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Abstract Background All the scoring methods for the DLQI miss the moderate impact of the disease on patients, which may underestimate the impact of psoriasis on patients’ quality of life. To improve the accuracy of the assessment of the Dermatology Life Quality Index score (DLQI) for patients with psoriasis, this study proposed and validated a new scoring method, the DLQI-NS, which includes the moderate impact option in the self-assessment of each item in psoriasis patients. Methods A cross-sectional study was conducted in which patients with psoriasis were enrolled. A total of 425 participants completed the DLQI, DLQI-NS and Skindex-16 questionnaires. Reliability, validity, ceiling and floor effects were evaluated of both DLQI and DLQI-NS questionnaires. Results About 14.4-32.5% of the patients reported a moderate impact on quality of life. The DLQI-NS allowed 17 more patients (4.0%) to achieve severe disease. The Cronbach’s alpha coefficient of the DLQI-NS was 0.90, and that of the DLQI was 0.89. The KMO test results for the DLQI-NS and DLQI were 0.927 and 0.916, respectively. One factor was identified for each questionnaire. The items of the DLQI-NS showed an item-total correlation from 0.52 to 0.82, and the DLQI questionnaire’s item-total correlation ranged from 0.47 to 0.83. The DLQI-NS, DLQI total score and Skindex-16 had Spearman’s rank correlation coefficients of 0.89 and 0.84, respectively. Both the DLQI-NS and DLQI showed significant moderate correlations with the BSA (0.51 vs. 0.50) and PASI (0.47 vs. 0.46). No ceiling effects were observed for any of the items of both questionnaires. Conclusion The validity and reliability of the DLQI-NS and DLQI were good, but the DLQI-NS was superior to the DLQI. The DLQI-NS is an effective self-assessment tool for assessing quality of life in psoriasis patients.

Objectives: To explore the risk factors and clinical outcomes of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and establish nomograms to predict the probability of CRKP infection and mortality in adult patients. Methods: Patients infected with KP from August 2019 to April 2021 in a tertiary hospital in Shanghai were enrolled. Risk factors associated with CRKP and 30-day mortality were identified using multivariate logistic regression analysis and Cox regression analysis. Results: Overall, 467 patients with KP infection were enrolled, wherein 210 (45.0%) patients were infected with CRKP and 257 (55.0%) patients with carbapenem-susceptible K. pneumoniae (CSKP). Five factors, namely Charlson's Comorbidity Index (CCI) ≥ 3, the use of central venous catheterization, prior hospitalization during the 3 months before infection, and previous exposure to carbapenems and broad-spectrum β-lactams, were found to be independently associated with CRKP infection. Based on these parameters, the nomogram showed a better performance as indicated by C-index of 0.94 (95% confidence interval [CI]: 0.92–0.96) and well-fitted calibration curves. CRKP was independently associated with 30-day mortality. Multivariate Cox regression analysis revealed that age ≥65 years, higher CCI scores, higher Sequential Organ Failure Assessment scores, the presence of respiratory failure, albumin levels ≤30 g/L, and non-appropriate treatments in 3 days, were associated with 30-day mortality. Conclusion: The predictive nomogram established in this study can facilitate the clinicians to make better clinical decisions when treating patients with KP infection. [ABSTRACT FROM AUTHOR]

Alfalfa (Medicago sativa L.) grown in acidic soils is often affected by phosphorus (P) deficiency, which results in reduced mineral nutrient content and forage quality. In this context, the effects of phosphorus (P) fertiliser remain unclear. In this study, we analysed the effects of P application on mineral nutrient content and forage quality in aluminium (Al)-sensitive (Longzhong) and Al-tolerant (Trifecta) alfalfa cultivars cultivated in two acidic soil environments. Mineral nutrient content and quality were affected by genotype, soil type, and P treatment concentration (p < 0.001). In limestone soil, for Longzhong and Trifecta, the optimal potassium (K), calcium (Ca), and magnesium (Mg) contents as well as crude protein content (CP) and ether extract (EE) values were observed at 20 mg P kg−1, that of the P content was observed at 40 mg P kg−1, and the minimum neutral detergent fibre (NDF) acid detergent lignin (ADL) values were observed at 40 mg P kg−1. In yellow soil, the maximum K, Ca, Mg, and P contents in Longzhong and Trifecta were observed at 40 mg P kg−1, whereas the maximum CP, EE, and ADL values were observed at 20 mg P kg−1. Our study provides an empirically based framework for optimising alfalfa fertilisation programmes in acidic soils. [ABSTRACT FROM AUTHOR]

This study presents the investigation of magnetic dipole transition lines of W13+ ions in the wavelength range of 200–700 nm at a low-energy electron beam ion trap. Seventeen lines emitted from W13+ ions have been observed with three being reported experimentally for the first time. The atomic structure calculation and spectra simulation of W13+ ions have been carried out using the multiconfiguration Dirac–Hartree–Fock method combined with the relativistic configuration interaction approach and the collisional–radiative model, respectively. The theoretical calculations are in reasonable agreement with the experimental observations, and most of the observed lines have been identified. [ABSTRACT FROM AUTHOR]

Background: Polymyxin B (PMB)-based combination therapies are used to treat severe carbapenem-resistant gram-negative bacterial (CR-GNB) infections. This observational study investigated the relationship between clinical factors, including PMB concentration, and clinical efficacy and safety. Patients and Methods: Polymyxin B regimens were optimized through therapeutic drug monitoring (TDM) and area under the concentration-time curve (AUC). In all, 382 samples were tested from 130 patients. Logistic regression was used to analyze the relationships between variables with clinical efficacy and 30-day mortality factors were analyzed by Cox regression. The sensitivity and specificity of Cmin and AUC for the occurrence of acute kidney injury (AKI) were determined by ROC curve analysis. Results: The clinical effectiveness of PMB was 65.4%. Multivariate logistic regression analysis revealed that lung infection, continuous renal replacement therapy, and C-reactive protein were independent factors significantly associated with efficacy. AKI occurred in 14.6% of the patients during treatment; age > 73 years (OR: 3.63; 95% CI: 1.035– 12.727; P = 0.044), Cmin greater than 2.3 μg/mL (OR: 7.37; 95% CI: 1.571– 34.580; P = 0.011), combined vancomycin (OR: 9.47; 95% CI: 1.732– 51.731; P = 0.009), and combined piperacillin-tazobactam (OR: 21.87; 95% CI: 3.139– 152.324; P = 0.002) were independent risk factors. The identified PMB cut-offs for predicting AKI were Cmin = 2.3 μg/mL and AUC = 82.0 mg h/L. Conclusion: Polymyxin B-based combination regimens are effective in treating CR-GNB infections, particularly bloodstream infections, but have shown unsatisfactory for lung infections. Cmin ≥ 2.3 μg /mL and AUC ≥ 82.0 mg h/L may increase PMB-associated AKI incidence. PMB dose should be adjusted based on TDM to ensure efficacy. [ABSTRACT FROM AUTHOR]

The deteriorating soil health under continuous monoculture is commonly found across various cropping systems. This study evaluated the effects of different tillage practices (conventional tillage and no till) and species mixtures (legumes and grasses) on arbuscular mycorrhizal fungi (AMF) community properties, soil nutrients, and enzyme activity in a 3-year experiment. Compared with traditional tillage, the number of AMF species under no-till conditions was increased, with the Glomus group being dominant. Under different tillage conditions, TN (total N) and AN (available N) contents under no till were significantly higher than those under conventional tillage, while no significant differences among other nutrients were found. The activities of soil acid phosphatase (S-ACP), soil dehydrogenase (S-DHA), and soil sucrose (S-SC) under conventional tillage were significantly higher than those under no till, and the cover crop mixtures also had an exclusive advantage in yield. Soil organic matter (SOM) indicated a significant negative correlation with glomalin-related soil protein (GRSP). The increase in diversity associated with the AMF species community was strongly correlated with the increase in three enzyme activities, and AN was negatively correlated with all species. Tillage did not significantly change soil chemistry, except for AN, and the high concentration of AN led to a decrease in AMF species. The results of this study showed that no till was an effective measure for enriching soil micro-organism population. Additionally, soil AMF diversity was improved by cover crop mixtures, and microbial diversity was higher than that under monoculture cover crops. Different AMF groups responded differently to tillage and cover crop mixtures. Across all mixtures, the combination of hairy vetch (Vicia villosa R.) and ryegrass (Lolium perenne L.) performed the best. [ABSTRACT FROM AUTHOR]

Objective To compare the dosimetric characteristics of single-arc volumetric modulated arc therapy(VMAT) and 5-field dynamic intensity-modulated radiotherapy(dIMRT) for early-stage peripheral lung adenocarcinoma patients with spherical or spheroidal tumor lesions, and explore the appropriate curvature of single-arc VMAT. Methods We collected 32 early-stage peripheral lung adenocarcinoma patients with spherical or spheroidal tumor lesions and designed three treatment plans for selected cases: single-arc 180° and single-arc 360° VMAT and 5-field dIMRT. The volume of each parameter was compared. Results The three types of plans could meet all the dosimetric requirements of the clinical target area. There was no significant statistical difference in maximum dose(Dmax), minimum dose(Dmin), mean dose(Dmean), homogeneity index(HI) and conformity index(CI) of PTV among three groups (P > 0.05). The mean lung dose (MLD), V5, V10 and V20 of the bilateral-lungs and affected-lung in the dIMRT plan group were lower than those of the other two single-arc VMAT plans, and those of single-arc 360° VMAT plan were slightly higher than those of the single-arc 180° VMAT plan (P < 0.05). Dmean of spinal cord was the lowest in dIMRT group and the highest in single-arc 360° VMAT group (P < 0.05). Dmean of esophagus in dIMRT group was less than those in the single-arc VMAT groups (P < 0.05). MUs was the lowest in dIMRT group and the highest in single-arc 360° VMAT group (P < 0.05). Conclusion For early-stage peripheral lung adenocarcinoma patients with spherical or spheroidal tumor lesions, 5-field dIMRT is preferred; for single-arc VMAT, 180° single-arc is better.

Spectral lines of the magnetic-dipole transition between the 3 d 2 D 3 / 2 , 5 / 2 levels of K-like Kr17+, Zr21+, Nb22+, Mo23+, and Ru25+ ions were measured in a compact electron beam ion trap. By means of dedicated calibration methods, the transition wavelengths of Kr17+, Zr21+, and Mo23+ ions reduce uncertainties by at least one order of magnitude and the wavelengths of Nb22+ and Ru25+ ions are measured for the first time at a few ppm level. In addition, the fine-structure energy splittings were systematically calculated using the multiconfiguration Dirac–Hartree–Fock method combined with the relativistic configuration interaction approach. The contributions of the core-valence and core-core electron correlations, the Breit interaction and QED effect were discussed in detail. The results show that it is essential to include deep core-valence correlation of L -shell and core-core valence correlation of 3 p subshell to obtain an agreement better than 0.15% with existing experimental values. The calculation model can be performed to predict the wavelength within a high accuracy for a wide range of potassium-like ions. [ABSTRACT FROM AUTHOR]

This work reported the investigation of optical spectra of Rh-like Xe9+ and Ru-like Xe10+ ions at a low-energy electron beam ion trap. The line from 4d92D3/2–2D5/2 M1 transition of Xe9+ ions was remeasured, the wavelength of which was determined to be 598.365(5) nm, and the uncertainty was significantly improved. In the region of 200–700 nm, four spectral lines emitted from Xe10+ ions were directly observed for the first time. The relativistic many-body perturbation method was adopted for the investigation of fine structure in Xe10+ ions. The theoretical and experimental results were in good agreement within 2%, and the four observed lines of Xe10+ ions were identified. [ABSTRACT FROM AUTHOR]