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Coarctation of the aorta is characterised by narrowing of the descending aorta and is a rare cause of secondary hypertension in children and young adults. The aortic stenosis lesion is in a special location with severe consequences, and long-term survival is very low, with high rates of disability and mortality, and can be challenging to detect due to its few clinical manifestations. We report a case of a young patient with atrial fibrillation, renal infarction, and acute cerebral infarction, which are consequences of untreated hypertension due to coarctation of the aorta. The purpose of this report is to emphasize the importance of early diagnosis and management of coarctation of the aorta as a cause of secondary hypertension in children and young adults.
CEOs who develop strong clan values as a result of exposure to clan culture in early life wish to bring honor to their clan, motivating them to engage in increased CSR activities. We propose that the influence of CEOs' clan values on CSR is subject to contextual boundaries. Specifically, we predict that the positive relationship between CEOs' clan values and CSR results primarily in an improved level of institutional CSR and varies with CEOs' personal attributes such as overseas experience and hometown identity. An analysis of a longitudinal sample of Chinese publicly listed firms for 2010–2019 provides strong support for our predictions. The implications for upper echelons theory and CSR research are discussed.
Purple nutsedge (Cyperus rotundus L.) is one of the world’s resilient upland weeds, primarily spreading through its tubers. Its emergence in rice (Oryza sativa L.) fields has been increasing, likely due to changing paddy-farming practices. This study aimed to investigate how C. rotundus, an upland weed, can withstand soil flooding and become a problematic weed in rice fields. The first comparative analysis focused on the survival and recovery characteristics of growing and mature tubers of C. rotundus exposed to soil-flooding conditions. Notably, mature tubers exhibited significant survival and recovery abilities in these environments. Based on this observation, further investigation was carried out to explore the morphological structure, nonstructural carbohydrates, and respiratory mechanisms of mature tubers in response to prolonged soil flooding. Over time, the mature tubers did not form aerenchyma but instead gradually accumulated lignified sclerenchymal fibers, with lignin content also increasing. After 90 d, the lignified sclerenchymal fibers and lignin contents were 4.0 and 1.1 times higher than those in the no soil-flooding treatment. Concurrently, soluble sugar content decreased while starch content increased, providing energy storage, and alcohol dehydrogenase activity rose to support anaerobic respiration via alcohol fermentation. These results indicated that mature tubers survived in soil-flooding conditions by adopting a low-oxygen quiescence strategy, which involves morphological adaptations through the development of lignified sclerenchymal fibers, increased starch reserves for energy storage, and enhanced anaerobic respiration. This mechanism likely underpins the flooding tolerance of mature C. rotundus tubers, allowing them to endure unfavorable conditions and subsequently germinate and grow once flooding subsides. This study provides a preliminary explanation of the mechanism by which mature tubers of C. rotundus from the upland areas confer flooding tolerance, shedding light on the reasons behind this weed’s increasing presence in rice fields.
This study aimed to understand the potassium voltage-gated channel KQT-like subfamily, member 1 gene polymorphism in a rural elderly population in a county in Guangxi and to explore the possible relationship between its gene polymorphism and blood sugar. The 6 SNP loci of blood DNA samples from 4355 individuals were typed using the imLDRTM Multiple SNP Typing Kit from Shanghai Tianhao Biotechnology Co. The data combining epidemiological information (baseline questionnaire and physical examination results) and genotyping results were statistically analyzed using GMDR0.9 software and SPSS22.0 software. A total of 4355 elderly people aged 60 years and above were surveyed in this survey, and the total abnormal rate of glucose metabolism was 16·11 % (699/4355). Among them, male:female ratio was 1:1·48; the age group of 60–69 years old accounted for the highest proportion, with 2337 people, accounting for 53·66 % (2337/4355). The results of multivariate analysis showed that usually not doing farm work (OR 1·26; 95 % CI 1·06, 1·50), TAG ≥ 1·70 mmol/l (OR 1·19; 95 % CI 1·11, 1·27), hyperuricaemia (OR 1·034; 95 % CI 1·01, 1·66) and BMI ≥ 24 kg/m2 (OR 1·06; 95 % CI 1·03, 1·09) may be risk factors for abnormal glucose metabolism. Among all participants, rs151290 locus AA genotype, A allele carriers (AA+AC) were 0.70 times more likely (0.54 to 0.91) and 0.82 times more likely (0.70 to 0.97) to develop abnormal glucose metabolism than CC genotype carriers, respectively. Carriers of the T allele at the rs2237892 locus (CT+TT) were 0.85 times more likely to have abnormal glucose metabolism than carriers of the CC genotype (0.72 to 0.99); rs2237897 locus CT gene. The possibility of abnormal glucose metabolism in the carriers of CC genotype, TT genotype and T allele (CT + TT) is 0·79 times (0·67–0·94), 0·74 times (0·55–0·99) and 0·78 times (0·66, 0·92). The results of multifactor dimensionality reduction showed that the optimal interaction model was a three-factor model consisting of farm work, TAG and rs2237897. The best model dendrogram found that the interaction between TAG and rs2237897 had the strongest effect on fasting blood glucose in the elderly in rural areas, and they were mutually antagonistic. Environment–gene interaction is an important factor affecting abnormal glucose metabolism in the elderly of a county in Hechi City, Guangxi.
COVID-19 was a collective traumatic event; however, different individuals may have perceived it differently.
Aims
This study investigated what older people in a collective culture perceived as stressful during COVID-19 and examined how different stressors related to COVID-19 infection and mental health risks.
Method
Thirty-six participants from diverse backgrounds engaged in a three-round Delphi study to generate items for a COVID-19-related stress scale for older adults (CSS-OA). Subsequently, 4674 people (aged ≥60 years) participated in a cross-sectional telephone survey; interviewers collected their responses to CSS-OA and information about COVID-19 infection, depressive symptoms, anxiety, loneliness and demographics. Exploratory factor analysis and confirmatory factor analysis were conducted on CSS-OA. A multiple indicator multiple cause (MIMIC) model was used to examine associations between CSS-OA and other measures.
Results
The Delphi process generated eight items, all secondary or tertiary stressors related to infection. Exploratory factor analysis revealed a three-factor model, and confirmatory factor analysis confirmed an excellent fit (comparative fit index = 0.99, root mean square error of approximation = 0.06). Pre-existing mental health conditions, having family members/friends infected with COVID-19, loneliness, anxiety and depressive symptoms were associated with higher stress. Conversely, self-infection with COVID-19, older age, being female and living alone were negatively associated with some domains of CSS-OA (all P < 0.05).
Conclusions
The Delphi process enhanced our understanding of what older people perceived as stressful, much of which resulted from certain healthcare strategies and reflected cultural influences. These and the MIMIC results highlight the need to balance public health policies with respect to infectious diseases and older people's mental health and quality of life.
The Indo-Pacific Warm Pool (IPWP) significantly influences the global hydrological cycle through its impact on atmospheric-oceanic circulation. However, gaining a comprehensive understanding of the hydrologic climate dynamics within the IPWP and its broader effects on the global climate have been hindered by spatial and temporal limitations in paleoclimate records on orbital timescales. In this study, we reconstructed precipitation records (approximated from δ18Osw-ivc) over the past 450 kyr, based on planktonic foraminiferal Mg/Ca and δ18O data obtained from International Ocean Discovery Program Site U1486 in the western tropical Pacific. The δ18Osw-ivc record revealed a generally consistent pattern with precession variations over the past 450 kyr, closely corresponding to changes in boreal summer insolation at the equator. The δ18Osw-ivc record displayed an anti-phased relationship with Chinese speleothem δ18O records on the precession band, with lower precipitation in the western tropical Pacific and higher precipitation in the East Asia summer monsoon region during periods of high Northern Hemisphere summer insolation. This anti-phased correlation primarily resulted from the north-south migration of the Intertropical Convergence Zone (ITCZ), influenced by the interhemispheric insolation contrast. By considering additional δ18Osw-ivc records from various locations within the IPWP region, we identified synchronous precipitation changes within the IPWP on the precession band. The synchronization of precipitation on both margins of the ITCZ’s seasonal range and differences between central and marginal regions of the ITCZ within the IPWP revealed the expansion and contraction of the ITCZ on precession band.
Aphis spiraecola Patch is one of the most economically important tree fruit pests worldwide. The pyrethroid insecticide lambda-cyhalothrin is commonly used to control A. spiraecola. In this 2-year study, we quantified the resistance level of A. spiraecola to lambda-cyhalothrin in different regions of the Shaanxi province, China. The results showed that A. spiraecola had reached extremely high resistance levels with a 174-fold resistance ratio (RR) found in the Xunyi region. In addition, we compared the enzymatic activity and expression level of P450 genes among eight A. spiraecola populations. The P450 activity of A. spiraecola was significantly increased in five regions (Xunyi, Liquan, Fengxiang, Luochuan, and Xinping) compared to susceptible strain (SS). The expression levels of CYP6CY7, CYP6CY14, CYP6CY22, P4504C1-like, P4506a13, CYP4CZ1, CYP380C47, and CYP4CJ2 genes were significantly increased under lambda-cyhalothrin treatment and in the resistant field populations. A L1014F mutation in the sodium channel gene was found and the mutation rate was positively correlated with the LC50 of lambda-cyhalothrin. In conclusion, the levels of lambda-cyhalothrin resistance of A. spiraecola field populations were associated with P450s and L1014F mutations. Our combined findings provide evidence on the resistance mechanism of A. spiraecola to lambda-cyhalothrin and give a theoretical basis for rational and effective control of this pest species.
Prolonged distress is a risk factor for burnout among health-care providers (HCP) and may contribute to demoralization. We examined sources of distress during the COVID-19 pandemic and associations with demoralization.
Methods
This prospective cross-sectional survey of HCP was conducted among palliative care providers of an academic medical center. Participants completed a survey evaluating sources of distress and the Demoralization Scale-II (DS-II) to measure the intensity of demoralization.
Results
Of 106 eligible participants, 74 (70%) completed the survey. DS-II median (range) score was 2 (0–19). There were no statistically significant associations with demographic characteristics. Participants reported high rates of distress for multiple reasons and high rates of sense of fulfillment (90%) and satisfaction (89%) with their profession.
Significance of results
Our study identified high levels of distress but low demoralization rates. Further study to evaluate fulfillment and satisfaction as protective factors against demoralization and burnout is indicated.
As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale–21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.
By combining the technique of energy selective surface and frequency selective rasorber, an energy selective rasorber is proposed, which performs selective energy protection in the low communication frequency band (0.8–2 GHz) and wave-absorbing property in the high-frequency band (6–18 GHz). The design consists of two layers, of which the bottom one contains a lumped diode structure for energy selection function in the transmission band, while together with the top layer, they perform a wideband wave absorbing function. The simulated and measured results agree well with each other, and both show good absorption in 6–18 GHz and energy-selective property around 1.86 GHz. That is, when the incident power changes from −30 to 14 dBm, the reflection coefficient changes from below −22 dB to above −2 dB, while the transmission coefficient changes from above −3 dB to below −17 dB.
Systolic blood pressure (SBP) is significantly associated with body composition in children and adolescents. However, which one of the components of body composition is the dominant contributor to SBP in children and adolescents remains unclear. We, therefore, aimed to determine the dominant contributor to SBP among components of body composition in a large cohort of American children and adolescents derived from the National Health and Nutrition Examination Survey with cross-sectional analysis. In total, 13 618 children and adolescents (median age 13 years; 6107 girls) with available data on whole-body dual-emission X-ray absorptiometry measurements were included. Multiple linear regression showed that SBP was associated with higher total fat-free mass in boys (β = 0·49, P < 0·001) and girls (β = 0·47, P < 0·001) and with higher total fat mass only in boys (β = 0·12, P < 0·001) after adjustment for covariates. When taking fat distribution into consideration, SBP was associated with higher trunk fat mass (boys: β = 0·28, P < 0·001; girls: β = 0·15, P < 0·001) but negatively associated with leg fat mass (Boys: β = −0·14, P < 0·001; Girls: β = −0·11, P < 0·001), in both boys and girls. Dominance analysis showed that total fat-free mass was the dominant contributor to SBP (boys: 49 %; girls: 55·3 %), followed by trunk fat mass (boys: 32·1 %; girls: 26·9 %); leg fat mass contributed the least to SBP in boys (18·9 %) and girls (17·8 %). Our findings indicated that total fat-free mass was not only associated with SBP but also the most dominant contributor to SBP variation in American children and adolescents.
Purple nutsedge (Cyperus rotundus L.) is a globally distributed noxious weed that poses a significant challenge for control due to its fast and efficient propagation through the tuber, which is the primary reproductive organ. Gibberellic acid (GA3) has proven to be crucial for tuberization in tuberous plants. Therefore, understanding the relationship between GA3 and tuber development and propagation of C. rotundus will provide valuable information for controlling this weed. This study shows that the GA3 content decreases with tuber development, which corresponds to lower expression of bioactive GA3 synthesis genes (CrGA20ox, two CrGA3ox genes) and two upregulated GA3 catabolism genes (CrGA2ox genes), indicating that GA3 is involved in tuber development. Simultaneously, the expression of two CrDELLA genes and CrGID1 declines with tuber growth and decreased GA3, and yeast two-hybrid assays confirm that the GA3 signaling is DELLA-dependent. Furthermore, exogenous application of GA3 markedly reduces the number and the width of tubers and represses the growth of the tuber chain, further confirming the negative impact that GA3 has on tuber development and propagation. Taken together, these results demonstrate that GA3 is involved in tuber development and regulated by the DELLA-dependent pathway in C. rotundus and plays a negative role in tuber development and propagation.
Placental trophoblastic cells play important roles in placental development and fetal health. However, the mechanism of trophoblastic cell fusion is still not entirely clear. The level of Tspan5 in the embryo culture medium was detected using enzyme-linked immunosorbent assay (ELISA). Fusion of BeWo cells was observed by immunofluorescence. Cell fusion-related factors and EMT-related factors were identified by qRT-PCR and western blotting. Notch protein repressor DAPT was used to verify the role of Tspan5 in BeWo cells. The expression of Tspan5 was significantly increased in embryo culture medium. The fusion of BeWo cells was observed after treatment with forskolin (FSK). Cell fusion-related factors (i.e. β-hCG and syncytin 1/2) and Tspan5 were significantly increased after FSK treatment. In addition, FSK treatment promoted EMT-related protein expression in BeWo cells. Knockdown of Tspan5 inhibited cell fusion and EMT-related protein levels. Notch-1 and Jagged-1 protein levels were significantly upregulated, and the EMT process was activated by overexpression of Tspan5 in FSK-treated BeWo cells. Interestingly, blocking the Notch pathway by the repressor DAPT had the opposite results. These results indicated that Tspan5 could promote the EMT process by activating the Notch pathway, thereby causing cell fusion. These findings contribute to a better understanding of trophoblast cell syncytialization and embryonic development. Tspan5 may be used as a therapeutic target for normal placental development.
This article examines China’s path to joining the International Chamber of Commerce (ICC), a private international organization founded in Paris in 1920, of which China was a member from 1931–1949 and from 1994 onwards. The article charts the actors and debates behind two meaningful encounters. The first took place while the Nanjing government was raising funds for economic reconstruction, and the ICC aimed to mediate China’s fundraising efforts through private multilateral channels. The second was in the 1980s, when the People’s Republic was seeking to enter the world trade system. ICC members acted as educators and facilitators of world trade practicalities for the People’s Republic, which eventually rejoined the ICC in 1994. The article draws on Chinese, European, and American source material collected from governments, chambers of commerce, and private businessmen to make a twofold contribution. First, it adds nuance to the narrative of China’s economic internationalization by identifying an important non-governmental diplomatic channel. Second, it questions the ICC’s self-proclaimed identity as a non-political economic organization by showing how the political was indissociable from the economic when it came to China’s membership.
Objectives: Rapid and accurate screening for carbapenemase-producing organism (CPOs) in hospitalized patients is critical for infection control and prevention. The Xpert Carba-R assay is designed for rapid detection of CPOs, but 1 assay is usually conducted for only 1 sample. We evaluated a pooling strategy for CPO screening using the Xpert Carba-R assay. Methods: Swab sets containing 2 swabs were collected from 415 unique patients at Peking University People’s Hospital. One swab was used for the pooling test, in which 5 swabs from different patients were mixed in 1 sample treatment solution. The prevalence of CPOs in the hospital (5.3%) predicted that 5:1 pooling was most economical. As the reference method, the other swab was tested by culture using sequencing. Results: Of 415 samples, 383 were CPO negative using the pooling test strategy and 31 were positive. All samples that were negative by pooling were negative by culture and sequencing. Among the 31 positive samples identified by the pooling strategy, 26 were positive by culture and sequencing (including 24 samples with 1 targeted gene and 2 samples with double targeted genes, 1 NDM+/IMP+ and 1 VIM+/IMP+), and 5 were negative. Overall, 198 tests were conducted in the study, and 217 were saved compared with testing individually. The efficiency of the pooling strategy was 215%. The overall sensitivity was 1 (95% CI, 0.840–1), the specificity was 0.987 (95% CI, 0.968–0.995), the accuracy was 0.987 (95% CI, 0.970–0.996), positive predictive value was 0.838 (95% CI, 0.655–0.939), and the negative predictive value was 1 (95% CI, 0.988–1). Conclusions: The pooling strategy using the Xpert Carba-R assay showed good potential in screening CPO with good sensitivity and a significantly lower cost.
Objectives: The number of lung transplants is increasing year by year in China and globally. With the widespread use of donation after brainstem death (DBD) donor lungs and donation after circulatory death (DCD) donor lungs, donor-derived infection (DDI) poses a major challenge in lung transplantation. Using donor lungs infected or colonized with carbapenem-resistant Enterobacteriaceae (CRE) may have serious implications in lung-transplant recipients. Currently, traditional microbial culture along with antimicrobial susceptibility testing cannot fully meet the need for rapid and accurate diagnosis of CRE infection in a donor before organ harvest. Methods: The Xpert Carba-R device (Cepheid, Sunnyvale, CA) was used to detect and differentiate Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Verona integron-encoded metallo-β-lactamase (VIM), active-on-imipenem (IMP), and OXA-48 carbapenemase genotypes in bronchial lavage fluid from donor lungs before organ harvest. Positive detection of 1 or more of these genotypes indicated a potentially CRE-infected donor lung, and these organs were removed from the lung transplantation cohort. Donor lungs negative for all KPC, NDM, VIM, IMP, and OXA-48 genotypes determined by the Xpert Carba-R device were used for lung transplantation. The incidence of CRE-associated DDI and infection-related complications were compared in the Xpert Carba-R screening group and an historic control group. Results: In this study, 21 donor lungs were tested with the Xpert Carba-R device to detect and differentiate carbapenemase genotypes. Among them, 4 were positive for 1 or more carbapenemase genotypes and were discarded, and the remaining 17 donor lungs showing no carbapenemase gene presence were used for lung transplantation. No CRE-associated DDI occurred in these 17 lung-transplant recipients. Conclusions: Rapid and accurate detection of the carbapenemase gene in donor lungs at the point of care before transplantation using the Xpert Carba-R device reduced the risk of CRE-associated DDI in lung-transplant recipients.
The purpose of this study was to analyse the clinical characteristics of patients with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) PCR re-positivity after recovering from coronavirus disease 2019 (COVID-19). Patients (n = 1391) from Guangzhou, China, who had recovered from COVID-19 were recruited between 7 September 2021 and 11 March 2022. Data on epidemiology, symptoms, laboratory test results and treatment were analysed. In this study, 42.7% of recovered patients had re-positive result. Most re-positive patients were asymptomatic, did not have severe comorbidities, and were not contagious. The re-positivity rate was 39%, 46%, 11% and 25% in patients who had received inactivated, mRNA, adenovirus vector and recombinant subunit vaccines, respectively. Seven independent risk factors for testing re-positive were identified, and a predictive model was constructed using these variables. The predictors of re-positivity were COVID-19 vaccination status, previous SARs-CoV-12 infection prior to the most recent episode, renal function, SARS-CoV-2 IgG and IgM antibody levels and white blood cell count. The predictive model could benefit the control of the spread of COVID-19.