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BackgroundThis study sought to illustrate whether urinary strontium levels were related to developing chronic kidney disease (CKD) in the United States population.MethodsA total of 5,005 subjects were identified from the National Health and Nutrition Examination Survey 2011–2016. Survey-weighted logistic regression analysis, multivariate linear regression analysis, restricted cubic spline (RCS) plots curve and stratified analyses were undertaken to explicate the correlation between urinary strontium and CKD.ResultsWith the increase of urinary strontium, the incidence rate of CKD and urinary albumin to creatinine ratio (UACR) levels gradually decreased, and estimated glomerular filtration rate (eGFR) levels gradually increased. After controlling all confounders, only urinary strontium in the fourth quartile was correlated to a lower CKD prevalence (OR: 0.59; 95% CI, 0.44–0.79) compared to the lowest quartile. Multivariate linear regression analysis showed that urinary strontium was positively correlated with eGFR but negatively with UACR. RCS curve suggested a nonlinear relationship between urinary strontium and CKD (P for non-linearity

IntroductionThe geriatric nutritional risk index (GNRI), a nutritional screening tool specifically for the aging population, has been proven to be associated with worse outcomes in chronic kidney disease patients, especially in the hemodialysis population. However, the predictive validity of GNRI in critically ill elderly patients with acute kidney injury (AKI) is yet to be determined. This analysis sought to examine the prognostic effects of GNRI on elderly AKI patients in intensive care units (ICUs).MethodsWe collected elderly AKI patient-relevant data from the Medical Information Mart for Intensive Care III database. AKI was diagnosed and staged according to the “Kidney Disease Improving Global Outcomes” criteria. In the study, 1-year mortality was considered the primary outcome, whereas in-hospital, ICU, 28-day and 90-day mortality, and prolonged length of stay in ICU and hospital were selected as the secondary outcomes.ResultsIn all, 3,501 elderly patients with AKI were selected for this study, with a 1-year mortality rate of 36.4%. We classified the study population into low (≤98) and high (>98) GNRI groups based on the best cutoff value. The incidence of endpoints was remarkably lower in patients with elevated GNRI (p < 0.001). When stratified by the AKI stage, patients with high GNRI at AKI stages 1, 2, and 3 had markedly lower 1-year mortality than those with low GNRI (all p < 0.05). The multivariable regression analysis identified the independent prognostic ability of GNRI on the research outcomes (all p < 0.05). Restricted cubic spline exhibited a linear correlation between GNRI and 1-year death (p for non-linearity = 0.434). The prognostic implication of GNRI on 1-year mortality was still significant in patients with the most subgroups.ConclusionIn critically ill elderly patients with AKI, elevated GNRI upon admission was strongly correlated with a lower risk of unfavorable outcomes.

Data insufficiency has become the primary factor affecting research on income disparity in China. To resolve this issue, this paper explores Chinese income distribution and income inequality using distribution functions. First, it examines 20 sets of grouped data on family income between 2005 and 2012 by the China Yearbook of Household Surveys, 2013, and compares the fitting effects of eight distribution functions. The results show that the generalized beta distribution of the second kind has a high fitting to the income distribution of urban and rural residents in China. Next, these results are used to calculate the Chinese Gini ratio, which is then compared with the findings of relevant studies. Finally, this paper discusses the influence of urbanization on income inequality in China and suggests that accelerating urbanization can play an important role in narrowing the income gap of Chinese residents.

Objectives: Breast reconstruction helps patients enhance their body image after mastectomy. Metallic ports in tissue expanders lead to dose attenuation during radiotherapy. Tissue expander volume shifts the metallic port position, possibly causing various dose alterations. This study aimed to evaluate the impact of the MAGNA-SITE TM tissue expander volume on tomotherapy. Methods: Boluses and MAGNA-SITE TM were placed on a Rando phantom to simulate the tissue expander under the pectoralis major. Computed tomography simulation images were transformed through replacing the electron density of (a) metallic artifact region only (Image metallic port) and (b) metallic port and artifact regions (Image Homo). Planning was calculated using fixed-beam and helical-mode techniques. Radiation was delivered with different volumes of the tissue expander. Results: Integrated 997 dose points were calculated. Planning with Image metallic port provided a calculated dose significantly closer to a realistic dose. The percentage of doses achieving the prescribed dose was significantly higher in the helical mode. In layer 2, the 100-mL tissue expander had a significantly lower measurement dose than all other volumes. Volume 150 mL had the highest increase in the measured dose difference from the plan dose at layer 2. Volume 250 mL had the highest percentage of measurement doses passing the 5% dose difference from plan dose. The coldest dose areas were noted in layers 1 and 2, especially in the metallic port–direct image mode. The average dose reduction of the measured cold areas was 6.03 ± 1.94%. Conclusion: Dose distribution was affected by the volume of the metallic port tissue expander. Tomotherapy with proper image heterogeneity correction and helical mode can reduce the attenuation from the metallic port. A tissue expander volume of 150 to 250 mL is suitable. Patients with high risk at the chest wall should be evaluated carefully to avoid underdosing. Radiation oncologists should closely cooperate with plastic surgeons to optimize treatment for each patient.

We propose an extended BCSâ€"Hubbard model and investigate its ground state phase diagram in an external magnetic field. By mapping the model onto a model of spinless fermions coupled with conserving Z 2 variables which are mimicked by pseudospins, the model is shown to be exactly solvable along the symmetric lines for an arbitrary on-site Hubbard interaction on the bipartite lattice. In the zero field limit, the ground states exhibit an antiferromagnetic order of pseudospins. In the large field limit, on the other hand, the pseudospins are fully polarized ordered. With the increase of the applied field, a first-order phase transition occurs between these kinds of phases when the on-site Coulomb interaction is less than a critical value U c. Above this critical U c, a novel intermediate phase emerges between the fully polarized and antiferromagnetic phases. The ground states in this phase are macroscopically degenerate, like in a spin ice, and the corresponding entropy scales linearly with the lattice size at zero temperature. [ABSTRACT FROM AUTHOR]

Using the scattering-matrix method, we investigate ballistic phonon transport and thermal conductance at low temperatures in a two-dimensional and a three-dimensional nanoscale structures modulated with a finite Cu/W superlattice. A comparative analysis for two-dimensional and three-dimensional models is made. The results show that the thermal conductance in three-dimensional model is larger than that in two-dimensional model for same structural parameters and temperature. In characteristics, however, the thermal conductance displays similar behaviors in both two-dimensional and three-dimensional models. Moreover, some interesting physical phenomena such as stop-frequency gap, resonant transmission, and universal quantized thermal conductance are observed in the structures. A brief analysis of these results is given. [ABSTRACT FROM AUTHOR]

We study theoretically ballistic phonon transport in a Ψ-shaped semiconductor nanowire at low temperatures. When ballistic acoustic phonons propagate through the nanowire, the region connecting the left lead and the three right leads of the nanowire acts as a cavity. Acoustic waves interfere with each other in the nanocavity to form standing waves with particular wavelengths due to multiple reflection by the boundaries of the cavity. Owing to the presence of the split cavity, different phonon modes are found to transport selectively into different channels, and phonon heat can be dissipated through different channels by properly tuning the parameters of the structure. This structure may be a promising split device for the ballistic phonon modes and control the phonon heat transport in nanophononics. [ABSTRACT FROM AUTHOR]

The scattering-matrix method is used to study the ballistic phonon transport and thermal conductance at low temperatures in a two-dimensional and a three-dimensional nanoscale structures modulated with a finite Cu/W superlattice. The results from the comparative analysis of two-dimensional and three-dimensional model showed the thermal conductance in three-dimensional model to be larger than that in two-dimensional model for same structural parameters and temperature.

The ballistic phonon transport in a [PSI]-shaped semiconductor nanowire is studied at low temperature. The thermal conductance of different channels could be controlled by altering their transverse widths and the geometric parameters of the nanocavity and the structure might find use as automatic separator of ballistic phonon modes at low temperatures.

A stereoselective synthesis of the hydroxyethylene dipeptide isostere is described. The route employs a substrate-directed kinetic protonation of an alpha/gamma-substituted lactone to afford the desired stereochemistry.

Objective: To compare the clinical effects of foscarnet sodium injection and interferon on human immunodeficiency virus (HIV)-infected patients complicated with herpes zoster. Methods: Ninety HIV-infected patients complicated with herpes zoster were divided into a treatment group and a control group that were both treated routinely first. Then the control group and treatment group were administered with interferon and foscarnet sodium injection respectively for four consecutive weeks. Results: After four weeks, the effective rates of the treatment and control groups were 95.6% and 80.0% respectively, which were significantly different (P < 0.05). The pain scores of the two groups were similar before treatment, but the scores of the treatment group were significantly lower than those of the control group two and four weeks after treatment (P < 0.05) as well as were significantly lower than those before treatment (P < 0.05). The numbers of CD4+ cells and the contents of IL-2 of both groups two and four weeks after treatment significantly exceeded those before treatment (P < 0.05), with significant inter-group differences also (P < 0.05). Two and four weeks after treatment, the treatment group scored significantly higher in physical activity, energy, sleep, social life and emotional reaction than the control group did (P < 0.05). Conclusions: HIV-infected patients are prone to being complicated with herpes zoster. Compared with interferon, foscarnet sodium injection better improves the clinical outcomes by effectively relieving pain and by regulating immune mediated inflammatory diseases, thus boosting the prognostic quality of life. [ABSTRACT FROM AUTHOR]