The annual range of precipitation, which is the difference between maximum and minimum precipitation within a year, is examined in climate model simulations under global warming. For global averages, ...the annual range of precipitation tends to increase as the globe warms. On a regional basis, this enhancement is found over most areas of the world, except for the bands along 30°S and 30°N. The enhancement in the annual range of precipitation is mainly associated with larger upward trends of maximum precipitation and smaller upward trends or downward trends of minimum precipitation. Based on the moisture budget analysis, the dominant mechanism is vertical moisture advection, both on a global average and on a regional scale. The vertical moisture advection, moisture convergence induced by vertical motion, includes the thermodynamic component, which is associated with increased water vapor, and the dynamic component, which is associated with changes in circulation. Generally, the thermodynamic component enhances the annual range of precipitation, while the dynamic component tends to reduce it. Evaporation has a positive contribution to both maximum and minimum precipitation, but very little to the annual range of precipitation. Even though evaporation and horizontal moisture advection are small for a global average, they could be important on a regional basis.
Inflammation triggers pulmonary vascular remodelling. Ferroptosis, a nonapoptotic form of cell death that is triggered by iron-dependent lipid peroxidation and contributes to the pathogenesis of ...several inflammation-related diseases, but its role in pulmonary hypertension (PH) has not been studied. We examined endothelial cell ferroptosis in PH and the potential mechanisms. Pulmonary artery endothelial cells (PAECs) and lung tissues from monocrotaline (MCT)-induced PH rats were analysed for ferroptosis markers, including lipid peroxidation, the labile iron pool (LIP) and the protein expression of glutathione peroxidase 4 (GPX4), ferritin heavy chain 1 (FTH1) and NADPH oxidase-4 (NOX4). The effects of the ferroptosis inhibitor ferrostatin-1 (Fer-1) on endothelial cell ferroptosis and pulmonary vascular remodelling in MCT-induced rats were studied in vitro and in vivo. Ferroptosis was observed in PAECs from MCT-induced PH rats in vitro and in vivo and was characterized by a decline in cell viability accompanied by increases in the LIP and lipid peroxidation, the downregulation of GPX4 and FTH1 expression and the upregulation of NOX4 expression. High-mobility group box 1 (HMGB1)/Toll-like receptor 4 (TLR4)/NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome signalling was measured by western blotting. These changes were significantly blocked by Fer-1 administration in vitro and in vivo. These results suggest that Fer-1 plays a role in inhibiting ferroptosis-mediated PAEC loss during the progression of PH. The ferroptosis-induced inflammatory response depended on the activation of HMGB1/TLR4 signalling, which activated the NLRP3 inflammasome in vivo. We are the first to suggest that pulmonary artery endothelial ferroptosis triggers inflammatory responses via the HMGB1/TLR4/NLRP3 inflammasome signalling pathway in MCT-induced rats. Treating PH with a ferroptosis inhibitor and exploring new treatments based on ferroptosis regulation might be promising therapeutic strategies for PH.
Masonry building has low construction requirements and it is widely used in agricultural houses in the middle of Anhui Province. However, the old farm houses have problems such as aging structure, ...high building energy consumption, irrational floor plan layout and poor living comfort. Nowadays, the structure of many farm houses has undergone major changes, among which the prefabricated farm houses have the advantages of high performance, short construction period and flexible construction, and the materials used and construction process conform to the principle of sustainable development. It is of great significance to carry out research on the construction of light steel prefabricated farm houses and its energy-saving optimization. Firstly, through field investigation and case analysis, the present situation of traditional farm houses in central Anhui was summarized. Secondly, the prefabricated energy-saving design of farm houses was optimized.
The Amazon river basin receives ~2000 mm of precipitation annually and contributes ~17% of global river freshwater input to the oceans; its hydroclimatic variations can exert profound impacts on the ...marine ecosystem in the Amazon plume region (APR) and have potential far-reaching influences on hydroclimate over the tropical Atlantic. Here, we show that an amplified seasonal cycle of Amazonia precipitation, represented by the annual difference between maximum and minimum values, during the period 1979-2018, leads to enhanced seasonalities in both Amazon river discharge and APR ocean salinity. An atmospheric moisture budget analysis shows that these enhanced seasonal cycles are associated with similar amplifications in the atmospheric vertical and horizontal moisture advections. Hierarchical sensitivity experiments using global climate models quantify the relationships of these enhanced seasonalities. The results suggest that an intensified hydroclimatological cycle may develop in the Amazonia atmosphere-land-ocean coupled system, favouring more extreme terrestrial and marine conditions.
Machine Learning and Artificial Intelligence (AI) more broadly have great immediate and future potential for transforming almost all aspects of medicine. However, in many applications, even outside ...medicine, a lack of transparency in AI applications has become increasingly problematic. This is particularly pronounced where users need to interpret the output of AI systems. Explainable AI (XAI) provides a rationale that allows users to understand why a system has produced a given output. The output can then be interpreted within a given context. One area that is in great need of XAI is that of Clinical Decision Support Systems (CDSSs). These systems support medical practitioners in their clinic decision-making and in the absence of explainability may lead to issues of under or over-reliance. Providing explanations for how recommendations are arrived at will allow practitioners to make more nuanced, and in some cases, life-saving decisions. The need for XAI in CDSS, and the medical field in general, is amplified by the need for ethical and fair decision-making and the fact that AI trained with historical data can be a reinforcement agent of historical actions and biases that should be uncovered. We performed a systematic literature review of work to-date in the application of XAI in CDSS. Tabular data processing XAI-enabled systems are the most common, while XAI-enabled CDSS for text analysis are the least common in literature. There is more interest in developers for the provision of local explanations, while there was almost a balance between post-hoc and ante-hoc explanations, as well as between model-specific and model-agnostic techniques. Studies reported benefits of the use of XAI such as the fact that it could enhance decision confidence for clinicians, or generate the hypothesis about causality, which ultimately leads to increased trustworthiness and acceptability of the system and potential for its incorporation in the clinical workflow. However, we found an overall distinct lack of application of XAI in the context of CDSS and, in particular, a lack of user studies exploring the needs of clinicians. We propose some guidelines for the implementation of XAI in CDSS and explore some opportunities, challenges, and future research needs.
Rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, prompted heightened surveillance in Shenzhen, China. The resulting data provide a rare opportunity to ...measure key metrics of disease course, transmission, and the impact of control measures.
From Jan 14 to Feb 12, 2020, the Shenzhen Center for Disease Control and Prevention identified 391 SARS-CoV-2 cases and 1286 close contacts. We compared cases identified through symptomatic surveillance and contact tracing, and estimated the time from symptom onset to confirmation, isolation, and admission to hospital. We estimated metrics of disease transmission and analysed factors influencing transmission risk.
Cases were older than the general population (mean age 45 years) and balanced between males (n=187) and females (n=204). 356 (91%) of 391 cases had mild or moderate clinical severity at initial assessment. As of Feb 22, 2020, three cases had died and 225 had recovered (median time to recovery 21 days; 95% CI 20–22). Cases were isolated on average 4·6 days (95% CI 4·1–5·0) after developing symptoms; contact tracing reduced this by 1·9 days (95% CI 1·1–2·7). Household contacts and those travelling with a case were at higher risk of infection (odds ratio 6·27 95% CI 1·49–26·33 for household contacts and 7·06 1·43–34·91 for those travelling with a case) than other close contacts. The household secondary attack rate was 11·2% (95% CI 9·1–13·8), and children were as likely to be infected as adults (infection rate 7·4% in children <10 years vs population average of 6·6%). The observed reproductive number (R) was 0·4 (95% CI 0·3–0·5), with a mean serial interval of 6·3 days (95% CI 5·2–7·6).
Our data on cases as well as their infected and uninfected close contacts provide key insights into the epidemiology of SARS-CoV-2. This analysis shows that isolation and contact tracing reduce the time during which cases are infectious in the community, thereby reducing the R. The overall impact of isolation and contact tracing, however, is uncertain and highly dependent on the number of asymptomatic cases. Moreover, children are at a similar risk of infection to the general population, although less likely to have severe symptoms; hence they should be considered in analyses of transmission and control.
Emergency Response Program of Harbin Institute of Technology, Emergency Response Program of Peng Cheng Laboratory, US Centers for Disease Control and Prevention.
Background
Colorectal cancer (CRC) is the third most common cancer in China, however, publicly available, descriptive information on the clinical epidemiology of CRC is limited.
Methods
Patients ...diagnosed with primary CRC during 2005 through 2014 were sampled from 13 tertiary hospitals in 9 provinces across China. Data related to sociodemographic characteristics, the use of diagnostic technology, treatment adoption, and expenditure were extracted from individual medical records.
Results
In the full cohort of 8465 patients, the mean ± SD age at diagnosis was 59.3 ± 12.8 years, 57.2% were men, and 58.7% had rectal cancer. On average, 14.4% of patients were diagnosed with stage IV disease, and this proportion increased from 13.5% in 2005 to 20.5% in 2014 (P value for trend < .05). For diagnostic techniques, along with less use of x‐rays (average, 81.6%; decreased from 90.0% to 65.7%), there were increases in the use of computed tomography (average, 70.4%; increased from 4.5% to 90.5%) and magnetic resonance imaging (average, 8.8%; increased from 0.1% to 20.4%) over the study period from 2005 to 2014. With regard to treatment, surgery alone was the most common (average, 50.1%), but its use decreased from 51.3% to 39.8% during 2005 through 2014; and the use of other treatments increased simultaneously, such as chemotherapy alone (average, 4.1%; increased from 4.1% to 11.9%). The average medical expenditure per patient was 66,291 Chinese Yuan (2014 value) and increased from 47,259 to 86,709 Chinese Yuan.
Conclusions
The increasing proportion of late‐stage diagnoses presents a challenge for CRC control in China. Changes in diagnostic and treatment options and increased expenditures are clearly illustrated in this study. Coupled with the recent introduction of screening initiatives, these data provide an understanding of changes over time and may form a benchmark for future related evaluations of CRC interventions in China.
Colorectal cancer (CRC) is the third most common cancer in China; however, there is limited publicly available descriptive information on the clinical epidemiology of CRC. The findings of this multicenter, retrospective epidemiologic survey provide an understanding of change over time and form the benchmark for future related evaluations of CRC interventions in China.
Macrophage polarization plays essential and diverse roles in most diseases, such as atherosclerosis, adipose tissue inflammation, and insulin resistance. Homeostasis dysfunction in M1/M2 macrophage ...polarization causes pathological conditions and inflammation. Neuroinflammation is characterized by microglial activation and the concomitant production of pro-inflammatory cytokines, leading to numerous neurodegenerative diseases and psychiatric disorders. Decreased neuroinflammation can be obtained by using natural compounds, including flavonoids, which are known to ameliorate inflammatory responses. Among flavonoids, quercetin possesses multiple pharmacological applications and regulates several biological activities. In the present study, we found that quercetin effectively inhibited the expression of lipocalin-2 in both macrophages and microglial cells stimulated by lipopolysaccharides (LPS). The production of nitric oxide (NO) and expression levels of the pro-inflammatory cytokines, inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2, were also attenuated by quercetin treatment. Our results also showed that quercetin significantly reduced the expression levels of the M1 markers, such as interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β, in the macrophages and microglia. The M1 polarization-associated chemokines, C-C motif chemokine ligand (CCL)-2 and C-X-C motif chemokine ligand (CXCL)-10, were also effectively reduced by the quercetin treatment. In addition, quercetin markedly reduced the production of various reactive oxygen species (ROS) in the microglia. The microglial phagocytic ability induced by the LPS was also effectively reduced by the quercetin treatment. Importantly, the quercetin increased the expression levels of the M2 marker, IL-10, and the endogenous antioxidants, heme oxygenase (HO)-1, glutamate-cysteine ligase catalytic subunit (GCLC), glutamate-cysteine ligase modifier subunit (GCLM), and NAD(P)H quinone oxidoreductase-1 (NQO1). The enhancement of the M2 markers and endogenous antioxidants by quercetin was activated by the AMP-activated protein kinase (AMPK) and Akt signaling pathways. Together, our study reported that the quercetin inhibited the effects of M1 polarization, including neuroinflammatory responses, ROS production, and phagocytosis. Moreover, the quercetin enhanced the M2 macrophage polarization and endogenous antioxidant expression in both macrophages and microglia. Our findings provide valuable information that quercetin may act as a potential drug for the treatment of diseases related to inflammatory disorders in the central nervous system.
Ecological civilization construction is China’s national development strategy, and improving the urban eco-environmental quality is the key to accelerating this strategy, while the high-speed rail ...(HSR) opening is an important factor affecting the urban eco-environmental quality. Using panel data of 290 cities in China from 2004 to 2020, this study explores the impact of HSR opening on urban eco-environmental quality and its heterogeneity from the perspective of direct impact and interaction between HSR connected cities. Compared with cities without HSR service, the eco-environmental quality of cities with HSR service has significantly increased by 0.023 standard deviations, which is about 4.11% of the total change in urban eco-environmental quality in the same period. Second, there is an inverted U-shaped relationship between eco-environmental quality and urban space expansion. Third, the impact of HSR on eco-environmental quality is heterogeneous, mainly manifested in different cities and urban agglomerations. It means that the government should focus on the differences in the economic foundation and development characteristics of various regions, steadily push forward the construction and operation of the HSR, and speed up the renovation of existing lines to help the green development of cities. The research results provide a policy basis for the government to handle the relationship between infrastructure construction and eco-environmental quality, and effectively promote green sustainable development.
Polyhydroxyalkanoates (PHA) are naturally occurring biopolymers, obtained from microorganisms. Properties like biodegradability and biocompatibility make PHA a part of today's commercial polymer ...industry. However, the production cost of PHA has been a great barrier to extend its application to large scale production. Substrates and usage of pure cultures constitute the main reason for its high production cost. On the other hand, rapid industrialization i.e., industrial sectors such as sugar, pulp and paper, fruit and food processing, dairies, slaughterhouses, and poultries, has resulted in the generation of the huge quantity of wastes. Consequently, becoming large source of environmental pollution and health hazard. This review emphasizes on the usage of various waste feedstocks obtained from industrial and agricultural industries as an alternate substrate for PHA production. As these waste materials are rich in organic material and also microbes, they can be the good starting material for PHA production. Additionally, advantages and economic importance of mixed cultures and also PHA applications are discussed. Future prospects and challenges in PHA production from waste feedstocks are also highlighted.
•Polyhydroxyalkanoates production from various waste resources is reviewed.•Efficient cheap substrates drive PHAs production more economical attractive.•Waste management play several advantages on PHAs circular economy.
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