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The association between total and truncal body fat and kidney stone (KS) remains unclear.To evaluate the association between total and truncal body fat and KS in the US adult population.The National Health and Nutrition Examination Survey (NHANES) comprises a series of nationally representative cross-sectional surveys. Data from females and males aged 20-59 yr who participated in four 2-yr NHANES cycles between 2011 and 2018 were obtained.Multivariable-adjusted logistic regression models were used to investigate the association between dual-energy x-ray absorptiometry (DXA) scan-measured total and truncal body fat percentage and mass with KS.A total of 10 271 participants (50.3% females) were included. Weighted KS prevalence was 8.11% in femalesand 7.55% in males. In males, higher fat percentage was associated with higher odds of KS (per 5% total fat: odds ratio [OR] = 1.19, 95% confidence interval [CI] 1.08-1.32; per 5% truncal fat: OR = 1.22, 95% CI 1.10-1.35), particularly in those aged 40-59 yr (per 5% total fat: OR = 1.36, 95% CI 1.16-1.59; per 5% truncal fat: OR = 1.41, 95% CI 1.20-1.65, p-interaction0.05). In females, higher fat percentage was associated with higher odds of KS overall (per 5% total fat: OR = 1.23, 95% CI 1.10-1.37; per 5% truncal fat: OR = 1.20, 95% CI 1.08-1.33) and in both age groups (20-39 and 40-59 yr, p-interaction0.05). The observed associations were stronger in "other" ethnicities and non-Hispanic white. Similar patterns were observed for per 5 kg body fat mass.Total and truncal fat parameters are associated with a higher prevalence of KS in adult females and males who are ≥40 yr old. Truncal fat mass may be at least equal or superior to total fat mass in assessing the association of body fat with KS. Further studies are warranted to elaborate on the pathophysiologic mechanism of this association to decrease the prevalence of KS.Total and truncal body fat are associated with a higher prevalence of kidney stone (KS) in adult females and males aged ≥40 yr. Truncal fat mass may be similar or superior to total fat mass in assessing the association between body fat and KS.

Background. Several large-scale studies suggest that Bacille Calmette–Guerin (BCG) vaccination in early childhood may reduce the risk of atopic diseases, but the findings remain controversial. Here, we aimed to investigate the potential correlation between early childhood BCG vaccination and the risk of developing atopic diseases. Methods. Eligible studies published on PubMed, EMBASE, and Cochrane CENTRAL were systematically sourced from 1950 to July 2021. Studies with over 100 participants and focusing on the association between BCG vaccine and atopic diseases including eczema, asthma, and rhinitis were included. Preliminary assessment of methods, interventions, outcomes, and study quality was performed by two independent investigators. Odds ratio (OR) with 95% confidence interval (CI) was calculated. Random effects of the meta-analysis were performed to define pooled estimates of the effects. Results. Twenty studies with a total of 222,928 participants were selected. The quantitative analysis revealed that administering BCG vaccine in early childhood reduced the risk of developing asthma significantly (OR 0.77, 95% CI 0.63 to 0.93), indicating a protective efficacy of 23% against asthma development among vaccinated children. However, early administration of BCG vaccine did not significantly reduce the risk of developing eczema (OR 0.94, 95% CI 0.76 to 1.16) and rhinitis (OR 0.99, 95% CI 0.81 to 1.21). Further analysis revealed that the effect of BCG vaccination on asthma prevalence was significant especially in developed countries (OR 0.73, 95% CI 0.58 to 0.92). Conclusion. BCG vaccination in early childhood is associated with reduced risk of atopic disease, especially in developed countries.

Background The contemporary prevalence and trends of kidney stones are not clear. Objective To evaluate the gender-specific prevalence and trends in kidney stones among the US population. Design, setting, and participants Data on self-reported history of kidney stones from 34 749 participants aged ≥20 yr from the National Health and Nutrition Examination Survey (NHANES) were analyzed. Intervention Six 2-yr study cycles (2007–2008 to 2017–2018) of nationally representative series of surveys evaluated the health status of the US population. Outcome measurements and statistical analysis Weighted prevalence estimates of kidney stones and 95% confidence intervals (CIs) were calculated in each study cycle. Multivariable-adjusted logistic regression models were used to investigate the temporal trends. Results and limitations In the 2017–2018 cycle, the prevalence of kidney stones was 10.9% (CI: 9.3–12.7) in men as compared with 9.5% (CI: 8–11.2) in women. The prevalence of kidney stones increased steadily from 6.5% in the 2007–2008 cycle to 9.4% in the 2017–2018 cycle (ptrend = 0.001) among women but not among men (ptrend = 0.1). These trends remained after adjusting for sociodemographic correlates in both genders. Sensitivity analyses further adjusting for dietary information held the same results in trends (men: ptrend = 0.15; women: ptrend = 0.001). Non-Hispanic white ethnicity, obesity, gout, history of two or more pregnancies, menopause, and using female hormones were associated with a higher prevalence of kidney stones. The main limitation is the cross-sectional design of the study. Conclusions Although kidney stones are more common in men than in women in the USA, the gender gap in kidney stone prevalence appears to be closing in the past decade. Kidney stones are consistently higher among non-Hispanic white and obese, and women who have had multiple pregnancies or have used female hormone therapy. Patient summary The prevalence of kidney stones remains higher in adult US men than in women, but the trend has been increasing only in women, closing the gender gap in kidney stone prevalence.

In this article, a survey of the point cloud compression (PCC) methods by organizing them with respect to the data structure, coding representation space, and prediction strategies is presented. Two paramount families of approaches reported in the literature—the projection- and octree-based methods—are proven to be efficient for encoding dense and sparse point clouds, respectively. These approaches are the pillars on which the Moving Picture Experts Group Committee developed two PCC standards published as final international standards in 2020 and early 2021, respectively, under the names: video-based PCC and geometry-based PCC. After surveying the current approaches for PCC, the technologies underlying the two standards are described in detail from an encoder perspective, providing guidance for potential standard implementors. In addition, experiment evaluations in terms of compression performances for both solutions are provided.

Background This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases at the start of the pandemic in China. Methods In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included. Demographic data, symptoms, laboratory values, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Results 58 patients were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12·9 ± 4·4 vs 8·3 ± 4·7; P = 0·0011), duration of viral shedding (15·7 ± 6·7 vs 11·8 ± 5·0; P = 0·0183), and hospital stay (20·7 ± 1·2 vs 14·4 ± 4·3; P = 0·0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1·28, 95%CI 1·06–1·54, per 0·1 × 109/L reduced; P = 0·007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0·14, 95%CI 0·02–0·80; P = 0·0275). Conclusions The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. However, this study was carried out right after the start of the pandemic with small sample size. Further prospective studies are warranted to confirm these findings. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029839. Registered 15 February 2020 - Retrospectively registered.

BACKGROUND/OBJECTIVES Children and adolescents spend a substantial amount of time being sedentary. The impact of prolonged sedentary patterns on fat distribution has not been elucidated especially in the context of physical activity level. Our objective is to examine the independent and joint associations of prolonged sedentary patterns and physical activity level with fat distribution among children and adolescents. SUBJECTS/METHODS This included US children (8-11 years) and adolescents (12-19 years) from the National Health and Nutrition Examination Survey 2003-2006. Sedentary patterns comprise accelerometer-measured average sedentary bout duration and self-reported time of sitting watching TV/videos. Fat distribution (trunk and total fat percentage) was determined via dual X-ray absorptiometry. RESULTS Among 810 children and 2062 adolescents, average sedentary bout duration was associated with greater total and trunk fat percentages only among male children, after adjusting for moderate-to-vigorous physical activity (MVPA) level by accelerometer. Prolonged sitting watching TV/videos was associated with higher total and trunk fat percentages in male children and all adolescents, independent of levels of MVPA (all P for trend

Objectives: Glucosamine and chondroitin supplements have been associated with reduced inflammation, as measured by C-reactive protein (CRP). It is unclear if associations vary by formulation (glucosamine alone vs. glucosamine+chondroitin), form (glucosamine hydrochloride vs. glucosamine sulfate), or dose. Design, Subjects, Setting, Location: The authors evaluated these questions using cross-sectional data collected between 1999 and 2010 on 21,917 US adults, surveyed as part of the National Health and Nutrition Examination Survey (NHANES). Exposures: Glucosamine and chondroitin use was assessed during an in-home interview; exposures include supplement formulation, form, and dose. Outcome/Analysis: CRP was measured using blood collected at interview. Survey-weighted linear regression was used to evaluate the multivariable-adjusted association between exposures and log-transformed CRP. Results: In early years (1999–2004), use of glucosamine (ratio = 0.87; 95% confidence interval [CI] = 0.79–0.96) and chondroitin (ratio = 0.83; 95% CI = 0.72–0.95) was associated with reduced CRP. However, associations significantly varied by calendar time (p-interaction = 0.04 and p-interaction = 0.01, respectively), with associations nonsignificant in later years (ratio = 1.09; 95% CI = 0.94–1.28 and ratio = 1.16; 95% CI = 0.99–1.35, respectively). Consequently, all analyses have been stratified by calendar time. Associations did not significantly differ by formulation in either set of years; however, significant associations were observed for combined use of glucosamine+chondroitin (ratio(early) = 0.82; 95% CI = 0.72–0.95; ratio(late) = 1.16; 1.00–1.35), but not glucosamine alone. Associations also did not significantly differ by supplement form. Even so, a significant inverse association was observed only for glucosamine sulfate in the early years (ratio = 0.78; 95% CI = 0.64–0.95); no significant association was observed for glucosamine hydrochloride. No significant trends were observed by dose. Conclusions: Although a significant inverse association was observed for glucosamine and chondroitin and CRP in early years, this association did not hold in later years. This pattern held for combined use of glucosamine+chondroitin as well as glucosamine sulfate, although associations did not significantly vary by supplement form, formulation, or dose. Further study is needed to better understand these associations in the context of calendar time.

Background Previous studies conducted in high altitude regions showed that maternal altitude was associated with low birth weight. The effect size of birth weight reduction is inclusive with unknown effects due to preterm birth. We systematically reviewed the literature and synthesize evidence on associations between altitude elevation from sea level and birth weight. Method We searched MEDLINE/PubMed, Embase, Scopus, Web of Science, and Cochrane database, from inception to May 5, 2020 for studies that reported maternal altitude and birth weight. Bayesian multilevel effect models were employed to estimate the effect size on birth weight (and gestational age) associated with altitude. Bayesian multilevel effect models were employed to estimate the effect size on birth weight (and gestational age) associated with altitude. Results The systematic search identified 1020 articles, with 52 articles meeting the inclusion criteria providing 207 estimates for the association of altitude and birth weight (n = 4,428,563), and with 22 articles providing 71 estimates for gestational age (n = 2,149,627). A reduction in mean birth weight of 96.98 g was associated with every 1000 m increase in altitude across 52 studies. A statistically significant but numerically minimal effect of maternal altitude elevation was observed on the gestational age (0.3 days), corresponding to a negligible estimation of 5 g lower birth weight. A relatively high heterogeneity of between-study association (I2>84.1%) and small study effect was found. Conclusion A clinically meaningful birth weight reduction was associated with maternal altitude elevation beginning from sea level. Future longitudinal studies are needed to elucidate the causal association and to understand the late effect of maternal altitude.

Introduction The study aimed to establish and internally validate a nomogram to predict successful smoking cessation in a Chinese outpatient population. Methods A total of 278 participants were included, and data were collected from March 2016 to December 2018. Predictors for successful smoking cessation were evaluated by 3-month sustained abstinence rates. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables for the model to predict successful smoking cessation, and multivariable logistic regression analysis was performed to establish a novel predictive model. The discriminatory ability, calibration, and clinical usefulness of the nomogram were determined by the concordance index (C-index), calibration plot, and decision curve analysis, respectively. Internal validation with bootstrapping was performed. Results The nomogram included living with a smoker or experiencing workplace smoking, number of outpatient department visits, reason for quitting tobacco, and varenicline use. The nomogram demonstrated valuable predictive performance, with a C-index of 0.816 and good calibration. A high C-index of 0.804 was reached with interval validation. Decision curve analysis revealed that the nomogram for predicting successful smoking cessation was clinically significant when intervention was conducted at a successful cessation of smoking possibility threshold of 19%. Conclusions This novel nomogram for successful smoking cessation can be conveniently used to predict successful cessation of smoking in outpatients.

Background: Liquid-based cytology (LBC) tests, including the liquid-based thin layer method, have demonstrated the highest potential for reducing false-negatives and improving sample quality. Method: This study aimed to evaluate the diagnostic role of LBC of bronchial brushing specimens in lung cancer. A total of 249 patients were analyzed in our study, involving 155 patients with combined bronchial brushing and bronchoalveolar lavage (BAL) and 94 patients with BAL alone. Results: The sensitivity in the combined bronchial brushing and BAL group was 61.4% in the diagnosis of lung cancer, which is much higher than with BAL alone. Rates of positive predictive values and negative predictive values in the combined group compared with the BALF alone group were 98.6% vs 100% and 47.6% vs 37.4%, respectively. Sensitivity in the BALF alone group was 12.5% in bronchoscopically invisible pulmonary lesions and as high as 52.1% in the combined group. Conclusion: The results from our study demonstrated that LBC of brushing samples could be used as an important complement of bronchoscopy and could have the potential to be widely applied.

Liver disease is associated with increased bleeding risk. The efficacy and safety of direct oral anticoagulants (DOACs) is a subject of contention in atrial fibrillation (AF) patients with liver disease. Electronic databases (PubMed, Embase, and Cochrane Library) were searched to retrieve studies on the efficacy and safety of DOACs versus warfarin in AF patients with liver disease from January 1980 to April 2020. A meta-analysis was conducted using a random-effects model. Six studies involving 41,859 patients were included. Compared with warfarin, DOACs demonstrated significant reduction in ischemic stroke (HR, 0.68; 95% CI (0.54–0.86)), major bleeding (0.74 (0.59–0.92)), and intracranial hemorrhage (ICH) (0.48 (0.40–0.58)), with no significant effect on gastrointestinal bleeding (P = 0.893) in AF patients with liver disease. Similar results were observed in regular-dose, reduced-dose, and active liver disease subgroups, albeit Asian patients had a slight reduction in major bleeding (P = 0.055). Furthermore, the pooled estimates of individual DOAC subgroups indicated that dabigatran and apixaban led to greater safety in major bleeding (P

Background: Patients with acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation benefit from higher positive end-expiratory pressure combined with conventional ventilation during the early extracorporeal membrane oxygenation period. The role of incremental positive end-expiratory pressure titration in patients with severe acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation remains unclear. This study aimed to determine the preferred method for setting positive end-expiratory pressure in patients with severe acute respiratory distress syndrome on veno-venous extracorporeal membrane oxygenation support. Methods: We retrospectively reviewed all subjects supported with veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome from 2009 to 2019 in the intensive care units in Tianjin Third Central Hospital. Subjects were divided into two groups according to the positive end-expiratory pressure titration method used: P-V curve (quasi-static pressure-volume curve-guided positive end-expiratory pressure setting) group or Crs (respiratory system compliance-guided positive end-expiratory pressure setting) group. Results: Forty-three subjects were included in the clinical outcome analysis: 20 in the P-V curve group and 23 in the Crs group. Initial positive end-expiratory pressure levels during veno-venous extracorporeal membrane oxygenation were similar in both groups. Incidence rates of barotrauma and hemodynamic events were significantly lower in the Crs group (all p 0.05). Conclusion: Respiratory system compliance-guided positive end-expiratory pressure setting may lead to more optimal clinical outcomes for patients with severe acute respiratory distress syndrome supported by veno-venous extracorporeal membrane oxygenation. Moreover, the operation is simple, safe, and convenient in clinical practice.

Background Sexual activity can be referred to as a health behavior and may also act as an indicator of health status. Aim To evaluate temporal trends in sexual activity and to examine associations of sexual activity with all-cause and cause-specific mortality risk. Methods We examined the trends and prevalence of sexual activity and association of sexual activity with all-cause and cause-specific mortality in a nationally representative sample using data from the US National Health and Nutrition Examination Survey from 2005 to 2016 and the National Health and Nutrition Examination Survey 2005-2014 Linked Mortality File (through December 31, 2015). Outcomes All-cause, cardiovascular disease, and cancer mortality. Results A total of 15,269 US adults (mean age, 39.1 years [standard error, 0.18 years]) were included in the trend analysis. In the 2015-2016 cycle, while 71.7% (95% CI, 67.7–75.7%) US adults aged 20-59 years engaged in sexual activity ≥ 12 times/year (monthly), only 36.1% (95% CI, 31.6–40.7%) of them engaged in sexual activity ≥ 52 times/year (weekly). Since the 2005–2006 cycle, the estimated prevalence of sexual activity, ≥52 times/year and ≥12 times/year, were both stable over time among overall and each age group (all P for trend >0.1). During a median follow-up of 5.7 years (range, 1–11 years) and 71,960 person-years of observation, among 12,598 participants with eligible information on mortality status, 228 deaths occurred, including 29 associated with cardiovascular disease and 62 associated with cancer. Overall, participants with higher sexual activity frequency were at a lower risk of all-cause death in a dose-response manner (P for trend = 0.020) during the follow-up period. In addition, the multivariable-adjusted hazard ratios for all-cause mortality, CVD mortality, cancer mortality, and other cause mortality among participants who had sex ≥52 times/year compared with those having sex 0–1 time/year were 0.51 (95% CI, 0.34 to 0.76), 0.79 (95% CI, 0.19 to 3.21), 0.31 (95% CI, 0.11 to 0.84), and 0.52 (95% CI, 0.28 to 0.96), respectively. Clinical Implications Sexual activity appears to be a health indicator of all-cause and cancer mortality in US middle-aged adults. Strengths & Limitations Clear strengths of the present study include the large representative sample of the noninstitutionalized US population as well as the identification of precise estimates in relation to sexual activity and mortality. However, because of the observational nature of the study design, causality could not be determined. Conclusions Sexual activity was found to be associated with a lower risk of mortality from all cause and cancer.

To deliver a systematic review of the literature synthesizing data on the association of occupational physical activity with lung cancer risk in observational studies. Systematic review with meta-analysis. A literature search was performed in the electronic databases of PubMed/Medline and Embase. We screened peer-reviewed articles from prospective cohort and case–control studies assessing the association of occupational physical activity with lung cancer risk. A sex-specific meta-analysis assessed the association of high (compared to low/sedentary) level occupational physical activity with lung cancer risk, estimating the relative risk (RR) and odds ratio (OR) with a 95% confidence interval (CI). The systematic search identified 2065 articles, among which, eight journal articles met the inclusion criteria. The meta-analysis adjusted for age, smoking status and/or intensity, with a pooled sample size of 532,282 participants (men: 219,410; women: 312,872). A random-effect model of four prospective and four case–control studies indicated that men who engage in high-level occupational physical activity had a 15% higher risk (OR 1.15, 95% CI 1.04–1.28) of lung cancer than those engaging in low/sedentary-level occupational physical activity. There was no association observed among women (OR = 1.01, 95% CI 0.77–1.34) based on three available studies (prospective cohort: n = 2; case–control: n = 1). Findings from the review suggest a higher risk of lung cancer among men reporting high-level occupational physical activity. Further prospective studies incorporating rigorous measures of domain-specific physical activity, detailed smoking status and intensity, and other occupational exposures are needed to elucidate this association. CRD42019137911.

Dense medium preparation is widely used in coal preparation, and the rheology of dense medium suspension is a key factor affecting the coal separation performance. The rheological properties of den...

To determine the association between fish intake and dietary polyunsaturated fatty acids (PUFA) and incidence of lung cancer. We systematically reviewed and meta-analyzed all available studies to quantify the associations of fish and PUFA consumption with risk of lung cancer. Relative risk (RR) with 95% confidence interval (CI) was calculated. 13 population-based prospective cohort studies involving 1,785,000 participants and two randomized control trials were included. Our study demonstrated that dietary PUFA significant reduced risk of lung cancer for men (RR 0.99, 95%CI 0.98 to 1.00) and the U.S. population (RR 0.99, 95%CI 0.98 to 1.00). Dose-response analysis indicated that a 5 g/day increment of dietary PUFA was associated with 5% lower risk of lung cancer (RR 0.95, 95%CI 0.91 to 0.99). In addition, PUFA supplementation is significant improved overall survival in patients with lung cancer (RR 1.98, 95%CI 1.09 to 3.59). Our study showed an inverse association between dietary PUFA and risk of lung cancer in males and among the U.S. population. Although smoking cessation is the single biggest factor associated with lung cancer risk reduction, this study adds to a growing body of evidence that diet may have a role in modestly reducing lung cancer risk.

BACKGROUND AND OBJECTIVES The objective of the current study is to evaluate the temporal trends in the prevalence of cigarette and electronic cigarette (e-cigarette) advertisement exposure by venue and sociodemographic correlates among US adolescents from 2012 to 2020. METHODS We conducted a serial cross-sectional analysis of nationally representative samples of middle and high school youth from the 2012–2020 National Youth Tobacco Survey. Advertisement exposure was defined as self-report of seeing advertisements “sometimes,” “most of the time,” and “always.” The prevalence of cigarette (and other tobacco products) and e-cigarette advertisement exposure, including overall and at specific venues (Internet, press, screen, and retail stores), was estimated by survey year. RESULTS A total of 139 795 adolescents aged 11 to 19 years old were included in the analysis. The prevalence of exposure to combustible cigarette marketing remained high across all years (any venue ranging from 77.0% [2018] to 91.1% [2014]). An increasing trend for cigarette advertisement exposure was observed from 2017 to 2020 after a drop in 2015 (β2012–2015 = 2.8, P for trend < .001; β2017–2020 = .7, P for trend = .03), driven by retail store–based and Internet-based exposure. A similar increasing pattern in the estimated prevalence of e-cigarette marketing was observed (β2014–2016 = 4.6, P for trend < .001; β2017–2020 = 5.1, P for trend < .001). CONCLUSIONS Given the high estimated prevalence of cigarette and e-cigarette marketing exposure among US adolescents, further regulation efforts for both off-line and online tobacco marketing are needed to mitigate adolescent exposure to content regarding these products, reducing susceptibility to uptake.

Semiconductor refrigeration utilizes Peltier effects to achieve cooling, and does not use any refrigerants. Due to its simple and compact structure, semiconductor refrigeration has become one of the most promising cooling technologies. However, as a semiconductor refrigeration system, the interactions among the main external factors that affect its performance are complicated. Based on experimental results and thermodynamic models, deeper insights are presented into semiconductor refrigeration in this study. Broader coupling between performance and main external parameters are analyzed, including the driving voltage of fans at both the hot and cold sides, and the working voltage of the semiconductor refrigeration chip. Optimal external parameters corresponding to a maximum COP and a maximum cooling capacity are obtained. For example, under the optimal working voltage of a semiconductor refrigeration chip with a fan driving voltage of 4 V at the hot side and 6 V at the cold side, Qc,max was increased by 60%, and was 326% higher than chips under 2 V and 10 V working voltages. Under the optimal fan driving voltage at the hot side with a 6 V fan driving voltage at the cold side and a 3 V working voltage of the chip, the maximum value of COP was respectively 140.3% and 104.3% larger than those with 0 V and 12 V fan driving voltages at the hot side. It is also found that the driving voltage of fans at the hot side has a greater influence on the optimal working voltage of a semiconductor refrigeration chip. This investigation could be applied in the optimization of the design and operational control of semiconductor refrigeration systems.

In the travel process of urban residents, travelers will take a series of activities such as imitation and exclusion by observing other people’s travel modes, which affects their following trips. This process can be seen as a repeated game between members of the travelers. Based on the analysis of this game and its evolution trend, a multi-dimensional game model of low-carbon travel for residents is established. The two dimensional game strategies include whether to accept the low-carbon concept and whether to choose low-carbon travel. Combined with evolutionary game theory, the low-carbon travel choices of residents in different cities are simulated, and the evolutionary stability strategies are obtained. Finally, the influences of the main parameters of the model on the evolution process and stability strategies are discussed. The results show that travelers would develop towards two trends. Cities with more developed public traffic system have a higher proportion of receiving low-carbon concept and choosing low-carbon travel. Cities with underdeveloped public transport system could increase this proportion by some measures such as encouraging residents to choose slow transport and increasing the propaganda of low-carbon travel, but the positive effects of the measures like propaganda have a limited impact on the proportion.

This paper studies the structural, electronic and optical properties of a new group IV-V two-dimensional (2D) material GeP under the influence of different strains by using the first-principles calculations. The strains discussed in this paper include both the uniaxial strain along the different lattice vector directions, as well as the biaxial strain. The results show that monolayer GeP is a 2D dynamically stable semiconductor with low structural symmetry. In terms of the electronic property, regardless of the compressive strain or tensile strain applied in any direction, the band-gap of the monolayer GeP exhibits a decreasing tendency, and it remains semiconductivity in the range of −10% compressive strain to 10% tensile strain. As for the optical property, it is anisotropic. When GeP is subjected to a strain, regardless of the directions, the optical property of monolayer GeP is significantly affected more by tensile strain than by compressive strain. When the monolayer GeP is subjected to a tensile strain, its optical absorption and reflectivity in the visible light region to some extent increase, while its transmittance reduces. When it is subjected to a compressive strain, the main change in optical properties such as absorption and reflectivity occurs in the deep ultraviolet region. In particular, the monolayer GeP is most susceptible to deformation by the strain in a direction, and only compressive strain in a direction will cause GeP to undergo a transition from an indirect band-gap semiconductor to a direct band-gap semiconductor, which results in the improvements of absorption efficiency and reflectivity efficiency in the low energy region. Our calculated results indicate that the electronic and optical properties of monolayer GeP can be efficiently and regularly regulated by strain. In the future, it can be a suitable 2D materials used in optically polarized devices, blue light-emitting diode devices, and strain-tunable photoelectric nanodevices .

By using first-principles calculations, we characterized the structural stability, electronic and optical properties of novel two-dimensional (2D) monolayer transition-metal dichalcogenide (TMDC) HfX2 (X = S, Se). In our study, the PBE method is mainly used to calculate the electronic and optical properties, and the HSE06 method is used to further modify the band gap and optical absorption edge. It is indicated that monolayer 1-T HfS2 and HfSe2 present a stable indirect band gap semiconductor when the strain is 0%. The band gap of all monolayer 1-T HfX2 decreases significantly and the optical absorption edge shows an obvious red-shift trend with an increasing in-layer biaxial compressive strain. When the compressive strain is greater than −8% in HfS2 and -6% in HfSe2 respectively, the band gap decreases to zero, and so the semiconductor-metal transition was produced. Conversely, the band gap increases insignificantly with the increasing in-layer biaxial tensile strain from 0% to +10% while the absorption edge reveals an inconspicuous blue-shift trend. The general rule for the change of the band gap and the absorption edge tuned by strain of monolayer HfX2 could be explained well according to the different changes of near-band-edge states. Moreover, with the vertical electric field (E-field) increases, there is the band gap decreases and the absorption edge red shifts in all monolayer HfX2 under different in-layer biaxial strains. Our study suggests that the strain and electric field (E-field) engineering are effective tunable approaches to alter the electronic and optical properties of monolayer HfX2. Namely, we suggest that the functions of TMD could be changed by setting up suitable strain and E-field on few-layer materials in the future.

Although alectinib is a well-tolerated and highly effective inhibitor of a second-generation anaplastic lymphoma kinase, special attention should be paid to the possibility of potentially severe and fatal adverse events such as interstitial pneumonia. We report a case of a patient with advanced non-small cell lung cancer treated with alectinib who developed immunohistochemically positive anaplastic lymphoma kinase (ALK(IHC +)) . However, due to the rapid emergence of drug-induced interstitial lung disease, alectinib treatment was halted. Once the interstitial lung disease had been successfully treated, we reluctantly chose crizotinib as a second-line treatment for ALK + NSCLC in this patient as he refused all other available treatments. Contrary to expectation, crizotinib performed well both in terms of its safety and efficacy. Our results suggest that crizotinib may provide a promising therapy option for patients with ALK + NSCLC accompanied by alectinib-induced interstitial lung disease. To our knowledge, this is a rare report of successful treatment of ALK + NSCLC with crizotinib after alectinib-induced interstitial lung disease.

BACKGROUND Cancer and its treatment damage the musculoskeletal system and induce neurotoxicity, affecting the key sensory inputs for maintaining balance. The present study describes the pattern of balance impairment and evaluated its association with mortality among US cancer survivors. METHODS Data on a nationally representative sample of cancer survivors from the US National Health and Nutrition Examination Survey from 1999 to 2015 was analyzed. Sensory-specific balance impairment was measured at baseline by the modified Romberg test of standing balance on firm and compliant support surfaces. The linked mortality data were updated through December 31, 2015. RESULTS Among 511 cancer survivors, 282 (48.3%) had a balance impairment, predominantly attributing to vestibular dysfunction (251; 89.0% of 282 and 44.5% of 511). A higher prevalence of balance impairment was observed among cancer survivors with advanced age, lower socioeconomic status or educational attainment, body mass index

This paper describes a novel framework for autonomous exploration in large and complex environments. We show that the framework is efficient as a result of its hierarchical structure, where at one level it maintains a sparse representation of the environment and at another level, a dense representation is used within a local planning horizon around the robot. The exploration path is computed at the two levels, coarsely at the global scale and finely around the robot. Such a framework produces detailed paths in the vicinity of the robot, while trades off data resolution far away from the robot for computational efficiency. In experiments, we evaluate our method with a real robot exploring large and complex indoor and outdoor environments. Results show that our method is twice as efficient in covering spaces while using less than one-fifth of processing in comparison to state-of-the-art methods.

In this paper, the AlGaN/GaN HEMTs with a partial GaN cap layer was successfully fabricated. The ohmic contact, and on-state output high temperature performance of AlGaN/GaN HEMTs with a partial GaN cap layer was tested at different temperatures. The measurement results have shown that the output saturation current gradually decreases with the increasing temperature. In the mean time, the degradation of the output saturation current of AlGaN/GaN HEMTs with a partial GaN cap layer is alleviated to some extent, compared with the conventional AlGaN/GaN HEMTs. This is due to the optimization of the electric field distribution and the corresponding optimization of the thermal field distribution through ISE TCAD simulation results.

ObjectiveLow-intensity transcranial ultrasound stimulation (TUS) is a non-invasive neuromodulation technique with high spatial resolution and feasible penetration depth. To date, the mechanisms of TUS modulated neural oscillations are not fully understood. This study designed a very low acoustic intensity (AI) TUS system that produces considerably reduced AI Ultrasound pulses (ISPTA < 0.5 W/cm2) when compared to previous methods used to measure regional neural oscillation patterns under different TUS parameters.MethodsWe recorded the local field potential (LFP) of five brain nuclei under TUS with three groups of simulating parameters. Spectrum estimation, time-frequency analysis (TFA), and relative power analysis methods have been applied to investigate neural oscillation patterns under different stimulation parameters.ResultsUnder PRF, 500 Hz and 1 kHz TUS, high-amplitude LFP activity with the auto-rhythmic pattern appeared in selected nuclei when ISPTA exceeded 12 mW/cm2. With TFA, high-frequency energy (slow gamma and high gamma) was significantly increased during the auto-rhythmic patterns. We observed an initial plateau in nuclei response when ISPTA reached 16.4 mW/cm2 for RPF 500 Hz and 20.8 mW/cm2 for RPF 1 kHz. The number of responding nuclei started decreasing while ISPTA continued increasing. Under 1.5 kHz TUS, no auto-rhythmic patterns have been observed, but slow frequency power was increased during TUS. TUS inhibited most of the frequency band and generated obvious slow waves (theta and delta band) when stimulated at RPF = 1.5 kHz, ISPTA = 8.8 mW/cm2.ConclusionThese results demonstrate that very low intensity Transcranial Ultrasound Stimulation (VLTUS) exerts significant neuromodulator effects under specific parameters in rat models and may be a valid tool to study neuronal physiology.

Background Chronic inflammation has been regarded as a risk factor for the onset and progression of human cancer, but the critical molecular mechanisms underlying this pathological process has yet to be elucidated. Methods In this study, we investigated whether interleukin (IL)-17-mediated inflammation was involved in cigarette smoke-induced genomic instability. Results Higher levels of both IL-17 and the DNA damage response (DDR) were found in the lung tissue of smokers than that of non-smokers. Similarly, elevated levels of IL-17 and the DDR were observed in mice after cigarette smoke exposure, and a positive correlation was observed between IL-17 expression and the DDR. In line with these observations, the DDR in the mouse lung was diminished in IL-17 KO when exposed to cigarette smoke. Besides, the treatment of human bronchial epithelium cells with IL-17 led to increased levels of the DDR and chromosome breakage. Conclusions These results suggest that cigarette smoke induces genomic instability at least partially through IL-17 mediated inflammation, implying that IL-17 could play an important role in the development of lung cancer.

An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) was conducted to evaluate the existing evidence of Tai Chi as a mind-body exercise for chronic illness management. MEDLINE/PubMed and Embase databases were searched from inception until March 31, 2019, for meta-analyses of at least two RCTs that investigated health outcomes associated with Tai Chi intervention. Evidence of significant outcomes (P value < 0.05) was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This review identified 45 meta-analyses of RCTs and calculated 142 summary estimates among adults living with 16 types of chronic illnesses. Statistically significant results (P value < 0.05) were identified for 81 of the 142 outcomes (57.0%), of which 45 estimates presenting 30 unique outcomes across 14 chronic illnesses were supported by high (n = 1) or moderate (n = 44) evidence. Moderate evidence suggests that Tai Chi intervention improved physical functions and disease-specific outcomes compared with nonactive controls and improved cardiorespiratory fitness compared with active controls among adults with diverse chronic illnesses. Between-study heterogeneity and publication bias were observed in some meta-analyses. © 2020 Elsevier Inc.

Objectives:\ud \ud The aim was to analyse the overall and sex-specific associations between cannabis use and physical activity and sedentary behaviour.\ud \ud Study design:\ud \ud Cross-sectional analyses from the National Health and Nutrition Examination Survey (NHANES).\ud \ud Methods:\ud \ud Data on cannabis use and leisure time physical activity and sedentary behaviour from NHANES cycles 2007–2008 to 2015–2016 were analysed. Multivariable regression models were carried out.\ud \ud Results:\ud \ud About 15,822 participants were analysed (mean age ± standard error = 37.5 ± 0.19 years, range 20–59 years). Significantly higher odds were found for being active and ever used cannabis in the overall sample (odds ratio [OR] = 1.2, 95% confidence interval [CI]: 1.1–1.4) and in males (OR = 1.3, 95% CI: 1.1 to 1.5) and females (OR = 1.2, 95% CI: 1.0–1.4), respectively. In respective of sedentary behaviour, ever used cannabis was associated with higher odds of TV viewing ≥2 h/day in the overall sample (OR = 1.2, 95% CI: 1.0–1.4). However, this association was observed in males only (OR = 1.3, 95% CI: 1.1–1.6). Ever used cannabis was associated with total sitting time (beta-coefficient = 0.3, 95%CI: 0.1–0.4), which was more evident in females (beta-coefficient = 0.4, 95% CI: 0.1–0.6).\ud \ud Conclusions:\ud \ud Cannabis consumption was associated with higher levels of physical activity and sitting time. When intervening to reduce cannabis consumption in the US populations, it may be appropriate to promote physical activity and ensure physical activity is maintained once cannabis consumption is stopped.

COVID-19 (Coronavirus disease-19) may present with neurological signs, but whether people already affected by neurological conditions are at a higher risk of contracting COVID-19 is still not known. We, therefore, aimed to investigate the association of previously diagnosed neurological conditions with COVID-19. 502,536 community-dwelling UK Biobank participants (54.4% male, mean age 56.6 ± 10.3 years) were included. Among these, 57,463 participants had a diagnosis of neurological conditions (11.43%) and a total of 1326 COVID-19-positive cases were identified (0.26%). Neurological conditions were identified through medical history and linkage to data on hospital admissions (ICD-10 code G00–G99). COVID-19 presence was diagnosed using the data provided by Public Health England. The association of previous diagnosis of neurological conditions with COVID-19 was evaluated through logistic regressions, adjusted for potential confounders, reported as odds ratios (ORs) with their 95% confidence intervals (CIs). Nerve, nerve root and plexus disorders (G50–G59) were the most common conditions identified. The presence of COVID-19 was almost doubled in neurological conditions compared to the general population (0.45 vs. 0.24%, p

Histones are considered potential risk factors that contribute to the development of septic acute kidney injury (SAKI) by inducing apoptosis and inflammation. This study aimed to explore the protective effects of heparin on septic acute kidney injury through the neutralization of extracellular histones (EH) and to uncover the underlying mechanism. C57BL mice (16 each) were randomly divided into the sham group, the sepsis group (established by cecal ligation and puncture operation, CLP), and the heparin intervention group. Mice in the heparin intervention group received a subcutaneous injection of unfractionated heparin (0.03 IU/g) 4 h after CLP. At 6 h after the operation, nine mice from each group were sacrificed by the removal of the eyeballs to harvest blood samples; the upper half of the right kidney was used as the study sample. Mice renal tubular epithelial cells cultivated in six-well plates were equally divided into five groups. We cultured cells treated with either histone (40 U), histone (40 U) + heparin (25 IU/ml), histone(40U) + lipopolysaccharides (LPS; 10 μg/ml), or histone (40 U) + LPS (10 μg/ml) + heparin (25 IU/ml) for 6 h. For the histone + heparin group and the histone + LPS + heparin group, histone (and LPS) were treated with heparin simultaneously. Mice in the heparin intervention group showed decreased levels of EH4, neutrophil gelatinase-associated lipocalin (NAGL), kidney injury molecule-1 (KIM-1), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6 in the blood serum, longer average 72-h survival rate, significantly decreased kidney tissue edema, and a clearer glomerular structure coupled with decreased protein and mRNA expression levels of kidney apoptosis-related proteins (cleaved Caspase-3/Caspase-3 and Bax/Bcl-2) compared with those in the sepsis group at 6 h after CLP (P < 0.05). Meanwhile, cells in the heparin intervention group exhibited lower expression levels of serum EH4 and inflammatory cytokines, a lower apoptosis rate, and decreased expression of apoptosis-related proteins, both at protein and mRNA levels, than those in the histone-stimulated group at 6 h after stimulation (P < 0.05). Heparin may alleviate apoptosis and inflammation through the neutralization of histones, thus playing a protective role against septic acute kidney injury.

Introduction: Peak oxygen uptake (VO 2peak ), as determined by cardiopulmonary exercise testing (CPET), is informative of cardiovascular fitness and heart failure (HF) disease progression. Due to their clinical meaningfulness, many patients with HF undergo multiple CPETs throughout their lifetimes. However, a gap in knowledge exists regarding the prognostic value of longitudinal changes in VO 2peak for mortality risk. The aim of this study was to investigate whether VO 2peak trajectories are predictive of mortality among patients with HF. Methods: Patients with HF who completed two CPETs (separated by at least 3 months, mean = 25.3 months) at Washington University School of Medicine between May 1993 and February 2020 were included in the study. Vital statuses and mortality dates were collected from May 2019 to May 2020 via electronic health records and the Social Security Death Index. Kaplan-Meier and Cox proportional hazards regression analyses were used to evaluate associations between changes in VO 2peak and mortality. Results: The sample included 162 patients with a mean age of 48.5 years (SD 10.5) at baseline. VO 2peak averaged 18.1 (SD 4.9) ml·kg -1 ·min -1 in 121 men and 15.1 (SD 4.1) ml·kg -1 ·min -1 in 41 women. During a median follow-up of 11.8 years (range 1-23 years), 70 patients died. A significant negative association between VO 2peak and mortality was observed (hazard ratio [HR] = 0.92; 95% Confidence Interval [CI] = 0.87 to 0.98; P = 0.011). Patients whose VO 2peak increased from their baseline to second CPET had higher survival rates compared to patients whose VO 2peak decreased. Moreover, the annual rate of change in VO 2peak was associated with mortality rates. A 9% lower mortality rate was observed for each unit increase in VO 2peak change (i.e., 1 ml·kg -1 ·min -1 ) for the entire follow-up period (HR = 0.91; 95% CI = 0.85 to 0.97) and at 10-year follow-up (HR = 0.91; 95% CI = 0.85 to 0.98), while a 12% lower mortality rate was observed at 5-year follow-up (HR = 0.88, 95% CI = 0.78 to 1.00) relative to baseline CPETs. Conclusion: Increases in VO 2peak were associated with increased survival rate among patients with HF. These findings highlight the importance of promoting exercise and cardiac rehabilitation for patients with HF.

Introduction: Cardiopulmonary exercise testing provides information about functional capacity via direct measurement of respiratory gas exchange. Whether peak oxygen consumption during exercise (VO 2peak ) is predictive of outcomes in patients with congenital heart disease is controversial. Hypothesis: VO 2peak has prognostic implications for death, left ventricular assist device (LVAD) placement, and cardiac transplant in adult patients with congenital cardiac diseases. Methods: Congenital heart disease patients were selected from a registry of cardiac patients who completed a VO 2peak exercise test at Washington University School of Medicine between May 1993 and October 2012. Diagnoses were verified by chart review and classified according to American Heart Association guidelines. Outcome data were verified via medical record, Social Security Death Index, or phone interview. A Cox proportional-hazard regression analysis was used to investigate the association between patient survival time and one or more predictor variables. Survival time was defined as the time elapsed between VO 2peak test and the earliest outcome of death, heart transplant, or LVAD placement. Results: The sample included 149 patients (49% women, mean ± SD age of 33.4 ± 11.5 years and body mass index of 25.7 ± 5.4 kg/m 2 ). Mean follow-up time was 11.8 ± 3.2 years. Mean VO 2peak was 23.0 ± 7.3 mL/kg/min for men and 20.0 ± 6.4 mL/kg/min for women. Age was comparable between men and women in the sample. In the univariate analysis, higher VO 2peak was associated with longer event-free survival time (HR 0.91, 95% CI 0.85-0.98, p= 0.01). In the multivariable analysis, higher VO 2peak was shown to be protective, independent of age and sex (HR 0.90, 95% CI 0.83-0.97, p=0.004). Conclusions: Among patients with congenital cardiac disease, higher VO 2peak independently predicted longer event-free survival. VO 2peak is a valuable clinical prognostic tool for patients with congenital cardiac disease.

Pulmonary lymphatic epithelioma-like carcinoma (LELC) is a rare and unique subtype, accounting for 0.9% of all lung cancers. To date, just over 200 cases have been reported worldwide. The Epstein–Barr virus plays a role in the pathogenesis of LELC. Most patients are from East Asia, especially southeastern China. Chest computed tomography mainly shows a single lump or nodule around the lung. In this article, we report a 49-year-old male patient from a non-epidemic area who was hospitalized for “intermittent blood in his phlegm for more than 4 months”. Imaging revealed two nodules in the left lower lobe of his lung. Transbronchial lung biopsy was performed on one of the nodules, and he was diagnosed with primary LELC. Single-photon emission computed tomography revealed that he had hypertrophic pulmonary osteoarthropathy, which is a rare symptom of paraneoplastic syndrome. Because the preoperative evaluation considered early-stage disease, video-assisted thoracoscopic surgery for the left lower lobe and mediastinal lymph node dissection were performed. Both lesions were eventually diagnosed as LELC. Fortunately, lymph node metastasis did not occur, and he did not receive other postoperative treatments. He was followed up for 1 year, and no recurrence was found.

Without a cure, dementia affects about 50 million people worldwide. Understanding the effects of dietary habits, a key lifestyle behavior, on memory impairment is critical to inform early behavioral modification to delay further memory loss and progression to dementia. We examined the associations of total energy intake and energy intake from macronutrients with memory impairment among older US adults using data from the nationally representative National Health and Nutrition Examination Survey study 2011&ndash, 2014. A total of 3623 participants aged &ge, 60 years were analyzed. Comparing to those with low total energy intake, individuals with high intake were more likely to have severe memory impairment (OR: 1.52, 95% CI: 1.15 to 2.02, ptrend = 0.005). Specifically, higher energy intake from carbohydrate (OR: 1.59, 95% CI: 1.12 to 2.26) and sugar (OR: 1.54, 95% CI: 1.11 to 2.16) were both significantly associated with the presence of memory impairment. Additionally, higher energy intake from fat, carbohydrate and sugar were significantly associated with more server memory impairment (fat: ptrend = 0.04, carbohydrate: ptrend = 0.03, sugar: ptrend = 0.02). High energy intake, either total or from carbohydrates, fat or sugar, is associated with memory impairment severity in the older US population. No such association was found in energy intake from protein.

Carbon and nitrogen contents and their isotopic components and AMS radiocarbon dating ages were measured for 57 coastal sediments from Weizhou Island to analyze the distribution of total inorganic carbon (TIC) and its carbon and oxygen isotopic components (δ13Ccarb and δ18Ocarb), total organic carbon (TOC) and total nitrogen (TN) contents and their stable isotopic components (δ13CTOC and δ15NTN) and environmental significance. The results showed that the oldest age of coastal sediments on Weizhou Island was 2750 cal. a BP, and the average TIC contents of A1, A2, B1, C1, and D1 in the intertidal zone were all greater than 5%, where δ13Ccarb and δ18Ocarb were enriched, while the TIC contents in A3, C2, and D2 of the supra-tidal zone were low, where δ13Ccarb and δ18Ocarb were depleted. Moreover, TIC decreased sharply from the estuary to upstream region in the C1-C2 section. The average C/N ratio was 7.02, and δ13CTOC and δ15NTN were between -14.96‰~-27.26‰ and -14.38‰~4.12‰, respectively. These measurements indicated that the TIC in coastal sediments mainly came from seawater. A1, A2, and B1 in the northern intertidal zone exhibited organic terrestrial signals because of C3 and C4 plant inputs, which proved that the important source of the northern coast of Weizhou Island came from the island. The lacustrine facies deposits were mainly distributed in the upper reaches of the river, the northern coastline was rapidly advancing toward the sea, and part of the southwestern coastal sediments rapidly accumulated to the shore under the influence of a storm surge. The relative sea level of the Weizhou Island area has continuously declined at a rate of approximately 2.07 mm/a, using beach rock as a marker, since the Holocene.

Background: Studies have shown an inverse association between use of glucosamine and chondroitin supplements and colorectal cancer risk. However, the association with the precursor lesion, colorectal adenoma and serrated polyp, has not been examined. Methods: Analyses include 43,163 persons from the Nurses' Health Study (NHS), Health Professionals Follow-up Study (HPFS), and NHS2 who reported on glucosamine/chondroitin use in 2002 and who subsequently underwent ≥1 lower gastrointestinal endoscopy. By 2012, 5,715 conventional (2,016 high-risk) adenomas were detected, as were 4,954 serrated polyps. Multivariable logistic regression for clustered data was used to calculate OR and 95% confidence intervals (CI). Results: Glucosamine/chondroitin use was inversely associated with high risk and any conventional adenoma in NHS and HPFS: in the pooled multivariable-adjusted model, glucosamine + chondroitin use at baseline was associated with a 26% (OR = 0.74; 95% CI, 0.60–0.90; Pheterogeneity = 0.23) and a 10% (OR = 0.90; 95% CI, 0.81–0.99; Pheterogeneity = 0.36) lower risk of high-risk adenoma and overall conventional adenoma, respectively. However, no association was observed in NHS2, a study of younger women (high-risk adenoma: OR = 1.09; 95% CI, 0.82–1.45; overall conventional adenoma: OR = 1.00; 95% CI, 0.86–1.17), and effect estimates pooled across all three studies were not significant (high-risk: OR = 0.83; 95% CI, 0.63–1.10; Pheterogeneity = 0.03; overall conventional adenoma: OR = 0.93; 95% CI, 0.85–1.02; Pheterogeneity = 0.31). No associations were observed for serrated polyps. Conclusions: Glucosamine/chondroitin use was associated with lower risks of high-risk and overall conventional adenoma in older adults; however, this association did not hold in younger women, or for serrated polyps. Impact: Our study suggests that glucosamine and chondroitin may act on early colorectal carcinogenesis in older adults.

There are complex nonlinear behaviors and mechanisms in the bolted joint interface. Thus, the bolted joint is crucial to the complex nonlinear dynamic response of the structure. However, in the traditional structural dynamic analysis, the screw connection is usually neglected, which makes it challenging to analyze and study the nonlinear dynamic behavior of bolted structures. Hence, based on the Timoshenko beam theory and finite element method, this paper introduces a model considering thread connection to analyze the dynamic response under different excitation. Eventually, the results indicate that owing to the local nonlinearity of bolts, the whole bolted cantilever beam shows hardening-type characteristics. In addition, the frequency response curve also depicts the typical nonlinear phenomenon of instability and uncertainty, namely bifurcation, which preliminarily verifies the correctness and accuracy of the bolted cantilever beam model.

International audience; With the rapid development of point cloud acquisition technologies, high-quality human-shape point clouds are more and more used in VR/AR applications and in general in 3D Graphics. To achieve near-realistic quality, such content usually contains an extremely high number of points (over 0.5 million points per 3D object per frame) and associated attributes (such as color). For this reason, disposing of efficient, dedicated 3D Point Cloud Compression (3DPCC) methods becomes mandatory. This requirement is even stronger in the case of dynamic content, where the coordinates and attributes of the 3D points are evolving over time. In this paper, we propose a novel skeleton-based 3DPCC approach, dedicated to the specific case of dynamic point clouds representing humanoid avatars. The method relies on a multi-view 2D human pose estimation of 3D dynamic point clouds. By using the DensePose neural network, we first extract the body parts from projected 2D images. The obtained 2D segmentation information is back-projected and aggregated into the 3D space. This procedure makes it possible to partition the 3D point cloud into a set of 3D body parts. For each part, a 3D affine transform is estimated between every two consecutive frames and used for 3D motion compensation. The proposed approach has been integrated into the Video-based Point Cloud Compression (V-PCC) test model of MPEG. Experimental results show that the proposed method, in the particular case of body motion with small amplitudes, outperforms the V-PCC test mode in the lossy inter-coding condition by up to 83% in terms of bitrate reduction in low bit rate conditions. Meanwhile, the proposed framework holds the potential of supporting various features such as regions of interests and level of details.

SummaryBackgroundStarting from early December 2019, cases of human infection with a novel coronavirus were identified in Wuhan, Hubei Province, China. It spreads rapidly to other cities and numerous countries. This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases.MethodsIn this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included from Ningbo First Hospital and Jingzhou Central Hospital. Demographic data, symptoms, laboratory values, comorbidities, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Logistic regression analysis was performed to assess risk factors in predicting the patients with SARS-CoV-2 pneumonia who would convert to severe cases.Findings120 patients (36 from Ningbo First Hospital and 84 from Jingzhou Central Hospital) were included in this study, among which 62 were excluded and 58 were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×109/L reduced; p=0.007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275).InterpretationThe low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. This finding may help clinicians more accurately predict prognosis, and triage priorities to improve clinical outcomes.Research in contextEvidence before this studySevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) is a novel coronavirus that have emerged in early December 2019, and has caused a novel coronavirus disease (COVID-19). It has been deemed as a public health emergency of global concern by The World Health Organization (WHO). We searched PubMed for articles published up to March 11, 2020, using the search terms (“novel coronavirus” OR “SARS-CoV-2” OR “COVID-19”) with no language or time restrictions. Previous work has described clinical characteristics of critically ill and non-critically ill patients with COVID-19. However, no published works have focused on clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases.Added value of this studyIn this retrospective and multicenter cohort study, we reported demographics characteristics, baseline symptoms, laboratory findings, corticosteroid usage and hospital course of patients with non-severe COVID-19 and severe COVID-19. Comparing with non-severe patients, severe patients with COVID-19 was found to have a longer: time to clinical recovery (12.9±4.4 vs 8.3±4.7; p=0.0011), duration of viral shedding (15.7±6.7 vs 11.8±5.0; p=0.0183), and hospital stay (20.7±1.2 vs 14.4±4.3; p=0.0211). By multivariate logistic regression, we found increasing odds of converting to severe cases associated with lower lymphocyte count (odds ratio 1.28, 95%CI 1.06–1.54, per 0.1×109/L reduced; p=0.007). Using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0.14, 95%CI 0.02–0.80; p=0.0275).Implications of all the available evidenceLow lymphocyte count in peripheral blood was an independent risk factor for patients who converted to severe cases. In addition, using of systematic corticosteroids in mild to moderate patients with SARS-CoV-2 pneumonia was associated with a reduced risk of converting to severe cases. These findings may help clinicians predict prognosis more accurately, and triage priorities to improve clinical outcomes. Further prospective studies are warranted to confirm these findings.

Myocardial cell injury or cardiomyopathy is associated with excessive inflammatory response and apoptosis of cardiac myocytes during sepsis. MicroRNA-23b (miR-23b) is a multifunctional miRNA that is considered to regulate immunosuppression in sepsis. The aim of this study was to examine the effect of miR-23b on cardiomyopathy induced by sepsis and to explore the potential mechanism involved. Sprague-Dawley rats were subjected to cecal ligation and puncture (CLP), and the level of miR-23b at different time points was measured by quantitative real-time polymerase chain reaction (qPCR). Then, we overexpressed miR-23b in vivo and in vitro. The rats were subjected to CLP 7 days after transfection. Cardiac function, inflammatory response, and heart tissues were examined 3 days thereafter. In an in vitro experiment, H9C2 cardiomyoblasts were stimulated with lipopolysaccharide (LPS) after transfection of miR-23b, following which apoptosis and the level of NF-κB were analyzed. The expression of miR-23b was upregulated during polymicrobial sepsis, and transfection of miR-23b lentivirus improved the outcome of sepsis-induced cardiomyopathy by attenuating inflammatory responses and protecting against histopathological damage. In in vitro experiments, elevated miR-23b inhibited excessive apoptosis of cardiomyocytes, which may be because activation of the NF-κB signaling pathway was inhibited by the decreased levels of TRAF6 and IKKβ. Therefore, miR-23b improved sepsis-induced cardiomyopathy by attenuating the inflammatory response, suppressing apoptosis, and preventing NF-κB activation via targeted inhibition of TRAF6 and IκκB. These results indicated that miR-23b may represent a novel therapeutic approach for clinical treatment of sepsis-induced cardiomyopathy.

Purpose: Increased nocturia episodes can be a clinical marker of poor health status. The present study aimed to evaluate patterns and temporal trends in nocturia and sociodemographic and lifestyle correlates in the US population. Methods: Participants, aged 20years or older, were included in this repeated cross-sectional study. The National Health and Nutrition Examination Survey from 2005 to 2016 was used. Participants were asked “During the past 30days, how many times per night did you most typically get up to urinate, from the time you went to bed at night until the time you got up in the morning?”. Individuals were categorized as either ≥ 1 nocturia episode or ≥ 2 nocturia episodes per night. Results: The estimated prevalence of ≥ 1 nocturia was high among men (20–39years, 56.8%; 40–59years, 70.2%; ≥ 60years, 82.7%) and women (20–39years, 68.9%; 40–59years, 74.3%; ≥ 60years, 84.7%), particularly in Non-Hispanic-blacks. From 2005–2016, the trends in prevalence of ≥ 1 nocturia increased for the age groups 20–39 and 40–59years among men (p < 0.001 and p = 0.001, respectively) and women 20–39 and 40–59years (p < 0.001 and p = 0.032, respectively), but a stable trend was observed among men and women who were 60years and older (p = 0.814, and p = 0.64, respectively). A significant increasing trend of ≥ 2 nocturia episodes was observed among men only aged 40–59years (p = 0.007). Conclusions: From 2005 through 2016, the secular trend in the frequency of nocturia increased in both men and women in general, which was significant under the age of 60years, particularly in Non-Hispanic-blacks. © 2019, Springer Nature B.V.

Purpose: To update the prevalence of depression in the US and identify whether misperception exists in depression assessed by self-report versus validated tools administered by trained professionals.\ud \ud Methods: We extracted data on sociodemographic characteristics, lifestyle factors, medical conditions, self-reported depression, and depressive symptoms from National Health and Nutrition Examination Survey (NHANES) study 2015-2018. We calculated the weighted prevalence and 95% CI of self-reported depression and depressive symptoms assessed by a validated tool PHQ-9 (score≥10) respectively. Then, we performed multivariable logistic regressions to identify the sociodemographic and lifestyle correlates. Finally, we calculated the agreement between depressive symptoms and self-reported depressive feeling to examine possible misperception.\ud Results: The present analysis included a total of 10,257 adults (Weighted N= 215,964,374) aged 20 years and older. Prevalence of depressive symptoms (PHQ-9 score ≥10) were 8.0 % from 2015 to 2018 in the US. 19.7 % and 11.3 % adults reported feeling depressed at least once a month and at least once a week, respectively. Depressive experience was largely misperceived in the US (Kappa agreement=50.98%, Cohen’s Kappa=0.16, p

Histone deacetylase (HDAC)2 is expressed in airway epithelium and plays a pivotal role in inflammatory cells. However, the role of HDAC2 in allergic airway inflammation remains poorly understood. In the present study, we determined the role of HDAC2 in airway inflammation using in vivo models of house dust mite (HDM)-induced allergic inflammation and in vitro cultures of human bronchial epithelial (HBE) cells exposed to HDM, IL-17A, or both. We observed that HDM-challenged Hdac2+/− mice exhibited substantially enhanced infiltration of inflammatory cells. Higher levels of T helper 2 cytokines and IL-17A expression were found in lung tissues of HDM-challenged Hdac2+/− mice. Interestingly, IL-17A deletion or anti-IL-17A treatment reversed the enhanced airway inflammation induced by HDAC2 impairment. In vitro, HDM and IL-17A synergistically decreased HDAC2 expression in HBE cells. HDAC2 gene silencing further enhanced HDM- and/or IL-17A-induced inflammatory cytokines in HBE cells. HDAC2 overexpresion or blocking IL-17A gene expression restored the enhanced inflammatory cytokines. Collectively, these results support a protective role of HDAC2 in HDM-induced airway inflammation by suppressing IL-17A production and might suggest that activation of HDAC2 and/or inhibition of IL-17A production could prevent the development of allergic airway inflammation.

The optical properties, structural properties and electronic properties of a new two-dimensional (2D) monolayer C3N under different strains are studied in this paper by using first-principles calculations. The applied strain includes in-layer biaxial strain and uniaxial strain. The monolayer C3N is composed of a number of hexagonal C rings with N atoms connecting them. It is a stable indirect band gap 2D semiconductor when the strain is 0%. It could maintain indirect semiconductive character under different biaxial and uniaxial strains from e = −10% to e = 10%. As for its optical properties, when the uniaxial strain is applied, the absorption and reflectivity along the armchair and zigzag directions exhibit an anisotropic property. However, an isotropic property is presented when the biaxial strain is applied. Most importantly, both uniaxial tensile strain and biaxial tensile strain could cause the high absorption coefficient of monolayer C3N to be in the deep ultraviolet region. This study implies that strain engineering is an effective approach to alter the electronic and optical properties of monolayer C3N. We suggest that monolayer C3N could be suitable for applications in optoelectronics and nanoelectronics.

Teeter Bed Separators (TBS) are liquid–solid fluidized beds that are widely used in separation of coarse particles in coal mining industry. The coal particles settle in the self-generating medium bed resulting in separation according to density. Due to the existence of self-generating medium beds, it is difficult to study the sedimentation of particles in TBS through experiments and detection methods. In the present research, a model was built to investigate the bed expansion characteristics with water velocity based on the Euler–Euler approach, and to investigate the settling of foreign particles through bed based on the Euler–Lagrange approach in TBS. Results show that the separation of in TBS should be carried out at low water velocity under the condition of stable fluidized bed. Large particles have a high slip velocity, and they are easily flowing through the bed into the light product leading to a mismatch. The importance of self-generating bed on separation of particle with narrow size ranges are clarified. The model provides a way for investigating the separation of particles in a liquid–solid fluidized bed and provides suggestions for the selection of operation conditions in TBS application.

Although airway fibrosis and epithelial-mesenchymal transition (EMT) contribute to airway remodeling in chronic obstructive pulmonary disease (COPD), the mechanisms underlying their development have not been fully elucidated. In the present study, we aimed to assess heparin-binding epidermal growth factor (HB-EGF) expression in the airways of patients with COPD and to elucidate the possible role of HB-EGF in the pathology of COPD. Sputum and lung tissue HB-EGF expression was evaluated in control subjects and patients with COPD. The relationships between HB-EGF expression, disease severity, collagen deposition (fibrosis), and EMT were investigated. In vitro, human bronchial epithelial (HBE) cells and lung fibroblast cells exposed to the recombinant HB-EGF, collagen deposition and EMT were assessed. We found that sputum HB-EGF expression was significantly increased in patients with COPD compared with non-smokers and smokers without COPD. There was a significant positive correlation between sputum HB-EGF and COPD assessment test (CAT) score. HB-EGF expression was significantly increased in the lung tissue samples of patients with COPD and associated with collagen deposition and N- and E-cadherin, and vimentin expression. In vitro, HB-EGF promoted collagen production in lung fibroblasts. Moreover, HB-EGF induced the EMT process through induction of N-and E-cadherin, and vimentin expression in HBE cells. Collectively, HB-EGF induces airway remodeling by modulating airway fibrosis and pulmonary EMT, and contributes to the COPD severity. The current data may provide insight into the underlying pathogenesis of COPD, in which HB-EGF has an important pathogenic role.

Background Fractional exhaled nitric oxide (FENO) is a useful and noninvasive biomarker for eosinophilic airway inflammation, particularly in asthma. However, its utility in chronic obstructive pulmonary disease (COPD) remains controversial. In this study, we performed a systematic review and meta-analysis to evaluate FENO levels in COPD. Methods A search of PubMed, Embase, Cochrane Library, and clinical trial registry was conducted from inception to January 2018. Studies were included if they reported FENO levels in patients with COPD and healthy controls. We then extracted relevant information and analyzed data. Standard mean difference (SMD) with 95% confidence interval (CI) was applied in this meta-analysis. Results A total of 2,073 studies were reviewed for eligibility, with 24 studies pooled for analysis. The FENO levels in patients with COPD were elevated mildly compared with healthy controls (SMD 1.28, 95% CI 0.60-1.96). A similar result was also observed in stable COPD, with an SMD of 1.21 (95% CI 0.47-1.96). On the other hand, we found no association between FENO levels and exacerbated COPD. Additionally, for patients with COPD, ex-smokers had higher levels of FENO than current smokers (SMD 2.05, 95% CI 1.13-2.97). Conclusion Our studies demonstrated a mild elevation of FENO in COPD, and the association between exacerbated COPD and FENO levels needs to be further explored. The potential mechanism is still unknown and conflicting.