Maintenance Chemotherapy With Chinese Herb Medicine Formulas vs. With Placebo in Patients With Advanced Non-small Cell Lung Cancer After First-Line Chemotherapy: A Multicenter, Randomized, Double-Blind Trial

Background: Chinese Herb Medicine Formulas (CHMF) was reported to improve the quality of life (QoL) in advanced NSCLC patients. The present study was designed to investigate whether maintenance chemotherapy plus CHMF in patients would improve QoL and progression-free survival (PFS).Methods: Seventy-one patients were enrolled from 8 medical centers in China, and were randomly assigned to a maintenance chemotherapy plus CHMF group (n = 35) or a maintenance chemotherapy plus placebo group (n = 36). The outcome measures included PFS, Karnofsky performance status (KPS) scores, QoL (assessed with the lung cancer symptom scale (LCSS) questionnaire), and adverse events (AEs).Results: Patients in the CHMF group showed significant improvements in median PFS (HR = 0.55, 95% CI 0.28–0.88, P = 0.019), KPS scores (P = 0.047), fatigue (cycle [C] 3: P = 0.03), interference with daily activities (C3: P = 0.04) and dyspnea (C2: P = 0.03) compared with patients in the placebo group. Compared with the placebo group, the incidence of AEs decreased in the CHMF group, including loss of appetite (C2: P = 0.011, C4: P = 0.004) and dry mouth (C4: P = 0.011).Conclusion: The essential finding of our study is that maintenance chemotherapy combined with CHMF may prolong PFS, relieve symptoms, improve QoL and alleviate the side effects

Can digital finance mitigate trust issues for chronically ill patients because of relative deprivation of income?

Objective The relative deprivation of income among chronically ill patients may create a perception of inequity in their access to quality healthcare, which may lead to a decline in patients’ trust and further increases the burden of chronic diseases. Digital finance could be the antidote. To promote equity in healthcare delivery, this study explores the mitigating effect of digital finance by elucidating the relationship between relative deprivation of income and chronically ill patients’ trust. Methods Using data from the China Family Panel Study, a Poisson regression model was applied to assess the effect of relative deprivation of income on chronically ill patients’ trust. A marginal effect analysis was used to verify the effect and a two-stage least squares method was used to test robustness. Results Chronically ill patients’ trust was at a medium level (5.98 ± 2.05). Relative deprivation of income significantly reduced patients’ trust (β=−0.056, p  < 0.1). The digital finance had a positive effect on patients’ trust (β=0.035, p  < 0.01) and alleviated the negative effect of relative deprivation of income on patients’ trust (β=0.105, p  < 0.01). The instrumental variable estimation results confirmed the robustness of the benchmark regression results. Conclusions The inequity resulting from relative deprivation of income undermines patients’ trust. Digital finance has a long-term effect on alleviating perception of inequity among chronically ill patients. The government should promote the integration of digital finance and smart healthcare to enhance patients’ trust and contribute to equality in healthcare delivery. Limitations include self-reported data and an insufficient correlation between selected indicators and healthcare services

Anaerobic Ammonium Oxidation in Acidic Red Soils

Anaerobic ammonium oxidation (anammox) has been proven to be an important nitrogen removal process in terrestrial ecosystems, particularly paddy soils. However, the contribution of anammox in acidic red soils to nitrogen loss has not been well-documented to date. Here, we investigated the activity, abundance, and distribution of anammox bacteria in red soils collected from nine provinces of Southern China. High-throughput sequencing analysis showed that Candidatus Brocadia dominates the anammox bacterial community (93.03% of sequence reads). Quantification of the hydrazine synthase gene (hzsB) and anammox 16S rRNA gene indicated that the abundance of anammox bacteria ranged from 6.20 × 106 to 1.81 × 109 and 4.81 × 106 to 4.54 × 108 copies per gram of dry weight, respectively. Contributions to nitrogen removal by anammox were measured by a 15N isotope-pairing assay. Anammox rates in red soil ranged from 0.01 to 0.59 nmol N g−1 h−1, contributing 16.67–53.27% to N2 production in the studied area, and the total amount of removed nitrogen by anammox was estimated at 2.33 Tg N per year in the natural red soils of southern China. Pearson correlation analyses revealed that the distribution of anammox bacteria significantly correlated with the concentration of nitrate and pH, whereas the abundance and activity of anammox bacteria were significantly influenced by the nitrate and total nitrogen concentrations. Our findings demonstrate that Candidatus Brocadia dominates anammox bacterial communities in acidic red soils and plays an important role in nitrogen loss of the red soil in Southern China

Spatio-temporal shifts in community structure and activity of nirS-type denitrifiers in the sediment cores of Pearl River Estuary.

Denitrification, an important process in microbial mediated nitrogen cycle, plays important roles in nitrogen loss in estuarine sediments. However, the function of denitrifiers in the estuarine subsurface sediments remained poorly understood. In this study, we analyzed the potential activity, abundance and community structure of nirS-type denitrifiers using 15N-labeled incubation quantitative-PCR and high throughput sequencing techniques in sediment cores from Pearl River Estuary (PRE). Results showed that subsurface sediments had nearly same level denitrification potential activity compare to surface sediments, although the abundance of nirS gene decreased sharply from surface to bottom in sediment cores. Meanwhile, nirS gene abundance exhibit significant temporal variations, which is consistent with denitrification potential activity. Moreover, the community structure and diversity of nirS-type denitrifiers in sediment cores exhibited remarkable temporal shift pattern. For spatial variation, no significant difference was observed of denitrifiers community structure in each sediment core from the surface to the subsurface, while there were significant different diversity characteristic among different cores. Redundancy analysis (RDA) showed that multiple environmental factors including salinity, pH, oxidation-reduction potential, nutrient content and organic substances synergistically shaped the diversity and distribution of nirS-type denitrifers in PRE sediments. Our results showed that nirS-type denitrifers played important roles in the nitrogen removal in subsurface sediments of PRE

Exploring PlanetScope Satellite Capabilities for Soil Salinity Estimation and Mapping in Arid Regions Oases

One reason for soil degradation is salinization in inland dryland, which poses a substantial threat to arable land productivity. Remote-sensing technology provides a rapid and accurate assessment for soil salinity monitoring, but there is a lack of high-resolution remote-sensing spatial salinity estimations. The PlanetScope satellite array provides high-precision mapping for land surface monitoring through its 3-m spatial resolution and near-daily revisiting frequency. This study’s use of the PlanetScope satellite array is a new attempt to estimate soil salinity in inland drylands. We hypothesized that field observations, PlanetScope data, and spectral indices derived from the PlanetScope data using the partial least-squares regression (PLSR) method would produce reasonably accurate regional salinity maps based on 84 ground-truth soil salinity data and various spectral parameters, like satellite band reflectance, and published satellite salinity indices. The results showed that using the newly constructed red-edge salinity and yellow band salinity indices, we were able to develop several inversion models to produce regional salinity maps. Different algorithms, including Boruta feature preference, Random Forest algorithm (RF), and Extreme Gradient Boosting algorithm (XGBoost), were applied for variable selection. The newly constructed yellow salinity indices (YRNDSI and YRNDVI) had the best Pearson correlations of 0.78 and −0.78. We also found that the proportions of the newly constructed yellow and red-edge bands accounted for a large proportion of the essential strategies of the three algorithms, with Boruta feature preference at 80%, RF at 80%, and XGBoost at 60%, indicating that these two band indices contributed more to the soil salinity estimation results. The best PLSR model estimation for different strategies is the XGBoost-PLSR model with coefficient of determination (R2), root mean square error (RMSE), and ratio of performance to deviation (RPD) values of 0.832, 12.050, and 2.442, respectively. These results suggest that PlanetScope data has the potential to significantly advance the field of soil salinity research by providing a wealth of fine-scale salinity information

Adaptive overcurrent protection scheme for distribution networks with connection of mobile energy storage devices

The increasing penetration of renewable energy sources in distribution networks has caused great challenges to the reliable operation of the conventional overcurrent protection schemes. In particularly, serious underreach and overreach problems of protection scope may occur under the ever growing application of mobile energy storage (MES) devices. To improve the adaptability to the connection of MES devices under distribution networks, this paper proposes an adaptive overcurrent protection scheme, which can avoid the unfavorable effects caused by infeed currents and out flowing currents. Firstly, the effects of MES device on the protection scope of the overcurrent protection strategy are investigated, considering the charging, discharging, and backup operation modes of MES device. Secondly, to adapt to the different operation modes, the equivalent impedance of MES device is calculated, and then it is introduced to determine the adaptive settings of fast current protection and time-critical fast current protection. Finally, the constructed adaptive overcurrent protection scheme can adapt to varied fault conditions, including different operation modes and output power of MES device, connection locations, fault locations, and fault types. Large amounts of simulation results show that the proposed adaptive overcurrent method can overcome the underreach and overreach problems of protection scope, demonstrating its good application prospects

Monasone Naphthoquinone Biosynthesis and Resistance in Monascus Fungi

The genes for Monascus naphthoquinone (monasone) biosynthesis are embedded in and form a composite supercluster with the Monascus azaphilone pigment biosynthetic gene cluster. Early biosynthetic intermediates are shared by the two pathways. Some enzymes encoded by the supercluster play double duty in contributing to both pathways, while others are specific for one or the other pathway. The monasone subcluster is independently regulated and inducible by elicitation with competing microorganisms. This study illustrates genomic and biosynthetic parsimony in fungi and proposes a potential path for the evolution of the mosaic-like azaphilone-naphthoquinone supercluster. The monasone subcluster also encodes a two-tiered self-resistance mechanism that models resistance determinants that may transfer to target microorganisms or emerge in cancer cells in case of naphthoquinone-type cytotoxic agents.Despite the important biological activities of natural product naphthoquinones, the biosynthetic pathways of and resistance mechanisms against such compounds remain poorly understood in fungi. Here, we report that the genes responsible for the biosynthesis of Monascus naphthoquinones (monasones) reside within the gene cluster for Monascus azaphilone pigments (MonAzPs). We elucidate the biosynthetic pathway of monasones by a combination of comparative genome analysis, gene knockouts, heterologous coexpression, and in vivo and in vitro enzymatic reactions to show that this pathway branches from the first polyketide intermediate of MonAzPs. Furthermore, we propose that the monasone subset of biosynthetic genes also encodes a two-tiered resistance strategy in which an inducible monasone-specific exporter expels monasones from the mycelia, while residual intracellular monasones may be rendered nontoxic through a multistep reduction cascade

Spatio-Temporal Changes in Water Use Efficiency and Its Driving Factors in Central Asia (2001&ndash;2021)

Although understanding the carbon and water cycles of dryland ecosystems in terms of water use efficiency (WUE) is important, WUE and its driving mechanisms are less understood in Central Asia. This study calculated Central Asian WUE for 2001&ndash;2021 based on the Google Earth Engine (GEE) platform and analyzed its spatial and temporal variability using temporal information entropy. The importance of atmospheric factors, hydrological factors, and biological factors in driving WUE in Central Asia was also explored using a geographic detector. The results show the following: (1) the average WUE in Central Asia from 2001&ndash;2021 is 2.584&ndash;3.607 gCkg&minus;1H2O, with weak inter-annual variability and significant intra-annual variability and spatial distribution changes; (2) atmospheric and hydrological factors are strong drivers, with land surface temperature (LST) being the strongest driver of WUE, explaining 54.8% of variation; (3) the interaction of the driving factors can enhance the driving effect by more than 60% for the interaction between most atmospheric factors and vegetation factors, of which the effect of the interaction of temperature (TEM) with vegetation cover (FVC) is the greatest, explaining 68.1% of the change in WUE. Furthermore, the interaction of driving factors with very low explanatory power (e.g., water pressure (VAP), aerosol optical depth over land (AOD), and groundwater (GWS)) has a significant enhancement effect. Vegetation is an important link in driving WUE, and it is important to understand the mechanisms of WUE change to guide ecological restoration projects