Assessment of Nutritional Risk Scores (the Nutritional Risk Screening 2002 and Modified Nutrition Risk in Critically Ill Scores) as Predictors of Mortality in Critically Ill Patients on Extracorporeal Membrane Oxygenation.

Nutritional risk is associated with intensive care unit (ICU) stay and mortality, the Nutritional Risk Screening 2002 (NRS 2002) and the modified Nutritional Risk in the Critically Ill (mNUTRIC) score are assessment instruments and useful in predicting the risk regarding mortality in ICU patients. Our aim was to assess the effects of mNUTRIC and NRS 2002 on mortality in patients on extracorporeal membrane oxygenation (ECMO). A retrospective cohort study was performed and 78 patients were included for final analysis. In the current study, the NRS 2002 and the mNUTRIC score within 24 hours before starting ECMO were applied to assess patients' nutritional status on ECMO and explore the relationship between nutritional status and patient outcomes. This study suggests that both mNUTRIC and NRS 2002 scores were found to be significant independent risk and prognostic factors for in-hospital and 90 day morality among ECMO patients based on multivariable logistic regression analysis ( p < 0.05), with those in the high-risk group having higher in-hospital and 90 day mortality rates than those identified as being at low risk ( p < 0.001). In comparison to the NRS 2002 score, the mNUTRIC score demonstrated a superior prognostic ability in ECMO patients.

Research on the Relationship between Chinese Elderly Health Status, Social Security, and Depression.

(1) Background: To explore the relationship between health status, social security status, and the occurrence of depression in older adults and provide a basis for mental health care services for the elderly population; (2) Methods: This study used the 2018 China Health and Senior Care Tracking Survey (CHARLS) data to select 8383 older people aged over 60 years old as the research subjects. The two-category Logistic model was used to analyze the research problem; (3) Results: Older adults with depressive tendencies accounted for 34.1% of the total older adults. The incidence of depression among female older adults reached 41.51%. The risk of depression in the elderly population was 40.3% lower in males than in females (OR = 0.597, 95% CI: 0.539−0.662). Self-rated health status, physical disability, and receipt of pensions affected the incidence of depression in older adults (all p < 0.05); (4) Conclusions: Focus on and intervene in the mental status of elderly females and disabled elderly people. Provide mental and economic support and mental health care services to the elderly at the family and social levels. Promote the healthy development of the mental health of the elderly and promote active aging.

Influence of urban spatial and socioeconomic parameters on PM2.5 at subdistrict level: A land use regression study in Shenzhen, China.

The intraurban distribution of PM2.5 concentration is influenced by various spatial, socioeconomic, and meteorological parameters. This study investigated the influence of 37 parameters on monthly average PM2.5 concentration at the subdistrict level with Pearson correlation analysis and land-use regression (LUR) using data from a subdistrict-level air pollution monitoring network in Shenzhen, China. Performance of LUR models is evaluated with leave-one-out-cross-validation (LOOCV) and holdout cross-validation (holdout CV). Pearson correlation analysis revealed that Normalized Difference Built-up Index, artificial land fraction, land surface temperature, and point-of-interest (POI) numbers of factories and industrial parks are significantly positively correlated with monthly average PM2.5 concentrations, while Normalized Difference Vegetation Index and Green View Factor show significant negative correlations. For the sparse national stations, robust LUR modelling may rely on a priori assumptions in direction of influence during the predictor selection process. The month-by-month spatial regression shows that RF models for both national stations and all stations show significantly inflated mean values of R2 compared with cross-validation results. For MLR models, inflation of both R2 and R2CV was detected when using only national stations and may indicate the restricted ability to predict spatial distribution of PM2.5 levels. Inflated within-sample R2 also exist in the spatiotemporal LUR models developed with only national stations, although not as significant as spatial LUR models. Our results suggest that a denser subdistrict level air pollutant monitoring network may improve the accuracy and robustness in intraurban spatial/spatiotemporal prediction of PM2.5 concentrations.

Assessment of background ozone concentrations in China and implications for using region-specific volatile organic compounds emission abatement to mitigate air pollution.

Mitigation of ambient ozone (O3) pollution is a great challenge because it depends heavily on the background O3 which has been poorly evaluated in many regions, including in China. By establishing the relationship between O3 and air temperature near the surface, the mean background O3 mixing ratios in the clean and polluted seasons were determined to be 35-40 and 50-55 ppbv in China during 2013-2019, respectively. Simulations using the chemical transport model (i.e., the Weather Research and Forecasting coupled with Chemistry model, WRF/Chem) suggested that biogenic volatile organic compounds (VOC) emissions were the primary contributor to the increase in the background O3 in the polluted season (BOP) compared to the background O3 in the clean season (BOC), ranging from 8 ppbv to 16 ppbv. More importantly, the BOP continuously increased at a rate of 0.6-8.0 ppbv yr-1 during 2013-2019, while the non-BOP stopped increasing after 2017. Consequently, an additional 2%-16% reduction in anthropogenic VOC emissions is required to reverse the current O3 back to that measured in the period from 2013 to 2017. The results of this study emphasize the importance of the relative contribution of the background O3 to the observed total O3 concentration in the design of anthropogenic precursor emission control strategies for the attainment of O3 standards.

Volatile organic compound (VOC) emissions and health risk assessment in paint and coatings industry in the Yangtze River Delta, China.

Solvent use and paint consumption are significant source sectors of volatile organic compounds (VOCs) emissions in China. The occupational painters have high risk of health effect due to exposure to high VOCs concentration. However, the toxic components in coating environment have not been carefully identified, and the health risks of VOCs exposure have not been sufficiently assessed. This study collected air samples from nine workshops of three major coating sectors in the Yangtze River Delta of China, namely cargo container coating, ship equipment coating, and furniture coating, to evaluate the non-cancer and cancer risk of toxic VOCs exposure to occupational painters under a normal working condition. The results show that the container coating had highest cancer risk (2.29 × 10-6-5.53 × 10-6) exceeding the safe limit of 1.0 × 10-6, while non-cancer risk of all workshops was lower than acceptable level of 1. Ethylbenzene and 1,2-dichloropropane should be targeted for priority removal during the container coating process in attempt to reduce adverse health effect on the occupational painters. This study helps better understand the health risk of VOCs exposure in coating workshops in China and provides information for policy-makers to formulate possible control of specific toxic compounds during coating process.

Regional discrepancies in spatiotemporal variations and driving forces of open crop residue burning emissions in China.

As a major source of secondary organic aerosol, open crop residue burning (OCB) emits a large number of trace gases and particulates to the atmosphere. Extensive OCB is detected during harvest seasons in most regions of China. Emissions from OCB have been widely investigated in China, but few studies have focused on regional discrepancies in spatiotemporal variations with a long timescale. In this study, emissions from OCB in three typical regions of China, including Northeast China, Chengdu-Chongqing and Guangdong, from 2003 to 2016, were estimated using a combination of statistical data and the Moderate Resolution Imaging Spectroradiometer (MODIS) observations, and regional discrepancies in spatiotemporal variations and driving forces were analyzed in detail. The results showed that OCB emissions of CO and PM2.5 in 2016 were 3.63 × 106 and 6.96 × 105 tons in Northeast China, 9.77 × 105 and 1.36 × 105 tons in Chengdu-Chongqing, and 1.24 × 105 and 1.19 × 104 tons in Guangdong, respectively. The OCB emissions in Northeast China maintained an overall increasing trend, which were mainly dominated by rural economic development and agricultural modernization, with great potential for reduction. In Chengdu-Chongqing, emissions increased until 2013 and then decreased, due to the impact of policies prohibiting OCB. In Guangdong, emissions showed annual fluctuations with a slightly decreasing trend influenced by metrological conditions and related policies. The analysis of the driving forces behind the regional discrepancies among these typical regions indicated that OCB emissions in China were characterized by uneven rural economic development, control policies, and natural conditions, suggesting that region-dependent control measures are needed for reducing OCB emissions. This study provided a better understanding of OCB emission characteristics in the three typical regions and revealed the diversity of OCB emission characteristics in China.

Assessment of respiration-induced motion and its impact on treatment outcome for lung cancer.

This study presented the analysis of free-breathing lung tumor motion characteristics using GE 4DCT and Varian RPM systems. Tumor respiratory movement was found to be associated with GTV size, the superior-inferior tumor location in the lung, and the attachment degree to rigid structure (e.g., chest wall, vertebrae, or mediastinum), with tumor location being the most important factor among the other two. Improved outcomes in survival and local control of 43 lung cancer patients were also reported. Consideration of respiration-induced motion based on 4DCT for lung cancer yields individualized margin and more accurate and safe target coverage and thus can potentially improve treatment outcome.

Assessment of inheritance pattern and agronomic performance of transgenic rapeseed having harpin Xooc-encoding hrf2 gene.

hrf2 gene is a member of the harpin-encoding gene family of rice-pathogenic bacterium Xanthomonas oryzae pv. oryzicola. In our previous studies, we observed that harpin(Xooc) could elicit hypersensitive cell death in non-host plants, induce disease and insect resistance in plants, and enhance plant growth. In this study, the rapeseed cultivar, Yangyou 4, was genetically engineered via Agrobacterium-mediated transformation to express the hrf2 gene. Polymerase chain reaction (PCR) and southern blot analyses of T(1) generation of transgenic rapeseed revealed stable integration and expression of the inserted gene hrf2. In addition, the resistance to Sclerotinia sclerotiorum was greatly enhanced. A comparison between agronomic characters of transgenic and control lines displayed significant differences in terms of plant height, stem width, number of pods per plant, number of seeds per pod, 1,000-seed weight, and seed yield per plant. Among lines with resistance to S. sclerotiorum, T(1)1 had improved agronomic traits compared with controls with a 22.7% seed yield increase. These results suggest that the introduction of the hrf2 gene into rapeseed can be an effective strategy for enhancing resistance to S. sclerotiorum.

Quantitative assessment of enamel hypomineralization by KaVo DIAGNOdent at different sites on first permanent molars of children in China.

PURPOSE: The purpose of this study was to identify the most caries-susceptible site of pits and fissures on first permanent molars by quantitative evaluation of the mineralization in both caries-active and caries-free children, and to provide helpful information for cost-effective, targeted prevention. METHODS: Eighty-four caries-free and 85 caries-active children were selected from 800 6- to 7-year-old children with fully erupted first permanent molars. Hypomineralization of the central fossa (CF) and lingual pit (LP) of the maxillary or buccal pit (BP) of mandibular first permanent molars were evaluated by KaVo DIAGNOdent. Statistical analysis included grouped t test and single-factor variance analysis and paired comparison. RESULTS: CF of mandibular first permanent molars had significantly greater hypomineralization than other sites. The hypomineralization of the maxillary CF is more severe than that of LP. The extent of the hypomineralization of each site at the first permanent molar in caries-active children was significantly higher than that in caries-free children. CONCLUSIONS: Central fossae of first mandibular molars are the most hypomineralized sites in both caries-free and caries-active groups. The results suggest that preventive interventions should be targeted at the CF of mandibular molars with special concern given to the caries-active population.

Color Doppler ultrasonographic assessment of the risk of injury to major branch of the middle hepatic vein during laparoscopic cholecystectomy.

OBJECTIVE: To investigate the causes of hemorrhage from the gallbladder bed during laparoscopic cholecystectomy. METHODS: 617 patients who had received laparoscopic cholecystectomy from September, 2000 to March, 2001 at this hospital were reviewed retrospectively. Ninety-one of these patients were selected randomly for prospective observation. Color Doppler ultrasound was used to examine the cause of venous hemorrhage from the gallbladder bed during laparoscopic cholecystectomy and to examine the anatomic relationship between the gallbladder bed and the branches of the middle hepatic vein in 91 patients preoperatively. RESULTS: A large branch of the middle hepatic vein extended closely behind the gallbladder bed in all 91 patients. The mean distance between the closest point (C point) of this branch to the gallbladder bed was 5.0+/-4.6 mm. The branch of the middle hepatic vein was completely adherent to the gallbladder bed in 14 (15.38%) of the 91 patients. The distance between this branch and the gallbladder bed was within 1 mm in 10 (10.99%) of the 91 patients. The inside diameter at C point of this branch was 3.2+/-1.1 mm. The C point was found on the left side of the longitudinal axis of the gallbladder in 31 (34.66%) of the 91 patients, on the right side in 39 patients (42.86%), just on the axis in 21 patients (23.08%). The venous blood flow rate at the C point was 9.9+/-3.3 cm/s. CONCLUSIONS: A large branch of the middle hepatic vein passes behind the gallbladder. The inside diameter of this branch is relatively larger. The bleeding of this branch during operation can only be stopped by transfixion. The closest point of this vein to the gallbladder is mostly situated on the right side of the longitudinal axis of the gallbladder. Patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy and should be identified preoperatively with ultrasound.