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Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.
Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.
Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.
Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
The study was conducted using data from 5 adult ICUs of a referral hospital.
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
The research was to introduce the experience of doubly committed subarterial ventricular septal defect (DCVSD) repaired through tricuspid approach.
From January, 2015 to September, 2019, 86 consecutive DCVSD paediatrics underwent repair via right subaxillary vertical incision (RAVI) through tricuspid approach. Perioperative and follow-up data were collected.
The age and weight at operation were 28.1 ± 18.5 (range: 7–101) months and 12.2 ± 4.2 (6–26.5) kg. There were two patients combined with discrete subaortic membrane, two patients with patent ductus arteriosus, one patient with atrial septal defect, and two patients with abnormal muscle bundle in right ventricular outflow tract. The mean size of ventricular septal defect was 7.0 ± 2.4 (3–13) mm. The defect was repaired with a piece of Dacron patch in 68 patients or directly with 1–2 pledgetted polypropylene sutures in 18 patients. The cardiopulmonary bypass time and aortic cross-clamp time were 46.2 ± 13.3 (23–101) minutes and 29.2 ± 11.5 (12–84) minutes. After 3.1 ± 2.4 (0–14) hours’ ventilator assist and 23.2 ± 32.1 (0–264) hours’ ICU stay, all patients were discharged safely. At the latest follow-up (27.9 ± 14.6 months), echocardiography showed trivial residual shunt in two patients. There was no malignant arrhythmia occurred and there was no chest deformity or asymmetrical development of the breast was found.
DCVSD repaired via right subaxillary vertical incision through tricuspid approach was safe and feasible, providing a feasible alternative to median sternotomy, and it can be performed with favourable cosmetic results.
Lipopolysaccharides (LPS) could induce milk fat depression via regulating the body and blood fat metabolism. However, it is not completely clear how LPS might regulate triglyceride synthesis in dairy cow mammary epithelial cells (DCMECs). DCMECs were isolated and purified from dairy cow mammary tissue and treated with LPS. The level of triglyceride synthesis, the expression and activity of the liver X receptor α (LXRα), enzymes related to de novo fatty acid synthesis, and the expression of the fatty acid transporters were investigated. We found that LPS decreased the level of triglyceride synthesis via a down-regulation of the transcription, translation, and nuclear translocation level of the LXRα. The results also indicated that the transcription level of the LXRα target genes, sterol regulatory element binding protein 1 (SREBP1), fatty acid synthetase (FAS), acetyl-CoA carboxylase-1 (ACC1), were significantly down-regulated in DCMECs after LPS treatment. Our data may provide new insight into the mechanisms of milk fat depression caused by LPS.
Although handwashing is an effective way to prevent infections, there is scarce evidence on predictors of handwashing during a pandemic. This paper aims to identify behavioural and demographic predictors of handwashing. The study surveyed 674 adults in Malaysia in May 2020 regarding whether the time spent on social media predicted handwashing contingent on gender and number of children. More time spent on social media was positively associated with handwashing for males with three or more children. However, for males without children, social media use was negatively associated with handwashing. The association was not significant for males with one or two children. For females, more time spent on social media was significantly linked to more handwashing only for females with one child. Gender, a traditional predictor of handwashing, was a useful predictor only for those who spent more than three hours per day on social media and had at most one child. Number of children was a novel negative predictor for males who did not use social media and who averaged one hour per day on social media, a positive predictor for males who spent lots of time on social media, but not a predictor for females. In sum, social media use predicts handwashing, and is thus a helpful variable for use in targeted health communication during a pandemic – particularly through social media. Further, more conventional predictors like gender and number of children exhibit contingency effects with social media use.
Background: Accurate identification of Clostridioides difficile infections (CDIs) from electronic data sources is important for surveillance. We evaluated how frequently laboratory findings were supported by diagnostic coding and treatment data in the electronic health record. Methods: We analyzed a retrospective cohort of patients in the Veterans’ Affairs Health System from 2006 through 2016. A CDI event was defined as a positive laboratory test for C. difficile toxin or toxin genes in the inpatient, outpatient, or long-term care setting with no prior positive test in the preceding 14 days. Events were classified as incident (no CDI in the prior 56 days), or recurrent (CDI in the prior 56 days) and were evaluated for evidence of clinical diagnosis based on International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes and at least 1 dose of an anti-CDI agent (intravenous or oral metronidazole, fidaxomicin, or oral vancomycin). We further assessed the possibility of treatment without testing by quantifying positive laboratory tests and diagnostic codes among inpatients receiving an anti-CDI agent. A course of anti-CDI therapy was defined as continuous treatment with the same drug. Results: Among 119,063 incident and recurrent CDI events, 70,114 (58.9%) had a diagnosis code and 15,850 (13.3%) had no accompanying treatment. The proportion of patients with ICD codes was highest among patients treated with fidaxomicin (82.6% of 906) or oral vancomycin (74.3% of 30,777) and was lower among patients receiving metronidazole (63.3% of 103,231) and those without treatment (29.9% of 15,850). The proportion of events with ICD codes and treatment was similar between incident and recurrent episodes. During the study period, there were ~470,000 inpatient courses of metronidazole, fidaxomicin, and oral vancomycin. Table 1 shows the presence of ICD codes and positive laboratory tests by anti-CDI agents. Among 51,100 courses of oral vancomycin, 51% had an ICD code and 44% had a positive test for C. difficile within 7 days of treatment initiation. Among 1,013 courses of fidaxomicin, 79% had an ICD code and 56% had a positive laboratory test. Conclusions: In this large cohort, there was evidence of substantial CDI treatment without confirmatory C. difficile testing and, to a lesser extent, some positive tests without accompanying treatment or coding. A combination of data sources may be needed to more accurately identify CDI from electronic health records for surveillance purposes.
Since the outbreak of 2019 novel coronavirus (2019-nCoV) infection in Wuhan City, China, pediatric cases have gradually increased. It is very important to prevent cross-infection in pediatric fever clinics, to identify children with fever in pediatric fever clinics, and to strengthen the management of pediatric fever clinics. According to prevention and control programs, we propose the guidance on the management of pediatric fever clinics during the nCoV pneumonia epidemic period, which outlines in detail how to optimize processes, prevent cross-infection, provide health protection, and prevent disinfection of medical staff. The present consideration statement summarizes current strategies on the pre-diagnosis, triage, diagnosis, treatment, and prevention of 2019-nCoV infection, which provides practical suggestions on strengthening the management of pediatric fever clinics during the nCoV pneumonia epidemic period.
This study introduces a new real-time kinematic (RTK) positioning method which is suitable for baselines of different lengths. The method merges carrier-phase wide-lane, and ionosphere-free observation combinations (LWLC) instead of using pseudo-range, and carrier-phase ionosphere-free combination (PCLC), or single-frequency pseudo-range and phase combination (P1L1). In a first step, the double-differenced wide-lane ambiguities were calculated and fixed using the pseudo-range and carrier-phase wide-lane combination observations. Once the double-differenced wide-lane integer ambiguities were known, the wide-lane combined observations were regarded as accurate pseudo-range observations. Subsequently, the carrier-phase wide-lane, and ionosphere-free combined observations were used to fix the double-differenced carrier-phase integer ambiguities, achieving the final RTK positioning. The RTK positioning analysis was performed for short, medium, and long baselines, using the P1L1, PCLC, and LWLC methods, respectively. For a short baseline, the LWLC method demonstrated positioning accuracy similar to the P1L1 method, and performed better than the PCLC method. For medium and long baselines, the positioning accuracy of the LWLC method was slightly higher than those of the PCLC and P1L1 methods. In conclusion, the LWLC method provided high-precision RTK positioning results for baselines with different lengths, as it used high-precision carrier-phase observations with fixed ambiguities instead of low-precision pseudo-range observations.
Schizotypy refers to schizophrenia-like traits below the clinical threshold in the general population. The pathological development of schizophrenia has been postulated to evolve from the initial coexistence of ‘brain disconnection’ and ‘brain connectivity compensation’ to ‘brain connectivity decompensation’.
In this study, we examined the brain connectivity changes associated with schizotypy by combining brain white matter structural connectivity, static and dynamic functional connectivity analysis of diffusion tensor imaging data and resting-state functional magnetic resonance imaging data. A total of 87 participants with a high level of schizotypal traits and 122 control participants completed the experiment. Group differences in whole-brain white matter structural connectivity probability, static mean functional connectivity strength, dynamic functional connectivity variability and stability among 264 brain sub-regions of interests were investigated.
We found that individuals with high schizotypy exhibited increased structural connectivity probability within the task control network and within the default mode network; increased variability and decreased stability of functional connectivity within the default mode network and between the auditory network and the subcortical network; and decreased static mean functional connectivity strength mainly associated with the sensorimotor network, the default mode network and the task control network.
These findings highlight the specific changes in brain connectivity associated with schizotypy and indicate that both decompensatory and compensatory changes in structural connectivity within the default mode network and the task control network in the context of whole-brain functional disconnection may be an important neurobiological correlate in individuals with high schizotypy.
Hydrothermal carbon microsphere (HTC) is a carbon-based fluorescent material, which can be synthesized by hydrothermal carbonization of glucose. In this article, a series of 4ZnO·B2O3·H2O:Ln3+/HTC (where Ln = Eu or Tb) composites were prepared under hydrothermal conditions. The effects of the glucose concentration on the morphology, photoluminescence (PL) intensity and emission color of Zn3.64:Eu0.24[B2O7]·H2O/HTCx and Zn3.55:Tb0.3[B2O7]·H2O/HTCy were investigated. The relationship between morphology and PL intensity of composites was discussed. The results revealed that the presence of HTC did not change the original emission color of 4ZnO·B2O3·H2O:Ln3+ (where Ln = Eu or Tb) materials, but greatly increased their PL intensity, the sphere-like morphology composites have the strongest PL intensity. The Zn3.64:Eu0.24[B2O7]·H2O/HTCx and Zn3.55:Tb0.3[B2O7]·H2O/HTCy emit bright red light and green light, respectively, under respective excitation wavelengths. The present research suggests that the 4ZnO·B2O3·H2O:Ln3+/HTC (where Ln = Eu or Tb) composites may be candidates of red and green phosphors for display and lighting applications.
Previous studies have shown conflicting findings regarding the relationship between maternal vitamin D deficiency (VDD) and fetal growth restriction (FGR). We hypothesised that parathyroid hormone (PTH) may be an underlying factor relevant to this potential association. In a prospective birth cohort study, descriptive statistics were evaluated for the demographic characteristics of 3407 pregnancies in the second trimester from three antenatal clinics in Hefei, China. The association of the combined status of vitamin D and PTH with birth weight and the risk of small for gestational age (SGA) was assessed by a multivariate linear and binary logistic regression. We found that declined status of 25-hydroxyvitamin D is associated with lower birth weight (for moderate VDD: adjusted β = −49·4 g, 95 % CI −91·1, −7·8, P < 0·05; for severe VDD: adjusted β = −79·8 g, 95 % CI −127·2, −32·5, P < 0·01), as well as ascended levels of PTH (for elevated PTH: adjusted β = −44·5 g, 95 % CI −82·6, −6·4, P < 0·05). Compared with the non-VDD group with non-elevated PTH, pregnancies with severe VDD and elevated PTH had the lowest neonatal birth weight (adjusted β = −124·7 g, 95 % CI −194·6, −54·8, P < 0·001) and the highest risk of SGA (adjusted risk ratio (RR) = 3·36, 95 % CI 1·41, 8·03, P < 0·01). Notably, the highest risk of less Ca supplementation was founded in severe VDD group with elevated PTH (adjusted RR = 4·67, 95 % CI 2·78, 7·85, P < 0·001). In conclusion, elevated PTH induced by less Ca supplementation would further aggravate the risk of FGR in pregnancies with severe VDD through impaired maternal Ca metabolism homoeostasis.
The addition of clay minerals in drilling fluids modifies the dispersion's viscosity. In this article, scientific advances related to the use of clays and clay minerals (bentonite, palygorskite, sepiolite and mixtures of clay minerals) in drilling fluids are summarized and discussed based on their specific structure, rheological properties, applications, prevailing challenges and future directions. The rheological properties of drilling fluids are affected by the temperature, type of electrolytes, pH and concentration of clay minerals. Bentonites are smectite-rich clays often used in drilling fluids, and their composition varies from deposit to deposit. Such variations significantly affect the behaviour of bentonite-based drilling fluids. Palygorskite is suitable for use in oil-based drilling fluids, but the gelation and gel structures of palygorskite-added drilling fluids have not received much attention. Sepiolite is often used in water-based drilling fluids as a rheological additive. Dispersions containing mixtures of clays including bentonite, kaolin, palygorskite and sepiolite are used in drilling fluids requiring specific features such as high-density drilling fluids or those used in impermeable slurry walls. In these cases, the surface chemistry–microstructure–property relationships of mixed-clay dispersions need to be understood fully. The prevailing challenges and future directions in drilling fluids research include safety, ‘green’ processes and high-temperature and high-pressure-resistant clay minerals.
The rhoptry kinase 18 of Toxoplasma gondii (TgROP18) has been identified as a key virulence factor that allows the parasite to escape from host immune defences and promotes its proliferation in host cells. Although much research is focused on the interaction between host cells and TgROP18, the development of monoclonal antibodies (mAbs) against TgROP18 has not been reported till date. To produce mAbs targeting TgROP18, two hybridomas secreting mAbs against TgROP18, designated as A1 and T2, were generated using cell fusion technology. The subtypes of the A1 and T2 mAbs were identified as IgG3 λ and IgM κ, and peptide scanning revealed that the core sequences of the antigenic epitopes were 180LRAQRRRSELVFE192 and 351NYFLLMMRAEADM363, respectively. The T2 mAb specifically reacted with both T. gondii type I and Chinese I, but not with T. gondii type II, Plasmodium falciparum or Schistosoma japonicum. Finally, the sequences of heavy chain and light chain complementarity-determining regions of T2 were amplified, cloned and characterized, making the modification of the mAb feasible in the future. The development of mAbs against TgROP18 would aid the investigation of the molecular mechanisms underlying the modulation of host cellular functions by TgROP18, and in the development of strategies to diagnose and treat Toxoplasmosis.
Cytokine release syndrome (CRS), or ‘cytokine storm’, is the leading side effect during chimeric antigen receptor (CAR)-T therapy that is potentially life-threatening. It also plays a critical role in viral infections such as Coronavirus Disease 2019 (COVID-19). Therefore, efficient removal of excessive cytokines is essential for treatment. We previously reported a novel protein modification tool called the QTY code, through which hydrophobic amino acids Leu, Ile, Val and Phe are replaced by Gln (Q), Thr (T) and Tyr (Y). Thus, the functional detergent-free equivalents of membrane proteins can be designed. Here, we report the application of the QTY code on six variants of cytokine receptors, including interleukin receptors IL4Rα and IL10Rα, chemokine receptors CCR9 and CXCR2, as well as interferon receptors IFNγR1 and IFNλR1. QTY-variant cytokine receptors exhibit physiological properties similar to those of native receptors without the presence of hydrophobic segments. The receptors were fused to the Fc region of immunoglobulin G (IgG) protein to form an antibody-like structure. These QTY code-designed Fc-fusion receptors were expressed in Escherichia coli and purified. The resulting water-soluble fusion receptors bind to their respective ligands with Kd values affinity similar to isolated native receptors. Our cytokine receptor–Fc-fusion proteins potentially serve as an antibody-like decoy to dampen the excessive cytokine levels associated with CRS and COVID-19 infection.
This study aimed to evaluate the clinical characteristics, risk factors and outcomes of adult patients with candidaemia caused by C. albicans vs. non-albicans Candida spp. (NAC). All adult hospitalised cases of candidaemia (2012–2017) at a tertiary hospital in Shenyang were included in the retrospective study, and a total of 180 episodes were analysed. C. parapsilosis was the most frequently isolated species (38.3%), followed by C. albicans (35.6%), C. glabrata (13.9%), C. tropicalis (10%) and others (2.2%). As initial antifungal therapy, 75.0%, 3.9%, 5.6% and 2.2% of patients received fluconazole, caspofungin, micafungin and voriconazole, respectively. Multivariate analyses revealed that total parenteral nutrition was associated with an increased risk of NAC bloodstream infections (BSI) (OR 2.535, 95% CI (1.066–6.026)) vs. C. albicans BSI. Additionally, the presence of a urinary catheter was associated with an increased risk of C. albicans BSI (OR 2.295 (1.129–4.666)) vs. NAC BSI. Moreover, ICU stay (OR 4.013 (1.476–10.906)), renal failure (OR 3.24 (1.084–9.683)), thrombocytopaenia (OR 7.171 (2.152–23.892)) and C. albicans (OR 3.629 (1.352–9.743)) were independent risk factors for candidaemia-related 30-day mortality, while recent cancer surgery was associated with reduced mortality risk (OR 26.479 (2.550–274.918)). All these factors may provide useful information to select initial empirical antifungal agents.
In this study, Mg-substituted tricalcium phosphate (Mg-TCP) nanoparticles were synthesized by hydrothermal reactions of Mg-calcite mesocrystals from echinoderm skeletons. Following the biomineralization of echinoderms, Mg-calcite powder was synthesized via the solid-state transition of Mg-amorphous calcium carbonate prepared by a wet-chemical precipitation method, which can also be used to fabricate Mg-TCP. We illustrated that Mg-calcite with a certain level of Mg substitution led to the formation of Mg-TCP through the ion-exchange reactions in the hydrothermal system. Therefore, this study provides a new pathway for the synthesis of Mg-TCP nanoparticles.
Signal-in-space (SIS) continuity and availability are important indicators of performance assessment for Global Navigation Satellite Systems (GNSSs). The BeiDou Navigation Satellite System (BDS) Open Service Performance Standard (BDS-OS-PS-1.0) has been released, and the corresponding public performance indicators have been provided, but the actual SIS performance is uncertain to users. SIS continuity and availability are primarily related to unscheduled outages (failures). Therefore, based on the existing failure classification system and actual operation modes, four types of failure modes are first analysed: long-term failure related to satellite service period, maintenance failure related to satellite manoeuvring, short-term failure associated with random repairable anomalies and equivalent failure corresponding to a combination of the above three types of failures. Second, based on the failure classification and selected precise and broadcast ephemerides from 2015–2016, the Mean Time Between Failure (MTBF) and Mean Time To Repair (MTTR) of each failure type are obtained using appropriate detection methods. Finally, using a corresponding assessment model, the SIS continuity and availability of BeiDou are calculated for individual and equivalent failure cases, and these are compared with the provided index in the BDS Open Service Performance Standard.