Efficacy of cataract surgeries performed during blindness prevention programs in Chongqing, China: a multicenter prospective study.

OBJECTIVE: To determine the efficacy of cataract surgeries in blindness prevention programs in Chongqing. METHODS: During February-December 2019, we prospectively enrolled 487 patients (592 eyes) undergoing cataract surgery during blindness prevention programs in 6 Chongqing district/county hospitals (experimental group) and 481 patients (609 eyes) undergoing cataract surgery in the First Affiliated Hospital of Chongqing Medical University (controls). Uncorrected visual acuity (UCVA), refractive status, best corrected visual acuity (BCVA), slit lamp examination, and visual function/quality of life (VF-QOL) questionnaire scores were evaluated preoperatively, and at 1 and 6 months postoperatively. RESULTS: In the experimental group, UCVA, BCVA, and VF-QOL scores at 1 and 6 months were better than the preoperative values (P < 0.05), but lower than the control-group values (P < 0.05). Rates of good UCVA and BCVA outcomes (≤ 0.5 logMAR) in the experimental group were 76.2% and 87.6%, respectively, at 1 month and 68.9% and 83.1%, respectively, at 6 months. Most eyes in the experimental (82.1%) and control (89.5%) groups had refractive errors within ± 1 D at 1 month. At 6 months, posterior capsule opacification (PCO) was more common in the experimental group (20.9% vs. 15.0%, P < 0.05). At 6 months, the main causes of visual impairment (UCVA > 0.5 logMAR) in the experimental group were uncorrected refractive errors (33.0%), PCO (29.5%), and fundus diseases (33.9%). CONCLUSION: Cataract surgeries in blindness prevention programs in Chongqing significantly improved visual acuity, VF, and QOL, but underperformed compared to surgeries in the tertiary teaching hospital.

Spectrally flat mid-infrared supercontinuum pumped by a high power 2 µm noise-like pulse.

We demonstrate spectrally flat high-power mid-infrared supercontinuum (MIR SC) generation with record-breaking power of 33.1 W and power conversion efficiency of 75.06%. It is pumped by a 2 µm master oscillator power amplifier system consisting of a figure-8 mode-locked noise-like pulse seed laser and dual-stage Tm-doped fiber amplifiers with repetition rate of 4.08 MHz. Through cascading a piece of ZBLAN fiber with 13.5 µm large core diameter by direct-low-loss fusion splicing, SCs with spectral ranges of 1.9-3.68 µm, 1.9-3.84 µm, 1.9-4.02 µm and average powers of 33.1 W, 29.8 W, 25.9 W are generated. To the best of our knowledge, all of them have achieved the highest output power under the same condition of MIR spectrum range. This high-power all-fiber MIR SC laser system has relatively simple architecture, high efficiency and flat spectrum, demonstrating the advantages of 2 µm noise-like pulse pump in high-power MIR SC generation.

Physiological analysis reveals the mechanism of accelerated growth recovery for rice seedlings by nitrogen application after low temperature stress.

Low temperature and overcast rain are harmful to directly seeding early rice, it can hinder rice growth and lower rice biomass during the seedling stage, which in turn lowers rice yield. Farmers usually use N to help rice recuperate after stress and minimize losses. However, the effect of N application on the growth recovery for rice seedlings after such low temperature stress and its associated physiological changes remain unclearly. Two temperature settings and four post-stress N application levels were used in a bucket experiment to compare B116 (strong growth recovery after stress) with B144 (weak growth recovery). The results showed that the stress (average daily temperature at 12°C for 4 days) inhibited the growth of rice seedlings. Compared to the zero N group, the N application group's seedling height, fresh weight and dry weight significantly increased after 12 days. In particular, the increases in all three growth indicators were relatively higher than that of N application at normal temperature, indicating the importance of N application to rice seedlings after low temperature stress. The antioxidant enzyme activity of rice seedlings increased significantly after N application, which reduced the damaging effect of ROS (reactive oxygen species) to rice seedlings. At the same time, the soluble protein content of seedlings showed a slow decrease, while the H2O2 and MDA (malondialdehyde) content decreased significantly. Nitrogen could also promote nitrogen uptake and utilization by increasing the expression of genes related to NH 4 + and NO 3 - uptake and transport, as well as improving the activity of NR (nitrate reductase) and GS (glutamine synthetase) in rice. N could affect GA3 (gibberellin A3) and ABA (abscisic acid) levels by regulating the anabolism of GA3 and ABA. The N application group maintained high ABA levels as well as low GA3 levels from day 0 to day 6, and high GA3 levels as well as low ABA levels from day 6 to day 12. The two rice varieties showed obvious characteristics of accelerated growth recovery and positive physiological changes by nitrogen application after stress, while B116 generally showed more obvious growth recovery and stronger growth-related physiological reaction than that of B144. The N application of 40 kg hm-2 was more conducive to the rapid recovery of rice growth after stress. The above results indicated that appropriate N application promoted rice seedling growth recovery after low temperature stress mainly by increasing the activities of antioxidant enzymes and nitrogen metabolizing enzymes as well as regulating the levels of GA3 and ABA. The results of this study will provide a reference for the regulation of N on the recovery of rice seedling growth after low temperature and weak light stress.

Brain recovery of the NAc fibers and prediction of craving changes in person with heroin addiction: A longitudinal study.

BACKGROUND: Progress have been made in brain function recovery after long-term abstinence in person with heroin addiction (PHA). However, less is known about whether the nucleus accumbens (NAc) white matter pathways can recover in PHA by prolonged abstinence. METHODS: Forty-two PHA and Thirty-nine age- and gender- matched healthy controls (HCs) were recruited. Two MRI scans were obtained at baseline (PHA1) and 8-month follow-up (PHA2). We employed tractography atlas-based analysis (TABS) method to investigate fractional anisotropy (FA) changes in NAc fiber tracts (i.e., Insula-NAc, ventral tegmental area (VTA)-NAc, medial prefrontal cortex (MPFC)-NAc) in PHA. A partial least square regression (PLSR) analysis was carried to explore whether FA of NAc fiber tracts can predict longitudinal craving changes. RESULTS: Relative to HCs, lower FA was found in the right Insula-NAc and VTA-NAc fiber tracts in PHA1, and PHA2 showed increased FA values in these tracts compared with PHA1. Furthermore, changes of FA of NAc fiber tracts can predict longitudinal craving changes (r = 0.51). Additionally, craving changes can also be predicted from FA changes in the left Insula-NAc (r = 0.601) and VTA-NAc (r = 0.384) fiber alone. CONCLUSIONS: Results indicated that the right Insula-NAc and VTA-NAc fiber tracts are potential biomarkers for brain recovery. Prediction of craving changes highlighted the utility of structural markers to inform clinical decision-making of treatment for PHA.

A Metamodel-Based Multi-Scale Reliability Analysis of FRP Truss Structures under Hybrid Uncertainties.

This study introduces a Radial Basis Function-Genetic Algorithm-Back Propagation-Importance Sampling (RBF-GA-BP-IS) algorithm for the multi-scale reliability analysis of Fiber-Reinforced Polymer (FRP) composite structures. The proposed method integrates the computationally powerful RBF neural network with GA, BP neural network and IS to efficiently calculate inner and outer optimization problems for reliability analysis with hybrid random and interval uncertainties. The investigation profoundly delves into incorporating both random and interval parameters in the reliability appraisal of FRP constructs, ensuring fluctuating parameters within designated boundaries are meticulously accounted for, thus augmenting analytic exactness. In application, the algorithm was subjected to diverse structural evaluations, including a seven-bar planar truss, an architectural space dome truss, and an intricate nonlinear truss bridge. Results demonstrate the algorithm's exceptional performance in terms of model invocation counts and accurate failure probability estimation. Specifically, within the seven-bar planar truss evaluation, the algorithm exhibited a deviation of 0.08% from the established failure probability benchmark.

2.1 µm, 1.52 µJ square-wave noise-like pulse from an all-fiber figure-of-9 Ho-doped oscillator and single-stage amplifier.

A 2.1 µm, high energy square-wave noise-like pulse (NLP) in an all-fiber Ho-doped fiber laser is proposed, which consists of an oscillator and a single-stage amplifier. In the figure-of-9 oscillator, mode-locking is achieved based on the nonlinear amplifying loop mirror, employing a long gain fiber to provide sufficient gain in 2.1 µm band and optimizing the cavity length to obtain maximum pulse energy output. With appropriate pump power and polarization state, the oscillator emits a 175.1 nJ square-wave NLP with center wavelength of 2102.2 nm and spike width of 540 fs. The 3-dB spectral width and pulse envelope width are 11.2 nm and 6.95 ns, respectively. The single-stage amplifier employs a bi-directional pump scheme. After amplification, 5.8 W NLP with a slope efficiency of 56.8% is obtained. The pulse energy of NLP is scaled to 1.52 µJ, which is the highest pulse energy of NLP at 2.1 µm to the best of our knowledge. The obtained high-energy square-wave NLP-fiber laser has great potential in mid-infrared laser generation.

Hectowatt-level GHz burst-mode all-fiber laser based on dissipative soliton resonance.

We demonstrate a high power Yb-doped burst-mode all-fiber laser system operating at GHz intra-burst repetition rate. To our knowledge, it is the first report utilizing dissipative soliton resonance (DSR) to generate tunable burst-mode rectangular pulses. Due to the tunable duration and the rapid rise/fall time for DSR pulses, a 1-10 ns adjustable burst pulse duration is achieved. The intra-burst with sinusoidal waveform can be tuned from 0.8 GHz to 1.5 GHz and actively modulated by an electro-optic modulator (EOM). Amplified by a three-stage Yb-doped fiber amplifier (YDFA), the output power achieves 304 W at 10 ns of burst duration, and the maximum peak power reaches over 50 kW at 2 ns of burst duration. This laser system is anticipated to be applied to generate high power arbitrary microwave signal.

Effect of ambient temperature on outpatient admission for osteoarthritis and rheumatoid arthritis in a subtropical Chinese city.

BACKGROUND: Current findings on the impact of weather conditions on osteoarthritis (OA) and rheumatoid arthritis (RA) are sparse and not conclusive. This study aimed to investigate the relationship between temperature change and OA/RA admission. METHODS: Daily OA/RA admission, meteorological data and pollutants from 1 January 2014 to 31 December 2017 in Hefei, China, were collected. We quantified the relationship between ambient temperature and OA/RA admission using a distributed lag nonlinear model (DLNM). Stratified analyses by gender and age were also examined. RESULTS: Temperature decrease was significantly associated with RA admission (25th percentile of temperature versus 50th percentile of temperature), with the acute and largest effect at current days lag (RR: 1.057, 95%CI: 1.005-1.111). However, no significant association between temperature and OA admission was observed. When conducting subgroup analyses by individual characteristics, we found that females and patients aged 41-65 years were more vulnerable to temperature decrease than males, patients aged 0-40 and ≧66 years, respectively. CONCLUSIONS: This study suggested that temperature decrease was a risk factor for increases in RA admission. Females and patients aged 41-65 years were particularly vulnerable to the effect of temperature decrease.

Repair Versus Non-Repair of Lateral Ulnar Collateral Ligament in Elbow Varus Posteromedial Rotatory Instability Treatment: A Comparative Study.

OBJECTIVE: To compare the effects of repairing and not repairing the lateral ulnar collateral ligament (LUCL) when surgically treating elbow varus posteromedial rotatory instability (PMRI). METHODS: In this retrospective study spanning June 2014 to February 2019, 24 patients with elbow PMRI who were treated surgically were assigned to group RL (Repair LUCL) or group NL (Non-repair LUCL) depending on whether the LUCL was repaired. Hospitalization time, operation time, intraoperative blood loss, and related complications were reviewed. The elbow range of motion (ROM), the visual analog scale (VAS), the Mayo elbow performance score (MEPS), and the disabilities of the arm, shoulder, and hand (DASH) score were used for functional assessment. RESULTS: Among the 24 patients with PMRI, 15 were assigned to group RL and nine were assigned to group NL. The mean blood loss (184.66 ± 20.3 vs 207.33 ± 19.447, P < 0.001), the operation time (98.88 ± 12.693 min vs 184.66 ± 20.3 min, P < 0.001) were significantly lower in group RL compared to group NL. There were no significant differences between the two groups in time until surgery and follow-up time (6.66 ± 1.838 vs 6.11 ± 1.900 days, 25.53 ± 2.099 vs 26.11 ± 2.891 months, P = 0.577, P = 0.486). All of the patients achieved bone union. The elbow flexion-extension ROM (122.00° ± 3.162°vs 121.11° ± 3.333° at 12 months, P = 0.520) and pronation-supination ROM (154.53° ± 3.335° vs 155.55° ± 4.639° at 12 months, P = 0.537). Both groups achieved similar results in MEPS score (90.53 ± 2.695 vs 89.77 ± 3.865, P = 0.578) and DASH (9.77 ± 1.897 vs 9.99 ± 1.550, P = 0.772) score at the final follow-up. And the MEPS score revealed excellent results (87% in group RL, 89% in group NL).The VAS scores decreased significantly in group RL (from 6.13 ± 0.990 to 1.93 ± 0.593) and group NL (from 5.77 ± 1.481 to 1.88 ± 0.781), and no significant differences in preoperative or final follow-up were observed between the two groups (P = 0.487, P = 0.876). Complications observed in group NL with one patient occurred cubital tunnel syndrome 3 months after the operation, the patient underwent ulnar nerve simple neurolysis and the symptoms were relieved after 3 weeks. CONCLUSION: For patients with elbow PMRI, satisfactory functional outcomes can be yielded with non-repair of the LUCL as long as the stable elbow joint is performed during operation.

Pulse evolution and multi-pulse state of coherently coupled polarization domain walls in a fiber ring laser.

Pulse evolution and multi-pulse state of coherently coupled polarization domain walls (PDW) is experimentally demonstrated in a novel fiber ring laser. Versatile pulse shapes benefit by wide range moving of PDW in the weakly birefringent fiber. The 8.6 m short-cavity structure is more compact and accessible based on a 976 nm pump with nearly zero negative dispersion (-0.0002 ps2). Besides, multi-pulse patterns such as PDW splitting, harmonic mode-locking, and periodic soliton collision are also observed under larger net negative dispersion (-3.09 ps2) and 151m-longer cavity. This is the first demonstration of coherently coupled PDW in a fiber laser using a bandpass filter and the formation of coherently coupled PDW is ascribed to the BPF's force filtering.

Impact of temperature variability on childhood allergic rhinitis in a subtropical city of China.

BACKGROUND: Many studies have shown an association of childhood respiratory diseases with short-term temperature variability such as diurnal temperature range (DTR) and temperature change between two neighboring days (TCN). However, the impact of temperature variability on allergic rhinitis (AR) has not been investigated so far. This study sought to evaluate the short-term effect of temperature variability (i.e., TCN and DTR) on AR, as well as to identify vulnerable subpopulations. METHOD: We collected daily data on emergency room visits and outpatients for AR and weather variables in Hefei, China during 2014-2016. A distributed lag non-linear model that controlled for long-term trend and seasonality, mean temperature, relative humidity, day of week was used to fit the associations of AR with DTR and TCN. Stratified analyses by age, sex and occupation were also performed. RESULTS: During the study period, there were a total of 53,538 cases and the average values of DTR and TCN were 8.4 °C (range: 1.0 °C to 21.2 °C) and 0 °C (range: - 12.2 °C to 5.9 °C), respectively. While we did not observe an adverse effect of DTR on AR, TCN was significantly associated with increased risk of AR. Specifically, a large temperature drop between two adjacent days (3.8 °C, 5th percentile of TCN) has a delayed and short-lasting effect on AR, with the estimated relative risk of 1.02 (95% confidence interval: 1.01 to 1.04) at lag 12. Moreover, boys and children older than 15 years seemed to be more vulnerable to the effect of TCN. CONCLUSIONS: This study provided evidence of an adverse effect of large temperature drops between two adjacent days on childhood AR. Attention paid to boys and older children may help prevent AR attacks.

Switchable generation of a sub-200 fs dissipative soliton and a noise-like pulse in a normal-dispersion Tm-doped mode-locked fiber laser.

We report on the switchable generation of a dissipative soliton (DS) pulse and a noise-like pulse (NLP) in an all-fiberized Tm-doped fiber laser in the normal-dispersion region. Mode-locking operation is achieved through a nonlinear polarization rotation component, and the cavity dispersion is compensated using ultra-high numerical aperture (UHNA4) fiber that is easy to integrate and low in cost. At a pump threshold of 510 mW, DS operation can first be achieved without additional filter. The 3 dB spectrum bandwidth of the DS pulse is greater than 50 nm, and the duration of the de-chirped pulse is 193 fs. By increasing the pump power to 880 mW, the mode-locking state can evolve into NLP operation with proper cavity polarization state. The 3 dB spectrum bandwidth and duration of de-chirped coherence spike are 105.6 nm and 121 fs, respectively. Meanwhile, ultra-broadband NLP (over 150 nm considering 3 dB spectrum width) can also be observed with the appropriate cavity parameters. All the proposed pulse patterns present good capacity for achieving narrow pulse width and withstanding high pulse energy.

Durational effect of particulate matter air pollution wave on hospital admissions for schizophrenia.

BACKGROUND: Short-term exposure to high level of ambient particulate matters (PM) concentrations has been linked with increased hospital admissions (HA) for schizophrenia. However, evidence is inconclusive about the added effect of multi-day exposure to high-level PM concentration on schizophrenia. This study aims to evaluate the durational effect of PM air pollution wave on schizophrenia. METHOD: Data on daily HA for schizophrenia, PM (PM2.5 and PM10) and meteorological variables over the period of 2014-2017 was collected in Jining, Shandong, China. Air pollution wave of PM was defined as ≥2 or ≥3 or ≥4 consecutive days with PM concentration ≥90th or ≥92.5th or ≥95th or ≥97.5th percentiles, respectively. A time-series Poisson regression model with duration as the variable of interest was used to evaluate the associations of PM air pollution wave with HA for schizophrenia. RESULTS: A total of 14650 hospital admissions for schizophrenia were identified. Under various air pollution wave definitions, both PM2.5 and PM10 had significant adverse effects on schizophrenia HA. PM2.5 wave defined as ≥2 consecutive days with concentration ≥90th, ≥92.5th, ≥95th and ≥97.5th percentile was associated with 4.8% (2.0%-7.6%), 4.9% (1.9%-7.9%), 5.5% (2.0%-9.2%), and 7.6% (2.9%-12.6%) increase of HA for schizophrenia at lag 6. PM2.5 waves defined as ≥3 consecutive days with concentration ≥90th, ≥92.5th, ≥95th and ≥97.5th percentile respectively corresponded to 5.0% (2.3%-7.8%), 5.1% (1.9%-8.4%), 6.9% (3.0%-10.8%) and 12.0% (5.3%-19.1%) increases in HA for schizophrenia at lag 6. The most significant associations were observed on the sixth day in different lag models. CONCLUSIONS: PM air pollution wave was associated with increased risk of hospital admissions for schizophrenia, with stronger associations among married and female patients.

Novel coronavirus (SARS-CoV-2) infection in a renal transplant recipient: Case report.

An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in Wuhan, China, with cases now confirmed in multiple countries. The clinical course of patients remains to be fully characterized, clinical presentation ranges from asymptomatic infection to acute respiratory distress syndrome and acute renal failure, and no pharmacological therapies of proven efficacy yet exist. We report a case of SARS-CoV-2 infection in a renal transplant recipient with excellent outcome. This case states the importance of close monitoring of the concentration of cyclosporine in patients treated with lopinavir/ritonavir; the routine treatment of corticosteroid can be continued. This is a rare report of SARS-CoV-2 infection in a renal transplant recipient. Further data are needed to achieve better understanding of the impact of immunosuppressive therapy on the clinical presentation, severity, and outcome of SARS-CoV-2 infections in solid organ transplant recipients.

Self-organized structures of bound states in a 2 µm dispersion-managed mode-locked fiber laser.

We report on the experimental generation of various self-organized structures of bound states in a near zero-dispersion mode-locked fiber laser. When the pump power is fixed at 492 mW, appropriately adjusting polarization controllers, the switching of the cavity feedback results in the evolution from the single pulse to the dispersion-managed soliton (i.e., stretched-pulse) pair. With the increase of pump power, bound states composed of more than two pulses can also be observed. Our results of the self-organized structures might enlarge the data-carrying capacity of current fiber-optical communication systems and benefit the investigation of nonlinear dynamics of bound states in fiber lasers at 2 µm.

Observation of sub-400fs, wavelength-switchable stretched pulse and bound-state pulse in Tm-doped fiber laser.

We report on the experimental observation of wavelength-switchable stretched pulse and bound-state pulse in a dispersion-managed Tm-doped laser. At a pump power of 572 mW, a stretched pulse with a pulse duration of 389 fs can be first obtained at 1961 nm. By increasing the pump power and appropriately adjusting the cavity polarization state, the mode-locking wavelength can be switched from 1961 nm to 1980 nm caused by the birefringence filtering effect based on nonlinear polarization rotation, and the corresponding pulse duration is 371 fs. Meanwhile, loosely bound states of two pulses and three pules at 1980 nm can be observed with appropriate cavity parameters.

Risk effects of high and low relative humidity on allergic rhinitis: Time series study.

BACKGROUND: The relationship between environmental factors and allergic rhinitis (AR) has become a focal point recently. However, few studies have investigated the adverse effects of both high relative humidity (RH) and low relative humidity. Moreover, the laged effect and disease burden of RH on AR were also neglected. OBJECTIVES: To explore the association of both high and low RH on daily AR hospital outpatients, and to quantify the corresponding disease burden attributable to RH. METHODS: In our study, we define 95th as high RH and 5th as low RH. A distributed lag non-linear model (DLNM) combined with a Poisson generalized linear regression model were applied to analyze the relationship between RH and hospital outpatients for AR. All patients were retrieved from Anhui Provincial Children's Hospital (n = 37,221) from January 2015 to December 2016. Daily meteorological and air pollutant data were collected by Hefei Meteorological Bureau and Environmental Protection Agency. Subgroup analyses were conducted by gender and occupational groups. RESULTS: Acute adverse effects of high and low RH on AR were explored respectively, with an increase of daily AR outpatients when encountered high and low RH. The low RH presented a risk effect at current day and lasted up to the eighth day. However, high RH began to appear a risk effect on the fourth day. Notably, the fraction of hospital outpatients attributable to low RH was 5.22% (95% CI: 1.92%, 8.33%) and high RH was 4.07% (95% CI: 1.13%, 7.30%) in the backward perspective. Additionally, male and students apparent to be more sensitive to the effects of low RH. CONCLUSION: This study suggests that both high and low RH are potential trigger for AR hospital outpatients in Hefei, China. Our studies might offer valuable messages to health practitioners and useful direction to decisions-makers respectively.

Trimester-specific association between antibiotics exposure during pregnancy and childhood asthma or wheeze: the role of confounding.

PURPOSE: We conducted the meta-analysis to respectively evaluate the risk of prenatal antibiotics use during specific trimesters (first, second, and third trimester) on childhood asthma or wheeze and to explore whether the association was biased by potential confounding. METHODS: The quality of included articles was assessed according to Newcastle-Ottawa Quality Assessment Scale and the Strengthening the Reporting of Observational Studies in Epidemiology. A random effects model was used to calculate pooled risk ratios and corresponding 95% confidence interval (CI), and publication bias was tested by Egger statistical test. RESULTS: Eight studies were included finally. We found a crude positive association of prenatal antibiotics use during each pregnancy trimester and risk of childhood asthma or wheeze with RRs of 1.28 (95% CI, 1.09-1.51) for the first trimester of pregnancy, 1.25 (95% CI, 1.02-1.52) for the second trimester, and 1.25 (95% CI, 1.05-1.49) for the third trimester. However, when considering potential factors of maternal infections and presence of siblings, the relationship for each trimester was insignificant. CONCLUSIONS: This systemic review and meta-analysis proposed a crude positive association between prenatal antibiotic use in every specific trimester and risk of childhood asthma or wheeze. However, adjustment for confounders decreased the relative risk estimates, supporting the concept that these associations are, at least in part, because of confounding by indication.

The short-term association between air pollution and childhood asthma hospital admissions in urban areas of Hefei City in China: A time-series study.

BACKGROUND: The impacts of air pollution on asthma attacks have become a hotspot. Previous studies mainly focused on the developed countries or cities. There have been very limited studies in less-developed region to quantify the effects of air pollutants on asthma admissions in children. This study aims to assess the short-term impact of air pollutants on asthma hospital admissions for children in Hefei, China. METHODS: Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) were applied to investigate the effects of air pollutants on daily childhood hospital admissions of asthma from 2015 to 2016, controlling for meteorological factors. Subgroup analyses by sex and age were performed. RESULTS: There were a total of 17,227 asthma admissions during 2015-2016. We found positive correlations between childhood asthma hospital visits and concentrations of NO2, O3, PM10 and PM2.5. Significantly, NO2 exhibited robust positive correlations with cumulative effects 1.551 (95% CI: 1.306-1.841, lag0-3 days) in single-pollutant model and 1.580 (95% CI: 1.315-1.899, lag0-3 days) in multiple-pollutant model. CONCLUSIONS: Air pollutants had adverse effects on childhood asthma. NO2 presented the greatest effect, followed by PM2.5. Results will be important for health authority and guardians to realize the severity of air pollution on the increased risk of asthma, so as to develop relevant strategies and health interventions to meet the challenges of childhood asthma and reduce air pollution.

Sequence analysis-based characterization and identification of neurovirulence-associated variants of 36 EV71 strains from China.

Enterovirus 71 (EV71) is the main pathogen of hand-foot-mouth disease (HFMD) and causes several neurological complications. As new strains of EV71 are constantly discovered, it is important to understand the genomic characteristics of the viruses and the mechanism of virulence. Herein, we isolated five strains of EV71 from HFMD patients with or without neurovirulence and sequenced their whole genomes. We then performed whole genome sequence analysis of totally 36 EV71 strains. The phylogenetic analysis of the VP1 region revealed all five isolated strains are clustered into C4a of C4 subgenotype. In addition, by comparing the complete genome sequences of 36 strains, 253 variable amino acid positions were found, 14 of which were identified to be associated with neurovirulence (P < 0.05). Moreover, a similar pattern of amino acid variants combination was identified in four strains without neurovirulence, indicating this type of variant pattern might be associated with avirulence. The strains with neurovirulence appeared to be distinguished from those without neurovirulence by the variants in VP1 and P2 regions, implying VP1 and P2 are the important regions associated with neurovirulence. Indeed, 3-D modeling of VP1 and P2 regions of non-neurovirulent and neurovirulent strains revealed that the different variants resulted in different protein structures and amino acid composition of ligand binding site, which might account for their difference in neurovirulence. In summary, our study reveals 14 variable amino acid positions of VP1, P2 and P3 regions are related to the virulence and that mutations in the capsid proteins of EV71 might contribute to neurovirulence.