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Xiaomin An,1,2,* Guohua Li,1,* Shu Wang,1 Tianrun Xie,1 Xiaoxiao Ren,1 Yongli Zhao1 1Department of Pediatrics, The Second Hospital of Dalian Medical University, Dalian, 116027, People’s Republic of China; 2Department of Nephrology, Xi’an Children’s Hospital, Xi’an, 710003, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongli Zhao, Department of Pediatrics, The Second Hospital of Dalian Medical University, Dalian, 116027, People’s Republic of China, Tel +86 0411 84671291, Email zhaoyongli79@163.comIntroduction: Our previous study conducted in an obesity-related renal injury rat model have established a connection between increased connexin 43 (Cx43) expression and renal injury. In this study, we investigated whether inhibiting Cx43 expression could provide renoprotection in a mouse model of obesity-related renal injury.Methods: Five-week-old C57BL/6J mice were fed with a high-fat diet for 12 weeks to establish an obesity-related renal injury model, then they were treated with Cx43 antisense oligodeoxynucleotide (AS) or scrambled oligodeoxynucleotide (SCR) by an implanted osmotic pump for 4 weeks. Finally, the glomerular filtration function, the histological change in the glomeruli, and the markers of podocyte injury (WT-1, Nephrin) and inflammatory infiltration of renal tissue (CD68, F4/80 and VCAM-1) were examined respectively.Results: The results showed that inhibiting Cx43 expression by AS in this mouse model of obesity-related renal injury can effectively improve glomerular filtration function, alleviate glomerular expansion and podocyte injury, and attenuate the inflammatory infiltration of renal tissue.Conclusion: Our results demonstrated that inhibiting Cx43 expression by AS could provide renoprotection for the mouse model of obesity-related renal injury.Keywords: childhood obesity, obesity-related renal injury, connexin 43, antisense oligodeoxynucleotide

Supplemental material, sj-docx-1-phr-10.1177_00333549231155473 for The New York State COVID-19 Healthcare Personnel Study: One-Year Follow-up of Physicians, Nurse Practitioners, and Physician Assistants, 2020-2021 by Charles DiMaggio, Ezra Susser, Spiros Frangos, David Abramson, Howard Andrews, Christina Hoven, Megan Ryan and Guohua Li in Public Health Reports

Supplemental material, sj-docx-1-phr-10.1177_00333549231155473 for The New York State COVID-19 Healthcare Personnel Study: One-Year Follow-up of Physicians, Nurse Practitioners, and Physician Assistants, 2020-2021 by Charles DiMaggio, Ezra Susser, Spiros Frangos, David Abramson, Howard Andrews, Christina Hoven, Megan Ryan and Guohua Li in Public Health Reports

This study aimed at characterizing the spatiotemporal variability in water quality in Hulun Lake. In an attempt to assess the water quality status of the lake, data acquired from 13 monitoring points in Hulun Lake from 2012 to 2020 was applied to the improved composite water quality identification index (WQI). The ordinary least squares (OLS) model was used to identify areas of the lake vulnerable to water pollution. The results showed an increase in the WQI value of Hulun Lake and the water quality deteriorated during 2012-2016. The water quality began to improve gradually in 2017. The main variable affecting water quality in the lake transitioned from chemical oxygen demand (CODcr) and total nitrogen (TN) to CODcr and total phosphorus(TP). This shift in major pol-lutants was an important factor contributing to deterioration in water quality. Seasonal differences in water quality may be attributed to migration of pollutants [CODcr, total dissolved solids (TDS)] to the subglacial water column during the ice-covered period and the subsequent blocking effect of the ice cap. A spatially based OLS model identified the critical impact of Chl.a on water quality. Water transfers were identified as a major factor contributing to an improvement in water quality and to pollutant transformation and contributed to increase in the water quality sensitive area. Despite recent efforts to improve the water quality of Hulun Lake, input of exogenous pollutants, increase in endogenous pollutants, as well as the anaerobic conditions of the ice layer pose significant challenges to the management of Hulun Lake. The implementation of pollutant control measures are, in particular, recommended on the northwest shore for managing the water quality of the lake.

Understanding the interaction between the star wheel arm and coal particles is important to efforts for improving the loading efficiency and reducing the energy consumption of the feeder star wheel. The interaction mechanism between the star wheel arm and coal particles is the theoretical basis of the research. First, the design method of the star wheel arm shape was provided, then a model of the star wheel was constructed with EDEM and a simulation structure. Finally, the influence of the parameters on loading efficiency and energy consumption was determined. Results have been shown that the coal particles in the active zone of the material pile exerts a fluidity effect on loading efficiency and torque. The loading efficiency and energy consumption have been increased with increase in the number of arm and height of the arm. The feeder inclination angle 14° is the best coal loading angle.

ObjectiveThe purpose of this study was to explore the association of cervical disorders on obstetric outcomes of singleton pregnancies in China.MethodsThis hospital-based retrospective cohort study of women with live singleton births included 71,097 Chinese women. We compared the risk of adverse obstetric outcomes in different types of pregnancies with cervical disorders with those with normal cervix. Logistic regression model was used to estimate the association between cervical disorders and adverse obstetric outcomes.ResultsWomen with cervical disorders had a higher risk of premature delivery (10.98 vs. 4.41%), preterm premature rupture of membranes (PPROM) (3.48 vs. 1.62%), low birth weight (LBW) (7.62 vs. 2.92%) and very low birth weight (VLBW) (2.01 vs. 0.28%) than women with normal cervix. After adjusting for confounding factors, compared with women with normal cervix, women with high-grade abnormal cervical cytology are at greater risk of premature birth (adjusted OR 1.971, 95% CI: 1.302–2.983), premature rupture of membranes (PROM) (adjusted OR 1.379, 95% CI: 1.047–1.815), LBW (adjusted OR 1.790, 95% CI: 1.059–3.025), and VLBW (adjusted OR 4.519, 95% CI: 1.662–12.292) than women with low-grade abnormal cervical cytology, and women with abnormal cervical cytology after treatment had a higher risk of premature birth (adjusted OR 2.060, 95% CI: 1.348–3.147), PROM (adjusted OR 1.381, 95% CI: 1.038–1.839), PPROM (adjusted OR 1.995, 95% CI: 1.022–3.892), LBW (adjusted OR 1.801, 95% CI: 1.046–3.102), and VLBW (adjusted OR 4.868, 95% CI: 1.788–13.255) than untreated women.ConclusionsOur research showed that pregnant women with cervical disorders were more likely to have premature delivery, PPROM, LBW, and VLBW. Moreover, pregnant women with high-grade abnormal cervical cytology and abnormal cervical cytology after treatment had a higher risk of premature birth, PROM, LBW, and VLBW.

To improve fermentation efficiency during L-tyrosine production, we established a novel method to produce L-tyrosine by repeated batch fermentation through cell recycling. According to the characteristics of the fermented broth, the cells were recovered using two dish centrifuges in series. First, L-tyrosine crystals were removed from the previous batch of fermented broth by selective centrifugation. The cells were then concentrated in another centrifuge and recycled for use in the next cycle of batch fermentation. L-tyrosine removal and cell recovery rates were 86% and 67%, respectively, in a centrifuge bioreactor. Through repeated batch fermentation, L-tyrosine productivity was increased by up to 44.1% compared with that for fed-batch fermentation, and the coupling of fermentation and separation was achieved, which is useful in reducing production costs. This study provides a rationale for the fermentation of low-solubility products by repeated batch or cell-recycle fermentation.

This work investigated the mechanism of increasing oil content in synchronously enhancing extrudability and self-support of β-carotene loaded starch-based emulsion-filled gels (S-EFG) during 3D printing in terms of gel properties. Increasing emulsion oil content enhanced the storage modulus, relaxation modulus, and hardness of gels, which indicated sodium caseinate-stabilized emulsions were active fillers in the starch gel. Thus, printed products with high oil content were less prone to collapse when selecting models with higher height. In addition, lower yield stress, relaxation time, and higher frequency dependence were observed in S-EFG with higher oil content (30–50 %) due to the lubricating/plasticizing effect of oils, which corresponded to the smoother extruded filament. Furthermore, the retention of β-carotene in high oil content gel was higher after heat treatment due to denser microstructure. These results indicated that the extrudability and self-supporting of S-EFG were simultaneously improved by increasing oil content under the active filling effect and lubricating/plasticizing effect of emulsions.

To simultaneously optimize the surface quality and machining efficiency of the electrical discharge machining (EDM) processes used to produce titanium alloy quadrilateral group small hole parts, a combined “EDM + AFM” machining technology is proposed in this paper as an efficient and high-quality machining approach. In the proposed method, TC4 titanium alloy is first machined using the EDM process with graphite electrodes and the abrasive flow machining (AFM) process is then used to finish the machined surface. The effects of various electrical parameters on EDM-derived surface quality and improvements in EDM-derived quality under the application of AFM were assessed and, using the final surface roughness as a constraint condition, the effects of various combinations of EDM and “EDM + AFM” on efficiency were studied. The results revealed that the thickness and surface roughness of the superficial recast layer of the TC4 titanium alloy increase with both current and pulse width; in particular, increasing these parameters can increase the surface roughness by two to three grades. Following AFM, the alloy has a more uniform hardness distribution and the surface stress state changes from tensile to compressive stress, indicating that the combined “EDM + AFM” machining scheme can significantly enhance the surface quality of EDM-produced titanium alloy quadrilateral small group holes. The combined scheme achieves a balancing point beyond which increasing the roughness or the number of machining holes enhances either the machining efficiency or the machining surface quality. In the case of typical titanium alloy quadrilateral group small hole parts, the combined machining process can improve the finishing efficiency and total machining efficiency by 71.2% and 25.36%, respectively.

BackgroundTo determine the non-inferiority of the seven common serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F) in the 13-valent pneumococcal conjugate vaccine (PCV13) with each serotype conjugated to a tetanus toxoid carrier protein and adsorbed on aluminum phosphate and the superiority of its six additional serotypes (1, 3, 5, 6A, 7F, and 19A) to the serotypes in the PCV7.MethodsParticipants were evenly randomized in a 1:1 ratio into either the PCV13 or PCV7 groups, to receive three doses of the vaccine at the age of 3, 4, and 5 months, respectively, and a booster dose between 12 and 15 months of age. Serotype-specific antibodies were measured using a standardized enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic activity (OPA) microcolony assay method.ResultsA total of 1,040 healthy infants were enrolled. All the seven common serotypes in the PCV13 were non-inferior to those in the PCV7 in terms of the serotype-specific IgG production induced; however, non-inferiority was not shown for serotype 6B after the infant series. The proportion of subjects who reached OPA antibody titers ≥ 1:8 in the PCV13 group was 89.25% or higher. Local reactions and systemic events were mild or moderate in severity and similar between the two groups. No new safety signals were observed.ConclusionThe newly developed PCV13 was immunogenic for all serotypes and had a comparable safety profile to the marketed PCV7.

High-quality single-crystalline NbSe2 nanosheet arrays were successfully synthesized by a salt and hydrogen co-assisted CVD method, and the crystal structure and morphology of the material were investigated by XRD, Raman spectroscopy and TEM/HRTEM. The metallic electrical transport properties of the materials were validated by experimental measurement and DFT computation. The NbSe2 nanosheet array photodetectors showed very high responsivity and external quantum efficiency to UV light.

ObjectiveWe aimed to determine the association between maternal characteristics and isolated maternal hypothyroxinemia (IMH).MethodsPregnancies registered at Shanghai First Maternity and Infant Hospital between January 2014 and September 2020 were included in this cross-sectional study. IMH was defined as free thyroxine (FT4) levels below the 10th percentile with TSH within the normal reference range. Multivariate logistic regression models were used to identify potential risk factors for IMH, including demographic information, anthropometric measurements and nutritional status.ResultsA total of 54586 singleton pregnancies were included, involving 6084 women with IMH and 48502 euthyroid women. Multivariate logistic regression analyses showed that the variables for women with ages ≥35 (adjusted OR = 1.30, 95% CI:1.20–1.40), non-local residence (adjusted OR = 1.16, 95% CI:1.09–1.23), multiparas (adjusted OR = 1.11, 95% CI:1.03–1.21), pre-pregnancy overweight (adjusted OR = 1.37, 95% CI:1.27–1.49) or obesity (adjusted OR = 1.35, 95% CI:1.18–1.54), and iron deficiency (adjusted OR = 1.27, 95% CI:1.20–1.35) were independent risk factors for IMH in the overall study population, which were identical to those in the first trimester subgroup.ConclusionsMaternal characteristics were associated with the onset of IMH. Maternal age, residence of origin, parity, pre-pregnancy body mass index (BMI) and iron status should be comprehensively considered to evaluate the risk of IMH, according to which obstetricians could determine an optimal assessment time for thyroid function.

Aquatic ecosystems are globally significant sources of greenhouse gases (GHG) to the atmosphere, offsetting the terrestrial sinks. A one-year field study was carried out in a shallow eutrophic Lake Wuliangsuhai, Inner Mongolia (draining waters from one of the largest irrigation areas in China), to estimate diffusive GHG fluxes and their relative importance in global warming potential (GWP). Our results showed high spatiotemporal variation in dissolved CO2, CH4 and N2O concentrations, while they did not differ significantly between the bottom and surface layers of the shallow waterbody. In general, GHG concentrations and diffusive fluxes were higher in the north part of the lake than in the south. GHG concentrations in the water under the ice were significantly higher than those during the open-water period. Spatial variability of GHG concentrations varied with the bathymetry of the lake. The location of study sites relative to the main inflow and abundance of submerged macrophytes were the main controlling factors of GHG concentrations, as indicated by the consistency of GHG concentrations at the sampling sites, particularly for N2O. The total diffusive GHG emission from Lake Wuliangsuhai was 76.9 ± 5.4 Gg CO2 equivalents yr−1, with CO2, CH4 and N2O contributing 16 %, 83 %, and 1 %, respectively. Overall, the results suggest that shallow lakes in mid-latitude arid areas with cold winters can be potentially important GHG sources. However, those lakes are insufficiently represented in the scientific literature, and therefore they deserve more research attention. Highlights • Greenhouse gases emissions from a shallow lake in semi-arid area were estimated. • Considerable spatiotemporal variation in dissolved CO2, CH4, and N2O concentrations. • Spatial variability of GHG was associated with lake bathymetry and abundance of macrophytes. • CH4 contributed 83% to the total emissions as CO2-equivalents. • Lakes are an important source of carbon to the atmosphere.

Modified hierarchical porous Hβ zeolite was obtained by metal modification of Hβ zeolite, which was treated with alkaline solution, and the catalysts before and after modification were characterized by means of X-ray diffraction(XRD), nitrogen adsorption-desorption, scanning electron microscopy(SEM), X-ray fluorescence(XRF), NH3 temperature-programmed desorption and Fourier-transform infrared spectroscopy(FTIR). The activities of acylation of anisole with acetic anhydride were also investigated. The results show that the Hβ zeolite, which was treated with alkaline solution has microporous and mesoporous structures that could improve the diffusion performance of chemical reaction. The amount of acid was modulated with metal modification. The Hβ zeolite modified by 5%(mass fraction) metal chromium had the best catalytic performance. The conversion of acetic anhydride acylation was 93.01% under the optimal conditions, which was higher than that of other catalysts. The catalyst not only showed good activity, but also exhibited a stable performance in regeneration tests.

The interaction mechanism between the star wheel arm and coal particles is the theoretical basis for the research of the feeder star wheel device. Based on the discrete element theory, the motion equation of coal particles in the process of coal harrowing with the feeder star wheel was established. With the aid of EDEM software, the coal model of the continuous miner with the simulation structure of coal wall, ground, feeder star wheel, and coal pile was reconstructed. The influence of the parameters includes the number of the arm of the star wheel, the height of the arm, and the inclination angle of the feeder on the loading efficiency and energy consumption of the feeder star wheel was revealed. The results have been shown that the fluidity effect of coal particles in the active zone of the material pile has been observed. The loading efficiency and torque of the feeder star wheel have been affected by this effect. The loading efficiency and energy consumption have been increased with the increase in the number of arm and height of the arm. The loading efficiency of feeder inclination angle 14° is the highest and the energy consumption is the lowest.

This paper examines the financial risk of China's iron and steel industry. Based on the risk theory in financing, investment and operation, this paper constructs a financial risk assessment model, which involves five aspects: solvency, profitability, operation ability, growth ability and cash flow. Further, using the factor analysis method, the author finds that there exists unreasonable capital structure, imperfect cost management system and poor cash flow situation in iron and steel industry, all of which are contribute to the causes of financial risk of our sample firms. These results are expected to provide help for the financial management in iron and steel enterprises in China.

L-tyrosine is a widely used aromatic amino acid with an increasing market demand. Improving the parameters of L-tyrosine production results in a more cost-effective process that is of great interest for industrial applications. E. coli GHLTYR-168 was used to ferment L-tyrosine, with a productivity of 1.73 g/(L·h) and a yield of 17.6%. To further increase its production efficiency, repeated batch fermentation was applied to L-tyrosine, in which both replacement time points and ratios were studied during different fermentations. The broth substitution time point had no significant effect on L-tyrosine subjected to repeated batch fermentation, and 70% broth replacement ratio was the best choice. Repeated batch fermentation was performed in 5 batches within 100 h, among which the efficiency of the third batch fermentation was the highest. In the third batch fermentation, the productivity and yield were 2.53 g/(L·h) and 30.1%, respectively. Compared with that during fed-batch fermentation, the productivity and yield of L-tyrosine increased by 43.8% and 74.0%, respectively, during repeated batch fermentation. This is the highest level of L-tyrosine fermentation reported so far. Thus, repeated batch fermentation of L-tyrosine can improve its production efficiency., Graphical abstract

Les ordonnances d'opioïdes postopératoires peuvent être associées à des risques d'intoxication non intentionnelle et de détournement de médicaments par d'autres membres du ménage. La présente étude avait pour objectif d'étudier l'association entre les ordonnances d'opioïdes prescrites à des mères après une intervention chirurgicale et l'incidence d'événements liés aux opioïdes chez leurs enfants (âgés de 1 à 24 ans).

BACKGROUND: Postoperative opioid prescriptions may be associated with risks of unintentional poisoning and drug diversion in other household members. The objective of this study was to explore the association between mothers’ postoperative opioid prescriptions and incidence of opioid-related events in their children (aged 1 to 24 years). DATA AND METHODS: This retrospective cohort study used individually linked administrative health data from Ontario, Canada. A population-based sample of 170,156 opioid-naïve mothers (aged 15 to 64) (see Figure 1) who underwent surgery between 2013 and 2017 in Ontario was linked through birth records to create a cohort of their 283,550 opioid-naïve children (aged 1 to 24). The association between postoperative opioid analgesic prescriptions filled by mothers within seven days of discharge after surgery and opioid-related events (emergency department presentations or inpatient admissions for opioid poisoning, or mental and behavioural disorders attributable to opioid use) in their children within one year of their mother’s discharge was assessed. RESULTS: Overall, 60.4% of the children in the cohort had a mother who filled a postoperative opioid prescription. The incidence of opioid-related events in children in the year after a mother’s surgery was low overall (n=36/283,550, 0.01%), but higher among children whose mother filled a postoperative opioid prescription (n=29/171,139, 0.02%, vs. n=7/112,411, 0.01%, p=0.02), including in an analysis adjusting for child’s age, mother’s age, rural residence, neighbourhood income quintile and mother’s Charlson comorbidity index score (adjusted odds ratio, 2.42 [95% confidence interval (CI), 1.05 to 5.54], p=0.04). INTERPRETATION: Postoperative opioid prescriptions for mothers may contribute to opioid-related events in their children. These findings further underscore the importance of safe, effective opioid prescribing, as well as of patient and public education about the use, storage and disposal of these medications.

Bridges are an important part of traffic engineering. They play an irreplaceable role in developing national economy, promoting cultural exchanges and consolidating national defense. The structural safety of bridges is the primary prerequisite for their role. However, due to the influence of many factors such as material aging, external environmental corrosion, longterm load action and accidental impact, the bridge structure will be damaged to different degrees, and the bridge will be destroyed when the damage accumulates to a certain degree. Once the bridge is damaged, it will have a great negative impact on human life safety, property safety, and social stability. Therefore, studying the method of rapid and accurate identification of bridge structure damage has great theoretical significance and engineering value. Based on the current status and existing problems of existing bridge structure damage identification, this paper proposes a continuous beam bridge structure damage identification technology based on deflection influence lines. Firstly, using graph multiplication and other theories, the expression of influence line function on the deflection of multi-span continuous beam bridge is derived. The influence line function of continuous beam bridge without structural damage is derived from the theoretical level, and the graph is drawn. Through the formula of the deflection influence line of healthy structure, it can be confirmed that the deflection influence line obtained quickly under the visual tracking technology can identify the damage of the structure. We use software modeling to find the best identification parameters. Using MIDAS/Civil software can establish the model and simulate the deflection influence lines of different measuring points of continuous beam bridge structures with different positions and different degrees of damage under the action of moving loads. Taking the continuous beam bridge deflection influence line, the difference between the deflection influence line of the first derivative and the second derivative, the first derivative and the second derivative and other parameters as the research objects, we explore how to use the deflection influence line to identify damage. Finally, after the comparison of multiple working conditions and multiple measuring points, it is found that the damage identification effect of the first derivative of the deflection influence line difference is the best.

A magnesia–alumina spinel phase (MgAlSP) and a magnesium–aluminum oxynitride phase (MgAlON) were formed in the closed pores of Al–MgO composite materials after the composites were annealed at high temperature in an oxidizing atmosphere. The MgAlSP and MgAlON phases were detected and investigated by X-ray diffraction, scanning electron microscopy, and energy dispersive spectrometry. The results indicated that the MgAlON phase first formed nanoscale particles on the surface of the spinel phase. These particles then interconnected with each other to form particle chain structures. With increasing temperature, the sizes of the MgAlON nanoparticles gradually increased. However, when the temperature was increased to 1550 °C, the chain structure of the particles decomposed and formed a granular MgAlON phase.

In order to extend the service life of the bridge and reduce the occurrence of catastrophic accidents, it is necessary to monitor and identify the damaged parts of the bridge in time. In this paper, the author firstly proposes a basic theory of deflection influence line, then analyzes the calculation basis and proposes a method of deflection influence line of simple supported structure. Finally, according to displacement-time curve of simply-supported beam structure under different load-moving speed can be obtained by using MIDAS, the mid span, damage degree and load-moving speed of structure model can be set to carry out the simulation calculation. The results show that: when the load moving speed is 10km/h, 30km/h, 60km/h and 100km/h, the influence line of deflection difference has no obvious change pattern, and there are different peak values, which cannot be used for damage identification. Under the static load condition, the influence lines of deflection difference at 1/2L position, 3/4L position and end part at 10% and 25% damage degree basically show linear change, while the deflection difference value at 1/2L position appears peak value, and the maximum deflection difference value at different damage positions shows nonlinear change. It indicates that the damage degree can be judged according to the deflection differences at the damage positions identified above.

The separation technology in the large-scale sand-dust environment ground simulation test system applicable to the environmental adaptability and reliability verification of aerospace electromechanical products is studied. The gas-solid two-phase numerical simulation method is adopted, and the possible cyclone separation, inertial separation methods are used to study the separation efficiency and regularity technology, which provides a basis for the separation design and test of the sand-dust environment simulation of large electromechanical products.

Cardiac function is determined by the dynamic equilibrium of various cell types and the extracellular matrix that composes the heart. Cardiovascular diseases (CVDs), especially atherosclerosis and myocardial infarction, are often accompanied by cell death and acute/chronic inflammatory reactions. Caspase‐dependent pyroptosis is characterized by the activation of pathways leading to the activation of NOD‐like receptors, especially the NLRP3 inflammasome and its downstream effector inflammatory factors interleukin (IL)‐1β and IL‐18. Many studies in the past decade have investigated the role of pyroptosis in CVDs. The findings of these studies have led to the development of therapeutic approaches based on the regulation of pyroptosis, and some of these approaches are in clinical trials. This review summarizes the molecular mechanisms, regulation and cellular effects of pyroptosis briefly and then discusses the current pyroptosis studies in CVD research.

Purpose: To examine the ability of existing triggers for intensive care unit (ICU) palliative care consultation to predict 6-month mortality, and derive new triggers for consultation based on risk factors for 6-month mortality. Materials and Methods: Retrospective cohort study of NY state residents who received intensive care, 2008-2013. We examined sensitivity and specificity of existing triggers for predicting 6-month mortality and used logistic regression to generate patient subgroups at high-risk for 6-month mortality as potential novel triggers for ICU palliative care consultation. Results: Of 1,019,849 patients, 195,847 (19.2%) died within 6 months of admission. Existing triggers were specific but not sensitive for predicting 6-month mortality, (sensitivity 0.3%-11.1%, specificity 96.5-99.9% for individual triggers). Using logistic regression, patient subgroups with the highest predicted probability of 6-month mortality were older patients admitted with sepsis (age 70-79 probability 49.7%, [49.5-50.0]) or cancer (non-metastatic cancer, age 70-79 probability 51.5%, [51.1-51.9]; metastatic cancer, age 70-79 probability 60.3%, [59.9-60.6]). Sensitivity and specificity of novel triggers ranged from 0.05% to 9.2% and 98.6% to 99.9%, respectively. Conclusions: Existing triggers for palliative care consultation are specific, but insensitive for 6-month mortality. Using a data-driven approach to derive novel triggers may identify subgroups of patients at high-risk of 6-month mortality.

To enhance the catalytic reactivity of millimeter-scale particles of sponge iron (s-Fe(0)), Cu(2+) ions were deposited on the surface of s-Fe(0) using a simple direct reduction reaction, and the catalytic properties of the bimetallic system was tested for removal of rhodamine B (RhB) from an aqueous solution. The influence of Cu(0) loading, catalyst dosage, particle size, initial RhB concentration, and initial pH were investigated, and the recyclability of the catalyst was also assessed. The results demonstrate that the 3∼5 millimeter s-Fe(0) particles (s-Fe(0)(3∼5mm)) with 5wt% Cu loading gave the best results. The removal of RhB followed two-step, pseudo-first-order reaction kinetics. Cu(0)-s-Fe(0) showed excellent stability after five reuse cycles. Cu(0)-s-Fe(0) possesses great advantages compared to nanoscale zero-valent iron, iron power, and iron flakes as well as its bimetals. The surface Cu(0) apparently catalyzes the production of reactive hydrogen atoms for indirect reaction and generates Fe-Cu galvanic cells that enhance electron transfer for direct reaction. This bimetallic catalyst shows great potential for the pre-treatment of recalcitrant wastewaters. Additionally, some oxides containing iron element are selected to simulate the adsorption process. The results prove that the adsorption process of FeOOH, Fe2O3 and Fe3O4 played minor role for the removal of RhB.

Background: The reported prevalence of autism spectrum disorder (ASD) has increased markedly in the past two decades. Recent research indicates that children with ASD are at a substantially increased risk of injury mortality, particularly from unintentional drowning. The purpose of this study was to explore the circumstances of fatal unintentional drowning incidents involving children with ASD under 15 years of age. Findings: During January 2000 through May 2017, US newspapers reported a total of 23 fatal drowning incidents involving 18 boys and 5 girls with ASD. Age of victims ranged from 3 to 14 years (mean = 7.7 ± 2.9 years). These drowning incidents most commonly occurred in ponds (52.2%), followed by rivers (13.0%), and lakes (13.0%). For 11 incidents with location data available, the distance between victim residence and the water body where drowning occurred averaged 290.7 m (± 231.5 m). About three-quarters (73.3%) of the drowning incidents occurred in the afternoon hours from 12:00 to 18:59. Wandering was the most commonly reported activity that led to drowning, accounting for 73.9% of the incidents. Conclusions: Fatal drowning in children with ASD typically occur in water bodies near the victims’ homes in the afternoon hours precipitated by wandering. Multifaceted intervention programs are urgently needed to reduce the excess risk of drowning in children with ASD.

Background Oral vaccines, such as those for rotavirus are less efficacious in children from underdeveloped regions, where most severe disease occurs, than in children from more affluent areas. This disparity may be due to altered gut microbiota composition (dysbiosis), environmental enteropathy (EE), high maternal antibody titers, malnutrition, or influence of concurrent enteropathogens. Composition of gut microbiota in children is influenced by method of delivery, environmental hygiene and nutritional status. Studies have shown composition of gut microbiota to be significantly different between African and northern European infants and between malnourished and well-nourished children. A recent study has shown that EE was associated with failure of the oral rotavirus vaccine Rotarix, and underperformance of the oral polio vaccine. An animal model to study the effects of enteric dysbiosis on oral vaccine immunity is needed to evaluate potential treatments to reverse the dysbiosis and/or improve vaccine efficacy. Pigs and humans have similar immune systems, high genomic and protein sequence homology, omnivorous diet, and colonic fermentation, making pigs valuable models in biomedical research. The neonatal gnotobiotic (Gn) pig is a well-established model of human rotavirus disease and immunity.

In this study, we adopted the chemical co-precipitation (CP) method and sol–gel method followed by calcination at temperatures of 100–900 °C for 12 h to synthesize CoFe 2 O 4 materials, which were further characterized by TEM, XRD and XPS techniques. The properties of CoFe 2 O 4 materials were evaluated in a microwave (MW) induced catalytic oxidation (MICO) process for the elimination of brilliant green (BG). The results showed that: (1) the removal rates of BG gradually decreased over a series of CoFe 2 O 4 materials prepared by CP method and calcinated with 100–700 °C (except 900 °C) for 12 h within three reuse cycles; for comparison, no removal of BG was obtained over CoFe 2 O 4 synthesized by sol–gel method and CoFe 2 O 4 -900 (CP); (2) no hydroxyl radicals were captured with salicylic acid used as molecular probe in the MICO process; (3) MW irradiation enhanced the release of residual NaOH within the microstructure of CoFe 2 O 4 and further discolored BG, because BG is sensitive to pH; (4) granular activated carbon (GAC), an excellent MW-absorbing material possessing higher dielectric loss tangent compared to that of a series of CoFe 2 O 4 materials, could not remove BG in suspensions at a higher efficiency, even if the loading amount was 20 g L −1 . Accordingly, MICO process over CoFe 2 O 4 materials and GAC could not effectively eliminate BG in suspensions.

OBJECTIVE: Reintubation after liberation from mechanical ventilation is viewed as an adverse event in intensive care units (ICUs). We sought to describe the frequency of reintubations across U.S. ICUs and to propose a standard, appropriate time cut-off for reporting of reintubation events. DESIGN & SETTING: We conducted a cohort study using data from the Project IMPACT database of 185 diverse ICUs in the U.S. PATIENTS: We included patients who received mechanical ventilation and excluded patients who received a tracheostomy, had a do-not-resuscitate order placed, or died prior to first extubation. MEASUREMENTS: We assessed the percentage of patients extubated who were reintubated; the cumulative probability of reintubation, with death and do-not-resuscitate orders after extubation modeled as competing risks, and time to reintubation. MAIN RESULTS: Among 98,367 patients who received mechanical ventilation without death or tracheostomy prior to extubation, 9,907 (10.1%) were reintubated, with a cumulative probability of 10.0%. Median time to reintubation was 15 hours (interquartile range 2-45 hours). Of patients who required reintubation in the ICU, 90% did so within the first 96 hours after initial extubation; this was consistent across various patient subtypes (89.3% for electives surgical patients up to 94.8% for trauma patients and ICU subtypes (88.6% for cardiothoracic ICUs to 93.5% for medical ICUs). CONCLUSIONS: The reintubation rate for ICU patients in US ICUs is approximately 10%. We propose a time cut-off of 96 hours for reintubation definitions and benchmarking efforts, as it captures 90% of ICU reintubation events. Reintubation rates can be reported as simple percentages, without regard for deaths or changes in goals of care that might occur.

Purpose Safe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States. Methods Data were crash records for school-age children (5–19 years) and adults (30–64 years), in 18 U.S. states for a 16-year period (1995–2010). Multilevel negative binomial models were used to examine the association between SRTS intervention and the risk of pedestrian and bicyclist injury in children aged 5–19 years. Results SRTS was associated with an approximately 23% reduction (incidence rate ratio = 0.77, 95% confidence interval = 0.65–0.92) in pedestrian/bicyclist injury risk and a 20% reduction in pedestrian/bicyclist fatality risk (incidence rate ratio = 0.80, 95% confidence interval = 0.68–0.94) in school-age children compared to adults aged 30–64 years. Conclusions Implementation of the SRTS program appears to have contributed to improving traffic safety for school-age children in the United States.

Experimental evidence of anesthesia-induced neurotoxicity has caused serious concern about the long-term effect of commonly used volatile anesthetic agents on young children. Several observational studies based on existing data have been conducted to address this concern with inconsistent results. We conducted a meta-analysis to synthesize the epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children. Using Bayesian meta-analytic approaches, we estimated the synthesized odds ratios (OR) and 95% credible interval (CrI) as well as the predictive distribution of a future study given the synthesized evidence. Data on 7 unadjusted and 6 adjusted measures of association were abstracted from 7 studies. The synthesized OR based on the 7 unadjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.9 (95% CrI, 1.2-3.0). The most likely unadjusted OR from a future study was estimated to be 2.2 (95% CrI, 0.6-6.1). The synthesized OR based on the 6 adjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.4 (95% CrI, 0.9-2.2). The most likely adjusted OR from a future study was estimated to be 1.5 (95% CrI, 0.5-4.0). We conclude that existent epidemiologic evidence suggests a modestly elevated risk of adverse behavioral or developmental outcomes in children who were exposed to anesthesia/surgery during early childhood. The evidence, however, is considerably uncertain.

During the past. decades, large-scale national neutron sources have been developed in Asia, Europe, and North America. Complementing such efforts, compact hadron beam complexes and neutron sources intended to serve primarily universities and industrial institutes have been proposed, and some have recently been established. Responding to the demand in China for pulsed neutron/proton-beam platforms that are dedicated to fundamental and applied research for users in multiple disciplines from materials characterization to hadron therapy and radiography to accelerator-driven sub-critical reactor systems (ADS) for nuclear waste transmutation, we have initiated the construction of a compact, yet expandable, accelerator complex-the Compact Pulsed Hadron Source (CPHS). It consists of an accelerator front-end (a high-intensity ion source, a 3-MeV radio-frequency quadrupole linac (RFQ), and a 13-MeV drift-tube linac (DTL)), a neutron target station (a beryllium target with solid methane and room-temperature water moderators/reflector), and experimental stations for neutron imaging/radiography, small-angle scattering, and proton irradiation. In the future, the CPHS may also serve as an injector to a ring for proton therapy and radiography or as the front end to an ADS test facility. In this paper, we describe the design of the CPHS technical systems and its intended operation.

由于温度会对云母晶体的最大双折射率产生影响,影响云母波片的使用精确度.利用偏光干涉法测定了云母晶体的最大双折射率温度系数.利用岛津UV-3101PC分光光度计,在其样品室中加入温控装置.测出80 μm,300 μm和813.5μm三个不同厚度的云母波片在不同温度下的偏光干涉谱,发现干涉谱发生漂移.通过对偏光干涉谱极值点所对应波长的精确判断,准确计算出相应温度下波片的最大双折射率.求出云母晶体在紫外波段和可见光波谱段的最大双折射率温度系数表达式.实验是在波长精度为0.05 nm时进行的,测量的双折射率精度可达到10-5.

Rationale: Use of triggers for palliative care consultation has been advocated in intensive care units (ICUs) to ensure appropriate specialist involvement for patients at high risk of unmet palliative care needs. The volume of patients meeting these triggers, and thus the potential workload for providers, is unknown. Objectives: To estimate the prevalence of ICU admissions who met criteria for palliative care consultation using different sets of triggers. Methods: Retrospective cohort study of ICU admissions from Project IMPACT for 2001–2008. We assessed the prevalence of ICU admissions meeting one or more primary palliative care triggers, and prevalence meeting any of multiple sets of triggers. Measurements and Main Results: Overall, 53,124 (13.8%) ICU admissions met one or more primary triggers for palliative care consultation. Variation in prevalence was minimal across different types of units (mean 13.3% in medical ICUs to 15.8% in trauma/burn ICUs; P = 0.41) and individual units (mean 13.8%, median 13.0%, interquartile range, 10.2–16.5%). A comprehensive model combining multiple sets of triggers identified a total of 75,923 (19.7%) ICU admissions requiring palliative care consultation; of them, 85.4% were captured by five triggers: (1) ICU admission after hospital stay greater than or equal to 10 days, (2) multisystem organ failure greater than or equal to three systems, (3) stage IV malignancy, (4) status post cardiac arrest, and (5) intracerebral hemorrhage requiring mechanical ventilation. Conclusions: Approximately one in seven ICU admissions met triggers for palliative care consultation using a single set of triggers, with an upper estimate of one in five patients using multiple sets of triggers; these estimates were consistent across different types of ICUs and individual units. These results may inform staffing requirements for providers to ensure delivery of specialized palliative care to ICU patients nationally.

Objectives: To analyse emergency department-based data on paediatric traumatic brain injury (TBI). Methods: This study constructed a retrospective cohort of 493 890 children who were born in New York City between 1999–2007 and who were enrolled in the New York Medicaid programme at the time of their birth and followed these children from birth to the end of 2007. Results: There were 62 089 injury-related emergency department visits, of which 1290 had ICD-9 codes consistent with TBI. Children with TBI were more likely to be male (59.4% vs 51.4%) and Hispanic (43.9% vs 26.3%) than those in the underlying birth cohort and were more than twice as likely to be admitted to the hospital for inpatient care (RR = 2.4, 95% CI = 2.2, 2.6). The most commonly listed cause of injury was falls (58.3%). Spatially-smoothed risk estimates indicated that some areas of the city are associated with a greater risk of paediatric TBI than others. Conclusions: Emergency department data can be used to describe paediatric TBI in ways not easily available through more routinely collected administrative health data. This information can be used to target prevention and control efforts.