Objective To analyze the impact of maternal gestational weight gain (GWG) on adverse outcomes for mothers and infants. Methods A retrospective analysis was conducted, collecting relevant information on 9,058 singleton pregnancies and newborns from prenatal check-ups and deliveries at Guangdong Women and Children Hospital from 2017 to 2022. The subjects were grouped according to different GWG, and logistic regression was used to analyze the impact of GWG on adverse outcomes, including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), large-for-gestational-age infants (LGA), small-for-gestational-age infants (SGA), and preterm births. Results Among the 9058 participants included in the study, there were 438 cases (4.8%) of HDP, including 266 cases (2.9%) of gestational hypertension and 172 cases (1.9%) of preeclampsia. Additionally, there were 2018 cases (22.3%) of GDM; Among the adverse birth outcomes for newborns, the prevalence was 9.7% for SGA, 9.9% for LGA, 1.4% for early/mid-term preterm births, and 4.2% for late preterm births. After adjusting for confounding factors, the results showed that, excessive GWG was a risk factor for HDP (OR=1.829, P <0.05) and LGA (OR=1.792, P<0.05) compared to the normal gestational weight gain group. Insufficient GWG increased the risk of GDM (OR=2.203, P<0.05), SGA (OR=1.474, P<0.05) and was also a risk factor for early/mid-term preterm infants (OR=3.326, P<0.05) and late preterm infants (OR=1.715, P<0.05). Conclusion Excessive GWG is a risk factor for the occurrence of HDP and LGA, while insufficient GWG increases the risk of GDM, SGA and preterm infants (especially early/mid-term preterm infants). Therefore, it is recommended to strengthen the monitoring of weight changes during pregnancy in women of childbearing age, guide nutritional management during pregnancy, and keep GWG within a reasonable range to prevent adverse outcomes for mothers and infants.
Designing feasible and effective architectures under diverse computational budgets, incurred by different applications/devices, is essential for deploying deep models in real-world applications. To achieve this goal, existing methods often perform an independent architecture search process for each target budget, which is very inefficient yet unnecessary. More critically, these independent search processes cannot share their learned knowledge (i.e., the distribution of good architectures) with each other and thus often result in limited search results. To address these issues, we propose a Pareto-aware Neural Architecture Generator (PNAG) which only needs to be trained once and dynamically produces the Pareto optimal architecture for any given budget via inference. To train our PNAG, we learn the whole Pareto frontier by jointly finding multiple Pareto optimal architectures under diverse budgets. Such a joint search algorithm not only greatly reduces the overall search cost but also improves the search results. Extensive experiments on three hardware platforms (i.e., mobile device, CPU, and GPU) show the superiority of our method over existing methods.
Objectives: Some genetic causes of heterotaxy have been identified in a small number of heterotaxy familial cases or animal models. However, knowledge on the genetic causes of heterotaxy in the fetal population remains scarce. Here, we aimed to investigate the clinical characteristics and genetic spectrum of a fetal cohort with heterotaxy. Methods: We retrospectively investigated all fetuses with a prenatal diagnosis of heterotaxy at a single center between October 2015 and November 2020. These cases were studied using the genetic testing data acquired from a combination of copy number variation sequencing (CNV-seq) and whole-exome sequencing (WES), and their clinical phenotypes were also reviewed. Result: A total of 72 fetuses diagnosed with heterotaxy and complete clinical and genetic results were enrolled in our research. Of the 72 fetuses, 18 (25%) and 54 (75%) had left and right isomerism, respectively. Consistent with the results of a previous study, intracardiac anomalies were more severe in patients with right atrial isomerism than in those with left atrial isomerism (LAI) and mainly manifested as atrial situs inversus, bilateral right atrial appendages, abnormal pulmonary venous connection, single ventricles or single atria, and pulmonary stenosis or atresia. In 18 fetuses diagnosed with LAI, the main intracardiac anomalies were bilateral left atrial appendages. Of the 72 fetuses that underwent CNV-seq and WES, 11 (15.3%) had positive genetic results, eight had definitive pathogenic variants, and three had likely pathogenic variants. The diagnostic genetic variant rate identified using WES was 11.1% (8/72), in which primary ciliary dyskinesia (PCD)-associated gene mutations (CCDC40, CCDC114, DNAH5, DNAH11, and ARMC4) accounted for the vast majority (n = 5). Other diagnostic genetic variants, such as KMT2D and FOXC1, have been rarely reported in heterotaxy cases, although they have been verified to play roles in congenital heart disease. Conclusion: Thus, diagnostic genetic variants contributed to a substantial fraction in the etiology of fetal heterotaxy. PCD mutations accounted for approximately 6.9% of heterotaxy cases in our fetal cohort. WES was identified as an effective tool to detect genetic causes prenatally in heterotaxy patients.
To verify the hypothesis that cystic fibrosis transmembrane conductance regulator (CFTR) is expressed in neurons of the human spinal cord, we investigated the presence and distribution of CFTR protein and mRNA in different segments of the human spinal cord obtained from autopsies. The techniques employed included reverse transcriptase-polymerase chain reaction (RT-PCR) to detect CFTR gene expression, in situ hybridization to detect mRNA distribution, and immunohistochemistry to detect protein distribution. The specificity of these experiments was established with extensive controls. We found widespread and abundant expression of CFTR in neurons of the human spinal cord. CFTR protein and mRNA are localized to the cytoplasm of neurons in all segments of the spinal cord but not to glial fibrillary acidic protein (GFAP)-positive cells. CFTR is a very important molecule, acting as a chloride channel and regulating many physiological functions, including salt transport, fluid flow, and intracellular ion concentrations. Its mutation causes cystic fibrosis. Our finding of abundant CFTR in the spinal cord suggests that this molecule may be significant in the normal function and pathology of the spinal cord.
In this paper, the S-transform is used to analyze the nuclear explosion and lightning electromagnetic pulses for NEMP and LEMP signals based on their non-stationary and non-linear characters. The region features of S-transform time-frequency spectrums of NEMP and LEMP signals are calculated to discriminate them. Then, the discrimination of NMEP is studied using nearest neighbor classification. At last, the discrimination result is analyzed based on the different mechanisms of the nuclear explosion and lightning. The experiment results indicated that, using the nearest neighbor pattern classification method, the average discrimination rate of NEMP and LEMP is over 85% based on angle relative to lateral axis region features of time-frequency spectrum. Finally, we get a conclusion that the image region features of the S-transform spectrum are effective features to discriminate NEMP and LEMP, which is possible to provide technical support for real-time, fast and effective monitoring of foreign nuclear test, and provide basis for decision making for the intelligence agencies.
Background Dupilumab is an antibody against interleukin-4 receptor α, used in the treatment of atopic dermatitis (AD). Objectives To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD. Methods In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300 mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both an Investigator's Global Assessment score of 0–1 and a reduction from baseline of ≥ 2 points at week 16. Results Overall, 165 patients (mean age 30·6 years; 71·5% male patients) were randomized; 82 patients were randomized to dupilumab and 83 patients were randomized to placebo. At week 16, 26·8% of patients in the dupilumab group and 4·8% of patients in the placebo group achieved the primary endpoint [difference 22·0%, 95% confidence interval (CI) 11·37–32·65; P < 0·001]. Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥ 75% reduction in the Eczema Area and Severity Index score (57·3% vs. 14·5%; difference 42·9%, 95% CI 29·75–55·97; P < 0·001) and had ≥ 3-point (52·4% vs. 9·6%; difference 42·8%, 95% CI 30·26–55·34; P < 0·001) and ≥ 4-point (39·0% vs. 4·8%; difference 34·2%, 95% CI 22·69–45·72; P < 0·001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of treatment-emergent adverse events during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis and injection site reaction was higher in the dupilumab group than in the placebo group. Conclusions In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favourable safety profile.
To evaluate the effectiveness of multiple risk factor interventions for hypertension prevention in the community.Twelve trials of multiple risk factor interventions for community-wide hypertension prevention according to the selective criteria were assessed by Meta-analysis, from 1970 to 1997. According to the heterogeneity of the studies, two different models, namely, Fixed Effect Model and Random Effect Model, were applied to analyze the results.The intervention effects of community-based hypertension control trials were estimated to be: a 1.75 mmHg (s(x) 0.57 mmHg) net decrease in mean systolic blood pressure, a 1.45 mmHg (s(x) 0.43 mmHg) net decrease in mean diastolic blood pressure in general population, 0.24 kg/m(2) (s(x) 0.08 kg/m(2)) and 0.32 kg/m(2) (s(x) 0.15 kg/m(2)) net decreases in body mass index among the total population and female population respectively, a 2.97% reduction in hypertension prevalence, and a 133/100,000 reduction in stroke prevalence in the Chinese population. The intervention effects for the treatment and controlled of hypertensive were significant to increase 25.07% and 40.45% in the rates and controlled of treatment respectively. No significant changes were noticed in the rates of smoking and hypertensive awareness in the general population.The results showed that the community-based multiple risk factor interventions for hypertension had positive impaction the reduction of risk factors to hypertension, thus to increase the effects on treatment and control of hypertension, decrease prevalences of hypertension and stroke.
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