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Abstract We measured the levels of High‐Mobility Group Box 1 (HMGB1), Receptor for Advanced Glycation Endproducts (RAGE), T Helper 17 cells (Th17), Regulatory T cells (Treg), and related cytokines in the peripheral blood of patients with severe preeclampsia (SPE) complicated with acute heart failure (AHF) to explore the expression changes in these indicators. In total, 96 patients with SPE admitted to Gansu Provincial Maternity and Child‐care Hospital between June 2020 and June 2022 were included in the study. The patients were divided into SPE+AHF (40 patients) and SPE (56 patients) groups based on whether they suffered from AHF. Additionally, 56 healthy pregnant women who either received prenatal examinations or were admitted to our hospital for delivery during the same period were selected as the healthy control group. An enzyme‐linked immunosorbent assay was performed to detect the expression levels of HMGB1, RAGE, interleukin (IL)‐17, IL‐6, transforming growth factor β (TGF‐β), IL‐10, and NT‐proBNP in plasma. Flow cytometry was employed to determine the percentages of Th17 and Treg cells. Compared to the healthy control group, the SPE+AHF and SPE groups had higher plasma levels of HMGB1 and RAGE expression, higher Th17 percentage and Th17/Treg ratio, and lower Treg percentage. Compared to the SPE group, the SPE+AHF group had higher plasma levels of HMGB1 and RAGE expression, higher Th17 percentage and Th17/Treg ratio, and lower Treg percentage (P

We propose a programmable topological metasurface to integrate intelligent modulations of spatial and surface waves. A general design method is presented to design the programmable metasurface elements with PIN diodes. The surface waves can be controlled to propagate along the topological domain-wall interface by programming the C3-symmetry elements, while the spatial waves are modulated by the patterns of C6-symmetry elements. By independently controlling the bias voltages of meta-elements, the programmable topological metasurface can generate different coding patterns with distinct combinations of C3- and C6-symmetries in real time, respectively achieving the dynamical manipulation of the surface- and spatial-wave by using distinct element states in a time-division manner. To validate the modulation performance, we perform both near- and far-field tests with different coding patterns. Experimental results demonstrate good agreement with numerical simulations, thereby showcasing the flexible manipulations of surface waves and spatial waves by the topological metasurface. The proposed metasurface opens up new possibilities for multifunctional metadevices, which hold great potentials for future wireless communications and smart sensing systems.

Poor medication adherence of patients with bipolar affective disorder is associated with stigma, drug adverse reactions and family economic burden. However, high-quality studies about n medication adherence in patients with bipolar affective disorder are relatively scarce. This paper reviewed studies on influencing factors, assessment tools and interventions of medication adherence in patients with bipolar affective disorder. Efforts should be made to investigate the intelligent tele-healthcare system and tele-healthcare-based interventions, and provide reference for establishment of a long-term accessible extended care. (双相情感障碍患者因病耻感、药物不良反应、家庭经济因素等原因, 其用药依从性水平较低。目前国内针对双相障碍服药依从性的高质量研究仍较少。本文对双相情感障碍服药依从性现状进行综述, 包括影响因素、评估工具及干预措施等。建议未来进一步探索适合我国的远程智能医疗系统、开展基于远程医疗的护理干预, 为患者提供更加便捷、远期的延续护理干预。)

Neuropathy in surgical-related locations has received concerns after total hip arthroplasty (THA), while the contralateral intercostal nerve (ICN) injury has not been reported. A 25-year-old female patient with a body mass index (BMI) of 17.9 kg/m2 visited the orthopedic outpatient clinic with complaints of progressive left hip pain for 20 days. She was diagnosed with left end-stage hip osteoarthritis and developmental dysplasia of the bilateral hips after radiographs and a detailed history-taking. After painstaking consideration, a cementless THA with the standard posterolateral approach was performed under general anesthesia. The procedure was difficult but successful. Unexpectedly, the numbness and slight tingling in the skin of the right breast, lateral chest wall, and axilla cropped up on the first postoperative day. Following the clinical features and the conclusion of the multidisciplinary discussion, we assume that ICN neuropathy is the diagnosis in this case due to compression of the lateral decubitus position during the operation. Her symptoms completely disappeared after using mecobalamin injection (0.5 mg, intramuscular injection, every other day) for 11 days. The Harris left hip score improved from 39 to 94, and the visual analogue scale from 7 was reduced to 2 on the day of discharge. There were no other complications within the first year after the operation. For THA, we should pay attention to some unexpected complications by virtue of the special position, especially in thin and low-BMI people, which suggested that further comprehensive perioperative nursing measures and the beneficial surgical position and anesthesia type were called for.

ObjectiveTo learn the epidemiological features of foodborne diseases， and to provide scientific basis for disease control.MethodsThe monitoring data of foodborne diseases in Minhang from 2016 to 2020 were analyzed. Stool or swab specimens were collected to detect salmonella， Vibrio parahaemolyticus， Escherichia coli， Shigella， Campylobacter jejuni and norovirus.ResultsThe information of 15 951 foodborne disease cases and 11 176 samples were collected， with the positive rate of 12.03%.The cases with diarrhea accounted for 99.90% of the total. The cases with fever accounted for 14.70% of the total. The cases with water stool accounted for 89.70% of the total. May to October were the epidemic periods of foodborne diseases in Minhang（79.78%）. The detection rate was the highest in the 30‒39 age group and cadre staff occupation（13.53%，13.49%）. The detection rates of foodborne bacteria and virus were 5.39% （Vibrio parahaemolyticus）， 3.25% （salmonella），1.44% （norovirus）， 1.06%（Escherichia coli）， 0.56% （Campylobacter jejuni）， 0.34% （mixed infection） and 0% （Shigella）. During this 5-year period， the positive rate of Vibrio parahaemolyticus decreased significantly， while the positive rate of salmonella and Escherichia coli and Campylobacter jejuni increased significantly. The main suspected food were aquatic products （29.44%）， meat （25.80%） and fruits （10.78%）. The main processing methods of suspected food were family workshop （41.12%） and restaurants （37.55%）. The total detection rate of the cases was the highest in the canteen， reaching 20.51%.ConclusionFoodborne disease cases have a seasonal peak. The positive detection of pathogens tends to be similar year by year. The main suspected food is aquatic products. The main resources of suspected food are family workshop， restaurants， and canteen. Targeted health education， supervision and management should be taken to prevent the occurrence of foodborne diseases and the outbreak of food poisoning

Objective To explore the effect of change in body mass on mortality during hospitalization in intensive care unit (ICU). Methods A multicenter and retrospective cohort study was conducted on patients who were firstly hospitalized in ICU and whose length of ICU stay were over 24 h, with data extracted from the eICU Collaborative Research Database. Univariate and multivariate logistic regression models were used to explore the relationship between body mass change and mortality in ICU patients. Interaction analysis was performed between body mass change and related covariates. Based on the results of interaction analysis and clinical practice, the association between body mass change and mortality was analyzed in subgroups stratified by age, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅳ score, length of ICU stay and baseline BMI at ICU admission. Results A total of 34 311 ICU patients were included, among which 55.1% were male, the white race accounted for 82.4% and 51.3% were ≥65 years old. Compared with those with decreased body mass, patients with increased body mass had higher rates of renal failure (1 938 cases, 11.1%), liver failure (106 cases, 0.6%), sepsis (2 442 cases, 14.0%), longer ICU stay, longer hospital stay and higher APACHEⅣ scores. The multivariate logistic regression model showed the in-hospital and ICU mortality in patients with body mass gain were 1.25 times(95%CI: 1.16~1.36, P < 0.001) and 1.36 times (95%CI: 1.22~1.50, P < 0.001) higher than those with body mass decreased respectively. This difference is more significant in patients with higher APACHEⅣ score and the longer ICU stay. The different age subgroup or different baseline BMI levels exerted no effect on the results mentioned. Conclusion The change in body mass is the independent risk factor of the in-hospital and ICU motality.

Objective To investigate the effect of silenced RBM8A gene on the biological behavior (proliferation, migration, and apoptosis) of human endometrial cancer HEC-1A cells and its possible mechanism. Methods The hairpin shRNA targeted by the RBM8A gene was designed, and the best shRNA silencing fragment was screened. The recombinant lentiviral interference vector carrying the target gene was constructed and used to infect HEC-1A cells. Cells with stable knockdown of RBM8A gene were screened by puromycin as the experimental group (shRBM8A), while the shRNA of nonsense sequence was designed as the control group (shControl). CCK-8 method was used to detect cell proliferation, and flow cytometry was used to detect cell apoptosis. Transwell assay was used to detect cell migration and invasion. Western blot was used to analyze the expression of apoptosis-related proteins and EMT signal transduction pathway related proteins. Results In comparison with the shControl group, after RBM8A knockdown, HEC-1A cell proliferation was reduced, apoptosis was increased, migration and invasion ability were significantly inhibited (P < 0.05), the expression of apoptosis-related proteins cleaved caspase 9 and caspase 3 increased, EMT-related protein E-cadherin expression increased, and Vimentin expression decreased. Conclusion RBM8A gene silencing can inhibit the proliferation, migration, and invasion and promote the apoptosis of endometrial cancer cells. The inhibition of EMT signal transduction pathway may be its mechanism.

Open Educational Resources (OER) in higher education cannot be put into practice without considering institutional contexts, which differ not only globally but also within the same country. Each institutional context provides educators with opportunities or limitations where Open Educational Practices (OEP) and OER for teaching and learning are involved. As part of a broader research project, and as a follow-up to national perspectives, an international comparison was conducted, based on institutional cases of nine different higher education systems (Australia, Canada, China, Germany, Japan, South Africa, South Korea, Spain, Turkey). Aspects regarding the availability of infrastructure and institutional policies for OER, as well as the existence of measures directed at OER quality assurance and at the promotion of the development and use of OER were covered. The resulting theoretical contribution sheds light on an international comparative view of OER and points towards country-specific trends, as well as differences among institutions. These aspects could provide an impetus for the development of institutional guidelines and measures. In line with international literature on the topic, recommendations are derived to promote/ enhance the use of OER in teaching and learning in higher education at the institutional level.

ObjectiveThis study aimed to understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） in Minhang District， Shanghai from 2009 to 2020， and provide a scientific basis for the prevention and control of HFMD.MethodsThe case information of HFMD was collected from the National Notifiable Infectious Diseases Reporting System of Chinese Center for Disease Control and Prevention. We used descriptive epidemiological methods to analyze the population characteristics， temporal and spatial distribution of HFMD， the pathogen composition of the case and its changing trend.ResultsFrom 2009 to 2020， a total of 66，198 cases of HFMD were reported in Minhang District， Shanghai， including 377 severe cases （severe case rate 0.57%） and 3 deaths （severs case fatality rate 0.80%）. There were more cases of HFMD in boys than in girls （1.5∶1）. HFMD patients aged under 5 years predominated， accounting for 88.91% of all cases. Majority of the cases （91.42%） were in scattered children （55.80%） and children in kindergartens （35.62%）. The incidence showed a cyclical trend， with low incidence years and high incidence years appearing alternately. The peak period was from April to July， and sometimes there were small peaks during October to December. A total of 12 years time-space scanning analysis revealed 3 clusters. The cluster centers were located in Wujing Town， Huacao Town and Xinzhuang Town， respectively. The proportion of EV71 in common cases was generally decreasing， and reduced to zero in 2019. The proportion of CoxA6 had increased year by year， and reached 75.00% in 2020. CoxA6 became the dominant pathogen in recent years. The number of severe cases had decreased year by year since 2010， and the dominant pathogen was EV71 （90.03% on average） in severe cases.ConclusionThe incidence of HFMD in Minhang District of Shanghai has a downward trend from 2014. The dominant pathogen changes from EV71 to CoxA6， and the dominant pathogen in severe cases is EV71. The discovered temporal and spatial clustering pattern is helpful for in-depth understanding of the distribution and epidemic trend of HFMD in Minhang District， and provides a scientific basis for epidemic prevention and control.

ObjectiveTo determine the epidemiological characteristics and risk factors of a norovirus GII.17 outbreak in Minhang District of Shanghai in 2018， and provide evidence for prevention and control measures of norovirus infection.MethodsDescriptive epidemiological analysis was performed. In addition， a retrospective cohort study was conducted to determine the risk factors.ResultsFrom May 30th to June 1st of 2018， a total of 132 cases （126 clinical cases and 6 confirmed cases） were documented，with an attack rate of 29.20%（132/452）.All cases were children in a kindergarten， with the average age of 5 years and 43.9% being male. The cases were reported in all the classes， with no clustering by class or floor．The epidemic curve was characterized by a point source exposure， which was estimated to be probably between 7 AM on May 30thand 0：30 AM on May 31st. The retrospective cohort study showed that the attack rate significantly differed between the children who had taken and did not take the school lunch （RR=∞） on May 30th，and those who had taken and did not take seafood noodles （RR=4.11， 95%CI：1.09-15.55） （P

In the present study, we reported the complete mitogenome sequence of Caenorhabditis tribulationis Stevens & Félix 2019. The whole mitogenome of C. tribulationis is 14006 bp in length with an extreme bias of high AT content (75.26%) (GenBank accession no. OL362111). The mitochondrial genome contains 12 protein-coding genes (PCGs), 22 transfer RNA (tRNAs) genes, 2 ribosomal RNA (12S rRNA and 16S rRNA) genes, and a control region. All genes were unidirectionally transcribed on the same strand, typical for other nematode mitogenomes. 9 PCGs were initiated by typical ATN codons, except for NAD2, CYTB and NAD4, which were start with TTG codons. All the PCGs were predicted to use the typical TAN as the stop codons. The phylogenetic analysis showed that the relationship of C. tribulationis is very close to other species in the family Rhabditidae and separated form species of the families Ascarididae, Toxocaridae, Anisakidae and Ascaridiidae with high bootstrap value support.

We propose an ultrathin reconfigurable Mach–Zehnder interferometer (MZI) for realizing dynamic frequency and amplitude modulations of spoof surface plasmon (SSP) signal. Active varactor diodes are integrated in the SSP unit cells on one of the MZI arms to introduce asymmetry to the MZI structure, which can control the interference patterns by varying bias voltages applied on the varactor diodes. We show that the spectral positions of multiple sharp interference dips are very sensitive to the change of diode capacitance, thereby allowing for good frequency modulation. We also demonstrate continuous amplitude modulation by tuning the varactor diodes at multiple selected frequencies. To verify the reconfigurable feature of the proposed SSP MZI, the frequency shift keying (FSK) and amplitude modulations have been experimentally demonstrated on the same structure. The modulation depth of the amplitude modulation can be further improved by designing geometrical parameters of the SSP structure, reaching a significant amplitude change from 0.88 to 0.05 in experiments.

Coprime array isAsparse array composed of two uniform linear arrays with different spacing. When the two subarrays are inAnon-coherent distributed configuration, the direction of arrival (DOA) method based on the covariance analysis of the complete coprime array is no longer effective. According to the essential attribute that the distance between the elements of two subarrays can eliminate the angle ambiguity, based on the mathematical derivation, Aspatial spectral product DOA estimation method for incoherent distributed coprime arrays is proposed. Firstly, the spatial spectrum of each subarray is calculated by using the snapshot data of each subarray, and then the DOA estimation is realized by multiplying the spatial spectrum of each subarray. The simulation results show that the estimation accuracy and angle resolution of the present method are better than those of the traditional ambiguity resolution methods, and the estimation performance is good in the mutual coupling and low SNR environment, with the good adaptability and stability. Moreover, by using the flexibility of distributed array, the matching error is effectively solved through the rotation angle.

Using CNKI 2361 and WOS 5036 literatures as data sources, the knowledge map of "energy security" was constructed with the help of CiteSpace. The evolution, research hotspots and frontier trends of energy security research at home and abroad from 1992 to 2020 are compared and analyzed. The results show that energy security research has experienced three stages: initial germination, rapid development, coexistence of continuous development and volatility. There is no core group of authors at home and abroad, but obviously research teams have been formed. There is stable cooperation within the teams, but the cooperation between different teams needs to be strengthened. There are obvious differences in research content, research hotspots, and research frontiers between domestic and foreign research on energy security. Foreign research focuses on energy security issues in developed countries, the construction of energy security concepts and evaluation index systems, focusing on energy strategies, economic growth, energy reserves, and response to climate challenges and optimization adjustments, while domestic research focuses on China's status and role in the world structure, as well as climate change and other coping strategies, advocates global cooperation and common governance, and pays attention to the issues of "The Belt and Road, Global Energy Governance, and Energy Revolution".

Nasopharyngeal carcinoma (NPC) is characterized by high morbidity and morality, especially in Southern China. Transcription factors intensively participate in the initiation and development of NPC. This study aimed to investigate the roles of Src-1 in NPC. mRNA level was determined by qRT-PCR. Western blot was carried out for the protein level. CCK-8 assay was performed to determine cell viability, colony formation for NPC cell proliferation, and transwell for cell migration and invasion ability. The results showed Steroid receptor coactivator 1 (Src-1) was overexpressed in SNE-2 and 6-10B. The expression of Src-1 and SP2 was in positive correlation. Overexpression of Src-1 promoted the cell viability, colony formation, and epithelial–mesenchymal transition (EMT), manifested by the increase of migration and invasion ability, while knockdown of Src-1 exerted opposite effects. Additionally, knockdown or overexpression of SP2 reversed the effects of overexpressed or downregulated Src-1, which was reversed by the depletion of SP2. Moreover, Src-1 interacted with SP2 to regulate EMT-related genes such as E-cad, N-cad, Vimentin, and ZEB1, and proliferation- and apoptosis-related genes, such as bax, cytochrome c, and cleaved caspase3 and bcl-2. Thus, blocking the interaction between Src-1 and SP2 may be a therapeutic target for inhibiting the metastasis of NPC.

This paper discusses the post requirements and system architecture of the dual-tutor teaching mode constructed by using virtual human system in helicopter equipment teaching under the environment of artificial intelligence. Taking theoretical course teaching as an example, the collaborative process of dualtutor mode is expounded.

Building upon previous work in innovation, technology, and economic fields, we propose a conceptual framework to address the interplay dynamics of public policy and the value chains of clean energy technology innovation systems, by focusing on market structural and strategic conditions in relation to the rate and direction of knowledge diffusion within activity-based value chains. Our framework extends beyond socio-technical transition models by considering such nuances as: 1) the implications of geography, 2) the locus of knowledge types, 3) the dynamics of financial and knowledge flow, and 4) emphasizing the importance of both market structure and institutional conditions. At the firm level, we consider dynamics of interactions between suppliers and customers, innovation activities, the competitive environment, and the firm’s broader strategic relationship to governance activities and structures; we allow for the fact that each of these aspects of a firm’s identity may have a strategically relevant geographic dimension (e.g., service territories, locational concentration of input resources, etc.). We provide a proof-of-concept application of the U.S. utility-scale solar photovoltaic (PV) and onshore wind sectors, including their interactions with the U.S. power market, which we in present in a web-based information platform (Energy I-SPARK, ei-spark.lbl.gov).

We theoretically investigate the illusion device designed by a conformal transformation that can render an elliptic defect behave like a flat mirror. Different from illusion devices consisting of the complementary medium and anti-object with negative permittivity and permeability, our proposed illusion device requires only isotropic positive permittivity medium. It offers a possible route to eliminate the lateral shift in the conventional quasi-conformal carpet cloak. Interestingly, with the same conformal transformation, we can achieve an impedance-matched flat absorber by simply varying the shape and the refractive index of the defects. Both the illumination device and the absorber in our design have broad bandwidth, wide-illumination range and polarization-insensitive performance.

Adiabatic waveguide taper and on-chip wavelength demultiplexer are the key components of photonic integrated circuits. However, these two kinds of devices which were designed by the traditional semi-analytic methods or the brute-force search methods usually have large size. Here, based on the regularized digital metamaterials, a two-channel focused wavelength demultiplexer with a footprint of 2.4 × 10 μm2 has been proposed. The designed demultiplexer can directly connect to a grating coupler under the absence of a long adiabatic waveguide taper. The objective first method and the modified steepest descent method are used to design the demultiplexer which splits 1520 nm and 1580 nm light. Experimental results show that the insertion loss of the upper (lower) channel of the demultiplexer is −1.77 dB (−2.10 dB) and the crosstalk is −25.17 dB (−12.14 dB). Besides, the simulation results indicate that the fabrication tolerance of the device can reach ±20 nm in etching depth and ±10 nm in plane size changing. Benefitted from the extensibility of the design method, other types of ultra-compact “focused” devices, like mode splitters, mode converters, and power splitters can also be designed. Most importantly, this design method can be used to design devices with more complicated functionalities, such as multi-channel focused wavelength demultiplexers.

Background: The sulfonylurea receptor 1–transient receptor potential melastatin 4 (SUR1–TRPM4) channel is a target key mediator of brain edema. Sulfonylureas (SFUs) are blockers of the SUR1–TRPM4 channel. We made two assessments for the pretreatment of SFUs: (1) whether it associates with lower perihematomal edema (PHE) and (2) whether it associates with improved clinical outcomes in diabetic patients who have acute basal ganglia hemorrhage.Methods: This retrospective case-control study was conducted in diabetic adults receiving regular SFUs before the onset of intracerebral hemorrhage (ICH). All of the patients received the clinical diagnosis of spontaneous basal ganglia hemorrhage. The diagnosis was confirmed by a CT scan within 7 days after hemorrhage. For each case, we selected two matched controls with basal ganglia hemorrhage based on admission time (≤5 years) and age differences (≤5 years), with the same gender and similar hematoma volume. The primary outcome was PHE volume, and the secondary outcomes were relative PHE (rPHE), functional independence according to modified Rankin Scale score and Barthel Index at discharge, and death rate in the hospital.Results: A total of 27 patients (nine cases and 18 matched controls), admitted between January 1, 2009 and October 31, 2018, were included in our study. There was no significant association between SFU patients and non-SFU patients on PHE volumes [15.4 (7.4–50.2 ml) vs. 8.0 (3.1–22.1) ml, p = 0.100]. Compared to non-SFU patients, the SFU patients had significantly lower rPHE [0.8 (0.7–1.3) vs. 1.5 (1.2–1.9), p = 0.006]. After we adjusted the confounding factors, we found that sulfonylureas can significantly reduce both PHE volume (regression coefficient: −13.607, 95% CI: −26.185 to −1.029, p = 0.035) and rPHE (regression coefficient: −0.566, 95% CI: −0.971 to −0.161, p = 0.009). However, we found no significant improvement in clinical outcomes at discharge, in the event of pretreatment of SFUs before the onset of ICH, even after we adjusted the confounding factors.Conclusion: For diabetic patients with acute basal ganglia hemorrhage, pretreatment of sulfonylureas may associate with lower PHE and relative PHE on admission. No significant effect was found on the clinical outcomes when the patients were discharged. Future studies are needed to assess the potential clinical benefits using sulfonylureas for ICH patients.

Objective: To establish a HPLC fingerprints evaluation method for Angelica Sinensis Radix (ASR) based on traditional decoction process of Ancient Classical Prescriptions of Traditional Chinese Medicine (ACPTCM). Methods: The fingerprints of 10 batches of ASR were further evaluated by chemometrics methods. The similarity analyzed with “Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine 2004A,” and hierarchical clustering analysis (HCA) and principal component analysis (PCA) were performed by SPSS (version 22.0, SPSS Inc., Chicago, IL, USA). Results: There were 12 common peaks, and the similarity degrees of 10 batches of samples were more than 0.923 and showed that all the samples from different origins were of good consistency. The samples were divided into 4 clusters by HCA. The results of PCA showed that the 3 factors were chosen, the quality of samples could be evaluated basically. The comprehensive score results show that the ASR with Lot.Nos.DG-18007, DG-18008 in Weiyuan County, Gansu and DG-18009 produced in Minle County, Gansu Province rank among the top 3 in all samples. Conclusions: These results demonstrated that the combination of HPLC chromatographic fingerprint and chemometrics offers an efficient and reliable approach for quality evaluation of ASR from different sources as Ancient Classical Prescriptions ingredients.