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The prognostic factor for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) care remains unclear. Therefore, a retrospective study was conducted aiming to estimate the in-hospital mortality rate and the risk factors for mortality in a high-burden setting. All patients with culture-confirmed TB that were admitted to the ICU of the hospital between March 2012 and April 2019 were identified retrospectively. Data, such as demographic characteristics, comorbidities, laboratory measures and mortality, were obtained from medical records. The Cox proportional hazards regression model was used to identify prognostic factors that influence in-hospital mortality. A total of 82 ICU patients with confirmed TB were included in the analysis, and 22 deaths were observed during the hospital stay, 21 patients died in the ICU. In the multivariable model adjusted for sex and age, the levels of serum albumin and white blood cell (WBC) count were significantly associated with mortality in TB patients requiring ICU care (all P < 0.01), the hazard ratios were 0.8 (95% confidence interval (CI): 0.7–0.9) per 1 g/l and 1.1 (95% CI: 1.0–1.2) per 1 × 109/l, respectively. In conclusion, in-hospital mortality remains high in TB patients requiring ICU care. Low serum albumin level and high WBC count significantly impact the risk of mortality in these TB patients in China.
Six acidic dykes were discovered surrounding the Laiziling pluton, Xianghualing area, in the western Cathaysia Block, South China. A number of captured zircons are found in two of these acidic dykes. By detailed U–Pb dating, Lu–Hf isotopes and trace-element analysis, we find that these zircons have ages clustered at c. 2.5 Ga. Two acidic dyke samples yielded upper intersection point 206U/238Pb ages of 2505 ± 42 Ma and 2533 ± 22 Ma, and weighted mean 207Pb/206Pb ages of 2500 ± 30 Ma and 2535 ± 16 Ma. The majority of these zircons have high (Sm/La)N, Th/U and low Ce/Ce* ratios, indicating a magmatic origin, but some grains were altered by later hydrothermal fluid. Additionally, the magmatic zircons have high Y, U, heavy rare earth element, Nb and Ta contents, indicating that their host rocks were mainly mafic rocks or trondhjemite–tonalite–granodiorite rock series. Equally, their moderate Y, Yb, Th, Gd and Er contents also indicate that a mafic source formed in a continental volcanic-arc environment. These zircons have positive ϵHf(t) values (2.5–6.9) close to zircons from the depleted mantle, with TDM (2565–2741 Ma) and TDM2 (2608–2864 Ma) ages close to their formation ages, indicating that these zircons originated directly from depleted mantle magma, or juvenile crust derived from the depleted mantle in a very short period. We therefore infer that the Cathaysia Block experienced a crustal growth event at c. 2.5 Ga.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Polymorphisms of genes participating in iron transportation have been associated with Alzheimer's disease (AD) risk. The association between transferrin (TF) gene rs1049296 (P570S) polymorphism and AD is controversial.
We performed meta analysis on data from 19 studies with 6310 cases and 13661 controls to reexamine the association between the TF gene rs1049296 polymorphism and AD. We applied a fixed-effects model to combine the odds ratio (OR) and 95% confidence intervals (95% CI). Egger's test was carried out to evaluate the potential publication bias.
The overall ORs with 95% CIs showed statistical association between the TF gene rs1049296 polymorphism and the risk of AD in the allele contrast, the recessive model and the dominant model for allele C2 (fixed-effects pooled OR 1.11; 95% CI 1.05 to 1.17, pooled OR 1.13; 95% CI 1.06 to 1.21, and pooled OR 1.23; 95% CI 1.03 to 1.47, respectively). In the contrast of C2C2+C2C1 vs C1C1, large heterogeneity among the Asian subgroup (p=0.041, I2= 68.6%) was observed but not among the overall population (p = 0.184, I2= 22.4%). No publication bias was observed.
The present meta analysis demonstrated that TF gene rs1049296 polymorphism is a genetic determinant of AD.
Growing yellow cattle (Bos taurus, n 30, 1·0–3·5 years old and 75–240 kg) from their native altitude (2000–2800 m) were used to evaluate the effects of altitude, ambient temperature (Ta) and solar radiation on the basal energy metabolism in this large mammal. Fasting heat production (FHP) was measured at altitudes of 2260, 3250 and 4270 m on the Tibetan plateau both in the summer and winter respectively, after a 90 d adaptation period at each experimental site. The gas exchanges of the whole animal were determined continuously for 3 (2260 and 3250 m) or 2 (4270 m) d after a 96 (2260 and 3250 m) or 48 (4270 m) h starvation period, using closed-circuit respiratory masks. Increasing altitude from 2260 to 3250 m at similar Ta in the summer significantly elevated FHP for all animals (P<0·01), and from 3250 to 4270 m for young cattle (P<0·05); increasing altitude from 2260 to 3250 m in the winter also significantly elevated FHP (P<0·05), but the increase was mainly due to the decrease of Ta and the increase in wind speed. No results were obtained at 4270 m in the winter, due to the problems of the animals, adaptating to the altitude. The magnitude of FHP elevation caused by increasing altitude was greater with summer sunshine or winter wind than without them. Increase of Ta from 10·0 to 22·0°C, in the presence of solar radiation, slightly (2260 m) or significantly (3250 and 4270 m, P<0·01) elevated FHP, but slightly reduced it in the absence of solar radiation; decrease of Ta from 0·0 to −30·0°C linearly increased FHP. At 3250 and 4270 m, FHP at the same Ta was higher with summer sunshine or winter wind (3250 m) than without them, but this did not occur at 2260 m. In conclusion, high altitude elevates FHP in yellow cattle in the warm season, and the summer solar radiation and winter wind at high altitude significantly increase metabolic rate. It may be also concluded that the effects of solar radiation on metabolic rate depend on the altitude and the environmental temperature.
Thirty growing yaks Bos grunniens or Poephagus grunniens, 1·0–3·5 years and 50–230kg, from their native altitudes (3000–4000m), were used to study the basal metabolism in this species and to evaluate the effects of high altitude and season on the energy metabolism. Fasting heat production (FHP) was measured at altitudes of 2260, 3250 and 4270m on the Tibetan plateau in both the summer and the winter, after a 90d adaptation period at each experimental site. Gas exchanges of the whole animals were determined continuously for 3d (4–5 times per d, 10–12 min each time) after a 96 h starvation period, using closed-circuit respiratory masks. Increasing altitude at similar ambient temperature (Ta) did not affect (P>0·10) FHP in the summer, but decreased (P<0·05) it at different Ta in the winter. However, the decrease of FHP in the winter was mainly due to the decrease of Ta instead of the increase of altitude. In the summer, the respiratory rate, heart rate and body temperature were unaffected by altitude, except for a decrease (P<0·05) in body temperature at 4270m; in the winter, they were decreased (P<0·05) by increasing altitude. In both seasons, the RER was decreased (P<0·05) by increasing altitude. At all altitudes for all groups, the daily FHP was higher (P<0·05) in the summer (Ta 6–24°C) than in the winter (Ta 0 to -30°C), and the Ta-corrected FHP averaged on 920 kJ/kg body weight0·52 at Ta 8–14°C and on 704 kJ/kg body weight0·52 at Ta -15°C respectively. We conclude that in the yak high altitude has no effect on the energy metabolism, whereas the cold ambient temperature has a significant depressing effect. The results confirm that the yak has an excellent adaptation to both high altitude and extremely cold environments.
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