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Background: In recent years, talaromycosis is reportedly on the rise in human immunodeficiency virus (HIV)-uninfected patients. However, the misdiagnosis and mistreatment of talaromycosis is more likely in HIV-uninfected patients than in HIV-infected patients because talaromycosis can be easily mistaken for tuberculosis or any other opportunistic infection. Therefore, we used metagenomic next-generation sequencing (mNGS), a novel gene detection method, for the diagnosis of talaromycosis in HIV-uninfected patients.Case Presentation: We report five cases diagnosed as talaromycosis by mNGS in HIV-uninfected patients, which were further confirmed by tissue culture. There were 3 male and 2 female patients. Two patients had a history of rat contact. The misdiagnosis duration ranged from 88 to 245 days. While the results of tissue culture changed from repeated negative to positive, the mNGS result for Talaromyces marneffei was positive earlier in 4 patients. The reads of Talaromyces marneffei in mNGS ranged from 5 to 414. After antifungal therapy, one of the outcomes was death due to the longest duration of misdiagnosis, and the other outcomes were clinical improvement.Conclusions: mNGS is perhaps a rapid and effective diagnosis approach for the early confirmation of talaromycosis. Antifungal therapy is recommended once Talaromyces marneffei was revealed by mNGS. mNGS might reduce misdiagnosis duration and improve prognosis. Through these findings, we hope to provide some reference for talaromycosis in HIV-uninfected patients diagnosed early with the help of mNGS. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to assess the attitudes of registered nurses toward older adults in China. Method: An online questionnaire was sent to registered nurses of five hospitals. The sample included 1,367 registered nurses in this study. Kogan's Attitudes toward Older People Scale and Facts of Aging Quiz were used to collect data. Descriptive statistics, independent t -tests, one-way analysis of variance and logistic regression were used for data analysis. Results: Registered nurses held a positive attitude toward older adults (155.09 ± 21.94). The experience of being cared by older adults (odds ratio [ OR ] = 1.545, p =.007) and relationship with older adults (OR = 2.440, p =.000) were associated with the attitudes of registered nurses. Discussion: Registered nurses in China held a positive attitude toward older adults. The results contribute to care practice for the older adults in hospitals. [ABSTRACT FROM AUTHOR]

Aims Acute respiratory distress syndrome (ARDS), one of the serious form of acute lung injury (ALI), is the primary cause of death in patients with ALI. Sini decoction (SND) is a widely used Traditional Chinese Medicine (TCM). However, the application of SND in ALI is rarely reported. Previous studies have found that renin-angiotensin-aldosterone system (RAAS) played vital and bidirectional roles in ALI. Therefore, the aim of the present study was to investigate protective effect of SND on ALI model induced by E. coli , as well as to further explore relations between RAAS and SND. Materials and methods The ALI model was evaluated by morphological observations and biochemical assays. The expression levels of angiotensin converting enzyme (ACE), Angiotensin II type 1 receptor (AT1R) and angiotensin converting enzyme 2 (ACE2) were examined by Western blotting. The expression levels of angiotensinII (AngII) and angiotensin-(1-7) (Ang-(1-7)) were measured through ELISA. MasR, IL-6, IL-1β and TNFα were all measured using qRT-PCR. Key findings SND significantly ameliorated E. coli -induced ALI, including reducing inflammatory factors in lung tissue and the activity of MPO in serum. Furthermore, SND could obviously decrease the expression of ACE, AngII and AT1R, which were induced by E. coli . On the other hand, SND could markedly activate ACE2-Ang-(1-7)-Mas pathway. Significance In this paper, we demonstrated that SND alleviates E. coli induced acute lung injury in mice via equilibrating ACE-AngII-AT1R and ACE2-Ang-(1-7)-Mas axis. [ABSTRACT FROM AUTHOR]

Highlights: [•] It is a fast and cost-effective method for the fast detection of hepatitis E virus, only simple equipment is needed in the detection. [•] This method has a good sensitivity, as low as 101 copies of HEV RNA can be detected. [•] This method enables visual detection of the result. It is a good alternative for point of care use. [Copyright &y& Elsevier]

Abstract: Background: Pulmonary fibrosis occurs in approximately 60% of patients with acute respiratory distress syndrome and has been significantly correlated with a poor outcome. The overexpression of angiotensin (Ang) II can induce lung inflammation and fibrosis. This observation, coupled with the knowledge that Ang-(1-7) is considered to be an endogenous antagonist of Ang II, led us to hypothesize that Ang-(1-7) would prevent lung remodeling in patients with acute respiratory distress syndrome. Materials and methods: The protocol involved five groups: (1) control, (2) lipopolysaccharide (LPS), (3) losartan as a positive control group, (4) Ang-(1-7), and (5) [D-Ala7]-Ang-(1-7) (A779), an antagonist of the Ang-(1-7) receptor. Acute lung injury was induced by an intratracheal injection of LPS 5 mg/kg in C57BL/6 mice. Losartan (10 mg/kg) was administered by gavage daily, starting from 1 d before LPS stimulation. Ang-(1-7) or A779 in saline (100 ng/kg/min) was infused subcutaneously 1 h before acute lung injury induction for 3 or 7 d. The lung tissues were harvested for analysis at day 3 or 7 after injection of LPS. Results: LPS stimulation resulted in significantly increased inflammation, edema, and lung collagen production. With Ang-(1-7) treatment, the lung fibrosis score and hydroxyproline level were significantly reduced, and the expression of transforming growth factor-β and Smad2/3 were decreased on days 3 and 7. Losartan attenuated lung fibrosis similarly to Ang-(1-7) after LPS exposure. In the A779 group, a tendency was seen to aggravate collagen deposition and lung remodeling. Conclusions: These findings indicate an antiremodeling role for Ang-(1-7) in acute lung injury, similar to the blocker of Ang II receptor, that might be at least partially mediated through an Ang-(1-7) receptor. [Copyright &y& Elsevier]

Abstract: The amino acid l-cysteine (l-Cys) was intercalated into a MgAl layered double hydroxide (LDH), and its oxidation reaction by hexacyanoferrate (III) (Fe(CN)6 3−) in the confined region between sheets of LDH has been studied in detail. Based on the measurement results of XRD, Raman and FT-IR, it was found that the interlayer l-Cys was oxidized to cystine by Fe(CN)6 3−. Furthermore, the kinetics of this reaction was investigated in batch mode. The influences of initial Fe(CN)6 3−concentration, l-Cys-LDH quantity and reaction temperature on the interlayer oxidation reaction have been studied, respectively. The reaction follows a diffusion-controlled mechanism represented by Crank-Ginstling and Brounshtein kinetic model with the apparent activation energy of 29.93kJ/mol. Therefore, this layered material may have prospective application as a novel “molecular reactor” for confined chemical reactions. [Copyright &y& Elsevier]

Our work used cecal ligation and puncture (CLP) mice model and 16S rDNA sequencing to explore whether the therapeutic mechanism of Sini Decoction (SND) on sepsis was related to the intestinal flora currently of concern. Twenty-four hours after surgery, tissues and serum from three groups (Control, CLP and CLP + SND) were collected for further analysis and colon contents were isolated for 16S rDNA analysis. Mortality, histological examination and inflammatory cytokines levels confirmed that the sepsis model was induced successfully and resulted in serious pathological damage, while all of these could be reversed by SND. In intestinal flora analysis, the microbial richness and abundance were recovered after SND treatment. Furthermore, at the phylum level, the abundance of Proteobacteria showed drastic increase after CLP. Similarly, CLP surgery significantly disrupted the balance of intestinal flora, with a huge increase of Escherichia-Shigella , a Gram-negative genus that might release lipopolysaccharide (LPS) and other genera. And these shifts could be defused by SND, indicating its function of regulating gut microbiota. This study demonstrates that SND could ameliorate the symptoms and pathology associated with sepsis in CLP model via modulating the flora in intestinal tract, which enriches a possible mechanism of SND's therapeutic effect. • The CLP model was used to simulate sepsis and caused severe tissue damage. • SND was proved to be effective in treating sepsis tissue injury and inflammation. • The therapeutic effect of SND was related to the recovery of gut flora composition. [ABSTRACT FROM AUTHOR]

The construction of tourist towns is an important aspect of new-type urbanization construction. In this study, 155 tourist towns in Fujian Province were selected as samples to analyze spatiotemporal differentiation using the geographical concentration index, nearest neighbor index, and local correlation index. Then, a geographic detector model was used to detect the factors that influence the spatiotemporal differentiation of tourist towns and to analyze the explanatory power and interaction of these detection factors. Finally, the mechanisms underlying the detection factors were discussed. Factors affecting the spatiotemporal differentiation of tourist towns in Fujian Province were core factors of traffic network, level of urbanization and population distribution; important factors of industrial structure and socioeconomic basis; and a fundamental factor of policy guidance. These six factors interacted to jointly affect the spatiotemporal differentiation of tourist towns in Fujian Province. The results of this study can provide a basis for the development of tourist towns in other similar regions and have reference value for better optimizing the pattern of urban and town systems and coordinating the synergistic development of urban and rural areas. [ABSTRACT FROM AUTHOR]

Sepsis, as life-threatening organ dysfunction caused by a dysregulated host response to infection, is characterized by the extensive release of cytokines and other mediators. Sini decoction (SND), a traditional Chinese prescription medicine, has been used clinically for the treatment of sepsis. But its explicit mechanism of action is still unclear. The present study aims to evaluate the potential protective effects of SND on sepsis-induced acute lung injury (ALI). After SND intervention, the lung tissues of each experimental group were collected. H&E sections were used to observe the pathological changes of lung tissue, and alveolar lavage fluid was collected to detect the infiltration of inflammatory cells. Level of inflammatory factors in lung tissue were analyzed by qRT-PCR. The change of Renin angiotensin system (RAS), as well as downstream MAPK/NF-κB signaling pathways were measured by Western blot. For in vitro experiments, human umbilical vein endothelial cells (HUVECs) were pretreated with lipopolysaccharide (LPS) and treated with SND. Subsequently, the expression levels of RAS and MAPK/NF-κB signaling pathways were measured by Western blot. In vivo, we found that SND significantly attenuated sepsis-induced pathological injury in the lung. SND also inhibited LPS-mediated inflammatory cell infiltration, the expression of pro-apoptotic proteins and the production of IL-6, IL-1β, TNF-α and MCP-1. In vitro, experiments using a co-culture of HUVECs with SND showed that there was a decrease in pro-apoptotic protein and pro-inflammatory mediator. In this research, we also found that SND protective action could be attributed to the regulation of renin-angiotensin system (RAS). MAPKs and NF-κB pathways. To conclude, our study demonstrated that SND ameliorates sepsis-induced-ALI via regulating ACE2-Ang (1-7)-Mas axis and inhibiting the MAPK signaling pathway. [ABSTRACT FROM AUTHOR]

Objectives: Our present study focused on assessing whether Sinomenine (SIN) could attenuate sepsis‐induced acute lung injury (ALI). Methods: The mice were conditioned with SIN 1 h before intraperitoneal injection of lipopolysaccharide (LPS). Lung wet/dry (W/D) ratio, inflammatory level in bronchoalveolar lavage fluid (BALF), malondialdehyde (MDA) levels, superoxide dismutase (SOD) activity and inflammatory cytokines production were detected. The expression of nuclear factor erythroid 2‐like 2 (Nrf2) and autophagy‐related proteins were detected by Western blot and immunohistochemical analyses. In addition, the RAW264.7 cells were treated with SIN 1 h before treatment with LPS. Inflammatory cytokines, iNOS and COX2 were detected. The expression of Nrf2 and autophagy‐related proteins were explored by Western blot analysis. Key findings: Experiments in vivo and in vitro discovered that LPS significantly increased the degree of injury, inflammatory cytokines production and oxidative stress. However, the increase was significantly inhibited by treatment of SIN. In addition, SIN was found to upregulate the expression of Nrf2 and autophagy‐related proteins both in vivo and in vitro. Conclusions: Our data suggested that SIN could attenuate septic‐associated ALI effectively, probably due to the inhibition of inflammation and oxidative stress through Nrf2 and autophagy pathways. [ABSTRACT FROM AUTHOR]

Concerns about income inequality and environmental pollution have been important aspects of achieving sustainable development goals. Promotion and use of organic food is one important way to reduce resource consumption and waste. In this study, the structural equation model (SEM) was used to analyze 450 questionnaire data, and the environmental values and perceived consumer effectiveness were used as mediating variables to explore the influence mechanism of income quality on the organic food purchase intention. An extended Value—Attitude—Behavior (VAB) theory was used as the research framework, and the results showed that: (1) income quality had a significant positive effect on environmental values, perceived consumer effectiveness, and organic food purchase intention; (2) perceived consumer effectiveness had a significant positive effect on organic food purchase intention and played a partial mediating role; and (3) environmental values and perceived consumer effectiveness played a chain mediating role between income quality and organic food purchase intention. Plain Language Summary: Organic food pays attention to the coordinated development with the natural environment, which has the characteristics of high quality, pure green and pollution-free. Compared with other foods (such as green foods, conventioanl foods), organic food have the highest sustainable attributes. This study aims to promote organic food consumption in China. Previous scholars have focused on the quantitative aspect of income, but this study introduces income quality into the study of organic food consumption and proves that income quality has good applicability in the study of organic food consumption. This study theoretically improves the explanation and prediction of organic food consumption, and in practice helps governments, certification agencies, agricultural enterprises and other entities to formulate reasonable and effective organic food management and strategic marketing from the perspective of consumers. [ABSTRACT FROM AUTHOR]

To investigate the long-term characteristics of precipitation in Xinjiang, China, two long-term monthly satellite precipitation datasets called CHIRPS (Climate Hazards Group Infrared Precipitation with Stations data) and PERSIANN-CDR (Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks - Climate Data Record) are evaluated and compared with in situ measurements from 105 meteorological stations for the period 1983–2014. The evaluation is performed at multiple temporal and spatial scales. Results based on comparisons with in situ measurements show that PERSIANN-CDR and CHIRPS have similar correlations. However, both of the BIAS and RMSE, CHIRPS outperformed PERSIANN-CDR with the smaller errors and bias. In terms of the long time-series comparison at temporal scale, CHIRPS is more accurate with gauge observations at monthly and annual scales while PERSIANN-CDR tends to overestimate the precipitation in the rain season (from May to September). Furthermore, compared with PERSIANN-CDR, results show that CHIRPS is more accurate in reflecting the spatial distribution of average monthly and annual precipitation. In summary, the study shows that CHIRPS is a valuable complement to gauge precipitation data and provides useful guidance when choosing satellite precipitation product for hydrometeorological applications in Xinjiang. [ABSTRACT FROM AUTHOR]

In the pathogenesis of diabetes mellitus (DM), islet microvasculares are severely damaged due to glucolipotoxicity and other reasons. Vascular endothelial growth factor (VEGF) is an indispensable and specific angiogenic factor in the pathogenesis and treatment of diabetic islet microvascular disease. Mesenchymal stem cells (MSCs) are regarded as a promising treatment of diabetes because of their immunosuppressive effect and multipotential differentiation potency. In this study, we tested whether MSCs over-expressing VEGF conditioned medium (MSC-VEGF-CM) could ameliorate pancreatic islet endothelial cells (MS-1) dysfunction induced by a common diabetic inducer palmitate (PA). We found that cell survival and migration were restrained by PA and partly repaired by the pro-protected of MSC-VEGF-CM. Meanwhile, PI-3K/AKT/m-TOR/eNOS and p38/MAPK signaling pathways were also up-regulated. Though apoptosis-related proteins, caspase-3 and caspase-9, had no significantly suppressed between MSC-VEGF-CM and MSC-CM alone, the expression levels of vascular surface factors such as CD31, VE-cadherin, occludin and ICAM-1, were remarkably up-regulated by the pro-protected of MSC-VEGF-CM. Our data suggested that MSC-VEGF-CM had therapeutic effect on the PA-induced dysfunction through the re-activation of PI-3K/AKT/m-TOR/eNOS and p38/MAPK signaling pathways. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the prevalence of frailty and associated factors among hospitalized older adults. It consisted of 184 hospitalized older adults recruited between October 2019 to January 2020. We used the FRAIL scale, Geriatric Depression Scale–15, and the Pittsburg Sleep Quality Index to collect data. Descriptive statistics, independent group t -test, Chi-square (χ2) tests, and logistic regression were applied to statistical analysis. It found that the prevalence of frailty among hospitalized older adults was 39.7%. Depression (Mild: OR = 5.312, 95% CI [2.384–11.833]; Moderate: OR = 6.630, 95% CI [2.077–21.160]) and low activities of daily living (ADL) (Slight dependence: OR = 5.667, 95% CI [1.308–24.557]; Moderate dependence: OR = 15.188, 95% CI [3.342–69.016]; Severe dependence: OR = 5.872, 95% CI [2.645–13.038]) were independent predictors of frailty. Future studies on the interventions to reduce depression, improve ADL and delay the progression of frailty are encouraged. We should focus more on ADL, emotional and psychological state of hospitalized older adults to prevent frailty. [ABSTRACT FROM AUTHOR]

Drought is one of the most devastating climate disasters. Hence, drought forecasting plays an important role in mitigating some of the adverse effects of drought. Data-driven models are widely used for drought forecasting such as ARIMA model, artificial neural network (ANN) model, wavelet neural network (WANN) model, support vector regression model, grey model and so on. Three data-driven models (ARIMA model; ANN model; WANN model) are used in this study for drought forecasting based on standard precipitation index of two time scales (SPI; SPI-6 and SPI-12). The optimal data-driven model and time scale of SPI are then selected for effective drought forecasting in the North of Haihe River Basin. The effectiveness of the three data-models is compared by Kolmogorov-Smirnov (K-S) test, Kendall rank correlation, and the correlation coefficients (R). The forecast results shows that the WANN model is more suitable and effective for forecasting SPI-6 and SPI-12 values in the north of Haihe River Basin. [ABSTRACT FROM AUTHOR]

Background and Aims Continuous renal replacement therapy (CRRT) is an important treatment in the intensive care unit (ICU). Nevertheless, the outcome of CRRT remains unclear. It is important to find a useful and easy indicator to predict the prognosis in patients on CRRT treatment. We undertook this study to observe the association between serum D-dimer level and mortality of ICU patients in the treatment of CRRT. Methods A total of 149 patients who received CRRT were enrolled in our study. We observed the correlation of D-dimer with the information of biochemical parameters, acute physiology and chronic health evaluation II (APACHE II) score. We analyzed the association between serum D-dimer level before CRRT and 28-d mortality retrospectively. Furthermore, we used Cox regression analysis to assess whether D-dimer could be the independent risk factor for mortality. Results There were significant correlations between D-dimer and C-reaction protein ( r 2 = 0.033, p = 0.026), creatinine ( r 2 = 0.066, p = 0.002) and APACHE II ( r 2 = 0.036, p = 0.021). The difference in 28-d mortality risk between elevated D-dimer group and normal D-dimer group was significant (HR 2.872, 95% CI 1.563–5.278, p = 0.001), and the elevated D-dimer level was an independent risk factor for 28-d mortality (HR 2.067, 95% CI 1.104–3.872, p = 0.023). The difference in 28-d mortality was significant between groups ( p <0.001). ROC curves showed that the area under the curve (AUC) of D-dimer was 0.763. Conclusion The present study demonstrates that serum D-dimer could be a useful and easy prognostic variable of 28-d mortality in critically ill patients who received CRRT. [ABSTRACT FROM AUTHOR]

Background The Surviving Sepsis Campaign has recommended early goal-directed therapy (EGDT) as an essential strategy to decrease mortality among patients with severe sepsis and septic shock. However, three latest multicenter trials failed to show its benefit in the patients with severe sepsis and septic shock. This article was to evaluate the effect of EGDT on the mortality of patients with severe sepsis and septic shock. Methods Relevant studies from PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were identified from January 1, 2001 to June 13, 2015. With both randomized controlled trials (RCTs) and non-RCTs selected, a meta-analysis on the effects of EGDT on all identified trials was performed. The primary outcome was the inhospital mortality. In subgroup, RCTs and non-RCTs were analyzed, respectively. Results A total of five RCTs and 10 non-RCTs involving 3285 patients in EGDT group and 3233 patients in the control group were identified. Pooled analyses of all studies showed significant difference in the inhospital mortality between the EGDT group and the control group (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.74–0.94; P = 0.003) with substantial heterogeneity (χ2 = 24.93, P = 0.04, I 2 = 44%). In subgroup analysis, there were no significant difference in inhospital mortality between the EGDT group and the control group (RR, 0.95; 95% CI, 0.83–1.10; P = 0.51) with no significant difference in heterogeneity (χ2 = 6.62, P = 0.16, I 2 = 40%) in RCTs. In non-RCTs, EGDT significantly reduced inhospital mortality (RR, 0.75; 95% CI, 0.65–0.88; P = 0.0003) with no significant difference in heterogeneity (χ2 = 11.96, P = 0.22, I 2 = 25%). Conclusions This meta-analysis suggests that EGDT can significantly reduce the mortality among patients with severe sepsis and septic shock. [ABSTRACT FROM AUTHOR]

The analysis of the spatiotemporal trends of precipitation and drought is relevant for the future development and sustainable management of water resources in a given region. In this study, precipitation and Standardized Precipitation Index (SPI) trends were analyzed through applying linear regression, Mann–Kendall, and Spearman’s Rho tests at the 5% significance level. For this goal, meteorological data from 9 meteorological stations in and around Aksu Basin during the period 1960–2010 was used, and two main annual drought periods were detected (1978-1979 and 1983–1986), while the extremely dry years were recorded in 1975 and 1985 at almost all of the stations. The monthly analysis of precipitation series indicates that all stations had increasing trend in July, October, and December, while both increasing and decreasing trends were found in other months. For the seasonal scale, precipitation series had increasing trends in summer and winter. 33% of the stations had the decreasing trend on precipitation in the spring series, and it was 11% in the autumn. At the same time, the SPI-12 values of all stations had the increasing trend. The significant trends were detected at Aheqi, Baicheng, Keping, and Kuche stations. [ABSTRACT FROM AUTHOR]

Owing to the huge amounts and perishable character of vegetable wastes, composting is one of the best options for recycling vegetable wastes post-harvest. The initial moisture content (MC) is critical for optimizing composting process, but the effect of high MC in undehydrated vegetable wastes on composting was rarely reported. For this, the plant-scale windrows were prepared by mixing cauliflower waste and maize straw at different ratios to control initial MC of 70 % (T1-70) and 80 % (T2-80), respectively, and composted in winter. As composting progressed, substantial organic matter degradation, progressive humification, decreases in electrical conductivity and increases of pH and germination index (GI) were observed in both treatments. Nonetheless, T1-70 accelerated heating rate early during composting, prolonged high temperature period (>50 °C) by 30 d, thus increased the harmless level of composting, and significantly improved the humification of end-products compared to T2-80. Results also revealed that T1-70 activated more indigenous microbes and enhanced microbial interactions early during composting, with the fungi enriched in T1-70 playing an important role in accelerating the composting process. Remarkably, the difference in composting temperatures, humification degree, and microbial communities between the two treatments was most significant during the maturation phase. In this phase, MWH_CFBk5 , Planktosalinus , Pseudopedobacter , and Luteimonas enriched in T1-70 were positively correlated with humification indices. It is suggested that the effect of initial MC, resulting from different ratios of vegetable waste to maize straw, on their composting was mediated by the composting temperature and microbial communities at low temperatures. [Display omitted] • High MC in vegetable waste significantly impacted its composting at low temperatures. • Initial MC of vegetable waste composting led to the greatest change during maturation. • Differential microbes were correlated with germination index and humification. • Initial MC of 70 % improved the maturity, humification and harmlessness of composts. [ABSTRACT FROM AUTHOR]

Drought identification and assessment are essential for regional water resources management. In this paper, the spatiotemporal characteristics of drought were evaluated based on monthly precipitation data from 33 synoptic stations during the period of 1960–2010. The percent of normal precipitation was applied to illustrate the driest years in Beijing-Tianjin-Hebei metropolitan areas (BTHMA) (1965, 1997, and 2002). The modified Reconnaissance Drought Index (RDI) was applied to capture the drought patterns and to estimate the drought severity at 33 meteorological stations. Agglomerative hierarchical cluster analysis (AHCA) and principal component analysis (PCA) were used to identify three different drought subregions R1, R2, and R3 based on the monthly precipitation values in BTHMA, which is located in southeast, north, and south of BTHMA, respectively. The year 1965 was the driest and 1964 was the wettest during the observed period. The characteristics of drought were analyzed in terms of the temporal evolution of the RDI-12 values and the frequency of drought for the three identified regions. The percentage of years characterized by drought was 13.73% for R1, 16.50% for R2, and 15.53% for R3. 66.91% of drought belongs to the near normal drought category. The obtained results can aid to improve water resources management in the area. [ABSTRACT FROM AUTHOR]

Background: The heterogeneity of lung injury in pulmonary acute respiratory distress syndrome (ARDS) may have contributed to the greater response of hyperinflated area with positive end-expiratory pressure (PEEP). PEEP titrated by stress index can reduce the risk of alveolar hyperinflation in patients with pulmonary ARDS. The authors sought to investigate the effects of PEEP titrated by stress index on lung recruitment and protection after recruitment maneuver (RM) in pulmonary ARDS patients. Materials and methods: Thirty patients with pulmonary ARDS were enrolled. After RM, PEEP was randomly set according to stress index, oxygenation, static pulmonary compliance (Cst), or lower inflection point (LIP) + 2 cmH2O strategies. Recruitment volume, gas exchange, respiratory mechanics, and hemodynamic parameters were collected. Results: PEEP titrated by stress index (15.1 ± 1.8 cmH2O) was similar to the levels titrated by oxygenation (14.5 ± 2.9 cmH2O), higher than that titrated by Cst (11.3 ± 2.5 cmH2O) and LIP (12.9 ± 1.6 cmH2O) (P < 0.05). Compared with baseline, PaO2/FiO2 and recruitment volume were significantly improved after PEEP titration with the four strategies (P < 0.05). PaO2/FiO2 and recruitment volume were similar when using PEEP titrated by stress index and oxygenation but higher than that titrated by Cst and LIP. Compared with baseline, lung compliance increased significantly when PEEP determined by Cst, but there was no difference of Cst in these four strategies. There was no influence of PEEP titration with the four strategies on hemodynamic parameters. Conclusions: PEEP titration by stress index might be more beneficial for pulmonary ARDS patients after RM. [ABSTRACT FROM AUTHOR]

Water column separation (WCS), the breaking of continuous water flow by a vapor cavity, is extremely dangerous because the rejoining of the separated water columns would lead to tremendous pressure rises. Therefore, the turbine draft-tube pressure after the load rejection in hydropower stations should be controlled to prevent such an unbearable load of turbine units. To understand the forming, growing and collapsing processes of WCS in pump-turbines during the load rejection transients with guide-vane closing, a model pumped-storage system was simulated by the one-dimensional and three-dimensional coupled computational fluid dynamics model, in which the water conveyance system and pump-turbine were treated as one-dimensional and three-dimensional domains, respectively. The entire processes of the breaking and rejoining of water flow in the pump-turbine, as well as the variations in the pressure field and hydraulic forces on the runner, were analyzed. The main finding is that the collision of the separated water liquids and the collapses of the cavities occur separately with a time difference, which induces two high-amplitude mono-pulses in both the axial and radial forces on the runner. These two successive hydraulic impacts are extremely destructive and should be considered with greater emphasis when evaluates the risk of WCS. • Water column separation in a pump-turbine during the load rejection was simulated. • The processes of breaking and rejoining of water flow were described in detail. • The collision of broken liquids and the collapses of cavities occur separately. • There are two hydraulic impacts on the runner following the water column separation. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • E.coli induced histological changes and increased W/D ratio and MPO activity, indicating tissues damage. • E.coli induced inflammation and oxidative stress by increasing the expression of inflammatory cytokines and MDA content. • Sinomenine has a protective effect against E.coli induced acute lung injury (ALI). • SIN ameliorates E.coli -induced lung injury through activation Nrf2-Keap1 and inhibition NF-κB pathways. Abstract Acute lung injury (ALI) is a common disease characterized by pulmonary inflammation and oxidative stress. Sinomenine (SIN) is an alkaloid originally extracted from the Chinese medicinal plant Sinomenium acutum. It has been shown to have anti-inflammatory and anti-oxidative effect. However, it's unclear whether SIN can alleviate ALI. In this study, we assessed the effect of SIN on Escherichia coli (E.coli) -induced ALI mouse model. Mice were conditioned with SIN or placebo 1 h before intratracheally instilled with E.coli. Lung water content, malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, Myeloperoxidase (MPO) levels and inflammatory cytokines production were measured. Immunohistochemistry and western blot were performed to measure target protein expression. E.coli induced histological changes indicating tissues damage and increased W/D ratio, MPO activity, MDA content, and inflammatory cytokines production in the Lung. Whereas in mice pretreated with SIN, these changes were absent. E.coli -induced NF-κB activation was also inhibited by SIN. In addition, SIN increased the expression of HO-1, NQO1 and Nrf2 in lung tissues. Our results suggest that SIN attenuates ALI through the inhibition of inflammation and oxidative stress. [ABSTRACT FROM AUTHOR]

Background Sepsis is a major health care problem, which affects millions of people around the world. Glucose metabolic reprogramming of immune cells plays a crucial role during advancement of sepsis. However, the association between glucose metabolic reprogramming and mortality in patients with sepsis is unclear. Lactate dehydrogenase (LDH) catalyzes the last step of glycolysis. Investigating the relationship between LDH and mortality is important to understand the effect of metabolic reprogramming on prognosis of patients with sepsis. Methods A total of 192 patients with sepsis were included in our study. Data on characteristics of patients, biochemical variables, and inflammatory mediator were collected. Association between the level of serum LDH and 28-day mortality was also analyzed. The correlations between serum LDH, interleukin-1β, creatinine, PaO 2 /FiO 2 , and lactate were also observed. The association between LDH and the risk of death was further analyzed. Moreover, receiver operating characteristic curve was depicted to compare the accuracy in prediction of LDH and other variables. Results There were statistic difference in 28-day mortality between elevated LDH group and normal LDH group ( P = 0.021). Level of serum LDH was an independent risk factor for death of patients with sepsis (hazard ratio 1.005, 95% confidence interval 1.002-1.007, P = 0.001). There were significant correlations between LDH, interleukin-1β (r = 0.514, P = 0.000), creatinine (r = 0.368, P = 0.000), PaO 2 /FiO 2 (r = −0.304, P = 0.000), and lactate (r = 0.560, P = 0.000). The receiver operating characteristic curves showed that the area under the LDH curve for prediction for mortality was 0.783. Conclusions Serum LDH is probably associated with 28-day mortality in patients with sepsis. [ABSTRACT FROM AUTHOR]

Background: In the acute respiratory distress syndrome (ARDS), lung-protective ventilation strategies combine the delivery of small tidal volumes (VT) with sufficient positive end-expiratory pressure (PEEP). However, an optimal approach guiding the setting of PEEP has not been defined. Monitoring volumetric capnography is useful to detect changes in lung aeration. Objectives: The aim of this study was to determine whether volumetric capnography may be a useful method to determine the optimal PEEP in ARDS. Methods: In 8 lung-lavaged piglets, PEEP was reduced from 20 to 4 cm H2O in steps of 4 cm H2O every 10 min followed by full lung recruitment. Volumetric capnography, respiratory mechanics, blood gas analysis, hemodynamic data and whole-lung computed tomography scans were obtained at each PEEP level. Results: After lung recruitment, end-expiratory lung volume progressively decreased from 1,160 ± 273 ml at PEEP 20 cm H2O to 314 ± 86 ml at PEEP 4 cm H2O. The ratio of alveolar dead space (VDalv) to alveolar VT (VTalv) and the phase III slope of volumetric capnography (SIII) reached a minimum at PEEP 16 cm H2O. At this PEEP level, overaerated lung regions were significantly reduced, nonaerated lung regions did not increase, and partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F) and static respiratory system compliance (Crs) reached a maximum. At PEEP levels <16 cm H2O, nonaerated lung regions significantly increased, P/F and Crs deteriorated, and VDalv/VTalv and SIII began to increase. Conclusions: In this surfactant-depleted model, PEEP at the lowest VDalv/VTalv and SIII allows an optimal balance between lung overinflation and collapse. Hence, volumetric capnography is a useful bedside approach to identify the optimal PEEP. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Sustainable food consumption behaviors are related to not only environment-friendly but also consumers' self-health concern. Several studies have shown that emphasizing the health attribute of food could increase eco-friendly food consumption. The effect of health attributes in combination with low-carbon foods needs to be emphasized when measuring consumer preference for sustainable foods. Brown rice is chosen in this study as a sustainable alternative. Five attributes including low-carbon, health, percentage, price, and cooking method were adopted in the choice experiment to test the main effect on consumers' preference in China. A total of 1215 respondents accomplished the questionnaire through an online survey. Results showed substitution percentage had the largest influence among the five attributes. In addition, consumers demonstrated positive attitudes towards health and low-carbon information displayed by both labels and brief claims on the front-of-package. However, soaking brown rice and substituting brown rice for white rice would decrease consumers' utility. The results indicated that the promotion of low carbon food consumption behaviors should consider the convenience and gradual change. We also measured the effect of the combination of health and low-carbon attributes, and a substitution effect was observed when information about these two attributes displayed simultaneously. It means these two attributes displayed together would discount rather than improve the premium of consumers. Meanwhile, the interaction between main attributes with socio-demographics indicated that consumers with higher-education level and richer knowledge of low-carbon exhibited a more positive attitude toward the low-carbon attribute and a more negative attitude towards health information. • We measure Chinese consumers' preference for low carbon and health attributes. • Substitution effect exists when health and low-carbon attributes displayed together. • Intermediate behavioral goals could be set to promote habitual behavior changes. • A vague label is more appealing than a brief introduction claim on the package. [ABSTRACT FROM AUTHOR]

As a novel tool, deep learning is used to solve complex problems in the real world and has been successfully applied to invert for seismic and electromagnetic data. In this study, we propose to use deep neural networks (DNNs) to recover the distribution of the physical properties of buried magnetic orebodies from the surface and airborne magnetic anomaly data. This approach is based on data training instead of prior-knowledge assumptions used in traditional inversion methods. Once our generalized network is established, the computing time to predict new magnetic data using this method can be significantly reduced. By implementing the forward modeling of different types of synthetic physical property models, we obtained enough datasets to train a DNN model so that the network can establish a nonlinear mapping directly from magnetic anomaly data to physical properties. The pre-trained network can be used to estimate the distribution of magnetization intensity from new input magnetic data. Two DNN structures were employed to test the feasibility and generalization of the proposed method by implementing Experiments in serval two-dimensional (2D) synthetic examples. Compared with the conventional method, the predicted distribution of magnetization intensity obtained by using our method is more concentrated and has better resolution to determine the boundary of the magnetic body. In a field example of Galinge iron ore deposits in China, the magnetization distribution of concealed iron orebodies inverted by the proposed approach was in good agreement with that detected by borehole data. DNNs have good nonlinear inversion capability and exhibit some excellent merits of strong learning ability, wide coverage and strong adaptability, which is a considerable application prospect in geophysical exploration. A large number of samples are generated by numerical simulation to train the neural network model. The magnetization intensity distribution that needs to be predicted can be obtained by inputting new magnetic data into the pre-trained network. Unlabelled Image • The use of deep-learning technique to invert magnetic data. • The method is tested to synthetic examples with satisfactory and reliable result. • Magnetic target sources are well defined by inversion of field data. • Our study provides a new perspective for magnetic data inversion. [ABSTRACT FROM AUTHOR]

Sepsis is a critical illness that contributes a high mortality, while Xijiao Dihuang decoction (XJDHT) has been used in treatment against sepsis for many years by clinical doctors. Clinical studies confirmed a good efficacy of XJDHT against sepsis. The aim of this study is to observe the efficacy of XJDHT in sepsis model rats and macrophages activated by LPS, and to verify the underlying mechanisms. The key components of XJDHT and its targets against sepsis were analyzed and selected by network pharmacology. The potential mechanisms that XJDHT regulates the progress of sepsis were verified in sepsis rats and NR8383 cell lines. XJDHT at a dose of 25 mg/kg was administrated to rats which endured cecal ligation and perforation (CLP). After MTT assay, XJDHT at a dose of 4 mg/mL was selected to treat NR8383 cell lines activated by LPS. In vivo experiment, the survival of the rats was assessed. The content of cytokine in serum were assessed by Enzyme-linked immunosorbent assays (ELISA). Contents of cytokine and key molecules in relative signaling pathway were assessed by immunohistochemical method. The pathway protein expressions were detected by Western blotting. In vitro experiment, immunofluorescence was used to assess the content of cytokine and signaling pathway. A total of 42 targets of XJDHT against sepsis were identified by network pharmacology. After eliminating overlapping compounds and proteins, there were 8 compounds in XJDHT that associating with the 42 sepsis-related targets. NF-κB and HIF-1α signaling pathway were recognized to play important role for XJDHT against sepsis. XJDHT improved survival rate in the XJDHT group compared with the model group. The contents of IL-6 increased in the model group compared with the control group with ELISA and immunohistochemistry, while XJDHT reduced the content of IL-6. The expressions of p65 and HIF-1α reduced significantly in the XJDHT group compared with the model group. In vitro study, the content of IL-6 elevated significantly after LPS stimulation, while XJDHT reduced this increase. Furthermore, expressions of protein of p65 and HIF-1α decreased significantly compared with the LPS group. To conclude, our study demonstrated that XJDHT at a dose of 25 g/kg is capable of improving the survival of sepsis via regulating the NF-κB and HIF-1α signaling pathway. [ABSTRACT FROM AUTHOR]