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Arbuscular mycorrhizal (AM) fungi have promising applications in low-quality farmlands all over the world, but research on their responses to conventional and organic farming systems in low-quality soil is limited. We hypothesized that the colonization activity and community diversity of AM fungi in conventional farming systems may not be lower than in organic farming on low-quality farmlands where beneficial symbiosis is required. We collected soil and maize root samples from medium to low fertility farmlands with conventional or organic farming systems in western Jilin Province, China. The colonization percentage and intensity, taxonomic and phylogenetic diversity, community composition of soil AM fungi, and soil factors were detected and compared between the two farming systems. The colonization intensity and operational taxonomic unit (OTU) taxonomic diversity on conventional farms were higher than on organic farms. Glomus was the most common genus on conventional farms, whereas Paraglomus and Glomus were the most common on organic farms. We also found a simpler AM fungal network structure with lower OTU phylogenetic diversity on conventional farms. Our findings suggested that though the conventional farming system resulted in different compositions and simpler structures of soil AM fungal community, there are potential diverse OTU resources currently present on conventional farms. This work has potential impacts on understanding the influence of different farming systems on soil AM fungi in low-quality farmlands and the development of efficient mycorrhizal inoculant production. [ABSTRACT FROM AUTHOR]

This study attempts to establish a Bayesian networks (BNs) based model for inferring the risk of AKI in gastrointestinal cancer (GI) patients, and to compare its predictive capacity with other machine learning (ML) models. From 1 October 2014 to 30 September 2015, we recruited 6495 inpatients with GI cancers in a tertiary hospital in eastern China. Data on demographics, clinical and laboratory indicators were retrospectively extracted from the electronic medical record system. Predictors of AKI were selected in gLASSO regression, and further incorporated into BNs analysis. The incidences of AKI in patients with esophagus, stomach, and intestine cancer were 20.5%, 13.9%, and 12.5%, respectively. Through gLASSO, 11 predictors were screened out, including diabetes, cancer category, anti-tumor treatment, ALT, serum creatinine, estimated glomerular filtration rate (eGFR), serum uric acid (SUA), hypoalbuminemia, anemia, abnormal sodium, and potassium. BNs model revealed that cancer category, treatment, eGFR, and hypoalbuminemia had direct connections with AKI. Diabetes and SUA were indirectly linked to AKI through eGFR, and anemia created connections with AKI through affecting album level. Compared with other ML models, BNs model maintained a higher AUC value in both the internal and external validation (AUC: 0.823/0.790). BNs model not only delineates the qualitative and quantitative relationship between AKI and its associated factors but shows the more robust generalizability in AKI prediction. [ABSTRACT FROM AUTHOR]

This study aims to delineate the incidence of electrolyte and acid-base disorders (EAD) in cancer patients, to figure out the risk factors of EAD, then to assess the impact of EAD on patients' in-hospital clinical outcomes. Patients with the diagnosis of malignancies hospitalized during 1 October 2014 and 30 September 2015 were recruited in Zhongshan Hospital, Fudan University in Shanghai of China. Demographic characteristics, comorbidities, and clinical data, including survival, length of stay and hospital cost, were extracted from the electronic medical record system. Electrolyte and acid-base data were acquired from the hospital laboratory database. Of 25,881 cancer patients with electrolyte data, 15,000 (58.0%) cases had at least one electrolyte and acid-base abnormity. Hypocalcemia (27.8%) was the most common electrolyte disorder, followed by hypophosphatemia (26.7%), hypochloremia (24.5%) and hyponatremia (22.5%). The incidence of simple metabolic acidosis (MAC) and metabolic alkalosis (MAL) was 12.8% and 22.1% respectively. Patients with mixed metabolic acid-base disorders (MAC + MAL) accounted for 30.2%. Lower BMI score, preexisting hypertension and diabetes, renal dysfunction, receiving surgery/chemotherapy, anemia and hypoalbuminemia were screened out as the major risk factors of EAD. In-hospital mortality in patients with EAD was 2.1% as compared to those with normal electrolytes (0.3%). The risk of death significantly increased among patients with severe EAD. Similarly, the length of stay and hospital cost also tripled as the number and grade of EAD increased. EAD is commonly encountered in cancer patients and associated with an ominous prognosis. Patients with comorbidities, renal/liver dysfunction, and anti-tumor therapy have a higher risk of EAD. Regular monitoring of electrolytes, optimum regimen for intravenous infusion, timely correction of modifiable factors and appropriate management of EAD should not be neglected during anti-tumor treatment. [ABSTRACT FROM AUTHOR]

Background: Patients who were diagnosed with hematologic malignancies (HM) had a higher risk of acute kidney injury (AKI). This study applies the Bayesian networks (BNs) to investigate the interrelationships between AKI and its risk factors among HM patients, and to evaluate the predictive and inferential ability of BNs model in different clinical settings.Methods: During 2014 and 2015, a total of 2501 inpatients with HM were recruited in this retrospective study conducted in a tertiary hospital, Shanghai of China. Patients' demographics, medical history, clinical and laboratory records on admission were extracted from the electronic medical records. Candidate predictors of AKI were screened in the group-LASSO (gLASSO) regression, and then they were incorporated into BNs analysis for further interrelationship modeling and disease prediction.Results: Of 2395 eligible patients with HM, 370 episodes were diagnosed with AKI (15.4%). Patients with multiple myeloma (24.1%) and leukemia (23.9%) had higher incidences of AKI, followed by lymphoma (13.4%). Screened by the gLASSO regression, variables as age, gender, diabetes, HM category, anti-tumor treatment, hemoglobin, serum creatinine (SCr), the estimated glomerular filtration rate (eGFR), serum uric acid, serum sodium and potassium level were found with significant associations with the occurrence of AKI. Through BNs analysis, age, hemoglobin, eGFR, serum sodium and potassium had directed connections with AKI. HM category and anti-tumor treatment were indirectly linked to AKI via hemoglobin and eGFR, and diabetes was connected with AKI by affecting eGFR level. BNs inferences concluded that when poor eGFR, anemia and hyponatremia occurred simultaneously, the patients' probability of AKI was up to 78.5%. The area under the receiver operating characteristic curve (AUC) of BNs model was 0.835, higher than that in the logistic score model (0.763). It also showed a robust performance in 10-fold cross-validation (AUC: 0.812).Conclusion: Bayesian networks can provide a novel perspective to reveal the intrinsic connections between AKI and its risk factors in HM patients. The BNs predictive model could help us to calculate the probability of AKI at the individual level, and follow the tide of e-alert and big-data realize the early detection of AKI. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) following cardiac surgery is common and associated with poor patient outcomes. Early risk assessment for development of AKI remains a challenge. The combination of urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) has been shown to be an excellent predictor of AKI following cardiac surgery, but reported studies are for predominately non-Asian populations.Methods: Adult patients were prospectively enrolled at Zhongshan hospital in Shanghai, China. The primary analysis was prediction of AKI and stage 2-3 AKI by [TIMP-2]*[IGFBP7] measured 4 h after postoperative ICU admission assessed using receiver operating characteristic curve (ROC) analysis. Kinetics of [TIMP-2]*[IGFBP7] following ICU admission were also examined.Results: We prospectively enrolled 57 cardiac surgery patients, of which 20 (35%) developed AKI and 6 (11%) developed stage 2-3 AKI. The area under the ROC curve (AUC) of [TIMP-2]*[IGFBP7] at 4 h after ICU admission was 0.80 (95% confidence interval (CI): 0.68-0.91) for development of AKI and 0.83 (95% CI: 0.69-0.96) for development of stage 2-3 AKI. Urinary [TIMP-2]*[IGFBP7] values at 4 h after ICU admission were significantly (P < 0.001) higher in patients who developed AKI than in patients who did not develop AKI (mean (standard error) of 1.08 (0.34) (ng/mL)2/1000 and 0.29 (0.05) (ng/mL)2/1000, respectively). The time-profile of [TIMP-2]*[IGFBP7] suggests the markers started to elevate by the time of ICU admission in patients who developed AKI and either decreased or remained flat in patients without AKI.Conclusion: The combination of urinary TIMP-2 and IGFBP7 4 h after postoperative ICU admission identifies patients at risk for developing AKI, not just stage 2-3 AKI following cardiac surgery. [ABSTRACT FROM AUTHOR]

Chongqing Fuling shale gas field, the largest shale gas exploration site in China, produces a large amount of oil-based drill cuttings (OBDC) every year, which is a hazardous waste. Traditional treatment methods such as solidification/stabilization did not recycle the valuable components such as petroleum hydrocarbons. Pyrolysis is proven to be an efficient method that can recover those components. This study firstly investigated the pyrolysis kinetics by two different methods on the basis of detailed material characterization, and then taking the workers and the surrounding ecological environment as the analysis object, the human health risk assessment (HHRA) and ecological risk assessment were evaluated respectively before and after pyrolysis. The results showed that the pyrolysis of OBDC was divided into three stages, and the cracking of light hydrocarbons stage was the key control step for pyrolysis process. The activation energy E increased gradually during the pyrolysis progress. The HHRA results showed that pyrolysis could greatly reduce the non-carcinogenic risk, carcinogenic risk and ecological risk by 59.6 %, 62.8 % and 75 % respectively. However, the carcinogenic risk after pyrolysis was still higher than the critical value 10−6. [Display omitted] • The pyrolysis of OBDC was divided into three stages. • The activation energy E increased with the reaction progress. • Pyrolysis can reduce the non-carcinogenic/carcinogenic risk and ecological risk. • Carcinogenic risk after pyrolysis was still higher than the critical value. [ABSTRACT FROM AUTHOR]

Background: The burden of gout is increasing worldwide, which places a heavy burden on society and healthcare systems. This study investigates the independent effects of age, period, and cohort on the gout prevalence from 1990 to 2019 in China, compares these effects by gender and then predicts the future burden of gout over the next decade., Methods: The data were obtained from the Global Burden of Disease (GBD) study in 2019. Joinpoint regression model was employed to calculate the annual percentage change (APC) in gout prevalence, and the age-period-cohort analysis was utilized to estimate the independent effects of age, period, and cohort. ARIMA model was extended to predict the gout epidemic in 2020-2029., Results: In 2019, there were 16.2 million cases of gout in China, with an age-standardized prevalence rate (ASPR) of 12.3‰ and 3.9‰ in men and women, respectively. During 1990-2019, the ASPR of gout was increasing significantly, with an average APC of 0.9%. The periods of 2014-2017 and 2001-2005 were "joinpoint" for men and women (APC: 6.3 and 5.6%). The age-period-cohort analyses revealed that the relative risk (RR) of developing gout increased with age, peaking at 70-74 years in men (RR age(70-74) = 162.9) and 75-79 years in women (RR age(75-79) =142.3). The period effect trended upward, with a more rapid increase in women (RR period(2019) = 2.31) than men (RR period(2019) = 2.23). The cohort effect generally peaked in the earlier cohort born in 1905-1909 for both sexes. Gout prevalence showed a strong positive correlation with the consumption of meat and aquatic products (r meat = 0.966, r aquaticproducts = 0.953). Within 2029, the ASPR of gout was projected to be 11.7‰ and 4.0‰ in men and women, respectively., Conclusion: The prevalence of gout is increasing at an alarming rate in China; thus, it is necessary to provide targeted health education, regular screening, and accessible urate-lowering therapy healthcare to prevent and protect against gout in China, particularly in older women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhu, Wang, Zhou, Jin, Shen, Zhang, Zhang, Ding and Li.)

Objectives: Acute kidney injury (AKI) is a common complication of cardiac surgery. This study aimed to explore the effects of hyperuricaemia, being overweight and hyperlipidaemia as risk factors for AKI in patients following cardiac surgery (cardiac surgery-associated acute kidney injury (CSA-AKI))., Design: Retrospective observational study., Setting: University teaching, grade-A tertiary hospital in Shanghai, China., Participants: Patients who underwent cardiac surgery from July 2015 to December 2015 in Zhongshan Hospital, Fudan University., Main Outcome Measures: We investigated the effect of hyperuricaemia, in combination with being overweight and hyperlipidaemia, on the risk of CSA-AKI., Results: A total of 1420 patients were enrolled. The AKI incidence in the highest uric acid group was 44.4%, while that in the lowest uric acid group was 28.5% (p<0.001). Patients in the higher uric acid quartiles were more likely to be overweight and hyperlipidaemic at the same time (p<0.001). Multivariate logistic regression analysis showed that hyperuricaemia was an independent risk factor for AKI (OR=1.237, 95% CI 1.095 to 1.885; p=0.009); being overweight or hyperlipidaemia alone was not an independent risk factor, but the combination of being overweight and hyperlipidaemia was (OR=1.544, 95% CI 1.059 to 2.252; p=0.024). In the final model, the OR value increased to 3.126 when hyperuricaemia was combined with being overweight and hyperlipidaemia, and the Hosmer-Lemeshow test showed that all three models fit well (p=0.433, 0.638 and 0.597, respectively)., Conclusions: The combination of being overweight and having hyperlipidaemia was an independent risk factor, but being overweight or having hyperlipidaemia alone was not. The combination of hyperuricaemia, being overweight and hyperlipidaemia further increased the risk of CSA-AKI., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a well-recognized complication with an ominous outcome., Hypothesis: Bayesian networks (BNs) not only can reveal the complex interrelationships between predictors and CSA-AKI, but predict the individual risk of CSA-AKI occurrence., Methods: During 2013 and 2015, we recruited 5533 eligible participants who underwent cardiac surgery from a tertiary hospital in eastern China. Data on demographics, clinical and laboratory information were prospectively recorded in the electronic medical system and analyzed by gLASSO-logistic regression and BNs., Results: The incidences of CSA-AKI and severe CSA-AKI were 37.5% and 11.1%. BNs model revealed that gender, left ventricular ejection fractions (LVEF), serum creatinine (SCr), serum uric acid (SUA), platelet, and aortic cross-clamp time (ACCT) were found as the parent nodes of CSA-AKI, while ultrafiltration volume and postoperative central venous pressure (CVP) were connected with CSA-AKI as children nodes. In the severe CSA-AKI model, age, proteinuria, and SUA were directly linked to severe AKI; the new nodes of NYHA grade and direct bilirubin created relationships with severe AKI through was related to LVEF, surgery types, and SCr level. The internal AUCs for predicting CSA-AKI and severe AKI were 0.755 and 0.845, which remained 0.736 and 0.816 in the external validation. Given the known variables, the risk for CSA-AKI can be inferred at individual levels based on the established BNs model and prior information., Conclusion: BNs model has a high accuracy, good interpretability, and strong generalizability in predicting CSA-AKI. It facilitates physicians to identify high-risk patients and implement protective strategies to improve the prognosis., (© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.)

Objective: Spot urine sodium and associated estimating equations provide a suitable alternative assessment of 24-hour sodium excretion in many large-scale studies, but not in chronic kidney disease (CKD) patients with decreased renal function. Herein, we aimed to develop a novel predictive equation., Design and Methods: We retrospectively enrolled all CKD patients at Stage 1-4 who received spot and 24-hour urinary analysis in our single center from January 1, 2014 to December 31, 2017. Multiple linear regression analysis generated a predictive equation for estimating 24-hour sodium excretion from spot urine samples in the derivation cohort admitted from 2014 to 2015, and then we assessed this predictive equation in a validation cohort admitted from 2016 to 2017., Results: All 5,235 patients were finally analyzed and divided into derivation (n = 2,460) and validation (n = 2,775) cohort according to the admission date. We generated a predictive equation and defined it as "CKDSALT" equation because it was used for the estimation of salt intake in CKD patients. When we measured sodium excretion as the gold standard, we compared this novel validation with other 3 equations: Kawasaki, INTERSALT, and Tanaka. The Bland-Altman plots indicated that the CKDSALT equation showed the lowest bias with limits of agreement (bias = -1.25 mmol, 95% confidence interval -121.3 to 123.8), and the best performance in any subgroup analysis: male and female, old and young, different levels of body mass index, various levels of estimated glomerular filtration rate, and 24-hour urine volume. The CKDSALT equation also had the highest Pearson (0.745) and intraclass correlation coefficient (0.853, 95% confidence interval 0.841-0.863) in all validation cohort and the above subgroups., Conclusion: Spot urine method by CKDSALT equation may be promising for estimating 24-hour urinary sodium excretion in CKD patients with normal renal function and patients with decreased estimated glomerular filtration rate., (Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The association between pre-operative cardiac catheterization and cardiac surgery associated acute kidney injury (CSA-AKI) has been reported inconsistently. The purpose of this study is to evaluate the effect of the catheterization timing and contrast media dose on the incidence of postoperative acute kidney injury., Methods: Patients who underwent cardiac catheterization and cardiac surgery successively from January 2015 to December 2015 were prospectively enrolled in this study. The primary outcome was CSA-AKI which was defined as the Kidney Disease: Improving Global Outcomes Definition and Staging (KDIGO) criteria. Univariate analysis and multivariate regression were performed to identify the predictors for CSA-AKI. Baseline characteristics were balanced with propensity score method for better adjustment., Results: A total of 1069 consecutive eligible patients were enrolled into this study. The incidence of CSA-AKI and AKI requiring renal replacement therapy (AKI-RRT) were 38.5% (412/1069) and 1.9% (20/1069) respectively. Preoperative estimated glomerular filtration rate less than 60 mL/min/1.73m 2 (OR = 2.843 95% CI 1.374-5.882), the time interval between catheterization and surgery≤7 days (OR = 2.546, 95% CI 1.548-4.189) and the dose of contrast media (CM) > 240 mg/kg (OR = 2.490, 95%CI 1.392-4.457) were identified as predictors for CSA-AKI. In the patients with the dose of CM > 240 mg/kg, the incidence of CSA-AKI was higher in patients who underwent cardiac catheterization ≤7 days before cardiac surgery than in those of > 7 days before cardiac surgery (39.4% vs. 28.8%, p = 0.025). The longer interval of more than 7 days was revealed to be inversely associated with CSA-AKI through logistic regression (OR = 0.579, 95% CI 0.337-0.994)., Conclusion: Catheterization within 7 days of cardiac surgery and a dose of CM > 240 mg/kg were associated with the onset of CSA-AKI. For patients who received a dose of CM > 240 mg/kg, postponing the cardiac surgery is potentially beneficial to reduce the risk of CSA-AKI.

Background: Acute kidney injury (AKI) following cardiac surgery is common and associated with poor patient outcomes. Early risk assessment for development of AKI remains a challenge. The combination of urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) has been shown to be an excellent predictor of AKI following cardiac surgery, but reported studies are for predominately non-Asian populations., Methods: Adult patients were prospectively enrolled at Zhongshan hospital in Shanghai, China. The primary analysis was prediction of AKI and stage 2-3 AKI by [TIMP-2]*[IGFBP7] measured 4 h after postoperative ICU admission assessed using receiver operating characteristic curve (ROC) analysis. Kinetics of [TIMP-2]*[IGFBP7] following ICU admission were also examined., Results: We prospectively enrolled 57 cardiac surgery patients, of which 20 (35%) developed AKI and 6 (11%) developed stage 2-3 AKI. The area under the ROC curve (AUC) of [TIMP-2]*[IGFBP7] at 4 h after ICU admission was 0.80 (95% confidence interval (CI): 0.68-0.91) for development of AKI and 0.83 (95% CI: 0.69-0.96) for development of stage 2-3 AKI. Urinary [TIMP-2]*[IGFBP7] values at 4 h after ICU admission were significantly (P < 0.001) higher in patients who developed AKI than in patients who did not develop AKI (mean (standard error) of 1.08 (0.34) (ng/mL) 2 /1000 and 0.29 (0.05) (ng/mL) 2 /1000, respectively). The time-profile of [TIMP-2]*[IGFBP7] suggests the markers started to elevate by the time of ICU admission in patients who developed AKI and either decreased or remained flat in patients without AKI., Conclusion: The combination of urinary TIMP-2 and IGFBP7 4 h after postoperative ICU admission identifies patients at risk for developing AKI, not just stage 2-3 AKI following cardiac surgery.