Design and implementation of an intelligent monitoring system for household added salt consumption in China based on a real-world study: a randomized controlled trial.

A high intake of salt is a major risk factor for cardiovascular diseases. Despite decades of effort to reduce salt consumption, the salt intake in China is still considerably above the recommended level. Thus, this study aims to design and implement an intelligent household added salt monitoring system (SALTCHECKER) to monitor and control added salt consumption in Chinese households. A randomized controlled trial will be conducted among households to test the effect of a SALTCHECKER in Chongqing, China. The test modalities are the SALTCHECKER (with a smart salt checker and a salt-limiting WeChat mini programme) compared to a salt checker (with only a weighing function). The effectiveness of the system will be investigated by assessing the daily added salt intake of each household member and the salt consumption-related knowledge, attitude and practice (KAP) of the household's main cook. Assessments will be performed at baseline and at 3 and 6 months. This study will be the first to explore the effect of the household added salt monitoring system on the reduction in salt intake in households. If the intelligent monitoring system is found to be effective in limiting household added salt consumption, it could provide scientific evidence on reducing salt consumption and preventing salt-related chronic diseases. Chinese clinical trial registry (Primary registry in the World Health Organization registry network): ChiCTR1800018586. Date of registration: September 25, 2018

Temporal, geographical and demographic trends of stroke prevalence in China: a systematic review and meta-analysis.

China has made large efforts to reduce stroke prevalence. We aimed to systematically examine the prevalence of stroke in China over the past two decades. Databases, including China National Knowledge Infrastructure, Wanfang, VIP, and PubMed, were systematically searched for studies published in English or Chinese that reported stroke prevalence in China during 2000-2017. Meta-analysis was conducted to estimate the pooled stroke prevalence and the variations in stroke prevalence subgroups stratified by age, gender, time period, and region. In total, 96 papers met the inclusion criteria. Meta-analysis showed that the overall estimated national prevalence was 5.1% (5.0-5.3%) with large variations across regions: 3.1% (2.5-3.6%) in south China, 3.4% (3.0-3.8%) in southwest China, 3.6% (3.3-3.8%) in east China, 5.0% (4.7-5.4%) in central China, 5.8% (4.6-7.1%) in northwest China, 6.0% (5.0-7.0%) in northeast China, and 8.0% (7.4-8.5%) in north China. Men had a higher prevalence than women [7.3% (6.9-7.7%) . 5.6% (5.2-6.0%)]. Stroke prevalence increased with age, was 1.2% (1.0-1.3%), 2.9% (2.6-3.2%), 5.9% (5.2-6.5%), and 8.7% (8.0-9.5%) in the 40-49, 50-59, 60-69, and ≥70 years old groups, respectively. Men, people being older, or living in northern China had higher stroke prevalence. More vigorous efforts are needed in China to prevent stroke.Funding: The study was supported in part by research grants from the China Medical Board (Grant No. 16-262), and the National Key Research and Development Program of China (Grant Number: 2017YFC0907200 & 2017YFC0907201), the National Natural Science Foundation of China (Grant Number: NSFC 81703220)

Combination of transbronchial cryobiopsy based clinic-radiologic-pathologic strategy and metagenomic next-generation sequencing for differential diagnosis of rapidly progressive diffuse parenchymal lung diseases

BackgroundThe complicated spectrum of rapidly progressive diffused parenchymal lung diseases (RP-DPLD) creates obstacles to the precise diagnosis and treatment. We evaluated the differential diagnostic value of transbronchial cryobiopsy (TBCB) based clinic-radiologic-pathologic (CRP) strategy combined with bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) in RP-DPLD patients.MethodsRP-DPLD patients who underwent the diagnostic strategy of TBCB-based CRP combined with BALF mNGS at Shanghai East Hospital from May 2020 to Oct 2022 were retrospectively analyzed. Clinical characteristics were summarized, including demographic data, high-resolution computed tomography (HRCT) findings, histopathology of TBCB and microbiological results. Diagnostic value of the combined strategy, as well as the sensitivity, specificity, and positive detection rates of mNGS were evaluated.ResultsA total of 115 RP-DPLD patients were enrolled, with a mean age of 64.4 years old and a male proportion of 54.8%. The pulmonary imaging findings in most patients were complex and diverse, with all patients showing bilateral lung diffuse lesions in HRCT, and progressively aggravated imaging changes within one month. After combining TBCB-based CRP strategy with mNGS, all participants received a corresponding diagnosis with 100% diagnostic yield. In these patients, 58.3% (67/115) were diagnosed with noninfectious RP-DPLD and 41.7% (48/115) with infection-related RP-DPLD. There were 86.1% of cases with known etiology according to the DPLD classification. BALF mNGS and traditional pathogen detection methods were performed in all patients, the positive detection rates were 50.4% (58/115) and 32.2% (37/115), respectively. Meanwhile, the mNGS showed significantly higher sensitivity and negative predictive value than the traditional pathogen detection methods for the diagnosis of infection-related RP-DPLD (100% vs 60.4% (p<0.001), 100% vs 75.6% (p<0.001), respectively). Among noninfectious RP-DPLD patients, the true negative rate of mNGS was 85.1% (57/67). All patients had their treatment regimen modified and the 30-day mortality was 7.0%.ConclusionThe novel strategy of TBCB-based CRP combined with mNGS provided dependable and sufficient evidence for the diagnosis, meanwhile further improved the accuracy of RP-DPLD treatment, as well as the prognosis of patients. Our results highlight the significant value of combined strategy in determining whether the RP-DPLD patients were infection associated or not

Fluorescein-guided surgery for high-grade glioma resection: a five-year-long retrospective study at our institute

ObjectiveThis study investigates the extent of resection, duration of surgery, intraoperative blood loss, and postoperative complications in patients with high-grade glioma who received surgery with or without sodium fluorescein guidance.MethodsA single-center retrospective cohort study was conducted on 112 patients who visited our department and underwent surgery between July 2017 and June 2022, with 61 in the fluorescein group and 51 in the non-fluorescein group. Baseline characteristics, intraoperative blood loss, surgery duration, resection extent, and postoperative complications were documented.ResultsThe duration of surgery was significantly shorter in the fluorescein group than in the non-fluorescein group (P = 0.022), especially in patients with tumors in the occipital lobes (P = 0.013). More critically, the gross total resection (GTR) rate was significantly higher in the fluorescein group than in the non-fluorescein group (45.9% vs. 19.6%, P = 0.003). The postoperative residual tumor volume (PRTV) was also significantly lower in the fluorescein group than in the non-fluorescein group (0.40 [0.12-7.11] cm3 vs. 4.76 [0.44-11.00] cm3, P = 0.020). Particularly in patients with tumors located in the temporal and occipital lobes (temporal, GTR 47.1% vs. 8.3%, P = 0.026; PRTV 0.23 [0.12-8.97] cm3 vs. 8.35 [4.05-20.59] cm3, P = 0.027; occipital, GTR 75.0% vs. 0.0%, P = 0.005; PRTV 0.15 [0.13-1.50] cm3 vs. 6.58 [3.70-18.79] cm3, P = 0.005). However, the two groups had no significant difference in intraoperative blood loss (P = 0.407) or postoperative complications (P = 0.481).ConclusionsFluorescein-guided resection of high-grade gliomas using a special operating microscope is a feasible, safe, and convenient technique that significantly improves GTR rates and reduces postoperative residual tumor volume when compared to conventional white light surgery without fluorescein guidance. This technique is particularly advantageous for patients with tumors located in non-verbal, sensory, motor, and cognitive areas such as the temporal and occipital lobes, and does not increase the incidence of postoperative complications

A Cryophyte Transcription Factor, CbABF1, Confers Freezing, and Drought Tolerance in Tobacco

Abscisic acid responsive element binding factors (ABFs) play crucial roles in plant responses to abiotic stress. However, little is known about the roles of ABFs in alpine subnival plants, which can survive under extreme environmental conditions. Here, we cloned and characterized an ABF1 homolog, CbABF1, from the alpine subnival plant Chorispora bungeana. Expression of CbABF1 was induced by cold, drought, and abscisic acid. Subcellular localization analysis revealed that CbABF1 was located in the nucleus. Further, CbABF1 had transactivation activity, which was dependent on the N-terminal region containing 89 residues. A Snf1-related protein kinase, CbSnRK2.6, interacted with CbABF1 in yeast two-hybrid analysis and bimolecular fluorescence complementation assays. Transient expression assay revealed that CbSnRK2.6 enhanced the transactivation of CbABF1 on ABRE cis-element. We further found that heterologous expression of CbABF1 in tobacco improved plant tolerance to freezing and drought stress, in which the survival rates of the transgenic plants increased around 40 and 60%, respectively, compared with wild-type plants. Moreover, the transgenic plants accumulated less reactive oxygen species, accompanied by high activities of antioxidant enzymes and elevated expression of stress-responsive genes. Our results thus suggest that CbABF1 is a transcription factor that plays an important role in cold and drought tolerance and is a candidate gene in molecular breeding of stress-tolerant crops

On the SPH-distribution class

Following up Neuts’ idea, the SPH-distribution class associated with bounded Q matrices for infinite Markov chains is defined. The main result in this paper is to characterize the SPH class through the derivatives of the distribution functions. Based on the characterization theorem, closure properties, the expansion, uniform approximation, and the matrix representations of the SPH class are also discussed by the derivatives of the distribution functions at origin

Comparing the efficacy of low-load resistance exercise combined with blood flow restriction versus conventional-load resistance exercise in Chinese community-dwelling older people with sarcopenic obesity: a study protocol for a randomised controlled trial

Abstract Introduction Sarcopenic obesity (SO) is characterised by decreased muscle mass, diminished muscle strength and/or reduced physical performance and a high percentage of body fat (PBF). Conventional-load resistance exercise (CRE) may be difficult for older people with SO owing to their declining physical functions. Low-load resistance exercise (LRE) combined with blood flow restriction (BFR; LRE-BFR) is a viable alternative to CRE for improving muscle mass and strength and potential exercise mode for managing SO. This study has two objectives: (1) to comprehensively evaluate the efficacy of CRE and LRE-BFR in improving body composition, muscle strength, physical performance, haematological parameters, cardiovascular disease (CVD) risk factors and quality of life and (2) to compare the efficacy of CRE and LRE-BFR and explore their potential mechanisms. Methods and analysis This work is a 12-week assessor-blinded randomised clinical trial that will be conducted thrice a week. Sarcopenia will be defined using the Asian Working Group for Sarcopenia 2019, and obesity will be determined using the criteria developed by the World Health Organization. Community-dwelling older people aged ≥ 65 years will be screened as the participants using inclusion and exclusion criteria. A total of 33 participants will be randomised into a CRE group (n = 11), an LRE-BFR group (n = 11) and a control group that will be given only health education (n = 11). The primary outcomes will be knee extensor strength and PBF, and the secondary outcomes will be body composition, anthropometric measurements, muscle strength of upper limbs, physical performance, haematological parameters, CVD risk factors and quality of life. The outcomes will be measured at the baseline (week 0), end of the intervention (week 12) and follow up (week 24). All the collected data will be analysed following the intention-to-treat principle. Ethics and dissemination The Ethics Research Committee has approved this study (approval No. CMEC-2022-KT-51). Changes or developments in this study will be reported at www.chictr.org.cn . Trial registration ChiCTR2300067296 (3 January 2023)

Distributed data possession checking for securing multiple replicas in geographically-dispersed clouds

In this paper, we provide a novel efficient Distributed Multiple Replicas Data Possession Checking (DMRDPC) scheme to validate the availability and data integrity in the cloud computing environment. In the DMRDPC scheme, the problem of Finding an Optimal Spanning Tree in a Complete Bidirectional Directed Graph (the FOSTCBDG problem) is vital, since the optimal spanning tree can be used to improve communication efficiency by optimizing the partial order of scheduling multiple replicas data possession checking. Particularly, on the Internet, data routing often aims to minimize the number of hops; but in a clouds environment, multi-hop among clouds may be more efficient than a single hop. With the increasing number of clouds, the FOSTCBDG problem is becoming more and more critical to improve the performance of cloud computing. Thus, we provide basic theories for the FOSTCBDG problem. We also propose an efficient Replace the Smallest Bandwidth Edge (RSBE) algorithm to approximately resolve the FOSTCBDG problem. The effectiveness of our proposed DMRDPC is validated by an experimental study, where bandwidths of a CBDG are simulated by checking the download speeds of several Google websites from the non-Google clouds at multiple locations around the world. JCSS Special Issue: Cloud Computing 201

Cerebral metabolism in HIV infected patients with non-cognitive disorder using single voxel magnetic resonance spectroscopy

Objective: To investigate the variance of metablites, including N-Acetyl aspartate (NAA), Choline (Cho) and Creatine (Cr), in brain regions of HIV infected patients with non-cognitive disorder and healthy volunteers by a 3.0 T magnetic resonance spectroscopy. Methods: Single voxel magnetic resonance spectroscopy was applied to measure the basal ganglia region, frontal lobe and parietal lobe in 69 HIV infected patients and 33 healthy volunteers. According to CD4 T cell count, the patients were divided into 2 groups, group A (≥200 cells/μL, 40 patients) and group B (<200 cells/μL, 29 patients). The normal control group, group C, consisted of 33 healthy volunteers. Results: The patients in groups A and B had lower ratio of NAA/Cr but higher ratio of Cho/Cr in the basal ganglia region than group C (P < 0.001; P = 0.021). Compared to groups B and C, the patients in group A had higher ratios of NAA/Cr and Cho/Cr (P = 0.013; P < 0.001) in the frontal lobe. In the parietal lobe, the patients in group A had higher ratio of Cho/Cr than groups B and C (P = 0.037). Conclusion: HIV infection induces inflammation in basal ganglia region, frontal lobe and parietal lobe before non-cognitive disorder occurs after HIV infection. However, the basal ganga region sees more neurons loss

Arsenic Levels and Speciation from Ingestion Exposures to Biomarkers in Shanxi, China: Implications for Human Health

Chronic exposure to arsenic (As) threatens human health. To systematically understand the health risks induced by As ingestion, we explored water and diet contributions to As exposure, and compared As in biomarkers and the arsenicosis in a geogenic As area in China. In this study, high percentages of water (77% of <i>n</i> = 131 total samples), vegetables (92%, <i>n</i> = 120), cereals (32%, <i>n</i> = 25), urine (70%, <i>n</i> = 99), nails (76%, <i>n</i> = 176), and hair (62%, <i>n</i> = 61) contained As higher than the acceptable levels. Dietary As contributed 92% of the average daily dose (ADD) when the water As concentration was less than 10 μg/L, for which 5 out of 30 examined participants were diagnosed with arsenicosis symptoms. The distinct positive correlation between ADD and As concentrations in urine, nails, and hair suggests different applicability for these biomarkers. Methylated As as the predominant urinary As species confirms that the ingested inorganic As is methylated and is excreted through urine. In situ microdistribution and speciation analysis indicates that As is mainly associated with sulfur in nails and hair. Nails, rather than hair and urine, could be used as a proper biomarker for arsenicosis. High ADD from the environment and low excretion could result in As toxicity to humans