Rapid authentication of variants of Gastrodia elata Blume using near-infrared spectroscopy combined with chemometric methods.

The variety is one of the most important factors to generate difference of chemical compositions, which unavoidably influences the quality of natural medicine. Thus, simple and rapid authentication of different variants has great academic and practical significance. In this study, the goal was achieved with the help of near infrared spectroscopy (NIR) and chemometrics by using Gastrodia elata Blume as an example. A total of 540 samples including two classes of variants and their forms were investigated as a whole. The mean spectra of samples of each class and their 2-D synchronous correlation spectra were simultaneously applied to discover the difference of chemical characteristics. After hybrid pre-processing of the first and second derivative combined with Savitzky-Golay and Norris filtering, partial least squares discrimination analysis (PLS-DA) on the basis of latent variable projection was used to assess the feasibility for classification. The results show higher prediction accuracy in both internal test set and external prediction set. In order to further improve the robustness for modeling, three methods for wavelength selection were comprehensively compared to optimize PLS-DA models, including variable importance in the projection (VIP), random frog (RF), and Monte Carlo uninformative variable elimination (MC-UVE). The prediction accuracy of combination of the 2nd derivative, Norris, MC-UVE and PLS-DA achieved to 99.11% and 98.89% corresponding to the internal test set and external prediction set, respectively. The strategies proposed in this work perform effectiveness for rapid and accurate authentication of variants of plants with high chemical complexity.

Nutritional Assessment in Early Allogenic Hematopoietic Stem Cell Transplant Patients, a Cross-Sectional Study.

BACKGROUND: Our study aims to comprehensively assess nutrition status and malnutritional prevalence in early allogenic hematopoietic stem cell transplant (allo-HSCT) patients. METHODS: This single-center, cross-sectional study included 171 patients within the 90 days post-transplantation (from September 2019 to April 2020). Data collected included demographic, 3 day 24-h diet record, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, laboratory tests, anthropometric indices, and body composition. RESULTS: One hundred and seventy-one patients with a mean age of 37.8 ± 11.3 and a male to female ratio of 102 to 69 were included. According to PG-SGA, 115 (67.3%) indicated the critical need for nutritional intervention and symptom management (PG-SGA score > 9). Forty-three (43.3%) of patients had experienced insufficient intakes of energy according to a 24-h diet record. Our study found that 120 (70.2%) patients had a body fat percentage and high triacylglycerol (64.9%). Reduced free fat mass index and low hand-grip strength were found in 133 (77.78%) and 104 (60.81%), respectively. The prevalence of malnutrition was 24.6% and the prevalence of sarcopenia was 13.5%. CONCLUSION: Although the prevalence was not high, this research has demonstrated a high risk of malnutrition and a lower muscle mass in early allo-HSCT. Furthermore, our study confirmed body composition assessment would be an excellent way to identify malnutrition precisely.

Change in global burden of unintentional drowning from 1990 to 2019 and its association with social determinants of health: findings from the Global Burden of Disease Study 2019.

OBJECTIVE: To systematically analyse global, regional and national burden change of unintentional drowning from 1990 to 2019, and to further quantify the contribution of social determinants of health (SDH) on the change. DESIGN: Data from the Global Burden of Disease Study 2019 were used in this study. SETTING AND PARTICIPANTS: Individuals of all ages and genders from 204 countries and territories. MAIN OUTCOME MEASURES: The main outcomes were the age-standardised rates (ASRs) of mortality and disability-adjusted life-years (DALYs) of unintentional drowning. The percentage change in the ASRs were used to estimate the joint effect of SDH on trends in global burden of drowning. RESULTS: We observed that the global burden of unintentional drowning declined markedly from 1990 to 2019, with age-standardised mortality rate and DALYs rate decreasing by 61.5% and 68.2%, respectively. Women, children, middle Socio-Demographic Index (SDI) countries, South-East Asia and Western Pacific region had higher reduction. At national level, greater reductions were observed in Armenia and Republic of Korea, but significant increases in Cabo Verde and Vanuatu. We found that every one percentile increase in six SDHs (Gross Domestic Product (GDP) per person, SDI, educational attainment, health spending, health workers and urbanisation) was associated with a decrease of 0.15% and 0.16% in drowning age-standardised mortality rate and DALYs rate globally, respectively. Health spending and GDP per capita were the main contributors to the reduction of drowning globally. CONCLUSIONS: The global burden of unintentional drowning significantly declined in the past three decades, and the improvement of SDHs such as GDP per capita and health spending mainly contributed to the decrease. Our findings indicate that improvement of SDHs is critical for drowning prevention and control.

Development of an inexact simulation-evaluation model for the joint analysis of water pricing and groundwater allocation policies.

A critical step in water management policy development is the analysis of its socio-economic and environmental implications. However, few methods could proactively and reliably predict and assess the impacts of policies while handling the inherent uncertainty. To fill such a gap, an inexact simulation-evaluation method was developed for analyzing the impacts of multiple water management policies under uncertainty. The interval positive mathematical programming (IPMP) method was proposed as the simulation tool by coupling interval programming with positive mathematical programming (PMP). The evaluation tool was developed by combining the interval TOPSIS method and the interval maximum deviation method. This simulation-evaluation method can directly communicate a policy's simulation outcomes into the evaluation process while addressing the uncertainties in both simulation and evaluation. The proposed method can also reproduce the actual situation with a calibration process, which enables accurate and smooth responses to policy changes. This approach was used for agricultural water management in arid north-west China. Seventy-five policy alternatives generated from three groundwater allocation limits and twenty-five differential water pricing levels were investigated. The impacts of these alternatives on farmer income, farmer employment, water consumption, planting areas, and fertilizer use were simulated using IPMP. Twenty-four non-inferior alternatives were selected and further evaluated with multi-dimensional criteria. The final results showed that, the water price for grain crops with traditional irrigation methods should rise by 60%, those for cash crops with drip irrigation should decrease by 60%, and the groundwater quota should be reduced by 20%. Compared with traditional models, IPMP can increase simulation accuracy by reproducing observed situations, enhance robustness by reflecting input uncertainty, and improve flexibility in decision-making by providing interval solutions. The inexact simulation-evaluation model can also be widely used to analyze other policies.

Experimental Study on Early Strength and Hydration Heat of Spodumene Tailings Cemented Backfill Materials.

Spodumene tailing is the associated solid waste of extracting lithium from spodumene. With the increase in the global demand for lithium resources, its emissions increase yearly, which will become a key factor restricting the economic development of the mining area. Mechanical and hydration reactions, as well as the microstructure of early CSTB, are studied under different tailings-cement ratios (TCR) and solid mass concentration (SC) conditions. The results show that the uniaxial compressive strength of early CSTB has a negative exponential correlation with the decrease in TCR and a positive correlation with the increase in SC: when the age of CSTB increases to 7 days, the strength increases with the rise in SC in an exponential function, and the sensitivity of strength to TCR is higher than that of SC. Compared to other tailings cemented backfill materials, the addition of spodumene tailings reduces the sulfate ion concentration and leads to a new exothermic peak (i.e., the third exothermic peak) for the hydration exotherm of CSTB. Additionally, with the increase in TCR or decrease in SC, the height of the third exothermic peak decreases and the occurrence time is advanced. At the same time, the duration of induction phase was prolonged, the period of acceleration phase was shortened, and the total amount of heat released was significantly increased. The decrease in TCR or the increase in SC led to the rise in the number of hydration products which can effectively fill the internal pores of CSTB, enhance its structural compactness, and increase its compressive strength. The above study reveals the influence of TCR and SC on the early strength, hydration characteristics, and microstructure of CSTB and provides an essential reference for the mix design of underground backfill spodumene tailings.

Ultrasound assessment of twin reversed arterial perfusion sequence for the prediction of adverse pregnancy outcomes in the first trimester.

OBJECTIVE: To investigate twin reversed arterial perfusion (TRAP) sequence for the prediction of TRAP-related adverse pregnancy outcomes at the gestational age of 11-14 weeks. METHODS: Pregnant women in the first trimester diagnosed with TRAP were recruited at West China Second University Hospital from January 2015 to June 2018. Systematic screening for the pump twin's crown-rump length (CRL) and acardiac twin's upper pole-rump length (URL) was conducted using ultrasonic detection. The (CRL - URL)/CRL and URL/CRL ratios were used to assess the pregnancy outcomes for the pump twin. Twenty-one pregnant women aged 21-39 years with a gestation of 11-14 weeks were recruited. RESULTS: TRAP was diagnosed on average (± standard deviation (SD)) at pregnancy week 13.1 ± 0.18. The pump twins' mean (± SD) CRL was 6.65 ± 1.1 cm. The incidence of intrauterine death for the pump twins was 19.0% (n = 4), the miscarriage rate was 14.3% (n = 3), and the live birth rate was 66.7% (n = 14). The (CRL - URL)/CRL ratios between the nonsurvival (intrauterine death and miscarriage) and survival groups significantly differed (0.33 ± 0.08 vs. 0.58 ± 0.08, p < 0.05). Similarly, the URL/CRL ratios between the nonsurvival and survival groups significantly differed (0.67 ± 0.08 vs. 0.42 ± 0.08, p < 0.05). CONCLUSION: The (CRL - URL)/CRL and URL/CRL ratios were valuable indicators for determining pregnancy outcomes of pump twins with TRAP at an early gestational age.

Elevated atmospheric CO2 enhances the phytoremediation efficiency of tall fescue (Festuca arundinacea) in Cd-polluted soil.

With the economic development of society, concentrations of atmospheric CO2 and heavy metals in soils have been increasing. The physiological responses of plants to the interaction between soil pollution and climatic change need to be understood. Pot experiments were designed to assess variations in Festuca arundinacea dry weight, leaf type, chlorophyll content, antioxidase activities, and Cd accumulation ability, under different atmospheric CO2 treatments. The results showed that the total dry weights increased with increasing CO2, and Cd concentrations in falling leaf tissues increased with raised atmospheric CO2, before reaching a peak at 600 ppm, above which they remained constant. Compared with the control (400 ppm), 600, 650, and 700 ppm CO2 treatments increased the proportions of the falling tissues by 1.7%, 3.3%, and 4.5%, respectively. Antioxidant enzyme activities in plant leaves increased with increasing atmospheric CO2 levels. The concentration of H2O2 in leaf tissues increased with increasing CO2, reaching a peak at 600 ppm, and then decreased significantly as the CO2 content increased further, to 700 ppm. The results in this study suggest that F. arundinacea could be regarded as a potential candidate for phytoremediation of Cd-polluted soil; especially if senescent and dead leaf tissues could be harvested, and that raised atmospheric CO2 levels could improve its soil remediation efficiency.Novelty statement Extrapolation of results from experiments of environmental impacts in greenhouse to real scale field requires to be considered cautiously. External factors such as water, temperature, humidity, and pollution are variable in real field. Plants will face a lot of beneficial or detrimental conditions which will influence the magnitude of the results. However, the elevation of CO2 is an inevitable phenomenon in future. Therefore, findings from experiments under artificial conditions are sometime a good choice to obtain knowledge about elevated CO2 related impacts on phytoremediation efficiency of a specific plant. The final goal of this work is to find a suitable CO2 fumigation strategy optimized for soil remediation. We report on that elevated atmospheric CO2 can increase the phytoremediation efficiency of Festuca arundinacea for Cd. This is significant because the combined influences of elevated atmospheric CO2 and metal pollution in terms of biomass yield, pollutant uptake, and phytoremediation efficiency would be more complex than the effects of each individual factor.

Urinary bisphenol A and its alternatives among pregnant women: Predictors and risk assessment.

BACKGROUND: Exposure to bisphenol A (BPA) has been associated with various adverse health outcomes. Recently, an increasing concern on its alternatives such as bisphenol S (BPS) and bisphenol F (BPF) has been aroused due to the restriction use of BPA. Few studies have identified predictors of exposure to BPA alternatives and assessed their health risks. OBJECTIVE: The aim of this study was to identify predictors of BPA and its alternatives and to assess their health risks among pregnant women. METHODS: We detected first morning urinary concentrations of BPA and its alternatives (BPS and BPF) among 1097 pregnant women from an established Chinese cohort. A questionnaire was conducted to obtain demographic characteristics, dietary habits, and lifestyles. We examined the predictors of creatinine-adjusted urinary BPA and its alternatives concentrations using multivariable linear regression. Risk assessment of exposure to BPA and its alternatives was calculated based on the estimated of daily intake (EDI). RESULTS: Geometric means of creatinine-adjusted urinary BPA, BPF, and BPS were 0.92, 0.12, and 0.08 µg/g creatinine, respectively. Pregnant women from Wuhan had lower concentrations of BPA, BPF, and ∑BPs (sum of BPA, BPF, and BPS) than those from Xiaogan. Intake of fried food was related to higher concentrations of BPA, and intake of pickled food was associated with higher concentrations of BPF and ∑BPs. The maximum EDI values for exposure to BPA, BPF, BPS, and ∑BPs ranged from 5.6428 to 13.3356 nmol/kg body weight/day, which were below the tolerable daily intake (TDI) for BPA defined by the European Food Safety Authority (EFSA) (18 nmol/kg body weight/day). The maximum hazard index (HI) value was 0.7409. CONCLUSION: Several predictors identified in this study may inform public recommendations to reduce exposure to BPA and its alternatives.

Trajectories of caregiver burden and related factors in family caregivers of patients with lung cancer.

OBJECTIVE: This study aimed to (1) identify the changes of 5 domains of family caregiver (FC) burden, overall burden, and its subtrajectories when caring for newly diagnosed advanced lung cancer patients during the first 6 months following cancer diagnosis; and (2) identify the FC-related and patient-related factors most associated with the overall FC burden and each of its subtrajectories. METHODS: A total of 150 newly diagnosed advanced lung cancer patient-FC dyads were recruited from a Taiwanese medical center. The overall FC burden was evaluated 4 times: before treatment, and 1, 3, and 6 months after treatment. The potential subtrajectory of the caregiver burden was investigated by latent class growth analysis. The FC-related and patient-related factors having the greatest effect on the overall FC burden and its subtrajectories over time were identified by generalized estimating equations. RESULTS: The highest level of burden domain was "Impact on daily schedule" over time. Generally, most of the FC reported a moderate level of overall burden over the investigation period. Three subtrajectories of the overall FC burden over time (% caregivers) were identified: high burden (34.7%), moderate burden (56.0%), and low burden (9.3%), respectively. The self-efficacy of FC was the strongest factor related to the changes of the FC's burden and burden in each subtrajectory. CONCLUSION: The results support the existing and different types of subtrajectories of the FC's burden. Health care professionals should provide care based on those differences. Further research to test interventions which integrate those important factors related to FC's burden, particularly FC's self-efficacy, is strongly suggested.

Predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men.

BACKGROUND: Certain phthalates are suspected to be endocrine disruptors that are adversely associated with male reproductive health. However, the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men have not been thoroughly studied. OBJECTIVE: To investigate the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among adult Chinese males. METHOD: We measured mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-octyl phthalate (MOP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) concentrations in seminal plasma and repeated spot-urine samples from 687 men who visited a reproductive center. Mixed-effect models were used to examine the associations of sociodemographic, lifestyle and medical factors with urinary metabolite concentrations. Linear regression models were used to identify predictors of metabolite concentrations in seminal plasma and correlations between metabolite concentrations in spot urine samples and seminal plasma. RESULTS: Measurements taken from spot urine samples poorly predicted same-day seminal plasma concentrations (all R2<0.10). Inverse associations were observed between education level and urinary MBP and MEOHP and between household income and urinary MMP; receiving intravenous infusion therapy was associated with increased urinary MBP, MEHHP and MEOHP, use of facial cleanser/cream was associated with increased MEP, and smoking was associated with increased MEHP. The predictors of metabolite concentrations in seminal plasma differed from those in urine, except for the association of intravenous infusion therapy with MBP. BMI was associated with increased seminal plasma MBP, MEHP and MEOHP, smoking was associated with increased MEP, and contact with plastics was associated with increased MEOHP. CONCLUSIONS: Phthalate metabolite concentrations in adult men varied in accordance with sociodemographic variables, lifestyle factors and intravenous therapy. Measures of metabolite levels in urine may not directly reflect the exposure status of the male reproductive system.

Integration of user centered design in the development of health monitoring system for elderly.

This paper presents a health monitoring system by incorporating the approach of user centered design (UCD) for enhancing system usability for the elderly. The system is designed for monitoring cardiovascular diseases (CVD) related physiological signals including electrocardiogram (ECG), pulse wave (PW) and body weight (BW). Ease of use and non-obtrusiveness are two key requirements for design criteria. Our health monitoring system is designed on three levels: personal medical device layer, mobile application layer and remote central service layer. A chair-based apparatus was built for physiological signal acquisition and a mobile application was developed for data delivery and health management. Finally, usability evaluation was conducted and the system efficiency was quantitatively analyzed by system usability scale (SUS). The results demonstrate that the performance of the system is acceptable for the elderly and the UCD principle is helpful for health system design.

Performance assessment of the Capilia TB assay and the BD ProbeTec ET system for rapid culture confirmation of Mycobacterium tuberculosis.

Because of the increasing numbers of nontuberculous mycobacterial isolates from clinical specimens, rapid and accurate methods for culture confirmation of Mycobacterium tuberculosis are urgently needed. The study evaluated the performance of the Capilia TB immunochromatographic assay (TAUNS, Numazu, Japan) for culture confirmation of M. tuberculosis using 242 culture-positive liquid media in 2 mycobacterial laboratories from November 2005 to February 2006. Among the 242 samples, 183 were also tested with the BD ProbeTec ET (CTB) assay (Becton Dickinson, Sparks, MD). The results of both assays were compared to the culture results and to each other. The overall sensitivity and specificity of the Capilia TB assay were 98.6% and 97.9%, respectively, and for the CTB assay were 97.3% and 97.1%, respectively. The positive and negative predictive values for the Capilia TB assay were 98.6% and 97.9%, respectively, and for the CTB assay were 98.2% and 95.8%, respectively. Among the 183 samples tested with both assays, 8 had discrepant results, including Capilia-TB-false-positive in 2, CTB-false-positive in another 2, CTB-false-negative in 2, Capilia TB-false-negative in 1, and both assays with false-negative results in the remaining one. This study demonstrated that the Capilia TB assay has a similar diagnostic value with the CTB assay. In addition, with the immunochromatographic method, it is less time-consuming and does not require other laboratory equipment.

The role of bronchoscopic assessment in esophageal cancer - clinical and survival analysis in 153 patients.

BACKGROUND AND PURPOSE: The diagnostic value and indications for fiberoptic bronchoscopy in the preoperative assessment of patients with esophageal cancer have not been fully studied. We evaluated the role of fiberoptic bronchoscopic examination in the stage work-up of patients with esophageal cancer and correlated the results with survival time analysis. METHODS: The medical records of 153 patients with an initial diagnosis of esophageal cancer were reviewed. Clinical data, bronchoscopic findings, treatment courses, and survival time of these patients were analyzed. RESULTS: On initial bronchoscopic examinations, distortion/compression of the normal structure and protrusion at the posterior wall of the trachea or bronchus were the most common bronchoscopic findings (35.9%). We stratified patients into 3 subgroups according to bronchoscopic findings of direct invasion, external compression, and negative findings. The symptoms of dyspnea, hoarseness, aspiration and fever were more frequent in patients with direct airway invasion compared with patients with external compression and negative bronchoscopic findings (p < 0.02). Washing and brushing cytology examinations were all negative in patients with external compression of the airway. There was a significant difference of survival time among these 3 groups of patients (direct invasion: 5.6 +/- 0.6 months; external compression: 12.3 +/- 0.9 months; negative findings: 13.3 +/- 1.1 months, p < 0.01). Direct airway invasion and original cancer stage were the most important variables for survival in the multivariate analysis, and the hazard ratio for prognosis was 2.5 (95% confidence interval [CI], 1.1-4.6) and 4.2 (95% CI, 1.5-9.3), respectively. Twelve patients (80%) with tracheoesophageal (TE) fistulae died within 3 months after diagnosis due to aspiration pneumonia and septic shock. CONCLUSIONS: The role of bronchoscopic examination in patients with esophageal cancer for preoperative evaluation resides in its ability to predict airway invasion and its impact on survival. Advanced cancer stage (stage IV) and direct airway invasion (especially TE fistula) were significantly associated with poor prognosis. These results suggest that patients suffering from dyspnea, hoarseness, aspiration and fever, implicating a high probability of airway invasion, are more likely to benefit from bronchoscopic examination and proper management in order to prevent aspiration or complications.

Negative expiratory pressure in the assessment of bronchodilator response: comparison of spirometry and the interrupter method.

BACKGROUND AND PURPOSE: The negative expiratory pressure (NEP) method offers a simple and rapid assessment of expiratory flow limitation (EFL) during tidal respiration. This study compared the value of NEP in the assessment of the bronchodilator test (BDT) with those of spirometry and the interrupter method. METHODS: Thirty two patients referred to the lung function laboratory for BDT were investigated. All patients underwent spirometry, interrupter airway resistance (Rint) and NEP measurements in the sitting position before and after inhalation of 500 microg of terbutaline. A positive BDT was defined as an increase in the forced expiratory volume in 1 second (FEV1) of > or = 12%. RESULTS: The ratio of FEV1 to forced vital capacity (FVC) was less than 70% in 21 (65.6%) patients, but EFL as demonstrated by NEP (EFL-N) was present in only 10 patients (31.3%). The baseline EFL-N was only weakly correlated with FEV1 (r = -0.36, p = 0.04), but not with Rint or FEV1/FVC. Among the 14 patients with positive BDT results, the change in FEV1 was correlated with the change in Rint (r = -0.69, p < 0.01), but not with the change in EFL-N. CONCLUSIONS: These data suggest that, compared with spirometry and the interrupter method, NEP applied in the sitting position is not sensitive in the assessment of bronchodilator response in patients with obstructive airway disorders.