A multi-subgroup predictive model based on clinical parameters and laboratory biomarkers to predict in-hospital outcomes of plasma exchange-centered artificial liver treatment in patients with hepatitis B virus-related acute-on-chronic liver failure

BackgroundPostoperative risk stratification is challenging in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) who undergo artificial liver treatment. This study characterizes patients’ clinical parameters and laboratory biomarkers with different in-hospital outcomes. The purpose was to establish a multi-subgroup combined predictive model and analyze its predictive capability.MethodsWe enrolled HBV-ACLF patients who received plasma exchange (PE)-centered artificial liver support system (ALSS) therapy from May 6, 2017, to April 6, 2022. There were 110 patients who died (the death group) and 110 propensity score-matched patients who achieved satisfactory outcomes (the survivor group). We compared baseline, before ALSS, after ALSS, and change ratios of laboratory biomarkers. Outcome prediction models were established by generalized estimating equations (GEE). The discrimination was assessed using receiver operating characteristic analyses. Calibration plots compared the mean predicted probability and the mean observed outcome.ResultsWe built a multi-subgroup predictive model (at admission; before ALSS; after ALSS; change ratio) to predict in-hospital outcomes of HBV-ACLF patients who received PE-centered ALSS. There were 110 patients with 363 ALSS sessions who survived and 110 who did not, and 363 ALSS sessions were analyzed. The univariate GEE models revealed that several parameters were independent risk factors. Clinical parameters and laboratory biomarkers were entered into the multivariate GEE model. The discriminative power of the multivariate GEE models was excellent, and calibration showed better agreement between the predicted and observed probabilities than the univariate models.ConclusionsThe multi-subgroup combined predictive model generated accurate prognostic information for patients undergoing HBV-ACLF patients who received PE-centered ALSS

Conceptual planning of urban–rural green space from a multidimensional perspective: A case study of Zhengzhou, China

The structure and function of green-space system is an eternal subject of landscape architecture, especially due to limited land and a need for the coordinated development of PLEs (production, living, and ecological spaces). To make planning more scientific, this paper explored green-space structure planning via multidimensional perspectives and methods using a case study of Zhengzhou. The paper applies theories (from landscape architecture and landscape ecology) and technologies (like remote sensing, GIS—geographic information system, graph theory, and aerography) from different disciplines to analyze current green-space structure and relevant physical factors to identify and exemplify different green-space planning strategies. Overall, our analysis reveals that multiple green-space structures should be considered together and that planners and designers should have multidisciplinary knowledge. For specific strategies, the analysis finds (i) that green complexes enhance various public spaces and guide comprehensive development of urban spaces; (ii) that green ecological corridors play a critical role in regional ecological stability through maintaining good connectivity and high node degree (Dg) and betweenness centrality index (BC) green spaces; (iii) that greenway networks can integrate all landscape resources to provide more secured spaces for animals and beautiful public spaces for humans; (iv) that blue-green ecological networks can help rainwater and urban flooding disaster management; and (v) that green ventilation corridors provide air cleaning and urban cooling benefits, which can help ensure healthy and comfortable urban–rural environments. In our view, this integrated framework for planning and design green-space structure helps make the process scientific and relevant for guiding future regional green-space structure

A Microarray Study of Middle Cerebral Occlusion Rat Brain with Acupuncture Intervention

Microarray analysis was used to investigate the changes of gene expression of ischemic stroke and acupuncture intervention in middle cerebral artery occlusion (MCAo) rat brain. Results showed that acupuncture intervention had a remarkable improvement in neural deficit score, cerebral blood flow, and cerebral infarction volume of MCAo rats. Microarray analysis showed that a total of 627 different expression genes were regulated in ischemic stroke. 417 genes were upregulated and 210 genes were downregulated. A total of 361 different expression genes were regulated after acupuncture intervention. Three genes were upregulated and 358 genes were downregulated. The expression of novel genes after acupuncture intervention, including Tph1 and Olr883, was further analyzed by Real-Time Quantitative Polymerase Chain Reaction (RT-PCR). Upregulation of Tph1 and downregulation of Olr883 indicated that the therapeutic effect of acupuncture for ischemic stroke may be closely related to the suppression of poststroke depression and regulation of olfactory transduction. In conclusion, the present study may enrich our understanding of the multiple pathological process of ischemic brain injury and indicate possible mechanisms of acupuncture on ischemic stroke

Relation between high density lipoprotein particles concentration and cardiovascular events: a meta-analysis

Abstract Background Trails aimed at raising high density lipoprotein(HDL) cholesterol concentration failed to make better cardiovascular outcomes. HDL particles may be better biomarkers reflecting properties of HDL. This meta-analysis was conducted to evaluate the relation between blood HDL particles level and cardiovascular events. Methods PubMed and other databases were searched for eligible studies and NewCastle-Ottawa Quality Assessment Scale(NOS) was used to assess the quality of included studies. A random or fixed-effect model was applied to calculate the pooled hazard ratio(HR). Results Twelve studies were finally included. The pooled HR(95%confidence interval) for per standard deviation(SD) increment and top quartile versus bottom quartile were 0.79(0.72,0.86) and 0.65(0.57,0.75), respectively. Subgroup analysis suggested that HR was significantly lower in subjects with a cardiovascular disease(CVD) history than that of people without established CVD. Subclass analysis indicated that HRs for per SD increment of small(0.85) and medium(0.84) HDL particles were significantly lower than that of large HDL particles(0.96). Conclusions HDL particle level in blood was inversely related to CVD events, indicating that HDL particles maybe a protective factor in patients with CVD, thus making HDL particles a potential biomarker and therapy target

Land Use Quality Assessment and Exploration of the Driving Forces Based on Location: A Case Study in Luohe City, China

With rapid urban population growth and industrial agglomeration, the urban land supply is becoming gradually tight. Improving land use quality (LUQ) is becoming increasingly critical. This study was carried out in the Luohe built-up zones between 2013 and 2021. The aim is to explore the growth characteristics of LUQ and determine the association between the inner urban location and the growth rate from the perspective of spatial heterogeneity. Therefore, based on a socio-economic-environmental framework, we selected an integration/GDP/population/artificial-surface Rate, and a remote-sensing-based ecological index to construct a LUQ assessment framework that is more stable and applicable for developing urban areas. Additionally, then, multiscale geographical weighted regression is adopted, which can better help us explore the scale of the location factors. The results show that: (1) The LUQ overall growth is gradually slowing. High-quality areas clustered in the urban center and subsystem elements spread outward along the national and provincial highways to drive boundary expansion; (2) In the W/E/SE direction, land use tends more towards physical sprawl than usual development and expansion; (3) Location factors were distinguished as global, semi-global, and local. The global factors constitute the homogenized locational space. Semi-global and local factors constitute a heterogeneous locational space. The latter is critical to guide LUQ growth. LUQ assessment can promote intensive land use. Exploring location factors can further guide the LUQ spatial growth and provide data in support of urban planning

The Variation of UTCI with the Background of Climate Change and Its Implications for Tourism in a Complicated Climate Region in Western China

Tourism plays an important role in Kashgar’s socio-economic development. Climate change has a profound impact on the development of tourism. However, basic research on climate change and its impact on tourism remains insufficient in Kashgar. Using the atmospheric reanalysis data ERA5 and the universal thermal climate index (UTCI) model, climate change and climate comfort were evaluated from 1979 to 2018. The annual mean UTCI was −2.3 °C, i.e., at the coolish level, with moderate cold stress, illustrating that Kashgar’s tourism climate was weak. The obvious increase in the annual mean air temperature led to an obviously increased UTCI and a lengthened comfortable period, which provides possibilities to exploit an attractive climate and the potential for tourism. The poor climate conditions imply that the development of Kashgar’s tourism should depend more on the diversification and uniqueness of tourism products and the quality of tourism services. Therefore, the development of increased tourism products and the expansion of tourism regions, in the context of improving climate conditions, were focused on. We expect this case study to provide a reference for consumer travel decision-making and a necessary scientific basis for the planning and implementation of a tourism-based national promotional strategy in western China

DNA damage response activated by high calcium and phosphorus induces premature aging of human aortic smooth muscle cells

Objective To investigate the mechanism of DNA damage response(DDR) pathway regulating calcification in human aortic smooth muscle cells(HASMCs). Methods The HASMCs were divided into the control group, model group, ATM treatment group, and PARP treatment group, and they were cultured for 12 days. Cell calcification was measured by Alizarin red staining and σ-Cresolphthalein; phosphorylation levels of histone γH2AX, protein levels of p16 and p21, and phosphorylation levels of ATM on Ser1981 were tested by Western blot, premature cell senescence by β-galactosidase staining; and p16 and p21 mRNA by qPCR. The level of oxidative stress was measured by 8-hydroxy-2′-deoxyguanosine (8-OHDG), and the level of IL-6 and IL-8 was measured by ELISA kit. Results The calcification was evident in the model group as compared with that in control group. There were significant changes in 8-OHDG, histone γH2AX phosphorylation, β -galactosidase staining, mRNA and protein of p16, p21 mRNA, release of IL 6 and IL 8 and ATM phosphorylation(P＜0.05).The changes in the model group alleviated by ATM and PARP treatment. Conclusions High calcium and phosphorus environment stimulates HASMCs to produce sustained DNA damage, triggers ATM phosphorylation, activates p16 protein expression, and induces premature cell senescence causing cell death and resulted in calcification

Highly stable Pt\u3csub\u3e3\u3c/sub\u3eNi nanowires tailored with trace Au for the oxygen reduction reaction

\u3cp\u3eOne dimensional and bimetallic platinum nickel (PtNi) nanowires are a representative type of electrocatalyst with efficient oxygen reduction reaction (ORR) activity, while the catalytic stability is limited and still needs to be addressed. Herein, thin Pt\u3csub\u3e3\u3c/sub\u3eNi nanowires were successfully synthesized with superior ORR activity and stability compared with the commercial Pt/C catalyst, and notably, the durability of the catalyst can be further boosted by the in situ deposition of trace Au during the synthetic process without sacrificing the high ORR activity. The mass and specific activity of the optimized catalyst were 3.08 A mg\u3csub\u3ePt\u3c/sub\u3e\u3csup\u3e-1\u3c/sup\u3e and 5.74 mA cm\u3csup\u3e-2\u3c/sup\u3e, respectively, which are approximately 14.7 and 16.9-fold that of a commercial JM Pt/C catalyst. Most importantly, the catalyst shows negligible performance degradation after 20000 continuous potential cycles, and the structural stability of the catalyst was also confirmed by comprehensive measurements. The DFT data confirmed that decoration with Au atoms could effectively stabilize the Pt\u3csub\u3e3\u3c/sub\u3eNi structure and composition by reducing the defect sites of Pt\u3csub\u3e3\u3c/sub\u3eNi-skin and suppressing the dissolution of Ni atoms. This work provides a strategic approach for rational fabrication of high-performance ORR electrocatalysts with satisfactory durability.\u3c/p\u3