Postoperative pneumonia (POP) is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and ...maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC) surgery.
Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later.
The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP.
Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.
Pesticide residues and microorganisms are major concerns when it comes to vegetable safety. Several techniques are employed to eliminate these contaminants, one of which is ozone microbubble water ...(OMB), known for its effectiveness. However, previous studies on OMB tested OMB’s effectiveness on pesticides and microorganisms separately, using different operative parameters for each. Therefore, this study aimed to investigate the efficacy of OMB in removing frequently detected pesticides in Taiwan, namely chlorantraniliprole and dimethomorph, and Salmonella Typhimurium and Escherichia coli. Napa cabbages (Brassica rapa subsp. pekinensis) were inoculated with these contaminants and subjected to OMB treatment (10 min of microbubble activation and 3 min of washing). The control groups included unwashed, municipal water, ozone treatment, microbubble treatment, and sodium hypochlorite washing. The concentrations of residual chlorantraniliprole and dimethomorph after OMB treatment were found to be 16.10% and 19.39%, respectively, of those washed with municipal water. Treatments with only ozone or microbubble showed higher residual concentrations (40.89% and 22.19% for chlorantraniliprole, and 59.37% and 35.47% for dimethomorph, respectively). Using water washing as the baseline, OMB reduced S. Typhimurium and E. coli by 2.11 and 2.31 log CFU g−1, respectively, whereas the reduction achieved by ozone or microbubble treatments alone was lower (∼1 log CFU g−1). Finally, there were no significant differences in the physical characteristics of the leaves (breaking force, cutting force, and color) between OMB and water washing. This study is the first to demonstrate the effective removal of pesticides and bacteria using OMB with the same operative parameters.
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•Optimum ozone microbubble (OMB) treatment was 3 min at 10 mg L-1 of ozone.•Average diameter of bubbles was 29.05 µm.•OMB reduced the two pesticides to 16.10% and 19.39% of those of water washing.•OMB achieved reductions of 2.11 and 2.31 log CFU g-1 of S. Typhimurium and E. coli.
With rapid spread of the urbanization, many environmental factors, such as climate, soil pH and nutrients have been changed. However, the plant pollination affected by urbanization was seldom ...conducted. Here, we studied the flower visitation rates, seed production, pollen limitation and flower morphological characters of Gentiana dahurica at 3 populations along an urban-peri-urban gradient around Xi'ning over 4 consecutive years, aiming to test the effects of urbanization on plant pollination service. Our results showed that the pollinator visit frequencies, interannual stability of pollinator assemblages and visit frequencies declined with the intensification of urbanization. As urbanization intensified, plant borne more flowers and the flower morphological sizes became "longer" (the length of flowers, filaments and styles were increased, but the width of flowers kept stable at the 3 populations); the flower duration, especially the female phase duration prolonged. The seed-set ratio of G. dahurica in natural condition decreased and more severe pollen limitation occurred in more urbanized populations. Also, an interannual variation of seed-set ratio and index of pollen limitation (IPL), which related with the variation of pollinator visit frequencies, were found in this study. These results suggest that the pollination service can be threatened by urbanization over a long-time interval for G. dahurica. This finding highlights the importance of pollinator affections acting on plant pollination system. Additionally, as pollinator assemblages and visit frequencies interannually changed, a long-time scale observation is needed to understand the plant-pollinator relationships.
•The changes of plant reproductive traits are strongly correlated with pollinators.•Changes of environmental conditions lead to the adjustment of plant resource allocation.•There is a trade-off ...between sexual reproduction and asexual reproduction.
That trade-offs result from the allocation of limited resources is a central concept of life history evolution. Many plants combine sexual reproduction with asexual reproduction, and the relationships between different reproductive modes reflect more general plant reproduction and resource allocation strategies, but how trade-offs between these reproductive modes affect fitness when plants face environmental changes, especially caused by changed growing seasons, is poorly understood. A long florescence (from late April to early November) and combined with sexual and asexual reproduction species, Trifolium repens, was selected in this study. We divided the flowering time of T. repens into three flowering phases, early (May to July), middle (July to September) and late (September to November), and compared the changes of environmental factors, pollinators, plant reproductive traits, resource allocation strategies and fitness of two reproductive modes at different phases, aiming to test how clonal plants change reproduction strategy to respond the environmental changes. Our results showed that the pollinator visitation activity was highest in early flowering phase and decreased as the season progressed. The seasonal fluctuations of environment condition and pollinators lead to significant differences in floral traits: the inflorescence size increased significantly in middle flowering phase (the flower length, flower numbers and inflorescence diameter were increased), and did not differ significantly between early and late flowering; the flower duration prolonged significantly in late flowering phase, but there was no significant difference between early and late flowering phase; inflorescence number and seed yield decreased along with the seasonal changing, i.e. bear the most at early, and the least inflorescences at late flowering phases. On the contrary, quantitative characteristics of stolon were increased as the season progressed. Correspondingly, a significant increase of resource allocated to sexual reproduction and decrease to asexual reproduction as the season progressed. These results indicate that the environmental factors in different flowering phases and corresponding variation in pollinators lead to different phenotypes, ultimately resulting in the divergence of plant reproductive traits. T. repens can adjust investment in the two reproductive modes with respect to the cost required for each new plant under different environment, and predicted to regulate overall fitness.
•Distinct limiting factors act on different early plant regeneration stages.•Both seed availability and interspecific competition restrict seedling emergence.•Only interspecific competition ...significantly impacts first-year seedling survival.•Survival of second-year seedlings is independent of all studied factors.•Population expansion suffers from same limiting factors as in the natural habitats.
Unraveling the mechanisms causing restricted regeneration and limited distribution range has become a core issue for biodiversity conservation. Anthropogenic disturbances are changing a variety of ecological factors, but how their relative importance varies across multiple regeneration stages is still unclear even in a single species. In this study, we focused on Metasequoia glyptostroboides, a relict species suffering a severely restricted regeneration in the wild, and performed controlled experiments using 54,600 seeds to investigate seedling emergence and growth in both its natural and adjacent unoccupied habitats to disentangle the roles of seed availability, interspecific competition and herbivore/omnivore attack across early regeneration stages. Our results showed that these factors mainly exerted their predominant effects at initial regeneration stages. Compared with herbivore/omnivore attack, seed availability and interspecific competition were the crucial factors regulating seedling emergence. The first-year seedling survival rate was only significantly influenced by interspecific competition, and the survival of second-year seedlings was independent of all these factors. Moreover, we detected similar impacts of these factors in the adjacent unoccupied habitats to those in the natural habitats, indicating their roles in limiting population expansion. Our findings provide some suggestions to assist the natural regeneration and range expansion of M. glyptostroboides, and our experiment design can be applied in the assessment of endangerment causes for other endangered plants.
•LiCl/HCl solution is considered as a medium to convert cellulose into glucose.•In this method, xylose and glucose yield is up to 81.8 and 79.1 mol%, respectively.•The unit total reducing sugar yield ...is about 682 g-sugar/kg-sugarcane bagasse.•The total reducing sugar yield is strongly influenced by LiCl concentration.•The optimum condition of cellulose hydrolysis can be obtained by using CRD.
Molten salt hydrates in diluted acid solutions are a great medium to dissolve cellulose by interrupting the formation of intra- and inter-hydrogen bonding in the crystalline structure of cellulose. In this study, lithium chloride in diluted HCl is used as an inexpensive and efficient way to dissolve and hydrolyze cellulose into glucose. 23 completely randomized design (CRD), including three replications at the center point, was applied to evaluate the effect of LiCl concentration, HCl concentration and cellulose concentration with respect to glucose yield. The composition of LiCl/HCl ionic solution for optimal glucose yield at 80 °C is determined to be 50 wt% of LiCl, 2 wt% of HCl, and 10 wt% of cellulose feedstock. A two stage method is designed for obtaining reducing sugars from sugarcane bagasse in which biomass is treated first with 2 wt% diluted HCl at 100 °C for xylose and then with LiCl/HCl ionic solutions in the second stage at 80 °C for glucose. Total reducing sugar yield of sugarcane bagasse is up to 94.8 wt% indicating that the developed LiCl/HCl ionic solution has potential to treat cellulose for the production of inexpensive fermentable sugar.
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To evaluate the effect of fluctuations in waist circumference (WC), weight, and body mass index (BMI) on the incidence of diabetes in older adults. A prospective cohort of 61,587 older adults (age, ...60-96 years) who did not have diabetes at study initiation was examined. Data on weight, BMI, and WC were collected, and participants were followed up until 31 December 2018. The main end point was new-onset diabetes. A Cox regression model was used to estimate the risk of diabetes (hazard ratios HRs and confidence intervals CI) in these participants. During a mean follow-up of 3.6 years, being overweight (HR 95% CI 1.87 1.62-2.17), obesity (1.41 1.26-1.59), abdominal obesity (1.42 1.28-1.58), and obesity plus abdominal obesity at baseline (1.93 1.66-2.25) increased the risk of diabetes onset. Compared with older adults who "maintained normal WC", those who "remained abdominally obese" (HR = 1.66), "became abdominally obese" (HR = 1.58), or "achieved normal WC" (HR = 1.36) were at a higher risk of diabetes onset, as well as those with an increase in WC > 3 cm or > 5% compared with the baseline level. Weight gain or loss > 6 kg or weight gain > 5%, increase or decrease in BMI > 2 kg/m.sup.2, or an increase in BMI > 10% were associated with a higher diabetes risk. The diabetes risk was reduced by 19% in overweight older adults who exercised daily. For older adults, WC, BMI, and healthy weight maintenance reduce the diabetes risk. The findings may provide evidence for developing guidelines of proper weight and WC control for older adults.
There is a lack of relevant studies evaluating the long-term impact of cardiovascular health factor (CVH) metrics on chronic kidney disease (CKD).
This study investigates the long-term change in CVH ...metrics in older people and explores the relationship between CVH metrics trajectory and CKD.
In total, 27,635 older people aged over 60 from the community-based Tianjin Chronic Kidney Disease Cohort study were enrolled. The participants completed five annual physical examinations between January 01, 2014, and December 31, 2018, and a subsequent follow-up between January 01, 2019, and December 31, 2021. CVH metrics trajectories were established by the group-based trajectory model to predict CKD risk. The relationships between baseline CVH, CVH change (ΔCVH), and CKD risk were also explored by logistic regression and restricted cubic spline regression model. In addition, likelihood ratio tests were used to compare the goodness of fit of the different models.
Six distinct CVH metrics trajectories were identified among the participants: low-stable (11.19%), low-medium-stable (30.58%), medium-stable (30.54%), medium-high-decreased (5.46%), medium-high-stable (18.93%), and high-stable (3.25%). After adjustment for potential confounders, higher CVH metrics trajectory was associated with decreased risk of CKD (P for trend < 0.001). Comparing the high-stable with the low-stable group, the risk of CKD decreased by 46%. All sensitivity analyses, including adjusting for baseline CVH and removing each CVH component from the total CVH, produced consistent results. Furthermore, the likelihood ratio test revealed that the model established by the CVH trajectory fit better than the baseline CVH and Δ CVH.
The higher CVH metrics trajectory and improvement of CVH metrics were associated with decreased risk of CKD. This study emphasized the importance of improving CVH to achieve primary prevention of CKD in older people.
is an increasingly important cause of invasive candidiasis. In China, relatively little is known of the molecular epidemiology of
and of its antifungal susceptibility patterns. Here we studied 411 ...non-duplicate
isolates from 411 patients at 11 hospitals participating in the National China Hospital Invasive Fungal Surveillance Net program (CHIF-NET; 2010-2014). Genotyping was performed using multilocus sequence typing (MLST) employing six genetic loci and by microsatellite analysis. Antifungal susceptibility testing was performed using Sensititre YeastOne™ YO10 methodology. Of 411 isolates, 35 sequence types (ST) were identified by MLST and 79 different genotypes by microsatellite typing; the latter had higher discriminatory power than MLST in the molecular typing of
. Using MLST, ST7 and ST3 were the most common STs (66.4 and 9.5% of all isolates, respectively) with 24 novel STs identified; the most common microsatellite types were T25 (30.4% of all isolates) and T31 (12.4%). Resistance to fluconazole (MIC > 32 μg/mL) was seen in 16.5% (68/411) of isolates whilst MICs of >0.5 μg/mL for voriconazole, >2 μg/mL for itraconazole and >2 μg/mL for posaconazole were seen for 28.7, 6.8, and 7.3% of isolates, respectively; 14.8% of all isolates cross-resistant/non-wide-type to fluconazole and voriconazole. Fluconazole resistant rates increased 3-fold over the 5-year period whilst that of isolates with non-WT MICs to voriconazole, 7-fold. All echinocandins exhibited >99% susceptibility rates against all isolates but notably one isolate exhibited multi-drug resistance to the azoles and echinocandins. The study has provided a global picture of the molecular epidemiology and drug resistance rates of
in China during the period of the study.
Accurate species identification of Candida, Cryptococcus, Trichosporon and other yeast pathogens is important for clinical management. In the present study, we developed and evaluated a yeast species ...identification scheme by determining the rDNA internal transcribed spacer (ITS) region length types (LTs) using a sequencer-based capillary gel electrophoresis (SCGE) approach. A total of 156 yeast isolates encompassing 32 species were first used to establish a reference SCGE ITS LT database. Evaluation of the ITS LT database was then performed on (i) a separate set of (n = 97) clinical isolates by SCGE, and (ii) 41 isolates of 41 additional yeast species from GenBank by in silico analysis. Of 156 isolates used to build the reference database, 41 ITS LTs were identified, which correctly identified 29 of the 32 (90.6%) species, with the exception of Trichosporon asahii, Trichosporon japonicum and Trichosporon asteroides. In addition, eight of the 32 species revealed different electropherograms and were subtyped into 2-3 different ITS LTs each. Of the 97 test isolates used to evaluate the ITS LT scheme, 96 (99.0%) were correctly identified to species level, with the remaining isolate having a novel ITS LT. Of the additional 41 isolates for in silico analysis, none was misidentified by the ITS LT database except for Trichosporon mucoides whose ITS LT profile was identical to that of Trichosporon dermatis. In conclusion, yeast identification by the present SCGE ITS LT assay is a fast, reproducible and accurate alternative for the identification of clinically important yeasts with the exception of Trichosporon species.
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