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Although the prevalence of unruptured intracranial aneurysm (UIA) lies between 2 and 5%, the consequences of aneurysm rupture are fatal. The burden of UIA is considerable in stroke patients. However, the best prevention and management strategy for UIA is uncertain among patients with a family history of stroke. Therefore, this study aimed to determine the epidemiological characteristics and risk factors for UIA based on a population with a family history of stroke. This study used random sampling to recruit participants with a family history of stroke among rural residents in Jixian, Tianjin, China. All participants underwent a questionnaire survey, physical examination, and cervical computed tomography angiography (CTA). CTA data were used to determine whether the subjects had UIA. The relationship between relevant factors and UIA was assessed using logistic regression analysis. A total of 281 residents were recruited in this study, with a mean age of 50.9 years. The prevalence of UIA in those with a family history of stroke was 10.3% overall (9.8% among men and 10.9% among women). Moreover, with each unit increase in body mass index (BMI), the prevalence of UIA decreased by 12.5%. Particularly among non-obese men, BMI had a stronger protective effect (OR: 0.672; 95%CI: 0.499–0.906; P = 0.009), and among non-obese men, an increase in low-density lipoprotein (LDL) was associated with an increased prevalence of UIA (OR: 3.638; 95%CI: 1.108–11.947; P = 0.033). Among the non-obese with a family history of stroke, BMI may be protective against UIA, especially in men. It is crucial to strictly control the LDL level in non-obese people to reduce the burden of UIA. [ABSTRACT FROM AUTHOR]

Excavations may cause excessive ground movements, resulting in potential damage to laterally adjacent tunnels. The aim of this investigation is to present a simple assessment technique using a multivariate adaptive regression splines (MARS) model, which can map the nonlinear interactions between the influencing factors and the maximum horizontal deformation of tunnels. A high-quality case history in Tianjin, China, is presented to illustrate the effect of excavation on the tunnel deformation and to validate the FEM. The hypothetical data produced by the FEM provide a basis for developing the proposed MARS model. Based on the proposed model, the independent and coupled effects of the input variables (i.e. the normalized buried depth of tunnels Ht/He, the normalized horizontal distance between tunnels and retaining structures Lt/He, and the maximum horizontal displacement of retaining structures, δRmax) on the tunnel response are analysed. The prediction precision and accuracy of the MARS model are validated via the artificial data and the collected case histories. [ABSTRACT FROM AUTHOR]

Urban agglomeration research has received increasing attention in China's national development strategies, and has become a hot topic in academic research. This study develops a theoretical framework that explores the formation mechanism and expansion process of urban agglomerations from the perspective of industrial evolution, and identifies the development issues and their causes by taking Yangtze Delta and Beijing-Tianjin-Hebei urban agglomerations as case studies. In the process of urban agglomeration formation within a free market, as has happened in Yangtze Delta region, the central city develops first, its secondary industry is then transferred to its neighboring cities, and the work division and cooperation with the neighboring cities is gradually established. However, in the 1990s, aiming to become an international metropolis, Beijing implemented a series of administrative policies to encourage the reduction of the secondary industry and the development of the tertiary industry, before its secondary industry were fully developed and transferred to its neighboring cities. This delayed the integration process and the development of the Beijing-Tianjin-Hebei urban agglomeration. This study builds a good foundation for the construction of the theoretical system's urban agglomeration study, and provides references for decision making in an urban agglomeration development. [ABSTRACT FROM AUTHOR]

We elucidated the factors, evolution, and compensation of antimicrobial resistance (AMR) in Mycobacterium tuberculosis (MTB) isolates under dual pressure from the intra-host environment and anti-tuberculosis (anti-TB) drugs. This retrospective case-control study included 337 patients with pulmonary tuberculosis from 15 clinics in Tianjin, China, with phenotypic drug susceptibility testing results available for at least two time points between January 1, 2009 and December 31, 2016. Patients in the case group exhibited acquired AMR to isoniazid (INH) or rifampicin (RIF), while those in the control group lacked acquired AMR. The whole-genome sequencing (WGS) was conducted on 149 serial longitudinal MTB isolates from 46 patients who acquired or reversed phenotypic INH/RIF-resistance during treatment. The genetic basis, associated factors, and intra-host evolution of acquired phenotypic INH/RIF-resistance were elucidated using a combined analysis. Anti-TB interruption duration of ≥30 days showed association with acquired phenotypic INH/RIF resistance (aOR = 2·2, 95% CI, 1·0–5·1) and new rpoB mutations (p = 0·024). The MTB evolution was 1·2 (95% CI, 1·02–1·38) single nucleotide polymorphisms per genome per year under dual pressure from the intra-host environment and anti-TB drugs. AMR-associated mutations occurred before phenotypic AMR appearance in cases with acquired phenotypic INH (10 of 16) and RIF (9 of 22) resistances. Compensatory evolution may promote the fixation of INH/RIF-resistance mutations and affect phenotypic AMR. The TB treatment should be adjusted based on gene sequencing results, especially in persistent culture positivity during treatment, which highlights the clinical importance of WGS in identifying reinfection and AMR acquisition before phenotypic drug susceptibility testing. [ABSTRACT FROM AUTHOR]