Background
The aim of this study was to investigate the prevalence of epidemiologic and physician‐diagnosed pollen‐induced AR (PiAR) in the grasslands of northern China and to study the impact of the ...intensity and time of pollen exposure on PiAR prevalence.
Methods
A multistage, clustered and proportionately stratified random sampling with a field interviewer‐administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count.
Results
A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05).
Conclusion
Pollen‐induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.
Summary
Long‐term prognosis varies widely among patients with hepatitis B virus (HBV)‐related liver cirrhosis. Our study aimed to investigate the applicability of albumin‐bilirubin (ALBI), Child‐Pugh ...and model for end‐stage liver disease (MELD) scores to the long‐term prognosis prediction of HBV‐related cirrhosis. Patients diagnosed with HBV‐associated cirrhosis from the First Affiliated Hospital of Wenzhou Medical University between January 2010 and December 2015 were enrolled in this study. The patients were followed up every 3 months. The prognostic performance of ALBI in long‐term outcome prediction for HBV‐related cirrhosis was compared with Child‐Pugh and MELD scores using time‐dependent receiver operating characteristic curve (tdROC) and decision curve analysis. A total of 806 patients were included in our study with 275 (34.1%) deceased during the follow‐up. Multivariate Cox regression analysis showed that ALBI grade was an independent predictor associated with mortality. The tdROC analysis showed that ALBI score (0.787, 0.830 and 0.833) was superior to MELD (0.693, P=.003; 0.717, P<.001; 0.744, P<.001) and Child‐Pugh score (0.641, P<.001; 0.649, P<.001; 0.657, P<.001) for predicting 1‐year, 2‐year and 3‐year mortality. Additionally, decision curves also got the similar results. In addition, patients with lower ALBI score had a longer life expectancy, even among patients within the same Child‐Pugh class. Thus, ALBI score was effective in predicting the long‐term prognosis for patients with HBV‐related cirrhosis and more accurate than Child‐Pugh and MELD scores.
Aim To evaluate the safety and efficacy of combined therapy with transarterial chemoembolization (TACE) and sorafenib for hepatocellular carcinoma (HCC) with portal venous tumour thrombus (PVTT). ...Materials and methods This study was approved by the institutional review board. From May 2009 to May 2012, 170 consecutive patients were newly diagnosed with advanced-stage HCC and treated with TACE plus sorafenib. Among them, 41 patients with PVTT were retrospectively enrolled in the study. The adverse events (AEs), overall survival (OS), time to progression (TTP), and prognostic factors were analysed. Statistical analysis was performed with the Kaplan–Meier method using the log-rank test and Cox regression models. Results The most common AEs were hand–foot skin reaction related to sorafenib and fever related to TACE. Procedure-related mortality and grade 4 AEs were not observed. Grade 3 AEs were observed in five patients. During the median follow-up period of 13.5 months (range 1.4–45 months), the 6-month and 1-year survival rates were 87.7% and 53.6%, respectively. The median OS was 13 months (range 1.4–44.8 months), and the median TTP was 7 months (range 1–18.6 months). The Child–Pugh class ( p = 0.022), extrahepatic metastasis ( p = 0.009), and gross morphological type (nodular type versus diffuse type; p = 0.008) were prognostic factors related to OS in the multivariate analysis. Conclusion TACE plus sorafenib in an interrupted therapeutic scheme was well tolerated and might improve OS for HCC patients with PVTT, especially in those with Child–Pugh class A, no extrahepatic metastasis, or nodular-type HCC.
The present work is undertaken to characterize a Granny Smith apple procyanidin extract (AE) and investigate the beneficial effect of the AE in the intestine
in vitro
. Each AE was characterized
via
...LC-ESI-MS. Caco-2 cells were used to study the preventive actions of the AE against the downregulation of tight junction protein expression, oxidative stress and inflammation induced by lipopolysaccharides (LPS). Phenolic compounds present in the AE, including chlorogenic acid, catechin, epicatechin, proanthocyanidin dimers, and proanthocyanidin trimers, were characterized. The expression of the tight junction protein, including occludin and zona occludens (ZO)-1, increased significantly in LPS + AE treated Caco-2 cells, compared to LPS induced Caco-2 cells. Proanthocyanidin dimers had the most potent effect on increasing tight junction protein expression. The addition of LPS to Caco-2 cells induced oxidative stress and inflammation. However, incubation with proanthocyanidin dimers prevented LPS-mediated oxidative stress, including the increase of SOD, HO-1, CAT, and GSH-Px mRNA expression, and counteracted LPS-mediated inflammation as evidenced by the down-regulation of inflammatory markers (NF-κβ, IL-6, and TNF-α mRNA expression). Our findings provide evidence that AE could upregulate tight junction protein expression, probably acting
via
the reduction of oxidative stress and inflammation.
Granny Smith apple procyanidin extracts upregulate tight junction protein expression, probably acting
via
the modulation of oxidative stress and inflammation in lipopolysaccharide-induced Caco-2 cells.
Flow forming was employed to manufacture the 2219 aluminium alloy thin-walled tubular parts with cross inner ribs (longitudinal and transverse inner ribs, LTIRs) integrally, which have been widely ...used in the aviation and aerospace fields. Electron backscattered diffraction (EBSD) examination along with micro-hardness tests was conducted on the typical zones of the flow formed part, thus to make a detailed study on the deformation modes as well as strain gradient induced heterogeneous microstructure and mechanical property. The wall thickness thinning is dominant at non-rib zone, while it is the die filling that mainly prevails at TIR and LIR zones, resulting in the occurrence of three different deformation modes. The plane strain deformation contributes to the severe fragmentation of ribbon-like grains at non-rib zone, while the axial tensile strain during longitudinal inner rib (LIR) forming and small radial tensile strain during transverse inner rib (TIR) forming cannot make the large ribbon-like grains refined effectively. In order to refine the microstructure and obtain uniform mechanical property, modifying the initial microstructure and changing the strain types at rib zones by full die filling, as well as subsequent annealing treatment should be considered.
Giant magnetic circular dichroism (MCD) that shows a different response to incident wave with left or right-handed circular polarization under external magnetic field is promising for magneto-optical ...sensing, revealing symmetry and degeneracy information of electronic states. However, traditional methods and materials that are used to obtain significant MCD involve highly strong external magnetic field. Based on the excitation of subradiant plasmonic mode and Fano resonance in graphene oligomers in the mid-infrared region, we numerically demonstrate that MCD is enhanced three times larger than the previously reported method, based on the resonance of electric dipole plasmonic mode. This giant MCD is attributed to the remarkably different excitation efficiency of subdradiant plasmonic mode due to the interparticle coupling under left or right-handed circular polarization incidence and external magnetic field. Our results offer an effective mechanism to enhance MCD signal at the nanoscale, which facilitates the sensing, spintronic, nanophotonics and other such fields.
The probiotic Lactobacillus rhamnosus GG is able to bind the potent hepatocarcinogen aflatoxin B₁ (AFB₁) and thus potentially restrict its rapid absorption from the intestine. In this study we ...investigated the potential of GG to reduce AFB₁ availability in vitro in Caco-2 cells adapted to express cytochrome P-450 (CYP) 3A4, such that both transport and toxicity could be assessed. Caco-2 cells were grown as confluent monolayers on transmembrane filters for 21 days prior to all studies. AFB₁ levels in culture medium were measured by high-performance liquid chromatography. In CYP 3A4-induced monolayers, AFB₁ transport from the apical to the basolateral chamber was reduced from 11.1% ± 1.9% to 6.4% ± 2.5% (P = 0.019) and to 3.3% ± 1.8% (P = 0.002) within the first hour in monolayers coincubated with GG (1 x 10¹⁰ and 5 x 10¹⁰ CFU/ml, respectively). GG (1 x 10¹⁰ and 5 x 10¹⁰ CFU/ml) bound 40.1% ± 8.3% and 61.0% ± 6.0% of added AFB₁ after 1 h, respectively. AFB₁ caused significant reductions of 30.1% (P = 0.01), 49.4% (P = 0.004), and 64.4% (P < 0.001) in transepithelial resistance after 24, 48, and 72 h, respectively. Coincubation with 1 x 10¹⁰ CFU/ml GG after 24 h protected against AFB₁-induced reductions in transepithelial resistance at both 24 h (P = 0.002) and 48 h (P = 0.04). DNA fragmentation was apparent in cells treated only with AFB₁ cells but not in cells coincubated with either 1 x 10¹⁰ or 5 x 10¹⁰ CFU/ml GG. GG reduced AFB₁ uptake and protected against both membrane and DNA damage in the Caco-2 model. These data are suggestive of a beneficial role of GG against dietary exposure to aflatoxin.
To investigate the performance of a deep-learning approach termed lesion-aware convolutional neural network (LACNN) to identify 14 different thoracic diseases on chest X-rays (CXRs).
In total, 10,738 ...CXRs of 3,526 patients were collected retrospectively. Of these, 1,937 CXRs of 598 patients were selected for training and optimising the lesion-detection network (LDN) of LACNN. The remaining 8,801 CXRs from 2,928 patients were used to train and test the classification network of LACNN. The discriminative performance of the deep-learning approach was compared with that obtained by the radiologists. In addition, its generalisation was validated on the independent public dataset, ChestX-ray14. The decision-making process of the model was visualised by occlusion testing, and the effect of the integration of CXRs and non-image data on model performance was also investigated. In a systematic evaluation, F1 score, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) metrics were calculated.
The model generated statistically significantly higher AUC performance compared with radiologists on atelectasis, mass, and nodule, with AUC values of 0.831 (95% confidence interval CI: 0.807–0.855), 0.959 (95% CI: 0.944–0.974), and 0.928 (95% CI: 0.906–0.950), respectively. For the other 11 pathologies, there were no statistically significant differences. The average time to complete each CXR classification in the testing dataset was substantially longer for the radiologists (∼35 seconds) than for the LACNN (∼0.197 seconds). In the ChestX-ray14 dataset, the present model also showed competitive performance in comparison with other state-of-the-art deep-learning approaches. Model performance was slightly improved when introducing non-image data.
The proposed LACNN achieved radiologist-level performance in identifying thoracic diseases on CXRs, and could potentially expand patient access to CXR diagnostics.
•A deep learning approach using Lesion-Aware Convolutional Neural Network was proposed.•It effectively classified 14 clinical important thoracic pathologies in chest x-rays.•The algorithm could localize regions of the image most indicative of each pathology.•The effect of non-image features on model performance was also verified.•This could potentially help improvement of healthcare delivery.
To study the effect of deformation mode together with loading path on the microstructure evolution of 2219 aluminium alloy at elevated temperature, plane strain compression (PSC) and uniaxial ...compression (UC) along different loading paths (rolling direction (RD), transverse direction (TD) and normal direction (ND)) as well as equal-channel angular pressing (ECAP) along RD were performed on the cubic and cylindrical samples cut from thick plate. Detailed microstructure evolution was characterized by optical microscope and electron backscattered diffraction (EBSD). The results indicate that the PSC deformation shows a higher stress level than UC and an increasing discrepancy in flow softening occurs with the increasing strain during PSC along different loading paths. The volume fraction of dynamic recrystallization (DRX) after RD-UC is higher than that of RD-PSC, while the grain refinement level is the lowest in the one pass ECAP. DRX is the main grain refinement mechanism for RD-UC, while deformation bands (DBs) are dominant in RD-PSC and ECAP. Due to the grain morphology anisotropy, a significant microstructural difference was exhibited in the PSCed samples along different loading paths. The grain refinement in hot working of 2219 aluminium alloy plate is greatly related to the deformation modes and loading paths in view of the brick-like grains.
A novel strategy for preparing large‐area, oriented silicon nanowire (SiNW) arrays on silicon substrates at near room temperature by localized chemical etching is presented. The strategy is based on ...metal‐induced (either by Ag or Au) excessive local oxidation and dissolution of a silicon substrate in an aqueous fluoride solution. The density and size of the as‐prepared SiNWs depend on the distribution of the patterned metal particles on the silicon surface. High‐density metal particles facilitate the formation of silicon nanowires. Well‐separated, straight nanoholes are dug along the Si block when metal particles are well dispersed with a large space between them. The etching technique is weakly dependent on the orientation and doping type of the silicon wafer. Therefore, SiNWs with desired axial crystallographic orientations and doping characteristics are readily obtained. Detailed scanning electron microscopy observations reveal the formation process of the silicon nanowires, and a reasonable mechanism is proposed on the basis of the electrochemistry of silicon and the experimental results.
Large‐area, highly oriented Si‐nanowire arrays are prepared on a Si wafer (see Figure) by “scratching” the surface of the wafer with metal particles. The etching technique shows little dependence on the orientation and doping type of the Si wafer. A local, site‐ specific etching mechanism is proposed.