Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty.

BACKGROUND: Venous thromboembolism (VTE) is a significant complication after joint arthroplasty. Diabetes is related to a few changes in coagulation and fibrinolysis that may lead to thrombophilia. We aimed to investigate the incidence of postoperative VTE and associated risk factors among patients with diabetes undergoing total hip (THA) or total knee anthroplasty (TKA) in a single centre in China. METHODS: Patients with diabetes who underwent THA or TKA from January 2016 to December 2018 (n = 400) at Beijing Jishuitan Hospital were recruited in this study. Lower limb venous Doppler ultrasound was performed before and after surgery to confirm deep venous thrombosis (DVT). Computer tomography pulmonary angiography was done to confirm pulmonary embolism (PE) for those with new postoperative DVT and typical symptoms of PE. A multivariate logistic regression model was conducted to examine factors associated with the development of postoperative VTE. RESULTS: The overall incidence of postoperative VTE in patients with diabetes after THA or TKA was 46.8 % (187 out of 400). Among the 187 VTE patients, 7.5 % (14 out of 187) had proximal vein thrombosis and 92.5 % (173 out of 187) had distal vein thrombosis. No PE occurred. Female patients and patients undergoing TKA had higher incidence of postoperative VTE. Patients who developed postoperative VTE were older, and had higher levels of preoperative D-Dimer and Caprini score. A high level of preoperative D-dimer (OR = 2.11, 95 %CI = 1.35-3.30) and the surgery of TKA (OR = 2.29, 95 %CI = 1.29-4.01) significantly increased the risk of developing postoperative VTE. Postoperative initiation of concomitant mechanical prophylaxis and low molecular weight heparin (LMWH) was protective for postoperative VTE (OR = 0.56, 95 %CI = 0.37-0.86). CONCLUSIONS: VTE is common in patients with diabetes undergoing joint arthroplasty. Patients undergoing TKA or with a high level of preoperative D-dimer are at a considerable risk of developing postoperative VTE. There may be a protective role of postoperative initiation of concomitant mechanical prophylaxis and LMWH for VTE.

Enhanced fuel characteristics and physical chemistry of microwave hydrochar for sustainable fuel pellet production via co-densification.

Microwave assisted hydrothermal treatment (MHTC) was compared with torrefaction in terms of carbonization efficiency and physicochemical characteristics of char products. The utilization of produced char was optimized for composite solid biofuel production. The results show that MHTC significantly improved the binding capability of the microwave hydrochar (MHC) particles during co-densification with unprocessed biomass and coal. One possible contributor to the improved binding is the pseudo lignin formed during the MHTC, which led to a better interlocking of the feedstock particles and promoted the solid bridge formation. Composite pellet prepared with 80 wt% of torrefaction char (TC-120), 10 wt% of microwave hydrochar (MHC-30), and 10 wt% of Coal-04 showed a higher heating value of 24.54 MJ/kg and energy density of 26.43 GJ/m3, which is significantly higher than that of the raw cotton stalk pellet (16.77 MJ/kg and 18.76 GJ/m3, respectively), showing great promise as a solid biofuel. The moisture resistance and oxidation reactivity are also significantly improved. The results demonstrate that MHCs provides dual functionalities in acting as binder and fuel promoter in the production of composite biofuel. This study can provide new insight into the unique functions of MHC during fuel application, which demonstrates the great potential of applying MHTC in energy recovery from lignocellulosic biomass.

Survival of Chinese people with type 2 diabetes and diabetic kidney disease: a cohort of 12 -year follow-up.

BACKGROUND: The prevalence of type 2 diabetes has grown significantly in China. However, little is known about the survival outcome of people with type 2 diabetes and diabetic kidney disease (DKD). The purpose of this study is to examine the survival of this population and the risk factors for mortality in one suburb cohort of Beijing, China. METHODS: Four hundred and forty-five people with DKD (48.8% male, age at onset of diabetes 48.8 ± 11.0 years, age at enrollment 57.5 ± 11.6 years) were enrolled in one suburb of Beijing, China between January 1st, 2003 and December 31st, 2015. Mortality ascertainment was censored by December 31st, 2015. Survival analysis was performed by Kaplan-Meier analysis, and Cox proportional hazards regression models were served for risk factor analysis of mortality. The Chiang method was used to estimate life expectancy by age. RESULTS: A total of 78 deaths were identified during the 3232 person-years of follow-up. Multivariate Cox regression analysis showed significantly higher risks of mortality with respect to older age, higher systolic blood pressure (SBP), lower body mass index (BMI) and lower estimated glomerular filtration rate (eGFR). The life expectancy at age of 50 was estimated to be 12.3 (95%, CI: 9.0-16.1) years. Circulatory disease was the leading cause of death in this population (accounting for 43.6% of all deaths), followed by diabetic complications (33.3%) and respiratory disease (6.4%). CONCLUSIONS: Data from one Chinese cohort from 2003 through 2015 showed that people with DKD faced higher risk of death and shorter life expectancy. Factors significantly increasing risk of death included older age, higher SBP, lower BMI and lower eGFR. There is an urgent need to early detection, closely monitoring and effective intervention on DKD.

Impact of age at diagnosis and duration of type 2 diabetes on mortality in Australia 1997-2011.

AIMS/HYPOTHESIS: Current evidence suggests that type 2 diabetes may have a greater impact on those with earlier diagnosis (longer duration of disease), but data are limited. We examined the effect of age at diagnosis of type 2 diabetes on the risk of all-cause and cause-specific mortality over 15 years. METHODS: The data of 743,709 Australians with type 2 diabetes who were registered on the National Diabetes Services Scheme (NDSS) between 1997 and 2011 were examined. Mortality data were derived by linking the NDSS to the National Death Index. All-cause mortality and mortality due to cardiovascular disease (CVD), cancer and all other causes were identified. Poisson regression was used to model mortality rates by sex, current age, age at diagnosis, diabetes duration and calendar time. RESULTS: The median age at registration on the NDSS was 60.2 years (interquartile range [IQR] 50.9-69.5) and the median follow-up was 7.2 years (IQR 3.4-11.3). The median age at diagnosis was 58.6 years (IQR 49.4-67.9). A total of 115,363 deaths occurred during 7.20 million person-years of follow-up. During the first 1.8 years after diabetes diagnosis, rates of all-cause and cancer mortality declined and CVD mortality was constant. All mortality rates increased exponentially with age. An earlier diagnosis of type 2 diabetes (longer duration of disease) was associated with a higher risk of all-cause mortality, primarily driven by CVD mortality. A 10 year earlier diagnosis (equivalent to 10 years' longer duration of diabetes) was associated with a 1.2-1.3 times increased risk of all-cause mortality and about 1.6 times increased risk of CVD mortality. The effects were similar in men and women. For mortality due to cancer (all cancers and colorectal and lung cancers), we found that earlier diagnosis of type 2 diabetes was associated with lower mortality compared with diagnosis at an older age. CONCLUSIONS/INTERPRETATION: Our findings suggest that younger-onset type 2 diabetes increases mortality risk, and that this is mainly through earlier CVD mortality. Efforts to delay the onset of type 2 diabetes might, therefore, reduce mortality.

Graphene Decorated with Uniform Ultrathin (CoP)x -(FeP)1-x Nanorods: A Robust Non-Noble-Metal Catalyst for Hydrogen Evolution.

Developing high-performance but low-cost hydrogen evolution reaction (HER) electrocatalysts with superior activity and stability for future sustainable energy conversion technologies is highly desired. Tuning of microstructure, configuration, and chemical composition are paramount to developing effective non-noble electrocatalysts for HER. Herein, a universal "nanocasting" method is reported to construct graphene decorated with uniform ternary (CoP)x -(FeP)1-x (0 ≤ x ≤ 1) nanorods hybrids with different chemical compositions [(CoP)x -(FeP)1-x -NRs/G] as a highly active and durable nonprecious-metal electrocatalyst for the HER. The optimized (CoP)0.54 -(FeP)0.46 -NRs/G electrocatalyst exhibits overpotentials of as low as 57 and 97 mV at 10 mA cm-2 , Tafel slopes of 52 and 62 mV dec-1 , exchange current densities of 0.489 and 0.454 mA cm-2 , and Faradaic efficiency of nearly 100% in acidic and alkaline media, respectively. More importantly, this electrocatalyst also exhibits high tolerance and durability in a wide pH range and keeps catalytic activity for at least 3000 cycles and 24 h of sustained hydrogen production. The excellent catalytic performance of the (CoP)x -(FeP)1-x -NRs/G electrocatalyst may be ascribed to its unique mesoporous structure and strong synergistic effect between CoP and FeP. Thus, the work provides a feasible way to fabricate cheap and highly efficient electrocatalyst as alternatives for Pt-based electrocatalysts for HER in electrochemical water splitting.

Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study.

AIMS/HYPOTHESIS: There is limited information about the impact of type 1 diabetes on life expectancy in a contemporary population. We examined the life expectancy of type 1 diabetic patients and explored the contribution of mortality at different ages and of different causes of death to years of life lost (YLL) compared with the general population. METHODS: We derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking the NDSS to the National Death Index. The Chiang method was used to estimate life expectancy and Arriaga's method was used to estimate the contributions of age-specific and cause-specific mortality to the YLL. RESULTS: A total of 5,981 deaths were identified during the 902,136 person-years of follow up. Type 1 diabetic patients had an estimated life expectancy at birth of 68.6 years (95% CI 68.1, 69.1), which was 12.2 years (95% CI 11.8, 12.7) less than that in the general population. The improvement in life expectancy at birth in 2004-2010 compared with 1997-2003 was similar for both type 1 diabetic patients (men, 1.9 years [95% CI 0.4, 3.3]; women, 1.5 years [95% CI 0.0, 3.2]) and the general population (men, 2.2 years; women, 1.4 years). Deaths at age <60 years accounted for 60% of the YLL from type 1 diabetes for men and 45% for women. The major contribution to YLL was mortality from endocrine and metabolic disease at age 10-39 years (men, 39-59%; women, 35-50%) and from circulatory disease at age ≥40 years (men, 43-75%; women, 34-75%). CONCLUSIONS/INTERPRETATION: Data from 1997 to 2010 showed that Australian type 1 diabetic patients had an estimated loss in life expectancy at birth of 12.2 years compared with the general population.

Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes.

AIMS/HYPOTHESIS: The aim of this work was to estimate the life expectancy (LE) and disability-free life expectancy (DFLE) for adults with and without diabetes. METHODS: The Chiang method and the adapted Sullivan method were used to estimate LE and DFLE by age and sex. Mortality data in 2011 were available from the National Diabetes Services Scheme for diabetes and from standard national mortality datasets for the general population. Data on prevalence of disability and severe or profound core activity limitation were derived from the 2012 Australian Survey of Disability, Ageing and Carers (SDAC). The definitions of disability used in the SDAC followed the International Classification of Functioning, Disability and Health. Data on diabetes prevalence were derived from the Australian Diabetes, Obesity and Lifestyle study. RESULTS: The estimated LE and DFLE (with 95% uncertainty interval [UI]) at age 50 years were 30.2 (30.0, 30.4) and 12.7 (11.5, 13.7) years, respectively, for men with diabetes, and the estimates were 33.9 (33.6, 34.1) and 13.1 (12.3, 13.9) years, respectively, for women with diabetes. The estimated loss of LE associated with diabetes at age 50 years was 3.2 (3.0, 3.4) years for men and 3.1 (2.9, 3.4) years for women, as compared with their counterparts without diabetes. The corresponding estimated loss of DFLE was 8.2 (6.7, 9.7) years for men and 9.1 (7.9, 10.4) years for women. Women with diabetes spent a greater number of absolute years and a greater proportion of their life with disability as compared with men with diabetes and women without diabetes. The gains in LE and DFLE across the whole population at age 50 years after hypothetically eliminating diagnosed diabetes were 0.6 (0.5, 0.6) years and 1.8 (1.0, 2.8) years. CONCLUSIONS/INTERPRETATION: In adults, diabetes results in a modest reduction in LE and a substantial reduction in DFLE. Efforts to identify the specific causes of disability and effective interventions are needed.

[Nuclear translocation of ß-catenin represses membrane localization of NIS in human thyroid cancer cells].

OBJECTIVE: To explore whether nuclear translocation of ß-catenin affects functional expression of sodium iodide symporter (NIS) in human thyroid cancer cells. METHODS: Two kinds of ß-catenin nuclear translocation cell models were firstly established with transfection of hypoxia inducible factor 1α (HIF-1α) and ß-catenin cDNA in human thyroid cancer cell line FTC133. Then the expression of ß-catenin were further interfered by shRNA in above two cell models. After that, the influence of ß-catenin nuclear localization on the functional expression of NIS, iodine uptake potency, epithelial-mesenchymal transition (EMT) characteristics, tumor growth curve and treatment effect inducing by radioactive iodine were comparatively analyzed in vitro and in vivo trials. Additionally, the underlying mechanism of NIS functional expression was also assessed via identifying the activation of ß-catenin signal pathway. RESULTS: In vitro assay showed prominent EMT phenotype in the above two ß-catenin nuclear translocation cell models, and in vitro proliferation and invasion potential of cancer cells markedly increased (all P<0.05); NIS protein expression translocated from cell membrane to cytoplasma. Cell iodide uptake in vitro decreased about 50.0% and 37.5%, respectively in above two ß-catenin translocation cell models (both P<0.05). Moreover, ß-catenin nuclear translocation was correlated with phosphorylation expressions of ß-catenin Ser45, Y654 and GSK-3ß Ser9. Most importantly, all above changes associated with ß-catenin nuclear translocation could be effectively reversed after blockade of ß-catenin expression. In the animal model, tumor growth potential and tumor mass were significantly inhibited by both blockade of ß-catenin and radioactive iodide ((131)I) (all P<0.05). Meanwhile, immunohistochemistry demonstrated that ß-catenin nuclear translocation remained in subcutaneous tumor cells after transplantation, and showed negatively associated with NIS membrane expression. CONCLUSION: ß-catenin nuclear translocation is a vital regulatory pathway involved in functional expression of NIS in human thyroid cancer cells.

Kinetic stability of Fe-based nanoparticles with rheological modification by xanthan gum: A critical stabilization concentration and the underlying mechanism.

Enhanced kinetic stability of Fe-NPs in groundwater is a focus in application of Fe-NPs for groundwater remediation. The effect of surfactants (Triton X-100 and SDBS) and polymers (XG, SA, CCS, PSS and PVP) on the kinetic stability of Fe-NPs were studied with sedimentation experiments. Polymers improved stability of nFe3O4 and XG had the best effect, while surfactants had minimal effect. There was a critical concentration (CSC) for XG to stabilize nFe3O4, which was 2.0 g/L. At such a concentration nFe3O4, nFe2O3, and nCuO did not settled in 10 h, while the settlement occurred below the concentration and increased with decreasing XG concentration. At CSC XG could stabilize 20 g/L of nFe3O4 for >30 days and 8.0 g/L of nZVI for 13 days. Rheology studies indicated that the enhanced stability was due to the entanglement of XG molecules in the concentration range of 0.5-2.8 g/L and the formation of a uniform entangled network at CSC concentration was responsible for non-sedimentation of Fe-NPs. At hyper-CSC concentrations under the regime of concentrated network (>2.8 g/L), the stability of nFe3O4 and nFe2O3 decreased due to depletion interaction. The rules for XG to stabilize particles and information about the critical concentration will improve XG application in groundwater remediation using Fe-NPs.

Molasses-based in situ bio-sequestration of Cr(VI) in groundwater under flow condition.

The in situ biosequestration of Cr(VI) in groundwater with molasses as the carbon source was studied based on column experiments and model simulation in this study. Compared with biological reduction, molasses-based chemical reduction did not cause significant Cr(VI) removal at molasses concentration as high as 1.14 g L-1. The molasses at a concentration as low as 0.57 g L-1 could support biofilm-based Cr(VI) sequestration under flow conditions and showed better sequestration performances than D-glucose and emulsified vegetable oil (8 g L-1). The existence of molasses (1.14 g L-1) decreased the pH of the effluent from 7.5 to 6.3 and the oxidation-reduction potential from 275 mV to 220 mV in the groundwater, which was responsible for reduction and thus the sequestration of Cr(VI). Advection-dispersion-reaction model well described the process of the Cr(VI) transport with biosequestration in the column (R2 ≥ 0.96). Owing to the Cr(VI) toxicity to the biofilms, the removal ratio decreased by 24% with a rise of Cr(VI) concentration from 8.6 to 43 mg L-1. The prolongation of hydraulic retention time could promote the performance of Cr(VI) biosequestration. The chemical form of Cr deposited as the product of bio-reduction was confirmed as Cr(OH)3·H2O and other complexes of Cr(III). Our work demonstrated the efficacy of molasses for in situ sequestration of Cr(VI) under the dynamic flow condition and provide some useful information for Cr-contaminated groundwater remediation.

[Epithelial-mesenchymal transition induces cancer stem cell generation in human thyroid cancer cells in vitro].

OBJECTIVE: Epithelial-mesenchymal transition (EMT) has been implicated in the initiation and conversion of early stage tumors into invasive malignancies and is associated with the "stemness" of cancer cells. The present study was designed to identify whether EMT induces cancer stem cell generation and tumor progression in human thyroid cancer cells in vitro. METHODS: FTC133 cells, as EMT-negative cells, were used for EMT induction by hypoxia-inducible factor-1α (HIF-1α) transfection. And EMT features were then examined by Western blot, immunofluorescent staining, invasion and proliferation assays. Moreover, stem-like side population (SP) cells were sorted with flow cytometry from FTC133 cells before and after EMT. The proportion of SP was compared and stemness, self-renewal and tumorigenicity in vitro were identified in SP cells. RESULTS: Overexpression of HIF-1α induced FTC133 cells to undergo EMT. And it down-regulated epithelial marker E-cadherin, up-regulated mesenchymal marker vimentin and caused nucleus translocation of ß-catenin and highly invasive and metastatic properties. Most importantly, the induction of EMT promoted proportion of stem-like side population cells (0.70% vs 0.03%, P < 0.05) with higher sphere formation and clone forming capability in contrast to non-side population cells. CONCLUSIONS: EMT can induce cancer stem cell generation and tumor progression in thyroid cancers. Further understanding the role of EMT and cancer stem cells in cancer progression may reveal new preventive and therapeutic targets for thyroid cancers.

Methylenetetrahydrofolate reductase C677T and A1298C polymorphisms and gastric cancer susceptibility: an updated meta-analysis.

Widely regarded as one of the most prevalent malignancies worldwide, gastric cancer (GC) is a common clinical condition of the digestive system. Reviewing 14 meta-analyses that evaluated the association between methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and GC risk, we observed inconsistent results, and the credibility of the significant correlation between the statistical results was ignored. With the aim of further exploring the association between MTHFR C677T and A1298C and the risk of GC, we searched electronic databases, pooling 43 relevant studies and calculating odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for each of the five genetic models. Subgroup and regression analyses were performed to look for sources of heterogeneity and publication bias was assessed by funnel plots. To assess the plausibility of statistically significant associations, we used the FPRP test and the Venice criteria. Overall data analysis showed that MTHFR C677T polymorphism was significantly associated with GC risk, especially in Asians, while MTHFR A1298C polymorphism was not associated with GC risk. However, in subgroup analysis by hospital-based controls, we found that MTHFR A1298C might be a protective factor for GC. After credibility assessment, the statistical association between MTHFR C677T and GC susceptibility study was classified as 'less credible positive result', while the result of MTHFR A1298C was considered unreliable. In summary, the present study strongly suggests that MTHFR C677T and A1298C polymorphisms are not significantly associated with the GC risk.

A hybrid framework for delineating the migration route of soil heavy metal pollution by heavy metal similarity calculation and machine learning method.

Soil heavy metal contamination was a global environmental issue that posed adverse impacts on ecological and human health risks. The controlling of soil heavy metal is mainly focused on the emission source and pipe-end treatment, less is known about the intermediate controlling process. The migration route of heavy metals exhibited the spatial evolution of pollutants from the sources to the pipe-end, which provided the more reasonable location for the target-oriented treatment of soil heavy metal. Here, we proposed a new view of heavy metal similarity, which quantitatively expressed how closely of the contaminations between the study area and the test areas. We found that the similarity of different heavy metals was unequally distributed across locations that were related with five main sources, namely agricultural activities, natural sources, traffic emissions, industrial activities, and other sources. Based on the similarity, a state-of-the-art machine learning method was applied to delineate the migration route of soil heavy metals. Thereinto, As was concentrated around livestock farms, and its migration route was close to the water system. Cd migration route was over-dispersed in the areas where located mine fields and chemical plants. Migration routes of Hg and Pb were along rivers, which were related to agricultural activities and natural sources. Overall, the perspective on similarity and migration routes provided theoretical basis and method to alleviate soil heavy metal pollution at regional scale and can be extended across largescale regions.

Holocene climatic controls on flooding regime along the Ussuri River in Northeast Asia.

Knowledge of the long-term flooding response to climatic changes is critical for probing the flooding future in an oncoming warmer world. In this paper, three well-dated wetland sedimentary cores with high-resolution grain-size records were employed to reconstruct the historical flooding regime along the Ussuri River during the past 7000 years. The results show that five flooding-prone intervals marked by increased mean rates of sand-fraction accumulation occurred at 6.4-5.9 ka BP, 5.5-5.1 ka BP, 4.6-3.1 ka BP, 2.3-1.8 ka BP, and 0.5-0 ka BP, respectively. These intervals are generally consistent with the higher mean annual precipitation controlled by the strengthened East Asian summer monsoon which has been widely documented in geological records across the monsoonal regions of East Asia. Considering the prevalent monsoonal climate along the modern Ussuri River, we suggest that the regional flooding evolution during the Holocene Epoch should be generally controlled by the East Asian summer monsoon circulation which was initially linked to the ENSO activities in the tropical Pacific Ocean. While for the last interval spanning 0.5-0 ka BP, human influence, compared with the long-serving climatic controls, has played a more critical role in driving the regional flooding regime.

Co-pyrolysis of biomass and polyethylene: Insights into characteristics, kinetic and evolution paths of the reaction process.

Investigation on the distribution and mechanism of co-pyrolysis products is vital to the directional control and high-value utilization of agriculture solid wastes. Co-pyrolysis, devolatilization, kinetics characteristics, and evolution paths of corn stalk (CS) and low-density-polyethylene (LDPE) were investigated via thermogravimetric experiments. The co-pyrolysis behaviors could be separated into two stages: firstly, the degradation of CS (150- 400 °C); secondly, the degradation of CS (400- 550 °C). The devolatilization index (DI) increased with the addition of LDPE. Furthermore, a combination of devolatilization chemical analysis with product analysis to analyze the intrinsic mechanism during co-pyrolysis. The results indicated that the yield of alkanes and olefin in gas products increased with the addition of LDPE. Additionally, LDPE pyrolysis maybe abstract hydrogen from CS pyrolysis and evolved into hydrogen, methane, and ethylene. Further, the co-pyrolysis kinetic parameters were computed by using model-free isoconversion methods, which showed promotion of CS pyrolysis and the reduced activation energy. All the activation energy were declined, which indicated a "bidirectional positive effect" during co-pyrolysis. The mean activation energy of P-cellulose (P-CE), P-hemicellulose (P-HM), P-lignin (P-LG), and LDPE decreased by 23.49 %, 12.89 %, 15.36 %, and 27.82 %, respectively. This study further proves the hydrogen donor transfer pathway in the co-pyrolysis process of CS and LDPE, providing theoretical support for the resource utilization of agricultural solid waste.

Holocene terrestrialization process on the Sanjiang Plain (China) and its significance to the East Asian summer monsoon circulation.

A wide-spread terrestrialization process has been reported occurring across the Sanjiang Plain in the Holocene Epoch, while little is known for its detailed process and links to regional climate variation. Here, we present high-resolution palynological and lithological data of a peatland's sedimentary profile in the central Sanjiang Plain. The study aims to reconstruct the local terrestrialization process and discuss its significance to the Holocene East Asian summer monsoon (EASM) evolution. The results indicate that a paleolake surrounded by broadleaved forests developed during ~7.4-4.5 ka BP, corresponding to a wet and warm stage with strengthened EASM. Thereafter, a wetland dominated by Cyperaceae and Poaceae was initiated with the terrestrialization process. This process lasted until 3.9 ka BP when a lithological mud-to-peat transition occurred indicating a peatland began to develop after the extinction of the paleolake. Considering the prevalent EASM climate on the modern Sanjiang Plain, this paleolake-to-peatland transition during 4.5-3.9 ka BP was attributed to the mid-Holocene EASM retreat in addition to the paleolake's autogenic infilling process. During the peatland developing stage, four dry intervals with weakened EASM occurred in 3.9-3.2 ka BP, 2.0-1.3 ka BP, 1.0-0.5 ka BP, and 0.1-0.0 ka BP. They were alternated with three wet stages of the strengthened EASM during 3.2-2.0 ka BP, 1.3-1.0 ka BP, and 0.5-0.1 ka BP. Our findings are supported by a series of paleoclimatic records across the monsoonal regions of China. We suggest that the EASM evolution associated with the tropical ocean-atmosphere interactions was initially modulated by the solar output variation.

Aerobic and anaerobic biodegradation of BDE-47 by bacteria isolated from an e-waste-contaminated site and the effect of various additives.

Degradation experiments are conducted to specifically compare the degradation of 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) by aerobic and anaerobic strains isolated from real e-waste sites contaminated by BDE-47. The effect of carbon sources, inducers and surfactants on the degradation was examined to strengthen such a comparison. An aerobic strain, B. cereus S1, and an anaerobic strain, A. faecalis S4, were obtained. The results indicated that BDE-47 could be used as the sole carbon source by B. cereus S1 and A. faecalis S4 under aerobic and anaerobic conditions, respectively. The degradation of BDE-47 by B. cereus S1 and A. faecalis S4 was illustrated a first-order kinetics process obtaining a removal efficiency of 61.6% and 51.6% with a first-order rate constant of 0.0728 d-1 and 0.0514 d-1, and corresponding half-life of 8.7 d and 13.5 d, respectively. The addition of carbon sources (yeast extract, glucose, acetic acid and ethanol) and inducers (2,4-dichlorophenol, bisphenol A and toluene) promoted BDE-47 degradation by both B. cereus S1 and A. faecalis S4 under aerobic and anaerobic conditions, while hydroquinone as the inducer inhibited the degradation. All of the surfactants tested (CTAB, Tween 80, Triton X-100, rhamnolipid and SDS) showed inhibitory effect. BDE-47 degradation by B. cereus S1 under aerobic condition was more efficient than A. faecalis S4 under anaerobic condition whether with or without the additives. The results of the study indicated that in the field sites contaminated by BDE-47, the aerobic condition can be more favorable for BDE-47 removal and the degradation can be further enhanced by applying suitable carbon sources and inducers.

Real-World Application of Insulin Pump Therapy Among Patients With Type 1 Diabetes in China: A Cross-Sectional Study.

Background: Although insulin pump therapy is an important treatment modality for patients with type 1 diabetes, rates of pump use appear to vary broadly internationally. This study aimed to investigate the application of insulin pump therapy among patients with type 1 diabetes in China. Methods: Data were collected from the Type 1 Diabetes Mellitus in China: Coverage, Costs and Care Study (3C Study). A total of 779 participants from this cross-sectional study were included. Multivariable logistic regression was used for data analysis. Results: The median (interquartile range) age at diagnosis of diabetes was 17 (10-28) years and the duration of diabetes was 4 (1-8) years. Among 779 patients, only 89 patients (11.4%) used an insulin pump to control blood glucose. A statistically significant difference was found in HbA1c favoring insulin pump therapy (8.3 ± 1.7% vs. 9.2 ± 2.6%) without obvious differences for severe hypoglycaemia. There were higher proportions of patients with no smoking, frequent daily intake of fruits and vegetables, and adequate self-blood glucose monitoring among patients with insulin pump therapy as compared to those using multiple daily insulin injections. Logistic regression analysis showed that younger age at diagnosis, longer duration of diabetes, higher education level of family members, and higher household income were associated with the use of an insulin pump. Conclusions: Data from 3C Study demonstrated that only a minority of patients with type 1 diabetes in China utilize insulin pump therapy. Insulin pump therapy was associated with better blood glucose control and self-management. Patients with younger age at diagnosis and longer duration of diabetes, and patients with better socioeconomic status were more likely to use an insulin pump.

Association of Bone Metabolism Indices and Bone Mineral Density with Diabetic Retinopathy in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Inpatient Study in China.

OBJECTIVE: This study is aimed at analyzing the association between bone metabolism indices and diabetic retinopathy (DR) in elderly patients with type 2 diabetes mellitus. METHODS: Data of 352 men and 284 postmenopausal women, aged more than 50 years, with type 2 diabetes mellitus were retrospectively analyzed. Patients were divided into three groups based on the degree of DR: nondiabetic retinopathy (NDR) group, background diabetic retinopathy (BDR) group, and proliferative diabetic retinopathy (PDR) group. RESULTS: (1) The diabetic duration and urinary albumin to creatinine ratio (UACR) were significantly higher in the PDR and BDR groups than in the NDR group (P < 0.05). The level of beta-C-terminal telopeptide (ß-CTX) in male patients was lower in the PDR and BDR groups than in the NDR group (P < 0.05). In addition, the level of procollagen 1 intact N-terminal (P1NP) in female patients was higher in the PDR and BDR groups than in the NDR group (P < 0.05). (2) For men and postmenopausal women, the proportion of vitamin deficiency was higher in the PDR and BDR groups than in the NDR group (P < 0.05). (3) The logistic regression analysis in men and postmenopausal women showed that the diabetic duration and lower levels of UACR and 25(OH)D were independent risk factors for DR (P < 0.05). (4) The diabetic duration was also an independent risk factor for PDR (P < 0.05); however, no independent correlation was found between the level of 25(OH)D and PDR (P > 0.05). CONCLUSIONS: A close association was observed between 25(OH)D level and DR in the elderly male patients and postmenopausal women with type 2 diabetes mellitus. P1NP and ß-CTX levels might be closely related to DR in elderly male patients and postmenopausal women with type 2 diabetes mellitus.

Gut-Lung Axis: Microbial Crosstalk in Pediatric Respiratory Tract Infections.

The gut microbiota is an important regulator for maintaining the organ microenvironment through effects on the gut-vital organs axis. Respiratory tract infections are one of the most widespread and harmful diseases, especially in the last 2 years. Many lines of evidence indicate that the gut microbiota and its metabolites can be considered in therapeutic strategies to effectively prevent and treat respiratory diseases. However, due to the different gut microbiota composition in children compared to adults and the dynamic development of the immature immune system, studies on the interaction between children's intestinal flora and respiratory infections are still lacking. Here, we describe the changes in the gut microbiota of children with respiratory tract infections and explain the relationship between the microbiota of children with their immune function and disease development. In addition, we will provide perspectives on the direct manipulation of intestinal microbes to prevent or treat pediatric respiratory infections.