Ecological risk assessment of heavy metals in tea plantation soil around Tai Lake region in Suzhou, China.

Tea plant [Camellia sinensis (L.) O. Kuntze] is one of the important foliar cash crops in China, and its root system absorbs heavy metal (HM) elements enriched in the soil and transports them to the over ground part. In order to ensure the safety of the soil ecological environment and tea raw materials in the tea production area, the HM contents of soil and tea plant leaves in Suzhou tea plantations were detected, the relationship between HMs and soil physicochemical properties was analyzed, and the ecological risk of HMs in tea plantation soils was evaluated by using relevant detection techniques and evaluation models. The results showed that the average pH of tea plantation soils around Tai Lake in Suzhou was within the range suitable for the growth of tea plants. The pH, soil organic matter, total nitrogen, available phosphorus and available potassium of tea plantation soil satisfying the requirements of high quality, high efficiency and high yield ('3H') tea plantation accounted for 47.06%, 26.47%, 8.82%, 79.41% and 67.65%, respectively. Site 2 fully met the requirements of '3H' tea plantation. In addition, the contents of cadmium (Cd) and mercury (Hg) were extremely variable, and the average contents exceeded the background value of soil in Jiangsu Province, but the HM contents of tea leaves all met the pollution-free standard, and the HM contents of tea leaves around Tai Lake in Suzhou were generally at a safe level. The composite ecological risk index ranged from 0.05 to 0.60, and 32 of the 34 sample sites (except site 21 and site 23) are the most suitable agricultural land for tea plantations.

Early assessment of acute kidney injury in severe acute pancreatitis with multimodal DWI: an animal model.

OBJECTIVES: To evaluate the feasibility of multimodal diffusion-weighted imaging (DWI) for detecting the occurrence and severity of acute kidney injury (AKI) caused by severe acute pancreatitis (SAP) in rats. METHODS: SAP was induced in thirty rats by the retrograde injection of 5.0% sodium taurocholate through the biliopancreatic duct. Six rats underwent MRI of the kidneys 24 h before and 2, 4, 6, and 8 h after this AKI model was generated. Conventional and functional MRI sequences were used, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DTI). The main DWI parameters and histological results were analyzed. RESULTS: The fast apparent diffusion coefficient (ADC) of the renal cortex was significantly reduced at 2 h, as was the fractional anisotropy (FA) value of the renal cortex on DTI. The mean kurtosis (MK) values for the renal cortex and medulla gradually increased after model generation. The renal histopathological score was negatively correlated with the medullary slow ADC, fast ADC, and perfusion scores for both the renal cortex and medulla, as were the ADC and FA values of the renal medulla in DTI, whereas the MK values of the cortex and medulla were positively correlated (r = 0.733, 0.812). Thus, the cortical fast ADC, medullary MK, FADTI, and slow ADC were optimal parameters for diagnosing AKI. Of these parameters, cortical fast ADC had the highest diagnostic efficacy (AUC = 0.950). CONCLUSIONS: The fast ADC of the renal cortex is the core indicator of early AKI, and the medullary MK value might serve as a sensitive biomarker for grading renal injury in SAP rats. CLINICAL RELEVANCE STATEMENT: The multimodal parameters of renal IVIM, DTI, and DKI are potential beneficial for the early diagnosis and severity grading of renal injury in SAP patients. KEY POINTS: • The multimodal parameters of renal DWI, including IVIM, DTI, and DKI, may be valuable for the noninvasive detection of early AKI and the severity grading of renal injury in SAP rats. • Cortical fast ADC, medullary MK, FA, and slow ADC are optimal parameters for early diagnosis of AKI, and cortical fast ADC has the highest diagnostic efficacy. • Medullary fast ADC, MK, and FA as well as cortical MK are useful for predicting the severity grade of AKI, and the renal medullary MK value exhibits the strongest correlation with pathological scores.

Laser triangulation measurement system with Scheimpflug calibration based on the Monte Carlo optimization strategy.

We propose a linear laser triangulation measurement system using Scheimpflug calibration based on the Monte Carlo optimization strategy. A Scheimpflug inclination camera calibration model is introduced in the measurement system for improving the image definition in small-range measurements with a large depth-of-field. To address the nonlinear optimization problem between the instrument resolution and measurement range, the Monte Carlo method is adopted to determine the optimal optical parameters (scattering angle, Scheimpflug angle, and focus length) in a practical measurement system. Furthermore, we experimentally constructed the measurement system to demonstrate the measurement precision by measuring a standard step block (measurement range 15 mm). The performance parameters of the maximum measurement error, maximum standard deviation, and linearity are obtained as ±7 µm, 0.225 µm, and 0.046%, respectively. Finally, the proposed measurement system based on the Monte Carlo optimization strategy is promising for high-precision measurements in industrial applications and provides guidance for optimizing the design parameters of ranging measurement sensors.

Cost-effectiveness analysis of BNT162b2 COVID-19 booster vaccination in the United States.

OBJECTIVES: To evaluate the cost-effectiveness of a booster strategy in the United States. METHODS: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of the Pfizer-BioNTech BNT162b2 (administered 6 months after the second dose) among older adults from a healthcare system perspective. RESULTS: Compared with 2 doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million in vaccination cost but save $6.7 million in direct medical cost and gain 3.7 quality-adjusted life-years in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that a booster strategy has a high chance (67%) of being cost-effective. Notably, the cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. If vaccine efficacies reduce by 10%, 30%, and 50%, this threshold will increase to 9.7/100,000, 13.9/100,000, and 21.9/100,000 person-day, respectively. CONCLUSION: Offering the BNT162b2 booster to older adults aged ≥65 years in the United States is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-CoV-2 transmission.

Association of residential greenness with geriatric depression among the elderly covered by long-term care insurance in Shanghai.

Residential greenness exposure has been linked to a number of physical and mental disorders. Nevertheless, evidence on the association between greenness and geriatric depression was limited and focused on developed countries. This study was aimed to investigate whether the relationship between residential greenness exposure and geriatric depression exists among the elderly with long-term care insurance (LTCI) in Shanghai, China. In 2018, a total of 1066 LTCI elderly from a cross-sectional survey completed a questionnaire in Shanghai. Residential greenness indicators, including normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were calculated from the Landsat 8 imagery data in different buffers (100-m, 300-m, and 500-m). Mediation analysis by perceived social support was conducted to explore potential mechanisms underlying the associations. In the fully adjusted model, one IQR increase of NDVI and SAVI in the 300-m buffer size was associated with an 11.9% (PR: 0.881, 95% CI: 0.795, 0.977) and 14.7% (PR: 0.853, 95% CI: 0.766, 0.949) lower prevalence of geriatric depression, respectively. Stronger association was observed in the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support significantly mediated 40.4% of the total effect for NDVI 300-m buffer and 40.3% for SAVI 300-m buffer to the greenness-depression association, respectively. Our results indicate the importance of residential greenness exposure to geriatric depression, especially for the elderly with lower education level, living in non-central area, and lower family monthly income. Perceived social support might mediate the association. Well-designed longitudinal studies are warranted to confirm our findings and investigate the underlying mechanisms.

Exploring the relationship between depression and different multimorbidity patterns among older people covered by long-term care insurance in Shanghai, China.

BACKGROUND: Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long-term care insurance in Shanghai, China. METHOD: This was a population-based cross-sectional study, with 1871 participants aged ≥60 years old who are covered by Shanghai long-term care insurance. Multimorbidity was defined as the presence of two or more chronic diseases at the same time. We collected information on chronic conditions using a self-reported medical history, and we used the 30-item Geriatric Depression Scale (GDS-30) to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms. RESULTS: Among the participants, the prevalence of multimorbidity was 64.7%, and the prevalence of depression was 64.6%. Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataracts showed strong associations with depression when co-occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio (AOR) 1.223; 95% confidence interval (CI) 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms. CONCLUSION: Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long-term care insurance.

Association between multimorbidity patterns and disability among older people covered by long-term care insurance in Shanghai, China.

BACKGROUND: Functional disability and multimorbidity are common among older people. However, little is known about the relationship between functional disability and different multimorbidity combinations. We aimed to identify multimorbidity patterns and explore the associations between these patterns and functional disability. METHODS: We investigated a multi-stage random sample of 1871 participants aged ≥60 years and covered by long-term care insurance in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases in an individual. Participants completed scales to assess basic and instrumental activities of daily living (BADL and IADL, respectively). Multimorbidity patterns were identified via exploratory factor analysis. Binary logistic regression models were used to determine adjusted associations between functional disability and number and patterns of multimorbidity. RESULTS: Multimorbidity was present in 74.3% of participants. The prevalence of BADL disability was 50.7% and that of IADL disability was 90.7%. There was a strong association between multimorbidity and disability. We identified three multimorbidity patterns: musculoskeletal, cardio-metabolic, and mental-degenerative diseases. The cardio-metabolic disease pattern was associated with both BADL (OR 1.28, 95%CI 1.16-1.41) and IADL (OR 1.41, 95%CI 1.19-1.68) disability. The mental-degenerative disease pattern was associated with BADL disability (OR 1.55, 95%CI 1.40-1.72). CONCLUSIONS: Multimorbidity and functional disability are highly prevalent among older people covered by long-term care insurance in Shanghai, and distinct multimorbidity patterns are differentially associated with functional disability. Appropriate long-term healthcare and prevention strategies for older people may help reduce multimorbidity, maintain functional ability, and improve health-related quality of life.

Local-Migrant Gaps in Healthcare Utilization Between Older Migrants and Local Residents in China.

BACKGROUND: Older migrants in China without local resident registration (hukou) are a vulnerable population and face barriers to receiving local healthcare. OBJECTIVES: We aimed to quantify the disparities in healthcare utilization between older migrants and local residents in Shanghai, China. DESIGN: This was a cross-sectional study. SETTING: The study was conducted in Shanghai, China, in 2016. PARTICIPANTS: Older adults (aged ≥60 years) were recruited based on a three-stage stratified cluster sampling method (2571 older locals and 1920 older migrants). MEASUREMENTS: We compared utilization of outpatient care, inpatient care, preventive care, emergency room (ER) admission, and dental care, as well as medication use between older migrants and local residents. The local-migrant gap was parsed into observed and unobserved components using the Blinder-Oaxaca decomposition method. RESULTS: Older migrants were less likely to utilize outpatient (odds ratio [OR] = 0.757; 95% confidence interval [CI] = 0.617-0.928), inpatient (OR = 0.642; 95% CI = 0.443-0.931), and preventive care (OR = 0.743; 95% CI = 0.643-0.858) and were more likely to use medication (OR = 1.254; 95% CI = 1.089-1.445) than local residents. Differences in ER admissions and dental care utilization were not significant in the regression analysis. The decomposition results indicated that 55% and 71% of the local-migrant gap in outpatient and preventive care utilization were attributable to individual characteristics, like health insurance. Unobserved components, including hukou-related factors and personal heterogeneous preferences, contributed 59% and 63% to utilization of inpatient care and medication use, respectively. CONCLUSION: We identified local-migrant gaps in healthcare utilization among older adults in China. Further research is needed into integration of the health insurance system, accessibility of public health welfare benefits, and reconstruction of social networks among older migrants. J Am Geriatr Soc 68:1560-1567, 2020.

Economic fabrication of a novel hybrid planar Grating/Fresnel lens for miniature spectrometers.

We propose a new technique to fabricate a highly specialized optical element, a hybrid planar Grating/Fresnel lens (G-Fresnel), which is particularly useful to improve or enable more-affordable miniature/portable spectrometers. Both the Fresnel and the grating surface are fabricated simultaneously by sandwiching soft PDMS between a hard grating and a pre-replicated negative Fresnel surface. Several adhesion reduction techniques are also investigated that help improve both fabrication and cost efficiency (by reducing the solidification time) as well as the lifetime of the mold. Alignment errors are systematically analyzed, and their effects on the G-Fresnel lens evaluated. A compact fabrication platform was built, which is smaller than a volume of 160☓140☓106 mm3 to fit into a conventional vacuum drying oven, for the fabrication of a G-Fresnel lens with a diameter of 25.4 mm, an equivalent focal length of 25 mm, and a blazed grating pattern with 600 lines/mm spacing. The solidification time was reduced to 2 hours thanks to the improved adhesion reduction technique that permits a PDMS drying-temperature as high as 65 °C. The fabricated G-Fresnel lens was evaluated with regard to both geometrical fabrication precision and optical performance. The measured results, using a step gauge and atomic force microscopy, confirm that this replication technique produces high-quality replicates of the master surface-profile. Furthermore, a prototype spectrometer that uses a G-Fresnel lens was built and evaluated. The spectrometer fits within a volume of about 100 mm☓50 mm☓30 mm, and it operates across a wide wavelength spectrum (450 nm to 650 nm). Both the calculation based on the optical software ZEMAX and the experimental measurements are consistent and confirm that the spectrometer with the G-Fresnel lens can provide a spectral resolution of better than 1.2nm.

Exposure assessment of lovastatin in Pu-erh tea.

This paper reports the results of an extensive survey on the levels of lovastatin in Pu-erh tea samples. The microbial source of lovastatin was assessed by testing the ability of fungi with higher isolation frequency in the Pu-erh tea samples to produce lovastatin on Czapek yeast extract agar (CYA). Lovastatin was not detected in any of the raw Pu-erh tea samples without storage but was found in almost all the ripe Pu-erh tea samples, with lovastatin contents ranging from 20.61 ng/gdw to 226.38 ng/gdw. After five years' storage, the lovastatin levels increased obviously in ripe Pu-erh tea samples and 55% of raw Pu-erh tea samples from 2007 were found to contain lovastatin with concentrations ranging between 28.41 ng/gdw and 228.61 ng/gdw. With increasing storage time, lovastatin concentration in ripe Pu-erh tea, and the occurrence and concentration of lovastatin for raw Pu-erh tea increased significantly. Three genera of fungi: Aspergillus, Penicillium and Trichoderma were often isolated from Pu-erh tea samples. A total of 40 strains from 3 fungal genera were selected to test their ability to produce lovastatin. Only 6 strains, Aspergillus tubingensis, Aspergillus wentii, Aspergillus fumigatus, Penicillium chrysogenum, Trichoderma asperellum and Trichoderma citrinoviride, were able to produce lovastatin reaching concentrations of 9.59 ± 0.42 ng/g CYA, 2.33 ± 0.21 ng/g CYA, 2.77 ± 0.13 ng/g CYA, 3.36 ± 0.69 ng/g CYA, 4.8 ± 0.17 ng/g CYA, and 1.47 ± 0.36 ng/g CYA respectively in Czapek yeast extract agar.