This study aimed to explore the combined association between the dietary antioxidant quality score (DAQS) and leisure-time physical activity on sleep patterns in cancer survivors. Data of cancer survivors were extracted from the National Health and Nutrition Examination Surveys database in 2007–2014 in this cross-sectional study. Weighted multivariable logistic regression models were used to estimate OR and 95 % CI for the association of DAQS and leisure-time physical activity on sleep patterns. The combined association was also assessed in subgroups of participants based on age and use of painkillers and antidepressants. Among the eligible participants, 1133 had unhealthy sleep patterns. After adjusting for covariates, compared with low DAQS level combined with leisure-time physical activity level < 600 MET·min/week, high DAQS level combined with leisure-time physical activity ≥ 600 MET·min/week was associated with lower odds of unhealthy sleep patterns (OR = 0·41, 95 % CI: 0·23, 0·72). Additionally, the association of high DAQS level combined with high leisure-time physical activity with low odds of unhealthy sleep patterns was also significant in < 65 years old (OR = 0·30, 95 % CI: 0·13, 0·70), non-painkiller (OR = 0·39, 95 % CI: 0·22, 0·71), non-antidepressant (OR = 0·49, 95 % CI: 0·26, 0·91) and antidepressant (OR = 0·11, 95 % CI: 0·02, 0·50) subgroups. DAQS and leisure-time physical activity had a combined association on sleep patterns in cancer survivors. However, the causal associations of dietary nutrient intake and physical activity with sleep patterns in cancer survivors need further clarification.

This commentary examines the synergy between meta-learned models of cognition and integrative learning in enhancing animal and human learning outcomes. It highlights three integrative learning modes – holistic integration of parts, top-down reasoning, and generalization with in-depth analysis – and their alignment with meta-learned models of cognition. This convergence promises significant advances in educational practices, artificial intelligence, and cognitive neuroscience, offering a novel perspective on learning and cognition.

Dietary antioxidant indices (DAI) may be potentially associated with relative telomere length (RTL) of leucocytes. This study aimed to investigate the relationship between DAI and RTL. A cross-sectional study involving 1656 participants was conducted. A generalised linear regression model and a restricted cubic spline model were used to assess the correlation of DAI and its components with RTL. Generalised linear regression analysis revealed that DAI (β = 0·005, P = 0·002) and the intake of its constituents vitamin C (β = 0·043, P = 0·027), vitamin E (β = 0·088, P < 0·001), Se (β = 0·075, P = 0·003), and Zn (β = 0·075, P = 0·023) were significantly and positively correlated with RTL. Sex-stratified analysis showed that DAI (β = 0·006, P = 0·005) and its constituents vitamin E (β = 0·083, P = 0·012), Se (β = 0·093, P = 0·006), and Zn (β = 0·092, P = 0·034) were significantly and positively correlated with RTL among females. Meanwhile, among males, only vitamin E intake (β = 0·089, P = 0·013) was significantly and positively associated with RTL. Restricted cubic spline analysis revealed linear positive associations between DAI and its constituents’ (vitamin E, Se and Zn) intake and RTL in the total population. Sex-stratified analysis revealed a linear positive correlation between DAI and its constituents’ (vitamin E, Se and Zn) intake and RTL in females. Our study found a significant positive correlation between DAI and RTL, with sex differences.

This article makes an intervention in the study of the May Fourth Movement by examining the role the mass media played in the diplomatic and domestic mobilization processes set in motion by China’s experience at the Paris Peace Conference. In contrast with the mainstream narrative that constructs the May Fourth Movement as a spontaneous response to the loss of Shandong at Versailles, this article shows that it was preceded by a proactive diplomatic strategy to mobilize ‘public opinion’ over the Shandong question. The Chinese delegation’s decision to launch a media campaign in support of their diplomatic agendas at Versailles inadvertently turned domestic media into a platform for political debate. As a result of competition between the political elites who dominated the mediascape, discussions over the Shandong question shifted from focusing on international diplomacy to domestic politics in the spring of 1919. An examination of the ‘media war’ during the May Fourth Movement further demonstrates that the political elites’ variable ability to adopt media strategies to shape and channel public opinion resulted in changing the political landscape of the post-May Fourth era. By focusing on the role of the mass media in the diplomatic and domestic mobilization in China’s strategy at Versailles and during the May Fourth Movement, this article forges new connections between the international and the domestic. It also invites further reflections on the nature of the May Fourth Movement by showing that the media was a tool of political mobilization that connected the political elite to the masses.

The Wood Snipe Gallinago nemoricola is one of the least known shorebird species, and its habitat associations are very poorly understood. Here we provide the first assessment of the habitat use of the Wood Snipe during the breeding season. Between May and July 2021 at a 4-km2 alpine meadow in Sichuan province, China, we conducted population surveys and behavioural observations to identify sites where breeding Wood Snipe occurred and foraged. We quantified the habitat characteristics and food resource availability of these sites and compared them with randomly selected “background” sites. Comparison between 34 occurrence sites and 25 background sites indicated that during the breeding season, Wood Snipes are not distributed evenly across alpine meadow habitats, but preferred habitats in the lower part (3,378–3,624 m) of the alpine meadow with intermediate levels of soil moisture. In addition, comparison between 17 foraging sites and 24 background sites showed that the Wood Snipe tended to forage at sites with higher soil fauna abundance. We found weak evidence for denser vegetation cover at its height and no evidence for other biotic habitat variables such as vegetation composition or other abiotic habitat variables such as slope, soil penetrability, or disturbance level to influence Wood Snipe habitat associations. Our results suggest that the actual distribution range of the Wood Snipe during the breeding season may be smaller than expected from the extent of apparently suitable habitat. We advise caution in evaluating the potential habitat availability and distribution of the Wood Snipe, and call for further research to better understand the ecology of this rare species to inform its conservation.

Objectives: Control of Clostridioides difficile infections (CDIs) in healthcare facilities presents significant challenges to infectious disease physicians, infection prevention and control practitioners, and environmental services staff. CDI is a common cause of infectious diarrhea and is associated with significant morbidity, mortality, and healthcare cost. A high infection rate was documented in our institution in 2017, higher than the national infection rate. Strategies to reduce hospital-onset CDI were implemented after review of international guidelines and relevant literature. The impact on hospital-onset CDI was assessed. Methods: The following strategies were implemented beginning early in 2018: (1) contact precautions for patients with diarrhea; (2) early recognition and diagnosis of C. difficile infection; (3) prompt isolation of C. difficile patients; (4) emphasis on hand hygiene and contact precautions; (5) enhanced environmental cleaning with chlorine-based disinfectant and use of UV-C and ionized hydrogen peroxide for equipment disinfection; (6) enhanced cleaning and disinfection using sporicidal wipes for shared high-risk equipment; (7) audit and feedback regarding compliance with practices and environmental cleaning; and (8) collaboration with antibiotics stewardship program (ASP) to reduce inappropriate antibiotic use. Hospital-onset CDI cases were tracked by infection prevention and control nurses using definitions from the Singapore Ministry of Health. Results: In total, 135 hospital-onset C. difficile infection cases occurred in 2017, a rate of 4.2 per 10,000 patient days. This rate gradually decreased to 3.0 in 2018 and to 2.3 in 2020, with an average of 87 infections per year. This rate further decreased to 1.8 infections per 10,000 patient days in 2021, with 61 clinical infections. Conclusions: Using multimodal strategies, CGH achieved a gradual and steady reduction in hospital-onset CDI over several years. These strategies require close collaboration among various departments to achieve the desired outcome.

Let $[t]$ be the integral part of the real number t and let $\mathbb {1}_{{\mathbb P}}$ be the characteristic function of the primes. Denote by $\pi _{\mathcal {S}}(x)$ the number of primes in the floor function set $\mathcal {S}(x) := \{[{x}/{n}] : 1\leqslant n\leqslant x\}$ and by $S_{\mathbb {1}_{{\mathbb P}}}(x)$ the number of primes in the sequence $\{[{x}/{n}]\}_{n\geqslant 1}$. Improving a result of Heyman [‘Primes in floor function sets’, Integers 22 (2022), Article no. A59], we show

$$ \begin{align*} \pi_{\mathcal{S}}(x) = \int_2^{\sqrt{x}} \frac{d t}{\log t} + \int_2^{\sqrt{x}} \frac{d t}{\log(x/t)} + O(\sqrt{x}\,\mathrm{e}^{-c(\log x)^{3/5}(\log\log x)^{-1/5}}) \quad\mbox{and}\quad S_{\mathbb{1}_{{\mathbb P}}}(x) = C_{\mathbb{1}_{{\mathbb P}}} x + O_{\varepsilon}(x^{9/19+\varepsilon}) \end{align*} $$

for $x\to \infty $, where $C_{\mathbb {1}_{{\mathbb P}}} := \sum _{p} {1}/{p(p+1)}$, $c>0$ is a positive constant and $\varepsilon $ is an arbitrarily small positive number.

Background: Outpatient parenteral antimicrobial therapy (OPAT) is used in the outpatient setting to treat infectious conditions that require a prolonged course of antimicrobials. OPAT has been shown to decrease length of hospital stay and healthcare costs without compromising patient care and has become a widely accepted practice nationally. Due to this trend, the study of OPAT is of vital importance and will continue to be relevant moving forward. Currently, few studies have explored risk factors associated with OPAT complications, and most are limited in their analysis by indication. Further work should be performed to expand upon what is currently known. We characterized factors associated with increased OPAT complication risk. Methods: We conducted a retrospective cohort study at 4 sites across NYU Langone Health in patients admitted from 2017 to 2020. We applied the following inclusion criteria: aged ≥18 years and discharged with OPAT. Complications were defined as follows: vascular-access-related (line occlusion, thrombosis, dislodgement, central-line associated bloodstream infection or CLABSI) and antimicrobial-related (laboratory derangement, drug reaction, Clostridioides difficile infection), all-cause 30-day readmission, and OPAT-related readmission. Data were obtained from electronic medical records and the OPAT database. This study was granted a waiver from informed consent by the NYU Institutional Review Board. Multivariate logistic regression was performed, adjusting for confounding variables (sex, age, hospital of admission, history of chronic medical conditions, line type, and line duration). Results: Overall, 1,846 patient encounters of 5,951 reviewed met inclusion criteria. The median age was 66 (IQR, 26), 42.2% were female. Moreover, 810 (44%) received a peripherally inserted central catheter (PICC) and 1,036 (56%) received a midline cathether. Also, 563 (30.5%) were discharged to subacute rehabilitation (SAR). The most frequent complications were line dislodgement (4.2% of all patients), laboratory derangement (3.0%), and drug reaction (2.4%). Furthermore, 27 patients (1.5%) developed CLABSI. Patients discharged to SAR were more likely to develop CLABSI (OR, 4.1l; P = .005), and they had higher rates of OPAT-related 30-day readmissions (OR, 2.675; P = .004) compared to those who were discharged home, after adjusting for key confounders. Conclusions: Discharge to SAR is strongly associated with increased risk of readmission for OPAT-related complications and CLABSI, after adjusting for key confounders. CLABSI prevention during SAR admission is a critically needed public health intervention.

Funding: None

Disclosures: None

Ediacaran cap dolostone atop Marinoan glacial deposits contains complex sedimentary structures with extremely negative δ13Ccarb values in close association with oscillations in palaeoclimatic and oceanographic proxy records. However, the precise geological, geochronological and geochemical context of the cap dolostone is not clarified, which hampers us from correctly interpreting the extremely negative δ13Ccarb values and their causal relationships with the Snowball Earth hypothesis. In this study, we conducted detailed in situ geochronological and geochemical analyses on the calcite within the cap dolostone from the Ediacaran Doushantuo Formation in South China in order to define its formation and relationship to the Snowball Earth hypothesis. Petrographic observations show that formation of dolomite pre-dates precipitation of calcite and pyrite, which pre-dates quartz cementation in the basal cap carbonate. Calcite cement within the cap dolostone yielded a U–Pb age of 636.5 ± 7.4/17.8 Ma (2σ, MSWD = 1.6, n = 36/40), which is within uncertainty of a published dolomite U–Pb age of 632 ± 17 Ma (recalculated as 629.3 ± 16.7/22.9 Ma). These age constraints negate the possibility that the calcite cement was formed by late Ediacaran or Cambrian hydrothermal activity. The rare earth element distribution patterns suggest a dominant seawater origin overprinted by subsequent early Ediacaran hydrothermal activity. The combined age, petrographic and geochemical data suggest oxidization of methane clathrates in response to complicated interplay between eustasy and isostatic rebound and hydrothermal fluids.

Two new genera and six new species of trilobites are systematically documented herein: Sinagnostus mirabilis new genus new species, Yanpingia punctata n. gen. n. sp., Illaenus taoyuanensis n. sp., Panderia striolatus n. sp., Nileus yichongqiaoensis n. sp., and Paratiresias peculiaris n. sp. The materials were collected from the Darriwilian (late Middle Ordovician) strata in the Upper Yangtze Region, South China. Also provided is an emended diagnosis of the genus Paratiresias based on the new species Paratiresias peculiaris, which is the oldest known species of this genus with an extremely narrow (sag. and exsag.) preglabellar field. Those Chinese species previously referred to Nanillaenus are reassigned to Illaenus sensu lato. These trilobites add new data for the Darriwilian trilobite macroevolution and show highly endemic to South China and the faunal exchanges between South China and Tarim, Kazakhstan, Alborz, as well as Sibumasu and North China.

UUID: http://zoobank.org/ec3be9be-b003-4367-910d-7a0ac4edc982

Almost all hospitals are equipped with air-conditioning systems to provide a comfortable environment for patients and staff. However, the accumulation of dust and moisture within these systems increases the risk of transmission of microbes and have on occasion been associated with outbreaks of infection. Nevertheless, the impact of air-conditioning on the transmission of microorganisms leading to infection remains largely uncertain. We conducted a scoping review to screen systematically the evidence for such an association in the face of the coronavirus disease 2019 epidemic. PubMed, Embase and Web of Science databases were explored for relevant studies addressing microbial contamination of the air, their transmission and association with infectious diseases. The review process yielded 21 publications, 17 of which were cross-sectional studies, three were cohort studies and one case−control study. Our analysis showed that, compared with naturally ventilated areas, microbial loads were significantly lower in air-conditioned areas, but the incidence of infections increased if not properly managed. The use of high-efficiency particulate air (HEPA) filtration not only decreased transmission of airborne bioaerosols and various microorganisms, but also reduced the risk of infections. By contrast, contaminated air-conditioning systems in hospital rooms were associated with a higher risk of patient infection. Cleaning and maintenance of such systems to recommended standards should be performed regularly and where appropriate, the installation of HEPA filters can effectively mitigate microbial contamination in the public areas of hospitals.

Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.