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Messenger RNA vaccines are considered to be a promising strategy in cancer immunotherapy, while their application on mesothelioma is still largely uncharacterized. This study aimed to identify potential antigens in mesothelioma for anti-mesothelioma mRNA vaccine development, and further determine the immune subtypes of mesothelioma for selection of suitable candidates from an extremely heterogeneous population. Gene expression data and corresponding clinicopathological information were obtained from the TCGA and gene expression omnibus, respectively. Then, the genetic alterations were compared and visualized using cBioPortal, and differentially expressed genes and their prognostic signatures were identified by GEPIA. The relationship between tumor-infiltrating immune cells and the expression of tumor antigens was systematically evaluated by TIMER online. Finally, the immune subtypes and immune landscape of mesothelioma were separately analyzed using consensus cluster and graph learning-based dimensional reduction. A total of five potential tumor antigens correlated with prognosis and infiltration of antigen-presenting cells, including AUNIP, FANCI, LASP1, PSMD8, and XPO5 were identified. Based on the expression of immune-related genes, patients with mesothelioma were divided into two immune subtypes (IS1 and IS2). Each subtype exhibited differential molecular, cellular and clinical properties. Patients with the IS1 subtype were characterized by an immune “cold” phenotype, displaying superior survival outcomes, whereas those with the IS2 subtype were characterized by an immune “hot” and immunosuppressive phenotype. Furthermore, immune checkpoints and immunogenic cell death modulators were differentially expressed between the IS1 and IS2 immune subtype tumors. The immunogenomic landscape of mesothelioma revealed a complex tumor immune microenvironment between individual patients. AUNIP, FANCI, LASP1, PSMD8, and XPO5 are putative antigens for the development of anti-mesothelioma mRNA vaccine and patients with the IS1 subtype may be considered for vaccination.

To explore how the living environment influences the establishment of gut microbiota in different species, as well as the extent to which changes in the living environment caused by captive breeding affect wildlife’s gut microbiota and health, we used 16S rRNA gene amplicon sequencing and shotgun metagenomic sequencing to compare the gut microbiome of two species of threatened equids, the Przewalski’s Horse and the Asian wild ass, in the wild and captivity. The results revealed that different species of Equidae living in the same environment showed remarkable convergence of gut microflora. At the same time, captive populations exhibited significantly “unhealthy” microbiota, such as low Alpha diversity, high levels of potentially pathogenic bacteria and biomarkers of physical or psychological disease, and enrichment of microbial functions associated with exogenous exposure and susceptibility, implying that the artificial environment created by captivity may adversely impact the health of wildlife to some extent. Our findings demonstrate the importance of the environmental factors for the establishment of gut microbiota and host health and provide new insights into the conservation of wildlife in captivity from the perspective of the microbiome.

To study the effect of berberine combined with formononetin on the migration of NPC cells, and to preliminarily explore the roles of the MAPK/ERK1/2 signaling pathway.Berberine combined with formononetin synergistically inhibited the proliferation, migration and invasion of NPC cells. After treatment, the expression of EMT-related proteins N-cadherin,vimentin and MAP4K4 decreased, that of E-cadherin increased, and that of p-c-Raf, p-MEK, p-ERK1/2 was down-regulated. After MAPK/ERK 1/2 signaling pathway was activated by EGF, the inhibitory effect of berberine combined with formononetin on the key proteins p-c-Raf, p-MEK, p-ERK1/2 of MAPK/ERK1/2 signaling pathway, and the downstream proteins N-cadherin and vimentin, and the promotion of E-cadherin were weakened. Meanwhile, the activation of MAPK/ERK1/2 signaling pathway reduced the inhibitory effect of berberine combined with formononetin on the migration of NPC cells.Berberine combined with formononetin decreases the activity of the MAPK/ERK1/2 signaling pathway, thus further inhibiting the migration of NPC cells.

The reservoir permeability of tight sandstone gas reservoirs is low, which makes it difficult to carry out displacement flow experiments on real cores underground conditions, so the microscopic flow mechanism can be hardly studied. Based on the lattice Boltzmann method (LBM), this paper simulated the flow process of formation water displaced by tight gas under the simulated reservoir conditions of high temperature and high pressure to clarify the distribution of bound water in the reservoir. Then, reservoir drying was experimentally studied using the laser etching model, and numerical simulation of reservoir drying was simplified by referring to the visualization results of the experiment. Finally, the influence of reservoir drying on the seepage capacity of tight gas was studied by means of numerical simulation. And the following research results were obtained. First, when the lattice Boltzmann model is used for high temperature and high pressure reservoirs, it satisfies the Laplace law and its numerical solution of two-phase Poiseuille flow rate is basically consistent with the analytical solution, which indicates that this model can be used to simulate gas–water immiscible displacement under reservoir conditions. Second, tight gas preferentially breaks through in large porous media connected channels, and after the breakthrough, the displacement rate of formation water decreases significantly. Third, the contact angle between formation water and rock wall has a significant influence on gas–water two-phase flow. The stronger the water wettability of the rock is, the lower the displacement rate is. Fourth, the bound water in tight sandstone gas reservoirs can be classified into four types, including adsorbed water film, blind end pore water, dead pore water and trapped water. In porous media, a large number of connected micro-channels are occupied by trapped water and adsorbed water film and the phenomenon of “water lock” is obvious, which seriously influences the seepage capacity of tight gas in the porous media of reservoir. Fifth, drying agent can react with bound water to produce a large number of bubbles, which will consume adsorbed water film, trapped water and blind end pore water, so as to improve the gas seepage capacity. Sixth, in the “water lock” regions formed by trapped water, the gas seepage capacity can be effectively improved by increasing the drying strength. On the whole, the tight gas permeability increases with the increase of drying strength, but its increase amplitude decreases gradually when the drying strength exceeds a certain degree.

The growing energy consumption and carbon emissions of Bitcoin mining could potentially undermine global sustainability efforts. Here, the authors show the annual energy consumption of the Bitcoin blockchain in China is expected to peak in 2024 at 296.59 Twh and generate 130.50 million metric tons of carbon emissions.

Abstract Background World Health Organization recommends countries introducing new drug and short treatment regimen for drug resistant tuberculosis (DR-TB) should develop and implement a system for active pharmacovigilance that allows for detection, reporting and management of adverse events. The aim of the study is to evaluate the frequency and severity of adverse events (AEs) of bedaquiline-containing regimen in a cohort of Chinese patients with multidrug-resistant (MDR)/extensively drug-resistant (XDR)-TB based on active drug safety monitoring (aDSM) system of New Drug Introduction and Protection Program (NDIP). Methods AEs were prospectively collected with demographic, bacteriological, radiological and clinical data from 54 sites throughout China at patient enrollment and during treatment between February, 2018 and December, 2019. This is an interim analysis including patients who are still on treatment and those that have completed treatment. A descriptive analysis was performed on the patients evaluated in the cohort. Results By December 31, 2019, a total of 1162 patients received bedaquiline-containing anti-TB treatment. Overall, 1563 AEs were reported, 66.9% were classified as minor (Grade 1–2) and 33.1% as serious (Grade 3–5). The median duration of bedaquiline treatment was 167.0 [interquartile range (IQR): 75–169] days. 86 (7.4%) patients received 36-week prolonged treatment with bedaquiline. The incidence of AEs and serious AEs was 47.1% and 7.8%, respectively. The most frequently reported AEs were QT prolongation (24.7%) and hepatotoxicity (16.4%). There were 14 (1.2%) AEs leading to death. Out of patients with available corrected QT interval by Fridericia's formula (QTcF) data, 3.1% (32/1044) experienced a post-baseline QTcF ≥ 500 ms, and 15.7% (132/839) had at least one change of QTcF ≥ 60 ms from baseline. 49 (4.2%) patients had QT prolonged AEs leading to bedaquiline withdrawal. One hundred and ninety patients reported 361 AEs with hepatotoxicity ranking the second with high occurrence. Thirty-four patients reported 43 AEs of hepatic injury referred to bedaquiline, much lower than that referred to protionamide, pyrazinamide and para-aminosalicylic acid individually. Conclusions Bedaquiline was generally well-tolerated with few safety concerns in this clinical patient population without any new safety signal identified. The mortality rate was generally low. These data inform significant positive effect to support the WHO recent recommendations for the wide use of bedaquiline.

Based on practical engineering, considering the characteristics of unsymmetrical loading, shallow burying, and weak surrounding rock of the tunnel, MIDAS finite element software is adopted to analyze the influence effect and deformation characteristics of a temporary steel support when the tunnel is excavated by a two-step center diaphragm method (CDM). The simulation results are compared with the field monitoring results. It can be seen that: (1) Affected by the unsymmetrical loading, the settlement of the right spandrel of the tunnel is obvious. The existence of a temporary steel support reduces the settlement of the surrounding rock at the spandrel greatly, making the distribution of principal stress at the spandrel more reasonable. (2) The deformation of the temporary steel support at the upper bench undergoes four stages: convergence, expansion, convergence, and stabilization; and the deformation at the lower bench undergoes five stages: convergence, expansion, convergence, expansion, and stabilization. (3) There is an obvious “bench-type” phenomenon in the principal stress change of the temporary steel support. The analysis results provide a scientific basis and technical guidance for the construction optimization of unsymmetrical loading tunnels using the same support technology.

Purpose: Total body irradiation (TBI) has been widely utilized as part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT), but is associated with significant toxicities. Targeted TBI using helical Tomotherapy allows precise and homogeneous tumor coverage and excellent sparing of organs at risk. The purpose of this study was to evaluate the clinical outcomes of a novel hypo-fractionation strategy for patients receiving total marrow and involved lymphoid irradiation (TMLI) as part of the conditioning regimen before HSCT. Methods and Materials: 61 patients (7 acute myelogenous leukemia (AML), 33 acute lymphoblastic leukemia (ALL), 18 non-Hodgkin’s lymphoma (NHL), 3 mixed acute leukemia (MAL)) received conditioning radiation treatment with TMLI (8 Gy to bone marrow, 10 Gy to involved field in 2 fractions per day) in conjunction with chemotherapy before transplantation. Results: The median age of 61 patients with TMLI was 24 (4–54) years. The prescribed dose covered the entire bone and involved target volume, and the dose of organs at risk (OAR) was reduced by 28%−78% of the prescription dose. Grade 1–2 nausea and vomiting occurred in 12 patients and grade 1–2 pain in 6 patients during radiotherapy. Fatigue occurred in 16 patients. 2 patients had diarrhea, enteritis, and 1 patient had fever. None of patient had grade 3–4 non-hematologic adverse reactions. Late (30 days after HSCT) grade 2 toxicities including reversible enteritis occurred in 3 patients. 5 patients developed infectious pneumonia. The 2 years progression-free survival (PFS) was 64.1% (95% CI: 0.16–0.22) and overall survival (OS) was 74.7% (95% CI: 0.19–0.24) for the 61 patients who had received their planned HSCT. The 2-year non-relapse mortality was significantly reduced to 5% in this patient cohort. Conclusions: This study demonstrates that hypo-fractionated TMLI (8 Gy to bone marrow, 10 Gy to involved field in a single day) as a conditioning regimen for lymphoma and acute leukemia was feasible and the clinical outcomes were acceptable.

Ischemic stroke is defined as an infarction in the brain, caused by impaired cerebral blood supply, leading to local brain tissue ischemia, hypoxic necrosis, and corresponding neurological deficits. At present, revascularization strategies in patients with acute ischemic stroke include intravenous thrombolysis and mechanical endovascular treatment. However, due to the short treatment time window (

AimGut microbiota is of crucial importance to cardiac health. Astragaloside IV (AS-IV) is a main active ingredient of Huangqi, a traditional edible and medicinal herb that has been shown to have beneficial effects on cardiac fibrosis (CF). However, it is still uncertain whether the consumption of AS-IV alleviates cardiac fibrosis through the gut microbiota and its metabolites. Therefore, we assessed whether the anti-fibrosis effect of AS-IV is associated with changes in intestinal microbiota and fecal metabolites and if so, whether some specific gut microbes are conducive to the benefits of AS-IV.MethodsMale C57BL-6J mice were subcutaneously injected with isoprenaline (ISO) to induce cardiac fibrosis. AS-IV was administered to mice by gavage for 14 days. The effects of AS-IV on cardiac function, myocardial enzyme, cardiac weight index (CWI), and histopathology of ISO-induced CF mice were investigated. Moreover, 16S rRNA sequencing was used to establish gut-microbiota profiles. Fecal-metabolites profiles were established using the liquid chromatograph-mass spectrometry (LC-MS).ResultsAS-IV treatment prevented cardiac dysfunction, ameliorated myocardial damage, histopathological changes, and cardiac fibrosis induced by ISO. AS-IV consumption increased the richness of Akkermansia, Defluviitaleaceae_UCG-011, and Rikenella. AS-IV also modulated gut metabolites in their feces. Among 141 altered gut metabolites, amino acid production was sharply changed. Furthermore, noticeable correlations were found between several specific gut microbes and altered fecal metabolites.ConclusionsAn increase of Akkermansia, Defluviitaleaceae_UCG-011, and Rikenella abundance, and modulation of amino acid metabolism, may contribute to the anti-fibrosis and cardiac protective effects of Astragaloside IV.

BackgroundInfluenza is associated with a large number of disease burdens, and it is generally recommended that all healthcare workers (HCWs) get an influenza vaccination. However, the vaccination rates among HCWs are still low. This study aimed to assess HCWs' knowledge, attitude, and practice (KAP) about the influenza vaccine, and by establishing a structural equation model (SEM) to explore the influencing factors of medical personnel's influenza vaccination in Chongqing, China.MethodsFrom September to November 2019, we conducted a cross-sectional survey in four sentinel hospitals and four non-sentinel hospitals in Chongqing, China. We calculated knowledge, attitude, and behavior scores for each study participant and assessed the level of knowledge, attitude, and behavior of the medical staff. An SEM was used to evaluate the relationship between latent variables, and the path graph between knowledge, attitude, and behavior was established.ResultsA total of 1,412 valid questionnaires were collected in this survey, including four sentinel hospitals (N = 606, 42.92%) and four non-sentinel hospitals (N = 806, 57.08%). Women (N = 1,102, 78.05%) were more than men (N = 310, 21.95%), with an average age of 32.36 ± 7.78 years old and under 30 years old (N = 737, 52.20%), respectively. Nurses (741, 52.48%) were the main subjects, followed by physicians (457, 32.37%). The final SEM model was obtained after the model was modified and adjusted. A bootstrap analysis of path coefficients was carried out on the final model. Knowledge has a direct influence on behavior. The normalized path coefficient is 0.071 (95% CI: 0.002–0.161), and the value of P of the hypothesis test result of the path coefficient is 0.042. The direct influence of knowledge on attitude standardization was 0.175 (95% CI: 0.095–0.281). The direct influence of attitude on practice standardization was 0.818 (95% CI: 0.770–0.862). The indirect effect of knowledge on the standardization of practice through attitude was 0.144 (95% CI: 0.076–0.235).ConclusionsAccording to the SEM, there is a direct positive correlation between KAP and the influenza vaccine. The indirect influence of knowledge on the standard of behavior through attitude is about two times as much as the direct influence on behavior, indicating that attitude plays a strong mediating role between knowledge and practice.

Objective Identifying organizational factors affecting venous thromboembolism (VTE) incidence and variations between hospitals. Methods From a 2019 survey of VTE and live births in 113 hospitals, organizational factors: (hospital type, characteristics, live birth number), resource availability: (D-dimer, B-scan ultrasonography of lower extremity veins, computed tomographic pulmonary angiography [CTPA], and competency: [risk assessment, use of anticoagulants and patient education], data were collected and the associations, weighted by live birth number, analyzed. Results Of 113 hospitals in China, 770,828 live births and 526 cases of VTE (68.2 per 100,000 live births) were reported. Nine hospitals lacked B-scan ultrasonography of lower extremity veins and 22 lacked CTPA. Prevalence rates of VTE rates were higher in general hospitals (Odds ratio [OR] = 4.251, 95% CI: 3.373-5.357), hospitals with live births < 10,000 (OR = 1.650-2.193), and hospitals without B-scan ultrasonography (OR = 1.661, 95% CI: 1.096-2.518). Hospitals implementing patient education, had a lower risk of VTE (OR = 0.296-0.374), and VTE rate decreased with the annual increase in live births. Conclusions Improved hospital resource availability and competency, especially patient education, is vital for reducing VTE-related maternal mortality and morbidity risk.

Abstract Background The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions. Methods A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed. Results Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P = 0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions. Conclusions Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.

Purpose To estimate influenza-associated excess mortality rates (EMRs) in Chongqing from 2012 to 2018. Methods We obtained weekly mortality data for all-cause and four underlying causes of death (circulatory and respiratory disease (CRD), pneumonia and influenza (P&I), chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IDH)), and influenza surveillance data, from 2012 to 2018. A negative-binomial regression model was used to estimate influenza-associated EMRs in two age groups (

Motivated by the observation that firms invest in carbon emissions reduction to decrease the cost of carbon tax as governments in numerous countries increasingly implement carbon tax to improve the environment, and broad researcher and practitioner agreement that carbon tax implementation always benefits the environment. However, we find that a carbon tax may actually hurt the environment based on a stylized game model with a better-informed retailer (one who controls the demand information sharing with the manufacturer) and a manufacturer. In particular, we find that the carbon emissions reduction may harm the environment if the carbon tax is moderate or both the carbon tax and the demand fluctuation are high. We further reveal free-riding behavior by the retailer, who may enjoy more profit sharing from the supply chain in the presence of carbon emissions reduction. Based on these observations, we argue that a carbon tax does not always benefit the environment when a manufacturer who receives demand information from the retailer responds better to market uncertainty.

Ubiquitous mobile multimedia applications bring great convenience to users. However, when enjoying mobile multimedia services, users provide personal data to service platforms. Although the service platforms always claim that the collected personal data are de-identified, the risk of re-identifying users through linkage attacks still exists and is incalculable. This paper proposes a rapid prediction model for the overall re-identification risk based on the statistics of data sets (i.e., the number of individuals, number of attributes, distribution of attribute values, and attribute dependency). Our proposed model reveals the impact of statistics on the overall re-identification risk and adopts random sampling and semi-random sampling methods to predict the overall re-identification risk of data sets with and without strong dependency ordered attribute pairs. Experimental results show that for the data sets without strong dependency ordered attribute pairs, the random sampling method has a high prediction accuracy (the prediction error is less than 0.05). For the data sets with strong dependency ordered attribute pairs, the semi-random sampling method has a high prediction accuracy (the prediction error is less than 0.09). Exploiting our model, governments and individuals can quickly assess the privacy leakage risk of their data sets, given only the statistic of the data sets. Besides, this model can also evaluate the privacy risk of data collection schemes in advance according to historical statistics, and identify suspected services.

Objective To evaluate the impact of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids on ovarian reserve in women of reproductive age. Materials and methods From September 2015 to September 2017, 84 patients with uterine fibroids in reproductive age were enrolled from Chongqing Haifu Hospital, Three Gorges Central Hospital of Chongqing and Aegisroen obstetric gynecology Clinic of Seoul, Korea. Blood was collected before HIFU treatment and 6 months after USgHIFU treatment. The enzyme-linked immune analysis was used for assay of circulating anti-Mullerian hormone (AMH). Results All the 84 patients were successfully treated with USgHIFU and 67 patients completed the follow-up. The median age of the 67 patients was 38 years at the time of treatment. The median AMH value before and 6 months after treatment was 1.26 ng/mL and 1.27 ng/mL, respectively. Patients who completed AMH measurements 6 months after treatment were further classified into three groups based on age, including younger than 35 years, 36 to 40 years, and older than 40 years. The median AMH values before treatment were 3.04 ng/mL, 1.73 ng/mL and 0.87 ng/mL, and the corresponding values 6 months after treatment were 3.24, 1.44 and 0.75, respectively. A significant difference in AMH level was observed in the group of patients at the age between 36 and 40 years (p 0.05). Conclusion Based on our results, we conclude that USgHIFU has no influence on ovarian reserve.

Background Disseminated peritoneal leiomyomatosis (DPL) is a rare, generally benign disorder. With the advent of laparoscopic surgery for uterine fibroids, the reported number of cases of DPL has significantly increased since the introduction of unconfined power morcellation. Morcellation and other procedures may be associated with DPL. Methods We present the case of a 48-year-old patient with DPL who underwent uterine artery embolization (UAE), laparoscopic myomectomy and high intensity focused ultrasound (HIFU) 11 years, 6 years, and 2 years before the final diagnosis of DPL was made. A subtotal hysterectomy with bilateral salpingo-oopherectomy was performed to remove the uterus, the fallopian tube and the ovaries. We carefully excised as many visible lesions as possible. Results After the surgical treatment performed in our center the patient became free of symptoms. Conclusion In our case, the occurrence of DPL is most likely associated with laparoscopic myomectomy using power morcellation. In addition, it should be noted whether some other factors played a role in stimulating the growth of the multiple nodules.

Objective: Ultrasound determination of chorionicity is poor in early pregnancy in China. In an effort to increase the accuracy rate of prompt chorionicity determination, clinical training was provided to primary care physicians. This study assesses the effects of implementing clinical guidelines on chorionicity determination. Methods: A multi-centered cohort study was conducted between January 2014 and June 2017 in 12 hospitals without fetal medicine centers. In 2014, the obstetricians and ultrasound physicians were trained in clinical practice and ultrasound examination relating to chorionicity determination. Linear and binary regression analyses were conducted to identify the effects of introducing the new protocols, including the diagnosis rate of chorionicty and perinatal outcomes, taking the data from 2014 as a baseline. Pregnancy outcomes were additionally adjusted for maternal age. Results: During the period of this study, 3,599 twin pregnancies from 12 centers were enrolled, and a total of 2,998 twin pregnancies were extracted. The rate of overall chorionicity determination, including antenatal and postpartum diagnosis, increased successively from 49.5% in 2014 to 93.5% in 2017 (P < 0.0001). The rate of ultrasonic chorionicity diagnosis before 14 weeks increased from 25.2% in 2014 to 65.0% in 2017 (P < 0.0001). These changes were associated with decreasing incidence of preterm birth, a lower risk of stillbirth, whether for one (P = 0.0456 in 2016) or two fetuses (P = 0.0470 in 2016; P = 0.0042 in 2017) and a decreased rate of admission to neonatal intensive care unit (43.0% in 2014, 37.4% in 2017; P = 0.0032). Conclusions: The implementation of a clinical practice guideline improved both overall and early chorionicity determinations. Regular training workshops of antenatal care are recommended to further promote capability in clinical diagnosis and treatment.

There has been renewed interest in assessing the pilot scheme for compiling the natural resources capitalization (NRC). A growing body of evidence highlights the good effects that the policy of NRC has on the construction of ecological civilization. No known empirical research has focused on exploring relationships between the policy of NRC and carbon emissions reduction. This paper employs the NRC as the ecological civilization policy to investigate whether the implementation of NRC has contributed to the carbon emissions reduction with a difference-in-differences (DID) method. The results showed that different variables of carbon emissions in four pilot cities can be effectively affected by the implementation of NRC. There were significant negative correlations between the carbon emissions per GDP (Gross Domestic Product) and the policy for Hulun Buir, Huzhou and Loudi cities, and a significant increase of carbon sequestration was found in Yan’an city. This research provides a timely and necessary study that the NRC policy could be a contributing factor to carbon emissions reduction. As a result of these investigations, suggestions were identified for future research. Further research should be undertaken to investigate the collaborative effects of multi-policies on environmental issues.

The “writers” of four types of adenosine (A)-related RNA modifications (N6-methyladenosine, N1-methyladenosine, alternative polyadenylation, as well as A-to-inosine RNA editing) are closely related to the tumorigenesis and progression of many cancer types, including skin cutaneous melanoma (SKCM). However, the potential roles of the crosstalk between these RNA modification “writers” in the tumor microenvironment (TME) remain unclear. The RNA modification patterns were identified using an unsupervised clustering method. Subsequently, based on differentially expressed genes responsible for the aforementioned RNA modification patterns, an RNA modification “writer” scoring model (W_Score) was constructed to quantify the RNA modification-associated subtypes in individual patients. Moreover, a correlation analysis for W_Score and the TME characteristics, clinical features, molecular subtypes, drug sensitivities, immune responses, and prognosis was performed. We identified three RNA modification patterns, corresponding to distinct tumor immune microenvironment characteristics and survival outcomes. Based on the W_Score score, which was extracted from the RNA modification-related signature genes, patients with SKCM were divided into high- and low-W_Score groups. The low-W_Score group was characterized by better survival outcomes and strengthened immunocyte infiltration. Further analysis showed that the low-W_Score group was positively associated with higher tumor mutation burden and PD-L1 expression. Of note, two immunotherapy cohorts demonstrated that patients with low W_Score exhibited long-term clinical benefits and an enhanced immune response. This study is the first to systematically analyze four types of A-related RNA modifications in SKCM, revealing that these “writers” essentially contribute to TME complexity and diversity. We quantitatively evaluated the RNA modification patterns in individual tumors, which could aid in developing personalized immunotherapy strategies for patients.

Walking stability is one of the key problems restricting the development of quadruped robots. Two new kinds of variable parameter quadruped robots with high stability were proposed. The two groups of variable parameter models were applied to quadruped robots with the full elbow joint or elbow joint for front legs and knee joint for back legs, respectively, and the stability of their linear motion under different variable parameters was deeply studied by Recurdyn. The quadruped robots with elbow joint for front legs and knee joint for back legs displayed good antijamming ability to lateral impact. According to the rigid-flexible simulation experiment, the largest force occurred in the knee joint during the movement of the quadruped robot. This provided a theoretical basis for the design of real quadruped robots.

When gob-side entry retaining is adopted in the mining face with large cutting height, due to large stope space, strong dynamic pressure, and other reasons, the filling body is usually broken and unstable due to improper width of filling body, and the stability of surrounding rock of a roadway is poor. Taking the actual project of Shaqu mine as the background, we analyze the stability factors of gob-side entry retaining with large mining height, and considering the lateral pressure and overlying load on the filling body, the mechanical model of a gob-side retaining roadway is established, the calculation method of the reserved width of the filling body is simplified, and the reasonable width of the filling body is obtained quantitatively. Through the monitoring results of numerical simulation and field test, the rationality of the calculation results of the reserved width of filling body is verified. The results show that if the width of the filling body is too small, it will not be able to bear the load of the overlying strata, resulting in the fragmentation of the filling body. The larger the width of the filling body, the greater the cutting resistance provided, which can reduce timely the stress on the roadway and above the filling body, and the more stable the retaining roadway is, but when the width increases to a certain value, the displacement of the surrounding rock of the roadway has changed little. When the width of the filling body is 4 m, the stability of gob-side entry retaining can be guaranteed.

The administration of mRNA-based tumour vaccines is considered a promising strategy in tumour immunotherapy, although its application against kidney renal clear cell carcinoma (KIRC) is still at its infancy stage. The purpose of this study was to identify potential antigens and to further select suitable patients for vaccination. Gene expression data and clinical information were retrieved from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. GEPIA2 was used to evaluate the prognostic value of selected antigens. The relationship of antigens presenting cell infiltration with antigen expression was evaluated by TIMER, and immune subtypes were determined using unsupervised cluster analysis. Tumour antigens LRP2 and DOCK8, which are associated with prognosis and tumour-infiltrating antigen-presenting cells, were identified in KIRC. A total of six immune subtypes were identified, and patients with immune subtype 1–4 (IS1–4) tumours had an immune ‘cold’ phenotype, a higher tumour mutation burden, and poor survival. Moreover, these immune subtypes showed significant differences in the expression of immune checkpoint and immunogenic cell death modulators. Finally, the immune landscape of KIRC revealed the immune-related cell components in individual patients. This study suggests that LRP2 and DOCK8 are potential KIRC antigens in the development of mRNA vaccines, and patients with immune subtypes IS1–4 are suitable for vaccination.

Background and ObjectivesIntermediate hyperglycemia in the first half of pregnancy, defined as a fasting plasma glucose level between 5.1- 6.9 mM, increases the risk of gestational diabetes mellitus, but clinical evidence for further management is lacking. We aim to evaluate the effectiveness of an early oral glucose tolerance test (OGTT) followed by the identification of intermediate hyperglycemia on pregnancy outcomes in real world setting.Subjects and MethodsA retrospective cohort study was conducted at the Obstetrics and Gynecology Hospital, Shanghai, China, between 2013 and 2017. Women with intermediate hyperglycemia at the first prenatal visit were identified and underwent an immediate (within one week) or a routine OGTT (24-28 gw) according to their wishes and received nutrition and exercise advice. Women diagnosed of gestational diabetes (GDM) were managed by standard interventions. Primary outcome was larger for gestational age (LGA). Secondary outcomes were primary cesarean delivery, preterm birth, shoulder dystocia or forceps delivery, preeclampsia, neonatal hypoglycemia, hyperbilirubinemia, and low Apgar score. Logistic regressions with or without a further propensity score-matched analysis were performed.ResultsAmong 42406 women involved, 1104 (2.6%) with intermediate hyperglycemia at the first prenatal visit were identified, of whom 176 (15.9%) underwent an early OGTT and 741 (67.1%) received a routine OGTT. Logistic regression showed that an early OGTT was not significantly associated with an altered risk of LGA (adjusted OR 1.13, 95% CI 0.73-1.75) but was related to an increased odds for neonatal hyperbilirubinemia (adjusted OR 2.89; 95% CI 1.55-5.37). No significant associations were observed for other secondary outcomes. These trends remained consistent in propensity score-matched models.ConclusionsOur data from a real-world setting did not support that an early OGTT among women with intermediate hyperglycemia at the first prenatal visit improved pregnancy outcomes.

Metal–organic frames (MOFs) have recently been used to support redox enzymes for highly sensitive and selective chemical sensors for small biomolecules such as oxygen (O2), hydrogen peroxide (H2O2), etc. However, most MOFs are insulative and their three-dimensional (3D) porous structures hinder the electron transfer pathway between the current collector and the redox enzyme molecules. In order to facilitate electron transfer, here we adopt two-dimensional (2D) metal–organic layers (MOLs) to support the HRP molecules in the detection of H2O2. The correlation between the current response and the H2O2 concentration presents a linear range from 7.5 μM to 1500 μM with a detection limit of 0.87 μM (S/N = 3). The sensitivity, reproducibility, and stability of the enzyme sensor are promoted due to the facilitated electron transfer.

(1) Background: Alzheimer’s disease (AD), an age-progressive neurodegenerative disease that affects cognitive function, causes changes in the functional connectivity of the default-mode network (DMN). However, the question of whether AD-related changes occur in the functional connectivity of the basal ganglia has rarely been specifically analyzed. This study aimed to measure the changes in basal ganglia functional connectivity among patients with AD and mild cognitive impairment (MCI) in their resting state using the functional connectivity density (FCD) value, the functional connectivity (FC) intensity, and the graph theory index, and to confirm their influence on clinical manifestations. (2) Methods: Resting-state functional MRI (rs-fMRI) and neuropsychological data from 48 participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) were used for analyses. The 48 ADNI participants comprised 16 patients with AD, 16 patients with MCI, and 16 normal controls (NCs). The functional connectivity of basal ganglia was evaluated by FCDs, FC strength, and graph theory index. We compared voxel-based FCD values between groups to show specific regions with significant variation and significant connectivity from ROI conduction to ROI analysis. Pearson’s correlation analyses between functional connectivity and several simultaneous clinical variables were also conducted. Additionally, receiver operating characteristic (ROC) analyses associated with classification were conducted for both FCD values and graph theory indices. (3) Results: The level of FCD in patients with cognitive impairment showed obvious abnormalities (including short-range and long-range FCD). In addition to DMN-related regions, aberrant functional connectivity was also found to be present in the basal ganglia, especially in the caudate and amygdala. The FCD values of the basal ganglia (involving the caudate and amygdala) were closely related to scores from the Mini-Mental State Examination (MMSE) and the Functional Activities Questionnaire (FAQ); meanwhile, the graph theory indices (involving global efficiency and degree) of the basal ganglia (involving the caudate, amygdala, and putamen) were also found to be closely correlated with MMSE scores. In ROC analyses of both FCD and graph theory, the amygdala was of the utmost importance in the early-stage detection of MCI; additionally, the caudate nucleus was found to be crucial in the progression of cognitive decline and AD diagnosis. (4) Conclusions: It was systematically confirmed that there is a phenomenon of change in the functional connections in the basal ganglia during cognitive decline. The findings of this study could improve our understanding of AD and MCI pathology in the basal ganglia and make it possible to propose new targets for AD treatment in further studies.

ObjectiveThe prognosis of patients with breast cancer liver metastasis (BCLM) was poor. We aimed at constructing a nomogram to predict overall survival (OS) for BCLM patients using the SEER (Surveillance Epidemiology and End Results) database, thus choosing an optimized therapeutic regimen to treat.MethodsWe identified 1173 patients with BCLM from the SEER database and randomly divided them into training (n=824) and testing (n=349) cohorts. The Cox proportional hazards model was applied to identify independent prognostic factors for BCLM, based on which a nomogram was constructed to predict 1-, 2-, and 3-year OS. Its discrimination and calibration were evaluated by the Concordance index (C-index) and calibration plots, while the accuracy and benefits were assessed by comparing it to AJCC-TNM staging system using the decision curve analysis (DCA). Kaplan-Meier survival analyses were applied to test the clinical utility of the risk stratification system.ResultsGrade, marital status, surgery, radiation therapy, chemotherapy, CS tumor size, tumor subtypes, bone metastatic, brain metastatic, and lung metastatic were identified to be independent prognostic factors of OS. In comparison with the AJCC-TNM staging system, an improved C-index was obtained (training group: 0.701 vs. 0.557, validation group: 0.634 vs. 0.557). The calibration curves were consistent between nomogram-predicted survival probability and actual survival probability. Additionally, the DCA curves yielded larger net benefits than the AJCC-TNM staging system. Finally, the risk stratification system can significantly distinguish the ones with different survival risk based on the different molecular subtypes.ConclusionWe have successfully built an effective nomogram and risk stratification system to predict OS in BCLM patients, which can assist clinicians in choosing the appropriate treatment strategies for individual BCLM patients.

Purely organic ultralong room temperature phosphorescence (URTP) attracts attention but high efficiencies are rarely achieved. Here the authors use ultrafast spectroscopy to investigate a system of 1,8-naphthalic anhydride in organic hosts and reveal that a cluster exciton forms as a transient state before the guest acts as an energy trap for the URTP state.

To effectively reduce the energy consumption,blocking rate and crosstalk between adjacent cores in a multi-core fiber for space division multiplexing elastic optical network (SDM-EON),an energy-saving algorithm considering idle light-path prediction was proposed.The extreme learning machine model was used to predict the traffic volume of each light-path in the network.Thus the idle light-path set and the maintenance time threshold of each idle light-path were obtained.Then,the actual maintenance time of the idle light-path was perceived by the prediction algorithm.Finally,in the light-paths where the actual maintenance time do not exceed the minimum maintenance time threshold and the inter-core crosstalk are lower than the crosstalk threshold,the idle light-path with the least loading energy consumption was selected to carry the new traffic.The simulation results show that compared with the traditional energy-saving algorithm,when the SDM-EON crosstalk limitation is satisfied,the proposed algorithm can lead better energy-saving while maintain the blocking rate at levels compatible.

Background: Early detection of influenza activity followed by timely response is a critical component of preparedness for seasonal influenza epidemic and influenza pandemic. However, most relevant studies were conducted at the regional or national level with regular seasonal influenza trends. There are few feasible strategies to forecast influenza activity at the local level with irregular trends. Methods: Multi-source electronic data, including historical percentage of influenza-like illness (ILI%), weather data, Baidu search index and Sina Weibo data of Chongqing, China, were collected and integrated into an innovative Self-adaptive AI Model (SAAIM), which was constructed by integrating Seasonal Autoregressive Integrated Moving Average model and XGBoost model using a self-adaptive weight adjustment mechanism. SAAIM was applied to ILI% forecast in Chongqing from 2017 to 2018, of which the performance was compared with three previously available models on forecasting. Findings: ILI% showed an irregular seasonal trend from 2012 to 2018 in Chongqing. Compared with three reference models, SAAIM achieved the best performance on forecasting ILI% of Chongqing with the mean absolute percentage error (MAPE) of 11·9%, 7·5%, and 11·9% during the periods of the year 2014–2016, 2017, and 2018 respectively. Among the three categories of source data, historical influenza activity contributed the most to the forecast accuracy by decreasing the MAPE by 19·6%, 43·1%, and 11·1%, followed by weather information (MAPE reduced by 3·3%, 17·1%, and 2·2%), and Internet-related public sentiment data (MAPE reduced by 1·1%, 0·9%, and 1·3%). Interpretation: Accurate influenza forecast in areas with irregular seasonal influenza trends can be made by SAAIM with multi-source electronic data. Keywords: Influenza, Influenza-like illness, Forecast, AI, Multi-source electronic data

Molecular systems displaying aggregation-induced emission (AIE) have important biomedical and optoelectronic applications. Here the authors report a further mechanism for AIE, through aromaticity reversal from the ground state to the excited state, in the non-aromatic annulene derivative of cyclooctatetrathiophene.

Objectives: Influenza A(H7N9) virus has emerged and resulted in human infections in Chongqing, southwestern China since 2017. This study aimed to describe the epidemiological characteristics of the first epidemic in this region. Methods: The epidemiological data of patients were collected. Live poultry markets (LPMs), commercial poultry farms (CPFs) and backyard poultry farms (BPFs) were monitored, and poultry sources were registered. Samples derived from the patients, their close contacts, and the environments were tested for influenza A(H7N9) virus by real-time reverse transcriptase polymerase chain reaction. Genetic sequencing and phylogenetic analysis were also conducted. Results: Since the confirmation of the first patient infected with influenza A(H7N9) virus on March 5, 2017, nine patients had been identified within four months in Chongqing. Their mean age was 45 years, 77.8% were male, 66.7% were urban residents and 55.6% were of poultry related occupation. All patients became infected after exposure to live chickens. The median time interval from initial detection of influenza A(H7N9) virus in Chongqing to the patients’ onset was 75 days. Since initial detection in February 2017, influenza A(H7N9) virus was detected in 21 (53.8%) counties within four months. The proportion of positive samples was 2.94% (337/11,451) from February 2017 to May 2018, and was higher (χ2 = 75.78, P

Molecular motion has attracted a wide range of interest for different applications. Here, the authors develop nanoparticles with internal molecular motion upon near infrared absorption and use the nanoparticles for photoacoustic imaging and demonstrate this application in vivo.

The nervous necrosis virus (NNV) mainly attacks the central nervous system of fish to cause viral nervous necrosis, which is an acute and serious prevalent disease in fish. Among different genotypes of NNV, red-spotted grouper nervous necrosis virus (RGNNV) is the most widely reported, with the highest number of susceptible species. To better understand the pathogenicity of RGNNV, we first developed a reverse genetic system for recombinant RGNNV rescue using B7GG and striped snakehead (SSN-1) cells. Furthermore, we constructed attenuated RGNNV strains rRGNNV-B2-M1 and rRGNNV-B2-M2 with the loss of B2 protein expression, which grew slower and induced less Mx1 expression than that of wild-type RGNNV. Moreover, rRGNNV-B2-M1 and rRGNNV-B2-M2 were less virulent than the wild-type RGNNV. Our study provides a potential tool for further research on the viral protein function, virulence pathogenesis, and vaccine development of RGNNV, which is also a template for the rescue of other fish viruses.

Due to their complex geological structure, it is difficult to systematically analyze the surface subsidence of coal mines in southwest China, and the factors that cause surface subsidence are also different from other coal mines. Focusing on the problem of surface subsidence caused by mining in southwest China’s mines, a grade evaluation system for surface subsidence of southwest mines is constructed based on the analytic hierarchy process, and ten evaluation indicators are established from the perspectives of mining disturbance and geological structure. A matter–element model of surface subsidence based on matter–element extension theory and a cloud model of surface subsidence based on cloud theory are then constructed. A coal mine in Anshun, Guizhou, is taken as an example to calculate the evaluation level of surface subsidence and thus verify the scientificity of extension theory and cloud theory. The results show that the main factors that affect the surface subsidence of southwest mines are the number of coal seam layers, mining height and comprehensive Platt hardness of rock, similar to that of northern plain coal mines. Surface slope and subsidence area are also very important. The comprehensive correlation degree of each grade of the coal mine is −0.29836, 0.192232, −0.1093 and −0.46531, and the coal mine is concluded to be in grade 2. The calculated similarity of the overall index evaluation cloud map of the coal mine and each grade is 0, 0.3453, 0.7872 and 0, respectively. The coal mine is in grade 2, which is a relatively safe state. Consistent with the calculation results of the extension model and in line with the field situation, the extension matter–element model and cloud model built in this paper can verify each other and have a certain scientificity.

In this study, taking the Sheng’an coal mine as an engineering background, the failure characteristics of the surrounding rock of a roadway under repeated mining in a close-distance coal seam is comprehensively illustrated through field measurements (e.g., drilling imaging), theory analysis and numerical simulation (finite difference method (FDM)). The results show that although the return airway 10905 remains intact, the apparent failure of the roadway’s roof and the coal pillar can be observed. In addition, the expression of floor failure depth caused by upper coal seam mining is obtained through elastic-plastic theory. Meanwhile, the deformation of the surrounding rock of the roadway increases with the increase of repeated mining times, especially for the horizontal displacement of the roadway on the coal pillar side. Moreover, the cracks’ evolution of surrounding rock in the roadway can be observed as asymmetric characteristics. Finally, the stability control technology of “asymmetric anchor net cable + I-steel” is proposed to prevent potential mining disasters, and the feasibility of this support scheme is verified by numerical simulation and field practices. It can meet the requirement of safe mining and provide guidelines to effectively solve the failure of a roadway in close-distance coal seam mining.

Abstract Background To report our experience in planning and delivering total marrow irradiation (TMI) and total marrow and lymphatic irradiation (TMLI) in patients with hematologic malignancies. Methods Twenty-seven patients undergoing bone marrow transplantation were treated with TMI/TMLI using Helical Tomotherapy (HT). All skeletal bones exclusion of the mandible comprised the treatment target volume and, for TMLI, lymph node chains, liver, spleen and/or brain were also included according to the clinical indication. Planned dose of 8Gy in 2 fractions was delivered over 1 day for TMI while 10Gy in 2 fractions BID was used for TMLI. Organs at risk (OAR) contoured included the brain, brainstem, lens, eyes, optic nerves, parotids, oral cavity, lungs, heart, liver, kidneys, stomach, small bowel, bladder and rectum. In particular, a simple method to avoid hot or cold doses in the overlapping region was implemented and the plan sum was adopted to evaluate dose inhomogeneity. Furthermore, setup errors from 54 treatments were summarized to gauge the effectiveness of immobilization. Results During the TMI/TMLI treatment, no acute adverse effects occurred during the radiation treatment. Two patients suffered nausea or vomiting right after radiation course. For the 9 patients treated with TMI, the median dose reduction of major organs varied 30–65% of the prescribed dose, substantially lower than the traditional total body irradiation (TBI). Meanwhile, average biological equivalent doses to OARs with 8Gy/2F TMI approach were not different from the conventional 12Gy/6F TMI approach. In the dose junction region, the 93% of PTV was covered by the prescribed dose without obvious hotspots. For the 27 patients, the overall setup corrections were lower than 3 mm except those in the SI direction for abdomen-pelvis region, demonstrating excellent immobilization. Conclusion The present study confirmed the technical feasibility of HT-based TMI/TMLI delivering 8-10Gy in 2 fractions over 1 day. For patients undergoing hematopoietic cell transplantation the proposed 8Gy/2F TMI (or 10Gy/2F TMLI) strategy may be a novel approach to improve delivery efficiency, increase effective radiation dose to target while maintaining low risk of severe organ toxicities.

When legged robots walk on rugged roads, they would suffer from strong impact from the ground. The impact would cause the legged robots to vibrate, which would affect their normal operation. Therefore, it is necessary to take measures to absorb impact energy and reduce vibration. As an important part of a goat’s foot, the hoof capsule can effectively buffer the impact from the ground in the goat’s running and jumping. The structure of the hoof capsules and its principle of buffering and vibration reduction were studied. Inspired by the unique shape and internal structure of the hoof capsules, a bionic foot was designed. Experimental results displayed that the bionic foot could effectively use friction to consume impact energy and ensured the stability of legged robot walking. In addition, the bionic foot had a lower natural vibration frequency, which was beneficial to a wide range of vibration reduction. This work brings a new solution to the legged robot to deal with the ground impact, which helps it adapt to a variety of complex terrain.

Objective: The present study aims to analyze the clinical characteristics and etiology of transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) complicated with acute respiratory distress syndrome (ARDS), in order to improve the early diagnosis rate and cure rate. Methods: A total of 816 patients with primary HCC received 2,200 TACE treatments from January 2014 to May 2018. Among these patients, 6 patients developed ARDS after TACE. The clinical data, lesion characteristics, laboratory tests, treatment process and prognosis of 6 patients were retrospectively analyzed. Results: The longest lesion diameter ranged within 5.0-10.2 cm (mean: 6.6 cm) in the 6 patients with primary HCC. Among these patients, 4 patients had lesions mainly located in the left lateral lobe of the liver, while 5 patients had no hepatic arteriovenous fistula detected before TACE. Nedaplatin, epirubicin and iodinated oil suspension chemoembolization were used in all 6 patients during TACE, and all of them experienced ARDS symptoms within 24-48 hours after TACE. However, no clear pathogenic bacteria were incubated in the sputum culture after the onset of the disease. Diffused exudative changes of both lungs were found in the chest X-ray, and the oxygenation index (PaO 2 /FiO 2 ) was within 100-300 mmHg. The symptoms of 6 patients improved after 3-6 days of hormone therapy. Conclusion: In this study, we found that although the incidence of ARDS after TACE was low in the treatment for HCC, the symptoms after onset were serious, and the early hormone therapy may be beneficial to improve the prognosis and reduce mortality. Further research with larger samples is still needed to confirm the pathogenesis of ARDS after TACE in the treatment for HCC.

Background: Long-chain per- and polyfluoroalkyl substances (PFASs) and their short-chain alternatives have been produced and used extensively in China. However, it is unclear whether these compounds contribute to the risk of gestational diabetes mellitus (GDM) in women residing in contaminated areas. Objective: The study was performed to explore the association between PFASs varying in chain length and the risk of developing GDM. Method: A nested case-control study was conducted in a prospective cohort of 2,460 pregnant women between July 1, 2017, and January 31, 2019 in Shanghai, China. Twelve PFASs of interest were measured using ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF MS) in the sera of pregnant women at 16–20 weeks. GDM was diagnosed by an oral glucose tolerance test administered over 24–28 gestational weeks. The cases and controls were matched by maternal age. The relationship between maternal serum PFAS level and GDM risk was determined by conditional logistic and linear regression analyses. Results: A total of 165 GDM cases and 330 controls were enrolled in the study cohort. The frequencies of detection of PFHpA, PFDS, and PFOSA were all ≤80%. Hence, they were excluded from any further risk analysis. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected at relatively high serum levels (medians 6.57 ng/mL and 8.07 ng/mL, respectively). The serum levels of perfluorobutanesulfonic acid (PFBS) and perfluorododecanoic acid (PFDoA) were significantly higher in the GDM group than they were in the control group (P = 0.02 and P