Abrupt climatic events recorded by the Ili loess during the last glaciation in Central Asia: Evidence from grain-size and minerals

The loess record of Central Asia provides an important archive of regional climate and environmental changes. In contrast to the widely investigated loess deposits in the Chinese Loess Plateau, Central Asian loess-paleosol sequences remain poorly understood. Here, we present an aeolian loess section in the southern Ili Basin. Based on granularity and mineralogical analyses, we reconstruct climatic changes during the last glaciation. The results indicated that most of the abrupt climatic events (such as Dansgaard-Oeschger events and Heinrich events) were imprinted in this loess section, although their amplitudes and ages showed some differences. Compared with the millennial oscillations recoded in loess and stalagmites in East Asia, the arid Central Asia responded more sensitively to the warming events than to the cooling events. The shifting trajectory of westerlies across Central Asia played an important role in dust deposition during the stadials. The North Atlantic climatic signals may have been transmitted from Central Asia to the East Asian monsoon regions via the westerlies

Adsorption Properties of Ni(II) by D301R Anion Exchange Resin

The adsorption of Ni(II) with D301R resin was investigated in this paper. The results showed that the saturated extent of adsorption Ni(II) by the resin was 84.3 mg/g. The equilibrium data of Ni(II) sorption was better described by Langmuir isotherm model (r2=0.994) while that of Ni(II) sorption also fitted in Freundlich isotherm model within the experimental concentration range. The amount of the constant (q0) of Ni(II) under 298 K in Langmuir model was 76.92 mg/g, which was close to the experimental results. The constant n was within 2–10 in Freundlich model; it was shown that adsorption of Ni(II) by the resin was easy to take place. The uptake kinetics followed the Lagergren pseudo-first-order rate equation (r2=0.9813). The particle diffusion controlled the adsorption process of Ni(II). The coefficient of the intraparticle diffusion increased with the increase of the pH values and the concentration of Ni(II) in aqueous solution. There was a drop of 20.1 cm−1 for the bending vibration frequency of N–H bond. Results showed that the adsorption of Ni(II) by D301R anion exchange resin was the surface complexation through the infrared spectrum analysis

The Technology and Application of Improving Bearing Capacity of Deep Peat Soil Subgrade

Peat soil is widely distributed in more than 500 countries around the world, covering an area of over 4 million square kilometers, among which the distribution area in China is about 40000 square kilometers, and most of Peat soil is distributed in swamps and forests. Peat soil is with high content of organic matter, poor engineering properties and low bearing capacity, which is very unfavorable to the safety and functionality of infrastructure construction. The Belt and Road, and the other two parts of the peat soil are studied in this paper. The key technologies of peat soil foundation are studied through literature review and comparative study. This will provide theoretical and technical support for repairing bridges, roads and houses in the distribution area of peat soil, and provide the theoretical basis and technical foundation for the construction of the “peat” Road area. Chinese Library Classification: TU0

Adverse renal outcomes following targeted therapies in renal cell carcinoma: a systematic review and meta-analysis

Introduction: To clarify the prevalence of adverse renal outcomes following targeted therapies in renal cell carcinoma (RCC).Methods: A systematic search was performed in MEDLINE, EMBASE, and Cochrane Central Library. Studies that had reported adverse renal outcomes following targeted therapies in RCC were eligible. Outcomes included adverse renal outcomes defined as either renal dysfunction as evidenced by elevated serum creatinine levels or the diagnosis of acute kidney injury, or proteinuria as indicated by abnormal urine findings. The risk of bias was assessed according to Cochrane handbook guidelines. Publication bias was assessed using Funnel plot analysis and Egger Test.Results: The occurrences of the examined outcomes, along with their corresponding 95% confidence intervals (CIs), were combined using a random-effects model. In all, 23 studies including 10 RCTs and 13 observational cohort studies were included. The pooled incidence of renal dysfunction and proteinuria following targeted therapies in RCC were 17% (95% CI: 12%–22%; I2 = 88.5%, p < 0.01) and 29% (95% CI: 21%–38%; I2 = 93.2%, p < 0.01), respectively. The pooled incidence of both types of adverse events varied substantially across different regimens. Occurrence is more often in polytherapy compared to monotherapy. The majority of adverse events were rated as CTCAE grades 1 or 2 events. Four studies were assessed as having low risk of bias.Conclusion: Adverse renal outcomes reflected by renal dysfunction and proteinuria following targeted therapies in RCC are not uncommon and are more often observed in polytherapy compared to monotherapy. The majority of the adverse events were of mild severity.Systematic Review Registration: Identifier CRD42023441979

Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial

Objective: To evaluate the effectiveness of a clinical decision support system (CDSS) in improving the use of guideline accordant antihypertensive treatment in primary care settings in China. Design: Pragmatic, open label, cluster randomised trial. Setting: 94 primary care practices in four urban regions of China between August 2019 and July 2022: Luoyang (central China), Jining (east China), and Shenzhen (south China, including two regions). Participants: 94 practices were randomised (46 to CDSS, 48 to usual care). 12 137 participants with hypertension who used up to two classes of antihypertensives and had a systolic blood pressure <180 mm Hg and diastolic blood pressure <110 mm Hg were included. Interventions: Primary care practices were randomised to use an electronic health record based CDSS, which recommended a specific guideline accordant regimen for initiation, titration, or switching of antihypertensive (the intervention), or to use the same electronic health record without CDSS and provide treatment as usual (control). Main outcome measures: The primary outcome was the proportion of hypertension related visits during which an appropriate (guideline accordant) treatment was provided. Secondary outcomes were the average reduction in systolic blood pressure and proportion of participants with controlled blood pressure (<140/90 mm Hg) at the last scheduled follow-up. Safety outcomes were patient reported antihypertensive treatment related events, including syncope, injurious fall, symptomatic hypotension or systolic blood pressure <90 mm Hg, and bradycardia. Results: 5755 participants with 23 113 visits in the intervention group and 6382 participants with 27 868 visits in the control group were included. Mean age was 61 (standard deviation 13) years and 42.5% were women. During a median 11.6 months of follow-up, the proportion of visits at which appropriate treatment was given was higher in the intervention group than in the control group (77.8% (17 975/23 113) v 62.2% (17 328/27 868); absolute difference 15.2 percentage points (95% confidence interval (CI) 10.7 to 19.8); P<0.001; odds ratio 2.17 (95% CI 1.75 to 2.69); P<0.001). Compared with participants in the control group, those in the intervention group had a 1.6 mm Hg (95% CI −2.7 to −0.5) greater reduction in systolic blood pressure (−1.5 mm Hg v 0.3 mm Hg; P=0.006) and a 4.4 percentage point (95% CI −0.7 to 9.5) improvement in blood pressure control rate (69.0% (3415/4952) v 64.6% (3778/5845); P=0.07). Patient reported antihypertensive treatment related adverse effects were rare in both groups. Conclusions: Use of a CDSS in primary care in China improved the provision of guideline accordant antihypertensive treatment and led to a modest reduction in blood pressure. The CDSS offers a promising approach to delivering better care for hypertension, both safely and efficiently. Trial registration: ClinicalTrials.gov NCT03636334