BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,ven...Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.展开更多
Chiral N-substituted amino amides and esters are ubiquitous scaffolds in pesticides and pharmaceutical chemicals,but their asymmetric synthesis remains challenging especially for those with multiple chiral centers.In ...Chiral N-substituted amino amides and esters are ubiquitous scaffolds in pesticides and pharmaceutical chemicals,but their asymmetric synthesis remains challenging especially for those with multiple chiral centers.In this study,IR104 from Streptomyces aureocirculatus was identified from 157 wild-type imine reductases for the synthesis of(S)-2-((R)-2-oxo-4-propylpyrrolidin-1-yl)butanamide(antiepileptic drug Brivaracetam)via dynamic kinetic resolution reductive amination from ethyl 3-formylhexanoate and(S)-2-aminobutylamide with high diastereoselectivity.To further improve the catalytic efficiency of IR104,its mutant D191E/L195I/E253S/M258A(M3)was identified by saturation mutagenesis and iterative combinatorial mutagenesis,which exhibited a 102-fold increase in the catalytic efficiency relative to that of wild-type enzyme and high diastereoselectivity(98:2 d.r.).Crystal structural analysis and molecular dynamics simulations provided some insights into the molecular basis for the improved activity of the mutant enzyme.The imine reductase identified in this study could accept chiral amino amides/esters as amino donors for the dynamic kinetic resolution reductive amination of racemicα-substituted aldehydo-esters,expanding the substrate scope of imine reductases in the dynamic kinetic resolution-reductive amination.Finally,IR104-M3 was successfully used for the preparation of Brivaracetam at gram scale.Using this mutant,various N-substituted amino amides/esters with two chiral centers were also synthesized with up to 99:1 d.r.and 96%yields and subsequently converted intoγ-andδ-lactams,providing an efficient protocol for the synthesis of these important compounds via enzymatic dynamic kinetic resolution-reductive amination from simple building blocks.展开更多
A 16-channel arrayed waveguide grating(AWG)with an 800 GHz channel spacing in the O-band has been developed and fabricated based on silica planar lightwave circuit(PLC)technology.By extending the wave⁃length allocatio...A 16-channel arrayed waveguide grating(AWG)with an 800 GHz channel spacing in the O-band has been developed and fabricated based on silica planar lightwave circuit(PLC)technology.By extending the wave⁃length allocation from 8 channels to 16 channels as specified in IEEE 802.3bs,we increased the number of chan⁃nels and boosted transmission capacity to meet the 1.6 Tbps and higher-speed signal transmission requirements for future data centers.Through optimizing the AWG structure,it has achieved insertion loss(IL)better than-1.61 dB,loss uniformity below 0.35 dB,polarization-dependent loss(PDL)below 0.35 dB,adjacent channel cross⁃talk under-20.05 dB,ripple less than 0.75 dB,center wavelength offset under 0.22 nm and 1 dB bandwidth ex⁃ceeding 2.88 nm.The AWG has been successfully measured to transmit 53 Gbaud 4-level pulse amplitude modu⁃lation(PAM4)signal per channel and the total transmission speed can reach over 1.6 Tbps.展开更多
Objective The national lifetime prevalence of urolithiasis is estimated at 6.6%in Iran.However,reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis.No prior large...Objective The national lifetime prevalence of urolithiasis is estimated at 6.6%in Iran.However,reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis.No prior large-scale study has reported the composition of kidney stones based on the gold-standard methods(X-ray diffraction or infrared spectroscopy)in Iran.This study aimed to provide the composition of kidney stones based on Fourier transform infrared spectroscopy.Methods This is a cross-sectional study assessing urinary stone composition from various cities in Iran at a referral center using infrared spectroscopy from February 2019 to March 2023.Results This study determined the stone composition of 1092 patients from 10 cities in Iran.Overall,the majority of stones were composed of calcium oxalate(n=498;45.6%)and uric acid(UA,n=488;44.7%)followed by cystine(n=49;4.5%)and struvite(n=28;2.6%).Stone composition in Shiraz and Isfahan was roughly similar with a higher percentage of UA stones(53.4%and 53.6%,respectively)while the capital city of Iran(Tehran)had less frequent UA stones(39.9%)with a higher percentage of calcium oxalate stones.The percentage of UA stones increased with age as it was 11.1%in children,42.7%in adults,and 83.3%in geriatric patients(p<0.001).About 29.6%of cystine stones were observed in children.Conclusion The most frequent stone composition among kidney stones in Iran was calcium oxalate and UA stones.This relative frequency of UA stones is considerably higher than many international reports from neighboring as well as distant countries.More cystine stones were observed in children and women.Geriatric patients’stones were mostly composed of UA.展开更多
BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal ...BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension(PH).AIM To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure(PVP).METHODS This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024.Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs.All patients'angiographic images were collected for analysis.The associations between WHVP and PVP in each group were analyzed via linear regression analysis,and a predictive model was established.RESULTS The 877 patients had a mean age of 52.6±13.0 years,with 582 males and 295 females.Patients were categorized into four groups on the basis of their anatomical structure.All groups showed strong correlations between WHVP and PVP.The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884(P<0.05);in the hepatic right vein-accessory hepatic venous angiography group,it was 0.721(P<0.05);in the hepatic right vein-middle hepatic venous angiography group,it was 0.344(P<0.05);and in the hepatic right vein-nonangiography group,it was 0.293(P<0.05).CONCLUSION The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP.Based on the different anatomical classifications of hepatic veins,WHVP can be used to estimate PVP,improving the accuracy of PVP prediction.展开更多
This study aims to eliminate the subjectivity and inconsistency inherent in the traditional International Association of Drilling Contractors(IADC)bit wear rating process,which heavily depends on the experience of dri...This study aims to eliminate the subjectivity and inconsistency inherent in the traditional International Association of Drilling Contractors(IADC)bit wear rating process,which heavily depends on the experience of drilling engineers and often leads to unreliable results.Leveraging advancements in computer vision and deep learning algorithms,this research proposes an automated detection and classification method for polycrystalline diamond compact(PDC)bit damage.YOLOv10 was employed to locate the PDC bit cutters,followed by two SqueezeNet models to perform wear rating and wear type classifications.A comprehensive dataset was created based on the IADC dull bit evaluation standards.Additionally,this study discusses the necessity of data augmentation and finds that certain methods,such as cropping,splicing,and mixing,may reduce the accuracy of cutter detection.The experimental results demonstrate that the proposed method significantly enhances the accuracy of bit damage detection and classification while also providing substantial improvements in processing speed and computational efficiency,offering a valuable tool for optimizing drilling operations and reducing costs.展开更多
Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery a...Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery and maternal-fetal prognosis of this type of delivery at csref of Kolondiéba. Materials and Methods: This was a retrospective cross-sectional study for one year (1 January 2023-31 December 2023). All patients admitted to the maternity ward of the center with at least one uterine scar and treated in the center were included. We extracted data from partograms, OR records, birth records and obstetric records. Input was done on Excel 2010 and analysis on SPSS.23. Results: The frequency of scarring uterus was 16.8% (217/1285 births). The average age was 27. Pauciparous were most represented (59%). Patients were received from community health centers (44.7%). Prenatal consultation sessions (1 - 3 sessions) were performed at (64.9%). Uterine scars were obstetric in (99%). The cesarean section was performed immediately in (59.4%), it was prophylactic in 17%. The uterine test was attempted in (25.34%) with (69%) success. We recorded 3.6% uterine ruptures, 8.7% postoperative complications, 5.5% stillbirths and one maternal death (0.46%). Conclusion: Births on a scarred uterus are frequent and associated with a high rate of complications.展开更多
As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utili...As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.展开更多
As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center direc...As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.展开更多
The asymmetric conjugate additions of aryl Grignard reagents to trisubstituted enones by chiral P,N ligand L6 with low catalyst loading(0.25–1.0 mol%)are disclosed.Chiral 2-ester chromanone and its analogs bearing a ...The asymmetric conjugate additions of aryl Grignard reagents to trisubstituted enones by chiral P,N ligand L6 with low catalyst loading(0.25–1.0 mol%)are disclosed.Chiral 2-ester chromanone and its analogs bearing a quaternary stereogenic centers at C2 position were produced in high to excellent yields,enantioselectivities and high turnover number.The notable features of this reaction include its broad substrate scope,complete 1,4-addition regioselectivities,applicability to both batch and flow for large scale synthesis.This report develops an efficient strategy to apply aryl Grignard reagents in asymmetric 1,4-conjugation reactions and provides a direct method to incorporate quaternary chiral centers toward the synthesis of biologically relevant chromanone derivatives.展开更多
The Dynamical Density Functional Theory(DDFT)algorithm,derived by associating classical Density Functional Theory(DFT)with the fundamental Smoluchowski dynamical equation,describes the evolution of inhomo-geneous flui...The Dynamical Density Functional Theory(DDFT)algorithm,derived by associating classical Density Functional Theory(DFT)with the fundamental Smoluchowski dynamical equation,describes the evolution of inhomo-geneous fluid density distributions over time.It plays a significant role in studying the evolution of density distributions over time in inhomogeneous systems.The Sunway Bluelight II supercomputer,as a new generation of China’s developed supercomputer,possesses powerful computational capabilities.Porting and optimizing industrial software on this platform holds significant importance.For the optimization of the DDFT algorithm,based on the Sunway Bluelight II supercomputer and the unique hardware architecture of the SW39000 processor,this work proposes three acceleration strategies to enhance computational efficiency and performance,including direct parallel optimization,local-memory constrained optimization for CPEs,and multi-core groups collaboration and communication optimization.This method combines the characteristics of the program’s algorithm with the unique hardware architecture of the Sunway Bluelight II supercomputer,optimizing the storage and transmission structures to achieve a closer integration of software and hardware.For the first time,this paper presents Sunway-Dynamical Density Functional Theory(SW-DDFT).Experimental results show that SW-DDFT achieves a speedup of 6.67 times within a single-core group compared to the original DDFT implementation,with six core groups(a total of 384 CPEs),the maximum speedup can reach 28.64 times,and parallel efficiency can reach 71%,demonstrating excellent acceleration performance.展开更多
This work’s goal was to compile a list of fishing-related violations in order to suggest ways to enhance the surveillance system.In order to accomplish this goal,the following approach was used:Executive consultation...This work’s goal was to compile a list of fishing-related violations in order to suggest ways to enhance the surveillance system.In order to accomplish this goal,the following approach was used:Executive consultation and archive exploitation;surveillance agent survey;surveillance system identification and description;identification of offenses and fleet involved in the Guinean exclusive and economic area in recent years;identification and categorization of offense causes;surveillance system evaluation;and suggestion for enhanced surveillance system measures.Monitoring of this strategy showed that:fishing operating zones,administrative paperwork,and fishing gear are all linked to the infractions committed in the Guinean exclusive and economic zone.Records show that there were 308 boardings between 2006 and 2021.IP(Intellectual Property)infringement rates are 59%,Motorized Artisanal Fishing is 25%,and Semi-industrial fishing is 16%.In Motorized Artisanal Fishing,the Guineans have committed 33,the Senegalese have committed 23,and the Leonese have committed 18.In Semi-industrial fishing,the Chinese have committed 17 and the Senegalese have committed 16.According to the stakeholder survey,Vessal Monitoring System monitored 79 vessels in industrial fishing and 49 in Semi-industrial fishing in 2021.Registration certificates,personnel,rescue gear,gross tonnage,coastal state fishing authority,and maritime radio license are typically the primary documents examined at sea.From 2006 to 2022,a total of 135 fleets-80 demersal trawlers,7 cephalopod boats,21 shrimp boats,22 pelagic trawlers,and 5 cargo ships-were implicated in violations in the Guinean exclusive and economic area.By integrating the automatic identification system and Vessal Monitoring systems for fisheries surveillance,establishing a marking system for fishing gear,investing in highly effective launches,and protecting the privacy of patrol activities,Guinea’s surveillance system might be improved more effectively.展开更多
Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods...Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.展开更多
On November 26,2021,a novel lineage (B.1.1.529) was categorized as the fifth virus of concern (VOC) and named Omicron by World Health Organization (WHO).Patients infected with COVID-19 Omicron variant are reported to ...On November 26,2021,a novel lineage (B.1.1.529) was categorized as the fifth virus of concern (VOC) and named Omicron by World Health Organization (WHO).Patients infected with COVID-19 Omicron variant are reported to have higher transmissibility,lower severity and mortality than those with previous subvariants.In terms of virulence,the Omicron subvariant is weaker than previous strains,with symptoms mostly being fever,running nose and other symptoms mainly seen in upper respiratory tract infections.However,the clinical characteristics of medical staff infected with Omicron variants have rarely been reported before.We conducted a survey in five centers and summarized these profiles to explore the clinical characteristics.展开更多
Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospe...Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.展开更多
BACKGROUND Kidney transplant recipients(KTRs)are most vulnerable to infection in the first year after transplantation.Tixagevimab and cilgavimab are neutralizing monoclonal antibodies directed against different epitop...BACKGROUND Kidney transplant recipients(KTRs)are most vulnerable to infection in the first year after transplantation.Tixagevimab and cilgavimab are neutralizing monoclonal antibodies directed against different epitopes of the receptor-binding domain of the severe acute respiratory syndrome coronavirus 2 spike protein.The purpose of this study is to report experience with tixagevimab/cilgavimab administered to KTRs who were within 1 year of transplantation.AIM To describe outcomes of KTRs who received tixagevimab/cilgavimab early posttransplant to prevent coronavirus disease 2019(COVID-19).METHODS This is a single-center retrospective cohort study of adult KTRs who underwent kidney transplantation from January 1,2022 to September 30,2022 and received tixagevimab/cilgavimab 300 mg/300 mg for prevention of COVID-19.Outcomes of interest were adverse events associated with tixagevimab/cilgavimab,COVID-19 breakthrough infection and COVID-19-associated hospitalization and complications.We also conducted a systematic review of the literature for the use of tixagevimab/cilgavimab as pre-exposure prophylaxis for COVID-19 in solid organ transplant recipients(SOTRs)from inception to December 31,2023.RESULTS There were 104 patients included with median age of 50 years(range 21-72 years).Omicron strain of the COVID-19 virus was the predominantly circulating variant at the time of current study.Patients testing positive for COVID-19 were given tixagevimab/cilgavimab for prophylaxis of complications during the median of 3 days(range 0-201 days)after kidney transplant,of whom 97(93.3%)received the antibodies prior to discharge.No discernable adverse effects attributable to the medication were observed during the time they received prophylaxis.The efficacy of the drug assessed through the absence of breakthrough infections were observed in 91 patients.13(12.5%)patients developed COVID-19 breakthrough infections during an overall median follow-up period of 125 days(range 10-257 days)after tixagevimab/cilgavimab.These infections were observed at median 105 days(range 6-211 days)after receiving the prophylactic medication.5(4.8%)of overall patients required hospitalization and there were no reported deaths in the cohort.Findings of the systematic review were consistent with our findings wherein tixagevimab/cilgavimab was well tolerated by SOTRs.CONCLUSION Tixagevimab/cilgavimab has a favorable safety profile when administered in newly transplanted kidney recipients.Although breakthrough infections were not uncommon,there was a low rate of hospitalization and no deaths.This study highlights the need to examine the efficacy of novel monoclonal antibodies administered for COVID-19 prophylaxis in newly transplanted recipients.展开更多
Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive hea...Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.展开更多
Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe an...Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe and life-threatening infections and are most likely to suffer more from the spread of untreatable resistant bacteria. Despite the generally increasing trends in AMR, there is hardly any documented data on AMR in orthopedic care. Methods: We analyzed data from the pathogenic isolates from pus and tissue from the laboratory from 2019 to 2023. We calculated the proportions of isolates resistant to commonly used antimicrobial classes. We used the chi-square test for trends to evaluate changes in AMR across the study period. Results: Out of the 286 isolates, 104 (43.5%) were from pus, 112 (46.9%) were from tissue samples and the remaining 9.6% were from different fluid aspirates like synovial fluid. Most of the isolates were from males (64.2%) and aged between 19 and 45 years (46.2%). The distribution of whether the bacteria were gram-positive or negative was relatively equal with 114 (45.2%) being gram-negative and 120 (47.6%) gram-positive. Generally, there was increased AMR across all antibiotics from 2019 to 2021 e.g. for Imipinem, it went from 0% in 2019 to 70.8% in 2021 and for Amoxyclav, it went from 10% in 2019 to 93.2% in 2021. There was a general decline in AMR noted from 2021 to 2023. However, currently, the highest resistance is noted in ceftriaxone (80.0%) and the lowest in Imipinem (11.76%). Conclusion: There is a general decreasing trend in AMR, most probably due to increasing policies governing the use of antibiotics. However, there is still high resistance to commonly used and affordable antibiotics. Continuous monitoring of AMR is still recommended to reduce the AMR problem in Uganda at large through public health policy and planning.展开更多
As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a ...As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a distributed approach enabling collaborative data processing without sharing raw data,offers promising solutions to challenges in multi-center medical data sharing.This review summarizes the progress of federated learning in multi-center medical data processing,analyzed from four perspectives:system architectures,data distribution strategies,clinical tasks,and algorithmic models.At the same time,this paper explores the challenges in practical applications,such as data heterogeneity,communication overhead,and privacy concerns.It proposes driving future research development by optimizing algorithms,strengthening privacy protection mechanisms,and enhancing computational efficiency.展开更多
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
基金supported by the Beijing Natural Science Foundation(No.Z230016)the National Key Research and Development Program of China(No.2022YFC 2502606)+4 种基金the Major Program of the National Natural Science Foundation of China(No.82293630)the Peking University Medicine Fund for the World’s Leading Discipline or Discipline Cluster Development(No.71003Y3035)the Plan Project of Tongzhou Municipal Science and Technology(No.KJ2024CX045)the National Natural Science Foundation of China(No.82170208)the Fundamental Research Funds for the Central Universities。
文摘Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.
文摘Chiral N-substituted amino amides and esters are ubiquitous scaffolds in pesticides and pharmaceutical chemicals,but their asymmetric synthesis remains challenging especially for those with multiple chiral centers.In this study,IR104 from Streptomyces aureocirculatus was identified from 157 wild-type imine reductases for the synthesis of(S)-2-((R)-2-oxo-4-propylpyrrolidin-1-yl)butanamide(antiepileptic drug Brivaracetam)via dynamic kinetic resolution reductive amination from ethyl 3-formylhexanoate and(S)-2-aminobutylamide with high diastereoselectivity.To further improve the catalytic efficiency of IR104,its mutant D191E/L195I/E253S/M258A(M3)was identified by saturation mutagenesis and iterative combinatorial mutagenesis,which exhibited a 102-fold increase in the catalytic efficiency relative to that of wild-type enzyme and high diastereoselectivity(98:2 d.r.).Crystal structural analysis and molecular dynamics simulations provided some insights into the molecular basis for the improved activity of the mutant enzyme.The imine reductase identified in this study could accept chiral amino amides/esters as amino donors for the dynamic kinetic resolution reductive amination of racemicα-substituted aldehydo-esters,expanding the substrate scope of imine reductases in the dynamic kinetic resolution-reductive amination.Finally,IR104-M3 was successfully used for the preparation of Brivaracetam at gram scale.Using this mutant,various N-substituted amino amides/esters with two chiral centers were also synthesized with up to 99:1 d.r.and 96%yields and subsequently converted intoγ-andδ-lactams,providing an efficient protocol for the synthesis of these important compounds via enzymatic dynamic kinetic resolution-reductive amination from simple building blocks.
基金Supported by the National Key Research and Development Program of China(2021YFB2800201)the Strategic Priority Research Program of Chinese Academy of Sciences(XDB43000000)。
文摘A 16-channel arrayed waveguide grating(AWG)with an 800 GHz channel spacing in the O-band has been developed and fabricated based on silica planar lightwave circuit(PLC)technology.By extending the wave⁃length allocation from 8 channels to 16 channels as specified in IEEE 802.3bs,we increased the number of chan⁃nels and boosted transmission capacity to meet the 1.6 Tbps and higher-speed signal transmission requirements for future data centers.Through optimizing the AWG structure,it has achieved insertion loss(IL)better than-1.61 dB,loss uniformity below 0.35 dB,polarization-dependent loss(PDL)below 0.35 dB,adjacent channel cross⁃talk under-20.05 dB,ripple less than 0.75 dB,center wavelength offset under 0.22 nm and 1 dB bandwidth ex⁃ceeding 2.88 nm.The AWG has been successfully measured to transmit 53 Gbaud 4-level pulse amplitude modu⁃lation(PAM4)signal per channel and the total transmission speed can reach over 1.6 Tbps.
文摘Objective The national lifetime prevalence of urolithiasis is estimated at 6.6%in Iran.However,reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis.No prior large-scale study has reported the composition of kidney stones based on the gold-standard methods(X-ray diffraction or infrared spectroscopy)in Iran.This study aimed to provide the composition of kidney stones based on Fourier transform infrared spectroscopy.Methods This is a cross-sectional study assessing urinary stone composition from various cities in Iran at a referral center using infrared spectroscopy from February 2019 to March 2023.Results This study determined the stone composition of 1092 patients from 10 cities in Iran.Overall,the majority of stones were composed of calcium oxalate(n=498;45.6%)and uric acid(UA,n=488;44.7%)followed by cystine(n=49;4.5%)and struvite(n=28;2.6%).Stone composition in Shiraz and Isfahan was roughly similar with a higher percentage of UA stones(53.4%and 53.6%,respectively)while the capital city of Iran(Tehran)had less frequent UA stones(39.9%)with a higher percentage of calcium oxalate stones.The percentage of UA stones increased with age as it was 11.1%in children,42.7%in adults,and 83.3%in geriatric patients(p<0.001).About 29.6%of cystine stones were observed in children.Conclusion The most frequent stone composition among kidney stones in Iran was calcium oxalate and UA stones.This relative frequency of UA stones is considerably higher than many international reports from neighboring as well as distant countries.More cystine stones were observed in children and women.Geriatric patients’stones were mostly composed of UA.
基金Supported by Capital Medical University Affiliated Beijing Shijitan Hospital Talent Development Program during the 14th Five-Year Plan,No.2023 LJRCLFQ.
文摘BACKGROUND Wedged hepatic venous pressure(WHVP)is a crucial variable for accurately assessing the hepatic venous pressure gradient(HVPG)and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension(PH).AIM To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure(PVP).METHODS This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024.Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs.All patients'angiographic images were collected for analysis.The associations between WHVP and PVP in each group were analyzed via linear regression analysis,and a predictive model was established.RESULTS The 877 patients had a mean age of 52.6±13.0 years,with 582 males and 295 females.Patients were categorized into four groups on the basis of their anatomical structure.All groups showed strong correlations between WHVP and PVP.The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884(P<0.05);in the hepatic right vein-accessory hepatic venous angiography group,it was 0.721(P<0.05);in the hepatic right vein-middle hepatic venous angiography group,it was 0.344(P<0.05);and in the hepatic right vein-nonangiography group,it was 0.293(P<0.05).CONCLUSION The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP.Based on the different anatomical classifications of hepatic veins,WHVP can be used to estimate PVP,improving the accuracy of PVP prediction.
基金support of the CNPC International Collaborative Research Project(No.2022DQ0410)。
文摘This study aims to eliminate the subjectivity and inconsistency inherent in the traditional International Association of Drilling Contractors(IADC)bit wear rating process,which heavily depends on the experience of drilling engineers and often leads to unreliable results.Leveraging advancements in computer vision and deep learning algorithms,this research proposes an automated detection and classification method for polycrystalline diamond compact(PDC)bit damage.YOLOv10 was employed to locate the PDC bit cutters,followed by two SqueezeNet models to perform wear rating and wear type classifications.A comprehensive dataset was created based on the IADC dull bit evaluation standards.Additionally,this study discusses the necessity of data augmentation and finds that certain methods,such as cropping,splicing,and mixing,may reduce the accuracy of cutter detection.The experimental results demonstrate that the proposed method significantly enhances the accuracy of bit damage detection and classification while also providing substantial improvements in processing speed and computational efficiency,offering a valuable tool for optimizing drilling operations and reducing costs.
文摘Introduction: Childbirth on a scarred uterus is a major issue for health centers, especially peripheral, due to the major obstetric risks it presents. The objectives were to evaluate the frequency, route of delivery and maternal-fetal prognosis of this type of delivery at csref of Kolondiéba. Materials and Methods: This was a retrospective cross-sectional study for one year (1 January 2023-31 December 2023). All patients admitted to the maternity ward of the center with at least one uterine scar and treated in the center were included. We extracted data from partograms, OR records, birth records and obstetric records. Input was done on Excel 2010 and analysis on SPSS.23. Results: The frequency of scarring uterus was 16.8% (217/1285 births). The average age was 27. Pauciparous were most represented (59%). Patients were received from community health centers (44.7%). Prenatal consultation sessions (1 - 3 sessions) were performed at (64.9%). Uterine scars were obstetric in (99%). The cesarean section was performed immediately in (59.4%), it was prophylactic in 17%. The uterine test was attempted in (25.34%) with (69%) success. We recorded 3.6% uterine ruptures, 8.7% postoperative complications, 5.5% stillbirths and one maternal death (0.46%). Conclusion: Births on a scarred uterus are frequent and associated with a high rate of complications.
文摘As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.
文摘As the core department in medical institutions responsible for cleaning,disinfecting,sterilizing,and supplying reusable medical devices,instruments,and items,the quality of work in the disinfection supply center directly impacts medical safety and infection control effectiveness.Professional protective training for personnel is crucial to ensure operational quality in this department.Systematic training enhances staff awareness of occupational exposure risks,standardizes protective measures in procedures,reduces cross-infection risks caused by improper operations,and ultimately lowers infection transmission risks.This paper analyzes the core content,implementation approaches,and practical role of professional protective training for disinfection supply center personnel in infection control.It aims to clarify the significant value of such training,providing references for medical institutions to optimize disinfection center management and strengthen infection control systems,thereby contributing to improved overall medical safety standards.
基金the financial support from the Sichuan Science and Technology Program(No.2022NSFSC0619)。
文摘The asymmetric conjugate additions of aryl Grignard reagents to trisubstituted enones by chiral P,N ligand L6 with low catalyst loading(0.25–1.0 mol%)are disclosed.Chiral 2-ester chromanone and its analogs bearing a quaternary stereogenic centers at C2 position were produced in high to excellent yields,enantioselectivities and high turnover number.The notable features of this reaction include its broad substrate scope,complete 1,4-addition regioselectivities,applicability to both batch and flow for large scale synthesis.This report develops an efficient strategy to apply aryl Grignard reagents in asymmetric 1,4-conjugation reactions and provides a direct method to incorporate quaternary chiral centers toward the synthesis of biologically relevant chromanone derivatives.
基金supported by National Key Research and Development Program of China under Grant 2024YFE0210800National Natural Science Foundation of China under Grant 62495062Beijing Natural Science Foundation under Grant L242017.
文摘The Dynamical Density Functional Theory(DDFT)algorithm,derived by associating classical Density Functional Theory(DFT)with the fundamental Smoluchowski dynamical equation,describes the evolution of inhomo-geneous fluid density distributions over time.It plays a significant role in studying the evolution of density distributions over time in inhomogeneous systems.The Sunway Bluelight II supercomputer,as a new generation of China’s developed supercomputer,possesses powerful computational capabilities.Porting and optimizing industrial software on this platform holds significant importance.For the optimization of the DDFT algorithm,based on the Sunway Bluelight II supercomputer and the unique hardware architecture of the SW39000 processor,this work proposes three acceleration strategies to enhance computational efficiency and performance,including direct parallel optimization,local-memory constrained optimization for CPEs,and multi-core groups collaboration and communication optimization.This method combines the characteristics of the program’s algorithm with the unique hardware architecture of the Sunway Bluelight II supercomputer,optimizing the storage and transmission structures to achieve a closer integration of software and hardware.For the first time,this paper presents Sunway-Dynamical Density Functional Theory(SW-DDFT).Experimental results show that SW-DDFT achieves a speedup of 6.67 times within a single-core group compared to the original DDFT implementation,with six core groups(a total of 384 CPEs),the maximum speedup can reach 28.64 times,and parallel efficiency can reach 71%,demonstrating excellent acceleration performance.
文摘This work’s goal was to compile a list of fishing-related violations in order to suggest ways to enhance the surveillance system.In order to accomplish this goal,the following approach was used:Executive consultation and archive exploitation;surveillance agent survey;surveillance system identification and description;identification of offenses and fleet involved in the Guinean exclusive and economic area in recent years;identification and categorization of offense causes;surveillance system evaluation;and suggestion for enhanced surveillance system measures.Monitoring of this strategy showed that:fishing operating zones,administrative paperwork,and fishing gear are all linked to the infractions committed in the Guinean exclusive and economic zone.Records show that there were 308 boardings between 2006 and 2021.IP(Intellectual Property)infringement rates are 59%,Motorized Artisanal Fishing is 25%,and Semi-industrial fishing is 16%.In Motorized Artisanal Fishing,the Guineans have committed 33,the Senegalese have committed 23,and the Leonese have committed 18.In Semi-industrial fishing,the Chinese have committed 17 and the Senegalese have committed 16.According to the stakeholder survey,Vessal Monitoring System monitored 79 vessels in industrial fishing and 49 in Semi-industrial fishing in 2021.Registration certificates,personnel,rescue gear,gross tonnage,coastal state fishing authority,and maritime radio license are typically the primary documents examined at sea.From 2006 to 2022,a total of 135 fleets-80 demersal trawlers,7 cephalopod boats,21 shrimp boats,22 pelagic trawlers,and 5 cargo ships-were implicated in violations in the Guinean exclusive and economic area.By integrating the automatic identification system and Vessal Monitoring systems for fisheries surveillance,establishing a marking system for fishing gear,investing in highly effective launches,and protecting the privacy of patrol activities,Guinea’s surveillance system might be improved more effectively.
基金supported by grants from Pudong New Area Traditional Chinese Medicine Brand Multiplication Plan-Chronic Nephropathy(PDZY-2021-0302)Construction of He Liqun’s famous TCM studio(PDZY-2022-0703)+2 种基金Clinical Observation on the Efficacy of Guben Tongluo Formula in Treating Chronic Kidney Disease Phase 1-3(PW2022D-12)Pilot Project of Inheritance,Innovation and Development of Traditional Chinese Medicine in Pudong New Area(YC-2023-0602)Pudong New Area’s Peak and Plateau Discipline Development in Clinical Medicine for Novel and Special Diseases(2025-PWXZ-15).
文摘Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.
文摘On November 26,2021,a novel lineage (B.1.1.529) was categorized as the fifth virus of concern (VOC) and named Omicron by World Health Organization (WHO).Patients infected with COVID-19 Omicron variant are reported to have higher transmissibility,lower severity and mortality than those with previous subvariants.In terms of virulence,the Omicron subvariant is weaker than previous strains,with symptoms mostly being fever,running nose and other symptoms mainly seen in upper respiratory tract infections.However,the clinical characteristics of medical staff infected with Omicron variants have rarely been reported before.We conducted a survey in five centers and summarized these profiles to explore the clinical characteristics.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[grant number 2021-I2M-1-037]the National Natural Science Foundation of China[grant numbers 82373647,and 82473697].
文摘Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.
文摘BACKGROUND Kidney transplant recipients(KTRs)are most vulnerable to infection in the first year after transplantation.Tixagevimab and cilgavimab are neutralizing monoclonal antibodies directed against different epitopes of the receptor-binding domain of the severe acute respiratory syndrome coronavirus 2 spike protein.The purpose of this study is to report experience with tixagevimab/cilgavimab administered to KTRs who were within 1 year of transplantation.AIM To describe outcomes of KTRs who received tixagevimab/cilgavimab early posttransplant to prevent coronavirus disease 2019(COVID-19).METHODS This is a single-center retrospective cohort study of adult KTRs who underwent kidney transplantation from January 1,2022 to September 30,2022 and received tixagevimab/cilgavimab 300 mg/300 mg for prevention of COVID-19.Outcomes of interest were adverse events associated with tixagevimab/cilgavimab,COVID-19 breakthrough infection and COVID-19-associated hospitalization and complications.We also conducted a systematic review of the literature for the use of tixagevimab/cilgavimab as pre-exposure prophylaxis for COVID-19 in solid organ transplant recipients(SOTRs)from inception to December 31,2023.RESULTS There were 104 patients included with median age of 50 years(range 21-72 years).Omicron strain of the COVID-19 virus was the predominantly circulating variant at the time of current study.Patients testing positive for COVID-19 were given tixagevimab/cilgavimab for prophylaxis of complications during the median of 3 days(range 0-201 days)after kidney transplant,of whom 97(93.3%)received the antibodies prior to discharge.No discernable adverse effects attributable to the medication were observed during the time they received prophylaxis.The efficacy of the drug assessed through the absence of breakthrough infections were observed in 91 patients.13(12.5%)patients developed COVID-19 breakthrough infections during an overall median follow-up period of 125 days(range 10-257 days)after tixagevimab/cilgavimab.These infections were observed at median 105 days(range 6-211 days)after receiving the prophylactic medication.5(4.8%)of overall patients required hospitalization and there were no reported deaths in the cohort.Findings of the systematic review were consistent with our findings wherein tixagevimab/cilgavimab was well tolerated by SOTRs.CONCLUSION Tixagevimab/cilgavimab has a favorable safety profile when administered in newly transplanted kidney recipients.Although breakthrough infections were not uncommon,there was a low rate of hospitalization and no deaths.This study highlights the need to examine the efficacy of novel monoclonal antibodies administered for COVID-19 prophylaxis in newly transplanted recipients.
文摘Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.
文摘Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe and life-threatening infections and are most likely to suffer more from the spread of untreatable resistant bacteria. Despite the generally increasing trends in AMR, there is hardly any documented data on AMR in orthopedic care. Methods: We analyzed data from the pathogenic isolates from pus and tissue from the laboratory from 2019 to 2023. We calculated the proportions of isolates resistant to commonly used antimicrobial classes. We used the chi-square test for trends to evaluate changes in AMR across the study period. Results: Out of the 286 isolates, 104 (43.5%) were from pus, 112 (46.9%) were from tissue samples and the remaining 9.6% were from different fluid aspirates like synovial fluid. Most of the isolates were from males (64.2%) and aged between 19 and 45 years (46.2%). The distribution of whether the bacteria were gram-positive or negative was relatively equal with 114 (45.2%) being gram-negative and 120 (47.6%) gram-positive. Generally, there was increased AMR across all antibiotics from 2019 to 2021 e.g. for Imipinem, it went from 0% in 2019 to 70.8% in 2021 and for Amoxyclav, it went from 10% in 2019 to 93.2% in 2021. There was a general decline in AMR noted from 2021 to 2023. However, currently, the highest resistance is noted in ceftriaxone (80.0%) and the lowest in Imipinem (11.76%). Conclusion: There is a general decreasing trend in AMR, most probably due to increasing policies governing the use of antibiotics. However, there is still high resistance to commonly used and affordable antibiotics. Continuous monitoring of AMR is still recommended to reduce the AMR problem in Uganda at large through public health policy and planning.
基金supported and funded by the National Natural Science Foundation of China(82101079)the Key R&D Program of Jiangsu Province(BE2023836)the National Key Research and Development Program of China(SQ2023YFC2400025).
文摘As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a distributed approach enabling collaborative data processing without sharing raw data,offers promising solutions to challenges in multi-center medical data sharing.This review summarizes the progress of federated learning in multi-center medical data processing,analyzed from four perspectives:system architectures,data distribution strategies,clinical tasks,and algorithmic models.At the same time,this paper explores the challenges in practical applications,such as data heterogeneity,communication overhead,and privacy concerns.It proposes driving future research development by optimizing algorithms,strengthening privacy protection mechanisms,and enhancing computational efficiency.
