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Studies have demonstrated the importance of the gut microbiota during pregnancy, and there is emerging literature on the postpartum maternal gut microbiota. The primary objective of this paper was to synthesize the literature on the postpartum gut microbiome composition and diversity measured in stool samples from healthy mothers of predominantly term infants. The secondary objectives were (1) to identify biological and environmental factors that influence postpartum maternal gut microbiota and (2) to assess health conditions and clinical intermediate measures associated with postpartum gut microbiota changes in all mothers. Electronic searches were conducted November 9, 2020 and updated July 25, 2021 without publication time limits on PubMed, Embase, CINHAL, Scopus, Cochrane Library, BioArchives, and OpenGrey.eu. Primary research on maternal gut microbiota in the postpartum (up to one year after childbirth) were eligible. Postpartum gut microbiota comparisons to pregnancy or non-pregnancy gut microbiota were of interest, therefore, studies examining these in addition to the postpartum were included. Studies were excluded if they were only conducted in animals, infants, pregnancy, or microbiome of other body locations (e.g., vaginal). Data extraction of microbial composition and diversity were completed and synthesized narratively. Studies were assessed for risk of bias. A total of 2512 articles were screened after deduplication and 27 were included in this review. Of the 27 included studies, 22 addressed the primary objective. Firmicutes was the predominant phylum in the early (

This study aimed to establish a collaborative approach to quantify local HIV transmission, which is an issue of great concern to public health.We linked HIV-1 pol gene sequences to demographic information and epidemiological investigations in Hangzhou (a central city in East China). We estimated local acquisition rates from collaboration of molecular network analysis (with a distance-based approach) and epidemiological investigations.Among 1064 newly diagnosed HIV patients, 857 pol sequences were acquired and subsequently analysed. Multiple subtypes were identified, with CRF07_BC (42.5%) and CRF01_AE (39.2%) predominating, followed by 13 other subtypes and 26 unique recombinant forms (URFs). By integrating the molecular network analysis and epidemiological investigations, we estimated that the proportion of local infection was 63.2%. Multivariable analyses revealed that individuals in clusters were more likely to be local residents, 50 years old or older, farmers, and to have a higher first CD4 count level (P0.05). Proportions of local acquisitions over 70% were observed in local residents (79.9%, 242/303), individuals 50 years old or older (73.6%, 181/246) and farmers (75.6%, 99/131).Molecular network analysis can augment traditional HIV epidemic surveillance. This study establishes a paradigm for quantifying local HIV transmission for generalization in other areas.

This study aimed to examine the association of bullying victimization with anxiety and depressive symptoms among Chinese adolescents and explored the role of coping styles in the foregoing associations.Data were drawn from the 2019 School-based Chinses Adolescents Health Survey (n = 19,809). Information about bullying victimization, coping styles, anxiety symptoms, and depressive symptoms were measured. Linear mixed-effects models were performed.After adjusting for covariates, verbal victimization (β = 1.94 for anxiety symptoms; β = 4.62 for depressive symptoms), relational victimization (β = 3.40 for anxiety symptoms; β = 8.37 for depressive symptoms), physical victimization (β = 2.63 for anxiety symptoms; β = 6.07 for depressive symptoms) and cyber victimization (β = 4.68 for anxiety symptoms; β = 10.72 for depressive symptoms) were associated with anxiety and depressive symptoms. Moreover, the severity of anxiety and depressive symptoms tended to increase with the number of victimization types. The interaction effects between bullying victimization and coping style on anxiety and depressive symptoms were significant. Further stratified analyses by coping styles indicated that the association of relational and cyber victimization on anxiety and depressive symptoms were significantly stronger in adolescents with negative coping style than in those with positive coping style.Causal inference is limited due to the cross-sectional design.Bullying victimization is associated with anxiety and depressive symptoms, and coping styles may play a moderate role in these associations. Interventions to promote mental health could focus on developing positive coping styles, particularly among adolescents with bullying victimization.

The COVID-19 pandemic is a traumatic stressor resulting in anxiety, depression, post-traumatic stress, and burnout among healthcare workers. We describe an intervention to support the health workforce and summarize results from its 40-week implementation in a large, tri-state health system during the COVID-19 pandemic.We conducted 121 virtual and interactive Stress and Resilience Town Halls attended by 3555 healthcare workers. Town hall participants generated 1627 stressors and resilience strategies that we coded and analyzed using rigorous qualitative methods (Kappa = 0.85).We identify six types of stressors and eight types of resilience strategies reported by healthcare workers, how these changed over time, and how town halls were responsive to emerging health workforce needs. We show that town halls dedicated to groups working together yielded 84% higher mean attendance and more sharing of stressors and resilience strategies than those offered generally across the health system, and that specific stressors and strategies are reported consistently while others vary markedly over time.The virtual and interactive Stress and Resilience Town Hall is an accessible, scalable, and sustainable intervention to build mutual support, wellness, and resilience among healthcare workers and within hospitals and health systems responding to emerging crises, pandemics, and disasters.

In order to better control the quality of Flos Puerariae (FP), the qualitative and quantitative analysis were initially performed by using chemical fingerprint and chemometrics methods in this study. Firstly, the fingerprint of FP was developed by HPLC and the chemical markers were screened out by similarity analysis (SA), hierarchical clustering analysis (HCA), principal components analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Next, the chemical constituents in FP were profiled and identified by HPLC coupled to Fourier transform ion cyclotron resonance mass spectrometer (HPLC-FT-ICR MS). Then, the characteristic constituents in FP were quantitatively analyzed by HPLC. As a result, 31 common peaks were assigned in the fingerprint and 6 of them were considered as qualitative markers. A total of 35 chemical constituents were detected by HPLC-FT-ICR MS and 16 of them were unambiguously identified by comparing retention times, UV absorption wavelength, accurate mass and MS/MS data with reference substances. Subsequently, the contents of glycitin, genistin, tectoridin, glycitein, genistein and tectorigenin in 13 batches of FP were detected, ranging from 0.4438 mg/g to 11.06 mg/g, 0.955 mg/g to 1.726 mg/g, 9.81 mg/g to 57.22 mg/g, 3.349 mg/g to 41.60 mg/g, 0.3576 mg/g to 0.989 mg/g and 2.126 mg/g to 9.99 mg/g, respectively. In conclusion, fingerprint analysis in combination with chemometrics methods could discover chemical markers for improving the quality control standard of FP. It is expected that the strategy applied in this study will be valuable for further quality control of other traditional Chinese medicines (TCMs).

Peripheral artery disease is 1 of 3 major clinical manifestations of atherosclerosis, the other 2 being coronary artery and cerebrovascular disease. Despite progress in surgery, antithrombotic therapy and therapies that modify conventional risk factors (lipid-, blood pressure-, and glucose-lowering interventions), patients with peripheral artery disease have an unacceptably high risk of vascular complications. Additional strategies to reduce this residual risk are needed. The accumulated evidence that inflammation plays an important role in the pathogenesis of atherosclerosis has spurred recent efforts to evaluate anti-inflammatory agents as an additional therapeutic approach for atherothrombosis prevention and treatment. In this review, we examine the evidence supporting the role of inflammation in atherosclerosis, review recent trials of anti-inflammatory approaches to reduce cardiovascular complications, and offer insights into the opportunities for novel anti-inflammatory strategies to reduce the burden of cardiovascular and limb complications in patients with peripheral artery disease.

The aim of this study was to report the outcomes of valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) at 5 years.TAVR for degenerated surgical bioprostheses in patients at high risk for reoperative surgery is an important treatment option that may delay or obviate the need for surgical intervention; however, long-term outcomes of this procedure are unknown.The PARTNER (Placement of Aortic Transcatheter Valves) 2 ViV and continued access registries prospectively enrolled patients with failed surgical bioprostheses at high risk for reoperation. Five-year clinical and echocardiographic follow-up data were obtained in 95.9% of patients.In 365 (96 registry and 269 continued access) patients, the mean age was 78.9 ± 10.2 years, the mean Society of Thoracic Surgeons predicted risk of surgical mortality score was 9.1 ± 4.7%, and New York Heart Association functional class was III or IV in 90.4%. At 5 years, the Kaplan-Meier rates of all-cause mortality and any stroke were 50.6% and 10.5%, respectively. Using Valve Academic Research Consortium 3 definitions, the incidence of structural valve deterioration, related hemodynamic valve deterioration, or bioprosthetic valve failure at 5 years was 6.6%. Aortic valve re-replacement was performed in 6.3% (n = 14), the majority of which was due to stenosis (n = 6) and combined aortic insufficiency/paravalvular regurgitation (n = 3). The mean gradient, Doppler velocity index, paravalvular regurgitation, and quality of life measured by Kansas City Cardiomyopathy Questionnaire scores in survivors remained stable from 30 days postprocedure through 5 years.At the 5-year follow-up, TAVR for bioprosthetic aortic valve failure in high surgical risk patients was associated with sustained improvement in clinical and echocardiographic outcomes.

Although people with HIV are living longer, as they age they remain disproportionately burdened with multimorbidity that is exacerbated in resource-poor settings. The geroscience hypothesis postulates that a discrete set of between five and ten hallmarks of biological ageing drive multimorbidity, but these processes have not been systematically examined in the context of people with HIV. We examine four major hallmarks of ageing (macromolecular damage, senescence, inflammation, and stem-cell dysfunction) as gerodrivers in the context of people with HIV. As a counterbalance, we introduce healthy ageing, physiological reserve, intrinsic capacity, and resilience as promoters of geroprotection that counteract gerodrivers. We discuss emerging geroscience-based diagnostic biomarkers and therapeutic strategies, and provide examples based on recent advances in cellular senescence, and other, non-pharmacological approaches. Finally, we present a conceptual model of biological ageing in the general population and in people with HIV that integrates gerodrivers and geroprotectors as modulators of homoeostatic reserves and organ function over the lifecourse.

Urban-rural integrated development has been widely conducted in China, and plenty of resource consumption and environmental problems have arisen during this process. Meanwhile, the importance of environmental governance has been emphasized in social collaborative governance. Although existing studies have focused on the governance policies on urban and rural development, the residents’ participation willingness toward collaborative governance should not be neglected, especially in environmental governance. Accordingly, this study identified the determinants influencing the participation intention toward the collaborative environmental governance of residents in the Yangtze River Delta Region by a combined theoretical model, which added three decisive predictors from the theory of planned behavior to the norm-activation model. We collected 312 valid questionnaires and employed structural equation modeling for analysis. Results implied that, in order of significance, personal norm, behavioral attitude, subjective norm, and perceived behavioral control presented positive influences on behavioral intention. Personal norm was significantly underlain by awareness of consequence and ascription of responsibility, and the significant influence of awareness of consequence on behavioral intention was not demonstrated. This study proposes related managerial implications to improve public participation willingness regarding collaborative environmental governance during urban-rural integrated development processes in the Yangtze River Delta Region.

Real-time polymerase chain reaction (qPCR) enables accurate detection and quantification of nucleic acids and has become a fundamental tool in biological sciences, bioengineering and medicine. By combining multiple primer sets in one reaction, it is possible to detect several DNA or RNA targets simultaneously, a process called multiplex PCR (mPCR) which is key to attaining optimal throughput, cost-effectiveness and efficiency in molecular diagnostics, particularly in infectious diseases. Multiple solutions have been devised to increase multiplexing in qPCR, including single-well techniques, using target-specific fluorescent oligonucleotide probes, and spatial multiplexing, where segregation of the sample enables parallel amplification of multiple targets. However, these solutions are mostly limited to three or four targets, or highly sophisticated and expensive instrumentation. There is a need for innovations that will push forward the multiplexing field in qPCR, enabling for a next generation of diagnostic tools which could accommodate high throughput in an affordable manner. To this end, the use of machine learning (ML) algorithms (data-driven solutions) has recently emerged to leverage information contained in amplification and melting curves (AC and MC, respectively) – two of the most standard bio-signals emitted during qPCR – for accurate classification of multiple nucleic acid targets in a single reaction. Therefore, this review aims to demonstrate and illustrate that data-driven solutions can be successfully coupled with state-of-the-art and common qPCR platforms using a variety of amplification chemistries to enhance multiplexing in qPCR. Further, because both ACs and MCs can be predicted from sequence data using thermodynamic databases, it has also become possible to use computer simulation to rationalize and optimize the design of mPCR assays where target detection is supported by data-driven technologies. Thus, this review also discusses recent work converging towards the development of an end-to-end framework where knowledge-based and data-driven software solutions are integrated to streamline assay design, and increase the accuracy of target detection and quantification in the multiplex setting. We envision that concerted efforts by academic and industry scientists will help advance these technologies, to a point where they become mature and robust enough to bring about major improvements in the detection of nucleic acids across many fields.

The partitioning of pollutants in the size-fractions of road dust particles is extremely important to their migration and bioavailability in the air environment. Herein, the pollution characteristics and sources of heavy metals (As, Cd, Cu, Cr, Pb, Zn, Co, Mn, Ni) and environmentally persistent free radicals (EPFRs) are investigated in 64 samples of mixed particle-size road dust in four size fractions (> 250 μm, 150–250 μm, 75–150 μm

SiCN ceramics show large potential in high temperature pressure sensors with excellent stability up to 1000 °C, as it is changeling for the most of the existing pressure sensors to work stably at a temperature above 600 °C. However, bulk SiCN ceramics are not compatible to microelectronic processing and exhibit slow response due to viscoelasticity, it is necessary to propose alternative method to prepare SiCN functional structures. In this work, SiCN piezoresistive thin films are prepared by magnetron sputtering, and the influence of sputtering power on their piezoresistive properties and interfacial strengths are studied. The gauge factors of SiCN films range from 2786 to 4714 at various sputtering powers, which are significantly higher than the range from 46 to 1105 for existing piezoresistive thin films. Upon an optimal sputtering power of 75 W for silicon nitride target, the obtained SiCN sample show the largest gauge factors in a large range from 0.5 to 3.4 MPa. Furthermore, the SiCN thin films present high critical loads up to 36.5 N in scratch tests and indicate strong interfacial adhesion with substrate. This work provides an important reference for developing SiCN-based MEMS pressure sensors.

Differences in culprit lesion characteristics remain unclear between premenopausal and postmenopausal women with acute coronary syndrome (ACS). Optical coherence tomography (OCT) enables high-resolution in vivo identification of plaques. We investigated potential differences in culprit lesions between premenopausal and postmenopausal women with ACS by means of OCT.We included 191 ACS patients who had undergone preinterventional OCT and stratified them into 2 groups according to their menopausal status: premenopausal (n = 97) and postmenopausal (n = 94). The characteristics of culprit lesions were compared between the 2 groups.Multivessel lesions were more commonly noted on angiography in the postmenopausal group than in the premenopausal group (40.21% vs 72.34%; P0.0001). On OCT, the most common type of culprit plaque was the fibrous plaque in the premenopausal group and the lipid plaque in the postmenopausal group. Compared with the premenopausal group, plaque rupture was more common in the postmenopausal group (39.18% vs 55.32%; P = 0.0254); culprit lesions had more vulnerable features, including macrophage accumulation (58.76% vs 87.23%; P0.0001), microchannel (38.14% vs 84.04%; P0.0001), cholesterol crystals (30.93% vs 62.77%; P0.0001), lipid-rich plaque (32.99% vs 58.51%; P0.0001), thin-cap fibroatheroma (3.09% vs 21.28%; P = 0.0001), and calcium (20.62% vs 44.68%; P = 0.0004); maximum lipid arc was larger (121.06 ± 110.99° vs 220.12 ± 115.47°, P0.0001); and lipid length was longer (5.78 ± 5.29 mm vs 12.90 ± 8.97 mm; P 0.0001).Compared with premenopausal women with ACS, postmenopausal women with ACS had more vulnerable culprit lesions. These finding suggest potential optimised lipid-lowering therapy for postmenopausal women with ACS.