Association between admission hemoglobin level and prognosis in sepsis patients based on a critical care database.

This study aimed to explore the association between admission hemoglobin level and clinical outcomes in sepsis based on Medical Information Mart for Intensive Care IV(MIMIC-IV) database. It was a retrospective study. Sepsis patients in the database were included. Data extraction from MIMIC-IV was performed by PostgreSQL 9.6 software. Three different models including crude model (adjusted for none), model I (adjusted for gender and age) and model II (adjusted for all potential cofounders) were constructed. A generalized liner model and a smooth fitting curve for indicating the relationship between hemoglobin level and 30-day mortality were performed. 6249 septic patients with a 30.18% of 30-day mortality were included. With 1 g/dl increment in hemoglobin level, the values of odds ratio (OR) in crude model, model I and model II were 0.96 (95% confidential interval (CI) 0.94-0.99, P = 0.0023), 0.96 (95%CI 0.93-0.98, P = 0.0010) and 0.87 (95%CI 0.79-0.95, P = 0.0020), respectively. The smooth fitting curve indicated a non-linear relationship and the turning point was 7.2 g/dl. Compared the hemoglobin group < 7.2 g/dl, the risk of 30-day mortality significantly decreased by 32% in the hemoglobin group ≥ 7.2 g/dl (OR = 0.68, 95%CI 0.51-0.93, P = 0.0142). The non-linear relationship between admission hemoglobin level and 30-day mortality in sepsis was found. Hemoglobin supplementation might be beneficial for septic patients with hemoglobin level < 7.2 g/dl.

The serum soluble ASGR1 concentration is elevated in patients with coronary artery disease and is associated with inflammatory markers.

BACKGROUND AND AIMS: Current research has suggested that asialoglycoprotein receptor 1 (ASGR1) is involved in cholesterol metabolism and is also related to systemic inflammation. This study aimed to assess the correlation between the serum soluble ASGR1 (sASGR1) concentration and inflammatory marker levels. Moreover, the second objective of the study was to assess the association between sASGR1 levels and the presence of coronary artery disease (CAD). METHODS: The study subjects included 160 patients who underwent coronary angiography. Ninety patients were diagnosed with CAD, while seventy age- and sex-matched non-CAD patients served as controls. We measured the serum sASGR1 levels using an ELISA kit after collecting clinical baseline characteristics. RESULTS: Patients with CAD had higher serum sASGR1 levels than non-CAD patients did (P < 0.0001). sASGR1 was independently correlated with the risk of CAD after adjusting for confounding variables (OR = 1.522, P = 0.012). The receiver operating characteristic (ROC) curve showed that sASGR1 had a larger area under the curve (AUC) than did the conventional biomarkers apolipoprotein B (APO-B) and low-density lipoprotein cholesterol (LDL-C). In addition, multivariate linear regression models revealed that sASGR1 is independently and positively correlated with high-sensitivity C-reactive protein (CRP) (ß = 0.86, P < 0.001) and WBC (ß = 0.13, P = 0.004) counts even after adjusting for lipid parameters. According to our subgroup analysis, this relationship existed only for CAD patients. CONCLUSION: Our research demonstrated the link between CAD and sASGR1 levels, suggesting that sASGR1 may be an independent risk factor for CAD. In addition, this study provides a reference for revealing the potential role of sASGR1 in the inflammation of atherosclerosis.

Co-immobilized multi-enzyme biocatalytic system on reversible and soluble carrier for saccharification of corn straw cellulose.

Herein, three enzymes (cellulase, ß-glucosidase, and pectinase) with synergistic effects were co-immobilized on the Eudragit L-100, and the recovery of co-immobilized enzymes from solid substrates were achieved through the reversible and soluble property of the carrier. The optimization of enzyme ratio overcomed the problem of inappropriate enzyme activity ratio caused by different immobilization efficiencies among enzymes during the preparation process of co-immobilized enzymes. The co-immobilized enzymes were utilized to catalytically hydrolyze cellulose from corn straw into glucose, achieving a cellulose conversion rate of 74.45% under conditions optimized for their enzymatic characteristics and hydrolytic reaction conditions. As a result of the reversibility and solubility of the carrier, the co-immobilized enzymes were recovered from the solid substrate after five cycles, retaining 54.67% of the enzyme activity. The aim of this study is to investigate the potential of co-immobilizing multiple enzymes onto the Eudragit L-100 carrier for the synergistic degradation of straw cellulose.

Effects of physical activity on the levels of remnant cholesterol: A population-based study.

Physical activity (PA) has the potential to bring about favourable changes in plasma lipid profile. However, the relationship between PA and remnant cholesterol (RC) remains unclear. We aimed to study the link between PA and RC using the database of the 2007-2020 National Health and Nutrition Examination Survey (NHANES). PA was categorized based on Physical Activity Guidelines for Americans. A multivariate linear regression model was used to determine the correlations between PA and RC. The study involved a total of 18,396 participants and revealed that individuals whose PA met the guidelines by engaging in moderate-intensity PA at least 150 min per week had lower body mass index and showed decreased levels of triglyceride, TC, and haemoglobin A1c compared to those who were physically inactive, exercising <150 min per week. Participants whose intensity of PA meets PA guidelines had a lower level of RC than those who did not met PA guidelines (ß = -1.3, 95% confidence interval [CI]: -1.9 to -0.7, p < 0.001), even after adjusting for confounders. During subgroup analysis, we observed that race (pinteraction = 0.0089) emerged as a significant factor of interaction.

Higher plasma aldosterone concentrations in patients with aortic diseases and hypertension: a retrospective observational study.

BACKGROUND: Aortic diseases remain a highly perilous macrovascular condition. The relationship between circulating aldosterone and aortic diseases is rarely explored, thus we investigated the difference in plasma aldosterone concentration (PAC) between patients with and without aortic disease in hypertensive people. METHODS: We analyzed 926 patients with hypertension, ranging in age from 18 to 89 years, who had their PAC measured from the hospital's electronic database. The case group and control group were defined based on inclusion and exclusion criteria. The analysis included general information, clinical data, biochemical data, and medical imaging examination results as covariates. To further evaluate the difference in PAC between primary hypertension patients with aortic disease and those without, we used multivariate logistic regression analysis and also employed propensity score matching to minimize the influence of confounding factors. RESULTS: In total, 394 participants were included in the analysis, with 66 individuals diagnosed with aortic diseases and 328 in the control group. The participants were predominantly male (64.5%) and over the age of 50 (68.5%), with an average PAC of 19.95 ng/dL. After controlling for confounding factors, the results showed hypertension patients with aortic disease were more likely to have high PAC levels than those without aortic disease (OR = 1.138, 95% CI [1.062 to 1.238]). Subgroup analysis revealed consistent relationship between PAC and primary hypertensive patients with aortic disease across the different stratification variables. Additionally, hypertensive patients with aortic disease still have a risk of higher PAC levels than those without aortic disease, even after propensity score matching. CONCLUSIONS: The results of this study suggest that primary hypertensive patients with aortic diseases have elevated levels of PAC, but the causal relationship between PAC and aortic disease requires further study.

Correlation between serum soluble ASGR1 concentration and low-density lipoprotein cholesterol levels: a cross-sectional study.

BACKGROUND: Recent studies have shown that loss-of-function mutations in hepatic asialoglycoprotein receptor 1 (ASGR1) are associated with low levels of circulating cholesterol and a reduced risk of coronary artery disease (CAD). In contrast to ASGR1 on the hepatocyte membrane, serum soluble ASGR1 (sASGR1) is a secreted form that has been detected in circulation. However, the functions of serum sASGR1 are unclear. This study aims to investigate the relationship between human serum sASGR1 concentration and low-density lipoprotein cholesterol (LDL-C) levels. METHODS: In a cohort of 134 participants who underwent coronary angiography examination, basic information was recorded, and blood samples were collected for biochemical testing. The serum sASGR1 concentration was determined by ELISA kits. The relationship between sASGR1 concentration and LDL-C levels was examined using linear regression models and interaction tests. Univariate and multivariate analyses were used to identify clinical variables that affect sASGR1 levels. RESULTS: After adjusting for potential confounders such as age, sex, BMI, and statin use, the serum sASGR1 concentration was positively correlated with LDL-C levels (ß = 0.093, 95% CI: 0.04 to 0.14, P < 0.001). Subgroup analysis and interaction tests showed that the effect of serum sASGR1 concentration on LDL-C levels was significantly influenced by hypertension status (P for interaction = 0.0067). The results of a multivariate linear regression analysis incorporating age, serum TG, LDL-C, nonesterified fatty acid (NEFA), white blood cell counts (WBCC), and fibrinogen revealed that LDL-C (ß = 1.005, 95% CI: 0.35 to 1.66, P = 0.003) and WBCC (ß = 0.787, 95% CI: 0.41 to 1.16, P < 0.0001) were independent influencing factors for serum sASGR1 levels. CONCLUSIONS: The serum sASGR1 concentration was positively correlated with LDL-C levels. In addition, hypertension status significantly affected the effect of serum sASGR1 on LDL-C levels. This study provides some research ideas for clinical doctors and researchers, as well as some references for additional research on serum sASGR1.

Comparison of Obesity-Related Indicators for Nonalcoholic Fatty Liver Disease Diagnosed by Transient Elastography.

BACKGROUND/AIMS: This study aimed to assess obesity-related indices in predicting nonalcoholic fatty liver disease (NAFLD) in the United States. These indices were analyzed separately in previous studies, but evidence comparing them together was still lacking. MATERIALS AND METHODS: We analyzed data from 8126 individuals in the National Health and Nutrition Examination Survey (NHANES) database and measured their body mass index (BMI), body roundness index (BRI), a body shape index, conicity index, body adiposity index, abdominal volume index (AVI), and waist-hip ratio. We used logistic analyses with odds ratios to evaluate the association between obesity-related indices and NAFLD and compared their diagnostic ability by receiver operating characteristic (ROC) curves, areas under the curve (AUCs), and net reclassification improvement (NRI). RESULTS: The AVI had the highest AUC (0.835 at controlled attenuation parameter [CAP] scores 263 dB/m and 0.831 at CAP scores 285 dB/m) in the ROC curve analysis. The AVI also showed better discriminatory ability than BMI (NRI = 0.0331 at CAP scores 263 dB/m and 0.0328 at CAP scores 285 dB/m), the same as BRI (NRI = 0.0283 at CAP scores 263 dB/m and 0.0272 at CAP scores 285 dB/m). In males, AVI (AUC = 0.8501 at CAP scores 263 dB/m and 0.8466 at CAP scores 285 dB/m) and BRI (AUC = 0.8517 at CAP scores 263 dB/m and 0.8497 at CAP scores 285 dB/m) had better predictive ability than BMI and similar to females. This was consistent across different age and race groups. CONCLUSION: AVI and BRI were better predictors of NAFLD than BMI.

The association between bedtime at night and diabetes in US adults: Data from National Health and Nutrition Examination Survey (NHANES) 2015-March -2020 pre-pandemic.

OBJECTIVE: The purpose of this study was to investigate the relationship between bedtime at night and the risk of diabetes in adults. METHODS: We extracted data from 14,821 target subjects from the NHANES database for a cross-sectional study. The data on bedtime came from the question in the sleep questionnaire: "What time do you usually fall asleep on weekdays or workdays?". Diabetes was defined as fasting blood sugar ≥ 126mg/dL, or glycohemoglobin ≥ 6.5%, or 2-hour Oral Glucose Tolerance Test blood sugar ≥ 200mg/dL, or taking hypoglycemic agent and insulin, or self-reported diabetes mellitus. A weighted multivariate logistic regression analysis was conducted to explore the relationship between bedtime at night and diabetes in adults. RESULTS: From 19:00 to 23:00, a significantly negative association can be found between bedtime and diabetes(OR, 0.91 [95%CI, 0.83, 0.99]). From 23:00 to 02:00, The relationship between the two was positive(OR, 1.07 [95%CI, 0.94, 1.22]), nevertheless, the P values was not statistically significant(p = 0.3524). In subgroup analysis, from 19:00-23:00, the relationship was negative across genders, and in males, the P-values were still statistically significant(p = 0.0414). From 23:00-02:00, the relationship was positive across genders. CONCLUSION: Earlier bedtime (before 23:00) increased the risk of developing diabetes. And this effect was not significantly different between male and female. For bedtime between 23:00-2:00, there was a trend of increasing the risk of diabetes as the bedtime was delayed.

Association of Dietary intake of vitamin E with chronic obstructive pulmonary disease events in US adults: A cross-sectional study of NHANES 2013-2018.

Introduction: Several studies have demonstrated that vitamin E intake is negatively associated with the development of several diseases, but the relationship between vitamin E intake and COPD in different groups of people is not clear. The aim was to investigate the relationship between vitamin E intake and COPD in different groups of people. Methods: This study used data from NHANES (National Health and Nutrition Examination Survey) from 2013-2018. A final total of 4,706 participants were included, univariate versus multivariate logistic regression and restricted cubic spline models adjusted for confounders were used to explore the relationship between vitamin E intake and COPD, and subgroup analyses were conducted to assess whether there are differences in the relationship between vitamin E intake and COPD in different populations or conditions. Results: After adjusting for potential confounders, higher vitamin E intake showed a significant negative association with COPD [Model 1(unadjusted covariates, OR = 0.48;95% CI:0.33-0.70; p < 0.001), Model 2(adjusted for age, sex, and race, OR = 0.48;95% CI:0.31-0.73; p < 0.01), and Model 3(adjusted for all covariates, OR = 0.57;95% CI:0.36-0.91; p = 0.02)]. And a restricted cubic spline curve showed a significant negative correlation between vitamin E intake and COPD (p for nonlinear = 0.2036). In the subgroup analysis, we found a negative association between vitamin E intake and COPD in all subgroups as well. Conclusion: After analyzing data based on the NHANES database from 2013-2018, the results showed that vitamin E intake among U.S. adults was well below the recommended levels and that higher vitamin E intake was negatively associated with COPD incidence.

Remnant cholesterol has a non-linear association with non-alcoholic fatty liver disease.

OBJECTIVE: We intend to look at the link between remnant cholesterol (RC) and nonalcoholic fatty liver disease (NAFLD). We hypothesise that there may be a positive and nonlinear relationship between RC and NAFLD. METHODS: The information for this investigation was obtained from the National Health and Nutrition Examination Survey 2017-2020 database. The RC value was obtained by subtracting the sum of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) from the total cholesterol (TC) level. NAFLD diagnosis was based on ultrasonography results. RESULTS: The analysis included 3370 participants and observed a positive relationship between RC and NAFLD, after adjusting for confounders. A non-linear association between RC and NAFLD was also identified in the research, with an inflection point of 0.96 mmol/l. The effect sizes of 3.88 (2.43 to 6.2) and 0.59 (0.21 to 1.71) were determined on the left and right sides of the inflection point, respectively. In subgroup analysis, we identified age (P for interaction = 0.0309) and waist circumference (P for interaction = 0.0071) as interaction factors. CONCLUSIONS: Elevated RC levels were found to be linked to NAFLD, even after controlling for traditional risk factors. Moreover, non-linear pattern in the relationship between RC and NAFLD was also identified.

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database.

This study aimed to investigate the relationship between serum ferritin level and prognosis in sepsis. It also explored the potential prognostic value of serum ferritin for predicting outcomes in sepsis based on a large public database. Sepsis patients in MIMIC-IV database were included. Different models including crude model (adjusted for none), model I (adjusted for age and gender) and model II (adjusted for all potential confounders) were performed. Smooth fitting curves were constructed for exploring the relationships between serum ferritin and mortalities of 28-day, 90-day, 180-day and 1-year. Receiver operator characteristic (ROC) curve analysis was utilized for assessing the predictive value of serum ferritin. 1947 sepsis patients were included. The mortalities of 28-day, 90-day, 180-day and 1-year were 20.18% (n = 393), 28.35% (n = 552), 30.30% (n = 590) and 31.54% (n = 614), respectively. In Model II (adjusted for all potential confounders), for every 1000 ng/ml increment in serum ferritin, the values of OR in mortalities of in 28-day, 90-day, 180-day and 1-year were 1.13 (95% CI 1.07-1.19, P < 0.0001), 1.15 (95% CI 1.09-1.21, P < 0.0001), 1.16 (95% CI 1.10-1.22, P < 0.0001) and 1.17 (95% CI 1.10-1.23, P < 0.0001), respectively. The relationships between serum ferritin level and outcomes were non-linear. The areas under the ROC curve (AUC) of ferritin for predicting mortalities of 28-day, 90-day, 180-day and 1-year were 0.597 (95% CI 0.563-0.629), 0.593 (95% CI 0.564-0.621), 0.595 (95% CI 0.567-0.623) and 0.592 (95% CI 0.564-0.620), respectively. The non-linear relationships between serum ferritin and clinical outcomes in sepsis were found. Serum ferritin had a predictive value for short-term and long-term outcomes in sepsis.

USP22 upregulates ZEB1-mediated VEGFA transcription in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a common solid tumor with high rate of recurrence and mortality. Anti-angiogenesis drugs have been used for the therapy of HCC. However, anti-angiogenic drug resistance commonly occurs during HCC treatment. Thus, identification of a novel VEGFA regulator would be better understanding for HCC progression and anti-angiogenic therapy resistance. Ubiquitin specific protease 22 (USP22) as a deubiquitinating enzyme, participates in a variety of biological processes in numerous tumors. While the molecular mechanism underlying the effects of USP22 on angiogenesis is still needed to be clarified. Here, our results demonstrated that USP22 acts as a co-activator of VEGFA transcription. Importantly, USP22 is involved in maintenance of ZEB1 stability via its deubiquitinase activity. USP22 was recruited to ZEB1-binding elements on the promoter of VEGFA, thereby altering histone H2Bub levels, to enhance ZEB1-mediated VEGFA transcription. USP22 depletion decreased cell proliferation, migration, Vascular Mimicry (VM) formation, and angiogenesis. Furthermore, we provided the evidence to show that knockdown of USP22 inhibited HCC growth in tumor-bearing nude mice. In addition, the expression of USP22 is positively correlated with that of ZEB1 in clinical HCC samples. Our findings suggest that USP22 participates in the promotion of HCC progression, if not all, at least partially via up-regulation of VEGFA transcription, providing a novel therapeutic target for anti-angiogenic drug resistance in HCC.

Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research.

Objective: This study aimed to explore the relationship between albumin level with short- and long-term outcomes in sepsis patients admitted in the intensive care unit (ICU) based on a large public database to provide clinical evidence for physicians to make individualized plans of albumin supplementation. Methods: Sepsis patients admitted in the ICU in MIMIC-IV were included. Different models were performed to investigate the relationships between albumin and mortalities of 28-day, 60-day, 180-day and 1-year. Smooth fitting curves were performed. Results: A total of 5357 sepsis patients were included. Mortalities of 28-day, 60-day, 180-day and 1-year were 29.29% (n = 1569), 33.92% (n = 1817), 36.70% (n = 1966) and 37.71% (n = 2020). In the fully adjusted model (adjusted for all potential confounders), with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 39% (OR = 0.61, 95% CI: 0.54-0.69), 34% (OR = 0.66, 95% CI: 0.59-0.73), 33% (OR = 0.67, 95% CI: 0.60-0.75), and 32% (OR = 0.68, 95% CI: 0.61-0.76), respectively. The non-linear negative relationships between albumin and clinical outcomes were confirmed by smooth fitting curves. The turning point of albumin level was 2.6g/dL for short- and long-term clinical outcomes. When albumin level ≤2.6g/dL, with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 59% (OR = 0.41, 95% CI: 0.32-0.52), 62% (OR = 0.38, 95% CI: 0.30-0.48), 65% (OR = 0.35, 95% CI: 0.28-0.45), and 62% (OR = 0.38, 95% CI: 0.29-0.48), respectively. Conclusion: Albumin level was associated with short- and long-term outcomes in sepsis. Albumin supplementation might be beneficial for septic patients with serum albumin<2.6g/dL.

Effect of reservoir characteristics and chemicals on filtration property of water-based drilling fluid in unconventional reservoir and mechanism disclosure.

The research objective of this investigation is to explore the influence of filtrate reducer and reservoir characteristics on the filtration reduction of drilling fluid during the drilling process, and the filtration reduction mechanism of drilling fluids is also revealed. The results obtained that a synthetic filtrate reducer can significantly reduce the filtration coefficient than that of the commercial filtrate reducer. Moreover, the filtration coefficient of drilling fluid constructed from synthetic filtrate reducer is reduced from 4.9 × 10-2 m3·min1/2 to 2.4 × 10-2 m3·min1/2 with an increase in the filtrate reducer content, which is much lower than that of the commercial filtrate reducer. The weaker filtration capacity of the drilling fluid containing the modified filtrate reducer is attributed to the combined action of the filtrate reducer containing multifunctional groups adsorbed on the sand surface and the hydration membrane adsorbed on the sand surface. Furthermore, the increase in reservoir temperature and shear rate increases the filtration coefficient of drilling fluid, indicating that low temperature and shear rate are conducive to improve the filtration capacity. Thus, the type and content of filtrate reducer are preferred during drilling in oilfield reservoir, but increasing reservoir temperature and shear rate are not recommended. It is necessary to confect the drilling mud with appropriate filtrate reducer such as the chemicals prepared herein during drilling operation.

Systematic investigation of metal dopants and mechanism for the SnO2 electron transport layer in perovskite solar cells.

SnO2, the most promising alternative to TiO2 as the electron transport layer (ETL), has attracted great attention for perovskite solar cells (PSCs) due to its high bulk electron mobility, good band energy at the ETL/perovskite interface, and high chemical stability. To enable more efficient carrier transfer and extraction, elemental doping with different metal cations has been studied in SnO2 ETLs. However, the systematic investigation of the doping mechanism lag far behind their efficiency promotion. In this paper, elements of the same main group (Li, Na, K) and period (K, Ca, Ga) have been selected for doping in SnO2. The results showed that among the properties of the dopants, the electronegativity has the greatest influence. The smaller the electronegativity of the doping species, the more conducive it is to carrier transmission and separation. The corresponding mechanism was proposed and discussed. At last, an efficiency of 20.92% of PSCs based on SnO2-K was achieved. In addition, the doped SnO2 is more beneficial for the growth of perovskite crystals, thus reducing grain boundaries and enhancing the stability of the device.

Adsorption of chloramphenicol from water using Carex meyeriana Kunth-derived hierarchical porous carbon with open channel arrays.

A carbon material with both open macrochannel arrays and abundant micro/mesopores was prepared, characterized, and applied for removing chloramphenicol (CAP) from water. In the preparation process, Carex meyeriana Kunth (CM) with natural channel arrays was used as the precursor for producing the biochar, and NaOH was used for removing silicon and formatting micro- and mesopores of the porous carbon. The product (PCCM) exhibited the highest specific surface area (2700.24 m2 g-1) among the reported CM-derived porous carbons. The adsorption performances of PCCM were evaluated through batch adsorption experiments. The maximum adsorption capacity of PCCM toward CAP was 1659.43 mg g-1. The adsorption mechanism was investigated with the aid of theoretical calculations. Moreover, PCCM exhibited better performance than other porous carbon adsorbents in fixed-bed experiments, which may be due to its structural advantages.

Association Between Lactate and 28-Day Mortality in Elderly Patients with Sepsis: Results from MIMIC-IV Database.

INTRODUCTION: This study aimed to explore the association of serum lactate with clinical outcomes in elderly patients with sepsis based on data from the MIMIC-IV database. METHODS: All elderly patients with sepsis (age ≥ 65 years) were included. Different models were constructed for exploring the relationships between lactate and 28-day mortality. A two-segment linear regression model was performed to verify the threshold effects of lactate on clinical outcomes and smooth curve fitting was performed. RESULTS: A total of 4199 elderly patients with sepsis were included. The 28-day mortality was 32.22% (n = 1395). After adjustment for all potential cofounders, for each 1 mmol/l increment in lactate, the odds ratio (OR) of 28-day mortality was 1.23 (95% CI 1.18-1.28, P < 0.0001). Smooth fitting curves indicated a non-linear positive relationship between lactate and 28-day mortality. The turning point of lactate level was 5.7 mmol/l: at ≤ 5.7 mmol/l, with each 1 mmol/l increment in lactate, the risk of 28-day mortality increased significantly (OR 1.32, 95% CI 1.25-1.38, P < 0.0001); the significantly positive relationship was still present at lactate > 5.7 mmol/l (OR 1.10, 95% CI 1.04-1.18, P = 0.0019). The area under the ROC curve (AUC) of lactate was 0.618 (95% CI 0.599-0.635) and the cutoff value of lactate was 2.4 mmol/l with a sensitivity of 0.483 and a specificity of 0.687. CONCLUSION: In elderly patients with sepsis, a non-linear positive relationship was discovered between serum lactate and 28-day mortality. Physicians should be alert to lactate assessment at admission and pay more attention to those patients with higher levels of lactate.

The combined action of biochar and nitrogen-fixing bacteria on microbial and enzymatic activities of soil N cycling.

This study aims to investigate the positive effects of the combined use of Enterobacter cloacae and biochar on improving nitrogen (N) utilization. The greenhouse pots experimental results showed the synergy of biochar and E. cloacae increased soil total N content and plant N uptake by 33.54% and 15.1%, respectively. Soil nitrogenase (NIT) activity increased by 253.02%. Ammonia monooxygenase (AMO) and nitrate reductase (NR) activity associated with nitrification and denitrification decreased by 10.94% and 29.09%, respectively. The relative abundance of N fixing microorganisms like Burkholderia and Bradyrhizobium significantly increased. Sphingomonas and Ottowia, two bacteria involved in the nitrification and denitrification processes, were found to be in lower numbers. The E. cloacae's ability to fix N2 and promote the growth of plants allow the retention of N in soil and make more N available for plant development. Biochar served as a reservoir of N for plants by adsorbing N from the soil and providing a shelter for E. cloacae. Thus, biochar and E. cloacae form a synergy for the management of agricultural N and the mitigation of negative impacts of pollution caused by excessive use of N fertilizer.

Adherence to endocrine therapy in patients with hormone receptor-positive early-stage breast cancer: a retrospective study.

BACKGROUND: The persistence and adherence to endocrine therapy (ET) in hormone receptor-positive (HR +) breast cancer patients remain far less than optimal. AIM: This retrospective study aimed to evaluate adherence to ET and to identify influencing factors in early-stage HR + breast cancer patients. METHOD: A stratified random sampling method was used to select patients admitted for breast cancer surgery at a university hospital in Shanghai, China. Patients who received ET medications in the hospital information system (HIS) were included. The primary outcomes were early discontinuation of and adherence to ET. Potential factors influencing the discontinuation and adherence were assessed using univariate and multivariate logistic regression analyses. RESULTS: In total, 706 patients were included, and 161 (22.8%) discontinued ET in less than five years from the first prescription. The discontinuation rates from the one-year to the five-year treatment were 5.38, 16.70, 32.27, 51.52, and 50.00%, respectively (P < 0.001). The rates of adherence (defined as medication possession ratio ≥ 80%) from the first to the fifth year were 85.18, 82.25, 82.18, 72.92, and 73.68%, respectively (P = 0.18). Age, insurance, and surgery type impacted ET discontinuation and adherence. However, the type of medication only impacted the adherence to ET. CONCLUSION: Persistence and adherence to ET in patients with breast cancer remain far from optimal and decrease over time. More attention should be paid to patients aged ≥ 70 years and those without insurance who tend to have early discontinuation of ET.

The association between bedtime at night and hypertension in adults.

OBJECTIVE: This research was conducted to explore the association between bedtime at night and the prevalence of hypertension in adults. METHODS: We conducted a cross-sectional study of 14,536 participants with data from the NHANES database. Bedtime was determined from the question in the sleep questionnaire: 'What time do you usually fall asleep on weekdays or workdays?.' Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, or diastolic blood pressure (DBP) ≥ 90 mmHg, or having been told by a doctor to have high blood pressure, or taking antihypertensive medication. We conducted a weighted multiple logistic regression analysis to explore the relationship between bedtime at night and the prevalence of hypertension in adults. RESULTS: The association between bedtime and hypertension showed a significantly U-shaped relationship. People who went to bed at 23:00 had the lowest risk of developing hypertension (OR, 0.68 [95%CI, 0.58, 0.81]). This U-shaped association still existed in different genders. In males (n = 7159), the adjusted OR was still lowest at 23:00. However, the adjusted OR was lowest at 0:00 in females(n = 7377). The interaction effect between bedtime and gender was significant (P = 0.0187). CONCLUSION: With the delay in bedtime, the association between bedtime and hypertension showed a significantly U-shaped relationship. Falling asleep at 23:00 has the lowest risk of developing hypertension.