Association between visceral obesity and 10-year risk of first atherosclerotic cardiovascular diseases events among American adults: National Health and Nutrition Examination Survey

BackgroundIn the United States, the relationship between visceral obesity and the risk of developing atherosclerosis cardiovascular disease (ASCVD) for the first time in 10 years is unclear.MethodsData for this cross-sectional study came from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. We collected variable information related to 10-year ASCVD risk and visceral obesity reliable indicators [Visceral obesity index (VAI) and Lipid accumulation product (LAP)]. And we used multiple logistic regression to analyze the correlation of visceral obesity indicators (VAI and LAP) with 10-year ASCVD risk. In addition, we assessed the linear relationship between VAI or LAP and 10-year ASCVD risk by smoothing curve fitting. Finally, we conducted subgroup analysis and sensitivity analysis after excluding participants with extreme VAI and LAP values to ensure that we obtained accurate and reliable results.ResultsOur study included a total of 1,547 participants (mean age: 56.5 ± 10.1, 60% of males). The results of the multiple logistic regression showed that compared with participants with the lowest VAI in the 1st Quartile (≤0.79), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (1.30–2.14), and Q4 (≥2.15) were 2.58 (95% CI: 1.24–5.36, P = 0.011), 15.14 (95% CI: 6.93–33.05, P < 0.001), respectively. Compared with participants with the lowest LAP in the 1st Quartile (≤28.29), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (46.52–77.00), and Q4 (≥77.01) were 4.63 (95% CI: 2.18–9.82, P < 0.001), 16.94 (95% CI: 6.74–42.57, P < 0.001), respectively. Stratified analysis showed that the association between VAI or LAP and the first ASCVD event was more pronounced in males.ConclusionHigher VAI or LAP scores are significantly associated with elevated 10-year ASCVD risk in adults aged 40 to 79 in the USA, which suggested that monitoring visceral obesity is crucial to reduce the risk of a first ASCVD event

Service utilization in community health centers in China: a comparison analysis with local hospitals

BACKGROUND: Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. METHODS: The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1). Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. RESULTS: The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. CONCLUSION: The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service

Characterization of monoclonal antibodies that specifically differentiate field isolates from vaccine strains of classical swine fever virus

Classical swine fever virus (CSFV) is a major animal pathogen threatening the global pork industry. To date, numerous anti-CSFV monoclonal antibodies (mAbs) and their recognizing epitopes have been reported. However, few mAbs were systematically characterized for the capacity to differentiate field CSFV isolates from CSF vaccine strains, and the molecular basis associated with antigenic differences between vaccines and field isolates is still largely unknown. In the present study, recombinant CSFV structural glycoproteins E2 of both virulent and vaccine strains and Erns of vaccine strain were expressed using eukaryotic cells and murine mAbs generated against E2 and Erns. After serial screening and cloning of the hybridomas, the viral spectra of mAbs were respectively determined by indirect fluorescent antibody assay (IFA) using 108 CSFVs, followed by Western blot analysis using expressed glycoproteins of all CSFV sub-genotypes including vaccine strains. The antigenic structures recognized by these mAbs were characterized by epitope mapping using truncated, chimeric, and site-directed mutated E2 and Erns proteins. We have identified two vaccine-specific, one field isolate-specific, and two universal CSFV-specific mAbs and five novel conformational epitopes with critical amino acid (aa) motifs that are associated with these five mAbs: 213EPD215, 271RXGP274, and 37LXLNDG42 on E2 and 38CKGVP42, W81, and D100/V107 on Erns. Particularly, E213 of E2 is field isolate-specific, while N40 of E2 and D100/V107 of Erns are vaccine strain-specific. Results from our study further indicate that N40D of E2 mutation in field strains was likely produced under positive selection associated with long-term mass vaccination, leading to CSFV evasion of host immune response. Taking together, this study provides new insights into the antigenic structure of CSFV E2 and Erns and the differentiating mAbs will contribute to the development of a diagnostic strategy to differentiate C-strain vaccination from natural infection (DIVA) of CSFV in terms of elimination of CSF in China

Role of the CBL family of E3-Ubiquitin ligases in the homeostasis of T follicular helper cells

The germinal center (GC) reaction is a hallmark of the humoral immune response against various pathogen infections. However, the GC reaction must be rigorously controlled because its disturbance is frequently linked to the production of autoantibodies and manifestation of autoimmune diseases. Recent studies have shown that T Follicular helper (TFH) cells play an indispensable role in both GC initiation and progression. While it is known that TFH development, functions and homeostasis must be properly regulated to control the quantity and quality of antibody responses, molecular mechanisms that control TFH biology, as well as that contributing to autoantibody-mediated diseases, remain elusive. In my thesis, I have studied the role of the CBL family of proteins in TFH cell development and function. I have found that ablation of CBLs (Cbl dko) in mouse T cells leads to the development of spontaneous SLE-like disease, characterized by the high serum titers of autoantibodies against dsDNA and ANA and severe kidney glomerulonephritis. Cbl dko mice possess substantially increased numbers of TFH cells and GC B cells. Analysis of Cbl dko TFH cells reveals a marked upregulation of ICOS and BCL6, two master regulators of TFH cells, and increased IL21 production, relative to WT controls. The altered expression of ICOS and BCL6 is not a result of enhanced transcription of the corresponding genes, but rather the reduced degradation of ICOS and BCL6 proteins, possibly due to the blockade of ICOS ubiquitination and BCL6 degradation in chaperon-mediated autophagosomes (CMA), respectively. Interestingly, I have found Cbl dko TFH cells have acquired ability to support bystander autoreactive B cell activation, indicating that CBLs-controlled strict cognate T-B interaction in the GC reaction is necessary to prevent autoantibody production. Together, my studies have identified that CBLs are central regulators in the maintenance of TFH cell homeostasis and GC reaction. My data also suggest that prevention of bystander autoreactive B cells from activation by CBLs or CBL-regulated pathways might contribute to human autoantibody-mediated diseases such as SLE. Further studies in this direction may provide new tools to treat human autoimmune diseases.La réaction du centre germinal (GC) est une caractéristique de la réponse immunitaire humorale contre divers pathogènes infectieux. Toutefois, la réaction du GC doit être rigoureusement contrôlée, car sa perturbation est fréquemment liée à la production d’autoanticorps et à la manifestation de maladies auto-immunes. Des études récentes ont montré que les cellules T folliculaires auxiliaires (TFH) jouent un rôle indispensable dans l’initiation et la progression du GC. Bien que l'on sache que le développement, les fonctions et l'homéostasie de la TFH doivent être correctement régulés pour contrôler la quantité et la qualité des réponses en anticorps, les mécanismes moléculaires contrôlant la biologie de la TFH, ainsi que ceux contribuant à des maladies causées par les autoanticorps, demeurent mal compris. Dans ma thèse, j'ai étudié le rôle de la famille des protéines CBL dans le développement et le fonctionnement des cellules TFH. J'ai découvert que l'ablation de CBL (Cbl dko) dans les cellules T de souris menait au développement d'une maladie spontanée semblable au SLE, caractérisée par des titres sériques élevés d'autoanticorps anti-ADNs et ANA et par une glomérulonéphrite rénale sévère. Les souris Cbl dko possèdent un nombre considérablement accru de cellules TFH et de cellules B GC. L'analyse des cellules Cbl dko TFH révèle une régulation à la hausse marquée d'ICOS et de BCL6, deux régulateurs essentiels des cellules TFH, et une production accrue d'IL21 par rapport aux contrôles WT. L'expression modifiée d'ICOS et de BCL6 n'est pas le résultat d'une transcription améliorée des gènes correspondants, mais plutôt de la dégradation réduite des protéines ICOS et BCL6, probablement en raison du blocage de l'ubiquitination d'ICOS et de la dégradation de BCL6 dans les autophagosomes médiée par le chaperon (CMA), respectivement. Il est intéressant de noter que j’ai observé que les cellules Cbl dko TFH ont acquis la capacité de supporter l’activation des cellules B auto-réactives, ce qui indique que l’interaction T-B de contact contrôlée strictement par les CBL dans la réaction GC est nécessaire pour empêcher la production d’autoanticorps. Ensemble, mes travaux ont identifié les CBL comme des régulateurs centraux dans le maintien de l'homéostasie des cellules TFH et de la réaction de la GC. Mes résultats suggèrent également que la prévention de l'activation des cellules B auto-réactives par des CBL ou des voies régulées par ces dernières pourrait contribuer à des maladies induites par les autoanticorps humains, telles que le LES. Des études complémentaires dans cette direction pourraient fournir de nouveaux outils pour traiter les maladies auto-immunes humaines

Optimal infrastructure condition sampling over space and time for maintenance decision-making under uncertainty

Infrastructure management is the process through which inspection, maintenance, and rehabilitation (IM&R) decisions are made to minimize the total life-cycle cost. Measurement, forecasting, and spatial sampling are three main sources of errors introducing uncertainty into the process. The first two uncertainties are captured in the infrastructure management literature. However, the third one has not been recognized and quantified. This paper presents a methodology where the spatial sampling uncertainty in question is captured and the sample size is incorporated as a decision variable in an optimization framework. An illustrative realistic example is presented to demonstrate an application of the developed framework. The results indicate that by not addressing the sampling uncertainty and decisions, the optimum IM&R decisions would not be achieved, and consequently, marked unnecessary overspending could take place.Infrastructure management Inspection, maintenance, and rehabilitation decision-making Optimization under uncertainty Condition assessment Spatial sampling

Optical Diffractive Convolutional Neural Networks Implemented in an All-Optical Way

Optical neural networks can effectively address hardware constraints and parallel computing efficiency issues inherent in electronic neural networks. However, the inability to implement convolutional neural networks at the all-optical level remains a hurdle. In this work, we propose an optical diffractive convolutional neural network (ODCNN) that is capable of performing image processing tasks in computer vision at the speed of light. We explore the application of the 4f system and the diffractive deep neural network (D2NN) in neural networks. ODCNN is then simulated by combining the 4f system as an optical convolutional layer and the diffractive networks. We also examine the potential impact of nonlinear optical materials on this network. Numerical simulation results show that the addition of convolutional layers and nonlinear functions improves the classification accuracy of the network. We believe that the proposed ODCNN model can be the basic architecture for building optical convolutional networks