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The autoimmune disease amyopathic dermatomyositis–associated interstitial lung disease, which is related to anti–melanoma differentiation–associated protein 5 antibodies, is often rapidly progressive. Patients who received glucocorticoids and tofacitinib had improved survival.

This paper establishes an intelligent framework for real-time prediction of trajectory deviations in the process of earth pressure balance (EPB) tunnelling. A hybrid model was developed which integrates principal component analysis (PCA) and a gated recurrent unit (GRU). PCA was adopted to mine the interrelated input parameters and reduce the accompanying data noise. A scroll window mode was implemented in the GRU to predict the shield movement in real time. The proposed PCA–GRU model was implemented and validated through a case study of the Guang-Fo intercity railway in Guangzhou, China. Another three machine learning models were also used for comparison. The results revealed that the proposed model predicted the shield moving trajectory with higher precision than other models. The implications for trajectory regulation were discussed using field data. The proposed prediction framework represents a promising solution for real-time prediction of the shield moving trajectory in EPB tunnelling.

The interaction between a waterproof curtain and withdrawal wells (or simply, the wall-well effect) is a key factor in controlling the environmental effects that occur during the dewatering of foundation pits. A series of laboratory investigations was conducted to study the changes in groundwater level during dewatering. The influence of the buried depth of the waterproof curtain placed in a dewatering confined aquifer (D), and the filter length of the pumping well (L), is investigated. Based on the laboratory test results, numerical simulations are used to analyse the ground settlement. The relationship between the approximate hydraulic gradients on both sides of the wall (Δi), or the ground settlement outside the excavation (S), using ratio RD (D divided by the thickness of the confined aquifer) or ratio RL (L divided by the thickness of the confined aquifer), can be simulated using a Boltzmann curve. The value of Δi increases while S decreases with an increase in RD, whereas Δi decreases while S increases with an increase in RL. The value of the contraflexure point of the Boltzmann curve is regarded as the effective value of RD or RL. Based on a comprehensive consideration, RD is suggested to be equal to or larger than the effective value, and RL is suggested to be equal to or lesser than the effective value.

Urban ground collapse (UGC) is becoming more common in China, resulting in significant socioeconomic losses and even personal casualties. The frequency of UGC accidents is highest in the east coastal area owing to developed urbanization, while it is lowest in the northeast area because of its smallest land area. Natural causes (such as geological conditions and rainfall) and artificial causes (such as groundwater withdrawal, underground pipeline breakage, underground engineering, and other reasons) all contribute to UGC accidents in China. Groundwater influences most factors that lead to UGC. Adverse geology, such as collapsible loess and karst geology, is sensitive to groundwater. The groundwater environment is vulnerable to rainfall, pipeline leakage or groundwater withdrawal. Under the action of groundwater, the steady state of the soil may change, which finally leads to UGC. Groundwater control, which is essential for mitigating the risk of UGC, can be implemented through detailed geological surveys, sponge city and utility tunnel construction, and groundwater–level control measurement.

Using the US collection from the Global Historical Climatology Network Daily (GHCN-D) precipitation data for the contiguous United States (CONUS), this study examines the changing characteristics of precipitation during 1951–2013. In addition to mean precipitation, all precipitation events are divided into three categories: light, moderate, and heavy based on percentile thresholds. The historical trends are established for precipitation total, frequency and intensity, as well as for total and frequency of different intensity categories. Results show that from 1951 to 2013, mean precipitation increased at 1.66 % per decade, a higher rate than previous estimates. About one third of the increase is attributed to frequency change, whereas the other two thirds are attributed to an intensity increase. There was a slight decrease in light precipitation, a small increase in moderate precipitation, and much higher increase for heavy precipitation. Spatially, eastern and northern parts of the CONUS experienced higher rates of increase, whereas western regions experienced less increase. A statistically significant positive correlation exists between mean precipitation and precipitation change, suggesting the wet regions experienced more precipitation increase than dry regions. Seasonally, precipitation increased most for the fall, less in other seasons. Particularly, there were significant decreasing trends in summer precipitation for many parts of western and central CONUS. Regional frequency analysis is used to examine the change in extreme precipitation events with return intervals longer than a year. Results show that extreme precipitation events increased for most of the CONUS with the exception of the west region. These changes were a result of both a shift in the mean state and the shape of the precipitation data distribution.

Tertiary lymphoid structures are immune cell aggregates linked with cancer outcomes, but their interactions with tumour cell aggregates are unclear. Using nasopharyngeal carcinoma as a model, here we analyse single-cell transcriptomes of 343,829 cells from 77 biopsy and blood samples and spatially-resolved transcriptomes of 31,316 spots from 15 tumours to decipher their components and interactions with tumour cell aggregates. We identify essential cell populations in tertiary lymphoid structure, including CXCL13 + cancer-associated fibroblasts, stem-like CXCL13 + CD8 + T cells, and B and T follicular helper cells. Our study shows that germinal centre reaction matures plasma cells. These plasma cells intersperse with tumour cell aggregates, promoting apoptosis of EBV-related malignant cells and enhancing immunotherapy response. CXCL13 + cancer-associated fibroblasts promote B cell adhesion and antibody production, activating CXCL13 + CD8 + T cells that become exhausted in tumour cell aggregates. Tertiary lymphoid structure-related cell signatures correlate with prognosis and PD-1 blockade response, offering insights for therapeutic strategies in cancers. The interactions between tertiary lymphoid structures (TLS) and tumor cell aggregates remain to be investigated. Here, single-cell and spatial transcriptomics reveal the cellular composition, formation, and function of TLS during tumour progression and immunotherapy response in nasopharyngeal carcinoma.

Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5 + DM) is an autoimmune condition associated with rapidly progressive interstitial lung disease and high mortality. The aetiology and pathogenesis of MDA5 + DM are still largely unknown. Here we describe the immune signatures of MDA5 + DM via single-cell RNA sequencing, flow cytometry and multiplex immunohistochemistry in peripheral B and T cells and in affected lung tissue samples from one patient. We find strong peripheral antibody-secreting cell and CD8 + T cell responses as cellular immune hallmarks, and over-stimulated type I interferon signaling and associated metabolic reprogramming as molecular immune signature in MDA5 + DM. High frequency of circulating ISG15 + CD8 + T cells at baseline predicts poor one-year survival in MDA5 + DM patients. In affected lungs, we find profuse immune cells infiltration, which likely contributes to the pro-fibrotic response via type I interferon production. The importance of type I interferons in MDA5 + DM pathology is further emphasized by our observation in a retrospective cohort of MDA5 + DM patients that combined calcineurin and Janus kinase inhibitor therapy show superior efficacy to calcineurin inhibitor monotherapy. In summary, this study reveals key immune-pathogenic features of MDA5 + DM and provides a potential basis for future tailored therapies. Anti-melanoma differentiation-associated gene 5-positive dermatomyositis is a severe autoimmune disease with largely unknown aetiology. Here authors identify the key immune cell types that contribute to the disease phenotype and implicate type I interferons signalling in the patho-mechanism.

Anti-melanoma differentiation-associated gene 5–positive dermatomyositis (MDA5+ DM) is a rare autoimmune disease predominantly reported in East Asia. MDA5+ DM is an intractable disease with impressively high mortality due to rapid-progressive interstitial lung disease (RPILD). Other typical clinical manifestations comprise DM-specific rash (Gottron’s papules, heliotrope rash) and amyopathic/hypomyopathic muscle involvement. Multiple prognostic factors have been identified. Baseline forced vital capacity (FVC) %-based staging could serve as a simplified risk stratification system. Serum biomarkers including MDA5 Ab titers, ferritin, KL-6 levels, and CD4+CXCR4+ T cell percentage could provide additional surrogate value of ILD severity and treatment response, as well as potential predictive value for survival. Spontaneous pneumomediastinum (PNM), ground-glass opacity (GGO), and consolidation were demonstrated to be the most significant features in pulmonary high-resolution computed tomography (HRCT) findings of MDA5+ DM-ILD. The semi-quantitative assessment of lesions in HRCT has also been demonstrated relevant to the outcome. The current treatment of this disease is still largely empirical. Immunosuppressive treatments, i.e., “triple therapy” (combination of high-dose glucocorticoids, tacrolimus, and intravenous cyclophosphamide) and JAK inhibitor-based therapy, are the mainstream regimens for MDA5+ DM-ILD, supported by the recently published trials. However, more efficacious regimen with favorable safety profile and high-level evidence is still urgently demanded for patients with MDA5+ DM-ILD, especially those at advanced-stage. We will summarize the terminology, etiology and pathogenesis, clinical features and outcome, prognostic factors, and treatment of MDA5+ DM-ILD in this review.

To promote sustainable development, the Chinese government launched a new municipal solid waste (MSW) classification strategy in 2017. Shanghai was selected as one of the first pilot cities for MSW classification. The Shanghai municipal government first established the new MSW classification policy in 2017. The Shanghai Municipal Solid Waste Management Regulation was published in 2019 and came into effect on 1 July 2019. This short communication reports on Shanghai’s new MSW classification policy and its implementation. The main content and measures adopted by Shanghai’s government to ensure the effective implementation of the new MSW classification policy are introduced. Besides, a SWOT (i.e., strengths, weaknesses, opportunities, and threats) analysis on the present policy and measures is conducted, and based on the results, some discussions and suggestions regarding the implementation of MSW classification in Shanghai and the whole of China are presented.

ObjectivesNeuropsychiatric SLE (NPSLE) lacks evidence-based treatment strategies. This study compared the effectiveness and safety profiles of obinutuzumab (OBZ) and rituximab (RTX) in patients with NPSLE.MethodsPatients with new-onset NPSLE meeting British Isles Lupus Assessment Group grade A criteria who received either OBZ or RTX between 2018 and 2024 at Renji Hospital, Shanghai Jiao Tong University School of Medicine (with ≥12 months follow-up) were included. Propensity score matching (1:2 ratio) based on age, sex and SLE Disease Activity Index (SLEDAI) was performed. The primary outcome was complete or partial response at 12 months. Kaplan-Meier curves compared therapeutic effectiveness. Safety profiles of OBZ and RTX were recorded.Results27 patients with new-onset NPSLE were included in this retrospective study, with 9 patients receiving OBZ and 18 patients receiving RTX. At 12 months, the primary outcome was achieved in 8 of 9 patients in the OBZ group and 13 of 18 patients in the RTX group (88.9% vs 72.2%; OR: 3.08, 95% CI 0.30 to 31.33; p=0.34). Compared with the RTX group, the OBZ group demonstrated higher lupus low disease activity state attainment (74.1% vs 52.3%; p=0.049), lower SLEDAI-2000 Scores (median (IQR): 2 (1–2) vs 4 (2–4.25); p=0.04) and a trend towards higher B cell depletion rates at 12 months (57.1% vs 20.0%; p=0.08). OBZ treatment significantly shortened hospitalisation by 7 days (14.7±5.4 vs 21.9±11.9 days; p=0.04) and achieved a deeper B cell depletion at 6 months (median CD19+B cells: 0.4 (0–1.4) vs 3.5 (2–19.3) cells/µL; p=0.01), compared with the RTX group. Safety profiles were comparable between groups, with both treatments well tolerated. No deaths occurred.ConclusionThese findings suggest OBZ may induce superior clinical responses in NPSLE through enhanced B cell depletion, with acceptable safety at 12 months, calling for further exploration.