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Abstract Healthcare-associated infections (HAIs) represent a major global health burden, which necessitate effective frameworks to identify potential risk factors and estimate the corresponding direct economic disease burden. In this article, we proposed a framework designed to address these needs through a case study conducted in a Tuberculosis (TB) hospital in Hubei Province, China, using data from 2018 to 2019. A comprehensive multistep procedure was developed, including ethical application, participant inclusion, risk factor identification, and direct economic disease burden estimation. In the case study, ethical approval was obtained, and patient data were anonymized to ensure privacy. All TB hospitalized patients over the study period were included and classified into groups with and without HAIs after screening the inclusion and exclusion criteria. Key risk factors, including gender, age, and invasive procedure were identified through univariate and multivariate analyses. Then, propensity score matching was employed to select the balanced groups with similar characteristics. Comparisons of medical expenditures (total medical expenditure, medicine expenditure, and antibiotics expenditure) and hospitalization days between the balanced groups were calculated as the additional direct economic disease burden measures caused by HAIs. This framework can serve as a tool for not only hospital management and policy-making, but also implementation of targeted infection prevention and control measures. Moreover, it has the potential to be applied in various healthcare settings at local, regional, national, and international levels to identify high-risk areas, optimize resource allocation, and improve hospital management and governance, as well as inter-organizational learning. Challenges to implement the framework are also raised, such as data quality, regulatory compliance, considerations on unique nature of communicable diseases and other diseases, and training need for professionals.

BackgroundThe incidence and mortality rates of cancer are the highest globally. Developing novel methodologies that precisely, safely, and economically differentiate between benign and malignant lung conditions holds immense clinical importance. This research seeks to construct a predictive model utilizing a combination of diverse biomarkers to effectively discriminate between benign and malignant lung diseases.MethodsThis retrospective study included patients admitted to the two general hospitals in Shanghai from 2014 to 2015. This study was developed using five tumor markers: carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), cytokeratin fragment 21-1 (CA211), squamous cell carcinoma antigen (SCC), and neuron specific enolase (NSE). The entire sample was divided into two groups according to the hospital: 1033 cases were included in the development cohort and 300 cases in the validation cohort. Logistic regression analysis was used for univariate analysis to explore individual correlations between each selected clinical variable and lung cancer diagnostic outcome. Diagnostic prediction models were constructed and validated based on independent prognostic factors identified using multifactorial analysis. A nomogram was created using these tumor markers (age and sex were additionally included) and validated using the concordance index and calibration curves. Clinical prediction models were evaluated using decision curve analysis.ResultsFully adjusted multivariate analysis showed that the risk of lung cancer was 2.38 times higher in men than in women. CEA positivity was associated with an 13.41-fold increased risk in lung cancer. The area under the curve (AUC) values for the development cohort and validation cohort models were 0.907 and 0.954, respectively. In the established nomogram, the AUC for the receiver operating characteristic curve was 0.907 (95% CI, 0.889–0.925). The validation model confirmed the strong discriminative power of the nomogram (AUC = 0.954). The described calibration curves demonstrated good fit predictions and observation probabilities. In addition, decision curve analysis concluded that the newly established nomogram has important implications for clinical decision making.ConclusionsCombined prediction models based on CEA, CA199, CA211, SCC, and NSE biomarkers could significantly the differentiation between benign and malignant lung diseases, thus facilitating better clinical decision making.

Discrimination between tectonic and non-tectonic events is crucial to assess seismic hazards and manage associated risks. However, the discrimination process is challenging due to the imbalanced distribution of tectonic and non-tectonic events. In this paper, we propose a ghost-attention network (GA-Net) consisting of multiple ghost modules and convolutional block attention modules (CBAMs) to solve this problem. Ghost module allows the network to extract feature maps using cost effective operations, which are suitable for small and unbalanced training sets. CBAM emphasizes meaningful features along channel and spatial axes, effectively learning which information to emphasize or suppress. We train the proposed GA-Net using seismic data from Shaanxi Province in China. The evaluation shows that on the test set, the proposed GA-Net achieves sensitivity, specificity, and accuracy of 96.40%, 93.24%, and 95.75%, respectively. In addition, a comparative analysis with several state-of-the-art networks establishes its superiority. Our GA-Net exhibits robust generalized performance on several training sets with different imbalanced levels and an independent dataset.

Unsatisfactory macroscopic strength is one of the important reasons that limit the application of cellulose composites. However, the mechanical properties of cellulose composites could be improved by the directional orientation of cellulose nanofibers. In this paper, a five-channel microfluidic chip was designed to fabricate core-sheath cellulose nanocrystal/ cationic polyacrylamide (CNC/CPAM) composite filament. The core spinning solution with high flow velocity promoted the extended arrangement of CPAM in sheath flow. CPAM with long chain structure could not only reduce the electrostatic repulsion between CNCs, but also ensures the fiber orientation by inhibiting the disorderly diffusion of CNCs, thus improving the toughness of the composite filament. The orientation of the composite fiber was studied by wide-angle X-ray scattering, showing an orientation index of 0.725. The mechanical properties of the composite fiber were tested by a universal material testing machine. The tensile strength was 510 ± 20 MPa, which was about 117% higher than that of pure CNC spun fiber, and the elongation at break was also increased by about 70%. The improvement in mechanical properties was attributed to the increase in the content of intramolecular and intermolecular hydrogen bonds. In addition, the demonstrated spinning technology provided a new way for preparing high-performance composite fibers.

Agricultural Photovoltaic (APV) has become more popular worldwide. Its core idea is to generate electricity and grow crops simultaneously on the same farmland. We developed two APV, Spectrum Splitting and Concentrated APV (SCAPV) and Even-lighting Agricultural Photovoltaic (EAPV). Our previous studies have investigated electricity generation, enhanced growth of plants/crops, and reduced water evaporation simultaneously on the same farmland. Furthermore, SCAPV and EAPV examined the better quality and increased yield of many plants, such as lettuce and cucumber. However, the effects of SCAPV and EAPV on sweet potato quality and yield have not been studied. Therefore, this study aims to investigate the impact of SCAPV and EAPV on evapotranspiration (ET) and sweet potato quality and yield. We conducted three treatments: SCAPV, EAPV, and open-air (CK). We planted 32 m2 of sweet potatoes and placed a weather station in each treatment. Our results showed that the 32 m2 of sweet potato yield under SCAPV, EAPV, and CK were 121.53 kg, 99.55 kg, and 77.84 kg, respectively. The dry rate in CK was 11.75% lower than 13.41% and 13.81% under SCAPV and EAPV, respectively. Soluble sugar content increased under EAPV. Anthocyanin content under SCAPV improved. Therefore, SCAPV and EAPV positively affect dry matter accumulation and enhance the sweet potato's growth. Average ET under SCAPV and EAPV compared with CK significantly reduced by 31% and 23%. SCAPV and EAPV could reduce irrigation and provide feasible green energy and sustainable APV solutions.

Abstract Radiation enteropathy (RE) is common in patients treated with radiotherapy for pelvic–abdominal cancers. Accumulating data indicate that gut commensal bacteria determine intestinal radiosensitivity. Radiotherapy can result in gut bacterial dysbiosis. Gut bacterial dysbiosis contributes to the pathogenesis of RE. Mild to moderate depressive symptoms can be observed in patients with RE in clinical settings; however, the rate of these symptoms has not been reported. Studies have demonstrated that gut bacterial dysbiosis induces depression. In the state of comorbidity, RE and depression may be understood as local and abscopal manifestations of gut bacterial disorders. The ability of comorbid depression to worsen inflammatory bowel disease (IBD) has long been demonstrated and is associated with dysfunction of cholinergic neural anti‐inflammatory pathways. There is a lack of direct evidence for RE comorbid with depression. It is widely accepted that RE shares similar pathophysiologic mechanisms with IBD. Therefore, we may be able to draw on the findings of the relationship between IBD and depression. This review will explore the relationship between gut bacteria, RE, and depression in light of the available evidence and indicate a method for investigating the mechanisms of RE combined with depression. We will also describe new developments in the treatment of RE with probiotics, prebiotics, and fecal microbial transplantation.

Plant glutamate receptor (GLR) homologs are crucial calcium channels that play an important role in plant development, signal transduction, and response to biotic and abiotic stresses. However, the GLR gene family has not yet been thoroughly and systematically studied in sweet potato. In this study, a total of 37 GLR genes were identified in the cultivated hexaploid sweet potato (Ipomoea batatas), and 32 GLR genes were discovered in each of the two diploid relatives (Ipomoea trifida and Ipomoea triloba) for the first time. Based on their evolutionary relationships to those of Arabidopsis, these GLRs were split into five subgroups. We then conducted comprehensive analysis to explore their physiological properties, protein interaction networks, promoter cis-elements, chromosomal placement, gene structure, and expression patterns. The results indicate that the homologous GLRs of the cultivated hexaploid sweet potato and its two relatives are different. These variations are reflected in their functions related to plant growth, hormonal crosstalk, development of tuberous roots, resistance to root rot, and responses to abiotic stress factors, all of which are governed by specific individual GLR genes. This study offers a comprehensive analysis of GLR genes in sweet potato and its two diploid relatives. It also provides a theoretical basis for future research into their regulatory mechanisms, significantly influencing the field of molecular breeding in sweet potatoes.

There are great differences in fruit planting techniques due to different regional environments. Farmers can't use the same standard in growing fruit. Most of the information about fruit planting comes from the Internet, which is characterized by complexity and heterogeneous multi-source. How to deal with such information to form the convenient facts becomes an urgent problem. Information extraction could automatically extract fruit cultivation facts from unstructured text. Temporal information is especially crucial for fruit cultivation. Extracting temporal facts from the corpus of cultivation technologies for fruit is also vital to several downstream applications in fruit cultivation. However, the framework of ordinary triplets focuses on handling static facts and ignores the temporal information. Therefore, we propose Basic Fact Extraction and Multi-layer CRFs (BFE-MCRFs), an end-to-end neural network model for the joint extraction of temporal facts. BFE-MCRFs describes temporal knowledge using an improved schema that adds the time dimension. Firstly, the basic facts are extracted from the primary model. Then, multiple temporal relations are added between basic facts and time expressions. Finally, the multi-layer Conditional Random Field are used to detect the objects corresponding to the basic facts under the predefined temporal relationships. Experiments conducted on public and self-constructed datasets show that BFE-MCRFs achieves the best current performance and outperforms the baseline models by a significant margin.

The prevalence of convolutional neural networks is hindered by their intricate structure and voluminous parameters, which consume significant processing resources during both training and inference. This study proposes a novel approach that involves treating convolutional kernels as tensors, utilizing suitable priori metrics to gauge their effectiveness, and employing a clustering algorithm to eliminate redundant convolutional kernels for network pruning. To measure the convolutional kernels, we use appropriate priori metrics and density-Based spatial clustering of applications with noise (DBSCAN) to cluster the convolutional kernels so that the cluster centroids are the reserved convolution kernels. The experimental results show that the method can effectively perform network lightweight while maintaining high accuracy. At the same time, the method can improve the efficiency of convolutional kernel utilization, thus reducing the computational resource consumption of the model. Empirical analyses conducted on datasets indicate that, in certain instances, the proposed pruning method outperforms established state-of-the-art methods.

Abstract Knowledge extraction aims to identify entities and extract relations between them from unstructured text, which are in the form of triplets. Analysis of the fruit nutrition domain corpus revealed many overlapping triplets, that is, multiple correspondences between a subject and multiple objects or the same subject and object. The current relevant methods mainly target the extraction of ordinary triplets, which cannot accurately identify overlapping triplets. To solve this problem, a deep learning based model for overlapping triplet extraction is proposed in this study. The relation is modeled as a function that maps a subject to an object. The hybrid information of the subject is entered into the relation-object extraction model to detect the object and relation. The experimental results show this model outperforms existing extraction models and achieves state-of-the-art performance on the manually labeled fruit nutrition domain dataset. In terms of application value, the proposed work can obtain a high-quality and structured fruit nutrition knowledge base, which provides application fundamentals for downstream applications of nutrition matching.

Improving the productivity and relative efficiency of traditional Chinese medicine (TCM) hospitals is pivotal for hospital managers and policymakers to optimize the utilization of TCM resources in China. This study aimed to measure the productivity and relative efficiency of public tertiary TCM hospitals in Hubei Province. The input and output indicators data were extracted from the Health Commission of Hubei Province (HCHP) from 2019 to 2021. The Bootstrap-Malmquist-DEA model was employed to measure the productivity and relative efficiency of the hospitals. The statistical significance was set at P

ABSTRACT: Objectives: Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) have posed major challenges to South Asia. The purpose of this study is to explore the direct medical economic burden attributable to HAIs and AMR in Nepal. Methods: A prospective study was conducted in a teaching hospital of Nepal from 16 December 2017 to 16 April 2018. The demographic, clinical, and financial expense data were extracted from medical records, laboratory reports, and hospital information system. STATA 12.0 was used to conduct descriptive analysis, χ2 test, t test, and propensity score matching. Results: The prevalence of HAIs was 3.31% in the hospital. The additional total medical expenses, medicine expenses, out-of-pocket expenses, and hospitalisation days per inpatient attributable to HAIs were $164.63, $114.96, $150.79, and 7 days, respectively. In contrast, the additional direct medical economic burden attributable to HAIs-AMR were US$ 381.15, US$ 202.37, US$ 370.56, and 9 days for each of the counterpart variables. The percentage of out-of-pocket expenses to total medical expenses was 94.24% among the HAIs inpatients, and the percentage was 96.75% among the HAIs-AMR inpatients. Conclusions: The prevalence of HAIs in the hospital was low, which might be underestimated in a resource-constrained setting. Therefore, this study can only be considered a preliminary one. Moreover, the additional direct medical economic burden was extraordinarily high among the HAIs and the HAIs-AMR inpatients, and most of the expenses were borne by themselves. A systemic solution for sustainable governance is required.

Drought stress (DS) is a potential abiotic stress that is substantially reducing crop productivity across the globe. Likewise, salinity stress (SS) is another serious abiotic stress that is also a major threat to global crop productivity. The rapid climate change increased the intensity of both stresses which pose a serious threat to global food security; therefore, it is urgently needed to tackle both stresses to ensure better crop production. Globally, different measures are being used to improve crop productivity under stress conditions. Among these measures, biochar (BC) has been widely used to improve soil health and promote crop yield under stress conditions. The application of BC improves soil organic matter, soil structure, soil aggregate stability, water and nutrient holding capacity, and the activity of both beneficial microbes and fungi, which leads to an appreciable increase in tolerance to both damaging and abiotic stresses. BC biochar protects membrane stability, improves water uptake, maintains nutrient homeostasis, and reduces reactive oxygen species production (ROS) through enhanced antioxidant activities, thereby substantially improving tolerance to both stresses. Moreover, BC-mediated improvements in soil properties also substantially improve photosynthetic activity, chlorophyll synthesis, gene expression, the activity of stress-responsive proteins, and maintain the osmolytes and hormonal balance, which in turn improve tolerance against osmotic and ionic stresses. In conclusion, BC could be a promising amendment to bring tolerance against both drought and salinity stresses. Therefore, in the present review, we have discussed various mechanisms through which BC improves drought and salt tolerance. This review will help readers to learn more about the role of biochar in causing drought and salinity stress in plants, and it will also provide new suggestions on how this current knowledge about biochar can be used to develop drought and salinity tolerance.

Background COVID-19 has affected research productivity across all areas of knowledge. Current evidence suggests that COVID-19 has had a blockbuster effect on journal impact factors (JIFs) and publication trends, while little is known on global health journals.Methods Twenty global health journals were included to analyse the impact of COVID-19 on their JIFs and publication trends. Indicator data, including numbers of publications, citations, articles with different types, etc, were extracted from journal websites and Web of Science Core Collection database. The JIFs from 2019 to 2021 were simulated for longitudinal and cross-sectional analyses. Interrupted time-series analysis and non-parametric tests were applied to assess whether COVID-19 had decreased non-COVID-19 publications from January 2018 to June 2022.Results In 2020, 615 out of 3223 publications were COVID-19 related, accounting for 19.08%. The simulated JIFs of 17 out of 20 journals in 2021 were higher than those in 2019 and 2020. Notably, 18 out of 20 journals had a decrease in their simulated JIFs after excluding COVID-19-related publications. Moreover, 10 out of 20 journals decreased their monthly numbers of non-COVID-19 publications after the COVID-19 outbreak. For all the 20 journals as a whole, after the COVID-19 outbreak in February 2020, the total number of non-COVID-19 publications significantly decreased by 14.2 compared with the previous month (p=0.013), and since then, on average, the publications had decreased by 0.6 per month until June 2022 (p

Abstract Background China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals. Methods Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the $$\widehat{{\uptau }}$$ τ ^ 2 and I 2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P

Information extraction (IE) is an important part of the entire knowledge graph lifecycle. In the food domain, extracting information such as ingredient and cooking method from Chinese recipes is crucial to safety risk analysis and identification of ingredient. In comparison with English, due to the complex structure, the richness of information in word combination, and lack of tense, Chinese IE is much more challenging. This dilemma is particularly prominent in the food domain with high-density knowledge, imprecise syntactic structure. However, existing IE methods focus only on the features of entities in a sentence, such as context and position, and ignore features of the entity itself and the influence of self attributes on prediction of inter entity relationship. To solve the problems of overlapping entity recognition and multi-relations classification in the food domain, we propose a span-based model known as SpIE for IE. The SpIE uses the span representation for each possible candidate entity to capture span-level features, which transforms named entity recognition (NER) into a classification mission. Besides, SpIE feeds extra information about the entity into the relation classification (RC) model by considering the effect of entity's attributes (both the entity mention and entity type) on the relationship between entity pairs. We apply SpIE on two datasets and observe that SpIE significantly outperforms the previous neural approaches due to capture the feature of overlapping entity and entity attributes, and it remains very competitive in general IE.

Abstract Background Maternal and child health (MCH) hospitals play an essential role in providing MCH services in China, while the supply has become increasingly challenging in the past decade, especially among secondary MCH hospitals. In this study we aimed to evaluate the technical efficiency (TE) of secondary MCH hospitals in Hubei province (China) to generate evidence-based decision-making for efficiency improvement. Methods The data were collected from the Department of Maternal and Child Health of Health Commission of Hubei Province in 2019. A total of 59 out of 74 secondary MCH hospitals were included as our study sample. Four input indicators (number of health professionals, number of beds, number of equipment with value greater than 10,000 RMB Yuan, building area for hospital operations) and three output indicators (number of total diagnostic patients, number of discharged patients, and number of birth deliveries) were selected based on previous literature. TE scores of the sample hospitals were estimated by using Bootstrap-Data Envelopment Analysis (Bootstrap-DEA). Results After bias-correction with Bootstrap-DEA model, the average TE score of the MCH hospitals was 0.673. 20 (33.89%) MCH hospitals had TE scores below the average. No MCH hospitals achieved excellent efficiency; 16 (27.11%) MCH hospitals reached good efficiency; and 26 (44.06%) MCH hospitals fell into poor and failing efficiency. Besides, 17 MCH hospitals had TE scores of 1 before bias-corrections, while none of them reached 1 after bias correction. Conclusions Significant capacity variations existed among the secondary MCH hospitals in terms of input and output indicators and their overall TE was low in Hubei of China. For better improvement, the secondary MCH hospitals in Hubei need to improve their internal management and strengthen the construction of their information systems. A series of policy supports are needed from the health and insurance administrations to optimize health resources. Third-party performance evaluation can be piloted to improve efficiency and overall performance of the MCH hospitals. The policy recommendations we raise for MCH hospitals in Hubei can be worth learning for some low- and middle- income countries.

Background: Lung adenocarcinoma (LUAD) is one of the most common and lethal cancer types worldwide. LINC0572 is a long non-coding RNA (lncRNA) that has been associated with the clinical characteristics of several types of malignancy. However, the biological mechanism of LINC0572 in LUAD is still unclear and remains to be elucidated. Methods: R packages and online bioinformatic tools were used to investigate the biological characteristics of LINC01572, including its abnormal expression, oncogenic role, and clinical prognostic value. In vitro and in vivo experiments were conducted to investigate the biological functions of LINC01572 in tumorigenesis and development. These included colony formation assays, cell migration assays, flow cytometry, cell counting kit-8 (CCK-8) cell proliferation and tumor transplant growth experiments. Results: Bioinformatics results showed that LINC01572 was overexpressed in both LUAD and lung squamous cell carcinoma (LUSC) patients. LINC01572 overexpression was associated with shorter overall survival (OS) in LUAD. Further study of clinical specimens confirmed that LINC01572 was highly expressed in the tumor tissue of non-small cell lung cancer (NSCLC) patients. In vitro experiments also confirmed that LINC01572 was overexpressed in tumor cell lines. Inhibition of LINC01572 expression significantly impaired cell proliferation, cell migration, and clone formation. Experiments in nude mouse revealed that transplanted tumors with low expression of LINC01572 had significantly slower rates of growth in terms of volume and weight compared to the control group (p < 0.05). In addition, gene set enrichment analysis (GSEA) and immune landscape profiling showed that LINC01572 can promote tumor initiation and progression by deregulating the cell cycle and immunocyte infiltration. Conclusions: LINC01572 is overexpressed in tumor tissue relative to adjacent normal tissue. Moreover, LUAD patients with high expression of LINC01572 showed a worse survival prognosis. LINC01572 is associated with tumor initiation, progression and immune dysregulation. It therefore has potential value as a novel biomarker and therapeutic target in LUAD.

Abstract Lung cancer is the leading cause of cancer‐related death globally and poses a considerable threat to public health. Asia has the highest prevalence of epidermal growth factor receptor (EGFR) mutations in patients with non‐small cell lung cancer (NSCLC). Despite the reasonable response and prolonged survival associated with EGFR‐tyrosine kinase inhibitor (TKI) therapy, the acquisition of resistance to TKIs remains a major challenge. Additionally, patients with EGFR mutations are at a substantially higher risk of brain metastasis compared with those harboring wild‐type EGFR. The role of radiotherapy (RT) in EGFR‐mutated (EGFRm) stage IV NSCLC requires clarification, especially with the advent of next‐generation TKIs, which are more potent and exhibit greater central nervous system activity. In particular, the feasible application of RT, including the timing, site, dose, fraction, and combination with TKI, merits further investigation. This review focuses on these key issues, and provides a flow diagram with proposed treatment options for metastatic EGFRm NSCLC, aiming to provide guidance for clinical practice.

Coagulation kinetics and floc properties are of great fundamental and practical importance in the field of water treatment. To investigate the performance of Fe(VI) and Fe(III) salt on particle coagulation, Malvern Mastersizer 2000 was employed to continuously and simultaneously monitor the kaolin floc size and structure change, and population balance modeling was used to investigate the coagulation mechanism. The results show dosage increase had positive effect on collision efficiency and floc strength and negative effect on restructure rate. Low shear rate resulted in higher collision efficiency and stronger floc. Low water temperature had a pronounced detrimental effect on coagulation kinetics. Temperature increase showed the most significant positive effect on collision efficiency, floc strength and restructure rate. The optimum pH zone for the coagulation was found to be between 6 and 8. Further pH increase lowered the collision efficiency and floc strength and increased the restructure rate. FeCl3 resulted in a larger ratio of the mass to volume of kaolin flocs (compactness) than those induced by ferrate. HIGHLIGHTS Population balance modeling achieved excellent approximation of coagulation process.; FeCl3 produced larger, stronger and more compact flocs than those by ferrate(VI).; Dosage increase had positive effect on collision efficiency and floc strength.; High temperature resulted in high collision efficiency, floc strength and restructure.; Optimum pH for both coagulation systems was between 6 and 8.;

Methods for selective modification of the N-terminus of proteins are of high interest, but mostly require specific amino acid residues. Here, the authors report a selective and fast method for N-terminal modification of proteins based on quinone-mediated oxidation of the alpha-amine to aldehyde or ketone, and apply it to diverse proteins.

Cinnamomum plants are rich in natural essential oils, which are widely used as materials in the fragrance, insecticidal, antibacterial agent, pharmaceutical, and food industries; however, few studies have investigated the essential oil components of Cinnamomum bodinieri. Therefore, this study investigated the diversity of essential oils from the leaves of 885 individual C. bodinieri plants across 32 populations in five provinces. Essential oils were extracted by hydrodistillation, and then qualitative and quantitative analyses of the compounds were performed by GC-MS and GC-FID. A total of 87 chemical constituents were identified in the essential oils, including 33 monoterpenes, 48 sesquiterpenes, and six other compounds. The average oil yield was 0.75%, and individual oil yields ranged from 0.01% to 4.28%. A total of 16 chemotypes were classified according to variations in the essential oil chemical constituents of C. bodinieri, among which the camphor-type, citral-type, and eucalyptol-type were dominant. Moreover, the borneol-type, cymol-type, elemol-type, methylisoeugenol-type, and selina-6-en-4-ol-type were reported in C. bodinieri for the first time. The yield and principal components of the essential oils were mainly affected by altitude, temperature, and sunshine duration, among which altitude had the most significant effect; thus, low-altitude areas are more suitable for the synthesis and accumulation of essential oils. Based on the different characteristics of the essential oils in the leaves of C. bodinieri, several excellent populations and individuals were identified in this study. Moreover, the findings provide a foundation for breeding superior varieties and studying essential oil biosynthesis mechanisms in the future.

Machilus robusta W. W. Smith is an evergreen plant distributed in the Yangtze River Basin and the south regions of China. Here we analyzed the complete chloroplast (cp) genome sequence of M. robusta to determine its structure and evolutionary relationship to other Lauraceae. The cp genome is 152,737 bp in length and has an overall GC content of 39.2% The genome includes a large single-copy (LSC) region of 93,706 bp and a small single-copy (SSC) region of 18,885 bp, and these are separated by a pair of inverted repeats (IRs) of 20,073 bp. The cp genome contains 128 genes, including 83 protein-coding, 37 tRNAs, and 8 rRNAs. Phylogenetic analysis based on complete cp genome sequences fully resolved M. robusta in a clade with M. balansae. This work provides new molecular data for evolutionary studies of the Lauraceae.

The mechanism of action of daptomycin, a lipopeptidic antibiotic, is unclear. Here, the authors show that Ca2+-daptomycin simultaneously interacts with lipid-coupled precursors of the bacterial cell envelope and with the anionic phospholipid phosphatidylglycerol, forming a tripartite complex.

The control of nitrogen (N) and phosphorus (P) loadings to receiving waters is often overcompensated for by catchment planners. The objectives of this study, which investigated nine catchments in the subtropics of China, were to (i) quantify the explicit relationships between the N and P loadings to receiving waters and the topographic, soil and landscape characteristics of catchments, (ii) identify key impact factors and (iii) identify the most influential N and P loading pathways via catchments. Our collective data indicated that elevation–relief ratio, soil elemental stoichiometry and landscape structure determined the N and P loadings of the studied agricultural catchments. The N export from catchments characterized by a woodland backdrop (Masson pine) mosaic with the intrusion of paddy fields in the subtropics was postulated to be driven by two simultaneous processes: discharge and retention. In addition, a soil C:P threshold ratio for the catchment N and P loadings was estimated to be in the range of 107–117. Our PLS-SEM path analyses suggested that to reduce the N export from agricultural catchments in the subtropics, mitigation practices in landscape ecosystems (e.g., landscape patterns, ditches and streams) need to be taken into consideration and predominantly deployed, despite traditional measures used for soils. Strategies to lower the catchment P export can be directly proposed at the source site. Our findings provide greater insights into the transport and retention of N and P nutrients through catchments and may optimally direct the focus of catchment planners, thus increasing the control efficacy of catchment N and P losses.

The conversion of forest hillslopes into tea fields changes the slope structure, soil properties, and vegetation, which may increase the great variations in the nitrogen (N) and phosphorus (P) losses through the surface runoff and induce agricultural non-point source pollution, particularly during the first years of conversion. Therefore, a natural forest system and a newly reclaimed tea system were compared to determine the land use conversion effects on the surface runoff and resulting N and P losses during 2013–2016. The results showed that the soil bulk density (BD) at all the depths and the saturated soil conductivities (Ks) in the surface soil were higher in the tea system than in the forest system, indicating that great land use conversion impacts soil’s physical and hydraulic properties. The annual surface runoff volumes and ratios were significantly higher in the tea system than in the forest system (p < 0.05), and this increased surface runoff was largely attributed to the slope structure and soil property changes. The total P (TP), dissolved P (DP), and particle P (PP) concentrations in the surface runoff volumes were similar in the two systems, while the total N (TN) concentrations were higher in the tea system than in the forest system due to the high N fertilizer application rates in the tea system. The percentages of dissolved N (DN) in the TN and particle N (PN) in the TN were, respectively, lower and higher in the tea system than in the forest system, which was associated with increased soil erodibility due to the land use conversion. The mean annual N and P losses through the surface runoff were higher in the tea system (11.07 ± 4.03 kg N ha−1 yr−1 and 1.73 ± 0.19 kg P ha−1 yr−1) than in the forest system (4.51 ± 0.66 kg N ha−1 yr−1 and 0.78 ± 0.18 kg P ha−1 yr−1). The N and P losses exponentially correlated with the surface runoff in both systems; however, the coefficients of determination (R2) were higher in the forest system than in the tea system, indicating that the exponential relationship between the surface runoff and the N and P losses should be more stable in the forest system than in the newly reclaimed tea system. Therefore, more effort should be dedicated to reducing the N and P losses though the surface runoff when forest hillslopes are converted into tea fields, particularly during the first three years of conversion.

Cinnamomum camphora is a traditional aromatic plant used to produce linalool and borneol flavors in southern China; however, its leaves also contain many other unutilized essential oils. Herein, we report geographic relationships for the yield and compositional diversity of C. camphora essential oils. The essential oils of 974 individual trees from 35 populations in 13 provinces were extracted by hydrodistillation and analyzed qualitatively and quantitatively by gas chromatography-mass spectrometry and gas chromatography-flame ionization detection, respectively. Oil yields ranged from 0.01% to 3.46%, with a significantly positive correlation with latitude and a significantly negative correlation with longitude. In total, 41 compounds were identified, including 15 monoterpenoids, 24 sesquiterpenoids, and two phenylpropanoids. Essential oil compositions varied significantly among individuals and could be categorized into various chemotypes. The six main chemotypes were eucalyptol, nerolidol, camphor, linalool, selina, and mixed types. The other 17 individual plants were chemotypically rare and exhibited high levels of methyl isoeugenol, methyl eugenol, δ-selinene, or borneol. Eucalyptol-type plants had the highest average oil yield of 1.64%, followed in decreasing order by linalool-, camphor-, mixed-, selina-, and nerolidol-type plants. In addition, the five main compounds exhibited a clear geographic gradient. Eucalyptol and linalool showed a significantly positive correlation with latitude, while selina-6-en-4-ol was significantly and negatively correlated with latitude. trans-Nerolidol and selina-6-en-4-ol showed significantly positive correlations with longitude, whereas camphor was significantly and negatively correlated with longitude. Canonical correspondence analysis indicated that environmental factors could strong effect the oil yield and essential oil profile of C. camphora.

Cinnamomum pauciflorum is a valuable aromatic tree of the genus Cinnamomum Trew in the family Lauraceae. To better determine its phylogenetic location with other Cinnamomum species, the complete chloroplast (cp) genome of C. pauciflorum was sequenced. The total cp genome size is 152,766 bp, consisting of a pair of inverted repeats (IRa/b) with a length of 20,074 bp separated by a large single-copy region (LSC) and a small single-copy region (SSC) which are 93,693 and 18,925 bp, respectively. The overall GC content of the cp genome is 39.14%. Maximum-likelihood analysis showed that C. pauciflorum has phylogenetic affinities with Cinnamomum osmophloeum, Cinnamomum aromaticum, Cinnamomum mollifolium, and Cinnamomum tenuipile, providing new insight into the evolution of Lauraceae.

Although a landscape is a multidimensional integrated synthesis, the relationship between land use and water quality was merely studied in relation to protecting the aquatic ecological service function from the ‘landscape perspective’. This study analyzed the integrated landscape pattern by coupling land use, soil property, and topography and determined the stream water total nitrogen (TN) and total phosphorus (TP) in Chinese subtropical catchments from 2010 to 2017 to reveal and quantify the relationship between multidimensional landscape patterns and stream water N and P levels using the GIS and partial least squares regression (PLSR) techniques. The results suggested that the areal proportions of tea field and residential area in the Ultisols and on the first three slope categories (0–28.02°) and paddy field in the Ultisols and on slope category I (0–5.35°) were positively correlated with the TN and TP, while forest in the Ultisols and on slope category IV (28.02–80.30°) was negatively correlated with the TN (p ≤ 0.05). For the multidimensional landscape metrics, the Euclidean nearest-neighbor distance (ENN_MN) and interspersion and juxtaposition index (IJI) were positively correlated with the TN, while the ENN_MN was positively correlated with the TP (p ≤ 0.05). The PLSR analysis explained the variations of TN and TP levels well (R2 ≥ 0.66), in which the areal proportions of the tea field and residential area in the Ultisols and on the first three slope categories (0–28.02°) and the paddy field in the Ultisols and on slope category I (0–5.35°) were the important variables for both TN and TP; however, the areal proportions of forest in the Ultisols and on slope category IV (28.02–80.30°) and the IJL were only important to the TN. Therefore, the multidimensional landscape pattern providing specific land use, soil property, and topography can be more capable in restoring and protecting stream N and P pollution at an applicable level.

# Purpose Kinesiology taping is a common intervention used to treat individuals with shoulder pain. While there have been several studies published to date evaluating the effectiveness of this intervention, a systematic review with meta-analysis synthesizing the collective effectiveness of kinesiology taping is not available. Therefore, the purpose of this study was to perform a systematic review with meta-analysis investigating the efficacy and treatment fidelity of kinesiology taping (KT) in combination with conservative interventions for shoulder pain. # Methods Databases (PubMed, EMBASE, SportDiscus, CINAHL) of studies published in English meeting criteria were searched to October 2019. Methodologic quality was assessed utilizing the Modified Downs and Black checklist. Treatment fidelity was evaluated using a modified fidelity tool. Random effects meta-analyses were performed when an outcome (disability, pain, range of motion (ROM)) was reported by two or more studies. Overall effect size (pooled random effects) was estimated for studies with acceptable clinical homogeneity. # Results When KT was used with conservative treatments, meta-analysis revealed large effect sizes for improvements in disability (standard mean difference (SMD) = -1.35; 95% CI, -2.09 to -0.60) and ROM (SMD = 0.96; 95% CI, 0.60-1.33) with no significant effects for pain. The average Modified Downs & Black score for bias was 11.5 ± 3.9. Of 10 retained studies, only two had good treatment fidelity. # Conclusions Adding KT to interventions performed in clinical settings appears to demonstrate efficacy regarding disability and ROM when compared to conservative interventions alone. However, despite reasonably good methodologic quality, fidelity was lacking in a majority of studies. Because of its impact on the implementation of evidence-based practice, lower fidelity should be considered when interpreting results.

The porosity defects in the ingot, which are caused by moisture absorption in slag during the electroslag remelting process, deserve the researcher’s attention in the summer wet season. The prediction of slag weight gain caused by moisture absorption is critical for developing slag baking and scheduling strategies and can assist workshop managers in making informed decisions during industrial production of electro slag remelting. The moisture absorption in slag under the conditions of different air humidity, experimental time, slag particle size, and CaO content in the slag are investigated by slag weight gain experiments. The purpose of this study is to predict the rate of weight gain in slag using observed weight gain data and machine learning (ML) models. The observation dataset includes features and rate of weight growth, which serve as independent and dependent variables, respectively, for ML models. Four machine learning models: linear regression, support vector regression, random forest regression, and multi-layer perceptron, were employed in this study. Additionally, parameters for machine learning models were selected using 5-fold cross-validation. Support vector regression outperformed the other three machine learning models in terms of root-mean-square errors, mean squared errors, and coefficients of determination. Thus, the ML-based model is a viable and significant method for forecasting the slag weight gain rate, whereas support vector regression can produce results that are competitive and satisfying. The results of slag weight gain data and ML models show that the slag weight gain increases with the increase of air humidity, experimental time, slag particle size, and CaO content in the slag. The porosity defect in the ingot during the ESR process often appears when the moisture in the slag exceeds 0.02%. Considering saving electric energy, the complexity of on-site scheduling, and 4 h of scheduling time, the slag T3 (CaF2:CaO:Al2O3:MgO = 37:28:30:5) is selected to produce H13 steel ESR ingot in the winter, and slag T2 (CaF2:CaO:Al2O3:MgO = 48:17:30:5) is selected to produce H13 steel ESR ingot in the summer.

The imbalance between precipitation and water evaporation has caused crop yield reduction, drought, and desertification. Furthermore, most parts of the world are short of water, including China. We proposed a low-cost polymer multilayer film to reduce water evaporation by only passing through several sunlight wavelengths necessary for photosynthesis. A series of experiments were conducted to characterize the influence of partial sunlight on the reduction of water evaporation. Evaporation containers and evaporation pans were placed in open-air (CK), under a glass shed (GS), and under a glass-shed covered with multilayer films (GMF). Our results showed a significant reduction in water evaporation under GMF. Cumulative soil surface evaporation of CK, GS and GMF over 45 days was 80.53 mm, 68.12 mm, and 56.79 mm, respectively. Under GMF, cumulative water evaporation from soil and pan surfaces decreased by 29% and 26%. The slope (β1≠0) of simple linear regression showed a significant relationship between evaporation time and cumulative water evaporation (p = 0.000 < α = 0.05 shown in the ANOVA table). The correlation coefficient was more than 0.91 in all treatments, suggesting a strong positive linear relationship. This study may contribute to future drought resistance and agrivoltaic sustainability development.

Examination of the mechanisms of the plant community assembly at a geographical scale is an interesting topic in ecology and biogeography, which are of great significance for the understanding of species coexistence and biodiversity conservation. But so far, only a few studies have simultaneously assessed the relative roles of multiple-scale factors in shaping the phylogenetic and functional structure of plant communities at a macroecological scale. In this study, we linked modern climate, glacial-interglacial climate change, and soil properties with the phylogenetic and functional structure of shrub and herbaceous plant communities in Inner Mongolia, China, an arid and semi-arid region. Our results showed that the functional structure of plant communities was more associated with modern climate and soil properties than the phylogenetic structure, especially for the soil properties. Modern precipitation was found in all the combinations of variables that were most closely related to the community structure in this arid and semi-arid region. These findings suggest that the phylogenetic and functional structure of biotic communities may be affected by processes at divergent spatial-temporal scales. That is, the functional structure is better linked with the modern and local factors while the phylogenetic structure is more associated with the historical and regional processes. This study highlights the importance of the associations between the different biodiversity dimensions and divergent drivers.

To investigate the growth, physiological changes and mechanism of drought resistance of Camellia oleifera GWu-2 under drought stress conditions, changes in the main growth and physiological indices of GWu-2 under different water gradients were studied. Factor analysis was used to study the differences between indicators under different water gradients, and correlation analysis was implemented to analyze the relationship between different factors. We observed that the growth state, enzyme secretion, stomatal morphology and leaf osmotic adjustment substances were significantly affected by drought stress. In particular, increases in leaf abscisic acid (ABA), indole acetic acid (IAA) and methyl jasmonate (MeJA) contents under drought stress were negatively correlated with the stomatal opening degree, and the ratio of ZR/GA3 was significantly correlated with the growth and physiological indicators of GWu-2, indicating that different hormones respond differently to drought stress and have different functions in the growth regulation and drought resistance of GWu-2. We concluded that the drought resistance mechanism of GWu-2 was controlled by maintaining root growth to obtain the necessary water, increasing the contents of osmotic substances of leaves to maintain water holding capacity, reducing the transpiration of water by increasing leaf ABA, IAA and MeJA content to close stomata and reducing the damage caused by drought by increasing the activity of superoxide dismutase (SOD).

Carbon dioxide (CO2) enrichment in an agricultural environment has been shown to enhance the efficiency of crop photosynthesis, increasing crop yield and product quality. There is a problem of the excessive use of CO2 gas when the CO2 is enriched for crops, such as soybean and other field crops. Given the application of micro-nanobubbles (MNBs) in agricultural production, this research takes CO2 as the gas source to prepare the micro-nanobubble water by the dissolved gas release method, and the response surface methodology is used to optimize the preparation process. The results show that the optimum parameters, which are the gas–liquid ratio, generator running time, and inlet water temperature for the preparation of CO2 micro-nanobubble water, are 2.87%, 28.47 min, and 25.52 °C, respectively. The CO2 content in the MNB water prepared under the optimum parameters is 7.64 mg/L, and the pH is 4.08. Furthermore, the particle size of the bubbles is mostly 255.5 nm. With the extension of the storage time, some of the bubbles polymerize and spill out, but there is still a certain amount of nanoscale bubbles during a certain period. This research provides a new idea for using MNB technology to increase the content and lifespan of CO2 in water, which will slow the release and increase the utilization of CO2 when using CO2 enrichment in agriculture.

The demand for smart irrigation and water-saving practices in agriculture has triggered the development of different soil moisture sensing techniques that can operate under harsh field conditions. In this study, a soil moisture sensing technology appropriate for the field applications was comprehensively evaluated. From a qualitative and quantitative perspective, the Delphi and analytic hierarchy process methods were used to construct an index system involving technological advantage, economic benefit, risk analysis, policy support, four second-level indicators, and 23 fourth-level indicators. The results showed that economic benefits account for the largest weight. The practical evaluation resulted in 12 farms that showed that the selected soil water sensing methods performed reasonably and exhibited obvious water-saving irrigation benefits, which are usually used for scheduling irrigation. The overall score of M4 in different soil types was 0.2% lower than that of M5. Farms with reasonable economic conditions and a high awareness scored 5.3% higher on technology than those with modest economic conditions, which clearly affects the evaluation scores of the two technologies. The evaluation results help farmers and government decision-making bodies in technology selection, production decision-making, and risk control.

ObjectiveTo investigate the role of thoracic spine manipulation (TSM) on pain and disability in the management of mechanical neck pain (MNP).Data sourcesElectronic databases PubMed, CINAHL, Pedro, Embase, AMED, the Cochrane Library, and clinicaltrials.gov were searched in January 2018.Study selectionEligible studies were completed RCTs, written in English, had at least 2 groups with one group receiving TSM, had at least one measure of pain or disability, and included patients with MNP of any duration. The search identified 1717 potential articles, with 14 studies meeting inclusion criteria.Study appraisal and synthesis methodsMethodological quality was evaluated independently by two authors using the guidelines published by the Cochrane Collaboration. Pooled analyses were analyzed using a random-effects model with inverse variance methods to calculate mean differences (MD) and 95% confidence intervals for pain (VAS 0-100mm, NPRS 0-10pts; 0 = no pain) and disability (NDI and NPQ 0-100%; 0 = no disability).ResultsAcross the included studies, there was increased risk of bias for inadequate provider and participant blinding. The GRADE approach demonstrated an overall level of evidence ranging from very low to moderate. Meta-analysis that compared TSM to thoracic or cervical mobilization revealed a significant effect favoring the TSM group for pain (MD -13.63; 95% CI: -21.79, -5.46) and disability (MD -9.93; 95% CI: -14.38, -5.48). Meta-analysis that compared TSM to standard care revealed a significant effect favoring the TSM group for pain (MD -13.21; 95% CI: -21.87, -4.55) and disability (MD -11.36; 95% CI: -18.93, -3.78) at short-term follow-up, and a significant effect for disability (MD -4.75; 95% CI: -6.54, -2.95) at long-term follow-up. Meta-analysis that compared TSM to cervical spine manipulation revealed a non-significant effect (MD 3.43; 95% CI: -7.26, 14.11) for pain without a distinction between immediate and short-term follow-up.LimitationsThe greatest limitation in this systematic review was the heterogeneity among the studies making it difficult to assess the true clinical benefit, as well as the overall level of quality of evidence.ConclusionsTSM has been shown to be more beneficial than thoracic mobilization, cervical mobilization, and standard care in the short-term, but no better than cervical manipulation or placebo thoracic spine manipulation to improve pain and disability.Trial registrationPROSPERO CRD42017068287.

A hydrogen peroxide (H2O2) solution was adapted for microwave pretreatment of microcrystalline cellulose, which can be further used for heavy metal adsorption. The H2O2 concentration, temperature, and retention time were the key factors affecting the microwave/hydrogen peroxide pretreatment process. A Box-Benhken design (BBD) with response surface methodology (RSM) was employed to design and optimize the microwave-hydrogen peroxide pretreatment process (H2O2 pretreatment) of cellulose. After the H2O2 pretreatment, the crystallinity of cellulose decreased by 20% and the degree of polymerization (DP) decreased by up to 30%. The optimal conditions obtained by BBD were a H2O2 concentration of 8.37%, a temperature of 90 °C, and a retention time 5.33 min. Under these conditions, a minimum DP of 91.74 was achieved. The results indicated that all three of the factors notably affected the reduction of cellulose polymerization degree and pronounced interactions existed among the response variables. The predictive model developed was able to optimize the pretreatment process for the reduction of cellulose polymerization degree, which could improve the cellulose modification reactivity.

Cytochrome P450 monooxygenases (CYPs) are a group of redox proteins that catalyze various oxidative reactions in plant secondary metabolism. To explore the function of the CYP71 gene in Ginkgo biloba under biotic and abiotic stresses, a full-length CYP gene, designated GbCYP71, was first isolated and characterized from leaves of G. biloba. It contained a 1512-bp open reading frame (ORF) encoding 503 amino-acid-deduced polypeptide whose theoretical molecular weight was 56.9 kDa. The genomic DNA sequence of GbCYP71 contained two exons and one intron. The cDNA of GbCYP71 was subcloned in a pET-32a vector and then transformed into E. coli strain BL21 (DE3). A protein with a molecular weight of 76.4 kDa was subsequently identified and found to be consistent with the above theoretical value. Transient expression analysis revealed that the GbCYP71 protein may be located in the G. biloba cell cytoplasm. GbCYP71 was expressed in almost all ginkgo tissues, including leaves, stamens, gynoecia, stems and, preferentially, roots. Expression-profiling analyses revealed that GbCYP71 can be induced by salinity stress and phytohormone signals, including salicylic acid, abscisic acid, methyl jasmonate and ethephon, but is repressed by heat and cold stresses. These results indicate that GbCYP71 mainly functions in responding to biotic and abiotic stresses.

This study seeks to measure the technical efficiency of Community Health Service Centers (CHSCs) in Wuhan City, China, to propose some policy recommendations to improve the efficiency of CHSCs. A total of 46 CHSCs in Wuhan City were included in the study as research subjects. Data of 11 selected input and output indicators were collected from Hubei Provincial Health and Family Planning Commission. R3.2.1 statistical software was used to estimate the efficiency scores of CHSCs using Bootstrap-Data Envelopment Analysis (DEA), and, on average, the bias-corrected technical efficiency score is found to be 0.7845. All the bias-corrected scores of CHSCs are lower than classical scores. At both local and regional level, large gaps exist in relative technical efficiency scores among the CHSCs, and 12 out of 46 CHSCs (26.09%) have efficiency scores at or below average levels. The results indicate big potential for the CHSCs in Wuhan to improve their technical efficiency, such as the optimization of health resources allocation, capacity building, information system strengthening, third party performance evaluation, and mechanisms design, and so on.

OBJECTIVE:To investigate the role of early initiation of rehabilitation on length of stay (LOS) and cost following total hip arthroplasty, total knee arthroplasty, or unicompartmental knee arthroplasty. DATA SOURCES:Electronic databases PubMed, CINAHL, Pedro, Embase, AMED, and the Cochrane Library were searched in July 2016. Five additional trials were identified through reference list scanning. STUDY SELECTION:Eligible studies were published in English language peer-reviewed journals; included participants that had undergone total hip arthroplasty, total knee arthroplasty, or unicompartmental knee arthroplasty reported clearly defined timing of rehabilitation onset for at least two groups; and reported at least one measure of LOS or cost. Inclusion criteria were applied by 2 independent authors, with disagreements being determined by a third author. Searching identified 1,029 potential articles, of which 17 studies with 26,614 participants met the inclusion criteria. DATA EXTRACTION:Data was extracted independently by 2 authors, with disagreements being determined by a third author. Methodological quality of each study was evaluated independently by 2 authors using the Downs and Black checklist. Pooled analyses were analyzed using a random-effects model with inverse variance methods to calculate standardized mean differences (SMD) and 95% confidence intervals for LOS. DATA SYNTHESIS:When compared with standard care, early initiation of physical therapy demonstrated a decrease in length of stay for the 4 randomized clinical trials (SMD = -1.90; 95% CI -2.76 to -1.05; I2 = 93%) and for the quasi-experimental and 5 prospective studies (SMD = -1.47; 95% CI -1.85 to -1.10; I2 = 88%). CONCLUSION:Early initiation of rehabilitation following total hip arthroplasty, total knee arthroplasty, or unicompartmental knee arthroplasty is associated with a shorter LOS, a lower overall cost, with no evidence of an increased number of adverse reactions. Additional high quality studies with standardized methodology are needed to further examine the impact of early initiation of physical therapy among patients with joint replacement procedures.

In this paper, a kinetic model of the first chlorine dioxide bleaching stage (D0) in an elemental chlorine-free (ECF) bleaching sequence is presented for bagasse pulps. The model is based on the rate of adsorbable organic halogen (AOX) formation. The effects of the chlorine dioxide dosage, the sulfuric acid dosage, and the reaction temperature on the AOX content of wastewater are examined. The reaction of AOX formation could be divided into two periods. A large amount of AOX was formed rapidly within the first 10 min. Ten minutes later, the AOX formation rate significantly decreased. The kinetics could be expressed as: dW⁄dt=660.8•e^(-997.98/T) 〖•[ClO〗_2 ]^0.877•[H2SO4 ]^0.355•W^(-1.065), where W is the AOX content, t is the bleaching time (min), T is the temperature (K), [ClO2] is the dosage of chlorine dioxide (kg/odt), and [H2SO4] is the dosage of sulfuric acid (kg/odt). The fit of the experiment results obtained for different temperatures, initial chlorine dioxide dosages, initial sulfuric acid dosages, and AOX content were very good, revealing the ability of the model to predict typical mill operating conditions.

The integrated recognition of spatio-temporal characteristics (e.g., speed, interaction with surrounding areas, and driving forces) of urbanization facilitates regional comprehensive development. In this study, a large-scale data-driven approach was formed for exploring the township urbanization process. The approach integrated logistic models to quantify urbanization speed, partial triadic analysis to reveal dynamic relationships between rural population migration and urbanization, and random forest analysis to identify the response of urbanization to spatial driving forces. A typical subtropical town was chosen to verify the approach by quantifying the spatio-temporal process of township urbanization from 1933 to 2012. The results showed that (i) urbanization speed was well reflected by the changes of time-course areas of urban cores fitted by a four-parameter logistic equation (R2 = 0.95−1.00, p < 0.001), and the relatively fast and steady developing periods were also successfully predicted, respectively; (ii) the spatio-temporal sprawl of urban cores and their interactions with the surrounding rural residential areas were well revealed and implied that the town experienced different historically aggregating and splitting trajectories; and (iii) the key drivers (township merger, elevation and distance to roads, as well as population migration) were identified in the spatial sprawl of urban cores. Our findings proved that a comprehensive approach is powerful for quantifying the spatio-temporal characteristics of the urbanization process at the township level and emphasized the importance of applying long-term historical data when researching the urbanization process.

BACKGROUND:Low back pain (LBP) is common and associated healthcare costs are significant. While clinical practice guidelines have been established in an attempt to reduce costs and healthcare utilization, it is unclear if adherence to physical therapy guidelines for those with LBP is efficacious. Therefore, the purpose of this study was to assess current evidence and evaluate the impact of physical therapy guideline adherence on subsequent healthcare costs and utilization for patients with LBP. METHODS:An electronic search was conducted in PubMed, CINAHL (EBSCO Host), AMED (Ovid), and PEDro. Studies included in this review were published in peer reviewed journals and the primary mode of treatment was administered by a physical therapist. Also, the definition of adherence was clearly defined based on claims data and at least one measure of cost or utilization reported. Quality assessment was evaluated via a modified Downs and Black checklist. Due to the conceptual heterogeneity in variable measurements, data were qualitatively synthesized and stratified by reported utilization and cost measures. RESULTS:A total of 256 results were identified and after omitting duplicates, 4 articles were retained, which were all retrospective in nature. Quality scores ranged between 19 and 21 points out of a possible 26 on the modified Downs and Black checklist. All identified studies used the same definition of guideline adherence, which focused on billing active codes and minimizing use of passive codes. The results demonstrated trends that, with a few exceptions, suggested those patients with LBP that were treated with an adherent guideline program demonstrated decreased healthcare utilization and an overall healthcare savings. CONCLUSION:Preliminary evidence suggests that adherence to established clinical practice guidelines may assist with decreasing healthcare utilization and costs. Additional research based on prospective randomized controlled trials are needed to provide high quality evidence regarding the impact of guideline adherence among patients with LBP.