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Obesity is the most common nutritional disorder worldwide and is associated with dyslipidemia and atherosclerotic cardiovascular disease. The hallmark of dyslipidemia in obesity is low high density lipoprotein (HDL) cholesterol (HDL-C) levels. Moreover, the quality of HDL is also changed in the obese setting. However, there are still some disputes on the explanations for this phenomenon. There is increasing evidence that adipose tissue, as an energy storage tissue, participates in several metabolism activities, such as hormone secretion and cholesterol efflux. It can influence overall reverse cholesterol transport and plasma HDL-C level. In obesity individuals, the changes in morphology and function of adipose tissue affect plasma HDL-C levels and HDL function, thus, adipose tissue should be the main target for the treatment of HDL metabolism in obesity. In this review, we will summarize the cross-talk between adipocytes and HDL related to cardiovascular disease and focus on the new insights of the potential mechanism underlying obesity and HDL dysfunction.

Background TB outbreaking in schools is extremely complex, and presents a major challenge for public health. Understanding the knowledge, attitudes and practices among student TB patients in such settings is fundamental when it comes to decreasing future TB cases. The objective of this study was to develop a Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ), and evaluate its psychometric properties. Methods This study was conducted in three stages: item construction, pilot testing in 10 student TB patients and psychometric testing, including reliability and validity. The item pool for the questionnaire was compiled from literature review and early individual interviews. The questionnaire items were evaluated by the Delphi method based on 12 experts. Reliability and validity were assessed using student TB patients ( n  = 416) and healthy students ( n  = 208). Reliability was examined with internal consistency reliability and test-retest reliability. Content validity was calculated by content validity index (CVI); Construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA); The Public Tuberculosis Knowledge, Attitudes and Practices Questionnaire (PTB-KAPQ) was applied to evaluate criterion validity; As concerning discriminant validity, T-test was performed. Results The final STBP-KAPQ consisted of three dimensions and 25 items. Cronbach’s α coefficient and intraclass correlation coefficient (ICC) was 0.817 and 0.765, respectively. Content validity index (CVI) was 0.962. Seven common factors were extracted by principal factor analysis and varimax rotation, with a cumulative contribution of 66.253%. The resulting CFA model of the STBP-KAPQ exhibited an appropriate model fit (χ2/df = 1.74, RMSEA = 0.082, CFI = 0.923, NNFI = 0.962). STBP-KAPQ and PTB-KAPQ had a strong correlation in the knowledge part, and the correlation coefficient was 0.606 ( p  < 0.05). Discriminant validity was supported through a significant difference between student TB patients and healthy students across all domains ( p  < 0.05). Conclusions An instrument, “Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ)” was developed. Psychometric testing indicated that it had adequate validity and reliability for use in KAP researches with student TB patients in China. The new tool might help public health researchers evaluate the level of KAP in student TB patients, and it could also be used to examine the effects of TB health education.

The development of the new energy vehicle (NEV) market in China has promoted the sustainability of the automotive industry, but has also brought pressures to NEV charging infrastructure. This paper aims to determine the strategic role of charging stations, particularly on whether they should provide service for plug-in hybrid electric vehicles (PHEVs) in the highway service area during peak holidays. Firstly, the charging service resource allocation for a charging station that provides services for both electronic vehicles (EVs) and PHEVs is studied. Secondly, different queueing disciplines are compared. At last, a comparison between scenarios where charging services are limited to EVs and those where services extend to both EVs and PHEVs is conducted. A queueing system considering customer balking and reneging is developed. The impacts of parameters, such as the NEV arrival rate and patience degree of different NEV drivers, on the optimal allocation plan, profit, and comparison results are discussed. The main conclusions are as follows: (1) If the EV arrival rate is greater than the charging service rate, the charging station should not provide charging services for PHEVs. Providing service only for EVs derives more revenues and profits and results in a shorter waiting queue. Conversely, if the total arrival rate of NEVs (including EVs and PHEVs) is lower than the charging service rate, then the charging station should also serve PHEVs. (2) If providing service for PHEVs, a mixed queueing discipline should be applied when the total arrival rate approximates the service rate. When the total NEV arrival rate is significantly lower than the charging service rate, the separate queueing discipline should be adopted. (3) When applying a separate queueing discipline, if a certain type of NEV has a higher arrival rate and the drivers exhibit greater patience, then more charging resources should be allocated to this type of NEV. If the charging service is less busy, the more patient the drivers are, the less service resources should be allocated to them, whereas, during peak times, the more patient the drivers are, the more service resources should be allocated to them.

Background Conventional treatments for Raynaud’s phenomenon (RP) often show limited effectiveness due to their inability to address both vascular and inflammatory aspects. This study evaluates the combination of high-density fat grafting (HDFG) with botulinum toxin A (BTX-A) for treating RP. Methods Eleven patients with 20 affected hands diagnosed with RP were recruited and randomly assigned to receive either HDFG combined with BTX-A (intervention group, n  = 11) or HDFG alone (control group, n  = 9). Efficacy was assessed using Visual Analog Scale (VAS) pain scores and McCabe Cold Sensitivity Scores, along with finger ulcer healing time and infrared thermal imaging to evaluate blood perfusion improvements. Results The HDFG-BTX group showed significant improvements in hand symptoms. VAS pain scores decreased from a pre-treatment mean of 5.33 to 0.84 post-treatment (mean reduction of 4.49, p  = 0.018), indicating effective pain relief. McCabe scores improved from 272.73 to 75.00 (mean reduction of 197.73, p  = 0.001), demonstrating reduced cold sensitivity. Ulcer healing time was shorter in the HDFG-BTX group (14.25 days) compared to HDFG alone (25.6 days, p  < 0.001), highlighting faster recovery. Infrared imaging indicated significant enhancements in blood perfusion. Conclusion HDFG combined with BTX-A is a reliable and beneficial intervention for RP, leading to high patient satisfaction. Key message • Combining high-density fat grafting with botulinum toxin A significantly improves symptoms in Raynaud’s phenomenon. • This novel therapy enhances pain relief, blood flow, and ulcer healing, demonstrating strong patient satisfaction.

Background Expanding tuberculosis preventive treatment (TPT) for high-risk populations with latent tuberculosis infection (LTBI) is a key component of the End TB Strategy. However, the high-risk population size is small, which may have limited impact on reducing TB incidence. We aimed to evaluate the health impact and cost-effectiveness of expanding TPT to key community-level population Methods We developed a dynamic transmission model incorporating the effect of TPT and seasonal variations in TB incidence. The model was calibrated by monthly pulmonary tuberculosis (PTB) case data during 2011–2018 from Shaanxi province, China, and validated by data in 2019. We first assessed the TB epidemic trend for seven expanding TPT strategies and sought the optimal TPT strategy that can reach the target of the End TB Strategy by 2035. Then, we calculated the incremental cost-effectiveness ratios (ICER) of this optimal TPT strategy with five TPT regimens (isoniazid monotherapy with two different durations, rifampin monotherapy, and combinations of isoniazid with rifampin or rifapentine) over 2025–2050, compared with no TPT, from a health system perspective. A willingness-to-pay threshold of US $36,378 (three times the per-capita gross domestic product of Shaanxi province in 2023) was used. Results The optimal TPT strategy is implementing TPT for all WHO-recommended populations and individuals with LTBI aged ≥ 50 at the community level (starting in 2025 with full coverage within 1 year), which could reduce the PTB incidence rate to 1.83/100,000 by 2035, meeting the WHO target of a 90% reduction (5.64/100,000) compared with 2015. This strategy with five TPT regimens was all cost-effective compared with no TPT, with ICER ranging from US $154 (3 months of daily rifampicin plus isoniazid, 3HR) to US $910 (9 months of daily isoniazid monotherapy, 9H) per quality-adjusted life-year (QALY) gained. Conclusions Rapid TPT implementation for all WHO-recommended populations and individuals with LTBI aged ≥ 50 at the community level is critical to achieving TB elimination by 2035. The 3HR regimen, widely performed in clinical practice in China, offers the greatest cost-effectiveness, which provides health economic evidence to expand this regimen further.

Background Visceral fat accumulation and obesity-induced chronic inflammation have been proposed as early markers for multiple disease states, especially in women. Nevertheless, the potential impact of fat distribution on α1-acid glycoprotein(AGP), a marker of inflammation, remains unclear. This research was conducted to investigate the relationships among obesity, fat distribution, and AGP levels. Methods A cross-sectional observational study was performed using blood samples from adult females recruited through the National Health and Nutrition Examination Survey from 2015 to 2018. Serum levels of AGP were measured using the Tina-quant α-1-Acid Glycoprotein Gen.2 assay. Based on the fat distribution data obtained from dual-energy X-ray absorptiometry assessments, body mass index (BMI), total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android fat/gynoid fat ratio (AGR), visceral percent fat (VPF), subcutaneous percent fat (SPF), visceral fat/subcutaneous fat ratio (VSR) were used as dependent variables. To investigate the link between fat distribution and AGP, multivariate linear regression analysis was utilized. Furthermore, a sensitivity analysis was also performed. Results The present study included 2,295 participants. After adjusting for covariates, BMI, TPF, APF, GPF, VPF, and SPF were found to be positively correlated with AGP levels (BMI: β = 23.65 95%CI:20.90–26.40; TPF: β = 25.91 95%CI:23.02–28.80; APF: β = 25.21 95%CI:22.49–27.93; GPF: β = 19.65 95%CI:16.96–22.34; VPF: β = 12.49 95%CI:9.08–15.90; SPF: β = 5.69, 95%CI:2.89–8.49; AGR: β = 21.14 95%CI:18.16–24.12; VSR: β = 9.35 95%CI:6.11–12.59, all P  < 0.0001). All the above indicators exhibited a positive dose–response relationship with AGP. In terms of fat distribution, both AGR and VSR showed positive associations with AGP ( P for trend < 0.0001). In particular, when compared to individuals in tertile 1 of AGR, participants in tertiles 2 and 3 had 13.42 mg/dL (95% CI 10.66–16.18) and 21.14 mg/dL (95% CI 18.16–24.12) higher AGP levels, respectively. Participants in the highest tertile of VSR were more likely to exhibit a 9.35 mg/dL increase in AGP compared to those in the lowest tertile (95% CI 6.11–12.59). Conclusions Overall, this study revealed a positive dose-dependent relationship between fat proportion/distribution and AGP levels in women. These findings suggest that physicians can associate abnormal serum AGP and obesity with allow timely interventions.

Background China faces many challenges in controlling tuberculosis (TB). One significant challenge is the control of college students’ TB. In particular, cross-sectional studies of college students’ knowledge, attitudes and practices (KAP) in regard to TB have attracted substantial attention. However, few measurement tools have been developed to aid processes related to expert consultation, pre-testing, reliability and validity testing. Our study developed the College Students’ TB Knowledge Attitudes and Practices Questionnaire (CS-TBKAPQ) following the scale development steps. Methods The construction of the CS-TBKAPQ was based on the Theory of Knowledge, Attitude, Belief, and Practice (KABP or KAP). The item pool was compiled from literature reviews and individual interviews. The reliability validation was assessed by calculating Cronbach’s α coefficient, the split-half reliability coefficient, and the test-retest reliability coefficient. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The diagnostic accuracy was evaluated using the World Health Organization Advocacy, Communication and Social Mobilization KAP Survey Questionnaire (WHO-TBKAPQ) as the reference standard. Results A total of 31 questionnaire items were proposed. Cronbach’s α coefficient, the split-half reliability coefficient and the test-retest reliability coefficient were 0.86, 0.78 and 0.91. Four factors that explained 62.52% of the total variance were also identified in EFA and confirmed in CFA. The CFA model fit indices were x 2 /df  = 1.82 ( p  < 0.001), GFI = 0.925, AGFI = 0.900, RMR = 0.068, and RMSEA = 0.049. The CS-TBKAPQ was significantly correlated with the WHO-TBKAPQ and the Chinese Public TB KAP Questionnaire (CDC-TBKAPQ) developed by the Chinese Center for Disease Control and Prevention ( r  = 0.59 , 0.60, p  < 0.001). The receiver operating characteristics curve (ROC) analysis suggested a cut-off point of 47.5, with which the CS-TBKAPQ showed a sensitivity of 73.63% and a specificity of 80.51% in identifying students with low-level KAP. The positive and negative predictive values were 83.23% and 69.91%. Conclusions The findings of this study demonstrate that the CS-TBKAPQ is a reliable and valid tool for measuring the KAP towards TB in college students.

Waste heat recovery from hot steel slag was determined in a granular bed through the combination of numerical simulation and an industrial test method. First, the effective thermal conductivity of the granular bed was calculated. Then, the unsteady-state model was used to simulate the heat recovery under three different flow fields (O-type, S-type, and nonshielding type (Nontype)). Second, the simulation results were validated by in-situ industrial experiments. The two methods confirmed that the heat recovery efficiencies of the flow fields from high to low followed the order of Nontype, S-type, and O-type. Finally, heat recovery was carried out under the Nontype flow field in an industrial test. The heat recovery efficiency increased from ∼76% and ∼78% to ∼81% when the steel slag thickness decreased from 400 and 300 to 200 mm, corresponding to reductions in the steel slag mass from 3.96 and 2.97 to 1.98 t with a blower air volume of 14687 m 3 /h. Therefore, the research results showed that numerical simulation can not only guide experiments on waste heat recovery but also optimize the flow field. Most importantly, the method proposed in this paper has achieved higher waste heat recovery from hot steel slag in industrial scale.

The prevalence of drug-resistant TB in Shaanxi Province is higher than other areas. This study was aimed to investigate the genetic diversity and epidemiology of Mycobacterium tuberculosis clinical strains in Shaanxi Province, China. From January to December 2016, a total of 298 Mycobacterium tuberculosis clinical isolates from smear-positive pulmonary tuberculosis patients were genotyped by Mcspoligotyping and 15-locus VNTR. We found that the Beijing family strains was the most prominent family(81.54%, 243/298). Other family strains included T family(9.06%, 27/298), U family(0.67%, 2/298), LAM9 family(0.34%, 1/298) and Manu family(0.34%, 1/298). The rates of multidrug-resistant (MDR) M.Tuberculosis, age, type of case and education between Beijing and non-Beijing family strains were not statistically different, while the distribution in the three different regions among these was statistically significant. VNTR results showed that strains were classified into 280 genotypes, and 33 (11.07%) strains could be grouped into 14 clusters. 11 of the 15-VNTR loci were highly or moderately discriminative according to the Hunter-Gaston discriminatory index. We concluded that the Beijing family genotype was the most prevalent genotype and 15-locus VNTR typing might be suitable for genotyping of M. tuberculosis in Shaanxi Province. There was less association between Beijing family genotypes and drug resistance in our study area.