Application of Strengthening Detail Management in Intensive-Care Unit Nursing Management

As the core work of the hospital, the intensive care unit (ICU) has gathered many of the most cutting-edge facilities and related medical staff. ICU is the core application way to treat high-risk patients, which often contains the deep hope of patients and their families. Therefore, it is critical to further improve the quality of care management and control in the intensive-care unit. The use of in-depth detail controls is critical to the daily care of patients in intensive-care unit, so it's worth exploring further.Â

GSI CTA evaluation of the vertebrobasilar artery in normal adults at high altitude

ObjectiveVascular geometry is influenced by several factors during its growth and development. Here, we compared the differences in vertebrobasilar geometry among residents of a plateau region at different altitudes and investigated the relationship between vascular geometry and altitude.MethodsData of some adults in the plateau region who experienced vertigo and headache as the main symptoms but had no evident abnormalities found during imaging examination were collected. They were divided into three groups based on an altitude gradient: group A (1,800–2,500 masl), group B (2,500–3,500 masl), and group C (over 3,500 masl). They underwent head–neck energy-spectrum computed tomography angiography with a gemstone spectral imaging scanning protocol. The following indices were observed: (1) vertebrobasilar geometric configurations (walking, tuning fork, lambda, and no confluence), (2) vertebral artery (VA) hypoplasia, (3) the bending number of bilateral VA intracranial segment, (4) length and tortuosity of the basilar artery (BA), and (5) anteroposterior (AP)–mid–BA angle, BA–VA angle, lateral–mid–BA angle, and VA–VA angle.ResultsOf the 222 subjects, 84 of them were included in group A, 76 in group B, and 62 in group C. The number of participants in walking, tuning fork, lambda, and no confluence geometries was 93, 71, 50, and 8, respectively. As altitude increased, the tortuosity of the BA also increased (1.05 ± 0.06 vs. 1.06 ± 0.08 vs. 1.10 ± 0.13, P = 0.005), as did the lateral–mid–BA angle (23.18° ± 9.53° vs. 26.05° ± 10.10° vs. 31.07° ± 15.12°, P = 0.007) and the BA–VA angle (32.98° ± 17.85° vs. 34.51° ± 17.96° vs. 41.51° ± 19.22°, P = 0.024). There was a relatively weak positive correlation between the altitude and the tortuosity of the BA (rs = 0.190, P = 0.005), the lateral–mid–BA angle (rs = 0.201, P = 0.003), and the BA–VA angle (rs = 0.183, P = 0.006) which showed a significant difference. Compared with groups A and B, there were more multibending groups and fewer oligo-bending groups in group C (P < 0.001). There was no difference found in the vertebral artery hypoplasia, actual length of the BA, VA–VA angle, and AP–mid–BA angle among the three groups.ConclusionAs the altitude increased, the tortuosity of the BA and the sagittal angle of the vertebrobasilar arterial system also increased. The increase in altitude can lead to changes in vertebrobasilar geometry

Geochronological, elemental and Sr-Nd-Hf-O isotopic constraints on the petrogenesis of the Triassic post-collisional granitic rocks in NW Thailand and its Paleotethyan implications

This study was jointly funded by the National Science Foundation of China (41190073), National Basic Research Program of China (2014CB440901 and 2016YFC0600303) and the Fundamental Research Funds for the Central Universities to SYSU.New U-Pb geochronological, petrologic, elemental and Sr-Nd-Hf-O isotopic data for the granites from the Inthanon and Sukhothai zones in NW Thailand in conjunction with correlations with SW China are presented to constrain the age and position of the Paleotethys Ocean in this region and the associated assembly of Southeast Asia. The geochronological data show that the granitic rocks in the Inthanon and Sukhothai zones, herein named Group 1 and Group 2 granites, respectively, yield similar crystallization ages of 230-200 Ma. Group 1 samples are characterized by monzogranite and granite with I- and S-type geochemical affinity and Group 2 samples by I-type monzogranite and granodiorite. They have generally similar chondrite-normalized REE and PM- normalized multi-element patterns but distinct Sr-Nd-Hf-O isotopic compositions. Group 1 samples have slightly higher initial 87Sr/86Sr ratios (0.7111- 0.7293) but lower εNd(t) values (-11.1 ~ -14.1) than those of Group 2 samples (87Sr/86Sr(i)=0.7073-0.7278 and εNd(t)=-8.3 ~ -11.0). Group 1 samples show the lower εHf(t) values (-5.4 ~ -18.2), older TDM (1.62-2.40 Ga) and higher δ18O values (+ 7.95-+9.94) than those of Group 2 samples (εHf(t) of -11.1-+4.80, TDM of 0.96-1.95 Ga and δ18O of + 4.95 ~+7.98) for the Triassic crystallization zircons. These geochemical signatures are similar to the Kwangsian and Indosinian granites in the South China and Indochina blocks but distinct from those of the Gangdese I-type granite and Sibumasu Paleozoic granite. Our data suggest that Group 1 samples mainly originated from the early Paleozoic supracrustal rocks containing metapelite and metavolcanic components, which had previously experienced the surface weathering. Group 2 samples were derived from a hybridized source of an old metamorphic and a newly underplated mafic component. Synthesis of our data with available regional observations indicate that the Inthanon zone represents the main suture zone of the eastern Paleotethyan Ocean in NW Thailand and links with the Changning-Menglian suture zone in SW Yunnan (SW China). In NW Thailand, a switch from the eastward subduction of the Paleotethyan oceanic plate to the collision of the Sibumasu with Indochina blocks occurred at ~ 237 Ma, and syn- and post-collisional time being at ~ 237-230 Ma and ~ 200-230 Ma, respectively. The late Triassic granites in the Inthanon and Sukhothai zones are representative of the post-collisional magmatic products.PostprintPeer reviewe

Prioritization of schizophrenia risk genes from GWAS results by integrating multi-omics data

Schizophrenia (SCZ) is a polygenic disease with a heritability approaching 80%. Over 100 SCZ-related loci have so far been identified by genome-wide association studies (GWAS). However, the risk genes associated with these loci often remain unknown. We present a new risk gene predictor, rGAT-omics, that integrates multi-omics data under a Bayesian framework by combining the Hotelling and Box–Cox transformations. The Bayesian framework was constructed using gene ontology, tissue-specific protein–protein networks, and multi-omics data including differentially expressed genes in SCZ and controls, distance from genes to the index single-nucleotide polymorphisms (SNPs), and de novo mutations. The application of rGAT-omics to the 108 loci identified by a recent GWAS study of SCZ predicted 103 high-risk genes (HRGs) that explain a high proportion of SCZ heritability (Enrichment = 43.44 and p=9.30×10−9). HRGs were shown to be significantly (padj=5.35×10−7) enriched in genes associated with neurological activities, and more likely to be expressed in brain tissues and SCZ-associated cell types than background genes. The predicted HRGs included 16 novel genes not present in any existing databases of SCZ-associated genes or previously predicted to be SCZ risk genes by any other method. More importantly, 13 of these 16 genes were not the nearest to the index SNP markers, and them would have been difficult to identify as risk genes by conventional approaches while ten out of the 16 genes are associated with neurological functions that make them prime candidates for pathological involvement in SCZ. Therefore, rGAT-omics has revealed novel insights into the molecular mechanisms underlying SCZ and could provide potential clues to future therapies

Origin of Permian OIB-like basalts in NW Thailand and implication on the Paleotethyan Ocean

Financial support from National Science Foundation of China (41190073, 41372198 and 40490613), National Basic Research Program of China (2014CB440901 and 2016YFC0600303) and “the Fundamental Research Funds for the Central Universities to SYSU” are gratefully acknowledged.The basaltic rocks in NW Thailand belong to part of giant Southeast Asian igneous zone that delineates the extension of the Paleotethyan Ocean from SW China into NW Thailand. The Chiang Mai basaltic samples from the Chiang Dao, Fang, Lamphun and Ban Sahakorn sections are divisible into two groups of high-iron basalt. Group 1 has SiO2 of 38.30–49.18 wt.%, FeOt of 13.09–25.37 wt.%, MgO of 8.38–1.60 wt.%, TiO2 of 3.92–6.30 wt.%, which is rarely observed in nature. Group 2 shows SiO2 = 44.71–49.21 wt.%, FeOt = 10.88–14.34 wt.%, MgO = 5.24–16.11 wt.%, TiO2 = 2.22–3.07 wt.% and mg# = 44–70. Olivine and pyroxene are responsible for the fractionation of the Group 2 magma whereas low oxygen fugacity during the late-stage differentiation of the Group 1 magma prolonged fractionation of ilmenite and magnetite. The onset of ilmenite and magnetite fractionations controls the distinct differentiation commencing at MgO = ~ 7 wt.%. Both groups show similar REE and primitive mantle-normalized patterns with insignificant Eu, Nb-Ta and Zr-Hf anomalies. They have similar Nd isotopic compositions with εNd(t) values ranging from + 2.8 to + 3.7 and similar Nb/La, Nb/U, Th/La, Zr/Nb, Th/Ta, La/Yb, Nb/Th, Nb/Y and Zr/Y, resembling those of OIB-like rocks. The representative basaltic sample yields the argon plateau age of 282.3 ± 1.4 Ma, suggestive of early Permian origin. Our data argue for Group 1 and Group 2 are coeval in the intra-oceanic seamount setting within the Paleotethyan Ocean, which at least continued till 283 Ma. These data, along with other observations, suggest that the Inthanon zone defines the main Paleotethyan suture zone, which northerly links with the Changning-Menglian zone in SW China.PostprintPeer reviewe

Assessment of the influence on Hypsizygus marmoreus stem waste as a sustainable alternative to corn in Holdobagy geese dietary

The processing of edible mushrooms generates a large amount of mushroom residue. How to handle this mushroom residue in a way that avoids environmental pollution and maximizes effective utilization is a current issue that needs to be explored. This study aimed to investigate the effects of substituting dietary corn with Hypsizygus marmoreus mushroom stem waste (HSW) in the diet of geese. The control group was fed with a basal diet (BD), and the other groups were fed the basal diet to which 12% (HSW12 group), 24% (HSW24 group), or 32% (HSW32 group) of HSW were added to replace the equivalent proportion of corn. The test lasted 28 days. The results showed that the average daily feed intake (ADFI) of the HSW12 and HSW24 groups at 35–49 d, and the HSW12 and HSW32 groups at 35–63 d, was significantly higher compared to the BD group (p<0.05). The average daily gain (ADG) of the HSW12 group was significantly higher than BD at 35–49 d (p<0.05), but there was no significant difference in the feed/gain (F/G) among the groups. The levels of serum total protein (TP), albumin (ALB), globulin (GLOB), glutathione peroxidase (GSH-Px), and catalase (CAT) in HSW24 group were significantly higher than those in the BD group (p<0.05). Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and malondialdehyde (MDA) decreased significantly, and there were no significant differences in carcass traits and meat quality. As 24% HSW supplementation had the best overall effect on the growth performance, serum biochemical indicators, meat quality, and carcass traits of geese, gut microbiota analysis was only performed on this group. The microbiota α-diversity of the cecum and ileum did not differ significantly between the BD and HSW24 groups. Principal coordinate analysis (PCoA) indicated that the difference in the cecum was significant in the β-diversity (p<0.05). Short chain fatty acid-producing bacteria and decomposing protein and carbohydrate bacteria (Prevotella) were enriched in the cecum in the HSW24 group. Gut immune regulating and nutritional bacteria, Lactococcus and Bacillus, respectively, were enriched in the ileum in HSW24 group. Spearman’s analysis indicated that Bacillus, Prevotella, and Clostridium were positively associated with serum protein and lipid metabolism. These results indicate that 24% HSW substitution of corn could improve goose serum ALB and fat metabolism, and increase serum antioxidant capacity, which may becaused by the improvement of goose cecal microbiota

Association between serum nickel and oral cancer incidence using propensity score matching and inverse probability of treatment weighting

BackgroundThe association between serum nickel (Ni) and oral cancer incidence is unclear and most of the previous studies were observational studies that did not control for confounding factors between groups.ObjectiveTo assess the correlation of serum Ni with oral cancer incidence based on propensity score matching (PSM) and inverse probability of treatment weighting (IPTW).MethodsA cohort of 456 newly diagnosed oral cancer patients was recruited from the First Hospital of Fujian Medical University during November 2011 to May 2019, and residents ordered their health check-up in hospitals or local community health centers over the same period were selected as a control group, which included a total of 1410 participants. Serum Ni was evaluated by inductively coupled plasma mass spectrometry. Case-control pairs were selected using a 1:1 PSM (caliper value of 0.02), and the study subjects in the case group and control group were weighted for subsequent analysis by IPTW. The general characteristics of the study subjects were tested for equilibrium before and after matching by chi-square test and standardized mean difference (SMD). This was followed by exploring the potential nonlinear dose-response relationship between serum Ni and oral cancer using restricted cubic splines as well as analyzing the association between serum Ni and oral cancer incidence by conditional logistic regression and weighted logistic regression.ResultsAfter controlling for between-group covariates by PSM and IPTW, the dose-response curves demonstrated that the risk of developing oral cancer tended to decline and then increase with the increasing serum Ni level. The outcome of the analysis using PSM demonstrated that as compared to the control group, the risk of developing oral cancer in the 0.09-16.80 μg·L−1 serum Ni group was negatively correlated with serum Ni level (OR=0.36, 95%CI: 0.24-0.54), whereas the risk of developing oral cancer in the >16.80 μg·L−1 serum Ni group was positively correlated with serum Ni level (OR=5.43, 95%CI: 2.76-10.68). After applying IPTW, a negative association was found between the risk of oral cancer and serum Ni concentration within a serum Ni window ranging from 0.09 to 20.55 μg·L−1 (OR=0.39, 95%CI: 0.29-0.52), while a positive association with an OR and 95%CI of 5.54 (3.62-8.49) for the Ni concentration > 20.55 μg·L−1.ConclusionIn this study, a J-shaped relationship between serum Ni concentration and the risk of developing oral cancer is found, which shows that high serum Ni concentration (>20.55 μg·L−1) may be a risk factor for oral cancer

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe