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Burn patients are at high risk of central line–associated bloodstream infection (CLABSI). However, the diagnosis of such infections is complex, resource-intensive, and often delayed. This study aimed to investigate the epidemiology of CLABSI and develop a prediction model for the infection in burn patients. The study analysed the infection profiles, clinical epidemiology, and central venous catheter (CVC) management of patients in a large burn centre in China from January 2018 to December 2021. In total, 222 burn patients with a cumulative 630 CVCs and 5,431 line-days were included. The CLABSI rate was 23.02 CVCs per 1000 line-days. The three most common bacterial species were Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa; 76.09% of isolates were multidrug resistant. Compared with a non-CLABSI cohort, CLABSI patients were significantly older, with more severe burns, more CVC insertion times, and longer total line-days, as well as higher mortality. Regression analysis found longer line-days, more catheterisation times, and higher burn wounds index to be independent risk factors for CLABSI. A novel nomogram based on three risk factors was constructed with an area under the receiver operating characteristic curve (AUROC) value of 0.84 (95% CI: 0.782–0.898) with a mean absolute error of calibration curve of 0.023. The nomogram showed excellent predictive ability and clinical applicability, and provided a simple, practical, and quantitative strategy to predict CLABSI in burn patients.
Nitrogen fertilizer and water are two major nutrients required for the optimal production of rice worldwide. The utilization of different irrigation techniques to save water and fertigation to maximize rice production has been the main focus. A field experiment was conducted to explore the responses of 16 rice varieties to different irrigation and nitrogen fertilizer regimes. Two nitrogen treatments, 270 kg ha−1 and 225 kg ha−1 (urea N ≥ 46.4%), and two irrigation regimes, 8.7 t ha−1 and 5.22 t ha−1, were applied three times. Plant height and the soil and plant analyser development (SPAD) values were measured throughout the growth period. The total yield and quality characteristics of the rice varieties were also determined. Based on the yield, the 16 rice varieties were divided into three groups: high yield (I), middle yield (II) and low yield (III) using cluster analysis. A positive correlation was found between the growth period and yield of these 16 rice varieties. In the water-deficient regime, the growth period of the 16 varieties was reduced by 1.68–2.93%. Furthermore, nitrogen- and water-deficient regimes had significant effects on the polishing rate, protein content and taste values of all varieties. At maturity stage under these regimes, plant height and chlorophyll SPAD values were decreased by 1.25–6.05% and 1.60–31.48%, respectively. Deficient nitrogen fertilization, along with appropriate irrigation, is an effective method for the efficient utilization of irrigation and fertilizer resources in rice-growing areas.
Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.
The purpose of this study was to report outcomes of double outlet right ventricle biventricular repair at a single institution in developing countries and to investigate post-operatively determined risk factors for mortality and late intervention.
Patients with double outlet right ventricle who underwent biventricular repair in our centre from January 2009 to December 2021 were included.
A total of 96 patients (male/female = 61/35) with biventricular repair were included. According to its specific anatomical type, the appropriate individual surgical plan was selected. Multivariate analysis indicated that prolonged cardiopulmonary bypass time(OR = 1.044; p = 0.012) and pre-operative moderate or above pulmonary hypertension(OR = 24.558; p = 0.023) were independent risk factors for early mortality. Univariate analysis showed that different anatomical types and different surgical methods had similar late intervention and late mortality. Concomitant coarctation of the aorta(OR = 40; p = 0.020) and concomitant ventricular septal defect enlargement(OR = 26.667; p = 0.005) were independent risk factors for late intervention by multivariate analysis.
Selection of appropriate surgical techniques based on different anatomical types often results in similar late outcomes. For patients with concomitant ventricular septal defect enlargement during the operation, it is necessary to fully expand and avoid damage to the conduction bundle. We should timely intervention in patients with coarctation of the aorta and pay attention to the occurrence of left ventricular outflow tract obstruction during follow-up.
This paper presents a new method to reveal the relation between the surface deformation and near-field amplitude of a reflector antenna based on complex geometrical optics, which could be used as an efficient way to estimate the antenna surface verified by simulation results. The measurement process based on this method is envisaged to be realized by a single scanning of the near-field amplitude which would overcome many limitations of radio holography and phase retrieval methods such as the frequency and elevation. The largest source of error in the original deformation-amplitude equation (DAE) has been corrected by considering the Gaussian feed as a complex point source. To track the ray trajectory so that the improved DAE could be solved, an iteration method including a golden section search algorithm is designed to make the solution converge. By solving the modified DAE, simulation result shows that a more accurate solution could be obtained, and the antenna surface could be recovered to a root mean square error of under 30 microns.
MicroRNAs (miRNAs) are small noncoding RNAs (sRNAs) that regulate gene expression by inhibiting translation or degrading mRNA. Although the functions of miRNAs in many biological processes have been reported, there is currently no research on the possible roles of miRNAs in Micromelalopha troglodyta (Graeser) involved in the response of plant allelochemicals. In this article, six sRNA libraries (three treated with tanic acid and three control) from M. troglodyta were constructed using Illumina sequencing. From the results, 312 known and 43 novel miRNAs were differentially expressed. Notably, some of the most abundant miRNAs, such as miR-432, miR-541-3p, and miR-4448, involved in important physiological processes were also identified. To better understand the function of the targeted genes, we performed Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The results indicated that differentially expressed miRNA targets were involved in metabolism, development, hormone biosynthesis, and immunity. Finally, we visualized a miRNA-mRNA regulatory module that supports the role of miRNAs in host–allelochemical interactions. To our knowledge, this is the first report on miRNAs responding to tannic acid in M. troglodyta. This study provides indispensable information for understanding the potential roles of miRNAs in M. troglodyta and the applications of these miRNAs in M. troglodyta management.
Viruses completely rely on the energy and metabolic systems of host cells for life activities. Viral infections usually lead to cytopathic effects and host diseases. To date, there are still no specific clinical vaccines or drugs against most viral infections. Therefore, understanding the molecular and cellular mechanisms of viral infections is of great significance to prevent and treat viral diseases. A variety of viral infections are related to the p38 MAPK signalling pathway, and p38 is an important host factor in virus-infected cells. Here, we introduce the different signalling pathways of p38 activation and then summarise how different viruses induce p38 phosphorylation. Finally, we provide a general summary of the effect of p38 activation on virus replication. Our review provides integrated data on p38 activation and viral infections and describes the potential application of targeting p38 as an antiviral strategy.
Schizophrenia is a severely debilitating psychiatric disorder with high heritability and polygenic architecture. A higher polygenic risk score for schizophrenia (SzPRS) has been associated with smaller gray matter volume, lower activation, and decreased functional connectivity (FC). However, the effect of polygenic inheritance on the brain white matter microstructure has only been sparsely reported.
Eighty-four patients with first-episode schizophrenia (FES) patients and ninety-three healthy controls (HC) with genetics, diffusion tensor imaging (DTI), and resting-state functional magnetic resonance imaging (rs-fMRI) data were included in our study. We investigated impaired white matter integrity as measured by fractional anisotropy (FA) in the FES group, further examined the effect of SzPRS on white matter FA and FC in the regions connected by SzPRS-related white matter tracts.
Decreased FA was observed in FES in many commonly identified regions. Among these regions, we observed that in the FES group, but not the HC group, SzPRS was negatively associated with the mean FA in the genu and body of corpus callosum, right anterior corona radiata, and right superior corona radiata. Higher SzPRS was also associated with lower FCs between the left inferior frontal gyrus (IFG)–left inferior temporal gyrus (ITG), right IFG–left ITG, right IFG–left middle frontal gyrus (MFG), and right IFG–right MFG in the FES group.
Higher polygenic risks are linked with disrupted white matter integrity and FC in patients with schizophrenia. These correlations are strongly driven by the interhemispheric callosal fibers and the connections between frontotemporal regions.
Reducing soil evaporation by different agricultural practices is important not only for water saving but also for its applicability by farmers. In wheat fields, the goal of efficient water management is to save water and increase yield. At present, the combined effects of maize-straw mulching (M) and crop density (D) on soil evaporation and temperature, wheat performance, and water use efficiency (WUE) are not clear. A field experiment was conducted for winter wheat (Triticum aestivum L.) in the North China Plain (NCP). The two levels of crop density included high (HD) and normal density (ND), and the three levels of mulch included high (HM), low (LM), and no mulch (NM). The results indicated that both straw mulching and high crop density had significant inhibitory effects on soil evaporation. Normal crop density with high mulch gave the lowest yield among all treatments because high mulching reduced the soil temperature and hindered the soil temperature increase in early spring. Compared with normal crop density with no mulch, the yield and WUE of winter wheat for high crop density with low mulch (HDLM) were enhanced by 20.6% and 21.9%, respectively. Compared with other treatments, HDLM gave the higher WUE due to the higher soil temperature, leaf area index, and biomass. Therefore, HDLM was an effective way to maximize the WUE of winter wheat in the NCP.
Over recent decades, Chinese giant salamanders Andrias spp. have declined dramatically across much of their range. Overexploitation and habitat degradation have been widely cited as the cause of these declines. To investigate the relative contribution of each of these factors in driving the declines, we carried out standardized ecological and questionnaire surveys at 98 sites across the range of giant salamanders in China. We did not find any statistically significant differences between water parameters (temperature, dissolved oxygen, ammonia, nitrite, nitrate, salinity, alkalinity, hardness and flow rate) recorded at sites where giant salamanders were detected by survey teams and/or had been recently seen by local respondents, and sites where they were not detected and/or from which they had recently been extirpated. Additionally, we found direct and indirect evidence that the extraction of giant salamanders from the wild is ongoing, including within protected areas. Our results support the hypothesis that the decline of giant salamanders across China has been primarily driven by overexploitation. Data on water parameters may be informative for the establishment of conservation breeding programmes, an initiative recommended for the conservation of these species.
The mortality of coronavirus disease 2019 (COVID-19) differs between countries and regions. This study aimed to clarify the clinical characteristics of imported and second-generation cases in Shaanxi. This study included 134 COVID-19 cases in Shaanxi outside Wuhan. Clinical data were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. In total, 34.3% of the 134 patients were severe cases, 11.2% had complications. As of 7 March 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, direct bilirubin, lactate dehydrogenase and hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P < 0.05). Baseline lymphocyte count was higher in survived patients than in non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 (IL-6) level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest computed tomography images in 51.5% of the pneumonia cases. Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.
Comprehensive screening of rice (Oryza sativa L. subsp. japonica Kato) germplasm resources with different nitrogen (N) efficiency levels is effective for improving N use efficiency (NUE) while reducing pollution and providing high quality, yield, and efficiency agriculture. We investigated 14 indices of 38 varieties under three N application levels to assess differences among genotypes. Rice varieties were classified for screening and identifying N efficient. Descriptive statistical analysis results indicated significant differences in relative yield, and also in NUE indices (agronomic utilization rate and partial productivity of N fertilizer). The genotype main effects and genotype–environment interaction effects (GGE) biplot analysis was used to evaluate suitable varieties, compare the stable and high yield capabilities of different varieties, find the ideal variety, and describe the correlation, discrimination and representativeness of the indices under different N application levels. Descriptive statistical, discrimitiveness and representativeness and factor analysis were used to select indices, in which the panicle number per plant and soil and plant analyzer development (SPAD) value were the key indices for evaluation and identification. Heatmap and hierarchical cluster analysis based on the average value of evaluation indices, and scatter plot based on the comprehensive value of N efficiency (P) according to formula showed that all varieties could be divided into five types under different N treatments. Our findings work toward developing N efficient rice varieties to improve NUE, reduce N fertilizer application and thus N waste, consequently mitigating the effects of rice production on the environment to ensure food security and sustainable agricultural development.
This paper presents an investigation of the precise point positioning (PPP) performance of a combined solution from BDS-2 and BDS-3 satellites. To simultaneously process different BDS signal observations, i.e., B1/B1C, B2/B2a and B3C, undifferenced and uncombined observations with ionosphere delay constrained by the deterministic plus stochastic ionosphere model are used in the basic model. Special attention is paid to code bias and receiver clock parameters in the derivation of the observation model. The analysis is carried out using more than one-month data for BDS-2 and BDS-3 collected at the CANB, DWIN, KNDY and PETH stations in the Asia-Pacific region. The results suggest that compared with BDS-2 alone, the BDS-2 and BDS-3 solution provides significantly more accurate PPP, with increases of 28%, 21% and 5% in the up, north and east directions, respectively. In addition, the average root mean square error decreases to 0·21, 0·13 and 0·16 m for the three directions. Furthermore, the PPP convergence time for BDS-2 and BDS-3 is about 1·5 h and less than 1 h for the horizontal and vertical components, respectively, whereas that for BDS-2 alone is about 2·3 h for both directions.
To assess helical tomotherapy (TOMO) current clinical application and practice in mainland China.
Materials and methods:
Data were collected for all TOMO units clinically operational in mainland China by 30 April 2016, including (a) the distribution of installation and staffing levels; (b) types of cancers treated; (c) utilisation efficiency; (d) quality assurance; (e) maintenance; (f) optional features; and (g) satisfaction levels. The data were collected as a census and analysed qualitatively and quantitatively.
As of 30 April 2016, 23 TOMO units were used clinically by 22 hospitals in mainland China. In the same period, 22,558 cancer patients were treated. For TOMO units with more than a year of clinical utilisation, a median of 378 cases were treated annually per machine. The median daily operation was 10·5 hours, and treatment headcount was 38·3 patients. The median service outage rate was 2·6%, and the most common cause was malfunction of the multi-leaf collimator. In terms of overall satisfaction levels, 3 hospitals were very satisfied, 16 were satisfied and 3 considered their satisfaction level as average.
The overall operation of TOMO is good, but there are some problems due to running at full capacity, lack of clinical efficacy research and insufficient quality assurance regulations.
Thermoregulation has been suggested to influence mitochondrial DNA (mtDNA) evolution. Previous studies revealed that the mitochondrial protein-coding genes of fish living in temperate climates have smaller dN/dS (Non-synonymous substitution rate/Synonymous substitution rate) than tropical species. However, it is unknown whether different geographic populations of one fish species experience stronger selective pressures between cold and warm climates. The biological characteristics of the Japanese sand lance, Ammodytes personatus in the North-western Pacific is well-suited for assessing the performance of mtDNA evolution among separate geographic populations. In this study, we focused on the mitochondrial ATP6 gene of A. personatus using 174 individuals from eight different sea temperature populations. Two distinct haplotype lineages and a significant population structure (P = 0.016) were found in this species. The frequencies of the two lineages varied with the changes of annual sea temperature. The southern lineage (lineage A, dN/dS = 0.0384) showed a larger dN/dS value than the northern lineage (lineage B, dN/dS = 0.0167), suggesting that sea temperature greatly influences the evolution of the two lineages. The result provides robust evidence of local adaptation between populations in A. personatus.
Haemorrhagic fever with renal syndrome (HFRS) is transmitted to humans mainly by rodents and this transmission could be easily influenced by meteorological factors. Given the long-term changes in climate associated with global climate change, it is important to better identify the effects of meteorological factors of HFRS in epidemic areas. Shandong province is one of the most seriously suffered provinces of HFRS in China. Daily HFRS data and meteorological data from 2007 to 2012 in Shandong province were applied. Quasi-Poisson regression with the distributed lag non-linear model was used to estimate the influences of mean temperature and Diurnal temperature range (DTR) on HFRS by sex, adjusting for the effects of relative humidity, precipitation, day-of-the-week, long-term trends and seasonality. A total of 6707 HFRS cases were reported in our study. The two peaks of HFRS were from March to June and from October to December, particularly, the latter peak in 2012. The estimated effects of mean temperature and DTR on HFRS were non-linear. The immediate and strong effect of low temperature and high DTR on HFRS was found. The lowest temperature −8.86°C at lag 0 days indicated the largest related relative risk (RRs) with the reference (14.85 °C), respectively, 1.46 (95% CI 1.11–1.90) for total cases, 1.33 (95% CI 1.00–1.78) for the males and 1.76 (95% CI 1.12–2.79) for the females. Highest DTR was associated with a higher risk on HFRS, the largest RRs (95% CI) were obtained when DTR = 15.97 °C with a reference at 8.62 °C, with 1.26 (0.96–1.64) for total cases and 1.52 (0.97–2.38) for the female at lag 0 days, 1.22 (1.05–1.41) for the male at lag 5 days. Non-linear lag effects of mean temperature and DTR on HFRS were identified and there were slight differences for different sexes.
The morphology, composition, and structure of precipitates in an Al–Si–Mg–Hf alloy after heat treatment at 560°C for 20 h were studied by means of Cs-corrected high-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM), energy dispersive X-ray spectrometry (EDS), high-resolution transmission electron microscopy (HRTEM), and first-principle calculations. Precipitates with three kinds of morphologies were observed. The rectangular and square precipitates were predominantly (Si2−xAlx)Hf phases, while the nanobelt-like precipitate is the Si2Hf phase. First-principle calculations were used to show that the Si6 and Si8 sites were the most favorable sites for Al incorporation in the orthorhombic Si2Hf phase.
Psychiatric disorders such as schizophrenia and major depressive disorder
(MDD) are likely to be caused by multiple susceptibility genes, each with
small effects in increasing the risk of illness. Identifying DNA variants
associated with schizophrenia and MDD is a crucial step in understanding
the pathophysiology of these disorders.
To investigate whether the SP4 gene plays a significant
role in schizophrenia or MDD in the Han Chinese population.
We focused on nine single nucleotide polymorphisms (SNPs) harbouring the
SP4 gene and carried out case–control studies in 1235
patients with schizophrenia, 1045 patients with MDD and 1235 healthy
controls recruited from the Han Chinese population.
We found that rs40245 was significantly associated with schizophrenia in
both allele and genotype distributions (Pallele = 0.0005, Pallele = 0.004 after Bonferroni correction; Pgenotype = 0.0023, Pgenotype = 0.0184 after Bonferroni correction). The rs6461563
SNP was significantly associated with schizophrenia in the allele
distributions (Pallele = 0.0033, Pallele = 0.0264 after Bonferroni correction).
Our results suggest that common risk factors in the SP4
gene are associated with schizophrenia, although not with MDD, in the Han