Microecological health assessment of water environment and sediment based on metagenomics: a case study of Guixi River in Chongqing, China.

River sediment is vital in containing water pollution and strengthening water remediation. This paper has conducted a study on the microecological health assessment of the sediment and water body of Guixi River in Dianjiang, Chongqing, China, using metagenomics sequencing and microbial biological integrity index (M-IBI) technology. The analysis of physical and chemical characteristics shows that the concentration of TN varies from 2.62 to 9.76 mg/L in each sampling section, and the eutrophication of the water body is relatively severe. The proportion of Cyanobacteria in the sampling section at the sink entrance is higher than that of other sites, where there are outbreaks of water blooms and potential hazards to human health. The dominant functions of each site include carbon metabolism, TCA cycle, and pyruvate metabolism. In addition, the main virulence factors and antibiotic resistance genes in sediment are Type IV pili (VF0082), LOS (CVF494), MymA operon (CVF649), and macrolide resistance genes macB, tetracyclic tetA (58), and novA. Correlation analysis of environmental factors and microorganisms was also performed, and it was discovered that Thiothrix and Acidovorax had obvious gene expression in the nitrogen metabolism pathway, and the Guixi River Basin had a self-purification capacity. Finally, based on the microecological composition of sediment and physical and chemical characteristics of the water body, the health assessment was carried out, indicating that the main pollution area was Dianjiang Middle School and the watershed near the sewage treatment plant. The findings should theoretically support an in-depth assessment of the water environment's microecological health.

Blood pressure states transitions among bus drivers: the application of multi-state Markov model.

PURPOSE: To explore the transition patterns among different levels of blood pressure for bus drivers. METHODS: A follow-up study was conducted to investigate the transition probabilities of three blood pressure states, the sojourn time in each state, the survival probabilities, and the risk factors affecting hypertension progression. Based on 5618 blood pressure measurements of 1883 Chinese bus drivers from 2017 to 2021, a multi-state Markov model was established. RESULTS: The mean age of participants was 41.43 ± 6.71 years, and 82.37% were male. The probabilities from normal state to hypertension within 1-year follow-up were 4.60% (male) and 2.13% (female); however, the corresponding changes over a 3-year follow-up had a significant increase to 20.27% (male) and 7.98% (female). The sojourn time of normal state and elevated state was 1.82 ± 0.09 years and 1.98 ± 0.08 years, respectively. The male participants, the increasing age, BMI, CHOL and TG were risk factors for progression from normal state to elevated state, and/or from elevated state to hypertensive state (HR: 1.04-2.53). CONCLUSIONS: Early preventive measures on the progression of hypertension should be taken for Chinese bus drivers, and at least one physical examination per year is strongly recommended. The government and bus companies should pay more attention to these kinds of bus drivers with high probabilities of hypertension: male, older than 40 years, with the higher values of BMI and blood lipid. The derived findings of sojourn time, transition probabilities and survival probabilities can provide reference for health professionals to make targeted intervention to reduce bus drivers' hypertension occurrence.

Multistate Markov model application for blood pressure transition among the Chinese elderly population: a quantitative longitudinal study.

OBJECTIVE: To explore the transitions of different blood pressure states based on a multistate Markov model among the Chinese elderly population. SETTING: A community health centre in Xiamen, China. PARTICIPANTS: 1833 elderly Chinese people. METHODS: A multistate Markov model was built based on 5001 blood pressure measurements from 2015 to 2020. Research was conducted to explore the process of hypertension progression, providing information on the transition probability, HR and the mean sojourn time in three blood pressure states, namely normal state, elevated state and hypertensive state. RESULTS: Probabilities of moving from the normal state to the hypertensive state in the first year were 16.97% (female) and 21.73% (male); they increased dramatically to 47.31% (female) and 51.70% (male) within a 3-year follow-up period. The sojourn time in the normal state was 1.5±0.08 years. Elderly women in the normal state had a 16.97%, 33.30% and 47.31% chance of progressing to hypertension within 1, 2 and 3 years, respectively. The corresponding probabilities for elderly men were 21.73%, 38.56% and 51.70%, respectively. For elderly women starting in the elevated state, the probabilities of developing hypertension were 25.07%, 43.03% and 56.32% in the next 1, 2 and 3 years, respectively; while the corresponding changes for elderly men were 20.96%, 37.65% and 50.86%. Increasing age, body mass index (BMI) and glucose were associated with the probability of developing hypertension from the normal state or elevated state. CONCLUSIONS: Preventive actions against progression to hypertension should be conducted at an early stage. More awareness should be paid to elderly women with elevated state and elderly men with normal state. Increasing age, BMI and glucose were critical risk factors for developing hypertension. The derived transition probabilities and sojourn time can serve as a significant reference for making targeted interventions for hypertension progression among the Chinese elderly population.

States Transitions Inference of Postpartum Depression Based on Multi-State Markov Model.

Background: Postpartum depression (PPD) has been recognized as a severe public health problem worldwide due to its high incidence and the detrimental consequences not only for the mother but for the infant and the family. However, the pattern of natural transition trajectories of PPD has rarely been explored. Methods: In this research, a quantitative longitudinal study was conducted to explore the PPD progression process, providing information on the transition probability, hazard ratio, and the mean sojourn time in the three postnatal mental states, namely normal state, mild PPD, and severe PPD. The multi-state Markov model was built based on 912 depression status assessments in 304 Chinese primiparous women over multiple time points of six weeks postpartum, three months postpartum, and six months postpartum. Results: Among the 608 PPD status transitions from one visit to the next visit, 6.2% (38/608) showed deterioration of mental status from the level at the previous visit; while 40.0% (243/608) showed improvement at the next visit. A subject in normal state who does transition then has a probability of 49.8% of worsening to mild PPD, and 50.2% to severe PPD. A subject with mild PPD who does transition has a 20.0% chance of worsening to severe PPD. A subject with severe PPD is more likely to improve to mild PPD than developing to the normal state. On average, the sojourn time in the normal state, mild PPD, and severe PPD was 64.12, 6.29, and 9.37 weeks, respectively. Women in normal state had 6.0%, 8.5%, 8.7%, and 8.8% chances of progress to severe PPD within three months, nine months, one year, and three years, respectively. Increased all kinds of supports were associated with decreased risk of deterioration from normal state to severe PPD (hazard ratio, HR: 0.42-0.65); and increased informational supports, evaluation of support, and maternal age were associated with alleviation from severe PPD to normal state (HR: 1.46-2.27). Conclusions: The PPD state transition probabilities caused more attention and awareness about the regular PPD screening for postnatal women and the timely intervention for women with mild or severe PPD. The preventive actions on PPD should be conducted at the early stages, and three yearly; at least one yearly screening is strongly recommended. Emotional support, material support, informational support, and evaluation of support had significant positive associations with the prevention of PPD progression transitions. The derived transition probabilities and sojourn time can serve as an importance reference for health professionals to make proactive plans and target interventions for PPD.

Nano-Fe3C@PGC as a novel low-cost anode electrocatalyst for superior performance microbial fuel cells.

We report a novel anode electrocatalyst, iron carbide nanoparticles dispersed in porous graphitized carbon (Nano-Fe3C@PGC), which is synthesized by facile approach involving a direct pyrolysis of ferrous gluconate and a following removal of free iron, but provides microbial fuel cells with superior performances. The physical characterizations confirm the unique configuration of iron carbide nanoparticles with porous graphitized carbon. Electrochemical measurements demonstrate that the as-synthesized Nano-Fe3C@PGC exhibits an outstanding electrocatalytic activity toward the charge transfer between bacteria and anode. Equipped with Nano-Fe3C@PGC, the microbial fuel cells based on a mixed bacterium culture yields a power density of 1856 mW m-2. The resulting excellent performance is attributed to the large electrochemical active area and the high electronic conductivity that porous graphitized carbon provides and the enriched electrochemically active microorganisms and enhanced activity towards the redox reactions in microorganisms by Fe3C nanoparticles.

The Dorsal 4-finger Technique: A Novel Method to Examine Metacarpophalangeal Joints in Patients with Rheumatoid Arthritis.

OBJECTIVE: To describe the dorsal 4-finger technique (DFFT) in examining metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) and compare it to the traditional 2-finger technique (TFT) using ultrasound (US) as a gold standard. METHODS: Four rheumatologists evaluated 180 MCP joints of 18 patients with RA. All patients underwent US for greyscale (GSUS) and power Doppler US (PDUS). Agreements between rheumatologists, the 2 techniques, and US were evaluated using Cohen κ and the first-order agreement coefficient (AC1) κ methods. RESULTS: The population comprised 17 females (94.4%) with a mean (SD) age and disease duration of 56.8 (14.4) and 21.8 (12.9) years, respectively. Eight patients (44.4%) were taking methotrexate monotherapy, while 10 patients (55.6%) were receiving biologics. US evaluation revealed 69 (38.3%) and 30 (16.7%) joints exhibited synovitis grade 2-3 by GSUS and PDUS, respectively. Effusion was documented in 30 joints (16.7%). The mean intraobserver agreement using the DFFT and TFT were 80.5% and 86%, respectively. The mean interobserver agreements using the DFFT and TFT were 84% and 74%, respectively. κ agreement with US findings was similar for both techniques in tender joints but was higher for the DFFT in nontender joints (0.33 vs 0.07, p = 0.015 for GSUS) and (0.48 vs 0.11, p = 0.002 for PDUS). The DFFT had a higher sensitivity in detecting ballottement by GSUS (0.47 vs 0.2, p < 0.001) and PDUS (0.60 vs 0.27, p < 0.001). CONCLUSION: The DFFT is a novel, reproducible, and reliable method to examine MCP joints, and it has a better correlation with US than the traditional TFT.

Exploring sub-optimal use of an electronic risk assessment tool for venous thromboembolism.

International guidelines and consensus groups recommend using a risk assessment tool (RAT) to assess Venous Thromboembolism (VTE) risk prior to the prescription of prophylaxis. We set out to examine how an electronic RAT was being used (i.e. if by the right clinician, at the right time, for the right purpose) and to identify factors influencing utilization of the RAT. A sample of 112 risk assessments was audited and 12 prescribers were interviewed. The RAT was used as intended in only 40 (35.7%) cases (i.e. completed by a doctor within 24 h of admission, prior to the prescription of prophylaxis). We identified several reasons for sub-optimal use of the RAT, including beliefs about the need for a RAT, poor awareness of the tool, and poor RAT design. If a user-centred approach had been adopted, it is likely that a RAT would not have been implemented or that problematic design issues would have been identified.

Government-insured routine eye examinations and prevalence of nonrefractive vision problems among elderly.

OBJECTIVE: To assess whether lack of government-insured annual routine eye examinations was associated with reduced vision health status among elderly Canadians. DESIGN: Cross-sectional survey. PARTICIPANTS: Respondents aged ≥ 65 years in the Canadian Community Health Survey 2000-2001. METHODS: The prevalence of nonrefractive vision problems (i.e., unable to see close or distance when wearing glasses or contact lenses) between Canadians with and without government-insured annual eye examinations was compared. RESULTS: Uninsured white individuals had a greater prevalence rate of vision problems (8.5%; 95% CI 6.8-10.2) than insured white individuals (6.4%; 95% CI 5.2-7.6) if their household incomes were less than the midlevel. In those with household incomes at the midlevel or higher, the prevalence rate was similar between the insured (4.3%) and uninsured (3.6%; p>0.05). Compared with elderly adults in the mid- to high-income level and living in insured provinces, white elderly adults residing in provinces with no insurance had 50% higher odds of reporting vision problems (adjusted odds ratio [OR] 1.5; 95% CI 1.1-2.0) if their income was less than the midlevel, but a 30% lower likelihood of having vision problems if their income was in the midlevel or higher (adjusted OR 0.7; 95% CI 0.6-1.0). The mean age at diagnosis of glaucoma and cataracts was about 2 years older for uninsured versus insured white individuals. Analyses among non-white individuals were not permitted because of small sample size. CONCLUSIONS: Lack of government-funded annual routine eye examinations is associated with increased levels of nonrefractive vision problems among low-income elderly adults.