Cardiovascular disease risk assessment and multidisciplinary care in prostate cancer treatment with ADT: recommendations from the APMA PCCV expert network.

PURPOSE: Androgen deprivation therapy (ADT) is the mainstay approach for prostate cancer (PCa) management. However, the most commonly used ADT modality, gonadotropin-releasing hormone (GnRH) agonists, has been associated with an increased risk of cardiovascular disease (CVD). METHODS: The PCa Cardiovascular (PCCV) Expert Network, consisting of multinational urologists, cardiologists and oncologists with expertise in managing PCa, convened to discuss challenges to routine cardiovascular risk assessment in PCa management, as well as how to mitigate such risks in the current treatment landscape. RESULTS: The experts identified several barriers, including lack of awareness, time constraints, challenges in implementing risk assessment tools and difficulties in establishing multidisciplinary teams that include cardiologists. The experts subsequently provided practical recommendations to improve cardio-oncology care for patients with PCa receiving ADT, such as simplifying cardiovascular risk assessment, individualising treatment based on CVD risk categories, establishing multidisciplinary teams and referral networks and fostering active patient engagement. A streamlined cardiovascular risk-stratification tool and a referral/management guide were developed for seamless integration into urologists' practices and presented herein. The PCCV Expert Network agreed that currently available evidence indicates that GnRH antagonists are associated with a lower risk of CVD than that of GnRH agonists and that GnRH antagonists are preferred for patients with PCa and a high CVD risk. CONCLUSION: In summary, this article provides insights and guidance to improve management for patients with PCa undergoing ADT.

A port statistics-based generic ballast water estimation and risk assessment approach and its application to Chinese ports.

The Ballast Water Management Convention now enters the experience-building stage, but developing countries have no adequate ballast water information yet. Against this background, considering the richness and generality of common port statistics, we develop a new generic approach to estimate discharge volumes and assess associated risks. This is one of the few efficient and feasible ways for port authorities to manage real discharged ballast water. Discharge volumes during 2017-2020 and risks in 2017 are analyzed for bulker and tanker. Results show that: (1) Ports in Yangtze River Delta and Bohai Rim received most ballast water, especially Ningbo-Zhoushan port as high-risk region receiving about 65 million tons per year; (2) With a higher ratio of discharge volumes to cargo throughputs, the tanker tends to release more ballast water than the bulker; (3) Chinese ports suffer more than 0.9 of the probability of non-indigenous species introduction. All these findings help implement convention globally.

Safety assessment of organic micropollutants in reclaimed water: Chemical analyses, ecological risk assessments, and in vivo endocrine-disrupting studies.

Reclaimed water from municipal wastewater has great potential in mitigating the water resource crisis, while the inevitable residue of organic micropollutants (OMPs) challenges the safety of reclaimed water reuse. Limited information was available regarding the overall adverse effects of mixed OMPs in reclaimed water, especially the endocrine-disrupting effects on living organisms. Herein, chemical monitoring in two municipal wastewater treatment plants showed that 31 of 32 candidate OMPs including polycyclic aromatic hydrocarbons (PAHs), phenols, pharmaceuticals and personal care products (PPCPs) were detected in reclaimed water, with a concentration ranging from ng/L to µg/L. Then, based on the risk quotient value, phenol, bisphenol A, tetracycline, and carbamazepine were ranked as high ecological risks. Most PAHs and PPCPs were quantified as medium and low risks, respectively. More importantly, using aquatic vertebrate zebrafish as an in vivo model, the endocrine-disrupting potentials of OMP mixtures were comprehensively characterized. We found that a realistic exposure to reclaimed water induced estrogen-like endocrine disruption and hyperthyroidism in zebrafish, abnormal expression of genes along the hypothalamus-pituitary-thyroid (-gonad) axes, reproductive impairment, and transgenerational toxicity. Based on the chemical analyses, risk quotient calculations, and biotoxicity characterization, this study contributed to understanding the ecological risks of reclaimed water and developing the control standards for OMPs. In addition, application of the zebrafish model in this study also highlighted the significance of in vivo biotoxicity test in water quality evaluation.

ACP-GBDT: An improved anticancer peptide identification method with gradient boosting decision tree.

Cancer is one of the most dangerous diseases in the world, killing millions of people every year. Drugs composed of anticancer peptides have been used to treat cancer with low side effects in recent years. Therefore, identifying anticancer peptides has become a focus of research. In this study, an improved anticancer peptide predictor named ACP-GBDT, based on gradient boosting decision tree (GBDT) and sequence information, is proposed. To encode the peptide sequences included in the anticancer peptide dataset, ACP-GBDT uses a merged-feature composed of AAIndex and SVMProt-188D. A GBDT is adopted to train the prediction model in ACP-GBDT. Independent testing and ten-fold cross-validation show that ACP-GBDT can effectively distinguish anticancer peptides from non-anticancer ones. The comparison results of the benchmark dataset show that ACP-GBDT is simpler and more effective than other existing anticancer peptide prediction methods.

Assessment of hepatic fat content and prediction of myocardial fibrosis in athletes by using proton density fat fraction sequence.

PURPOSE: To explore the characteristics of the hepatic fat content in athletes, and predict late gadolinium enhancement (LGE) based on magnetic resonance imaging-proton density fat fraction (MRI-PDFF). MATERIAL AND METHODS: From March 2020 to March 2021, 233 amateur athletes and 42 healthy sedentary controls were prospectively recruited. The liver fat content of four regions of interest (ROIs 1-4), the mean liver fat fraction (FF), cardiac function, and myocardium LGE were recorded, respectively. The values of ROIs 1-4 and FF were compared between athletes and controls. According to the liver fat content threshold for distinguishing athletes and controls, the cutoff total exercise time that induced a change in liver fat was obtained. The correlations among the liver fat content, cardiac function, and other parameters were analyzed. Moreover, the liver fat content was used to predict myocardium LGE by logistic regression. RESULTS: There were significant differences for the values of ROI 1, ROI 3, ROI 4, and FF between athletes and controls (allp< 0.05). The cutoff total exercise time for inducing a change in the liver fat content was 1680 h (area under the curve [AUC] = 0.593, specificity = 83.3,p< 0.05). Blood indexes, cardiac function, and basic clinical parameters were related to liver fat content (allp< 0.05). The prediction model for LGE had an AUC value of 0.829 for the receiver operator characteristic curve. CONCLUSION: MRI-PDFF could assess liver fat content and predict cardiac fibrosis in athletes for risk stratification and follow-up.

Microseismic Dynamic Response and Multi-Source Warning during Rockburst Monitoring Based on Weight Decision Analysis.

To prevent rockburst disasters and improve the accuracy of warnings for rockburst, based on the microseismic data of the 1366 working face of Hengda Coal Mine collected by the microseismic monitoring system, Fourier transform, wavelet packet transform, and Hilbert-Huang transform analysis methods are used for time-frequency domain joint analysis. The time-frequency differences of the main frequency, amplitude, frequency band percentage, and instantaneous energy of the high-energy microseismic event and the events before high-energy microseismic event are obtained. The analysis shows that the high-energy event has obvious low frequency characteristics, and when the high-energy event occurs, the instantaneous energy shows an obvious "inverted V" trend. At the same time, it is found that the acoustoelectric indexes show a trend of "rising" or "inverted V" when the high-energy event occurs. On this basis, the unascertained measure comprehensive evaluation model of rock burst hazard is established by analytic hierarchy process (AHP). Based on the analysis of microseismic data and the acoustoelectric index of the 1366 working face in Hengda coal mine, it is of great significance to determine the warning indicators for rockburst, improve the accuracy of uncertainty quantitative analysis for rockburst, and improve the discrimination accuracy of rockburst risk.

Progress on the Integrity Protection in the Natural World Heritage Site and Agroforestry Development in the Buffer Zone: An Implications for the World Heritage Karst.

In the face of increasing development pressure, how to fulfill the obligations under the World Cultural and Natural Heritage Convention and maintain the integrity of the Natural World Heritage Site (NWHS) is a major problem to be solved at present. Agroforestry (AF) development in the buffer zone maintains the integrity of NWHS and promotes sustainable ecological and economic development in the buffer zone. Still, few studies on the knowledge system of integrity protection of NWHS and AF development in the buffer zone research have been conducted. To fill this gap, this study conducts a systematic literature review based on 128 related articles retrieved from the Web of Science (WoS) database and the China National Knowledge Infrastructure (CNKI) database. Firstly, quantitative studies were conducted to analyze the annual numbers, content and study regions of the published literature. Secondly, the main research progress and achievements of integrity protection of WNHS and AF development in the buffer zone are classified and summarized. On this basis, this paper proposed key scientific issues that remain to be addressed in future, as well as exploring the implications for the World Heritage (WH) karst. This study is a scientific reference for the balanced development of NWHS integrity protection and AF in the buffer zone.

Dietary Patterns and Nutrient Intake in University Students of Macao: A Cross-Sectional Study.

BACKGROUND: Nutritional status affects the health of the public and is one of the key factors influencing social-economic development. To date, little research on the nutritional status of the Macao university student population has been conducted. OBJECTIVES: To identify and evaluate the dietary pattern and the nutritional intake among Macao university students. METHODS: The Macao students were selected by the stratified cluster random sampling method. A semi-quantitative food frequency questionnaire was used to investigate food consumption. Data were analyzed through a t-test and factor analysis by using SPSS Version 24.0. RESULTS: A total of 1230 questionnaires were distributed. From the respondents, 1067 (86.7%) were valid. In general, we identified three major dietary patterns in this population: (1) fruit and vegetable dietary pattern, characterized by abundant consumption of fruits and vegetables; (2) grain and high fat dietary pattern, characterized as high intakes of grains and animal foods; (3) high sugar dietary pattern, characterized by a large quantity of daily sugary drinks. The average daily intake of vitamin A, thiamine, calcium, and iodine were significantly lower than the Chinese Recommended Nutrient Intake (RNI) in the subjects. Conclusions: The dietary pattern of Macao students is similar to that of other Asians. Surprisingly, the daily intake of vitamin A, thiamine, calcium, and iodine by Macao university students is significantly lower than the Chinese RNI.

Impact of population agglomeration in big cities on carbon emissions.

The study explored the influencing mechanism of population agglomeration in large cities on carbon emissions, including technological innovation, industrial structure, and transportation effects. Moreover, we attempt to explore the nonlinear impact of population agglomeration in large cities on carbon emissions. We used the panel data of 207 big cities with a permanent resident population of more than 1 million to study the relationship between population agglomeration and carbon emissions. We found that population agglomeration to big cities increased urban carbon emissions significantly. The results of the mechanism analysis showed that population agglomeration to big cities raised carbon emissions by the channel of industrial structure and transportation effects. The channel of technological innovation effect decreased carbon emissions but did not offset the growth of carbon emissions caused by industrial structure and transportation effects. Nonlinear estimation findings demonstrated that the impact of population agglomeration on carbon emissions was different in big cities with varying levels of population.

Assessment of carbonaceous aerosols in suburban Nanjing under air pollution control measures: Insights from long-term measurements.

The concentrations of organic carbon (OC) and elemental carbon (EC) in fine particulate matter (PM2.5) were analyzed using a semicontinuous carbon analyzer to characterize their carbonaceous components at the Nanjing University site from August 2013 to December 2018. OC was divided by the minimum R squared (MRS) method into primary organic carbon (POC) and secondary organic carbon (SOC). The results showed that annual mean POC and EC concentrations declined from 10.00 to 3.62 µg m-3 and from 6.73 to 3.40 µg m-3, respectively, during 2013-2018. The apparent reduction in POC and EC concentrations indicated that the implementation of air pollution control measures helped reduce carbonaceous aerosol pollution. Higher concentrations of POC and EC were recorded during the cold season and lower in the warm season. The annual mean SOC concentrations varied between 4.35 and 3.18 µg m-3 from 2013 to 2018. Elevated SOC was observed during the warm season, most likely attributable to the enhanced photochemical activity at high temperatures. Regarding the diurnal variation, the high concentrations of POC and EC were observed at night and in the morning due to stronger primary emissions and accumulations of pollutants with low boundary-layer heights, while the peak of SOC was observed at approximately noon due to the increases in photochemical activity. Nonparametric wind regression analysis showed the higher concentrations of POC, SOC and EC in the northwesterly, southwesterly to southeasterly, and southwesterly winds with high speeds. Concentration-weighted trajectory (CWT) analysis suggests that the areas with potentially high contributions to POC and EC changed from the north to the western areas of China, and that northern China played an increasingly important role in the SOC concentration of Nanjing. These results demonstrate that controlling emissions from the western and the northern areas in China may further alleviate carbonaceous aerosol pollution in Nanjing.

Improved Monitoring and Assessment of Meteorological Drought Based on Multi-Source Fused Precipitation Data.

Meteorological drought, one of the most frequent climate-related disasters, causes great danger for human health and socioeconomic development. With an aim to improve the accuracy of meteorological drought monitoring, this study collected multi-source remotely-sensed precipitation products, i.e., the Tropical Rainfall Measuring Mission (TRMM), the Global Precipitation Measurement Mission (GPM), and Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS), and compared their performance over Hubei Province, China. The geographic difference analysis was used to blend the best-fitted product with gauged precipitation data. Based on the fused dataset with verification, the spatio-temporal characteristics of drought were investigated. Results showed that GPM performed the best in precipitation numerical evaluation and event detection with a 5 mm/d threshold. The fused data accurately captured 80% of historical drought events and indicated that extreme annual droughts mainly occurred in the northern and northwestern regions, while slight, moderate, and severe droughts mainly occurred in the central and eastern parts. The short-term drought exhibited the highest frequency of 33% in summer and the lowest frequency of 27% in spring, while the medium-term drought showed a higher frequency in autumn and winter. This could be a preliminary assessment of drought based on multi-source fused precipitation data for precise drought outlook and risk management.

Assessment of genotoxic chemicals using chemogenomic profiling based on gene-knockout library in Saccharomyces cerevisiae.

Understanding the adverse effects of genotoxic chemicals and identifying them effectively from non-genotoxic chemicals are of great worldwide concerns. Here, Saccharomyces cerevisiae (yeast) genome-wide single-gene knockout screening approach was conducted to assess two genotoxic chemicals (4-nitroquinoline-1-oxide (4-NQO) and formaldehyde (FA)) and environmental pollutant dichloroacetic acid (DCA, genotoxicity is controversial). DNA repair was significant enriched in the gene ontology (GO) biology process (BP) terms and KEGG pathways when exposed to low concentrations of 4-NQO and FA. Higher concentrations of 4-NQO and FA influenced some RNA metabolic and biosynthesis pathways. Moreover, replication and repair associated pathways were top ranked KEGG pathways with high fold-change for low concentrations of 4-NQO and FA. The similar gene profiles perturbed by DCA with three test concentrations identified, the common GO BP terms associated with aromatic amino acid family biosynthetic process and ubiquitin-dependent protein catabolic process via the multivesicular body sorting pathway. DCA has no obvious genotoxicity as there was no enriched DNA damage and repair pathways and fold-change of replication and repair KEGG pathways were very low. Five genes (RAD18, RAD59, MUS81, MMS4, and BEM4) could serve as candidate genes for genotoxic chemicals. Overall, the yeast functional genomic profiling showed great performance for assessing the signatures and potential molecular mechanisms of genotoxic chemicals.

Uneven development of the lead industry leads to regional differences in blood lead levels of children.

Children's exposure to lead is a global health problem, especially in low- and middle-income countries. However, research on the relationship between children's blood lead levels (BLLs) and the development of the lead industry is still limited. This study examined whether children's BLLs were associated with the development of lead industry in different regions. Using survey data on the BLLs of children living in 250 prefectures in China with corresponding data on their economic factors and lead industries, we explored the regional variation of children's BLLs using statistical methods. The results show that the level of economic development in leaded areas was associated with inequity in children's BLLs and met the environmental Kuznets hypothesis. In areas without lead industries, there was little correlation between the level of economic development and the BLLs of children and thus the environmental Kuznets hypothesis was not supported. Lead mines, lead smelting and chemical companies are major sources of blood lead in children living in leaded areas. This study demonstrated the success of control policies for lead-acid battery manufacturers in promoting the prevention and control of childhood lead poisoning in China. China should consciously support the improvement of children's BLLs in undeveloped areas with lead industries through national financing and policies to avoid the continuous effects of the regional inequality problem of high children's BLLs.

[Inpatient Care Expenditure of Terminally Ill Patients in the Geriatric Ward of Peking Union Medical College Hospital].

Objective To describe the inpatient care expenditure of the terminally ill patients in the geriatric ward of Peking Union Medical College Hospital and facilitate future research on the economic outcomes of hospice and palliative care.Methods The histories of patients admitted to the Department of Geriatrics of Peking Union Medical College Hospital during 2018 were reviewed by trained doctors.According to the diagnosis and overall health state,terminally ill patients were selected and enrolled in the study.Demographics,health and disease information,prescriptions,and expenditure details were retrieved from the HIS system.Results In 2018,35 patients were terminally ill and eligible for hospice care,including 20 males and 15 females,with the average age of(78±8)years(59-91 years),the average age-adjusted Charlson Comorbidity Index of 10±3,and the median Barthel index of 40(10,70).These patients had malignant tumor(23 cases),heart failure(4 cases),end-stage renal disease(1 case),end-stage liver disease(2 cases),dementia(4 cases)and other severe diseases(3 cases).The patients received standard care within the scope of internal medicine and geriatrics.Finally,8 patients died during hospitalization,and 27 were discharged alive.The 35 patients had the median length of stay of 15(12,23)days,the median inpatient expenditure of CNY 21 500(13 800,37 600),and the median daily expenditure of CNY 1425(970,2503).The percentage of expenditure was(28.5±12.3)% for medication,(33.2±18.0)% for tests and examinations,and 11.5%(6.4%,15.8%)for accommodation and medical services.The medications for symptom control costed CNY(77±58)per day on average,accounting for(5.2±3.5)% of the total expenditure.Conclusions The inpatient expenditure for terminally ill patients in the tertiary grade A hospital was higher than that reported in community hospitals providing hospice care.In terms of expenditure constitution,the money spent on medications and tests/examinations were similar,and the percentage of expenditure on medications for symptom control was low.There is a need for further research on the economic impact of hospice and palliative care among terminally ill patients in China.

Ecotoxicity assessment of a molybdenum mining effluent using acute lethal, oxidative stress, and osmoregulatory endpoints in zebrafish (Danio rerio).

The present study investigated the ecotoxicity of raw mining effluent from the largest molybdenum (Mo) open-pit mine in the Qinling mountains, China, and the treated effluent with neutralization and coagulation/adsorption processes, using zebrafish (Danio rerio). The results showed the following: (1) the mining effluent is acid mine drainage (AMD) and is highly toxic to zebrafish with a 96-h median lethal concentration (LC50) of 3.80% (volume percentage) of the raw effluent; (2) sublethal concentrations of the raw effluent (1/50, 1/10, and 1/2 96-h LC50) induced oxidative stress and osmoregulatory impairment, as reflected by the alterations in activities of superoxide dismutase and catalase and contents of malondialdehyde, and inhibition of Na+, K+-ATPase activity in gills and muscle after 28 days of sub-chronic exposure when compared with the unexposed group; and (3) the treatment of the raw effluent with neutralizer (NaOH) and adsorbent activated carbon reduced the acute lethal effect of raw effluent. The used endpoints including acute lethal and biochemical parameters related to oxidative stress and osmoregulatory impairment in zebrafish are cost-effective for toxicity assessment of AMD like the studied Mo mining effluent. Mining effluent management strategies extended by these results, i.e., the restriction of discharging raw and diluted effluent to adjacent waterways and the introduction of bio-monitoring system across all mining drainages in this area, were also proposed and discussed.

Assessment of cardiac tumors by 18F-FDG PET/CT imaging: Histological correlation and clinical outcomes.

BACKGROUND: To evaluate the diagnostic value of 18F-FDG PET/CT in distinguishing benign versus malignant cardiac tumors as well as to assess its prognostic value. METHODS: We analyzed 38 patients with cardiac tumors who underwent 18F-FDG PET/CT and followed for median 8.5 ± 12.5 months. SUVmax and TBRmax (maximum tumor-to-background ratio) by receiver-operating characteristic (ROC) curve analysis were used to obtain threshold for the diagnosis of malignancy as defined by histology (n = 38). Survival was assessed and correlated with the dignity of the lesions and PET parameters. RESULTS: Optimal cut-off values indicating malignancy were as follows: SUVmax = 3.44, with 100% sensitivity and 92.9% specificity, and TBRmax = 1.55, with 95.8% sensitivity and 92.9% specificity. A significant difference of 18F-FDG uptake was observed between primary benign (n = 14, SUVmax = 2.35 ± 1.31, TBRmax = 1.05 ± 0.50) compared to primary malignant cardiac tumors (n = 11, SUVmax = 8.90 ± 4.23, TBRmax = 3.82 ± 1.44) as well as cardiac metastases and lymphoma (n = 13, SUVmax = 14.37 ± 8.05, TBRmax = 6.19 ±  3.38) (all P < .001). Survival rate was significantly lower in patients with malignant as compared to benign cardiac tumors (P < .05). Regression analysis revealed that the lesion dignity determined by the cut-off value of SUVmax was an independent predictor for death in patients with cardiac tumors (P < .05). CONCLUSION: 18F-FDG uptake in cardiac tumors can differentiate between benign and malignant cardiac tumors and predicts survival.

Dynamic assessment of the central vein throughout the cardiac cycle in adults with no right heart disease by cardiac CT.

PURPOSE: The aim of this study was to investigate the effect of the cardiac cycle on the vena cava and determine the phase of measuring maximum diameters. METHODS: A total of 152 patients who underwent cardiac computed tomography (CT) were included. Patients' basic information was collected. The major axis, minor axis, and cross-sectional area (CSA) of the vena cava in 10 phases reconstructed at 10% step from 5% to 95% R-R interval were measured in four planes (SVC1 layer: the bifurcation of the pulmonary artery; SVC2 layer: the superior vena cava (SVC) into the right atrium; IVC1 layer: the intersection of the inferior vena cava (IVC) and the right atrium; IVC2 layer: the IVC into the anterior hepatic plane). The difference in vena cava diameters between cardiac cycles was determined using the linear mixed model. RESULTS: The variations in diameter and CSA of the SVC in cardiac cycles were statistically significant (p < 0.05), while those of the suprahepatic IVC were not. In the SVC1 layer, the maximum value of the SVC major and minor axes was observed in 85% and 45% phases, respectively, while that in the SVC2 layer was observed in 45% phases. The maximum SVC diameters in the SVC1 and SVC2 layers were 19.48 ± 2.57 mm and 17.43 ± 3.09 mm, respectively. The SVC and IVC diameters and CSA were positively correlated with the body surface area in the linear mixed model. CONCLUSION: The maximum SVC diameter and CSA were mostly observed in 45% phase, which provides a reference for selecting the best phase to measure the abnormality of vena cava diameter in the future.

Assessment of Hypokalemia and Clinical Characteristics in Patients With Coronavirus Disease 2019 in Wenzhou, China.

Importance: Severe acute respiratory syndrome coronavirus 2 has caused a global outbreak of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 binds angiotensin-converting enzyme 2 of the rennin-angiotensin system, resulting in hypokalemia. Objective: To investigate the prevalence, causes, and clinical implications of hypokalemia, including its possible association with treatment outcomes, among patients with COVID-19. Design, Setting, and Participants: This cohort study was conducted at Wenzhou Central Hospital and Sixth People's Hospital of Wenzhou, Wenzhou, China, from January 11, 2020, to February 15, 2020. Participants included patients who received a diagnosis of COVID-19 according to the criteria issued by the Chinese Health Bureau and were admitted to the hospital. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L). The clinical features, therapy, and outcomes were compared between the 3 groups. Data analysis was conducted in March 2020. Interventions: The patients were given general support and antiviral therapy. Their epidemiological and clinical features were collected. Main Outcomes and Measures: The prevalence of hypokalemia and response to treatment with potassium supplements were measured by analyzing plasma and urine potassium levels. Results: One hundred seventy-five patients (87 female patients [50%]; mean [SD] age, 45 [14] years) were classified as having severe hypokalemia (31 patients [18%]), hypokalemia (64 patients [37%]), and normokalemia (80 patients [46%]). Patients with severe hypokalemia had statistically significantly higher body temperature (mean [SD], 37.6 °C [0.9 °C]) than the patients with hypokalemia (mean [SD], 37.2 °C [0.7 °C]; difference, 0.4 °C; 95% CI, 0.2-0.6 °C; P = .02) and the patients with normokalemia (mean [SD], 37.1 °C [0.8 °C]; difference, 0.5 °C; 95% CI, 0.3-0.7 °C; P = .005). Patients with higher levels of hypokalemia also had higher creatine kinase levels (severe hypokalemia, mean [SD], 200 [257] U/L [median, 113 U/L; interquartile range {IQR}, 61-242 U/L]; hypokalemia, mean [SD], 97 [85] U/L; and normokalemia, mean [SD], 82 [57] U/L), higher creatine kinase-MB fraction (severe hypokalemia, mean [SD], 32 [39] U/L [median, 14 U/L; IQR, 11-36 U/L]; hypokalemia, mean [SD], 18 [15] U/L; and normokalemia, mean [SD], 15 [8] U/L), higher lactate dehydrogenase levels (mean [SD], severe hypokalemia, 256 [88] U/L; hypokalemia, 212 [59] U/L; and normokalemia, 199 [61] U/L), and higher C-reactive protein levels (severe hypokalemia, mean [SD], 29 [23] mg/L; hypokalemia, mean [SD], 18 [20] mg/L [median, 12, mg/L; IQR, 4-25 mg/L]; and normokalemia, mean [SD], 15 [18] mg/L [median, 6 U/L; IQR, 3-17 U/L]). Of 40 severely and critically ill patients, 34 (85%) had hypokalemia. Patients with severe hypokalemia were given potassium at a dose of 40 mEq per day, for a total mean (SD) of 453 (53) mEq potassium chloride, during the hospital stay. The patients responded well to potassium supplements as they recovered. Conclusions and Relevance: The correction of hypokalemia is challenging because of continuous renal potassium loss resulting from the degradation of angiotensin-converting enzyme 2. The high prevalence of hypokalemia among patients with COVID-19 suggests the presence of disordered rennin-angiotensin system activity, which increases as a result of reduced counteractivity of angiotensin-converting enzyme 2, which is bound by severe acute respiratory syndrome coronavirus 2.

In vivo assessment of inflammation in carotid atherosclerosis by noninvasive photoacoustic imaging.

Objectives: The objective of this study was to demonstrate the feasibility of using noninvasive photoacoustic imaging technology along with novel semiconducting polymer nanoparticles for in vivo identifying inflammatory components in carotid atherosclerosis and assessing the severity of inflammation using mouse models. Methods and Results: Healthy carotid arteries and atherosclerotic carotid arteries were imaged in vivo by the noninvasive photoacoustic imaging system. Molecular probes PBD-CD36 were used to label the inflammatory cells to show the inflammation information by photoacoustic imaging. In in vivo imaging experiments, we observed the maximum photoacoustic signal enhancement of 4.3, 5.2, 8 and 16.3 times between 24 h post probe injection and that before probe injection in four carotid arteries belonging to three atherosclerotic mice models. In the corresponding carotid arteries stained with CD36, the ratio of 0.043, 0.061, 0.082 and 0.113 was found between CD36 positive (CD36(+)) expression area and intima-media area (P < 0.05). For the CD36(+) expression less than 0.008 in eight arteries, no photoacoustic signal enhancement was found due to the limited system sensitivity. The photoacoustic signal reflects CD36(+) expression in plaques, which shows the feasibility of using photoacoustic imaging for in vivo assessment of carotid atherosclerosis. Conclusion: This research demonstrates a semiconducting polymer nanoparticle along with photoacoustic technology for noninvasive imaging and assessment of inflammation of carotid atherosclerotic plaques in vivo.

Static resource allocation of advanced reservation requests in elastic optical networks.

Considering the flexibility characteristic of advanced reservation (AR) requests, the problem of static routing, modulation, spectrum, and time assignment (RMSTA) of AR requests in elastic optical networks is studied in this paper, in order to deploy the spectrum resource economically and enable more requests to be served. The multi-objective integer linear program (ILP) model, which can minimize the maximum utilized frequency and time slot indices as well as find a trade-off between them, is used to formulate the RMSTA problem. Then the proportion optimal RMSTA (PO-RMSTA) heuristic algorithm with three sorting strategies is proposed to get the sub-optimal solutions. The PO-RMSTA algorithm and sorting strategies, ascending order of elastic time (AET), descending order of data volume (DDV), and ascending order of alternative schemes (AAS), are simulated in our work and proved to obtain the approximate optimal solutions. The sorting policy AET achieved the best performance when minimizing the maximum utilized frequency slot index, whereas the sorting policy DDV worked best when minimizing the maximum utilized time slot index. As for the compromise between two indices, both AET and AAS provided satisfying results.