Abstract Objective We describe the development and structure of a novel mobile application in a mixed model of prenatal care, in the context of the COVID-19 pandemic. Furthermore, we assess the acceptability of this mobile app in a cohort of patients. Methods First, we introduced a mixed model of prenatal care; second, we developed a comprehensive, computer-based clinical record to support our system. Lastly, we built a novel mobile app as a tool for prenatal care. We used Flutter Software version 2.2 to build the app for Android and iOS smartphones. A cross-sectional study was carried out to assess the acceptability of the app. Results A mobile app was also built with the main attribute of being connected in real-time with the computer-based clinical records. The app screens detail information about activities programmed and developed in the prenatal care according to gestational age. A downloadable maternity book is available and some screens show warning signs and symptoms of pregnancy. The acceptability assessment was mostly rated positively regarding the characteristics of the mobile app, by 50 patients. Conclusion This novel mobile app was developed as a tool among pregnant patients to increase the information available about their pregnancies in the provision of a mixed model of prenatal care in the context of the COVID-19 pandemic. It was fully customized to the needs of our users following the local protocols. The introduction of this novel mobile app was highly accepted by the patients.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

A novel recognition method was put forward to identify the producing areas of the flue-cured tobacco leaves rapidly and non-destructively by using a near-infrared (NIR) spectrometer and a multi-layer-extreme learning machine (ML-ELM) algorithm. In contrast to traditional linear discriminant analysis (LDA) and extreme learning machine (ELM) algorithms, the accuracy, sensitivity and specificity were the highest for the proposed ML-ELM algorithm. The ML-ELM models for different producing areas of Yunnan tobacco leaves had the best generalization ability and prediction results. Besides, the above three algorithms were also identified by using the chemical index data. The experimental results indicated that the NIR spectroscopy technology together with ML-ELM algorithm achieved the best prediction performance both using the NIR spectral data and chemical index data. It indicates that the combination of NIR and ML-ELM can recognize different producing areas of Yunnan tobacco leaves rapidly, accurately, and non-destructively.

Abstract Fragmentation is the main energy dissipation form of foam concrete under explosion loading. To characterize the energy dissipation of foam concrete fragmentation quantitatively, explosion loading experiments of foam concrete plates under different stand-offs and plate thicknesses were carried out. The statistical characteristics of fragments and the energy dissipation law of foam concrete plate fragmentation were studied using image processing, fracture mechanics theory and fractal theory. An engineering calculation model of fragmentation fractal dimension and energy dissipation density of foam concrete plates were established. Results show that: the fragmentation of foam concrete plates under different explosion conditions is a fractal in the statistical sense. With the increase in stand-off and plate thickness, the fragment size of foam concrete plates increases, and the fragmentation fractal dimension decreases linearly. The linear relationship between the energy dissipation density and the fragmentation fractal dimension of foam concrete are expressed as D f = 0.0165 ω + 1.053.

Abstract Compared with central penetration, the eccentric penetration of jet into a liquid-filled composite armor (LCA) shows a more obvious lateral displacement due to the asymmetric impact by the shock wave and liquid radial reflux. Based on this characteristic, the reaming process in the liquid layer during the shaped charge jet (SCJ) penetrates into the strongly-constrained liquid-filled composite armor (SLCA) eccentrically, the interference process of jet is subjected to the asymmetric impact by the shock wave and liquid radial reflux, and the lateral movement process of the SCJ under lateral force loading is analyzed to study the influence of SLCA on the stability of incoming SCJ during eccentric penetration. Theoretical and X-ray experimental results show that when the eccentricity distance is [0 mm, 12 mm], the severely disturbed velocity range and total disturbed velocity range of the SCJ increase with the increase of the eccentricity distance, while the maximum lateral displacement of the SCJ decreases slightly with the increase of the eccentricity distance at [1 mm, 12 mm].

Abstract Thermophilic bacteria play an important role in aroma formation during pile-fermentation process of dark tea. With the aim to reveal the impact of thermophilic bacteria on volatile compounds in dark tea, Bacillus licheniformis (thermophilic bacteria) were inoculated into sun-dried green tea for spontaneous fermentation. In this study, headspace solid phase microextraction combined to gas chromatography mass spectrometry (HS-SPME-GC-MS), odor activity value (OAV), principal component analysis (PCA) and orthogonal partial least squares discrimination analysis (OPLS-DA) were employed to investigated the characteristics of volatile compounds during thermophilic bacteria pile-fermentation. According to HS-SPME-GC-MS, a total of 64 volatile compounds were identified. PCA revealed that tea samples could be clearly discriminated from each other. Furthermore, sulcatone, hexanoic acid, linalool, 2-methyl-trans-decalin, myrtenal, and α-ionone were found to play an important role in discrimination of tea samples, based on OPLS-DA. In addition, the OAV could effectively characterize the aroma contribution of volatile compounds during thermophilic bacteria pile-fermentation, and (Z)-linalool oxide (furanoid), α-ionone, (E)-2-nonenal, and linalool were the critical volatile compounds of aroma quality in dark tea. This study provides insight into volatile compounds characteristics during thermophilic bacteria pile-fermentation in dark tea.

SUMMARY OBJECTIVE: The aim of this study was to analyze the effect of tirofiban on new cerebral microhemorrhage after mechanical thrombectomy in patients with acute ischemic stroke. METHODS: In total, 203 patients with acute ischemic stroke treated by mechanical thrombectomy in our department of neurology were enrolled as the research objects. The patients were divided into two groups: the patients who used tirofiban within 24 h after surgery were assigned to the study group (78 subjects), while patients who did not use tirofiban were assigned to the conventional group (125 subjects). Magnetic resonance imaging was used to detect new-onset cerebral microbleeds in patients with stroke after surgery. The National Institute of Health Stroke Scale, modified ranking scale, and activity of daily living scale were used to assess the prognosis of patients, and the general data and the occurrence of adverse effects between two groups were compared to comprehensively evaluate the efficacy and safety of tirofiban. RESULTS: The proportion of atrial fibrillation in the research group was significantly lower than that in the conventional group. The research group had a much lower rate of new-onset cerebral microbleeds than the conventional group (p<0.001). There was no significant difference in the proportion of adverse reactions between the two groups (p>0.05). CONCLUSION: The application of tirofiban in mechanical thrombectomy of patients with acute ischemic stroke has high safety, effectively reduces the occurrence of new cerebral microhemorrhage, and provides a guarantee for patient safety.

ABSTRACT Objective: To evaluate the effect of beinaglutide on weight loss and plasma protein patterns of inflammation/obesity relevant cytokines and biomarkers. Materials and methods: This study involved 36 adult patients with a body mass index (BMI) of ≥ 24 kg/m2 and T2DM. Beinaglutide was administered for three months. Changes in body weight, fasting plasma glucose (FPG) level, 2 h postprandial plasma glucose (2h-PG) level, glycosylated hemoglobin (HbA1c) level, BMI and visceral and subcutaneous fat areas were measured at baseline and after three months of treatment. In addition, relevant inflammation/obesity cytokines and biomarkers were measured. Results: After three months, beinaglutide treatment led to significant changes, including in body weight, BMI, FPG level, HbA1c level, visceral and subcutaneous fat areas. In addition, serpin E1, leptin, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) also decreased significantly. The plasma protein concentrations of CRP (Log2 transformed) were found to be positively correlated with the percentage of weight loss (R = 0.514 and p-value = 0.021). Conclusion: Beinaglutide treatment resulted in weight loss, plasma glucose control and anti-inflammatory effects in patients with T2DM and overweight/obesity.

ABSTRACT The coronavirus 19 (COVID-19) pandemic and the measures implemented for its control meant the interruption of prenatal care, with potential risk to maternal and fetal health. However, conventional in-person prenatal care would imply exposure and risk of infection in patients and health care providers. The Instituto Nacional Materno Perinatal (INMP) has incorporated teleconsultation as part of a new model of mixed prenatal care, which aims to reduce in-person appointments and, therefore, the contact and risk of viral transmission. The prenatal care package performs essential activities to care for pregnant women of specific gestational ages with a greater impact on perinatal and maternal outcomes. This new model could be generalized nationally and be part of the solution to the disparities of healthcare in Peru, through policies for the use of telemedicine in prenatal care that facilitate its implementation, as well as its sustainability after the COVID-19 pandemic.

RESUMEN La pandemia del coronavirus 19 (COVID-19) y las medidas instauradas para su control significaron la interrupción de la atención prenatal, con potencial riesgo en la salud materna y fetal. Por otro lado, la atención prenatal convencional presencial implicaría exposición y riesgo de infección en pacientes y proveedores de salud. El Instituto Nacional Materno Perinatal (INMP) ha incorporado la teleconsulta como parte de un nuevo modelo de atención prenatal mixto, cuyo objetivo es disminuir las citas presenciales y, por tanto, el contacto y riesgo de transmisión viral. El paquete de atención prenatal incluye actividades esenciales para atender gestantes en edades gestacionales específicas con mayor impacto en los desenlaces perinatales y maternos. Este nuevo modelo podría generalizarse a nivel nacional y ser parte de la solución a las disparidades de atención en el Perú, mediante políticas del uso de la telemedicina en la atención prenatal que faciliten su implementación, así como su sostenibilidad después de la pandemia de COVID-19.

Abstract To improve the crashworthiness and energy absorption of thin-walled tube structures, a bionic thin-walled tube was designed based on the structural characteristics of antler osteon and the principle of structural bionics and had the same inner and outer diameters and the same gradient thickness as antler osteon. A nonlinear finite element method is used to simulate the crashworthiness of a thin-walled tube with equal gradient thickness variation (EGTTS) under axial and oblique loads. The crashworthiness of EGTTS-7 (Egtts with 7 layers) was evaluated using the complex proportional assessment(COPRAS). A multi-objective particle swarm optimization (MOPSO) algorithm was used to optimize the EGTTS-7 and the Pareto boundary was used to obtain the optimal structure parameters of the EGTTS-7 by using the loading angles of 0°, 10°, 20°, and 30°. It is found that the crashworthiness of the EGTTS is best when the axial load weight factor of the case is large. Compared with EGTTS and circular tubes(CT), F max can be reduced by up to 50.1% and EA can be increased by up to 22.7%.

Abstract microRNA (miRNA) had been found played an important role in occurrence and development of acute myocardial infarction (AMI) disease. In this paper, we found that the circulating miR-223-3p in AMI patients was significantly higher than that in unstable angina (UA) patients and healthy people. Univariate and logistic regression analysis showed the circulating miR-223-3p was a protective factor in the occurrence of AMI. We also found that the circulating miR-223-3p was negatively correlated with the serum CK-MB, cTnI, AST, LDH, TNF-α, IL-6, IL-1β and IL-8. The luciferase reporter gene system confirmed that miR-223-3p targeted inhibition of NLRP3 expression in THP-1 and human peripheral blood mononuclear cell (PBMC), and miR-223-3p was negatively correlated with the expression of NLRP3 in the PBMC of AMI patients. In PBMC of healthy people, miR-146a-mimic could increase the expression of NLRP3, but decreased the level of TNF-α secretion. Moreover, H2C9 cells apoptosis by TNF-α in a dose-dependent. In conclusion, these results suggested that miR-223-3p suppressed inflammation to protect cardiomyocytes by targeting NLRP3 in AMI patients.

Abstract Objective: Results from randomized controlled trials (RCTs) and real-world study (RWS) appear to be discordant. We aimed to investigate whether data derived from RCTs and RWS evaluating long-term all-cause mortality of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) were in agreement. Methods: RCTs or RWS comparing TAVI and SAVR, reporting longterm (≥2-year follow-up) all-cause mortality, were identified. We also carried out subgroup analyses to access the effect in different subgroups. A pre-designated data extraction form including 5 domains and 26 items was used to explore the relationship between RCTs and RWS. Mortality and effect in different subgroups were evaluated using random-effects meta-analyses. Results: Five RCTs (5421 participants, TAVI: 2759, SAVR: 2662) and 33 RWS (20839 participants; TAVI: 6585, SAVR: 14254) were identified. Pooled RCT analysis showed no difference in all-cause mortality between TAVI and SAVR (HR=0.97, 95% CI: 0.88-1.07; P=0.55). In RWS, TAVI was associated with an increased risk of allcause mortality (HR=1.46, 95% CI: 1.26-1.69; P<0.001) compared to SAVR. Conclusion: These results highlight the inconsistencies between RCTs and RWS in assessing long-term all-cause mortality in the treatment of AS using TAVI or SAVR, which may be caused by interactions of clinical characteristics or study design. RCTs as well as RWS are both developing and improving; the advantages of one kind of design, measurement and evaluation can and should be thoughtfully referred to the other.

Abstract The purpose of this study was to analyze the differential expression of DEC1 in oral normal mucosa (NM), oral leukoplakia (OLK) and oral squamous cell carcinoma (OSCC). Surgically excised specimens from patients with OLK (n = 47), OSCC (n = 30) and oral normal mucosa (n=11) were immunostained for DEC1. The expression of DEC1 protein was evaluated, and its association with the clinicopathological features was analyzed. The expression of DEC1 in NM, OLK and OSCC tissues increased in turn, and significant differences were observed among the groups (P < 0.0001). In terms of the association between DEC1 expression and epithelial dysplasia, DEC1 expression was lower in hyperkeratosis without dysplasia (H-OLK) than in OLK with moderate to severe dysplasia (S-OLK), and these differences were significant (p < 0.05). The expression of DEC1 in OSCC with OLK was significantly higher than that in OSCC without OLK (p < 0.01). Therefore, DEC1 could be a potential biomarker of malignant transformation in the carcinogenesis of OSCC, which may provide a new research direction for the transformation of oral potentially malignant disorders (OPMDs) into OSCC.