Objectives
Anemia is associated with severe outcomes in adult community‐acquired pneumonia (CAP), but few studies investigated its association with pediatric CAP. Hence, we tried to delineate the ...association of anemia with the clinical outcomes of CAP in children.
Methods
This retrospective cohort study was conducted from 2010 to 2019 in a medical center. Inpatients aged 6 months to 17 years who were diagnosed with CAP and without major underlying diseases were included. The subjects' clinical data within 24 h of admission and clinical outcomes were collected. We accessed the rates of adverse outcomes and the adjusted odds ratios (ORs) of these outcomes between anemic and nonanemic patients, as well as among patients with different types of anemia.
Results
In this study of 3601 patients, the prevalence of anemia was 11.6% (418/3601). Anemic patients had higher rates of intensive care (16.8% vs. 3.6%; p < 0.001), endotracheal intubation (11.0% vs. 1.3%; p < 0.001), and empyema (8.6% vs. 0.6%; p < 0.001) than nonanemic patients. In addition, anemia was independently associated with intensive care (adjusted OR, 3.00; 95% confidence interval CI, 2.03–4.42), endotracheal intubation (adjusted OR, 3.79; 95% CI, 2.17–6.63), and empyema (adjusted OR, 4.72; 95% CI, 2.30–9.69). Iron‐deficiency anemia (IDA) and normocytic anemia were associated with these adverse outcomes but not with anemia due to thalassemia trait.
Conclusion
Anemia is a biomarker associated with poor outcomes in pediatric CAP, and patients with IDA or normocytic anemia should be carefully monitored and managed since they may have higher disease severity.
Abstract
Context
Maternal lipids during pregnancy and placental growth factors are associated with excess fetal growth. However, how these factors interact to increase the risk of delivering ...large-for-gestational-age (LGA) neonates remains unclear. In this study, we investigated the relationship between maternal plasma triglycerides (TGs) and free fatty acids (FFAs) during pregnancy, cord blood insulin-like growth factors (IGF), and LGA.
Objective
In a cell model, we studied the effect of different FAs on placental IGF-1 secretion.
Methods
This cohort study included pregnant women with term pregnancy and without diabetes or hypertensive disorders in pregnancy. Maternal fasting plasma TGs and FFAs were measured in the second trimester. Cord blood IGF-1, IGF-2, and IGF binding protein-1 and protein-3 were measured at the time of delivery. A human trophoblast cell line, 3A-sub-E, was used to evaluate the effect of different FFAs on placental IGF-1 secretion.
Results
We recruited 598 pregnant women–neonate pairs. Maternal plasma TG (180 mg/dL 152.5-185.5 mg/dL vs 166 mg/dL 133-206 mg/dL, P = .04) and cord blood IGF-1 concentrations (72.7 ± 23.0 vs 54.1 ± 22.8 ng/mL, P < .001) were higher in the LGA group and were significantly associated with birth weight z score. Maternal plasma free palmitic acid (PA) and stearic acid (SA), but not oleic acid (OA) or linoleic acid (LA), were significantly associated with cord blood IGF-1 concentrations. In 3A-sub-E cells, treatment with PA, SA, and LA, but not OA, induced IGF-1 expression and secretion.
Conclusion
Certain FFAs can induce placental IGF-1 secretion, which suggests a potential pathophysiology linking maternal plasma lipids and LGA.
We present an evaluation of airborne intensity‐modulated continuous‐wave (IM‐CW) lidar measurements of atmospheric column CO2 mole fractions during the Atmospheric Carbon and Transport–America ...(ACT‐America) project. This lidar system transmits online and offline wavelengths simultaneously on the 1.57111‐μm CO2 absorption line, with each modulated wavelength using orthogonal swept frequency waveforms. After the spectral characteristics of this system were calibrated through short‐path measurements, we used the HITRAN spectroscopic database to calculate the average‐column CO2 mole fraction (XCO2) from the lidar‐measured optical depths. Using in situ measurements of meteorological parameters and CO2 concentrations for calibration data, we demonstrate that our lidar CO2 measurements were consistent from season to season and had an absolute calibration error (standard deviation) of 0.80 ppm when compared to XCO2 values calculated from in situ measurements. By using a 10‐s or longer moving average, a precision of 1 ppm or better was obtained. The estimated CO2 measurement precision for 0.1‐, 1‐, 10‐, and 60‐s averages was determined to be 3.4, 1.2, 0.43, and 0.26 ppm, respectively. These correspond to measurement signal‐to‐noise ratios of 120, 330, 950, and 1,600, respectively. The drift in XCO2 over 1‐hr of flight time was found to be below 0.1 ppm. These analyses demonstrate that the measurement stability, precision, and accuracy are all well below the thresholds needed to study synoptic‐scale variations in atmospheric XCO2.
Key Points
Demonstrate the MFLL laser spectrometer for use in column CO2 retrievals
Demonstrate the viability of this instrument for use in ACT America project goals
Provide a methodology for doing CO2 or perhaps other types of retrievals using lidar
Toxoplasma gondii is an opportunistic, zoonotic pathogen with a worldwide distribution. There are large variations in the seroprevalence of T. gondii infection in different regions of the world. ...Although toxoplasmosis became a notifiable communicable disease in Taiwan in 2007, little is known about its epidemiology among the general population. This cross-sectional study aimed to survey the seroprevalence of T. gondii infection and its risk factors among healthy blood donors in Taiwan. Through collaborating with the Taiwan Blood Services Foundation, a total of 1,783 healthy blood donors from all six-branch blood service centers participated in this study. The blood samples were tested for the presence of T. gondii antibodies and DNA using enzyme immunoassays and real-time PCR, respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection. Of the 1,783 participants, 166 (9.3%) tested positive for anti-Toxoplasma IgG, while 5 (0.28%) tested positive for anti-Toxoplasma IgM. The five IgM positive donors had high avidity antibodies suggestive of past infection. No active parasitemia was detected by real-time PCR assays. Multivariate logistic regression showed that undercooked pork meat consumption (adjusted odds ratio OR = 2.9; 95% confidence interval CI: 1.3-6.5), raw mussels consumption (adjusted OR = 5.3; 95% CI: 1.5-19.1), having a cat in the household (adjusted OR = 2.0; 95% CI: 1.2-3.2), a lower education level (adjusted OR = 1.6; 95% CI: 1.1-2.3), and donation place in eastern Taiwan (adjusted OR = 2.5; 95% CI: 1.6-3.9) were independent risk factors for Toxoplasma seropositivity. These findings provide information on the seroprevalence and epidemiology of T. gondii infection among healthy blood donors in Taiwan.
With nearly 1 million observations of column‐mean carbon dioxide concentration (X
CO2) per day, the Orbiting Carbon Observatory 2 (OCO‐2) presents exciting possibilities for monitoring the global ...carbon cycle, including the detection of subcontinental column CO2 variations. While the OCO‐2 data set has been shown to achieve target precision and accuracy on a single‐sounding level, the validation of X
CO2 spatial gradients on subcontinental scales remains challenging. In this work, we investigate the use of an integrated path differential absorption (IPDA) lidar for evaluation of OCO‐2 observations via NASA's Atmospheric Carbon and Transport (ACT)‐America project. The project has completed eight clear‐sky underflights of OCO‐2 with the Multifunctional Fiber Laser Lidar (MFLL)—along with a suite of in situ instruments—giving a precisely colocated, high‐resolution validation data set spanning nearly 3,800 km across four seasons. We explore the challenges and opportunities involved in comparing the MFLL and OCO‐2 X
CO2 data sets and evaluate their agreement on synoptic and local scales. We find that OCO‐2 synoptic‐scale gradients generally agree with those derived from the lidar, typically to ±0.1 ppm per degree latitude for gradients ranging in strength from 0 to 1 ppm per degree latitude. CO2 reanalysis products also typically agree to ±0.25 ppm per degree when compared with an in situ‐informed CO2 “curtain.” Real X
CO2 features at local scales, however, remain challenging to observe and validate from space, with correlation coefficients typically below 0.35 between OCO‐2 and the MFLL. Even so, ACT‐America data have helped investigate interesting local X
CO2 patterns and identify systematic spurious cloud‐related features in the OCO‐2 data set.
Key Points
OCO‐2 and lidar tend to agree on synoptic‐scale X
CO2 gradients, over a few hundred kilometers, to within 0.1 ppm per degree latitude
There is very little agreement among tested data sets on smaller‐scale X
CO2 features, on the order of tens of kilometers
The OCO‐2 X
CO2 data set contains some systematic spurious retrievals apparently due to 3D cloud effects, which should be addressed in the future
Hypertension is a risk factor of incident diabetes. In 2017, the ACC/AHA updated the definition of hypertension to above 130/80 mmHg, while the 2018 ESC/ESH guideline and the JNC7 criteria remained ...the cutoff of 140/90 mmHg. This study was aimed to investigate how different cutoffs of hypertension affect the association of hypertension to incident diabetes and the progression of insulin resistance.
A total of 1177 subjects without diabetes at baseline were followed for 4.5 years. Diabetes was diagnosed by the results of oral glucose tolerance tests and hemoglobin A1c, or if anti-diabetic agents were used.
Hypertension by both criteria was associated with incident diabetes. Change of HOMA2-IR every 5 years (ΔHOMA2-IR/5 yr) was higher in subjects with hypertension than those without (adjusted p = 0.044). Subjects with treated hypertension had the highest risk of diabetes (HR 2.98, p < 0.001) and ΔHOMA2-IR/5 yr, compared with subjects with normal blood pressure. However, the associations of hypertension, HR of incident diabetes and ΔHOMA2-IR/5 yr were attenuated by the 2017 ACC/AHA criteria, as compared with that by the JNC7 and 2018 ESC/ESH criteria.
Hypertension by both criteria is associated with incident diabetes and accelerated progression of insulin resistance, and the associations are attenuated by the 2017 ACC/AHA criteria.
Global atmospheric energy balance is one of the fundamental processes for the earth's climate system. This study uses currently available satellite data sets of radiative energy at the top of ...atmosphere (TOA) and surface as well as latent and sensible heat over the oceans for the year 2000 to assess the global annual energy budget. Over land, surface radiation data are used to constrain assimilated results and to force the radiation, turbulent heat, and heat storage into balance due to a lack of observation‐based turbulent heat flux estimates. Global annual means of the TOA net radiation obtained from both satellite direct measurements and calculations are close to zero. The net radiative energy fluxes into the surface and the surface latent heat transported into the atmosphere are about 113 and 86 W/m2, respectively. The estimated atmospheric and surface heat imbalances are about −8 and 9 W/m2, respectively, values that are within the uncertainties of surface radiation and sea surface turbulent flux estimates and the likely systematic biases in the analyzed observations. The potential significant additional absorption of solar radiation within the atmosphere suggested by previous studies does not appear to be required to balance the energy budget: the spurious heat imbalances in the current data are much smaller (about half) than those obtained previously and debated about a decade ago. Progress in surface radiation and oceanic turbulent heat flux estimations from satellite measurements has significantly reduced the bias errors in the observed global energy budgets of the climate system.
Halophytes such as Salicornia europaea have evolved to exhibit unique mechanisms controlled by complex networks and regulated by numerous genes and interactions to adapt to habitats with high ...salinity. However, these mechanisms remain unknown.
To investigate the mechanism by which halophytes tolerate salt based on changes in the whole transcriptome, we performed transcriptome sequencing and functional annotation by database search. Using the unigene database, we conducted digital gene expression analysis of S. europaea at various time points after these materials were treated with NaCl. We also quantified ion uptakes. Gene functional enrichment analysis was performed to determine the important pathways involved in this process.
A total of 57,151 unigenes with lengths of >300 bp were assembled, in which 57.5% of these unigenes were functionally annotated. Differentially expressed genes indicated that cell wall metabolism and lignin biosynthetic pathways were significantly enriched in S. europaea to promote the development of the xylem under saline conditions. This result is consistent with the increase in sodium uptake as ions pass through the xylem. Given that PSII efficiency remained unaltered, salt treatment activated the expression of electron transfer-related genes encoded by the chloroplast chromosome. Chlorophyll biosynthesis was also inhibited, indicating the energy-efficient state of the electron transfer system of S. europaea.
The key function of adjusting important primary metabolic pathways in salt adaption was identified by analyzing the changes in the transcriptome of S. europaea. These pathways could involve unique salt tolerance mechanisms in halophytes. This study also provided information as the basis of future investigations on salt response genes in S. europaea. Ample gene resources were also provided to improve the genes responsible for the salt tolerance ability of crops.
SomaticSeq is an accurate somatic mutation detection pipeline implementing a stochastic boosting algorithm to produce highly accurate somatic mutation calls for both single nucleotide variants and ...small insertions and deletions. The workflow currently incorporates five state-of-the-art somatic mutation callers, and extracts over 70 individual genomic and sequencing features for each candidate site. A training set is provided to an adaptively boosted decision tree learner to create a classifier for predicting mutation statuses. We validate our results with both synthetic and real data. We report that SomaticSeq is able to achieve better overall accuracy than any individual tool incorporated.
A multilayered cloud retrieval system (MCRS) is updated and used to estimate ice water path in maritime ice‐over‐water clouds using Visible and Infrared Scanner (VIRS) and Tropical Rainfall Measuring ...Mission (TRMM) Microwave Imager (TMI) measurements acquired over the Tropics between January and August 1998. Lookup tables of top‐of‐atmosphere 0.65‐μm reflectance are developed for ice‐over‐water cloud systems using radiative transfer calculations for various combinations of ice‐over‐water cloud layers. The liquid and ice water paths, LWP and IWP, respectively, are determined with the MCRS using these lookup tables with a combination of microwave (MW), visible (VIS), and infrared (IR) data. LWP, determined directly from the TMI MW data, is used to define the lower‐level cloud properties to select the proper lookup table. The properties of the upper‐level ice clouds, such as optical depth and effective size, are then derived using the Visible–Infrared Solar‐infrared Split‐Window technique (VISST), which matches the VIRS IR, 3.9 μm, and VIS data to the multilayer cloud lookup table reflectances and a set of emittance parameterizations. Initial comparisons with surface‐based radar retrievals suggest that this enhanced MCRS can significantly improve the accuracy and decrease the IWP in overlapped clouds by 42 and 13% compared to using the single‐layer VISST and an earlier simplified MW–VIS–IR (MVI) differencing method, respectively, for ice‐over‐water cloud systems. The tropical distribution of ice‐over‐water clouds is the same as derived earlier from combined TMI and VIRS data, but the new values of IWP and optical depth are slightly larger than the older MVI values and exceed those of single‐layered clouds by 7 and 11%, respectively. The mean IWP from the MCRS is 8–14% greater than that retrieved from radar retrievals of overlapped clouds over two surface sites, and the standard deviations of the differences are similar to those for single‐layered clouds. Examples of a method for applying the MCRS over land without MW data yield similar differences with the surface retrievals. By combining the MCRS with other techniques that focus primarily on optically thin cirrus over low water clouds, it will be possible to more fully assess the IWP in all conditions over ocean except for precipitating systems.
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