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In view of most current studies on text sentiment classification focus on the deep learning model to obtain the sentimental characteristics of English text. Chinese text sentiment analysis is rarely involved, and only the context information of the statement is considered, but the syntax information of the statement is rarely considered. In this paper, a novel sentiment classification model is proposed (Dependency Tree Graph Convolutional Network, DTGCN) combined Chinese syntactically dependent tree with graph convolution. Firstly, the Bi-GRU (Bi-directional Gated Recurrent Unit) model is used to learn the contextual feature representation of a given text. Secondly, the syntax-dependent tree structure of a given text is constructed, then obtain its adjacency matrix according to the syntax-dependent tree, with the initial features extracted from the bidirectional gate control network, input into the graph convolutional neural network (GCN) to extract the sentimental features of the text; the obtained sentimental characteristics are then input into the classifier SoftMax for text sentimental polarity classification. Finally, the data set is compared with the mainstream neural network model. The experimental results show that the accuracy of the proposed DTGCN model proposed on the data set is 90.51% and the recall rate is 90.34%. Compared with the benchmark models (LSTM, CNN, TextCNN and Bi-GRU), the proposed DTGCN model shows a 4.45% advantage in accuracy. It shows that the proposed DTGCN model can effectively use the grammatical information of Chinese text to mine the hidden relationship in statements, it can improve the accuracy of Chinese text sentiment classification. In addition, the proposed DTGCN model not only improves the performance of sentiment classification in the essay, it also provides a new research method for social network public opinion identification.

OBJECTIVE To determine the effects of changes in serum luteinizing hormone (LH) levels in the early stages of the gonadotropin-releasing hormone antagonist (GnRH-A) protocol on in vitro fertilization and embryo transfer/intracytoplasmic sperm injection clinical outcomes. METHODS Data from 2116 fresh embryo transfer cycles with the GnRH-A protocol were retrospectively analyzed. Patients were divided into two groups, ΔLH-increased and ΔLH-decreased, according to changes in serum LH levels on the day of GnRH-A addition compared with that on the start day of ovarian stimulation. Patients in whom ΔLH increased were categorized according to early-onset LH increases (serum LH level ≥10 mIU/mL or twice the baseline). RESULTS ΔLH increased and decreased in 14.9% and 85.1% of patients, respectively. The fertilization rate was lower, and fewer oocytes were retrieved in patients with increased ΔLH compared to those with decreased ΔLH (p .05). CONCLUSIONS Early increases in LH levels during GnRH-A protocol might affect the number of oocytes retrieved, but not the clinical outcomes.

Background This study aimed to explore the prognostic value of tumor mutational burden (TMB) combined with smoking status in advanced non‐small cell lung cancer (NSCLC) patients who received immune checkpoint inhibitor therapy (anti PD‐1/PD‐L1 therapy) combined with chemotherapy or anti‐angiogenesis therapy. Methods We conducted a retrospective analysis of NSCLC patients who underwent next‐generation sequencing test (either 295‐gene panel NGS or 1021‐gene panel NGS) from September 2017 to November 2020. The relationship between TMB and smoking status was investigated. Kaplan–Meier survival analysis was used to compare progression‐free survival (PFS) of the NSCLC patients who received combination immunotherapy grouped by TMB value and smoking status. Results We enrolled 323 cases and 388 cases of NSCLC patients in the 295‐gene panel cohort and 1021‐gene panel cohort, respectively. Positive correlation between TMB and smoking status was found in lung adenocarcinoma, but not in lung squamous cell carcinoma. Participants with both high TMB and smoking status who received immune checkpoint therapy combined with chemotherapy or anti‐angiogenesis therapy had longer PFS than other participants (p, The tumor mutational burden (TMB) value correlated with smoking status in lung adenocarcinoma patients, but not in lung squamous cell carcinoma patients in both NGS panels. The TMB value combined with smoking status might be used as a potential prognostic indicator for advanced non‐small cell lung cancer patients receiving immune checkpoint inhibitor combination therapy.

Objective: To analyze and evaluate the clinical efficacy of different treatment options for patients with peri-implant infection. Methods: The study period was from June 2019 to June 2020. Seventy-six patients with peri-implant infection that were treated in Stomatological Hospital of Hefei were selected as study samples. The patients were divided into a research group and a control group by random number table method in which the sample size of each group was n=38. Patients in the control group were treated with drugs combined with ultrasonic cleaning while patients in the research group were treated with guided bone regeneration combined with flap curettage. The indicators of the two groups were compared and analyzed. Results: The plaque index (PLI), probing depth (PD), and sulcus bleeding index (SBI) of the two groups after treatment were lower than those before treatment (P < 0.05). There was no significant difference between the groups (P > 0.05). However, the height of the implant marginal bone of the study group after treatment was higher than that of the control group (P < 0.05). Conclusion: The use of guided bone regeneration combined with flap curettage for patients with infection around dental implants promotes the fusion of bone and implants. The clinical effect was significant and this should be comprehensively promoted in medical institutions at all levels.

BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyro-phosphate dihydrate crystals, but it is invasive. Pseudogout of the temporo-mandibular joint (TMJ) is uncommon, and it rarely invades the skull base or penetrates into the middle cranial fossa. The disease has no characteristic clinical manifestations and is easily misdiagnosed. CASE SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa. A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region. Another patient, a 52-year-old man with a mass in the left TMJ for 6 years, was admitted to the hospital. Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area. Both patients underwent excision of the lesion. The lesion was pathologically diagnosed as tophaceous pseudogout. The symptoms in these patients were relieved after surgery. CONCLUSION Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction. A pathological examination is the gold standard for diagnosing this disease. Surgical treatment is currently the recommended treatment, and the prognosis is good after surgery.

Nocardiosis is a rare, life-threatening, opportunistic, and suppurative infection. Its clinical manifestation lacks specificity, which makes early diagnosis difficult. A retrospective analysis of the clinical records of 11 patients with nocardiosis admitted to our hospital from January 2013 to November 2018 was conducted. All patients had at least one underlying disorder, such as an autoimmune disease (6/11), a blood malignancy (2/11), avascular necrosis of the femoral head (1/11), bronchiectasis (1/11), or pneumonia (1/11). The first-line treatment was trimethoprim–sulfamethoxazole (TMP–SMX); one or two additional antibiotics were given according to the drug-sensitive test. The median time from onset to treatment was 3 weeks (ranging from 1 to 9 weeks). The median duration of treatment after diagnosis was 20.5 weeks (ranging from 7 to 47 weeks). Eight patients were discharged and survived, and three patients died. This indicates that early use of TMP–SMX combined with sensitive antibiotics could improve the condition of patients and improve the cure rate (8/11). Clinically, it is necessary to consider the possibility of nocardiosis in patients with long-term use of immunosuppressants and poor response to treatment of common bacterial infections. Early diagnosis, timely treatment, and combination drug therapy are keys to improving the outcomes of patients with nocardiosis.

AIMS Laparoscopic surgery is widely used for diagnosing ovarian endometriosis but it has medical risks. This study explored the application of blood indicators in diagnosis and staging of ovarian endometriosis, aiming to develop a noninvasive diagnostic method. METHODS A total of 190 ovarian endometriosis patients were included in observation group, among these participants, 77 patients among them were stages I-II, and the rest 113 patients were stages III-IV, and a total of 103 healthy women as control group. Serum biochemical indexes, tumor markers, and cytokines levels in two groups were used for the diagnosis and staging of the disease. Area under the receiver operating characteristic (ROC) curve (AUC) predicted the value of individual and joint tests for indicators. RESULTS Biochemical indexes, namely, alkaline phosphatase (ALP), total protein (TP), and glucose (Glu) could distinguish patients from normal women; and that ALP and Glu could indicate disease staging. In tumor markers, alpha fetoprotein (AFP), carcinoembryonic antigen (CA) 125, CA199 and human epididymis protein 4 (HE4) helped to diagnose endometriosis; CA125, HE4, and cytokeratin 19 fragment (CYFRA21-1) could differentiate stages. In cytokines, vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF)-α, interleukin (IL)-6, soluble fms-like tyrosine kinase receptor 1 (sflt-1), monocyte chemoattractant protein (MCP)-1 therefore, have values to diagnose endometriosis; VEGF, TNF-α, IL-6, and sflt-1 helped to differentiate disease staging. CONCLUSION Serological indicators in ovarian endometriosis patients were different from healthy women, which were of certain differential values in diagnosis and disease staging. The current study provided a novel strategy for endometriosis diagnosis.

In view of that most of the current community discovery methods in social network do not consider node self-transfer and node bias, so that it is not possible to extract the graph features effectively, which leads to the ineffective problem by the community discovery, this paper proposes a novel social network community discovery algorithm (Local Distance Laplace, LDL). First, a Laplace matrix decomposition model is constructed based on the principle of matrix decomposition. Secondly, considering the high cost of global social network information acquisition and calculation, a community discovery model based on local distance is proposed. Finally, the optimal community structure is selected by using the NRO (Node Rank Optimization) function. A comprehensive comparative analysis is made on eleven real and synthetic networks. At the same time, validation analysis is conducted on eleven different social networks (Karate, Dolphins, Lemis, Public book, Football, Celegansnertal, Email, Public blogs, Netscience, Power, Hep_th). The experimental simulation results show that: in the real network, the proposed LDL algorithm improved the overall performance by nearly 7% compared with the seven state of art optimal methods (CoVeC, EDBC, JNMF, EADP, LPANNI, LSA, SCFS). The novel algorithm is reasonable and effective and it can also be extended to multi-scale community discovery.

Background To determine the safety and efficacy of different doses of tolvaptan for treating Chinese cirrhotic patients with or without hyponatraemia who still had ascites after routine therapy with diuretics. Methods In the present placebo-controlled, randomized, double-blinded, multicentre clinical trial, patients with cirrhotic ascites who failed to adequately respond to a combination of an aldosterone antagonist plus an orally administered loop diuretic were randomly placed at a 4:2:1 ratio into 3 groups [the 15 mg/day tolvaptan group (N = 301), 7.5 mg/day tolvaptan group (N = 153) and placebo group (N = 76)] for 7 days of treatment. The effects and safety were evaluated on days 4 and 7. A change in body weight from baseline on day 7 of treatment was the primary endpoint. Results The administration of 7.5 or 15 mg/day tolvaptan significantly decreased body weight from baseline on day 7 of treatment compared to that with placebo treatment (P = 0.026; P = 0.001). For the secondary endpoints, changes in abdominal circumference from baseline and improvements in ascites were markedly different in the treatment groups and the placebo group on day 7 (P7.5 = 0.05, P15.0 = 0.002 and P7.5 = 0.037, P15.0 = 0.003), but there was no difference between the 7.5 mg/day and 15 mg/day dosage groups. The 24-h cumulative urine volume was higher in the 7.5 mg/day and 15 mg/day tolvaptan groups than the placebo group (P = 0.002, P P = 0.004). Sodium serum concentrations were higher in patients with hyponatraemia after tolvaptan treatment, with no significant difference between the two dosage groups. The incidence of serious adverse drug reactions was not different between the groups (P = 0.543). Conclusions Tolvaptan treatment at 7.5 mg per day might be a good therapeutic choice for Chinese cirrhotic patients with ascites who did not achieve satisfactory clinical responses to previous treatment regimens with combination therapy with an aldosterone antagonist and an orally administered loop diuretic. Trial registration NCT01349348. Retrospectively registered May 2011.

When the metal film becomes far thinner than the electron mean free path (EMFP) in their bulk counterpart, many exotic optical properties accompanied with numbers of novel applications may emerge. Herein, the photonic spin Hall effect (PSHE) occurring on the surface of one-dimensional photonic crystal consisting of ultrathin Au films, monolayer transition metal dichalcogenides (TMDCs), and one defective layer is investigated. The Au film thickness ranges from 2.4 to 40 nm which covers the thickness range below the EMFP (37.7 nm) in bulk Au. Results show that ultrathin Au films are more competent to enhance the PSHE than bulk Au film. In particular, the maximum spin-dependent transverse displacement (37.94 times of the incident wavelength) at the Au film thickness of 4.4 nm is more than 12-fold higher than that at the bulk Au film with thickness of 40 nm. Besides it may be due to the coupling between the short-range surface plasmon polaritons and the B excitonic resonance in monolayer WS2, among four monolayer TMDCs (i.e., MoS2, MoSe2, WS2, WSe2), the photonic crystal with monolayer WS2 gives the strongest PSHE. Additionally, evolutions of photonic spin Hall shifts with the refractive index of defective layer, incident wavelength, and incident angle are also studied in detail. These findings shed light on the superiority of ultrathin metal films for light manipulation in spinoptics and may provide new routes to tailor the optical helicity in nanophotonic devices.

Synthetic biology applies engineering principles for the deliberate design, engineering, and de novo creation of artificial biological systems with certain functions. Due to the complexity of living systems and lack of rational design principles, iterative trial-and-error experiments are often necessary, but the dependence on human researchers limits the throughput, efficiency, and consistency of such endeavor. To overcome these limitations, biofoundries are developed as an integrated infrastructure for accelerating the “design-build-test-learn” cycles in synthetic biology research and biotechnology applications. Computer-aided design and robotic automation are applied in the physical manufacturing and prototyping of engineered DNA and genetically reprogrammed organisms. Currently, many biofoundries are being created around the world, and a Global Biofoundry Alliance has been established to promote coordination and collaboration. This paper aims to summarize the recent advances in synthetic biology automation and introduce design and construction of current and future biofoundries. We start with key technologies that promote automation in synthetic biology, including computer-aided design, high-throughput instrumentation, robotic integration, automation-compatible workflows for DNA assembly and chassis engineering, and analytical approaches. For bio-design automation, we introduce existing software tools such as j5 from Agile Biofoundry, iBioCAD from Illinois Biological Foundry for Advanced Biomanufacturing (iBioFAB), and CUBA from Edinburgh Genome Foundry (EGF). Moreover, software and hardware for creating automated build and test workflows are summarized, followed by recent advances in DNA synthesis, DNA assembly, nucleic acid extraction and analysis, chassis manipulation, and high-throughput testing. Notable examples are discussed, including automated DNA assembly using the Golden-Gate method, multiplex automated yeast genome engineering, and artificial intelligence (AI)-guided optimization of biosynthetic pathways. Then, representative biofoundries and their software systems, robotic platforms, and available workflows are discussed. Biofoundries are categorized by various formats of integration, including full integration (e.g., iBioFAB and EGF), modular integration (e.g., London Biofoundry, Singapore Biofoundry, and Concordia Genome Foundry), and manual integration. Commercial biofoundries are also compared and contrasted with their academic counterparts, using the ones at Gingko Bioworks Inc. as an example. Furthermore, the design of Shenzhen Biofoundry is discussed in detail, whereby a centralized cloud lab is envisioned to serve the domestic and international synthetic biology communities. Shenzhen Biofoundry will consist of a build platform for engineered DNA, phage, bacteria and yeast, a test platform for optics, chromatography and mass spectrometry, and fermentation scale-up, and a design/learn/cloud platform to coordinate and integrate the whole facility. We conclude with the future challenges and promises of biofoundries and synthetic biology automation. We propose key research directions, including new automation technologies, data-driven and intelligent design, and automation-compatible workflows in synthetic biology. Systems approach and interdisciplinary collaboration are necessary for biofoundries development, which requires synergistic integration of synthetic biology, analytical chemistry, robotics, instrumentation, informatics, and smart manufacturing. Just like foundries initiated the magnificent prosperity of the semiconductor industry, biofoundries will unleash the potential of synthetic biology to revolutionize our society.

Severe drug eruption (SDE), a common skin disease, becomes dangerous when it occurs in patients with human immunodeficiency virus (HIV). However, the molecular mechanisms are poorly understood. Forty patients including HIV+ SDE+ (n = 15), HIV- SDE+ (n = 15) and HIV+ SDE- (n = 10) subjects were enrolled in our study. All HIV+ patients were at acquired immune deficiency syndrome (AIDS) stage. Serum levels of TNF-α, IFN-γ, IL-4, IL-13, IL-6, CXCL9, and CCL17 were quantified by ELISA. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) loads were quantified by RT-qPCR. CD4, CD8, Th1, Th2, TNF-α-CD8, and IFN-γ-CD8 T cell populations were measured by flow cytometry. Levels of biochemical indexes in HIV+ SDE+ patients were significantly different from in HIV- SDE+ patients (P < .05). EBV and CMV viral loads were significantly higher in HIV+ SDE+ patients, but not in HIV- SDE+ patients (P < .05). Inflammatory cytokines TNF-α and IFN-γ were significantly elevated in HIV+ SDE+ patients (P < .05). Th2/Th1 populations and TNF-α secreting or IFN-γ secreting CD8+ T cells, were significantly up-regulated in HIV+ SDE+ patients compared to HIV- SDE+ patients (P < .05). Conversely, the CD4/CD8 ratio was significantly down-regulated in HIV+ SDE+ patients compared to HIV- SDE+ patients (P < .05). HIV infection confers distinct clinical phenotypes and immune inflammatory mechanisms in SDE. Sustained EBV and CMV activation, unbalanced Th2/Th1 and overactive CD8+ T cells mediating a pro-inflammatory response could act as distinct mechanisms in the aggravation of SDE in HIV+ SDE+ patients.

To explore possible associations between maternal use of micronutrient supplements and the subsequent vitamin levels and symptoms in offspring with autism spectrum disorder (ASD), a total of 416 children with ASD and 201 typically developing (TD) children were enrolled. The children born to mothers without folic acid (FA) and micronutrient supplementation during pregnancy had more severe social cognition impairments, social communication impairments, autism behaviour mannerisms, developmental delays in adaptive and gross motor behaviour and gastrointestinal problems than children born to mothers who used FA and micronutrient supplements (P＜0.05). Interestingly, there was an association between maternal micronutrient supplementation and vitamin A (VA), vitamin D (VD) and folate levels in the ASD children (P

The development of new drugs for nonalcoholic steatohepatitis (NASH) is a current focus of research in the management of liver disease. Here we provided an overview of NASH drug pipelines and the challenges faced in conducting phases II and III clinical trials. These challenges include the selection and definition of research populations, rational selection of study end-points, choice of noninvasive diagnostic indicators, accounting for confounding factors and safety assessments. Furthermore, we discussed how to establish guidelines for study design and end-points in complex clinical trials of anti-NASH drugs.

Background During the recovery period of general anesthesia, patients are disturbed by residual anesthetic drugs, manifesting as clinical signs of confusion, drowsiness and disorientation, and even abnormal psychology and limb agitation at varying degrees in severe cases. These stress reactions are detrimental to the postoperative recovery, which can be life-threatening. Operating room nursing intervention (ORNI) is a novel nursing model that prevents stress reactions during the recovery period of general anesthesia. However, whether ORNI can improve the psychological condition and reduce the incidence of emergence agitation in the recovery period of general anesthesia remains controversial. Therefore, this study aims to evaluate the effect of ORNI on the psychological status and incidence of emergence agitation in the recovery period of general anesthesia through a systematic review and meta-analysis, thus providing clinical evidence to support it. Methods Randomized controlled trials reporting the effect of ORNI on the recovery period of general anesthesia published before October 2021 will be searched in the Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, China Biomedical Literature Database, PubMed, Embase, the Cochrane Library, and Web of Science. Eligible literatures will be screened out according to inclusion and exclusion criteria, and their quality will be assessed using the Cochrane Risk of Bias Assessment Tool. Meta-analysis will be performed using Revman 5.4 software. Results This study will evaluate the effect of the ORNI on the recovery period of general anesthesia by calculating the incidence of emergence agitation, and grading the self-rating anxiety scale and self-rating depression scale scores. Conclusion This study will provide a reliable evidence-based basis for the application of ORNI in the recovery period of general anesthesia. Osf registration number DOI 10.17605/OSF.IO/P3A4T.

Background Unexpected spontaneous ovulation typically occurs in patients with poor ovarian response (POR); however, reliable predictors are lacking. We analyzed explore the predictive value of decreased serum estradiol (E2) levels on the day after human chorionic gonadotropin (hCG) trigger during in vitro fertilization (IVF) cycles. Methods We retrospectively analyzed clinical data (n = 978) in IVF cycles between 2017 and 2020. According to decreased ratios of E2 levels (△E2%) between day 1 and day 0 of hCG trigger, patients were divided into: ≤10% (group A), 10–20% (group B), and ≥ 20% (group C). Basic characteristics and laboratory data were compared using analysis of variance or Mann–Whitney U-test. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the relationship between △E2% and spontaneous unexpected ovulation. Fresh embryo transfer cycles in groups A, B, and C were subgrouped as A1, B1, and C1, respectively; clinical outcomes were compared. Results Mean E2 and luteinizing hormone (LH) levels, ratio of premature LH peak and high progesterone levels, time interval between hCG trigger and oocyte retrieval, number of follicles ≥ 11 mm in diameter, and dose regimen of gonadotropin among the three groups showed significant differences (P P for trend 10 mIU/mL) or high progesterone level (> 1.0 ng/mL) on the day of hCG, area under ROC curve (AUC) was 0.849 (95 % CI, 0.764–0.934, P P P > 0.05). Conclusions E2 levels on the day after hCG trigger are valuable for predicting unexpected ovulation. However, their decreased levels do not directly affect clinical pregnancy outcomes.

Background: Frequent/urgent urination is an event of multifactorial origin where involuntary leakage of urine occurs. Epidemiological study of this condition is of high importance due to its negative impact on the psychological, physical, and social well-being of the victims.Objective: This cross-sectional study aimed to investigate the prevalence of frequent/urgent urination in older adults in China.Method: In this study, a face-to-face questionnaire survey was conducted between April 2019 and August 2019 among 4,796 older adult populations in the communities of Tianjin jizhou and Xiamen jimei of China. Descriptive analysis, univariate regression, and all statistics were conducted in IBM SPSS v22. The count data were analyzed by chi-square test. P < 0.05 was considered statistically significant.Results: In the total investigated population, the prevalence of frequent or urgent urination was found in 1,164 patients (24.3%) where 31.7% (664/2,097) were male patients and 18.7% (500/2,699) were female patients, having a male-to-female ratio of 1.7:1. The prevalence was higher in the 70- to 84-year-old group (men: 33.3–34.8%, women 19.5–20.8%), whereas it was relatively low in the 65- to 69-year-old group and in older adults over 85 years of age (men 28.8, 30.3%, women 16.7, 18.5%, respectively). In terms of the course of the disease, among the population aged 65 years and above, 17.3% men and 9.9% women had frequent urination/urgency lasting for 1–4 years; 5–9 years in about 4.5% population (7.4% men and 4.2% women); 10–19 years in 4.9% men and 2.3% women; and more than 20 years duration in 1.6% men and 1.9% women. On the severity scale, mild frequent/urgent urination was observed in 24.6% of men and 15.4% women of Chinese older adults. Moderate cases were observed in 6.3% of men and 2.9% of women, whereas severe cases were found in 0.8% men and 0.2% women. Benign prostatic hyperplasia (BPH)/hypertrophy was the main risk factor for frequent/urgent urination in Chinese older adult men (P < 0.001). Obesity, hypertension, diabetes, heart disease, anxiety, depression, constipation, and brain injury were the other risk factors for frequent/urgent urination in Chinese older adult men and women. The results of this survey showed that smoking or drinking habits did not increase the prevalence of frequent/urgent urination in Chinese older adults.Conclusions: According to the results of this survey, the prevalence rate of frequent/urgent urination is high, and the course of the disease is long in Chinese older adults. BPH and depression, anxiety, and age-related chronic diseases increase the risk of frequent/urgent urination in Chinese older adults.

Objective In China, polyene phosphatidylcholine (PPC) is widely used to treat alanine aminotransferase (ALT) elevation associated with various liver diseases. Here, we assessed the efficacy and safety of PPC in treating drug-induced liver injury (DILI). Methods Data from a multicenter retrospective cohort study (DILI-R) were analyzed to compare PPC and magnesium isoglycyrrhizinate (MgIG) for treatment of DILI. We used the Roussel Uclaf causality assessment method (RUCAM) to evaluate patients with DILI. Patients with RUCAM scores ≥6 were included in the study, while those with RUCAM scores Results Among the DILI patients, 64 of 183 (34.97%) achieved normal ALT levels after treatment in both the PPC and the MgIG groups. Conclusion There were no significant differences in safety biomarkers including serum creatinine, blood urea nitrogen, white blood cells, platelets, hemoglobin, and albumin between patients treated with PPC or MgIG. The safety and efficacy of these two agents for treatment of DILI were comparable.

Background Herbal and Dietary Supplements (HDS) are capable of causing liver injury, however, the extent of HDS-induced liver injury compared to western medication (WM)-induced liver injury has not been well studied. Methods This was a three-year, retrospective study from 308 centers across Mainland China. 3,877 patients with liver injury due to HDS and 3,796 patients with liver injury due to WM were analyzed. Demographic and clinical characteristics, implicated agents, and severity of liver injury were analyzed using descriptive statistics. Results The HDS group was older (average age 47.65 ± 14.8 years) and had more females (57.92%). The latency to onset of liver injury was greater in the HDS group than in the WM group (41 vs. 35 days, P

Background Vitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD). The influence of vitamin A (VA) levels on sleep regulation and sleep disturbances in ASD has garnered concern. The present study aimed to characterize the association of VA levels with sleep disturbances in children with ASD. Methods This cross-sectional study compared children with ASD (n = 856) to typically developing children (TDC; n = 316). We used the Children’s Sleep Habits Questionnaire to assess sleep disturbances, Childhood Autism Rating Scale to evaluate the severity of autism symptoms, and Autism Behavior Checklist and Social Responsiveness Scale to assess autism behaviors. Serum VA levels were estimated using high-performance liquid chromatography. Multivariable linear regression and two-way analysis of variance were performed to investigate if VAD was related to sleep disturbances in children with ASD. Results Children with ASD had lower serum VA levels and a higher prevalence of sleep disturbances than TDC did. The incidence of VAD in ASD children with sleep disturbances was higher, and the symptoms more severe than those without sleep disturbances and TDC. Interestingly, the interaction between VAD and sleep disturbances was associated with the severity of autism symptoms. Conclusion VAD and sleep disturbances are associated with the core symptoms of ASD in children. Regular monitoring of sleep and VA levels may be beneficial for children with ASD. Trial registration Chinese Clinical Trial Registry, registration number: ChiCTR-ROC-14005442, registration date: December 9th 2014.

AIMS This study aimed to create a structural equation model to evaluate the associations among demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college students. METHODS A survey was undertaken using a self-administered questionnaire and targeting 2233 students from Eastern China. Structural equation modeling with the bootstrap approach was utilized to estimate the interrelationships and the strength of the associations among measured variables based on the hypothetical model. RESULTS Among the total participants, 14.7% of the female college students reported having performed breast self-examination. The final structural equation model showed highly satisfactory fitness on indices. Breast self-examination behavior was significantly linked to demographic factors, breast cancer related-knowledge, attitudes, and health education. Health education had the greatest influence on breast self-examination behavior. In addition, breast cancer related-knowledge was significantly associated with demographic factors and health education. Health education and knowledge all significantly affected attitudes towards breast cancer. CONCLUSION Breast self-examination behavior was influenced by demographic factors, breast cancer related-knowledge, attitudes towards breast cancer, and health education in a sample of female college students in China. Health education was the most important predictor of breast self-examination behavior.

The aim of this study was to apply machine learning methods to deeply explore the risk factors associated with adverse drug events (ADEs) and predict the occurrence of ADEs in Chinese pediatric inpatients. Data of 1,746 patients aged between 28 days and 18 years (mean age = 3.84 years) were included in the study from January 1, 2013, to December 31, 2015, in the Children’s Hospital of Chongqing Medical University. There were 247 cases of ADE occurrence, of which the most common drugs inducing ADEs were antibacterials. Seven algorithms, including eXtreme Gradient Boosting (XGBoost), CatBoost, AdaBoost, LightGBM, Random Forest (RF), Gradient Boosting Decision Tree (GBDT), and TPOT, were used to select the important risk factors, and GBDT was chosen to establish the prediction model with the best predicting abilities (precision = 44%, recall = 25%, F1 = 31.88%). The GBDT model has better performance than Global Trigger Tools (GTTs) for ADE prediction (precision 44 vs. 13.3%). In addition, multiple risk factors were identified via GBDT, such as the number of trigger true (TT) (+), number of doses, BMI, number of drugs, number of admission, height, length of hospital stay, weight, age, and number of diagnoses. The influencing directions of the risk factors on ADEs were displayed through Shapley Additive exPlanations (SHAP). This study provides a novel method to accurately predict adverse drug events in Chinese pediatric inpatients with the associated risk factors, which may be applicable in clinical practice in the future.

Transmissible Spongiform Encephalopathy is sub-acute transmissible neurodegenerative disease which affects both human and animals. Among those that affect humans, Creutzfeldt- Jakob disease is the most common. This disease has a genetic basis and characteristic of an infectious disease. Magnetic Resonance Imaging is an important tool in diagnosis of Creutzfeldt-Jakob disease and can assist especially in the early stages of the disease, when the clinical features might not be typical and Electroencephalogram shows normal or nonspecific abnormalities. Newer Magnetic Resonance Imaging techniques such as Diffusion Weighted Imaging have shown to be more sensitive in detecting this disease at its early stage. We report a single case of probable Creutzfeldt-Jakob disease and its peculiar findings on brain magnetic resonance imaging.

Large-scale wind farms are generally integrated by long-distance transmissions, but power grids cannot sufficiently support the access point voltage of these wind farms. The access point voltage undergoes a stability problem under wind speed variations. However, the reactive power compensation device cannot reconcile the requirements of response speed and compensation capacity. Despite their fast power decoupling control, the reactive power capability of doubly fed induction generators is restricted by active power output. To satisfy the reactive power demand of system under wind speed variations, coordinating the reactive power capability and active power output of wind farm is the key solution, based on which a novel active control idea is proposed. The reactive power capability of wind farm and the reactive power demand of system are both studied, and the controllable conditions of access point voltage are analyzed. Active voltage control strategies, including active adjustment of reactive power reference, active speed control, and active pitch angle intervention according to wind speed ranges, are proposed. In the simulation, the method is verified to adequately consider the reactive power demand, and excavate the wind farm reactive power capability. The method also effectively suppresses the change of grid voltage under wind speed variations.

Background Drug-induced liver injury (DILI) is the most common reason for a drug to be withdrawn from the market. Apart from stopping the offending drug, no regimens are available for treating idiosyncratic DILI in clinical practice. Methods We carried out a randomized, double-blind, multidoses, active drug controlled, multicentre phase II trial to assess the safety and efficacy of the study drug, magnesium isoglycyrrhizinate (MgIG), as compared to tiopronin, a standard therapy for DILI in China. The primary outcome was the proportion of alanine aminotransferase (ALT) normalization at week 4 after study drug administration. Logistic regression was used to examine the odds of ALT normalization between low dose (Group A) and high dose (Group B) vs active control (Group C). Results One hundred and seventy-four eligible subjects were randomized and enrolled into three groups: 59 in group A, 56 in group B and 59 in group C. It was shown that group A and group B lowered ALT level even at early stage of study drug administration; when compared with Group C (61.02%), the proportions of ALT normalization at week 4 were significantly greater in Group A (84.75%, P = .0029) and Group B (85.71%, P = .0037) respectively. The results from the univariate logistic model showed that the odds of ALT normalized among subjects in Group A were about 3.6 times greater (OR = 3.55, 95% CI: 1.47-8.57, P = .0049) than subjects in Group C. Similar effect was observed among subjects in Group B (OR = 3.83, 95% CI: 1.54-9.55, P = .0039). Conclusions This trial provided preliminary evidence that MgIG is an effective and safe treatment for patients with acute DILI.

Background CMUSE is a rare disease whose diagnosis remains difficult because the lesion is confined to the small bowel. Case presentation Here, we present a case of 43-year-old female patient suffered chronic abdominal pain for 20 years, and finally diagnosed with CMUSE. Capsule endoscopy was performed when general endoscopic investigation failed to find the lesion, but the capsule was stranded in the small intestine. Moreover, capsule retention results in acute intestinal obstruction. Thus, surgery was performed and CMUSE was confirmed. The patient was recovered after partial small intestine resection. Conclusions Capsule retention occurred in nearly 60% of patients with CMUSE. Capsule endoscopy should be avoided when the patient is suspected of CMUSE, especially with severe anemia and radiologic finding in the ileum.

In recent years, transplantation of mesenchymal stem cells (MSCs) has attracted much attention as a potential cell-based therapy for acute liver failure (ALF). As an inducible enzyme, heme oxygenase 1 (HO-1) has been reported to have cytoprotective, anti-apoptotic and immunoregulatory effects. Autophagy, a conserved catabolic process in cells, may be an important pathway for MSCs to treat ALF. In this study, we aimed to explore whether MSCs treat ALF by regulating autophagy and whether HO-1 was involved in the same pathway. Bone marrow-derived MSCs were isolated from Sprague-Dawley rats and cultured according to an established protocol. Co-culture systems of MSCs and hepatocytes were used to assess autophagy in the treatment of ALF. Meanwhile, MSCs were transplanted into rats with d-galactosamine (Gal)-induced ALF. Autophagy inhibitor (3-methyladenine, 3-MA), HO-1 inhibitor (zinc protoporphyrin, ZnPP) and PI3K specific inhibitor (LY294002) were employed in the study. Blood samples and liver tissues were collected before euthanasia. Survival rate, liver function, inflammatory factors, histology, Ki67 and TUNEL staining were determined. MSCs transplantation alleviated ALF both in vivo and in vitro. Autophagy and autophagy-related proteins were significantly up-regulated during MSCs treatment. 3-MA attenuated the therapeutic effect of MSCs. Administration of LY294002 before ALF induction inhibited hepatocyte autophagy. During the MSCs treatment, the HO-1 expression was increased, while inhibiting HO-1 attenuated the therapeutic effect of MSCs as well as hepatocyte autophagy. These findings suggested MSCs could alleviate ALF by increasing the HO-1 expression, which played an important role in activating autophagy through PI3K/AKT signaling pathway.

Wind speed fluctuations are extremely easy to cause the voltage change frequently. The existing voltage control methods are lacking in adjustment range and response speed. When wind speed fluctuates substantially or rapidly, voltage exceeding limit and the resulting grid safety problems cannot be avoided. Therefore, reasonably distributing and utilizing the reactive power of variable speed wind turbines in the whole network are an inevitable choice. However, the controllable reactive capacity of wind turbines is limited by converter capacity and active power, and thus, the grid demand may not be met. A new idea of active and reactive power-coordinated control for preventing voltage exceeding limit due to wind speed fluctuations was proposed. The effects of wind speed fluctuations on voltage were analyzed, and the controllable reactive capacity of variable speed wind turbines under wind speed fluctuations was studied. The relationship between voltage and the active and reactive power of wind farms was deduced. The theory and method of active and reactive power coordinated control before wind speed fluctuations were proposed based on the model predictive control theory. The control model based on multi-timescale was established. Finally, it was verified that the method can solve the voltage problems and maximize the system economy.

With a high proportion of wind power being transmitted through ac and dc lines, a new power grid pattern has gradually emerged. A dc inverter is prone to commutation failure, which may lead to cascading trip of ac lines for overload, resulting in serious consequences. However, existing control methods have problems of over- or under-shedding and are unsuitable for high-proportion wind power transmission systems. Accordingly, a new fault overload control method based on emergency acceleration of doubly fed induction generator (DFIG) is proposed. The fast power control capability of DFIG is fully utilized; the active power of power grid could be rapidly balanced. First, the fault characteristics of a wind power ac/dc transmission system under the fault of dc receiving-end grid are analyzed, and the power flow transfer after self-recovery from the dc commutation failure is derived. Second, by analyzing the power characteristics of DFIG, a fault overload control idea of the wind power transmission system is proposed based on emergency acceleration of DFIG. At last, the maximum controllable capacity of a wind farm is analyzed, and a fault overload control strategy of the wind power transmission system is proposed. The simulation results prove that the proposed method can rapidly reduce the output of wind farms and prevent the overload of ac lines.

A regional power grid containing high-density wind power is generally connected to a load centre through long-distance transmission lines. Voltage problems, caused by wind speed fluctuation, in the sending-end grid have become increasingly serious. The variable speed wind turbine has been used to compensate the deficit in reactive power. However, the available methods could not meet the requirement because the controllable range of reactive power contributed by wind farms cannot be adjusted. A new idea of reactive power control realised by the active control before wind speed fluctuation was proposed to prevent the voltage variation. Firstly, the influence of wind speed fluctuation on voltage was analysed, and the power controllable range of wind turbines was studied. The principle and strategy of the active control of reactive power were proposed based on the model predictive control theory. Then, the active control model was established according to the system dynamic demand for reactive power. According to wind speed forecasting, the reactive control capability of wind turbine was excavated to meet the grid demand by adjusting active power before wind speed variation, and the reduced active power of wind farms is optimally compensated by thermal powers. Finally, the method was proven to solve voltage problems.

Our study aimed to develop an immune prognostic signature that could provide accurate guidance for the treatment of esophageal squamous cell cancer (ESCC). By implementing Single-Sample Gene Set Enrichment Analysis (ssGSEA), we established two ESCC subtypes (Immunity High and Immunity Low) in GSE53625 based on immune-genomic profiling of twenty-nine immune signature. We verified the reliability and reproducibility of this classification in the TCGA database. Immunity High could respond optimally to immunotherapy due to higher expression of immune checkpoints, including PD1, PDL1, CTLA4, and CD80. We used WGCNA analysis to explore the underlying regulatory mechanism of the Immunity High group. We further identified differentially expressed immune-related genes (CCR5, TSPAN2) in GSE53625 and constructed an independent two-gene prognostic signature we internally validated through calibration plots. We established that high-risk ESCC patients had worse overall survival (P=0.002, HR=2.03). Besides, high-risk ESCC patients had elevated levels of infiltrating follicle-helper T cells, naïve B cells, and macrophages as well as had overexpressed levels of some immune checkpoints, including B3H7, CTLA4, CD83, OX40L, and GEM. Moreover, through analyzing the Genomics of Drug Sensitivity in Cancer (GDSC) database, the high-risk group demonstrated drug resistance to some chemotherapy and targeted drugs such as paclitaxel, gefitinib, erlotinib, and lapatinib. Furthermore, we established a robust nomogram model to predict the clinical outcome in ESCC patients. Altogether, our proposed immune prognostic signature constitutes a clinically potential biomarker that will aid in evaluating ESCC outcomes and promote personalized treatment.

Delineating the margins of Oral squamous cell carcinoma (OSCC) is a critical step for optimaltumor resection. The aim of this study was to evaluate the accuracy of lesion surgical margin identification using autofluorescence visualization.Thirty patients with OSCC were included in this study. For each lesion, the fluorescence loss boundary was determined using VELscope before ablative surgical resection (with a 1.5-2cm safety margin) was performed. A total of 126 samples were obtained from 30 surgical specimens, each containing the tissue from the fluorescence loss boundary to surgical margin. The status of each sample was determined by oral pathologists and the staining intensities of Ki-67, E-cadherin, and Vimentin at the fluorescence loss boundary and surgical margin were evaluated by immunohistochemistry.Fluorescence loss regions were identified in all patients. Of the 126 samples collected, HE staining identified 77 normal epithelia (61.1%), 26 mild dysplasia (20.6%), 17 severe dysplasia (13.4%) and 6 carcinomas in situ (4.9%). A significant correlation was found between the differentiation grade of tumor cells and the pathological status of the surgical marginal specimens (P0.05). Forty-two of the 126 samples were randomly selected for further immunohistochemical staining. No significant differences were seen in Ki-67, E-cadherin, or Vimentin expression at the fluorescence loss boundary or surgical margin, however, the proteins' expression level was positively correlated with the degree of dysplasia (P0.01).Autofluorescence visualization has potential as a simple surgical margin setting device for OSCC and may help delineate the superficial area of OSCC with acceptable accuracy. However, when considering the inherent limitations of this system, we suggest that the approach should only be applied under certain conditions, such as when dealing with superficial, well-differentiated lesions.

Mobile advertisement is an emerging and important application of mobile commerce. In recent years, consumers’ clicks on social media advertising have exceeded over 50%, but purchasing behaviors do not follow up after ad-clicking. It's an important issue about how to promote customer purchase intention after looking at social media advertising. This study is based on Ducoffe's [1] advertisement value model, adding ad click to explore the influence on consumers’ purchase intention. This study took social media users as the research subject and collected 313 valid questionnaires through the Internet. The results show that: (1) informativeness, entertainment had positive effects on advertising value, while irritation had negative effects on advertising value; (2) advertising attitude had a positive effect on advertising clicks; (3) advertising value had positive effects on advertising attitude; (4) advertising attitude had positive effects on purchase intention; (5) advertising clicks had positive effects on purchase intention. In addition, advertisement attitude was the biggest factor that affected purchase intention.

Background Patients with traumatic injuries are often accompanied by emotional disorders, which seriously impede functional gains. The objective of this study was to identify the prevalence and risk factors associated with underlying anxiety and depression in orthopaedic trauma patients. Methods From July 2015 to December 2017, all orthopaedic trauma patients were included in the retrospective study. Patients with conditions that might affect cognitive impairment were excluded from the study. Basic demographic data were collected. All patients were screened for emotional disorders on admission using a simple questionnaire called “Huaxi Emotional-Distress Index” (HEI). Bivariate analyses and logistic regression were used to identify the factors associated with a HEI score of > 8. Results One hundred and sixty-two patients (8.1%) had a HEI score of > 8. About 1.0% of enrolled patients had severe emotional disorders (HEI score ≥ 17). The reasons caused by emotional disorders in patients with orthopaedic trauma were a higher Injury Severity Score (ISS), a higher visual analogue score (VAS) and type of surgery. On logistic regression, marital status was a protective factor for emotional disorders, while VAS and ISS were the risk factors for emotional disorders. Conclusions Although a significantly low percentage of orthopaedic trauma patients in our setting have emotional disorders, traumatic orthopaedic surgeons still need to pay attention to the risk of emotional disorders and integrate effective screening tools into clinical practice to screen for these factors and stratify emotional disorders. Appropriate targeted psychological intervention and treatment should be adopted according to the stratification of emotional disorders.

With the rapid development of cloud computing, major cloud providers have launched various cloud services with different functions to meet customer's needs. Therefore, flexibility is extremely important when developers use these cloud services. However, APIs of cloud services change dozens of times annually without backward compatibility. It means developers have to adapt these clouds with manual efforts. Such efforts make the multi-cloud collaboration extremely complex and cannot meet the demand of flexibility. This paper describes a configuration-based multi-cloud collaboration framework, which can support new clouds with comprehensible configurations. Meanwhile, if cloud APIs are updated without backward compatibility, it can restore services during runtime with minimized configuration. The main technologies used in this article include automatic discovery, unified abstraction, dynamic mapping and incremental update. We tested the virtual machine and container services of seven well-known cloud providers. The system can support heterogeneous clouds well. When the APIs are updated, the system can restore services in less than 200 milliseconds. At the same time, the extra cost of our framework is acceptable to cloud users.

Veterinary antibiotics are intensively and widely used in animal farming to treat or prevent diseases, as well as improve growth rate and feed efficiency. Animal manure is an important reservoir of veterinary antibiotics due to their high excretion rates, and thus manure application has been a critical source of veterinary antibiotics in agro-ecosystems. However, how veterinary antibiotics affect agroecosystem functions is still unclearly understood. In this study, we evaluated the effects of veterinary antibiotics on soil bacteria and earthworms in agricultural land with long-term manure application. The potential mechanisms of antibiotic-induced changes in crop yields were also revealed. The results showed that the increasing prevalence of veterinary antibiotics in agro-ecosystems inhibited earthworm abundance and bacterial diversity, and then decreased the bioavailability of soil nutrients. Furthermore, high-dose exposure to veterinary antibiotics improved the abundance of plant pathogenic bacteria. Analysis indicated that veterinary antibiotics played an important underlying role in driving the negative effects on peanut grain yields via disturbing microbe- and earthworm-mediated soil available nutrient contents. The direct toxicity effects of antibiotics on peanut relative yields were stronger than their indirect mediating effects. Additionally, the tradeoffs between antibiotics and agroecosystem functions increased at low exposure levels and then decreased at high exposure levels, which indicated the effects of antibiotics on agroecosystem functions were dose-dependent, except for earthworm biomass. Antibiotic contamination will impose threats to agricultural sustainability was highlighted and should be paid more attention.

Constructing a nanostructured electrochromic film and enhancing the bonding strength between the electrochromic film and electrode would effectively improve the charge transport and stability of the electrochromic film. In the present study, nanoporous WO3 films, including WO3 films without polydopamine (W-x, x = 2, 3, and 4) and WO3 films with polydopamine (PW-x, x = 2, 3, and 4), were built using a low-temperature hydrothermal method. The PW-x films showed significantly improved electrochromic cycle stability compared to the W-x films because the bonding strength between the ITO glass electrode and the WO3 film was enhanced by polydopamine (PDA) film. Notably, the PW-2 film still retained 90.8% of its original optical contrast after 5000 cycles. In addition, both the W-2 and PW-2 films exhibited high optical contrast from visible to infrared regions owing to their 3D network nanoporous structure; their optical contrasts were 71.5% and 69.7% at 700 nm, respectively. Both the W-2 and PW-2 films also exhibited high coloration efficiency and areal capacitance; their coloration efficiencies were 80.4 and 72.5 cm2/C, and areal capacitances were 59.38 and 75.32 mF/cm2, respectively. PW-2 film is promising for electrochromic energy-saving smart windows with power storage.

Objective: The study aimed to compare the nutritional status and symptoms of preschool children with autism spectrum disorder (ASD) from two regions of China, and to analyze the association between nutritional status and symptoms of ASD. Methods: In this cross-sectional study, 738 ASD children and 302 typically developing children (TD) were recruited from Chongqing and Hainan of China. Symptoms of ASD children were evaluated with the Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood Autism Rating Scale (CARS). Neurodevelopment of ASD children was assessed with the Gesell Developmental Scale (GDS). Nutritional status was evaluated by anthropometric measures, biochemical detection of micronutrients, and providing questionnaire and food frequency questionnaire (FFQ) to caregivers. Results: Comparing ASD children with local TD children, ASD children consumed fewer whole grains, milk and dairy products, beans and soy products, vegetables, and fruits than local TD children in both regions. The serum concentrations of folate, vitamin B12 (VB12), and vitamin D (VD) were consistently lower in ASD children in both regions. Comparing the ASD children between the two regions, the ASD children in Chongqing had significantly higher mean scores of CARS, SRS, and ABC than those in Hainan. The ASD children in Chongqing consumed fewer whole grains, seafood, and fruits than those in Hainan. The serum concentrations of ferritin, vitamin A (VA), VB12, and VD were reduced in the ASD children of Chongqing than those in Hainan, and the ASD children in Chongqing had higher deficiency rates of zinc, ferritin, VA, and VD than those in Hainan. The serum levels of VA, VD, and folate showed a negative association with symptom scores of ASD children. VD and zinc levels had a positive association with the GDS scores of ASD children. Conclusions: ASD children exhibit a higher risk of nutrient deficiencies than neurotypical children, and there are regional differences in the nutritional status of ASD children. Micronutrients VA, VD, folate, and zinc levels were correlated with symptoms and development of ASD children. Therefore, it is essential to provide detailed nutrition evaluation and individualized nutrition interventions for ASD children from different backgrounds.

Background Adherence to medication plays an important role in the control of disease progression and treatment costs for patients with chronic obstructive pulmonary disease (COPD). Existing studies are mostly retrospective studies based on local medical insurance databases and prescription records and therefore cannot analyze or determine the causes of poor adherence in COPD patients. Methods This is a prospective study that enrolled 1,223 COPD patients, including 929 newly diagnosed patients and 294 previously diagnosed patients. Telephone follow-up was conducted to administer a questionnaire on treatment adherence and collect detailed information on the prescriptions and the actual use of medications for COPD. The follow-up period was 24 weeks. Results COPD patients had adherence rates of 74.65%, 49.63%, and 33.61% at 4-, 12-, and 24-week telephone follow-ups, respectively. Cox regression showed that women, newly diagnosed patients, patients with a mild Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, and patients with fewer routes of administration had poorer adherence. According to the subgroup analysis of the diagnostic status, the overall adherence of the newly diagnosed patients was poorer than that of the previously diagnosed patients. Among the causes of nonadherence, drug stoppage after remission (27.2%) was the most common cause, followed by economic factors (21.5%) and poor efficacy (21.1%). Conclusions This is the first study focusing on the adherence behavior of newly diagnosed COPD patients and the first large-scale clinical study on the Chinese population. Overall, sex, diagnostic status (newly diagnosed and previously diagnosed), GOLD stage, and routes of administration were the four major factors that affected the adherence of COPD patients.

Fucosidosis is a rare lysosomal storage disease, resulting from a deficiency in an alpha- l -fucosidase enzyme. There are fewer than 120 cases of this disease worldwide and very few reported in Chinese children. Here, we report a Chinese boy presenting with psychomotor regression, dermatological abnormality, dysostosis multiplex, and classic changes observed with head magnetic resonance imaging. He was diagnosed with fucosidosis, with a previously reported homozygous mutation of c.393(exon2)T > A, p.Tyr131Stop, in the FUCA1 gene. Increasing awareness of fucosidosis will help in the early diagnosis of this disease and could shed light on the therapeutic role of hematopoietic stem cell transplantation, which may be effective in early stages of the disease.

This study aimed to identify markers of early cognitive impairment after acute mild ischemic cerebrovascular disease. To further explore the relationship between neuroimaging markers of vascular and neurodegenerative injuries and post-stroke cognitive impairment, 86 patients with transient ischemic attack/acute mild ischemic stroke were recruited. Demographic information, clinical data, stroke scale scores (Modified Rankin Scale, National Institutes of Health Stroke Scale), and neuroimaging parameters (medial temporal lobe atrophy, global cortical atrophy, white matter hyperintensities, location and number of acute infarcts) were collected. All participants underwent neuropsychological evaluation at the time of discharge. The neurocognitive assessment was conducted using the Montreal Cognitive Assessment-Basic and Trail-Making Test A. It was found that low Montreal Cognitive Assessment-Basic scores were associated with global cortical atrophy and lower education levels. The completion time on the Trail-Making Test A was significantly correlated with medial temporal lobe atrophy and less education. It is concluded that global cortical atrophy and lower education levels can be used as rapid indicators of early cognitive impairment in patients after a transient ischemic attack and acute mild ischemic stroke. Medial temporal lobe atrophy also appears to be associated with mental processing speed in patients after a transient ischemic attack and acute mild ischemic stroke.

As human society has developed, food production has developed into a transboundary supply chain that produces wastes during each stage. Decomposed food wastes may release greenhouse gases that contribute to the warming effects of the climate; if incinerated, they could also become sources of SO2 and NOx air emissions, which mix with the precipitation and, thus, acidify the soil and water. Degraded and soluble leachate from the food residuals, abundant in nitrogen and phosphorus, may facilitate eutrophication of surface and groundwater. In this chapter, the added impacts on the climate and water resources in relation to food waste are evaluated based on carbon and water footprints. The results showed that the production of livestock, in general, produced a higher carbon footprint than that of plant-based food. On the other hand, the production of cereals, in particular, rice production, contributed to a large amount of total water footprint due to the need of irrigation. Using newly developed treatment technologies, food waste can be a good source for resources and energy recovery that offsets the carbon emission. However, the uncontrolled or contained leachate from food waste treatment can still cost a considerable amount of gray water footprint. In terms of the waste produced during food production, developing countries contributed greater footprints for less-than perfect agricultural practices and waste treatments. They are, however, the major food producers worldwide. On the other hand, developed countries are larger contributors to the footprints during the consumption stages of the food supply chain. Consumers in these countries tend to dispose large quantities of undesirable food after purchasing. To reduce food waste, it may be mutually beneficial for developed countries to export useful technologies in terms of agricultural practices and waste treatments to developing countries. For waste reduction after the food is purchased, education and policy that incentivize consumers to reduce food waste may be the key.

Objective To study the man–car relationship in the 5G era with the man–computer interaction of future smart cars as the object. Method An analysis of the current situation of man–car relations based on the development of automobiles and conduct research on them in the 5G era. Taking the starting point of bringing a better travel experience for users, by building a three-dimensional model of the future smart cars, the man–car relationship in the 5G era will be integrated into the design process of the future smart cars. Result (Combining with the changes in user needs and social environment in the 5G era, discuss the relationship between smart cars and people in the future, and form the design trend in the field of smart cars in the future). Conclusion With the advent of the 5G era, unmanned driving is gradually realized, users are liberated from the heavy driving tasks, the man and car cooperation will be more harmonious during driving, and the man–car relationship will be closer. The man–car relationship changed from a man adapt to car to a car adapt to man and then a man and car adapt to each other and finally reached harmonious unity. In the future, smart cars are no longer just a means of transportation, but more like a close friend who accompanies you and understands you, bringing you intimate and exclusive travel services.

With the wider usage of ART in clinical practice, the side effects of ART have been of concern. ART-associated side effects and toxicity include gastrointestinal adverse effects, liver toxicity, cutaneous and adnexal side effects such as drug eruptions, lipodystrophy, skin hyperpigmentation, and nail hyperpigmentation, etc. In this chapter, the authors summarize the clinical characteristics of skin and cutaneous appendages manifestations caused by ART and other HIV-related side effects, including drug eruption, lipoatrophy, lipohypertrophy, skin hyperpigmentation, nail hyperpigmentation, and gynecomastia.

Ningbo is a coastal megacity located at the East Coast of China and developing rapidly with proactive trading and export economic activities. The city owns a ranked top ten international port and it is the major strategic spot of 21st century maritime Silk Road from the “Belt and Road” policy established for promoting further international trades and developments. In future, populations and economy in Ningbo are expected continuously growing in the next few decades. The demand of quality freshwater resources thus is enormously increasing. Ningbo municipal government has established the “Five water management” (五水共治) policy in 2013 that aims to manage (i) sewage discharge; (ii) flooding; (iii) surface water; (iv) water conservation and (v) freshwater supply. Indeed, the municipal government also liaised and initiated the “Sponge City Program” after 2015 that Ningbo was selected as one of the pilot city; these policies and practices are successful up to now. This article adopts the case study of Ningbo to investigate the reasons of municipal government to promote the policy, to understand the public perception of this water management policy in Ningbo through conducted semi-structured interviews. During the 2017 and 2019, we conducted a questionnaire (N = 110) and interviews (N = 10) that follow up for justification of the public perception with the local communities. Our findings indicated that the communities had not been engaged closely with these practices, but generally supporting these two urban water management practices; and agreed that the urban water conditions (urban floods and pollution) had been improved. Also, the article discusses whether these (5 Water and SCP) practices can be extensively applied in other Chinese cities. We will provide recommendations at the end of the article.

Background Japanese encephalitis (JE) is a leading cause of childhood viral encephalitis both at global level and in China. Vaccination is recommended as a key strategy to control JE. In China most JE cases have been reported in southwest provinces, which include Yunnan. In this study, we quantify the epidemiological shift of JE in Yunnan Province from 2005 to 2017, covering before and after the introduction of JE vaccination into routine Expanded Program on Immunization (EPI) in 2007. Methods We used routinely collected data in the case-based JE surveillance system from 2005 through 2017 in Yunnan. Cases were reported from hospital and county-level Centers for Disease Control in line with the National JE Surveillance Guideline. Epidemiological data were extracted, analysed and presented in appropriate ways. Immunization coverage was estimated from actual JE doses administered and new births for each year. Results A total 4780 JE cases (3077 laboratory-confirmed, 1266 clinical and 437 suspected) were reported in the study period. Incidence of JE (per 100 000 population) increased from 0.95 in 2005 to 1.69 in 2007. With increase in vaccination coverage, incidence rates decreased steadily from 1.16 in 2009 to 0.17 in 2017. However, seasonality remained similar across the years, peaking in June–September. Banna (bordering Myanmar and Laos), Dehong (bordering Myanmar), and Zhaotong (an inland prefecture) had the highest incidence rates of 2.3, 1.9, and 1.6, respectively. 97% of all cases were among local residents. As vaccination coverage increased (and incidence decreased), proportion of JE cases among children Conclusions The 13-year JE surveillance data in Yunnan Province showed dramatic decrease of total incidence and a shift from children to adults. Improving vaccination coverage, including access to adults at risk, and strengthening the JE surveillance system is needed to further control or eliminate JE in the province.

With the development of large wind farms, the voltage problem caused by the power changes of wind farms occurs continuously because of the wind speed variation. The problem cannot be resolved by extra reactive power compensation because of the limitations in cooperation and response speed. A doubly fed induction generator (DFIG) possesses the power decoupling control capability, which can be used to prevent the voltage change rapidly. However, the dynamic processes of the power demands of the grid and the power limits of the DFIG have not been considered. Therefore, a vector equivalent model of the DFIG considering the controllability of the rotor voltage is established. The feasible power ranges that are limited by the electromagnetic process and controller response are deduced. The dynamic requirement and limitation of the reactive power under the wind speed variation are investigated. The emergency control strategy of reactive power contributed by the DFIG is proposed on the basis of the requirement and limitation. The simulation shows that the rapid adjustment capability of the DFIG can be fully utilised by the proposed method.

OBJECTIVE To evaluate tolvaptan as a novel therapeutic option for Chinese patients with liver cirrhosis-associated ascites in a phase 2 clinical trial. METHODS This randomized, double-blind, placebo-controlled, multicenter trial was conducted in patients with insufficient responses to combination therapies of an oral loop diuretic and an aldosterone antagonist. Reduction in body weight and abdominal circumference, increase in 24-h cumulative urine volume and improvement in serum sodium level from baseline to the end of treatment in the tolvaptan groups (15 mg/day or 30 mg/day orally) were compared with those in the placebo group. Drug safety was also assessed. RESULTS Sixty-two patients were allocated to the placebo group, 56 to the tolvaptan 15-mg group and 63 to the tolvaptan 30-mg group. Their mean changes in body weight were -0.5 ± 1.6 kg, -2.1 ± 2.0 kg and -1.9 ± 2.0 kg, respectively. Body weight reductions in both tolvaptan groups were significantly greater than that in the placebo group (difference -1.6, 95% confidence interval [CI] -2.5 to -0.8, and difference -1.4, 95% CI, -2.2 to -0.7, both P

Vitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD). The influence of vitamin A (VA) levels on sleep regulation and sleep disturbances in ASD has garnered concern. The present study aimed to characterize the association of VA levels with sleep disturbances in children with ASD. This cross-sectional study compared children with ASD (n = 856) to typically developing children (TDC; n = 316). We used the Children’s Sleep Habits Questionnaire to assess sleep disturbances, Childhood Autism Rating Scale to evaluate the severity of autism symptoms, and Autism Behavior Checklist and Social Responsiveness Scale to assess autism behaviors. Serum VA levels were estimated using high-performance liquid chromatography. Multivariable linear regression and two-way analysis of variance were performed to investigate if VAD was related to sleep disturbances in children with ASD. Children with ASD had lower serum VA levels and a higher prevalence of sleep disturbances than TDC did. The incidence of VAD in ASD children with sleep disturbances was higher, and the symptoms more severe than those without sleep disturbances and TDC. Interestingly, the interaction between VAD and sleep disturbances was associated with the severity of autism symptoms. VAD and sleep disturbances are associated with the core symptoms of ASD in children. Regular monitoring of sleep and VA levels may be beneficial for children with ASD. Chinese Clinical Trial Registry, registration number: ChiCTR-ROC-14005442 , registration date: December 9th 2014.