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BACKGROUND: To analyze early changes in white blood cells (WBCs), C-reactive protein (CRP) and procalcitonin (PCT) in children with multiple trauma, before secondary inflammation develops. METHODS: This single-center retrospective study collected data from patients with blunt traumatic injury admitted to the pediatric intensive care unit (PICU). According to the prognostic outcome of 28 d after admission to the PICU, patients were divided into survival group (n=141) and non-survival group (n=36). Characteristics between the two groups were compared. Receiver operation characteristic (ROC) curve analysis was conducted to evaluate the capacity of different biomarkers as predictors of mortality. RESULTS: The percentages of children with elevated WBC, CRP, and PCT levels were 81.36%, 31.07%, and 95.48%, respectively. Patients in the non-survival group presented a statistically significantly higher injury severity score (ISS) than those in the survival group: 37.17±16.11 vs. 22.23±11.24 (t=6.47, P<0.01). WBCs were also higher in non-survival group than in the survival group ([18.70±8.42]×109/L vs. [15.89±6.98] ×109/L, t=2.065, P=0.040). There was no significant difference between the survival and non-survival groups in PCT or CRP. The areas under the ROC curves of PCT, WBC and ISS for predicting 28-day mortality were 0.548 (P=0.376), 0.607 (P=0.047) and 0.799 (P<0.01), respectively. CONCLUSIONS: Secondary to multiple trauma, PCT levels increased in more patients, even if their WBC and CRP levels remained unchanged. However, early rising WBC and ISS were superior to PCT at predicting the mortality of multiple trauma patients in the PICU. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the aerodynamics including the global performance and flow characteristics of a longshrouded contra-rotating rotor by developing a full 3D RANS computation. Through validations by current experiments on the same shrouded contra-rotating rotor, the computation using sliding mesh method and the computational zone with an extended nozzle downstream flow field effectively works; the time-averaged solution of the unsteady computation reveals that more uniform flow presents after the downstream rotor, which implies that the rear rotor rotating at opposite direction greatly compensates and reduces the wake; the unsteady computations further explore the flow field throughout the whole system, along the span and around blade tips. Complex flow patterns including the vortices and their interactions are indicated around the blade roots and tips. For further identifying rotor configurations, the rotor- rotor distance and switching two rotor speeds were studied. The computation reveals that setting the second rotor backwards decreases the wake scale but increases its intensity in the downstream nozzle zone. However, for the effect of switching speeds, computations cannot precisely solve the flow when the rear rotor under the windmill because of the upstream rotor rotating much faster than the other one. All the phenomena from computations well implement the experimental observations. [ABSTRACT FROM AUTHOR]

This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = −21.44; 95% confidence intervals [95% CIs] [−25.08, −17.79]; P < 0.00001), shorter wound healing time (SMD = −3.66; 95% CI [−5.46, −1.85]; P < 0.0001), less intraoperative blood loss (SMD = −9.64; 95% CI [−11.37, −7.90]; P < 0.00001), better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001), lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed. [ABSTRACT FROM AUTHOR]

This paper aims to quantify the benefits of a shrouded coaxial rotor configuration through experimental comparisons with free (not shrouded) rotors in hover. The experiment shows that both the figure of merit of contrarotating rotors and the system power loading are improved by the shroud inclusion. Improvements are induced by a suction effect at the inlet, which can be optimized by a regulation effect of the mass flow. Compared to free rotors, the strong suction peak formed on the shroud leading edge by a 65% increase in mass flow, allowing the shroud to contribute up to 56% of the total thrust. More uniform pressure distribution in the downstream rotor and less contraction of the slipstream decrease losses and increase the rotor efficiency. The shrouded system efficiency is further improved if the upstream rotor rotates slower than the rear one, for a given total shaft power, because a stronger pressure depression occurs upstream of the rotors to generate more mass flow. On the other hand, the system behavior is insensitive to the interrotor distance. [ABSTRACT FROM AUTHOR]