Effects of meteorological factors on the incidence of meningococcal meningitis

Background and Objectives: Substantial climate changes have led to the emergence and re-emergence of various infectious diseases worldwide, presenting an imperative need to explore the effects of meteorological factors on serious contagious disease incidences such as that of meningococcal meningitis (MCM).Methods: The incidences of MCM and meteorology data between 1981 and 2010 were obtained from Chaoyang city. Structure Equation Modeling was used to analyze the relationships between meteorological factors and the incidence of MCM, using the LISREL software.Results: The SEM results showed that Adjusted Goodness of Fit Index (AGFI) = 0.30, Goodness of Fit Index (GFI) = 0.63, and Root Mean Square Error of Approximation (RMSEA) = 0.31. Humidity and temperature both had negative correlations with MCM incidence, with factor loads of -0.32 and -0.43, while sunshine was positively correlated with a factor load of 0.42. For specific observable variables, average air pressure, average evaporation, average air temperature, and average ground temperature exerted stronger influence, with item loads between observable variables and MCM incidence being -0.42, 0.34, -0.32, and -0.32 respectively.Conclusion: Public health institutions should pay more attention to the meteorological variables of humidity, sunshine, and temperature in prospective MCM control and prevention.Keywords: Meningococcal meningitis, Neisseria meningitidis, epidemiology, humidity, temperature, sunshine, meteorological variables, structure equation mode

Evaluation of electroacupuncture as a non-pharmacological therapy for astrocytic structural aberrations and behavioral deficits in a post-ischemic depression model in mice

BackgroundAscending clinical evidence supports that electroacupuncture (EA) is effective in treating post-ischemic depression (PID), but little is known about how it works at the cellular level. Astrocytes are exquisitely sensitive to their extracellular environment, and under stressful conditions, they may experience aberrant structural remodeling that can potentially cause neuroplastic disturbances and contribute to subsequent changes in mood or behavior.ObjectivesThis study aimed to investigate the effect of EA on behavioral deficits associated with PID in mice and verify the hypothesis that astrocytic morphology may be involved in this impact.MethodsWe established a PID animal model induced by transient bilateral common carotid artery occlusion (BCCAO, 20 min) and chronic restraint stress (CRS, 21 days). EA treatment (GV20 + ST36) was performed for 3 weeks, from Monday to Friday each week. Depressive- and anxiety-like behaviors and sociability were evaluated using SPT, FST, EPM, and SIT. Immunohistochemistry combined with Sholl and cell morphological analysis was utilized to assess the process morphology of GFAP+ astrocytes in mood-related regions. The potential relationship between morphological changes in astrocytes and behavioral output was detected by correlation analysis.ResultsBehavioral assays demonstrated that EA treatment induced an overall reduction in behavioral deficits, as measured by the behavioral Z-score. Sholl and morphological analyses revealed that EA prevented the decline in cell complexity of astrocytes in the prefrontal cortex (PFC) and the CA1 region of the hippocampus, where astrocytes displayed evident deramification and atrophy of the branches. Eventually, the correlation analysis showed there was a relationship between behavioral emotionality and morphological changes.ConclusionOur findings imply that EA prevents both behavioral deficits and structural abnormalities in astrocytes in the PID model. The strong correlation between behavioral Z-scores and the observed morphological changes confirms the notion that the weakening of astrocytic processes may play a crucial role in depressive symptoms, and astrocytes could be a potential target of EA in the treatment of PID

Effects of meteorological factors on the incidence of meningococcal meningitis.

Background and Objectives: Substantial climate changes have led to the emergence and re-emergence of various infectious diseases worldwide, presenting an imperative need to explore the effects of meteorological factors on serious contagious disease incidences such as that of meningococcal meningitis (MCM). Methods: The incidences of MCM and meteorology data between 1981 and 2010 were obtained from Chaoyang city. Structure Equation Modeling was used to analyze the relationships between meteorological factors and the incidence of MCM, using the LISREL software. Results: The SEM results showed that Adjusted Goodness of Fit Index (AGFI) = 0.30, Goodness of Fit Index (GFI) = 0.63, and Root Mean Square Error of Approximation (RMSEA) = 0.31. Humidity and temperature both had negative correlations with MCM incidence, with factor loads of -0.32 and -0.43, while sunshine was positively correlated with a factor load of 0.42. For specific observable variables, average air pressure, average evaporation, average air temperature, and average ground temperature exerted stronger influence, with item loads between observable variables and MCM incidence being -0.42, 0.34, -0.32, and -0.32 respectively. Conclusion: Public health institutions should pay more attention to the meteorological variables of humidity, sunshine, and temperature in prospective MCM control and prevention

Family-clinician shared decision making in intensive care units : cluster randomized trial in China

We thank the China Medical Board, which financially supported our study.Objective To investigate if a Family-Clinician Shared Decision-Making (FCSDM) intervention benefits patients, families and intensive care units (ICUs) clinicians.  Methods Six ICUs in China were allocated to intervention or usual care. 548 patients with critical illness, 548 family members and 387 ICU clinicians were included into the study. Structured FCSDM family meetings were held in the intervention group. Scales of SSDM, HADS, QoL2 and CSACD were used to assess families’ satisfaction and distress, patients’ quality of life, and clinicians’ collaboration respectively.  Results Comparing the intervention group with the control group at post-intervention, there were significant differences in the families’ satisfaction (P =0.0001), depression level (P =0.005), and patients’ quality of life (P =0.0007). The clinicians’ mean CSCAD score was more positive in the intervention group than controls (P < 0.05). There was no significant between-group differences on ICU daily medical cost, but the intervention group demonstrated shorter number of days’ stay in ICU (P=0.0004).  Conclusion The FCSDM intervention improved families’ satisfaction and depression, shortened patients’ duration of ICU stay, and enhanced ICU clinicians’ collaboration.  Practice implications Further improvement and promotion of the FCSDM model are needed to provide more evidence to this field in China.Publisher PDFPeer reviewe

Pendelluft as a predictor of weaning in critically ill patients: An observational cohort study

Objective: Weaning failure is associated with adverse clinical outcomes. This study aimed to evaluate the accuracy of pendelluft during the spontaneous breathing trials (SBT) as a predictor of weaning outcome of patients with mechanical ventilation.Methods: An observational cohort study included 60 critically ill patients who were eligible for extubation. Pendelluft and electrical activity of the diaphragm (Edi) were monitored at baseline and every 10 minutes for the first 30 min of SBT denoted as T0, T1, T2, and T3. The pendelluft was measured using electrical impedance tomography (EIT), and Edi parameters were collected by Edi catheter. Patients were followed up after extubation and were divided into success group and failure group. Pendelluft, Edi parameters, respiratory parameters, and clinical outcomes such as intensive care units (ICU) stay, mortality, and 28-day ventilator-free days were compared between the two groups. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of pendelluft to predict weaning outcome.Results: Fifty patients (50/60) were successfully weaned from the machine and 10 (10/60) failed, with weaning failure rate of 16.7%. Respiratory parameters such as rapid shallow breathing index (RSBI), respiratory rate (RR) and Edi parameters such as maximum value of Edi (Edimax), Edi variation between a maximum and minimum(ΔEdi) in the failure group were higher than those in the success group. The ICU stay and the 28-day ventilator-free days in the failure group were significantly longer than those in the success group. The 28-day mortality rate was higher in the failure group. The pendelluft mainly occurred in the early stage of SBT. Ventral pendelluft and total pendelluft in the failure group were higher than those in the success group at T1. Edimax and ΔEdi were positively correlated with pendelluft. The area under ROC curve (AUC) showed moderate predictive ability for ventral pendelluft in predicting weaning failure at T1 (AUC 0.76, 95% CI 0.58–0.94, cut-off value &gt; 3% global tidal variation).Conclusion: Pendelluft is one of the factors leading to weaning failure, which may be related to diaphragm function. Measuring pendelluft volume maybe helpful to predict weaning

Development and validation of a patient-specific model to predict postoperative SIRS in older patients: A two-center study

IntroductionPostoperative systemic inflammatory response syndrome (SIRS) is common in surgical patients especially in older patients, and the geriatric population with SIRS is more susceptible to sepsis, MODS, and even death. We aimed to develop and validate a model for predicting postoperative SIRS in older patients.MethodsPatients aged ≥65 years who underwent general anesthesia in two centers of Third Affiliated Hospital of Sun Yat-sen University from January 2015 to September 2020 were included. The cohort was divided into training and validation cohorts. A simple nomogram was developed to predict the postoperative SIRS in the training cohort using two logistic regression models and the brute force algorithm. The discriminative performance of this model was determined by area under the receiver operating characteristics curve (AUC). The external validity of the nomogram was assessed in the validation cohort.ResultsA total of 5,904 patients spanning from January 2015 to December 2019 were enrolled in the training cohort and 1,105 patients from January 2020 to September 2020 comprised the temporal validation cohort, in which incidence rates of postoperative SIRS were 24.6 and 20.2%, respectively. Six feature variables were identified as valuable predictors to construct the nomogram, with high AUCs (0.800 [0.787, 0.813] and 0.822 [0.790, 0.854]) and relatively balanced sensitivity (0.718 and 0.739) as well as specificity (0.718 and 0.729) in both training and validation cohorts. An online risk calculator was established for clinical application.ConclusionWe developed a patient-specific model that may assist in predicting postoperative SIRS among the aged patients

Crosstalk-free achromatic full Stokes imaging polarimetry metasurface enabled by polarization-dependent phase optimization

Imaging polarimetry is one of the most widely used analytical technologies for object detection and analysis. To date, most metasurface-based polarimetry techniques are severely limited by narrow operating bandwidths and inevitable crosstalk, leading to detrimental effects on imaging quality and measurement accuracy. Here, we propose a crosstalk-free broadband achromatic full Stokes imaging polarimeter consisting of polarization-sensitive dielectric metalenses, implemented by the principle of polarization-dependent phase optimization. Compared with the single-polarization optimization method, the average crosstalk has been reduced over three times under incident light with arbitrary polarization ranging from 9 μm to 12 μm, which guarantees the measurement of the polarization state more precisely. The experimental results indicate that the designed polarization-sensitive metalenses can effectively eliminate the chromatic aberration with polarization selectivity and negligible crosstalk. The measured average relative errors are 7.08%, 8.62%, 7.15%, and 7.59% at 9.3, 9.6, 10.3, and 10.6 μm, respectively. Simultaneously, the broadband full polarization imaging capability of the device is also verified. This work is expected to have potential applications in wavefront detection, remote sensing, light-field imaging, and so forth

Integrative omics reveals rapidly evolving regulatory sequences driving primate brain evolution

Although the continual expansion of the brain during primate evolution accounts for our enhanced cognitive capabilities, the drivers of brain evolution have scarcely been explored in these ancestral nodes. Here, we performed large-scale comparative genomic, transcriptomic, and epigenomic analyses to investigate the evolutionary alterations acquired by brain genes and provide comprehensive listings of innovatory genetic elements along the evolutionary path from ancestral primates to human. The regulatory sequences associated with brain-expressed genes experienced rapid change, particularly in the ancestor of the Simiiformes. Extensive comparisons of single-cell and bulk transcriptomic data between primate and nonprimate brains revealed that these regulatory sequences may drive the high expression of certain genes in primate brains. Employing in utero electroporation into mouse embryonic cortex, we show that the primate-specific brain-biased gene BMP7 was recruited, probably in the ancestor of the Simiiformes, to regulate neuronal proliferation in the primate ventricular zone. Our study provides a comprehensive listing of genes and regulatory changes along the brain evolution lineage of ancestral primates leading to human. These data should be invaluable for future functional studies that will deepen our understanding not only of the genetic basis of human brain evolution but also of inherited disease

The interaction between interculture, feminism and intermediality in theatre adaptation: An investigation exploring the concept of the ‘feminist corpse’ when adapting an episode from a Qing dynasty classic Chinese novel – Xueqin Cao’s A Dream of Red Mansions (红楼梦) for contemporary UK theatre audiences

This doctoral project researches the intercultural issues raised for a Chinese writer and director when composing a feminist adaptation of an episode from the Qing dynasty novel A Dream of Red Mansions (红楼梦) for contemporary UK theatre audiences. It seeks to address gaps in the field of theatre adaptation of Chinese classics in an intercultural context, the relationship between theatre adaptation and intermediality, and how feminist theory might inform adaptation and performance praxis. As the central motif of my practice-led research, the original concept of ‘feminist corpse’ refers to both a living body played by a performer and a concept shaped by feminist theories, which creates a framework connecting intercultural discussions between China and the UK, East Asia and the West. Developed through the recreation of the role of You Erjie (a character who was forced to kill herself under ancient Chinese feudal patriarchy), this concept has been generated to reflect the intercultural feminist issue of the East Asian woman being treated as an aesthetic object against wider socio-cultural patriarchal power dynamics (including the contemporary Western context), which is manifested in suicide in both the original and adapted texts. To resist gender and race oppression while giving her suicide agency, the ‘feminist corpse’ is constructed through my reflection on the relationship between the writer and the female corpse, exposing the issues behind female suicide (especially woman’s autonomy, female power and female relationships under patriarchy), and advocating an intercultural solidarity against gender inequalities. As an active, binding and theatrical agent, it informs the direction of my adaptation, and identifies feminist topics and theories while building international feminist dialogues. It also fosters intercultural collaborative workshops and the production process, inspires intermedial applications, contributes to body politics and embodied performance, and reflects contemporary social issues

Research on the Evaluation of Coordinated Development of Tourism&ndash;Economy&ndash;Ecological Environment along the Silk Road Economic Belt

Tourism is currently one of the important development industries in many countries and regions, and a healthy environment is an important basis and carrier for the sustainable development of the tourism economy. Ensuring a harmonious relationship between tourism, the economy, and the environment has become one of the keys to achieving sustainable development of tourism destinations. Based on panel data on tourism, the economy, and the environment from nine provinces along the Silk Road Economic Belt from 2015 to 2019, this study has built a comprehensive evaluation index system of the tourism&ndash;economy&ndash;ecological environment (TEE). The entropy evaluation method, comprehensive evaluation model, and coupling and coordination degree model were used for quantitative analysis of the coordination development level and for assessing the spatial&ndash;temporal evolution patterns of coupling coordination for the TEE system in nine provinces along the Silk Road Economic Belt. The results show that the value of the TEE system is generally on the rise. Still, the growth rate of tourism and the economy subsystem is significantly higher than that of the environment subsystem. The coupling coordinating the development of the TEE system shows an increasing trend with a high degree of coupling. The coordination degree is relatively low, with significant gradient differences and apparent polarization. The main constraint to the coordinated development of the Silk Road Economic Belt is tourism and the economy