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Fungal keratitis is challenging to diagnose and treat and remains a significant cause of blindness worldwide. The easiest and most common method of drug delivery for patients with fungal keratitis is eye drop administration. However, the therapeutic effect of traditional eye drops is unsatisfactory, largely due to the intrinsic nature of the ocular barriers, which limit drug absorption; the rapid decrease in the drug concentration caused by tears; and the side effects induced by the uncontrolled release of ocular drugs. Oxidative stress and inflammation are the main causes of corneal tissue necrosis in fungal keratitis, and reducing reactive oxygen species (ROS) and the inflammatory response are important goals in developing drugs for fungal keratitis. In the current study, we developed a ROS-responsive and controllable nanocarrier (GC-EB) that efficiently delivered a clinically used antifungal drug, voriconazole (VOR), to treat fungal keratitis. In vitro and in vivo results demonstrated that the developed GC-EB-VOR exhibited high penetration through corneal barriers, good retention in the cornea and controllable drug release under low concentrations of ROS. As a result, ROS were effectively depleted and the inflammatory response was inhibited; thus, GC-EB-VOR shows promising antifungal efficacy. This work may provide a new strategy for developing nanodrugs to improve the therapeutic effect of eye drop instillation on fungal keratitis and reduce the risk of blindness.

Background Nearly half of bronchiectasis patients receiving bronchial artery embolization (BAE) still have recurrent hemoptysis, which may be life-threatening. Worse still, the underlying risk factors of recurrence remain unknown. Methods A retrospective cohort was conducted of patients with idiopathic bronchiectasis who received BAE from 2015 to 2019 at eight centers. Patients were followed up for at least 24 months post BAE. Based on the outcomes of recurrent hemoptysis and recurrent severe hemoptysis, a Cox regression model was used to identify risk factors for recurrence. Results A total of 588 individuals were included. The median follow-up period was 34.0 months (interquartile range: 24.3–53.3 months). The 1-month, 1-year, 2-year, and 5-year cumulative recurrent hemoptysis-free rates were 87.2%, 67.5%, 57.6%, and 49.4%, respectively. The following factors were relative to recurrent hemoptysis: 24-h sputum volume (hazard ratio [HR] = 1.99 [95% confidence interval [95% CI]: 1.25–3.15, p = 0.015]), isolation of Pseudomonas aeruginosa (HR = 1.50 [95% CI: 1.13–2.00, p = 0.003]), extensive bronchiectasis (HR = 2.00 [95% CI: 1.29–3.09, p = 0.002]), and aberrant bronchial arteries (AbBAs) (HR = 1.45 [95% CI: 1.09–1.93, p = 0.014]). The area under the receiver operating characteristic curve of the nomogram was 0.728 [95% CI: 0.688–0.769]. Conclusions Isolation of Pseudomonas aeruginosa is an important independent predictor of recurrent hemoptysis. The clearance of Pseudomonas aeruginosa might effectively reduce the hemoptysis recurrence rate.

To compare the clinical and microbiological characteristics in patients with bacterial keratitis with hypopyon (BKH), bacterial keratitis-related endophthalmitis (BKE), and bacterial endophthalmitis without keratitis (BE).Data from all inpatients who were clinically diagnosed with BKH, BKE, and BE from 2018 to 2020 were collected retrospectively. The demographics, predisposing risk factors, clinical characteristics, microbiological profiles, and antibiotic susceptibility of the patients were evaluated.Approximately 9.46% (28/296) of eyes with BKH progressed to endophthalmitis. The hypopyon (OR = 5.35, 95% CI: 2.17-7.08) and corneal perforation (OR = 2.47, 95% CI: 1.04-4.86) were significantly related to the development of BKE. The odds ratios for hypopyon of less than 1 mm, 1-3 mm, and greater than 3 mm were 1, 2.09 (95% CI: 1.17-3.15), and 4.12 (95% CI:2.59-5.68), respectively. The predominant causative pathogen was Staphylococcus epidermidis (36.43%, 38.89%), followed by Streptococci (14.73%, 16.67%), Staphylococcus aureus (8.53%, 7.79%), and Pseudomonas aeruginosa (9.30%, 7.14%) in eyes with BKH and BE. However, the main pathogens were Pseudomonas aeruginosa (37.50%) and Staphylococcus aureus (31.25%) in eyes with BKE. In the BKH, BKE, and BE groups, almost 100% of Staphylococcus aureus isolates were sensitive to vancomycin (97.70%, 100%, 95.56%), about a half were sensitive to fluoroquinolones (51.85%, 39.90%, 62.34%), and approximately 30% were sensitive to trimethoprim/sulfa (27.77%, 21.56%, 33.56%) and cefazolin (41.47%, 20.31%, 38.81%). The susceptibility of Pseudomonas aeruginosa to fluoroquinolones antibiotics was 55.75%, 66.67%, and 62.58%, respectively, in the three groups.The height of hypopyon and corneal perforation are risk factors for progression to endophthalmitis in eyes with bacterial keratitis. When Staphylococcus aureus and Pseudomonas aeruginosa are identified, vigilance is required for advanced endophthalmitis.

The bellows structure in an air spring can be constantly reinforced to cope with the complicated work environment, but it exerts a stronger and stronger effect on the stiffness characteristics of the air spring. However, there is not any effective way for the parameterized solution of the bellows stiffness of the air spring. With the precise transfer matrix method, the bellows stiffness characteristics of a cord-reinforced air spring with winding formation under preload conditions were analyzed in this paper. The thin-shell theory was used to solve the bellows pre-stress of the air spring under preload conditions. The pre-stress was introduced into the equilibrium equation for the bellows. Based on the geometrical and physical equations for the bellows with the complex cord winding characteristics, the precise integration method was borrowed to construct a transfer matrix for the bellows of the air spring under preload conditions. The state vector of the bellows in the air spring was solved through boundary conditions. The iteration method was adopted to develop the expression for the bellows stiffness characteristics, and combined with the theoretical model of pneumatic stiffness to solve the stiffness characteristics of the air spring. The comparison with the prototype test results verified the validity and correctness of the theoretical model. On this basis, we explored the influence of preload conditions, geometrical structure, and material characteristics on the stiffness characteristics of the air spring. The research findings will provide significant guidance for the structural design and material selection of cord-reinforced air springs with winding formation.

Background: To compare the 6-month changes in aberration and biomechanics after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for high astigmatism. Methods: In this retrospective case control study, 47 eyes with high astigmatism (≥ 2.5 D, HA group) and 47 eyes with low astigmatism (≤ 1.0 D, LA group) underwent FS-LASIK. Preoperative and follow-up examinations included visual outcomes, higher order aberrations (HOAs) and biomechanics. Biomechanical parameters include a deformation amplitude ratio of 2 mm (DA ratio 2 mm), integrated inverse radius (IIR), stiffness parameter at first applanation (SP-A1), and ambrosio relational thickness through the horizontal meridian (ARTh). Results: Six months postoperatively, there was no significant difference in the efficacy and safety index (both P > 0.05) between the two groups, but the cylinder was higher in the HA group. The HOAs increased significantly after surgery in both groups (all P P P > 0.05). Significant decreases in SP-A1 and ARTh and significant increases in the IIR and DA ratio of 2 mm (all P Conclusion: FS-LASIK had relative comparable efficacy and safety in correcting high and low myopic astigmatism, with higher astigmatic under-correction in eyes with high astigmatism. High astigmatism in eyes after FS-LASIK could introduce larger corneal aberrations, but the impact on corneal stiffness was the same as that in eyes with low astigmatism.

Background To investigate the effects of rigid gas permeable contact lens (RGP-CL) wear on contrast visual acuity in patients after penetrating keratoplasty. Methods Nineteen patients (19 eyes), aged 30.45 ± 5.83 years, who had received penetrating keratoplasty and were successfully fitted with RGP-CLs at our hospital from July 2017 to June 2018 were included. Contrast visual acuities at 100%, 25%, and 10% with spectacles and RGP-CLs were analyzed using the Chi-square test. The wavefront aberrations at the anterior surface of the cornea before and 1 month after RGP-CL wear were compared using the matched sample t-test. Results The mean best spectacle-corrected visual acuities were 0.390 ± 0.135 logMAR, 0.706 ± 0.182 logMAR, and 0.952 ± 0.223 logMAR at the 100%, 25%, and 10% contrast levels, respectively, which were significantly lower than the RGP-CL-corrected visions at the three levels (0.255 ± 0.133 logMAR, 0.488 ± 0.168 logMAR, and 0.737 ± 0.159 logMAR; all P 04 was reduced from 3.734 ± 1.061 μm to 2.622 ± 0.725 μm after wearing the RGP-CLs (P ≤ 0.001). The astigmatism parameters of Z− 22 and Z22 were also reduced from 3.761 ± 2.309 μm and 3.316 ± 2.147 μm to 2.637 ± 1.722 μm and 2.016 ± 1.184 μm, respectively (P Conclusion For post-keratoplasty patients, RGP-CLs can help to improve visual performance, especially low contrast visual acuity. The improvement may be related to the reduction of corneal aberrations, mainly the spherical and astigmatism aberrations.

Background Bronchiectasis is a highly heterogeneous chronic airway disease with marked geographic and ethnic variations. Most influential cohort studies to date have been performed in Europe and USA, which serve as the examples for developing a cohort study in China where there is a high burden of bronchiectasis. The Establishment of China Bronchiectasis Registry and Research Collaboration (BE-China) is designed to: (1) describe the clinical characteristics and natural history of bronchiectasis in China and identify the differences of bronchiectasis between the western countries and China; (2) identify the risk factors associated with disease progression in Chinese population; (3) elucidate the phenotype and endotype of bronchiectasis by integrating the genome, microbiome, proteome, and transcriptome with detailed clinical data; (4) facilitate large randomized controlled trials in China. Methods The BE-China is an ongoing prospective, longitudinal, multi-center, observational cohort study aiming to recruit a minimum of 10,000 patients, which was initiated in January 2020 in China. Comprehensive data, including medical history, aetiological testing, lung function, microbiological profiles, radiological scores, comorbidities, mental status, and quality of life (QoL), will be collected at baseline. Patients will be followed up annually for up to 10 years to record longitudinal data on outcomes, treatment patterns and QoL. Biospecimens, if possible, will be collected and stored at − 80 °C for further research. Up to October 2021, the BE-China has enrolled 3758 patients, and collected 666 blood samples and 196 sputum samples from 91 medical centers. The study protocol has been approved by the Shanghai Pulmonary Hospital ethics committee, and all collaborating centers have received approvals from their local ethics committee. All patients will be required to provide written informed consent to their participation. Conclusions Findings of the BE-China will be crucial to reveal the clinical characteristics and natural history of bronchiectasis and facilitate evidence-based clinical practice in China. Trial registration Registration Number in ClinicalTrials.gov: NCT03643653

Anthracnose caused by Colletotrichum species, is one of the most destructive diseases affecting strawberry production worldwide. Fungi of the genus Colletotrichum, being ancient and co-evolved with flowering plants, rank eighth among the top ten economically important fungal pathogens and have diversified to adapt to various hosts. Since it was first reported in United States in 1931, strawberry anthracnose has spread globally, resulting in devastating economic, social, and ecological consequences. In a sense, to produce organic strawberry is impracticable largely because of this disease. Colletotrichum species pathogenic to strawberry have been widely characterized. The review focused on providing an accurate inventory of Colletotrichum species pathogenic to strawberry via revisiting the discovery history scrupulously over 90 years. A total of 23 Colletotrichum species clustered into five species complexes and two singleton taxa were accepted as strawberry pathogens with global occurrence illustrated. The relative prevalence of distinct Colletotrichum species associated with strawberry was systematically analyzed in China. Finally, the host range of the prevailing C. fructicola and C. siamense, also the top two Colletotrichum species causing serious damages on the earth was summarized, with a goal of diagnosing accurately and improving anthracnose management in agricultural ecosystem.

Background Birth weight is considered not only to undermine future growth, but also to induce lifelong diseases; the aim of this study is to explore the relationship between birth weight and adult bone mass. Methods We performed multivariable regression analyses to assess the association of birth weight with bone parameters measured by dual-energy X-ray absorptiometry (DXA) and by quantitative ultrasound (QUS), independently. We also implemented a systemic Mendelian randomization (MR) analysis to explore the causal association between them with both fetal-specific and maternal-specific instrumental variables. Results In the observational analyses, we found that higher birth weight could increase the adult bone area (lumbar spine, β-coefficient= 0.17, P < 2.00 × 10−16; lateral spine, β-coefficient = 0.02, P = 0.04), decrease bone mineral content-adjusted bone area (BMCadjArea) (lumbar spine, β-coefficient= − 0.01, P = 2.27 × 10−14; lateral spine, β-coefficient = − 0.05, P = 0.001), and decrease adult bone mineral density (BMD) (lumbar spine, β-coefficient = − 0.04, P = 0.007; lateral spine; β-coefficient = − 0.03, P = 0.02; heel, β-coefficient = − 0.06, P < 2.00 × 10−16), and we observed that the effect of birth weight on bone size was larger than that on BMC. In MR analyses, the higher fetal-specific genetically determined birth weight was identified to be associated with higher bone area (lumbar spine; β-coefficient = 0.15, P = 1.26 × 10−6, total hip, β-coefficient = 0.15, P = 0.005; intertrochanteric area, β-coefficient = 0.13, P = 0.0009; trochanter area, β-coefficient = 0.11, P = 0.03) but lower BMD (lumbar spine, β-coefficient = − 0.10, P = 0.01; lateral spine, β-coefficient = − 0.12, P = 0.0003, and heel β-coefficient = − 0.11, P = 3.33 × 10−13). In addition, we found that the higher maternal-specific genetically determined offspring birth weight was associated with lower offspring adult heel BMD (β-coefficient = − 0.001, P = 0.04). Conclusions The observational analyses suggested that higher birth weight was associated with the increased adult bone area but decreased BMD. By leveraging the genetic instrumental variables with maternal- and fetal-specific effects on birth weight, the observed relationship could be reflected by both the direct fetal and indirect maternal genetic effects.

LaBO3 (B = Fe, Mn, and FeMn) perovskite-type oxides were prepared by sol–gel method and then used as catalysts in CO hydrogenation for light olefins. The catalysts were characterized using XRD, H2-TPR, SEM, CO (CO2)-TPD, and XPS. The results showed that the lattice oxygen migration and oxygen vacancies promoted oxygen mobility by doping Mn2+ at the B site, Moreover, the presence of manganese as a promoter in the catalyst increased olefin selectivity compared with the olefin selectivity of the catalyst containing iron at the B-site and exhibited resistance to carbon deposition; while reducing the metal elements. In CO hydrogenation, potassium-promoted LaFeMnO3 catalysts afforded high catalytic activity and C2=–C4= selectivity. An O/P value of 5.0 and a C2=–C4= fraction of 54% were achieved for all hydrocarbons with low methane selectivity.

A series of CuZn/xCe-ZnAl2O4 catalysts (CZ/xCe-ZAO) with different contents of Ce doping (x = 0, 3, 5, and 7 wt%) were prepared by precipitation. The samples were applied for the hydrogenation production from methanol decomposition. Ce doping was found to effectively improve the reaction activity of the catalysts. CZ/5Ce-ZAO exhibits 100.0% methanol conversion and selectivity to hydrogenation of 98.9% at 300 °C (WHSV = 1.5 h−1), which is superior to those of the comparison catalysts. Moreover, the TOF for CZ/5Ce-ZAO increased by 54.7% compared with the pristine sample without Ce doping. In addition, CZ/5Ce-ZAO showed significantly improved stability compared with that of the un-doped catalysts. The obtained catalysts were systematically characterized by N2 sorption, XRD, H2-TPR, XPS, TEM, N2O-TPD, TG–DTA. The results suggested that stronger metal-support interaction (SMSI) existed in the Ce doped samples increased the dispersion of Cu species, which was responsible for the outstanding catalytic performance. Besides, such SMSI was also helpful for inhibiting the sintering of the copper species during the reaction and enhancing stability. CZ/5Ce-ZnAl2O4 shows significantly improved stability compared with the undoped and commercial catalysts.

Non-compressible hemorrhage is an unmet clinical challenge that accounts for high mortality in trauma. Rapid pressurized blood flows under hemorrhage impair the function and integrity of hemostatic agents and the adhesion of bioadhesive sealants. Here, we report the design and performance of bioinspired microstructured bioadhesives, formed with a macroporous tough xerogel infused with functional liquids. The xerogel can rapidly absorb interfacial fluids such as whole blood and promote blood clotting, while the infused liquids facilitate interfacial bonding, sealing, and antibacterial function. Their synergy enables the bioadhesives to form tough adhesion on ex vivo human and porcine tissues and diverse engineered surfaces without the need for compression, as well as on-demand instant removal and storage stability. We demonstrate a significantly improved hemostatic efficacy and biocompatibility in rats and pigs compared to non-structured counterparts and commercial products. This work opens new avenues for the development of bioadhesives and hemostatic sealants.

Background The aim of the study was to assess the feasibility of a standardized tracheostomy decannulation protocol in patients with prolonged tracheostomy referred to a rehabilitation hospital. Methods This prospective cohort study recruited conscious patients with prolonged tracheostomy who were referred to the pulmonary rehabilitation department of a tertiary rehabilitation hospital between January 2019 and December 2021. A pulmonary rehabilitation team used a standardized tracheostomy decannulation protocol developed by the authors. The primary outcome was the success rate of decannulation. Secondary outcomes included decannulation time from referral and reintubation rate after a follow-up of 3 months. Results Of the 115 patients referred for weaning from mechanical ventilation and tracheostomy decannulation over the study period, 80.0% (92/115) were finally evaluated for tracheostomy decannulation. The mean time of tracheostomy in patients transferred to our department was 70.6 days. After assessment by a multidisciplinary team, 57 patients met all the decannulation indications and underwent decannulation. Fifty-six cases were successful, and 1 case was intubated again. The median time to decannulation after referral was 42.7 days. Reintubation after a follow-up of 3 months did not occur in any patients. Conclusions A standardized tracheostomy decannulation protocol implemented by a pulmonary rehabilitation team is associated with successful tracheostomy decannulation in patients with prolonged tracheostomy. Not every tracheostomy patient must undergo upper airway endoscopy before decannulation. Tolerance of speaking valve continuously for 4 h can be used as an alternative means for tube occlusion. A swallow assessment was used to evaluate the feeding mode and did not affect the final decision to decannulate. Trial registration: 2018bkky-121.

There are three epidemiological types of visceral leishmaniasis in China, which are caused by Leishmania strains belonging to the L. donovani complex. The mechanisms underlying their differences in the population affected, disease latency, and animal host, etc., remain unclear. We investigated the protein abundance differences among Leishmania strains isolated from three types of visceral leishmaniasis endemic areas in China. Promastigotes of the three Leishmania strains were cultured to the log phase and harvested. The protein tryptic digests were analyzed with liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS), followed by label-free quantitative analysis. The MS experiment was performed on a Q Exactive mass spectrometer. Raw spectra were quantitatively analyzed with the MaxQuant software (ver 1.3.0.5) and matched with the reference database. Differentially expressed proteins were analyzed using the bioinformatics method. The MS analysis was repeated three times for each sample. A total of 5012 proteins were identified across the KS-2, JIASHI-5 and SC6 strains in at least 2 of the three samples replicate. Of them, 1758 were identified to be differentially expressed at least between 2 strains, including 349 with known names. These differentially expressed proteins with known names are involved in biological functions such as energy and lipid metabolic process, nucleotide acid metabolic process, amino acid metabolic process, response to stress, cell membrane/cytoskeleton, cell cycle and proliferation, biological adhesion and proteolysis, localization and transport, regulation of the biological process, and signal transduction. The differentially expressed proteins and their related biological functions may shed light on the pathogenicity of Leishmania and targets for the development of vaccines and medicines.

Neuroinflammation is the key factor associated with the progression of Parkinson’s disease (PD). Pramipexole (PPX) has anti-inflammatory and antioxidant properties. This study explored the effects of PPX on PD and its related mechanisms. A PD rat model was established using 6-hydroxydopamine (6-OHDA). Thirty rats were divided into the following three groups: control, PD, and PD + PPX. The rats in the PD and PD + PPX groups were first administered 6-OHDA and then respectively treated with saline and PPX. Afterward, rotational behavior tests were performed to evaluate the efficiency of PPX. The level of tyrosine hydroxylase (TH) was measured using immunohistochemical staining. Subsequently, real-time quantitative PCR (RT-qPCR) and western blot were used to determine the expression of α-synuclein (α-syn), nuclear receptor subfamily 4 group A member 2 (Nurr1), and nuclear factor kappa B (NF-κB). PPX improved the motor behavior of PD rats caused by 6-OHDA. The number of TH-positive neurons in the PD group was significantly lower than that in the control group (P

In the present research, a novel MOF-containing Zn(II) ions as nodes were created via the reaction between Zn salt and 2-hydroxy-4-(pyridin-4-yl)benzaldehyde (HL), a N,O-hetrodonor ligand under a solvothermal reaction condition, and its chemical formula is [Zn(L)2]·2DMA·CH3OH (1). The structural analysis results show that complex 1 has a 3D porous framework with 1D channels running along the c axis, and its network could be simplified into a four-linked nbo-type topological network. Complex 1 possesses outstanding luminescent performances and it can determine selectively the Fe3+ ions with a high Ksv value of 3.5 × 104 M−1 and a low LOD (limit of detection) of 0.3 µM. Its treatment on the primary immune thrombocytopenia (ITP) was evaluated in this present research, and its specific mechanism was also studied in the meantime. Firstly, the levels of lgG and lgA on the platelets were determined via the enzyme-linked immunosorbent assay detection kit. Furthermore, the PD-L1 relative expression on the platelets was detected employing the real-time RT-PCR (reverse transcription-polymerase chain reaction) assay.

Melanoma is a highly aggressive malignant skin tumor with a high rate of metastasis and mortality. In this study, a comprehensive bioinformatics analysis was used to clarify the hub genes and potential drugs. Download the GSE3189, GSE22301, and GSE35388 microarray datasets from the Gene Expression Omnibus (GEO), which contains a total of 33 normal samples and 67 melanoma samples. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) approach analyze DEGs based on the DAVID. Use STRING to construct protein-protein interaction network, and use MCODE and cytoHubba plug-ins in Cytoscape to perform module analysis and identified hub genes. Use Gene Expression Profile Interactive Analysis (GEPIA) to assess the prognosis of genes in tumors. Finally, use the Drug-Gene Interaction Database (DGIdb) to screen targeted drugs related to hub genes. A total of 140 overlapping DEGs were identified from the three microarray datasets, including 59 up-regulated DEGs and 81 down-regulated DEGs. GO enrichment analysis showed that these DEGs are mainly involved in the biological process such as positive regulation of gene expression, positive regulation of cell proliferation, positive regulation of MAP kinase activity, cell migration, and negative regulation of the apoptotic process. The cellular components are concentrated in the membrane, dendritic spine, the perinuclear region of cytoplasm, extracellular exosome, and membrane raft. Molecular functions include protein homodimerization activity, calmodulin-binding, transcription factor binding, protein binding, and cytoskeletal protein binding. KEGG pathway analysis shows that these DEGs are mainly related to protein digestion and absorption, PPAR signaling pathway, signaling pathways regulating stem cells' pluripotency, and Retinol metabolism. The 23 most closely related DEGs were identified from the PPI network and combined with the GEPIA prognostic analysis, CDH3, ESRP1, FGF2, GBP2, KCNN4, KIT, SEMA4D, and ZEB1 were selected as hub genes, which are considered to be associated with poor prognosis of melanoma closely related. Besides, ten related drugs that may have therapeutic effects on melanoma were also screened. These newly discovered genes and drugs provide new ideas for further research on melanoma.

A high-speed (HS) permanent magnet (PM) synchronous motor (HSPMSM) with a carbon fiber-reinforced plastic (CFRP) protective sleeve in the surface-mounted rotor was explored in this study. In view of retaining the PMs at HS operations, the high-strength CFRP sleeve was designed on the basis of a process that could be summarized as follows. First, a multi-physics analysis of the rotor was conducted. The requirements to the CFRP sleeve were obtained from electromagnetic analysis, loss analysis, heat flow coupling computational fluid dynamics analysis, structural analysis, and rotor dynamics analysis. Second, the CFRP sleeve was designed by theoretical analysis. From the results, the thickness values of the carbon fibers in the circumferential and helical directions were chosen to be 4 and 1 mm, respectively, while the helical angle of carbon fibers was chosen to be 70°. Then, a plate-shaped CFRP product and a cylindrical CFRP product were fabricated to verify the strength and stiffness of the CFRP sleeve. The performance test results show that the hoop strength and elastic modulus and the axial strength and elastic modulus of the plate-shaped CFRP products at 20 °C are 1963 MPa @ 156 GPa and 550 MPa @ 36 GPa, respectively. The hoop strain and axial strain of the cylindrical CFRP product under 35 MPa are about 3000 and 1900 μe, which meet the design requirements of the HSPMSM.

Background/objectives Chronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time. Subjects/methods To identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD. Results In cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR). Conclusions In this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.

To evaluate the diagnostic performance of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for grading hepatic inflammation. In this retrospective cross-sectional dual-center study, 91 patients with chronic liver disease were recruited between September 2014 and September 2018. Patients underwent 3.0-T MRI examinations within 6 weeks from a liver biopsy. IVIM parameters, perfusion fraction (f), diffusion coefficient (D), and pseudo-diffusion coefficient (D*), were estimated using a voxel-wise nonlinear regression on DWI series (10 b-values from 0 to 800 s/mm2). The reference standard was histopathological analysis of hepatic inflammation grade, steatosis grade, and fibrosis stage. Intraclass correlation coefficients (ICC), univariate and multivariate correlation analyses, and areas under receiver operating characteristic curves (AUC) were assessed. Parameters f, D, and D* had ICCs of 0.860, 0.839, and 0.916, respectively. Correlations of f, D, and D* with inflammation grade were ρ = − 0.70, p

The causes of chronic antibiotic refractory pouchitis (CARP) and pouch failure in inflammatory bowel disease (IBD) patients remain unknown. Our previous small study showed peripouch fat area measured by MRI was associated with pouchitis. To explore the relationship between peripouch fat area on CT imaging and pouch outcomes. This is a historical cohort study. Demographic, clinical, and radiographic data of IBD patients with abdominal CT scans after pouch surgery between 2002 and 2017 were collected. Peripouch fat areas and mesenteric peripouch fat areas were measured on CT images at the middle pouch level. A total of 435 IBD patients were included. Patients with higher peripouch fat areas had a higher prevalence of CARP. Univariate analyses demonstrated that long duration of the pouch, high weight or body mass index, the presence of primary sclerosing cholangitis or other autoimmune disorders, and greater peripouch fat area or mesenteric peripouch fat area were risk factors for CARP. Multivariable analyses demonstrated that the presence of primary sclerosing cholangitis or autoimmuned disorders, and greater peripouch fat area (odds ratio [OR] 1.031; 95% confidence interval [CI] 1.016–1.047, P

Vibration energy harvesting is a promising approach for sustainable energy generation from ambience to meet the development of self-powered systems. Here, we propose a novel compact non-resonant magnetically modulated rotational energy harvester (MMR-EH) for low frequency and irregular vibration. Through the rational arrangement of multiple magnetic fields in space, a ring route with low potential energy is established. A movable magnet can be non-contact modulated by the magnetic force to move along the ring route under irregular vibration, which is instrumental in electromechanical energy conversion. A dynamic model of the MMR-EH is developed based on the energy method and verified experimentally. The effects of key parameters on the magnetically modulated route are analysed. The simulation and experimental results demonstrate that the MMR-EH can effectively harvest the energy from ultra-low frequency (3 Hz) and irregular vibration. At a reciprocating vibration frequency of 10 Hz and an amplitude of 20 mm, the harvester can produce an average power of 0.29 mW.

As a typical contact-free manipulation technique that removes friction and contamination risk, levitation has gradually become a preferred candidate for various applications. Magnetic levitation using diamagnetism, beyond Earnshaw’s theorem, is a kind of passive stable levitation that can be achieved at normal temperatures with no energy input. Appealingly, most seemingly nonmagnetic materials can be levitated in a magnetic field and can stabilize free levitation of magnetic materials. This review focuses on the fundamental principles of magnetic levitation using diamagnetism, with emphasis on its burgeoning applications. The theoretical basis associated with the magnetic levitation using diamagnetism is discussed by elucidating the characteristics of diamagnetic materials, and the key levitation mechanisms are clarified. Afterwards, state-of-the-art applications in various aspects, including sensing and measurement, actuating and micromanipulation, energy harvesting and magnetic gravity compensation, are summarized and compared. Finally, the review concludes with a brief outlook on future perspectives.

Inspired by the safe landing of a cat falling from a high altitude, a bio-inspired polygonal skeleton (BIPS) structure is proposed, and its nonlinear characteristics are systematically studied to explore its potential application in the suppression of vibration. The polygon is formed by the skeleton structure of the cat’s entire body and the ground. The BIPS system consists of two symmetrical bionic legs with three robs (as skeleton) and four horizontal springs (as muscle). Two bionic legs are connected through the bearing platform (as spine), which could adjust the distance between the two bionic legs. A theoretical model is developed to characterize its stiffness nonlinearity through geometrical and mechanical analysis. Parameter analysis reveals that the BIPS structure has diverse stiffness, including nonlinear positive stiffness and negative stiffness. By imitating adjustment of leg posture and telescopic function of the spine (control the distance between legs), these flexible stiffness properties can be adjusted by structure parameters. In addition, the load capacity and working range can also be designed by the length of the bars, the initial angle, the mounting position, and the spring stiffness. The experimental setup is established, and the vibration isolation performance under various excitation is tested. The experimental results verify the accuracy of the dynamic model and also show that the proposed BIPS structure can suppress the vibration effectively under a variety of excitations. These peculiarities may provide potential possibility of an innovative approach to passive vibration control and isolation.

The use of engineering procurement construction (EPC) mode is currently a trend in hydropower engineering construction. The clarification of the internal relationship between hydropower EPC projects and the realization of synergy has great significance in improving management efficiency and implementation effect. In this work, a three-dimensional system and a system model of hydropower EPC project management synergy are constructed. The mechanism and factors that influence the degree of management synergy are analyzed on the basis of management synergy theory. Furthermore, the evaluation index system and the degree of synergy model are established, and grey relational analysis is utilized to identify the key factors that affect the synergy degree. Thus, this study aims to facilitate the hydropower EPC project management synergy, provide a quantitative method for synergy degree evaluation, and propose corresponding promotion strategies. Results show that the order degree of each subsystem presents a steady upward trend. Specifically, the order degree of the subsystem at the trial operation stage is low, which is the major restriction on the further improvement of the synergy degree of EPC project management. The key factors in improving the synergy level of hydropower EPC project management are mainly concentrated in the information and organization synergy subsystems, including the construction degree of information platform, the performance of functions, the timeliness of information transfer, and the functions of the information platform.

In the USA, fibrolamellar hepatocellular carcinoma (FLC) accounts for 1–2% of all cases of hepatocellular carcinoma. FLC remains poorly understood. We aim to investigate the incidence, demographics, tumor characteristics, treatment, and prognosis of patients with FLC. Data on FLC between 2000 and 2016 were extracted from the SEER database and analyzed. A total of 300 patients with FLC were identified where 126 were male. Median age at diagnosis was 27 ± 22 years. The overall age-adjusted incidence of FLC between 2000 and 2016 was 0.02 per 100,000 per year. A bimodal distribution was observed where the highest incidences occurred between 15–19 years and 70–74 years. Most tumors on presentation were moderately differentiated (20.7%), while the most common stage at presentation was stage 1 (21.7%) followed by stages 3 and 4 (20.0% and 20.3%, respectively); 50.3% of these tumors were surgically resected, while 8.0% received radiation and 45.3% received chemotherapy. One- and 5-year cause-specific survival for FLC was 72.0% and 32.9%, respectively, with a median survival of 32.9 months. HCC had a median survival time of 11.7 months. Patients who were not treated with surgical intervention had about 3 times increased risk for death (HR 2.8, 95% CI 1.68–4.72, P = 0.000). Radiation and chemotherapy did not significantly affect outcomes. FLC presents with a bimodal distribution in both early and elderly individuals. Compared to HCC, FLC has a higher recurrence rate but better survival outcome. Surgical intervention is superior to chemotherapy and radiation.

Pouch prolapse is a rare pouch complication which often leads to pouch failure in inflammatory bowel disease (IBD) patients. Its exact cause remains unknown. Floppy pouch complex (FPC) was defined as the presence of any one of the following pouch disorders: pouch prolapse, afferent limb syndrome (ALS), redundant loop, and pouch folding. We aimed to explore the role of peripouch fat area in the occurrence of pouch prolapse and FPC. Pouch patients with available pouchoscopy and abdominal CT scans who were followed up between 2011 and 2017 in Cleveland Clinic were reviewed. Peripouch fat was measured on CT images. Of the 93 included patients, 31 were females; 87 had J pouches and 6 had S pouches. The median duration of pouch was 8.0 (interquartile range [IQR] 5.0–16.5) years. A total of 18 cases (19.4%, 18/93) were identified as FPC, including 12 pouch prolapse, 5 ALS, 1 redundant loop, and 3 pouch folding. Patients with pouch prolapse had lower peripouch fat area (13.6 (9.3–18.5) vs. 27.6 (11.0–46.2)cm2, P = 0.022) than those without. Patients with FPC had lower peripouch fat area (15.4 (11.4–20.6) vs. 27.6 (11.0–46.9)cm2, P = 0.040) than those without. Univariate and multivariate analyses demonstrated that lower peripouch fat area, lower weight, and family history of IBD were independent predictors of pouch prolapse and FPC. A lower peripouch fat area was observed in inflammatory bowel disease patients with pouch prolapse and FPC. Longitudinal studies are needed to further elucidate the role of peripouch fat in the pathogenesis of pouch prolapse and FPC.

We derive the chiral kinetic equation in 8 dimensional phase space in non-Abelian $SU(N)$ gauge field within the Wigner function formalism. By using the "covariant gradient expansion", we disentangle the Wigner equations in four-vector space up to the first order and find that only the time-like component of the chiral Wigner function is independent while other components can be explicit derivative. After further decomposing the Wigner function or equations in color space, we present the non-Abelian covariant chiral kinetic equation for the color singlet and multiplet phase-space distribution functions. These phase-space distribution functions have non-trivial Lorentz transformation rules when we define them in different reference frames. The chiral anomaly from non-Abelian gauge field arises naturally from the Berry monopole in Euclidian momentum space in the vacuum or Dirac sea contribution. The anomalous currents as non-Abelian counterparts of chiral magnetic effect and chiral vortical effect have also been derived from the non-Abelian chiral kinetic equation., Comment: 19 pages, no figures

BackgroundMethicillin-resistantStaphylococcus aureus(MRSA) is a major nosocomial pathogen subdivided into lineages termed sequence types (STs). Since the 1950s, successive waves of STs have appeared and replaced previously dominant lineages. One such event has been occurring in China since 2013, with community-associated (CA-MRSA) strains including ST59 largely replacing the previously dominant healthcare-associated (HA-MRSA) ST239. We previously showed that ST59 isolates tend to have a competitive advantage in growth experiments against ST239. However, the underlying genomic and phenotypic drivers of this replacement event are unclear.MethodsHere, we investigated the replacement of ST239 using whole-genome sequencing data from 204 ST239 and ST59 isolates collected in Chinese hospitals between 1994 and 2016. We reconstructed the evolutionary history of each ST and considered two non-mutually exclusive hypotheses for ST59 replacing ST239: antimicrobial resistance (AMR) profile and/or ability to colonise and persist in the environment through biofilm formation. We also investigated the differences in cytolytic activity, linked to higher virulence, between STs. We performed an association study using the presence and absence of accessory virulence genes.ResultsST59 isolates carried fewer AMR genes than ST239 and showed no evidence of evolving towards higher AMR. Biofilm production was marginally higher in ST59 overall, though this effect was not consistent across sub-lineages so is unlikely to be a sole driver of replacement. Consistent with previous observations of higher virulence in CA-MRSA STs, we observed that ST59 isolates exhibit significantly higher cytolytic activity than ST239 isolates, despite carrying on average fewer putative virulence genes. Our association study identified the chemotaxis inhibitory protein (chp) as a strong candidate for involvement in the increased virulence potential of ST59. We experimentally validated the role ofchpin increasing the virulence potential of ST59 by creating Δchpknockout mutants, confirming that ST59 can carrychpwithout a measurable impact on fitness.ConclusionsOur results suggest that the ongoing replacement of ST239 by ST59 in China is not associated to higher AMR carriage or biofilm production. However, the increase in ST59 prevalence is concerning since it is linked to a higher potential for virulence, aided by the carriage of thechpgene.

The wavelength-dependent transit depth indicates the atmosphere composition of an exoplanet. We analyze the transit depth of HATS-5b using the data from the Transiting Exoplanet Survey Satellite (TESS) and compare the radius ratio of the planet to the star with the different band result in previous work. We generate a photometric pipeline to obtain the TESS light curve. The fitting of the HATS-5b light curve derives similar bandpass independent parameters compared to the reference work, e.g., the differences in the inclination and the semi-major axis within 1 $\sigma$ . We fix the bandpass-independent parameters to values from the previous work for comparison purposes. The wavelength-dependent $R_{p}/R_{\ast}$ obtained is 2.5% (1.9 $\sigma$ ) smaller compared to the joint band result from the referenced work. The difference of $R_{p}$ / $R_{\ast}$ suggests a haze-dominant model preferred by observation (with $\chi^{2}=1.68$ ) when fitting with different atmospheric models. The opaque featureless atmospheric model has a $\chi^{2}\sim4$ , while the other models are ruled out with $\chi^{2}> 7$ . We also predict an $R_{p}/R_{\ast}$ difference of ∼1 $\%$ , correlating the presence of water at $z$ -band observation. This difference is detectable at 3 $\sigma$ if the photometry precision reaches 500 ppm with 2 minute exposure for one-night observation.