Identification of differential m6A RNA methylomes and ALKBH5 as a potential prevention target in the developmental neurotoxicity induced by multiple sevoflurane exposures.

Sevoflurane, as a commonly used inhaled anesthetic for pediatric patients, has been reported that multiple sevoflurane exposures are associated with a greater risk of developing neurocognitive disorder. N6-Methyladenosine (m6A), as the most common mRNA modification in eukaryotes, has emerged as a crucial regulator of brain function in processes involving synaptic plasticity, learning and memory, and neurodevelopment. Nevertheless, the relevance of m6A RNA methylation in the multiple sevoflurane exposure-induced developmental neurotoxicity remains mostly elusive. Herein, we evaluated the genome-wide m6A RNA modification and gene expression in hippocampus of mice that received with multiple sevoflurane exposures using m6A-sequencing (m6A-seq) and RNA-sequencing (RNA-seq). We discovered 19 genes with differences in the m6A methylated modification and differential expression in the hippocampus. Among these genes, we determined that a total of nine differential expressed genes may be closely associated with the occurrence of developmental neurotoxicity induced by multiple sevoflurane exposures. We further found that the alkB homolog 5 (ALKBH5), but not methyltransferase-like 3 (METTL3) and Wilms tumor 1-associated protein (WTAP), were increased in the hippocampus of mice that received with multiple sevoflurane exposures. And the IOX1, as an inhibitor of ALKBH5, significantly improved the learning and memory defects and reduced neuronal damage in the hippocampus of mice induced by multiple sevoflurane exposures. The current study revealed the role of m6A methylated modification and m6A-related regulators in sevoflurane-induced cognitive impairment, which might provide a novel insight into identifying biomarkers and therapeutic strategies for inhaled anesthetic-induced developmental neurotoxicity.

Development and validation of an early mortality risk model for pediatric hemophagocytic lymphohistiocytosis: a comparison with HScore, PELOD-2, P-MODS, and pSOFA.

There has been no severity evaluation model for pediatric patients with hemophagocytic lymphohistiocytosis (HLH) that uses readily available parameters. This study aimed to develop a novel model for predicting the early mortality risk in pediatric patients with HLH using easily obtained parameters whatever etiologic subtype. Patients from one center were divided into training and validation sets for model derivation. The developed model was validated using an independent validation cohort from the second center. The prediction model with nomogram was developed based on logistic regression. The model performance underwent internal and external evaluation and validation using the area under the receiver operating characteristic curve (AUC), calibration curve with 1000 bootstrap resampling, and decision curve analysis (DCA). Model performance was compared with the most prevalent severity evaluation scores, including the PELOD-2, P-MODS, and pSOFA scores. The prediction model included nine variables: glutamic-pyruvic transaminase, albumin, globulin, myohemoglobin, creatine kinase, serum potassium, procalcitonin, serum ferritin, and interval between onset and diagnosis. The AUC of the model for predicting the 28-day mortality was 0.933 and 0.932 in the training and validation sets, respectively. The AUC values of the HScore, PELOD-2, P-MODS and pSOFA were 0.815, 0.745, 0.659 and 0.788, respectively. The DCA of the 28-day mortality prediction exhibited a greater net benefit than the HScore, PELOD-2, P-MODS and pSOFA. Subgroup analyses demonstrated good model performance across HLH subtypes. The novel mortality prediction model in this study can contribute to the rapid assessment of early mortality risk after diagnosis with readily available parameters.

Long-term outcomes of central neurocytoma - an institutional experience.

INTRODUCTION: Central Neurocytoma (CN) is a rare, WHO grade 2 brain tumor that predominantly affects young adults. Gross total resection (GTR) is often curative for CNs, but the optimal treatment paradigm including incorporation of RT, following subtotal resection (STR) and for scarcer pediatric cases has yet to be established. METHODS: Patients between 2001 and 2021 with a pathologic diagnosis of CN were reviewed. Demographic, treatment, and tumor characteristics were recorded. Recurrence free survival (RFS) and overall survival (OS) were calculated according to the Kaplan Meier-method. Post-RT tumor volumetric regression analysis was performed. RESULTS: Seventeen adults (≥ 18 years old) and 5 children (< 18 years old) met the criteria for data analysis (n = 22). With a median follow-up of 6.9 years, there was no tumor-related mortality. Patients who received STR and/or had atypical tumors (using a cut-off of Ki-67 > 4%) experienced decreased RFS compared to those who received GTR and/or were without atypical tumors. RFS at 5 years for typical CNs was 67% compared to 22% for atypical CNs. Every pediatric tumor was atypical and 3/5 recurred within 5 years. Salvage RT following tumor recurrence led to no further recurrences within the timeframe of continued follow-up; volumetric analysis for 3 recurrent tumors revealed an approximately 80% reduction in tumor size. CONCLUSION: We provide encouraging evidence that CNs treated with GTR or with RT after tumor recurrence demonstrate good long-term tumor control.

MiR827 positively regulates the resistance to chilli veinal mottle virus by affecting the expression of FBPase in Nicotiana benthamiana.

MicroRNA(miRNA) is a class of non-coding small RNA that plays an important role in plant growth, development, and response to environmental stresses. Unlike most miRNAs, which usually target homologous genes across a variety of species, miR827 targets different types of genes in different species. Research on miR827 mainly focuses on its role in regulating phosphate (Pi) homeostasis of plants, however, little is known about its function in plant response to virus infection. In the present study, miR827 was significantly upregulated in the recovery tissue of virus-infected Nicotiana tabacum. Overexpression of miR827 could improve plants resistance to the infection of chilli veinal mottle virus (ChiVMV) in Nicotiana benthamiana, whereas interference of miR827 increased the susceptibility of the virus-infected plants. Further experiments indicated that the antiviral defence regulated by miR827 was associated with the reactive oxygen species and salicylic acid signalling pathways. Then, fructose-1,6-bisphosphatase (FBPase) was identified to be a target of miR827, and virus infection could affect the expression of FBPase. Finally, transient expression of FBPase increased the susceptibility to ChiVMV-GFP infection in N. benthamiana. By contrast, silencing of FBPase increased plant resistance. Taken together, our results demonstrate that miR827 plays a positive role in tobacco response to virus infection, thus providing new insights into understanding the role of miR827 in plant-virus interaction.

Global prevalence of depressive symptoms among people living with HIV/AIDS: a systematic review and meta-analysis of the past five years.

A clear and accurate assessment of depressive symptoms among people living with HIV/AIDS (PLWHA) in the past five years is essential to help develop reasonable and sound interventions to improve their depressive symptoms. PubMed, Web of Science, MEDLINE, Cochrane, Embase, CINAHL, and APA were searched from 1 January 2017 to 12 April 2022. The data were analyzed using STATA 15 Software to pool the global prevalence of depressive symptoms in PLWHA. Ultimately, 103785 PLWHA from 81 original studies were included. The pooled analysis showed that the global prevalence of depressive symptoms in PLWHA over the past five years was 0.35 (95% CI: 0.31-0.38), with differences in depressive symptoms in PLWHA by geographic location, gender, assessment instruments, alcohol use, smoking, marriage, co-morbid disease, financial situation, and educational level. Scientific and timely public health interventions should be developed among PLWHA to improve their depressive symptoms and thereby improve mental health and clinical outcomes.

Decoupling and Parameter Extraction Methods for Conical Micro-Motion Object Based on FMCW Lidar.

Micro-Doppler time-frequency analysis has been regarded as an important parameter extraction method for conical micro-motion objects. However, the micro-Doppler effect caused by micro-motion can modulate the frequency of lidar echo, leading to coupling between structure and micro-motion parameters. Therefore, it is difficult to extract parameters for micro-motion cones. We propose a new method for parameter extraction by combining the range profile of a micro-motion cone and the micro-Doppler time-frequency spectrum. This method can effectively decouple and accurately extract the structure and the micro-motion parameters of cones. Compared with traditional time-frequency analysis methods, the accuracy of parameter extraction is higher, and the information is richer. Firstly, the range profile of the micro-motion cone was obtained by using an FMCW (Frequency Modulated Continuous Wave) lidar based on simulation. Secondly, quantitative analysis was conducted on the edge features of the range profile and the micro-Doppler time-frequency spectrum. Finally, the parameters of the micro-motion cone were extracted based on the proposed decoupling parameter extraction method. The results show that our method can effectively extract the cone height, the base radius, the precession angle, the spin frequency, and the gravity center height within the range of a lidar LOS (line of sight) angle from 20° to 65°. The average absolute percentage error can reach below 10%. The method proposed in this paper not only enriches the detection information regarding micro-motion cones, but also improves the accuracy of parameter extraction and establishes a foundation for classification and recognition. It provides a new technical approach for laser micro-Doppler detection in accurate recognition.

Enzymatic Assembly of DNA Nanostructures and Fragments with Sequence Overlaps.

Homologous recombination, an evolutionarily conserved DNA double-strand break repair pathway to protect genome stability, has long been exploited for the in vivo and in vitro assembly of multiple DNA duplex fragments in molecular cloning. Whether such methods can also be applied in the self-assembly of DNA nanostructures remains underexplored. Here, we report an enzymatic approach for the self-assembly of high-order DNA constructs with overlapping segments. In our system, a DNA polymerase with exonuclease activity was introduced to produce ssDNA overhangs for specific sticky end cohesion, and as many as 25 DNA structural units were designed to be hierarchically assembled. Using this approach, we successfully constructed a variety of high-order DNA nanostructures, including tubes and extended oligomers, from homogeneous assembly and custom multimers from heterogeneous assembly. Our strategy expands the construction toolbox of complex DNA nanostructures and highlights the potential to enhance the assembly of duplex fragments in molecular cloning.

A Three-Step Screening Procedure for Early Identification of Children at High Risk of Hemophagocytic Lymphohistiocytosis.

PURPOSE: The first step in diagnosing hemophagocytic lymphohistiocytosis (HLH) is to suspect its presence and then order the appropriate diagnostic tests. The development of screening procedures for HLH could facilitate early diagnosis. In this study, we evaluated the utility of fever, splenomegaly, and cytopenias as screening criteria for identifying pediatric HLH at an early stage, built a screening model using commonly measured laboratory parameters, and developed a step-wise screening procedure for pediatric HLH. METHODS: The medical records of 83,965 pediatric inpatients, including 160 patients with HLH, were collected retrospectively. The utility of fever, splenomegaly, hemoglobin level, and platelet and neutrophil counts at hospital admission as screening criteria for HLH was evaluated. For HLH patients who might be missed by screening based on the presence of fever, splenomegaly, and cytopenias, a screening model using common laboratory parameters was developed. Following that, a three-step screening procedure was then developed. RESULTS: The criteria of cytopenias affecting two or more lineages plus fever or splenomegaly had a sensitivity of 51.9% and a specificity of 98.4% for identifying HLH in pediatric inpatients. Our screening score model comprises six parameters: splenomegaly, platelet count, neutrophil count, albumin level, total bile acid level, and lactate dehydrogenase level. The use of the validation set had a sensitivity of 87.0% and a specificity of 90.6%. A three-step screening procedure has been developed: Step 1: Is fever or splenomegaly present? (Yes: risk for HLH should be considered, go to Step 2; No: less likely HLH); Step 2: Are cytopenias affecting at least two lineages? (Yes: consider HLH; No: go to Step 3); Step 3: Calculate the screening score. Is the sum of the score greater than 37? (Yes: consider HLH; No: less likely HLH). The overall sensitivity and specificity of the three-step screening procedure were 91.9% and 94.4%, respectively. CONCLUSION: A significant proportion of pediatric HLH patients present at the hospital without having all three symptoms: fever, splenomegaly, and cytopenias. Our three-step screening procedure, utilizing commonly available clinical and laboratory parameters, can effectively identify pediatric patients who may be at high risk for HLH.

Proteomic Analysis of Pediatric Hemophagocytic Lymphohistiocytosis: a Comparative Study with Healthy Controls, Sepsis, Critical Ill, and Active Epstein-Barr virus Infection to Identify Altered Pathways and Candidate Biomarkers.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome characterized by excessive activation of the immune system, along with uncontrolled proliferation of activated macrophages and lymphocytes. The clinical features of HLH often overlap with the clinical features of other severe inflammatory conditions such as sepsis, hindering accurate and timely diagnosis. In this study, we performed a data-independent acquisition mass spectrometry-based plasma proteomic analysis of 33 pediatric patients with HLH compared with four control groups: 39 healthy children, 43 children with sepsis, 39 children hospitalized in the pediatric intensive care unit without confirmed infections, and 21 children with acute Epstein-Barr virus infection. Proteomic comparisons between the HLH group and each of the control groups showed that HLH was characterized by alterations in complement and coagulation cascades, neutrophil extracellular trap formation, and platelet activation pathways. We identified eight differentially expressed proteins in patients with HLH, including plastin-2 (LCP1), vascular cell adhesion protein 1, fibrinogen beta chain, fibrinogen gamma chain, serum amyloid A-4 protein, extracellular matrix protein 1, apolipoprotein A-I, and albumin. LCP1 emerged as a candidate diagnostic marker for HLH with an area under the curve (AUC) of 0.97 in the original cohort and an AUC of 0.90 (sensitivity = 0.83 and specificity = 1.0) in the validation cohort. Complement C1q subcomponent subunit B was associated with disease severity in patients with HLH. Based on comparisons with multiple control groups, this study provides a proteomic profile and candidate biomarkers of HLH, offering researchers novel information to improve the understanding of this condition.

Decreased NK cells in cases of severe adenovirus pneumonia with liver dysfunction in pediatric intensive care unit: Evidence from 330 patients.

BACKGROUND: Although the human adenovirus infection is common, adenovirus infection with liver dysfunction is rare. METHODS: To retrospectively analyze and compare the clinical characteristics and outcomes of pediatric patients diagnosed with severe adenovirus pneumonia with and without liver dysfunction, who were admitted to the pediatric intensive care unit of Hunan Children's Hospital (South China University) between January 2018 and June 2022. RESULTS: Of the 330 severe adenovirus pneumonia cases analyzed (mean age, 19.88 ± 18.26 months), 102 were girls and 228 were boys. They were divided into two groups: those with liver dysfunction (n = 54) and without liver dysfunction (n = 276). Comparison analysis showed no significant between-group differences in body mass index and levels of white blood cells, neutrophils, platelets, albumin, total bilirubin, direct bilirubin, indirect bilirubin, creatine kinase, procalcitonin, creatinine, and urea nitrogen. However, the levels of alanine aminotransferase (175.99 U/L vs 30.55 U/L) and aspartate transaminase (215.96 U/L vs 74.30 U/L) were significantly higher in patients with liver dysfunction compared to those without liver dysfunction. Further analysis showed that pediatric patients with liver dysfunction had a significantly lower percentage of natural killer (NK) cells (6.93% vs 8.71%) and higher mortality rate (22% vs 9%) than those without liver dysfunction. CONCLUSION: A decrease in serum NK cell levels in pediatric patients with severe adenovirus pneumonia could serve as a marker for monitoring the onset or progression of hepatic damage.

First Report of Fusarium oxysporum Causing Root Rot on Pleione bulbocodioides in China.

The members of Pleione (Orchidaceae) are popular worldwide due to their beautiful flowers and medicinal values. In October 2021, we observed the typical symptoms of yellow or brown leaves, rotted root, and plant death on P. bulbocodioides (Sup. S1a). Nearly 30% of the plants showed disease symptom in the farm in Zhaotong city, Yunnan Province, China. Three fresh root samples with typical symptoms were collected from the plants of P. bulbocodioides in the field. The root sections (3mm × 3mm) from the border of the symptomatic tissue were cut and sterilized with 75% ethanol for 30 s, followed by 3% sodium hypochlorite (NaClO) for 2 min, and then rinsed three times with sterile water. The sterilized root tissues were inoculated on potato dextrose agar (PDA) at 28℃ in the incubator for 3 days. The colonies were obtained and sub-cultured from the hyphal tip to the new PDA to further purify. The colonies grew up on PDA at 28℃ for 1 week, the hyphal color from white turned to purple, the center of colony became brick red. The colonies produced abundant microconidia, macroconidia and chlamydospores, but no sporodochia was observed (Sup. S2). The microconidia were oval and irregularly oval, zero to one septate, and measured 2.0 × 5.2 to 4.1 × 12.2 µm (n = 20). The macroconidia were falcate, slender, with a distinct curve to the latter half of the apical cell, three to five septate, and measured 4.0 × 15.2 to 5.1 × 39.3 µm (n = 20). Morphological characterization showed that the three isolates were similar, and appeared to be Fusarium oxysporum (Leslie and Summerell, 2006). For molecular identification, total genomic DNA of two representative isolates DSL-Q and DSL-Y were extracted with CTAB method, and the PCR amplification were performed. The sequence of partial elongation factor (TEF1-α) gene was amplified using the primer pair EF-1/EF-2 (O'Donnell et al. 1998). The sequence of ß-tublin gene (TUB2) was amplified using the primer pair T1/T22 (O'Donnell and Cigelnik, 1997). The sequences from the two isolates were obtained and sequenced. Clustal2.1 searches indicated that the sequences of the three loci of the two isolates revealed 97.8% to 100%similarity to F. oxysporum strains and were deposited in GenBank (accession nos. OP150481 and OP150485 for TEF1-α; OP150483 and OP186426 for TUB2). A pathogenicity test was performed to confirm Koch,s postulates. Inoculum was obtained from the two isolates by cultivating in 500 mL of potato dextrose broth on a shaker at 25℃. After 10 days, the hyphae grew into a cluster. The 6 individuals of P. bulbocodioides were divided into two groups. Three individuals grew in the bark substrate containing hyphae cluster, while another 3 individuals grew in the bark substrate containing sterile agar medium. The plants were kept in a greenhouse (constant temperature at 25℃, day and night for 12 h). After 20 days, the group inoculated with F. oxysporum isolates showed the same disease symptoms as observed on the plants in the field, while the control plants remained disease free. F. oxysporum was reisolated from the infected tissues (Sup. S1b, c). Phylogenetic dendrograms of Fusarium oxysporum were grouped by TEF1-α and TUB2 sequence (Sup. S3). The results confirmed that this fungus was identical to those identified by colony morphology, phylogenetic relationship and TEF1-α and TUB2 sequence. To our knowledge, this is the first report of F. oxysporum causing root rot on Pleione species in China. This is a pathogenic fungus in the production of Pleione species. Our study is helpful for the identification of root rot on Pleione species and the development of disease control strategy on cultivation.

Source-specific probabilistic risk evaluation of potentially toxic metal(loid)s in fine dust of college campuses based on positive matrix factorization and Monte Carlo simulation.

Contamination, hazard level and source of 10 widely concerned potentially toxic metal(loid)s (PTMs) Co, As, Pb, Cr, Cu, Zn, Ni, Mn, Ba, and V in fine dust with particle size below 63 µm (FD63) were investigated to assess the environmental quality of college campuses and influencing factors. PTMs sources were qualitatively analyzed using statistical methods and quantitatively apportioned using positive matrix factorization. Probabilistic contamination degrees of PTMs were evaluated using enrichment factor and Nemerow integrated enrichment factor. Eco-health risk levels of content-oriented and source-oriented for PTMs were evaluated using Monte Carlo simulation. Mean levels of Zn (643.8 mg kg-1), Pb (146.0 mg kg-1), Cr (145.9 mg kg-1), Cu (95.5 mg kg-1), and Ba (804.2 mg kg-1) in FD63 were significantly larger than soil background values. The possible sources of the concerned PTMs in FD63 were traffic non-exhaust emissions, natural source, mixed source (auto repair waste, paints and pigments) and traffic exhaust emissions, which accounted for 45.7%, 25.4%, 14.5% and 14.4% of total PTMs contents, respectively. Comprehensive contamination levels of PTMs were very high, mainly caused by Zn pollution and non-exhaust emissions. Combined ecological risk levels of PTMs were low and moderate, chiefly caused by Pb and traffic exhaust emissions. The non-cancer risks of the PTMs in FD63 to college students fell within safety level, while the carcinogenic PTMs in FD63 had a certain cancer risks to college students. The results of source-specific health risk assessment indicated that Cr and As were the priority PTMs, and the mixed source was the priority pollution source of PTMs in FD63 from college campuses, which should be paid attention to by the local government.

Nutritional status as a predictor of the incidence of pressure injury in adults: A systematic review and meta-analysis.

AIM: Pressure injuries are a significant health care problem worldwide, and many factors influence their occurrence and development. The purpose of this systematic review and meta-analysis was to investigate the role of nutritional status in the development rate of pressure injuries as a potentially modifiable risk factor. METHODS: Study designs included cohort (prospective and retrospective), case-control, and RCTs if the association between nutrition status and pressure injuries was reported. Databases searched included: PubMed, CINAHL, Embase, Scopus, Web of Science, and Cochrane Library on April 20th, 2022. The data were analyzed using OR and random effect model in Revman5.3 and STATA 15 Software. Report this systematic review and meta-analysis according to the PRISMA 2020 statement. RESULTS: A total of 22 separate studies were retained in this systematic review. Of these, 16 articles were included in the meta-analysis. Three studies were assessed as low risk and sixteen as a moderate risk of bias. All RCTs were B quality. The odds ratio of the incidence of pressure injuries in malnourished and non-malnourished patients was 3.66(95% CI: 2.77-4.83). In the three RCTs studies(n = 870), the odds ratio of the incidence of pressure ulcers in patients with standard nutrition to those with specific nutritional interventions was 1.35(95%CI:1.02-1.78). CONCLUSIONS: This systematic review and meta-analysis showed that nutritional status is significantly associated with pressure injuries. Malnutrition can increase the incidence of pressure injuries, and specific nutritional interventions can reduce the incidence of pressure injuries compared to standard nutrition.

Application of an infrared thermography-based model to detect pressure injuries: a prospective cohort study.

BACKGROUND: It is challenging to detect pressure injuries at an early stage of their development. OBJECTIVES: To assess the ability of an infrared thermography (IRT)-based model, constructed using a convolution neural network, to reliably detect pressure injuries. METHODS: A prospective cohort study compared validity in patients with pressure injury (n = 58) and without pressure injury (n = 205) using different methods. Each patient was followed up for 10 days. RESULTS: The optimal cut-off values of the IRT-based model were 0·53 for identifying tissue damage 1 day before visual detection of pressure injury and 0·88 for pressure injury detection on the day visual detection is possible. Kaplan-Meier curves and Cox proportional hazard regression model analysis showed that the risk of pressure injury increased 13-fold 1 day before visual detection with a cut-off value higher than 0·53 [hazard ratio (HR) 13·04, 95% confidence interval (CI) 6·32-26·91; P < 0·001]. The ability of the IRT-based model to detect pressure injuries [area under the receiver operating characteristic curve (AUC)lag 0 days , 0·98, 95% CI 0·95-1·00] was better than that of other methods. CONCLUSIONS: The IRT-based model is a useful and reliable method for clinical dermatologists and nurses to detect pressure injuries. It can objectively and accurately detect pressure injuries 1 day before visual detection and is therefore able to guide prevention earlier than would otherwise be possible. What is already known about this topic? Detection of pressure injuries at an early stage is challenging. Infrared thermography can be used for the physiological and anatomical evaluation of subcutaneous tissue abnormalities. A convolutional neural network is increasingly used in medical imaging analysis. What does this study add? The optimal cut-off values of the IRT-based model were 0·53 for identifying tissue damage 1 day before visual detection of pressure injury and 0·88 for pressure injury detection on the day visual detection is possible. Infrared thermography-based models can be used by clinical dermatologists and nurses to detect pressure injuries at an early stage objectively and accurately.

Utility of plasma beta-hydroxybutyrate to define resolution of diabetic ketoacidosis.

BACKGROUND: Diabetic ketoacidosis (DKA) is a common, life-threatening complication of type 1 diabetes (T1D) characterized by unregulated ketogenesis caused by relative or absolute insulin deficiency. DKA management requires frequent biochemical monitoring. Plasma ß-hydroxybutyrate (BOHB) has not been included in traditional definitions of DKA resolution. OBJECTIVE: The aim of this study was to determine a cut-point level of BOHB to define DKA resolution in patients with T1D treated with intravenous (IV) insulin. SUBJECTS: We identified patients with T1D receiving IV insulin for DKA treatment at a quaternary children's hospital from January 1, 2017 through December 31, 2020 who had plasma measurements of BOHB after DKA onset and whose DKA resolved by traditional laboratory criteria (venous pH (vpH) ≥ 7.3, serum bicarbonate (HCO3 ) ≥ 15 mmol/L, and/or anion gap (AG) ≤ 14 mmol/L). METHODS: Associations between plasma BOHB and vpH, HCO3 , and AG were evaluated via scatterplots. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate BOHB cut-points to predict DKA resolution. RESULTS: We analyzed 403 patients with 471 unique encounters. Plasma BOHB showed the most robust relationship with AG. The ROC curve comparing plasma BOHB to the accepted definition of DKA resolution, AG ≤14 mmol/L, had an AUC of 0.92. A BOHB value of <1.5 mmol/L had a sensitivity of 83% and specificity of 87%; this cut-point correctly classified 86% of the observations. CONCLUSIONS: A plasma BOHB value of <1.5 mmol/L can be used to define resolution of DKA.

Spatial distribution, pollution level, and health risk of Pb in the finer dust of residential areas: a case study of Xi'an, northwest China.

The spatial distribution, pollution level, and exposure risk of Pb in the finer dust (particle size < 63 µm) of residential areas in Xi'an, northwest China were investigated in this study. Geographical information systems and geodetector methods were used to analyze the spatial variability of Pb content in the finer dust of Xi'an and its forming mechanism. The enrichment factor was used to assess the extent of Pb pollution, and the hazard index was used to evaluate the health risks to children and adults exposed to Pb. The results showed that the average content of Pb in the finer dust of residential areas in Xi'an was 99.9 mg kg-1. In the Xi'an urban area, a higher Pb content was mainly found in the finer dust near the Second Ring Road of Xi'an City, and the Pb content in the old town of Xi'an City was relatively lower than that near the Second Ring Road. The results of geodetector analysis indicate that the spatial variability of Pb in the finer dust of the Xi'an urban area was primarily controlled by the interaction among vehicle emissions, daily behavior of residents, and industrial emissions. Pb in the finer dust from residential areas in all districts showed moderate enrichment. The non-cancer risks of Pb in the finer dust were within the safe range for both children and adults. However, the prolonged exposure risk of Pb in the finer dust of residential areas should be considered for children.

Risk and sources of heavy metals and metalloids in dust from university campuses: A case study of Xi'an, China.

College students study and live at university for several years; however, the pollution levels, ecological health risks, and sources of heavy metals and metalloids (HMMs) in the dust found at university campuses are still unknown. In this study, dust samples from university campuses in Xi'an were collected and the Zn, Mn, As, Pb, V, Cr, Co, Cu, Ba, and Ni contents were measured using X-ray fluorescence spectrometry. The pollution levels and ecological health risks of these HMMs were evaluated using the geo-accumulation, pollution load, and potential ecological risk indices and a health risk assessment model while their sources were apportioned using positive matrix factorization. The mean HMM concentrations in the dust were higher than the corresponding background values in the topsoil of Shaanxi Province. The Mn, V, Co, As, and Ni concentrations in the dust samples analyzed were within the levels categorized as no pollution by the geo-accumulation index standard, whereas other HMMs caused pollution to different degrees. Assessment of the pollution load index indicated that the dust samples analyzed were moderate contamination with HMMs. Pb and Cu in the dust presented considerable and moderate ecological risks, respectively; the other HMMs presented low ecological risks. The combined ecological risk of the HMMs measured in the dust samples was considerable. The non-carcinogenic and carcinogenic risks to male and female college students were within the safe levels. This study found three main sources of the HMMs measured in the dust: traffic, natural, and mixed sources (the latter including automobile repair industry waste and paints and pigments), which accounted for 47.5%, 29.3%, and 23.2% of the total HMM concentration, respectively.

Development and validation of the reproductive health literacy questionnaire for Chinese unmarried youth.

OBJECTIVES: This study aimed to develop and validate the reproductive health literacy questionnaire for Chinese unmarried youth aged 15-24. METHODS: We conducted a validity and reliability study of the questionnaire through a cross-sectional survey and test-retest analysis in four districts in Shanghai between April and June 2017. A total of 1587 participants completed a self-administered questionnaire anonymously on-site and the trained investigators conducted quality check afterwards. Sixty participants among them completed the test-retest assessment with 2 weeks interval. The reliability was determined by internal consistency, spilt-half reliability and test-retest reliability. The construct validity was assessed by confirmatory factor analysis. RESULTS: The 58-question reproductive health literacy questionnaire for Chinese unmarried youth demonstrated high internal consistency (Cronbach's α = 0.919), spilt-half reliability (Guttman splitting coefficient = 0.846) and test-retest reliability (correlation coefficient = 0.720). The confirmatory factor analysis showed that the construct of the questionnaire fitted well with the hypothetical model. The reproductive health literacy scores in unmarried girls aged 15-24 were higher than boys (P < 0.05) and college students who lived in rural areas when they were middle and high school obtained lower score than those living in cities and suburbs (P < 0.01). CONCLUSION: The reproductive health literacy questionnaire for Chinese unmarried youth demonstrated good reliability and validity, which could potentially be used as an effective evaluation instrument to assess reproductive health literacy among Chinese young people.

Despite growing research into evaluation structures for adolescent health literacy in the general population, there is currently a research scarcity in health literacy assessment tools for youth sexual and reproductive health. This is the first time the WHO health literacy framework has been used to construct and evaluate reproductive health literacy among Chinese youth. In this study, we described the questionnaire's development process, reliability and validity, and utilisation among 1587 unmarried youth in Shanghai, China. Our findings indicated that the 58-item questionnaire we developed is effective to assess the reproductive health literacy in Chinese unmarried youth aged 15­24, which includes four aspects of literacy ability (accessing, understanding, appraising, and applying) to three health domains (reproductive health determinants, behavioural risk factors, and health service utilisation). The development of this tool can not only measure the reproductive health literacy level, but also be used for long-term monitoring, as well as facilitating effect evaluation of intervention. This questionnaire may also help to develop target interventions to improve reproductive health literacy of Chinese young people.

Analyzing environmental risk, source and spatial distribution of potentially toxic elements in dust of residential area in Xi'an urban area, China.

A comprehensive study on concentration, spatial distribution, pollution, ecological-health risk and source of potentially toxic elements (PTEs) in dust of residential area in Xi'an, China were conducted to explore the environmental quality of residential area in urban district. The results show that the concentrations of V, Ni, and Mn in the dust were less than, while the contents of Cr, Zn, Pb, Cu, and Ba in the dust were obviously larger than, the soil background values of Shaanxi. The high-value area of PTEs primarily concentrated in densely populated areas, heavily trafficked areas and the surroundings of plants. Cr, Pb and Zn posed moderate enrichment and Pb possessed moderate ecological risk in the dust. The comprehensive pollution levels of PTEs in the dust were uncontaminated to moderately contaminated and their comprehensive ecological risk were moderate. The non-carcinogenic risks of the PTEs for adults and children were in the safe level and the carcinogenic risks of Ni and Cr were under the current acceptable value. Four major sources were discriminated on basis of the multivariate statistical analysis results and the content characteristics, enrichment degrees, and the spatial distribution features of the PTEs, viz. Mn, V, and Ni primarily came from natural source; Pb, Zn, and Cu mainly originated from traffic source; and Ba and Cr were respectively from construction source and coal-fired power plant source, which respectively contributed 22.8%, 28.3%, 47.3%, and 1.6% to the total content of PTEs determined in the dust.

Self-intumescent polyelectrolyte for flame retardant poly (lactic acid) nonwovens.

The demand for eco-friendly poly (lactic acid) (PLA) nonwovens grows at a high rate in the past several decades, however, only a little attention has been received for flame retardant PLA nonwoven fabrics. In this work, a novel halogen-free self-intumescent polyelectrolyte tris (hydroxymethyl)-aminomethane polyphosphate (APTris) was synthesized by reacting ammonium polyphosphate with tris (hydroxymethyl) aminomethane, and was then used to improve the fire resistance of PLA nonwovens via a dip-nip process. The flammability characterization indicated the limiting oxygen index value was increased to 30.0% from 18.3%, and the damaged area in the vertical burning test was reduced by about 87.0% by the presence of APTris. The cone calorimeter test results revealed that the peak heat release rate and total heat release of the treated sample were decreased by 41.0% and 28.2% respectively compared with that of the control PLA nonwoven sample. The char residue was increased to 12.3 from 1.7 wt % at 800 °C. It is suggested that the dense char barrier formed at the presence of APTris prevents heat, smoke, and gas transfer, and hence enhance thermal dilatability and flame retardancy of PLA nonwovens. This simple sustainable halogen-free treatment has great potential to produce cleaner commercialized flame-retardant PLA nonwovens.