Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

[Diagnosis and treatment understanding of Waldenström macroglobulinemia in China: a cross-sectional study]

Objective: To conduct a nationwide physician survey to better understand clinicians' disease awareness, treatment patterns, and experience of Waldenström macroglobulinemia (WM) in China. Methods: This cross-sectional study was conducted from February 2022 to July 2022 by recruiting clinicians with WM treatment experience from hematology, hematology-oncology, and oncology departments throughout China. Quantitative surveys were designed based on the qualitative interviews. Results: The study included 415 clinicians from 219 hospitals spread across thirty-three cities and twenty-two provinces. As for diagnosis, the laboratory tests prescribed by physicians for suspected WM patients were relatively consistent (92% -99% recommendation for laboratory, 79% -95% recommendation for pathology, 96% recommendation for gene testing, and 63% -83% recommendation for imaging examination). However, from a physician's perspective, there was 22% misdiagnosis occurred in clinical practice. The rate of misdiagnosis was higher in lower-level hospitals than in tertiary grade A hospitals (29% vs 21%, P<0.001). The main reasons for misdiagnosis were that WM was easily confused with other diseases, and physicians lacked the necessary knowledge to make an accurate diagnosis. In terms of gene testing in clinical practice, 96% of participating physicians believed that WM patients would require gene testing for MYD88 and CXCR4 mutations because the results of gene testing would aid in confirming diagnosis and treatment options. In terms of treatment, 55% of physicians thought that the most important goal was to achieve remission, while 54% and 51% of physicians wanted to improve laboratory and/or examination results and extend overall survival time, respectively. Among patients with treatment indications, physicians estimated that approximately 21% of them refused to receive treatment, mainly owing to a lack of affordable care and disease awareness. When selecting the most appropriate treatment regimens, physicians would consider patient affordability (63% ), comorbidity (61% ), and risk level (54% ). Regimens containing Bruton tyrosine kinase inhibitor (BTKi) were most widely recommended for both treatment-naïve and relapsed/refractory patients (94% for all patients, 95% for treatment-naïve patients, and 75% for relapsed/refractory patients), and most physicians recommended Ibrutinib (84% ). For those patients who received treatment, physicians reported that approximately 23% of patients did not comply with the treatment regimen due to a lack of affordability and disease awareness. Furthermore, 66% of physicians believe that in the future, increasing disease awareness and improving diagnosis rates is critical. Conclusions: This study is the first national physician survey of WM conducted in China. It systematically describes the issues that exist in WM diagnosis and treatment in China, such as a high rate of misdiagnosis, limited access to gene testing and new drugs, and poor patient adherence to treatment. Chinese doctors believe that improving doctors' and patients' understanding of WM is one of the most urgent issues that must be addressed right now.

Potential Predictive Immune and Metabolic Biomarkers of Tumor Microenvironment Regarding Pathological and Clinical Response in Esophageal Cancer After Neoadjuvant Chemoradiotherapy: A Systematic Review

INTRODUCTION

The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced in post-surgery treatment of locally advanced esophageal cancer (EC) with residual pathological disease after neoadjuvant chemoradiotherapy (nCRT). F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) remains a valuable imaging tool to assess therapy response and to visualize metabolic TME; however, there is still a paucity in understanding the interaction between the TME and nCRT response. This systematic review investigated the potential of TME biomarkers and 18F-FDG-PET/CT features to predict pathological and clinical response (CR) after nCRT in EC.

METHODS

A literature search of the Medline and Embase electronic databases identified 4190 studies. Studies regarding immune and metabolic TME biomarkers and 18F-FDG-PET/CT features were included for predicting pathological response (PR) and/or CR after nCRT. Separate analyses were performed for 18F-FDG-PET/CT markers and these TME biomarkers.

RESULTS

The final analysis included 21 studies-10 about immune and metabolic markers alone and 11 with additional 18F-FDG-PET/CT features. High CD8 infiltration before and after nCRT, and CD3 and CD4 infiltration after nCRT, generally correlated with better PR. A high expression of tumoral or stromal programmed death-ligand 1 (PD-L1) after nCRT was generally associated with poor PR. Moreover, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of the primary tumor were potentially predictive for clinical and PR.

CONCLUSION

CD8, CD4, CD3, and PD-L1 are promising immune markers in predicting PR, whereas TLG and MTV are potential 18F-FDG-PET/CT features to predict clinical and PR after nCRT in EC.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

[The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers]

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

Tularemia cases increase in the USA from 2011 through 2019

Tularemia is a rare but potentially serious bacterial zoonosis, which has been reported in the 47 contiguous states of the USA during 2001-2010. This report summarizes the passive surveillance data of tularemia cases reported to the Centers for Disease Control and Prevention from 2011 through 2019. There were 1984 cases reported in the USA during this period. The average national incidence was 0.07 cases per 100,000 person-years (PY), compared to 0.04 cases per 100,000 PY during 2001-2010. The highest statewide reported case 2011-2019 was in Arkansas (374 cases, 20.4% of total), followed by Missouri (13.1%), Oklahoma (11.9%), and Kansas (11.2%). Regarding race, ethnicity, and sex, tularemia cases were reported more frequently among white, non-Hispanic, and male patients. Cases were reported in all age groups; however, individuals 65 years-old and older exhibited the highest incidence. The seasonal distribution of cases generally paralleled the seasonality of tick activity and human outdoor activity, increasing during spring through mid-summer and decreasing through late summer and fall to winter lows. Improved surveillance and education of ticks and tick- and water-borne pathogens should play a key role in efforts to decrease the incidence of tularemia in the USA.

Dietary metabolizable energy and crude protein levels affect pectoral muscle composition and gut microbiota in native growing chickens

The experiment aimed to study effects of dietary metabolizable energy (ME) and crude protein (CP) levels alone and in interaction on performance, pectoral muscle composition and gut microbiota in native growing chickens. A total of 648 10-wks-old Beijing-You Chicken (BYC) female chickens were randomly allocated to 9 groups with 6 replicates per group and 12 chickens per replicate, and the chickens were fed with a 3 × 3 factorial diets (3 levels of dietary ME: 11.31 MJ/kg, 11.51 MJ/kg, 11.71 MJ/kg; and 3 levels of dietary CP: 14%, 15%, 16%). The results showed that dietary ME and CP levels didn't affect average feed intake (AFI), body weight gain, feed gain ratio (P > 0.05), but ME level significantly affected the AFI (P < 0.05); mortality rate of 11.31 MJ/kg group was the highest (P < 0.05). Dietary ME, CP levels, and the interaction significantly affected pectoral CP and crude fat (CF) content of the growing chickens (P < 0.01). Dietary CP level had opposite effects on pectoral CP and CF content (P < 0.01). The 16% CP increased the pectoral CF content, which may have a negative impact on meat flavor. Dietary ME level affected 11 types of pectoral free amino acids (FAA) contents, including aspartic acid, L-threonine (P < 0.05), also amino acid classification, for example, total amino acid (TAA) and essential amino acid (EAA) content (P < 0.05). The 11.51 MJ/kg group had the highest TAA, EAA, delicious amino acid (DAA) content and EAA percentage (P < 0.05), while 11.31 MJ/kg group had the lowest bitter amino acid (BAA) content and BAA percentage and the highest fresh and sweet amino acid (FSAA) percentage (P < 0.05). Dietary CP level significantly affected glutamine and tyrosine content (P < 0.05). The interaction of dietary ME and CP level affected C20:3n6 content, saturated fatty acid (SFA), and unsaturated fatty acid (UFA) percentage (P < 0.05). The CP level significantly affected SFA percentage (P < 0.05). The 16% CP level increased the diversity of gut microbiota, but at the same time increased the relative abundance of Proteobacteria (P < 0.05), which is a sign of microbiota disorder. The increase of dietary ME level resulted in a gradual decrease in the diversity and relative abundance of gut microbiota. In conclusion, the present study suggested that the medium dietary ME (11.51 MJ/kg) and low CP (14-15%) levels can be helpful for enhancing pectoral muscle composition, increase meat quality such as flavor and nutritional value, and benefit for gut microbiota in native growing chickens.

[New agents-based induction chemotherapy followed by autologous stem cell transplantation and maintenance treatment strategy for multiple myeloma: a single center retrospective study of 300 cases]

Objective: To examine the survival and influential factors of an integrated approach of novel agents, autologous hematopoietic stem cell (auto-HSCT) , and maintenance therapy in patients with multiple myeloma (MM) patients from a single center over the past 15 years. Methods: In our center, 300 MM patients who received an integrated strategy of new agents, auto-HSCT, and maintenance therapy over 15 years were retrospectively and prospectively analyzed. Results: The complete remission rates (CR) and ≥very good partial remission rates (VGPR) following induction therapy, transplantation, and maintenance therapy were respectively 35.3% and 55.2% , 72.4% and 80.0% , 89.2% , and 93.4% . When compared to patients receiving double-drug induction, the ≥VGPR and ORR of patients receiving triple-drug induction were improved. No difference existed in CR, ≥VGPR, and ORR between the PAD (bortezomib + liposome doxorubicin+ dexamethasone) and RAD (lenalidomide + liposome doxorubicin + dexamethasone) regimens, but the benefits speed differed. The negative rate of flow minimal residual disease following induction, transplantation, and maintenance was 18.8% (54 cases) , 41.4% (109 cases) , and 58.7% (142 cases) , respectively. The median time to progress (TTP) was 78.7 months and the median overall survival (OS) was 109 months. The median TTP for RISS-Ⅰ-Ⅲ patients were 111.8 months, 77.4 months, and 30.6 months, and the median OS was 118.8 months, 91.4 months, and 48.5 months, respectively. At various points during treatment, the TTP and OS of patients obtaining CR and MRD negative were longer than those of patients who did not obtain CR and MRD negative. TTP was noticeably shorter in high-risk cytogenetic patients compared to standard-risk patients even when CR was acquired during induction. There was no difference in TTP between patients with high-risk cytogenetics and those with standard-risk cytogenetics if MRD negative was acquired during induction. According to a multivariate analysis, the R-ISS stage was a poor predictor of TTP and OS at various treatment intervals. Therapeutic effectiveness was a newly independent prognostic factor following treatment. Conclusion: A median survival of almost 10 years is possible for MM patients who receive an integrated strategy of induction regimens followed by auto-HSCT and maintenance therapy, which significantly improves prognosis. However, this approach did not significantly benefit high-risk cytogenetic MM patients.

Modeling Effects of Vertebrate Host Exclosures and Host-Targeted Acaricides on Lone Star Tick (Amblyomma americanum, L.) Infestations

We used a spatially explicit model to simulate the potential effects of exclosures and acaricides targeted at medium-sized mammalian hosts on the local distribution and abundance of lone star ticks (Amblyomma americanum) within forestlands of the southeastern United States. Both exclosures and acaricides were successful in markedly reducing the densities of all off-host tick life stages inside the treatment areas. Densities dropped to almost zero immediately inside the edges of the exclosures, with noticeably depressed densities extending outward 30 to 60 m from the exclosures, and the simulated exclosures maintained their effectiveness as their sizes were decreased from 4.5 to 2.25 to 0.8 ha. Densities exhibited a smooth gradient across the edges of the acaricide-treated areas, with depressed densities extending ≈100 m outward from the edges, but with perceptible densities extending ≈60 m inward from the edges; thus, the simulated acaricide areas lost their effectiveness as size was decreased to slightly less than one-half the diameter of the activity range of the targeted host. Our simulation results indicated that off-host nymph densities responded to reductions of medium-sized host densities. These results suggest that targeting acaricides at medium-sized hosts may be an effective, and currently under-utilized, method for tick suppression.

Increasing Incidence of Spotted Fever Group Rickettsioses in the United States, 2010-2018

Spotted fever group Rickettsia species are intracellular bacteria transmitted by tick or mite vectors and that cause human diseases referred to as spotted fever group rickettsioses, or spotted fevers. In the United States, the most recognized and commonly reported spotted fevers are Rocky Mountain spotted fever (RMSF) (Rickettsia rickettsii), Rickettsia parkeri rickettsiosis, Pacific Coast tick fever (Rickettsia species 364D), and rickettsialpox (Rickettsia akari). In this study, we summarize and evaluate surveillance data on spotted fever cases reported to the Centers for Disease Control and Prevention (CDC) through the National Notifiable Diseases Surveillance System from 2010 to 2018. During this period, there were 36,632 reported cases of spotted fevers with 95.83% (N = 35,104) reported as meeting the case definition as probable and 4.17% (N = 1528) reported as meeting the case definition as confirmed. The average national incidence of total cases, both probable and confirmed, was 12.77 cases per million persons per year. The highest statewide incidence was in Arkansas, with 256.84 per million per year, whereas the lowest incidence occurred in California, with 0.32 per million per year (note that spotted fevers were not notifiable in Hawaii and Alaska). Cases of spotted fevers were reported more frequently among males by gender, White by race, and non-Hispanic by ethnicity. The incidence of spotted fevers increased significantly from 2010 to 2018, but it is uncertain how many of the reported cases were RMSF and how many developed from more moderate spotted fevers. Improvement of the ability to differentiate between spotted fever group Rickettsia species is needed.

Landscape Complexity has Mixed Effects on an Invasive Aphid and Its Natural Enemies in Sorghum Agroecosystems

Landscapes with more complex composition and configuration are generally expected to enhance natural enemy densities and pest suppression. To evaluate this hypothesis for an invasive aphid pest of sorghum, Melanaphis sorghi Theobald (Hemiptera: Aphididae), sampling in sorghum fields for aphids and natural enemies was conducted over two years in a southern U.S. coastal production region. Landscape composition and configuration of crop and noncrop elements were assessed using correlation and multivariate regression modeling to detect relationships with insects at different spatial scales. Significant models found more complex landscape configuration, particularly the amount of habitat edges, was associated with increased aphid and natural enemy abundance. Composition associated with noncrop habitats had the opposite effect. Numerical response of natural enemies was taxa dependent, with parasitism lower as landscape complexity increased, while predator numerical response was not affected by landscape complexity. These results indicate landscape complexity may increase both aphid and natural enemy abundance, but with decreasing parasitism and little association with predator numerical response. These relationships are likely contingent on overall environmental suitability to aphid population increase as results were less evident in the second year when average aphid abundance regularly exceeded the economic threshold. This study supports the importance of configuration, especially habitat borders, as a critical metric for determining pest-natural enemy dynamics within a large-scale cereal agroecosystem.

Interleukin-20 is involved in dry eye disease and is a potential therapeutic target

Background

Dry eye disease (DED) is a common disease in ophthalmology, affecting millions of people worldwide. Recent studies have shown that inflammation is the core mechanism of DED. IL-20 is a proinflammatory cytokine involved in various inflammatory diseases. Therefore, we aimed to explore the role of this cytokine in the pathogenesis of DED and evaluate the therapeutic potential of the anti-IL-20 monoclonal antibody (mAb) 7E for DED treatment.

Methods

Clinical tear samples from patients with DED and non-DED controls were collected and their IL-20 protein levels were determined. We established three DED animal models to explore the role of IL-20 and the efficacy of IL-20 antibody in DED. Benzalkonium chloride (BAC)-induced over-evaporative DED, extra-orbital lacrimal gland excision (LGE)-induced aqueous tear-deficient DED, and desiccating stress (DS)-induced combined over-evaporative and aqueous tear-deficient DED animal models were established to investigate the role of IL-20. The anti-IL-20 antibody 7E was established to neutralize IL-20 activity. The effects of IL-20 or 7E on human corneal epithelial cells and macrophages under hyperosmotic stress were analyzed. 7E was topically applied to eyes to evaluate the therapeutic effects in the DED animal models.

Results

IL-20 was significantly upregulated in the tears of patients with DED and in the tears and corneas of DED animal models. Under hyperosmotic stress, IL-20 expression was induced via NFAT5 activation in corneal epithelial cells. 7E suppressed hyperosmotic stress-induced activation of macrophages. IL-20 induced cell death in corneal epithelial cells and 7E protected cells from hyperosmotic stress-induced cell death. Blocking IL-20 signaling with 7E protected mice from BAC-induced, LGE-induced, and DS-induced DED by reducing DED symptoms and inhibiting inflammatory responses, macrophage infiltration, apoptosis, and Th17 populations in the conjunctiva and draining lymph nodes.

Conclusions

Our results demonstrated the functions of IL-20 in DED and presented a potential therapeutic option for this condition.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12929-022-00821-2.

Evaluation of Areawide Forecasts of Wind-borne Crop Pests: Sugarcane Aphid (Hemiptera: Aphididae) Infestations of Sorghum in the Great Plains of North America

Airborne pests pose a major challenge in agriculture. Integrated pest management programs have been considered a viable response to this challenge, and pest forecasting can aid in strategic management decisions. Annually recurrent areawide sugarcane aphid [Melanaphis sacchari (Zehntner) (Hemiptera: Aphididae)] infestations of sorghum [Sorghum bicolor (L.) Moench (Poales: Poaceae)] in the Great Plains of North America is one of such challenges. As part of the response, a spatially-explicit individual-based model was developed that simulates sugarcane aphid infestations over the southern-to-central part of the region. In this work, we evaluated model forecasts using 2015-2018 field data. The ranges of forecasted days of first infestation significantly overlapped with those observed in the field. The average days of first infestation observed in the field were approximated by the model with differences of less than 28 days in Texas and southern Oklahoma (2015-2018), and in northern Oklahoma (2016-2017). In half of these cases the difference was less than 14 days. In general, the modeled average day of first infestation was earlier than the observed one. As conceptual modeling decisions may impact model forecasts and as various socio-environmental factors may impact spatio-temporal patterns of field data collection, agreement between the forecasts and the observed estimates may vary between locations and seasons. Predictive modeling has the potential to occupy a central position within areawide integrated pest management programs. More detailed consideration of local agricultural practices and local environmental conditions could improve forecasting accuracy, as could broader participation of producers in field monitoring efforts.

[Analysis on cancer incidence and mortality attributed to human papillomavirus infection in China, 2016]

Objective: We aim to evaluate the morbidity and mortality of cancer attributable to human papillomavirus (HPV) infection in China in 2016. Methods: Based on the cancer incidence and mortality rates, national population data, and population attributable fraction (PAF) in China, we calculated the number of incidence and death cases attributed to HPV infection in different areas, age groups, and gender in China in 2016. The standardized incidence and mortality rates for cancer attributed to HPV infection were calculated by using Segi's population. Results: In 2016, a total of 124 772 new cancer cases (6.32 per 100 000) were attributed to HPV infection in China, including 117 118 cases in women and 7 654 cases in men. Of these cancers, cervical cancer was the most common one, followed by anal cancer, oropharyngeal cancer, penile cancer, vaginal cancer, laryngeal cancer, oral cancer, and vulvar cancer. A total of 41 282 (2.03 per 100 000) deaths were attributed to HPV infection, of which 37 417 occurred in women and 3 865 in men. Most deaths were caused by cervical cancer, followed by anal cancer, oropharyngeal cancer, penile cancer, laryngeal cancer, vaginal cancer, oral cancer, and vulvar cancer. The incidence and mortality rates of cervical cancer increased rapidly with age, peaked in age group 50-54 years, then decreased obviously. The morbidity and mortality rates of non-cervical cancer increased with age. The cancer case and death numbers in rural areas (57 089 cases and 19 485 deaths) were lower than those in urban areas (67 683 cases and 21 797 deaths). However, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of cervical cancer were higher in rural areas than in urban areas. There were no significant differences in ASIR and ASMR of non-cervical cancers between urban areas and rural areas. Conclusions: The incidence of cancers attributed to HPV infection in China was lower than the global average, but the number of incidences accounted largely, furthermore there is an increasing trend of morbidity and mortality. The preventions and controls of cervical cancer and male anal cancer are essential to contain the increases in cancer cases and deaths attributed to HPV infection.

Natural Enemies, Mediated by Landscape and Weather Conditions, Shape Response of the Sorghum Agroecosystem of North America to the Invasive Aphid Melanaphis sorghi

The sorghum (Sorghum bicolor [L.]) agroecosystem of North America provided an opportunity to evaluate agroecosystem response to an invading insect herbivore, Melanaphis sorghi (Theobald) (sorghum aphid) (previously published as Melanaphis sacchari Zehntner) (Hemiptera: Aphididae) onto a widely planted crop that experiences a range of agro-landscape and weather conditions. Initial sorghum risk assessments after M. sorghi's invasion in the mid-2010s provided forecasts of range expansion and annual migration, which were based on aphid life history, extent of sorghum cultivation and susceptibility to M. sorghi, and weather (aphid-plant-weather [APW] risk scenario). A more comprehensive risk assessment proposed here brings top-down forces of M. sorghi-natural enemy interactions to the forefront as mediated by agro-landscape and weather conditions (aphid-enemy/landscape-weather mediated [AE/LW] risk scenario). A hypothesis of regional differences in aphids and natural enemies and sensitivity to agro-landscape and weather was tested using empirical data of insect, landscape, and weather data across 5 years and four regions (two in the U.S. Great Plains [South GP and North GP], one farther south (South), and one in the southeast U.S. [South E]). Natural enemies were widespread with two parasitoids and four coccinellid species common across regions, but regional variation in M. sorghi and natural enemy abundance was detected. The AE/LW risk scenario accounted for natural enemy abundance and activity that was highest in the South region, functioned well across agro-landscape and weather conditions, and was accompanied by average low M. sorghi abundance (~23 M. sorghi per leaf). Positive correlations of natural enemy-M. sorghi abundance also occurred in the South GP region where M. sorghi abundance was low (~20 M. sorghi per leaf), and selected natural enemy activity appeared to be mediated by landscape composition. Melanaphis sorghi abundance was highest in the South E region (~136 aphids/leaf) where natural enemy activity was low and influenced by weather. The AE/LW risk scenario appeared suited, and essential in the South region, in assessing risk on a regional scale, and sets the stage for further modeling to generate estimates of the degree of influence of natural enemies under varying agro-landscape and weather conditions considered in the AE/LW risk scenario. Broadly, these findings are relevant in understanding agroecosystem resilience and recommending supportive management inputs in response to insect invasions in context of natural enemy activity and varied environmental conditions.

Experimental Evidence of Intrinsic Current Generation by Turbulence in Stationary Tokamak Plasmas

High-β_{θe} (a ratio of the electron thermal pressure to the poloidal magnetic pressure) steady-state long-pulse plasmas with steep central electron temperature gradient are achieved in the Experimental Advanced Superconducting Tokamak. An intrinsic current is observed to be modulated by turbulence driven by the electron temperature gradient. This turbulent current is generated in the countercurrent direction and can reach a maximum ratio of 25% of the bootstrap current. Gyrokinetic simulations and experimental observations indicate that the turbulence is the electron temperature gradient mode (ETG). The dominant mechanism for the turbulent current generation is due to the divergence of ETG-driven residual flux of current. Good agreement has been found between experiments and theory for the critical value of the electron temperature gradient triggering ETG and for the level of the turbulent current. The maximum values of turbulent current and electron temperature gradient lead to the destabilization of an m/n=1/1 kink mode, which by counteraction reduces the turbulence level (m and n are the poloidal and toroidal mode number, respectively). These observations suggest that the self-regulation system including turbulence, turbulent current, and kink mode is a contributing mechanism for sustaining the steady-state long-pulse high-β_{θe} regime.

Effects of light regime on circadian rhythmic behavior and reproductive parameters in native laying hens

The paper aimed to study the effects of light regime on circadian rhythmic behavior and reproductive parameters in a native laying hen, Beijing You Chicken (BYC) during 22 to 30 wk. A total of 630 19-wk-old BYC female chicken were allocated to 6 light regime groups with 3 replicates per group and 35 birds per replicate, reared in individually lit floor pens with separate outdoor areas. A 2 × 3 factorial experiment (2 lighting patterns: continuous and intermittent lighting; 3 photoperiods: 16 h, 14 h, 12 h) was arranged, including 16L:8D for group 1; 12L:2D:4L:6D for group 2; 14L:10D for group 3; 10L:2D:4L:8D for group 4; 12L:12D for group 5, and 8L:4D:4L:8D for group 6, respectively. The circadian rhythmic behavior of the hens, including feeding, egg-laying and sleeping behaviors were observed by scan sampling and target sampling method for consecutive 3 d every other week during 22 to 30 wk. Infrared cameras were set outside each pen to record the rhythmic behaviors of the birds every other hour (6:00–7:00;8:00–9:00;10:00–11:00;12:00–13:00;14:00–15:00;16:00–17:00;18:00–19:00;20:00–21:00;22:00–23:00;0:00–1:00;2:00–3:00;4:00–5:00). Theovarian weight, oviduct weight, oviduct length, the number of large yellow follicles (LYF), and small yellow follicles (SYF) were measured at the end of 30 wk. The egg-laying rate during 22 to 30 wk was measured. The results showed that the highest feeding frequency was given by the 16L:8D, and the lowest given by the 12L:12D (P < 0.05). The average feeding duration was the longest in the 8L:4D:4L:8D at 6:00 to 8:00 (18.67 min/hen) (P < 0.05), and the shortest in the 8L:4D:4L:8D at 18:00 to 20:00 (3.75 min/hen) (P < 0.05). The highest egg-laying frequency was given by the 8L:4D:4L:8D (0.28), the lowest given by the 10L:2D:4L:8D (0.21) (P < 0.05). The shortest egg-laying duration occurred at 6:00 to 8:00, was given by the 16L:8D (8 min/hen), and the longest egg-laying duration occurred at 18:00 to 20:00, was given by 16L:8D and 8L:4D:4L:8D (>20.5 min/hen) (P < 0.05). The highest sleeping frequency was given by the 12L:2D:4L:6D, the lowest was given by the 12L:12D (P < 0.05). At 6:00 to 8:00, the shortest sleeping duration was given by 12L:2D:4L:6D (1.5 s/hen), at 18:00 to 20:00, the longest given by 8L:4D:4L:8D (14.3 s/hen) (P < 0.05). Lighting pattern and photoperiod alone or in interaction had no effect on egg-laying rate during 22 to 30 wk (P > 0.05), but had significant effects on ovarian weight, oviduct weight, oviduct length, the number of LYF and SYF (P < 0.05), and the continuous groups were all significantly higher than the intermittent groups (P < 0.05). The present study indicated that light regimes affected the frequency and duration of circadian behavior in BYC laying hens, and the continuous light was more beneficial to the reproductive development than the intermittent light in the early laying period.

[Analysis on prevalence and epidemic risk of animal plague in different ecological plague foci in Inner Mongolia Autonomous Region]

The risk of plague epidemics and relapse of various types of plague foci persists in Inner Mongolia Autonomous Region. For Marmota sibirica plague foci, the animal plague has not been found but antibody has been detected positive. Nowadays, Marmota sibirica has been increasing in population and distribution in China. In bordering countries Mongolia and Russia, the animal plague has been continuously prevalent. For Spermophilus dauricus plague foci, the animal plague has been taken place now and then. Compared to the above foci, the animal plague is most prevalent in Meriones unguiculatus plague foci and frequently spread to humans. Due to higher strain virulence and historical disaster in Marmota sibirica plague foci and Spermophilus dauricus plague foci, plague prevention and control should be strengthened on these foci. In addition to routine surveillance, epidemic dynamics need to be further monitored in these two foci, in order to prevent their relapse and spread to humans.

Effects of lighting regimes on performance, pineal melanopsin expression and melatonin content in native laying hens aged from 19 to 34 weeks

Melanopsin, a key light sensitive pigment, plays an important role in the regulation of bio-rhythm and photo-adaptation in poultry. This study aimed to investigate the effects of different lighting regimes on performance, pineal melanopsin expression and melatonin content in a native chicken, Beijing You Chicken (BYC) aged from 19 to 34 wk. A total of 900 nineteen-wk-old BYC female chicken having no significant body weight differences were randomly allocated to 3 groups with 3 replicates each, 100 birds each replicate, reared in individually lit floor pens with separate outdoor areas. Three different lighting regimes were used, including continuous 16 h (16L:8D, 6:00–22:00) for group 1, intermittent 16 h (12L:2D:4L:6D, 6:00–18:00, 20:00–24:00) for group 2, and continuous 12 h (12L:12D, 6:00–18:00) for group 3, respectively. The performance was measured for 19 to 34 wk. Serum melatonin (Mel), prolactin (Prl), luteinizing hormone (LH), and 17-beta estradiol (E2) contents were measured at 24 wk, 29 wk, and 34 wk of age, the relative expression of pineal melanopsin gene (Opn4 mRNA) was measured on 1 d at 9:00, 13:00, 17:00, 21:00, 1:00, and 5:00 at 29 wk of age, and at the end of 29 wk and 34 wk. The results showed that the egg mass, egg-laying rate, and feed egg ratio of BYC were not affected by lighting regimes for 19 to 34 wk (P > 0.05), except for the average feed intake (AFI) (P < 0.05). The AFI in the 12L:12D group was significantly higher than that in the 16L:8D group (P < 0.05), but had no difference with that in the 12L:2D:4L:6D group. The pineal Opn4 mRNA level was significantly upregulated in the 12L:2D:4L:6D group and downregulated in the 12L:12D group when compared with 16L:8D group at 29 and 34 wks of age (P < 0.05). The Mel content in the 16L:8D group was lower than that in the other 2 groups at 29 wk of age (P < 0.05), there was no difference in Mel content between 16L:8D group and 12L:2D:4L:6D group at 34 wk of age (P > 0.05). The present study suggested that the pineal melanopsin expression of the birds in the intermittent 16 h lighting group was higher than in the continuous 16 h and 12 h lighting group, and a significant negative correlation was found between melanopsin expression and Mel content at 34 wk of age, which may interact to promote the photo-adaptation of the native chicken and affect the future laying performance.

Environmental determinants of Batrachochytrium dendrobatidis and the likelihood of further dispersion in the face of climate change in Texas, USA

One of the major drivers of amphibian population declines is Batrachochytrium dendrobatidis (Bd). We sought to identify the major environmental drivers of Bd prevalence in Texas, USA, by drawing results from museum specimens. We sampled one of the largest museum collections in Texas, the Biodiversity Research and Teaching Collections at Texas A&M University. Our sampling focused on the 9 amphibian species with the widest geographical distribution within the state, where we sub-sampled 30% of each species per decade from 1930 to present via skin swabs, totaling 1501 independent sampling events, and used quantitative real-time PCR (qPCR) to detect pathogen presence. We analyzed several geo-referenced variables describing climatic conditions to identify potential factors influencing the likelihood of presence of Bd using boosted regression trees. Our final model suggests the most influential variables are mean temperature of driest quarter, annual mean temperature, temperature annual range, and mean diurnal range. The most likely suitable range for Bd is currently found in the Blackland Prairie and Cross Timbers ecoregions. Results of our future (to the year 2040) projections suggest that Bd could expand its current distribution. Our model could play an important role when developing an integrated conservation plan through (1) focusing future field work on locations with a high likelihood of presence, (2) assisting in the choice of locations for restoration, and (3) developing future research plans including those necessary for projecting reactions to climate change. Our model also could integrate new presence data of Bd when they become available to enhance prediction precision.

Effects of light regime on the hatching performance, body development and serum biochemical indexes in Beijing You Chicken

The paper aimed to study the effects of light regime during the incubation on hatching performance, body development and serum biochemical indexes in Beijing You Chicken (BYC). A total of 1,408 BYC eggs were randomly allocated into 4 groups: 24 h dark as the control (Inc24D); 3 light regimes were 8 h light and 16 h dark group (Inc8L:16D); 12 h light and 12 h dark group (Inc12L:12D); 16 h light and 8 h dark group (Inc16L:8D), respectively. There were 352 eggs in each group, 4 replicates each group and 1 tray each replicate, 88 eggs each tray. Light-emitting diode (LED) strips, white light with temperature of 4,500 to 5,000 K, 150 to 200 lx were set up. The results showed that light regimes had no significant effects on hatching rate of eggs, hatching rate of fertile eggs and healthy rate of chicks (P > 0.05), but the hatching rate of eggs was the lowest in the Inc24D group (87.22%), and the highest in the Inc12L:12D group (93.64%); Lighted incubation significantly affected the incidence of leg problems of 1-day-old chicks (P < 0.05). The incidence rate of leg problems was the highest in the Inc24D group (4.21%), and was decreased in Inc12L:12D and Inc16L:8D groups (P < 0.05). Femur length in the Inc12L:12D group was greater than that in the Inc24D and Inc16L:8D groups (P = 0.011), but there were no differences between Inc8L:16D group and other three groups (P > 0.05). The relative brain weight of 1-day-old chicks was higher in Inc24D and Inc16L:8D groups than in Inc8L:16D group (P = 0.052), but had no difference with Inc12L:12D group. Light regimes during incubation had no effects on serum total protein, albumen, globulin, and urea nitrogen content of 1-day-old chicks (P > 0.05), while the globulin content in Inc12L:12D group was numerically greater than in other three groups (P = 0.063). Lysozyme content in Inc12L:12D group was higher than that in the Inc24D and Inc8L:16D groups (P < 0.05), but had no difference with that in Inc16L:8D group. Light regime had no effect on serum total antioxidant capability (T-AOC) (P > 0.05), but significantly affected the activities of glutathione peroxidase (GSH-Px) and total superoxide dismutase (T-SOD) (P < 0.05). The GSH-Px and T-SOD activities in the Inc12L:12D group were higher than those in the Inc24D and Inc8L:16D groups. The MDA content of Inc24D was the highest (9.67 nmol/mL) compared to the others, which was very close to the significant level (P = 0.056). In conclusion, 12 h light and 12 h dark incubation has the potential to improve the hatching performance of BYC eggs, benefit for the long bone development, improve some serum immune and antioxidant indexes, and reduce the leg problems in 1-day-old chicks.

Integrated control of the cattle tick, Rhipicephalus australis (Acari: Ixodidae), in New Caledonia through the Pasture and Cattle Management method

Development of the Pasture and Cattle Management (PCM) method is a priority to control the cattle tick, Rhipicephalus australis, in New Caledonia. The PCM method provides the foundation for sustainable integrated tick control because approximately 95% of cattle ticks in infested pastures are off the host in the non-parasitic life stages, and the practice of treating cattle intensely with chemical acaricides is a risk for the emergence of resistance to these active ingredients in commercial acaricidal products available for veterinary use. Here, we report the findings of an assessment survey to document the utility of the PCM method. Analyses of questionnaire data provided by 21 beef cattle producers describing their management of 37 herds informed how to (1) assess the ability of PCM to reduce acaricide use and (2) prioritize best practices and define recommendations to breeders promoting efficient tick control with minimum acaricide use. Boosted regression tree analysis showed a significant (p = 0.002) reduction of ≈33% in the number of acaricide treatments from 7.9 to 5.3 per year by using PCM. Of the 24 factors identified as potentially affecting acaricide use, six factors accounted for ≈86% of the variability in number of acaricide treatments applied annually. The six most influential factors involved farm characteristics as well as pasture and herd management recommendations. These results demonstrated the usefulness of PCM for integrated control of R. australis infestations while reducing acaricide use to improve cattle production in New Caledonia.

The phytotoxin COR induces transcriptional reprogramming of photosynthetic, hormonal and defence networks in tomato

Coronatine (COR) is a non-host specific phytotoxin secreted by Pseudomonas syringae pv. tomato that can induce leaf chlorosis and increase the virulence of pathogens during plant-pathogen interactions. Studies have shown that COR can regulate multiple physiological processes in plants, but its involvement in bacterial pathogenesis and plant growth regulation is not well understood. In this study, transcriptome sequencing was carried out on 4-week-old tomato leaves that were either mock-treated or treated with COR. Transcriptome sequencing led to the identification of 6144 differentially expressed genes (DEGs), of which 4361 genes were downregulated and 1783 genes were upregulated upon COR treatment. To obtain functional information on the DEGs, we annotated these genes using GO and KEGG databases. Functional classification analysis showed that the DEGs were primarily involved in photosynthesis, chlorophyll and carotenoid biosynthesis, jasmonic acid (JA) synthesis and phenylpropane metabolism. A total of 23 genes related to chlorophyll biosynthesis had significant changes, of which 22 genes were downregulated and one gene was upregulated, indicating that chlorophyll biosynthesis was inhibited upon COR treatment. A total of 17 photosystem I related genes and 22 photosystem II related genes involving 20 protein subunits were also downregulated. In the JA synthesis pathway, 25 genes were up regulated, and six genes were downregulated in COR treated samples. COR was also involved in the regulation of multiple secondary metabolites. The identified DEGs will help us better understand the virulence effects and physiological functions of COR and provide a theoretical basis for breeding resistance into economically important crops.

Simulated dynamics of southern cattle fever ticks (Rhipicephalus (Boophilus) microplus) in south Texas, USA: investigating potential wildlife-mediated impacts on eradication efforts

Background

Cattle fever ticks (CFT), Rhipicephalus (Boophilus) annulatus and R. (B.) microplus, are vectors of microbes causing bovine babesiosis and pose a threat to the economic viability of the US livestock industry. Efforts by the Cattle Fever Tick Eradication Program (CFTEP) along the US-Mexico border in south Texas are complicated by the involvement of alternate hosts, including white-tailed deer (Odocoileus virginianus) and nilgai (Boselaphus tragocamelus).

Methods

In the present study, we use a spatially explicit, individual-based model to explore the potential effects of host species composition and host habitat use patterns on southern cattle fever ticks (SCFT, R. (B.) microplus) infestation dynamics and efficacy of eradication schemes.

Results

In simulations without eradication efforts, mean off-host larval densities were much higher when cattle were present than when only white-tailed deer and nilgai were present. Densities in mesquite and meadows were slightly higher, and densities in mixed brush were much lower, than landscape-level densities in each of these scenarios. In eradication simulations, reductions in mean off-host larval densities at the landscape level were much smaller when acaricide was applied to cattle only, or to cattle and white-tailed deer, than when applied to cattle and nilgai. Relative density reductions in mesquite, mixed brush, and meadows depended on host habitat use preferences. Shifting nilgai habitat use preferences increasingly toward mixed brush and away from mesquite did not change mean off-host larval tick densities noticeably at the landscape level. However, mean densities were increased markedly in mesquite and decreased markedly in mixed brush, while no noticeable change in density was observed in meadows.

Conclusions

Our results suggest that continued integration of field data into spatially explicit, individual-based models will facilitate the development of novel eradication strategies and will allow near-real-time infestation forecasts as an aid in anticipating and preventing wildlife-mediated impacts on SCFT eradication efforts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-04724-3.

Using Data Surveillance to Understand the Rising Incidence of Babesiosis in the United States, 2011-2018

Babesiosis is a tick-borne disease that is caused by intraerythrocytic protozoan parasites of the genus Babesia. Common symptoms of babesiosis are generally characterized as nonspecific flu-like symptoms, such as fever or chills. Human infections are reported to the Centers for Disease Control and Prevention (CDC) through the National Notifiable Diseases Surveillance System (NNDSS). This study summarizes data of Babesia infections reported to the CDC by the NNDSS from 2011 to 2018. In total, there were 14,159 reported cases of babesiosis, and the incidence rate was 5.55 cases per million persons per year, displaying an increasing trend during the study period. The demographic group most affected was middle-aged and elderly white males. Infections were most abundant in the New England and the Mid-Atlantic regions of the United States. Our study provides useful results for a basic understanding of incidence, spatial and temporal distribution, and severity of babesiosis.

Effects of white-tailed deer habitat use preferences on southern cattle fever tick eradication: simulating impact on "pasture vacation" strategies

BACKGROUND

Rhipicephalus (Boophilus) annulatus and Rhipicephalus (Boophilus) microplus (southern cattle fever tick; SCFT), collectively known as cattle-fever ticks (CFTs), are vectors of protozoal parasites (Babesia bigemina and Babesia bovis) that cause bovine babesiosis (also known as cattle fever). One traditional strategy for CFT eradication involves the implementation of a "pasture vacation," which involves removing cattle (Bos taurus) from an infested pasture for an extended period of time. However, vacated pastures are often inhabited by wildlife hosts, such as white-tailed deer (WTD; Odocoileus virginianus), which can serve as alternate hosts for questing CFTs. We hypothesized that the distribution of host-seeking larvae among habitat types post-pasture vacation would reflect habitat use patterns of WTD, and in turn, affect the subsequent rate of pasture infestation by CFT.

METHODS

We adapted a spatially explicit, individual-based model to simulate interactions among SCFT, cattle, and WTD as a tool to investigate the potential effects of WTD habitat use preferences on the efficacy of a pasture vacation. We parameterized the model to represent conditions typical of rangelands in south Texas, USA, simulated a 1-year pasture vacation under different assumptions regarding WTD habitat use preferences, and summarized effects on efficacy through (1) time post-vacation to reach 100% of pre-vacation densities of host-seeking larvae, and (2) the ecological conditions that resulted in the lowest host-seeking larval densities following pasture vacation.

RESULTS

Larval densities at the landscape scale varied seasonally in a similar manner over the entire simulation period, regardless of WTD habitat use preferences. Following the removal of cattle, larval densities declined sharply to < 100 larvae/ha. Following the return of cattle, larval densities increased to > 60% of pre-vacation densities ≈ 21 weeks post-vacation, and reached pre-vacation levels in less than a year. Trends in larval densities in different habitat types paralleled those at the landscape scale over the entire simulation period, but differed quantitatively from one another during the pasture vacation. Relative larval densities (highest to lowest) shifted from (1) wood/shrub, (2) grass, (3) mixed-brush during the pre-vacation period to (1) mixed-brush, (2) wood/shrub, (3) grass or (1) wood/shrub, (2) mixed-brush, (3) grass during the post-vacation period, depending on WTD habitat use preferences.

CONCLUSIONS

By monitoring WTD-driven shifts in distributions of SCFT host-seeking larvae among habitat types during simulated pasture vacation experiments, we were able to identify potential SCFT refugia from which recrudescence of infestations could originate. Such information could inform timely applications of acaricides to specific refugia habitats immediately prior to the termination of pasture vacations.

Interleukin-24 protects against liver injury in mouse models

Background

Interleukin-24 (IL-24) binds to two kinds of receptor complexes, namely IL-20R1/IL-20R2 and IL-20R2/IL-22R1, which are also bound by IL-20. IL-20 plays a detrimental role in liver fibrosis. Due to the sharing of receptor complexes, we aimed to determine whether IL-24 also participates in liver fibrosis.

Methods

Clinical biopsy specimens from various stages of liver fibrosis were used to analyze IL-24 expression. IL-24 protein was administered to mice with thioacetamide (TAA)-induced liver injury. The direct effects of IL-24 on mouse primary hepatocytes or hepatic stellate cells (HSCs) were analyzed. Wild-type, IL-20R1-, and IL20R2-deficient mice were used to establish a model of acute TAA-induced liver injury.

Findings

Among patients with more severe liver fibrosis, there was a reduced IL-24/IL-20 ratio. Administration of IL-24 protein protected mice from TAA-induced liver injury and reduction of liver inflammation by antioxidant effects. IL-24 protected hepatocytes from TAA-induced apoptosis and prevented liver fibrosis through the inhibition of the HSCs activation. The protective role of IL-24 acted on liver cells were mainly IL-20R1-independent. IL-20R2-deficient mice exhibited more severe liver injury upon TAA treatment, thus confirming the protective role of IL-24.

Interpretation

IL-24 plays a key protective role in the progression of liver injury and has therapeutic potential for treating liver injuries.

Funding

This work was supported by the Ministry of Science and Technology of Taiwan (MOST 106–2320-B-006–024) and Taiwan Liver Disease Prevention & Treatment Research Foundation.

Socio-technical scales in socio-environmental modeling: Managing a system-of-systems modeling approach

System-of-systems approaches for integrated assessments have become prevalent in recent years. Such approaches integrate a variety of models from different disciplines and modeling paradigms to represent a socio-environmental (or social-ecological) system aiming to holistically inform policy and decision-making processes. Central to the system-of-systems approaches is the representation of systems in a multi-tier framework with nested scales. Current modeling paradigms, however, have disciplinary-specific lineage, leading to inconsistencies in the conceptualization and integration of socio-environmental systems. In this paper, a multidisciplinary team of researchers, from engineering, natural and social sciences, have come together to detail socio-technical practices and challenges that arise in the consideration of scale throughout the socio-environmental modeling process. We identify key paths forward, focused on explicit consideration of scale and uncertainty, strengthening interdisciplinary communication, and improvement of the documentation process. We call for a grand vision (and commensurate funding) for holistic system-of-systems research that engages researchers, stakeholders, and policy makers in a multi-tiered process for the co-creation of knowledge and solutions to major socio-environmental problems.

Enhanced biosurveillance of high-consequence invasive pests: southern cattle fever ticks, Rhipicephalus (Boophilus) microplus, on livestock and wildlife

Background

Some tick species are invasive and of high consequence to public and veterinary health. Socioeconomic development of rural parts of the USA was enabled partly through the eradication by 1943 of cattle fever ticks (CFT, Rhipicephalus (Boophilus) annulatus and R. (B.) microplus). The southern cattle fever ticks (SCFT, R. (B.) microplus) remain a real and present threat to the USA animal agriculture because they are established in Mexico. Livestock-wildlife interactions in the Permanent Quarantine Zone (PQZ) established by the century-old Cattle Fever Tick Eradication Programme (CFTEP) in south Texas endanger its operations.

Methods

We describe a spatially-explicit, individual-based model that simulates interactions between cattle, white-tailed deer (WTD, Odocoileus virginianus), and nilgai (Boselaphus tragocamelus) to assess the risk for SCFT infestations across the pathogenic landscape in the PQZ and beyond. We also investigate the potential role of nilgai in sustaining SCFT populations by simulating various hypothetical infestation and eradication scenarios.

Results

All infestation scenarios resulted in a phase transition from a relatively small proportion of the ranch infested to almost the entire ranch infested coinciding with the typical period of autumn increases in off-host tick larvae. Results of eradication scenarios suggest that elimination of all on-host ticks on cattle, WTD, or nilgai would have virtually no effect on the proportion of the ranch infested or on the proportions of different tick habitat types infested; the entire ranch would remain infested. If all on-host ticks were eliminated on cattle and WTD, WTD and nilgai, or cattle and nilgai, the proportions of the ranch infested occasionally would drop to 0.6, 0.6 and 0.2, respectively. Differences in proportions of the ranch infested from year to year were due to primarily to differences in winter weather conditions, whereas infestation differences among tick habitat types were due primarily to habitat use preferences of hosts.

Conclusions

Infestations in nilgai augment SCFT refugia enabled by WTD and promote pest persistence across the landscape and cattle parasitism. Our study documented the utility of enhanced biosurveillance using simulation tools to mitigate risk and enhance operations of area-wide tick management programmes like the CFTEP through integrated tactics for SCFT suppression.

Modeling rangelands as spatially-explicit complex adaptive systems

Rangelands cover one third of the earth's land area, provide livelihoods for one billion persons, and most have been degraded by overgrazing of domestic livestock. Recent debate about best management practices often has centered on comparison of continuous grazing and rotational grazing. Resolution to this debate may lie in viewing rangelands as complex adaptive systems. We describe a spatially-structured, individual-based model of rangelands that embodies this perspective, and simulate forage dynamics and cattle production under semi-arid rangeland conditions typical of the southern Great Plains of the USA employing both continuous and rotational grazing. Relative "success" of simulated grazing schemes depended primarily on the evaluation metric used (e.g., rangeland ecological condition, sale weight of cattle, secondary production efficiency) and the particular manage scheme employed, and neither continuous nor rotational grazing schemes were uniformly more successful. Our results demonstrate that solution of the grazing systems debate is unlikely to be found in a single group of grazing schemes, but, rather, in adaptive management of feedbacks among system components. The present work provides an example of how modeling rangelands as complex adaptive systems can aid in the evaluation of management schemes.

[Clinical effect of X-N advancement flap in repairing pressure ulcer on the buttock or back]

Objective: To explore the clinical effect of X-N advancement flap in repairing pressure ulcer on the buttock or back. Methods: From June 2018 to June 2019, 20 patients with grade Ⅳ pressure ulcers on the buttock or back were hospitalized and treated in the Department of Traumatology, Burns and Plastic Surgery of Fourth Affiliated Hospital of Guangxi Medical University, including 15 males and 5 females, aged 48-89 years. The area of the patient's wound was 8 cm×5 cm-15 cm×12 cm after debridement, and all were repaired with the X-N advancement flap designed by the author. The flap was designed according to the direction of skin relaxation on both sides of the wound, and the skin was incised in X-shape and sutured in N-shape. The width and advancement distance of the flap were recorded, and the ratio of the advancement distance to the width of the flap was calculated. The flap survival, complication, and follow-up were observed and recorded. Results: The width of the flap was (5.9±1.2) cm, the advancement distance of the flap was (10.3±2.5) cm, and the ratio of the advancement distance to the width of the flap was 1.8±0.4. All the flaps survived, and none of the flaps had blood flow disorder. Local dehiscence occurred in the flap of one patient 1 week after surgery, which was healed after laying on the floating bed, strengthened care, and wound dressing change. The flap of one patient developed infection 5 days after surgery, which was healed after partial suture removal, smooth drainage, and replacement with sensitive antibiotics. The wounds of the remaining 18 patients were all cured. After 3 months of follow-up, the flaps survived well with good elasticity and texture. Conclusions: The X-N advancement flap can make the skin and soft tissue move forward effectively. It is simple and effective to repair pressure ulcers on the back or buttock of patients with this flap, which is worthy of clinical promotion and application.

Preformed Cooper Pairs in Layered FeSe-Based Superconductors

Superconductivity arises from two distinct quantum phenomena: electron pairing and long-range phase coherence. In conventional superconductors, the two quantum phenomena generally take place simultaneously, while in the underdoped high- T_{c} cuprate superconductors, the electron pairing occurs at higher temperature than the long-range phase coherence. Recently, whether electron pairing is also prior to long-range phase coherence in single-layer FeSe film on SrTiO_{3} substrate is under debate. Here, by measuring Knight shift and nuclear spin-lattice relaxation rate, we unambiguously reveal a pseudogap behavior below T_{p}∼60  K in two kinds of layered FeSe-based superconductors with quasi2D nature. In the pseudogap regime, a weak diamagnetic signal and a remarkable Nernst effect are also observed, which indicates that the observed pseudogap behavior is related to superconducting fluctuations. These works confirm that strong phase fluctuation is an important character in the 2D iron-based superconductors as widely observed in high-T_{c} cuprate superconductors.

Probiotic fermented feed improved the production, health and nutrient utilisation of yellow-feathered broilers reared in high altitude in Tibet

1. Probiotic fermented feed (PFF) has been widely used in poultry production. The current study was designed to investigate whether PPF could alleviate the negative effects of hypoxia on yellow-feathered broilers reared at high altitude on the Tibet Plateau. 2. A total of 480, one-day-old male Lingnan yellow-feathered broilers were divided into four treatment groups with six replicates, each containing 20 broiler chickens. Broilers in the four groups were offered either a basal diet (without antibiotics) or test diets containing 5, 10 and 15% of PFF respectively. The experiment lasted for eight weeks. 3. Birds fed the 10% PFF diet exhibited increased (P < 0.05) average daily gain (ADG) on d 28 and 56, body weight (BW) on d 56, total tract apparent digestibility (TTAD) of dry matter (DM), crude protein (CP) and gross energy (GE). Feeding diets supplemented with 10% PFF increased (P < 0.05) digestive activity and gut development in duodenum and jejunum. Supplementation with 10% or 15% PFF significantly increased (P < 0.05) the caecal populations of Lactobacilli and Bifidobacteria spp. and decreased (P < 0.05) caecal E. coli and Salmonella spp. on d 28 and 56. 4. The ADG and BW on d 56, protease activity in duodenum on d 56 and jejunum on d 28 and 56, villus height and villi absorptive area in duodenum and jejunum and caecal Bifidobacteria spp. showed a quadratic (P < 0.05) dose response as supplemental PFF level increased. The TTAD of DM and CP and caecal Lactobacilli spp. increased linearly with PFF level. The caecal populations of E. coli and Salmonella spp. decreased linearly with PFF level. 5. In conclusion, addition of PFF in broiler diets had the potential to improve production performance, nutrient utilisation, intestinal digestive function and caecal microflora in yellow broiler chickens raised at high altitude.

Roles of nurses and National Nurses Associations in combating COVID-19: Taiwan experience

As the COVID‐19 pandemic continues to expand worldwide, Taiwan has effectively contained the spread domestically and protected its citizens after registering its first case relatively early on 21 January 2020. Proactive preparedness and deployment by the national government, timely evidence and experience‐based judgements and decision‐making, information transparency, rapid response, and effective communication and measures have all been critical to combating COVID‐19 in Taiwan. Nurses play a pivotal role in providing direct health care as well as providing contact tracing and care for the quarantined clients and community care services. The Taiwan Nurses Association and other nurses’ associations serve a vital leadership role in advocating for nurses, raising public awareness, enhancing nursing’s professional profile, and sharing experiences via national and international platforms. The implications for nursing and health policy are that we need to well prepare for any unpredicted emerging pandemic in the future. Providing adequate personal protective equipment and safe staffing should be the highest priority for the governments and policymakers around the world to combat pandemic successfully.

[The impact of metabolic syndrome and its individual components on long-term prognosis of patients undergoing percutaneous coronary intervention]

Objective: To investigate the impact of metabolic syndrome (MS) and its individual components on long-term prognosis of patients undergoing percutaneous coronary intervention(PCI). Methods: Patients who underwent PCI in Fuwai Hospital in 2013 were enrolled and divided to two groups: with MS and without MS. The primary endpoint of 2-year follow-up was major adverse cardiovascular events (MACE), including death, myocardial infarction, and repeat revascularization. Results: Of the 10 422 PCI patients, there were 5 656 (54.27%) without MS and 4 766 (45.73%) with MS. Patients in the MS group were younger, tended to be male and had more comorbidities. There were no significant differences between the two groups in the proportion of drug-coated stents and the success rate of interventional therapy. The 2-year follow-up showed that the incidence of MACE in the MS group was significantly higher than that in the MS-free group (12.0% vs 10.0%, P<0.001), which was mainly due to the significantly higher revascularization rate in the MS group than in the non-MS group (9.5% vs 7.9%, P=0.003). Cox's regression analysis showed that MS was an independent risk factor for MACE. In MS component analysis, abnormal glucose metabolism was an independent risk factor for MACE events. Conclusions: Among the patients undergoing PCI, the incidence of MACE in patients with MS is significantly higher than that in patients without MS, and MS was an independent risk factor for MACE. In addition, hyperglycemia is an independent predictor for MACE.

Increasing Incidence of Anaplasmosis in the United States, 2012 Through 2016

Anaplasmosis is a tick-borne disease that is primarily caused by the rickettsial bacterium Anaplasma phagocytophilum. Anaplasmosis is a febrile disease with common symptoms, including headaches, fever, and lethargy, but it can cause serious organ failure and even death if left untreated. Human infections are reported annually to the Centers for Disease Control and Prevention (CDC) through the National Notifiable Diseases Surveillance System (NNDSS). This report analyzed the cases of anaplasmosis reported by the NNDSS from 2012 to 2016. In total, there were 15,778 reported A. phagocytophilum infections, and the incidence rate was 7.27 cases per million persons per year, with the number of reported cases increasing each year. The demographic group most affected was middle-aged and elderly white males. Infections were most abundant in the coastal northeast and northern midwest regions. Our study provides useful results for a basic understanding of incidence, distribution, and severity of A. phagocytophilum infections.

[Long-term prognostic value of mean platelet volume in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention]

Objective: To evaluate the relationship between admission mean platelet volume (MPV) and 2-year cardiac mortality in patients with stable coronary artery disease (CAD) undergoing elective percutaneous coronary intervention (PCI), and explored the consistence of this relationship in diabetes mellitus (DM) and non-DM subgroups. Method: A total of 4 293 patients who underwent PCI in Fuwai Hospital in 2013 were enrolled and divided into two groups according to MPV as follows: lower MPV (n=2 219, MPV≤10.5fL) and higher MPV (n=2 074, MPV>10.5fL). Result: Patients with high MPV had a higher rate of DM (30.4%(674/2 219) vs 34.5%(715/2 074)), smoking (53.3%(1 183/2219) vs 57.0%(1 182/2 074)), and previous coronary artery bypass grafting (CABG) (4.0%(88/2 219) vs 5.4%(112/2 074)), while left ventricular ejection fraction (LVEF) (64±7 vs 63±7), and glomerular filtration rate (eGFR) (92±14 vs 91±15) were lower compared with patients in the low MPV group (all P<0.05). In the laboratory examination, patients with high MPV had higher glycosylated hemoglobin, and lower platelet count (all P<0.05). In coronary angiography, there was no significant difference in SYNTAX scores, left main/three-vessel lesions, stent type, success rate of operation, and total stent length (all P>0.05). Compared with low MPV group, patients with high MPV had ahigher cardiac mortality [18 (0.9%) vs 5 (0.2%), P=0.004]. Kaplan-Meier analysis showed that compared to low MPV group, cardiac mortality in high MPV group was significantly higher (Log-rank P=0.004). Multivariate Cox regression analysis showed that high MPV was independently associated with 2-year cardiac mortality (HR 4.127, 95%CI 1.373 to 12.405, P=0.012). Receiver operating characteristic curve (ROC) analysis also showed that MPV had a good diagnostic value in predicting 2-year cardiac mortality (area under the curve=0.624, 95%CI: 0.511-0.738, P=0.04). Subgroup analysis showed that in patients with DM (HR 2.090, 95%CI 1.217-3.589, P=0.008) and male (HR 1.561, 95%CI 1.007-2.421, P=0.047), MPV was significantly related with cardiac mortality. Conclusion: In patients with stable CAD who underwent elective PCI, high MPV was independently associated with an increase in 2-year cardiac mortality, especially in patients with DM and male gender.

Increased Incidence of Ehrlichia chaffeensis Infections in the United States, 2012 Through 2016

Human ehrlichioses are tick-borne diseases that have been increasing in incidence in the United States during recent years. Ehrlichia chaffeensis is one of the primary bacteria that cause ehrlichiosis in humans, which typically results in fever-like symptoms, but may also be fatal if left untreated. E. chaffeensis infections are reported to the Centers for Disease Control and Prevention (CDC) through the National Notifiable Diseases Surveillance System (NNDSS). This study analyzed the cases of E. chaffeensis infections reported by the NNDSS from 2012 through 2016. There were 6786 cases and the incidence rate was 4.46 cases per million persons per year. The demographic group most commonly infected was white males between the ages of 40 and 64. Infections were most abundant in the southeast and midwest, particularly in Arkansas, Missouri, Tennessee, and Oklahoma, as well as much of the east coast. The number of cases reported each year from 2012 through 2016 was higher than the number reported in any of the previous 4 years. Ongoing surveillance and reporting of tick-borne diseases are critical to inform public health practice and guide disease treatment and prevention efforts.

Visceral leishmaniasis on the Indian Subcontinent: Efficacy of fipronil-based cattle treatment in controlling sand fly populations is dependent on specific aspects of sand fly ecology

BACKGROUND

Visceral leishmaniasis (VL) is a deadly disease transmitted by the sand fly Phlebotomus argentipes on the Indian subcontinent, with a promising means of vector control being orally treating cattle with fipronil-based drugs. While prior research investigating the dynamic relationship between timing of fipronil-based control schemes and the seasonality of sand flies provides insights into potential of treatment on a large scale, ecological uncertainties remain. We investigated how uncertainties associated with sand fly ecology might affect our ability to assess efficacy of fipronil-based control schemes. To do this, we used a previously-described, individual-based, stochastic sand fly model to quantify how uncertainties associated with 1) the percentage of female sand flies taking blood meals from cattle, and 2) the percentage of female sand flies ovipositing in organic matter containing feces from treated cattle might impact the efficacy of fipronil-based sand fly control schemes.

PRINCIPAL FINDINGS

Assuming no prior knowledge of sand fly blood meal and oviposition sites, the probabilities of achieving effective sand fly population reduction with treatments performed 3, 6 and 12 times per year were ≈5-22%, ≈27-36%, and ≈46-54%, respectively. Assuming ≥50% of sand flies feed on cattle, probabilities of achieving efficacious control increased to ≈8-31%, ≈15-42%, and ≈52-65%. Assuming also that ≥50% of sand flies oviposit in cattle feces, the above probabilities increased further to ≈14-53%, ≈31-81%, and ≈89-97%.

CONCLUSIONS

Our assessments of the efficacy of fipronil-based cattle treatments in controlling sand fly populations depend on our assumptions regarding key aspects of sand fly ecology. Assessments are most sensitive to assumptions concerning the percentage of sand flies ovipositing in feces of treated cattle, thus emphasizing the importance of identifying sand fly oviposition sites. Our results place the evaluation of fipronil-based cattle treatment within a broader ecological context, which could aid in the planning and execution of a largescale field trial.

Effects of indoor stocking density on performance, egg quality, and welfare status of a native chicken during 22 to 38 weeks

This study investigated the effects of indoor stocking density on performance, egg quality, and welfare status of a native chicken, Beijing You Chicken (BYC), during 22 to 38 wk. A total of 1,040 19-wk-old BYC pullets were randomly allocated to 4 groups (2 replicates each) and reared in 8 individual floor pens with separate covered shed and uncovered outdoor areas. The indoor stocking densities were 5, 6, 7, and 8 hens/m2, and the birds were fed corn-soybean based diets. The performance was calculated for 22 to 30, 30 to 38, and 22 to 38 wk, and egg quality indices were measured at the end of weeks 26, 29, and 36. The feather cover and gait score of the birds were assessed at the end of weeks 29 and 36. The results showed that average feed intake (AFI) and mortality rate of BYC in the 8 hens/m2 group were higher than other groups during 22 to 30 wk (P = 0.001 and P = 0.005); the egg mass and egg-laying rate were higher in groups with lower stocking density, in contrast to the feed egg ratio during 30 to 38 wk. The AFI, mortality rate, and 38-wk body weight were affected by stocking density during 22 to 38 wk (P < 0.05). Most of egg quality indices were not changed by stocking density (P > 0.05), except for individual indicators, such as Haugh unit at week 26 (P = 0.012) and egg grade at week 29 (P = 0.026). The feather cover and gait scores of birds were affected by indoor stocking density at 36 wk of age, with the 8 hens/m2 group having lower scores than the 5, 6, and 7 hens/m2 groups (P = 0.042 and P = 0.039), whereas the 7 hens/m2 groups having no difference with the 5 and 6 hens/m2 groups (P > 0.05). Overall, the results suggested that the performance and egg quality of BYC were not significantly affected by equal to or less than 7 hens/m2 under this system (P > 0.05), but 8 hens/m2 had an adverse effect on the performance and welfare status of the native chicken during 22 to 38 wk.

Dynamics of animal joint space use: a novel application of a time series approach

BACKGROUND

Animal use is a dynamic phenomenon, emerging from the movements of animals responding to a changing environment. Interactions between animals are reflected in patterns of joint space use, which are also dynamic. High frequency sampling associated with GPS telemetry provides detailed data that capture space use through time. However, common analyses treat joint space use as static over relatively long periods, masking potentially important changes. Furthermore, linking temporal variation in interactions to covariates remains cumbersome. We propose a novel method for analyzing the dynamics of joint space use that permits straightforward incorporation of covariates. This method builds upon tools commonly used by researchers, including kernel density estimators, utilization distribution intersection metrics, and extensions of linear models.

METHODS

We treat the intersection of the utilization distributions of two individuals as a time series. The series is linked to covariates using copula-based marginal beta regression, an alternative to generalized linear models. This approach accommodates temporal autocorrelation and the bounded nature of the response variable. Parameters are easily estimated with maximum likelihood and trend and error structures can be modeled separately. We demonstrate the approach by analyzing simulated data from two hypothetical individuals with known utilization distributions, as well as field data from two coyotes (Canis latrans) responding to appearance of a carrion resource in southern Texas.

RESULTS

Our analysis of simulated data indicated reasonably precise estimates of joint space use can be achieved with commonly used GPS sampling rates (s.e.=0.029 at 150 locations per interval). Our analysis of field data identified an increase in spatial interactions between the coyotes that persisted for the duration of the study, beyond the expected duration of the carrion resource. Our analysis also identified a period of increased spatial interactions before appearance of the resource, which would not have been identified by previous methods.

CONCLUSIONS

We present a new approach to the analysis of joint space use through time, building upon tools commonly used by ecologists, that permits a new level of detail in the analysis of animal interactions. The results are easily interpretable and account for the nuances of bounded serial data in an elegant way.

[High dose melphalan (HDM) is superior to cyclophosphamide plus etoposide and busulfan (CVB) as the conditioning regimen in autologous stem cell transplantation for multiple myeloma]

目的

比较大剂量美法仑（HDM）和环磷酰胺、依托泊苷联合白消安（CVB）预处理方案应用于新诊断多发性骨髓瘤（NDMM）患者自体造血干细胞移植（ASCT）的安全性、近期及远期疗效。

方法

回顾性分析2011年1月至2017年8月期间接受PAD（硼替佐米+脂质体阿霉素+地塞米松）方案诱导治疗序贯ASCT的NDMM患者共123例，按接受预处理方案分为CVB组（82例）和HDM组（41例）。

结果

①非血液学不良反应方面两者无显著区别。②CVB组中性粒细胞植入和血小板植入较HDM组快，中性粒细胞植入时间为第10（9~35）天对第11（9~12）天（z=−3.433，P=0.001）；血小板植入时间为11（7~55）d对HDM组13（10~35）d（z=−3.506，P<0.001）；但CVB组也更早进入粒细胞缺乏（粒缺）及显著血小板减少，最终粒缺及显著血小板减少持续时间两组间尚未显示出差别；但CVB组的发热持续时间以及相应抗生素使用时间显著延长。③CVB组经过移植后获得传统疗效进步的患者比例显著低于HDM组（9/46对14/28，P=0.021）；而且移植后3个月CVB组的微小残留病（MRD）阴性率有低于HDM组的趋势（31.7%对48.8%，P=0.065）。④无论单因素还是多因素分析均显示两种预处理方案并不影响接受PAD诱导序贯ASCT及维持治疗的NDMM患者的至进展时间（TTP）（P= 0.619）及总生存（OS）时间（P=0.295）。

结论

HDM预处理方案血液学不良反应、减低MM肿瘤负荷以及使用方便性方面较CVB方案具有优势，但采用两种预处理方案的ASCT治疗MM的TTP和OS未见明显差异。

[Clinical characteristics and prognosis between male and female patients with premature coronary artery disease after intervention]

Objective: To compare the clinical characteristics and long-term prognosis between male and female patients with premature coronary artery disease (PCAD) post coronary intervention, and analyse the risk factors of major adverse cardio-cerebrovascular events (MACCE) and bleeding events. Methods: This was a prospective single-center observational study. From January 2013 to December 2013, 4 744 patients diagnosed as PCAD and treated with percutaneous coronary intervention (PCI) in Fuwai Hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and patients were followed up for 2 years after PCI and the incidence of events including MACCE and bleeding was analyzed. The baseline data and clinical events of PCAD patients of different genders were compared. Survival curves were estimated by Kaplan-Meier method. Univariate and multivariate Cox regression were used to analyze whether gender was an influencing factor of different clinical events of PCAD patients within 2 years after PCI, and other relevant influencing factors of MACCE and bleeding events. Results: Among the 4 744 PCAD patients included, there were 3 390 (71.5%) male aged (47.0±5.4) years old and 1 354 (28.5%) female aged (57.0±5.8) years old. Compared with female patients, male patients had higher body mass index, higher proportion of hyperlipidemia, smoking, myocardial infarction, previous PCI, preoperative estimated glomerular filtration rate, ST-segment elevation myocardial infarction, radial artery approach, intravenous ultrasound use and chronic occlusive lesions (all P<0.05). Age, left ventricular ejection fraction, prevalence of hypertension, diabetes mellitus, past stroke history, non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and the use of calcium channel blockers were lower in male patients than in female patients (all P<0.05). The 2-year follow-up results showed that the incidence of BARC type 1 hemorrhage was significantly higher in female patients than in male patients (6.9%(92/1 343) vs. 3.7%(126/3 378), P<0.001); however, the incidence of MACCE, all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC type 2-5 hemorrhage were similar between the two groups (all P>0.05). Multivariate Cox regression analysis showed that gender was an independent risk factor for BARC type 1 bleeding in PCAD patients (HR=2.180, 95%CI 1.392-3.416, P<0.001), but it was not an independent risk factor for MACCE and BARC type 2-5 bleeding(all P>0.05). Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (the HRs(95%CI) were 1.289(1.052-1.580), 1.030(1.019-1.042), 1.758(1.365-2.264), 1.264(1.040-1.537), respectively); gender (HR=1.579, 95%CI 1.085-2.297, P=0.017), hyperlipidemia (HR=1.305, 95%CI 1.005-1.695, P=0.046), anticoagulant drugs including low molecular weight heparin (HR=1.321, 95%CI 1.002-1.741, P=0.048) or sulfonate(HR=1.659, 95%CI 1.198-2.298, P=0.002) were the independent risk factors for bleeding events. Conclusions: There are differences in clinical and coronary artery lesion characteristics between different genders in patients with PCAD. The incidence of minor bleeding is significantly higher in female PCAD patients than in male PCAD patients. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS are the independent risk factors for MACCE, and gender, hyperlipidemia, anticoagulant drugs including low molecular weight heparin or sulfonate are the independent risk factors for bleeding events in patients with PCAD.

Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.