Evaluation and Projection of Population Exposure to Temperature Extremes over the Beijing−Tianjin−Hebei Region Using a High-Resolution Regional Climate Model RegCM4 Ensemble

Temperature extremes over rapidly urbanizing regions with high population densities have been scrutinized due to their severe impacts on human safety and economics.First of all,the performance of the regional climate model RegCM4 with a hydrostatic or non-hydrostatic dynamic core in simulating seasonal temperature and temperature extremes was evaluated over the historical period of 1991–99 at a 12-km spatial resolution over China and a 3-km resolution over the Beijing−Tianjin−Hebei(JJJ)region,a typical urban agglomeration of China.Simulations of spatial distributions of temperature extremes over the JJJ region using RegCM4 with hydrostatic and non-hydrostatic cores showed high spatial correlations of more than 0.8 with the observations.Under a warming climate,temperature extremes of annual maximum daily temperature(TXx)and summer days(SU)in China and the JJJ region showed obvious increases by the end of the 21st century while there was a general reduction in frost days(FD).The ensemble of RegCM4 with different land surface components was used to examine population exposure to temperature extremes over the JJJ region.Population exposure to temperature extremes was found to decrease in 2091−99 relative to 1991−99 over the majority of the JJJ region due to the joint impacts of increases in temperature extremes over the JJJ and population decreases over the JJJ region,except for downtown areas.Furthermore,changes in population exposure to temperature extremes were mainly dominated by future population changes.Finally,we quantified changes in exposure to temperature extremes with temperature increase over the JJJ region.This study helps to provide relevant policies to respond future climate risks over the JJJ region.

Combined proteomic and metabolomic studies on the liver of Amur sturgeon Acipenser schrenckii under titanium dioxide nanoparticle exposure

Nanomaterials,particularly titanium dioxide nanoparticles(TiO_(2)-NPs),are extensively utilized across various industries.However,their environmental release has raised concerns regarding their potential ecological and environmental impacts.The reproductive toxicity of TiO_(2)-NPs in fish species has attracted considerable attention,yet conflicting research outcomes have been reported.We investigated the effects of TiO_(2)-NPs exposure on the liver of juvenile Amur sturgeon Acipenser schrenckii using label-free proteomic and untargeted metabolomic analyses.The experiment included a control group and three groups exposed to different concentrations of TiO_(2)-NPs(low,TL;medium,TM;high,TH).Compared to the control group,9,19,and 25 proteins and 35,73,and 158 metabolites were differentially expressed in the TH,TM,and TL TiO_(2)-NP-exposed groups,respectively.The differentially expressed genes(DEGs)were enriched in the Kyoto Encyclopedia for Genes and Genomes(KEGG)pathways related to glycolysis and gluconeogenesis.Moreover,among the 126 correlated proteins,the most enriched pathways were associated with endocytosis and protein processing in the endoplasmic reticulum.Notably,syringic acid was significantly downregulated across all three TiO_(2)-NP-exposed groups.To obtain a comprehensive overview of the TiO_(2)-NP-induced expression changes,a co-regulated network of proteins and metabolites associated with TiO_(2)-NPs exposure was constructed.Exposure to TiO_(2)-NPs led to enrichment and alteration of pathways related to immune responses,including endocytosis,protein processing in the endoplasmic reticulum,and peroxisome proliferator-activated receptor(PPAR)signaling.In conclusion,our findings indicate that exposure to TiO_(2)-NPs might disrupt glucose metabolism and induce immune responses,thus contributing to our understanding of the environmental impacts of nanomaterials and highlighting the need for further research and development of potential mitigation strategies.

The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning

BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

Surface ozone in global cities:A synthesis of basic features,exposure risk,and leading meteorological driving factors

Long-term exposure to high surface ozone(O_(3))concentrations,a complex oxidative atmospheric pollutant,can adversely impact human health.Based on O_(3)monitoring data from 261 cities worldwide in 2020,generalized additive model(GAM)and spatial data analysis(SDA)methods were applied in this study to quantitatively evaluate the spatiotemporal distribution of O_(3)concentration,exposure risk,and dominant meteorological factors.Results indicated that over 40%of the cities worldwide were exposed to harmful O_(3)concentration ranges(40-60μg/m^(3)),with most cities distributed in China and India.Moreover,significant seasonal variations in global O_(3)concentrations were observed,presenting as summer(45.6μg/m^(3))>spring(47.3μg/m^(3))>autumn(38.0μg/m^(3))>winter(33.6μg/m^(3)).Exposure analysis revealed that approximately 12.2%of the population in 261 cities were exposed to an environment with high O_(3)concentrations(80-160μg/m^(3)),with about 36.32 million people in major countries.Thus,the persistent increase in high O_(3)levels worldwide is a critical factor contributing to threats to human health.Furthermore,GAM results indicated temperature,relative humidity,and wind speed as primary determinants of O_(3)variability.The synergy of meteorological factors is critical for understanding O_(3)changes.Our findings are important for enforcing robust air quality policies and mitigating public risk.

Spatial Optimization Strategies for High Temperature Heat Exposure Based on Thermally Vulnerable Populations and Case Studies

The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on the potential impact of extreme heat exposure on human survival and habitability.The physiological condition of lower adaptability to high temperature environments and the assessment of individuals who may have higher tolerance time in high temperature environments based on spatial perspectives suggest the need for targeted spatial optimization strategies for commuters and disadvantaged populations.This is demonstrated through a case study.These optimization measures encompass a variety of aspects,including the integration of transportation systems,the expansion of grey space corridors,the improvement of green space layout,and the implantation of green infrastructure.The study aims to reduce the exposure time of thermally vulnerable individuals to high temperature environments through spatial optimization strategies,to enhance the resilience of urban green spaces to heat stress,and to reduce the probability of heat-wave occurrence.

The Influence of Aerial Exposure on Sea Anemones Aulactinia veratra Mucin Genes Expression Using the RNA Sequencing

Mucin genes are the main component of mucus. The sea anemone species, Aulactinia veratra (Phylum Cnidaria) contains different types of mucin genes. In the intertidal zone, A. veratra is found to be exposed to air during the low tide and produces large quantities of mucus as an external covering. The relation between low tide and mucus secretion is still unclear, and what is the role of mucin during arial exposure is not yet investigated. This study hypothesised that the mucin genes in A. veratra would have significantly high expression in response to aerial exposure. Therefore, the aim of current study was to examine and analyses the response of A. veratra mucins in response to an experiment involving three hours of aerial exposure. To achieve this, aim the RNA-sequencing and bioinformatics analyses were used to examine the expression profile of A. veratra mucin genes in response to aerial exposure. The generated results have shown that, Mucin4-like and mucin5B-like were up-regulated in response to the three hours of aerial exposure in A. veratra. This finding shows a significant role of mucin5B-like and mucin4-like genes in response to air stress at low tide. The data generated from this study could be used in conjunction with future mucin gene studies of sea anemones and other cnidarians to compare A. veratra mucin gene expression results across time, and to extend our understanding of mucin stress response in this phylum.

Incidence and Management of Occupational Blood Exposure (OBE) among Medical Students at the University of Bangui

Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.

Expression levels of K_(ATP)channel subunits and morphological changes in the mouse liver after exposure to radiation

BACKGROUND ATP sensitive K+(K_(ATP))channels are ubiquitously distributed in various of cells and tissues,including the liver.They play a role in the pathogenesis of myocardial and liver ischemia.AIM To evaluate the radiation-induced changes in the expression of K_(ATP)channel subunits in the mouse liver to understand the potential role of K_(ATP)channels in radiation injury.METHODS Adult C57BL/6 mice were randomly exposed toγ-rays at 0 Gy(control,n=2),0.2 Gy(n=6),1 Gy(n=6),or 5 Gy(n=6).The livers were removed 3 and 24 h after radiation exposure.Hematoxylin and eosin staining was used for morphological observation;immunohistochemical staining was applied to determine the expression of K_(ATP)channel subunits in the liver tissue.RESULTS Compared with the control group,the livers exposed to 0.2 Gyγ-ray showed an initial increase in the expression of Kir6.1 at 3 h,followed by recovery at 24 h after exposure.Exposure to a high dose of 5.0 Gy resulted in decreased expression of Kir6.1 and increased expression of SUR2B at 24 h.However,the expression of Kir6.2,SUR1,or SUR2A had no remarkable changes at 3 and 24 h after exposure to any of these doses.CONCLUSION The expression levels of Kir6.1 and SUR2B in mouse liver changed differently in response to different radiation doses,suggesting a potential role for them in radiation-induced liver injury.

Autonomous VR Exposure Therapy for Anxiety Disorders Using Conversational AI—Ethical and Technical Implications and Preliminary Results

The need for psychotherapy is very high and the lack of care causes a lot of suffering and high costs. This paper presents an interdisciplinary approach to creating an AI-guided exposure therapy for fear of heights in virtual reality (VR). First, ethical principles for the use of conversational AI in psychotherapy were translated into technical requirements and made measurable. Based on this, an autonomous virtual reality exposure therapy was iteratively developed with a therapist. The feasibility and implementation of the ethical principles were tested with a patient. The patient was very satisfied with the VR setup. The AI therapist was also rated positively, although there is still room for improvement regarding conversational skills. Overall, the paper shows how AI can contribute responsibly to improving the psycho-therapeutic supply. It also provides guidelines that make ethical principles tangible and measurable for developers.

Assessment of Occupational Radiation Exposure for Radiotherapy Healthcare Workers at Kenyatta National Hospital Using Thermoluminescence Dosimeter LiF:Mg,Ti

Kenyatta National Hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.

中国城市PM_(2.5)污染暴露不平等及其驱动因素——基于Theil指数和LMDI分解

聚焦大气污染物PM_(2.5),对2015~2021年污染物浓度进行人口规模赋权,构建中国城市PM_(2.5)污染暴露水平指标,基于GINI系数和Theil指数测度污染暴露不平等,并按城市行政层级、省份进行差异分解;基于对数平均迪氏指数分解法(LMDI),分别对污染暴露水平、不平等程度进行驱动因素分解,探究其变化背后的社会经济因素.结果表明:中国城市PM_(2.5)污染暴露不平等总体温和,GINI系数保持在0.2以内且呈递减趋势.不同行政级别城市间未表现出污染暴露不平等,而省际差异对污染暴露不平等的贡献达68.4%;总体上能源的污染暴露乘数、政府绿色支出能耗强度是PM_(2.5)污染暴露水平的主要抑制因素,对污染暴露水平的驱动贡献超过60%.政府支出结构、支出规模、经济发展和人口因素对PM_(2.5)污染暴露起促增作用,但各因素在不同层级的城市间具有异质性;能源的污染暴露乘数、绿色支出能耗强度对不平等的动态抑制作用弱化,主要依靠能源绿色化的治污策略面临挑战.据此提出更好发挥政府作用,持续降低中国PM_(2.5)污染暴露水平,实现环境公共服务更加均等化的政策启示.

Characteristics of glucose and lipid metabolism and the interaction between gut microbiota and colonic mucosal immunity in pigs during cold exposure

Background Cold regions have long autumn and winter seasons and low ambient temperatures.When pigs are unable to adjust to the cold,oxidative damage and inflammation may develop.However,the differences between cold and non-cold adaptation regarding glucose and lipid metabolism,gut microbiota and colonic mucosal immunological features in pigs are unknown.This study revealed the glucose and lipid metabolic responses and the dual role of gut microbiota in pigs during cold and non-cold adaptation.Moreover,the regulatory effects of dietary glucose supplements on glucose and lipid metabolism and the colonic mucosal barrier were evaluated in cold-exposed pigs.Results Cold and non-cold-adapted models were established by Min and Yorkshire pigs.Our results exhibited that cold exposure induced glucose overconsumption in non-cold-adapted pig models(Yorkshire pigs),decreasing plasma glucose concentrations.In this case,cold exposure enhanced the ATGL and CPT-1αexpression to promote liver lipolysis and fatty acid oxidation.Meanwhile,the two probiotics(Collinsella and Bifidobacterium)depletion and the enrichment of two pathogens(Sutterella and Escherichia-Shigella)in colonic microbiota are not conducive to colonic mucosal immunity.However,glucagon-mediated hepatic glycogenolysis in cold-adapted pig models(Min pigs)maintained the stability of glucose homeostasis during cold exposure.It contributed to the gut microbiota(including the enrichment of the Rikenellaceae RC9 gut group,[Eubacterium]coprostanoligenes group and WCHB1-41)that favored cold-adapted metabolism.Conclusions The results of both models indicate that the gut microbiota during cold adaptation contributes to the protection of the colonic mucosa.During non-cold adaptation,cold-induced glucose overconsumption promotes thermogenesis through lipolysis,but interferes with the gut microbiome and colonic mucosal immunity.Furthermore,glucagon-mediated hepatic glycogenolysis contributes to glucose homeostasis during cold exposure.

A systematic review of occupational exposure to respirable coal mine dust(RCMD)in the U.S.mining industry

Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.

Knowledge of radiation exposure associated with common trauma imaging modalities among orthopaedic surgeons,emergency medicine physicians,and general surgeons in the United States

BACKGROUND:Few contemporary studies have assessed physicians’knowledge of radiation exposure associated with common imaging studies,especially in trauma care.The purpose of this study was to assess the knowledge of physicians involved in caring for trauma patients regarding the effective radiation doses of musculoskeletal(MSK)imaging studies routinely utilized in the trauma setting.METHODS:An electronic survey was distributed to United States orthopaedic surgery,general surgery,and emergency medicine(EM)residency programs.Participants were asked to estimate the radiation dose for common imaging modalities of the pelvis,lumbar spine,and lower extremity,in terms of chest X-ray(CXR)equivalents.Physician estimates were compared to the true effective radiation doses.Additionally,participants were asked to report the frequency of discussing radiation risk with patients.RESULTS:A total of 218 physicians completed the survey;102(46.8%)were EM physicians,88(40.4%)wereorthopaedicsurgeons,and28(12.8%)weregeneralsurgeons.Physicians underestimated the effective radiation doses of nearly all imaging modalities,most notably for pelvic computed tomaography(CT)(median 50 CXR estimation vs.162 CXR actual)and lumbar CT(median 50 CXR estimation vs.638 CXR actual).There was no difference between physician specialties regarding estimation accuracy(P=0.133).Physicians who regularly discussed radiation risks with patients more accurately estimated radiation exposure(P=0.007).CONCLUSION:The knowledge among orthopaedic and general surgeons and EM physicians regarding the radiation exposure associated with common MSK trauma imaging is lacking.Further investigation with larger scale studies is warranted,and additional education in this area may improve care.

Assessing the effects of alternative fuel treatments to reduce wildfire exposure

Effective landscape-scale fuel management strategies are essential for reducing wildfire risk in Mediterranean fire-prone areas.In this study,the minimum travel time(MTT)fire-spread algorithm as implemented in FlamMap was applied to assess the potential of alternative fuel treatments for lowering wildfire losses in a 5,740-ha study area in eastern Sardinia,Italy.Twenty-seven wildfires at 10-m resolution were simulated considering three wind speeds(15,18,and 21 km h-1)to compare fuel treatments:no treatment(NT),irrigated agroforestry areas with shrub clearing(T1),prescribed fire in eucalyptus stands(T2),and irrigated grasslands(T3).The simulations replicated a recent large wildfire that occurred in the study area(Orrìwildfire,2019)and considered the weather and fuel moisture conditions associated with this event.The average wildfire exposure outputs(burned area,probability of burning,conditional flame length,potential crown fire occurrence,and surfaces withflame lengths above 2.5 m)decreased after fuel treatments,compared to no treatment.T1 was the most effective strategy in mitigating wildfire hazards and provided the most significant performance for several wildfire exposure indicators.Treating only 0.5%of the study area(~30 ha)resulted in a decrease in all wildfire exposure metrics to~10%within the study area.In addition,the total surface characterized by high flame length(average>2.5 m)was the lowest in the T1 treatment.This study can help land and fire managers optimize fuel treatment opportunities and wildfire risk mitigation strategies in Mediterranean areas.

Monte Carlo calculation of the exposure of Chinese female astronauts to earth’s trapped radiation on board the Chinese Space Station

With the development of China’s crewed space mission,the space radiation risk for astronauts is increasingly prominent.This paper describes a simulation of the radiation doses experienced by a Chinese female voxel phantom on board the Chinese Space Station(CSS)performed using the Monte Carlo N-Particle(MCNP)software.The absorbed dose,equivalent dose,and effective dose experienced by the voxel phantom and its critical organs are discussed for different levels of shielding of the Tianhe core module.The risk of space-radiation exposure is then assessed by comparing these doses with the current risk limits in China(the skin dose limit for short-term low-earth-orbit missions)and the NASA figures(National Council on Radiation Protection and Measurements Report No.98)for female astronauts.The results obtained can be used to guide and optimize the radiation protection provided for manned space missions.

Development of a protocol for videoconferencing-based exposure and response prevention treatment of obsessive-compulsive disorder during the COVID-19 pandemic

BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment.Moreover,the pandemic forced a global switch to telemental health(TMH)services to maintain the standards and continuity of care.Consequently,clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD.However,several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.AIM To describe the formulation,implementation,feasibility,and usefulness of videoconferencing-based ERP(VC-ERP)treatment for OCD during the coronavirus disease 2019 pandemic.METHODS This prospective,observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo(July 2020-June 2021).All patients with OCD were assessed using the home-based TMH services of the department.The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment.After a systematic evaluation of the available treatment options,an initial protocol for delivering VC-ERP was developed.Guidelines for clinicians and educational materials for patients and their families were prepared.The protocol was implemented among patients with OCD attending the TMH services,and their progress was monitored.The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders.Feasibility and efficacy outcomes were examined.RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases,10th version criteria.Out of 115 patients who attended the services during the study period,37 were excluded from the final analysis.Of the remaining 78 patients,VC-ERP was initiated in 43 patients.Six patients dropped out,and three were hospitalized for inpatient ERP.Eleven patients have completed the full VC-ERP treatment.One patient completed the psychoeducation part of the protocol.VC-ERP is ongoing in 22 patients.The protocol for VC-ERP treatment was developed and upgraded online.A large proportion of the eligible patients(n=34/43;79%)actively engaged in the VC-ERP treatment.Drop-out rates were low(n=6/43;14%).Satisfaction with the treatment was adequate among patients,caregivers,and clinicians.Apart from hospitalization in 3 patients,there were no other adverse events.Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol.Therefore,the feasibility of VC-ERP treatment in terms of operational viability,service utilization,service engagement,need for additional in-person services,frequency of adverse events,and user satisfaction was adequate.The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment.Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD.The results suggest that VC-ERP can be a useful option in resource-constrained settings.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Cold exposure promotes coronavirus infection by altering the gut microbiota and lipid metabolism to reduce host immunity

Objective:Cold exposure has been suggested to be advantageous for the spread and infection of the coronavirus,and the gut microbiota influences the severity of the infection by modulating host inflammatory and immune responses.However,it remains unclear whether the promotion of viral infection through cold exposure is linked to the gut microbiota.Methods:In this study,we performed an unbiased analysis of gut microbiota,serum,and lung tissue metabolome changes in cold-exposed and virus-infected mice,alongside the assessment of immune-inflammatory indicators in serum and lung tissue.Results:The results revealed that both cold exposure and viral infection significantly decreased the percentage of peripheral blood lymphocytes(CD4^(+)T cells,CD8^(+)T cells,and B cell)and increased the expression of inflammatory factors(IL-6,IL-1β,TNF-α,and IFN-γ).Meanwhile,cold exposure disrupted the homeostasis of gut microbiota,elevating the abundance of pathogenic bacteria(Staphylococcus)and diminishing the abundance of beneficial bacteria(Alistipes).Notably,in virus-infected mice exposed to a cold environment,the reduction in the abundance of beneficial bacteria Alistipes was more pronounced than in cases of single virus infection and cold exposure.Analysis of altered serum and lung tissue metabolites highlighted glycerophospholipids,fatty acids,and eicosanoids as the most affected metabolites by cold exposure.These metabolites,closely associated with virus infection,exhibited a significant correlation with immune-inflammatory indicators.Conclusion:These findings establish a mechanistic connection between cold exposure and virus infection,suggesting that cold exposure-induced dysregulation of gut microbiota and lipid metabolism diminishes host immunity,promoting virus infection.

Cold exposure alters proteomic profiles of the hypothalamus and pituitary in female rats

Objective:Studies have shown that both short-term and long-term cold exposures disturb the biological process.The aim of the present study is to investigate the effects of intermittent cold exposure on proteomic profiles in the hypothalamus and pituitary of female Sprague-Dawley(SD)rats.Materials and methods:The rats were exposed to-10°C in a cabin for 4 h per day,and the treatment lasted for 14 days.The comparative label-free LC-MS/MS analysis was performed to investigate the changes of proteomic profiles in the hypothalamus and pituitary.ELISA analysis was used to validate the expression of differential proteins.Results:22 differential proteins in the hypothalamus and 75 differential proteins in the pituitary were identified by the label-free proteomic analysis.Gene ontology annotation and enrichment analysis indicated that cold exposure disrupted protein phosphorylation,filopodium assembly,intracellular protein transport,peripheral nervous system neuron axonogenesis,spinal cord development,Golgi organization,positive regulation of pseudopodium assembly,and cell-cell adhesion.Three proteins(Cdc42,Ptprs,and Setd7)were down-regulated in the cold exposure group.Conclusion:The results indicate that intermittent cold exposure alters the proteomic profiles of hypothalamus and pituitary in female rats.