Intervertebral disc degeneration(IVDD)is the primary contributor to a range of spinal diseases.Dynamin-related protein 1(Drp1)-mediated mitochondrial fission has recently been identified as a new cause of nucleus pulp...Intervertebral disc degeneration(IVDD)is the primary contributor to a range of spinal diseases.Dynamin-related protein 1(Drp1)-mediated mitochondrial fission has recently been identified as a new cause of nucleus pulposus cell(NPC)death and IVDD,but the underlying mechanisms remain unclear.Although the effects of Drp1 phosphorylation in IVDD have been studied,it is currently unknown if small ubiquitin-like modifications(SUMOylation)of Drp1 regulate IVDD.This study aimed to investigate the functions and mechanisms of mitochondria-anchored protein ligase(MAPL),a mitochondrial SUMO E3 ligase,during IVDD progression.The expression of genes related to SUMOylation and mitochondrial dynamics in TNF-α-stimulated NPCs was analysed via RNA sequencing.展开更多
BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical...BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical for improving the quality of life and minimizing complications.This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.AIM To evaluate the effect of this combined nursing model on postoperative self-care ability,disease knowledge,mood state,and complication rates in patients undergoing rectal cancer surgery.METHODS Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference(routine care)and experimental(problem management-guided health education combined with positive incentive nursing)groups.The outcomes included exercise of self-care agency scale,disease knowledge(hospital-specific questionnaire),mood state(profile of mood states),and complication rates.RESULTS The experimental group demonstrated significant improvements in self-care ability(P<0.05),with higher scores for health knowledge,self-concept,self-care skills,and self-care responsibility than the reference group.Disease knowledge scores also improved markedly in the experimental group(P<0.05).Mood state scores showed a significant decrease in the negative dimensions(e.g.,anxiety and depression)and an increase in energy vitality(P<0.05).Additionally,the experimental group exhibited a lower complication rate than the reference group(7.5%vs 27.5%,P<0.05).CONCLUSION The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities,disease knowledge,and emotional well-being while reducing complication rates.This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.展开更多
Objective This study aimed to identify high-risk areas for type 2 diabetes mellitus(T2DM)mortality to provide relevant evidence for interventions in emerging economies.Methods Empirical Bayesian Kriging and a discrete...Objective This study aimed to identify high-risk areas for type 2 diabetes mellitus(T2DM)mortality to provide relevant evidence for interventions in emerging economies.Methods Empirical Bayesian Kriging and a discrete Poisson space-time scan statistic were applied to identify the spatiotemporal clusters of T2DM mortality.The relationships between economic factors,air pollutants,and the mortality risk of T2DM were assessed using regression analysis and the Poisson Log-linear Model.Results A coastal district in East Guangdong,China,had the highest risk(Relative Risk[RR]=4.58,P<0.01),followed by the 10 coastal districts/counties in West Guangdong,China(RR=2.88,P<0.01).The coastal county in the Pearl River Delta,China(RR=2.24,P<0.01),had the third-highest risk.The remaining risk areas were two coastal counties in East Guangdong,16 districts/counties in the Pearl River Delta,and two counties in North Guangdong,China.Mortality due to T2DM was associated with gross domestic product per capita(GDP per capita).In pilot assessments,T2DM mortality was significantly associated with carbon monoxide.Conclusion High mortality from T2DM occurred in the coastal areas of East and West Guangdong,especially where the economy was progressing towards the upper middle-income level.展开更多
BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors fo...BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors for hypofibrinogenemia asso-ciated with hemocoagulase are poorly understood.AIM To determine risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.METHODS We performed a retrospective analysis of the medical documentation of hospit-alized patients treated with hemocoagulase for gastrointestinal bleeding.Hypofib-rinogenemia was defined as a decrease in plasma fibrinogen concentration to less than 2.0 g/L.The included patients were divided into two groups:acquired hypofibrinogenemia group and non-hypofibrinogenemia group.We used logistic regression analysis to identify potential risk factors and established risk assess-RESULTS There were 36 patients in the acquired hypofibrinogenemia group and 73 patients in the non-hypofibrinogenemia group.The hypofibrinogenemia group showed higher rates of intensive care unit admissions(P=0.021),more female patients(P=0.005),higher in-hospital mortality(P=0.027),larger hemocoagulase doses(P=0.026),more Packed Red Cells transfusions(P=0.024),and lower baseline fibrinogen levels(P<0.000).Binary logistic regression was employed to examine the risk factors associated with acquired hypofibrinogenemia.The analysis revealed that baseline fibrinogen[odds ratio(OR)0.252,95%CI:0.137-0.464,P<0.000],total hemocoagulase doses(OR 1.074,95%CI:1.015-1.137,P=0.014),and female gender(OR 2.856,95%CI:1.015–8.037,P=0.047)were statist-ically significant risk factors.CONCLUSION Higher doses of total hemocoagulase,female gender,and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.展开更多
Because of the aggressive threaten of heat stroke and a lack of understanding of the mechanism of action, mammal animal models for experimental heat stroke were well developed. During the past 5 decades, anesthetized ...Because of the aggressive threaten of heat stroke and a lack of understanding of the mechanism of action, mammal animal models for experimental heat stroke were well developed. During the past 5 decades, anesthetized mouse, rat, rabbit, dog, baboon and monkey were used as animal model for experimental heat stroke. However, anesthetized mammals models have some limitations, such as neuroprotective effect of anesthetic agents, possible disturbance on injury and recovery of stroke animals by anesthetic agents, difficulty of discussing animal behavior before and after heat stroke, it was also difficult for the models to evaluate cognitive function of animal under hot environment. Considering humanitarian, only awaked and unrestrained mouse heat stroke model was accepted so far. Therefore, we also developed an awaked and unrestrained rat heat stroke model, and found it was helpful to evaluate drug effectiveness for animal behavior and cognitive function under hot environment.展开更多
Malaria and typhoid fever are debilitating diseases responsible for the deaths of thousands of lives annually. Over the last decade both diseases have received increasing attention with particular focus on malaria. Ho...Malaria and typhoid fever are debilitating diseases responsible for the deaths of thousands of lives annually. Over the last decade both diseases have received increasing attention with particular focus on malaria. However, recent reports indicate an increasing co-infection rate between mala- ria and typhoid fever. Familiar signs and symptoms of both diseases have led to the belief in some communities that it’s a new disease. In this study, we investigated the relationship between mala- ria and typhi O and H antigens among patients reporting with fever. Patients reporting with fever from April 2013-March 2014 were recruited for the study. Our results showed that there was no association between having malaria and typhoid fever infection. However, having fever was asso- ciated with having both diseases. Also, fever among patients was more likely to be caused by Sal- monella typhi O and H antigens than plasmodium parasites. Infections of both diseases were higher in wet season than in dry season. The study recommends that malaria and typhoid fever intervention programs are increased in endemic areas. Also attention should be paid to typhoid fever infection rates in the country.展开更多
Cardiovascular diseases increase continually in the worldwide scale,and its specific pathogenesis has not been completely clear.The gas signal molecule hydrogen sulfide(H2S)is a new type of neuroactive substance,which...Cardiovascular diseases increase continually in the worldwide scale,and its specific pathogenesis has not been completely clear.The gas signal molecule hydrogen sulfide(H2S)is a new type of neuroactive substance,which plays many biological roles in many systems such as cardiovascular system.In recent years,a lot of research has confirmed H2S has myocardial protective effect on cardiovascular diseases such as atherosclerosis,ischemia-reperfusion injury,hypertension and heart failure.This paper reviews the research status of myocardial protective effect of H2S on cardiovascular diseases.展开更多
Dear Editor,The intervertebral disc(IVD)is a crucial fibrocartilaginous structure that connects adjacent vertebrae.It plays a fundamental role in maintaining spinal stability and absorbing mechanical stress.Each disc ...Dear Editor,The intervertebral disc(IVD)is a crucial fibrocartilaginous structure that connects adjacent vertebrae.It plays a fundamental role in maintaining spinal stability and absorbing mechanical stress.Each disc is composed of three parts:the inner nucleus pulposus(NP),the outer annulus fibrosus(AF),and the superior and inferior cartilage endplates(CEPs).Degeneration of IVDs is a primary contributor to various spinal disorders,such as cervical spondylosis,low back pain,and lumbar disc herniation,all of which lead to a significant reduction in the quality of life of patients and impose a substantial economic burden.In China,IVD degeneration(IVDD)is the third most common chronic disease following hypertension and diabetes,highlighting the widespread impact of IVDD on public health.1 Non-degenerated adult IVDs are devoid of a vascular system within。展开更多
A novel control scheme is presented to eliminate the negative effects of communication disturbances,which introduces active disturbance rejection control(ADRC)in the control strategy design to achieve the objectives o...A novel control scheme is presented to eliminate the negative effects of communication disturbances,which introduces active disturbance rejection control(ADRC)in the control strategy design to achieve the objectives of the restoration of the bus voltage and the sharing of the power even in the presence of disturbances and delays in communication.Simultaneously,its dynamic disturbance decoupling feature is used to realise the decoupling between power and voltage,so that the proposed controller only exchanges power information with its neighbours,reducing the communication burden and simplifying control structure.The control performance of the strategy is verified by employing steady-state analysis.The impact of controller parameters is studied by establishing a small signal model.Finally,both simulation cases and experimental tests prove the feasibility of this scheme.展开更多
Background:Gonorrhea and chlamydia testing rates are poor among Chinese men who have sex with men(MSM).A quasi-experimental study suggested that a pay-it-forward strategy increased dual gonorrhea/chlamydia testing amo...Background:Gonorrhea and chlamydia testing rates are poor among Chinese men who have sex with men(MSM).A quasi-experimental study suggested that a pay-it-forward strategy increased dual gonorrhea/chlamydia testing among MSM.Pay-it-forward offers an individual a gift(e.g.,a free test)and then asks the same person if they would like to give a gift to another person.This article reports the protocol of a randomized controlled trial to evaluate dual gonorrhea/chlamydia test uptake and other outcomes among MSM in three arms-a pay-it-forward arm,a pay-what-you-want arm,and a standard of care arm.Methods:Three hundred MSM will be recruited at three HIV testing sites in Guangzhou and Beijing.Testing sites include two hospital-based MSM sexually transmitted diseases clinics and one MSM community-based organization.Eligible participants will be born biologically male,aged 16 years or older,reporting previous anal sex with another man,having never participated in the pay-it-forward program,without previous gonorrhea and chlamydia testing in the past 12 months,and residing in China.Following a cluster randomized design,every cluster of ten participants will be randomly allocated into one of three arms:(1)a pay-it-forward arm in which men are offered free gonorrhea and chlamydia testing and then asked whether they would like to donate("pay it forward")toward testing for future testers;(2)a pay-what-you-want arm in which men are offered free testing and told to decide how much to pay after receiving the test;(3)a standard of care arm in which men can pay the full price for dual gonorrhoea and chlamydia testing.The primary outcome is dual gonorrhoea/chlamydia testing as verified by administrative records.Secondary outcomes include incremental cost per test,incremental cost per diagnosis,community connectedness,and social cohesion.Primary outcome will be calculated for each arm using intention-to-treat and compared using one-sided 95%confidence intervals with a margin of 20%increase defined as superiority.Discussion:This study will examine the pay-it-forward strategy in comparison to the standard of care in improving test uptake for gonorrhea and chlamydia.We will leverage the cluster randomized controlled trial to provide scientific evidence on the potential effect of pay-it-forward.Findings from this study will shed light on novel intervention methods for increasing preventive health service utilization and innovate ways to finance it among communities.Trial registration:ClinicalTrials.gov,NCT03741725.Registered on 12 November 2018.展开更多
To the Editor:Asthma is a complex chronic inflammatory lung disease,and its pathogenesis is not fully understood.It is believed that airway epithelium primarily acts as a defensive barrier to protect the lung from all...To the Editor:Asthma is a complex chronic inflammatory lung disease,and its pathogenesis is not fully understood.It is believed that airway epithelium primarily acts as a defensive barrier to protect the lung from allergens,avoiding the asthma.The integrity of the airway epithelial barrier is dependent on tight junctions comprised of zona occludens(ZO)1 to 3,occludin,and claudin 1 to 5,and adherens junctions mainly formed by E-cadherin,b-catenin,and junctional adhesion molecule,which maintain apicobasal polarity of bronchial epithelial cells.展开更多
This paper presents a control strategy for multiple unmanned aerial vehicle systems(multi-UAVs)time-coordinated path following with desired endpoint roll attitudes.It utilizes the strong maneuvering capabilities of ag...This paper presents a control strategy for multiple unmanned aerial vehicle systems(multi-UAVs)time-coordinated path following with desired endpoint roll attitudes.It utilizes the strong maneuvering capabilities of agile fixed-wing UAVs and incorporates an end-roll expectation.The strategy consists of four steps:time-coordinated control,position control,roll angle planning and attitude control.The position and attitude controllers exhibit Lyapunov exponential stability.The time-coordinated controller addresses the synchronization problem by adjusting the speed based on the coordinated state to achieve progress adjustment.The position controller operates based on the cross-track error and altitude error in the Gravity-Referenced Moving frame.By employing an optimization approach and designing a penalty function,the roll angle sequence is computed.The attitude inner-loop control operates in the SO(3)space and allows for control of large deviations.High-fidelity simulation validates the effectiveness of the proposed method,with normalized coordination error and following error controlled within 2%and 1.2m.展开更多
基金supported by National Natural Science Foundation of China(82272549,82472505,and 82472498)National key Research and Development plan,Ministry of Science and Technology of the People’s Republic of China(2022YFC2407203)+2 种基金the Young Health Talents of Shanghai Municipal Health Commission,China(2022YQ011)China Medical Education Association(3030537245)The Youth Talent Project of Huashan Hospital(30302164006).
文摘Intervertebral disc degeneration(IVDD)is the primary contributor to a range of spinal diseases.Dynamin-related protein 1(Drp1)-mediated mitochondrial fission has recently been identified as a new cause of nucleus pulposus cell(NPC)death and IVDD,but the underlying mechanisms remain unclear.Although the effects of Drp1 phosphorylation in IVDD have been studied,it is currently unknown if small ubiquitin-like modifications(SUMOylation)of Drp1 regulate IVDD.This study aimed to investigate the functions and mechanisms of mitochondria-anchored protein ligase(MAPL),a mitochondrial SUMO E3 ligase,during IVDD progression.The expression of genes related to SUMOylation and mitochondrial dynamics in TNF-α-stimulated NPCs was analysed via RNA sequencing.
文摘BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical for improving the quality of life and minimizing complications.This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.AIM To evaluate the effect of this combined nursing model on postoperative self-care ability,disease knowledge,mood state,and complication rates in patients undergoing rectal cancer surgery.METHODS Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference(routine care)and experimental(problem management-guided health education combined with positive incentive nursing)groups.The outcomes included exercise of self-care agency scale,disease knowledge(hospital-specific questionnaire),mood state(profile of mood states),and complication rates.RESULTS The experimental group demonstrated significant improvements in self-care ability(P<0.05),with higher scores for health knowledge,self-concept,self-care skills,and self-care responsibility than the reference group.Disease knowledge scores also improved markedly in the experimental group(P<0.05).Mood state scores showed a significant decrease in the negative dimensions(e.g.,anxiety and depression)and an increase in energy vitality(P<0.05).Additionally,the experimental group exhibited a lower complication rate than the reference group(7.5%vs 27.5%,P<0.05).CONCLUSION The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities,disease knowledge,and emotional well-being while reducing complication rates.This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.
基金Medical Research Ethics Review Committee of the Guangdong Provincial Center for Disease Control and Prevention,China(No.W96-027E-202307).
文摘Objective This study aimed to identify high-risk areas for type 2 diabetes mellitus(T2DM)mortality to provide relevant evidence for interventions in emerging economies.Methods Empirical Bayesian Kriging and a discrete Poisson space-time scan statistic were applied to identify the spatiotemporal clusters of T2DM mortality.The relationships between economic factors,air pollutants,and the mortality risk of T2DM were assessed using regression analysis and the Poisson Log-linear Model.Results A coastal district in East Guangdong,China,had the highest risk(Relative Risk[RR]=4.58,P<0.01),followed by the 10 coastal districts/counties in West Guangdong,China(RR=2.88,P<0.01).The coastal county in the Pearl River Delta,China(RR=2.24,P<0.01),had the third-highest risk.The remaining risk areas were two coastal counties in East Guangdong,16 districts/counties in the Pearl River Delta,and two counties in North Guangdong,China.Mortality due to T2DM was associated with gross domestic product per capita(GDP per capita).In pilot assessments,T2DM mortality was significantly associated with carbon monoxide.Conclusion High mortality from T2DM occurred in the coastal areas of East and West Guangdong,especially where the economy was progressing towards the upper middle-income level.
基金Supported by The First Batch of Key Discipline on Public Health in Chongqing.
文摘BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors for hypofibrinogenemia asso-ciated with hemocoagulase are poorly understood.AIM To determine risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.METHODS We performed a retrospective analysis of the medical documentation of hospit-alized patients treated with hemocoagulase for gastrointestinal bleeding.Hypofib-rinogenemia was defined as a decrease in plasma fibrinogen concentration to less than 2.0 g/L.The included patients were divided into two groups:acquired hypofibrinogenemia group and non-hypofibrinogenemia group.We used logistic regression analysis to identify potential risk factors and established risk assess-RESULTS There were 36 patients in the acquired hypofibrinogenemia group and 73 patients in the non-hypofibrinogenemia group.The hypofibrinogenemia group showed higher rates of intensive care unit admissions(P=0.021),more female patients(P=0.005),higher in-hospital mortality(P=0.027),larger hemocoagulase doses(P=0.026),more Packed Red Cells transfusions(P=0.024),and lower baseline fibrinogen levels(P<0.000).Binary logistic regression was employed to examine the risk factors associated with acquired hypofibrinogenemia.The analysis revealed that baseline fibrinogen[odds ratio(OR)0.252,95%CI:0.137-0.464,P<0.000],total hemocoagulase doses(OR 1.074,95%CI:1.015-1.137,P=0.014),and female gender(OR 2.856,95%CI:1.015–8.037,P=0.047)were statist-ically significant risk factors.CONCLUSION Higher doses of total hemocoagulase,female gender,and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
基金supported by grants from National Natural Science Foundation of China(31071042)Chinese Postdoctoral Scientific Foundation(20100480774)
文摘Because of the aggressive threaten of heat stroke and a lack of understanding of the mechanism of action, mammal animal models for experimental heat stroke were well developed. During the past 5 decades, anesthetized mouse, rat, rabbit, dog, baboon and monkey were used as animal model for experimental heat stroke. However, anesthetized mammals models have some limitations, such as neuroprotective effect of anesthetic agents, possible disturbance on injury and recovery of stroke animals by anesthetic agents, difficulty of discussing animal behavior before and after heat stroke, it was also difficult for the models to evaluate cognitive function of animal under hot environment. Considering humanitarian, only awaked and unrestrained mouse heat stroke model was accepted so far. Therefore, we also developed an awaked and unrestrained rat heat stroke model, and found it was helpful to evaluate drug effectiveness for animal behavior and cognitive function under hot environment.
文摘Malaria and typhoid fever are debilitating diseases responsible for the deaths of thousands of lives annually. Over the last decade both diseases have received increasing attention with particular focus on malaria. However, recent reports indicate an increasing co-infection rate between mala- ria and typhoid fever. Familiar signs and symptoms of both diseases have led to the belief in some communities that it’s a new disease. In this study, we investigated the relationship between mala- ria and typhi O and H antigens among patients reporting with fever. Patients reporting with fever from April 2013-March 2014 were recruited for the study. Our results showed that there was no association between having malaria and typhoid fever infection. However, having fever was asso- ciated with having both diseases. Also, fever among patients was more likely to be caused by Sal- monella typhi O and H antigens than plasmodium parasites. Infections of both diseases were higher in wet season than in dry season. The study recommends that malaria and typhoid fever intervention programs are increased in endemic areas. Also attention should be paid to typhoid fever infection rates in the country.
文摘Cardiovascular diseases increase continually in the worldwide scale,and its specific pathogenesis has not been completely clear.The gas signal molecule hydrogen sulfide(H2S)is a new type of neuroactive substance,which plays many biological roles in many systems such as cardiovascular system.In recent years,a lot of research has confirmed H2S has myocardial protective effect on cardiovascular diseases such as atherosclerosis,ischemia-reperfusion injury,hypertension and heart failure.This paper reviews the research status of myocardial protective effect of H2S on cardiovascular diseases.
基金supported by the National Natural Science Foundation of China,China(82472505,82472498,82272549,82072488,82102620,and 82170255)the National Key Research and Development plan,Ministry of Science and Technology of the People’s Republic of China(2022YFC2407203)+2 种基金the Young Health Talents of Shanghai Municipal Health Commission,China(2022YQ011)the China Medical Education Association(2023-020)and the Youth Talent Project of Huashan Hospital(30302164006).
文摘Dear Editor,The intervertebral disc(IVD)is a crucial fibrocartilaginous structure that connects adjacent vertebrae.It plays a fundamental role in maintaining spinal stability and absorbing mechanical stress.Each disc is composed of three parts:the inner nucleus pulposus(NP),the outer annulus fibrosus(AF),and the superior and inferior cartilage endplates(CEPs).Degeneration of IVDs is a primary contributor to various spinal disorders,such as cervical spondylosis,low back pain,and lumbar disc herniation,all of which lead to a significant reduction in the quality of life of patients and impose a substantial economic burden.In China,IVD degeneration(IVDD)is the third most common chronic disease following hypertension and diabetes,highlighting the widespread impact of IVDD on public health.1 Non-degenerated adult IVDs are devoid of a vascular system within。
基金National Natural Science Foundation of China,Grant/Award Number:52277211Start-up Fund of North China University of Technology,Grant/Award Number:110051360023XN224-24。
文摘A novel control scheme is presented to eliminate the negative effects of communication disturbances,which introduces active disturbance rejection control(ADRC)in the control strategy design to achieve the objectives of the restoration of the bus voltage and the sharing of the power even in the presence of disturbances and delays in communication.Simultaneously,its dynamic disturbance decoupling feature is used to realise the decoupling between power and voltage,so that the proposed controller only exchanges power information with its neighbours,reducing the communication burden and simplifying control structure.The control performance of the strategy is verified by employing steady-state analysis.The impact of controller parameters is studied by establishing a small signal model.Finally,both simulation cases and experimental tests prove the feasibility of this scheme.
基金the National Key Research and Development Program of China(2017YFE0103800)the National Institutes of Health NIAID NIAID K24AI143471,1UG3HD096929-01,NIA P30(P30AG034420)+3 种基金UNC-South China STD Research Training Center(FIC 1D43TW009532-01)UNC Center for AIDS Research(NIAID 5P30AI050410)Doris Duke Charitable Foundation(International Clinical Research Fellowship to TZ)SESH(Social Entrepreneurship to Spur Health)Global.
文摘Background:Gonorrhea and chlamydia testing rates are poor among Chinese men who have sex with men(MSM).A quasi-experimental study suggested that a pay-it-forward strategy increased dual gonorrhea/chlamydia testing among MSM.Pay-it-forward offers an individual a gift(e.g.,a free test)and then asks the same person if they would like to give a gift to another person.This article reports the protocol of a randomized controlled trial to evaluate dual gonorrhea/chlamydia test uptake and other outcomes among MSM in three arms-a pay-it-forward arm,a pay-what-you-want arm,and a standard of care arm.Methods:Three hundred MSM will be recruited at three HIV testing sites in Guangzhou and Beijing.Testing sites include two hospital-based MSM sexually transmitted diseases clinics and one MSM community-based organization.Eligible participants will be born biologically male,aged 16 years or older,reporting previous anal sex with another man,having never participated in the pay-it-forward program,without previous gonorrhea and chlamydia testing in the past 12 months,and residing in China.Following a cluster randomized design,every cluster of ten participants will be randomly allocated into one of three arms:(1)a pay-it-forward arm in which men are offered free gonorrhea and chlamydia testing and then asked whether they would like to donate("pay it forward")toward testing for future testers;(2)a pay-what-you-want arm in which men are offered free testing and told to decide how much to pay after receiving the test;(3)a standard of care arm in which men can pay the full price for dual gonorrhoea and chlamydia testing.The primary outcome is dual gonorrhoea/chlamydia testing as verified by administrative records.Secondary outcomes include incremental cost per test,incremental cost per diagnosis,community connectedness,and social cohesion.Primary outcome will be calculated for each arm using intention-to-treat and compared using one-sided 95%confidence intervals with a margin of 20%increase defined as superiority.Discussion:This study will examine the pay-it-forward strategy in comparison to the standard of care in improving test uptake for gonorrhea and chlamydia.We will leverage the cluster randomized controlled trial to provide scientific evidence on the potential effect of pay-it-forward.Findings from this study will shed light on novel intervention methods for increasing preventive health service utilization and innovate ways to finance it among communities.Trial registration:ClinicalTrials.gov,NCT03741725.Registered on 12 November 2018.
基金National Natural Science Foundation of China(Nos.81970032 and 81870026)
文摘To the Editor:Asthma is a complex chronic inflammatory lung disease,and its pathogenesis is not fully understood.It is believed that airway epithelium primarily acts as a defensive barrier to protect the lung from allergens,avoiding the asthma.The integrity of the airway epithelial barrier is dependent on tight junctions comprised of zona occludens(ZO)1 to 3,occludin,and claudin 1 to 5,and adherens junctions mainly formed by E-cadherin,b-catenin,and junctional adhesion molecule,which maintain apicobasal polarity of bronchial epithelial cells.
基金supported in part by the National Natural Science Foundation of China under Grant No.61876187.
文摘This paper presents a control strategy for multiple unmanned aerial vehicle systems(multi-UAVs)time-coordinated path following with desired endpoint roll attitudes.It utilizes the strong maneuvering capabilities of agile fixed-wing UAVs and incorporates an end-roll expectation.The strategy consists of four steps:time-coordinated control,position control,roll angle planning and attitude control.The position and attitude controllers exhibit Lyapunov exponential stability.The time-coordinated controller addresses the synchronization problem by adjusting the speed based on the coordinated state to achieve progress adjustment.The position controller operates based on the cross-track error and altitude error in the Gravity-Referenced Moving frame.By employing an optimization approach and designing a penalty function,the roll angle sequence is computed.The attitude inner-loop control operates in the SO(3)space and allows for control of large deviations.High-fidelity simulation validates the effectiveness of the proposed method,with normalized coordination error and following error controlled within 2%and 1.2m.
