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Carsharing emerges as a flexible and sustainable transportation mode to deal with severe urban challenges. This paper addresses a joint design problem of carsharing systems by an integer linear programming (ILP) model. Strategic planning of stations' number, location and parking capacities and tactical planning of the fleet size and initial vehicle distribution are collaboratively optimized by considering all-day vehicle relocation and dynamic trip selection at the operational level. For the first time, vehicle relocation and demand selection are integrated with the joint optimization of strategic and tactical planning. We present a greedy heuristic algorithm embedding ILP to solve the problem. The case study of Chengdu demonstrates that the algorithm is computationally efficient when dealing with large-scale problems. The results identify how vehicle relocation and trip selection work in different scenes of travel time and demands and we conclude operators should target at medium-long trips by discount or promotion. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectivesMaterial and MethodsResultsConclusions and SignificanceThe effect of batroxobin on hearing recovery in patients with Sudden Sensorineural Hearing Loss (SSNHL) is still controversial, and acupuncture shows auxiliary benefits for SSNHLTo investigate the effectiveness of combining acupuncture with batroxobin therapy for patients with SSNHL.One hundred and fifty-six patients with SSNHL were retrospectively enrolled in this study, and categorized into the control group (only batroxobin treatment) and observation group (batroxobin and acupuncture treatment). Pure Tone Audiograms (PTA) threshold and clinical outcomes of hearing recovery were compared. Logistic regression analysis was used to evaluate the association between hearing recovery and potential risk factors.Compared to the control group, the observation group had a higher overall effective rate (p = 0.006) and improvement in PTA threshold (p = 0.007). Among SSNHL patients with high-frequency and flat-type hearing loss, observation group demonstrated superior hearing recovery post-treatment compared to the control group (p < 0.05). Additionally, hearing recovery in patient with SSNHL were associated with SSNHL types, disease duration, neutrophil count and acupuncture (p < 0.05).Combining batroxobin and acupuncture treatments enhences the improvement of hearing recovery in SSNHL patients compared to only batroxobin treatments, especially high-frequency and flat-type hearing loss. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is one of the most common complications for critically ill patients with cirrhosis, but it has remained unclear whether urine output fluctuations are associated with the risk of AKI in such patients. Thus, we explored the influence of 24-h urine-output trajectory on AKI in patients with cirrhosis through latent category trajectory modeling. This retrospective cohort study examined patients with cirrhosis using the MIMIC-IV database. Changes in the trajectories of urine output within 24 h after admission to the intensive care unit (ICU) were categorized using latent category trajectory modeling. The outcome examined was the occurrence of AKI during ICU hospitalization. The risk of AKI in patients with different trajectory classes was explored using the cumulative incidence function (CIF) and the Fine-Gray model with the sub-distribution hazard ratio (SHR) and the 95% confidence interval (CI) as size effects. The study included 3,562 critically ill patients with cirrhosis, of which 2,467 (69.26%) developed AKI during ICU hospitalization. The 24-h urine-output trajectories were split into five classes (Classes 1–5). The CIF curves demonstrated that patients with continuously low urine output (Class 2), a rapid decline in urine output after initially high levels (Class 3), and urine output that decreased slowly and then stabilized at a lower level (Class 4) were at higher risk for AKI than those with consistently moderate urine output (Class 1). After fully adjusting for various confounders, Classes 2, 3, and 4 were associated with a higher risk of AKI compared with Class 1, and the respective SHRs (95% CIs) were 2.56 (1.87–3.51), 1.86 (1.34–2.59), and 1.83 1.29–2.59). The 24-h urine-output trajectory is significantly associated with the risk of AKI in critically ill patients with cirrhosis. More attention should be paid to the dynamic nature of urine-output changes over time, which may help guide early intervention and improve patients' prognoses. [ABSTRACT FROM AUTHOR]

To understand the mercury (Hg) pollution characteristics and health risks in indoor and outdoor dust of Huainan residential areas, 122 dust samples were collected indoors and outdoors. Average Hg contents in indoor and outdoor dusts of Huainan city were 0.321 ± 0.724 (n= 61) and 0.072 ± 0.163 (n= 61) mg/kg respectively. The average Hg content in indoor dust was characterized by PJ (Panji district) > XJJ (Xiejiaji district) > DT (Datong district) > TJA (Tianjiaan district), and in the order of PJ > DT > XJJ >TJA in outdoor dust. According to enrichment factor and geo-accumulation index, the enrichment degree and pollution intensity for Hg are ranked as “very high enrichment” and “heavily polluted” in indoor dust, and “significant enrichment” and “moderately polluted” in outdoor dust Hg concentrations in indoor dust were highly significantly associated with the coal combustion and frequency of open windows, and Hg concentrations in outdoor dust were significantly associated with the coal combustion and traffic density. The inhalation of Hg vapor is the main route of Hg exposure to adult and children. The hazard risks of Hg for different exposure ways in indoor and outdoor dust were more risk for children than for adults, but have no obvious health risk for them. [ABSTRACT FROM PUBLISHER]

This study aimed to analyze the effect and mechanism of immunization of oral KISS1 DNA vaccine on the proliferation of goat testicular Leydig cells. Ten 8-week-old male goats were randomly divided into KISS1 DNA vaccine and control groups for immunization (five goats each group). These goats were sacrificed at 8 weeks after primary immunization, and the tissue samples of hypothalamus, pituitary, and testis and Leydig cell samples were collected for RT-PCR and CCK8 assay. Immunization with the oral KISS1 DNA vaccine effectively inhibited the proliferation of Leydig cells, the expression of hypothalamus KISS1, GPR54, and GnRH mRNA, pituitary GnRHR and LH mRNA, testicular LHR mRNA, and apoptosis-inhibitory gene Bcl-2 mRNA in Leydig cells. By contrast, the immunization enhanced the mRNA expression of apoptosis-promoting gene Bax and Clusterin in Leydig cells. These findings indicate that immunization with the oral KISS1 DNA vaccine can inhibit the proliferation of goat testicular Leydig cells mainly via the hypothalamic–pituitary–testicular axis and apoptosis-related genes. [ABSTRACT FROM AUTHOR]