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The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
As rarely large flake graphite (9 mesh) was recently exploited in China, it was innovatively developed as the raw material to prepare a novel wound dressing based on large expanded graphite (EG) in this work. The EG worms were prepared in an easy oxidative intercalation and thermal expansion method. Afterward, chitosan was grafted onto the surface of EG by chemical modification, forming CS-EG worms. CS-EG sponge dressings were then obtained by pressing a number of CS-EG worms together by external force. Due to the porous structure and large specific surface area, the produced CS-EG sponges exhibited outstanding adsorption capacity for wound exudate. They could also promote blood coagulation by adsorbing the blood cells and proteins quickly and effectively, showing excellent hemostatic performance. The eminent performances and the simple preparation process ensure the great application potential of CS-EG as a dressing material. This is also the first time to report the application of the traditional carbon material, EG, to act as a dressing material after chemical modification.
While maternal folate deficiency has been linked to poor pregnancy outcomes such as neural tube defects, anaemia and low birth weight, the relationship between folate and preterm birth (PTB) in the context of the US post-folic acid fortification era is inconclusive. We sought to explore the relationship between maternal folate status and PTB and its subtypes, i.e. spontaneous and medically indicated PTB.
Boston Birth Cohort, a predominantly urban, low-income, race/ethnic minority population at a high risk for PTB.
Mother–infant dyads (n 7675) enrolled in the Boston Birth Cohort. A sub-sample (n 2313) of these dyads had maternal plasma folate samples collected 24–72 h after delivery.
Unadjusted and adjusted logistic regressions revealed an inverse relationship between the frequency of multivitamin supplement intake and PTB. Compared with less frequent use, multivitamin supplement intake 3–5 times/week (adjusted OR (aOR) = 0·78; 95 % CI 0·64, 0·96) or >5 times/week (aOR = 0·77; 95 % CI 0·64, 0·93) throughout pregnancy was associated with reduced risk of PTB. Consistently, higher plasma folate levels (highest v. lowest quartile) were associated with lower risk of PTB (aOR = 0·74; 95 % CI 0·56, 0·97). The above associations were similar among spontaneous and medically indicated PTB.
If confirmed by future studies, our findings raise the possibility that optimizing maternal folate levels across pregnancy may help to reduce the risk of PTB among the most vulnerable US population in the post-folic acid fortification era.
Mean annual air temperature (MAAT) and precipitation isotope records for the Holocene were obtained from the analysis of the relative distribution of branched glycerol dialkyl glycerol tetraethers and compound-specific hydrogen isotope ratios of leaf waxes from a sediment core from Aweng Co on the western Tibetan Plateau (WTP). Our results indicate that the Indian monsoon mainly influenced Aweng Co during the Holocene. During the early Holocene, when summer insolation was at a maximum, the monsoonal influence was strong and the climate was warm and wet. Both the summer and winter insolation were relatively weak, and Aweng Co was cool and dry during the middle Holocene (6–3 ka), indicating a weakening of the Indian monsoon. The southward displacement of the Intertropical Convergence Zone and relatively low atmospheric methane content may have contributed to the middle Holocene cooling on the WTP. During the late Holocene, with a further increase in winter insolation and decrease in summer insolation, the summer monsoon weakened and the MAAT on the WTP gradually increased. Depleted leaf wax hydrogen isotope ratios during the late Holocene can be attributed to accelerated glacier melting because of the elevated MAAT.
This note is concerned with the bicriteria scheduling problem on a series-batching
machine to minimize maximum cost and makespan. An
O(n5) algorithm has been established
previously. Here is an improved algorithm which solves the problem in
Let F(z) be a rational map with degree at least three. Suppose that there exists an annulus such that (1) H separates two critical points of F, and (2) F:H→F(H) is a homeomorphism. Our goal in this paper is to show how to construct a rational map G by twisting F on H such that G has the same degree as F and, moreover, G has a Herman ring with any given Diophantine type rotation number.
We design a way that the anode hosts provide lithium ion in lithium ion battery operation. If the limiting factors of the cathode materials are less, there will be more alternatives for it. It was proven to be successful by two kinds of test cells based on LixCn as anode material, and β-FeOOH or Cr8O21 as cathode materials. Their theoretical capacities are much higher than those present electrode materials. Unlike the lithium secondary batteries with lithium metal foil or lithium alloy as anode, this type of lithium ion batteries with LixCn as anode prohibit dendrite formation during charging-discharge process. The idea of lithium ion sources coming from the anode can come true successfully as a result that steady protecting solution be sought for LixCn.
Enamel is made up of enamel prisms separated by thin layer of organic sheaths. The mechanical properties of the prisms and the organic sheaths are obviously different from each other due to different compositions and microstructures. However, quantitative measurements of such differences have been a challenge in the past. The objective of this study is to accurately study the mechanical properties in the isolated domains within single enamel prism. The technique of nanoindentation combined with Atomic Force Microscopy (AFM) was employed to test the enamel specimens from mature human maxillary third molar. It was revealed that the nanohardness and elastic modulus of the sheaths were about 73.6% and 52.7% lower than those of the prisms. AFM topographies of the residual indent impressions also visually confirmed the differences. In addition to nanoindentation tests, the microstructures of enamel were carefully investigated in terms of hierarchical levels of organization to understand the structural reasons of the mechanical differences. We found a close relation between the variations of mechanical properties of enamel and its hierarchical structure. The analysis of the mechanical properties within enamel upon hierarchy is not only helpful to understand its unique property, but may also inspire ideas for the design of novel synthetic materials.
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