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Near‐infrared (NIR) phosphor‐converted light–emitting diodes (pc‐LEDs) are increasingly used in night vision, surveillance, and biomedicine. A major challenge is to identify a phosphor that efficiently converts blue light into wideband NIR emission. In this paper, a rare‐earth divalent europium (Eu2+)‐activated halogen oxide (Sr3GeO4Cl2) phosphor is unlocked via a high‐temperature solid‐state reaction. The Sr3GeO4Cl2:Eu2+ phosphor emits a wide spectrum (500–950 nm) with a peak at 700 nm when excited by 450 nm blue light. Extended X‐ray absorption fine structure (EXAFS) analysis reveals that the NIR emission primarily originates from Eu2+ ions, and the Eu─O bond length closely resembles the Sr─O bond length. Lattice engineering, specifically Ge/Si cation substitution, increased Eu2+ incorporation into the crystal lattice, boosting luminescence intensity by 75%–122% and quantum efficiency from 15% to 26%. This is related to the combined effect of reduced non‐radiative energy transfer and changes in the local lattice structure of Eu2+. A NIR pc‐LED device using the optimized phosphor showed a photoelectric efficiency of 16.5% and an optical output of 25.07 mW at 100 mA. This study not only explores new Eu2+‐activated NIR phosphors but also highlights the importance of crystal engineering to enhance luminescence properties, guiding future research for efficient NIR pc‐LED development. [ABSTRACT FROM AUTHOR]

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Integration of the human papillomavirus (HPV) genome into the cellular genome is a key event that leads to constitutive expression of viral oncoprotein E6/E7 and drives the progression of cervical cancer. However, HPV integration patterns differ on a case‐by‐case basis among related malignancies. Next‐generation sequencing technologies still face challenges for interrogating HPV integration sites. In this study, utilizing Nanopore long‐read sequencing, we identified 452 and 108 potential integration sites from the cervical cancer cell lines (CaSki and HeLa) and five tissue samples, respectively. Based on long Nanopore chimeric reads, we were able to analyze the methylation status of the HPV long control region (LCR), which controls oncogene E6/E7 expression, and to identify transcriptionally‐active integrants among the numerous integrants. As a proof of concept, we identified an active HPV integrant in between RUNX2 and CLIC5 on chromosome 6 in the CaSki cell line, which was supported by ATAC‐seq, H3K27Ac ChIP‐seq, and RNA‐seq analysis. Knockout of the active HPV integrant, by the CRISPR/Cas9 system, dramatically crippled cell proliferation and induced cell senescence. In conclusion, identifying transcriptionally‐active HPV integrants with Nanopore sequencing can provide viable targets for gene therapy against HPV‐associated cancers. [ABSTRACT FROM AUTHOR]

Introduction: Programmed death 1 (PD‐1)/programmed death ligand 1 (PD‐L1) blockade has changed the landscape of treatment for metastatic urothelial cancer, but single‐agent cytotoxic T‐lymphocyte–associated protein 4 (CTLA‐4) blockade in metastatic urothelial cancer has been underexplored. A prior phase 2 trial of tremelimumab in PD‐1/PD‐L1–blockade naive patients with metastatic urothelial cancer revealed activity comparable to that observed with PD‐1/PD‐L1 blockade raising the hypothesis that these classes of immune checkpoint inhibitors might be non‐cross‐resistant. Methods: The current phase 2 trial treated patients with PD‐1/PD‐L1 blockade‐resistant metastatic urothelial cancer with single‐agent tremelimumab (750 mg intravenously every 28 days for up to 7 cycles). The primary end point was objective response rate. Results: Twenty‐six patients were enrolled and 24 patients were evaluable for response. The objective response rate was 8.3%, composed of a total of two partial responses that lasted 10.9 and 24.0 months. Stable disease was observed in another 20.8% of patients, with a median duration of stable disease of 5.4 months. Diarrhea occurred in 15 patients (58%), elevated hepatic transaminases occurred in seven patients (27%), and adrenal insufficiency occurred in two patients (8%); one patient died after experiencing immune‐related hepatitis. Conclusions: High dose CTLA‐4 blockade in patients with PD‐1/PD‐L1–resistant metastatic urothelial cancer has modest activity and is associated with treatment‐related toxicity similar to prior reports. The current phase 2 trial sought to test that cytotoxic T‐lymphocyte–associated protein 4 blockade demonstrates anticancer activity in patients with metastatic urothelial cancer and is non‐cross‐resistant with programmed death 1 (PD‐1)/programmed death ligand 1 (PD‐L1) blockade. Tremelimumab in patients with PD‐1/PD‐L1–resistant metastatic urothelial cancer demonstrated modest activity and is associated with treatment‐related toxicity similar to prior reports. [ABSTRACT FROM AUTHOR]

Introduction: Recently, chloride channel CLIC‐like 1 (CLCC1) was reported to be a novel ALS‐related gene. We aimed to screen CLCC1 variants in our ALS cohort and further explore the genotype–phenotype correlation of CLCC1‐related ALS. Methods: We screened rare damaging variants in CLCC1 from our cohorts of 1005 ALS patients and 1224 healthy controls with whole‐exome sequencing in Central South China. Fisher's exact test was conducted for association analysis at the entire gene level and single variant level. Results: In total, four heterozygous missense variants in CLCC1 were identified from four unrelated sporadic ALS patients and predicted to be putative pathogenic by in silico tools and protein model prediction, accounting for 0.40% of all patients (4/1005). The four variants were c.A275C (p.Q92P), c.G1139A (p.R380K), c.C1244T (p.T415M), and c.G1328A (p.R443Q), respectively, which had not been reported in ALS patients previously. Three of four variants were located in exon 10. Patients harboring CLCC1 variants seemed to share a group of similar clinical features, including earlier age at onset, rapid progression, spinal onset, and vulnerable cognitive status. Statistically, we did not find CLCC1 to be associated with the risk of ALS at the entire gene level or single variant level. Conclusion: Our findings further expanded the genetic and clinical spectrum of CLCC1‐related ALS and provided more genetic evidence for anion channel involvement in the pathogenesis of ALS, but further investigations are needed to verify our findings. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to assess the level of moral courage among nurses in China, and to explore related influential factors, to help nursing managers take measures to improve nurses' moral courage. Design: A cross‐sectional study. Methods: The data adopted a convenient sampling method. From September to December 2021, 583 nurses from five hospitals in Fujian Province completed the Chinese version of the Nurses' Moral Courage Scale (NMCS). Data were analysed using descriptive statistics, chi‐square test, T‐test, Pearson correlation analysis and multiple regression analysis. Results: The Chinese nurses perceived themselves, on average, as morally courageous. The mean NMCS score was 3.64 ± 0.692. The six factors showed statistically significant correlations (p < 0.05) with moral courage. Regression analysis showed that the main factors influencing nurses' moral courage were active learning of ethics knowledge and nursing was a career goal. Conclusion: This study provides the self‐evaluation level and related influencing factors of Chinese nurses' moral courage. There is no doubt that nurses still need strong moral courage to face unknown ethical problems and challenges in the future. Nursing managers should pay attention to the cultivation of nurses' moral courage, using various forms of educational activities to help nurses alleviate moral problems and improve their moral courage, to maintain patients' access to high‐quality nursing. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron variant is undergoing continuous evolution and convergent mutation. These new subvariants are raising concerns that they may evade neutralizing monoclonal antibodies (mAbs). We investigated the serum neutralization efficacy of Evusheld (cilgavimab and tixagevimab) against SARS‐CoV‐2 Omicron BA.2, BA.2.75, BA.2.76, BA.5, BF.7, BQ.1.1, and XBB.1.5. A total of 90 serum samples from healthy individuals were collected in Shanghai. Anti‐RBD antibodies were measured and symptoms of infection with COVID‐19 were compared among those individuals. The neutralizing activity of serum against Omicron variants was analyzed by pseudovirus neutralization assays in 22 samples. Evusheld retained neutralizing activity against BA.2, BA.2.75, and BA.5, albeit with somewhat reduced titers. However, the neutralizing activity of Evusheld against BA.2.76, BF.7, BQ.1.1, and XBB.1.5 significantly decreased, with XBB.1.5 showing the greatest escape activity among the subvariants. We also observed that Evusheld recipients displayed elevated antibody levels in their serum, which efficiently neutralized the original variant, and exhibited different characteristics of infection than those who did not receive Evusheld. The mAb has partial neutralization activity against Omicron sublineages. However, the increasing doses of mAb and a larger size of population should be further investigated. [ABSTRACT FROM AUTHOR]

Fibrosis of the liver is a degenerative alteration that occurs in the majority of chronic liver disorders. Further progression can lead to cirrhosis, liver failure, and hepatocellular carcinoma, which can seriously affect the health and lives of patients. The field of liver fibrosis research has flourished in the last 20 years, with approximately 9000 articles retrieved from the Web of Science Core Collection database alone. In order to identify future research hotspots and potential paths in a thorough and scientifically reliable manner, it is important to organize and visualize the research on this topic from a holistic and very general perspective. This study used bibliometric analysis with CiteSpace and VOSviewer software to provide a quantitative analysis, hotspot mining, and commentary of articles published in the field of liver fibrosis over the last 20 years. This bibliometric analysis contains a total of 8994 articles with 45667 authors from 6872 institutions in 97 countries, published in 1371 journals and citing 156 309 references. The literature volume has steadily increased over the last 20 years. Research has focused on gastroenterology and hepatology, pharmacology and pharmacy, and medicine, research, and experimental areas. We found that the pathological mechanisms, diagnostic and quantitative methods, etiology, and antifibrotic strategies constitute the knowledge structure of liver fibrosis. Finding mechanisms for liver fibrosis regression, identifying precise noninvasive diagnostic and prognostic biomarkers, and creating efficient liver fibrosis patient treatments are the main goals of current research. [ABSTRACT FROM AUTHOR]

Construction of bifunctional catalysts with balanced adsorption toward multiple reactants and intermediates is crucial for efficient urea‐assisted water splitting. Nickel Sulfide (NiS) is considered as a promising choice for both urea oxidation reaction (UOR) and hydrogen evolution reaction (HER), whereas the highly occupied d orbital of Ni sites results in too weak reactant adsorption to achieve satisfactory bifunctionality. Herein, considering the adsorption‐energy scaling limitations, another Mo4+ site with empty d orbital is introduced into NiS crumpled nanoflowers as a reactant mediator for accelerated urea electrolysis. Based on the in situ characterizations and theoretical calculations, a dual‐center catalytic mechanism is proposed that the Mo4+ sites govern the reactant adsorption, subsequently cooperate with nearby Ni sites to promote the reactant dissociation, intermediate formation, and product desorption. The crumpled flower‐like nanostructure also provides abundant active sites and rapid mass transfer. Consequently, the Mo‐NiS exhibits excellent UOR/HER bifunctionality in an anion‐exchange membrane (AEM) flow electrolyzer. Compared with the pure‐water electrolysis system, the urea‐assisted water electrolyzer saves 15% energy to produce hydrogen. Besides, this electrolyzer obtains an ampere‐level current density of 1 A cm−2 at the cell voltage of 2.0 V, about 2.56 times higher than that of the assembly of RuO2||Pt/C, and robust durability. [ABSTRACT FROM AUTHOR]

The physician assistant/associate (PA) profession originated in the United States; PAs play an active role in alleviating the shortage of health and medical resources and improving the quality of medical care. This position has been introduced in and developed by many countries. Based on extensive literature research, this article summarizes the three main features of PAs, namely, that there is professional education for training PAs, the PA is an independent and exclusive professional type and PAs assist doctors in completing medical work. With reference to the innovative concept of the PA profession, this article summarized the existing "assistant" position in China that is similar to the PA position, compared it with the three features of PAs, revealed the shortcomings of the existing "assistant" position in China, provided a reference for the development of relevant careers in China, and provided solutions for solving the problems of medical and health resources in China. [ABSTRACT FROM AUTHOR]

Tumor recurrence remains the major cause of management failure after surgical resection of glioblastoma (GBM). Immunotherapy has the potential to effectively eradicate tumors and trigger immune memory to prevent tumor recurrence but not improve the outcomes of GBM patients. Here, an injectable, reactive oxygen species‐degradable therapeutic hydrogel (ADU‐AAV‐PD1@Gel), capable of sustained local release of soluble PD‐1 (sPD‐1) and stimulator of interferon gene (STING) agonist ADU‐S100 (ADU), is developed and applied in a GBM surgical resection model. Adeno‐associated virus serotype 9 is employed to stably express sPD‐1 blocking the PD‐1/PD‐L1 pathway. Concomitantly, the released ADU activates the STING pathway to improve tumor immunogenicity and response to therapy. This therapeutic hydrogel combined with radiotherapy (RT) effectively promotes sustained T cells infiltration and restores T cells effector function, which exhibits a robust antitumor immune response and significantly suppresses tumor growth. Moreover, ADU‐AAV‐PD1@Gel combined with RT treatment can also induce a long‐term immune memory to prevent GBM recurrence. As a result, ADU‐AAV‐PD1@Gel provides a novel strategy for effective radioimmunotherapy of GBM relapse post‐resection. [ABSTRACT FROM AUTHOR]

Atherosclerosis with unstable plaques is the dominant pathological basis of lethal cardio‐cerebrovascular diseases, which can cause acute death due to the rupture of plaques. Plaque‐targeted drug delivery to achieve promoted treatment remains the main challenge because of the systemic occurrence of atheroma. Herein, a rapamycin (RAP) spherical nucleic acid (SNA) structure, capable of specifically accumulating in plaques for synergistic atherosclerosis treatment is constructed. By designing consecutive phosphorothioate (PS) at 3' terminus of the deoxyribonucleic acid (DNA) strand, multiple hydrophobic RAPs are covalently grafted onto the PS segment to form an amphiphilic drug‐grafted DNA (RAP‐DNA), which successively self‐assembles into micellar SNA (RAP‐SNA). Moreover, the phosphodiester‐DNA segment constitutes the outer shell of RAP‐SNA, enabling further hybridization with functional siRNA (targeting lectin‐like oxidized low‐density lipoprotein receptor‐1, LOX‐1) to obtain the drug codelivered SNA (LOX‐1/RAP‐SNA). With two active ingredients inside, LOX‐1/RAP‐SNA can not only induce robust autophagy and decrease the evil apoptosis of the pathological macrophages, but also simultaneously prohibit the LOX‐1‐mediated formation of damageable foam cells, realizing the effect of synergistic therapy. As a result, the LOX‐1/RAP‐SNA significantly reduces the progression of atheroma and stabilizes the plaques, providing a new strategy for synergistically targeted atherosclerosis treatment. [ABSTRACT FROM AUTHOR]

Fe2TiO5 powders are synthesized via nonhydrolytic sol‐gel method, and the effects of titanium sources on the synthesis and morphology of Fe2TiO5 powders are investigated via differential thermal analysis‐thermogravimetric (DTA‐TG), X‐ray diffraction (XRD), Transmission Electron Microscope (TEM), Field Emission‐Scanning Electron Microscope (FE‐SEM) and Fourier Transform Infrared (FT‐IR). It is beneficial for the low‐temperature synthesis of Fe2TiO5 to form Fe−O−Ti bonds when TiCl4 and Ti(OC4H9)4 are used as titanium source. But it is difficult to synthesize pure Fe2TiO5 phase and the powders synthesized are seriously agglomerated, when TiCl4 is used as titanium source. When Ti{OCH(CH3)2}4 is used as the titanium source, Fe2TiO5 phase can not be synthesized until 800 °C, which is due to Fe−O−Ti bond does not form in the xerogels. Fe2TiO5 powders prepared with Ti(OC4H9)4 as titanium source are small in particles size of 100–200 nm with high dispersion and element uniformity. [ABSTRACT FROM AUTHOR]

Crustaceans are often exposed to hypoxic stress in intensive aquaculture systems. Such stress leads to physiological, behavioural and biochemical changes, which can cause various metabolic disorders or even death. Crustacean response mechanisms to hypoxia stress are known to be complex, with their regulation involving multiple genes. In this review, after briefly exploring some known causes of hypoxic stress in aquaculture systems, we discuss the physiological adaptation strategies used by crustaceans in response to hypoxia and summarise recent information regarding the effects of hypoxia on the behaviour, survival, antioxidant ability, metabolic processes and innate immunity of crustaceans. In addition, we give particular emphasis to the known molecular mechanisms underlying hypoxia related to the hypoxia‐inducible factor 1 (HIF‐1) signalling pathway, the adenosine 5′‐monophosphate‐activated protein kinase signalling (AMPK) pathway, and apoptosis. Practically, it is clear that multiple measures need to be taken to prevent and regulate the adverse effects of hypoxic stress in intensive aquaculture systems, including development of hypoxia‐resistant breeds and nutritional regulation techniques. Overall, this review provides a theoretical basis for understanding the molecular mechanisms underlying hypoxic stress in crustaceans, while making conceptual connections with data from related study areas in other species. [ABSTRACT FROM AUTHOR]

Summary: Although the genetic basis for endosperm development in maize (Zea mays) has been well studied, the mechanism for coordinating grain filling with increasing kernel size remains elusive. Here, we report that increased kernel size was selected during modern breeding and identify a novel DELLA‐like transcriptional regulator, ZmGRAS11, which positively regulates kernel size and kernel weight in maize. We find that Opaque2, a core transcription factor for zein protein and starch accumulation, transactivates the expression of ZmGRAS11. Our data suggest that the Opaque2‐ZmGRAS11 module mediates synergistic endosperm enlargement with grain filling. [ABSTRACT FROM AUTHOR]

Problem: This study aims to investigate the effects of alpha‐linolenic acid (ALA) on the gut microbiota (GM) and the abdominal environment in mice with endometriosis (EMS). Methods: The effects of faecal microbiota transplantation (FMT) from EMS mice on mice treated with antibiotic cocktail were conducted. The 16S rRNA sequencing and PICRUSt software were used to detect the structure and function of GM respectively. The protein levels of Claudin 4 and ZO‐2 in the intestinal wall were detected using the western blotting. The level of LPS in the abdominal cavity was detected using enzyme‐linked immunosorbent assay (ELISA). The content of macrophages in the abdominal cavity was detected using flow cytometry. Results: The exogenous supplementation of ALA could restore the abundance of Firmicutes and Bacteroidota in EMS mice. After the ALA treatment, the abundance of 125 functional pathways and 50 abnormal enzymes related to GM in EMS mice was significantly improved (p <.05). The expression of the ZO‐2 protein in the intestinal wall was decreased, and the level of LPS in the abdominal cavity was significantly increased after FMT from EMS mice (p <.05). ALA could increase the expression of the ZO‐2 protein in the intestinal wall of EMS mice, reduce the level of LPS in the abdominal cavity (p <.05) and reduce the aggregation of peritoneal macrophages (p <.05). Conclusion: Alpha‐linolenic acid can improve the GM, intestinal wall barrier and abdominal inflammatory environment and reduce the level of LPS in mice with EMS. [ABSTRACT FROM AUTHOR]

Bi2MoO6 nanoflakes are synthesized via a normal hydrothermal method. Bi2MoO6 photocatalysts show lower photocatalytic activity for the degradation of methylene blue under visible light irradiation. In order to further enhance the degradation efficiency, Bi2MoO6 is used to activate the peroxymonosulfate for the degradation of methylene blue under visible light. Bi2MoO6 nanoflakes show excellent degradation efficiency in the Bi2MoO6/Vis/peroxymonosulfate (PMS) system. Moreover, the influences of PMS dosage, pH value, and inorganic anions on photodegradation are evaluated. The mechanism of activating peroxymonosulfate is proved by radical quenching experiment, which reveals that sulfate radicals govern the removal of methylene blue. [ABSTRACT FROM AUTHOR]

The relationship between insulin-like growth factor-1 (IGF-1) and systolic blood pressure (SBP) is controversial in adults and children. The purpose of this study was to investigate the relationship between the IGF-1 standard deviation score (IGF-1 SDS) and SBP in children with short stature. A cross-sectional analysis including 1315 children with short stature was conducted from March 2013 to October 2020. We estimated IGF-1, blood pressure and other laboratory tests, and anthropometric indicators were also evaluated. Subgroup analyses of the pubertal stage, sex, growth hormone levels, thyroid hormone levels, fasting blood glucose levels, and triglyceride levels were performed. A positive association between the IGF-1 SDS and SBP was observed by univariate analysis (p < .001). We further found a nonlinear association between the IGF-1 SDS and SBP. The inflection point for the curve was found at an IGF-1 SDS level of -2.91. In multivariate piecewise linear regression, there was a positive association between the IGF-1 SDS and SBP when the IGF-1 SDS was greater than -2.91 (β 1.56, 95% CI: 0.91, 2.22; p < .001). However, we did not observe a significant relationship between the IGF-1 SDS and SBP when the IGF-1 SDS level was less than -2.91 (β -0.95, 95% CI -3.17, 1.28; p = .379). This association was consistent across subgroup analyses. The present study demonstrated that there is a nonlinear relationship between the IGF-1 SDS and SBP in children with short stature. Increased serum IGF-1 levels were associated with elevated SBP when the IGF-1 levels reached the inflection point. [ABSTRACT FROM AUTHOR]

Despite tremendous progress in efficiency and stability, perovskite solar cells are still facing the challenge of scalability and reproducibility. Vapor–solid reaction methods that derived from the chemical vapor deposition have been regarded as facile approaches to prepare perovskite films with large size. However, different from the precise control of compounding ratio by weighting in the solution process, the perovskite films deposited by vapor–solid reaction methods always suffer from undesired I−/Br− ratio, leading to poor performance of the solar device. Thus, controllable halogen exchange in the vapor–solid reaction process is significant for the further development of this technique. Herein, different alkali‐metal ions (such as Na+, K+, and Rb+) are added into the inorganic CsBr/PbI2 framework, and it is found that the halogen exchange in the vapor–solid reaction process can be regulated by these ions. After optimization, high‐quality Rb‐Cs0.14FA0.86Pb(BrxI1‐x)3 films with proper I−/Br− ratio are successfully obtained. Perovskite solar cells based on the as‐prepared perovskite films exhibit a significant enhancement on Voc and the champion power conversion efficiency reaches 19.6% with a Voc of 1.13 V. [ABSTRACT FROM AUTHOR]

Prenatal genetic screening should be an informed, autonomous patient choice. Extrinsic factors which influence patient decision‐making threaten the ethical basis of prenatal genetic screening. Prior research in the area of medical decision‐making has identified that labeling may have unanticipated effects on patient perceptions and decision‐making processes. This Internet‐administered study explored the impact of option labeling on the noninvasive prenatal screening (NIPS) selections of US adults. A total of 1,062 participants were recruited through Amazon Mechanical Turk (MTurk) and randomly assigned to one of three possible label sets reflecting provider‐derived and industry‐derived option labels used in prenatal screening. Multinomial logistic regression analysis showed option labeling had a statistically significant impact on the NIPS selections of study participants (p =.0288). Outcomes of the Satisfaction with Decision Scale (SWD) indicated option labels did not play a role in participant satisfaction with screening selection. The results of this study indicate a need for further evaluation of the impact NIPS option labeling has on patient screening decisions in real‐world clinical interactions. Clinical providers and testing laboratories offering NIPS should give careful consideration to the option labels used with prenatal screening so as to minimize influence on patient screening selection and decision‐making processes. [ABSTRACT FROM AUTHOR]

Objective: This study examined family-reported ambulatory care quality and its association with emergency department and hospital utilization, and how these relationships differed across levels of medical complexity.Data Sources: The 2006-2013 Medical Expenditure Panel Survey (MEPS).Study Design: Secondary analysis of MEPS data. Variables fitting the National Quality Measures Clearinghouse clinical quality measures domain framework were selected. Exploratory factor analysis grouped ambulatory quality into 12 access, experience, or process measures. Weighted negative binomial regression stratified by health status identified associations between ambulatory quality and ED visits or hospitalizations.Data Collection: 41,497 children ≤18 years were included. The 5-item special health care needs (SHCN) screener categorized health status as complex, less complex, or no SHCN.Principal Findings: Weighted SHCN proportions were 1.6 Percent complex, 18.2 Percent less complex, and 80.0 Percent no SHCN. Mean ED visits were 130 and 335 visits/1000 children/year for no/ complex SHCN, respectively. Mean hospitalizations were 20 and 175 hospitalizations/1000 children/year for no/complex SHCN, respectively. ED visits were associated with 8 of 12 quality measures for no/less complex SHCN. For example, usually/always receiving needed care right away was associated with 22 Percent lower ED visit rate (95% CI 0.64-0.96). Hospitalizations were associated with 4 of 12 quality measures for less complex SHCN. In complex SHCN, associations between ambulatory quality and ED/hospital use were weak and inconsistent.Conclusions: Ambulatory quality may best predict ED and hospital use for children with no or less complex SHCN. Whether and how ambulatory care predicts emergency and hospital care in complex SHCN remains an important question. [ABSTRACT FROM AUTHOR]

A high‐performance NH2‐MIL‐88B(Fe)‐SA−V for the direct catalytic oxidation of benzene hydroxylation using hydrogen peroxide as the oxidant was designed and prepared. The synthesized material was characterized by scanning electron microscopy, x‐ray powder diffraction, flourier transform infrared spectroscopy and nitrogen adsorption‐desorption. The influence of different parameters on the catalytic performance of NH2‐MIL‐88B(Fe)‐SA−V for benzene hydroxylation was researched. Under optimized condition, the high yield of 22.2% and selectivity of 98.6% were obtained, while the pure NH2‐MIL‐88B(Fe) only gained the yield of 1.2%. Furthermore, the V/Fe3O4 catalyst was obtained by calcination of NH2‐MIL‐88B(Fe)‐SA−V in N2 for photocatalytic recycle, and the yield and selectivity of phenol were 20.2% and 98.2% respectively. And the V/Fe3O4 has good photocatalytic efficiency after several recycling tests in the acid reaction condition. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac tamponade is a common life‐threatening complication during radiofrequency ablation of atrial fibrillation (RAAF) and is mostly managed by pericardiocentesis. Thus far, the optimal timing for drain removal has not been established. Methods and Results: We retrospectively enrolled patients with cardiac tamponade complicating RAAF. The ablation was performed with interrupted novel oral anticoagulants, interrupted warfarin or uninterrupted warfarin protocols. An observation period of at least 30 minutes after the last aspiration via the drain was used to monitor the reaccumulation of pericardial fluid, and then, the patients were divided into an early removal (ER) group in the electrophysiology (EP) laboratory and a delayed removal (DR) group in the ward. A total of 51 patients were included: 25 patients in the ER group and 26 patients in the DR group. There were no significant differences in baseline demographics between the two groups, and no cardiac tamponade reoccurred in either group in the ward. Unlike the DR group, the ER group showed an association with a decreased rate of chest pain (P =.000), fever (P =.001), nausea (P =.000), in‐hospital recurrent AF (P =.010), and antibiotic use (P =.012). Anticoagulation was earlier (P =.009), and the median in‐hospital stay was shorter (P =.001) in the ER group than in the DR group. Conclusions: ER of the pericardial drain after no evidence of pericardial bleeding for at least 30 minutes in the EP laboratory is safe and associated with a better early hospital course. [ABSTRACT FROM AUTHOR]

Background: Monitoring of ventilation with capnography or a stethoscope is recommended because the detection of ventilatory abnormalities can be significantly delayed by the use of pulse oximetry alone in patients receiving supplemental oxygen. The aim of this study was to evaluate the diagnostic performance of the pretracheal stethoscope with pulse oximetry and capnography in detecting adverse respiratory events during propofol sedation in nonintubated children. We hypothesized that use of the pretracheal stethoscope would facilitate earlier detection of adverse respiratory events. Methods: This was a prospective observational study of children undergoing procedural sedation at a pediatric sedation program. A pretracheal stethoscope, pulse oximetry, and nasal capnography were attached at the discretion of the sedation nurse and provider to monitor ventilation. Results: We enrolled 104 patient encounters (mean recorded time, SD 8.3 ± 5.3 minutes) from February, 2015 to March, 2017. The pretracheal stethoscope was the first monitor to detect adverse events in 64% (25/39) of patients compared to 18% (7/39) for capnography and 15% (6/39) for pulse oximetry. Auscultation performed best at detecting upper airway obstruction but capnography and pulse oximetry performed best at detecting hypoventilation. The positive predictive value for detecting a true ventilation abnormality and 95% CI of the pretracheal stethoscope, pulse oximetry, and capnography was 100% (90%‐100%), 18% (10%‐31%), and 27% (18%‐38%), respectively. The negative predictive value and 95% CI of the pretracheal stethoscope, pulse oximetry, and capnography was 88% (82%‐92%), 68% (59%‐75%), and 70% (61%‐78%), respectively. Limitations are short observation time, nonstandardized application of respiratory monitors, and too much focus on auscultation. Conclusion: A pretracheal stethoscope in conjunction with capnography and pulse oximetry detects most sedation‐related adverse events first. Auscultation performed best at detecting upper airway obstruction but capnography and pulse oximetry performed best at detecting hypoventilation. [ABSTRACT FROM AUTHOR]

Protein therapeutics are increasingly used to treat various diseases, yet they often suffer from short serum half‐lives. An emerging strategy to extend lifetime in vivo is to attach fatty acids onto proteins to increase their binding to human serum albumin (HSA). Herein, the genetic encoding of ϵ‐N‐heptanoyl‐l‐lysine (HepoK) is reported, which introduces a fatty‐acid‐containing amino acid into proteins with exquisite site‐specificity and homogeneity, overcoming issues associated with existing chemical conjugation methods. The expression in E .coli and purification of HepoK‐incorporated glucagon‐like peptide‐1 (GLP1) is demonstrated. GLP1(HepoK) showed stronger binding to HSA than GLP1(WT), without impairing the stimulation of the GLP1 receptor in cells. Moreover, GLP1(HepoK) decreased blood glucose level to the same level as GLP1(WT) in mice, showing longer‐lasting effects than GLP1(WT). HepoK incorporation will also be useful for investigating the function of protein lipidation. Long live the proteins: The incorporation of the unnatural amino acid, ϵ‐N‐heptanoyl‐l‐lysine, into proteins, via the expansion of the genetic code, is reported to extend protein half‐life via the association with serum albumin. This site‐specific technology overcomes the problems associated with chemical conjugation, and has implications for both protein therapeutics and the study of the functions of protein lipidation. [ABSTRACT FROM AUTHOR]

Several large prospective studies show an association between serum uric acid (SUA) and cancer, however there is a lack of evidence in China. We aimed to investigate the effects of SUA levels on cancer incidence and mortality in China. This study included 20,577 adult hypertensive patients with valid SUA measurements who participated in the China Stroke Primary Prevention Trial where subjects were randomly assigned to receive a double-blind treatment of either 10 mg enalapril (n = 10,286) or 10.8 mg enalapril-folic acid (n = 10,291). Subjects were prospectively followed for a median of 4.5 years. Cox proportional hazards models were used to calculate hazards ratios (HR) of cancer risk associated with SUA. A total of 232 participants developed cancer. SUA was independently associated with increased cancer risk in the enalapril group [HR: 1.12, (95% CI: 1.03-1.22)]. Compared to the lowest tertile, combined subjects with SUA levels from the upper two tertiles had a higher risk of cancer in the enalapril group [T2 + T3: HR: 1.58, (95% CI: 1.02-2.47)]. In cancer site-specific analyses, a positive association of SUA levels with digestive cancer and all fatal cancer was also observed [HR: 1.18, (95% CI: 1.09-1.27); HR: 1.15, (95% CI: 1.03-1.28), respectively] in the enalapril group. Interestingly, SUA levels were not associated with the risk of cancer or related mortality in the enalapril folic acid group. Our results suggest that elevated SUA is independently and positively associated with the risk of total cancer incidence, digestive cancer incidence and cancer mortality among hypertensive Chinese. [ABSTRACT FROM AUTHOR]

Heart transplantation in children with intellectual disability is a controversial issue. We sought to describe the prevalence and outcomes of heart transplantation in children with intellectual disability and hypothesized that recipients with intellectual disability have comparable short-term outcomes compared to recipients without intellectual disability. We performed a retrospective cohort analysis of children receiving a first heart-alone transplant in the UNOS STAR database from 2008 to 2013. Recipients with intellectual disability were compared to those without using chi-square tests. Kaplan-Meier curves were constructed for patient and graft survival. Cox proportional hazard models were used to estimate the association between intellectual disability and graft failure and patient survival. Over the study period, 107 children with intellectual disability underwent initial heart transplantation, accounting for 8.9% of first pediatric heart transplants (total=1204). There was no difference in the incidence of acute rejection between groups in the first year after transplant. Mean functional status scores at follow-up improved in both groups after transplantation, but tended to be lower among children with intellectual disability than children without. Log-rank tests did not suggest significant differences in graft survival between those with and without intellectual disability during the first 4 years following transplantation. Children with intellectual disability constitute a significant portion of total heart transplants with short-term outcomes comparable to children without intellectual disability. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To characterize initial voice treatment selection following vocal fold mucosal resection in a Medicare population.Study Design: Retrospective analysis of a large, nationally representative Medicare claims database.Methods: Patients with > 12 months of continuous Medicare coverage who underwent a leukoplakia- or cancer-related vocal fold mucosal resection (index) procedure during calendar years 2004 to 2009 were studied. The primary outcome of interest was receipt of initial voice treatment (thyroplasty, vocal fold injection, or speech therapy) following the index procedure. We evaluated the cumulative incidence of each postindex treatment type, treating the other treatment types as competing risks, and further evaluated postindex treatment utilization using the proportional hazards model for the subdistribution of a competing risk. Patient age, sex, and Medicaid eligibility were used as predictors.Results: A total of 2,041 patients underwent 2,427 index procedures during the study period. In 14% of cases, an initial voice treatment event was identified. Women were significantly less likely to receive surgical or behavioral treatment compared to men. From age 65 to 75 years, the likelihood of undergoing surgical treatment increased significantly with each 5-year age increase; after age 75 years, the likelihood of undergoing either surgical or behavioral treatment decreased significantly every 5 years. Patients with low socioeconomic status were significantly less likely to undergo speech therapy.Conclusion: The majority of Medicare patients do not undergo voice treatment following vocal fold mucosal resection. Further, the treatments analyzed here appear disproportionally utilized based on patient sex, age, and socioeconomic status. Additional research is needed to determine whether these observations reflect clinically explainable differences or disparities in care.Level Of Evidence: 2c. Laryngoscope, 126:2505-2512, 2016. [ABSTRACT FROM AUTHOR]

Tracheal collapse is a progressive airway disease that can ultimately result in complete airway obstruction. Intraluminal tracheal stents are a minimally invasive and viable treatment for tracheal collapse once the disease becomes refractory to medical management. Intraluminal stent size is chosen based on the maximum measured tracheal diameter during maximum inflation. The purpose of this prospective, cross-sectional study was to compare tracheal lumen diameter measurements and subsequent selected stent size using both fluoroscopy and CT and to evaluate inter- and intraobserver variability of the measurements. Seventeen healthy Beagles were anesthetized and imaged with fluoroscopy and CT with positive pressure ventilation to 20 cm H2O. Fluoroscopic and CT maximum tracheal diameters were measured by three readers. Three individual measurements were made at eight predetermined tracheal sites for dorsoventral (height) and laterolateral (width) dimensions. Tracheal diameters and stent sizes (based on the maximum tracheal diameter + 10%) were analyzed using a linear mixed model. CT tracheal lumen diameters were larger compared to fluoroscopy at all locations ( P-value < 0.0001). When comparing modalities, fluoroscopic and CT stent sizes were statistically different. Greater overall variation in tracheal diameter measurement (height or width) existed for fluoroscopy compared to CT, both within and among observers. The greater tracheal diameter measured with CT and lower measurement variability has clinical significance, as this may be the imaging modality of choice for appropriate stent selection to minimize complications in veterinary patients. [ABSTRACT FROM AUTHOR]

Aim To characterize the prospective trajectory of parent-reported behavior and social competence problems in children with new or recent onset epilepsy from diagnosis to 5 to 6 years after diagnosis compared to healthy control participants. Method Thirty-five children (21 males, 14 females; mean age 14y 1mo [SD 3y 4mo] range 8-18y) with new/recent onset idiopathic generalized ( IGE) and 34 children with localization-related epilepsies ( LRE; 19 males, 15 females; mean age 10y 8mo [ SD 2y 2mo] range 8-18y) underwent behavioral assessment (Child Behavior Checklist) at baseline, 2 years, and 5 to 6 years after diagnosis. The assessment comprised the summary scales Total Behavior Problems Internalizing Problems, Externalizing Problems, and Total Competence. Sixty-two children with normal development served as comparison participants. Analyses were based on random effects regression modeling comparing trajectories with respect to time since epilepsy diagnosis among groups. Results Differences in parent-reported behavioral problems between LRE and IGE syndrome groups and healthy comparison participants were detectable at or near the time of diagnosis and remained either stable (competence) or tended to abate (behavior problems) over the ensuing 5 to 6 years without evidence of progressive worsening. These trends were evident for both LRE and IGE groups, with no differences between them. Interpretation Behavior and competence problems in children with LRE and IGE are not characterized by progressive worsening over a 5- to 6-year period. Behavioral problems are present near the time of diagnosis and tend to abate over time, with competence problems being more persistent across serial assessments, and present in both LRE and IGE groups. [ABSTRACT FROM AUTHOR]

Aim To characterize the prospective trajectory of cognitive development in children with new or recent onset epilepsy from baseline to 5 to 6 years after diagnosis. Method Sixty-nine children (40 males, 29 females; age 8-18y), with new or recent onset epilepsies underwent neuropsychological assessment shortly after diagnosis (Wave 1), 2 years (Wave 2), and 5 to 6 years after diagnosis (Wave 3). Intelligence, academic achievement, language, executive function, and psychomotor speed were evaluated. Sixty-two children (28 males, 34 females; age 8-18) with typical development served as a comparison group at each time point. The cognitive data were examined by syndrome (localization-related epilepsy [ LRE]; idiopathic generalized epilepsy [ IGE]; comparison group). Mixed effect regression models compared trajectories among groups with respect to time since diagnosis. Results Cognitive abnormalities exhibited by children with epilepsy in arithmetic computation, response inhibition, attention, fine motor dexterity, and psychomotor speed (all p values <0.001), are detectable at or near the time of diagnosis and largely remain stable over the ensuing 5 to 6 years without evidence of progressive worsening or recovery. This course is evident across both LRE and IGE groups, with the LRE group performing better for some outcomes (arithmetic, response inhibition, psychomotor speed) and never worse than the IGE group. Interpretation Cognitive development in children with LRE and IGE is not characterized by progressive deterioration or lack of age-appropriate development; rather, development lags behind that of children with typical development. Cognitive abnormalities, when detected, are present near the time of diagnosis, persist over time, and require early intervention. [ABSTRACT FROM AUTHOR]

Fe2TiO5 powders are synthesized via nonhydrolytic sol‐gel method, and the effects of titanium sources on the synthesis and morphology of Fe2TiO5 powders are investigated via differential thermal analysis‐thermogravimetric (DTA‐TG), X‐ray diffraction (XRD), Transmission Electron Microscope (TEM), Field Emission‐Scanning Electron Microscope (FE‐SEM) and Fourier Transform Infrared (FT‐IR). It is beneficial for the low‐temperature synthesis of Fe2TiO5 to form Fe−O−Ti bonds when TiCl4 and Ti(OC4H9)4 are used as titanium source. But it is difficult to synthesize pure Fe2TiO5 phase and the powders synthesized are seriously agglomerated, when TiCl4 is used as titanium source. When Ti{OCH(CH3)2}4 is used as the titanium source, Fe2TiO5 phase can not be synthesized until 800 °C, which is due to Fe−O−Ti bond does not form in the xerogels. Fe2TiO5 powders prepared with Ti(OC4H9)4 as titanium source are small in particles size of 100–200 nm with high dispersion and element uniformity. [ABSTRACT FROM AUTHOR]