For any positive integers $k_1,k_2$ and any set $A\subseteq \mathbb {N}$, let $R_{k_1,k_2}(A,n)$ be the number of solutions of the equation $n=k_1a_1+k_2a_2$ with $a_1,a_2\in A$. Let g be a fixed integer. We prove that if $k_1$ and $k_2$ are two integers with $2\le k_1<k_2$ and $(k_1,k_2)=1$, then there does not exist any set $A\subseteq \mathbb {N}$ such that $R_{k_1,k_2}(A,n)-R_{k_1,k_2}(\mathbb {N}\setminus A,n)=g$ for all sufficiently large integers n, and if $1=k_1<k_2$, then there exists a set A such that $R_{k_1,k_2}(A,n)-R_{k_1,k_2}(\mathbb {N}\setminus A,n)=1$ for all positive integers n.

The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remain unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolisation and radiofrequency ablation. Relevant randomised controlled trials (RCT) were obtained from PubMed, EMBASE and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival and tumour recurrence. The secondary outcomes were hospital stay, nutrition status, biochemistry profile, complication rate of liver treatment and adverse effect of BCAA supplementation. In total, eleven RCT involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumour recurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference (MD): 0·11 g/dl, 95 % CI: 0·02, 0·20; 5 RCT) at 6 months and cholinesterase level (MD: 50·00 U/L, 95 % CI: 21·08, 78·92; 1 RCT) at 12 months and reduced ascites incidence (risk ratio: 0·39, 95 % CI: 0·21, 0·71; 4 RCT) at 12 months compared with the control group. Additionally, BCAA administration significantly increased body weight at 6 months and 12 months and increased arm circumference at 12 months. In conclusion, BCAA supplementation significantly improved the liver function, reduced the incidence of ascites and increased body weight and arm circumference. Thus, BCAA supplementation may beneficial for selected patients undergoing liver intervention.

SARS-CoV-2 rapidly spreads among humans via social networks, with social mixing and network characteristics potentially facilitating transmission. However, limited data on topological structural features has hindered in-depth studies. Existing research is based on snapshot analyses, preventing temporal investigations of network changes. Comparing network characteristics over time offers additional insights into transmission dynamics. We examined confirmed COVID-19 patients from an eastern Chinese province, analyzing social mixing and network characteristics using transmission network topology before and after widespread interventions. Between the two time periods, the percentage of singleton networks increased from 38.9$ \% $ to 62.8$ \% $$ (p<0.001) $; the average shortest path length decreased from 1.53 to 1.14 $ (p<0.001) $; the average betweenness reduced from 0.65 to 0.11$ (p<0.001) $; the average cluster size dropped from 4.05 to 2.72 $ (p=0.004) $; and the out-degree had a slight but nonsignificant decline from 0.75 to 0.63 $ (p=0.099). $ Results show that nonpharmaceutical interventions effectively disrupted transmission networks, preventing further disease spread. Additionally, we found that the networks’ dynamic structure provided more information than solely examining infection curves after applying descriptive and agent-based modeling approaches. In summary, we investigated social mixing and network characteristics of COVID-19 patients during different pandemic stages, revealing transmission network heterogeneities.

Objectives: In this study, we compared the performance of a rapid polymerase chain reaction (PCR) method in detecting carbapenemase-producing organisms (CPOs) and its impact on infection prevention and control (IPC) measures compared with a culture PCR method. Methods: All patients requiring CPO screening were included. Rectal swabs were collected with double rayon swabs (Copan 139C). They were simultaneously analyzed for the presence of CPOs using rapid PCR assay (Xpert Carba-R assay, Cepheid, Sunnyvale, CA) and a culture–PCR method (ChromID CARBA-SMART, bioMerieux, Marcy-l’Etoile, France). For CARBA-SMART, only colored colonies (ie, Enterobacterales) were evaluated for CPOs according to the prevailing institutional protocol. We tracked time to CPO detection. Using CPO positivity from either the rapid PCR or the culture PCR method as the gold standard, we calculated the sensitivity and specificity of both tests. We calculated the number of epidemiologically linked contacts generated when the first test results were known. We prospectively followed the ward census to identify the putative additional number of contacts generated by the later known result. Contacts were patients who shared the same ward (with overlapping time) as the CPO patients. Results: Between April 2019 and June 2020, culture PCR method detected CPOs in 316 (1.3%) of 24,514 samples (blaOXA48, N = 211; blaNDM, N = 51; blaIMI, N = 21; blaIMP, N = 10; blaKPC, N = 9; mixed genotypes, N = 14). The rapid PCR test detected CPOs in 605(2.5%) of 24,514 samples (blaOXA48, N = 266; blaNDM, N = 161; blaIMP, N = 99; blaVIM, N = 29; blaKPC, N = 15; mixed genotypes, N = 35). The sensitivity of direct PCR and culture PCR methods were 94.2% (95% CI, 92.1%–95.8%) and 43.5% (95% CI, 39.6%–47.4%), respectively. Both tests had 100% specificity. The median times to detection for the rapid PCR and culture PCR methods were 3–4 hours and 4 days, respectively. Compared with rapid PCR, the culture PCR method generated additional 7,415 contacts when it also tested positive for CPOs and an additional 23,135 contacts when it tested negative for CPOs. Conclusions: In our study, the rapid PCR test was more sensitive, identified CPO faster, and generated fewer epidemiologically linked contacts than the culture PCR method.

Objectives: In Australia, the prevalence of SSI is 3.6%, with a particularly high burden in colorectal procedures of 8.7%. ChloraPrep (2% chlorhexidine gluconate (CHG)–70% isopropyl alcohol formulation) is a preoperative sterile alcoholic CHG solution prefilled in a ready-to-use applicator. We compared the costs and SSI outcomes of adopting ChloraPrep versus a bulk aqueous povidone iodine (PVI) solution for colorectal procedures in a public hospital setting. Methods: We used a budget-impact tool to evaluate the clinical and economic impacts of skin preparation methods. The PVI SSI rate was assumed to be the baseline rate observed in Australia (8.7%). The ChloraPrep SSI rate was derived by applying the demonstrated ChloraPrep SSI reduction versus PVI (41%) to the PVI SSI rate. The cost of ChloraPrep was AU$8 (US $5.50) and the cost of PVI solution was AU$3 (US $2). The PVI equipment cost AU$2.13 (US $1.47). Additional average length of stay was 9.4 days, and the daily average cost was AU$2,347 (US $1,618). The average skin preparation time was 3.5 minutes using ChloraPrep and 8.5 minutes using PVI. The hospital-acquired complication (HAC) penalty for SSI was calculated using the national efficient price (AU $5,797 or US $3,996), national weighted activity unit (4.6261), and adjustment rate for patient complexity levels (high, 4.8%; moderate, 5.9%; and low, 7.9%). Results: The model estimated SSI rates were 5.1% using ChloraPrep and 8.7% for PVI. For every 1,000 patients, skin preparation cost was estimated to be AU$8,100 (US $5.583) using ChloraPrep and AU$5,200 (US $3.585) using PVI. SSI treatment cost was estimated to be AU$449,900 (US $310,127) for ChloraPrep and AU$762,500 (US $525,610) for PVI. In addition, 330 bed days could be avoided and at least 80 operating room hours could be saved with 35 SSIs avoided. With 35 SSIs avoided, a potential reduction of AU$26,500 (US $18,267) in HAC penalty could be expected. This intervention could yield an overall cost savings of AU$336,300 (US $231,820). Conclusions: Using ChloraPrep for skin preparation prior to colorectal procedures could result in lower SSI rates and cost savings from treating fewer SSIs. Operational efficiency might also be improved.

This study presents zircon U–Pb geochronology and Hf and O isotope data for granitic rocks in the Zijinshan ore field, southwestern Fujian Province, China. The intrusive rocks comprise monzogranite, granite and granodiorite. The magmatic zircon U–Pb ages from these granitic rocks can be divided into four episodes: episodes 1 (157.9–159.9 Ma) and 2 (141 Ma) in the Late Jurassic and episodes 3 (108.1–103.2 Ma) and 4 (97.5–99.7 Ma) in the Middle and Late Cretaceous, respectively. Patterns of rare-earth elements (REE) show enrichment in light REE and obvious negative Eu anomalies. These rocks are also enriched in Rb, Th, U, La, Ce, Nd and Hf, and depleted in Ba, Nb, Sr, P and Ti. The increasing La/Yb ratio and decreasing heavy REE content with decreasing age may imply an increasing contribution of mantle-derived materials from the Late Jurassic to Cretaceous. The zircon ϵ Hf(t) and δ18O values, ranging from −37.7 to −2.8 and 12.0 ‰ to 6.3 ‰, respectively, indicate that the lower crust is an important source of granitic rocks. There was a significant increase in ϵ Hf(t) values and a decrease in δ18O values in the younger magmatic episodes (3 and 4), which ranged from −11.4 to −0.6 and 10.7 to 6.3 ‰, respectively. This suggests an increasing contribution of mantle-derived magma to the crustal melts from the Late Jurassic to late Early Cretaceous in response to the changing regional tectonic setting from compression to extension and an increasing interaction between the crust and mantle.

Late Palaeozoic igneous rock associations in response to subduction, accretion, and final closure of the eastern Palaeo-Asian Ocean play a significant role in understanding the geodynamic evolution of the southeastern Central Asian Orogenic Belt. Previous studies have identified a Permian arc magmatic belt associated with the southward-dipping subduction of the eastern Palaeo-Asian Ocean along the Solonker–Changchun suture zone. The genetic mechanism and associated geodynamic settings are of great importance in deciphering the evolution of the eastern Palaeo-Asian Ocean. This paper presents zircon U–Pb–Hf isotope and whole-rock geochemical analyses for a suite of magmatic rocks including the early Permian diorite porphyrites (ca. 281.0 Ma), andesites (ca. 276 Ma) and rhyolites (ca. 275 Ma) in the Kulun region. The diorite porphyrites and andesites have high SiO2 and total alkali contents, and low MgO contents and Mg no. values, with enrichments in large ion lithophile elements and depletions in high-field-strength elements. These geochemical characteristics, together with low-Sr and high-Yb contents, a weak concave-upward shape of middle rare earth elements and negative Eu anomalies, suggest that these intermediate igneous rocks were generated by partial melting of amphibolitic lower crust at a crustal depth of 30–40 km. The rhyolites have heterogeneous isotopic compositions, with ϵHf(t) values and TDM2 ages of –20.8 to +0.5 and 3578∼1494 Ma, implying that they were likely derived from partial melting of a mixed source dominated by recycled ancient crust with minor juvenile crustal materials. The rhyolites show potassic affinity with relatively high K2O and very low Na2O, which was attributed to liquid immiscibility of felsic magma and subsequent limited fractional crystallization of plagioclase. The regional igneous associations, metamorphic events, and coeval sedimentary rocks along the Solonker–Changchun suture zone indicate that the early Permian igneous rocks were formed in an active continental arc environment in response to southward subduction of the eastern Palaeo-Asian Ocean.

Pregnancy is a complex biological process. The establishment and maintenance of foetal–maternal interface are pivotal events. Decidual immune cells and inflammatory cytokines play indispensable roles in the foetal–maternal interface. The disfunction of decidual immune cells leads to adverse pregnancy outcome. Tumour necrosis factor (TNF)-α, a common inflammatory cytokine, has critical roles in different stages of normal pregnancy process. However, the relationship between the disorder of TNF-α and adverse pregnancy outcomes, including preeclampsia (PE), intrauterine growth restriction (IUGR), spontaneous abortion (SA), preterm birth and so on, is still indefinite. In this review, we thoroughly reviewed the effect of TNF-α disorder on pathological conditions. Moreover, we summarized the reports about the adverse pregnancy outcomes (PE, IUGR, SA and preterm birth) of using anti-TNF-α drugs (infliximab, etanercept and adalimumab, certolizumab and golimumab) currently in the clinical studies. Overall, IUGR, SA and preterm birth are the most common adverse pregnancy outcomes of anti-TNF-α drugs. Our review may provide insight for the immunological treatment of pregnancy-related complication, and help practitioners make informed decisions based on the current evidences.

The extinct family Hylicellidae, as the ancestral group of modern cicadomorphans, had a wide distribution and a very high species-level biodiversity from the Triassic to Early Cretaceous. We herein report 11 new hylicellid specimens from the Jurassic Daohugou beds of Inner Mongolia, NE China, and execute geometric morphometric analysis (GMA) to elucidate their systematic position. Our GMA and subsequent morphometric statistics indicate that 10 of our new specimens can be compared to the holotype of Cycloscytina gobiensis, and one is new to science. Cycloscytina incompleta new species is erected based on this specimen, with the following discriminatory tegminal traits: C3 almost as long as and slightly narrower than C2, and the forking position of stem M distinctly migrates towards wing apex and much apicad of the stem CuA bifurcating. Additionally, Cycloscytina plachutai is herein transferred to the procercopid genus Procercopina, resulting in P. plachutai new combination. To date, just a few body structures of Hylicellidae have been revealed, and the new whole-bodied hylicellids reported herein provide some novel insights on the evolution of basal Clypeata. This study also emphasizes the use of morphometric analysis in the systematics of wing-bearing insects such as hylicellids.

UUID: http://zoobank.org/84a67eba-9b7c-4e27-a436-764802c4cdfb.

Routine coronavirus disease 2019 (COVID-19) screening found 1 asymptomatic COVID-19 patient. An emergency sampling team was organized consisting of 1200 health-care workers, and a total of 3.2228 million COVID-19 samples had been collected and detected. This study summarizes the on-site management experience in large-scale COVID-19 nucleic acid testing from various aspects: staff preparation, materials preparation, site layout, logistics support, and information system support. Suggestions are put forward for the deficiencies and parts needing improvement. Such deficiencies included some sampling sites were not properly chosen, different areas were unclearly marked off from each other, and some site moving lines were confounding; how to communicate with the street service workers who had little professional knowledge on the epidemic spread or the working principles of the workflow and site layout; and the way to resolve conflicts on site.

Previous studies have suggested that maternal active smoking can increase the risk of birth defects, but evidence on second-hand tobacco smoke (SHS) is limited. We aimed to assess the association between maternal exposure to SHS and birth defects in a Chinese population. The data were based on a large-scale cross-sectional survey conducted in Shaanxi Province, China. Considering the characteristics of survey design and the potential impact of confounding factors, we adopted propensity score matching (PSM) to match the SHS exposure group and the non-exposure group to attain a balance of the confounders between the two groups. Subsequently, conditional logistic regression was employed to estimate the effect of SHS exposure on birth defects. Furthermore, sensitivity analyses were conducted to verify the key findings. After nearest neighbor matching of PSM with a ratio of 2 and a caliper width of 0.03, there were 6,205 and 12,410 participants in the exposure and control group, respectively. Pregnant women exposed to SHS were estimated to be 58% more likely to have infants with overall birth defects (OR = 1.58, 95% CI: 1.30–1.91) and 75% more likely to have infants with circulatory system defects (OR = 1.75, 95% CI: 1.26–2.44). We also observed that the risk effect of overall birth defects had an increasing trend as the frequency of exposure increased. Additionally, sensitivity analyses suggested that our results had good robustness. These results indicate that maternal exposure to SHS likely increases the risk of overall birth defects, especially circulatory system defects, in Chinese offspring.

Diarrhoea caused by pathogens such as enterotoxigenic E. coli (ETEC) is a serious threat to the health of young animals and human infants. Here, we investigated the protective effect of fructo-oligosaccharides (FOS) on the intestinal epithelium with ETEC challenge in a weaned piglet model. Twenty-four weaned piglets were randomly divided into three groups: (1) non-ETEC-challenged control (CON); (2) ETEC-challenged control (ECON); and (3) ETEC challenge + 2·5 g/kg FOS (EFOS). On day 19, the CON pigs were orally infused with sterile culture, while the ECON and EFOS pigs were orally infused with active ETEC (2·5 × 109 colony-forming units). On day 21, pigs were slaughtered to collect venous blood and small intestine. Result showed that the pre-treatment of FOS improved the antioxidant capacity and the integrity of intestinal barrier in the ETEC-challenged pigs without affecting their growth performance. Specifically, compared with ECON pigs, the level of GSH peroxidase and catalase in the plasma and intestinal mucosa of EFOS pigs was increased (P < 0·05), and the intestinal barrier marked by zonula occluden-1 and plasmatic diamine oxidase was also improved in EFOS pigs. A lower level (P < 0·05) of inflammatory cytokines in the intestinal mucosa of EFOS pigs might be involved in the inhibition of TLR4/MYD88/NF-κB pathway. The apoptosis of jejunal cells in EFOS pigs was also lower than that in ECON pigs (P < 0·05). Our findings provide convincing evidence of possible prebiotic and protective effect of FOS on the maintenance of intestinal epithelial function under the attack of pathogens.

Thioredoxin-interacting protein (TXNIP) plays a key role in diabetes development and prognosis through its role in pancreatic β-cell dysfunction and death as well as in upregulating the inflammatory response in hyperglycemia. DNA methylation (DNAm) of TXNIP (TXNIP-cg19693031) is associated with the prevalence and incidence of type 2 diabetes (T2D); however, its role in inflammation and its relationship with T2D remain unclear. We aimed to investigate the epigenetic associations of TXNIP-cg19693031 with a panel of inflammatory biomarkers and to examine whether these inflammatory biomarkers modify the association between TXNIP-cg19693031 methylation and diabetes in 218 middle-aged male twins from the Emory Twin Study. We confirmed the association of TXNIP-cg19693031 DNAm with T2D, as well as with HbA1c, insulin and fasting glucose. We found that hypomethylation at TXNIP-cg19693031 is strongly associated with both type 2 diabetes and higher levels of inflammatory biomarkers (VCAM-1, ICAM-1, MMP-2, sRAGE and P-selectin); however, the relationship between TXNIP-cg19693031 and T2D is independent of the levels of these inflammatory biomarkers. Our results suggest that DNA methylation of TXNIP is linked with multiple biological processes, through which the TXNIP may have broad influence on chronic disease risk.

The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.