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BackgroundCoronary microvascular dysfunction (CMD) is associated with increased cardiovascular events in patients with angina with non-obstructive coronary (ANOCA), especially heart failure. Conventional echocardiography is difficult to identify early alterations in cardiac function due to CMD.MethodsWe recruited 78 ANOCA patients. All patients underwent conventional echocardiography examination, adenosine stress echocardiography and examination of coronary flow reserve (CFR) by transthoracic echocardiography. Based on the CFR results, patients were divided into the CMD group (CFR ResultsThere was no significant difference in conventional echocardiography parameters, 2D-STE related indices or MW at rest between the two groups. Global work index (GWI), global contractive work (GCW), and global work efficiency (GWE) were lower in the CMD group than in the non-CMD group at stress (p = 0.040, 0.044, p p = 0.001, 0.001, 0.009, respectively) and a decrease in PSD and GWW (p = 0.001, 0.015, respectively). In the CMD group, the response to adenosine was mainly manifested as an increase in GWW and a decrease in GWE (p = 0.002, and 0.006, respectively). In the multivariate regression analysis, we found that ΔGWW (difference in GWW before vs. after adenosine stress) and ΔPSD (difference in PSD before vs. after adenosine stress) were independent factors associated with CMD. The ROC curves showed that the composite prediction model consisting of ΔGWW and ΔPSD had excellent diagnostic value for CMD (area under the curve = 0.913).ConclusionIn the present study, we found that CMD caused deterioration of myocardial work in ANOCA patients under adenosine stress, and that increased cardiac contraction asynchrony and wasted work may be the main changes caused by CMD.

Background: To evaluate whether the LiDCO-rapid monitor had any advantages compared to continuous epidural analgesia to bring beneficial for hypertensive pregnant women and their newborns. Methods: In total 160 parturients with hypertensive disorder complicating pregnancy were enrolled and randomly divided into continuous spinal analgesia group (CSA) and continuous epidural analgesia group (EA). The LiDCO-rapid system was used to monitor the hemodynamic changes of all participants. The inflammatory factors and stress response hormones were measured in the participants' serum. Results: The first stage of labor in CSA was longer than EA (P Trial registration: ChiCTR-INR-17012659 Date of registration: 13/09/2017

Proton exchange membrane fuel cells (PEMFCs) have great potential to become the next generation green energy technique, but its application is limited by the slow kinetics of the cathode oxygen reduction reaction (ORR) in acidic medium.

In order to improve the effect of intensive care, this paper proposes a lean nursing intervention method and evaluates the lean nursing intervention through a controlled experiment. According to the actual situation of intensive care, this paper starts with the research from several aspects of patients’ ICU nursing time, patients’ satisfaction, patients’ pathological knowledge familiarity, patients’ autonomous nursing, and enthusiasm of patients and their families. Moreover, this paper collects and displays experimental results through mathematical statistics, gives patients lean management concepts and methods based on routine care, and finds that it has good management effects. Thus, lean management concepts and methods can effectively improve the anxiety state of critically ill patients, improve the patient’s knowledge of disease, and reduce adverse nursing events to improve patient nursing satisfaction, which is worthy of further promotion in the clinic.

No study has examined the differential value of arterial intima thickness in the subtypes of acute ischaemic stroke. This study aimed to assess whether intima thickness of carotid artery (CIT), radial artery (RIT) and dorsalis pedis artery (PIT) have an independent and additive value in differentiating ischaemic stroke subtypes due to large‐artery atherosclerosis (LAA) or small‐vessel occlusion (SVO). One hundred and sixty‐one patients with LAA and 79 patients with SVO were recruited. CIT, RIT and PIT were measured with a 24‐MHz ultrasound transducer. Binary logistic regression analysis was used to evaluate the differential values of the different parameters in the two subtypes. ROC curve analyses were plotted to compare the differential performance of different parameters and the combination model. Both RIT and PIT were substantially thicker in LAA than in SVO stroke patients. RIT and carotid intima‐media thickness had similar performances in differentiating stroke subtypes. Introduction of RIT to traditional atherosclerotic associated risk factors had a marginal satisfactory differential performance for LAA and SVO stroke patients (AUC 0.775). RIT is a promising parameter for LAA and SVO subgroup classification. The combination of RIT and traditional risk factors might be a promising tool for differentiating ischaemic stroke subgroups.

Summary Background The addition of camrelizumab to gemcitabine and cisplatin showed promising activity as first-line therapy in patients with recurrent or metastatic nasopharyngeal carcinoma in a phase 1 trial. We therefore compared camrelizumab plus gemcitabine and cisplatin with placebo plus gemcitabine and cisplatin in a randomised phase 3 trial. Methods In this randomised, double-blind, phase 3 trial done at 28 hospitals in China, patients were eligible if they were aged 18–75 years, had an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, and had previously untreated recurrent or metastatic nasopharyngeal carcinoma. Patients were randomly assigned (1:1; using an interactive web-response system with a block size of four) to receive either camrelizumab (200 mg on day 1) or matching placebo intravenously, plus gemcitabine and cisplatin (gemcitabine 1000 mg/m2 on days 1 and 8; cisplatin 80 mg/m2 on day 1) intravenously every 3 weeks for four to six cycles, followed by maintenance therapy with camrelizumab or placebo, until radiographic progression, unacceptable toxicity, start of new anticancer treatment, investigator decision, or withdrawal of consent. Stratification factors used in randomisation were liver metastases, previous radical concurrent chemoradiotherapy, and ECOG performance status. The allocation sequence was generated by an independent randomisation group. The primary endpoint was progression-free survival per independent review committee. The significance threshold for independent review committee-assessed progression-free survival was p=0·0086 (one-sided) at the interim analysis. Efficacy and safety analyses included all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov , NCT03707509 , and is closed for enrolment but is ongoing. Findings Between Nov 13, 2018, and Nov 29, 2019, 343 patients were screened and 263 were eligible and were randomly assigned to the camrelizumab group (n=134) or placebo group (n=129). At the prespecified interim analysis (June 15, 2020), independent review committee-assessed progression-free survival was significantly longer in the camrelizumab group (median 9·7 months [95% CI 8·3–11·4]) than in the placebo group (median 6·9 months [5·9–7·3]; hazard ratio 0·54 [95% CI 0·39–0·76]; one-sided p=0·0002). As of Dec 31, 2020, the most common grade 3 or worse adverse events of any cause were decreased white blood cell count (89 [66%] of 134 patients in the camrelizumab group vs 90 [70%] of 129 patients in the placebo group), decreased neutrophil count (86 [64%] vs 85 [66%]), anaemia (53 [40%] vs 57 [44%]), and decreased platelet count (53 [40%] vs 52 [40%]). Serious adverse events were reported in 59 (44%) of 134 patients in the camrelizumab group and 48 (37%) of 129 patients in the placebo group. Treatment-related deaths occurred in five (4%) patients in the camrelizumab group (two unknown cause of death, one multiple organ dysfunction syndrome, one pharyngeal haemorrhage, and one arrhythmia) and one ( Interpretation Our findings suggest that camrelizumab plus gemcitabine and cisplatin could be a new standard of care for patients with recurrent or metastatic nasopharyngeal carcinoma in the first-line setting. Longer follow-up is needed to confirm this conclusion. Funding Jiangsu Hengrui Pharmaceuticals (formerly Jiangsu Hengrui Medicine). Translation For the Chinese translation of the abstract see Supplementary Materials section.

Background and Objectives The quality of the built environmental features in long-term care (LTC) homes significantly influences residents’ functioning (e.g., wayfinding, self-care, and social interaction) and well-being. There is limited research on the characteristics of the built environment of LTC and its influence on residents’ quality of life in countries in the Asia–Pacific region (e.g., East Asia and South Asia). The older adult population in this region is expected to increase significantly in the coming decades. There are distinctive perceptions of nursing home, nursing home environments, and sociocultural norms in this geographic region. Given this context, a better understanding of the built environment of LTC facilities in this region can inform design professionals and policymakers for evidence-based decision-making. The present study undertakes a scoping review of the empirical research on the characteristics and influence of the built environment of LTC facilities on residents’ quality of life in the Asia–Pacific context. Research Design and Methods Online relevant databases were used to identify articles published 2000–2021, from which we selected 33 publications. Results Three substantive themes were generated from the synthesis of the selected publications. These themes are (a) perceptions of nursing home, (b) impact of the built environment on residents’ quality of life, and (c) assessment of the LTC built environment. Discussion and Implications We identified research gaps in understanding the role of the built environment in nursing homes in the particular geographic context and future research directions. Five planning and design principles for LTC were derived from the synthesis of key findings to inform design professionals and policymakers.

HMGA1 is a chromatin-binding protein and performs its biological function by remodeling chromatin structure or recruiting other transcription factors. However, the role of abnormally high level of HMGA1 in cancer cells and its regulatory mechanism still require further investigation. In this study, we performed a prognostic analysis and showed that high level of either HMGA1 or FOXM1 was associated with poor prognosis in various cancers based on the TCGA database. Furthermore, the expression pattern of HMGA1 and FOXM1 showed a significant strong positive correlation in most type of cancers, especially lung adenocarcinoma, pancreatic cancer and liver cancer. Further analysis of the biological effects of their high correlation in cancers suggested that cell cycle was the most significant related pathway commonly regulated by HMGA1 and FOXM1. After knockdown of HMGA1 and FOXM1 by specific siRNAs, an obvious increased G2/M phase was observed in the siHMGA1 and siFOXM1 groups compared to the siNC group. The expression levels of key G2/M phase regulatory genes PLK1 and CCNB1 were significantly downregulated. Importantly, HMGA1 and FOXM1 were identified to form a protein complex and co-located in the nucleus based on co-immunoprecipitation and immunofluorescence staining, respectively. Thus, our results provide the basic evidence that HMGA1 and FOXM1 cooperatively accelerate cell cycle progression by up-regulating PLK1 and CCNB1 to promote cancer cell proliferation.

For single-phase ground fault in resonant grounded power supply system, it is difficult to detect the fault line, while the existing methods have the shortcomings such as slow speed and large amount of computation. In our work the system natural oscillation wave contained in the zero sequence current is found to have opposite polarity and greater amplitude in fault line compared to that in non-fault line, and is proved to have a corresponding relationship with the first intrinsic mode function (IMF1) extracted from the same zero sequence current by empirical mode decomposition (EMD) of (Hilbert-Huang transform (HHT). Therefore, a new method for determining the single-phase ground fault line is proposed by finding the IMF1, extracted from the zero sequence current of each line by EMD of HHT, with the largest amplitude and opposite polarity compared to that of other lines. Meanwhile, EMD algorithm is improved to further enhance the fault detection rate based on the system natural oscillation wave's frequency and its attenuation trend in resonant grounding system. Simulation experiment and real data analysis indicate that the mentioned method is correct and fast.

A new type of brushless reverse claw-pole electrically excited generator is proposed for the problems of the low sine degree of the induced electromotive force waveform and the high harmonic content of the output voltage of the conventional electrically excited claw-pole generator. The design uses the equivalent magnetic network method to establish the equivalent magnetic circuit model of the motor and determines the equation for calculating the magnetoresistance of the isosceles trapezoidal variable section claw-pole structure. It derives the mathematical model of the no-load induced electric potential of the generator and completes to optimize the motor parameters with the no-load induced electric potential as the target. This study shows that the brushless reverse claw-pole electrically excited generator has the advantages of uniform magnetic field distribution, high harmonic fundamental amplitude of induced electromotive force and low harmonic content. It can better meet the application requirements compared with the conventional electrically excited claw-pole generator.

Much attention has been devoted to disposing traditional-sized poly(methyl methacrylate) (PMMA) waste by pyrolysis for methyl methacrylate (MMA). The pyrolysis of micron-sized PMMA waste, which may be different from that of traditional-sized PMMA waste, received little concern. The present study investigated the kinetics and volatile products of micron-sized PMMA waste pyrolysis in inert atmosphere using thermogravimetry and Fourier transform infrared analysis. A global optimization algorithm namely Shuffled Complex Evolution (SCE) was employed to simultaneously optimize the kinetic parameters. Results indicated that one shoulder and one peak occurred in the MLR variations with temperature. The values of the MLR at the shoulder and peak, the average MLR all increased with the heating rate. The optimized kinetic parameters by SCE can be utilized to well reproduce the experimental thermogravimetric data. The values of activation energy and natural logarithm of pre-exponential factor were in the range of 235.95–248.61 kJ/mol and 16.96–28.76 min−1, respectively. The value of activation energy of micron-sized PMMA waste pyrolysis under the present study was greater than that of the traditional-sized PMMA pyrolysis in the previous studies. MMA and CO2 were the major volatile products generated from the micron-sized PMMA waste pyrolysis. The volatile products yield at peak was much larger than that at shoulder. The MMA and CO2 yield were in the range of 87.98–93.54% and 6.46–12.02%, respectively. High MMA yield may be obtained from the pyrolysis of micron-sized PMMA waste in inert atmosphere by appropriately increasing the heating rate adopted in the reactors in the practical applications.

Background Suboptimal tissue perfusion and oxygenation during surgery may be responsible for postoperative nausea and vomiting in some patients. This trial tested the hypothesis that muscular tissue oxygen saturation–guided intraoperative care reduces postoperative nausea and vomiting. Methods This multicenter, pragmatic, patient- and assessor-blinded randomized controlled (1:1 ratio) trial was conducted from September 2018 to June 2019 at six teaching hospitals in four different cities in China. Nonsmoking women, 18 to 65 yr old, and having elective laparoscopic surgery involving hysterectomy (n = 800) were randomly assigned to receive either intraoperative muscular tissue oxygen saturation–guided care or usual care. The goal was to maintain muscular tissue oxygen saturation, measured at flank and on forearm, greater than baseline or 70%, whichever was higher. The primary outcome was 24-h postoperative nausea and vomiting. Secondary outcomes included nausea severity, quality of recovery, and 30-day morbidity and mortality. Results Of the 800 randomized patients (median age, 50 yr [range, 27 to 65]), 799 were assessed for the primary outcome. The below-goal muscular tissue oxygen saturation area under the curve was significantly smaller in patients receiving muscular tissue oxygen saturation–guided care (n = 400) than in those receiving usual care (n = 399; flank, 50 vs. 140% · min, P < 0.001; forearm, 53 vs. 245% · min, P < 0.001). The incidences of 24-h postoperative nausea and vomiting were 32% (127 of 400) in the muscular tissue oxygen saturation–guided care group and 36% (142 of 399) in the usual care group, which were not significantly different (risk ratio, 0.89; 95% CI, 0.73 to 1.08; P = 0.251). There were no significant between-group differences for secondary outcomes. No harm was observed throughout the study. Conclusions In a relatively young and healthy female patient population, personalized, goal-directed, muscular tissue oxygen saturation–guided intraoperative care is effective in treating decreased muscular tissue oxygen saturation but does not reduce the incidence of 24-h posthysterectomy nausea and vomiting. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

In this paper, several major factors affecting the erosion wear of WC–Co cemented carbide were tested and analyzed by the cemented carbide solid particle erosion test. In addition to the erosion angle, the impact velocity, the hardness and dimensions of the abrasive and the degree of fracture of the abrasive after impacting the target material also have a significant effect on the erosion wear results. Abrasives with a high degree of fragmentation after erosion have lower erosion wear efficiency for cemented carbides. The increase in Co content and WC grain size will lead to the decline of erosion resistance of cemented carbide. After the energy spectrum analysis of the target material after erosion, it was found that Co particles were first detached during the erosion process. Later, due to the instability of the entire microstructure, a series of erosion wears was caused.

Background: Long non-coding RNAs (lncRNAs) modulate numerous cellular processes, including DNA damage repair. Here, we investigated the clinical importance of lncRNAs associated with mutational burden in hepatocellular carcinoma (HCC). Methods: Prognosis-related lncRNAs associated with mutational burden were screened and determined to score the mutational burden-associated lncRNA signature (MbLncSig) from TCGA. Prognostic values and predictive performance of the MbLncSig score were analysed. Results: Four mutational burden-associated lncRNAs (AC010643.1, AC116351.1, LUCAT1 and MIR210HG) were identified for establishing the MbLncSig score. The MbLncSig score served as an independent risk factor for HCC prognosis in different subgroup patients. The predictive performance of one-year and three-year OS was 0.739 and 0.689 in the entire cohort, respectively. Moreover, the MbLncSig score can further stratify the patient survival in those with TP53 wild type or mutation. Conclusions: This study identified a four-lncRNA signature (the MbLncSig score) which could predict survival in HCC patient with/without TP53 mutation.

No study has examined myocardial work in subjects with cancer therapy-related cardiac dysfunction (CTRCD). Myocardial work, as a new ultrasonic indicator, reflects the metabolism and oxygen consumption of the left ventricle. The aim of this study was to test the relative value of new indices of myocardial work and global longitudinal strain (GLS) in detecting changes in myocardial function during the treatment of breast cancer by two-dimensional and three-dimensional echocardiography. We enrolled 79 breast cancer patients undergoing different tumor treatment regimens. Follow-up observation was conducted before and after chemotherapy. The effects of breast cancer chemotherapy and targeted therapy on the development of CTRCD [defined as an absolute reduction in left ventricular ejection fraction (LVEF) of >5% to p < 0.05). The three-dimensional strain changes after T6 and T8 had no advantages compared with GLS. Body mass index (BMI), the GLS change rate after the second cycle of chemotherapy (G2v) and the 3D-GCS change rate after the second cycle of chemotherapy (C2v) were independent factors that could predict the occurrence of CTRCD during follow-up, among which BMI was the best predictor (area under the curve, 0.922). In conclusion, the current study determined that GLS was superior to GWI in predicting cardiac function in patients with tumors with little variation in blood pressure. BMI, G2v and C2v can be used to predict the occurrence of CTRCD.

In this paper, a new hybrid excitation drive motor (HEDM) was proposed to solve the problem of an uncontrollable magnetic field of a permanent magnet motor. The rotor part of the motor was composed of a combined magnetic pole permanent magnet rotor and a brushless electric claw rotor, in which the combined magnetic pole permanent magnet rotor has a parallel magnetic circuit structure. According to the characteristics of the parallel rotor structure, the equivalent magnetic circuit model was established, and the no-load leakage flux coefficient of the claw pole rotor was calculated. The Taguchi method was used for objective optimization of the permanent magnet rotor structure. The distortion rate of no-load back electromotive force (EMF) was taken as the first optimization goal; the cogging torque and the average torque were taken as the second optimization goal; and the torque fluctuation coefficient was a constraint condition. The optimal parameter matching under the mixed horizontal matrix was obtained. The parameters of the claw pole were optimized by using the method of uniform variables, and the dimension parameters of the motor were obtained. Finite element analysis and prototype tests were carried out for the optimized motor structure. The rationality and feasibility of the new HEDM as a vehicle motor were verified, which provided a possibility for the application of the new energy vehicle drive motor field.

PURPOSEGEM20110714 (ClinicalTrials.gov identifier: NCT01528618 ), the first randomized, phase III study of systemic chemotherapy in recurrent or metastatic nasopharyngeal carcinoma (NPC), reported significant progression-free survival improvement with gemcitabine plus cisplatin (GP) versus fluorouracil plus cisplatin (FP; hazard ratio, 0.55; 95% CI, 0.44 to 0.68; P < .001). Data from the final analysis of overall survival (OS) are presented here.METHODSFrom February 2012 to October 2015, 362 patients were randomly assigned to receive either GP (gemcitabine 1 g/m2once daily on days 1 and 8 and cisplatin 80 mg/m2once daily on day 1; n = 181) or FP (fluorouracil 4 g/m2in continuous intravenous infusion over 96 hours and cisplatin 80 mg/m2once daily on day 1; n = 181) once every 21 days. The primary end point was progression-free survival, which has been previously reported; OS was a secondary end point.RESULTSAfter a median follow-up time of 69.5 months with GP and 69.7 months with FP, 148 (81.8%) and 166 (91.7%) deaths occurred in the GP and FP arms, respectively. The estimated hazard ratio for OS was 0.72 (95% CI, 0.58 to 0.90; two-sided P = .004). The median OS was 22.1 months (95% CI, 19.2 to 25.0 months) with GP versus 18.6 months (95% CI, 15.4 to 21.7 months) with FP. The OS probabilities at 1, 3, and 5 years were 79.9% versus 71.8%, 31.0% versus 20.4%, and 19.2% versus 7.8%, respectively. Poststudy therapy was administered in 51.9% and 55.2% of patients in the GP and FP arms, respectively.CONCLUSIONAmong patients with previously untreated advanced nasopharyngeal carcinoma, those who receive GP have longer OS than those receive FP. Gemcitabine plus cisplatin should be considered a preferred front-line option for these patients.

Aiming at the current problems of low excitation efficiency and poor reliability of single-rotor hybrid excitation generators, the large axial length of dual-rotor structure, and difficulty in magnetic field analysis, a new type of the dual-rotor hybrid excitation generator topology with high power density is proposed, with two rotors side-by-side coaxial, sharing a set of armature windings, and the magnetic fields do not interfere with each other, so the magnetic field analysis and optimization of the two rotors can be carried out separately. The magnetic density distribution of the new permanent magnet (PM) claw pole rotor is analyzed by the joint application of the equivalent magnetic circuit method and the equivalent magnetic network method, which ensures the simplicity of calculation and improves the calculation accuracy. The multi-objective optimization of the key structural parameters is carried out based on the Latin hypercube sampling–Pareto frontier solution method. The subdomain method is improved by segmented equivalence, the unique solution of the salient-pole rotor magnetic field is obtained, and the multi-objective optimization of the salient-pole rotor is used by the particle swarm algorithm. The trial prototype was experimental, and the results showed that the output characteristics of the optimized hybrid excitation generator were significantly improved, and the overall performance of the generator was improved.

Aims To investigate differences in the prevalence of left ventricular (LV) and left atrial (LA) remodelling in hypertensive patients using various thresholds defined by international guidelines and data from the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) study and different indexation methods. Methods and results LV mass (LVM), relative ventricular wall thickness, and LA volume (LAV) were measured using 2D echocardiography in 612 healthy volunteers selected from the EMINCA study population and 306 adult Chinese patients with hypertension who were age- and gender-matched using propensity score-matched analysis. LVM and LAV values were indexed to body surface area (BSA), height2.7, height1.7, and height2 recommended by guidelines or investigators. Using a previously reported method, LV geometry was divided into normal geometry, concentric remodelling, eccentric hypertrophy, and concentric hypertrophy. The prevalence of LV hypertrophy (LVH) and LV geometric patterns in hypertensive patients were compared using different thresholds and indexation methods. Echocardiographic thresholds from guidelines and healthy volunteers exhibited notable differences, particularly for LAV indexed to height2 and for LVM indexed to height1.7, which resulted in a significantly lower prevalence of LA dilatation and LVH in healthy volunteers. The total proportion of abnormal LV geometric patterns was significantly lower with thresholds from healthy volunteers than from guidelines when LVM was indexed to BSA, height1.7, and height2,7. Conclusion Using current echocardiographic thresholds and indexing methods recommended by guidelines may lead to significant misdiagnosis of LA dilatation, and abnormal LV geometry in Chinese patients with hypertension, and thresholds based on ethnic-specific normal echocardiographic reference values and an accurate indexing algorithm are warranted.

Meteorological factors, which are cyclical and regular, have an essential impact on human health. Accurate health risk prediction based on meteorological factors is essential for optimal resource allocation in healthcare units. However, due to the non-stationary and nonlinear of the original hospitalization sequence, traditional methods are less robust to predict it. This study aims to investigate hospital admission prediction models using time series pre-processing algorithms and deep learning approach based on Meteorological factors. Using the hospital electronic medical record data of Panyu Central Hospital and meteorological data of Panyu district from 2003-2019, 46,089 eligible patients with lower respiratory tract infections (LRTIs) and four meteorological factors were identified to build and evaluate the prediction models. A novel hybrid model, Cascade GAM-CEEMDAN-LSTM Model (CGCLM) was established in combination with Generalized Additive Model (GAM), Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) and Long-Short Term Memory Networks (LSTM) for predicting daily admissions of patients with LRTIs. The experimental results show that the CGCLM multistep method proposed in this paper outperforms the single LSTM model in the prediction of health risk time series at different time window sizes. Moreover, our results also indicate that the CGCLM has the best prediction performance when the time window is set to 61 days (RMSE=1.12, MAE=0.87, R2=0.93). Adequate extraction of exposure-response relationships between meteorological factors and diseases and suitable handling of sequence pre-processing have an important role in time series prediction. This hybrid climate-based model to LRTIs disease prediction can also be extended to the time series prediction of other epidemic disease.

BACKGROUND Maternal and child health (MCH)–related mobile apps are becoming increasingly popular among pregnant women; however, few apps have demonstrated that they lead to improvements in pregnancy outcomes. OBJECTIVE This study aims to investigate the use of MCH apps among pregnant women in China and explore associations with pregnancy outcomes. METHODS A retrospective study was conducted at 6 MCH hospitals in northern China. Women who delivered a singleton baby at >28 weeks’ gestation at the study hospitals were sequentially recruited from postnatal wards from October 2017 to January 2018. Information was collected on the women’s self-reported MCH app use during their pregnancy, along with clinical outcomes. Women were categorized as nonusers of MCH apps and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight RESULTS The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 24.7% (457/1850); intermittent, 47.4% (876/1850); and continuous, 27.9% (517/1850). Among app users, the most common reasons for app use were health education (1393/1393, 100%), self-monitoring (755/1393, 54.2%), and antenatal appointment reminders (602/1393, 43.2%). Nonusers were older, with fewer years of education, lower incomes, and higher parity (Pany app use and CAPO (6.8% in nonusers compared with 6.3% in any app users; odds ratio 0.77, 95% CI 0.48-1.25). CONCLUSIONS Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. Any app use was not found to be associated with improved pregnancy outcomes, highlighting the need for rigorous development and testing of apps before recommendation for use in clinical settings.

This paper is a follow-up study for the phenomenon of vapor explosion for single water droplet impacting on a hot liquid pool. To explore the effects of vapor explosion on the dynamics of single droplet interacting with burning liquid pool, a series of experiments of pure water, water droplet with 5% NaCl, water droplet with 3% AFFF, and HFE-7100 droplet impacting on high-temperature burning oil were performed. For the cases of pure water, water droplet with 5% NaCl, and water droplet with 3% AFFF, vapor explosion can occur when the oil temperature reaches 210 °C. For the case of HFE-7100 droplet, however, the vapor explosion can only appear when the oil temperature ranges from 180 to 190 °C. Moreover, the vapor explosion has a significant effect on flame expansion. The flame expansion intensity is quantified by calculating the flame area and volume. Flame expansion intensity can rank as pure water droplet > droplet with 5% NaCl > droplet with 3% AFFF.

In this study, the regimes of detonation transmission through a single orifice plate were investigated systematically in a 6-m length and 90-mm inner diameter round tube. A series of experiments on the detonation propagation mechanisms in hydrogen-air mixtures were performed. A single obstacle with different orifice size (d) from 10 to 60 mm was adopted to study the effects of the induced perturbations on the detonation propagation. Here, the thickness of orifice plate (δ) was fixed at 10.33 mm. Detonation velocity was determined from the time-of-arrival (TOA) of the detonation wave recorded by eight high-speed piezoelectric pressure transducers (PCB102B06). Detonation cellular size was obtained by the smoked foil technique. The characteristic of detonation velocity evolution were quantitatively analyzed after it passes through a single obstacle, and particular attention was paid to the cases for which the blockage ratio (BR) is greater than 0.9, i.e., the cases of small hole diameter of d 1 where λ is the detonation cell size.

As an over-expressed flavoprotein in several kinds of tumor cells, NAD(P)H: quinone oxidoreductase-1 (NQO1) is considered as a potent biomarker in early-stage cancer diagnosis. Developing a fast, selective and sensitive method of monitoring NQO1 on cellular level will greatly promote cancer diagnosis in clinical practice. In this paper, a fast NQO1 responsive fluorescence probe SYZ-30 containing quinone acid and 7-nitro-2,1,3-benzoxadiazole (NBD) fluorophore is constructed. The probe could selectively respond to NQO1 and rapidly emit strong fluorescence in vitro within only 5 min. Notably, the peak fluorescent intensities at 550 nm showed a linear relationship with NQO1 concentrations in the range of 3–30 ng/ml and limit of detection (LOD) was 0.0667 ng/ml. Furthermore, it was validated that the probe has good biocompatibility and could be applied for bio-imaging in NQO1 over-expressed cancer cells, together with its mitochondria targeting ability. Importantly, confocal fluorescence imaging confirmed the NQO1 detection ability on cellular level, which can be used for real-time detection of several cancer subtypes like adenocarcinoma. To conclude, the probe is rapidly responsive, highly sensitive and selective which will potentially become a practical tool for early cancer detection and diagnosis.

Conventional chemotherapeutic drugs cause systemic side effects due to nonspecific interactions with healthy tissues, which significantly hinders their tolerability and efficacy. Herein, we develop...

The I6P7 peptide was proved to specifically bind to the interleukin-6 receptor, which can be exploited as an effective tumor-targeting moiety. Herein, a novel tumor-targeting fluorescent probe (DMP) conjugated with the I6P7 peptide was designed and synthesized. This probe was validated to possess valuable photophysical properties. The biocompatibility was evaluated by investigating its cytotoxicity on HUVEC and U87 cells, respectively. The tumor cell affinity has been confirmed by bio-imaging of this probe on different human cancer cells (U87, A549 and MCF-7 cells) and normal cells (HUVEC cell). The probe demonstrates low cytotoxicity, high tumor cell affinity and favorable mitochondria-targeting capability. Overall, these results revealed that DMP can serve as an important fluorescent probe for tumor-targeted bio-imaging.

A series of experiments were conducted concerning the influence of liquid pool temperature on the formation of surface bubble. Single water droplet impacted on an ethanol pool 56 mm in depth, and the droplet diameter is about 2 mm. The impaction processes were recorded using a high-speed photography camera with 2000 fps. All the experiments were performed at 20 °C and the ethanol pool was heated by a hot plate. The result reveals that the critical Weber number for forming surface bubble is affected by the pool temperature, decreasing with the increase of impacted liquid temperature.

Objective To investigate the effect of exosomes derived from human placental mesenchymal stem cells (hPMSC-exs) on lipopolysaccharide (LPS)-induced injury of human pulmonary microvascular endothelial cells (HPMECs) and its possible mechanism. Methods hPMSCs were expanded and cultured in vitro and the cell culture supernatant was collected. The hPMSC-exs in the supernatant was separated and purified by ExoQuick exosomes extraction and purification kit. The morphological characteristics of exosomes were observed by transmission electron microscopy, and the expression of specific markers CD9 and CD63 on the surface of exosomes was detected by Western blotting. A non-contact co-culture system of hPMSCs and HPMECs was constructed. The experiment included a control group, an LPS injury group, an hPMSC group and an hPMSC-exs group. After 12 hours of co-cultivation, the fluorescence intensity of FITC-dextran from the upper chamber into the lower chamber was detected to reflect the permeability of single-layer pulmonary vascular endothelium; DiI-labeled hPMSC-exs was observed under a fluorescence microscope to judge the migration effect of hPMSC-exs on the damaged endothelium; CCK-8 assay was used to detect the proliferation level of the upper chamber cells in each group; JC-1 staining was used to detect the mitochondrial membrane potential of upper ventricular cells in each group; Western blotting was performed to detect the expression of autophagy-related protein LC3 and beclin-1 of HPMECs in the lower chamber. Results The diameter of hPMSC-exs was 30-120 nm, and the expression of CD9 and CD63 was positive, which matched the phenotypic characteristics of hPMSC-exs. Compared with the LPS injury group, the fluorescence intensity of FITC-dextran decreased; LC3II/I ratio and cell proliferation rate increased; beclin-1 protein expression was up-regulated in the hPMSC group and the hPMSC-exs group. Compared with the hPMSC group, the structure of endothelial cells was roughly intact under the fluorescence microscope; the FITC-dextran fluorescence intensity, endothelial cell proliferation rate, mitochondrial membrane potential, expression levels of LC3-II/I and beclin-1 did not change significantly in the hPMSC-exs group. Conclusion hPMSC-exs can alleviate the damage of HPMECs induced by LPS and improves mitochondrial function in the cells. Its mechanism may be related to enhance the autophagy of HPMECs.

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods (‘disposable medical mask + anesthetic facemask’ and ‘anesthetic facemask only’) on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO(2)) reduced significantly at each time points when subjects wearing a disposable medical mask. There was no significant difference in other parameters, and our data showed that age growth and smoking had no significant effects on the difference of PaO(2) between the groups with and without masks. This study demonstrates effective oxygen supplementation through anesthetic facemask in subjects with spontaneous breathing who is wearing a disposable medical mask, whose pulse oxygen saturation and arterial oxygen saturation can reach 100% rapidly, and this provides a theoretical basis for the management of patients with disseminated respiratory diseases to wear masks in the operating room; however, the rate and amount of PaO(2) increase are both decreased as compared to those who is not wearing a disposable medical mask during supplementary oxygenation. Whether this difference will affect the clinical outcome needs further study.

This paper presents the outcomes and mechanisms of single droplet impacting on a heated solid surface with changing temperature. Two noncontact measurement techniques including a Thermal Infrared Imager and a High-speed Digital Recording Camera were adopted in the experiments to explore the cooling effect of the droplet on the heated surface with varying temperatures and to record the typical phenomena, respectively. Four typical impact regimes including flattening, bubble, transition from bubble to atomization and atomization during the droplet impact were observed and a comprehensive map based on non-dimensional analysis was built to describe the relationships among the typical regimes. For quantitative analysis, the empirical correlations were acquired to predict the non-dimensional maximum spreading diameter based on non-dimensional analysis. The non-dimensional droplet resident time decreases linearly with the increase of T w T s a t log 10 Re . The heat flux of average droplet was calculated and the result showed that it increases with the non-dimensional parameter T w T s a t log 10 Re .The transient temperature of the heated surface was measured to quantify the effectiveness of cooling.

Background Maternal and child health (MCH)–related mobile apps are becoming increasingly popular among pregnant women; however, few apps have demonstrated that they lead to improvements in pregnancy outcomes. Objective This study aims to investigate the use of MCH apps among pregnant women in China and explore associations with pregnancy outcomes. Methods A retrospective study was conducted at 6 MCH hospitals in northern China. Women who delivered a singleton baby at >28 weeks’ gestation at the study hospitals were sequentially recruited from postnatal wards from October 2017 to January 2018. Information was collected on the women’s self-reported MCH app use during their pregnancy, along with clinical outcomes. Women were categorized as nonusers of MCH apps and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight Results The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 24.7% (457/1850); intermittent, 47.4% (876/1850); and continuous, 27.9% (517/1850). Among app users, the most common reasons for app use were health education (1393/1393, 100%), self-monitoring (755/1393, 54.2%), and antenatal appointment reminders (602/1393, 43.2%). Nonusers were older, with fewer years of education, lower incomes, and higher parity (P Conclusions Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. Any app use was not found to be associated with improved pregnancy outcomes, highlighting the need for rigorous development and testing of apps before recommendation for use in clinical settings.

Background Osteosarcoma (OS) is a common severe illness globally. Lupeol has been reported to participate in the pathophysiologic properties of various cancers, including OS. This study aimed to explore the effects of lupeol on proliferation, invasion, and apoptosis on OS cells and the underlying mechanism. Methods The cell viability of OS cells was determined by 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. The expression levels of miR-212-3p and high-mobility group AT-hook 2 (HMGA2) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) in OS cells. The cell apoptosis and invasion were detected by flow cytometry and transwell invasion assays, respectively. The functional target of miR-212-3p was predicted by online software and confirmed by luciferase reporter assay. The protein level of HMGA2 was measured by western blot analysis. Results Lupeol suppressed cell viability and invasion, and promoted apoptosis by upregulating the expression of miR-212-3p in OS cells. Knockdown of miR-212-3p restored the anti-tumor effect of lupeol. Interestingly, miR-212-3p directly targeted HMGA2 and suppressed its expression. Moreover, HMGA2 reversed the inhibited impact on viability and invasion, and the promoted effect on apoptosis induced by upregulation of miR-212-3p. Also, lupeol administration exerts its anti-tumor effect by overexpression of miR-212-3p to suppress the expression of HMGA2 in OS cells. Conclusion Lupeol inhibited OS progression by modulating the miR-212-3p/HMGA2 axis in vitro.

Suboptimal tissue perfusion and oxygenation during surgery may be responsible for postoperative nausea and vomiting in some patients. This trial tested the hypothesis that muscular tissue oxygen saturation-guided intraoperative care reduces postoperative nausea and vomiting.This multicenter, pragmatic, patient- and assessor-blinded randomized controlled (1:1 ratio) trial was conducted from September 2018 to June 2019 at six teaching hospitals in four different cities in China. Nonsmoking women, 18 to 65 yr old, and having elective laparoscopic surgery involving hysterectomy (n = 800) were randomly assigned to receive either intraoperative muscular tissue oxygen saturation-guided care or usual care. The goal was to maintain muscular tissue oxygen saturation, measured at flank and on forearm, greater than baseline or 70%, whichever was higher. The primary outcome was 24-h postoperative nausea and vomiting. Secondary outcomes included nausea severity, quality of recovery, and 30-day morbidity and mortality.Of the 800 randomized patients (median age, 50 yr [range, 27 to 65]), 799 were assessed for the primary outcome. The below-goal muscular tissue oxygen saturation area under the curve was significantly smaller in patients receiving muscular tissue oxygen saturation-guided care (n = 400) than in those receiving usual care (n = 399; flank, 50 vs. 140% · min, P0.001; forearm, 53 vs. 245% · min, P0.001). The incidences of 24-h postoperative nausea and vomiting were 32% (127 of 400) in the muscular tissue oxygen saturation-guided care group and 36% (142 of 399) in the usual care group, which were not significantly different (risk ratio, 0.89; 95% CI, 0.73 to 1.08; P = 0.251). There were no significant between-group differences for secondary outcomes. No harm was observed throughout the study.In a relatively young and healthy female patient population, personalized, goal-directed, muscular tissue oxygen saturation-guided intraoperative care is effective in treating decreased muscular tissue oxygen saturation but does not reduce the incidence of 24-h posthysterectomy nausea and vomiting.

Background Long non‐coding RNAs (lncRNAs) perform pivotal regulatory roles in tumor development. Our previous work revealed that the lncRNA gastric cancer‐associated transcript 3 (GACAT3) was significantly overexpressed and associated with tumor size and metastasis in gastric cancer. Methods Total RNAs were extracted from colorectal cancer (CRC) and reverse transcribed, and then quantitative real‐time PCR (qRT‐PCR) was conducted. Cell counting was performed to assess the effect of GACAT3 on CRC cell line proliferation. Bioinformatics prediction, dual luciferase assay, miRNA mimics, siRNAs, and transfection experiments were applied to determine whether GACAT3 and LINC00152 are reciprocally regulated by miR‐103. The relationship between their expression levels and clinicopathological factors of patients was explored. A receiver operating characteristic (ROC) curve was used to assess the potential diagnostic value of GACAT3 and LINC00152. Results GACAT3 was identified to be highly expressed in CRC tissues and associated with cell proliferation. Furthermore, we demonstrated that GACAT3 acted as a competing endogenous RNA of LINC00152 and they were both regulated by miR‐103. Moreover, analysis of clinicopathological characteristics revealed that GACAT3 and LINC00152 were positively correlated with the depth of invasion, TNM stage, lymph node metastasis, and CA19‐9 level. Importantly, a combination of GACAT3 and LINC00152 showed a superior diagnostic capacity compared with the use of the two molecules alone. Conclusion Our work shows that GACAT3 and LINC00152 are both overexpressed in CRC and they act as a ceRNA network. Therefore, our data suggest that GACAT3 and LINC00152 may be a promising potential diagnostic biomarker for CRC.