The severity assessment of Parkinson's disease based on plasma inflammatory factors and third ventricle width by transcranial sonography.

BACKGROUND: Predicting Parkinson's disease (PD) can provide patients with targeted therapies. However, disease severity can be roughly evaluated in clinical practice based on the patient's symptoms and signs. OBJECTIVE: The current study attempted to explore the factors linked with PD severity and construct a predictive model. METHOD: The PD patients and healthy controls were recruited from our study center while recording their basic demographic information. The serum inflammatory markers levels, such as Cystatin C (Cys C), C-reactive protein (CRP), RANTES (regulated on activation, normal T cell expressed and secreted), Interleukin-10 (IL-10), and Interleukin-6 (IL-6) were determined for all the participants. PD patients were categorized into early and mid-advanced groups based on the Hoehn and Yahr (H-Y) scale and evaluated using PD-related scales. LASSO logistic regression analysis (Model C) helped select variables based on clinical scale evaluations, serum inflammatory factor levels, and transcranial sonography measurements. The optimal harmonious model coefficient λ was determined via 10-fold cross-validation. Moreover, Model C was compared with multivariate (Model A) and stepwise (Model B) logistic regression. The area under the curve (AUC) of a receiver operator characteristic (ROC), brier score, calibration curve, and decision curve analysis (DCA) helped determine the discrimination and calibration of the predictive model, followed by configuring a forest plot and column chart. RESULTS: The study included 113 healthy individuals and 102 PD patients, with 26 early and 76 mid-advanced patients. Univariate analysis of variance screened out statistically significant differences among inflammatory markers Cys C and RANTES. The average Cys C level in the mid-advanced stage was significantly higher than in the early stage (p < 0.001) but not for RANTES (p = 0.740). The LASSO logistic regression model (λ.1se = 0.061) associated with UPDRS-I, UPDRS-II, UPDRS-III, HAMA, PDQ-39, and Cys C as the included independent variables revealed that the Model C discrimination and calibration (AUC = 0.968, Brier = 0.049) were superior to Model A (AUC = 0.926, Brier = 0.079) and Model B (AUC = 0.929, Brier = 0.071) models. CONCLUSION: The study results show multiple factors are linked with PD assessment. Moreover, the inflammatory marker Cys C and transcranial sonography measurement could objectively predict PD symptom severity, helping doctors monitor PD evolution in patients while targeting interventions.

Aberrant gray matter volume and functional connectivity in Parkinson's disease with minor hallucination.

Background: Minor hallucination (MH) is the most common psychotic symptom in Parkinson's disease (PD); it can develop into well-structured visual hallucination (VH), suggesting that MH may be a staccato form of well-structured VH. However, it remains unclear whether the pathogenesis is the same. Therefore, the aim of this study was to investigate the altered gray matter volume (GMV) and functional connectivity (FC) of MH in PD to further understand the complex mechanisms. Materials and methods: We included 67 PD patients who attended the outpatient clinic of Nanjing Medical University Affiliated Brain Hospital and recruited 31 healthy controls (HC). Demographic data and clinical characteristics of all subjects were recorded, and cranial structural magnetic resonance imaging (MRI) and resting-state functional MRI data were acquired. Patients were classified into the PD with MH (PD-MH) group and PD without hallucinations or delusions (PD-NH) group. Voxel-based morphometry was used to analyze the differences in GMV in the structural pattern. Seed-based FC was used to analyze the functional pattern. Gaussian random field correction was used, with voxel level P < 0.001 and cluster level P < 0.05 representing statistically significant differences. Finally, the correlation between FC values and scores on the clinical characteristics assessment scale was analyzed. Results: In the GMV analysis, compared to the PD-NH group, the PD-MH group had reduced GMV in the medial superior frontal gyrus (SFGmed). In the FC analysis, the FC between the SFGmed and the left middle occipital gyrus and right calcarine sulcus decreased in the PD-MH group compared with the PD-NH group, while the FC between SFGmed and the left middle temporal gyrus increased. Correlation analysis revealed that the FC values of the SFGmed and right calcarine sulcus were correlated with the assessment scores for anxiety and sleep symptoms. The FC values of the SFGmed and left middle occipital gyrus were correlated with assessment scores for rapid eye movement disorder. Conclusion: The aberrant structure and function of the default mode network and visual processing areas seems to facilitate the generation of MH in PD, as the alteration was previously found in well-structured VH, suggesting that the two hallucinations have similar pathophysiological mechanisms.

Proportion of renewable energy consumption and economic growth: theoretical and empirical analysis.

The energy consumption revolution led by renewable energy replacing fossil energy has become an important means of energy conservation, emission reduction, quality improvement, and efficiency enhancement to achieve sustainable development. Based on the perspective of energy consumption value, this paper introduces renewable energy and fossil energy into Solow growth model and theoretically analyzes the economic growth effect of renewable energy replacing fossil energy. It shows that with the increase of the proportion of renewable energy in the short term, there is an inverted "U-shaped" curve, in which economic growth increases first and then decreases. Subsequently, this paper selects 34 countries from the year of 2007 to 2017 as sample data to verify the theoretical hypothesis. The results provide evidence to the theoretical hypothesis, and the economic growth will decrease once the proportion of renewable energy consumption reaches to 58% approximately. At present, most countries have not yet reached this inflection point and then can promote renewable energy development by building technological innovation-driven systems and distributed energy systems.

Clinical determinants of coronary artery disease burden and vulnerability using optical coherence tomography co-registered with intravascular ultrasound.

OBJECTIVES: We investigated clinical determinants of disease burden and vulnerability using optical coherence tomography (OCT) co-registered with intravascular ultrasound (IVUS) in a large cohort of patients. METHODS: A total of 704 patients [44.5% with acute coronary syndromes (ACS)] underwent coronary intervention. IVUS plaque burden and OCT lipid, macrophage and calcium indices and the presence of thrombus, plaque rupture and thin-cap fibroatheroma (TCFA) were analyzed. RESULTS: Median patient age was 66 years with 81.8% men, 34.4% with diabetes mellitus and 15.5% with preadmission statins. Median lesion length was 25.7 mm, and 33.0% had a TCFA. Adjusted models indicated (1) older patient age was related to more calcium, but fewer macrophages; (2) men were related to more thrombus with plaque rupture while women had more thrombus without plaque rupture; (3) ACS presentation was related to morphological acute thrombotic events (more thrombus with/without rupture) and plaque vulnerability (more TCFA, more lipid and macrophages and larger plaque burden); (4) diabetes mellitus was related to a greater atherosclerotic disease burden (more lipid and calcium and larger plaque burden) and more thrombus without rupture; (5) hypertension was related to more macrophages; (6) current smoking was related to less calcium; and (7) renal insufficiency and preadmission statin therapy were not independently associated with IVUS or OCT plaque morphology. CONCLUSION: Patient characteristics, especially diabetes mellitus and aging, affect underlying atherosclerotic burden, among which a greater lipidic burden along with sex differences influence local thrombotic morphology that affects clinical presentation.

Risk assessment of the step-by-step return-to-work policy in Beijing following the COVID-19 epidemic peak.

Novel coronavirus (COVID-19) is a new strain of coronavirus first identified in Wuhan, China. As the virus spread worldwide causing a global pandemic, China reduced transmission at considerable social and economic cost. Post-lockdown, resuming work safely, that is, while avoiding a second epidemic outbreak, is a major challenge. Exacerbating this challenge, Beijing hosts many residents and workers with origins elsewhere, making it a relatively high-risk region in which to resume work. Nevertheless, the step-by-step approach taken by Beijing appears to have been effective so far. To learn from the epidemic progression and return-to-work measures undertaken in Beijing, and to inform efforts to avoid a second outbreak of COVID-19, we simulated the epidemiological progression of COVID-19 in Beijing under the real scenario of multiple stages of resuming work. A new epidemic transmission model was developed from a modified SEIR model for SARS, tailored to the situation of Beijing and fitted using multi-source data. Because of strong spatial heterogeneity amongst the population, socio-economic factors and medical capacity of Beijing, the risk assessment was undertaken spatiotemporally with respect to each district of Beijing. The epidemic simulation confirmed that the policy of resuming work step-by step, as implemented in Beijing, was sufficient to avoid a recurrence of the epidemic. Moreover, because of the structure of the model, the simulation provided insights into the specific factors at play at different stages of resuming work, allowing district-specific recommendations to be made with respect to monitoring at different stages of resuming work . As such, this research provides important lessons for other cities and regions dealing with outbreaks of COVID-19 and implementing return-to-work policies.

Spatial production or sustainable development? An empirical research on the urbanization of less-developed regions based on the case of Hexi Corridor in China.

The relationships between spatial production, urbanization and sustainable development are becoming a focus of the international academic cycle. Urbanization dominated by spatial production driven by capital and power often produces and enlarges uneven development, which leads to multiple eco-environmental problems. Thus, the key to development lies in whether the pattern of urbanization is in harmony with the ecological environment. However, previous researches mainly concentrate on spatial production in developed countries or regions. The urbanization and sustainable development of less-developed regions, with complex and fragile ecological environments, are often overlooked. It is a new idea to explain the relationships and interactions between spatial production, urbanization and sustainable development based on less-developed regions by the theory of spatial production. The paper chooses the Hexi Corridor as a typical case, puts forward a conceptual framework and explores the process of spatial production from 2000 to 2017. The results reveal that urbanization in the Hexi Corridor is a multidimensional socio-spatial process: power and capital gave birth to a higher urbanization and accelerated the process of urbanization, however, the urban-rural gap between regions has not narrowed accordingly. Driven by comprehensive interests, local governments often take some extreme measures to forcefully promote the urbanization process, thereby violating the goals and requirements of sustainable development. At present, there is an urgent need to coordinate the relationship between urban and rural regions on different scales and transform the urbanization model from traditional spatial production to a new-type of urbanization with people-oriented and sustainable development.

Assessment of ventilator-associated pneumonia by combining 8-isoprostane and nitric oxide levels in exhaled breath condensate with the clinical pulmonary infection score.

OBJECTIVE: To investigate the effectiveness of combining the 8-isoprostane and nitric oxide (NO) levels in exhaled breath condensate (EBC) with the clinical pulmonary infection score (CPIS) to assess ventilator-associated pneumonia (VAP) in patients on mechanical ventilation. METHODS: Thirty-two patients with VAP served as the observation group and 32 patients without VAP served as the control group. The correlations of 8-isoprostane and NO levels in EBC with CPIS, chest X-ray score, oxygenation index, and lung injury score (LIS) were analyzed. The area under the curve (AUC) was compared with experimental data using the receiver operating characteristic curve (ROC) to predict VAP. RESULTS: The 8-isoprostane and NO levels in EBC of VAP patients on mechanical ventilation were positively correlated with CPIS, chest X-ray score, and LIS, but negatively correlated with oxygenation index. The AUC of simplified CPIS combined with 8-isoprostane and NO levels in EBC for predicting VAP was 0.914, which suggests that this is a highly effective for making a diagnosis. CONCLUSIONS: The simplified CPIS combined with the 8-isoprostane and NO levels in EBC of patients on mechanical ventilation is effective for evaluating and diagnosing VAP. 8-Isoprostane and NO levels in EBC could be used as biomarkers to evaluate VAP.

[Vertical distribution characteristics of nutrients and heavy metals in sediments of Lake Hongze].

In order to understand the vertical distribution characteristics of nutrients and heavy metals in sediments of Lake Hongze, three core sediment samples at 3 sites (one near the Huaihe River inlet of Lake Hongze, one at the western part of the lake and one at the lake center) were collected in June of 2008. By measurement of total nitrogen (TN), total phosphorus (TP) and heavy metals (Cu, Zn, Pb, Cd, Fe, Al, Cr, Hg, Mn, As) and by analyzing of their vertical characteristics, investigation revealed the nutrient evolution processes and pollution history. Sediment near Huaihe river mouth was more polluted by the Huaihe River watershed. The nutrients TN, TP and organic matter (OM) concentrations in this core sample were 390.8-643.7, 428.6-538.6, 5 194.3-9 164.9 mg x kg(-1) respectively. Zn, Cd, Al, Fe and Mn in the sediment in this area were affected by human activities less than other heavy metals. Western Lake sediment was affected by the Huaihe River, inlet river and human activities in cities along western lake shoreline. TN, TP and OM concentrations in this core sample were 633.4-2 677.3, 480.0-1115.9, 7 140.8-47 849.7 mg x kg(-1) respectively. The pollution extents of TN, OM and heavy metals in sediment were exacerbated since the late of 1970s, but the situation was improved since the 1990s. As and Cr in the sediments were influenced by human activities more than other heavy metals. Main pollution source in sediment at the lake center were detritus from the lake watershed. TN, TP and OM concentrations in this core sample were 904.7-1 585.4, 526.3-750.1, 10 635.6-19 020.6 mg x kg(-1) respectively. The correlations among nutrients and heavy metals in sediment are significant, and their vertical distribution patterns were similar. The concentrations of nutrients and heavy metals increased from bottom to surface. Nutrients and heavy metal pollution in sediment had the same vertical distribution characteristics which coincided with the lake watershed economic development stage. The sediment in Lake Hongze can be described by the Turbidity Flood Model.

Availability and quality of emergency obstetric care, an alternative strategy to reduce maternal mortality: experience of Tongji Hospital, Wuhan, China.

The burden of maternal mortality (MM) and morbidity is especially high in Asia. However, China has made significant progress in reducing MM over the past two decades, and hence maternal death rate has declined considerably in last decade. To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital, Wuhan, China, this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009. Two baseline periods of equal length were used for the comparison of variables. A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations, either 71.35% of all activities. No maternal death was recorded. Mean age of women was 29.31 years with a wide range of 14-52 years. About 96.26% of women had higher levels of schooling, university degrees and above and received the education of secondary school or college. About 3.74% received primary education at period two (P2) from 2005 to 2009, which was significantly higher than that of period one (P1) from 2000 to 2004 (P<0.05) (OR: 0.586; 95% CI: 0.442 to 0.776). About 65.69% were employed as skilled or professional workers at P2, which was significantly higher than that of P1 (P<0.05). About 34.31% were unskilled workers at P2, which was significantly higher than that of P1 (P<0.05). Caesarean section was performed for 9,930 women (88.48%) and the percentage of the procedure increased significantly from 19.25% at P1 to 69.23% at P2 (P<0.05). We were led to conclude that, despite the progress, significant gaps in the performance of maternal health services between rural and urban areas remain. However, MM reduction can be achieved in China. Priorities must include, but not limited to the following: secondary healthcare development, health policy and management, strengthening primary healthcare services.

[Distribution and potential ecological risk assessment of heavy metals in surface sediments of Hongze Lake].

In order to investigated horizontal distribution patterns of heavy metals in surface sediments of Hongze Lake, heavy metal contents in every samples were measured by Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES) and Atomic Fluorescence spectrometry (AFS) and the potential ecological risks of each heavy metals were analyzed. The average contents of heavy metals Cu, Zn, Pb, Cd, Cr, Hg, As, Fe, Al and Mn are 34.99 mg/kg, 72.44 mg/kg, 18.82 mg/kg, 3.24 mg/kg, 57.59 mg/kg, 0.07 mg/kg, 23.67 mg/kg, 29.63 mg/g, 37.19 mg/g and 0.69 mg/g, respectively. Horizontal distribution patterns of every heavy metals (Cu, Zn, Pb, Cd, Fe, Al, Cr, Hg, Mn and As) in surface sediments were very similar. By impact of hydodynamical and topographical condition, the contents of heavy metals were significantly lower in the inflow river mouth areas than that of open water area in the eastern part of the lake, and that of bays and outflow river mouth areas. This distribution pattern belongs to Turbidity Flood Model. These heavy metals are highly related with each other positively, indicating that they are from the same pollution source. The geo-accumulation index (I(geo)) and the Hakanson potential ecological risk index were applied for assessing the status of sediment heavy metal enrichment and the extent of potential ecological risk. The pollution extent of heavy metals followed the order: Cd > As > Cu > Cr > Zn > Hg > Pb, while the single potential ecological risk of heavy metals followed the order: Cd > As > Hg > Cu > Pb > Cr > Zn. The pollution extent and potential ecological risk of Cd were the most serious among all heavy metals. The distribution pattern of Cd individual potential ecological risk indices is exactly the same as that of general potential ecological risk indices for all heavy metals, indicating the important contribution of Cd in the general indices. Analysis showed that heavy metal pollution and the potential ecological risk existed in three risk regions: the central open water area and outflow river mouth region (S9, S1 and S8), the northern bay region (S6) and the western bay region (S5).