Search results for: Ye Qing

Authors: Hainan Chen, Jina Qing, Xiao Zhu, Ling Gao, Ampadu O. Jackson, Min Zhang, Kai Yin

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Objective: Editing macrophage activation to dampen inflammatory diseases by promoting the repolarization of inflammatory (M1) macrophages to anti-inflammatory (M2) macrophages is highly associated with mitochondrial respiration. Recent studies have suggested that mitochondrial apolipoprotein A-1 binding protein (APOA1BP) was essential for the cellular metabolite NADHX repair to NADH, which is necessary for the mitochondrial function. The exact role of APOA1BP in the repolarization of M1 to M2, however, is uncertain. Material and method: THP-1-derived macrophages were incubated with LPS (10 ng/ml) or/and IL-4 (100 U/ml) for 24 hours. Biochemical parameters of oxidative phosphorylation and M1/M2 markers were analyzed after overexpression of APOA1BP in cells. Results: Compared with control and IL-4-exposed M2 cells, APOA1BP was downregulated in M1 macrophages. APOA1BP restored the decline in mitochondrial function to improve metabolic and phenotypic reprogramming of M1 to M2 macrophages. Blocking oxidative phosphorylation by oligomycin blunts the effects of APOA1BP on M1 to M2 repolarization. Mechanistically, LPS triggered the hydration of NADH and increased its hydrate NADHX which inhibit cellular NADH dehydrogenases, a key component of electron transport chain for oxidative phosphorylation. APOA1BP decreased the level of NADHX via converting R-NADHX to biologically useful S-NADHX. The mutant of APOA1BP aspartate188, the binding site of NADHX, fail to repair oxidative phosphorylation, thereby preventing repolarization. Conclusions: Restoring mitochondrial function by increasing mitochondrial APOA1BP might be useful to improve the reprogramming of inflammatory macrophages into anti-inflammatory cells to control inflammatory diseases.

Keywords: inflammatory diseases, macrophage repolarization, mitochondrial respiration, apolipoprotein A-1 binding protein, NADHX, NADH

Procedia PDF Downloads 142

Authors: Haifeng Zhou, Tsungyang Liow, Xiaoguang Tu, Eujin Lim, Chao Li, Junfeng Song, Xianshu Luo, Ying Huang, Lianxi Jia, Lianwee Luo, Qing Fang, Mingbin Yu, Guoqiang Lo

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With the development of technology, countries gradually allocated more and more frequency spectrums for civilization and commercial usage, especially those high radio frequency bands indicating high information capacity. The field effect becomes more and more prominent in microwave components as frequency increases, which invalidates the transmission line theory and complicate the design of microwave components. Here a modeling approach based on numerical search algorithm is proposed to design various building blocks for microwave circuits to avoid complicated impedance matching and equivalent electrical circuit approximation. Concretely, a microwave component is discretized to a set of segments along the microwave propagation path. Each of the segment is initialized with random dimensions, which constructs a multiple-dimension parameter space. Then numerical searching algorithms (e.g. Pattern search algorithm) are used to find out the ideal geometrical parameters. The optimal parameter set is achieved by evaluating the fitness of S parameters after a number of iterations. We had adopted this approach in our current projects and designed many microwave components including sharp bends, T-branches, Y-branches, microstrip-to-stripline converters and etc. For example, a stripline 90° bend was designed in 2.54 mm x 2.54 mm space for dual-band operation (Ka band and Ku band) with < 0.18 dB insertion loss and < -55 dB reflection. We expect that this approach can enrich the tool kits for microwave designers.

Keywords: microwave component, microstrip and stripline, bend, power division, the numerical search algorithm.

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Authors: Yue Sun, Yuan Wang

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The Grand Canal of China has been in use for more than two thousand years. It runs through the central and eastern regions of China and communicates with the five major river systems of Haihe River, Yellow River, Huaihe River, Yangtze River and Qiantang River from north to south. It is a complex, systematic and comprehensive water conservancy project in the period of agricultural civilization and includes the three parts of the Beijing-Hangzhou Canal, the Sui and Tang Dynasties Canal and the Eastern Zhejiang Canal. It covers eight provinces and cities including Beijing, Tianjin, Hebei, Shandong, Jiangsu, Zhejiang, Henan and Anhui. The Grand Canal is an important channel connecting the Central Plains and the Beijing-Hangzhou Canal, and it is also an important waterway trade channel. Nowadays, although the Grand Canal no longer bears the burden of communicating water transportation between the north and the south, the site of the Grand Canal is still a “historical museum” of the lifestyle of people who lived on the canal from the Ming and Qing Dynasties to the Republic of China. By means of literature reading and field investigation, this paper compares the different protection strategies of the Grand Canal in the region between the ancient villages of Huaxian and Xunxian, which witness the vicissitudes of canal water transport, to explore whether the protective renovation of historical and cultural routes is “protection” or “destruction”, and puts forward some protection suggestions.

Keywords: The Grand Canal, heritage conservation, cultural route, ancient villages, strategies

Procedia PDF Downloads 131

Authors: Chun-Qing Li, Guoyang Fu, Wei Yang

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A significant portion of current water networks is made of cast iron pipes. Due to aging and deterioration with corrosion being the most predominant mechanism, the failure rate of cast iron pipes is very high. Although considerable research has been carried out in the past few decades, most are on the effect of corrosion on the structural capacity of pipes using strength theory as the failure criterion. This paper presents a reliability-based methodology for the assessment of corrosion affected cast iron pipe cracking failures. A nonlinear limit state function taking into account all three fracture modes is proposed for brittle metal pipes with mixed mode fracture. A stochastic model of the load effect is developed, and time-dependent reliability method is employed to quantify the probability of failure and predict the remaining service life. A case study is carried out using the proposed methodology, followed by sensitivity analysis to investigate the effects of the random variables on the probability of failure. It has been found that the larger the inclination angle or the Mode I fracture toughness is, the smaller the probability of pipe failure is. It has also been found that the multiplying and exponential coefficients k and n in the power law corrosion model and the internal pressure have the most influence on the probability of failure for cast iron pipes. The methodology presented in this paper can assist pipe engineers and asset managers in developing a risk-informed and cost-effective strategy for better management of corrosion-affected pipelines.

Keywords: corrosion, inclined surface cracks, pressurized cast iron pipes, stress intensity

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

Procedia PDF Downloads 130

Authors: Hao-Su Liu, Jun-Qing Lei

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This study introduces the theory of modified particle swarm optimizer and its application in time-domain expressions for bridge self-excited aerodynamic forces. Based on the indicial function expression and the rational function expression in time-domain expression for bridge self-excited aerodynamic forces, the characteristics of the two methods, i.e. the modified particle swarm optimizer and conventional search method, are compared in flutter derivatives’ fitting process. Theoretical analysis and numerical results indicate that adopting whether the indicial function expression or the rational function expression, the fitting flutter derivatives obtained by modified particle swarm optimizer have better goodness of fit with ones obtained from experiment. As to the flutter derivatives which have higher nonlinearity, the self-excited aerodynamic forces, using the flutter derivatives obtained through modified particle swarm optimizer fitting process, are much closer to the ones simulated by the experimental. The modified particle swarm optimizer was used to recognize the parameters of time-domain expressions for flutter derivatives of an actual long-span highway-railway truss bridge with double decks at the wind attack angle of 0°, -3° and +3°. It was found that this method could solve the bounded problems of attenuation coefficient effectively in conventional search method, and had the ability of searching in unboundedly area. Accordingly, this study provides a method for engineering industry to frequently and efficiently obtain the time-domain expressions for bridge self-excited aerodynamic forces.

Keywords: time-domain expressions, bridge self-excited aerodynamic forces, modified particle swarm optimizer, long-span highway-railway truss bridge

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Authors: Jiahua Zhang, Qing Chang, Fengmei Yao

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Studying on the response of vegetation phenology to climate change at different temporal and spatial scales is important for understanding and predicting future terrestrial ecosystem dynamics andthe adaptation of ecosystems to global change. In this study, the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) dataset and climate data were used to analyze the dynamics of grassland phenology as well as their correlation with climatic factors in different eco-geographic regions and elevation units across the Tibetan Plateau. The results showed that during 2003–2012, the start of the grassland greening season (SOS) appeared later while the end of the growing season (EOS) appeared earlier following the plateau’s precipitation and heat gradients from southeast to northwest. The multi-year mean value of SOS showed differences between various eco-geographic regions and was significantly impacted by average elevation and regional average precipitation during spring. Regional mean differences for EOS were mainly regulated by mean temperature during autumn. Changes in trends of SOS in the central and eastern eco-geographic regions were coupled to the mean temperature during spring, advancing by about 7d/°C. However, in the two southwestern eco-geographic regions, SOS was delayed significantly due to the impact of spring precipitation. The results also showed that the SOS occurred later with increasing elevation, as expected, with a delay rate of 0.66 d/100m. For 2003–2012, SOS showed an advancing trend in low-elevation areas, but a delayed trend in high-elevation areas, while EOS was delayed in low-elevation areas, but advanced in high-elevation areas. Grassland SOS and EOS changes may be influenced by a variety of other environmental factors in each eco-geographic region.

Keywords: grassland, phenology, MODIS, eco-geographic regions, elevation, climatic factors, Tibetan Plateau

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Authors: Dan Wang, Qing Ma, Xiaodan Wang, Tianjiao Qi

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The sound of peddling in Beijing, also called “yo-heave-ho” or “cry of one's ware”, is a unique folk culture and usually found in Beijing hutong. For the civilians in Beijing, sound of peddling is part of their childhood. And for those who love the traditional culture of Beijing, it is an old song singing the local conditions and customs of the ancient city. For example, because of his great appreciation, the British poet Osbert Stewart once put sound of peddling which he had heard in Beijing as a street orchestra performance in the article named "Beijing's sound and color".This research aims to collect and integrate the voice/photo resources and historical materials of sound concerning peddling in Beijing by digital technology in order to protect the intangible cultural heritage and pass on the city memory. With the goal in mind, the next stage is to collect and record all the materials and resources based on the historical documents study and interviews with civilians or performers. Then set up a metadata scheme (which refers to the domestic and international standards such as "Audio Data Processing Standards in the National Library", DC, VRA, and CDWA, etc.) to describe, process and organize the sound of peddling into a database. In order to fully show the traditional culture of sound of peddling in Beijing, web design and GIS technology are utilized to establish a website and plan holding offline exhibitions and events for people to simulate and learn the sound of peddling by using VR/AR technology. All resources are opened to the public and civilians can share the digital memory through not only the offline experiential activities, but also the online interaction. With all the attempts, a multi-media narrative platform has been established to multi-dimensionally record the sound of peddling in old Beijing with text, images, audio, video and so on.

Keywords: sound of peddling, GIS, metadata scheme, VR/AR technology

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Authors: Meng Qing Feng, Otsile Morake

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Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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Authors: He Li Wen, Meng Qing Xiang, Li De Yong, Zhang Ya Wei, Ren Li Ping

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Stress always exerts some extent adverse effects on the animal production, food safety and quality concerns. Stress is commonly-seen in livestock industry, but there is rare literature focusing on the effects of nutrition stress. What’s more, the research always concentrates on the effect of single stress additionally, there is scarce information about the stress effect on waterfowl like goose as they are commonly thought to be tolerant to stress. To our knowledge, it is not always true. The object of this study was to evaluate the response of growing Greylag geese offered different fiber sources to the comprehensive stress, primarily involving the procedures of fasting, transport, capture, etc. The birds were randomly selected to rear with the diets differing in fiber source, being corn straw silage (CSS), steam-exploded corn straw (SECS), steam-exploded wheat straw (SEWS), and steam-exploded rice straw (SERS), respectively. Blood samples designated for the determination of stress status were collected before (pre-stress ) and after (post-stress ) the stressors carried out. No difference (P>0.05) was found on the pre-stress blood parameters of growing Greylags fed alternative fiber sources. Irrespective of the dietary differences, the comprehensive stress decreased (P<0.01) the concentration of SOD and increased (P<0.01) that of CK. Between the dietary treatments, the birds fed CSS had a higher (P<0.05)post-stress concentration of MDA than those offered SECS, along with a similarity to those fed the other two fiber sources. There was no difference (P>0.05) found on the stress response of the birds fed different fiber sources. In conclusion, SOD and CK concentration in blood may be more sensitive in indicating stress status and dietary fiber source exerted no effect on the stress response of growing Greylags. There is little chance to improve the stress status by ingesting different fiber sources.

Keywords: blood parameter, fiber source, Greylag goose, stress

Procedia PDF Downloads 482

Authors: Qing Li, Maiko Kobayashi, Shigeyoshi Kumeda, Hiroko Ochiai, Toshiya Ochiai, Takashi Miura, Takahide Kagawa, Michiko Imai, Toshiaki Otsuka, Tomoyuki Kawada

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In the present study, we investigated the effects of a forest bathing program on cardiovascular and metabolic parameters. Nineteen healthy male subjects (mean age: 51.3 ± 8.8 years) were selected after obtaining informed consent. These subjects took day trips to a forest park named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled in the morning before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured by an ambulatory automatic blood pressure monitor. The Japanese version of the profile of mood states (POMS) test was conducted before, during and after the trips. Ambient temperature and humidity were monitoring during the trips. The forest bathing program significantly reduced pulse rate, and significantly increased the score for vigor and decreased the scores for depression, fatigue, and confusion in the POMS test. The levels of urinary noradrenaline and dopamine after forest bathing were significantly lower than those after urban area walking, suggesting the relaxing effect of the forest bathing program. The level of adiponectin in serum after the forest bathing program was significantly greater than that after urban area walking. There was no significant difference in blood pressure between forest and urban area trips during the trips.

Keywords: ambient temperature, blood pressure, forest bathing, forest therapy, human health, POMS, pulse rate

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Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

Procedia PDF Downloads 228

Authors: Zhi-Wei Zheng, Zhong-Qi Liu, Jia-Ling Qiu, Shan-Qing Guo, Zhong-Wei Jia, Chun Hao

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Objectives: The purpose of this study was to understand and examine the association between diurnal mood variation and sexual/health-related status among men who have sex with men (MSM) using data from MSM Chinese Twitter messages. The study consists of 843,745 postings of 377,610 MSM users located in Guangdong that were culled from the MSM Chinese Twitter App. Positive affect, negative affect, sexual related behaviors, and health-related status were measured using the Simplified Chinese Linguistic Inquiry and Word Count. Emotions, including joy, sadness, anger, fear, and disgust were measured using the Weibo Basic Mood Lexicon. A positive sentiment score and a positive emotions score were also calculated. Linear regression models based on a permutation test were used to assess associations between affective states and sexual/health-related status. In the results, 5,871 active MSM users and their 477,374 postings were finally selected. MSM expressed positive affect and joy at 8 a.m. and expressed negative affect and negative emotions between 2 a.m. and 4 a.m. In addition, 25.1% of negative postings were directly related to health and 13.4% reported seeking social support during that sensitive period. MSM who were senior, educated, overweight or obese, self-identified as performing a versatile sex role, and with less followers, more followers, and less chat groups mainly expressed more negative affect and negative emotions. MSM who talked more about sexual-related behaviors had a higher positive sentiment score (β=0.29, p < 0.001) and a higher positive emotions score (β = 0.16, p < 0.001). MSM who reported more on their health status had a lower positive sentiment score (β = -0.83, p < 0.001) and a lower positive emotions score (β = -0.37, p < 0.001). The study concluded that psychological intervention based on an app for MSM should be conducted, as it may improve mental health.

Keywords: affect, men who have sex with men, sexual related behavior, health-related status, social media

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Authors: Ziwei Guo, Liangping Hong, Zhiguo Ye

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The exogenous modernization process in China and other late-coming countries, is not resulted from a gradual growth of their own modernity features, but a conscious response to external challenges. Under this context, it had been equally important for Chinese cities to make themselves ‘Chinese’ as well as ‘modern’. Wuhan was the first opened inland treaty port in late Qing Dynasty. In the following one hundred years, Wuhan transferred from a feudal town to a modern industrial city. It is a good example to illustrate the urban construction and cultural heritage through the process and impact of social transformation. An overall perspective on transformation will contribute to develop the city`s uniqueness and enhance its inclusive development. The study chooses the history of Wuhan from 1861 to 1957 as the study period. The whole transformation process will be divided into four typical periods based on key historical events, and the paper analyzes the changes on urban structure and constructions activities in each period. Then, a lot of examples are used to compare the features of Wuhan modern city heritage in the four periods. In this way, three characteristics of Wuhan modern city heritage are summarized. The paper finds that globalization and localization worked together to shape the urban physical space environment. For Wuhan, social transformation has a profound and comprehensive impact on urban construction, which can be analyzed in the aspects of main construction, architecture style, location and actors. Moreover, the three towns of Wuhan have a disparate cityscape that is reflected by the varied heritages and architecture features over different transformation periods. Lastly, the protection regulations and conservation planning of heritage in Wuhan are discussed, and suggestions about the conservation of Wuhan modern heritage are tried to be drawn. The implications of the study are providing a new perspective on modern city heritage for cities like Wuhan, and the future local planning system and heritage conservation policies can take into consideration the ‘Modern Cultural Transformation Route’ in this paper.

Keywords: modern city heritage, transformation, identity, Wuhan

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Authors: Emile Niringiyimana, LI Ji Qing, Giovanni Dushimimana, Virginie Umwere

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The development and utilization of renewable energy (RE) can not only effectively reduce carbon dioxide (CO2) emissions, but also became a solution to electricity shortage mitigation in rural areas. Hybrid RE systems are promising ways to provide consistent and continuous power for isolated areas. This work investigated the prospect and cost effectiveness of hybrid system complementarity between a 100kW solar PV system and a small-scale 200kW hydropower station in the South of Rwanda. In order to establish the optimal size of a RE system with adequate sizing of system components, electricity demand, solar radiation, hydrology, climate data are utilized as system input. The average daily solar radiation in Rukarara is 5.6 kWh/m2 and average wind speed is 3.5 m/s. The ideal integrated RE system, according to Homer optimization, consists of 91.21kW PV, 146kW hydropower, 12 x 24V li-ion batteries with a 20kW converter. The method of enhancing such hybrid systems control, sizing and choice of components is to reduce the Net present cost (NPC) of the system, unmet load, the cost of energy and reduction of CO2. The power consumption varies according to dominant source of energy in the system by controlling the energy compensation depending on the generation capacity of each power source. The initial investment of the RE system is $977,689.25, and its operation and maintenance expenses is $142,769.39 over a 25-year period. Although the investment is very high, the targeted profits in future are huge, taking into consideration of high investment in rural electrification structure implementations, tied with an increase of electricity cost and the 5 years payback period. The study outcomes suggest that the standalone hybrid PV-Hydropower system is feasible with zero pollution in Rukara community.

Keywords: HOMER optimization, hybrid power system, renewable energy, NPC and solar pv systems

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Authors: Luojie Tang

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Riverside space is an important public space and ecological corridor in urban areas, but mountainous urban rivers are often overlooked due to their deep valleys and poor accessibility. This article takes the Qing Shui Xi River in Chongqing as an example, and through long-term field inspections, measurements, interviews, and online surveys, summarizes the problems of poor accessibility, limited space for renovation, lack of waterfront facilities, excessive artificial intervention, low average runoff, severe river water pollution, and difficulty in integrated watershed management in riverside space. Based on the current situation and drawing on relevant experiences, this article summarizes the design methods for riverside space in deep valley rivers in mountainous urban areas. Regarding spatial design techniques, the article emphasizes the importance of integrating waterfront spaces into the urban public space system and vertical linkages. Furthermore, the article suggests different design methods and improvement strategies for the already developed areas and new development areas. Specifically, the article proposes a planning and design strategy of "protection" and "empowerment" for new development areas and an updating and transformation strategy of "improvement" and "revitalization" for already developed areas. In terms of ecological restoration methods, the article suggests three focus points: increasing the runoff of urban rivers, raising the landscape water level during dry seasons, and restoring vegetation and wetlands in the riverbank buffer zone while protecting the overall pattern of the watershed. Additionally, the article presents specific design details of the Qingshuixi River to illustrate the proposed design and restoration techniques.

Keywords: deep-cut river, design method, mountainous city, Qingshuixi river in Chongqing, waterfront space design

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Authors: Su Yin Chiam, Qing Xin Zhang, Jaehoon Chung

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Complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) have obtained increased attention in the biosensor community because CMOS technology provides cost-effective and high-performance signal processing at a mass-production level. In order to supply biological samples and reagents effectively to the sensing elements, there are increasing demands for seamless integration of microfluidic components on the fabricated CMOS wafers by post-processing. Although the PDMS microfluidic channels replicated from separately prepared silicon mold can be typically aligned and bonded onto the CMOS wafers, it remains challenging owing the inherently limited aligning accuracy ( > ± 10 μm) between the two layers. Here we present a new post-processing method to create three-dimensional microfluidic components using two different polarities of photoresists, an epoxy-based negative SU-8 photoresist and positive SPR220-7 photoresist. The positive photoresist serves as a sacrificial layer and the negative photoresist was utilized as a structural material to generate three-dimensional structures. Because both photoresists are patterned using a standard photolithography technology, the dimensions of the structures can be effectively controlled as well as the alignment accuracy, moreover, is dramatically improved (< ± 2 μm) and appropriately can be adopted as an alternative post-processing method. To validate the proposed processing method, we applied this technique to build cell-trapping structures. The SU8 photoresist was mainly used to generate structures and the SPR photoresist was used as a sacrificial layer to generate sub-channel in the SU8, allowing fluid to pass through. The sub-channel generated by etching the sacrificial layer works as a cell-capturing site. The well-controlled dimensions enabled single-cell capturing on each site and high-accuracy alignment made cells trapped exactly on the sensing units of CMOS biosensors.

Keywords: SU-8, microfluidic, MEMS, microfabrication

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Authors: Bing-Qing Lu, Hui-Tzu Min

Abstract:

Recent research, supported by sociocultural theory, has shown that collaborative writing in the second language (L2) contexts afford students opportunities to interact with each other to co-construct knowledge during the co-composing process. To date, much research on pair interaction in L2 collaborative writing settings has centered on intermediate and advanced learners by using static categorization of pair interaction patterns. Little is known about the fluid nature of pair interaction during collaborative writing, especially among low-proficiency learners. This study, thus, is aimed to explore the interaction dynamics of low-proficiency L2 learners during collaborative writing via examining the interaction pattern, focus of interaction, and the language related episodes (LREs) of 5 low-proficiency L2 writers from Taiwan. Employing a micro-level functional analytical method to capture the changing nature of pair interaction dynamics, the researchers calculated the number of characters/words produced by each pair member during CW and then classified their utterances into four task related-aspects--content, organization, language use, and task management--to determine each pair member's relative contribution to different dimensions of the evolving text. The LREs were also identified and examined. The results show that, of the five pairs, three pairs changed their interaction patterns when discussing different aspects of writing. Regarding the focus of their interaction, all five pairs paid attention to content most, followed by language use, task management, and organization. They were able to successfully resolve the majority of language issues (75.2%) in LREs and use the correct forms in their writing. These findings lend support to the fluid nature of pairs’ interactions and the changing roles of L2 learners in collaborative writing and highlighted the necessity of examining learners’ interaction patterns from a micro-level perspective. These findings also support previous research that low-proficiency pairs are able to correctly revolve 2/3 of their produced LREs, suggesting that collaborative writing may also be suitable for L2 low-proficiency learners.

Keywords: collaborative writing, low-proficiency L2 learners, micro-level functional analysis, pair interaction pattern

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Authors: Kuan Yin Hsiao, Shyh Ming Kuo, Yi Jhen Wu, Chin Wen Chuang, Chuen-Fu Lin, Wei-qing Yang, Han Hsiang Huang

Abstract:

Anti-tumor effects of natural products, like compounds from marine sponges and soft corals, have been investigated for decades. Polymeric nanoparticles prepared from biodegradable and biocompatible molecules, such as Hyaluronan (HA), Chitosan (CHI) and gelatin have been widely studied. Encapsulation of anti-cancer therapies by the biopolymeric nanoparticles in drug delivery system is potentially capable of improving the therapeutic effects and attenuating their toxicity. In the current study, the anti-bladder cancer effects of heteronemin extracted from the sponge Hippospongia sp. with or without HA and CHI nanoparticle encapsulation were assessed and evaluated in vitro. Results showed that IC50 (half maximal inhibitory concentration) of heteronemin toward T24 human bladder cancer cell viability is approximately 0.18 µg/mL. Both plain and HA nanoparticles-encapsulated heteronemin at 0.2 and 0.4 µg/mL significantly reduced T24 cell viability (P<0.001) while HA nanoparticles-encapsulated heteronemin showed weaker viability-inhibitory effects on L929 fibroblasts compared with plain heteronemin at the identical concentrations. HA and CHI nanoparticles-encapsulated heteronemin exhibited significantly stronger inhibitory effects against migration of T24 human bladder cancer cell than those exerted by plain heteronemin at the same concentrations (P<0.001). The flow cytometric results showed that 0.2 µg/mL HA and CHI nanoparticles-encapsulated heteronemin induced higher early apoptosis rate than that induced by plain heteronemin at the same concentration. These results show that HA and CHI nanoparticle encapsulation is able to elevate anti-migratory and apoptosis-inducing effects exerted by heteronemin against bladder cancer cells in vitro. The in vivo anti-bladder cancer effects of the compound with or without HA/CHI nanoparticle encapsulation will be further investigated and examined using murine tumor models. The data obtained from this study will extensively evaluate of the anti-bladder cancer effects of heteronemin as well as HA/CHI-encapsulated heteronemin and pave a way to develop potential bladder cancer treatment.

Keywords: heteronemin, nanoparticles, hyaluronan, chitosan, bladder cancer

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Authors: Na Zhou, Chun-Lai Zhang, Qing Li, Bingqi Zhu, Xun-Ming Wang

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The understanding of the dynamics of aeolian sand in the Yarlung Zangbo River Valley (YLZBV), southern Qinghai-Tibetan Plateau, including its origins, transportation,and deposition, remains preliminary. In this study, we investigated the extensive origin of aeolian sediments in the YLZBV by analyzing the distribution and composition of sediment’s grain size and geochemical composition in dune sediments collected from the wide river terraces. The major purpose is to characterize the sedimentological and geochemical compositions of these aeolian sediments, trace back to their sources, and understand their influencing factors. As a result, the grain size and geochemistry variations, which showed a significant correlation between grain sizes distribution and element abundances, give a strong evidence that the important part of the aeolian sediments in the downstream areas was firstly derived from the upper reaches by intense fluvial processes. However, the sediments experienced significant mixing process with local inputs and reconstructed by regional wind transportation. The diverse compositions and tight associations in the major and trace element geochemistry between the up- and down-stream aeolian sediments and the local detrital rocks, which were collected from the surrounding mountains, suggest that the upstream aeolian sediments had originated from the various close-range rock types, and experienced intensive mixing processes via aeolian- fluvial dynamics. Sand mass transported by water and wind was roughly estimated to qualify the interplay between the aeolian and fluvial processes controlling the sediment transport, yield, and ultimately shaping the aeolian landforms in the mainstream of the YLZBV.

Keywords: grain size distribution, geochemistry, wind and water load, sand source, Yarlung Zangbo River Valley

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Authors: Siming Wang, Qing Ni, Yu Wu, Ruihai Xu, Hong Ye

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Porous electric heaters, compared to conventional electric heaters, exhibit excellent heating performance due to their large specific surface area. Porous electric heaters employ porous metallic materials or conductive porous ceramics as the heating element. The former attains a low heating power with a fixed current due to the low electrical resistivity of metal. Although the latter can bypass the inherent challenges of porous metallic materials, the fabrication process of the conductive porous ceramics is complicated and high cost. This work proposed a porous ceramic electric heater with dielectric honeycomb ceramic as a substrate and surface conductive coating as a heating element. The conductive coating was prepared by the sol-gel method using silica sol and methyl trimethoxysilane as raw materials and graphite powder as conductive fillers. The conductive mechanism and degradation reason of the conductive coating was studied by electrical resistivity and thermal stability analysis. The heating performance of the proposed heater was experimentally investigated by heating air and deionized water. The results indicate that the electron transfer is achieved by forming the conductive network through the contact of the graphite flakes. With 30 wt% of graphite, the electrical resistivity of the conductive coating can be as low as 0.88 Ω∙cm. The conductive coating exhibits good electrical stability up to 500°C but degrades beyond 600°C due to the formation of many cracks in the coating caused by the weight loss and thermal expansion. The results also show that the working medium has a great influence on the volume power density of the heater. With air under natural convection as the working medium, the volume power density attains 640.85 kW/m3, which can be increased by 5 times when using deionized water as the working medium. The proposed honeycomb ceramic electric heater has the advantages of the simple fabrication method, low cost, and high volume power density, demonstrating great potential in the fluid heating field.

Keywords: conductive coating, honeycomb ceramic electric heater, high specific surface area, high volume power density

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Boris Bajer, Andrea Havranova, Miroslav Vlcek, Richard Imrich, Adela Penesova

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Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, and also prevent cardiovascular diseases, as it showed many studies (the Finnish Diabetes Prevention Study, Diabetes Prevention Program (DPP), . the China Da Qing Diabetes Prevention Study, etc.) Therefore the aim of our study was to compare the effect of intensified lifestyle intervention on cardiometabolic parameters. Methods: It is an ongoing randomized interventional clinical study (NCT02325804) focused on the reduction of body weight/fat. Intervention: hypocaloric diet (30% restriction of calories) and physical activity 150 minutes/week. Before and after 8 weeks of intervention all patients underwent complete medical examination (measurement of physical fitness, resting metabolic rate (RMR), body composition analysis, oral glucose tolerance test, parameters of lipid metabolism, and other cardiometabolic risk factors. Results: So far 39 patients finished the intervention. The average reduction of body weight was 6,8 + 4,9 kg (0-15 kg; p=0,0006), accompanied with significant reduction of body fat percentage (p ≤ 0,0001), amount of fat mass (p=0,03), waist circumference (p=0.02). Amount of lean mass and RMR remained unchanged. Heart rate (p=0,02), systolic and diastolic blood pressure was reduced (p=0,01 p=0,02 resp.) as well as insulin sensitivity was improved. Lipid parameters also changed - cholesterol, LDL decreased (p=0,05, p=0,04 resp.), while triglycerides showed tendency to decrease (p=0,055). Liver function improved, alanine aminotrasnferase (ALT) were reduced (p=0,01). Physical fitness significantly improved (as measure VO2 max (p=0,02). Conclusion: Results of our study are in line with previous results about the beneficial effect of intensive lifestyle changes on the reduction of cardiometabolic risk factors and improvement of liver function. Supported by grants APVV 15-0228; VEGA 2/0161/16

Keywords: obesity, weight loss, diet lipids, blood pressure, liver enzymes

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Authors: Qing Liu, Jean-fabien Capsal, Claude Richard

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In this current contribution, authors are dedicated to investigate influence of the crystal lamellae orientation on electromechanical behaviors of relaxor ferroelectric Poly (vinylidene fluoride –trifluoroethylene -chlorotrifluoroethylene) (P(VDF-TrFE-CTFE)) films by control of polymer microstructure, aiming to picture the full map of structure-property relationship. In order to define their crystal orientation films, terpolymer films were fabricated by solution-casting, stretching and hot-pressing process. Differential scanning calorimetry, impedance analyzer, and tensile strength techniques were employed to characterize crystallographic parameters, dielectric permittivity, and elastic Young’s modulus respectively. In addition, large electrical induced out-of-plane electrostrictive strain was obtained by cantilever beam mode. Consequently, as-casted pristine films exhibited surprisingly high electrostrictive strain 0.1774% due to considerably small value of elastic Young’s modulus although relatively low dielectric permittivity. Such reasons contributed to large mechanical elastic energy density. Instead, due to 2 folds increase of elastic Young’s modulus and less than 50% augmentation of dielectric constant, fully-crystallized film showed weak electrostrictive behavior and mechanical energy density as well. And subjected to mechanical stretching process, Film C exhibited stronger dielectric constant and out-performed electrostrictive strain over Film B because edge-on crystal lamellae orientation induced by uniaxially mechanical stretch. Hot-press films were compared in term of cooling rate. Rather large electrostrictive strain of 0.2788% for hot-pressed Film D in quenching process was observed although its dielectric permittivity equivalent to that of pristine as-casted Film A, showing highest mechanical elastic energy density value of 359.5 J/m^3. In hot-press cooling process, dielectric permittivity of Film E saw values at 48.8 concomitant with ca.100% increase of Young’s modulus. Films with intermediate mechanical energy density were obtained.

Keywords: crystal orientation, electrostroctive strain, mechanical energy density, permittivity, relaxor ferroelectric

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Authors: Lina Sun

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Chinese traditional drawings related to buildings and construction apply a unique geometry differentiating with western Euclidean geometry and embrace a collection of special terminologies, under the category of tu (the Chinese character for drawing). This paper will on one side etymologically analysis the terminologies of Chinese traditional architectural drawing, and on the other side geometrically deconstruct the composition of tu and locate the visual narrative language of tu in the pictorial tradition. The geometrical analysis will center on selected series of Yang-shi-lei tu of the construction of emperors’ mausoleums in Qing Dynasty (1636-1912), and will also draw out the earlier architectural drawings and the architectural paintings such as the jiehua, and paintings on religious frescoes and tomb frescoes as the comparison. By doing these, this research will reveal that both the terminologies corresponding to different geometrical forms respectively indicate associations between architectural drawing and the philosophy of Chinese cosmology, and the arrangement of the geometrical forms in the visual picture plane facilitates expressions of the concepts of space and position in the geometrical cosmology. These associations and expressions are the collective intentions of architectural drawing evolving in the thousands of years’ tradition without breakage and irrelevant to the individual authorship. Moreover, the architectural tu itself as an entity, not only functions as the representation of the buildings but also express intentions and strengthen them by using the Chinese unique geometrical language flexibly and intentionally. These collective cosmological spatial intentions and the corresponding geometrical words and languages reveal that the Chinese traditional architectural drawing functions as a unique architectural site with subjectivity which exists parallel with buildings and express intentions and meanings by itself. The methodology and the findings of this research will, therefore, challenge the previous researches which treat architectural drawings just as the representation of buildings and understand the drawings more than just using them as the evidence to reconstruct the information of buildings. Furthermore, this research will situate architectural drawing in between the researches of Chinese technological tu and artistic painting, bridging the two academic areas which usually treated the partial features of architectural drawing separately. Beyond this research, the collective subjectivity of the Chinese traditional drawings will facilitate the revealing of the transitional experience from traditions to drawing modernity, where the individual subjective identities and intentions of architects arise. This research will root for the understanding both the ambivalence and affinity of the drawing modernity encountering the traditions.

Keywords: Chinese traditional architectural drawing (tu), etymology of tu, collective subjectivity of tu, geometrical cosmology in tu, geometry and composition of tu, Yang-shi-lei tu

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Authors: Haifeng Zhou, Tsungyang Liow, Xiaoguang Tu, Eujin Lim, Chao Li, Junfeng Song, Xianshu Luo, Ying Huang, Lianxi Jia, Lianwee Luo, Kim Dowon, Qing Fang, Mingbin Yu, Guoqiang Lo

Abstract:

Several Germanium photodetectors (PD) built on silicon micro-disks are fabricated on the standard Si photonics multiple project wafers (MPW) and demonstrated to exhibit very low dark current, satisfactory operation bandwidth and moderate responsivity. Among them, a vertical p-i-n Ge PD based on a 2.0 µm-radius micro-disk has a dark current of as low as 35 nA, compared to a conventional PD current of 1 µA with an area of 100 µm2. The operation bandwidth is around 15 GHz at a reverse bias of 1V. The responsivity is about 0.6 A/W. Microdisk is a striking planar structure in integrated optics to enhance light-matter interaction and construct various photonics devices. The disk geometries feature in strongly and circularly confining light into an ultra-small volume in the form of whispering gallery modes. A laser may benefit from a microdisk in which a single mode overlaps the gain materials both spatially and spectrally. Compared to microrings, micro-disk removes the inner boundaries to enable even better compactness, which also makes it very suitable for some scenarios that electrical connections are needed. For example, an ultra-low power (≈ fJ) athermal Si modulator has been demonstrated with a bit rate of 25Gbit/s by confining both photons and electrically-driven carriers into a microscale volume.In this work, we study Si-based PDs with Ge selectively grown on a microdisk with the radius of a few microns. The unique feature of using microdisk for Ge photodetector is that mode selection is not important. In the applications of laser or other passive optical components, microdisk must be designed very carefully to excite the fundamental mode in a microdisk in that essentially the microdisk usually supports many higher order modes in the radial directions. However, for detector applications, this is not an issue because the local light absorption is mode insensitive. Light power carried by all modes are expected to be converted into photo-current. Another benefit of using microdisk is that the power circulation inside avoids any introduction of the reflector. A complete simulation model with all involved materials taken into account is established to study the promise of microdisk structures for photodetector by using finite difference time domain (FDTD) method. By viewing from the current preliminary data, the directions to further improve the device performance are also discussed.

Keywords: integrated optical devices, silicon photonics, micro-resonator, photodetectors

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Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Su Yin Chiam, Zhipeng Ding, Guang Yang, Danny Jian Hang Tng, Peiyi Song, Geok Ing Ng, Ken-Tye Yong, Qing Xin Zhang

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Brain-machine interfaces (BMI) is a ground rich of exploration opportunities where manipulation of neural activity are used for interconnect with myriad form of external devices. These research and intensive development were evolved into various areas from medical field, gaming and entertainment industry till safety and security field. The technology were extended for neurological disorders therapy such as obsessive compulsive disorder and Parkinson’s disease by introducing current pulses to specific region of the brain. Nonetheless, the work to develop a real-time observing, recording and altering of neural signal brain-machine interfaces system will require a significant amount of effort to overcome the obstacles in improving this system without delay in response. To date, feature size of interface devices and the density of the electrode population remain as a limitation in achieving seamless performance on BMI. Currently, the size of the BMI devices is ranging from 10 to 100 microns in terms of electrodes’ diameters. Henceforth, to accommodate the single cell level precise monitoring, smaller and denser Nano-scaled nanowire electrode arrays are vital in fabrication. In this paper, we would like to showcase the fabrication of high aspect ratio of vertical silicon nanowire electrodes arrays using microelectromechanical system (MEMS) method. Nanofabrication of the nanowire electrodes involves in deep reactive ion etching, thermal oxide thinning, electron-beam lithography patterning, sputtering of metal targets and bottom anti-reflection coating (BARC) etch. Metallization on the nanowire electrode tip is a prominent process to optimize the nanowire electrical conductivity and this step remains a challenge during fabrication. Metal electrodes were lithographically defined and yet these metal contacts outline a size scale that is larger than nanometer-scale building blocks hence further limiting potential advantages. Therefore, we present an integrated contact solution that overcomes this size constraint through self-aligned Nickel silicidation process on the tip of vertical silicon nanowire electrodes. A 4 x 4 array of vertical silicon nanowires electrodes with the diameter of 290nm and height of 3µm has been successfully fabricated.

Keywords: brain-machine interfaces, microelectromechanical systems (MEMS), nanowire, nickel silicide

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Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Qing Zhang, Janak L. Pathak, Macro N. Helder, Richard T. Jaspers, Yin Xiao

Abstract:

Introduction: Nanomaterial-based bone regeneration is greatly influenced by the immune microenvironment. Tissue-engineered nanomaterials mediate the inflammatory response of macrophages to regulate bone regeneration. Silica nanoparticles have been widely used in tissue engineering-related preclinical studies. However, the effect of topological features on the surface of silica nanoparticles on the immune response of macrophages remains unknown. Purposes: The aims of this research are to compare the influences of normal and pollen-like silica nano-surface topography on macrophage immune responses and to obtain insight into their potential regulatory mechanisms. Method: Macrophages (RAW 264.7 cells) were exposed to mesoporous silica nanoparticles with normal morphology (MSNs) and pollen-like morphology (PMSNs). RNA-seq, RT-qPCR, and LSCM were used to assess the changes in expression levels of immune response-related genes and proteins. SEM and TEM were executed to evaluate the contact and adherence of silica nanoparticles by macrophages. For the assessment of the immunomodulation-mediated osteogenic potential, BMSCs were cultured with conditioned medium (CM) from LPS pre-stimulated macrophage cultures treated with MSNs or PMSNs. Osteoimmunomodulatory potential of MSNs and PMSNs in vivo was tested in a mouse cranial bone osteolysis model. Results: The results of the RNA-seq, RT-qPCR, and LSCM assays showed that PMSNs inhibited the expression of pro-inflammatory genes and proteins in macrophages. SEM images showed distinct macrophage membrane surface binding patterns of MSNs and PMSNs. MSNs were more evenly dispersed across the macrophage cell membrane, while PMSNs were aggregated. PMSNs-induced macrophage anti-inflammatory response was associated with upregulation of the cell surface receptor CD28 and inhibition of ERK phosphorylation. TEM images showed that both MSNs and PMSNs could be phagocytosed by macrophages, and inhibiting nanoparticle phagocytosis did not affect the expression of anti-inflammatory genes and proteins. Moreover, PMSNs-induced conditioned medium from macrophages enhanced BMP-2 expression and osteogenic differentiation mBMSCs. Similarly, PMSNs prevented LPS-induced bone resorption via downregulation of inflammatory reaction. Conclusions: PMSNs can promote bone regeneration by modulating osteoimmunological processes through surface topography. The study offers insights into how surface physical contact cues can modulate the regulation of osteoimmunology and provides a basis for the application of nanoparticles with pollen-like morphology to affect immunomodulation in bone tissue engineering and regeneration.

Keywords: physical contact, osteoimmunology, macrophages, silica nanoparticles, surface morphology, membrane receptor, osteogenesis, inflammation

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