Echocardiographic assessment of pediatric heart transplantation: A single-center experience in China.

BACKGROUND: Pediatric heart transplant (HT) has become the standard of care for end-stage heart failure in children worldwide. Serial echocardiographic evaluations of graft anatomy and function during follow-up are crucial for post-HT management. However, evolution of cardiac structure and function after pediatric HT has not been well described, especially during first year post-HT. This study aimed to characterize the evolution of cardiac structure and function after pediatric HT and investigate the correlation between biventricular function with adverse clinical outcomes. METHODS: A single-center retrospective study of echocardiographic data obtained among 99 pediatric HT patients was conducted. Comprehensive echocardiographic examination was performed in all patients at 1-, 3-, 6-, 9- and 12-months post-HT. We obtained structural, functional and hemodynamic parameters from both left- and right-side heart, such as left ventricular stroke volume (LVSV), left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), etc. The cardiac evolution of pediatric HT patients during first post-HT year was described and compared between different time points. We also explored the correlation between cardiac function and major adverse transplant events (MATEs). RESULTS: 1) Evolution of left heart parameters: left atrial length, mitral E velocity, E/A ratio, LVSV and LVEF significantly increased while mitral A velocity significantly decreased over the first year after HT (P < .05). Compared with 1 month after HT, interventricular septum (IVS) and left ventricular posterior wall (LVPW) decreased at 3 months but increased afterwards. (2) Evolution of right heart parameters: right ventricular base diameter and mid-diameter; right ventricular length diameter, tricuspid E velocity, E/A ratio, tricuspid annular velocity e' at free wall, and RVFAC increased, while tricuspid A velocity decreased over the first year after HT (P < .05). (3) Univariate logistic regression model suggests that biventricular function parameters at 1-year post-HT (LVEF, RVFAC, tricuspid annular plane systolic excursion and tricuspid lateral annular systolic velocity) were associated with MATEs. CONCLUSION: Gradual improvement of LV and RV function was seen in pediatric HT patients within the first year. Biventricular function parameters associated with MATEs. The results of this study pave way for designing larger and longer follow-up of this population, potentially aiming at using multiparameter echocardiographic prediction of adverse events.

A cooperative construction strategy for multi-parameter spatial variant random fields and its application in groundwater pollution risk assessment.

The spatial variability of hydrogeological parameters is a significant source of uncertainty in groundwater numerical modeling and has a certain risk impact on the prediction of pollutant migration and transformation. Current research has focused on the effects of single-parameter spatial variant random fields or utilizing random sampling methods to randomly combine multiple-parameter spatial variant random fields while ignoring the correlation between parameters. This paper proposes an innovative concept of associated random variables to construct multi-parameter synergistic spatial variant random fields, ensuring both the spatial variability and inherent correlation of the parameters. A hypothetical case was constructed, and the Monte Carlo sampling experiment based on computer simulation was used to assess groundwater pollution risks with multiple associated parameters. The results show that hydraulic conductivity and porosity are the main sensitive parameters. The associated random variable allows for the representation of positive correlation, negative correlation, and no correlation between the hydraulic conductivity and porosity. The pollutant mass concentrations in each observation well conform to the generalized extreme value distribution, and the pollution risks of each water well as well as the concentration distribution intervals of pollutants with different probabilities can be obtained. The influence of associated parameters on the cumulative risk of contaminants in observation wells and pollution degree range is only related to their mathematical distribution and is independent of correlations between parameters. This study addresses the issues of spatial variability and inherent correlation of hydrogeological parameters, which are of great significance for groundwater pollution risk assessment and the promotion of sustainable water quality management of groundwater resources.

Emerging Roles of RNA Methylation in Development.

More than 170 different types of chemical modifications have been identified on diverse types of RNA, collectively known as the epitranscriptome. Among them, N6-methyladenine (m6A), 5-methylcytosine (m5C), N1-methyladenine (m1A), and N7-methylguanosine (m7G) as the ubiquitous post-transcriptional modification are widely involved in regulating the metabolic processes such as RNA degradation, translation, stability, and export, mediating important physiological and pathological processes such as stress regulation, immune response, development, and tumorigenesis. Recently, the regulatory role of RNA modification during developmental processes is getting more attention. Therefore, the development of low-input even single-cell and high-resolution sequencing technologies is crucial for the exploration of the regulatory roles of RNA modifications in these important biological events of trace samples.This account focuses on the roles of RNA modifications in various developmental processes. We describe the distribution characteristics of various RNA modifications, catalytic enzymes, binding proteins, and the development of sequencing technologies. RNA modification is dynamically reversible, which can be catalyzed by methyltransferases and eliminated by demethylases. RNA m6A is the most abundant post-transcriptional modification on eukaryote mRNA, which is mainly concentrated near the stop codon, and involves in RNA metabolism regulation. RNA m5C, another most studied RNA modification, has been identified in a various of organisms and RNA species, mainly enriched in the regions downstream of translation initiation sites and broadly distributes across the whole coding sequence (CDS) in mammalian mRNAs. RNA m1A, with a lower abundance than m6A, is widely distributed in various RNA types, mainly locates in the 5' untranslated region (5'UTR) of mRNA and regulates translation. RNA m7G, one of the most common RNA modifications in eukaryotes, has been identified at cap regions and internal positions of RNAs and recently gained considerable attention.Thanks to the development of sequencing technology, m6A has been found to regulate the tumorigenic process, including tumor proliferation, invasion, and metastasis by modulating oncogenes and tumor suppressor genes, and affect oocyte maturation and embryonic development through regulating maternal and zygotic genes. m5C related proteins have been identified to participate in embryonic development, plant growth, and neural stem cell differentiation in a m5C dependent manner. m1A also has been revealed to be involved in these developmental processes. m7G dysregulation mainly involves in neurodevelopmental disorders and neurodegenerative diseases.Collectively, we summarized the gradually exhibited roles of RNA methylation during development, and discussed the possibility of RNA modifications as candidate biomarkers and potential therapeutic targets. The technological development is anticipated as the major driving force to expand our knowledge in this field.

[Pollution Characteristics and Risk Assessment of Heavy Metals in Surface Dusts and Surrounding Green Land Soils from Yellow River Custom Tourist Line in Lanzhou].

In order to investigate the contamination levels of dust and its surrounding green land soil heavy metal pollution and potential ecological and health risks in the scenic areas of urban waterfront parks, the gardens, squares, and theme parks of the Yellow River Custom Tourist Line in Lanzhou were selected as the research area, using 27 dust samples and 26 soil samples from its surrounding green lands. The contamination characteristics and potential ecological risks of eight heavy metals (Cr, Ni, Cu, Zn, As, Cd, Hg, and Pb) were evaluated using the geo-accumulation index (Igeo), single-factor pollution index (Pi), Nemerow integrated pollution index (PN), and improved potential ecological risk index (RI). The human health risk assessment was also evaluated using the exposure risk model. The results showed that the average concentrations of the other heavy metals in the surface dusts were higher than the background values of Gansu Province and Lanzhou City, except that the As mean concentrations in the surface dusts and the surrounding green land soils were slightly lower than the Gansu Province background values. For its surrounding green land soils, the mean concentrations of the other heavy metals (Cu, Zn, Cd, Hg, and Pb) exceeded the soil background values of Gansu Province and Lanzhou City, whereas the Cr and Ni mean concentrations were lower than their corresponding soil background values of Gansu Province and Lanzhou City. The geo-accumulation and single-factor pollution indices demonstrated that a slight to moderate pollution of Cr, Cu, Zn, Cd, Hg, and Pb occurred in surface dusts, and Cu, Zn, Cd, Hg, and Pb appeared in varying degrees of contamination levels in its surrounding green land soils. The Nemerow integrated pollution index analysis manifested that the overall contamination status of the study areas was between slightly and heavily polluted. The potential ecological risk index suggested that Cd and Hg were recognized as significant pollutant elements and that the RI of the other heavy metals were all below 40, presenting slight ecological risk. The health risk assessment indicated that ingestion was the dominant exposure pathway for heavy metals from the surface dusts and the surrounding green land soils, and no carcinogenic and noncarcinogenic risks posed threats to adults and children.

Does the carbon emission rights trading pilot policy aggravate local government fiscal pressure? Evidence from China.

The carbon emission rights trading pilot (CERTP) policy is an important measure to promote low-carbon economic development. This pilot policy also affects the entry and survival of enterprises and is thus related to local government fiscal pressure. The objective of this paper is to examine whether the CERTP policy increases local government fiscal pressure. Based on the quasi-natural experiment of China's CERTP policy, using a dataset from 314 prefecture-level cities in China over the period 2005 to 2019, this paper applies the staggered difference-in-differences (DID) model to examine the impact of the CERTP policy on local government fiscal pressure, and further tests the spatial spillover effects and potential mediation mechanisms of this pilot policy. The results indicate that the implementation of the CERTP policy significantly increases local government fiscal pressure, especially in the eastern regions and regions with low economic development levels, which provides further evidence of a causal relationship between the CERTP policy and fiscal pressure. The results of the spatial spillover effects confirm that the implementation of the CERTP policy in neighboring prefecture-level cities would increase local government fiscal pressure in the local region. The results of the mediation mechanism effect reveal that the CERTP policy aggravates local government fiscal pressure by inhibiting the progress of green technology by enterprises, hindering the emergence of new enterprises, and increasing the number of closures of high-carbon emissions enterprises. This paper recommends that when implementing the CERTP policy, it is necessary to weigh the overall impact of the policy, not just its effect on carbon emissions reduction. The fiscal sustainability of local governments cannot be ignored.

Silk fibroin based wearable electrochemical sensors with biomimetic enzyme-like activity constructed for durable and on-site health monitoring.

Flexible biomimetic sensors have encountered a bottleneck of sensitivity and durability, as the sensors must directly work within complex body fluid with ultra-trace biomarkers. In this work, a wearable electrochemical sensor on a modified silk fibroin substrate is developed using gold nanoparticles hosted into N-doped porous carbonizated silk fibroin (AuNPs@CSF) as active materials. Taking advantage of the inherent biocompatibility and flexibility of CSF, and the high stability and enzyme-like catalytic activity of AuNPs, AuNPs@CSF-based sensor exhibits durable stability and superior sensitivity to monitor H2O2 released from cancer cell (4T1) and glucose in sweat. The detection limits for H2O2 and glucose are low to be 1.88 µM and 23 µM respectively, and the sensor can be applied in succession within 30 days at room temperature. Further, physical cross-linking of polyurethane (PU) with SF well matches with the skin tissue mechanically and provides a flexible, robust and stable electrode-tissue interface. AuNPs@CSF is applied successfully for wearable electrochemical monitoring of glucose in human sweat.The present AuNPs@CSF will possess a potential application in clinical diagnosing of H2O2- or glucose-related diseases in future.

Environmental barriers and participation restrictions in community-dwelling individuals with spinal cord injury in Jiangsu and Sichuan Provinces of China: Results from a cross-sectional survey.

OBJECTIVE: (1) to describe environmental barriers and participation restrictions experienced by people with spinal cord injury (SCI) from China, (2) to examine associations between lesion characteristics and participation restrictions, considering a mediating role of environmental barriers, (3) to identify those environmental barriers that have the largest influence on participation. DESIGN: Cross-sectional study. This study is part of the International Spinal Cord Injury Survey (InSCI). SETTING: Community, Jiangsu and Sichuan Province, China. PARTICIPANTS: 1355 persons with SCI. INTERVENTIONS: Not applicable. OUTCOME MEASURES: Participation restrictions were measured with items from the Model Disability Survey, Environmental Barriers were measured with the Nottwil Environmental Factors Inventory-Short Form. RESULTS: Participants experienced a median of five (IQR 1-9) environmental barriers and five (IQR 0-9) participation restrictions. Environmental barriers were mainly reported in relation to climate, insufficient resources and accessibility, and participation restrictions mainly occurred in using public transportation, taking care of others, and getting to places. In an adjusted zero-inflated Poisson model, people with more severe injuries reported a greater number of environmental barriers (complete injury: IRR = 1.31, 95%CI = [1.24,1.38]) and participation restrictions (tetraplegia: IRR = 1.15, 95%CI = [1.10,1.21]; complete injury: IRR = 1.25, 95%CI = [1.18,1.31]). Moreover, environmental barriers (IRR = 1.07, 95%CI = [1.06,1.08]) were a significant predictor of participation restrictions and partially mediated the association of lesion completeness with participation restrictions. Barriers related to accessibility of public places (IRR = 1.47, 95%CI = [1.33,1.62]), accessing homes (IRR = 1.32, 95%CI = [1.21,1.44]), long distance transportation (IRR = 1.11, 95%CI = [1.04,1.20]), communication devices (IRR = 1.07, 95%CI = [1.01,1.15]) and state services (IRR = 1.10, 95%CI = [1.02,1.19]) had the greatest negative impact on participation. CONCLUSION: Social participation of people with SCI is seriously restricted in China. Removing environmental barriers will be an important element of programs to address this problem.

Dissipation dynamics and comparative dietary exposure assessment of mefentrifluconazole in rice.

A fast and sensitive analytical method based on UHPLC coupled with tandem mass spectrometry was established to investigate the dissipation and final residual amounts of mefentrifluconazole in rice, and dietary risk to consumers was evaluated. The method provided good linearity (R2 ≥ 0.9979), accuracy (recovery range, 79.0-101.5%), precision (relative standard deviation range, 1.3-13.9%), and sensitivity (limit of quantification, 0.005 mg/kg). The dissipation dynamics of mefentrifluconazole in rice followed first-order kinetics, with half-lives of 2.8-16.6 days. The final residues of mefentrifluconazole in various samples of harvested brown rice ranged from less than the limit of quantification to 0.092 mg/kg, the latter value being higher than the maximum residue limit recommended by the European Union. Comparative dietary exposure of mefentrifluconazole was assessed using field data and Chinese dietary patterns for different genders, regions, and age data. Although the results showed acceptable levels of risk for both acute exposure (the percentage of the acute reference dose ≤ 0.7483%) and chronic dietary intake (the percentage of acceptable daily intake ≤ 31.8516%), more studies of children are needed because they are at higher risk than other groups. This work provides the necessary data for registering and establishing the maximum residue limit for mefentrifluconazole in rice in China and reveals the potential risks to different groups of long-term application of mefentrifluconazole to rice and other crops.

Identifying the characteristics and potential risk of seawater intrusion for southern China by the SBM-DEA model.

Seawater intrusion (SWI) seriously affects the economic development of coastal areas in southern China, and understanding its mechanisms is the basis for effective control of SWI. Hydrogeochemical methods and slack-based measurement data envelopment analysis (SBM-DEA) are used to study the characteristics and potential risk of SWI in coastal cities of southern China. Types and distribution of SWI, coastal groundwater evolution, geological-geographic and economic threatens of SWI, potential SWI risk, and environmental management recommendations are explored. The results show that the intrusion areas of Zhejiang and Guangdong account for 94.1 % of the total intrusion area of southern China, and the intrusion degree in Zhejiang is the highest, followed by Guangdong and Fujian. SWI is prone to occur on the sandy and silty coasts of the plain area of southern China; it accelerates the groundwater evolution speed and shortens the evolution path. SBM-DEA can be well applied to evaluate the potential risk of SWI events, and the results indicate a noticeable difference in the environmental performance level of coastal cities in southern China. The low environmental performance level (<0.3) and severe SWI of Taizhou and Zhanjiang indicate that SWI gradually worsens with economic development. In contrast, the high environmental performance level (>0.7) and low SWI of Wenzhou, Fuzhou, Quanzhou, Shantou, and Beihai indicate that the potential risk of SWI is gradually decreasing. Moreover, this study confirms that the environmental Kuznets curve (EKC) phenomenon exists in SWI events for southern China, and SWI-EKC indicates that the urban development of south China is approaching maturity. The specific case of SWI and EPL in coastal cities of south China jointly indicates that optimizing industrial structure, implementing a resources management policy, and improving citizens' environmental awareness are fundamental measures to resolve the contradiction between economic development and environmental problems.

Functional Assessment of 3D-Printed Multifunction Assistive Hand Device for Chronic Stroke Patients.

Patients with chronic stroke often have difficulty opening their hands and performing grasping movements. Several passive hand orthoses for assisting hand rehabilitation have been developed and demonstrated to be clinically effective. However, current devices have several limitations, such as supporting only a single grasping motion and using an abnormal grasping posture. Therefore, this study developed a three-dimensional (3D)-printed multifunctional hand device (3DP-MFHD) to solve these problems and evaluated the feasibility of using the device during home rehabilitation. Six participants were enrolled, and each of them was provided with the 3DP-MFHD. In addition to a task-oriented training course, the participants were asked to train at home for 4 weeks for at least 5 days per week and 40 min per day. The results revealed that hand grip force increased by 36.1%, lateral pinch force increased by 17.6%, and the Action Research Arm Test score increased by 54.1%. The 3DP-MFHD is a promising means to facilitate hand rehabilitation and improve hand strength and function in patients with chronic stroke. The 3DP-MFHD can be used as part of home rehabilitation.

Multi-objective optimization of the coastal groundwater abstraction for striking the balance among conflicts of resource-environment-economy in Longkou City, China.

Rational coastal groundwater planning is of great significance to freshwater supply for sustainable social-economic development, and to environmental protection in case of seawater intrusion (SI). Quantifying the relation among groundwater quality, quantity, and the related social-economic benefits in a coastal region with intense spatio-temporal variation in groundwater abstraction is helpful to the restoration of the coastal aquifer, and the practical policymaking. However, due to the comprehensive reality involving interdisciplinary principles, it is usually difficult to integrate all the main attributes of groundwater resources into a mono-policymaking process, which might lead to biased decisions, producing a series of adverse impacts on the environment and the social economy. This study thereby develops a combined simulation-optimization model (S-O model) in the coastal part of Longkou City, China, for striking the balance among the three main attributes of groundwater, i.e., the groundwater quantity, groundwater quality or its environmental function, and its related economic yield involving the agricultural and industrial sectors. It is seen that the industrial sector contributed over 80% of the economic yield by consuming over 10% of the total groundwater resource, and the massive agricultural use of groundwater was mainly responsible for the SI. The results of the multi-objective optimization provided practical alternative schemes for groundwater abstraction in terms of maximizing economic yield and minimizing SI. Moreover, the decision discrepancy caused by partial management only considering the groundwater quantity and quality would lower the water use efficiency, and then cause unacceptable economic losses for the enterprises and the government. Our research highlights that the interdisciplinary management of groundwater resources based on the S-O model could significantly improve practicability in groundwater policymaking, and provides a typical reference for the other developing regions facing difficulty in groundwater management during coastal urban planning and economic transformation.

Exposure to environmental concentrations of natural pyrethrins induces hepatotoxicity: Assessment in HepG2 cell lines and zebrafish models.

Natural pyrethrins are one variety of botanical pesticide, and are commonly used in organic and ecological agriculture. However, the hepatotoxicity of natural pyrethrins is unknown. In this study, the impact of natural pyrethrins on human HepG2 cells, which are prominent cell model for toxic-induced hepatotoxicity evaluations, was investigated in accordance with the ROS production and the mechanism of DNA damage and repair. And we report the liver toxicity of natural pyrethrins in zebrafish. Our result revealed a significant increase in ROS production, suggesting oxidative stress. Besides, the most notable genotoxic effect of oxidation-induced DNA damage was observed for natural pyrethrins, as detected by neutral comet assay and γH2AX/8-oxoG staining. As revealed by the results, oxidative DNA damage is responsible for the cytotoxic exposure of natural pyrethrins to HepG2 cells in humans. The observed damage is chronic toxicity, which may cause irreversible DNA damage and more severe toxic effects on human HepG2 cells. This can account for the complicated response to DNA impairment. Visual observations of zebrafish liver and oil red staining also demonstrated that natural pyrethrins induced liver degeneration, liver size changes and liver steatosis in zebrafish. In conclusion, the health of humans can be endangered by natural pyrethrins as a result of hepatotoxicity.

[Application of Array-based Comparative Genomic Hybridization in Diagnostic Assessment of Abnormal Prenatal Serological Screening Results of Down's Syndrome].

OBJECTIVE: To explore the application of array-based comparative genomic hybridization (a-CGH) technology in the prenatal diagnostic assessment of abnormal serological prenatal screening results of Down's syndrome (DS). METHODS: A total of 3 578 amniotic fluid samples from pregnant women who underwent amniocentesis for prenatal diagnosis solely due to abnormal serological prenatal screening results were selected. The samples were categorized into 3 groups, 2 624 in the high-risk group, 662 in the borderline-risk group, and 292 in the abnormal multiple of median (MoM) group. a-CGH was performed on the Agilent CGX ™ (8×60K) platform and the data were analyzed by the Genoglyphix ® software. RESULTS: The overall detection rate of chromosomal abnormalities was 3.38% (121/3 578). Among the chromosomal abnormalities, 49.59% (60/121) was aneuploidies, 42.15% (51/121) was pathogenic copy number variants (pCNVs), and 8.26% (10/121) was likely pathogenic CNVs (lpCNVs). The detection rate of copy number variant of uncertain significance (VUS) was 1.03% (37/3 578). In the high-risk, the borderline-risk and the abnormal MoM groups, the detection rate of chromosomal abnormalities was 3.54% (93/2 624), 2.87% (19/662) and 3.08% (9/292), respectively; the detection rate of p/lp CNVs was 1.64% (43/2 624), 1.81% (12/662) and 2.05% (6/292), respectively; the detection rate of trisomy 21 and trisomy 18 was 1.37% (36/2 624), 0.76% (5/662) and 0.34% (1/292) in the three groups, respectively. There were no significant differences in all the detection rate among these groups ( P>0.05). One sample with X(51)/XYY(49) confirmed by fluorescence in situ hybridization (FISH) was misdiagnosed by a-CGH. CONCLUSION: Prenatal diagnosis with a-CGH is of great significance for reducing birth defects in pregnancies with abnormal serological prenatal screening results of DS. It can also be used to detect CNVs of microdeletion/microduplication syndromes.

The effect of multiple interventions to balance healthcare demand for controlling COVID-19 outbreaks: a modelling study.

For controlling recent COVID-19 outbreaks around the world, many countries have implemented suppression and mitigation interventions. This work aims to conduct a feasibility study for accessing the effect of multiple interventions to control the COVID-19 breakouts in the UK and other European countries, accounting for balance of healthcare demand. The model is to infer the impact of mitigation, suppression and multiple rolling interventions for controlling COVID-19 outbreaks in the UK, with two features considered: direct link between exposed and recovered population, and practical healthcare demand by separation of infections. We combined the calibrated model with COVID-19 data in London and non-London regions in the UK during February and April 2020. Our finding suggests that rolling intervention is an optimal strategy to effectively control COVID-19 outbreaks in the UK for balancing healthcare demand and morality ratio. It is better to implement regional based interventions with varied intensities and maintenance periods. We suggest an intervention strategy named as "Besieged and rolling interventions" to the UK that take a consistent suppression in London for 100 days and 3 weeks rolling intervention in other regions. This strategy would reduce the overall infections and deaths of COVID-19 outbreaks, and balance healthcare demand in the UK.

A conjunctive management framework for the optimal design of pumping and injection strategies to mitigate seawater intrusion.

Coastal aquifer management (CAM) considering conjunctive optimization of pumping and injection system for seawater intrusion (SI) mitigation poses significant decision-making challenges. CAM needs to pose multiple objectives and massive decision variables to explore tradeoff strategies between the conflicting resources, economic, and environmental requirements. Here, we investigate a joint artificial injection scheme for ameliorating SI by establishing an evolutionary multi-objective decision-making framework that combines simulation-optimization (S-O) modelling with a cost-benefit analysis, and demonstrate the framework on a large-scale CAM case in Baldwin County, Alabama. First, a SI numerical model, using SEAWAT, was configured to predict the vulnerable region as an SI encroachment area with the scenarios of minimum and maximum pumping capacity. As a result, a smaller number of candidate sites were selected in the SI encroachment area for implementing groundwater injection to avoid the computationally infeasible SI optimization with an inordinate number of injection related decision variables. Second, the effective S-O methodology of niched Pareto tabu search combined with a genetic algorithm (NPTSGA), which considers the moving-well option, was applied to discover optimal pumping/injection (P/I) strategies (including P/I rates and injection well locations) between three conflicting management objectives under complicated SI constraints. Third, for practical operation of the P/I schemes, a cost-benefit analysis provides judgment criteria to allow decision-makers to implement more sustainable P/I strategies to capture the different realistic preferences. The implementation of three extreme optimization solutions for the case study indicates that, compared to the initial unoptimized scheme, a maximum increase of a factor of 3 in groundwater extraction rates, a maximum reduction of 17% in extent of SI, and a maximum 82.3 million US dollars in comprehensive benefits are specifically achieved by conjunctive P/I optimization. The robustness in the decision alternatives attributed to the uncertainty in physical parameters of hydraulic conductivity was discovered through global sensitivity analysis. The proposed framework provides a decision support system for multi-objective CAM with combined pumping control and engineering measures for SI mitigation.

Fluoride absorption, transportation and tolerance mechanism in Camellia sinensis, and its bioavailability and health risk assessment: a systematic review.

Tea is the one of the most popular non-alcoholic caffeinated beverages in the world. Tea is produced from the tea plant (Camellia sinensis (L.) O. Kuntze), which is known to accumulate fluoride. This article systematically analyzes the literature concerning fluoride absorption, transportation and fluoride tolerance mechanisms in tea plants. Fluoride bioavailability and exposure levels in tea infusions are also reviewed. The circulation of fluoride within the tea plantation ecosystems is in a positive equilibrium, with greater amounts of fluoride introduced to tea orchards than removed. Water extractable fluoride and magnesium chloride (MgCl2 ) extractable fluoride in plantation soil are the main sources of absorption by tea plant root via active trans-membrane transport and anion channels. Most fluoride is readily transported through the xylem as F- /F-Al complexes to leaf cell walls and vacuole. The findings indicate that tea plants employ cell wall accumulation, vacuole compartmentalization, and F-Al complexes to co-detoxify fluoride and aluminum, a possible tolerance mechanism through which tea tolerates higher levels of fluoride than most plants. Furthermore, dietary and endogenous factors influence fluoride bioavailability and should be considered when exposure levels of fluoride in commercially available dried tea leaves are interpreted. The relevant current challenges and future perspectives are also discussed. © 2020 Society of Chemical Industry.

Preimplantation genetic testing for a family with usher syndrome through targeted sequencing and haplotype analysis.

BACKGROUND: Preimplantation genetic testing for monogenic defects (PGT-M) has been available in clinical practice. This study aimed to validate the applicability of targeted capture sequencing in developing personalized PGT-M assay. METHODS: One couple at risk of transmitting Usher Syndrome to their offspring was recruited to this study. Customized capture probe targeted at USH2A gene and 350 kb flanking region were designed for PGT-M. Eleven blastocysts were biopsied and amplified by using multiple displacement amplification (MDA) and capture sequencing. A hidden Markov model (HMM) assisted haplotype analysis was performed to deduce embryo's genotype by using single nucleotide polymorphisms (SNPs) identified in each sample. The embryo without paternal rare variant was implanted and validated by conventional prenatal or postnatal diagnostic means. RESULTS: Four embryos were diagnosed as free of father's rare variant, two were transferred and one achieved a successful pregnancy. The fetal genotype was confirmed by Sanger sequencing of fetal genomic DNA obtained by amniocentesis. The PGT-M and prenatal diagnosis results were further confirmed by the molecular diagnosis of the baby's genomic DNA sample. The auditory test showed that the hearing was normal. CONCLUSIONS: Targeted capture sequencing is an effective and convenient strategy to develop customized PGT-M assay.

The Attributable Direct Medical Cost of Healthcare Associated Infection Caused by Multidrug Resistance Organisms in 68 Hospitals of China.

Healthcare associated infection (HAI) is known to increase the economic burden of patients while the medical cost due to MDRO HAI is even higher. Three hundred eighty-one multidrug resistance organisms (MDROs) healthcare associated infection (HAI) case-patients and three hundred eighty-one matched control-patients were identified between January and December in 2015. The average total hospitalization medical cost of the case group was $6127.65 and that of the control group was $2274.02. The difference between the case group and the control group was statistically significant (t = 21.07; P < 0.01). The attributable cost of MDRO HAI was $3853.63. The direct medical costs due to different MDRO infections were different. The increased medical costs of CR-AB, CR-KP, and CR-PA were significantly higher than that of MRSA, MRSE, ESBL E. coli, and ESBL Kp (P < 0. 05). Among the subitem expenses, the drug cost increased the most (the average cost was $1457.72), followed by the treatment fee and test fee; the differences were statistically significant (P < 0.01).

Application of Internet+-based Tsinghua PINS Remote Tech to improve sacral neuromodulation programming procedure.

OBJECTIVE: To explore the feasibility and safety of the Tsinghua PINS Remote Tech to facilitate sacral neuromodulation programming procedure. METHOD: For 22 patients who had previously participated in the phase III clinical trial for treating overactive bladder with the Tsinghua PINS sacral neuromodulation system during several Hospital, PINS Remote Tech was applied to perform postoperative parameter adjustment in order to evaluate the safety and reliability of this new technique. Telephone surveys on Remote Tech-related questionnaires were also conducted. RESULTS: 17/22 patients underwent 26 parameter adjustments, average adjustment frequency was 1.53 times per person; the average adjustment time was 23.4 ± 5.1 min (15-32 min). The total effective rate of the Remote control was 14/17 (82.3%). 7/17 (41.1%) patients' symptoms recurrence due to not knowing how to handle patient controller, these patients were instructed on how to use it correctly through Remote Tech even without reprogramming it. Other 10 patients received reprogramming. There was no discomfort during and after parameter adjustment. The questionnaire survey showed that the remote technology saved patients' time and lowered financial costs, significantly improved patient satisfaction. All patients expressed their willingness to recommend it to other patients. CONCLUSION: The PINS Remote Tech can significantly reduce the financial cost and provide a remote reprogram control service that is as safe and reliable as outpatient program control.