Severe liver injury and clinical characteristics of occupational exposure to 2-amino-5-chloro-N,3-dimethylbenzamide: A case series

Background:The 2-amino-5-chloro-N,3-dimethylbenzamide is a key intermediate in the synthesis of pesticides and pharmaceuticals.However,no literature currently exists on 2-amino-5-chloro-N,3-dimethylbenzamide poisoning in humans.This study aimed to reveal the health hazard of this chemical for humans and summarize the clinical characteristics of patients with occupational 2-amino-5-chloro-N,3-dimethylbenzamide poisoning.Methods:This observational study included four patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning from June 2022 to July 2022.The entire course of the incidents was described in detail.Blood 2-amino-5-chloro-N,3-dimethylbenzamide concentrations were detected by a mass spectrometer.Hema-toxylin and eosin staining was performed to assess liver injury,and immunofluorescence was used to evaluate hepatic mitophagy.Results:The 2-amino-5-chloro-N,3-dimethylbenzamide powder(99%purity)entered the human body mainly via the skin and respiratory tract due to poor personal protective measures.The typical course of 2-amino-5-chloro-N,3-dimethylbenzamide poisoning was divided into latency,rash,fever,organic dam-age,and recovery phases in accordance with the clinical evolution.Rash and fever may be the important premonitory symptoms for further organ injuries.The chemical was detected in the blood of all patients and caused multiple organ injuries,predominantly liver injury,including kidney,myocardium,and micro-circulation.Three patients recovered smoothly after comprehensive treatments,including artificial liver therapy,continuous renal replacement therapy,glucocorticoids,and other symptomatic and supportive treatments.One patient survived by liver transplantation.The postoperative pathological findings of the removed liver showed acute liver failure,and immunofluorescence staining confirmed the abundance of mitophagy in residual hepatocytes.Conclusions:This study is the first to elaborate the clinical characteristics of patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning.The chemical enters the body through the respiratory tract and skin during industrial production.The 2-amino-5-chloro-N,3-dimethylbenzamide poisoning causes multiple-organ dysfunction with a predominance of liver injury.Liver transplantation may be an effective option for patients with severe liver failure.The mechanisms of liver injury induced by 2-amino-5-chloro-N,3-dimethylbenzamide might involve abnormal mitochondrial function and mitophagy.

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.

Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases

Autophagy is a cellular catabolic process characterized by the formation of double-membrane autophagosomes.Transmission electron microscopy is the most rigorous method to clearly visualize autophagic engulfment and degradation.A large number of studies have shown that autophagy is closely related to the digestion,secretion,and regeneration of gastrointestinal(GI)cells.However,the role of autophagy in GI diseases remains controversial.This article focuses on the morphological and biochemical characteristics of autophagy in GI diseases,in order to provide new ideas for their diagnosis and treatment.

Research on the influences of motion characteristics of jetting projectile charge under water

Shaped charge warhead is important for enhancing the damage performance of underwater weapons.This paper used finite element analysis software and based on JPC water penetration experiments to examine the influence of liner parameters(wall thickness,material),charge aspect ratio,and stand-off distance on the movement characteristics of JPC in water.The findings reveal that the head diameter of the JPC increases and experiences significant erosion after entering the water,the effective length of the JPC in water undergoes two distinct phases:a growth phase and a decrease phase,with the velocity of the JPC decaying exponentially.Increasing the liner thickness,stand-off distance and the charge aspect ratio can improve the erosion resistance and the velocity retention capacity of the JPC.The optimal ranges for liner thickness and stand-off distance are 0.0363D_(k) to 0.0545D_(k)(D_(k) is the charge diameter),the stand-off distance should be within 1.0D_(k).After the charge aspect ratio higher than 1.25,the charge structure exerts minimal influence the movement characteristics of the JPC in water.Material density plays a crucial role in the velocity decay pattern of the JPC during penetration.JPC with higher densities exhibit superior velocity retention capabilities in water,with the velocity decay pattern converging if the densities are similar.Consequently,copper,tantalum and tungsten liners are deemed appropriate for underwater shaped charge warhead.Finally,the results will provide an important reference for the design of underwater shaped charge warhead.

Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Grain Yield,Biomass Accumulation,and Leaf Photosynthetic Characteristics of Rice under Combined Salinity-Drought Stress

Simultaneous stresses of salinity and drought often coincide during rice-growing seasons in saline lands,primarily due to insufficient water resources and inadequate irrigation facilities.Consequently,combined salinity-drought stress poses a major threat to rice production.In this study,two salinity levels(NS,non-salinity;HS,high salinity)along with three drought treatments(CC,control condition;DJ,drought stress imposed at jointing;DH,drought stress imposed at heading)were performed to investigate their combined influences on leaf photosynthetic characteristics,biomass accumulation,and rice yield formation.Salinity,drought,and their combination led to a shortened growth period from heading to maturity,resulting in a reduced overall growth duration.Grain yield was reduced under both salinity and drought stress,with a more substantial reduction under the combined salinity-drought stress.The combined stress imposed at heading caused greater yield losses in rice compared with the stress imposed at jointing.Additionally,the combined salinity-drought stress induced greater decreases in shoot biomass accumulation from heading to maturity,as well as in shoot biomass and nonstructural carbohydrate(NSC)content in the stem at heading and maturity.However,it increased the harvest index and NSC remobilization reserve.Salinity and drought reduced the leaf area index and SPAD value of flag leaves and weakened the leaf photosynthetic characteristics as indicated by lower photosynthetic rates,transpiration rates,and stomatal conductance.These reductions were more pronounced under the combined stress.Salinity,drought,and especially their combination,decreased the activities of ascorbate peroxidase,catalase,and superoxide dismutase,while increasing the contents of malondialdehyde,hydrogen peroxide,and superoxide radical.Our results indicated a more significant yield loss in rice when subjected to combined salinity-drought stress.The individual and combined stresses of salinity and drought diminished antioxidant enzyme activities,inhibited leaf photosynthetic functions,accelerated leaf senescence,and subsequently lowered assimilate accumulation and grain yield.

Investigation of hydroxyl-terminated polybutadiene propellant breaking characteristics and mechanism impacted by submerged cavitation water jet

A submerged cavitation water jet(SCWJ)is an effective method to recycle solid propellant from obsolete solid engines by the breaking method.Solid propellant's breaking modes and mechanical process under SCWJ impact are unclear.This study aims to understand those impact breaking mechanisms.The hydroxyl-terminated polybutadiene(HTPB)propellant was chosen as the research material,and a self-designed test system was used to conduct impact tests at four different working pressures.The high-speed camera characterized crack propagation,and the DIC method calculated strain change during the impact process.Besides,micro and macro fracture morphologies were characterized by scanning electron microscope(SEM)and computed tomography(CT)scanning.The results reveal that the compressive strain concentration region locates right below the nozzle,and the shear strain region distributes symmetrically with the jet axis,which increases to 4% at first 16th ms,the compressive strain rises to 2% and 6% in the axial and transverse direction,respectively.The two tensile cracks formed first at the compression strain concentrate region,and there generate many shear cracks around the tensile cracks,and those shear cracks that develop and aggregate cause the cracks to become wider and cut through the tensile cracks,forming the tensile-shear cracks and the impact parts eventually fail.The HTPB propellant forms a breaking hole shaped conical after impact 10 s.The mass loss increases by 17 times at maximum,with the working pressure increasing by three times.Meanwhile,the damage value of the breaking hole remaining on the surface increases by 7.8 times while 2.9 times in the depth of the breaking hole.The breaking efficiency is closely affected by working pressures.The failure modes of HTPB impacted by SCWJ are classified as tensile crack-dominated and tensile-shear crack-dominated damage mechanisms.

Liquefaction susceptibility and deformation characteristics of saturated coral sandy soils subjected to cyclic loadings-a critical review

Coral sandy soils widely exist in coral island reefs and seashores in tropical and subtropical regions.Due to the unique marine depositional environment of coral sandy soils,the engineering characteristics and responses of these soils subjected to monotonic and cyclic loadings have been a subject of intense interest among the geotechnical and earthquake engineering communities.This paper critically reviews the progress of experimental investigations on the undrained behavior of coral sandy soils under monotonic and cyclic loadings over the last three decades.The focus of coverage includes the contractive-dilative behavior,the pattern of excess pore-water pressure(EPWP)generation and the liquefaction mechanism and liquefaction resistance,the small-strain shear modulus and strain-dependent shear modulus and damping,the cyclic softening feature,and the anisotropic characteristics of undrained responses of saturated coral sandy soils.In particular,the advances made in the past decades are reviewed from the following aspects:(1)the characterization of factors that impact the mechanism and patterns of EPWP build-up;(2)the identification of liquefaction triggering in terms of the apparent viscosity and the average flow coefficient;(3)the establishment of the invariable form of strain-based,stress-based,or energy-based EPWP ratio formulas and the unique relationship between the new proxy of liquefaction resistance and the number of cycles required to reach liquefaction;(4)the establishment of the invariable form of the predictive formulas of small strain modulus and strain-dependent shear modulus;and(5)the investigation on the effects of stress-induced anisotropy on liquefaction susceptibility and dynamic deformation characteristics.Insights gained through the critical review of these advances in the past decades offer a perspective for future research to further resolve the fundamental issues concerning the liquefaction mechanism and responses of coral sandy sites subjected to cyclic loadings associated with seismic events in marine environments.

Analysis of mesoscopic mechanical dynamic characteristics of ballast bed with under sleeper pads

The meso-dynamical behaviour of a high-speed rail ballast bed with under sleeper pads(USPs)was studied.The geometrically irregular refined discrete element model of the ballast particles was constructed using 3D scanning techniques,and the 3D dynamic model of the rail-sleeper-ballast bed was constructed using the coupled discrete element method-multiflexible-body dynamics(DEM-MFBD)approach.We analyse the meso-mechanical dynamics of the ballast bed with USPs under dynamic load on a train and verify the correctness of the model in laboratory tests.It is shown that the deformation of the USPs increases the contact area between the sleeper and the ballast particles,and subsequently the number of contacts between them.As the depth of the granular ballast bed increases,the contact area becomes larger,and the contact force between the ballast particles gradually decreases.Under the action of the elastic USPs,the contact forces between ballast particles are reduced and the overall vibration level of the ballast bed can be reduced.The settlement of the granular ballast bed occurs mainly at the shallow position of the sleeper bottom,and the installation of the elastic USPs can be effective in reducing the stress on the ballast particles and the settlement of the ballast bed.

Low-temperature characteristicsof rubbers and performance testsof type 120 emergencyvalve diaphragms

Purpose–The type 120 emergency valve is an essential braking component of railway freight trains,butcorresponding diaphragms consisting of natural rubber(NR)and chloroprene rubber(CR)exhibit insufficientaging resistance and low-temperature resistance,respectively.In order to develop type 120 emergency valverubber diaphragms with long-life and high-performance,low-temperatureresistant CR and NR were processed.Design/methodology/approach–The physical properties of the low-temperature-resistant CR and NRwere tested by low-temperature stretching,dynamic mechanical analysis,differential scanning calorimetryand thermogravimetric analysis.Single-valve and single-vehicle tests of type 120 emergency valves werecarried out for emergency diaphragms consisting of NR and CR.Findings–The low-temperature-resistant CR and NR exhibited excellent physical properties.The elasticityand low-temperature resistance of NR were superior to those of CR,whereas the mechanical properties of thetwo rubbers were similar in the temperature range of 0℃–150℃.The NR and CR emergency diaphragms metthe requirements of the single-valve test.In the low-temperature single-vehicle test,only the low-temperaturesensitivity test of the NR emergency diaphragm met the requirements.Originality/value–The innovation of this study is that it provides valuable data and experience for futuredevelopment of type 120 valve rubber diaphragms.

Microscopic characteristics of tight sandstone reservoirs and their effects on the imbibition efficiency of fracturing fluids:A case study of the Linxing area,Ordos Basin

The Linxing area within the Ordos Basin exhibits pronounced reservoir heterogeneity and intricate micro-pore structures,rendering it susceptible to water-blocking damage during imbibition extraction.This study delved into the traits of tight sandstone reservoirs in the 8th member of the Shihezi Formation(also referred to as the He 8 Member)in the study area,as well as their effects on fracturing fluid imbibition.Utilizing experimental techniques such as nuclear magnetic resonance(NMR),high-pressure mercury intrusion(HPMI),and gas adsorption,this study elucidated the reservoir characteristics and examined the factors affecting the imbibition through imbibition experiments.The findings reveal that:①The reservoir,with average porosity of 8.40%and average permeability of 0.642×10^(-3)μm^(2),consists principally of quartz,feldspar,and lithic fragments,with feldspathic litharenite serving as the primary rock type and illite as the chief clay mineral;②Nano-scale micro-pores and throats dominate the reservoir,with dissolution pores and intercrystalline pores serving as predominant pore types,exhibiting relatively high pore connectivity;③Imbibition efficiency is influenced by petrophysical properties,clay mineral content,and microscopic pore structure.Due to the heterogeneity of the tight sandstone reservoir,microscopic factors have a more significant impact on the imbibition efficiency of fracturing fluids;④A comparative analysis shows that average pore size correlates most strongly with imbibition efficiency,followed by petrophysical properties and clay mineral content.In contrast,the pore type has minimal impact.Micropores are vital in the imbibition process,while meso-pores and macro-pores offer primary spaces for imbibition.This study offers theoretical insights and guidance for enhancing the post-fracturing production of tight sandstone reservoirs by examining the effects of these factors on the imbibition efficiency of fracturing fluids in tight sandstones.

Reservoir characteristics and formation model of Upper Carboniferous bauxite series in eastern Ordos Basin,NW China

Through core observation,thin section identification,X-ray diffraction analysis,scanning electron microscopy,and low-temperature nitrogen adsorption and isothermal adsorption experiments,the lithology and pore characteristics of the Upper Carboniferous bauxite series in eastern Ordos Basin were analyzed to reveal the formation and evolution process of the bauxite reservoirs.A petrological nomenclature and classification scheme for bauxitic rocks based on three units(aluminum hydroxides,iron minerals and clay minerals)is proposed.It is found that bauxitic mudstone is in the form of dense massive and clastic structures,while the(clayey)bauxite is of dense massive,pisolite,oolite,porous soil and clastic structures.Both bauxitic mudstone and bauxite reservoirs develop dissolution pores,intercrystalline pores,and microfractures as the dominant gas storage space,with the porosity less than 10% and mesopores in dominance.The bauxite series in the North China Craton can be divided into five sections,i.e.,ferrilite(Shanxi-style iron ore,section A),bauxitic mudstone(section B),bauxite(section C),bauxite mudstone(debris-containing,section D)and dark mudstone-coal section(section E).The burrow/funnel filling,lenticular,layered/massive bauxite deposits occur separately in the karst platforms,gentle slopes and low-lying areas.The karst platforms and gentle slopes are conducive to surface water leaching,with strong karstification,well-developed pores,large reservoir thickness and good physical properties,but poor strata continuity.The low-lying areas have poor physical properties but relatively continuous and stable reservoirs.The gas enrichment in bauxites is jointly controlled by source rock,reservoir rock and fractures.This recognition provides geological basis for the exploration and development of natural gas in the Upper Carboniferous in the study area and similar bauxite systems.

Computer vision-aided DEM study on the compaction characteristics of graded subgrade filler considering realistic coarse particle shapes

The compaction quality of subgrade filler strongly affects subgrade settlement.The main objective of this research is to analyze the macro-and micro-mechanical compaction characteristics of subgrade filler based on the real shape of coarse particles.First,an improved Viola-Jones algorithm is employed to establish a digitalized 2D particle database for coarse particle shape evaluation and discrete modeling purposes of subgrade filler.Shape indexes of 2D subgrade filler are then computed and statistically analyzed.Finally,numerical simulations are performed to quantitatively investigate the effects of the aspect ratio(AR)and interparticle friction coefficient(μ)on the macro-and micro-mechanical compaction characteristics of subgrade filler based on the discrete element method(DEM).The results show that with the increasing AR,the coarse particles are narrower,leading to the increasing movement of fine particles during compaction,which indicates that it is difficult for slender coarse particles to inhibit the migration of fine particles.Moreover,the average displacement of particles is strongly influenced by the AR,indicating that their occlusion under power relies on particle shapes.The dis-placement and velocity of fine particles are much greater than those of the coarse particles,which shows that compaction is primarily a migration of fine particles.Under the cyclic load,the interparticle friction coefficientμhas little effect on the internal structure of the sample;under the quasi-static loads,however,the increase inμwill lead to a significant increase in the porosity of the sample.This study could not only provide a novel approach to investigate the compaction mechanism but also establish a new theoretical basis for the evaluation of intelligent subgrade compaction.

A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression

Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.

Autophagy Alleviates Cold Exposure-induced Tight Junction Injury in Murine Ileum

Cold exposure is a pervasive stressor in the polar and subpolar regions,exerting both acute and chronic effects on individuals.This environmental factor is known to induce physiological stress,compromise immune response efficacy,and increase susceptibility to various diseases.Chronic cold exposure,characterized by repetitive nonconsecutive exposure to suboptimal temperatures over an extended duration.

Adsorption,in vitro digestion and human gut microbiota regulation characteristics of three Poria cocos polysaccharides

Poria cocos(PC)is a famous traditional Chinese medicine(TCM)and a widely used healthcare ingredient,which has antiobesity,enhancing immunity and improving sleep effects.Traditionally,only water-soluble poria polysaccharide(WSP)is extracted and applied for clinical application,while insoluble polysaccharide(alkali-soluble poria polysaccharide,ASP)is discarded as herb residue.However,the whole PC has also been historically utilized as functional herbal food.Considering the beneficial role of dietary fiber and the traditional use of PC,ASP may also contribute substantially to the therapy function of PC.Compared to WSP,little attention has been paid to ASP and ASP modified product carboxymethyl poria polysaccharide(CMP)which has been used as an antitumor adjuvant drug.In this study,the oil,cholesterol,metal ions and polyphenols adsorption ability,in vitro simulated digestive and the gut microbiota fermentation characteristics of WSP,ASP and CMP were studied to evaluate the functional values of three P.cocos polysaccharides(PCPs).The results showed that all three PCPs had good adsorption capacity on cholesterol,polyphenols and metal ions(Cd^(2+)/Zn^(2+)/Mg^(2+)),among which ASP showed the highest capacity than WSP and CMP.The adsorption capacity of all three PCPs on heavy metal ions(Cd^(2+)/Zn^(2+))was stronger than that of non-heavy metal ions(Mg^(2+));The in vitro digestibility of all three PCPs was very low,but WSP was slightly higher than ASP and CMP;Moreover,the indigestible residue of all three PCPs could improve the richness and diversity of gut microbiota,among which ASP had the greatest influence.In general,ASP and CMP could significantly promote the proliferation of some probiotics and inhibit the growth of some harmful bacteria.The gut microbiota diversity of CMP was reduced,but the richness of probiotics,especially Parabacteroides distasonis was significantly enhanced compared with the ASP group,and the growth of harmful bacteria Klebsiella pneumoniae was inhibited after CMP treatment.The short-chain fatty acids(SCFAs)analysis results showed that all three PCPs could significantly promote the production of acetic acid,propionic acid and the total acid content compared with blank control group,and SCFAs producing activity was positively correlated with the proliferative capacity of probiotics.Taken together,the good adsorption characteristics and gut microbiota regulatory activity of ASP may lay foundation for its lipid-lowering and immune-improving function.Additionally,the probiotic effect of CMP and ASP indicated that except for only use the water extract of PC in clinic,CMP and ASP also can be used in healthcare to take full advantage of this valuable medicine.

Feasibility of Integrating Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP) into Routine Leprosy Control Program in Bukedi and Teso Regions in Uganda

Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.

Gravel hardness effect on compaction characteristics of gravelly soil

The compaction characteristics of gravelly soil are affected by gravel hardness.To investigate the evolution and influencing mechanism of different gravel hardness on the compaction characteristics of gravelly soil,heavy compaction tests and crushing tests were conducted on gravelly soils with gravels originated from hard,soft and extremely soft rocks.According to orthogonal experiments and variance analysis,it was found that hardness has a significant impact on the maximum dry density of gravelly soil,followed by gravel content,and lastly,moisture content.For gravel compositions with an average saturated uniaxial compressive strength less than 60 MPa,the order of compacted maximum dry density is soft gravels>hard gravels>extremely soft gravels.Each type of gravelly soil has a threshold for gravel content,with 60%for hard and soft gravels and 50%for extremely soft gravels.Beyond these thresholds,the compacted dry density decreases significantly.There is a certain interaction between hardness,gravel content,and moisture content.Higher hardness increases the influence of gravel content,whereas lower hardness increases the influence of moisture content.Gravelly soils with the coarse aggregate(CA)between 0.7 and 0.8 typically achieve higher dry densities after compaction.In addition,the prediction equations for the particle breakage rate and CA ratio in the Bailey method were proposed to estimate the compaction performance of gravelly soil preliminarily.The results further revealed the compaction mechanism of different gravelly soils and can provide reference for subgrade filling construction.

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.

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.