Evaluating IL-6 and IL-10 as rapid diagnostic tools for Gram-negative bacteria and as disease severity predictors in pediatric sepsis patients in the intensive care unit

BackgroundTo explore the diagnostic performance of interleukin (IL)-6 and IL-10 in discriminating Gram bacteria types and predicting disease severity in intensive care unit (ICU)-hospitalized pediatric sepsis patients.MethodWe retrospectively collected Th1/Th2 cytokine profiles of 146 microbiologically documented sepsis patients. Patients were categorized into Gram-positive (G+) or Gram-negative (G-) sepsis groups, and cytokine levels were compared. Subgroup analysis was designed to eliminate the influence of other inflammatory responses on cytokine levels.ResultsAfter propensity score matching, 78 patients were matched and categorized according to Gram bacteria types. Compared with G+ sepsis, IL-6 and IL-10 were significantly elevated in G- sepsis (p < 0.05). Spearman test proved the linear correlation between IL-6 and IL-10 (r = 0.654, p < 0.001), and their combination indicators (ratio and differences) were effective in identifying G- sepsis. In the subgroup analysis, such cytokine elevation was significant regardless of primary infection site. However, for patients with progressively deteriorating organ function [new or progressive multiple organ dysfunction syndrome (NPMODS)], differences in IL-6 and IL-10 levels were less significant between G+ and G- sepsis. In the receiver operating characteristic (ROC) curves of the G- sepsis group, the area under the curve (AUC) value for IL-6 and IL-10 was 0.679 (95% CI 0.561–0.798) and 0.637 (95% CI 0.512–0.762), respectively. The optimal cutoff value for diagnosing G- sepsis was 76.77 pg/ml and 18.90 pg/ml, respectively. While for the NPMODS group, the AUC for IL-6 and IL-10 was 0.834 (95% CI 0.766–0.902) and 0.781 (95% CI 0.701–0.860), respectively.ConclusionIL-6 and IL-10 are comparably effective in discriminating G+/G- sepsis in pediatric intensive care unit (PICU) patients. The deteriorated organ function observed in ICU patients reveals that complex inflammatory responses might have contributed to the cytokine pattern observed in severe sepsis patients, therefore confounding the discriminating efficacy of Th1/Th2 cytokines in predicting Gram bacteria types

Projected changes of ecosystem productivity and their responses to extreme heat events in northern asia

Change of ecosystem productivity and its response to climate extremes in the context of global warming are of great interest and particular concern for ecosystem management and adaptation. Using the simulations with and without the CO2 fertilization effect from the Yale Interactive Biosphere (YIBs) model driven by seven CMIP5 climate models, this article investigates the future change in the gross primary productivity (GPP) of the Northern Asian ecosystem as well as the impacts from extreme heat events under the RCP2.6 and RCP8.5 scenarios, respectively. The results show an overall increase of GPP in Northern Asia during the growing season (May-September) under both scenarios, in which the CO2 fertilization effect plays a dominant role. The increases in GPP under RCP8.5 are larger than that under RCP2.6, and the greatest projected increases occur in western Siberia and Northeast China. The extreme heat events are also projected to increase generally and their influences on the Northern Asian ecosystem GPP exhibit spatiotemporal heterogeneity. Under the RCP2.6 scenario, the positive and adverse effects from the extreme heat events coexist in Northern Asia during the middle of the 21st century. During the end of the 21st century, the areas dominated by positive effects are expected to expand particularly in Northeast China and central-western Siberia. For the RCP8.5 scenario, the facilitation effects of the extreme heat events are widely distributed in Northern Asia during the middle of the 21st century, which tends to decline in both intensity and extent during the end of the 21st century. The case is similar after the CO2 fertilization effect is excluded

Variability of spring ecosystem water use efficiency in Northeast Asia and its linkage to the Polar-Eurasia pattern

Given that water use efficiency (WUE) is an important indicator to measure the trade-off between carbon uptake and water consumption within the ecosystem, better understanding the variation of ecosystem WUE and related driving factors is of great interest. In this study, the variability of spring ecosystem WUE in Northeast Asia (NEA) was investigated. The results show that its primary mode exhibits a monosign variation. This mode is directly controlled by the variability of gross primary productivity. The climate conditions also play remarkable roles, featuring that warm surface air temperature (high soil moisture) favors enhanced ecosystem WUE in northern (southern) NEA. Further analysis reveals that the Polar-Eurasia (POL) pattern can significantly impact the variability of spring ecosystem WUE in NEA through changing surface air temperature and soil moisture. When the POL pattern lies in the positive phase during spring, anticyclonic circulation anomalies with an equivalent barotropic structure prevail over northern NEA, concurrent with anomalous easterlies over southern NEA and a weakening of the East Asian jet (EAJ). Accordingly, anomalous downward motion is introduced over northern NEA, resulting in higher surface air temperature which is beneficial for the increase of local ecosystem WUE. Meanwhile, the easterly anomalies help to increase water vapor transport into southern NEA and the weakened EAJ can induce anomalous ascending over southern NEA, favoring the increase of precipitation and hence soil moisture, which consequently enhances the ecosystem WUE in southern NEA

Table_1_Evaluating IL-6 and IL-10 as rapid diagnostic tools for Gram-negative bacteria and as disease severity predictors in pediatric sepsis patients in the intensive care unit.docx

BackgroundTo explore the diagnostic performance of interleukin (IL)-6 and IL-10 in discriminating Gram bacteria types and predicting disease severity in intensive care unit (ICU)-hospitalized pediatric sepsis patients.MethodWe retrospectively collected Th1/Th2 cytokine profiles of 146 microbiologically documented sepsis patients. Patients were categorized into Gram-positive (G+) or Gram-negative (G-) sepsis groups, and cytokine levels were compared. Subgroup analysis was designed to eliminate the influence of other inflammatory responses on cytokine levels.ResultsAfter propensity score matching, 78 patients were matched and categorized according to Gram bacteria types. Compared with G+ sepsis, IL-6 and IL-10 were significantly elevated in G- sepsis (p ConclusionIL-6 and IL-10 are comparably effective in discriminating G+/G- sepsis in pediatric intensive care unit (PICU) patients. The deteriorated organ function observed in ICU patients reveals that complex inflammatory responses might have contributed to the cytokine pattern observed in severe sepsis patients, therefore confounding the discriminating efficacy of Th1/Th2 cytokines in predicting Gram bacteria types.</p

A dual evolutionary bagging for class imbalance learning

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI linkBagging, as a commonly-used class imbalance learning method, combines resampling techniques with ensemble learning to provide a strong classifier with high generalization for a skewed dataset. However, integrating different numbers of base classifiers may obtain the same classification performance, called multi-modality. To seek the most compact ensemble structure with the highest accuracy, a dual evolutionary bagging framework composed of inner and outer ensemble models is proposed. In inner ensemble model, three sub-classifiers are built by SVM, MLP and DT, respectively, with the purpose of enhancing the diversity among them. For each sub-dataset, a classifier with the best performance is selected as a base classifier of outer ensemble model. Following that, all optimal combinations of base classifiers is found by a multi-modal genetic algorithm with a niche strategy in terms of their average G-mean. A combination that aggregates the smallest number of base classifiers by the weighted sum forms the final ensemble structure. Experimental results on 40 KEEL benchmark datasets and a practical one of coal burst show that dual ensemble framework proposed in the paper provides the simplest ensemble structure with the best classification accuracy for imbalance datasets and outperforms the state-of-the-art ensemble learning methods

Transfusion-Associated HIV Infection in Pediatric Leukemia Patients (Two Case Reports)

Background: Leukemia is the second most malignant tumor in children. The chemotherapy induced anemia (CIA) and hemorrhage are the most popular side-effects due to the myelosuppression of chemotherapy. So far, multitransfusion is still the timely and effective measure in curing these complications. The acquisition of HIV infection and subsequent development of AIDS by component transfusion from donors at risk is well known, and prognosis of HIV infection is particularly severe in patients with leukemia. Case Presentation: We report two leukemic cases that were infected with HIV through transfusion. The first patient was totally transfused with 16 U RBC, 20 U platelets and 820 ml fresh frozen plasma, and later test showed that his first used FFP carried the HIV. For the second 2 U RBC, 5 U platelets and 1500 ml fresh frozen plasma were transfused to her. Late test of her used blood products showed that the fourth RBC carried the HIV. Both results were confirmed by the local Center for Disease Control (CDC). They were not transfused before the diagnosis of leukemia. Their parents were healthy with negative HIV-Ab Conclusion: Since the two leukemic patients suffered transfusion-associated HIV with poor prognosis, we must take more efforts to utilize blood products judiciously, manage blood donors, test blood samples etiologically, shorten HIV testing "window periods" and develop preventive vaccination against HIV to reduce the incidence as low as possible

Capillary Evaporation‐Induced Fabrication of Compact Flake Graphite Anode with High Volumetric Performance for Potassium Ion Batteries

Abstract Improvement in volumetric performance is growing requirements for rechargeable batteries of lightweight and compact size. Flake graphite (FG) with thin lamellar structure realizes a satisfactory K‐ion storage performance, but its low packing density leads to poor volumetric capacity. Herein, this work fabricates an FG anode with improved packing density by hydrothermal treatment of the FG with graphene oxide and subsequent capillary evaporation‐induced drying process. A three‐dimensional flake graphite/reduced graphene oxide (FG/rGO) hydrogel is formed after hydrothermal treatment, which can be compressed during drying process via the capillary force generated by water evaporation, resulting in a compact structure with enhanced packing density. Compared to the pristine FG electrode (106.0 mAh cm−3), the FG/rGO‐82 anode realizes an ultrahigh volumetric capacity of 218.9 mAh cm−3 and good rate performance with a retained capacity of 152.3 mAh cm−3 at 2 C. Moreover, the FG/rGO‐82 exhibits excellent cycle stability with a capacity retention of 90.1% after 300 cycles. Even under a high mass loading of 7.4 mg cm−2, it still remains a volumetric capacity of 145.4 mAh cm−3 after 300 cycles at 1 C. The results prove that the capillary evaporation induced drying of hydrogel is an effective way to prepare electrode material with high volumetric capacity

Little do more: a highly effective Pt-1/FeOx single-atom catalyst for the reduction of NO by H-2

A FeOx supported Pt single-atom catalyst (Pt-SAC) exhibited much higher NO conversion and selectivity to N-2 than the supported Pt nanocatalyst (Pt-Nano). This better performance was attributed to not only the stronger NO adsorption and easier dissociation of the N-O bond but also the presence of more oxygen vacancies on the Pt-SAC

Local experience with extracorporeal membrane oxygenation in children with acute fulminant myocarditis.

To analyze the clinical effect of extracorporeal membrane oxygenation (ECMO) in children with acute fulminant myocarditis, we retrospectively analyzed the data of five children with acute fulminant myocarditis in the intensive care unit (ICU) at the Affiliated Children's Hospital, Zhejiang University from February 2009 to November 2012. The study group included two boys and three girls ranging in age from 9 to 13 years (median 10 years). Body weight ranged from 25 to 33 kg (mean 29.6 kg). They underwent extracorporeal membrane oxygenation (ECMO) through a venous-arterial ECMO model with an average ECMO supporting time of 89.8 h (40-142 h). Extracorporeal circulation was established in all five children. After treatment with ECMO, the heart rate, blood pressure, and oxygen saturation were greatly improved in the four children who survived. These four children were successfully weaned from ECMO and discharged from hospital machine-free, for a survival rate of 80% (4/5). One child died still dependent on the machine. Cause of death was irrecoverable cardiac function and multiple organ failure. Complications during ECMO included three cases of suture bleeding, one case of acute hemolytic renal failure and suture bleeding, and one case of hyperglycemia. During the follow-up period of 4-50 months, the four surviving children recovered with normal cardiac function and no abnormal functions of other organs. The application of ECMO in acute fulminant myocarditis, even in local centers that experience low incidence of this disease, remains an effective approach. Larger studies to determine optimal timing of placement on ECMO to guide local centers are warranted