Basic Disease Research Articles

Risk factors and predictors of recurrence of febrile seizures in children in Nantong, China: a retrospective cohort study

BackgroundAlthough most children with febrile seizures (FS) have a favorable prognosis, some experience recurrence within 1–3 years. Age, peak temperature, and family history are now recognized as important risk factors for FS recurrence, yet studies in this area are lacking in China. This study aimed to investigate the risk factors for FS recurrence in children in Nantong, China, and to develop a prediction model.MethodsThis retrospective cohort study analyzed 463 children diagnosed with febrile seizures (FS) who presented to the Affiliated Hospital of Nantong University between January 2015 and June 2020. Basic information, disease characteristics, and laboratory and imaging data were collected. A follow-up survey was conducted one year post-discharge to assess the recurrence status of FS in children. Univariate logistic regression and random forest models were used to identify and rank the predictive ability of risk factors for recurrence.ResultsOf the 463 children with FS, 70 experienced recurrences within 1 year of discharge, resulting in a one-year recurrence rate of 15%. Age (OR = 0.61, 95% CI: 0.46, 0.80, P < 0.001), duration of the first episode (OR = 1.03, 95% CI: 1.00, 1.06, P = 0.040), and peak temperature (OR = 0.68, 95% CI: 0.47, 0.98, P = 0.036) were identified as independent risk factors for FS recurrence. Age had the highest relative importance in predicting FS recurrence, followed by the duration of the first episode, with an area under the ROC curve of 0.717.ConclusionYoung age and duration of the first seizure are important independent risk factors for FS recurrence and are key considerations for predicting recurrence. Further research is needed to confirm the potential use of Neutrophil–lymphocyte ratio (NLR) as a predictor of FS recurrence.

Pay attention to the identification and management of perioperative stroke

Perioperative stroke is a serious complication that leads to perioperative death, prolonged hospitalization, and permanent or temporary neurological impairment. Early identification and diagnosis is the key of improving the prognosis of perioperative stroke patients, which requires surgeons to have a complete understanding of patient risk factors, early rapid identification of symptoms and timely diagnosis. The core of the prevention strategy is delaying the operating time, reducing known risk factors, drug intervention (such as the use of antiplatelet drugs or anticoagulants), optimizing the control of the basic disease, and identifying high-risk patients in the preoperative evaluation to implement a more personalized perioperative management plan, to reduce the incidence of perioperative stroke and related adverse consequences.

Epidemiological study on non-drug-resistant Acinetobacter

Objective. To explore the prevalence of non-drug-resistant Acinetobacter, in order to provide a theoretical basis for clinical anti-infection treatment of non-drug-resistant Acinetobacter. Methods. The medical records of inpatients in various departments of the hospital were retrospectively sorted out, and the data covered many aspects of human body such as blood, saliva, sputum and tissue. Immediately after collection, samples were labeled and stored in a refrigerator at 8°C to investigate clinical distribution and prevalence. Results. Among the 158 strains of non-drug-resistant A. baumannii, 30 strains were obtained from sputum samples (18.98%). The second most common type was 11 strains in urine (6.96%); 44 blood samples, accounting for 27.85%. The age distribution was as follows: 8 strains (11.39%) were minors under 18 years of age; There were 20 plants (12.66%) aged from 18 to 30 years old; 75 strains (47.47%) were over 60 years old. Nine of the 158 non-resistant strains were included, accounting for the highest proportion of A. Boumani, followed by A. Boumani Hospital and A. Boumani Pittsburgh. At present, the bacterial strain is mostly detected in blood samples, and is mainly distributed in middle-aged and old patients over 50 years old, and is relatively popular in ICU and FMW departments. Conclusion. The drug-resistant A. baumannii in hospital specimens tends to accumulate in ICU, and the nosocomial infection caused by this disease is mainly concentrated in the elderly and patients with various basic diseases, with a high detection rate. Acinetobacter strains are generally resistant, and polymyxin B and minocycline are often the first choice of therapy.

Relative effect size-based profiles as an alternative to differentiation analysis in multi-species single-cell transcriptional studies.

Combining data from experiments on multispecies studies provides invaluable contributions to the understanding of basic disease mechanisms and pathophysiology of pathogens crossing species boundaries. The task of multispecies gene expression analysis, however, is often challenging given annotation inconsistencies and in cases of small sample sizes due to bias caused by batch effects. In this work we aim to demonstrate that an alternative approach to standard differential expression analysis in single cell RNA-sequencing (scRNA-seq) based on effect size profiles is suitable for the fusion of data from small samples and multiple organisms. The analysis pipeline is based on effect size metric profiles of samples in specific cell clusters. The effect size substitutes standard differentiation analyses based on p-values and profiles identified based on these effect size metrics serve as a tool to link cell type clusters between the studied organisms. The algorithms were tested on published scRNA-seq data sets derived from several species and subsequently validated on own data from human and bovine peripheral blood mononuclear cells stimulated with Mycobacterium tuberculosis. Correlation of the effect size profiles between clusters allowed for the linkage of human and bovine cell types. Moreover, effect size ratios were used to identify differentially regulated genes in control and stimulated samples. The genes identified through effect size profiling were confirmed experimentally using qPCR. We demonstrate that in situations where batch effects dominate cell type variation in single cell small sample size multispecies studies, effect size profiling is a valid alternative to traditional statistical inference techniques.

A simple modification to the classical SIR model to estimate the proportion of under-reported infections using case studies in flu and COVID-19

BackgroundUnder-reporting and, thus, uncertainty around the true incidence of health events is common in all public health reporting systems. While the problem of under-reporting is acknowledged in epidemiology, the guidance and methods available for assessing and correcting the resulting bias are obscure. ObjectiveWe aim to design a simple modification to the Susceptible – Infected – Removed (SIR) model for estimating the fraction or proportion of reported infection cases. MethodsThe suggested modification involves rescaling of the classical SIR model producing its mathematically equivalent version with explicit dependence on the reporting parameter (true proportion of cases reported). We justify the rescaling using the phase plane analysis of the SIR model system and show how this rescaling parameter can be estimated from the data along with the other model parameters. ResultsWe demonstrate how the proposed method is cross-validated using simulated data with known disease cases and then apply it to two empirical reported data sets to estimate the fraction of reported cases in Missoula County, Montana, USA, using: (1) flu data for 2016–2017 and (2) COVID-19 data for fall of 2020. ConclusionsWe establish with the simulated and COVID-19 data that when most of the disease cases are presumed reported, the value of the additional reporting parameter in the modified SIR model is close or equal to one, so that the original SIR model is appropriate for data analysis. Conversely, the flu example shows that when the reporting parameter is close to zero, the original SIR model is not accurately estimating the usual rate parameters, and the re-scaled SIR model should be used. This research demonstrates the role of under-reporting of disease data and the importance of accounting for under-reporting when modeling simulated, endemic, and pandemic disease data. Correctly reporting the “true” number of disease cases will have downstream impacts on predictions of disease dynamics. A simple parameter adjustment to the SIR modeling framework can help alleviate bias and uncertainty around crucial epidemiological metrics (e.g.: basic disease reproduction number) and public health decision making.

ФАКТОРЫ РИСКА РЕЗИСТЕНТНОСТИ ЮНОШЕСКОЙ МИОКЛОНИЧЕСКОЙ ЭПИЛЕПСИИ

Abstract. Introduction. Juvenile myoclonic epilepsy is the most common form of genetic generalized epilepsy, which is included in the group of idiopathic generalized epilepsies. The etiology of drug-resistant forms of juvenile myoclonic epilepsy, which represent a serious clinical problem, is currently a controversial issue. Aim. To reveal the most significant risk factors of resistance in juvenile myoclonic epilepsy. Materials and Methods. The observational retrospective study included 56 patients, 46 (82%) women and 10 (18%) men. Inclusion criteria: patients diagnosed with juvenile myoclonic epilepsy based on the criteria of the International League Against Epilepsy, treatment for at least 2 years. The type and frequency of epileptic seizures, the onset and course of the disease, concomitant diseases, family history, all available results of 1-2 hours video electroencephalographic monitoring with sleep, and magnetic resonance imaging results were analyzed. Depending on the treatment effect, all patients were divided into two groups: 1 – without seizures, 2 – with seizures. Lack of complete seizure control for at least 2 years was considered intractable epilepsy. Risk ratios as outcomes for dichotomous variables in two compared groups for various characteristics and their confidence intervals were calculated using the Review Manager program (v5.3). Differences were considered significant at P&lt;0.05. Results and Discussion. As a result, there were obtained data on the resistance of juvenile myoclonic epilepsy depending on the age of disease onset, the type of epileptic seizures, changes in the electroencephalogram, and the type of antiepileptic treatment. Conclusions. The most significant risk factors of resistance in juvenile myoclonic epilepsy have been identified: frequent generalized tonic-clonic seizures (more than 5 times a year) accompanying the basic disease, depression, anxiety, and lack of response to the treatment with valproic acid. At the same time, non-compliance, sleep disturbances, consumption of alcohol and energy drinks during therapy are factors that can be controlled during the physician’s individual work with the patient aimed at the explanation and prevention of risks in treatment.

#543 Cognitive improvement in end stage renal disease patients post transplantation—a prospective observational study

Abstract Background and Aims Global life expectancy at birth has increased from 66.8 years in 2000 to 73 years in 2019, as per data given by WHO in 2020. With the aging of the population, chronic kidney disease has become one of the common non communicable diseases in the world as well as one of the leading causes of mortality. Cognitive impairment begins early during chronic kidney disease and parallels kidney function decline. Cognitive dysfunction may affect the patient's daily functioning, employment options, medical adherence, medical decision making and is an independent predictor of mortality. Kidney transplantation can correct the metabolic derangements and eliminate the fluid and osmotic shifts that patients can experience on dialysis. However, cognitive impairments still persist post transplant and diagnosing and managing cognitive impairment is critical. Although there is a well established survival benefit of renal transplantation, the evidence of its effect on cognitive function is limited and not entirely consistent. Additional clinically relevant questions include whether existing comorbid conditions and associated endothelial dysfunction result in cognitive impairment that is not reversible with kidney transplant and which domains of cognition improve after transplant. This study aims to determine the proportion of patients showing cognitive improvement 3 months and 6 months post renal transplantation using Montreal Cognitive Assessment and to find the cognitive domains which show improvement post renal transplantation. This study also focusses on various parameters post transplant which may have affect the cognition of kidney transplant recipients. Method This study is a prospective observational study, conducted in a total of 100 patients, age group between 18 to 60 years who underwent renal transplantation in Medanta Hospital, India. Patients were enrolled in the study after taking informed consent. Patient demographics including age, sex, basic disease, co morbidities, dialysis vintage were recorded. Montreal cognitive assessment score was recorded during pre transplant period and was again recorded at 3 months and at 6 months posttransplant during outpatient department visits. Any episodes of infection, rejection or graft loss were recorded up to a period of 6 months post transplantation. Results with Figures 26 patients out of 100 showed improvement in Montreal Cognitive assessment score three months post renal transplantation and 56 patients out of 100 showed improvement in Montreal Cognitive assessment score 6 months post transplantation, when compared to their score at pre transplant level. The Mean Montreal cognitive assessment score at pre transplant level was 24.08 ± 3.08, at 3 months post-transplant was 24.32 ± 2.90 and at 6 months post-transplant was 25.28 ± 3.05. The difference between the mean score at 3 months post transplant when compared to mean score at pre transplant level was not found to be statistically significant p value 0.07. The difference between the mean score at 6 months post transplant when compared to the mean score at pre transplant level was found to be statistically significant p value &amp;lt;0.001. Among the various cognitive domains tested, delayed recall showed significant improvement after 3 months and 6 months post transplant with p values of 0.016 and &amp;lt; 0.001 respectively. Conclusion Significant cognitive improvement was seen 6 months post renal transplant. Delayed recall showed significant improvement after 3 and 6 months post renal transplant. This study concluded that patients who showed improvement in cognition 6 months post transplant did not show any significant correlation between the parameters studied such as serum sodium, calcium, haemoglobin, creatinine, age, rates of rejection and infection or use of any specific induction agent and improvement in Montreal cognitive assessment score. The screening for cognitive functions after kidney transplantation is not yet a routine practice and must be included in the routine follow up of the kidney transplant recipients.

Liver cancer in China: the analysis of mortality and burden of disease trends from 2008 to 2021

BackgroundLiver cancer is one of the most common cancers in China. To understand the basic death situation and disease burden change trend, we analyze the death information of liver cancer among Chinese residents from 2008 to 2021.MethodsData was collected from the Cause-of-Death Surveillance dataset of the National Cause-of-Death Surveillance System from 2008 to 2021. Excel 2016 was used for data entry and to calculate the Crude Mortality Rate (CMR), Age-Standardized Mortality Rate (ASMR), Potential Years of Life Lost (PYLL), and Potential Years of Life Lost Rate (PYLLR). SPSS 25.0 was used to statistically analyze CMR, ASMR, PYLL, and other indicators. Annual percent change (APC) and average APC(AAPC) was used for trend analysis and tested by t tests. Joinpoint 4.9.1.0 was used to calculate APC and AAPC. Age-Period-Cohort model was used to assess the effects of age, period, and birth cohort on liver cancer mortality.ResultsFrom 2008 to 2021, 491,701 liver cancer deaths were reported in the National Disease Surveillance Points System. The ASMR of liver cancer in Chinese residents decreased from 27.58/100,000 in 2008 to 17.95/100,000 in 2021 at an average annual rate of 3.40% (t = -5.10, P < 0.001). The mortality rate was higher in males than in females (all P < 0.001) and higher in rural areas than in urban areas (all P < 0.001). The mortality rate of liver cancer varied significantly among eastern, central, and western China (all P < 0.001). The PYLLR of liver cancer in Chinese residents decreased from 2.89‰ in 2008 to 2.06‰ in 2021 at an average annual rate of 2.40% (t = -5.10, P < 0.001). Males had a lower PYLLR than females, decreasing at average annual rates of 2.20% (t = -5.40, P < 0.001) and 2.90% (t = -8.40, P < 0.001), respectively. Urban areas had a lower PYLLR than rural areas, decreasing at average annual rate of 3.30% (t = -4.00, P < 0.001) and 2.50% (t = -11.60, P < 0.001), respectively. Eastern, central, and western China decreased at average annual rates of 3.40%, 2.30%, and 2.10%, respectively (t = -7.80, -3.60, -7.10, P < 0.001 for all). The risk of China liver cancer mortality increased with age, decreased with birth cohort.ConclusionsThe mortality and disease burdens of liver cancer in China decreased yearly and were higher in males and in people living in rural areas, with significant differences among those living in eastern, central, and western China.

Partially Differentiated Ileal and Rectal Human CFTR-F508del Enteroids Secrete Fluid in Response to cAMP and cGMP: Targeted Preclinical Studies of Pharmaco-Therapy of CF Constipation

Introduction: Treatment of Cystic Fibrosis (CF) patients with Trikafta is prolonging life. This has allowed the importance of other causes of morbidity in these patients to become clearer and to emphasize the need to improve their quality of life by developing additional treatments. Chronic constipation is one such continuing unsolved medical issue for patients with CF even on Trikafta. In general, approaches to treat chronic constipation include increasing intestinal fluid secretion that involves inhibiting intestinal NaCl absorption and/or stimulating intestinal Cl secretion, with inhibition of the latter being the primary defect in CF. Drug development efforts have mostly aimed to improve CFTR function and control pancreatic insuffciency. We have recently reported an enterocyte population in the human ileal and colon that is present between the crypt Cl− secretory cells and the mature small intestinal villus or colonic surface Na+ absorptive cells that contain both DRA and CFTR. This population is called partially differentiated enterocytes. This study was undertaken to derive a strategy to stimulate intestinal fluid secretion from partially differentiated enterocytes in the F508del-CF-patient population by enhancing residual CFTR F508del activity using drugs that stimulate cAMP and cGMP. Methods: Ileal and rectal enteroids from F508del CF patients and healthy subjects (HS/normal) were studied. Enteroids were maintained in growth media containing Wnt3A, R-spondin, and Noggin (undifferentiated/UD); induced to partially differentiate (3d-DF) or fully differentiate (6d-DF) by removal of growth factors (Wnt3A and R-spondin) for 3 or 6 days, respectively. Forskolin-induced swelling (FIS) assay and live cell microscopy were used to determine fluid secretion in enteroids. A relative increase in organoid surface area over a time series of 60 min was measured to quantify FIS response. mRNA expression was determined using qRT-PCR. Results: Compared to HS enteroids, F508del enteroids had significantly higher mRNA expression of LGR5, and Ki67 in the UD state. Expression of goblet cell marker MUC2 and enteroendocrine (EEC) marker ChgA increased with differentiation in both HS and F508del, while 6d-DF F508del enteroids had a significantly higher ChgA compared to 6d-DF enteroids from HS. UD F508del enteroids had significantly higher expression of phosphodiesterase-3a (PDE3a) than HS enteroids, which further increased with differentiation, but did not change in HS. While UD and 6d-DF F508del rectal and ileal enteroids did not swell when exposed to cAMP (forskolin) and cGMP (linaclotide), 3d-DF F508del enteroids showed a swelling response when exposed to cAMP (forskolin) and cGMP (linaclotide). Fluid secretion from 3d-DF F508del enteroids was ~50% (cAMP) and ~67% (cGMP) of the response of intestinal enteroids from HS enteroids. Combinations of CFTR correctors and potentiators mimicking the makeup of Trikafta only partially enhanced fluid secretion in F508del CF enteroids as compared to HS. However, cGMP (linaclotide) additively enhanced Trikafta-induced fluid secretion from 3d-DF F508del enteroids. Conclusions: CFTR F508del can be stimulated by cAMP and cGMP in partially differentiated enterocyte populations. Our findings identify a novel role of the partially differentiated ileal and rectal enterocyte populations which behave in a way that offers the potential to improve treatment for CF constipation. Funding: This study is partly supported by Cystic Fibrosis Foundation grant CF-SINGH20G0, National Institutes of Health grants R01-DK-116352 and P30-DK-89502 (the Hopkins Basic and Translational Research Digestive Diseases Research Core Center). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Digital Subtraction Angiogram: Beginners Perspective

Digital Subtraction Angiography (DSA) is a modern technique which integrates digital data collection and computer processing to produce a medical image. X-ray signals are detected electronically rather than on film and then converted to digital form to be processed by a computer before being displayed. DSA is an integral investigation in the management of patients with neurovascular diseases. It is basically used for diagnosis, but in many instances, it may be therapeutic in the same sitting. Indications for diagnostic DSA include both extracranial and intracranial vascular diseases. A sound understanding of the principles of appropriate periprocedural care and anatomy, catheter technique and basic disease pathology are vital to use DSA as a diagnostic as well as therapeutic purposes. Bang. J Neurosurgery 2023; 12(2): 102-113

Hubungan Pemberian ASI Eksklusif, Kelengkapan Imunisasi Dasar dan Penyakit Infeksi pada Balita Usia 1-5 Tahun dengan Kejadian Wasting Di Kabupaten Tuban

Wasting is a malnutrition condition where the toddler's weight does not match the height or z-score value of &lt; - 2SD. One of the direct factors that affect the nutritional status of toddlers or the occurrence of wasting is a history of exclusive breastfeeding, completeness of basic immunizations and infectious diseases. This study aims to analyze the relationship between exclusive breastfeeding, completeness of basic immunization, and infectious diseases with the incidence of wasting in toddlers aged 1-5 years in Tuban Regency. This type of research is cross sectional. The population in this study of all wasting toddlers in Tuban Regency in 2022 was 6,240, and a sample of 400 wasting toddlers from 10 health centers with the highest wasting prevalence in Tuban Regency. The sampling technique used is cluster random sampling, a collection method using secondary data from each puskesmas. The results of the study conducted after being analyzed using SPSS 26 for windows with the spearman test obtained (p &lt; 0.05) then H1 was accepted. For exclusive breastfeeding history (p = 0.000), baseline immunization history (p = 0.000) and infectious disease history (p = 0.000).

Reasons for Silicone Breast Implant Removal After Long-Term Implantation in Chinese Patients Without Complications: A Questionnaire-Based Study.

There are few studies of Chinese patients who request siliconebreast implant removal after at least 10 years of implantation without any complications. This study aimed to study the characteristics of these patients, explore their reasons for breast implant removal andassociate factors that affect their choice, so as to provide valuable information on clinical decision making. A total of 55 eligible female patients (110 breasts) were enrolled from 2016 to 2022. A preoperative questionnaire survey before removal surgery and a telephone follow-up 1 year after removal surgery were conducted to collect data. The mean age of the patients was 40.6±8.8 years with the average time from breast augmentation to implant removal or replacement ranged from 10 to 15 years. Concerns about the aging of silicone gel-filled breast implant and the adverse effects of its long-term placement on body health were the top two reasons for breast implant removal. 63% of patients refused implant replacement, who were nearly 10 years older than those accepted implant replacement (p<0.05). Older age at implant removal (OR=0.67; 95%CI: 0.44-0.89) and a history of basic diseases (OR=0.02; 95%CI: 0.00-0.39) were statistically associated with lower rate of implant replacement. Concerns about the aging of silicone gel-filled breast implant were the main reason for uncomplicated patients to remove their breast implants. A comprehensive analysis based on patient's subjective choice and physical condition was suggested when an uncomplicated patient asks for implant removal. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Identification of Age-Related Characteristic Genes Involved in Severe COVID-19 Infection Among Elderly Patients Using Machine Learning and Immune Cell Infiltration Analysis.

Elderly patients infected with severe acute respiratory syndrome coronavirus 2 are at higher risk of severe clinical manifestation, extended hospitalization, and increased mortality. Those patients are more likely to experience persistent symptoms and exacerbate the condition of basic diseases with long COVID-19 syndrome. However, the molecular mechanisms underlying severe COVID-19 in the elderly patients remain unclear. Our study aims to investigate the function of the interaction between disease-characteristic genes and immune cell infiltration in patients with severe COVID-19 infection. COVID-19 datasets (GSE164805 and GSE180594) and aging dataset (GSE69832) were obtained from the Gene Expression Omnibus database. The combined different expression genes (DEGs) were subjected to Gene Ontology (GO) functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Diseases Ontology functional enrichment analysis, Gene Set Enrichment Analysis, machine learning, and immune cell infiltration analysis. GO and KEGG enrichment analyses revealed that the eight DEGs (IL23A, PTGER4, PLCB1, IL1B, CXCR1, C1QB, MX2, ALOX12) were mainly involved in inflammatory mediator regulation of TRP channels, coronavirus disease-COVID-19, and cytokine activity signaling pathways. Three-degree algorithm (LASSO, SVM-RFE, KNN) and correlation analysis showed that the five DEGs up-regulated the immune cells of macrophages M0/M1, memory B cells, gamma delta T cell, dendritic cell resting, and master cell resisting. Our study identified five hallmark genes that can serve as disease-characteristic genes and target immune cells infiltrated in severe COVID-19 patients among the elderly population, which may contribute to the study of pathogenesis and the evaluation of diagnosis and prognosis in aging patients infected with severe COVID-19.

An SEIHR model with age group and social contact for analysis of Fuzhou COVID-19 large wave

BackgroundThe structure of age groups and social contacts of the total population influenced infection scales and hospital-bed requirements, especially influenced severe infections and deaths during the global prevalence of COVID-19. Before the end of the year 2022, Chinese government implemented the national vaccination and had built the herd immunity cross the country, and announced Twenty Measures (November 11) and Ten New Measures (December 7) for further modifications of dynamic zero-COVID polity on the Chinese mainland. With the nation-wide vaccination and modified measures background, Fuzhou COVID-19 large wave (November 19, 2022–February 9, 2023) led by Omicron BA.5.2 variant was recorded and prevailed for three months in Fujian Province. MethodsA multi-age groups susceptible-exposed-infected-hospitalized-recovered (SEIHR) COVID-19 model with social contacts was proposed in this study. The main object was to evaluate the impacts of age groups and social contacts of the total population. The idea of Least Squares method was governed to perform the data fittings of four age groups against the surveillance data from Fujian Provincial Center for Disease Control and Prevention (Fujian CDC). The next generation matrix method was used to compute basic reproduction number for the total population and for the specific age group. The tendencies of effective reproduction number of four age groups were plotted by using the Epiestim R package and the SEIHR model for in-depth discussions. The sensitivity analysis by using sensitivity index and partial rank correlation coefficients values (PRCC values) were operated to reveal the differences of age groups against the main parameters. ResultsThe main epidemiological features such as basic reproduction number, effective reproduction number and sensitivity analysis were extensively discussed for multi-age groups SEIHR model in this study. Firstly, by using of the next generation matrix method, basic reproduction number R0 of the total population was estimated as 1.57 using parameter values of four age groups of Fuzhou COVID-19 large wave. Given age group k, the values of R0k (age group k to age group k), the values of R0k (an infected of age group k to the total population) and the values of R^0k (an infected of the total population to age group k) were also estimated, in which the explorations of the impacts of age groups revealed that the relationship R0k>R0k>R^0k was valid. Then, the fluctuating tendencies of effective reproduction number Rt were demonstrated by using two approaches (the surveillance data and the SEIHR model) for Fuzhou COVID-19 large wave, during which high-risk group (G4 group) mainly contributed the infection scale due to high susceptibility to infection and high risks to basic diseases. Further, the sensitivity analysis using two approaches (the sensitivity index and the PRCC values) revealed that susceptibility to infection of age groups played the vital roles, while the numerical simulation showed that infection scale varied with the changes of social contacts of age groups. The results of this study claimed that the high-risk group out of the total population was concerned by the local government with the highest susceptibility to infection against COVID-19. ConclusionsThis study verified that the partition structure of age groups of the total population, the susceptibility to infection of age groups, the social contacts among age groups were the important contributors of infection scale. The less social contacts and adequate hospital beds for high-risk group were profitable to control the spread of COVID-19. To avoid the emergence of medical runs against new variant in the future, the policymakers from local government were suggested to decline social contacts when hospital beds were limited.

Roles of Nucleic Acids in Protein Folding, Aggregation, and Disease.

The role of nucleic acids in protein folding and aggregation is an area of continued research, with relevance to understanding both basic biological processes and disease. In this review, we provide an overview of the trajectory of research on both nucleic acids as chaperones and their roles in several protein misfolding diseases. We highlight key questions that remain on the biophysical and biochemical specifics of how nucleic acids have large effects on multiple proteins' folding and aggregation behavior and how this pertains to multiple protein misfolding diseases.

How far? Travel burdens for children admitted to hospitals in the Western Cape Province of South Africa.

The ability to access effective hospital care for children is a significant determinant of good health outcomes. The Western Cape is a large land area with a wide array of human settlements- both in urban and rural spaces. For many children in the Western Cape, after-hours access to healthcare becomes constrained when primary care clinics close and hospitals are either far away or difficult to get to. The cumulative travel burden of communities across this area is not known. The recently established data gathering capacity of the Provincial Health Data Centre of the Western Cape represents a new capacity to study this. This study intends to describe the cumulative travel burdens of children in communities throughout the Western Cape, and how they compare relative to one another, with a particular focus on the after-hours period in a week. Over a period of 5 years from 2017-2021, all the admission details to every hospital in the Western Cape of children under 18 years of age were collected, with basic demographic and disease data including place of residence. The distance each child travelled to their first admission facility was calculated and represented within defined communities across the metro of Cape Town and the rural Western Cape. There were 574 220 admissions over the 5-year period, of which 360 783 were able to be used for travel analysis. The majority of admissions were for children under 5 years of age, were in the City of Cape Town and occurred after hours. Median travel distance was less for children outside of Cape Town, but the range of travelled distances was greater. Communities across the Western Cape, particularly rural communities, reflected significant variation in their cumulative travel burdens. Using a large health dataset, this study demonstrates in a novel way for South Africa, the distances children travel to access admission facilities. A wide variation exists across all parts of the province, but particularly in rural areas. These findings could be further interrogated for people's choices of facility and method of travel. Detailed service area modelling and extending primary care working hours are potential considerations for improving access at scale and at the local community level.

Effect of statins on severity of coronary artery lesion and clinical prognosis in patients with coronary heart disease

To investigate the effect of statins on the severity of coronary artery lesion in patients with coronary heart disease, and to analyze the risk factors of clinical prognosis. A retrospective cohort study was conducted. The clinical data of 156 patients with coronary heart disease and completed the second re-examination of coronary CT angiography (CCTA) who were admitted to the department of cardiovascular medicine of Peking University People's Hospital from January 2017 to December 2021 were collected. According to whether they took statins regularly according to the doctor's instructions after being diagnosed with coronary heart disease based on the first CCTA examination, the patients were divided into statin group and non-statin group, and the clinical characteristics of the two groups and the results of the second re-examination of CCTA were compared and analyzed. According to whether the patients had major adverse cardiovascular and cerebrovascular events (MACCE) within 3-5 years after diagnosis of coronary heart disease, the patients were divided into MACCE group and non-MACCE group, and the clinical characteristics of the two groups were compared and analyzed. Multivariate Logistic regression analysis was used to screen the risk factors related to the adverse prognosis (occurrence of MACCE) of patients with coronary heart disease. (1) A total of 156 patients with coronary heart disease were enrolled, including 113 patients (72.44%) in the statin group and 43 patients (27.56%) in the non-statin group. Except for low density lipoprotein (LDL) and serum creatinine (SCr), there was no significant difference in gender, age, body mass index (BMI), basic diseases, smoking history, the first CCTA display of coronary artery lesions and plaque characteristics, the interval between the two CCTA and other laboratory indicators between the two groups. Compared with the non-statin group, the statin group had a significant reduction in the overall increase rate of coronary artery stenosis score (Gensini score) in the CCTA re-examination and the incidence of MACCE [Gensini score increase rate: 25.66% (29/113) vs. 46.51% (20/43), incidence of MACCE: 9.73% (11/113) vs. 30.23% (13/43), both P < 0.05]. (2) Among 156 patients with coronary heart disease, 24 cases (15.38%) experienced MACCE within 3-5 years after diagnosis, while 132 cases (84.62%) did not experience MACCE. The proportion of patients in the MACCE group who regularly took statins after diagnosis was significantly lower than that in the non-MACCE group [45.83% (11/24) vs. 77.27% (102/132), P < 0.01], and D-dimer and glycosylated hemoglobin (HbA1c) were significantly higher than those in the non-MACCE group [D-dimer (μg/L): 148.50 (101.25, 314.75) vs. 88.10 (59.03, 132.12), HbA1c: 6.45% (6.20%, 7.93%) vs. 6.10% (5.81%, 6.92%), both P < 0.05]. Compared with the non-MACCE group, in the first CCTA examination of patients in the MACCE group, the total percentage of atheroma volume (PAV), fibrous-fat PAV, necrotic core PAV and Gensini score were significantly increased [total PAV: 43.05% (29.19%, 60.60%) vs. 24.57% (16.94%, 39.09%), fibrous-fat PAV: 18.61% (8.48%, 26.44%) vs. 6.81% (4.16%, 12.57%), necrotic core PAV: 5.96% (2.98%, 8.71%) vs. 2.29% (1.47%, 4.36%), Gensini score: 30.25 (23.50, 38.30) vs. 19.50 (13.20, 31.10), all P < 0.05]. Multivariate Logistic regression analysis showed that regular use of statins [odds ratio (OR) = 0.282, 95% confidence interval (95%CI) was 0.110-0.727, P = 0.008], D-dimer (OR = 1.011, 95%CI was 1.005-1.017, P < 0.001), necrotic core PAV (OR = 1.323, 95%CI was 1.120-1.563, P = 0.001) and Gensini score (OR = 1.038, 95%CI was 1.004-1.073, P = 0.028) were independent risk factors for MACCE within 3-5 years after diagnosis in patients with coronary heart disease. For patients with coronary heart disease, D-dimer, necrotic core PAV, and Gensini scores should be closely monitored. Statins can effectively alleviate the severity of coronary artery disease and reduce the occurrence of MACCE in patients with coronary artery disease.

Corneal blindness in the developing world: The role of prevention strategies.

Corneal blindness is an important contributor to the burden of global blindness and has a greater prevalence in low-income countries of the developing world where resources and infrastructure are limited. The causes of corneal blindness too are different from high-income countries and include infectious keratitis, ocular trauma, and xerophthalmia. Persons with these indications tend to have unfavourable outcomes after corneal transplantation, limiting their chances of benefitting from this sight-saving procedure. However, most causes of corneal blindness in the developing world are preventable. This highlights the importance of understanding the unique challenges in these regions and the need for targeted interventions. This article discusses various prevention strategies, including primordial, primary, and secondary prevention, aimed at reducing the burden of corneal blindness in low-income countries. These include capacity building, training, and awareness campaigns to reduce the risk factors of ocular trauma, infectious keratitis, and to improve access to first aid. It is also important to promote safe eye practices and tackle nutritional deficiencies through public health interventions and policy changes. Providing the required training to general ophthalmologists in the management of basic corneal surgeries and diseases and enhancing the accessibility of eye care services in rural areas will ensure early treatment and prevent sequelae. Current treatment modalities belong to the tertiary level of prevention and are largely limited to corneal transplantation. In developing nations, there is a scarcity of donor corneal tissue necessitating an urgent expansion of eye banking services. Alternative approaches to corneal transplantation such as 3D printed corneas, cultured stem cells, and biomaterials should also be explored to meet this demand. Thus, there is a need for collaborative efforts between healthcare professionals, policymakers, and communities to implement effective prevention strategies and reduce the prevalence of corneal blindness in the developing world.

Analysis of Mineralization and Disease Characteristics of Bronzes Unearthed in Archaeology

Bronze artifacts unearthed by archaeologists are affected by underground burial environment and other factors, and most of them have different degrees of corrosion. Bronze artifacts unearthed by archaeologists have different degrees of mineralization. Establishing a data analysis database for basic structure and disease analysis of mineralized bronze artifacts is a necessary prerequisite for developing targeted reinforcement materials and realizing accurate protection. Based on the characteristic analysis of the mineralized bronzes, this paper systematically analyzed the mineralization and disease characteristics of the mineralized bronzes by Confocal Super Depth-of-Field Microscope(CSDTM), scanning electron microscopy (SEM), energy spectrum analysis(EDS) and XRD, and compared and analyzed the microscopic morphology, composition and phase structure of the bronzes under the same burial environment, so as to provide support for subsequent targeted protection and reinforcement.

Effects of helium-oxygen mechanical ventilation on inflammatory response of diseased lung segments and diaphragm function in patients with pneumonia

To investigate the clinical effect of helium-oxygen mechanical ventilation on inflammation of the diseased lung segment and diaphragm function in patients with acute respiratory distress syndrome (ARDS) caused by pneumonia who suffered difficulty weaning from mechanical ventilation. A prospective controlled study was conducted. A total of 40 patients with ARDS caused by pneumonia and requiring tracheal intubation with difficulty weaning from mechanical ventilation, admitted to the department of critical care medicine in Pingtan Branch of Fujian Medical University Union Hospital from October 2020 to December 2021 were enrolled. Patients were divided into nitrogen oxygen ventilation group and helium-oxygen ventilation group according to random number table, with 20 cases in each group. The nitrogen oxygen ventilation group was given 60% nitrogen and 40% oxygen ventilation treatment, and the helium-oxygen ventilation group was given 60% helium and 40% oxygen ventilation treatment. Peak airway pressure (Ppeak), plateau airway pressure (Pplat), tidal volume (VT), minute ventilation volume (MV) and pulse oxygen saturation (SpO2) were collected at 0, 1, 2, 3 hours after ventilation treatment. At the same time, the concentrations of inflammatory factors interleukin-6 (IL-6) and C-reactive protein (CRP) in epithelial lining fluid in patients with diseased lung segments were measured before and after ventilation treatment for 3 hours, and the diaphragmatic excursion and the diaphragmatic thickening fraction were measured before and after ventilation treatment for 3 hours. There were no significant differences in gender, age, oxygenation index, serum CRP, serum procalcitonin (PCT), body temperature, serum creatinine (SCr), alanine aminotransferase (ALT), fasting blood glucose (FPG), hemoglobin (Hb), and basic heart and lung diseases between the two groups. Under the condition that VT and SpO2 are relatively unchanged, the airway pressure in helium-oxygen ventilation group decreased significantly after 1 hour of ventilation [Ppeak (cmH2O, 1 cmH2O≈0.098 kPa): 22.80±4.47 vs. 28.00±5.07, Pplat (cmH2O): 19.15±3.90 vs. 23.20±3.81, both P < 0.05], and the airway pressure in the nitrogen oxygen ventilation group increased significantly after 1 hour [Ppeak (cmH2O): 22.35±2.13 vs. 19.75±1.94, Pplat (cmH2O): 18.50±1.70 vs. 16.50±1.88, both P < 0.05]. There were no significant differences in CRP and IL-6 levels in epithelial lining fluid in the diseased lung segment before and after ventilation in the nitrogen oxygen ventilation group, while the levels of these indexes in the helium-oxygen ventilation group after ventilation were significantly lower than those before ventilation, and significantly lower than those in the nitrogen oxygen ventilation group [CRP (mg/L): 10.15 (6.39, 15.84) vs. 16.10 (11.63, 18.66), IL-6 (μg/L): 1.15 (0.78, 1.86) vs. 2.67 (1.67, 4.85), both P < 0.05]. There were no statistically significant differences in the diaphragmatic excursion and the diaphragmatic thickening fraction before and after ventilation in the nitrogen oxygen ventilation group, while the above indexes in the helium-oxygen ventilation group were significantly higher than those before ventilation, and were significantly higher than those in the nitrogen oxygen ventilation group [diaphragmatic excursion (cm): 1.93 (1.69, 2.20) vs. 1.34 (1.22, 1.83), diaphragmatic thickening fraction: (48.22±8.61)% vs. (33.29±11.04)%, both P < 0.05]. Helium-oxygen ventilation can reduce the airway pressure of patients with mechanical ventilation, alleviate the inflammatory response of lung segment, improve the function of respiratory muscle, and is expected to be an important treatment for severe lung rehabilitation.