Meta-analysis of the effects of helmet-assisted non-invasive ventilation in the treatment of acute respiratory failure

OBJECTIVE

To study the efficacy of helmet-assisted non-invasive ventilation and conventional ventilation in the treatment of acute respiratory failure (ARF).

MATERIALS AND METHODS

Cochrane Library, PubMed, Embase and CNKI databases were searched for randomized controlled trials and case-control trials of helmet-assisted noninvasive ventilation in the treatment of ARF. The outcome measures included respiratory rate, intubation rate, complication rate, mortality rate and arterial blood gas analysis of the commonly used indicators (PaCO2/ PaO2 / pH). The results of the included studies' odds ratio (OR) and its 95% confidential interval (CI) were analyzed using Stata software.

RESULTS

The results of the analysis showed that the in-hospital mortality, intubation rate and complication rate were all significantly decreased with the p-value less than 0.05, which was statistically significant.

CONCLUSIONS

Helmet-assisted noninvasive ventilation can significantly reduce hospital mortality, intubation rate and complication rate, improving the survival rate and prognosis of patients with ARF.

Thermal and Quantum Melting Phase Diagrams for a Magnetic-Field-Induced Wigner Solid

A sufficiently large perpendicular magnetic field quenches the kinetic (Fermi) energy of an interacting two-dimensional (2D) system of fermions, making them susceptible to the formation of a Wigner solid (WS) phase in which the charged carriers organize themselves in a periodic array in order to minimize their Coulomb repulsion energy. In low-disorder 2D electron systems confined to modulation-doped GaAs heterostructures, signatures of a magnetic-field-induced WS appear at low temperatures and very small Landau level filling factors (ν≃1/5). In dilute GaAs 2D hole systems, on the other hand, thanks to the larger hole effective mass and the ensuing Landau level mixing, the WS forms at relatively higher fillings (ν≃1/3). Here we report our measurements of the fundamental temperature vs filling phase diagram for the 2D holes' WS-liquid thermal melting. Moreover, via changing the 2D hole density, we also probe their Landau level mixing vs filling WS-liquid quantum melting phase diagram. We find our data to be in good agreement with the results of very recent calculations, although intriguing subtleties remain.

Novel GLI3 Mutations in Chinese Patients with Non-syndromic Post-axial Polydactyly

BACKGROUND

Polydactyly, characterized by supernumerary digits in the upper or lower extremities, is the most common congenital digital abnormalities. It derives from the defective patterning of anteroposterior axis of the developing limb, with various etiology and clinical heterogeneity. The patients with post-axial polydactyly type A (PAPA) have the typical symptom of a well-formed supernumerary digit outside the fifth digit.

OBJECTIVE

The aim of present study was to identify the causative mutations of two unrelated Han Chinese patients with non-syndromic PAPA.

METHODS

Two unrelated Han Chinese patients and 100 ethnicity-matched, unrelated normal controls were recruited for this study. BGISEQ-500 exome sequencing was performed in the two patients, followed by validation in the patients and 100 controls by using Sanger sequencing.

RESULTS

Two mutations in the GLI family zinc finger 3 gene (GLI3), including a frameshift mutation c.3437_3453delTCGAGCAGCCCTGCCCC (p.L1146RfsX95) and a nonsense mutation c.3997C>T (p.Q1333X), were identified in two patients but were absent in the 100 healthy controls.

CONCLUSION

The two GLI3 mutations, p.L1146RfsX95 and p.Q1333X, may account for non-syndromic PAPA in the two patients, respectively. The findings of this study may expand the mutational spectrum of GLI3-PAPA and provide novel insights into the genetic basis of polydactyly.

Gender and age differences in the association between sleep characteristics and fasting glucose levels in Chinese adults

AIM

The present study examined the associations between night-time sleep duration, midday napping duration and bedtime, and fasting glucose levels, and whether or not such associations are dependent on gender and age.

METHODS

This study was a cross-sectional analysis of 172,901 adults aged≥40 years living in mainland China. Sleep duration was obtained by self-reports of bedtime at night, waking-up time the next morning and average napping duration at midday. Fasting plasma glucose (FPG)≥7.0mmol/L was defined as hyperglycaemia. Independent associations between night-time sleep duration, midday naptime duration and bedtime with hyperglycaemia were evaluated using regression models.

RESULTS

Compared with night-time sleep durations of 6-7.9h, both short (<6h) and long (≥8h) night-time sleep durations were significantly associated with an increased risk of hyperglycaemia in women [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.01-1.29 and OR: 1.14, 95% CI: 1.08-1.21, respectively], and revealed a U-shaped distribution of risk in women and no significant association in men. Long midday nap durations (≥1h) were significantly but weakly associated with hyperglycaemia (OR: 1.04, 95% CI: 1.01-1.09) compared with no napping without interactions from gender or age, whereas the association between bedtime and fasting glucose levels did vary according to gender and age.

CONCLUSION

Night-time sleep duration, midday napping duration and bedtime were all independently associated with the risk of hyperglycaemia, and some of the associations between these sleep characteristics and hyperglycaemia were gender- and age-dependent.

[Effects of parental rearing patterns and their consistency on the emotional and behavioral problems of preschool children]

Objective: To explore the effect of parental rearing patterns and their consistency on the emotional and behavioral problems of preschool children. Methods: From October to November 2017, 27 987 children aged 3 to 6 years old from 109 kindergartens in 11 cities of Hubei, Anhui and Jiangsu Provinces were selected by using the cluster sampling method. A total of 27 200 valid questionnaires which were completed by subjects' parents were collected. The emotional and behavioral problems of preschool children were collected by "strengths and difficulties questionnaire" and the parental rearing patterns were evaluated by the "Parental Behavior Scale". The differences in emotional and behavioral abnormality rates of preschool children with different characteristics were analyzed; with emotional and behavioral problems as dependent variables and parental support/participation and compulsion/hostility as independent variables, the multivariate logistic regression model was used to analyze the effect of parental rearing patterns and their consistency on the emotional and behavioral problems of preschool children. Results: The age of children was (4.35±0.96) years old, and 51.4% of children were 13 975 males. There were 24 634 (90.6%) urban children and 17 916 (65.9%) only children. Both parents with strong support/participation accounted for 14.9%, and those with poor support/participation accounted for 11.9%; both parents with strong compulsion/hostility accounted for 15.2%, and those with low compulsion/hostility accounted for 11.3%. The rates of emotional symptoms, conduct behavior, hyperactive behavior, peer interaction, total difficulty score, and abnormal prosocial behavior of preschool children were 9.5%, 9.5%, 18.2%, 24.5%, 11.2%, and 10.2%, respectively. The multivariate logistic regression model analysis showed that after adjusting for gender, only child, living area, family economic status, mother's age and education level, father's education level, and other factors, compared with fathers/mothers with strong support/participation and low compulsion/hostility and parents with strong support/participation and low compulsion/hostility, preschool children who had fathers/mothers with poor support/participation and strong compulsion/hostility or parents with poor support/participation and strong compulsion/hostility were more likely to have emotional symptoms, conduct behavior, hyperactive behavior, peer interaction, total difficulty score, and abnormal prosocial behavior (P<0.05). Conclusions: Parental rearing patterns and their consistency are related to the emotional and behavioral problems of preschool children.

[Determination of chlormequat chloride residues in animal derived foods by high performance liquid chromatography-tandem mass spectrometry]

A method for the determination of chlormequat chloride (CCC) residues in animal derived foods by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was developed. The samples were extracted with acetonitrile containing 1% (v/v) acetic acid and defatted with n-hexane, followed by clean-up on a cationic solid phase extraction column. The analytes were separated on a Venusil MP C18(2) column (150 mm×2.1 mm, 3 μm) under a gradient elution program using acetonitrile and 0.1% (v/v) formic acid aqueous solution as the mobile phases. Then, the analytes were detected by tandem mass spectrometry using a positive electrospray ionization (ESI⁺) source in the multiple reaction monitoring (MRM) mode. Matrix-matched internal standard calibration curves were used for quantitative analysis. The calibration curves showed good linearity in the range of 0.200-500 μg/L for CCC, with correlation coefficients (r²) no less than 0.9993. The limit of quantification (LOQ) of the method was 0.500 μg/kg. The average recoveries of CCC in pork, beef, mutton, chicken, egg, pig kidney, beef liver, sheep kidney, chicken liver and milk matrices at spiked levels of 0.500-500 μg/kg were 93.4%-101%, and the relative standard deviations were 2.3%-8.0%. The method has less matrix interference, with high sensitivity, accuracy and reliability, and it is suitable for the quantitative detection of CCC residues in animal derived foods.

A social cost-benefit analysis of two One Health interventions to prevent toxoplasmosis

Background

In the Netherlands, toxoplasmosis ranks third in disease burden among foodborne pathogens, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. We performed a Social Cost-Benefit Analysis (SCBA) to evaluate the net value of two potential interventions, freezing meat and improving biosecurity in pig farms, for the Dutch society.

Methods

We assessed the costs and benefits of the two interventions and compared them with the current practice of education, especially during pregnancy. A ‘minimum scenario’ and a ‘maximum scenario’ was assumed, using input parameters with least benefits to society and input parameters with most benefits to society, respectively.

Results

The freezing meat intervention was far more effective than the biosecurity intervention. Despite high freezing costs, freezing two meat products: steak tartare and mutton leg yielded net social benefits in both the minimum and maximum scenario, ranging from €10.6 million to €31 million for steak tartare and €0.6 million to €1.5 million for mutton leg. The biosecurity intervention would result in net costs in all scenarios ranging from €1 million to €2.5 millions.

Conclusions

From a public health perspective (i.e. reducing the burden of toxoplasmosis) freezing steak tartare and leg of mutton is to be considered.

Decreased Expression of TIM-3 on Th17 Cells Associated with Ophthalmopathy in Patients with Graves' Disease

Purpose:

Thyroid-associated Ophthalmopathy (TAO) is one of the most common orbital immunological diseases in adults. CD4+ helper T (Th) cells play important roles in the pathogenesis of TAO. But the mechanisms regulating CD4+ T cell activity is unclear. This study examines T cell immunoglobulin domain and mucin domain 3 (TIM-3) expression in helper T cell type 1 (Th1), Th17, and regulatory T cells in sufferers of TAO.

Methods:

Participants were divided into 3 groups: patients with TAO, patients with Graves’ disease but without orbitopathy (GD), and healthy control patients (HC). Peripheral blood samples were collected for each patient in the designated group. Flow cytometry methods assessed the frequency of Th1 (CD4+IFN-γ+), Th17 (CD4+IL-17+), regulatory T cells (CD4+CD25hiCD127lo), and TIM-3 protein expression. Mean fluorescence intensity (MFI) measured the magnitude of TIM-3 expression and the percentage of TIM-3+ cells for each patient.

Results:

Compared to the GD group, TAO patients possessed higher frequencies of Th1 and Th17 cells in peripheral blood samples. The percentage of TIM-3+ Th1 and Th17 cells was significantly lower in the TAO patients than the GD group. Across all patients sampled, TIM-3+ cell percentage negatively correlated with Th1 cell frequency. Th1 and Th17 cells exhibited significantly decreased expression of TIM-3 in TAO patients compared to healthy controls. Regulatory T cells showed little TIM-3 expression and we observed no significant differences in frequency between groups.

Conclusion:

These results suggest a role for TIM-3 in the regulation of Th1 and Th17 cells and the pathogenesis of Graves’ ophthalmopathy.

Vibrational spectroscopic study on feed molecular structure properties of oil-seeds and co-products from Canadian and Chinese bio-processing and relationship with protein and carbohydrate degradation fractions in ruminant systems

The objective of this study was to apply ATR-FTIR spectroscopy to reveal feed molecular structure properties of oil-seeds and co-products and relationship with protein and carbohydrate degradation fractions in ruminant systems. The oil-seeds and co-products were from both various bio-processing industries in Canada and China. The protein and carbohydrate degradation fractions were evaluated with updated CNCPS system. Results showed that in the co-products from canola processing industries there are strong relationship between 1) soluble true protein (PA2) fraction and the following protein molecular structure spectral characteristics; spectral peak area of amide I and amide II (r = 0.56, P = 0.001), area of amide I (r = 0.67, P < 0.001), height of amide I (r = 0.74, P < 0.001), amide I and II ratio (r = 0.57, P = 0.001), α-helix (r = 0.82, P < 0.001), and β-sheet (r = 0.61, P < 0.001), 2) slowly degradable true protein (PB2) fraction and height of amide I (r = -0.60, P = 0.001), α-helix (r = -0.72, P < 0.001), and β-sheet (r = -0.51, P = 0.004), 3) soluble fiber (CB2) fraction and α-helix and β-sheet height ratio (r = -0.63, P < 0.001), and 4) unavailable NDF (CC) fraction and height of amide I (r = 0.55, P = 0.002). These results indicated feed molecular structure spectral properties of the oil-seeds and co-products related to CNCPS protein and carbohydrate degradation fractions in ruminant systems.

Probing the Melting of a Two-Dimensional Quantum Wigner Crystal via its Screening Efficiency

One of the most fundamental and yet elusive collective phases of an interacting electron system is the quantum Wigner crystal (WC), an ordered array of electrons expected to form when the electrons' Coulomb repulsion energy eclipses their kinetic (Fermi) energy. In low-disorder, two-dimensional (2D) electron systems, the quantum WC is known to be favored at very low temperatures (T) and small Landau level filling factors (ν), near the termination of the fractional quantum Hall states. This WC phase exhibits an insulating behavior, reflecting its pinning by the small but finite disorder potential. An experimental determination of a T vs ν phase diagram for the melting of the WC, however, has proved to be challenging. Here we use capacitance measurements to probe the 2D WC through its effective screening as a function of T and ν. We find that, as expected, the screening efficiency of the pinned WC is very poor at very low T and improves at higher T once the WC melts. Surprisingly, however, rather than monotonically changing with increasing T, the screening efficiency shows a well-defined maximum at a T that is close to the previously reported melting temperature of the WC. Our experimental results suggest a new method to map out a T vs ν phase diagram of the magnetic-field-induced WC precisely.

Wigner solid pinning modes tuned by fractional quantum Hall states of a nearby layer

We studied a bilayer system hosting two-dimensional electron systems (2DESs) in close proximity but isolated from one another by a thin barrier. One 2DES has low electron density and forms a Wigner solid (WS) at high magnetic fields. The other has much higher density and, in the same field, exhibits fractional quantum Hall states (FQHSs). The WS spectrum has resonances which are understood as pinning modes, oscillations of the WS within the residual disorder. We found the pinning mode frequencies of the WS are strongly affected by the FQHSs in the nearby layer. Analysis of the spectra indicates that the majority layer screens like a dielectric medium even when its Landau filling is ~¹/₂, at which the layer is essentially a composite fermion (CF) metal. Although the majority layer is only ~ one WS lattice constant away, a WS site only induces an image charge of ~0.1e in the CF metal.

[A randomized single blind comparison of conventional bowel preparation and unplanned preoperative preparation for pelvic organ prolapse]

Objective: To investigate the influence of conventional preoperative intestinal preparation and unplanned preparation on the visual field of pelvic organ prolapse repair surgery. Methods: The patients who underwent transvaginal pelvic organ prolapse repair surgery in Peking University People's Hospital from September 2017 to July 2018 were selected as the research objects except those who had undergone colorectal surgery and chronic constipation. The surgery doctor was blinded by intestinal preparation. There was no intestinal preparation in non intestinal preparation group and polyethylene glycol was taken orally in intestinal preparation group. The main outcome measures were the effect of intestinal contents on the surgical field, the presence of fecal leakage, and the nature and volume of fecal leakage. The standard of fecal contamination was: mild, less than 15 ml, moderate, 15-30 ml, and severe, >30 ml. Secondary indicators were patient satisfaction and symptoms of routine bowel preparation. Results: A total of 120 patients (60 cases of non intestinal preparation group, 60 cases of intestinal preparation group) were selected, including transvaginal hysterectomy, vaginal anterior or posterior colporrhaphy (some patients with anterior prolapse repair with mesh), sacrospinal ligament suspension, total colpectomy and colpocleisis, laparoscopic sacral colpopexy, anti-incontinence surgery. The median age of the patients in non intestinal preparation group was 62 years, and the median age of intestinal preparation group was 60 years. There were no significant differences in median age, anesthesia, operation method, blood loss, operation time and perioperative infection between the two groups (all P>0.05). Fecal contamination occurred in 10% (6/60) of the patients without intestinal preparation and 32% (19/60) of the patients with intestinal preparation (P=0.042). Comparing the two groups, 10% (6/60) of the patients with intestinal preparation had moderate and severe contamination, and the patients without intestinal preparation was only 2% (1/60), there was significant difference (P=0.017). In intestinal preparation group, nausea (8%, 5/60), vomiting (5%, 3/60), abdominal distension (22%, 13/60), fatigue (5%, 3/60) and palpitation (2%, 1/60) were higher than those in non intestinal preparation group. Conclusions: Intestinal preparation with oral laxatives before pelvic organ prolapse repair surgery is not beneficial to the cleaning of the surgical field and increases the discomfort of intestinal preparation. It is safe and feasible for most patients with pelvic organ prolapse to perform pelvic organ prolapse repair surgery without intestinal preparation.

Reactive Transport Simulation of Fracture Channelization and Transmissivity Evolution

Underground fractures serve as flow conduits, and they may produce unwanted migration of water and other fluids in the subsurface. An example is the migration and leakage of greenhouse gases in the context of geologic carbon sequestration. This study has generated new understanding about how acids erode carbonate fracture surfaces and the positive feedback between reaction and flow. A two-dimensional reactive transport model was developed and used to investigate the extent to which geochemical factors influence fracture permeability and transmissivity evolution in carbonate rocks. The only mineral modeled as reactive is calcite, a fast-reacting mineral that is abundant in subsurface formations. The X-ray computed tomography dataset from a previous experimental study of fractured cores exposed to carbonic acid served as a testbed to benchmark the model simulation results. The model was able to capture not only erosion of fracture surfaces but also the specific phenomenon of channelization, which produces accelerating transmissivity increase. Results corroborated experimental findings that higher reactivity of the influent solution leads to strong channelization without substantial mineral dissolution. Simulations using mineral maps of calcite in a specimen of Amherstburg limestone demonstrated that mineral heterogeneity can either facilitate or suppress the development of flow channels depending on the spatial patterns of reactive mineral. In these cases, fracture transmissivity may increase rapidly, increase slowly, or stay constant, and for all these possibilities, the calcite mineral continues to dissolve. Collectively, these results illustrate that fluid chemistry and mineral spatial patterns need to be considered in predictions of reaction-induced fracture alteration and risks of fluid migration.