Publications by authors named "Miao Cai"

62 Publications

Tandem molecular self-assembly for selective lung cancer therapy with an increase in efficiency by two orders of magnitude.

Nanoscale 2021 Jun 14. Epub 2021 Jun 14.

State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Collaborative Innovation Center of Chemical Science and Engineering, and National Institute of Functional Materials, Nankai University, Tianjin 300071, P. R. China.

In situ self-assembly of prodrug molecules into nanomedicine can elevate the therapeutic efficacy of anticancer medications by enhancing the targeting and enrichment of anticancer drugs at tumor sites. However, the disassembly and biodegradation of nanomedicine after enrichment prevents the further improvement of the efficiency, and avoiding such disassembly and biodegradation remains a challenge. Herein, we rationally designed a tandem molecular self-assembling prodrug that could selectively improve the therapeutic efficacy of HCPT against lung cancer by two orders of magnitude. The tandem molecular self-assembly utilized an elevated level of alkaline phosphatase and reductase in lung cancer cells. The prodrug first self-assembled into nanofibers by alkaline phosphatase catalysis and was internalized more efficiently by lung cancer cells than free HCPT. The resulting nanofiber was next catalyzed by intracellular reductase to form a more hydrophobic nanofiber that prevented the disassembly and biodegradation, which further significantly improved the efficacy of HCPT against lung cancer both in vitro and in vivo.
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http://dx.doi.org/10.1039/d1nr01174jDOI Listing
June 2021

Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study.

Environ Int 2021 Sep 9;154:106564. Epub 2021 Apr 9.

Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Department of Medicine, Washington University in Saint Louis, 4921 Parkview Pl, Saint Louis, MO 63110, United States; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, 915 N Grand Blvd, Saint Louis, MO 63106, United States; Institute for Public Health, Washington University in Saint Louis, 600 S Taylor Ave, Saint Louis, MO 63110, United States. Electronic address:

Background: Ecologic analyses suggest that living in areas with higher levels of ambient fine particulate matter air pollution (PM) is associated with higher risk of adverse COVID-19 outcomes. Studies accounting for individual-level health characteristics are lacking.

Methods: We leveraged the breadth and depth of the US Department of Veterans Affairs national healthcare databases and built a national cohort of 169,102 COVID-19 positive United States Veterans, enrolled between March 2, 2020 and January 31, 2021, and followed them through February 15, 2021. Annual average 2018 PM exposure, at an approximately 1 km resolution, was linked with residential street address at the year prior to COVID-19 positive test. COVID-19 hospitalization was defined as first hospital admission between 7 days prior to, and 15 days after, the first COVID-19 positive date. Adjusted Poisson regression assessed the association of PM with risk of hospitalization.

Results: There were 25,422 (15.0%) hospitalizations; 5,448 (11.9%), 5,056 (13.0%), 7,159 (16.1%), and 7,759 (19.4%) were in the lowest to highest PM quartile, respectively. In models adjusted for State, demographic and behavioral factors, contextual characteristics, and characteristics of the pandemic a one interquartile range increase in PM (1.9 µg/m) was associated with a 10% (95% CI: 8%-12%) increase in risk of hospitalization. The association of PM and risk of hospitalization among COVID-19 individuals was present in each wave of the pandemic. Models of non-linear exposure-response suggested increased risk at PM concentrations below the national standard 12 µg/m. Formal effect modification analyses suggested higher risk of hospitalization associated with PM in Black people compared to White people (p = 0.045), and in those living in socioeconomically disadvantaged neighborhoods (p < 0.001).

Conclusions: Exposure to higher levels of PM was associated with increased risk of hospitalization among COVID-19 infected individuals. The risk was evident at PM levels below the regulatory standards. The analysis identified those of Black race and those living in disadvantaged neighborhoods as population groups that may be more susceptible to the untoward effect of PM on risk of hospitalization in the setting of COVID-19.
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http://dx.doi.org/10.1016/j.envint.2021.106564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040542PMC
September 2021

Association between maternal outdoor physical exercise and the risk of preterm birth: a case-control study in Wuhan, China.

BMC Pregnancy Childbirth 2021 Mar 12;21(1):206. Epub 2021 Mar 12.

Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA.

Background: China had the second largest proportion of preterm birth (PTB) internationally. However, only 11% of pregnant women in China meet international guidelines for maternal physical activity, a significantly lower proportion than that in Western countries. This study aims to examine the association between outdoor physical exercise during pregnancy and PTB among Chinese women in Wuhan, China.

Methods: A case-control study was conducted among 6656 pregnant women (2393 cases and 4263 controls) in Wuhan, China from June 2011 to June 2013. Self-reported measures of maternal physical exercise (frequency per week and per day in minutes) were collected. Adjusted odds ratios were estimated using Bayesian hierarchical logistic regression and a generalized additive mixed model (GAMM).

Results: Compared to women not involved in any physical activity, those who participated in physical exercise 1-2 times, 3-4 times, and over five times per week had 20% (aOR: 0.80, 95% credible interval [95% CI]: 0.68-0.92), 30% (aOR: 0.70, 95% CI: 0.60-0.82), and 32% (aOR: 0.68, 95% CI: 0.59-0.78) lower odds of PTB, respectively. The Bayesian GAMM showed that increasing physical exercise per day was associated with lower risk of PTB when exercise was less than 150 min per day; however, this direction of association is reversed when physical exercise was more than 150 min per day.

Conclusion: Maternal physical exercise, at a moderate amount and intensity, is associated with lower PTB risk. More data from pregnant women with high participation in physical exercise are needed to confirm the reported U-shape association between the physical exercise and risk of preterm birth.
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http://dx.doi.org/10.1186/s12884-021-03678-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955628PMC
March 2021

Temporal Trends in Incidence Rates of Lower Extremity Amputation and Associated Risk Factors Among Patients Using Veterans Health Administration Services From 2008 to 2018.

JAMA Netw Open 2021 01 4;4(1):e2033953. Epub 2021 Jan 4.

Clinical Epidemiology Center, Department of Veterans Affairs, St Louis Health Care Systems, St Louis, Missouri.

Importance: Lower extremity amputation (LEA) is associated with significant morbidity and mortality. However, national temporal trends of LEA incidence rates among US veterans and associated factors have not been well characterized.

Objective: To describe the temporal trends of LEA, characterize associated risk factors, and decompose the associations of these risk factors with changes in temporal trends of LEA among US veterans using Department of Veteran Affairs (VA) services between 2008 and 2018.

Design, Setting, And Participants: This cohort study used VA data from 2008 to 2018 to estimate incidence rates of LEA among veterans using VA services. Cox regression models were used to identify risk factors associated with LEA. Decomposition analyses estimated the associations of changes in prevalence of risk factors with changes in LEA rates. Data were analyzed from October 1, 2007, to September 30, 2018.

Main Outcomes And Measures: Toe, transmetatarsal, below-knee, or above-knee LEA.

Results: A total of 6 493 141 veterans were included (median [interquartile range] age, 64 [54-76] years; 6 060 390 [93.4%] men). Veterans were studied for a median (interquartile range) of 10.9 (5.6-11.0) years. Between 2008 and 2018, rates of LEA increased from 12.89 (95% CI, 12.53-13.25) LEA per 10 000 persons to 18.12 (95% CI, 17.70-18.54) LEA per 10 000 persons, representing a net increase of 5.23 (95% CI, 4.68-5.78) LEA per 10 000 persons. Between 2008 and 2018, toe amputation rates increased by 3.24 (2.89-3.59) amputations per 10 000 persons, accounting for 62.0% of the total increase in LEA rates. Transmetatarsal amputations increased by 1.54 (95% CI, 1.27-1.81) amputations per 10 000 persons; below-knee amputation rates increased by 0.81 (95% CI, 0.56-1.05) amputations per 10 000 persons; and above-knee amputation rates decreased by 0.37 (95% CI, 0.14-0.59) amputations per 10 000 persons. Compared with men, women had decreased risk of any LEA (hazard ratio [HR], 0.34 [95% CI, 0.31-0.37]). Factors associated with increased risk of any LEA included Black race (HR, 1.25 [95% CI, 1.21-1.28]) or another non-White race (ie, Asian, Latino, or other; HR, 2.36 [95% CI, 2.30-2.42]), obesity (HR, 1.59 [95% CI, 1.55-1.63]), diabetes (HR, 6.38 [95% CI, 6.22-6.54]), chronic kidney disease (CKD; eg, CKD stage 5: HR, 3.94 [95% CI, 3.22-4.83]), and smoking status (eg, current smoking: HR, 1.97 [95% CI, 1.92-2.03]). Decomposition analyses suggested that while changes in demographic composition, primarily driven by increased proportion of women veterans, associated with a decrease of 0.18 (95% CI, 0.14-0.22) LEA per 10 000 persons, and decreases in smoking rates, associated with a decrease of 0.88 (95% CI, 0.79-0.97) LEA per 10 000 persons. However, these were overwhelmed by increased rates of diabetes, associated with an increase of 1.86 (95% CI, 1.72-1.99) LEA per 10 000 persons; peripheral arterial disease, associated with an increase of 1.53 (95% CI, 1.41-1.65) LEA per 10 000 persons; CKD, associated with an increase of 1.45 (95% CI, 1.33-1.57) LEA per 10 000 persons; and other clinical factors, including body mass index, cancer, cardiovascular disease, cerebrovascular disease, chronic lung disease, dementia, and hypertension, associated with an increase of 1.45 (95% CI, 1.33-1.57) LEA per 10 000 persons.

Conclusions And Relevance: This cohort study found that incidence rates of LEA among veterans using VA services increased between 2008 and 2018. Efforts aimed at reducing burden of LEA should target the reduction of diabetes, peripheral arterial disease, and CKD at the individual and population levels.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.33953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823225PMC
January 2021

County-Level Contextual Characteristics and Disparities in Life Expectancy.

Mayo Clin Proc 2021 01;96(1):92-104

Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, MO; Veterans Research & Education Foundation of Saint Louis, Saint Louis, MO; Department of Medicine, Washington University School of Medicine, Saint Louis, MO; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, Saint Louis, MO; Institute for Public Health, Washington University in Saint Louis, Saint Louis, MO. Electronic address:

Objective: To estimate the contribution of county-level contextual factors to differences in life expectancy in the United States.

Methods: We used a counterfactual approach to estimate the years of life expectancy lost associated with 45 potentially modifiable county-level contextual characteristics in the United States in the year 2016. Contextual data and life expectancy data were obtained from the County Health Ranking Project and the U.S. Small-Area Life Expectancy Estimates Project, respectively.

Results: Median census-tract-level life expectancy was 78.90 (interquartile range, 76.30-81.00) years, and the range across census tracts spanned 41.20 years. Large variations in life expectancy existed within and between states and within and between counties; the gap between counties was 20.30 years and gaps within counties ranged from 0 to 34.60 years. An array of 45 county-level factors was associated with 4.30 years of life expectancy loss. County-level adult smoking, food insecurity, adult obesity, physical inactivity, college education, and median household income were associated with 1.24-, 0.89-, 0.58-, 0.35-, 0.33-, and 0.14-year losses in life expectancy, respectively; and altogether were associated with a 3.53-year loss in life expectancy. The contribution of contextual factors to years of life expectancy lost varied among states and was more pronounced in states with lower life expectancy and in areas of increased socioeconomic deprivation and increased percentage of Black race.

Conclusion: Substantial geographic variation in life expectancy was observed. Six county-level contextual factors were associated with a 3.53-year loss in life expectancy. The findings may inform and help prioritize approaches to reduce inequalities in life expectancy in the United States.
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http://dx.doi.org/10.1016/j.mayocp.2020.04.043DOI Listing
January 2021

Improving the Level of the Tyrosine Biosynthesis Pathway in through Knockout and Atmospheric and Room Temperature Plasma (ARTP) Mutagenesis.

ACS Synth Biol 2021 01 4;10(1):49-62. Epub 2021 Jan 4.

The Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, College of Life Sciences, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin 300071, PR China.

In recent years, many studies have been conducted on the expression of multiple aromatic compounds by . The concentration of l-tyrosine, as a precursor of such valuable compounds, is crucial for the biosynthesis of aromatic metabolites. In this study, a novel function of was found to be related to tyrosine biosynthesis, which has not yet been reported. Knockout of this gene could significantly improve the ability of yeast cells to synthesize tyrosine, and its -coumaric acid (-CA) titer was approximately 3.9-fold higher than that of the wild-type strain BY4742. Subsequently, this strain was selected for random mutagenesis through an emerging mutagenesis technique, namely, atmospheric and room temperature plasma (ARTP). After two rounds of mutagenesis, five tyrosine high-producing mutants were obtained. The highest production of -CA was 7.6-fold higher than that of the wild-type strain. Finally, transcriptome data of the strain and the five mutants were analyzed. The genome of mutagenic strains was also resequenced to reveal the mechanism underlying the high titer of tyrosine. This system of target engineering combined with random mutagenesis to screen excellent mutants provides a new basis for synthetic biology.
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http://dx.doi.org/10.1021/acssynbio.0c00448DOI Listing
January 2021

A Novel Microwave Treatment for Sleep Disorders and Classification of Sleep Stages Using Multi-Scale Entropy.

Entropy (Basel) 2020 Mar 17;22(3). Epub 2020 Mar 17.

College of Continuing Education, Guilin University of Electronic Technology, Guilin 541004, China.

The aim of this study was to develop an integrated system of non-contact sleep stage detection and sleep disorder treatment for health monitoring. Hence, a method of brain activity detection based on microwave scattering technology instead of scalp electroencephalogram was developed to evaluate the sleep stage. First, microwaves at a specific frequency were used to penetrate the functional sites of the brain in patients with sleep disorders to change the firing frequency of the activated areas of the brain and analyze and evaluate statistically the effects on sleep improvement. Then, a wavelet packet algorithm was used to decompose the microwave transmission signal, the refined composite multiscale sample entropy, the refined composite multiscale fluctuation-based dispersion entropy and multivariate multiscale weighted permutation entropy were obtained as features from the wavelet packet coefficient. Finally, the mutual information-principal component analysis feature selection method was used to optimize the feature set and random forest was used to classify and evaluate the sleep stage. The results show that after four times of microwave modulation treatment, sleep efficiency improved continuously, the overall maintenance was above 80%, and the insomnia rate was reduced gradually. The overall classification accuracy of the four sleep stages was 86.4%. The results indicate that the microwaves with a certain frequency can treat sleep disorders and detect abnormal brain activity. Therefore, the microwave scattering method is of great significance in the development of a new brain disease treatment, diagnosis and clinical application system.
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http://dx.doi.org/10.3390/e22030347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516818PMC
March 2020

Entropy Generation Methodology for Defect Analysis of Electronic and Mechanical Components-A Review.

Entropy (Basel) 2020 Feb 23;22(2). Epub 2020 Feb 23.

School of Mechanical and Electrical Engineering, Guilin University of Electronic Technology, Guilin 541004, China.

Understanding the defect characterization of electronic and mechanical components is a crucial step in diagnosing component lifetime. Technologies for determining reliability, such as thermal modeling, cohesion modeling, statistical distribution, and entropy generation analysis, have been developed widely. Defect analysis based on the irreversibility entropy generation methodology is favorable for electronic and mechanical components because the second law of thermodynamics plays a unique role in the analysis of various damage assessment problems encountered in the engineering field. In recent years, numerical and theoretical studies involving entropy generation methodologies have been carried out to predict and diagnose the lifetime of electronic and mechanical components. This work aimed to review previous defect analysis studies that used entropy generation methodologies for electronic and mechanical components. The methodologies are classified into two categories, namely, damage analysis for electronic devices and defect diagnosis for mechanical components. Entropy generation formulations are also divided into two detailed derivations and are summarized and discussed by combining their applications. This work is expected to clarify the relationship among entropy generation methodologies, and benefit the research and development of reliable engineering components.
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http://dx.doi.org/10.3390/e22020254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516701PMC
February 2020

Acute Kidney Injury in a National Cohort of Hospitalized US Veterans with COVID-19.

Clin J Am Soc Nephrol 2020 12 16;16(1):14-25. Epub 2020 Nov 16.

Clinical Epidemiology Center, Research and Development Service, Veterans Affairs St. Louis Health Care System, St. Louis, Missouri

Background And Objectives: Coronavirus disease 2019 (COVID-19) is associated with higher risk of AKI. We aimed to describe rates and characterize predictors and health outcomes associated with AKI in a national cohort of US veterans hospitalized with COVID-19.

Design, Setting, Participants, & Measurements: In a cohort of 5216 US veterans hospitalized with COVID-19 identified through July 23, 2020, we described changes in serum creatinine and examined predictors of AKI and the associations between AKI, health resource utilization, and death, utilizing logistic regressions. We characterized geographic and temporal variations in AKI rates and estimated variance explained by key variables utilizing Poisson regressions.

Results: In total, 1655 (32%) participants had AKI; 961 (58%), 223 (13%), and 270 (16%) met Kidney Disease Improving Global Outcomes definitions of stage 1, 2, and 3 AKI, respectively, and 201 (12%) received KRT. Eight percent of participants had AKI within 1 day of hospitalization, and 47% did not recover to baseline serum creatinine by discharge. Older age, Black race, male gender, obesity, diabetes, hypertension, and lower eGFR were significant predictors of AKI during hospitalization with COVID-19. AKI was associated with higher mechanical ventilation use (odds ratio, 6.46; 95% confidence interval, 5.52 to 7.57) and longer hospital stay (5.56 additional days; 95% confidence interval, 4.78 to 6.34). AKI was also associated with higher risk of death (odds ratio, 6.71; 95% confidence interval, 5.62 to 8.04); this association was stronger in Blacks ( value of interaction <0.001). Hospital-level rates of AKI exhibited substantial geographic variability, ranging from 10% to 56%. Between March and July 2020, AKI rates declined from 40% to 27%; proportions of AKI stage 3 and AKI requiring KRT decreased from 44% to 17%. Both geographic and temporal variabilities were predominately explained by percentages of Blacks (31% and 49%, respectively).

Conclusions: AKI is common during hospitalization with COVID-19 and associated with higher risk of health care resource utilization and death. Nearly half of patients with AKI did not recover to baseline by discharge. Substantial geographic variation and temporal decline in rates and severity of AKI were observed.

Podcast: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_11_16_CJN09610620_final.mp3.
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http://dx.doi.org/10.2215/CJN.09610620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792643PMC
December 2020

Differential effects of different delivery methods on progression to severe postpartum hemorrhage between Chinese nulliparous and multiparous women: a retrospective cohort study.

BMC Pregnancy Childbirth 2020 Oct 31;20(1):660. Epub 2020 Oct 31.

Peking University Shenzhen Hospital, Shenzhen, 518036, China.

Background: Delivery methods are associated with postpartum hemorrhage (PPH) both in nulliparous and multiparous women. However, few studies have examined the difference in this association between nulliparous and multiparous women. This study aimed to explore the difference of maternal and neonatal characteristics and delivery methods between Chinese nulliparous and multiparous women, and then examine the differential effects of different delivery methods on PPH between these two-type women.

Methods: Totally 151,333 medical records of women who gave birth between April 2013 to May 2016 were obtained from the electronic health records (EHR) in a northern province, China. The severity of PPH was estimated and classified into blood loss at the level of < 900 ml, 900-1500 ml, 1500-2100 ml, and > 2100 ml. Neonatal and maternal characteristics related to PPH were derived from the same database. Multiple ordinal logistic regression was used to estimate associations.

Results: Medical comorbidities, placenta previa and accreta were higher in the nulliparous group and the episiotomy rate was higher in the multiparous group. Compared with spontaneous vaginal delivery (SVD), the adjusted odds (aOR) for progression to severe PPH due to the forceps-assisted delivery was much higher in multiparous women (aOR: 9.32; 95% CI: 3.66-23.71) than in nulliparous women (aOR: 1.70; 95% CI: 0.91-3.18). The (aOR) for progression to severe PPH due to cesarean section (CS) compared to SVD was twice as high in the multiparous women (aOR: 4.32; 95% CI: 3.03-6.14) as in the nulliparous women (aOR: 2.04; 95% CI: 1.40-2.97). However, the (aOR) for progression to severe PPH due to episiotomy compared to SVD between multiparous (aOR: 1.24; 95% CI: 0.96-1.62) and nulliparous women (aOR: 1.55; 95% CI: 0.92-2.60) was not significantly different. The (aOR) for progression to severe PPH due to vacuum-assisted delivery compared to SVD in multiparous women (aOR: 2.41; 95% CI: 0.36-16.29) was not significantly different from the nulliparous women (aOR: 1.05; 95% CI: 0.40-2.73).

Conclusions: Forceps-assisted delivery and CS methods were found to increase the risk of severity of the PPH. The adverse effects were even greater for multiparous women. Episiotomy and the vacuum-assisted delivery, and SVD were similar to the risk of progression to severe PPH in either nulliparous or multiparous women. Our findings have implications for the obstetric decision on the choice of delivery methods, maternal and neonatal health care, and obstetric quality control.
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http://dx.doi.org/10.1186/s12884-020-03351-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603680PMC
October 2020

LvCSN5 is involved in WSSV infection via interaction with wsv006.

Dev Comp Immunol 2021 Jan 13;114:103870. Epub 2020 Sep 13.

Key Laboratory of Maricultural Organism Disease Control Ministry of Agriculture, Qingdao Key Laboratory of Mariculture Epidemiology and Biosecurity, Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao, China; Laboratory for Marine Fisheries Science and Food Production Processes, Qingdao National Laboratory for Marine Science and Technology, China. Electronic address:

As an extremely virulent pathogen, white spot syndrome virus (WSSV) greatly threatens shrimp aquaculture worldwide. The interaction between virus and host is important for viral infection. In the present study, a yeast two-hybrid (Y2H) library was constructed to clarify the functions of wsv006, and the interaction between wsv006 and shrimp Litopenaeus vannamei (L. vannamei) was analyzed. Furthermore, we explored the role of the wsv006-interacting molecule L. vannamei COP9 constitutive photomorphogenic-like protein subunit 5 (LvCSN5) in WSSV infection. Y2H assay showed that wsv006 interacted with LvCSN5, and co-immunoprecipitation (Co-IP) assay confirmed such interaction. Multiple alignments of amino acid sequences with other species revealed that the LvCSN5 had high identity with Penaeusmonodon CSN5 (PmCSN5). LvCSN5 was mainly expressed in intestine, eye and hepatopancreas. In addition, the relative expression of LvCSN5 was significantly up-regulated both in intestine and hepatopancreas following the WSSV challenge. Besides, the relative expressions of IE1 and VP28, as well as the viral copy numbers were significantly increased in the LvCSN5-silenced shrimp. Our findings suggested that LvCSN5 was involved in WSSV infection by interacting with wsv006.
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http://dx.doi.org/10.1016/j.dci.2020.103870DOI Listing
January 2021

Holiday and weekend effects on mortality for acute myocardial infarction in Shanxi, China: a cross-sectional study.

Int J Public Health 2020 Jul 31;65(6):847-857. Epub 2020 Jul 31.

Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Objectives: To examine the effects of holiday and weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in China.

Methods: Patients with AMI in 31 tertiary hospitals in Shanxi, China from 2014 to 2017 were included (N = 54,968). Multivariable logistic regression models were used to examine the effects of holiday and weekend admission on in-hospital mortality.

Results: Compared to non-holiday and weekday admissions, holiday and weekend admissions, respectively, were associated with increases in risk-adjusted mortality rates. Chinese National Day was associated with an additional 10 deaths per 1000 admissions (95% confidence interval (CI): (0, 20))-a relative increase from baseline mortality of 64% (95% CI: (1%, 128%)). Sunday was associated with an additional 4 deaths per 1000 admissions (95% CI: (0, 7))-a relative increase from baseline mortality of 23% (95% CI: (3%, 45%)). We found no evidence of gender differences in holiday or weekend effects on mortality.

Conclusions: Holiday and weekend admissions were associated with in-hospital AMI mortality. The admissions on Chinese National Day and Sunday contributed to the observed "holiday effect" and "weekend effect," respectively.
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http://dx.doi.org/10.1007/s00038-020-01443-xDOI Listing
July 2020

Optimization of the l-tyrosine metabolic pathway in by analyzing -coumaric acid production.

3 Biotech 2020 Jun 18;10(6):258. Epub 2020 May 18.

The Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, College of Life Sciences, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin, 300071 People's Republic of China.

In this study, we applied a series of genetic modifications to wild-type strain BY4741 to address the bottlenecks in the l-tyrosine pathway. A tyrosine ammonia-lyase (TAL) gene from , which can catalyze conversion of l-tyrosine into -coumaric acid, was overexpressed to facilitate the analysis of l-tyrosine and test the strain's capability to synthesize heterologous derivatives. First, we enhanced the supply of precursors by overexpressing transaldolase gene , enolase II gene , and pentafunctional enzyme gene resulting in a 1.55-fold increase in -coumaric acid production. Second, feedback inhibition of 3-deoxy-d-arabino-heptulosonate-7-phosphate synthase and chorismate mutase was relieved by overexpressing the mutated feedback-resistant and , and a 3.61-fold improvement of -coumaric acid production was obtained. Finally, formation of byproducts was decreased by deleting pyruvate decarboxylase gene and phenylpyruvate decarboxylase gene , and -coumaric acid production was increased 2.52-fold. The best producer-when , , , , , and were overexpressed, and and were deleted-increased -coumaric acid production by 14.08-fold (from 1.4 to 19.71 mg L). Our study provided a valuable insight into the optimization of l-tyrosine metabolic pathway.
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http://dx.doi.org/10.1007/s13205-020-02223-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275107PMC
June 2020

The global and national burden of chronic kidney disease attributable to ambient fine particulate matter air pollution: a modelling study.

BMJ Glob Health 2020 25;5(3):e002063. Epub 2020 Mar 25.

Clinical Epidemiology Center, VA Saint Louis Health Care System, Saint Louis, Missouri, USA.

Introduction: We aimed to integrate all available epidemiological evidence to characterise an exposure-response model of ambient fine particulate matter (PM) and the risk of chronic kidney disease (CKD) across the spectrum of PM concentrations experienced by humans. We then estimated the global and national burden of CKD attributable to PM.

Methods: We collected data from prior studies on the association of PM with CKD and used an integrative meta-regression approach to build non-linear exposure-response models of the risk of CKD associated with PM exposure. We then estimated the 2017 global and national incidence, prevalence, disability-adjusted life-years (DALYs) and deaths due to CKD attributable to PM in 194 countries and territories. Burden estimates were generated by linkage of risk estimates to Global Burden of Disease study datasets.

Results: The exposure-response function exhibited evidence of an increase in risk with increasing PM concentrations, where the rate of risk increase gradually attenuated at higher PM concentrations. Globally, in 2017, there were 3 284 358.2 (95% UI 2 800 710.5 to 3 747 046.1) incident and 122 409 460.2 (108 142 312.2 to 136 424 137.9) prevalent cases of CKD attributable to PM, and 6 593 134.6 (5 705 180.4 to 7 479 818.4) DALYs and 211 019.2 (184 292.5 to 236 520.4) deaths due to CKD attributable to PM. The burden was disproportionately borne by low income and lower middle income countries and exhibited substantial geographic variability, even among countries with similar levels of sociodemographic development. Globally, 72.8% of prevalent cases of CKD attributable to PM and 74.2% of DALYs due to CKD attributable to PM were due to concentrations above 10 µg/m, the WHO air quality guidelines.

Conclusion: The global burden of CKD attributable to PM is substantial, varies by geography and is disproportionally borne by disadvantaged countries. Most of the burden is associated with PM levels above the WHO guidelines, suggesting that achieving those targets may yield reduction in CKD burden.
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http://dx.doi.org/10.1136/bmjgh-2019-002063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173767PMC
March 2020

Comparing the Performance of Charlson and Elixhauser Comorbidity Indices to Predict In-Hospital Mortality Among a Chinese Population.

Clin Epidemiol 2020 18;12:307-316. Epub 2020 Mar 18.

Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA.

Objective: Earlier comorbidity measures have been developed or validated using the North American population. This study aims to compare five Charlson or Elixhauser comorbidity indices to predict in-hospital mortality using a large electronic medical record database from Shanxi, China.

Methods: Using the primary diagnosis code and surgery procedure codes, we identified four hospitalized patient cohorts, hospitalized between 2013 and 2017, in Shanxi, China, as follows: congestive heart failure (CHF, n=41,577), chronic renal failure (CRF, n=40,419), diabetes (n=171,355), and percutaneous coronary intervention (PCI, n=39,097). We used logistic regression models and -statistics to evaluate the in-hospital mortality predictive performance of two multiple comorbidity indicator variables developed by Charlson in 1987 and Elixhauser in 1998 and three single numeric scores by Quan in 2011, van Walraven in 2009, and Moore 2017.

Results: Elixhauser comorbidity indicator variables had consistently higher -statistics (0.824, 0.843, 0.904, 0.853) than all other four comorbidity measures, across all four disease cohorts. Moore's comorbidity score outperformed the other two score systems in CHF, CRF, and diabetes cohorts (-statistics: 0.776, 0.832, 0.869), while van Walraven's score outperformed all others among PCI patients (-statistics: 0.827).

Conclusion: Elixhauser comorbidity indicator variables are recommended, when applied to large Chinese electronic medical record databases, while Moore's score system is appropriate for relatively small databases.
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http://dx.doi.org/10.2147/CLEP.S241610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090198PMC
March 2020

Multilevel Associations Between Patient- and Hospital-Level Factors and In-Hospital Mortality Among Hospitalized Patients With Head and Neck Cancer.

JAMA Otolaryngol Head Neck Surg 2020 05;146(5):444-454

Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.

Importance: Risk factors for in-hospital mortality of patients with head and neck cancer (HNC) are multilevel. Studies have examined the effect of patient-level characteristics on in-hospital mortality; however, there is a paucity of data on multilevel correlates of in-hospital mortality.

Objective: To examine the multilevel associations of patient- and hospital-level factors with in-hospital mortality and develop a nomogram to predict the risk of in-hospital mortality among patients diagnosed with HNC.

Design, Setting, And Participants: This cross-sectional study used the 2008-2013 National Inpatient Sample database. Hospitalized patients 18 years and older diagnosed (both primary and secondary diagnosis) as having HNC using the International Classification of Diseases, Ninth Revision, Clinical Modification codes were included. Analysis began December 2018.

Main Outcomes And Measures: The primary outcome of interest was in-hospital mortality. A weighted multivariable hierarchical logistic regression model estimated patient- and hospital-level factors associated with in-hospital mortality. Moreover, a multivariable logistic regression analysis was used to build an in-hospital mortality prediction model, presented as a nomogram.

Results: A total of 85 440 patients (mean [SD] age, 62.2 [13.5] years; 61 281 men [71.1%]) were identified, and 4.2% (n = 3610) died in the hospital. Patient-level risk factors associated with higher odds of in-hospital mortality included age (adjusted odds ratio [aOR], 1.03 per 1-year increase; 95% CI, 1.02-1.03), male sex (aOR, 1.23; 95% CI, 1.12-1.35), higher number of comorbidities (aOR, 1.14; 95% CI, 1.11-1.17), having a metastatic cancer (aOR, 1.49; 95% CI, 1.36- 1.64), having a nonelective admission (aOR, 3.26; 95% CI, 2.83-3.75), and being admitted to the hospital on a weekend (aOR, 1.30; 95% CI, 1.16-1.45). Of the hospital-level factors, admission to a nonteaching hospital (aOR, 1.48; 95% CI, 1.24-1.77) was associated with higher odds of in-hospital mortality. The nomogram showed fair in-hospital mortality discrimination (area under the curve of 72%).

Conclusions And Relevance: This cross-sectional study found that both patient- and hospital-level factors were associated with in-hospital mortality, and the nomogram estimated with fair accuracy the probability of in-hospital death among patients with HNC. These multilevel factors are critical indicators of survivorship and should thus be considered when planning programs or interventions aimed to improve survival among this unique population.
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http://dx.doi.org/10.1001/jamaoto.2020.0132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082768PMC
May 2020

Characterization and ACE Inhibitory Activity of Fermented Milk with Probiotic K25 as Analyzed by GC-MS-Based Metabolomics Approach.

J Microbiol Biotechnol 2020 Jun;30(6):903-911

Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, Beijing Technology and Business University, Beijing 100048, P.R. China.

Addition of probiotics to yogurt with desired health benefits is gaining increasing attention. To further understand the effect of probiotic on the quality and function of fermented milk, probiotic fermented milk (PFM) made with probiotic K25 and yogurt starter ( ssp. and ) was compared with the control fermented milk (FM) made with only the yogurt starter. The probiotic strain was shown to survive well with a viable count of 7.1 ± 0.1 log CFU/g in the PFM sample after 21 days of storage at 4°C. The strain was shown to promote formation of volatiles such as acetoin and 2,3-butanediol with milk fragrance, and it did not cause post-acidification during refrigerated storage. Metabolomics analysis by GC-MS datasets coupled with multivariate statistical analysis showed that addition of K25 increased formation of over 20 metabolites detected in fermented milk, among which γ-aminobutyric acid was the most prominent. Together with several other metabolites with relatively high levels in fermented milk such as glyceric acid, malic acid, succinic acid, glycine, alanine, ribose, and 1,3-dihydroxyacetone, they might play important roles in the probiotic function of K25. Further assay of the bioactivity of the PFM sample showed significant ( < 0.05) increase of ACE inhibitory activity from 22.3% at day 1 to 49.3% at day 21 of the refrigerated storage. Therefore, probiotic K25 could be explored for potential application in functional dairy products.
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http://dx.doi.org/10.4014/jmb.1911.11007DOI Listing
June 2020

Biosynthesis of Caffeic Acid from Glucose by Engineered .

ACS Synth Biol 2020 04 19;9(4):756-765. Epub 2020 Mar 19.

The Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, College of Life Sciences, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin 300071, PR China.

Caffeic acid is a plant phenolic compound possessing extensive pharmacological activities. Here, we identified that -coumaric acid 3-hydroxylase from was capable of hydroxylating -coumaric acid to form caffeic acid in . Then, we introduced a combined caffeic acid biosynthetic pathway into and obtained 0.183 mg L caffeic acid from glucose. Next we improved the tyrosine biosynthesis in by blocking the pathway flux to aromatic alcohols and eliminating the tyrosine-induced feedback inhibition resulting in caffeic acid production of 2.780 mg L. Finally, the medium was optimized, and the highest caffeic acid production obtained was 11.432 mg L in YPD medium containing 4% glucose. This study opens a route to produce caffeic acid from glucose in and establishes a platform for the biosynthesis of caffeic acid derived metabolites.
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http://dx.doi.org/10.1021/acssynbio.9b00431DOI Listing
April 2020

A Review of Data Analytic Applications in Road Traffic Safety. Part 1: Descriptive and Predictive Modeling.

Sensors (Basel) 2020 Feb 18;20(4). Epub 2020 Feb 18.

Farmer School of Business, Miami University, Oxford, OH 45056, USA.

This part of the review aims to reduce the start-up burden of data collection and descriptive analytics for statistical modeling and route optimization of risk associated with motor vehicles. From a data-driven bibliometric analysis, we show that the literature is divided into two disparate research streams: (a) predictive or explanatory models that attempt to understand and quantify crash risk based on different driving conditions, and (b) optimization techniques that focus on minimizing crash risk through route/path-selection and rest-break scheduling. Translation of research outcomes between these two streams is limited. To overcome this issue, we present publicly available high-quality data sources (different study designs, outcome variables, and predictor variables) and descriptive analytic techniques (data summarization, visualization, and dimension reduction) that can be used to achieve safer-routing and provide code to facilitate data collection/exploration by practitioners/researchers. Then, we review the statistical and machine learning models used for crash risk modeling. We show that (near) real-time crash risk is rarely considered, which might explain why the optimization models (reviewed in Part 2) have not capitalized on the research outcomes from the first stream.
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http://dx.doi.org/10.3390/s20041107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070501PMC
February 2020

A Review of Data Analytic Applications in Road Traffic Safety. Part 2: Prescriptive Modeling.

Sensors (Basel) 2020 Feb 17;20(4). Epub 2020 Feb 17.

Farmer School of Business, Miami University, Oxford, OH 45056, USA.

In the first part of the review, we observed that there exists a significant gap between the predictive and prescriptive models pertaining to crash risk prediction and minimization, respectively. In this part, we review and categorize the optimization/ prescriptive analytic models that focus on minimizing crash risk. Although the majority of works in this segment of the literature are related to the hazardous materials (hazmat) trucking problems, we show that (with some exceptions) many can also be utilized in non-hazmat scenarios. In an effort to highlight the effect of crash risk prediction model on the accumulated risk obtained from the prescriptive model, we present a simulated example where we utilize four risk indicators (obtained from logistic regression, Poisson regression, XGBoost, and neural network) in the shortest path algorithm. From our example, we demonstrate two major designed takeaways: (a) the shortest path may not always result in the lowest crash risk, and (b) a similarity in overall predictive performance may not always translate to similar outcomes from the prescriptive models. Based on the review and example, we highlight several avenues for future research.
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http://dx.doi.org/10.3390/s20041096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070673PMC
February 2020

Efficacy of BPPV diagnosis and treatment system for benign paroxysmal positional vertigo.

Am J Otolaryngol 2020 May - Jun;41(3):102412. Epub 2020 Feb 4.

Department of Neurology, Zhejiang Hospital, Hangzhou 310013, China. Electronic address:

Objectives: To evaluate the efficacy of automatic benign paroxysmal positional vertigo (BPPV) diagnosis and treatment system for BPPV compared with the manual repositioning group.

Methods: Two hundred thirty patients diagnosed as idiopathic BPPV who were admitted from August 2018 to July 2019 in Zhejiang Hospital were included. Among them, 150 patients of posterior semicircular canal BPPV(pc-BPPV), 53 patients of horizontal semicircular canal BPPV(hc-BPPV), and 27 patients of horizontal semicircular canal calculus (hc-BPPV-cu) were randomly treated with BPPV diagnosis and treatment system(the experimental group) or manual repositioning (the control group). Resolution of vertigo and nystagmus on the Dix-Hallpike and Roll test on day 3,day 7,day 14 and day 28 follow-up after first treatment was the main outcome measure to assess the efficacy of treatment.

Results: At 3-day and 7-day follow-up after treatment with BPPV diagnosis and treatment system, 79%, 91%had complete resolution of vertigo and nystagmus, the effective rate in the experimental group were significantly higher than those in the control group, the differences were statistically significant(P < .05). On day 14, the effective rate in the experimental group (96%) was slightly higher than that in the control group(91%), but there was no significant difference between the two groups. And at 28-day after the first treatment, the effective rate was 100% in the experimental group and the control group. The repositioning efficiency of pc-BPPV (the first, second, third treatment), hc-BPPV (the first, second, third treatment), hc-BPPV-cu(the first, second treatment) in the experimental group were higher than the control group, and the secondary reposition of pc-BPPV in the experimental group was significantly higher than the control group(96%vs.84%; P < .05). While for the hc-BPPV-cu patients, the effective rate of the third treatment in the experimental group was slightly lower than that of the control group, but the differences were not statistically significant.

Conclusions: BPPV diagnosis and treatment system is effective for the treatment of BPPV, with a better effective rate than those treated with manual maneuver, and is safe and easy to perform on patients.
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http://dx.doi.org/10.1016/j.amjoto.2020.102412DOI Listing
October 2020

Parkinsonism caused by Intracranial ependymoma: A rare case report and literature review.

Aging Med (Milton) 2019 Dec 27;2(4):223-226. Epub 2019 Dec 27.

Department of Neurology Zhejiang Hospital Hangzhou China.

Background: Ependymomas, especially intracranial ependymomas, are rare neoplasms of the CNS. The clinical courses of patients with intracranial ependymomas can be quite variable. At present, data on parkinsonism caused by ependymomas are scarce.

Case Presentation: A 13-year-old girl presented with parkinsonism symptoms of clumsiness in her left leg and hand. Her mother was diagnosed with Parkinson's disease at age 30, nine years previously. Magnetic resonance imaging showed a lesion in the temporal lobe with long-T1 signal, mixed-T2 signal. The patient was taken in for a right tumorectomy and was diagnosed as having an ependymoma postoperatively. The patient's symptoms fully resolved in the postoperative phase.

Conclusion: The case describes the mechanism of intracranial ependymoma involving parkinsonism symptoms. Our findings suggest that in some patients presenting with atypical PD symptoms the underlying cause should not be overlooked; MRI examination is necessary.
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http://dx.doi.org/10.1002/agm2.12093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003710PMC
December 2019

Comparative transcriptome analysis of genomic region deletion strain with enhanced L-tyrosine production in Saccharomyces cerevisiae.

Biotechnol Lett 2020 Mar 21;42(3):453-460. Epub 2019 Dec 21.

The Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, College of Life Sciences, Nankai University, Tianjin, 300071, China.

Objective: To determine the effect of large genomic region deletion in a Saccharomyces cerevisiae strain on tyrosine yield and to identify new genetic modification targets through transcriptome analysis.

Results: TAL was used to produce p-coumaric acid (p-CA) from tyrosine to quantity tyrosine yield. S. cerevisiae mutant strain NK14 with deletion of a 23.8 kb genomic region was identified to have p-CA production of 10.3 mg L, while the wild-type strain BY4741 had p-CA production of 1.06 mg L. Analysis of growth patterns and stress tolerance showed that the deletion did not affect the growth phenotype of NK14. Transcriptome analysis suggested that, compared to BY4741, genes related to glycolysis (ENO2, TKL1) and the tyrosine pathway (ARO1, ARO2, ARO4, ARO7, TYR1) were upregulated in NK14 at different levels. Besides genes related to the tyrosine biosynthetic pathway, amino acid transporters (AVT6, VBA5, THI72) and transcription factor (ARO80) also showed changes in transcription levels.

Conclusions: We developed a strain with improved tyrosine yield and identified new genetic modification candidates for tyrosine production.
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http://dx.doi.org/10.1007/s10529-019-02784-1DOI Listing
March 2020

Algal toxicity, accumulation and metabolic pathways of galaxolide.

J Hazard Mater 2020 02 1;384:121360. Epub 2019 Oct 1.

College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, 518060, China. Electronic address:

Galaxolide (HHCB) is known to be persistent during wastewater treatment and has raised increasing concern due to its high detection frequency in the environment and potentially negative effects. However, little information is available on the degradation of HHCB by algae, the degradation mechanisms and the toxicity of HHCB on algae. In the present study, HHCB was found to be toxic to Navicula sp. and Scenedesmus quadricauda, with a 3 d EC of 0.050 and 0.336 mg L, respectively. Both microalgae showed high removal efficiency (72.9-100%) for HHCB. S. quadricauda showed a more satisfactory effect in the bioremediation of HHCB than Navicula sp. A total of four metabolites were found in the biotransformation processes of HHCB, and its possible metabolic pathways were proposed. Hydroxylation, methoxylation, methylation, ketonization, demethylation, and oxaloacetate conjunction contributed to the metabolism of HHCB in algal cells.
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http://dx.doi.org/10.1016/j.jhazmat.2019.121360DOI Listing
February 2020

Evaluation survey of microbial disinfection methods in UV-LED water treatment systems.

Sci Total Environ 2019 Apr 24;659:1415-1427. Epub 2018 Dec 24.

School of Mechanism and Electrical Engineering, Guilin University of Electronic Technology, Guilin 541004, China; Delft Institute of Microsystems and Nanoelectronics (Dimes), Delft University of Technology, Mekelweg 6, 2628CD Delft, the Netherlands.

Ultraviolet (UV) disinfection is an early discovered technology that is currently and widely used for water treatment and food hygiene treatment. A newly emerging technology of UV disinfection, that is, UV light-emitting diodes (UV-LEDs), has aroused considerable research attention. UV-LEDs feature numerous advantages compared with traditional UV mercury vapor lamps and are expected to replace traditional UV lamps. Researchers currently perform studies to obtain data and develop methods for UV-LED water treatment systems. This article analyzes the latest research status and discusses the types of inactivation factors, such as the wavelength selectivity of UV light source, control of UV dose, effect of inactivation rate constant (K) (cm/mJ), working mode of water sample, external auxiliary system, and UV sensitivity of pathogenic bacteria in water. The wavelengths of approximately 260 and 280 nm normally feature strong inactivation characteristics. When compared with the approximately 260 nm wavelength chip, the around 280 nm wavelength chip proves to be a better choice as its higher wavelength light power can result in faster disinfection capacity of bacteria. UV dose can also be used as the reference value for disinfection of drinking water, whereas the inactivation rate constant (K) (cm/mJ) varies with different microorganism internal structures. Changing the working mode or adding an auxiliary system can also enhance the inactivation effect in water treatment system settings. In addition, we can compare the inactivation capacities of several pathogens as follows: ΦX174 > Escherichia coli > T type bacteriophage >Bacillus subtilis > MS2 or Qβ > human adenovirus. The in-depth investigation and discussion of inactivation factors and the mechanism of action in UV-LEDs water treatment systems will establish a more efficient UV-LED disinfection method in the future, provide a guiding direction, and promote the standardization and normalization of pathogen inactivation mechanism in UV-LED water treatment systems.
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http://dx.doi.org/10.1016/j.scitotenv.2018.12.344DOI Listing
April 2019

Effects of High-Temperature Storage on the Elasticity Modulus of an Epoxy Molding Compound.

Materials (Basel) 2019 Feb 25;12(4). Epub 2019 Feb 25.

School of Mechanical and Electrical Engineering, Guilin University of Electronic Technology, No. 1 Jinji Road, Guilin 541004, China.

Changes in the elasticity modulus of an epoxy molding compound (EMC), an electronic packaging polymer, under high-temperature air storage conditions, are discussed in this study. The elasticity modulus of EMC had two different compositions (different filling contents) under different temperatures (175, 200, and 225 °C) and aging times (100, 500, and 1500 h), which were analyzed by using dynamic mechanic analysis technology. The results revealed that the elasticity modulus increased in the thermal aging process, with an increase in the temperature and the aging time. The increments of the glassy and rubbery states were similar. However, the growing rate was significantly different, and the growth of the rubbery state was significantly higher than that of the glassy state. The filling content influenced the degree of aging of the materials significantly. At a low filling content, long-term aging under high temperatures completely changed the material structure, and the mechanical properties of the polymer were reduced.
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http://dx.doi.org/10.3390/ma12040684DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416563PMC
February 2019

Lithium Titanate Matrix-Supported Nanocrystalline Silicon Film as an Anode for Lithium-Ion Batteries.

ACS Appl Mater Interfaces 2019 Jan 20;11(1):534-540. Epub 2018 Dec 20.

Guangxi Key Laboratory of Manufacturing Systems and Advanced Manufacturing Technology , Guilin University of Electronic Technology , Guilin 541004 , PR China.

A facile preparation method of a Si-based anode with excellent cycling property is urgently required in the process of preparing lithium-ion batteries (LIBs). Here, lithium titanate (LTO) matrix-supported nanocrystalline Si film is prepared by radio frequency (RF) magnetron cosputtering utilizing LTO and silicon (Si) targets as the sputtering source. LTO-supported nanocrystalline Si film electrodes revealed a repeatable specific capacity of 1200 mA h g at 150 mA g with a maintenance of more than 75% even after 800 cycles. The remarkable electrochemical properties of the LTO-Si composite films could be attributed to the LTO matrix, preventing the electrolyte from directly making contact with the nanocrystalline Si materials, alleviating the stress of the periodic volume change and further providing efficient and rapid pathways for lithium-ion transport. The results suggest that Si-based LTO composite films are prospective anodes for LIBs, with high capacities and long cycling stabilities.
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http://dx.doi.org/10.1021/acsami.8b13878DOI Listing
January 2019

Does Hospital Competition Harm Inpatient Quality? Empirical Evidence from Shanxi, China.

Int J Environ Res Public Health 2018 10 17;15(10). Epub 2018 Oct 17.

Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

This study aimed to determine whether hospital competition is associated with improved in-hospital mortality in Shanxi, China. We included a total of 46,959 hospitalizations for acute myocardial infarction (AMI) and 44,063 hospitalizations for pneumonia from 2015 to 2017. Hospital competition was measured as Herfindahl⁻Hirschman Index based on the patient predicted flow approach. Two-level random-intercept logistic models were applied to explore the effects of hospital competition on quality for both AMI and pneumonia diagnoses. Hospital competition exerts negative or negligible effects on inpatient quality of care, and the pattern of competition effects on quality varies by specific diseases. While hospital competition is insignificantly correlated with lower AMI in-hospital mortality (odds ratio (OR): 0.94, 95% confidence interval (CI): 0.77⁻1.11), high hospital competition was, in fact, associated with higher in-hospital mortality for pneumonia patients (OR: 1.99, 95% CI: 1.51⁻2.64). Our study suggests that simply encouraging hospital competition may not provide effective channels to improve inpatient quality of health care in China's current health care system.
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http://dx.doi.org/10.3390/ijerph15102283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210984PMC
October 2018

Rural Versus Urban Patients: Benchmarking the Outcomes of Patients with Acute Myocardial Infarction in Shanxi, China from 2013 to 2017.

Int J Environ Res Public Health 2018 09 5;15(9). Epub 2018 Sep 5.

Dongfang College, Zhejiang University of Finance and Economics, Hangzhou 314408, China.

Rural-urban disparity in China attracts special international attention in view of the imbalance of economic development between rural and urban areas. However, few studies used patient level data to explore the disparity of health outcomes between rural and urban patients. This study aims to evaluate the trend of health outcomes between rural and urban patients hospitalized with acute myocardial infarction (AMI) in China. Using an electronic medical records (EMRs) database in Shanxi, China, we identified 87,219 AMI patients hospitalized between 2013 and 2017. We used multivariable binary logistic regressions and two-part models to estimate the association between region of origin (rural/urban) and two outcomes, in-hospital mortality and out-of-pocket (OOP) expenses. Rural patients were associated with lower in-hospital mortality and the adjusted Odds Ratios (ORs) were 0.173, 0.34, 0.605, 0.522, 0.556 (-values < 0.001) from 2013 to 2017, respectively. For the OOP expenses, rural patients were experiencing increasing risk of having OOP expenses, with the ORs of 0.159, 0.573, 1.278, 1.281, 1.65. The coefficients for the log-linear models in the five years were 0.075 ( = 0.352), 0.61, 0.565, 0.439, 0.46 (-values < 0.001). Policy makers in China should notice and narrow the gap of health outcomes between rural and urban patients.
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http://dx.doi.org/10.3390/ijerph15091930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165441PMC
September 2018