Sequential respiratory support in septic patients undergoing continuous renal replacement therapy: A study based on MIMIC-III database

Objective

Oxygen and hemodynamic management are important for providing a sufficient adequate oxygen-containing blood to the organs for septic patients. In present study, we aimed to explore the application of sequential respiratory support (SRS) and the association of SRS with the outcome of septic patients who needed continuous renal replacement therapy (CRRT).

Methods

We extracted the medical information of septic patients who received CRRT within 24 h of intensive care unit (ICU) admission from the MIMIC-III v1.4. SRS was defined as receiving firstly oxygen therapy followed by mechanical ventilation (MV) within 24 h of admission to ICU. The propensity score matching (PSM) was performed to compare the differences in clinical characteristics and outcomes of patients with or without SRS. Finally, we developed logistic regression models to analyze the effects of SRS on hospital mortality.

Results

A total of 181 patients entered in this study, and there were 80 patients undergoing MV including SRS group (n = 61) and non-SRS group (n = 19). In the multivariate logistic regression, the value of SRS was associated with the lower risk of hospital mortality adjusted by minimum systolic BP (SBP), maximum lactate, vasopressor use, and sequential organ failure assessment (SOFA) score or Logistic Organ Dysfunction System (LODS) scores within the first 24 h of ICU stay. After PSM adjusted by SBP, maximum lactate, vasopressor use, SOFA, and LODS, there were 31 patients in SRS group with a and 18 cases in non-SRS group, displaying a significantly lower hospital mortality in SRS group than that in patients without SRS (19.4 % vs. 83.3 %, P < 0.001). In addition, age, qSOFA, necessitating the administration of vasopressor, and duration of vasopressor were significantly correlated with the hospital mortality in septic patients undergoing CRRT and SRS.

Conclusions

Receiving SRS within the first 24 h upon admission to the ICU was independently associated with the hospital mortality in patient with sepsis undergoing CRRT, and patients who were directly received MV had a high risk of death.

Deposition of ZnO thin films with different powers using RF magnetron sputtering method: Structural, electrical and optical study

Zinc Oxide thin films at room temperature with good crystallinity quality have been deposited at different Radio Frequency powers. Magnetron sputtering technique has been carried out on glass and oriented Si(100) substrates. The film structure has been characterized by X-ray Diffraction (XRD) and MicroRaman spectroscopy, which possesses a wurtzite structure with (002) preferential orientation selecting suitable conditions. Scanning electron microscope (SEM) and atomic force microscopy (AFM) have been utilized to determine the films surface morphology. The stoichiometry has been verified by Energy dispersive X-ray spectroscopy (EDX) analysis. The optical behaviors of the deposited films have been characterized by Ultraviolet Visible (UV-Vis) (optical transmittance measurements) as well as by Photoluminance characterization. Electrical properties, Current-Voltage (I-V) and Capacitance-Voltage (C-V) have been studied in details for Zinc Oxide on Silicon film that deposited at different Radio Frequency power. The high transparency, electrical behavior and smooth surface allow to use these Zinc Oxide films in photovoltaic cells and optoelectronics application.

Mapping specific groundwater nitrate concentrations from spatial data using machine learning: A case study of chongqing, China

Groundwater resources is not only important essential water resources but also imperative connectors within the intricate framework of the ecological environment. High nitrate concentrations in groundwater can exerting adverse impacts on human health. It is imperative to accurately delineate the distribution characteristics of groundwater nitrate concentrations. Four different machine learning models (Gradient Boosting Regression (GB), Random Forest Regression (RF), Extreme Gradient Boosting Regression (XG) and Adaptive Boosting Regression (AD)) which combine spatial environmental data and different radius contributing area was developed to predict the distribution of nitrate concentration in groundwater. The models use 595 groundwater samples and included topography, remote sensing, hydrogeological and hydrological, climate, nitrate input, and socio-economic predictor. Gradient Boosting Regression model outperforms the other models (R2 = 0.627, MAE = 0.529, RMSE = 0.705, PICP = 0.924 for test dataset) under 500 m radius contributing area. A high-resolution (1 km) groundwater nitrate concentration distribution map reveal in the majority of the study area, groundwater nitrate concentrations are below 1 mg/L and high nitrate concentration (>10 mg/L) proportion in southeast, northeast and central main urban area karst valley regions is 1.89%, 0.91%, and 0.38% respectively. In study area, hydrogeological conditions, soil parameters, nitrogen input factors, and percentage of arable land are among the most influential explanatory factors. This work, serving as the inaugural application of utilizing effective spatial methods for predicting groundwater nitrate concentrations in Chongqing city, furnish decision-making support for the prevention and control of groundwater pollution, particularly in areas primarily dependent on groundwater for water supply and holds profound significance as a milestone achievement.

Exploration of therapeutic models for psycho-cardiology: From cardiac to psychological rehabilitation

The prevalence and mortality of cardiovascular disease are relatively high. Currently, depression has been proven to be an independent risk factor for the occurrence and poor prognosis of cardiovascular disease. Psycho-cardiovascular comorbidity, as a reciprocal cause and effect, affects each other, leading to the deterioration of clinical prognosis and forming a vicious circle. Coronary artery disease comorbidity with depression is a common disease in psycho-cardiology medicine. This paper expounds on the exploration of the treatment model of psycho-cardiology from the aspects of epidemiological characteristics, comorbidity mechanism, screening, diagnosis, and treatment.

Review of the marine energy environment-a combination of traditional, bibliometric and PESTEL analysis

Marine renewable energy is regarded as a nascent renewable energy resource that is less utilized due to a number of challenges in the sector. This paper focused on using both traditional and bibliometric analysis approaches to review the marine energy industry. It also assessed the various opportunities and challenges in the sector beyond technological challenges using PESTEL analysis. The results from the study identified the availability of renewable energy targets, international and national greenhouse gas (GHG) emissions reduction targets, job creation, skill transfer from offshore industries, renewable support, and low GHG emissions as the major opportunities for the sector. The challenges in the sector include the lack of commonality in device designs, high initial capital costs, lack of appropriate legal and regulatory frameworks, lack of funding, fragmentations in regulatory institutions, bad macro-economic indicators in some countries, environmental challenges, the survivability of the various technologies in the harsh oceanic environment, and strong competition from other renewable energy sources. The outcome of the bibliometric analysis spanning from 2013 to 2023 shows that tidal power is the focus of research in the field, and most studies are either focused on ways to improve its efficiency in terms of technology or on the identification of resource potentials for the siting of the various marine renewable power systems. Recommendations such as strong cooperation between the government and private sector, increased public education, collaboration with existing players in the marine sector, and increased research and development, among others, were proposed for the development of the sector.

Constipation in patients with motor neuron disease: A retrospective longitudinal study

Background

Constipation has been recently recognized as a complication associated with motor and autonomic dysfunction in patients with motor neuron disease (MND), typified by amyotrophic lateral sclerosis (ALS). However, the long-term characteristics of constipation remain unclear in patients with MND. We longitudinally investigated the prevalence and risk factors of constipation in a consecutive cohort of patients with MND.

Methods

Data from Japanese patients with MND enrolled in a single-center registry from June 2017 to December 2021 were retrospectively investigated. The diagnosis of ALS was based on the updated Awaji criteria, and other MND subtypes were also included. The presence or absence of constipation symptoms was determined by referring to the Rome III criteria. The clinical backgrounds and symptoms of patients with and without constipation were compared.

Results

Among 155 consecutive patients (female, 63; age, 66.5 ± 12.4 years), 30.3% had constipation at diagnosis and 52.9% after a median follow-up of 18 months. Univariate analysis showed that female sex, use of tracheostomy and invasive ventilation, and delivery of enteral nutrition were more frequent in the constipation group. The Revised Amyotrophic Lateral Sclerosis Functional Rating Scale score was significantly lower in the constipation group, especially for the sub-items related to physical motor function. Multivariate analysis showed that the use of enteral nutrition was an independent risk of constipation, with an odds ratio of 3.69 (95% CI, 1.49-9.17; p = 0.005).

Conclusion

Constipation had a high prevalence in patients with MND with impaired motor function. Controlling defecation is important in patients with MND, especially during enteral nutrition.

Viruses and thrombocytopenia

Thrombocytopenia, characterized by a decrease in platelet count, is a multifaceted clinical manifestation that can arise from various underlying causes. This review delves into the intriguing nexus between viruses and thrombocytopenia, shedding light on intricate pathophysiological mechanisms and highlighting the pivotal role of platelets in viral infections. The review further navigates the landscape of thrombocytopenia in relation to specific viruses, and sheds light on the diverse mechanisms through which hepatitis C virus (HCV), measles virus, parvovirus B19, and other viral agents contribute to platelet depletion. As we gain deeper insights into these interactions, we move closer to elucidating potential therapeutic avenues and preventive strategies for managing thrombocytopenia in the context of viral infections.

Zhuang-Gu-Fang intervenes vasculogenic and osteogenic coupling in GK rats through Notch1/Noggin/VEGF pathway

Background

Zhuang-Gu-Fang (ZGF) has been proved to treat osteoporosis in ovariectomized rats by increasing osteogenic related factors Leptin, Ghrelin and Peptide YY(PYY). However, the mechanism of ZGF in the treatment of diabetic osteoporosis (DOP) remains unclear. The aim of this study was to explore the therapeutic effect of ZGF on DOP and its potential molecular mechanism.

Methods

Using GK rats as models, the pharmacodynamic effects of ZGF on bone loss were evaluated by hematoxylin-eosin (H&E) staining and micro-computed.tomography (micro-CT). The expression levels of CD31 and endomucin (Emcn) were detected by immunofluorescence to assess the role of ZGF in angiogenic osteogenic coupling. Finally, real-time quantitative PCR (RT-PCR) and Western Blot (WB)were used to detect the expression levels of osteogenic and angiogenesis-related genes and proteins Notch1, Noggin and vascular endothelial growth factor (VEGF).

Results

Administration of ZGF demonstrated a significant mitigation of bone loss attributable to elevated glucose levels. H&E staining and micro-CT showed that ZGF notably improved the integrity of the trabecular and cortical bone microarchitecture. Moreover, ZGF was found to augment the density of type H vessels within the bone tissue, alongside elevating the expression levels of Osterix, a transcription factor pivotal for bone formation. Furthermore, our findings suggest that ZGF facilitates the activation of the Notch1/Noggin/VEGF pathway, indicating a potential mechanism through which ZGF exerts its osteoprotective effects.

Conclusion

Our results suggest that ZGF potentially facilitates the formation of type H vessels through the Notch1/Noggin/VEGF pathway. This action not only enhances angiogenic-osteogenic coupling but also contributes to the improvement of bone structure and density. Consequently, ZGF emerges as a promising therapeutic agent for the prevention and management of DOP, offering a novel approach by leveraging angiogenesis-dependent osteogenesis.

The predictive model of hydrobiological diversity in the Asana-Tumilaca basin, Peru based on water physicochemical parameters and sediment metal content

The hydrobiological diversity in the basin depends on biotic and abiotic factors. A predictive model of hydrobiological diversity for periphyton and macrobenthos was developed through multiple linear regression analysis (MLRA) based on the physicochemical parameters of water (PPW) and metal content in sediments (MCS) from eight monitoring stations in the Asana-Tumilaca Basin during the dry and wet seasons. The electrical conductivity presented values between 47.9 and 3617 μS/cm, showing the highest value in the Capillune River due to the influence of geothermal waters. According to Piper's diagram, the water in the basin had a composition of calcium sulfate and calcium bicarbonate-sulfate. According to the Wilcox diagram, the water was found to be between good and very good quality, except for in the Capillune River. The Shannon-Wiener diversity indices (H') were 2.62 and 2.88 for periphyton, and 2.10 and 2.44 for macrobenthos, indicating moderate diversity; for the Pielou's evenness index (J'), they were 0.68 and 0.70 for periphyton, and 0.68 and 0.59 for macrobenthos, indicating similar equity, in the dry and wet seasons, respectively, for both indices. In the model there were three cases, where the first two cases only worked with PPW or MCS, and case 3 worked with PPW and MCS. For case 3, the predicted values for H' and J' of periphyton and macrobenthos concerning those observed presented correlation coefficients of 0.7437 and 0.6523 for periphyton and 0.9321 and 0.8570 for macrobenthos, respectively, which were better than those of cases 1 and 2. In addition, principal component analysis revealed that the As, Pb, and Zn contents in the sediments negatively influenced the diversity, uniformity, and richness of the macrobenthos. In contrast, Cu and Cr had positive impacts because of the adaptation processes.

Associations between sleep problems and cardiometabolic risk in maintenance hemodialysis patients: A multicenter study

The incidence of cardiovascular disease is increasing around the world, and it is one of the main causes of death in chronic kidney diseases patients. It is urgent to early identify the factors of cardiometabolic risk. Sleep problems have been recognized as a risk factor for cardiometabolic risk in both healthy people and chronic patients. However, the relationship between sleep problems and cardiometabolic risk has not been clearly explored in hemodialysis patients. This study aimed to investigate the relationship between sleep problems and cardiometabolic risk in 3025 hemodialysis patients by a multicenter study. After adjusting for confounders, binary logistic regression models showed that hemodialysis patients reported sleep duration greater than 7 h were more likely to be with hypertension, hyperglycemia, hypertriglyceridemia, and hypercholesterolemia. Patients reported sleep duration less than 7 h were more likely to be with hypertriglyceridemia and hypercholesterolemia, but the risks of hyperglycemia and Low HDL-cholesterol were decreased. Poor sleep quality was negatively correlated to low HDL cholesterol and hypertriglyceridemia. Moreover, gender-based differences were explained.

Meta-analysis investigating the impact of the LEPR rs1137101 (A>G) polymorphism on obesity risk in Asian and Caucasian ethnicities

Obesity is a chronic condition which is identified by the buildup of excess body fat caused by a combination of various factors, including genetic predisposition and lifestyle choices. rs1137101 (A > G) polymorphism in the CHR1 domain of LEPR protein linked to different diseases including obesity. Nevertheless, the connection between this polymorphism and the likelihood of developing obesity has not been determined definitively. Therefore, a meta-analysis was conducted to assess the relationship between rs1137101 and the risk of obesity. The meta-analysis included all studies meeting pre-defined criteria, found through searching databases up until February 2023. A combined odds ratio with a 95% confidence interval was estimated as overall and in continent subgroups for homozygous, heterozygous, recessive, dominant and allelic models using the fixed or the random-effects model. The meta-analysis identified 39 eligible studies with cases and controls (6099 cases/6711 controls) in 38 articles under different ethnic backgrounds. The results indicated a significant relationship between rs1137101 and the likelihood of developing obesity in each of the genetic models [the homozygous model (GG vs. AA: 95% Confidence Interval = 1.12-1.73, Odds Ratio = 1.39, P value = 0.003); the heterozygous model (AG vs. AA: 95% Confidence Interval = 1.07-1.42, Odds Ratio = 1.23, P value = 0.005); the dominant model (AG/GG vs AA: 95% Confidence Interval = 1.10-1.49, Odds Ratio = 1.28, P value = 0.001); the recessive model (GG vs AA/AG: 95% Confidence Interval = 1.02-1.45, Odds Ratio = 1.21, P value = 0.03); and the allelic model (G vs A; 95% Confidence Interval = 1.07-1.33, Odds Ratio = 1.19, P value = 0.002)] tested. Additionally, with an FDR <0.05, all genotypic models demonstrated statistical significance. The association remained significant among subgroups of Asian and Caucasian populations, although analysis in some genetic models did not show a significant association. Begg's and Egger's tests did not show publication biases. In sensitivity analysis, one particular study was found to have an impact on the Recessive model's significance, but other models remained unaffected. The current meta-analysis found significant indications supporting the association between rs1137101 and obesity. To avail a deeper understanding of this association, future research should include large-scale studies conducted in diverse ethnic populations.

Predicting construction cost under uncertainty using grey-fuzzy earned value analysis

Insufficient emphasis on planning and control is one of the major causes of several delayed and cost-overrun construction projects. To improve such performances, many studies have been conducted on project control techniques such as Earned Value Analysis (EVA) and its modifications: fuzzy EVA and grey EVA. Since there is no analytical model integrating fuzzy theory and grey theory simultaneously with EVA, this research aimed at predicting construction cost under uncertainty using grey-fuzzy EVA. Consequently, simple and valid project cost control grey-fuzzy EVA algorithms were developed to ensure continuous project cost performance improvement in the presence of imprecise data. In addition, an analysis result interpretation scheme was presented. Grey-fuzzy EVA was compared with fuzzy EVA and grey EVA to check its validity. Then, a case study of a road project in Addis Ababa, Ethiopia, was presented to demonstrate the application of grey-fuzzy EVA. This research contributes determinations of the lower limit, median, and upper limit of predicted costs and degree of greyness using grey-fuzzy EVA, which simplifies cost analysis, requires only a small number of data points (BAC, PV, AC, and Progress), needs no experts to create a membership function, and is comprehensible for practitioners as compared to fuzzy EVA and grey EVA used separately.

Dexamethasone inhibits androgen receptor-negative prostate cancer cell proliferation via the GR-FOXO3a-GAS5 axis

Background

Studies have shown that glucocorticoid receptor (GR) has inconsistent effects on the proliferation of prostate cancer cells, we found dexamethasone inhibited the proliferation of androgen receptor-negative prostate cancer cells, but the underlying mechanisms remain to be illustrated.

Methods

GR expression and its prognosis role were analyzed based on the TCGA dataset. Bioinformatic analysis was performed to identify the candidate of GR downstream, which includes FOXO3a. After overexpressing FOXO3a in PC-3 cells, cell counting kit-8 (CCK-8) and migration assays were performed to evaluate cell proliferation and migration ability. Regulation of FOXO3a on GAS5 was also analyzed by JASPAR and PCR.

Results

GR had low expression in prostate cancer and predicted poor prognosis. FOXO3a was identified as the downstream of GR to inhibit the proliferation of prostate cancer cells. Moreover, FOXO3a directly induces GAS5 expression, forming the GR-FOXO3a-GAS5 signaling pathway.

Conclusion

Our study showed that GR played a role as a tumor suppressor gene in androgen receptor-negative prostate cancer cells via the GR-FOXO3a-GAS5 axis. Our results suggested patients with prostate cancer should be classified and develop a treatment plan according to the expression of AR and GR.

Three sessions of repeated sprint training in normobaric hypoxia improves sprinting performance

The objective of the present study was to evaluate the impacts of three-session repeated sprint training conducted in normobaric hypoxia with 48-h intervals on sprint performance, arterial oxygen saturation (SpO2), and rating of perceived exertion (RPE) scores. A total of 27 moderately trained male university students voluntarily took part in this study. In this single-blind placebo-controlled study, subjects were assigned into normobaric hypoxia (FiO2: 13.6%; HYP), normobaric normoxia (FiO2: 20.9%; PLA), and control group (CON). The HYP and PLA groups underwent three repeated sprint training sessions (a total of four sets of five times 5-s sprints with a 5-min rest between sets and a 30-s rest between each sprint) on a cycle ergometer in normobaric hypoxia or normoxia conditions. Pre- and post-tests were performed 72 h before and after the training period. Three participants were excluded from the study, and the data from twenty-four participants were analyzed. Contrary to what was observed in the pre and post tests, no time and condition interactions were observed in the relative peak power output (PPO), mean power output (MPO), percentage of sprint decrement score (Sdec%), and RPE parameters. Time effect was found in all observed variables respectively; relative PPO (F = 5.784, p = 0.045, η2 = 0.74), relative MPO (F = 3.927, p = 0.042, η2 = 0.66) and large time effect found for Sdec% (F = 11.430, p = 0.046, 0.83), and RPE (F = 14.990, p = 0.008, η2 = 0.96). A notable increase in relative peak power output (PPO) and mean power output (MPO) was observed in the post-test in comparison to the pre-test values, indicating statistical significance. The increase in PPO was in HYP 13.44% (p = 0.006), in PLA 7.48% (p = 0.264) and in CON 2.66% (p = 0.088). The decrease in Sdec% was in HYP -13.34%% (p = 0.048), PLA -10.54 (p = 0.577) and CON -4.83 (p = 0.644) at post-test. The results show that although there were no statistical differences between the groups, notable differences in performance-related variables were observed in the HYP group after 3 sessions of repetitive sprint training in hypoxia.

Assessing the impact of emergency measures in varied population density areas during a large dengue outbreak

Background

The patterns of dengue are affected by many factors, including population density and climate factors. Densely populated areas could play a role in dengue transmission due to increased human-mosquito contacts, the presence of more diverse and suitable vector habitats and breeding sites, and changes in land use. In addition to population densities, climatic factors such as temperature, relative humidity, and precipitation have been demonstrated to predict dengue patterns. To control dengue, emergency measures should focus on vector management. Most approaches to assessing emergency responses to dengue risks involve applying simulation models or describing emergency activities and the results of implementing those responses. Research using real-world data with analytical methods to evaluate emergency responses to dengue has been limited. This study investigated emergency control measures associated with dengue risks in areas with high and low population densities, considering their different control capacities.

Methodology

Data from the 2015 dengue outbreak in Kaohsiung City, Taiwan, were utilized. The government database provided information on confirmed dengue cases, emergency control measures, and climatic data. The study employed a distributed lag non-linear model (DLNM) to assess the effect of emergency control measures and their time lags on dengue risk.

Principal findings

The findings revealed that in areas with high population density, the absence of emergency measures significantly elevated the risks of dengue. However, implementing emergency measures, especially a higher number, was associated with lower risks. In contrast, in areas with low population density, the risks of dengue were only significantly elevated at the 1st week lag if no emergency control measures were implemented. When emergency activities were carried out, the risks of dengue significantly decreased only for the 1st week lag.

Conclusions

Our findings reveal distinct exposure-lag-response patterns in the associations between emergency control measures and dengue in areas with high and low population density. In regions with a high population density, implementing emergency activities during a significant dengue outbreak is crucial for reducing the risk. Conversely, in areas of low population density, the necessity of applying emergency activities may be less pronounced. The implications of this study on dengue management could provide valuable insights for health authorities dealing with limited resources.

Atrophy of hippocampal subfields and amygdala nuclei in subjects with mild cognitive impairment progressing to Alzheimer's disease

The hippocampus and amygdala are the first brain regions to show early signs of Alzheimer's Disease (AD) pathology. AD is preceded by a prodromal stage known as Mild Cognitive Impairment (MCI), a crucial crossroad in the clinical progression of the disease. The topographical development of AD has been the subject of extended investigation. However, it is still largely unknown how the transition from MCI to AD affects specific hippocampal and amygdala subregions. The present study is set to answer that question. We analyzed data from 223 subjects: 75 healthy controls, 52 individuals with MCI, and 96 AD patients obtained from the ADNI. The MCI group was further divided into two subgroups depending on whether individuals in the 48 months following the diagnosis either remained stable (N = 21) or progressed to AD (N = 31). A MANCOVA test evaluated group differences in the volume of distinct amygdala and hippocampal subregions obtained from magnetic resonance images. Subsequently, a stepwise linear discriminant analysis (LDA) determined which combination of magnetic resonance imaging parameters was most effective in predicting the conversion from MCI to AD. The predictive performance was assessed through a Receiver Operating Characteristic analysis. AD patients displayed widespread subregional atrophy. MCI individuals who progressed to AD showed selective atrophy of the hippocampal subiculum and tail compared to stable MCI individuals, who were undistinguishable from healthy controls. Converter MCI showed atrophy of the amygdala's accessory basal, central, and cortical nuclei. The LDA identified the hippocampal subiculum and the amygdala's lateral and accessory basal nuclei as significant predictors of MCI conversion to AD. The analysis returned a sensitivity value of 0.78 and a specificity value of 0.62. These findings highlight the importance of targeted assessments of distinct amygdala and hippocampus subregions to help dissect the clinical and pathophysiological development of the MCI to AD transition.

Impact of anesthetics on rat hippocampus and neocortex: A comprehensive proteomic study based on label-free mass spectrometry

Anesthesia is regarded as an important milestone in medicine. However, the negative effect on memory and learning has been observed. In addition, the impact of anesthetics on postoperative cognitive functions is still discussed. In this work, in vivo experiment simulating a general anesthesia and ICU sedation was designed to assess the impact of two intravenous (midazolam, dexmedetomidine) and two inhalational (isoflurane, desflurane) agents on neuronal centers for cognition (neocortex), learning, and memory (hippocampus). More than 3600 proteins were quantified across both neocortex and hippocampus. Proteomic study revealed relatively mild effects of anesthetics, nevertheless, protein dysregulation uncovered possible different effect of isoflurane (and midazolam) compared to desflurane (and dexmedetomidine) to neocortical and hippocampal proteins. Isoflurane induced the upregulation of hippocampal NMDAR and other proteins of postsynaptic density and downregulation of GABA signaling, whereas desflurane and dexmedetomidine rather targeted mitochondrial VDAC isoforms and protein regulating apoptotic activity.

Rural households' livelihood adaptation strategies in the face of changing climate: A case study from Pakistan

Rural and agricultural communities' adaptation to climate change has gained significant attention owing to many countries' vulnerability to climate change risks. A similar trend has been witnessed in South Asia, a highly climate-vulnerable region, where research has grown dramatically considering the agriculture sector's vulnerability to climate-induced disasters. However, little attention has been paid to the adaptation of the livelihoods of rural households. This research, therefore, takes the case of Pakistan to explore livelihood adaptation strategies of rural households to climate change and investigate the factors that expedite or halt the adoption of livelihood diversification strategies. A multistage sampling design is used in this research, where 480 rural households from the Punjab province of Pakistan were selected and interviewed using stratified and random sampling approaches. A multivariate probit (MVP) regression model is employed to analyze the factors affecting households' adoption of livelihood adaptation strategies. The results show that besides adaptation of agronomic operations (agricultural adaptation strategies), rural households in the study area employed a wide range of strategies to adapt their livelihoods to climate change. These strategies include poultry and livestock farming, value addition of farm produce, trading of animals and farm commodities, small businesses (shops, etc.), daily wage labor, horticultural crop farming, and non-farming jobs. The estimates of the MVP model revealed that respondents' education, household size, income, access to a credit facility, access to farm advisory services, and access to climate forecasts have significantly influenced the choice of livelihood adaptation strategies. Based on these findings, this research recommends that the authorities should make efforts to improve farmers' understanding of the adaptation of climate change risks and educate them to adopt multiple livelihood options to improve the resilience of their livelihoods to climate-induced risks. This research has important policy implications for other countries with similar socio-economic features.

Surveillance of COVID-19 vaccines: A comprehensive analysis of the first immunization drive in Ecuador

The initial phase of the COVID-19 vaccination in Ecuador occurred between April and November 2021. Initially, it focused on priority populations, including health professionals and other front-line workers. During this period, there was limited knowledge about the vaccine's adverse effects. A non-probability, observational study was conducted among university staff in Guayaquil, Ecuador, who received the AstraZeneca vaccine (n = 423) between April and November 2021. This study aimed to compare the acute adverse reactions by doses and to report the incidence of long-term adverse reactions within the AstraZeneca group. As a result, comparing acute adverse reactions between doses, the odds ratio for local pain, headache, muscle pain, fever, and chills are statistically higher after the first dose than the second dose. Survival curves indicated these symptoms appeared mainly within the first 6 h post-vaccination. This is the first pharmacovigilance study from Ecuador that analyzes survival probabilities for the AstraZeneca vaccine's adverse effects.

The nonlinear impact of financial flexibility on corporate sustainability: Empirical evidence from the Chinese manufacturing industry

In the face of challenges ushered in by globalization and technological advancements, financial flexibility has emerged as a pivotal strategy for attaining sustainable development in China's manufacturing sector. Financial flexibility allows firms to manage internal cash flows, alleviate external financing constraints, and augment their capability to absorb risks. Using the framework of Financial Flexibility Theory and Institutional Theory, this study examines data from A-share listed manufacturing firms on the Shanghai and Shenzhen Stock Exchanges from 2011 to 2021. The research aims to investigate the nexus between financial flexibility and sustainable performance, while also probing the moderating roles of environmental uncertainty and governmental grants. The key findings of the study unveil an inverted U-shaped relationship between financial flexibility and sustainable performance. Moreover, environmental uncertainty exerts a significant negative influence on sustainable performance. When both environmental uncertainty and governmental grants are substantial, the inverted U-shaped correlation between financial flexibility and sustainable performance intensifies. The innovation of this study lies in revealing the optimal zone of financial flexibility for enterprises under the influence of environmental uncertainty and government grants. Amidst an increasingly intricate macro-environment, this research furnishes pragmatic insights for optimizing sustainable performance in manufacturing enterprises and offers a series of empirically grounded suggestions for enterprise managers, government departments, and investors, guiding them to enhance sustainable performance through judicious calibration of financial flexibility levels.

How to successfully improve the biodiversity of city grasslands?

Urban grasslands (UG) are among the most common types of urban green areas. They are usually species poor, and spontaneous plant migration, which can increase biodiversity, is limited. To improve the range of ecosystem services provided by UG, various seed mixtures are applied during the establishment and restoration of UG. These mixtures vary in content, quality, and cost. High-quality seed mixtures are expensive and are usually only available in small amounts. Meanwhile, alternative methods of seed introduction (e.g., fresh hay application, seeds harvested by brush) have not been well studied in UG restoration, and inexpensive commercial mixtures could have low quality and lead to poor restoration outcomes. Here, we tested the effectiveness of different seed sources to create high-quality UG at two study sites. Based on the results, all seed addition methods increased the species richness of restored grasslands. The outcome of seed addition was satisfactory regardless of differences in residual vegetation species composition and soil properties between the sites. The species richness on plots that received a commercial mixture of flower meadow plants dedicated to pollinators decreased after overwintering. The alternative seed sources (fresh hay and seed incidentally collected during mowing) yielded grassland quality that was comparable to that on plots that received high-quality mixtures with known seed origin (a seminatural meadow mixture and a mixture with the addition of grasses).

Comparison of three VST orthokeratology lenses in axial length growth and average corneal reshaping in myopia children: A retrospective self-controlled study

Purpose

To determine the differences in myopia control efficiency and corneal reshaping between three different brands of orthokeratology (OK) lenses (Lucid, Euclid, and Alpha).

Method

We retrospectively reviewed subjects who started simultaneously using different brands of OK lenses. For each participant, every 6 months in the 19 months of following, the changes in axial length (AL), horizontal and vertical maximum distances of the treatment zone (HMDTZ and VMDTZ), width of the high convex zone (WHCZ), distance of decentration, and horizontal and vertical components of the decentration vector were measured. The average values of the above data, the average value of the decentration vector (ADV), and the average value of decentration calculated algebraically (ADA) were calculated.

Results

All the three pairs (Lucid (n = 46) vs. Euclid (n = 46): groups Lucid-versus-Euclid-Lucid (LE-L) and LE-E), Lucid (n = 50) vs. Alpha (n = 50): groups LA-L and LA-A), and Euclid (n = 17) vs. Alpha (n = 17): groups EA-E and EA-A) showed good comparability. Regarding the change in AL during 19 months, none of the pairs showed significant differences (LE-L:0.27 ± 0.24 mm, LE-E:0.31 ± 0.24 mm (p = 0.68); LA-L:0.36 ± 0.26 mm, LA-A:0.36 ± 0.27 mm (p = 0.85); EA-E:0.34 ± 0.27 mm, EA-A:0.41 ± 0.28 mm (p = 0.63)). Regarding treatment zone, Lucid showed the largest HMDTZ and VMDTZ (both p < 0.05). Regarding the WHCZ, none of the pairs showed significant differences. For the ADV and ADA, Lucid had more ADV and ADA than Euclid (ADV: LE-L:0.73 ± 0.44 mm, LE-E:0.55 ± 0.45 mm, p < 0.05; ADA: LE-L:0.80 ± 0.41 mm, LE-E:0.63 ± 0.44 mm, p < 0.05), and the remaining pairs showed no significant difference. For the overall cohort with 113 eyes, the change in AL was weakly correlated with both ADV and ADA (both p < 0.05). Regarding the ADV/ADA, all pairs showed no significant differences, indicating equal lens position stability.

Conclusion

After OK, there were no significant differences between the different pairs of the three brands in AL growth, WHCZ, or lens position stability, although Lucid had a larger treatment zone than Euclid and Alpha, and Lucid had more decentration than Euclid. A larger lens decentration were weakly related to less AL growth.

Investigating the alterations of endocannabinoidome signaling in the human small intestine in the context of obesity and type 2 diabetes

Background

Human studies have linked obesity-related diseases, such as type-2 diabetes (T2D), to the modulation of endocannabinoid signaling. Cannabinoid CB1 and CB2 receptor activation by the endocannabinoids (eCBs) 2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA), both derived from arachidonic acid, play a role in homeostatic regulation. Other long chain fatty acid-derived endocannabinoid-like molecules have extended the metabolic role of this signaling system through other receptors. In this study, we aimed to assess in depth the interactions between the circulating and intestinal tone of this extended eCB system, or endocannabinoidome (eCBome), and their involvement in the pathogenesis of diabetes.

Methods

Plasma and ileum samples were collected from subjects with obesity and harboring diverse degrees of insulin resistance or T2D, who underwent bariatric surgery. The levels of eCBome mediators and their congeners were then assessed by liquid chromatography coupled to tandem mass spectrometry, while gene expression was screened with qPCR arrays.

Findings

Intestinal and circulating levels of eCBome mediators were higher in subjects with T2D. We found an inverse correlation between the intestinal and circulating levels of monoacylglycerols (MAGs). Additionally, we identified genes known to be implicated in both lipid metabolism and intestinal function that are altered by the context of obesity and glucose homeostasis.

Interpretation

Although the impact of glucose metabolism on the eCBome remains poorly understood in subjects with advanced obesity state, our results suggest a strong causative link between altered glucose homeostasis and eCBome signaling in the intestine and the circulation.

Circulating TIGIT±PD1+TPH, TIGIT ± PD1+TFH cells are elevated and their predicting role in systemic lupus erythematosus

It is well established that increased peripheral helper T cells (TPH) and follicular helper T cells (TFH) was found in systemic lupus erythematosus (SLE) patients. However, the expression patterns and immunomodulatory roles of TIGIT and PD1 on TPH/TFH in SLE are poorly understood. The expression patterns of TIGIT and PD1 on TPH and TFH cells were examined using flow cytometry and their expression patterns in SLE patients were then further evaluated for their correlation with auto-antibodies, disease activity and severity, B cell differentiation. Logistic regression was used to analyze the risk factors. And the receiver operating characteristic curves and logistic regression model were created to evaluate the predicting role in SLE. TIGIT±PD1+TPH, TIGIT±PD1+TFH cells in the peripheral blood of SLE patients were upregulated, whereas TIGIT+PD1-TFH was downregulated. TIGIT ± PD1+TPH, TIGIT ± PD1+TFH cells positively correlated with auto-antibodies production, disease activity and severity, whereas TIGIT+PD1-TFH cells negatively correlated. TIGIT ± PD1+TPH, TIGIT-PD1+TFH were positively correlated with the frequency of plasmablasts. Furthermore, higher TIGIT+PD1+TPH and TIGIT+PD1+TFH were shown to be risk factors for SLE, whereas TIGIT+PD1-TFH was found to be a protective factor, according to logistic regression analysis. A further logistic regression model showed that combination of TPH/TFH and routine blood indicators may has potential predicting value for SLE, with AUC of 0.957. The increased TIGIT ± PD1+TPH, increased TIGIT ± PD1+TFH, decreased TIGIT+PD1-TFH correlates with disease severity and activity, may boost our comprehending of the role of TIGIT and PD1 on TPH/TFH in SLE, and a logistic regression model based on combination of TPH/TFH and routine blood indicators shows prominent value for predicting SLE.

Parliamentary question: Insights from the Federal National Council in the UAE

This paper highlights the paramount role of parliamentary questioning as a control mechanism exercised by the Federal National Council (FNC) in the United Arab Emirates (UAE). The surge in its utilization, attributed to heightened awareness among FNC members and ministers, has significantly enhanced the Council's control capabilities, especially in the absence of alternative parliamentary control instruments such as interpellations. The paper underscores the simplicity and adaptability of parliamentary questioning, which spans diverse topics and addresses everyday state matters, rectifies errors, monitors law implementation, and fills legislative gaps. The structure of the paper comprises two sections: the first scrutinizes procedural requirements within the UAE's Constitution and the FNC's Bylaw, while the second section explores practical examples, offering insights into the distinctive nature of the FNC's parliamentary questioning compared to regional practices.