Prognostic relevance of ventricular arrhythmias in surgical patients with gastrointestinal tumors.

BACKGROUND: Individuals diagnosed with gastrointestinal tumors are at an increased risk of developing cardiovascular diseases. Among which, ventricular arrhythmia is a prevalent clinical concern. This suggests that ventricular arrhythmias may have predictive value in the prognosis of patients with gastrointestinal tumors. AIM: To explore the prognostic value of ventricular arrhythmias in patients with gastrointestinal tumors receiving surgery. METHODS: We retrospectively analyzed data from 130 patients undergoing gastrointestinal tumor resection. These patients were evaluated by a 24-h ambulatory electrocardiogram (ECG) at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2020. Additionally, 41 general healthy age-matched and sex-matched controls were included. Patients were categorized into survival and non-survival groups. The primary endpoint was all-cause mortality, and secondary endpoints included major adverse cardiovascular events (MACEs). RESULTS: Colorectal tumors comprised 90% of cases. Preoperative ambulatory ECG monitoring revealed that among the 130 patients with gastrointestinal tumors, 100 (76.92%) exhibited varying degrees of premature ventricular contractions (PVCs). Ten patients (7.69%) manifested non-sustained ventricular tachycardia (NSVT). The patients with gastrointestinal tumors exhibited higher PVCs compared to the healthy controls on both conventional ECG [27 (21.3) vs 1 (2.5), P = 0.012] and 24-h ambulatory ECG [14 (1.0, 405) vs 1 (0, 6.5), P < 0.001]. Non-survivors had a higher PVC count than survivors [150.50 (7.25, 1690.50) vs 9 (0, 229.25), P = 0.020]. During the follow-up period, 24 patients died and 11 patients experienced MACEs. Univariate analysis linked PVC > 35/24 h to all-cause mortality, and NSVT was associated with MACE. However, neither PVC burden nor NSVT independently predicted outcomes according to multivariate analysis. CONCLUSION: Patients with gastrointestinal tumors exhibited elevated PVCs. PVCs > 35/24 h and NSVT detected by 24-h ambulatory ECG were prognostically significant but were not found to be independent predictors.

Quantifying the mitigating effect of organic matter on heavy metal availability in soils with different manure applications: A geochemical modelling study.

Manure is one of the main sources of heavy metal (HM) pollution on farmlands. It has become the focus of global ecological research because of its potential threat to human health and the sustainability of food systems. Soil pH and organic matter are improved by manure and play pivotal roles in determining soil HM behavior. Geochemical modeling has been widely used to assess and predict the behavior of soil HMs; however, there remains a research gap in manure applications. In this study, a geochemical model (LeachXS) coupled with a pH-dependent leaching test with continuously simulations over a broad pH range was used to determine the effects and pollution risks of pig or cattle manure separate application on soil HMs distribution. Both pig and cattle manure applications led to soil pH reduction in alkaline soils and increased organic matter content. Pig manure application resulted in a potential 90.5-156.0 % increase in soil HM content. Cattle manure did not cause significant HM contamination. The leaching trend of soil HMs across treatments exhibited a V-shaped change, with the lowest concentration at pH = 7, gradually increasing toward strong acids and bases. The dissolved organic matter-bound HM content directly increased the HM availability, especially for Cu (up to 8.4 %) after pig manure application. However, more HMs (Cr, Cu, Zn, Ni) were in the particulate organic matter-bound state than in other solid phases (e.g., Fe-Al(hydr) oxides, clay minerals), which inhibited the HMs leaching by more than 19.3 % after cattle manure application. Despite these variations, high HM concentrations introduced by pig manure raised the soil contamination risk, potentially exceeding 40 times at pH ±1. When manure is returned to the field, reducing its HM content and mitigating possible pollution is necessary to realize the healthy and sustainable development of circular agriculture.

Genetically predicted obstructive sleep apnea is causally associated with an increased risk for periodontitis.

BACKGROUND: Although obstructive sleep apnea (OSA) and periodontitis are associated, whether this association is causative is uncertain. METHODS: We conducted a bidirectional Mendelian randomization (MR) analysis using data from publically accessible genome-wide association studies. The single-nucleotide polymorphisms (SNPs) for OSA were derived from 16,761 cases and 201,194 controls. The pooled data of periodontitis association involved up to 17,353 individuals. Disease-associated single-nucleotide polymorphisms were selected as an instrumental variable at the genome-wide significance level (p < 5.0 × 10- 6). Subsequently, the causal effects were estimated using three different methods: inverse variance weighting (IVW), MR-Egger, and weighted median. Then, these causal estimates were expressed as dominance ratios [odds ratio (OR)]. RESULTS: The MR analysis revealed that genetically determined OSA promotes the development of periodontitis [ IVW OR = 1.117, 95% confidence interval (CI) = 1.001-1.246, p = 0.048). Furthermore, no causal effect of genetically predicted periodontitis on OSA was noted in the reverse MR analysis (IVW OR = 1, 95% CI: 0.95-1.06, p = 0.87). The trend in results from the MR-Egger regression and weighted median (WM) was consistent with that in results from the IVW method. The robustness of the results was confirmed by the sensitivity analysis. CONCLUSIONS: In summary, the results of our MR investigation suggest an association between OSA and periodontitis, proposing that early screening and treatment of OSA is beneficial for the prevention and prognosis of periodontitis.

Irrigation Optimization via Crop Water Use in Saline Coastal Areas-A Field Data Analysis in China's Yellow River Delta.

Freshwater resources are becoming increasingly scarce in coastal areas, limiting crop productivity in coastal farmlands. Although the characteristic of crop water use is an important factor for water conservation in coastal farmlands, it has not been studied extensively. This study aimed to depict the water use process of soil-plant systems under saline stress in coastal ecosystems and optimize water management. An intensive observation experiment was performed within China's Yellow River Delta to identify the water use processes and crop coefficients (KC) and also quantify the impacts of salt stress on crop water use. The results show that shallow groundwater did not contribute to soil water in the whole rotation; KC values for wheat-maize, wheat-sorghum, and wheat-soybean rotation systems were 45.0, 58.4, and 57% less, respectively, than the FAO values. The water use efficiency of the maize (8.70) and sorghum (9.00) in coastal farmlands was higher than that of the soybean (4.37). By identifying the critical periods of water and salt stress, this paper provides suggestions for water-saving and salinity control in coastal farmlands. Our findings can inform the sustainable development of coastal farmlands and provide new insights to cope with aspects of the global food crisis.

Myocardial injury before noncardiac surgery.

Non-cardiac surgical procedures present a significant circulatory stress and can potentially trigger cardiovascular events, such as myocardial infarction and heart failure. Myocardial injury before non-cardiac surgery is associated with an increased risk of mortality and major cardiovascular complications during perioperative period, as well as up to 5 years after non-cardiac surgery. While the definition of preoperative myocardial injury is not yet clear, it is generally understood as myocardial injury resulting from various causes of troponin elevation without acute coronary syndrome prior to surgery. Detecting preoperative myocardial injury through routine troponin monitoring is crucial for reducing perioperative risk, but it is also challenging. The aim of this review is to discuss the definition of preoperative myocardial injury, its pathophysiology, implications on clinical practice and decision-making for patients with elevated troponin levels before non-cardiac surgery.

A food-web model as a tool for the ecosystem-level management of bivalves in an Atlantic coastal lagoon.

The Ria de Aveiro is an important coastal lagoon for wildlife in Portugal, where the production of bivalves reaches approximately 2700 tons annually. However, the illegal overfishing of bivalves is frequent in this lagoon, which causes critical changes in the ecosystem. In this study, using a developed food-web model (Ecopath model), the ecological carrying capacity (ECC) and maximum sustained yield (MSY) of the Manila clam, Ruditapes philippinarum were estimated, and the effects of further increases in clam biomass on other species were investigated. The results showed that 1) the current biomass and legal catch of R. philippinarum do not yet exceed the ECC (172.40 tons km-2) or the MSY (86.20 tons km-2 year-1) in Ria de Aveiro; 2) the harvested Manila clams of the MSY represent removing from the ecosystem âˆ¼ 581 tons carbon (C) and ∼83 tons nitrogen (N) annually, with substantial ecological and economic implications; and 3) a further increase in the biomass levels of this species may cause the ecotrophic efficiency of other groups to become unrealistic, potentially leading to decreases in ecosystem transfer efficiency, biodiversity and health. The results here are expected to guide the sustainable development and management of bivalve aquaculture in Ria de Aveiro and the protection of the local environment.

Temporal and spatial analysis of anthropogenic mercury and CO2 emissions from municipal solid waste incineration in China: Implications for mercury and climate change mitigation.

The contribution of municipal solid waste incineration (MSWI) to anthropogenic mercury and CO2 emissions have become increasingly important over the past decade. This study developed an inventory of anthropogenic mercury emissions and CO2 emissions during the period of 2014-2020, of MSWI process in China using a bottom-up inventory at the plant level. Overall, national MSWI anthropogenic mercury emissions increased from 2014 to 2020 by province. It was estimated that total 8321.09 kg of anthropogenic mercury emissions from 548 MSWI plants were scattered in 31 provinces of mainland China in 2020. The average intensity of mercury emission in China was 0.06 g·t-1 in 2020, which was much lower than the pre-2010 level. Furthermore, the increased CO2 emission generated by MSWI from 2014 to 2020 is 1.97 times. Anthropogenic mercury emissions and CO2 emissions were concentrated mainly in developed coastal provinces and cities. The general uncertainty of national mercury emissions and CO2 emissions was estimated to be -123% to 323% and -130% to 335%, respectively. Furthermore, future emissions were predicted from 2030 to 2060 based on different scenarios of the independent and collaborative effects of control proposals, the results indicate that the enhancement of advanced air pollution control technologies and effective management of MSWI represent pivotal factors in realizing future reductions in CO2 and mercury emissions. The findings will supplement those for mercury and CO2 emissions, and be useful for relevant policy-making and to improve urban air quality, as well as human health.

Balancing potato yield, soil nutrient supply, and nitrous oxide emissions: An analysis of nitrogen application trade-offs.

Potato has been promoted as a national key staple food to alleviate pressure on food security in China. Appropriate nitrogen (N) application rate is prerequisite and is crucial for increasing yield, improving fertilizer efficiency, and reducing N losses. In the present study, we determined the optimum N application rates by analyzing field trial data from the main potato producing areas of China between 2004 and 2020. We considered the equilibrium relationships between potato yield, N uptake, partial N balance (PNB), and N2O emission under different soil indigenous N supply (INS) scenarios. The results showed that N rate, INS, and their interactions all significantly affect potato yield and nutrient uptake increment. On average, N application increased potato yield and N uptake by 29.5 % and 56.7 %, respectively. The relationship between N rate and yield increment was linear-plateau, while the relationship between N rate and N uptake increment was linear-linear. Soil INS accounted for 63.5 % of total potato N requirement. Potato yield increment and nutrient uptake increment were exponentially negatively correlated with INS and had a significant parabolic-nonlinear relationship with the interaction of N fertilizer application rate and INS. PNB was negatively correlated with fertilizer N supply intensity as a power function. Based on our analysis, a N application rate of 166 kg N ha-1 was found to be sufficient when the target yield was <34 t ha-1. However, when the target yield reached 40, 50 and 60 t ha-1, the recommended N application rate increased to 182, 211, and 254 kg N ha-1, respectively, while ensuring N2O emissions low with an emission factor of 0.2 %. Our findings will help guide potato farming toward cleaner production without compromising environmental benefit.

Fate of 15N-labelled urea as affected by long-term manure substitution.

Quantifying the fate of fertilizer nitrogen (N) is essential to develop more sustainable agricultural fertilization practices. However, the fate of chemical fertilizer N, particularly in long-term manure substitution treatment regimes, is not fully understood. The present study aimed to investigate the fate of 15N-labelled urea in a chemical fertilizer treatment (CF, 240 kg 15N ha-1) and N manure 50 % substitution treatment (1/2N + M, 120 kg 15N ha-1 + 120 kg manure N ha-1) in two continuous crop seasons, based on a 10-year long-term experiment in the North China Plain (NCP). The results showed that manure substitution greatly enhanced 15N use efficiency (15NUE) (39.9 % vs. 31.3 %) and suppressed 15N loss (6.9 % vs. 7.5 %) compared with the CF treatment in the first crop. However, the N2O emissions factor in the 1/2N + M treatment was increased by 0.1 % (0.5 kg 15N ha-1 for CF vs. 0.4 kg 15N ha-1 for 1/2N + M) compared with the CF treatment, although N leaching and NH3 volatilization rates decreased by 0.2 % (10.8 kg 15N ha-1 for CF vs. 5.1 kg 15N ha-1 for 1/2N + M) and 0.5 % (6.6 kg 15N ha-1 for CF vs. 2.8 kg 15N ha-1 for 1/2N + M), respectively. In which, only NH3 volatilization presented significantly difference between treatments. It is important to note that in the second crop, the residual 15N in soil (0-20 cm) remained mostly in the soil for the CF (79.1 %) and the 1/2N + M treatment (85.3 %), and contributed less to crop N uptake (3.3 % vs. 0.8 %) and leached losses (2.2 % vs. 0.6 %). This proved that manure substitution could enhance the stabilization of chemical N. These results suggested that long-term manure substitution effectively increases NUE, suppresses N loss, and improves N stabilization in soil, but negative impacts such as N2O emissions due to climate change should be investigated further.

Wearable Multi-Channel Pulse Signal Acquisition System Based on Flexible MEMS Sensor Arrays with TSV Structure.

Micro-electro-mechanical system (MEMS) pressure sensors play a significant role in pulse wave acquisition. However, existing MEMS pulse pressure sensors bound with a flexible substrate by gold wire are vulnerable to crush fractures, leading to sensor failure. Additionally, establishing an effective mapping between the array sensor signal and pulse width remains a challenge. To solve the above problems, we propose a 24-channel pulse signal acquisition system based on a novel MEMS pressure sensor with a through-silicon-via (TSV) structure, which connects directly to a flexible substrate without gold wire bonding. Firstly, based on the MEMS sensor, we designed a 24-channel pressure sensor flexible array to collect the pulse waves and static pressure. Secondly, we developed a customized pulse preprocessing chip to process the signals. Finally, we built an algorithm to reconstruct the three-dimensional pulse wave from the array signal and calculate the pulse width. The experiments verify the high sensitivity and effectiveness of the sensor array. In particular, the measurement results of pulse width are highly positively correlated with those obtained via infrared images. The small-size sensor and custom-designed acquisition chip meet the needs of wearability and portability, meaning that it has significant research value and commercial prospects.

Application of translation wavelet transform with new threshold function in pulse wave signal denoising.

BACKGROUND: The wrist pulse wave under the optimal pulse pressure plays an important role in detecting human body's physiological and pathological information. Wavelet threshold filtering is a common method for pulse wave de-noising. However, traditional filtering methods cannot smoothen the whole pulse wave well and highlight the details. OBJECTIVE: In view of this, an attempt is made in this paper to propose the pulse wave denoising algorithm for pulse wave under optimal pulse pressure according to the translation invariant wavelet transform (TIWT) and the new threshold function. METHODS: Firstly, by using hyperbolic tangent curve and combining the advantages of soft threshold function and hard threshold function, the new threshold function is derived. Secondly, based on the TIWT, pseudo-Gibbs phenomenon gets suppressed. RESULTS: The experiments show that in comparison to the traditional wavelet filtering algorithm, the novel algorithm can better maintain the pulse wave geometric characteristics and has a higher signal to noise ratio (SNR). CONCLUSION: The TIWT with improved new threshold compensates the shortcomings of the traditional wavelet threshold denoising methods in a better way. It lays a foundation for extracting time-domain characteristics of pulse wave.

The novel role of etoposide in inhibiting the migration and proliferation of small cell lung cancer and breast cancer via targeting Daam1.

OBJECTIVES: Daam1 (Dishevelled-associated activator of morphogenesis 1) is a Wnt/PCP signaling protein that engages in cytoskeleton reorganization and is abnormally activated in certain tumors. Daam1 is closely related to cancer metastasis, which is expected to become a target for cancer treatment. However, the natural small molecules targeting Daam1 have not been identified. MATERIALS AND METHODS: We screened several natural small molecules that may bind to Daam1 by Sybyl molecular simulation docking technique. As a first-line drug for the treatment of small cell lung cancer, etoposide was chosen for further investigation. Next, we used Micro Scale Thermophoresis (MST) to verify the interaction of etoposide and Daam1. Small cell lung cancer H446 cells and breast cancer MCF-7 cells were treated with etoposide and subjected to Western blotting to measure the Daam1 expression. The effect of etoposide on cell proliferation was determined by CCK-8 assay in vitro and by a tumor-bearing mouse model in vivo. Wound healing assay and Boyden chamber assay were used to evaluate the role of etoposide in the migration and invasion ability of tumor cells. The effect of etoposide on the microfilament assembly was visualized by immunofluorescence staining with phalloidine. Finally, the possible mechanism of down-regulation of Daam1 expression after etoposide-induced small cell lung cancer cells was detected by a half-life experiment and immunofluorescence staining with lysosomal marker LAMP1. RESULTS: Sybyl molecular modeling docking technique was performed to screen a natural chemical library for molecules that bound to the FH2 domain of Daam1 and found etoposide was virtually interacted with Daam1. MST validated etoposide directly bound to the FH2 domain of Daam1. Etoposide significantly down-regulated the expression of Daam1 in small cell lung cancer H446 cells and breast cancer MCF-7 cells. Moreover, 270 µmol/L etoposide largely inhibited the proliferation, migration, and invasion of H446 cells and MCF-7 cells. Immunofluorescence staining experiments revealed that etoposide induced the disassembly of microfilaments in H446 cells and MCF-7 cells, which were rescued by Daam1 overexpression. In nude mice transplanted with H446 cells, 5, 10, 20 mg/kg etoposide (drug/weight) injected via tail vein largely retarded the proliferation of subcutaneous tumors. Etoposide induced Daam1 to shorten its half-life and enter the lysosome degradation pathway, and eventually leading to the downregulation of Daam1 expression. CONCLUSIONS: Etoposide is a novel natural small molecule targeting Daam1. Etoposide inhibits the proliferation, migration and invasion of small cell lung cancer cells and breast cancer cells, and also suppresses tumor proliferation of small cell lung cancer in vivo.

The association of preoperative high-sensitivity cardiac troponin i and long-term outcomes in colorectal cancer patients received tumor resection surgery.

BACKGROUND: This study aimed to evaluate the association between preoperative hs-cTnI and long-term mortality and major adverse cardiovascular events (MACE) in colorectal cancer patients. METHODS: This single-center retrospective cohort study included 1105 consecutive colorectal cancer patients who received tumor resection surgery between January 2018 and June 2020. Inclusion criteria were an age ≥ 18 years and had been tested for hs-cTnI on admission within 7 days prior to tumor resection surgery. Exclusion criteria were emergent surgery, failure to received tumor resection surgery, hospital death, there was clinical evidence of unstable coronary artery disease or pulmonary embolism occurred before operation according to medical record. The primary endpoint was all-cause death. Secondary endpoint was major adverse cardiovascular events (MACE). RESULTS: A total of 1105 patients were enrolled: 1032 with normal hs-cTnI and 73 with elevated hs-cTnI. The mean follow-up was 24.4 ± 10.8 months, 176 patients died and 39 patients met MACE. In the elevated troponin group, 50%, 32.1% and 17.9% died from cancer, cardiovascular and other causes, while those in the normal troponin group were 75.7%, 2% and 22.3%, there was statistical difference between 2 groups (P < 0.001). Patients with elevated preoperative hs-cTnI had significantly higher mortality (P < 0.001) and more MACE (P < 0.001) compared with those with normal hs-cTnI. A propensity-matching analysis were performed, resulting in 151 patients with normal hs-cTnI and 60 patients with elevated hs-cTnI. The matched population had the similar results for all-cause death (P = 0.009) and MACE (P = 0.001). The results were consistent after further excluding 147 patients who had received chemoradiotherapy prior to surgery in subgroup analysis. The results of multivariate Cox regression analysis shown that hs-cTnI was one of the best predictors for all-cause death (hazard ratio [HR] 2.278; 95% confidence interval [CI] 1.19-4.361) and MACE (HR, 3.523; 95%CI, 1.477-8.403) in total populations, similar results were found in subgroup analysis. CONCLUSIONS: Colorectal cancer patients without myocardial ischemia manifestation but with elevated hs-cTnI prior to tumor resection surgery were at increased risk for long-term all-cause death and MACE, irrespective of whether they have received chemoradiotherapy prior to surgery.

Prediction of Soil Water-Soluble Organic Matter by Continuous Use of Corn Biochar Using Three-Dimensional Fluorescence Spectra and Deep Learning.

The purpose is to study the soil's water-soluble organic matter and improve the utilization rate of the soil layer. This exploration is based on the theories of three-dimensional fluorescence spectroscopy, deep learning, and biochar. Chernozem in Harbin City, Heilongjiang Province, is taken as the research object. Three-dimensional fluorescence spectra and a deep learning model are used to analyze the content of water-soluble organic matter in the soil layer after continuous application of corn biochar for six years and to calculate different fluorescence indexes in the whole soil depth. Among them, the three-dimensional fluorescence spectrum theory provides the detection standard for the application effect detection of biochar, the deep learning theory provides the technical support for this exploration, and the biochar theory provides the specific research direction. The results show that the application of corn biochar for six consecutive years significantly reduces the average content of water-soluble organic matter in different soil layers. Among them, the highest average content of soil water-soluble organic matter is "nitrogen, potassium, phosphorous" (NPK) and the lowest is "boron, carbon" (BC). Comparing the soil with BC alone, in the topsoil, the second section (330-380 nm/200-250 nm) with BC + NPK increases by 13.3%, the third section (380-550 nm/220-250 nm) increases by 8.4%, and the fourth section (250-380 nm/250-600 nm) increases by 50.1%. The combination of nitrogen (N) + BC has a positive effect of 20.7%, 12.2%, and 28.4% on sections I, II, and IV, respectively. In addition, in the topsoil, the combination of NPK + BC significantly increases the content of acid-like substances compared with the application of BC alone. In the black soil, with or without fertilizer NPK, there is no significant difference in the level of fulvic acid-like components. The prediction of soil water-soluble organic matter after continuous application of corn biochar based on three-dimensional fluorescence spectra and deep learning is carried out, which has reference significance for the rapid identification and early prediction of subsequent soil activity.

Effects of Biochar on the Fluorescence Spectra of Water-Soluble Organic Matter in Black Soil Profile after Application for Six Years.

At present, extracting water-soluble organic matter (WSOM) from agricultural organic waste is primarily used to evaluate soil organic matter content in farmland. However, only a few studies have focused on its vertical behavior in the soil profile. This study aims to clarify the three-dimensional fluorescence spectrum characteristics of the WSOM samples in 0-60 cm black soil profile before and after different chemical fertilizer treatments after six years of fertilization. Fluorescence spectroscopy combined with fluorescence and ultraviolet-visible (UV-Vis) spectroscopies are used to divide four different fertilization types: no fertilization (T0), nitrogen phosphorus potassium (NPK) (T1), biochar (T2), biochar + NPK (T3), and biochar + N (T4) in a typical black soil area. The vertical characteristics of WSOC are also analyzed. The results showed that after six years of nitrogen application, T2 had a significant effect on the fluorescence intensity of Zone II (decreasing by 9.6% in the 0-20 cm soil layer) and Zone V (increasing by 8.5% in the 0-20 cm soil layer). The fluorescent components identified in each treatment group include ultraviolet radiation A humic acid-like substances (C1), ultraviolet radiation C humic acid-like substances (C2), and tryptophan-like substance (C3). As compared with the land with T1, the content of C2 in the 20-60 cm soil layer with T2 was lower, while that of C2 in the surface and subsoil with T3 was higher. In addiiton, there were no significant differences in the contents of C1, C2, and C3 by comparing the soils applied with T3 and T4, respectively. The composition of soil WSOM was found to be significantly influenced by the addition of a mixture of biochar and chemical fertilizers. The addition of biochar alone exerted a positive effect on the humification process in the surface soil (0-10 cm). NPK treatment could stimulate biological activity by increasing biological index values in deeper soil layers (40-50 cm). Nitrogen is the sovereign factor that improves the synergism effect of chemical fertilizer and biochar during the humification process. According to the UV-Vis spectrum and optical index, soil WSOM originates from land and microorganisms. This study reveals the dynamics of WSOC in the 0-60 cm soil layer and the biogeochemical effect of BC fertilizer treatment on the agricultural soil ecosystem.

Pulse Wave Analysis Method of Cardiovascular Parameters Extraction for Health Monitoring.

OBJECTIVE: A pulse waveform is regarded as an information carrier of the cardiovascular system, which contains multiple interactive cardiovascular parameters reflecting physio-pathological states of bodies. Hence, multiple parameter analysis is increasingly meaningful to date but still cannot be easily achieved one by one due to the complex mapping between waveforms. This paper describes a new analysis method based on waveform recognition aimed for extracting multiple cardiovascular parameters to monitor public health. The objective of this new method is to deduce multiple cardiovascular parameters for a target pulse waveform based on waveform recognition to a most similar reference waveform in a given database or pattern library. METHODS: The first part of the methodology includes building the sub-pattern libraries and training classifier. This provides a trained classifier and the sub-pattern library with reference pulse waveforms and known parameters. The second part is waveform analysis. The target waveform will be classified and output a state category being used to select the corresponding sub-pattern library with the same state. This will reduce subsequent recognition scope and computation costs. The mainstay of this new analysis method is improved dynamic time warping (DTW). This improved DTW and K-Nearest Neighbors (KNN) were applied to recognize the most similar waveform in the pattern library. Hence, cardiovascular parameters can be assigned accordingly from the most similar waveform in the pattern library. RESULTS: Four hundred and thirty eight (438) randomly selected pulse waveforms were tested to verify the effectiveness of this method. The results show that the classification accuracy is 96.35%. Using statistical analysis to compare the target sample waveforms and the recognized reference ones from within the pattern library, most correlation coefficients are beyond 0.99. Each set of cardiovascular parameters was assessed using the Bland-Altman plot. The extracted cardiovascular parameters are in strong agreement with the original verifying the effectiveness of this new approach. CONCLUSION: This new method using waveform recognition shows promising results that can directly extract multiple cardiovascular parameters from waveforms with high accuracy. This new approach is efficient and effective and is very promising for future continuous monitoring of cardiovascular health.

Risk factors of preoperative myocardial injury in patients with gastrointestinal tumors.

BACKGROUND: Recent studies indicated that the prognosis of patients with gastrointestinal tumors is frequently influenced by its complications, notably myocardial injury. The main object is to investigate the occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor. METHODS: 1126 patients who received gastrointestinal tumor related surgery from May 2018 to June 2020 in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively collected and divided into the non-myocardial injury group and the myocardial injury group (high-sensitive cardiac troponin I (hs-cTnI) ≥ 0.028 ng/ml). The occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor are analyzed. The influence of myocardial injury on the ICU detention time in gastrointestinal tumor patients is also studied. RESULTS: In total, 78 (6.93%) patients developed myocardial injuries. Compared with patients in the non-myocardial injury group, patients in the myocardial injury group have a higher prevalence of cardiovascular risk factors (including advanced age and higher smoking ratio), a higher prevalence of comorbidities (such as previous coronary artery disease, hypertension, atrium fibrillation and diabetes), and a higher rate of premedication (such as anticoagulation, ß-blocker, Angiotensin-converting enzyme inhibitor/Angiotensin II receptor blocker, and diuretic) (all with P-value < 0.05). In addition, patients in the myocardial injury group also presented with a higher revised cardiac risk index (Lee index), higher neutrophil granulocyte ratio, lower hemoglobin, and higher likelihood of impaired cardiac structure and function (all with P-value < 0.05). There was a trend of statistical significance in the ICU detention time between the myocardial injury group and the non-myocardial injury group (1[1,3] vs. 2[1,10], P = 0.064). In this study, there were 7 patients presented with clinical symptoms in the myocardial injury group (chest discomfort in 4 cases, non-compressive precordial chest pain in 1 case, dyspnea in 2 cases). In the multivariate analysis, advanced age, increased Lee index score, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction (LVEF), increased interventricular septum were independent risk factors for myocardial injury. CONCLUSION: In conclusion, advanced age, increased Lee index, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction, and increased ventricular septum were independent risk factors for preoperative myocardial injury in patients with gastrointestinal tumors. The proportion of clinical symptoms in gastrointestinal tumor patients with myocardial injury was low, indicating the necessity to closely monitor the cardiac status of individuals with gastrointestinal tumors.

Field performance of sweet sorghum in salt-affected soils in China: A quantitative synthesis.

Sweet sorghum is a high-yield crop with strong resistance, which has the potential to support the development of the forage farming industry in China where vast salt-affected lands are potentially arable. Nutrient management is imperative for sweet sorghum growing on salt-affected lands. Although nitrogen (N) synthetic fertilizers have long been recognized as a key factor for increasing crop yields, their effects on sweet sorghum cultivation are under debate. Consequently, this study integrated the current available observations of yield (n = 255) and partial factor productivity of nitrogen (NPFP, n = 242) of sweet sorghum in salt-affected lands, which included both inland (n = 189) and coastal (n = 66) areas. We quantitatively analyzed the effects of climatic, soil properties and management measures on biomass yield and NPFP of sweet sorghum, comparing the differences between inland and coastal salt-affected lands. We found that average biomass yield and NPFP of sweet sorghum in coastal areas were 19,082.48 ± 8262.75 kg/ha and 107.29 ± 51.44 kg/kg respectively, both significantly lower than that in inland areas (p < 0.05). The N application rate did not have significant promoting effect on the biomass yield of sweet sorghum in inland salt-affected areas (p > 0.05), whereas in coastal salt-affected areas, N application significantly increased the biomass yield of sweet sorghum. Increasing soil organic matter content could promote NPFP in inland areas. The recommended N application rate for inland salt-affected and coastal salt-affected areas were 100 kg/ha and 150 kg/ha respectively. The results indicate that it is crucial to apply nutrient management measures based on the local climatic and soil conditions, since the causes of salinity differ in coastal and inland salt-affected lands. More systematic field studies are required in the future to optimize the management of water and nutrients for sweet sorghum planting in salt-affected lands.

Improving nitrogen contribution in maize post-tasseling using optimum management under mulch drip irrigation in the semiarid region of Northeast China.

Film-mulched drip irrigation has become an important strategy in maize cultivation in the semiarid region of Northeast China. Most farmers concentrate nitrogen (N) fertilizer use early in maize growth, which leads to low N use efficiency and large N losses. Therefore, a three-year (2018 to 2020) field experiment was conducted to determine the optimal N management strategy for maize under film mulch with drip irrigation in the semiarid region of Northeast China. The experiment included five treatments with the total amount of N fertilizer (210 kg N ha-1) applied in different proportions at sowing, sixth-leaf (V6), twelfth-leaf (V12), tasseling (VT), and blister (R2) stages of maize growth: N1, 100-0-0-0-0; N2, 50-50-0-0-0; N3, 30-50-20-0-0; N4, 20-30-30-20-0; and N5, 10-20-30-20-20. The control (CK) did not receive N fertilizer. Maize yield, N uptake and use, changes in soil inorganic N content, and N balance were investigated. Compared with the single basal application (N1), split-N applications (N2, N3, N4, N5) increased maize yield from 13.8% to 24.5% by increasing kernel number per ear and 1000-kernel weight and also improved N accumulation from VT to physiological maturity (PM) stages and its contribution to grain N uptake. In addition, compared with N1, split-N applications also decreased N losses by increasing inorganic N contents in the 0-40 cm soil layer and by decreasing N leaching in the 60-200 cm soil layer. Regression analysis demonstrated that N accumulation after the VT stage was positively related with maize yield. Among treatments, N4 had the highest yield, N recovery efficiency, agronomic efficiency, and partial factor productivity, with respective increases of 24.5%, 14.7 percentage point, 11.4 kg kg-1, and 11.4 kg kg-1 compared with those in N1. As a result, N losses were also reduced by 33.7% in N4 compared with those in N1. In conclusion, the split-N management strategy with four N applications under film-mulched drip irrigation has great potential to improve maize yield, increase N use efficiency, and reduce N loss in the semiarid region of Northeast China.

Application value of joint STOP-Bang questionnaire and Epworth Sleepiness Scale in screening for obstructive sleep apnea.

Objective: This paper evaluates the application value of the STOP-Bang questionnaire combined with the Epworth Sleepiness Scale (ESS) in screening for obstructive sleep apnea (OSA) in the population. Method: Thousand-six hundred seventy-one patients with suspected OSA who visited the Sleep Medicine Center of the First Affiliated Hospital of Guangzhou Medical University from August 2017 to August 2020 were monitored by overnight polysomnography (PSG) after completing the ESS scale and STOP-Bang questionnaire. The sensitivity, specificity, positive predictive value, negative predictive value and receiver operating characteristic (ROC) curves of the two scales were calculated, and the accuracy in predicting OSA of the STOP-Bang questionnaire combined with ESS was analyzed. Results: With Apnea Hypopnea Index (AHI) cutoffs of ≥5, ≥15 and ≥30 events/h, the areas under the ROC curve scored by STOP-Bang were 0.724, 0.703 and 0.712, and those of ESS were 0.632, 0.634 and 0.695; the diagnostic odds ratio (DOR) values of STOP-Bang for OSA, moderate to severe OSA, and severe OSA were 3.349, 2.651 and 3.189, and those of ESS were 2.665, 2.279 and 3.289. The STOP-Bang score of three was used as the cut-off point for OSA diagnosis with higher sensitivity and lower specificity, while ESS had higher specificity. STOP-Bang (≥3) combined with ESS significantly improved its specificity for predicting OSA. Conclusion: The STOP-Bang questionnaire is a simple and effective new tool for screening patients for OSA, while a STOP-Bang score of ≥3 combined with ESS can further improve its specificity. Thus, we suggest further screening with ESS after a STOP-Bang score of ≥3 in suspected patients.