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To examine the relationship between obstructive sleep apnea (OSA) and suicide risk in persons with traumatic brain injury (TBI) has received little empirical investigation. We hypothesized that OSA would predict suicide risk following TBI. Secondary analysis of the TBI Model Systems longitudinal multicenter study. Neurorehabilitation units at five Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Veterans admitted for TBI rehabilitation who completed a 1 year (N=392), 2-year (N=444), 5-year (N=498), or 10-year follow up (N=252). Lost to follow up rate was 7.8-14.5% depending on follow up year. Not applicable. Suicide ideation and suicide attempts. Post-TBI suicide ideation was predicted by pre-TBI suicide attempts (aOR = 2.81, p =.020), concurrent depression symptom severity (aOR = 1.24, p <.001), and lower concurrent participation (a =.060, p =.037). Post-TBI suicide attempts was predicted by pre-TBI suicide attempts (aOR = 4.53, p =.002), concurrent headache severity (aOR = 1.53, p =.024), and concurrent suicidal ideation (aOR = 3.53, p =.007). Contrary to study hypotheses, OSA diagnosis did not predict either suicidal ideation (p =.191) or suicide attempts (p =.992). Consistent with prior literature, depression, participation, headache severity, prior suicidal ideation, and prior suicide attempts predicted post-TBI suicide risk. Limitation of this study include self-report method of OSA identification, and lack of information on OSA severity and OSA treatment. This material is the result of work supported with resources and the use of facilities at the James A. Haley Veterans' Hospital. The views expressed in this presentation are of the authors and do not necessarily represent official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-22-C-0016 with DHA Contracting Office (CO-NCR) HT0014 and, therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.TBICOEinfo@health.mil. UNCLASSIFIED. [ABSTRACT FROM AUTHOR]

• An approach based on VNIR-SWIR hyperspectral imaging was proposed to detect bioactive compound contents in tea. • Prediction models were constructed for detecting the contents of five bioactive compounds in tea. • An IBS-CARS-Fusing method was developed to refine feature wavelengths for VNIR-SWIR hyperspectral data. • Thermal map of LCMA was employed to visualize spatial distribution of bioactive compounds. Hyperspectral imaging (HSI) provides opportunity for non-destructively detecting bioactive compounds contents of tea leaves and high detection accuracy require extracting effective features from the complex hyperspectral data. In this paper, we proposed a feature wavelength refinement method called interval band selecting-competitive adaptive reweighted sampling-fusing (IBS-CARS-Fusing) to extract feature wavelengths from visible-near-infrared (VNIR) and short-wave-near-infrared (SWIR) hyperspectral images. Combined with the proposed IBS-CARS-Fusing method, a kernel ridge regression (KRR) model was established to predict the contents of bioactive compounds including chlorophyll a , chlorophyll b , carotenoids, tea polyphenols, and amino acids in Dancong tea. It was revealed that the IBS-CARS-Fusing method can improve R p 2 of KRR model for these bioactive compounds by 4.77%, 4.60%, 6.74%, 15.52%, and 13.10%, respectively, and R p 2 of the model reached high values of 0.9500, 0.9481, 0.8946, 0.8882, and 0.8622. Additionally, a leaf compound mass per area thermal map was used to visualize the spatial distribution of the compounds. [ABSTRACT FROM AUTHOR]

Bone is regarded as one of few tissues that heals without fibrous scar. The outer layer of the periosteum is covered with fibrous tissue, whose function in bone formation is unknown. We herein developed a system to distinguish the fate of fibrous-layer periosteal cells (FL-PCs) from the skeletal stem/progenitor cells (SSPCs) in the cambium-layer periosteum and bone marrow in mice. We showed that FL-PCs did not participate in steady-state osteogenesis, but formed the main body of fibrocartilaginous callus during fracture healing. Moreover, FL-PCs invaded the cambium-layer periosteum and bone marrow after fracture, forming neo-SSPCs that continued to maintain the healed bones throughout adulthood. The FL-PC-derived neo-SSPCs expressed lower levels of osteogenic signature genes and displayed lower osteogenic differentiation activity than the preexisting SSPCs. Consistent with this, healed bones were thinner and formed more slowly than normal bones. Thus, the fibrous periosteum becomes the cellular origin of bones after fracture and alters bone properties permanently. [Display omitted] • SSPC-Simultracer distinguishes FL-PCs from BMSCs/CL-PCs • BMSCs/CL-PCs maintain bone homeostasis • FL-PCs form the main body of callus during fracture healing • FL-PC-derived neo-SSPCs maintain the healed bone post fracture Bone has long been regarded as one of few tissues that heals without fibrous scar. Liu et al. discover that fibroblasts at the out-layer periosteum repair bone fracture and maintain the healed bone throughout mouse adulthood, which alters the bone parameters permanently. [ABSTRACT FROM AUTHOR]

To examine the relationship between staff perceived irritability, anger, and aggression and posttraumatic stress disorder (PTSD) in veterans with traumatic brain injury (TBI) of all severity levels. Longitudinal cohort design. Veterans Affairs Polytrauma Transitional Rehabilitation Programs. Veterans and service members with TBI of all severity levels enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers' Traumatic Brain Injury Model System national database (N=240). Not applicable. Univariable and multivariable logistic regression modeling was used to examine the association between irritability, anger, and aggression and potential risk factors, including PTSD symptoms. Irritability, anger, and aggression was measured as a single construct using an item from the Mayo-Portland Adaptability Inventory-4 that was rated by program staff at admission and discharge from the inpatient rehabilitation program. PTSD symptoms were assessed using the PTSD Checklist–Civilian Version. PTSD symptoms uniquely predicted program staff-rated irritability, anger, and aggression at discharge even after controlling for severity of TBI, age, male sex, education, and annual earnings. The model explained 19% of the variance in irritability, anger, and aggression. When TBI severity and PTSD symptoms were considered simultaneously in a sample of veterans, only PTSD symptoms predicted staff-rated irritability, anger, and aggression. Given the negative outcomes linked with irritability, anger, and aggression, veterans may benefit from assessment and treatment of PTSD symptoms within rehabilitation settings. [ABSTRACT FROM AUTHOR]

This study examined the formation of fouling films deposited on the surface of a polyethersulfone (PES) membrane during the filtration of alginate solutions with various ionic strengths. Membrane fouling was characterized by changes of the transmembrane pressure (TMP) and ex situ measured attenuated total reflectance (ATR) Fourier-transform IR (FTIR) spectra at varying stages of filtration runs. The ATR spectra that comprise the vibration bands characteristic of the PES substrate and the deposited film were processed taking into the gradual weakening of the PES substrate-specific bands, whose intensity was shown to depend on the wavenumber of IR radiation and the thickness of the deposited layer. Strongly linear correlations between ratios of first derivatives intensity and wavenumbers of the PES reference lines were established. Calculations of the PES bands' attenuation coefficients allowed determining the apparent thickness and ATR FTIR vibrations of the fouling films per se. Strong correlations between TMP development and ATR-determined apparent thickness of the fouling layers were observed. The intensity of ATR absorbance at 3200 cm−1 was linearly correlated with TMP development for small TMP values before the point of rapidly developing failure of the hydraulic permeability of the system was reached. Image 1 • PES membrane fouling was characterized by ATR FTIR spectra. • An expression for the two-film ATR spectra was established and verified. • First derivatives of ATR spectra vs. IR wavenumber was found linearly correlated. • A strong correlation between TMP and d f f a p p from the ATR spectra was established. [ABSTRACT FROM AUTHOR]

This study investigated the indirect photodegradation of sulfadimidine (SM 2) and sulfapyridine (SP) in the presence of chromophoric dissolved organic matter (CDOM), and studied the influences of main marine factors (salinity, pH, NO 3 − and HCO 3 −). Reactive intermediate (RI) trapping experiments demonstrated that triplet CDOM (3CDOM*) played a major role in the photodegradation of SM 2 with a 58% photolysis contribution, and the contributions to the photolysis of SP were 32%, 34% and 34% for 3CDOM*, hydroxyl radical (HO·) and singlet oxygen (1O 2), respectively. Among the four CDOMs, JKHA, with the highest fluorescence efficiency, exhibited the fastest rate of SM 2 and SP photolysis. The CDOMs were composed of one autochthonous humus (C1) and two allochthonous humus (C2 and C3). C3, with the strongest fluorescence intensity, had the strongest capacity to generate RIs and accounted for approximately 22%, 11%, 9% and 38% of the total fluorescence intensity of SRHA, SRFA, SRNOM and JKHA, respectively, indicating the predominance of CDOM fluorescent components in the indirect photodegradation of SM 2 and SP. These results demonstrated the photolysis mechanism: The photosensitization of CDOM occurred after its fluorescence intensity decreased, and a large number of RIs (3CDOM*, HO· and 1O 2 , etc.) were generated by energy and electron transfer, then these RIs reacted with SM 2 and SP to cause photolysis. The increase in salinity stimulated the photolysis of SM 2 and SP consecutively. The photodegradation rate of SM 2 first increased and then decreased with increasing pH, whereas the photolysis of SP was remarkably promoted by high pH but remained stable at low pH. NO 3 − and HCO 3 − had little effect on the indirect photodegradation of SM 2 and SP. This research may contribute to a better understanding of the fate of SM 2 and SP in the ocean and provide new insights into the transformation of other sulfonamides (SAs) in marine ecological environments. [Display omitted] • The indirect photodegradation of sulfadimidine (SM 2) and sulfapyridine (SP) was triggered by 3CDOM*, HO· and 1O 2. • RIs production was dominated by the fluorescent components of CDOM. • Salinity and pH had significant influence, whereas HCO 3 − and NO 3 − had little effect. [ABSTRACT FROM AUTHOR]

Objectives To present initial descriptive findings from the Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRC) Traumatic Brain Injury (TBI) Model Systems (MS) National Database. Design Prospective cohort study. Setting VA PRC TBIMS National Database. Participants 712 service members and veterans with TBI who consented to participate between January 2010 and June 2015. Interventions Not applicable. Main Outcome Measures Demographics, preinjury characteristics, injury characteristics, rehabilitation course, functional outcomes, and discharge disposition by TBI severity level. Results The study cohort was predominantly male with moderate to severe TBI secondary to vehicular accident or blast injury. Sixty-five percent were active duty service members; one-third had been injured during deployment. One-third reported mental health treatment and/or alcohol use problems in the year predating the index TBI. The median number of days between injury and PRC admission was 42.5. Nearly 25% reported clinical levels of posttraumatic stress disorder; 75% reported mild to moderate neurobehavioral symptomatology. The median length of stay in the PRC was 36 days; those with severe TBI had the longest lengths of stay. Functional independence ratings improved from admission to discharge across all TBI severity levels. A majority were discharged to urban areas to reside with spouses or other residents in private residences or adult homes, with some variability by injury severity. Conclusions The VA PRC TBIMS national database is a rich source of information on a unique group of individuals with TBI and promises to complement existing knowledge on TBI in the civilian population. [ABSTRACT FROM AUTHOR]

Background Limited literature has examined characteristics of infants with hypoplastic left heart syndrome (HLHS) who remain hospitalized during the interstage period. We described their epidemiologic characteristics, in-hospital outcomes, and identified risk factors that predict the need for superior cavopulmonary anastomosis (SCPA) during the same hospitalization. Methods This retrospective multicenter database analysis included infants with HLHS who underwent stage 1 palliation from 2004 through 2013. Results Among 5374 infants with HLHS, 314 (5.8%) underwent SCPA during the same hospitalization as stage 1 palliation. They had a higher incidence of baseline comorbidities, complications, and interventions than infants who were discharged. Despite an overall increase in need for SCPA in the same hospitalization across different eras, there was no significant statistical difference in mortality in the two groups in the same era. Septicemia, necrotizing enterocolitis, modified Blalock-Taussig shunt, cardiac catheterization, cardiopulmonary resuscitation, extracorporeal membrane oxygenation, gastrostomy tube, and antiarrhythmic agents were independently associated with increased odds of undergoing SCPA during the same hospitalization. Patients undergoing right ventricle to pulmonary artery shunt were less likely to remain hospitalized until stage 2 palliation. Nonsurvivors in the SCPA group had greater need for interventions and worse intensive care unit outcomes. Conclusions Infants with HLHS who remain hospitalized after stage 1 until their stage 2 palliation differ significantly from infants who were discharged. Several clinical characteristics, comorbidities, and need for interventions are associated with the likelihood for undergoing stage 2 palliation during the same hospitalization. Timely identification and intervention of adjustable causes of heart failure may improve outcomes. [ABSTRACT FROM AUTHOR]

Background Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge. Methods This retrospective analysis of the Pediatric Heath Information System data set included infants with HLHS who underwent stage 1 Norwood operation, a hybrid procedure, or heart transplant from 2004 through 2013. Results We identified 5721 infants with HLHS, and 126 underwent tracheostomy placement. Infants in the tracheostomy group had more morbidities and a higher mortality rate across the study period. Diagnosis of chromosomal abnormalities, anomalies of the trachea and esophagus, larynx, diaphragm and nervous system, bilateral vocal cord paralysis, and necrotizing enterocolitis, and procedures including extracorporeal membrane oxygenation support, cardiac catheterization, and gastrostomy tube were independently associated with tracheostomy placement in the study population. Despite an overall increase in rates of tracheostomy performed in infants with HLHS during the study period, the mortality rate did not improve among tracheostomy patients. Conclusions Several risk factors were identified in infants with HLHS in whom a tracheostomy was placed during their first hospitalization. Despite an overall increase in rates of tracheostomies during the study period, the mortality rate did not improve among these patients. Appropriate family counseling and thorough preoperative case selection is suggested when discussing possible tracheostomy placement in infants with HLHS. [ABSTRACT FROM AUTHOR]

Background We describe the clinical characteristics and epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in children with cystic fibrosis (CF) from the U.S. CF center with the highest MRSA prevalence. Methods Medical records of children with CF were retrospectively reviewed from 1997-2009. MRSA clinical isolates from 2007-2009 were analyzed by polymerase chain reaction and pulsed field gel electrophoresis. Results The prevalence of MRSA was 1% in 1997 and 49% in 2009. Fifty-five children (26%) had persistent MRSA infection. Sixty-eight percent of MRSA isolates were hospital-associated (HA) MRSA, of which 52% were pulsed-field type USA 100. Ninety-three percent of HA MRSA isolates were clindamycin resistant. Twelve children acquired MRSA before 1 year of age, 83% of whom were hospitalized prior to acquisition of MRSA. Ten of 11 sibling pairs carried indistinguishable MRSA strains. Children with persistent MRSA were hospitalized more often ( P  = .01), required inhaled medications more frequently ( P  = .01), and had higher rates of Pseudomonas aeruginosa coinfection ( P  < .001). Conclusion MRSA prevalence in children with CF is increasing, and most children are infected with HA MRSA. Exposure to health care facilities and gastrointestinal surgeries may facilitate early acquisition of MRSA. Siblings carry indistinguishable MRSA strains, indicating household transmission of MRSA. Children with persistent MRSA had worse pulmonary morbidity. Coinfection with MRSA and P aeruginosa is likely associated with further increased pulmonary morbidity. [ABSTRACT FROM AUTHOR]

• The multifunctional transparent fire-retardant coating reinforced with talc was fabricated. • Excellent fire protection, smoke suppression and adhesion properties were obtained. • Uniform dispersion of talc imparted indeed transparency in the range of 84.5%-88.9%. • Antibacterial rate against E. coli bacteria reached 99.0% after introducing talc. • Remarkable enhancement on ageing resistance was achieved by adding talc. To enhance the fire safety of historic buildings, developing fire-retardant coatings with integrated decoration, fire protection, ageing resistance and antibacterial performances is imperative. Here, a novel multifunctional transparent fire-retardant coating with fire protection, smoke suppression, antibacterial and anti-ageing functions was successfully fabricated using talc as a multifunctional synergist. Mechanical tests show that the multifunctional coating containing talc shows an improvement in pencil hardness and adhesion classification while keeping a high transparency. Moreover, adding talc is conductive to fabricate a physical barrier with super compactness and intumescence, which endows the coatings with excellent fire protection and smoke suppression functions. Especially, when the mass ratio of PPB to talc is 95:5, the obtained MTPPB3 coating retains a high-level transparency of 85.8%, accompanying with a 72.6% reduction in flame spread rating and a 57.0% reduction in smoke density rating compared to MTPPB0 without talc. TG analysis shows that the multifunctional coatings containing talc exhibit sharp enhancements in thermal stability and char yield, and MTPPB3 retains 32.7% residue at 800 °C. Meanwhile, the addition of talc results in high antibacterial rate against E. coli bacteria and durable flame-retardant and smoke suppression effects, and MTPPB3 shows an antibacterial rate of 99.0% against E. coli bacteria. This work provides a promising way to fabricate multifunctional transparent fire-retarded coatings with outstanding functions of decoration and fire protection. [Display omitted] [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the outcomes of bioprosthetic pulmonary valve replacement (PVR) in children. This is a retrospective review of all bioprosthetic PVR in children (≤ 20-year old) between 1992 and 2013 at a single institution. Most outcomes studied included pulmonary valve reintervention and bioprosthetic valve function. A total of 136 bioprosthetic PVRs were identified for 123 patients. The median age and body weight at the time of operation were 13.2 years and 48.4 kg. There were 1 early death and 3 late deaths during the median follow-up of 7.2 years (0-22.0 years). The actuarial transplant-free survival was 97.6% at 10 years. There were 43 bioprosthesis reinterventions with 29 reoperations and 14 catheter-based interventions. The freedom from bioprosthesis reintervention was 89.6% and 55.0% at 5 and 10 years, respectively. Echocardiographic bioprosthesis dysfunction (≥ moderate bioprosthesis insufficiency, ≥ 50 mmHg peak gradient through bioprosthesis, or bioprosthesis endocarditis with vegetation) was found in 57 bioprostheses. The freedom from bioprosthesis dysfunction was 74.0% and 32.8% at 5 and 10 years, respectively. Results from the Cox proportional hazards models showed that age had significant association with freedom from bioprosthesis reintervention and freedom from bioprosthesis dysfunction (P < 0.001 and P = 0.03), whereas bioprosthesis type had nonsignificant association with freedom from bioprosthesis dysfunction (P = 0.068). Bioprosthetic PVR in children had excellent early outcomes but rapidly deteriorating midterm outcomes. Careful and close follow-up are necessary for children with bioprosthesis in the pulmonary position. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to document the attitudes and practice patterns of pediatric surgeons regarding use of RTUS with CVC placement. Methods An analytic survey composed of 20 questions was sent via APSA headquarters to all practicing members. Answers were summarized as frequency and percentage. Distributions of answers were compared using the chi-square tests. P-values ≤ 0.05 were considered statistically significant. Results 361 of 1072 members chose to participate for a response rate of 34%. Most placed CVCs into the subclavian veins (SCV) of patients without coagulopathy, with the left SCV chosen approximately four times more often than the right. Conversely, RTUS use at the internal jugular vein (IJV) was significantly greater than that for the SCV (p < 0.001). Coagulopathy, multiple previous catheters, and morbid obesity were identified as patient characteristics that would encourage RTUS use. The most commonly cited potential barriers to RTUS use were lack of formal ultrasound training and the belief that ultrasound is not necessary. Conclusions Variability exists among pediatric surgeons regarding use of RTUS during CVC placement. Additional studies are needed to document actual frequency of use, how RTUS is implemented, and its efficacy of preventing adverse events in children. [ABSTRACT FROM AUTHOR]

Background The purposes of this study were to review our early outcomes using valved expanded polytetrafluoroethylene (ePTFE) conduits, with or without bulging sinus structure, for right ventricular outflow tract reconstruction and to examine the mechanical properties of the ePTFE material after bulging sinuses were created. Methods A retrospective review was performed of all patients who received the valved ePTFE conduit between 2008 and 2014 at a single institution. The surface morphologies and the mechanical strengths of the ePTFE conduit with bulging sinuses examined by scanning electron microscopy and unidirectional pull test were compared with those of the original ePTFE material. Results There were 120 operations with the valved ePTFE conduit (60 with bulging sinuses). The patients median age and weight were 6.9 years and 23.7 kg. The conduits were a median size of 22 mm. At 5 years, freedom from conduit reoperation was 92.7% (95% confidence interval, 82.7% to 97.0%), and freedom from severe conduit insufficiency or more than a 50 mm Hg gradient was 74.8% (95% confidence interval, 60.8% to 84.4%). No significant differences in the surface morphologies were observed by the scanning electron microscopy or in the maximum tolerated loads obtained by the pull test between the original ePTFE material and the ePTFE with bulging sinuses (121 and 122 N in longitudinal direction and 115 and 121 N in circumferential direction; p = 0.88 and p = 0.68). Conclusions The valved ePTFE conduits demonstrated excellent early clinical outcomes. The mechanical property examinations showed no obvious difference after bulging sinuses were created on the ePTFE material. [ABSTRACT FROM AUTHOR]

Background Patients with end-stage heart failure possess many attributes that place them at risk for prolonged mechanical ventilation (MV). However, there are only limited data on MV support among children after ventricular assist device (VAD) implantation. We report the duration of MV after VAD placement, indications for respiratory support in the postimplantation period, and associated patient factors. Methods This single-center retrospective study included 43 consecutive children (aged <18 years) with end-stage heart failure who were supported with a VAD as a bridge to transplantation from January 2005 to December 2011. Multivariable analysis was performed using the multiple Poisson regression model for the duration of MV. Results Overall, 33% (n = 14) remained on MV until heart transplant or death. Of those requiring pre-VAD extracorporeal membrane oxygenation (ECMO) support, 63% (n = 12 of 19) remained on MV until heart transplant or death compared with 8% (n = 2 of 24) among those not on ECMO before VAD ( p < 0.001). Patients with moderate or severe mitral regurgitation while on VAD support had 1.7-times more MV days compared with those with none or trivial on-VAD mitral regurgitation. In addition, previous support on ECMO, those with moderate or severe tricuspid regurgitation, and those with only left VAD implants had an increased risk of prolonged MV. Conclusions Our results suggest that VAD recipients previously supported on ECMO, those with moderate or severe mitral regurgitation, moderate or severe tricuspid regurgitation, and those with only left VAD implants had an increased risk of prolonged MV. Future studies in larger cohorts are necessary to confirm the findings from this single-institutional experience. [ABSTRACT FROM AUTHOR]

Objective To describe epidemiology and outcomes associated with cardiac arrest among critically ill children across hospitals of varying center volumes. Methods Patients <18 years of age in the Virtual PICU Systems (VPS, LLC) Database (2009–2013) were included. Patients with both cardiac and non-cardiac diagnoses were included. Data on demographics, patient diagnosis, cardiac arrest, severity of illness and outcomes were collected. Hierarchical cluster analysis was performed to categorize all the participating centers into low, low-medium, high-medium, and high volume groups using the center volume characteristics (annual hospital discharges per center, annual extracorporeal membrane oxygenation per center, and annual mechanical ventilators per center). Multivariable models were used to evaluate association of center volume with incidence of cardiac arrest, and mortality after cardiac arrest, adjusting for patient and center characteristics. Results Of 329,982 patients (108 centers), 2.2% ( n = 7390) patients had cardiac arrest with an associated mortality of 35% ( n = 2586). In multivariable models controlling for patient and center characteristics, center volume was not associated with either the incidence of cardiac arrest (OR: 1.00; 95% CI: 0.95–1.06; p = 0.98), or mortality in those with cardiac arrest (OR: 0.93; 95% CI: 0.82–1.06; p = 0.27). These associations were similar across cardiac and non-cardiac disease categories. Furthermore, we demonstrated that there was no correlation between incidence of cardiac arrest and mortality in those with cardiac arrest across different study hospitals in adjusted models. Conclusions Both incidence of cardiac arrest, and mortality in those with cardiac arrest vary substantially across hospitals. However, center volume is not associated with either of these outcomes, after adjusting for patient and center characteristics. [ABSTRACT FROM AUTHOR]

Objective: There is cross-center variability with regard to timing repair of non–ductal-dependent tetralogy of Fallot (TOF). We hypothesized that earlier repair in the neonatal period is associated with increased mortality and morbidity. Methods: This was a retrospective analysis of the Pediatric Health Information System of tetralogy of Fallot patients undergoing complete repair from 2004 through 2010 between the ages of 1 day to younger than 19 years. Patients with pulmonary valve atresia, those who received prostaglandin during hospital admission, and those who underwent prior shunt palliation were excluded. Results: A total of 4698 patients met our inclusion criteria, of whom 202 were younger than 30 days old (group A), 861 were 31 to 90 days old (group B), 1796 were 91 to 180 days old (group C), and 1839 were older than 180 days (group D). In-hospital mortality, intensive care unit length of stay, and total hospital length of stay were significantly higher in group A. Patients in group A had a significantly increased postoperative requirement for mechanical ventilation, intravenous blood pressure support, medical diuresis, extracorporeal membrane oxygenation, gastrostomy tube insertion, heart catheterization, and surgical revision. Significant institutional variability was noted for timing of TOF complete repair, with one third of the centers performing 75% of the repairs at younger than 30 days old. The institutional approach to timing TOF complete repair showed no relation to surgical volume. Conclusions: Across all centers analyzed, primary neonatal elective TOF repair (<30 days of age) is associated with significantly higher postoperative in-hospital morbidity and mortality, although a few centers have shown an ability to use this strategy with excellent survivability. [Copyright &y& Elsevier]

Objective: To identify the characteristics of children with cystic fibrosis with low initial forced expiratory volume in 1 second (FEV1) % predicted and to investigate their outcome. Study design: Patients were categorized into low or high initial FEV1 groups using cluster analysis. Comparisons of the demographic and clinical data were performed between the 2 groups. Results: From 122 children, 21 clustered into the low and 101 into the high FEV1 group. The mean FEV1 was 69% ± 12% predicted for the low and 95% ± 12% predicted for the high FEV1 group (P < .001). The low FEV1 group had lower body mass index percentiles (P = .003), were hospitalized more frequently (P = .001), and had been on dornase alfa longer (P = .006). Low FEV1 group had more patients with positive cultures for Pseudomonas aeruginosa (P = .002) and Stenotrophomonas maltophilia (P < .001) and had more total number of cultures positive for mucoid P aeruginosa (P = .009) and methicillin resistant Staphylococcus aureus + P aeruginosa (P = .005). The low FEV1 group continued to have low FEV1 measurements, their FEV1 declined slower, required more hospitalizations per year (P = .01), and had more cultures for mucoid (P = .003) and nonmucoid P aeruginosa (P = .02) ± methicillin resistant S aureus (P = .002) in comparison with the high FEV1 group. Poor adherence was associated with lower initial FEV1 values in females, and early, rapid decline of FEV1 in males. Conclusions: Some children with cystic fibrosis may present with poor lung function early in life and continue to have subnormal lung function associated with reduced body mass index, more frequent hospitalization, and higher rates of infection. Such children may benefit from careful evaluation and close follow-up. [Copyright &y& Elsevier]

Sulfonamides (SAs) are ubiquitous antibiotics that are increasingly detected in the aquatic environment, and may cause potential harm to the environment and humans. Indirect photodegradation has been considered to be a promising natural degradation process for antibiotics in the environment. Chromophoric dissolved organic matter (CDOM) is an important participant in the indirect photodegradation of antibiotics. Indirect photodegradation of sulfathiazole (ST) and sulfamerazine (SM) were studied in the presence of CDOM and marine factors (salinity, pH, nitrate (NO 3 −) and bicarbonate (HCO 3 −)) to simulate photodegradation of these compounds in the coastal seawater environment. The main findings are as follows. First, the indirect photodegradation rates of ST and SM in the presence of CDOM were significantly increased and followed the pseudofirst order kinetics. Second, 1O 2 played a critical role in the indirect photodegradation of ST and its contribution rate was 54.2%; 3CDOM⁎ performed similarly in the case of SM with a 58.0% contribution rate. Third, CDOM was divided into four fluorescent components by excitation-emission matrix spectroscopy and parallel factor analysis (EEMs-PARAFAC), including three exogenous components and an autochthonous component. The exogenous components with high molecular weight and higher number of aromatic groups played a decisive role in the indirect photodegradation of ST and SM due to their ability to generate higher levels of reactive intermediates (RIs). Finally, seawater factors (salinity, pH, NO 3 − and HCO 3 −) influenced the indirect photodegradation of ST and SM by influencing the steady-state concentrations of RIs. This report is the first study of indirect photodegradation of ST and SM from the perspective of the CDOM components and simulated coastal waters. Unlabelled Image • 1O 2 (3CDOM⁎) played a critical role in the indirect photodegradation of ST (SM). • The exogenous components had stronger photochemical activity. • The CDOM components were correlated with the indirect photodegradation of ST (SM). • Seawater factors affected the indirect photodegradation of ST(SM) by affecting RIs. [ABSTRACT FROM AUTHOR]

• HPS inhibited proliferation of HCT116 cells significantly. • HPS induced cell cycle arrest in the S and G2/M phases, and increased apoptosis. • HPS down-regulated the AKT pathway by decreasing phosphor-AKT. • HPS induced MAPK pathway by increasing phosphor-p38. This study demonstrated that a homogeneous polysaccharide (HPS) extracted from Hawthorn exerted anti-cancer effects on colon cancer cells. Human colon cancer cell line HCT116 were treated with 125–1000 µg/mL HPS for 12 h and subsequent analysis was performed on proliferation and signaling pathways. HPS significantly inhibited proliferation of HCT116 cells when analyzed using WST-1 assay and immunofluorescence staining of Ki-67. Flow cytometric studies revealed that HPS could arrest the cell cycle in the S and G2/M phases and increase the rate of apoptosis. HPS downregulated the expression of Cyclin A1/D1/E1 and CDK-1/2. HPS induced apoptosis on HCT116 cells through upregulation of caspase3, 7, 8, 9 and Fas, FADD, TNF-R1, TRADD, upregulation of caspase3 protein was also observed. HPS has an anti-cancer potential in the treatment of human colon cancer which makes it a potential candidate in functional foods for cancer patients. [ABSTRACT FROM AUTHOR]

Background: Small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and postnatally were previously shown to improve high-density lipoprotein (HDL) cholesterol efflux capacity (CEC) and length in the children of supplemented mothers at 18 mo of age in the International Lipid-Based Nutrient Supplements (iLiNS) DYAD trial in Ghana. However, the effects of SQ-LNS on maternal HDL functionality during pregnancy are unknown. Objective: The goal of this cross-sectional, secondary outcome analysis was to compare HDL function in mothers supplemented with SQLNS vs. iron and folic acid (IFA) during gestation. Methods: HDL CEC and the activities of 3 HDL-associated enzymes were analyzed in archived plasma samples (N = 197) from a subsample of females at 36 weeks of gestation enrolled in the iLiNS-DYAD trial in Ghana. Correlations between HDL function and birth outcomes, inflammatory markers C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP), and the effects of season were explored to determine the influence of these factors on HDL function in this cohort of pregnant females. Results: There were no statistically significant differences in HDL CEC, plasma lecithin-cholesterol acyltransferase (LCAT) activity, cholesteryl ester transfer protein (CETP) activity, or phospholipid transfer protein (PLTP) activity between mothers supplemented with SQ-LNS compared with IFA control, and no statistically significant relationships between maternal HDL function and childbirth outcomes. LCAT activity was negatively correlated with plasma AGP (R = -0.19, P = 0.007) and CRP (R = -0.28, P < 0.001), CETP and LCAT activity were higher during the dry season compared to the wet season, and PLTP activity was higher in the wet season compared to the dry season. Conclusions: Mothers in Ghana supplemented with SQ-LNS compared with IFA during gestation did not have measurable differences in HDL functionality, and maternal HDL function was not associated with childbirth outcomes. However, seasonal factors and markers of inflammation were associated with HDL function, indicating that these factors had a stronger influence on HDL functionality than SQ-LNS supplementation during pregnancy. [ABSTRACT FROM AUTHOR]

Deduplication, which stores only one copy of duplicate data, is used extensively in cloud storage to reduce the overhead associated with storage. Unfortunately, client-side encryption prevents cloud storage from performing deduplication due to the randomness of traditional encryption. Some existing schemes can balance encryption and deduplication, but their interaction with third-party servers or online users adds additional overhead to the system. Also, the ownership of outsourced data will change frequently due to users' requests to upload/delete/modify the data. But many existing schemes that can achieve dynamic ownership management have security flaws or require users to manage multiple keys. By focusing on these troubles, we have developed a secure deduplication scheme that does not rely on any third-party entities and supports data ownership management. More specifically, we take advantage of elliptic curve cryptography to design a key-sharing method so that different owners of the same data can share a random key only by interacting with the cloud service provider. And the broadcast encryption is used to manage the ownership of data, and this allows the cloud service provider to control users' access to outsourced data by updating the broadcast key. In addition, the security analysis shows that the proposed scheme can meet the required security and that it outperforms other related schemes. The detailed simulation comparisons with other related schemes demonstrate that the proposed scheme has good performance. [ABSTRACT FROM AUTHOR]

• The PLL/WS2/LIG electrode with 2D-on-2D layered structure exhibits an excellent electrochemical property towards CBZ. • The flexible electrochemical sensor, encapsulated by 3D printing, achieve the non-destructive in-situ detection of CBZ on tea leaves. • Easy-to-use visual online cloud platform is developed for convenient and intelligent detection. • Real-time intelligent analysis is realized to monitor the change in CBZ residues to guarantee food safety. Excessive use of carbendazim (CBZ) for controlling fungal disease may result in pesticide residues in growth environments. There is an urgent requirement for real-time detection of CBZ content to enable rapid assessment of pesticide residues. Herein, a novel electrochemical sensor was created, which utilizes a laser-induced graphene (LIG) electrode modified with two-dimensional (2D) tungsten disulfide (WS 2) nanosheets and a poly(L-lysine) (PLL) film to construct a 2D-on-2D layered structure. The PLL/WS 2 /LIG electrode exhibits strong charge transfer, excellent electrocatalytic performance, and high CBZ adsorption capacity, thus leading to enhanced sensitivity. As a result, the sensor exhibits a low detection limit of 1.2 ng/mL (6.2 nM), high sensitivity up to 135.1 μA(μg/mL)−1cm−2, and a wide response range of 0.01 to 1.5 μg/mL. Moreover, an intelligent analysis system, consisting of a portable device that connects to an online cloud platform equipped with a machine learning model and visualization software, has been developed for the real-time detection of CBZ residues on tea leaves in tea plantations. This study demonstrates that the PLL/WS 2 /LIG sensor and the intelligent analysis system have great potential to monitor pesticide residues to guarantee food safety. [Display omitted] [ABSTRACT FROM AUTHOR]

• Successful synthesis of a novel multifunctional transparent fireproof coating. • Exfoliated h-BN keeps the transparent coating with a high transparency. • h-BN boosts the fire resistance and smoke suppression of the coatings. • h-BN offers significant anti-aging with less blistering and cracking. • h-BN exhibits up to 99.0% E. coli inhibition, ensuring antibacterial efficacy. To solve the problems of traditional transparent fireproof coatings with a single-function nature and susceptibility to environmental aging, a novel functionalized exfoliated boron nitride (h-BN) with organophosphate (PPB) was synthesized and applied in an amino resin, preparing an integrated coating with decorative, fire-resistant, antibacterial, and weathering functions. The results indicate that the introduction of h-BN not only maintains the coating's high transparency but also enhances its hardness and adhesion capabilities. Furthermore, the presence of h-BN positively influences the flame retardance and smoke suppression of MBPPB coatings. Notably, when the mass ratio of PPB to h-BN is 98:2, the resulting MBPPB4 coating reduces the flame spread rate (FSR) by 45.7% and the smoke density rating by 62.6% compared to MBPPB0 coating without h-BN. Thermogravimetric analyses indicate that coatings containing h-BN exhibit superior char formation and thermal stability, where the MBPPB3 coating, with a PPB to h-BN ratio of 98.5:1.5, shows a 49.8% higher char yield at 800 °C than MBPPB0. The accelerated aging test demonstrates that the incorporation of h-BN also reduces the incidence of coatings blistering and cracking, thereby exhibiting outstanding weatherability. Additionally, h-BN significantly enhances the coating's antibacterial efficacy, with an E. coli inhibition rate of up to 99.0% for MBPPB3 coating. [Display omitted] [ABSTRACT FROM AUTHOR]