Risk factors analysis and prediction model construction for severe pneumonia in older adult patients.

Objective: Pneumonia is a common and serious infectious disease that affects the older adult population. Severe pneumonia can lead to high mortality and morbidity in this group. Therefore, it is important to identify the risk factors and develop a prediction model for severe pneumonia in older adult patients. Method: In this study, we collected data from 1,000 older adult patients who were diagnosed with pneumonia and admitted to the intensive care unit (ICU) in a tertiary hospital. We used logistic regression and machine learning methods to analyze the risk factors and construct a prediction model for severe pneumonia in older adult patients. We evaluated the performance of the model using accuracy, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and calibration plot. Result: We found that age, comorbidities, vital signs, laboratory tests, and radiological findings were associated with severe pneumonia in older adult patients. The prediction model had an accuracy of 0.85, a sensitivity of 0.80, a specificity of 0.88, and an AUC of 0.90. The calibration plot showed good agreement between the predicted and observed probabilities of severe pneumonia. Conclusion: The prediction model can help clinicians to stratify the risk of severe pneumonia in older adult patients and provide timely and appropriate interventions.

[Work Environment-Mediated Job Burnout and Intention-to-Stay in Registered Nurses].

BACKGROUND: Nurse engagement and retention are critical issues affecting the quality of healthcare. Although the work environment is known to affect nursing performance and patient outcomes, little is known regarding the impact of this environment on nurse burnout and future work intention, especially in non-Western settings. PURPOSE: This study explored the extent to which Taiwanese nurses' perceptions of their practice environment mediates burnout levels and intention-to-stay. METHODS: This descriptive, correlational study, conducted between September and December 2020, recruited nurses employed at a regional teaching hospital located in a relatively rural region in Taiwan. The participants completed standardized questionnaires, including a demographic information form, the 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI), the 22-item Maslach Burnout Inventory (MBI-HSS), and the 6-item Intention-to-stay (ITS) scale. The mediating effect among the variables related to intention-to-stay was examined using Model 4 of the PROCESS macro and tested using the bootstrapping method (repeated 5,000 times) with a p value < .05. RESULTS: The mean age of the 376 participants was 34.3 years (SD = 8.1). Nearly one-third (30.3%) scored > 27 on the emotional exhaustion subscale of the MBI-HSS, indicating they were "highly burned-out". Also, nearly one-third (30.6%) were uncertain about their intention to stay with their current employer. Burnout was associated with intention-to-stay (ß = -.088, p < .001), and holding a positive perception toward their practice environment was shown to mediate the relationship between burnout and intention-to-stay (ß = -.015; p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Targeted interventions and technical support that promote a collaborative climate and psychological empowerment in clinical practice may alleviate burnout and intention-to-leave in nurses and improve workplace quality.

The Association Between Leucine and Diabetic Retinopathy in Different Genders: A Cross-Sectional Study in Chinese Patients With Type 2 Diabetes.

Objective: To explore the association between serum leucine (leu) and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D) and then to analyze the influence of gender on the association. Method: The electronic medical records of 1,149 T2D patients who met inclusion and exclusion criteria were retrieved from the Second Affiliated Hospital of Dalian Medical University and the First Affiliated Hospital of Jinzhou Medical University. Serum leu levels of all subjects were measured by liquid chromatography-mass spectrometry. Logistic regression was used to obtain the odds ratio (OR) and CI of leu-DR risk in multiple models. When using these models, restricted cubic spline (RCS) was used to test the potential non-linear relationship between multiple continuous independent variables, such as leu and DR (classification), and dependent variables. We also used the additive interaction method to evaluate the interaction effect between leu and gender on DR. Results: Leu was a protective factor of DR [0.78 (0.66, 0.92)]. When gender was divided into male and female, the above relationship was statistically significant only in men [0.73 (0.58, 0.94)]. Three indicators of additive interaction-RERI, AP, and S-suggested that there is no interaction between gender and leu on the risk of DR. Conclusions: Male T2D patients with high leu levels may have a lower risk of DR.

Acetylcarnitine Is Associated With Cardiovascular Disease Risk in Type 2 Diabetes Mellitus.

Objective: This study aimed to identify the association between specific short-chain acylcarnitines and cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Method: We retrieved 1,032 consecutive patients with T2DM who meet the inclusion and exclusion criteria from the same tertiary care center and extracted clinical information from electronic medical records from May 2015 to August 2016. A total of 356 T2DM patients with CVD and 676 T2DM patients without CVD were recruited. Venous blood samples were collected by finger puncture after 8 h fasting and stored as dried blood spots. Restricted cubic spline (RCS) analysis nested in binary logistic regression was used to identify possible cutoff points and obtain the odds ratios (ORs) and 95% confidence intervals (CIs) of short-chain acylcarnitines for CVD risk in T2DM. The Ryan-Holm step-down Bonferroni procedure was performed to adjust p-values. Stepwise forward selection was performed to estimate the effects of acylcarnitines on CVD risk. Result: The levels of C2, C4, and C6 were elevated and C5-OH was decreased in T2DM patients with CVD. Notably, only elevated C2 was still associated with increased CVD inT2DM after adjusting for potential confounders in the multivariable model (OR = 1.558, 95%CI = 1.124-2.159, p = 0.008). Furthermore, the association was independent of previous adjusted demographic and clinical factors after stepwise forward selection (OR = 1.562, 95%CI = 1.132-2.154, p = 0.007). Conclusions: Elevated C2 was associated with increased CVD risk in T2DM.

Lanthanide-Aromatic Iminodiacetate Frameworks with Helical Tubes: Structure, Properties, and Low-Temperature Heat Capacity.

A series of lanthanide coordination polymers [LnL(H2O)2] n [Ln = Pr (1), Nd (2), Sm (3), Eu (4), and Gd (5), H3L = N-(4-carboxy-benzyl)iminodiacetic acid] was hydrothermally prepared and structurally characterized. All the five compounds have been confirmed as 3D Ln-CPs with one-dimensional helical tunnels composed of four helical chains, although there are different coordination geometries around Ln3+. Enantiomeric helixes in 1-3, and absolute left-handed and right-handed helical chains in 4 and 5, respectively, lead to different tunnel spaces. Their conformations can also be featured by different space groups and unit cell dimensions. Photoluminescence measurement on 3 and 4 show characteristic emission peaks of Sm3+ and Eu3+ ions, respectively. The low-temperature heat capacity of 1-4 has been investigated in the temperature range of 1.9-300 K. Their heat capacity values are nearly equal below 10 K and display a crossover with the value order C p,m(2) > C p,m(1) ≈ C p,m(4) > C p,m(3) above 10 K. The measured heat capacities have been fitted, and the corresponding thermodynamic functions were consequently calculated based on the fitting parameters. The standard molar entropies at 298.15 K have been determined to be (415.71 ± 4.16), (451.32 ± 4.51), (308.53 ± 3.09), and (407.62 ± 4.08) J·mol-1·K-1 for 1, 2, 3, and 4, respectively.

Decreased plasma n6 : n3 polyunsaturated fatty acids ratio interacting with high C-peptide promotes non-alcoholic fatty liver disease in type 2 diabetes patients.

AIMS/INTRODUCTION: To explore relationships between polyunsaturated fatty acids (PUFA) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes, and whether insulin action has an interactive effect with PUFA on NAFLD progression. MATERIALS AND METHODS: We extracted clinical and omics data of 482 type 2 diabetes patients from a tertiary hospital consecutively from April 2018 to April 2019. NAFLD was estimated by ultrasound at admission. Plasma fasting n3 and n6 fatty acids were quantified by liquid chromatography-tandem mass spectrometry analysis. Restricted cubic spline nested in binary logistic regression was used to select the cut-off point, and estimate odds ratios and 95% confidence intervals. Additive interactions of the n6 : n3 ratio with insulin action for NAFLD were estimated using relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Relative excess risk due to interaction >0, attributable proportion due to interaction >0 or synergy index >1 indicates biological interaction. Spearman correlation analysis was used to obtain partial correlation coefficients between PUFA and hallmarks of NAFLD. RESULTS: Of 482 patients, 313 were with and 169 were without NAFLD. N3 ≥800 and n6 PUFA ≥8,100 µmol/L were independently associated with increased NAFLD risk; n6 : n3 ratio ≤10 was associated with NAFLD (odds ratio 1.80, 95% confidence interval 1.20-2.71), and the effect size was amplified by high C-peptide (odds ratio 8.89, 95% confidence interval 4.48-17.7) with significant interaction. The additive interaction of the n6 : n3 ratio and fasting insulin was not significant. CONCLUSION: Decreased n6 : n3 ratio was associated with increased NAFLD risk in type 2 diabetes patients, and the effect was only significant and amplified when there was the co-presence of high C-peptide.

Integrated proteomics and metabolomics analysis of tea leaves fermented by Aspergillus niger, Aspergillus tamarii and Aspergillus fumigatus.

Post-fermented Pu-erh tea (PFPT) is a microbially-fermented tea with distinct sensory qualities and multiple health benefits. Aspergillus are the dominant fungi in the fermentation and the main contributors to the characteristics of PFPT, so their underlying functions warrant detailed study. Here, tea leaves were fermented by Aspergillus niger, Aspergillus tamarii and Aspergillus fumigatus, and resulting samples (designated as Asn, Ast and Asf, respectively) were analyzed by proteomic and metabolomic methods. Changes to the composition of flavonoids, glycerophospholipids, organo-oxygen compounds and fatty acids resulting from Aspergillus fermentation were observed. Carbohydrate-active enzymes, e.g., endoglucanases and cellulases, for degradation of cellulose, starch, lignin, pectin, xylan and xyloglucan were identified. Glycoside hydrolase, glycosyltransferases, tannase, laccases, vanillyl-alcohol oxidases and benzoquinone reductase were identified and hypothesized to catalyze hydrolysis, oxidation, polymerization and degradation of phenolic compounds. Together, functions of Aspergillius were demonstrated as production of enzymes to change concentrations and compositions of metabolites in tea leaves.

[Vertical Distribution Characteristics of PAHs in Soils with Different Land Use Types During Rapid Urbanization].

To study the vertical distribution characteristics of polycyclic aromatic hydrocarbons (PAHs) in the soils from different land use types during urbanization, three land use types (urban land, cultivated land, and woodland) were selected in the eastern part of Shenyang, where urbanization is occurring rapidly. In each case, five soil samples were obtained from different depths (0-1 m). Change in the concentrations of PAHs, vertical migration factors, and the distribution and sources of PAHs were analyzed in the vertical soil profiles. Total concentrations of PAHs in the different soil type were ordered as follows:city 1 (513.19-12689.04 µg·kg-1); dry field (36.18-7196.10 µg·kg-1); paddy field (70.92-747.53 µg·kg-1); city 2 (19.39-636.47 µg·kg-1); and woodland (4.79-349.24 µg·kg-1). PAHs were mainly trapped in shallow soils in urban and forest land, but can migrate deeper into the soil profile in cultivated land. High-ring PAHs were abundant at depths of 0-30 cm, while low-ring PAHs were abundant deeper in the soil profiles. SOM had a significant effect on the vertical distribution of PAHs, and the physical and chemical properties of PAHs had a significant influence on their migration ability. However, combustion sources from industrial activities and transportation in the region are still considered the main sources of PAHs despite the fact that some low-ring PAHs derive from petroleum product inputs.

[Pollution Characteristic and Risk Assessment of Polycyclic Aromatic Hydrocarbons in the Groundwater of Shen-Fu New City in the Hunhe River Basin].

To protect the safety of water used by the residents in Shen-Fu New City, which is undergoing the process of urbanization, 49 groundwater samples were collected along the Hunhe River Basin and 16 US EPA priority control polycyclic aromatic hydrocarbons (PAHs) were analyzed. The occurrence, distribution characteristics, sources, and potential health risk of drinking the groundwater were also assessed in this study. The results show that PAHs were detected in all samples. The concentration of PAHs ranges from 4.38 to 2005.02 ng·L-1, with an average value of (414.64±526.13) ng·L-1. Based on the comparison of the concentration level with that of other regions, the results in this study indicate a higher pollution level. The 3-4 ring PAHs are dominant; the average value was (190.93±238.96) ng·L-1 and (140.01±234.69) ng·L-1, respectively, accounting for 80% of the total PAHs. The distribution of PAHs in the groundwater is affected by the land use types. The concentration of PAHs is higher when the land use type is cultivated land, while it is lower when it is forest land. The source of PAHs was identified using Principal Component Analysis-Multiple Linear Regression (PCA-MLR). It was revealed that 36.26% of the PAHs are due to incomplete combustion of petroleum and gas, 32.72% are due to coal combustion, 28.17% originate from petroleum spills, and 2.87% are due to traffic emissions. The cancer risk levels releated to drinking the groundwater range from 5.55×10-10 to 5.65×10-6 and 13.60% of the values is in the range of 10-6-10-4. The levels are higher than the baseline of the acceptable risk, indicating the potential cancer risk. More attention should be paid to the quality of the groundwater.

[Knockout of BMAL1 Gene Induces Apoptosis of HL-60 Cells and Inhibits its Proliferation].

OBJECTIVE: To explore the biological function of BMAL1 in human acute myeloid leukemia by means of the HL-60 cell line in whica circadian gene BMAL1 was konocked-out by the CRISPR/Cas9 technology. METHODS: Two sgRNAs for BMAL1 were designed and the PX459 knockout vectors containing the sgRNA were constructed. The activity of 2 sgRNAs was detected by T7 endonuclease I. the BMAL1 knocked out HL-60 cells were prepared by transient transfection of the target vectors into the cells. Western blot was used to detect the expression of BMAL1 protein. The apoptosis of the targeted cells was detected by flow cytometry. The proliferation status of the cells was assessed by the CCK-8 assay. RESULTS: The PX459-sgRNA vectors were successfully constructed and screened to assure the activity of the targeting vector. It was found that the expression of BMAL1 protein was not detected in BMAL1-knocked out HL- 60 cells. Further, it was shown that BMAL1 knockdout could promote the apoptosis of HL-60 cells and inhibit the cell proliferation ability. CONCLUSION: BMAL1 knocked out HL-60 cells have bean successfully established using the CRISPR/Cas9 gene editing technique, and BMAL1 knockout can promote the HL-60 cell apoptosis and inhibit its proliferation.These result reveal the biological role of the BMAL1 circadian gene in acute myeloid leukemia.

[Sources and Risk Assessment of Polycyclic Aromatic Hydrocarbons from the Urbanization Process of Topsoil].

To study the effects of urbanization on concentration, sources, and health risks of polycyclic aromatic hydrocarbons (PAHs), 95 topsoil samples were collected from Liaoning Province. For this assessment, 21 PAHs were analyzed via gas chromatography-mass spectrometry and discussed. The results show the total concentrations of the 21 PAHs in background, Shen-Fu, Shen-Yang, and Fu-Shun were 1496.76 µg·kg-1, 3000.50 µg·kg-1, 8705.11 µg·kg-1, and 8178.90 µg·kg-1, respectively, which is positively correlated with the urbanization levels. Diagnostic ratios and PMF modal analysis indicate that the sources of the PAHs in soils were most likely coal combustion and traffic combustion (petroleum combustion). The main sources of PAHs in the four areas were petrochemical combustion (41.0%), coal combustion (64.4%), traffic combustion (67.5%), and traffic combustion (62.0%), that is, with the urbanization process, human activity (mainly traffic combustion) gradually become the major contributor of PAHs to the environment. Health risk assessment showed that the risk of cancer exposure through soil digestion and skin exposure was higher. There is a higher health risk from PAHs in urban soils, and the health risks associated with children and adolescents are greater than with other residents, requiring more attention.

[Concentration, Sources and Ecological Risks of PAHs of Different Land Use Types in Shenfu New City].

The concentration level of polycyclic aromatic hydrocarbon (PAHs) in topsoil from Shenfu New City in urbanization was studied. 54 topsoil samples were collected from Shenfu New City and 4 different land uses (urban land, rural land, forest land, cultivated land) were included. The concentration of PAHs in different land uses was analyzed, the sources of soil PAHs were analyzed by using diagnostic ratios and principal component analysis, and the ecological risks were calculated using toxic equivalency concentrations of BaP and the incremental lifetime cancer risk(ILCR)model. Results indicated that the concentrations of ∑PAHs in urban land, cultivated land, rural land and forest land were in the range of 184-18276, 230-14102, 151-3205, 303-2980 µg·kg-1, respectively. Four land uses had similar sources, the main sources were coal combustion and traffic emission. According to the calculation of ecological risks, there were potential health risks for residents in Shenfu New City, especially urban land, meanwhile, residents were easily exposed to soil PAHs through dermal contact.

The Anthropometric Measurement of Schober's Test in Normal Taiwanese Population.

The measurement of lower back mobility is essential in the assessment of lower back pain including ankylosing spondylitis. Original Schober's test (OST) and modified Schober's test (MST) are popularly conducted in daily rheumatology and orthopedics clinical practices. To our knowledge, this report is the only anthropometric reference study in a normal oriental population. The OST declined with age from 5.0 cm in the youngest (20-30 years old) to 3.1 cm in the aged (70-80 years old) male subjects and from 3.6 cm to 2.4 cm in the female subjects. The male OST was significantly more than the female OST. There was a good correlation between OST and MST in each of the three age groups of both sexes.

Nardosinane-type sesquiterpenoids of Nardostachys chinensis Batal.

Four new nardosinane-type sesquiterpenoids nardosinanones F-I (1-2, 4-5), along with eight known sesquiterpenoids (3, 6-12) were isolated from the underground parts of Nardostachys chinensis Batal. Their structures were elucidated on the basis of extensive spectroscopic analysis. Compounds 1 and 2 were new nardosinane sesquiterpenoids processing a rare 4,11-epoxy group in nature. In addition, compounds 1, 5-7, 11 and 12 showed protective effects on neonatal rat cardiomyocyte injury induced by hydrogen peroxide.

Suppression of TRPM7 inhibits proliferation, migration, and invasion of malignant human glioma cells.

BACKGROUND: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor with a dismal prognosis. Despite intensive study on tumor biology, the underlying mechanisms of the unlimited proliferation and progressive local invasion are still poorly understood, and no effective treatment has been developed for GBM patients. AIMS: We determine the role of TRPM7 channels in the growth, migration, and infiltration of malignant glioma cells. METHODS: Using a combination of RT-PCR, Western blot, and patch-clamp techniques, we demonstrated the expression of functional TRPM7 channels of A172 cells, a human glioma cell line, as well as in human glioma tissues. Furthermore, we evaluated the role of TRPM7 in growth, migration, and infiltration of A172 cells with MTT and transwell migration and invasion assays. RESULTS: We showed the expression of functional TRPM7 channels in both A172 cells and human glioma tissues. Suppression of TRPM7 expression with TRPM7-siRNA dramatically reduced the proliferation, migration, and invasion of A172 cells. Pharmacological inhibition of TRPM7 channel with 2-aminoethoxydiphenyl borate (2-APB) showed a similar effect as TRPM7-siRNA. CONCLUSION: We demonstrate that human glioma cells express functional TRPM7 channel and that activation of this channel plays an important role in the proliferation, migration, and invasion of malignant glioma cells. TRPM7 channel may represent a novel and promising target for therapeutic intervention of malignant glioma.

A new lignan glycoside from Forsythia suspensa.

Phytochemical investigation on Forsythia suspensa (Thunb.) Vahl afforded ten compounds, including five lignan glycosides and five phenylethanoid glycosides. The compounds were isolated by using HP-20 macroporous resin, silica gel, octadecyl silica gel (ODS), size exclusion chromatography resin HW-40 chromatography, and preparative HPLC. The structures were established through application of extensive spectroscopic methods, including ESI-MS, 1D-and 2D-NMR spectroscopy. They were identified as forsythialanside E (1), 8'-hydroxypinoresinol-4'-O-ß-D-glucoside (2), 8'-hydroxypinoresinol (3), lariciresinol-4'-O-ß-D-glucoside (4), lariciresinol-4-O-ß-D-glucoside (5), forsythoside H (6), forsythoside I (7), forsythoside F (8), plantainoside B (9), and plantainoside A (10). Compound 1 was a new lignan glycoside.

Quinoid glycosides from Forsythia suspensa.

Phytochemical investigation on Forsythia suspensa (Thunb.) Vahl afforded 10 compounds, including quinoid glycosides, lignan glycosides, phenylethanoid glycoside and allylbenzene glycoside together with 13 known ones. Their structures were established based on extensive spectroscopic data analyses, including IR, UV, HRESIMS, 1D NMR and 2D NMR. Absolute configurations were determined by ECD calculation method and chemical degradation. In addition, all compounds were evaluated for their antiviral activity against influenza A (H1N1) virus and several were further evaluated against respiratory syncytial virus (RSV) in vitro. Among them, two previously known compounds showed significant activities against RSV with EC50 values of 3.43 and 6.72 µM.

Nardoaristolones A and B, two terpenoids with unusual skeletons from Nardostachys chinensis Batal.

Nardoaristolones A and B, two novel terpenoids derived from the aristolane-type sesquiterpenoid, were isolated from the underground parts of Nardostachys chinensis Batal. Nardoaristolone A is the first reported aristolane-chalcone derivative, while nardoaristolone B possesses a nor-aristolane sesquiterpenoid skeleton with an unusual 3/5/6 tricyclic ring system. Their structures were elucidated by spectroscopic measurements, and the absolute configurations were established by single-crystal X-ray diffraction experiments.

Defective protein kinase A and C pathways are common causes of disordered zona pellucida (ZP)--induced acrosome reaction in normozoospermic infertile men with normal sperm-ZP binding.

OBJECTIVE: To determine association between defective protein kinases C (PKC) and A (PKA) and disordered zona pellucida (ZP)-induced acrosome reaction (DZPIAR) in normozoospermic infertile men with normal sperm-ZP binding. DESIGN: Sperm from DZPIAR infertile men were treated without (control) or with (test) phorbol myristate acetate (PMA, PKC activator) or dibutyryl cyclic AMP (dbcAMP, PKA activator) under in vitro standard culture condition. The ZP-induced AR was assessed and compared between control and test. SETTING: Public and private hospital-based clinical assisted reproduction technology (ART) centers. PATIENT(S): A total of 51 DZPIAR infertile men were involved in this study. INTERVENTION(S): None. MAIN OUTCOMES MEASURE(S): Sperm-ZP binding and the ZP-induced IAR. RESULT(S): Both PMA and dbcAMP enhanced ZP-induced AR up to a normal level (≥25%) in some subjects with DZPIAR: 29 (57%) with PMA and 27 (53%) with dbcAMP. Overall 35 (69%) had the ZP-induced AR enhanced to normal by PMA or dbcAMP but 16 (31%) had little or no response to either agent. Fourteen men responded to the two activators differently: 8 effective only with PMA and 6 effective only with dbcAMP. CONCLUSION(S): Defective upstream of PKC and PKA pathways are highly associated with disordered ZPIAR in normozoospermic infertile men with normal sperm-ZP binding.

Preparation, structure and near-infrared luminescent property of Yb(III) complex with 2,4,6-pyridinetricarboxylic acid.

A rare earth ytterbium complex with 2,4,6-pyridinetricarboxylic acid (H(3)pta) has been synthesized by hydrothermal method, the formula is {[Yb(2)(pta)(2)(H(2)O)(3)]·H(2)O}(n). The complex crystallized in monoclinic system, P2(1)/c space group with lattice parameters a = 11.6556(19)Å, b = 7.8364(12), c = 22.020(4), α = γ = 90º, ß = 92.120(3), Z = 4, GOF = 1.026, R1 = 0.0334, wR2 = 0.0660. The pta anions connect four rare earth Yb(III) ions with two different coordination modes. The complex exhibit intense characteristic near-infrared luminescence of Yb(III) ions at 990 nm with excitation of UV-rays.