two-dimensional plane-strain case where the tunnel runs transversely to the structure. A newly developed mechanical model tunnel was used to simulate tunnel volume loss within the centrifuge tests. The research makes the use of the novel coupled centrifuge-numerical modelling (CCNM) hybrid testing equipment and methodologies developed at the University of Nottingham to simulate the tunnel-structure interaction problem within the centrifuge tests. The CCNM process allows more accurate simulation of the tunnel-structure interactions by adjusting the loads applied to the foundation piles within the centrifuge model according to outcomes of a numerical model that is used to simulate the structure domain simultaneously with the centrifuge model domain. In addition, to measure the axial force along the foundation piles and bending moment of the protective walls, optical fibre Bragg grating (FBG) sensors were used during the centrifuge tests. This research represents the one of the first applications of FBG sensors in a geotechnical centrifuge. Greenfield tunnelling centrifuge tests were carried out using the newly developed rigid boundary mechanical model tunnel. The result showed good consistency in terms of soil displacement mechanisms with data from conventional flexible membrane model tunnels. An available empirical method for describing the variation of settlement trough shape in sand was modified based on the current centrifuge results. The outcomes of this work provide a more in-depth understanding of the effect of model tunnel boundary condition and will benefit future researchers considering which type of model tunnel to adopt when developing centrifuge tests related to tunnelling. The tunnel structure interaction tests using the CCNM approach considered two cases of structure stiffness: a zero stiffness structure (constant pile head load), and full structure stiffness (based on a five storey steel frame building with four foundation piles running transverse to the tunnel direction). These tests served as a baseline for comparison with the protective wall tests. The structure stiffness affects pile head settlement and the variation in the pile head load with tunnel volume loss. The pile located closest to the tunnel showed the most significant pile head settlement with tunnelling, and FBG data indicated the loss of end bearing force and shaft resistance along the pile during tunnel volume loss. Post-tunnelling pile jacking tests were performed and indicated that the amount of displacement required to re-mobilise the shaft resistance along the pile depends on the amount of loss in shaft resistance during tunnelling. In the tunnel-building interaction tests including protective walls (TSPPWI), two protective walls (made out of aluminium plate) were used with different embedded depths, referred to as `short' (toe of the wall located at the tunnel spring line) and `long' (toe of the wall located below the tunnel invert). The use of a protective wall can reduce the soil movements on the building side of the wall. Results demonstrate that the ‘long’ wall provides a more significant reduction in soil movements with tunnelling than the `short' wall. During tunnelling, the protective walls reduced the amount of settlement of the building foundation piles, as well as the change in pile head load. The efficiency of the walls was quantified using the settlement of the piles with respect to the case without a protective wall. Results indicate that the `long' protective wall provides higher efficiency, but the efficiency reduces for the piles located further away from the tunnel. Despite the use of protective walls, the FBG sensors indicated that the pile shaft resistance reduced with tunnelling, and during post-tunnelling pile jacking, a more significant pile head displacement was required to fully re-mobilise the shaft resistance for the piles that lost most of their shaft resistance during tunnel volume loss. The outcomes from these tests will help engineers to refine their design of protective walls in practice, and enable more efficient and cost-effective protective measures to be adopted.

Background Compared with stable angina, acute myocardial infarction (AMI) phenotype is related with the elevated inflammatory activity. However, time-dependent change of inflammatory level and its prognostic implication has not been fully understood according to the disease entity. Methods We enrolled total 4,263 patients who underwent percutaneous coronary intervention (PCI) with serial measurement of high-sensitivity C-reactive protein (hsCRP) at on-admission and 1-month post-PCI. The risks of MACE (a composite of death, MI or stroke), and major bleeding were evaluated up to 4 years after procedure. Results Compared with the non-AMI group (n=1,887), the AMI group (n=2,376) showed the significant decrease of hs-CRP during 1 month (∇0.5 vs. ∇0.1 mg/L; P Conclusion In PCI-treated patients, patients presented with AMI showed the greater values of inflammatory activity and its prognostic implication during the early phase, but combined inflammatory risk appeared similar across the disease entity during the late phase. This result may support that clinical benefit of post-PCI anti-inflammatory treatment would be constant regardless of the disease entity during the stabilized phase. Funding Acknowledgement Type of funding sources: None.

To better explore the pathophysiology of FA and its therapy, we aimed to establish a simple and practicable FA model with Freund's adjuvant and introduce an easy and reliable laboratory evaluation method for assessment of inflammation in intestinal segments at different anatomical locations. BALB/c mice were sensitized with ovalbumin combined with Freund's adjuvant. Complete Freund's adjuvant was chosen for the first sensitization and two weeks later incomplete Freund's adjuvant was used for a second sensitization. Two weeks later, the sensitized mice were challenged with 50 mg ovalbumin every other day. After the 6 challenge, all mice were assessed for systemic anaphylaxis, and then sacrificed for sample collection. All sensitized mice showed anaphylactic symptoms and markedly increased levels of serum ovalbumin-specific IgE and IgG1. The activity of mast cell protease-1 (mMCPT-1) was significantly increased in the serum and interstitial fluid of the duodenum, jejunum, ileum, and colon. A successful FA model was established, of which inflammation occurred in the duodenum, jejunum, ileum, and colon. This model provides a reliable and simple tool for analysis of the mechanism of FA and methods of immunotherapy. Moreover, combined detection of ovalbumin-specific antibody and local mMCPT-1 levels could potentially be used as the major indicator for assessment of food allergy.

Background The preservation of biological and physiological vitality as well as the formation of dentin are among the main tasks of human dental pulp for a life time. Odontoblastic differentiation of human dental pulp stem cells (hDPSCs) exhibits the capacity of dental pulp regeneration and dentin complex rebuilding. Exploration of the mechanisms regulating differentiation and proliferation of hDPSCs may help to investigate potential clinical applications. BTB and CNC homology 1 (BACH1) is a transcription repressor engaged in the regulation of multiple cellular functions. This study aimed to investigate the effects of BACH1 on the proliferation and odontoblastic differentiation of hDPSCs in vitro. Methods hDPSCs and pulpal tissues were obtained from extracted human premolars or third molars. The distribution of BACH1 was detected by immunohistochemistry. The mRNA and protein expression of BACH1 were examined by qRT-PCR and Western blot analysis. BACH1 expression was regulated by stable lentivirus-mediated transfection. Cell proliferation and cell cycle were assessed by cell counting kit-8 assay, 5-Ethynyl-2'-deoxyuridine assay and flow cytometry. The expression of mineralization markers, alkaline phosphatase (ALP) activity and alizarin red S staining were conducted to assess the odontoblastic differentiation ability. Results BACH1 expression was stronger in the odontoblast layer than in the cell rich zone. The total and nuclear protein level of BACH1 during odontoblastic differentiation was downregulated initially and then upregulated gradually. Knockdown of BACH1 greatly inhibited cell proliferation, arrested cell cycle, upregulated the heme oxygenase-1 (HO-1) expression and attenuated ALP activity, decreased calcium deposits and downregulated the expression of mineralization markers. Treatment of Tin-protoporphyrin IX, an HO-1 inhibitor, failed to rescue the impaired odonto/osteogenic differentiation capacity. Overexpression of BACH1 increased cell proliferation, ALP activity and the expression of mineralization markers. Conclusions Our findings suggest that BACH1 is an important regulator of the proliferation and odontoblastic differentiation of hDPSCs in vitro. Manipulation of BACH1 expression may provide an opportunity to promote the regenerative capacity of hDPSCs.

Ethylene glycol is the main component of antifreeze, due to its special sweetness, it is easy to cause misuse. In this paper, the clinical data of 4 cases of acute ethylene glycol poisoning admitted to Beijing Chao-Yang Hospital from August 2016 to August 2021 were retrospectively analyzed to explore the clinical characteristics of acute ethylene glycol poisoning cases. Early and accurate assessment of the disease and early hemodialysis treatment is the key to cure acute ethylene glycol poisoning.乙二醇作为防冻剂等的主要成分，由于其特殊的甜味，易引起误服。本文通过分析2016年8月至2021年8月北京朝阳医院收治的4例急性乙二醇中毒病例的临床资料，探讨急性乙二醇中毒病例的临床特征。尽早准确评估病情，早期血液透析治疗是救治急性乙二醇中毒的关键。.

Anaerobic digestion is a widely applicated technology for the treatment of wastes. Though it has been developed for many years, there are still some existing problems that need to be solved especially when it is used in a large scale in China. Substantial researches have been carried out and tried to increase biogas production and treatment efficiency in anaerobic digestion. In this review, the development and problems existed in anaerobic digestion are summarized like raw materials, indicators; hydrogen sulfide, ammonia; temperature, optimization, biogas slurry and residues in order to supply the suggestions for the researchers for the further development of anaerobic digestion and its application in a large scale in China.

In this study, we aimed to assess the safety and efficacy of Janus kinase (JAK) inhibitors in patients with ankylosing spondylitis (AS).We conducted a Bayesian network meta-analysis using direct and indirect data from randomized controlled trials (RCTs), and examined the safety and efficacy of JAK inhibitors in active AS patients exhibiting inadequate response or intolerance to two or more non-steroidal anti-inflammatory drugs (NSAIDs).RCTs included a total of 406 patients (203 experimental subjects and 203 controls) from three studies on upadacitinib, filgotinib, and tofacitinib. Assessment of SpondyloArthritis International Society 20% improvement (ASAS20), ASAS40, and ASAS5/6 responses were significantly higher in the JAK inhibitor group than in the placebo group. Other efficacy outcomes, such as ASAS partial remission, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50), Ankylosing Spondylitis Disease Activity Score (ASDAS), Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) scores, and Bath Ankylosing Spondylitis Functional Index (BASFI) were also significantly higher in the JAK inhibitor group compared to the placebo group. The JAK inhibitors significantly improved disease activity (ASAS partial remission, BASDAI50, ASDAS), function (BASFI), and MRI outcomes (SPARCC MRI spine). However, the incidence of adverse events (AEs) and serious adverse events (SAEs), and the rate of withdrawal attributed to AEs did not differ between the JAK inhibitor and placebo groups.JAK inhibitors were effective in active AS patients exhibiting an inadequate response or intolerance to two or more NSAIDs, without the risk of SAEs; this suggests that based on our data, studies are warranted to further investigate the use of JAK inhibitors for treating AS.ZIEL: In der vorliegenden Studie war es das Ziel, die Sicherheit und Wirksamkeit von Januskinase(JAK)-Inhibitoren bei Patienten mit ankylosierender Spondylitis (AS) zu untersuchen.Dazu führten die Autoren eine Bayes-Netzwerk-Metaanalyse durch, für die direkte und indirekte Daten aus randomisierten kontrollierten Studien (RCT) verwendet wurden, und untersuchten die Sicherheit und Wirksamkeit von JAK-Inhibitoren bei Patienten mit aktiver AS, die ein unzureichendes Ansprechen oder eine Intoleranz auf 2 oder mehr nichtsteroidale Antiphlogistika (NSAID) zeigten.Die RCT umfassten 406 Patienten (203 Versuchsteilnehmer und 203 Kontrollen) aus 3 Studien zu Upadacitinib, Filgotinib und Tofacitinib. Das Ansprechen gemäß Assessment of SpondyloArthritis International Society mit 20 % Verbesserung (ASAS20), ebenso ASAS40 und ASAS5/6, war in der JAK-Inhibitor-Gruppe signifikant höher als in der Placebogruppe. Auch andere Ergebnisse in Bezug auf die Wirksamkeit, wie eine ASAS-Teilremission, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50), Ankylosing Spondylitis Disease Activity Score (ASDAS), Scores in der Magnetresonanztomographie (MRT) gemäß Spondyloarthritis Research Consortium of Canada (SPARCC) und Bath Ankylosing Spondylitis Functional Index (BASFI), waren in der JAK-Inhibitor-Gruppe signifikant höher als in der Placebogruppe. Die JAK-Inhibitoren führten zu einer signifikant verbesserten Krankheitsaktivität (ASAS-Teilremission, BASDAI50, ASDAS), Funktion (BASFI) und MRT-Ergebnissen (SPARCC-Scores für MRT der Wirbelsäule). Jedoch unterschieden sich die Inzidenz von Nebenwirkungen (AE) und schweren AE (SAE) sowie die Rate derer, die aufgrund von AE aus der Studie ausschieden, nicht zwischen der JAK-Inhibitor- und der Placebogruppe.JAK-Inhibitoren waren – ohne das Risiko von SAE – bei Patienten mit aktiver AS wirksam, die ein unzureichendes Ansprechen auf 2 oder mehr NSAID oder eine entsprechende Intoleranz aufwiesen; demzufolge sind auf Basis der vorgestellten Daten Studien gerechtfertigt, in denen die Anwendung von JAK-Inhibitoren zur Therapie der AS weiter untersucht wird.

We surveyed randomized controlled trials (RCTs) examining the efficacy and safety of anifrolumab 300 mg in patients with active systemic lupus erythematosus (SLE) despite receiving standard therapy, using MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and manual searches. Meta-analysis performed to determine treatment efficacy and safety outcomes of three RCTs (459 patients and 468 controls) revealed that the BICLA responses were significantly higher in the anifrolumab group than in the placebo group (OR = 2.071, 95%CI 1.575–2.725, p

Evaluation of the effectiveness and safety of secukinumab and ixekizumab in active ankylosing spondylitis (AS) patients. A Bayesian network meta-analysis was conducted using direct and indirect data from five randomized controlled trials that examined the efficacy and safety of secukinumab 150 mg every 4 weeks and ixekizumab 80 mg every 2 weeks (IXEQ2W) or every 4 weeks (IXEQ4W) in active AS patients. Data from 1433 patients were analyzed. The Assessment of Spondyloarthritis International Society evaluation 20% response rates (ASAS20) were significantly higher with secukinumab 150 mg, IXEQ2W, IXEQ2W, and adalimumab 40 mg (odds ratio [OR] 2.75, 95% Bayesian credible interval [CrI] 2.04–3.69; OR 2.59, 95% CrI 1.69–3.98; OR 2.45, 95% CrI 1.60–3.75; and OR 1.94, 95% CrI 1.13–3.37, respectively) compared to the placebo group. Efficacies of secukinumab and ixekizumab were numerically higher compared to adalimumab 40 mg, although there was no significant difference in the ASAS20 response rates. The ASAS40 response rate showed a pattern of distribution similar to the ASAS20 response rate, with the exception of the ixekizumab group, which was associated with the most favorable surface under the cumulative ranking curve (SUCRA) for the ASAS40 response rate. Based on the SUCRA rating, secukinumab 150 mg had the highest probability of being the best ASAS20 response rate therapy, followed by IXEQ2W, IXEQ4W, adalimumab 40 mg, and placebo. There was no significant difference between the treatments regarding the number of serious adverse events (SAEs). Secukinumab and ixekizumab were effective in active AS treatment, without the risk of SAEs.

On the basis of the well-known theoretical concepts and some experimentally substantiated hypotheses, we propose a mathematical model aimed at description of the effect of diffusion-mobile hydrogen on the corrosion of pipe materials of crucial metal structures. The influence of hydrogenation of the metal on the corrosion rate of heat-exchange equipment is quantitatively evaluated.

The relative efficacy and tolerability of tofacitinib, baricitinib, upadacitinib, and filgotinib were assessed in patients with rheumatoid arthritis (RA) with inadequate responses to biologic disease-modifying antirheumatic drugs (bDMARDs).We performed a Bayesian network meta-analysis to combine direct and indirect evidence from randomized controlled trials (RCTs) to examine the efficacy and safety of tofacitinib, baricitinib, upadacitinib, and filgotinib in RA patients with inadequate responses to bDMARDs.Four RCTs comprising 1399 patients met the inclusion criteria. Tofacitinib, baricitinib, upadacitinib, and filgotinib achieved significant American College of Rheumatology 20% (ACR20) responses versus placebo. The ranking probability based on the surface under the cumulative ranking curve (SUCRA) indicated that upadacitinib 15 mg had the highest probability of being the best treatment for achieving the ACR20 response rate, followed by filgotinib 200 mg, baricitinib 4 mg, filgotinib 100 mg, tofacitinib 5 mg, and placebo. The ranking in SUCRA based on the ACR50 response rate indicated that baricitinib 4 mg had the highest probability of achieving the ACR50 response rate, followed by filgotinib 200 mg, tofacitinib 5 mg, upadacitinib 15 mg, filgotinib 100 mg, and placebo. Tofacitinib 5 mg showed a significantly higher ACR70 response rate than filgotinib 100 mg and upadacitinib 15 mg. Tofacitinib 5 mg, filgotinib 200 mg, and placebo showed a significantly lower serious adverse event rate than upadacitinib 15 mg.Tofacitinib, baricitinib, upadacitinib, and filgotinib were effective treatment options for RA patients with an inadequate response to bDMARDs but with different efficacy and safety profiles.ZIEL: Bei Patienten mit rheumatoider Arthritis (RA) und inadäquater Reaktion auf biologische krankheitsmodizifierende Antirheumatika (bDMARD) wurde die relative Wirksamkeit und Verträglichkeit von Tofacitinib, Baricitinib, Upadacitinib und Filgotinib ermittelt.Eine Bayes-Netzwerk-Metaanalyse wurde durchgeführt, um direkte und indirekte Evidenz aus randomisierten kontrollierten Studien (RCT) zu kombinieren und so die Wirksamkeit und Sicherheit von Tofacitinib, Baricitinib, Upadacitinib und Filgotinib bei RA-Patienten mit inadäquatem Ansprechen auf bDMARD zu untersuchen.Die Einschlusskriterien wurden von 4 RCT mit 1399 Patienten erfüllt. Unter Tofacitinib, Baricitinib, Upadacitinib und Filgotinib zeigte sich eine signifikant höhere ACR20-Ansprechrate (gemäß American College of Rheumatology) als unter Placebo. Wie die Rangfolgewahrscheinlichkeit, basierend auf der Oberfläche unter der kumulativen Rangfolgenkurve (SUCRA, „surface under the cumulative ranking curve“), ergab, stellte Upadacitinib 15 mg mit größter Wahrscheinlichkeit die beste Behandlung zur Erzielung der ACR20-Ansprechrate dar, es folgten Filgotinib 200 mg, Baricitinib 4 mg, Filgotinib 100 mg, Tofacitinib 5 mg und Placebo. Die auf der ACR50-Ansprechrate basierende SUCRA-Rangfolge zeigte, dass für Baricitinib 4 mg die höchste Wahrscheinlichkeit bestand, die ACR50-Ansprechrate zu erzielen, es folgten Filgotinib 200 mg, Tofacitinib 5 mg, Upadacitinib 15 mg, Filgotinib 100 mg und Placebo. Tofacitinib 5 mg wies eine signifikant höhere ACR70-Ansprechrate auf als Filgotinib 100 mg und Upadacitinib 15 mg. Für Tofacitinib 5 mg, Filgotinib 200 mg und Placebo zeigte sich eine signifikant niedrigere Rate schwerer unerwünschter Ereignisse als für Upadacitinib 15 mg.Für RA-Patienten mit inadäquater Reaktion auf bDMARD erwiesen sich Tofacitinib, Baricitinib, Upadacitinib und Filgotinib als wirksame Therapieoptionen, jedoch mit unterschiedlichen Wirksamkeits- und Sicherheitsprofilen.

Objective This study aimed to assess the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) in patients with active antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods We performed a meta-analysis of four randomized clinical trials (RCTs; 300 patients) to examine the relative efficacy and safety of MMF compared to CYC in patients with active AAV. Results There was no significant difference in remission at 6 months between MMF and CYC (odds ratio [OR] 1.311, 95% confidence interval [CI] 0.570-3.017, P = 0.524). Additionally, the relapse rate did not differ between the MMF and CYC groups (OR 1.331, 95% CI 0.497-3.568, P = 0.570). There was no significant difference in serious adverse event (SAE; OR 1.232, 95% CI 0.754-2.014, P = 0.404) and infection rates (OR 0.958, 95% CI 0.561-1.634, P = 0.873) between the MMF and CYC groups. Some heterogeneity was found in the meta-analysis of remission and relapse rates (I2 = 57.4%, 63.4%), but no between-study heterogeneity was found during the meta-analysis of SAE and infection rate. Egger's regression test showed no evidence of publication bias (Egger's regression test P-values >0.1). Conclusion MMF was an equally effective alternative treatment to CYC and MMF was comparable to CYC in patients with active AAV in terms of safety, suggesting that MMF can be used as an alternative to CYC for remission induction in AAV.

To systematically investigate the relationship between circulating interleukin-23 (IL‑23) levels and ankylosing spondylitis (AS) and establish a correlation between these hematological indices and AS activity/severity. We searched the Medline, Embase, and Cochrane databases; performed a meta-analysis comparing serum/plasma IL‑23 levels in patients with AS to those of controls; and examined the correlation coefficients between serum/plasma IL‑23 levels and AS activity. Ten studies including 1724 patients with AS and 1589 controls were included in this meta-analysis. This meta-analysis showed that circulating IL‑23 levels were significantly higher in the AS than in the control group (standardized mean difference [SMD] 1.479; 95% confidence interval [CI] 0.308–2.650; p = 0.013). Stratification by ethnicity showed a significantly increased IL‑23 level in the AS group in an Asian population (SMD 1.551; 95% CI 0.543–2.558; p = 0.003). Stratification by adjustment for age and sex revealed significantly higher IL‑23 levels in the AS adjustment group. Subgroup analysis of sample size showed a significantly higher IL‑23 level for a small (n

Acute methanol poisoning harms the optic nerve and central nervous system, can cause irreversible damage, even coma or death in severe cases. This article reported four cases of methanol poisoning. 3 patients mistakenly ingested industrial alcohol containing methanol, the most serious patient suffered from coma, vision loss and other symptoms, the blood methanol concentration was 869.3 μg/ml. Another patient was poisoning caused by inhalation of methanol, with symptoms such as total blindness in the right eye and decreased visual acuity in the left eye. After active supportive treatment, 2 patients had partial recovery of visual acuity, and 2 patients had no sequelae. This article discussed the clinical features, treatment and prognosis of optic nerve damage caused by methanol poisoning, in order to raise awareness of this disease.急性甲醇中毒危害视神经及中枢神经系统，可造成不可逆性损伤，严重者伴昏迷、甚至死亡。本文报道4例甲醇中毒患者。其中，3名患者误服含甲醇的工业酒精，较重的一名患者出现昏迷、视力下降等症状，毒物检测提示血甲醇浓度为869.3 μg/ml；1名患者为吸入性甲醇中毒，出现右眼全盲、左眼视力下降等症状。经过积极对症支持治疗，2例患者视力部分恢复，2例患者无后遗症。本文讨论了甲醇中毒致神经病变的临床特征和治疗预后，以提高对此病的认识。.

Schistosomiasis is an important zoonotic parasitic disease, and is categorized as a neglected tropical disease by the World Health Organization. Following the concerted efforts for more than 70 years, great achievements have been made in the national schistosomiasis control program in China, and the prevalence, disability and mortality due to schistosomiasis has remarkably dropped. Nevertheless, the frequent identification of imported schistosomiasis and the resulting potential transmission risk in mainland China have been recently paid much attention following the implementation of the "Belt and Road Initiative" and the China-Africa Cooperation Forum. This review describes the advances in the diagnostic tools for schistosomiasis, including pathogenic techniques, immunodiagnostic techniques and nucleic acid assays, in order to consolidate schistosomiasis control achievements and promote the capability for detection of external biological safety risks.

Convolutional neural networks (CNNs) have demonstrated expert-level performance in cutaneous tumour classification using clinical images, but most previous studies have focused on dermatologist-versus-CNN comparisons rather than their combination. The objective of our study was to evaluate the potential impact of CNN assistance on dermatologists for clinical image interpretation.A multi-class CNN was trained and validated using a dataset of 25,773 clinical images comprising 10 categories of cutaneous tumours. The CNN's performance was tested on an independent dataset of 2107 images. A total of 400 images (40 per category) were randomly selected from the test dataset. A fully crossed, self-control, multi-reader multi-case (MRMC) study was conducted to compare the performance of 18 board-certified dermatologists (experience: 13/18 ≤ 10 years; 5/18＞10 years) in interpreting the 400 clinical images with or without CNN assistance.The CNN achieved an overall accuracy of 78.45% and kappa of 0.73 in the classification of 10 types of cutaneous tumours on 2107 images. CNN-assisted dermatologists achieved a higher accuracy (76.60% vs. 62.78%, P 0.001) and kappa (0.74 vs. 0.59, P 0.001) than unassisted dermatologists in interpreting the 400 clinical images. Dermatologists with less experience benefited more from CNN assistance. At the binary classification level (malignant or benign), the sensitivity (89.56% vs. 83.21%, P 0.001) and specificity (87.90% vs. 80.92%, P 0.001) of dermatologists with CNN assistance were also significantly improved than those without.CNN assistance improved dermatologist accuracy in interpreting cutaneous tumours and could further boost the acceptance of this new technique.

The Chuo Ban Chu of Shang Si Yuan in the Qing Dynasty was an institution for Mongolian physicians who provided bone injury diagnosis and treatment for the royal family. This paper reports on an examination of the archives at the First Historical Archives of China, where 171 relevant archives were obtained. Based on this data, the paper summarises and verifies the directories of 112 Mongolian physicians, the authenticity and inheritance of 26 of these physicians, and a brief biography of 16 of them in each period of the Qing Dynasty.清代上驷院绰班处是由蒙古医生组成的主要为皇室提供骨伤科医疗服务的机构。通过对中国第一历史档案馆馆藏上驷院绰班处相关档案史料进行实地调查，共获得171条档案史料，经整理与考证，总结了清代各朝共112位蒙古医生名录，26位蒙古医生长的承袭情况，并为其中16位蒙古医生撰写了小传。.

The case of oral hydrochloric acid poisoning is rare in clinic, and it is easy to be misdiagnosed when the poison is not clear. The clinical data of 1 case of oral hydrochloric acid poisoning successfully treated was retrospectively analyzed to provide reference for diagnosis and treatment of similar clinical cases.口服盐酸中毒的病例临床少见，在毒物不明确的情况下容易误诊。本文对成功救治的1例口服盐酸中毒患者的临床资料进行回顾性分析，为临床类似病例提供诊治参考。.

This study explores the evolutionary history of ecological niche characters in the Eurasian snowfinch lineage. Specifically, we use new analytical approaches to reconstruct ecological niche evolution, taking uncertainty in knowledge of the ecological niche limits into account. We found an overall pattern of niche conservatism in relation to both temperature and precipitation characteristics of niches, but for one dramatic niche evolution event, in Montifringilla nivalis. Interestingly, this species is also that which has by far the broadest geographic distribution among snowfinches. We conclude that an evolutionary change in niche characteristics perhaps within M. nivalis (i.e., present in some and not all of its populations) made possible the broad, westward range expansion of that species, thus changing the distributional potential of the snowfinch lineage dramatically.

The mechanical properties and microstructure of 7075 aluminum alloy during the two-stage aging process have been studied by means of Rockwell hardness test, tensile test, X-ray diffraction, scanning electron microscopy, transmission electron microscopy (TEM) and high-resolution TEM. The results illustrated that there existed double peaks for both the hardness and strength in 7075 aluminum alloy during the two-stage aging process. Furthermore, the aging time to reach the second peak was obviously shortened compared to single-stage aging process. At the first peak aging state, the strengthening effect of the alloy was dominated by high-density GP zones, but η′ phase (MgZn2) was mainly the strengthening phase at the second peak aging state.

This study systemically reviewed the evidence regarding associations between polymorphisms in interleukin-17 (IL-17) genes and osteoarthritis (OA) susceptibility, and the relationship between circulating IL-17 levels and OA. We performed a meta-analysis of the associations between the IL-17A rs2275913 and IL-17F rs763780 polymorphisms and risk for OA and serum/plasma IL-17 levels in OA patients and controls. Eight studies including 2214 OA patients and 2474 controls were included. Our meta-analysis identified a significant association between OA and the AA genotype of the IL-17A rs2275913 polymorphism in a pooled cohort of affected individuals, compared to the case in a pooled cohort of control participants (OR = 1.516, 95% CI = 1.260–1.825, P

Based on non-equilibrium Green's function and density functional theory, a first-principles study of the transport properties of a molecular device is performed. This device is composed of two octacene molecules separated by a ethyl barrier, which are then linked to Ag leads through thiolates. The device shows low bias negative differential resistance effect with dual-peaks, which may be useful for designing molecular devices with low power-dissipation and multi-function in the future.

Aim To develop an education and training programme to enhance bedside nurses' knowledge, competency and compliance in accurately performing delirium screening in intensive care units. Background Delirium in intensive care units is associated with several poor patient outcomes. Delirium detection can be improved by enhancing nurses' knowledge, competency and compliance in accurately performing delirium screening. Methods A descriptive quantitative study with pretest-post-test design was adopted. There were 245 nurses from five intensive care units who participated in the study. Multiple-choice questions were used to assess nurses' knowledge change before and after the education programme. Competency was assessed before and 2 months after the programme by simulation with a standardized patient, followed by real patients at the bedside. Compliance data on screening were collected from the documentation of the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the ICU before and 3 and 10 months after the programme. Data collection took 1 year, from June 2014 to May 2015. Results Despite nurses' improved knowledge and good competency, delirium screening documentations after 3 months were poor. However, screening documentations subsequently improved when measured at 10 months, following further emphasis by the senior nursing staff. Implications for nursing practice and policy Nursing administrators and bedside nurses need to be involved in the policy-making process and plan a training programme for the new nursing staff in the high-risk areas. A short refreshment course should be offered to the nursing staff 3 months after the initial training programme. Conclusions Improved knowledge and competency in assessment did not improve compliance and documentation of delirium screening. Therefore, it is important to reinforce nurses' compliance of delirium screening over time.

In order to solve the corrosion and wear of 7050 aluminium alloy (AA7050) caused by the marine environment and prepare excellent coating structure to prolong its service life, the micro-arc oxidati...

We experimentally investigate how jargon affects investment willingness for investors with different industry knowledge, and whether such effects vary with good or bad jargon. We find that for investors without industry knowledge, jargon decreases investment willingness because it decreases understanding. However, for investors with some but low industry knowledge, jargon increases investment willingness because it increases perceived product premium. Such effects exist whether good or bad jargon is used. Finally, investors with high industry knowledge differentiate between good and bad jargon, and reduce investment willingness only when bad jargon is used. These findings have implications for regulators, managers, and investors. Ministry of Education (MOE) Accepted version We are grateful for helpful comments from Michelle Hanlon (editor), William Mayew (referee), Pjotr Akulinitsev, Bradley Bennett, Jeremy Bentley, Lukas Helikum, Yoon Ju Kang, Kyle Stubbs, Tu Xu, Yao Yu, and seminar participants at University of Massachusetts Amherst and Nanyang Technological University. We thank Nikki Mackenzie, Matt Starliper, Yanjia Yang, and Tongrui Cao for research assistance, and the Singapore Ministry of Education Academic Research Fund Tier 1 (RG58/17) for financial support.

In 2019, an outbreak of e-cigarette/vaping product use-associated lung injury (EVALI) across the United States was responsible for acute harm, hospitalizations, and mortality among individuals using vape products, including youth and young adults. The objective of this study is to describe and evaluate the public health surveillance and emergency response activities that occurred in Massachusetts during the 2019 EVALI outbreak.Descriptive process and policy evaluation.Between September and December 2019, the Massachusetts Department of Public Health temporarily removed access to e-cigarettes in stores, conducted tobacco retailer educational activities, and promoted tobacco cessation communications. The public health response was monitored through online adult panel surveys, in-school youth surveys, retailer compliance checks, and existing tobacco control program surveillance.Massachusetts residents indicated high awareness of the EVALI outbreak and the corresponding public health response. Tobacco retailers were compliant with the temporary state prohibition on the sale of e-cigarettes. In response to reduced access to vaping products in stores, both adult and youth survey respondents reported reduced use, increased quit attempts, or complete e-cigarette cessation.Emergency action undertaken by state public health programs and other governmental agencies corresponded with reduced availability of e-cigarettes and an increase in self-reported quit behaviors. Existing public health infrastructure at the state and local levels in Massachusetts facilitated an environment in which emergency and permanent protective measures could be implemented.

Gravity wave (GW) activities in the upper mesosphere (80–100 km) and their potential sources are investigated using meteor radar observations at King Sejong Station, Antarctica (KSS; 62.22°S, 58.78°W) during recent 14 years (2007–2020). GW activities are estimated by horizontal wind variances of small-scale GWs (periods