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Survivin is a member of apoptosis inhibitor proteins that evokes cellular proliferation and inhibits apoptosis. However, the role of survivin in community-acquired pneumonia (CAP) patients remains to be firmly established. The aim of this cohort study was to evaluate the correlations of serum survivin with the severity and prognosis of CAP patients.This research included 470 eligible CAP patients. Serum fasting samples were drawn from patients, and serum survivin was measured by enzyme-linked immunosorbent assay (ELISA). Meanwhile, demographic characteristics and clinical information were collected. The prognosis of CAP patients was tracked.Serum survivin gradually decreased with elevated CAP severity scores. Additionally, the correlative analysis suggested that serum survivin was associated with many clinical characteristics. Furthermore, mixed linear and logistic regression models indicated that serum survivin was negatively associated with severity. After adjusting for confounding factors, logistic regression analyses found that lower serum survivin on admission elevated the risks of mechanical ventilation, vasoactive agent usage, longer hospital stays, ICU admission, and even death during hospitalization. Serum survivin in combination with CAP severity scores elevated the predictive capacities for severity and death in CAP patients compared with a single indicator.On admission, there are inverse dose-response associations of serum survivin with severity and poor prognosis in CAP patients, demonstrating that serum survivin may be involved in the pathophysiology process of CAP. Serum survivin may serve as a potential biomarker for disease evaluation and prognosis in CAP patients.

A further study on the rarely reported soft coral Sarcophyton mililatensis disclosed five new flexible cembrane-type macrocyclic diterpenes sarcomililatols C-G (1-5) and two known analogues 6 and 7. The structures and absolute configurations of natural macrocyclic compounds 1-6 were established by the extensive spectroscopic analysis, X-ray diffraction analysis, time-dependent density functional theory/electronic circular dichroism (TDDFT ECD) calculations, chemical reaction, and modified Mosher's method. In the bioassays, the macrocyclic diterpene 2 exhibited potent TNF-α inhibition (IC

With the increasing awareness of the risks and impacts of climate change, scholars tend to pay more attention to the applications of indicators, which access the effectiveness of climate change adaptation. This study aims to evaluate the overall progress of climate change adaptation in China during 2010–2018 in a quantitative manner. The Index for Climate Change Adaptation in China (ICCAC) has been thus developed by adopting the analytic hierarchy process weighting and expert scoring method. Namely, ICCAC is composed of national climate change impacts, adaptation actions in key sectors, adaptation progress in key sectors, and the national adaptation policy framework. Overall, the ICCAC and its four sub-indexes increased significantly from 2010 to 2018, on a yearly-basis. Each sub-index implied that the socio-economic impacts caused by climate change in China have been alleviated gradually; specifically, the mainstream endeavor of key sectors has witnessed remarkable progress, however, it is worth noting that the gap between individual adaptation actions and policies still exists; the implementation effect of policies in key sectors is not as affluent as that of actions; the current adaptation endeavor in key areas is still closely related to the mainstream business of corresponding competent ministries rather than adaptation-aimed actions; the national adaptation policy framework has been primarily formed, but there are still some deficiencies. As a result, the gap in China's adaptation process could be mainly manifested in the following five aspects: i) adaptation effectiveness assessment in forestry and urban infrastructure is urgently needed; ii) policies in marine and water resources sectors need structural reforms; iii) evaluation criteria for national adaptation are not necessarily sufficient; iv) the improvement of adaptive management efficiency has stagnated recently; and v) the adaptation works of relevant Ministries should be coordinated and put forward the corresponding strategies. Finally, this study presents four proposals: conducting an evaluation of adaptation actions in all key sectors, integrating climate change impacts into sectoral planning decisions, launching concrete action plans for adaptation, establishing a complete policy framework on adaptation.

To evaluate the efficacy and risk of cataract surgery (phacoemulsification with intraocular lens [IOL] implantation) combined with endoscopic goniosynechialysis (EGSL) for advanced primary angle-closure glaucoma (PACG).Retrospective, continuous case series.A total of 16 patients (18 eyes) with advanced PACG were enrolled in this study between February 2014 and March 2016. Advanced glaucoma inclusion criteria were based on the method proposed in the Advanced Glaucoma Intervention Study, with a visual field score of 18 points or more.All patients underwent cataract surgery with EGSL by the same experienced surgeon. Paired t test and generalized estimating equation analyses were performed.The extent of peripheral anterior synechiae (PAS), number of intraocular pressure (IOP)-lowering drugs, IOP, best-corrected visual acuity (BCVA), and visual fields before and after surgery. The incidence of complications was recorded.The mean follow-up duration was 13.8 months (standard deviation, 2.7 months). The mean difference (preoperative minus postoperative) in PAS was 202.7° (95% confidence interval [CI], 43.5°). The mean difference (preoperative minus postoperative) in the number of IOP-lowering drugs and IOP was 2.0 (95% CI, ±0.5), and 9.4 mmHg (95% CI, ±2.1 mmHg) respectively. The mean improvement in BCVA was 0.29 logMAR (95% CI, ±0.14). A positive correlation was found between the extent of postoperative PAS and postoperative IOP (B = 8.2; P0.001) and also between postoperative PAS and postoperative number of IOP-lowering drugs (B = 28.9; P0.001). Anterior chamber hemorrhage and exudation occurred in 4 patients and 2 patients, respectively, after surgery. Posterior capsular opacification occurred in 5 patients after surgery.Cataract surgery with EGSL could be an effective surgical method for the treatment of advanced PACG.

In nonadaptive combinatorial group testing (CGT), it is desirable to identify a small set of up to d defectives from a large population of n items with as few tests (i.e. large rate) and efficient identifying algorithm as possible. In the literature, d -disjunct matrices ( d -DM) and d -separable matrices ( d -SM) are two classical combinatorial structures having been studied for several decades. It is well-known that a d -DM provides a more efficient identifying algorithm than a d -SM, while a d -SM could have a larger rate than a d -DM. In order to combine the advantages of these two structures, in this paper, we introduce a new notion of strongly d -separable matrix ( d -SSM) for nonadaptive CGT, which is sandwiched between d -DM and d -SM. We show that a d -SSM has the identifying algorithm more efficient than a d -SM, as well as the largest rate no less than a d -DM. In addition, the general bounds on the largest rate of d -SSM are established. Moreover, by the random coding method with expurgation, we derive an improved lower bound on the largest rate of 2-SSM which is much higher than the best known result of 2-DM.