The accumulation of original phosphogypsum (OPG) has occupied considerable land resources, which have induced significant environmental problems worldwide. The OPG-based cemented paste backfill (OCPB) has been introduced as a promising solution. In this study, a water-washing pre-treatment was used to purify OPG, aiming to optimize the transport performance and mechanical properties of backfills. The overall results proved that in treated phosphogypsum-based cemented paste backfill (TCPB), the altered particle size distribution can alleviate the shear-thinning characteristic. The mechanical properties were significantly optimized, of which a maximum increase of 183% of stress value was observed. With more pronounced AE signals, the TCPB samples demonstrated better residual structures after the ultimate strength values but with more unstable cracks with high amplitude generated during loading. Principal component analysis confirmed the adverse effects of fluorine and phosphorus on the damage fractal dimensions. The most voluminous hydration products observed were amorphous CSH and ettringite. The interlocked stellate clusters may be associated with the residual structure and the after-peak AE events evident in TCPB, indicate that more significant stress should be applied to break the closely interlocked stitches. Ultimately, the essential findings in this experimental work can provide a scientific reference for efficient OPG recycling. Phosphate plays an indispensable role in modern agriculture, owing to the rapidly growing demand for phosphorus fertilizer ,2,3. HowCemented paste backfill (CPB), as a relatively safe and reliable approach to broaden the mining solid waste and benefit by-product recycling ,24,25, hFor this reason, the main objective of this study has been to analyze the influence of water-washing pre-treatment on the rheological behavior and AE parameters of OCPB and TPCB samples, emphasizing the monitoring of the complex fracture behavior after hardening. The TPG was prepared through deionized water (DW) washing, and OCPB and TCPB samples with two mix proportions were accordingly prepared for rheology behavior, mechanical properties, AE characteristics, mineralogical characterization, and microstructures examination. This study aims to provide a laboratory basis for early alarm mechanical failures when applying OPG to underground structures. A flow chart is plotted in 2/g. OPG was sampled from a phosphoric acid production plant in Hubei province, China. The TPG was obtained by previous water-washing pre-treatment [The OPC used in this study was CEM I 42.5R, with a specific surface area of 1.69 mreatment . Before reatment ,44,45.The OCPB and TCPB were prepared according to The chemical compositions and particle size distribution of the OPG and TPG samples were determined by X-ray fluorescence  and a laser particle analyzer . The OCPB and TCPB used for the following analysis were collected at the surface of the main fractures in each loaded sample, then dried at 50 ± 5 °C for 24 h and powered in an agate mortar. XRD analysis of the collected pieces was performed using an X-ray diffractometer  employed with Cu Kα line radiation. The XRD patterns were appraised using the references in the PDF-2 database . SEM/EDX observation was employed for the microstructure of backfills on the JSM-6490LV scanning electron microscope . Before being subjected to the SEM/EDX tests, the powder samples were gilded to confirm good conductivity.−1 in 180 s. All rheological measurements were performed at a relatively steady ambient temperature of 20 ± 1 °C.Rheological measurements were carried out using a controlled stress rheometer equipped with a coaxial rotating cylinder . The prepared OCPB and TCPB samples were first mixed for 2 min to guarantee the homogeneity of the mortars. Then, before being poured into the rheometer, the mortars were kept at rest for 3 min. During the equilibrium test, the shear rate was ramped up from 0 to 45 sConsidering the poor mechanical performance of 7 day cured OCPB samples, the specimens were subjected to a biomechanical testing machine   adopted 3, SiO2, and Al2O3 were the main oxides both in OPG and TPG, despite the relative content of silica and calcium being raised after water-washings. Phosphate and fluoride, which can negatively affect the mechanical strength and hydration process of CPB samples [ samples ,12,20, bc is applied in the modified Bingham model to reduce the error at both low and high shear rate conditions [DS is the statistical parameter error, mX is the measured value, fX is the calculated value from each model, and NDP is the number of data points.Recorded shear stress and viscosity performing as functions of shear rate are shown in nditions . Considenditions ,53. The nditions . The CroR square figures, all the given models show adequate fit responses. However, in terms of the DS value, the Herschel–Bulkley model performs a more significant fitting result to the tested pastes. Besides, the τ0 values calculated from the models all demonstrate the optimization of water-washing pre-treatment to yield stress, regardless of the mix proportion. Especially in the Herschel–Bulkley model, τ0 values of mix proportions A and B are increased by 13.0% and 15.6%. Although n values of the tested pastes are all below one, the values of OCPB pastes are smaller than that of TCPB, indicating a more pronounced non-Newtonian characteristic. From the Cross model, the presented ∞η results indicate that the infinite shear viscosity was relatively constant. However, the η0 values found could be predominant with the OPC concentration and the water-washings. That is to say, although all the flocculant network structures of the tested mortars are all destroyed rapidly after mixing, the microscopic structure of TCPB mortar is more stable than OCPB. In general, the shear-thinning behavior of CPB might be attributed to attractive and repulsive forces, such as Brownian forces and steric hindrance forces [If only considering the e forces ,56. Aftee forces ,57. Simue forces ,22. Aftey-axis), AE scatterplots (right y-axis), and energy rates of OCPB and TCPB specimens. In general, with the water-washing pre-treatment, the unconfined compressive stress values of TCPB samples were significantly enhanced, especially the value (1.19 MPa) of the 28 days cured B2 sample  algorithm [D values of data sets that include a time sequence. Once the set of points ) demonstrates a linear correlation relationship in a log–log coordinate, it can be concluded that the fitted set has fractal characteristics at a given scale. Hence, the fractal dimension D can be estimated as the slope of the straight-line portiond is the coefficient constant representing the material characteristic. Thus C(r) is approximately given by Equation (3)N = n – m + 1, n is the dimension of the original constructed phases space, after m (m < n) isolated sets of points have been removed from the constructed space, N vectors can be obtained from reconstructed phases space, and |ix−jx| is the distance between any pair of points. The Heaviside function [The fractal dimension set of D ,59. As algorithm  is widelfunction  is definr can be calculated by Equation (5)s is the scale factor, to acquire a prominent fractal characteristic, the s values are given as 0.2, 0.4, 0.6, 0.8, 1.0, 1.2, and 1.4. While using the G–P algorithm, a previous study [mD was defined as the ratio of ln C(r) to ln r. Then, the m value was selected in the period when the mD values gradually kept stabilizing. mD with m values ranging from 2 to 30.The value of us study  demonstrm-mD curves’ general trend all remain steady, especially the mD values of OCPB specimens which stabilize from 0.90 to 0.95. After a short period of increase, the mD values of A2-7D and B2-28D samples re-stabilizes at m values at 11 and 20. Therefore, the figure for the phase space dimension m was chosen as 20 for the AE fractal analysis for the further step. In addition, the values of TCPB were concentrated at ranges from 0.98 to 1.05 and from 1.15 to 1.80, respectively, which are far higher than OCPB, indicating that besides the contribution of OPC content and the curing age, water-washing pre-treatments also greatly enhance the fitted mD values. Subsequently, with the determined m values, the ln C(r) and ln r values were plotted as in It was shown clearly that, apart from the A2-7D and B2-28D samples, the computed R2 figures, it can be seen that all the ln C(r) and ln r values demonstrate obvious linear correlation, proving that the tested specimens all have fractal characteristics. For the A1 and A2 samples, the D values slightly increased with the curing age, which is not observed in ratio B. Besides, although different proportions were prepared, the D values remain approximately constant. The possible factors which correlate to this behavior, with the D values fluctuating around 1, could be ascribed to the inherent character of weak strength and residual stress after loading.From the calculated In order to limit the variables in the experimentation and obtain a correlation between the previous dependent and independent variables, the PCA results of the D-values, curing ages, and UCS values are collated in N values is based on the time used for a completed compression process, ND is assumed to identify the energy released per second of modalities in each structural element. The calculated ND values are summarized in b-value is derived from the seismic magnitude–frequency equation (Equation (6)) [b-value indicates faster and unstable crack growth accompanied by relatively high amplitude AE events in large numbers.H is the number of hits having amplitudes larger than A, A is the signal amplitude (dB), a is an empirically derived constant, 2.5 is used in this study.Since the opting for ion (6)) . It reprND values as the function of loading time, more delicate information was captured. At the initial stage of uniaxial loading, all ND values exhibited a linear upward trend corresponding to the coalescence of pre-existing voids and the rubbing of cracks [b-value results (ND values in the initial stage. Besides, samples with higher OPC content and water-washing pre-treatment showed more substantial fluctuations representing the release of stored energy. The downward trend was demonstrated in the final loading stage for the 7 day cured samples with A1 and A2 proportions (b-values, especially in the water-washing treated samples. To progressively understand the relevance between AE signals and hydration systems, the mineralogical composition and morphology were studied.By defining f cracks . Because results  show thaportions a. Howeve2, it was confirmed that it can decompose by carbonation at 25 °C in a moist atmosphere [X-ray diffraction patterns of OCPB and TCPB samples are presented in mosphere ,72. As rmosphere  because The morphology shows that despite some micro-cracks and uncovered gypsum crystals being observed after 28 days of curing, the initial water-filled space reduced significantly, comparing the 7 day open and friable microstructures a,c,d,f. Although many studies have been conducted ,71,73, tThe main goal of this study was to quantify the rheological characterization and failure performance of TCPB, thereby supplying more information for OPG recycling scenarios. Based on the results and discussion, the following conclusions were drawn:In rheological characterization, all tested pastes demonstrated great shear-thinning and pseudoplastic characters, and the generalized Herschel–Bulkley model had the lowest deviation value. Besides, after water-washings, 13% and 16% of yield stress increase were observed with the ratios of A and B, respectively. The optimized particle size distribution of TPG could contribute to the non-Newtonian properties of TCPB mixtures.Accompanied by more active AE events, the mechanical properties of the TCPB significantly increased. In both systems, the deformation performance and the activity of AE signals during compression were positively correlated. The AE counts occur during the quiet compaction period, whereas fragmentation dominates in the later stages. Two systems demonstrated similar internal damage fractal characteristics, with the fractal dimensions decreased to approximately 1.0 at the major crack generation period. With PCA, fluorine and phosphorus were confirmed to have an essential side effect on the fractal dimensions, preceded only by calcium and sulfate.b-values, representing unstable cracks with a high amplitude which were prone to generate in TCPB samples.By defining fractal dimension values as a function of loading time, TCPB showed a rebound trend at the final stage, indicating more robust residual structures in these uniaxially compressed specimens. In addition, water-washings can bring downward trends to the b-values rebound trend in TCPB. However, the hardened phase assemblage hypothesis is the more likely explanation and needs to be developed for future progress.Through the microstructure and mineralogical analysis, water-washings obviously optimized the pore structures. Another interesting observation is that, in both systems, acicular ettringite was found that joins in the form of stellate clusters. Such a radiative structure may produce better mechanical properties, with the stress to break the interlocked “arms” contributing to the residual stress and the


On day 7, HMA was significantly higher in albumin-treated patients, while HNA2 significantly increased only in the crystalloids-treated group, reaching values comparable with the albumin group. When pooling the septic patients regardless of treatment, albumin oxidation was similar across all SOFA groups at day 1, but at day 7 HMA was lower at higher SOFA scores. Mortality rate was independently associated with albumin oxidation levels measured at day 7 (HMA log-rank = 0.027 and HNA2 log-rank = 0.002), irrespective of treatment group. In adjusted regression analyses for 90-day mortality, this effect remained significant for HMA and HNA2. Our data suggest that the oxidation status of albumin is modified according to the time of exposure to oxidative stress (differences between day 1 and day 7). After 7 days of treatment, lower SOFA scores correlate with higher albumin antioxidant capacity. The trend toward a positive effect of albumin treatment, while not statistically significant, warrants further investigation.Inflammation and oxidative stress characterize sepsis and determine its severity. In this study, we investigated the relationship between albumin oxidation and sepsis severity in a selected cohort of patients from the Albumin Italian Outcome Study (ALBIOS). A retrospective analysis was conducted on the oxidation forms of human albumin  in 60 patients with severe sepsis or septic shock and 21 healthy controls. The sepsis patients were randomized (1:1) to treatment with 20% albumin and crystalloid solution or crystalloid solution alone. The albumin oxidation forms were measured at day 1 and day 7. To assess the albumin oxidation forms as a function of oxidative stress, the 60 sepsis patients, regardless of the treatment, were grouped based on baseline sequential organ failure assessment (SOFA) score as surrogate marker of oxidative stress. At day 1, septic patients had significantly lower levels of HMA and higher levels of HNA1 and HNA2 than healthy controls. HMA and HNA1 concentrations were similar in patients treated with albumin or crystalloids at day 1, while HNA2 concentration was significantly greater in albumin-treated patients ( Human serum albumin, through its cysteine-associated thiol group (–SH) at position 34, is the main antioxidant compound in the extracellular compartment . AlbuminHuman mercapto-albumin (HMA), in which the thiol groups are present in their reduced form (–SH).Human non-mercapto-albumin 1 (HNA1), in which oxidation of the reduced thiol group (–SH) results in a disulfide bond .Human non-mercapto-albumin 2 (HNA2), in which the oxidation of the reduced thiol group (–SH) is irreversible due to binding with sulfonic and sulfinic acid, or to nitrosilation  proportionally decreases its antioxidant capabilities . While tIn this study, we investigated the characteristics of albumin oxidation status and the concentrations of several biomarkers in a subset of patients with severe sepsis or septic shock from the Albumin Italian Outcome Study ALBIOS; .n = 21, aged 48–80) from healthy (not diagnosed with Alzheimer Disease) age-matched subjects were kindly supplied by ACE Foundation – Catalan Institute of Applied Neurosciences  from their sample repository.The study population consisted of a total of 60 patients, 40 with septic shock and 20 with severe sepsis , selecteThe oxidative state of albumin was measured at days 1 and 7. To assess the redox state of albumin in plasma samples, anionic exchange HPLC  was performed using a Shodex-Asahipak ES-502N column  coupled to a fluorescent detector (Waters) as previously described . Thawed Pentraxin 3 (PTX3), presepsin, and chromogranin A (CgA) were assayed at days 1 and 7, as previously described  as index+ by metmyoglobin. The antioxidants in the sample cause a decrease of the absorbance at 750 nm and those values are compared with that of Trolox, a water soluble tocopherol analog, and is quantified as mM Trolox equivalents. MPO was assayed using a colorimetric enzyme-linked immunosorbent assay (ELISA) according to manufacturer’s instructions . Lipid peroxidation, expressed as MDA, was determined using commercially available kits . The method relies on the reaction of MDA, an end product of lipid peroxidation, with thiobarbituric acid producing thiobarbituric acid reactive substance, a pink chromogen, which can be measured spectrophotometrically at 532 nm.Total antioxidant capacity concentration was measured using the Antioxidant Assay kit . The assay is based on the ability of antioxidants in the sample to inhibit oxidation of 2,2ꞌ-azino-di-[3-ethylbenzthiazoline sulfonate] to ABTSThe first endpoint was the difference in the oxidation status of albumin between crystalloids-treated and albumin-treated patients, at day 1 and 7. The secondary endpoint was the assessment of oxidation status of albumin as a function of oxidative stress. In order to investigate the relationship between oxidative stress and the oxidative status of albumin, baseline SOFA score, a surrogate for oxidative stress intensity, was used to stratify patients into three groups  irrespective of treatment allocation. Oxidative stress, the primary cause of organ failure in sepsis, should be at its peak at baseline compared to the following days.2, or one-way ANOVA, depending on the nature of the variable. The three albumin forms were expressed as both absolute concentrations (g/L), and fractions of total concentration. Comparisons were made by means of one-way ANOVA. Biomarkers were compared between treatment groups by means of Mann–Whitney test for non-parametric variables. Additionally, the change of albumin concentrations and fractions measured at day 1 and day 7 was assessed by means of paired Student’s t-test.Baseline clinical characteristics between ALBIOS-treatment arms were compared by means of Chi2 test, one-way ANOVA, or Kruskal-Wallis, as appropriate. Albumin forms at day 1 and day 7 were correlated with the corresponding SOFA scores by means of Pearson or Spearman rank, depending on the distribution of the data.As a surrogate for sepsis severity, patients were divided in three groups by baseline SOFA score , patients characteristics between these groups were compared by means of Chip < 0.05. Data were analyzed using SPSS Software .To assess the association of albumin oxidation forms and 90-day mortality, concentrations of the three albumin-forms were dichotomized using cut-offs estimated from ROC-curves. These dichotomous variables were then included in Kaplan Meier curves and Log Rank analyses. Finally, Cox proportional hazards models were employed (univariately and adjusted for shock and treatment) to assess the independent association of albumin concentration forms and 90-day mortality. Statistical significance was defined as Baseline clinical characteristics and the most relevant physiological variables of the patient population were well-balanced between the two ALBIOS treatment arms .p < 0.0001). On day 1, HMA concentrations in sepsis patients were significantly reduced in albumin and crystalloids groups compared to healthy controls and to a similar extent. Conversely, the oxidized form HNA2 was significantly increased in both treatment groups compared to healthy controls  at day 1 are presented in controls .p < 0.0001). As expected, the difference in albumin concentration between groups was larger at day 7 than at day 1  at day 1 and day 7 compared to crystalloids-treated patients (at day 1 .p = 0.007). The HNA2 concentration increased in both groups over time. However, the increase was statistically significant only for the crystalloids-treated group .In addition to the absolute concentration of the albumin forms, The association between baseline SOFA score and the “intensity” of sepsis in this population is shown in p < 0.0001). Most of the biomarkers, except CgA, decreased from day 1 to day 7, suggesting a decrease in the extent of inflammatory activation and associated oxidative stress in these patients over time. However, the patients in the higher SOFA score group had significantly higher levels of most biomarkers.At day 7, the SOFA score decreased across the SOFA groups. Expectedly, the SOFA score at day 7 was higher in those who started with a higher SOFA score at baseline , while HNA1-concentration had a larger increase in high SOFA-group (+0.1 vs. +3.0 g/L). Unexpectedly, HNA2 concentration increase did not differ substantially among baseline SOFA groups, as shown in p = 0.040 and p = 0.006).The relationship of albumin oxidation forms and mortality was explored by means of ROC curves. Using these curves, the optimal cut-offs for discriminating between surviving and deceased patients were identified: 8.87, 14.99, and 2.32 g/L for HMA, HNA1 and HNA2, respectively. Upon creating binary variables including this cut-off and inserting these in Kaplan–Meier curves , both HMp = 0.016; HNA2: OR = 0.2 (0.0–0.7), p = 0.015]. After adjusting for treatment and shock in the regression analyses, these results remained significant: .We then included these binary variables in Cox proportional hazard analyses: univariate, lower HMA and higher HNA2 concentrations at day 7 were associated with a significant increase in 90-day mortality [HMA: OR = 3.2 (95% CI: 1.2–8.1), In this study, we found: (1) albumin oxidation was far higher in septic patients than in normal subjects; (2) treatment with albumin and crystalloids appeared to be able to prevent the decrease in HMA observed after 7 days of treatment with crystalloids alone; (3) time and level of exposure to oxidative stress, as inferred from the baseline SOFA score, played a substantial role in determining the oxidation status of albumin and (4) in the change of circulating biomarkers; and (5) HMA and HNA2 are in opposing fashion associated with 90-day mortality independent of shock or treatment.It is well-known that the development of oxidative stress is a distinctive feature of sepsis . OxidatiNot surprisingly, during sepsis a ROS storm may quantitatively alter the oxidation status of albumin leading to a decrease in HMA and an increase in HNA1 and HNA2. In this study, we found that after the 1st day of treatment, the fraction of reduced albumin, HMA, and the fraction of reversibly oxidized albumin, HNA1, were similar between patients treated with albumin or crystalloids. Patients infused with albumin had a significantly higher total albumin on day 1 and showed a significant greater concentration of irreversibly oxidized albumin, HNA2. The different concentration of HNA2 could be attributed either to natural processes or a greater amount of irreversibly oxidized albumin fraction in the infused albumin. Considering the similar content of HMA, HNA1 in albumin and crystalloids treated patients at day 1, it is tempting to say that the difference of HNA2 was due mainly to continuous oxidative stress in the crystalloid arm and to both oxidative stress and to exogenous infused oxidized albumin in the albumin-treated group .Despite the observation that modified albumin  can be internalized and degraded by cells , the halMoreover, we hypothesized that the baseline SOFA score could be used as a surrogate marker for the ROS storm, as the blow phase of sepsis and septic shock is highest in the initial period of the syndrome and declines a few days later . DividinThis supports the hypothesis that the baseline SOFA score was proportional to the intensity of the ROS storm and that this intensity decreased or vanished over 1 week. In support of the assumption that baseline SOFA score reflects intensity of oxidative stress is the higher MDA and MPO concentrations at higher SOFA scores . AltogetWhile a positive correlation between biomarker levels and SOFA score may exist, this relationship does not seem to occur between albumin oxidation forms and sepsis severity scores when analyzing pooled patients.Unexpectedly, albumin oxidation forms were similar at day 1 throughout the SOFA groups. At first, this finding seemed paradoxical. Indeed, when ROS intensity peaked at day 1, the oxidation of albumin was independent of ROS intensity. However, when the ROS storm had decreased by day 7, oxidation status was sharply different between patients exposed to higher or lower intensity of ROS storm. In particular, HMA became remarkably different at day 7 indicating an ongoing consumption of the antioxidant body stores after 1 week. This would be more important for patients with higher baseline SOFA scores. In agreement with this observation, a weak correlation between higher HMA values and lower SOFA scores at day 7 was observed. Similarly, TAC as a measure of the total antioxidant capacity, while similar across SOFA scores at day 1, tended to be higher at lower SOFA scores at day 7.p = 0.332) were found in the group with lowest SOFA scores, It is possible that the mechanisms responsible for returning oxidized albumin to its initial reduced status are fully operational at the onset of the syndrome and decrease with time. Furthermore, when separating albumin and crystalloids treatment arms among SOFA groups, after 7 days of treatment, higher percentages of albumin-treated patients  than those detected in our work .While the oxidative fractions of albumin are related to the intensity of stress, the absolute concentrations of each fraction in g/L indicate how much albumin was available to react with ROS and how much of albumin already underwent this reaction, reversibly or irreversibly. Since ROS can induce chain reactions, the oxidation of albumin indicates that other molecules are substantially spared from the oxidative cascade. In previous studies , we founIn conclusion, the data presented here suggest that the oxidation status of albumin in patients with sepsis is related to the time of exposure to oxidative stress (differences between day 1 and day 7). After 7 days of treatment, lower SOFA scores correlate with higher albumin antioxidant capacity. The trend toward a positive effect of albumin treatment, while not statistically significant, warrants further investigation.Data is available upon request, to be examined and accepted by the Steering Committee of ALBIOS trial.This study was reviewed and approved by each Ethics Committee of the 100 centers included in the ALBIOS trial. The patients/participants provided their written informed consent to participate in this study.MBo, JM, RL, and LGa have made substantial contributions to the conception and design of the work. AP, FVq, MBu, FVs, DN, RB, CS, FR, LGi, MM, and IP contributed to the acquisition of data. MBo, JM, AP, SM, RL, and LGa contributed to the analysis and interpretation of data. MBo, JM, MP, FM, MC, PC, RL, MQ, and LGa have drafted the work or substantively revised it. All authors have approved the submitted version , and have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.MC, FM, and AP are full-time employees of Grifols, a manufacturer of plasma derivatives. Grifols had no access to clinical data from ALBIOS and did not perform statistical analyses of data, but only provided editorial support. Publication costs of this manuscript were sustained by Grifols. LG and PC received honoraria from Grifols.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Chickpea straw nutritive value could be predicted using NIRS.The potential of near infrared reflectance spectroscopy (NIRS) to predict the nutritive value of chickpea straw was identified. Spectral data of 480 samples of chickpea straw (40 genotypes) were scanned with a spectral range of 1108 to 2492 nm. The samples were reduced to 190 representative samples based on the spectral data then divided into a calibration set (160 samples) and a cross-validation set (30 samples). All 190 samples were analysed for dry matter, ash, crude protein, neutral detergent fibre, acid detergent fibre, acid detergent lignin, Zn, Mn, Ca, Mg, Fe, P, and in vitro gas production metabolizable energy using conventional methods. The prediction equations were generated by multiple regression analysis. The NIRS prediction equations in the study accurately predicted the nutritive value of chickpea straw . Breeding programs targeting improving food-feed traits of chickpea could use NIRS as a fast, cheap, and reliable tool to screen genotypes for straw nutritional quality.Multidimensional improvement programs of chickpea require screening of a large number of genotypes for straw nutritive value. The ability of near infrared reflectance spectroscopy (NIRS) to determine the nutritive value of chickpea straw was identified in the current study. A total of 480 samples of chickpea straw representing a nation-wide range of environments and genotypic diversity (40 genotypes) were scanned at a spectral range of 1108 to 2492 nm. The samples were reduced to 190 representative samples based on the spectral data then divided into a calibration set (160 samples) and a cross-validation set (30 samples). All 190 samples were analysed for dry matter, ash, crude protein, neutral detergent fibre, acid detergent fibre, acid detergent lignin, Zn, Mn, Ca, Mg, Fe, P, and in vitro gas production metabolizable energy using conventional methods. Multiple regression analysis was used to build the prediction equations. The prediction equation generated by the study accurately predicted the nutritive value of chickpea straw (R Chickpea is one of the key pulses in the world . CultivaDeveloping NIRS equations for chickpea straw nutritional analysis would facilitate the process of chickpea improvement for food and feed production, which would promote sustainable food production in mixed farming systems. Although the reliability of NIRS has been well investigated for temperate feeds, no studies have reported on the feasibility of the use of NIRS to determine the nutritive value of chickpea straw. Thus, the goal of the current study is to determine the accuracy and robustness of NIRS to determine the nutritive value of chickpea straw for screening the genotype in multi-dimensional improvement programs.A total of 480 samples of chickpea straw from preliminary and national variety trials were used in the current study. The description of the sampling areas is presented in All samples were ground (1 mm sieve size), dried at 60 °C overnight in an oven to standardize the moisture content, and then scanned using Foss NIRS 5000 with software package WinISI II in a spectral range of 1108 to 2492 nm . Optical values were recorded as log 1/Reflectance.v/v), filtered through four layers of cheesecloth, and added to the buffer solution , which was kept in a water bath at 39 °C under continuous CO2 flushing. The buffered rumen fluid (30 mL) was transferred into 100 mL syringes containing 0.2 g of straw sample and immediately placed into a water bath at 39 °C. The 24 h gas production was recorded and used to calculate ME according to Menke and Steingass [In total, 190 samples were subsampled out of the 480 samples using the CENTRE algorithm based on NIRS spectra data . The samteingass . Phospho2), standard error of calibration (SEC), and SEP. Statistical analysis of the data was performed using WinISI II software.The spectral data were not subjected to any mathematical treatment. The CENTRE algorithm was used to calculate the GH value  of each sample. Samples with GH ≥ 3 were considered as outliers. No outliers were found in the data; thus, all 190 samples were divided into two groups: a calibration group (160 samples) and a cross-validation group (30 samples). Multiple regression analysis was used to build the equations using the calibration group. The chemical composition of the validation set was predicted using the prediction equations and then the standard error of prediction was calculated (SEP). Calibration equations were evaluated using the coefficient of determination . R2c Zn, Ca, Fe, Mn Mg, and P ranged from 0.71 to 0.93. The SEC of the proximate analysis ranged from 0.19% in DM to 0.85% in NDF. The SEC of ME was relatively small (0.06 MJ/kg DM) and the SEC of the mineral composition of chickpea straw ranged between 0.33% and 1.92%.Results of the NIRS calibration are presented in 2v of the CP, NDF, ADF, ADL, and ME was higher than 0.96. Although, DM had a lower R2v of 0.78. The mineral composition of chickpea straw had a high R2v ranging between 0.68 and 0.92. The SEP of the proximate analysis and ME of chickpea straw ranged from 0.036% to 1.3%. The SEP of the mineral composition of chickpea straw Zn, Ca, Mg, Mn, Fe, and P was less than 3%.The results of the NIRS equations validation are shown in Improved varieties of chickpea produce significantly higher yields of grains compared to the local genotypes. They have high tolerance to drought and disease . Thus, a2c and R2v of the chemical composition of chickpea straw were 0.78 for DM and higher than 0.96 for ash, CP, NDF, ADF, and ADL. This indicates a high match between the NIRS spectral data and conventional lab data of DM, ash, CP, NDF, ADF, and ADL of chickpea samples. In addition to this, SEC and SEP of NIRS equations for proximate analysis and cell wall constituents of chickpea straw were lower than 1%. Thus, these NIRS equations could predict the chemical composition of chickpea straw using spectral data. This is in agreement with previous studies, which reported that NIRS is an accurate method to predict the nutritive value of a range of animal feed [Rmal feed ,24,25,262c and R2v of ME of chickpea straw were high (0.99), indicating a strong correlation between the spectral data and in vitro ME data. The NIRS prediction equation of ME had low SEC and SEP (<0.1%). Therefore, the NIRS model produced from the current study is accurate in determining ME of chickpea straw samples. This is in agreement with results in the literature, which reported on the possibility of predicting some biological parameters including digestibility and ruminal gas production of feed using their spectral data . Therefore, the mineral composition of chickpea straw could be accurately predicted via the NIRS models generated by the current study. This is in disagreement with Goi et al.’s [Ral data , meat , and pret al.’s ,35,36). Stationary NIRS is a feasible replacement technology to the conventional nutritional analyses to determine the chemical composition, ME, and mineral content  of chickpea straw. This would decrease the cost (as it requires only technician time and cost of sample processing) and time of the analysis and environmental hazard associated with the conventional nutritional analysis methods. Chickpea breeders can screen chickpea genotypes for straw nutritive value using NIRS when chickpea programs target improving food and feed traits. These programs would release chickpea genotypes that are superior in grain yield and straw nutritive value, leading to more sustainable food production and food security in mixed farming systems.


Accumulating evidence has revealed that peripheral immunity is involved in Parkinson’s disease (PD). However, the results regarding the percentage of T-cell subsets are inconsistent, and the changes of immunoglobins levels have been seldom studied in PD patients.Serum levels of the percentage of T-cell subsets and immunoglobulins were measured in 761 PD patients and 761 age- and gender-matched healthy controls. The correlations between the variables of peripheral immune activation (PIA) and the clinical characteristics of PD were analyzed using correlation analysis.The pooled results showed that PD patients had higher proportional levels of CD3+ T and CD4+ T lymphocytes than healthy controls. CD8+ T cell percentages were similar in PD patients and controls, and the CD4/CD8 ratio was significantly higher in the PD population. No significant differences in IgG, IgA, or IgM levels between these two groups were found. CD4+ T cell percentage was inversely correlated with the H&Y stage, and IgG level was positively correlated with disease duration and UPDRS part III. Subgroup analyses showed that these associations existed in female patients, but not in male patients.The enhanced immune activation in the peripheral system is indicated in PD, and dynamic alterations in CD4+ T cell percentage and IgG level suggest an active role for peripheral immunity in the disease progression, especially in female PD patients. Parkinson’s disease (PD) is a progressive neurodegenerative disorder, and the role of adaptive immune system and humoral immunity needs to be clarified in PD; profiling of peripheral T cells and immunoglobulin may be able to provide insight into biologic markers of disease. Adaptive immunity has become implicated as a pathogenic factor in the onset and progression of PD. The infiltration of immune cells in the central nervous system (CNS), particularly the substantia nigra (SN), was identified in both postmortem PD patients and animal models . These bGiven the chronic inflammatory nature of PD, humoral immunity could play another role in disease progression. Lewy bodies (LB) shows strong immunolabelling for immunoglobulin G (IgG) and about one-third of DA neurons in SN show surface immunoreactivity for IgG , and theYet another study found that the frequency of anti-synuclein antibodies in the peripheral blood serum of sporadic PD patients is not different from those in healthy controls . This isSince functional profiling of peripheral immune activities could provide important disease biomarkers, we conducted this study to investigate peripheral immune abnormalities in PD. The current study was designed: (1) to measure the percentage of T cell subset, and the levels of serum immunoglobulins IgG, IgM, IgA in PD patients and normal controls and (2) to test whether the peripheral immune activation (PIA) state of PD patients would correlate with disease characteristics.This study was performed within the Department of Neurology, West China Hospital of Sichuan University; a large, regional referral movement disorders clinic in Southwest China. A total of 761 PD patients who met the current consensus criteria for PD  were recPatients who showed evidence of systemic inflammation in clinical examination or biochemical blood tests  were excluded. Patients with manifestations of monoclonal gammopathy, non-malignant endocrine abnormalities, neoplastic disorders, auto-antibodies (high-titer GM1 ganglioside antibody), and infection  were also excluded. None of the patients had a history of using anti-inflammatory drugs, steroids, acetylsalicylic acid or statins during the past 2 months before enrollment. Any patient with a family history of PD or common chronic diseases was also excluded.In accordance with study protocols, peripheral blood samples (∼9 ml each set) were obtained by venipuncture performed between 9:00 and 11: 00 am after fasting from midnight from each patient and healthy controls. Blood was collected into a sterile 7.5 ml tube with a clot activator and double gel for transport . All the experiments in this study were conducted in the Division of Clinical Immunology, West China Hospital, affiliated with Sichuan University. Flow cytometric assay for analysis of cell viability was performed. The lymphocyte subsets were identified and determined using the BD FACSCanto II Flow Cytometer . For each sample, at least 10,000 cells were analyzed and the percentage of the cells expressing CD3+, CD4+ and CD8+ markers were evaluated. The levels of immunoglobulins IgG, IgM, and IgA were quantified by means of nephelometry on an Image 800 nephelometer . A portion of each collected sample was analyzed to detect infectious diseases. According to the manufacturer’s instructions, all the tests were performed by board-certified laboratory technicians who were blinded to clinical data.We collected clinical data regarding sex, age at onset, disease duration, diagnostic delay, personal history, chronic disease history, treatment regimen and motor complications through a standardized personal interview. The diagnostic delay is defined as the duration from the first appearance of motor symptoms to clinical diagnosis of PD. We made a detailed record of chronic disease history, such as hypertension, diabetes, and hyperlipemia. The use of antiparkinson drug was recorded at the time of enrollment and L-DOPA equivalent daily doses (LEDD) were evaluated according to the guidelines . PatientT-test was applied to analyze the difference in the detected variables of PIA for comparisons between PD patients and controls. Chi-square tests compared sex ratios between PD and control groups. Spearman’s rho correlation was used to calculate the correlations between the detected PIA variables and the H&Y stage, while Pearson’s correlation was applied to evaluate the correlations with UPDRS part III, NMSS, and PDQ-39. Multivariate general linear models (GLMs) were used to investigate the associations with clinical variables, with CD4+ T lymphocyte percentage or IgG level as an independent variable. Clinical variables included in the GLMs were as follows: age at assessment, sex, disease duration, UPDRS part III, and LEDD. All data was presented in the form of mean ± standard deviation, and they were analyzed using SPSS 17.0. A p-value of < 0.05 was considered statistically significant.The distribution of the detected variables of PIA, including percentage of T lymphocyte subset and levels of IgG, IgM, and IgA were tested for normality using skewness and kurtosis, Shapiro–Wilk and Shapiro–Francia tests. The Student’s p = 0.024) (p = 0.002). In the subgroup analyses of patients with different gender, CD4+ T cell percentage was found to be inversely correlated with UPDRS part III, H&Y stage, LEDD, and PDQ-39 in female patients, but not in male patients (p = 0.003).The demographic features of included PD patients and controls were listed in = 0.024) . PD patipatients , 5. Femap = 0.011 and 0.031, respectively) (p = 0.011). In subgroup analyses, a positive relationship between IgG level and disease duration was found in female PD patients (p = 0.049).The levels of immunoglobulins IgG, IgM, and IgA were determined by routine laboratory testing. The results showed no significant differences in IgG, IgM, and IgA level between PD patients and controls . The subctively) . Higher patients , 5, and Recent studies have indicated that the activity of the immune system in the CNS of PD patients, however; few studies to date have explored the status of peripheral immune response. To our knowledge, the current study included the largest sample in determining whether peripheral immune abnormalities are involved in PD by evaluating the T cell subsets and determining the humoral immunity in PD patients and healthy subjects.in vivo study found that levodopa treatment could inhibit the number of peripheral IFN-γ-producing T cells  gene expression profile and the phenotypes of CD4+ T cells also represented the peripheral immune abnormalities in PD. For the TF gene expression, studies have shown that PD patients had higher levels of STAT6, GATA3, and FOXP3, and lower levels of TBX21, STAT3, STAT4, RORC, and NR4A2 than control subjects. In addition, patients with inidiopathic REM sleep behavior disorder (iRBD) were also had a similar TF gene expression with PD patients . Since iIn the present study, our study indicated that the serum levels of IgG, IgA, and IgM in PD patients did not differ from those in control subjects. Similarly, our previous study also found that IgG and IgM concentrations were not significantly different between ALS patients and healthy controls . We condThe principal role of neuroinflammation is indicated in the progression of PD, and the presence of activated microglia and the elevated cytokine levels in CNS are associated with neuroinflammation. Also, overstimulated immune system due to the gut dysbiosis and the enhanced intestinal permeability can persuade systemic inflammation in PD . TherefoSeveral limitations of this study need to be addressed. First, CD4+ T lymphocytes may be proinflammatory (Th 1 and Th17), or anti-inflammatory (Th2 and Treg). However, in the present study, we did not evaluate the imbalance of CD4+ T cell subsets. Second, a peculiar TF gene expression profile can reflect the imbalance of CD4+ T cells in PD. Therefore, it would be more convincing to examine the expression of peripheral TFs, including TBX21, STAT1, STAT3, STAT4, STAT6, RORC, GATA3, FOXP3, NR4A2, MEF2s, Nurr1, Pitx3, and En1/2. Third, we did not evaluate antiparkinsonian treatment’s effect on the periphery immunity in the present study.This study validated the enhanced immune activation in the peripheral system of PD. In addition, dynamic alterations in CD4+ T cell percentage and IgG level indicated an active role for peripheral immunity in the disease progression and neuronal health. A better understanding of the peripheral immune response is likely to have therapeutic implications; further prospective studies are required to confirm our findings.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.The studies involving human participants were reviewed and approved by The Ethical Committee of West China Hospital of Sichuan University. The patients/participants provided their written informed consent to participate in this study.XC contributed the major role in the acquisition of data, analyzed the data, and drafted the manuscript for intellectual content. WF, RO, JL, JY, JF, BC, YC, and QW contributed to data collection. HS interpreted the data and revised the manuscript for intellectual content. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 . The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 ( Non-communicable diseases have become a huge threat to the lives and health of the global public; the onset and long-term treatment of chronic diseases will not only reduce the quality of life of the patients and their families but also cause society to rapidly increase in huge expenditures and bear heavy burdens ,2,3. IscIn order to raise public awareness of salt reduction and promote salt reduction behaviors, many action plans and studies had been launched in the mainland of China in the past few decades ,14,15,16Education on salt-related knowledge and how to reduce salt intake could reduce 24 h urinary sodium of children and their families from the School-EduSalt study, and better diet-related knowledge, attitudes and behaviors were associated with higher health status ,20. HoweThe WeChat public platform of China Healthy Lifestyle for All Campaign (ID: qmjkshfsxd) was built in 2014; articles about healthy lifestyles including graphics, audio and video were published on this platform from time to time. The followers of this WeChat public platform had increased significantly year by year, and it was followed by 63,793 WeChat users on December 31 of 2018. A ten day salt-related survey was conducted on this WeChat public platform in 2019 (24 September–3 October) and 2020 (11–20 September). The online survey was approved by Chinese Center for Disease Control and Prevention Institutional Review Board (No.202108). The online survey was only published one time each year on this WeChat public platform, the link address of this survey was posted and pushed to all the followers of the platform and then forwarded to the WeChat Moments. All WeChat users can enter the survey platform through the link address to fill out the questionnaire online independently. After the survey completed, the data of participants were recorded in the form of online submission on WeChat. The survey record could not be submitted if the respondent failed to answer all questions. After submitting, the correct answers were not provided to the participant to avoid contamination of survey results between different participants. Additionally, we provided a “salt-score”  to each participant based on their record, and they could share this score with their friends from WeChat Moments, which was aimed at improving the sense of participation of respondents and to attract more WeChat users to participate in this survey.General information of each participant was investigated at first, including gender, age, education level, region and self-reported health status. Then, the participant was invited to complete a salt-related knowledge, willingness and behavior questionnaire. This questionnaire was designed based on the 10 core messages of salt reduction publicity week published by National Health Commission of the People’s Republic of China at 20 August 2019 , and theFour questions were applied to assess salt-knowledge status : knowledge about foods that contain salt, condiments that contain salt and should be used less, maximum daily salt intake of healthy adults and diseases that related to excessive salt intake. For question “foods that contain salt”, five foods contained salt, but no salty taste was chosen, including fine dried noodles, bread, biscuit, cheese and ice cream, and each food was scored 1 point. Soy sauce, oyster sauce, bean paste and monosodium glutamate (MSG) were chosen for the question, “Condiments that contain salt and should be used less”; each condiment scored 1 point. For the question, “Maximum daily salt intake of healthy adults”, six options were provided, including 2 g, 4 g, 5 g, 6 g, 8 g and do not know, but only the response of 5 g or 6 g can score 1 point. Three diseases, including hypertension, heart disease and stroke were presented for “Diseases that related to excessive salt intake”; each disease scored 1 point.Six behaviors related to salt reduction  were considered in this questionnaire: using salt measuring spoons, asking restaurants to use less salt, reading the sodium content on the nutrition facts table, choosing foods with low sodium content, regularly using low-sodium salt, using chili, garlic, vinegar, pepper, etc. to enhance the flavor of food and gradually reducing the amount of salt used in cooking. Participants can respond “Have this behavior” or “Did not have this behavior” for each behavior, and only people who had the behavior can score 1 point. High salt intake behavior : frequency of using high-salt condiments such as oyster sauce, bean paste, MSG, etc., frequency of eating processed foods and canned foods, frequency of eating pickled mustard tubers, salted vegetables and sauce foods. Each behavior was classified into four levels: “Regularly”, “Occasionally”, “Rarely” and “Never”. The response of “Regularly” scored 3 points, “Occasionally” scored 2 points, “Rarely” scored 1 point and “Never” scored 0. More information about the calculation method of salt-related knowledge and behavior scores is presented in Descriptive statistics including frequency and percentage, median and interquartile range (IQR) were conducted for general variables, salt-related knowledge and behaviors. The comparison of general information, salt-related knowledge and behaviors status in 2019 and 2020 was conducted using the chi-square test. Since salt-related knowledge and behavior scores were not of normal distribution as tested by the Kolmogorov–Smirnov test, the Wilcoxon rank sum test was used for comparing salt-related knowledge and behavior scores between 2019 and 2020. Wilcoxon rank-sum test and Kruskal–Wallis test were used for comparing the salt-related knowledge and behavior scores between subgroups. The correlation of salt-related knowledge and behavior scores was examined by Spearman correlation analysis. All statistical analyses were performed in the SPSS 22.0 software , and the significance level was 0.05.During the survey periods, a total of 2362 records in 2019 and 14947 records were collected. After excluding the duplicate records from the same individuals or the answering time lower than 1 min or not from the mainland of China, 2109 participants’ data in 2019 and 12732 participants’ data in 2020 were left for further analysis. The general information of these participants is presented in n = 629) were male, 34.7% (n = 732) were over 45-year-old, 8.1% (n = 170) had an education level of middle school and below, 40.4% (n = 852) came from the middle region and 11.2% (n = 237) were self-reported hypertension patients. Among those participants in 2020, 29.2% (n = 3714) were male, 39.4% ( n= 5021) were over 45 years old, 16.0% (n = 2031) had an education level of middle school and below, 19.5% (n = 2482) came from the middle region and 13.2% (n = 1677) were self-reported hypertension patients. Variables including age, education level, region, answering time and self-reported health status were significantly different between 2019 and 2020 . Most participants answered the questionnaire within 1 to 5 min. Among those participants in 2019, 29.8% .In 2019, 23.4%, 52.8% and 23.8% of participants reported that they had salty, moderate and bland taste, compared to 21.8%, 53.7% and 24.4% in 2020, respectively. 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 . In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contain salt. The percentage of those knowing fine dried noodles, bread, biscuit, cheese and ice cream contain salt in 2019 were significantly higher than those in 2020 , respectively. A number of 63.1% in 2019 and 61.5% in 2020 of participants believed all four condiments contain salt and should be used less, with no significant difference . Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults in both years. The proportion of choosing 5 g as the maximum daily salt intake of healthy adults decreased from 42.3% in 2019 to 35.4% in 2020, 40.6% and 43.1% for choosing 6 g. About 98% of participants knew that excessive salt intake would increase the risk of hypertension in 2019 and 2020. However, only 77.4% in 2019 and 74.0% in 2020 of participants knew that strokes related to excessive salt intake, with a significant difference .Results of salt-related knowledge status of participants from 2019 and 2020 are presented in p-value < 0.05). A number of 81.7% of participants used chili, garlic, vinegar, pepper, etc. to enhance the flavor of food and gradually reduced the amount of salt used in cooking in 2019, slightly increased to 82.7% in 2020 .Results of behaviors status related to high salt intake between 2019 and 2020 are shown in The percentage of regularly eating pickled mustard tubers, salted vegetables and sauce foods increased from 27.3% in 2019 to 31.4% in 2020, and the order of different frequencies changed from occasionally > rarely > regularly > never in 2019 to occasionally > regularly > rarely > never in 2020. Compared to 11.5% in 2019, the percentage of regularly using high-salt condiments such as oyster sauce, bean paste and MSG increased by 3% in 2020.p-value < 0.05). Salt-related knowledge score, salt reduction behavior score and high-salt intake behavior score were calculated separately, and the results were summarized in The salt-related knowledge and behavior scores among different groups were also compared. In both 2019 and 2020, salt-related knowledge scores of females were higher than those of males, while their high-salt intake behavior scores were lower than males; salt-related knowledge and high-salt intake behavior scores in the 45-years-old-and-below group were higher, but the salt reduction behavior score was relatively lower than the over-45-years-old group; higher education level came with higher scores of salt-related knowledge and salt reduction behaviors; for participants with salty taste or without a willingness for salt reduction, salt-related knowledge and salt reduction behaviors scores were low, but the high-salt intake behavior scores were high. This study found that the percentage of WeChat users who had the willingness of reducing the amount of cooking salt in their households was quite high between 2019 and 2020 in China, but the awareness level of salt-related knowledge varied greatly, similar to the result of a survey of 2444 Chinese consumers in 2017 . Over 60The publicity and advocacy of the recommended maximum daily salt intake are helpful for carrying out public health interventions and salt-reduction behaviors ,38,39. TBehaviors such as using a quantitative salt spoon and reading the sodium content of food products can help people understand the amount of salt intake, then take salt constriction behaviors ,42. AskiFemales and better-educated people were more likely to have higher levels of salt-related knowledge, and they were more interested in and more active in salt reduction ,25,33,48This study was based on the WeChat platform for all WeChat users. The subjects voluntarily participated in the online survey and could exit freely, and the results of the survey were more in line with the real situation of the participants. However, there are also several limitations in our study. First, the questionnaire was pushed to all WeChat users based on the CHLA public platform; self-reported gender, age and other information may not be as accurate as offline, face-to-face surveys, and the respondents may be more concerned about lifestyle and dietary nutrition than the general population, and extrapolation of the conclusions of this study to the entire population might be limited. However, these participants who actively interested in this survey are targeted residents of the CHLA Campaign publicity and intervention. The results revealed the weak publicity knowledge points and intervention groups of the CHLA Campaign, and could provide a reference for setting the salt reduction action goal in the future. Second, we analyzed the change of salt-related knowledge and behavior between 2019 and 2020 based on two cross-sectional surveys, but did not follow up with the same participants; changes of participants during the 2-year period cannot be observed. Additionally, the total number of responders in 2020 was much higher than those in 2019, which might be caused by the COVID-19 pandemic, the theme activity of Healthy Lifestyle Promotion Month in early September and the increasing followers of our WeChat public platform, and the sample bias of the comparison results in this study may exist, which would make our study less persuasive. Third, attitude-related questions such as reasons for a reluctance to salt reduction, responsibility for salt reduction and preference of salt-reduction measures, which were often used in previous articles ,22,33 maIn order to dynamically understand the public’s awareness and practice of the salt reduction core information released by the CHLA public platform and to select targeted and effective salt reduction interventions for the CHLA Campaign, a WeChat-based online questionnaire was established. The status and changes of salt-related knowledge and behaviors of Chinese WeChat users between 2019 and 2020 were analyzed. Results show that the willingness of reducing the amount of cooking salt in households was very high, but the level of salt-related knowledge decreased and the proportion of salt reduction and high-salt intake behaviors increased from 2019 to 2020, which may due to the potential impact of COVID-19 epidemic. The distribution of salt-related knowledge and behaviors between subgroups was basically indifferent within 2 years. The results also point out that promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future, which will be fully considered in CHLA Campaign salt reduction action. According to the results, the national CHLA office has produced new video materials and standard education series courseware relate to salt reduction and graphic materials on low-salt diet strategies for people with hypertension or cardiovascular diseases. Additionally, we have integrated these existing salt reduction materials and developed a WeChat mini-program for WeChat users’ online intervention, which will be used in the next step to promote the national salt reduction action. In addition, we are also adjusting the content and long-term goals of the upcoming salt-reduction action plan based on the survey results. We believe that this WeChat-based survey will provide basic data for the follow-up investigation, which we will definitely continue to conduct, and it might be a useful instrument for other salt-reduction activities.


Substance use is highly prevalent among Chilean adolescents, and the damage it causes at the neurobiological, psychological, and social levels is known. However, there are no validated screening instruments that also assess risk and protective factors for this population in Chile, which is essential for evaluating future prevention interventions.To determine the psychometric properties of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap) questionnaire.A cross-sectional study was carried out in 13 schools in the city of Santiago de Chile. The sample included 2261 adolescents ranging from 10 to 14 years old. Linguistic and cultural adaptation was assessed using focus groups with adolescents, the construct validity was evaluated using confirmatory factor analysis, and measures of its reliability were also determined. Furthermore, the associations regarding risk and protective factors with substance use were explored.Substance use questions were well understood and seemed to adequately capture the consumption of different drugs. Regarding the subscales of risk and protective factors, the analyses showed that most subscales had good psychometric properties, and few needed some degree of improvement . After the changes, most final subscales had good or adequate goodness of fit adjustments and good or acceptable internal consistency. Finally, the main associated factors with the substance use outcomes were: future substance use and school bonding for tobacco use; negative beliefs about alcohol, future substance use, school bonding and refusal skills for alcohol use; and negative beliefs about marihuana, positive attitudes towards drugs, risk perception, and substance abuse index for marihuana use. Normative beliefs increased the risk for all substances use.The current findings suggest that the EU-Dap is a valid and reliable instrument, and it may help to evaluate the effectiveness of drug use prevention interventions. Most adults with substance abuse disorders started substance use during adolescence, and it is known that the earlier life consumption begins, the greater the risk of dependence in the future , 2. ThisSubstance use and mental disorders are among the main contributors to disease among children and adolescents in the Americas region, representing 5.2% of the disability-adjusted life years (DALYs) and 17.2% of the years lived with a disability (YLD) in the population from 0 to 14 years.In 2015, Chile led this region in tobacco use in the last month among adolescents in secondary education, reaching a prevalence of 23.7% . RegardiSubstance use among adolescents has been associated with the onset of psychiatric disorders such as depression and anxiety disorders , 10, in Overall, substance use has a significant economic impact in Chile. For example, in 2019, the costs of only the GES benefits were $319,714,800. In addition, approximately $899,388 is spent annually on hospitalization for alcohol and drug detoxification in adolescents. This figure is estimated using the data for the average cost per day of hospitalization, which is $45 in the year 2020 ; the aveIn order to prevent substance use and its consequences, several school-based programs have been evaluated worldwide . For insTo assess the prevalence of substance misuse, screen this problem among adolescents, and evaluate the effectiveness of preventive interventions , it is nOther instruments have been associated with the evaluation of prevention programs. Two of the most effective programs, the LifeSkills Training program  and the Overall, it is crucial to have validated instruments to assess preventive interventions. Additionally, the validation process must be performed in a sample with similar features regarding age and cultural context to the population where the intervention is planned to be implemented , 30.We are conducting a large study to assess the effectiveness of the culturally adapted Unplugged program in Chile (known as “Yo Sé Lo Que Quiero” [“I Know What I Want”]). In order to obtain robust results from this evaluation, we need to have a validated instrument; therefore, we decided to use the same questionnaire as in Europe and Brazil to perform future comparisons between countries. Thus, the aims of this study were the following: (1) culturally adapt the EU-Dap questionnaire to early adolescents in Chile, (2) assess the validity of the internal factor structure of the subscales contained in the questionnaire evaluating risk and protective factors, (3) assess the reliability of these subscales and (4) assess the possible relationships between all risk and protective factors and substance abuse measured by the questionnaire.th to 8th grades. Study 2 refers to a cross-sectional study conducted in a large sample of students attending the same grades, aiming to assess the psychometric properties of the instrument.Two studies were conducted in this validation. Study 1 refers to the linguistic and cultural adaptation of the questionnaire and a pilot study of the understanding of the questions in a small group of adolescents attending 5For the study, a cultural adaptation was made based on the Spanish version of the EU-Dap questionnaire, where Spanish idioms and words that are not used in Chile were changed. Additionally, the English version was used along with the Spanish version to better understand the meaning of each of the questions to avoid potential cultural adaptations present in the Spanish version used in Spain. It is worth mentioning that the original author of the EU-Dap questionnaire gave us permission to use and modify the original questionnaire in the context of this cultural adaptation.th grade students, 36 6th grade students, 33 7th grade students, and 35 8th grade students), from one school representing the middle-income status, and it was selected for convenience. Later, two focus groups were subsequently held inviting students who previously answered the questionnaire, as described above: the first focus group included 5th and 6th graders and the second, 7th and 8th graders. Regarding the selection of the participants in each focus group, six students per class were randomly selected ; and there were equal proportions of males and females. The purpose of these focus groups was to assess in-depth the understanding and wording of the questions included in the questionnaire. The qualitative data analysis of the focus groups was evaluated by content analysis and Grounded Theory  attended a public school, 28.9% [27.1–30.8] attended a subsidized school, and 32.2% [30.3–34.2] attended a private school. Students came from different school socioeconomic backgrounds in equal proportions: 30.5% [28.7–32.4] came from a low socioeconomic level, 37.3% [35.3–39.3] came from a medium socioeconomic status, and 32.2% [30.3–34.2] came from a high socioeconomic level. See A total of 2,261 students participated. Their ages ranged from 10 to 14 years old, and 53,3% [51.3–55.4] were male. Most students live with their parents and siblings. The average age for each grade level was 10.7 (SD = 0.65) years old for 5th grade. For example, the last month prevalence among 8th graders was 5.9% [3.5–9.7] for females and 3.8% [2.1–6.8] for males. The prevalence of alcohol use was the highest compared to the other substances, with the lifetime prevalence reaching 39.2% [37.2–41.3] among all grades. Males passed females regarding alcohol use in all periods for 5th-7th graders; however, among 8th graders, females had a higher prevalence in all periods. 2.1% [1.6–2.8] had been drunk in the last 30 days, and the highest proportion was among 8th graders. In every grade, the prevalence of binge drinking in the last 30 days was higher among females than males, especially among 8th graders . Like alcohol use, males passed females regarding marijuana use in all periods for 5th-7th graders; however, among 8th graders, females had a higher prevalence in all periods. , except for the decision-making skills subscale (ω = 0.59).Applying the factor loading criteria mentioned in the Methodology, the majority of 16 subscales kept all the items originally included in the construct, except four subscales which ended up with a reduced number of items: self-esteem, nine items (1 item was removed), family functioning, 16 items (4 items were removed), assertiveness, five items (1 item was removed), and normative beliefs, three items (2 removed). See The subscales “positive and negative beliefs about tobacco use”, “positive and negative beliefs about alcohol use”, “positive and negative beliefs about marijuana use”, “positive and negative attitudes towards drugs” and “self-esteem” had two oppositive dimensions; therefore, two subscales for each construct were created. See Finally, the items that did not load into any of the subscales, we decided to keep them in the questionnaire and perform association analyses using them as individual items. We considered the content of these items valuable, and they were assessed as risk or protective factors for substance use outcomes.CFI index showed acceptable or good adjustment for positive and negative beliefs about marijuana use, future substance use, substance abuse index, parental involvement, normative beliefs and refusal skills. Regarding the SRMR, good or acceptable fit was found for the following subscales: positive and negative beliefs about tobacco, self-esteem, poor problem-solving skills, parental involvement, school bonding, assertiveness, normative beliefs, and refusal skills. Additionally, the RMSEA index was good or acceptable for substance abuse index, parental involvement, family functioning, normative beliefs, and refusal skills. Finally, most subscales had either good or acceptable internal reliability (range 0.65 to 0.95), except for decision-making skills, with ω = 0.59. See The results of the univariable associations are presented in Regarding multivariable analyses, negative beliefs about alcohol use decreased the odds of 30-day prevalence alcohol and the 30-day prevalence of binge drinking in females. Positive attitudes towards drugs increased the odds of 30-day prevalence of marijuana use, and negative beliefs about marijuana decreased the risk of 12-month prevalence of marijuana use. The Future substance use subscale score increased the risk of alcohol use and binge drinking among females in the last 30 days. The substance abuse index increased the risk of marijuana use in the two time periods studied. On the other hand, school bonding decreased the odds of tobacco, alcohol, and drunkenness 30-day prevalence, and risk perception decreased the odds of 30-day prevalence of marijuana use. Higher scores in the normative beliefs subscale increased the risk for the three substances: 30-day alcohol, 30-day tobacco, and 12-month marijuana prevalence. Finally, refusal skills decreased the risk of alcohol and drunkenness 30-day prevalence. See The effect size estimation for one of the relevant associations explored in this study, “Alcohol use in the last 30 days” as the dependent variable and “Normative Beliefs” as an independent variable, was Cohen’s d of -0.60 (95% CI = -0.41: -0.79), which is considered a medium effect size .This is the first validation of the EU-Dap questionnaire in an early adolescent population in Spanish-speaking Latin American countries. The results of our study showed that the EU-Dap questionnaire has good psychometric properties. Substance use questions were well understood and seemed to adequately capture the consumption of different drugs. Regarding the subscales of risk and protective factors, the evidence of construct validity using confirmatory factor analysis showed that most of the final subscales had good or adequate goodness of fit adjustments. Regarding reliability, all of the final subscales had good or acceptable internal consistency according to the omega coefficient . AssociaThe general content of the questionnaire was well understood, and only words and small changes in the structure of the questions were required. Similar results were found in the validation in Brazil . These rRegarding the factor structure of the EU-Dap questionnaire, to our knowledge, no other publications are exploring the validity of the different subscales contained in the instrument. The fact that most subscales exploring risk and protective factors had good item structure is important, considering that some of these variables might be used to study the mediating effect of the Unplugged intervention. Having a valid instrument to assess this and other variables, will help to conduct similar analyses after we complete the cRCT in schools in Chile or other research teams conduct other evaluations of different programs. Similarly, it is crucial to have reliable instruments, and our results support this idea.We also explored the associations between risk and protective factors and substance use outcomes. This approach allowed us to examine the association of potentially modifiable factors with substance use and provide support for using these scales to evaluate the effectiveness of preventive interventions. For example, normative beliefs had one of the strongest associations in our study. This variable was considered a mediator factor in the effectiveness of the Unplugged program in Europe, and several activities of the program aimed to improve this factor .Comparing our results with another study among Chilean adolescents that measured the impact of risk and protective factors in the use of tobacco, alcohol, and marijuana , both hiAnother critical variable was school bonding, which reduced the risk for tobacco and alcohol use in the last 30 days. This relationship has already been reported in Chile  and elseFurthermore, building refusal skills may also appear to be a protective factor . IncludiWe also highlight the importance of negative beliefs about alcohol and marihuana as potential protectives factors, findings also found in a Brazilian Unplugged study . FurtherThis study has some limitations. First, this was a self-reported questionnaire, so information bias and social desirability bias may exist. Therefore, the substance use prevalence figures may have been overestimated or underestimated. Second, this is a cross-sectional study, so no causality may have been claimed regarding the associations . Third, As previously mentioned, the EU-Dap questionnaire was developed to evaluate a preventive substance use program. According to these findings, we have a valid and reliable questionnaire available to evaluate the effectiveness of the “Yo Sé Lo Que Quiero” (Unplugged) in Chile and other Spanish speaking countries, or any other intervention aiming to reduce risk factors such as normative beliefs and increase protective factors such as negative beliefs about substance use, refusal skills, and school bonding.S1 Questionnaire(DOCX)Click here for additional data file.S2 Questionnaire(DOCX)Click here for additional data file.S1 Table(DOCX)Click here for additional data file.S2 Table(DOCX)Click here for additional data file.S3 Table(DOCX)Click here for additional data file.S4 Table(DOCX)Click here for additional data file.S5 Table(DOCX)Click here for additional data file.


Mycobacterium avium complex (MAC) infection. APAP was diagnosed based on serum anti-granulocyte-macrophage colony-stimulating factor antibody, bronchoalveolar lavage fluid (BALF) findings, and transbronchial lung biopsy. Nodular shadows with cavities were visible on chest CT images, and Mycobacterium intracellulare was identified by BALF culture. Rifampicin, ethambutol, and clarithromycin were administered, and 4 months later, the nodular shadows of MAC had disappeared, and APAP was remarkably improved. Thus, in cases of APAP exacerbation complicated with infections, such as MAC, control of the infections may improve APAP.Herein, we present the case of a 63-year-old man with autoimmune pulmonary alveolar proteinosis (APAP) complicated by  PAP is Mycobacterium avium complex (MAC) infection are relatively rare. Furthermore, there is no established strategy for treating exacerbations of APAP associated with infection, including MAC.PAP can be complicated by mycobacterial infections, and tuberculosis is the most common . HoweverHerein, we present a case of improved APAP when treated only with antimicrobials against coexisting MAC infection.2A 63-year-old man was referred to our department for the treatment of exacerbation of APAP (October 201X). Four years and eight months ago, he was admitted to a nearby hospital. In a health check-up, an abnormal shadow was seen on a chest radiograph . Chest c2 was 97% in ambient air. In the past, he smoked 40–60 cigarettes daily and was still smoking 4–5 cigarettes daily at that time. Pulmonary function tests (PFTs) at the time of the first visit revealed vital capacity of 85.2%, forced expiratory volume 1.0 (sec) of 70.2%, carbon monoxide diffusing capacity (DLco) of 68.9%, and DLco per alveolar volume of 89.8%. A chest radiograph demonstrated diffuse GGA in both lung fields. Blood examination revealed a lactate dehydrogenase level of 295 U/L and a KL-6 level of 12,110 U/mL, with no elevated levels of inflammatory markers (2 widening (33 mmHg). Furthermore, although acid-fast smear and polymerase chain reaction results for Mycobacteriumu avium complex were negative, Mycobacterium intracellulare was identified after 3 weeks of BALF culturing at the nearby hospital. Based on the appearance of nodular shadows with cavities on chest CT and the detection of M. intracellulare from BALF, APAP complicated by MAC infection was diagnosed.At the first visit to our department, his SpO markers . Arteria2 increased but the imaging findings also remarkably improved , ethambutol (750 mg/day), and clarithromycin (800 mg/day) (RECAM), not only had the SpOimproved F. In addimproved . However3The present case demonstrates two notable clinical findings. First, in rare cases, APAP can be complicated by MAC infection. Second, in the case of APAP complicated by MAC infection, control of infection by treatment for MAC may also contribute to the improvement of APAP.Mycobacterium tuberculosis, and MAC was seen in only three cases (14.3%). Furthermore, these opportunistic infections may precede or follow the diagnosis of APAP. On the other hand, it has been reported that the detection rate of MAC in BALF is higher in PAP [Mycobacterium infections in BALF and image findings.It has been reported that 5–13% of patients with APAP develop secondary infections . In a lie cases 1.3%. FurtInfections including MAC may be associated with exacerbation of APAP, and treatment for the infections may also contribute to the improvement of APAP. In a case of PAP with pulmonary tuberculosis  and anotThere are reports of the spontaneous remission of PAP ,11. This4APAP can be complicated opportunistic infections, including MAC and exacerbated by the infections. In cases of exacerbation of APAP, it may be essential to search for infectious etiologies, including MAC. Control of infection prior to WLL may be effective for the improvement of APAP.This case report did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.None.


In this study, we provide the reader with an overview of quantum dot application in solar cells to replace dye molecules, where the quantum dots play a key role in photon absorption and excited charge generation in the device. The brief shows the types of quantum dot sensitized solar cells and presents the obtained results of them for each type of cell, and provides the advantages and disadvantages. Lastly, methods are proposed to improve the efficiency performance in the next researching. Solar cells have grown very rapidly over the past few decades, which are divided into three generations: the first generation is a monocrystalline and polycrystalline Si solar cell with an efficiency of 26.7%  and 21.9photon − Egap) mostly as heat. Third generation solar cells aim for conversion efficiencies beyond the Shockley–Queisser limit through advanced photovoltaic concepts such as multijunction cells, optical up and down converters, and multiple carrier generation by impact ionization. Their development has been based on different p–n junctions and the use of quantum dots (QDs) to replace dyes. Performance above 40% has been obtained 2, which ch as Mg , Ag [116ch as Mg , Co [118ch as Mg , into Cd2+ QDs, by controlling the doping concentration and layer thickness. Without doping, photons whose energy was less than the pure QDs bandgap cannot be absorbed. However, by the presence of doping energy levels inside the pure QDs bandgap, those aforementioned photons were able to be absorbed. This led to a significant improvement of the photoexcited electron density and hence the current density of QDSSCs [2/QDs interface and TiO2 diffusion layer resistance (Rct2) or electrolyte/counter electrode resistance (Rct1), were dramatically decreased, while the significant increasement of photoexcited electron lifetime in the QDs CB was observed [As reported by Tung et al., by doping Mn and Cu into CdSe QDs, the efficiencies of QDSSCs were increased from 2.55% with pure tandem-structure photoanode to 3.77% and 4.22% with Mn- and Cu-doped photoanode, respectively. These results have good agreement with those in Reference . The curf QDSSCs ,121,122.observed .3−/I− electrolyte as a Figure 9. However, the resistance of the counter electrode/electrolyte interface is relatively high, which reduces the electron transport efficiency through the cathode surface [3−/I− electrolyte and hence limit the light absorption ability of those QDs. Several cathode materials, such as nanocarbon tubes, CuS, nanocarbon tube–Cu2S, NiS, or Au  and FF low [2, as discussed above. In addition to the polysulfide electrolyte, the pseudo-solid [Among them, liquid polysulfide electrolyte has been widely used due to its compatibility with QDs and counter electrodes, which greatly improve the QDSSCS performance . This eld FF low . To protdo-solid  or soliddo-solid  electroldo-solid  and guando-solid .Currently, QDs have been made with high purity, quality, less defects, manipulated bandgap energy, and good optical properties to replace photosensitive molecules. However, the PCE of QCSSCs has not exceeded 10%, which is much lower than that from theoretical calculations. There are two major issues one has to overcome:2 interface, electron diffusion process inside the TiO2 membrane, and QDs corrosion by electrolyte or electron loss due to redox reaction at the electrolyte/counter electrode interface. Among them, the losses due to internal and surface defects of QDs are limited for those QDs synthesized by the colloidal process at high temperature or extended for those made by the CBD or SILAR method. Losses due to electrolyte corrosion can be improved by using passivation surfactants, such as ZnS or SiO2, to limit the contact between QDs and electrolytes. However, more defects are observed in the multilayer photoanodes with tandem structure.Firstly, substantial excitation electron loss in QDSSCs. There are many types of losses in QDSSCs operation, such as the recombination process inside QDs or on their surfaces due to imperfect fabrication, electron loss when transported through the QDs/TiOSecondly, researching on the new kind of QDs materials.a.QDSSCs based on QDs possessing intermediate band (IB)1, E2, and E3 are absorbed, corresponding to the energy gap between two VBs of the two materials, valence and CBs of the narrower bandgap material and two CBs of the two materials, respectively. These absorptions result in the enhancement of the excited electron concentration in the CB of a wider bandgap material, which is then collected and transferred to an external circuit and creates the electric current density. These IB structure materials have great potential to replace traditional photosensitive materials due to predicted PCE in QDSSCs up to 46% [Limitations in traditional solar cells, such as a narrow absorption spectrum of photosensitive materials, leads to the degradation of absorbed photon density, current density, and open circuit potential. Those photons, which have energy larger or equal than the photosensitive material bandgap, are absorbed. For materials with IB structure, this issue is overcome since the material is a compound of two or more materials with different bandgap energies. As can be seen in p to 46% . b.Graphene thin film with QDs for photoanode fabrication4 cm2 V−1 s−1 so having prominent electrical, optical, thermal dynamics, and mechanical properties [2 membrane for 6% conversion efficiency [Graphene is a two-dimensional single layer of carbon atoms, which has a large surface area and high electronic mobility of 1.5 × 10operties ,152,153.operties . Therefooperties . Zhong aficiency . Graphen2 layer [2 layer . The sup2 layer .


Common to several allergic diseases is the generation of immunoglobulin E (IgE) by plasma cells, when exposed to an innocuous antigen. Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway inflammatory diseases. Asthma is mediated in some patients through eosinophilic inflammatory mechanisms that include allergic sensitization and Th2-mediated immune airway response. COPD, on the other hand is mainly considered a Th1-mediated inflammatory process with neutrophilic predominance or a non-Th2 inflammation, occasionally associated with the presence of airway bacteria or viruses. IgE production appears to play an important role in the development of both COPD and asthma, as it has been associated to respiratory symptoms, lung function, bacterial and viral infections, airway remodeling and bronchial hyperreactivity in both diseases. The aim of this review is to summarize all current data concerning the role of specific and total IgE in COPD and asthma and to highlight similarities and differences in view of possible therapeutic interventions. T lymphocytes are distinguished by the presence of cell membrane molecules known as cluster of differentiation 4 (CD4) and CD8. The CD4 T-lymphocytes are also known as helper T cells and can be further subdivided into Th1 and Th2, producing, respectively, Th1- and Th2-type cytokines  by plasma cells, when exposed to an innocuous antigen . Upon inAsthma and chronic obstructive pulmonary disease (COPD) are two common chronic airway inflammatory diseases. Asthma is often mediated through an eosinophilicinflammatory mechanism that includes allergic sensitization and Th2-mediated immune airway responses . COPD, o1 reversibility, a higher sputum eosinophil count, higher FENO levels and more exacerbations in the past year  from the SPIROMICS cohort and 36% of the COPD patients (N = 696) from the COPDGene cohort presented with atopy, defined as positive sensitization to any of the 10 indoor and outdoor allergens measured in the study  when compared to controls (n = 51)  and grass pollens (pooids and panicoids) presented the highest specific IgE-binding intensities in COPD  and house dust mites   and the cockroach allergen Bl. germanica, but no significant specific IgE-binding to pollens, house dust mites or the cockroach allergen Pr. americana (P < 0.01), poorest lung function  and increased exacerbation rate   in COPD patients when compared to controls and an increased number of exacerbations was detected in the COPD patients that were sensitized against air-fungi   and negatively with lung function , suggesting that indoor air and surfaces represent a potential source of fungal allergen exposure  were increased in COPD ((n = 51) . House d in COPD . A signiOPD n = 2, 55.8% aOPD n = 2, 55.8% aOPD n = 2, 55.8% aOPD n = 2, 55.8% aOPD n = 2, 55.8% aOPD n = 2, 55.8% aOPD n = 2, 55.8% a1/FVC), independent of smoking and asthma status  and this was in turn related to the reduction of asthma and COPD with asthmatic characteristics exacerbations following omalizumab treatment, as omalizumab suppresses this receptor –15. In vD. farinae and D. pteronyssinus), German cockroach and mold mix] they were found to be more frequently positive at least to one specific IgE when compared to controls  (p > 0.05). A higher proportion of current smokers had elevated total IgE levels and at least one positive specific IgE, when compared to former smokers  . However < 0.05) . Moreove smokers . This is smokers .Several observational studies have associated allergic sensitization by 1 year of age with respiratory viral infections in infancy –59, and A viral infection can attract several cell types, such as Th1 cells, CD8 cells, neutrophils and DC, to the site of inflammation, and they can all participate in the allergic response of the patient  Figure . MoreoveThe etiology of IgE production during viral infections is not yet clearly understood, as IgE production is normally a result of Th2-biased responses . In seveSpecifically, the Respiratory Syncytial Virus (RSV) was suggested to enhance Th2 sensitization to aeroallergens . Some stHuman rhinovirus (HRV) is also known to be a major cause of asthma exacerbations in infants and infection with HRV is associated with a higher incidence of asthma onset , 89–91. Children with parainfluenza infection in the first year of life had higher odds of developing asthma in their second year of life . In anotA growing body of evidence implicates viral respiratory tract infections as the predominant risk factor associated with exacerbations of COPD and the development of chronic airway disease , 100. MoStreptococcus pneumoniae has been related to adult asthma exacerbation  triggers histamine release through both IgE- and non-IgE-dependent mechanisms  and of fibronectin (24 h) are stimulated , as well as by stimulating their proliferation  Figure . When ASimulated . All theimulated .in vitro  was sufficient to stimulate ASMC remodeling by upregulating microRNA-21-5p, which in turn downregulated phosphatase and tensin homolog (PTEN) expression and supported mammalian target of rapamycin (mTOR) signaling  in vitro . They reignaling . Interesignaling . Therefoignaling .1 (Airway hyperreactivity is a general term to describe the increased response of the airways to bronchoconstricting agonists, such as methacholine or histamine, a hallmark of asthma . In COPD1 . Moreove1  and also1 . However1  (Table 11 (Remodeling of the airways is a well-recognized feature of COPD, depended on COPD severity based on post-bronchodilator FEV1 . There a1 –144. HowA recent study demonstrated that IgG antibodies play a key role in controlling IgE-mediated inflammatory responses in patients with nasal polyps, by interfering with allergens potentially binding to cell-bound IgEs . DepletiAllergen-specific IgGs are competing with IgEs for allergen binding, thereby decreasing the allergen-induced effector cell activation . This suIn this review we summarized current data concerning the role of IgE in COPD and asthma . It appeMK and DS: conception of the review topic. MK, EP, AG, and DS: literature review, writing of the manuscript, finalization of the manuscript, and approval of the submitted article. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.