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Objective To compare the effects of repairing and not repairing the lateral ulnar collateral ligament (LUCL) when surgically treating elbow varus posteromedial rotatory instability (PMRI). Methods In this retrospective study spanning June 2014 to February 2019, 24 patients with elbow PMRI who were treated surgically were assigned to group RL (Repair LUCL) or group NL (Non‐repair LUCL) depending on whether the LUCL was repaired. Hospitalization time, operation time, intraoperative blood loss, and related complications were reviewed. The elbow range of motion (ROM), the visual analog scale (VAS), the Mayo elbow performance score (MEPS), and the disabilities of the arm, shoulder, and hand (DASH) score were used for functional assessment. Results Among the 24 patients with PMRI, 15 were assigned to group RL and nine were assigned to group NL. The mean blood loss (184.66 ± 20.3 vs 207.33 ± 19.447, P, Schematic drawings for the surgical technique. (A) Surgical diagram of group NL with reconstruct the anteromedial facet coronoid fracture. (B) Surgical diagram of group RL with reconstruct the anteromedial facet coronoid fracture and repair of the lateral ulnar collateral ligament.

Background Current findings on the impact of weather conditions on osteoarthritis (OA) and rheumatoid arthritis (RA) are sparse and not conclusive. This study aimed to investigate the relationship between temperature change and OA/RA admission. Methods Daily OA/RA admission, meteorological data and pollutants from 1 January 2014 to 31 December 2017 in Hefei, China, were collected. We quantified the relationship between ambient temperature and OA/RA admission using a distributed lag nonlinear model (DLNM). Stratified analyses by gender and age were also examined. Results Temperature decrease was significantly associated with RA admission (25th percentile of temperature versus 50th percentile of temperature), with the acute and largest effect at current days lag (RR: 1.057, 95%CI: 1.005–1.111). However, no significant association between temperature and OA admission was observed. When conducting subgroup analyses by individual characteristics, we found that females and patients aged 41–65 years were more vulnerable to temperature decrease than males, patients aged 0–40 and ≧66 years, respectively. Conclusions This study suggested that temperature decrease was a risk factor for increases in RA admission. Females and patients aged 41–65 years were particularly vulnerable to the effect of temperature decrease.

Pulse evolution and multi-pulse state of coherently coupled polarization domain walls (PDW) is experimentally demonstrated in a novel fiber ring laser. Versatile pulse shapes benefit by wide range moving of PDW in the weakly birefringent fiber. The 8.6 m short-cavity structure is more compact and accessible based on a 976 nm pump with nearly zero negative dispersion (-0.0002 ps2). Besides, multi-pulse patterns such as PDW splitting, harmonic mode-locking, and periodic soliton collision are also observed under larger net negative dispersion (-3.09 ps2) and 151m-longer cavity. This is the first demonstration of coherently coupled PDW in a fiber laser using a bandpass filter and the formation of coherently coupled PDW is ascribed to the BPF’s force filtering.

Background The relationship between environmental factors and allergic rhinitis (AR) has become a focal point recently. However, few studies have investigated the adverse effects of both high relative humidity (RH) and low relative humidity. Moreover, the laged effect and disease burden of RH on AR were also neglected. Objectives To explore the association of both high and low RH on daily AR hospital outpatients, and to quantify the corresponding disease burden attributable to RH. Methods In our study, we define 95th as high RH and 5th as low RH. A distributed lag non-linear model (DLNM) combined with a Poisson generalized linear regression model were applied to analyze the relationship between RH and hospital outpatients for AR. All patients were retrieved from Anhui Provincial Children's Hospital (n = 37,221) from January 2015 to December 2016. Daily meteorological and air pollutant data were collected by Hefei Meteorological Bureau and Environmental Protection Agency. Subgroup analyses were conducted by gender and occupational groups. Results Acute adverse effects of high and low RH on AR were explored respectively, with an increase of daily AR outpatients when encountered high and low RH. The low RH presented a risk effect at current day and lasted up to the eighth day. However, high RH began to appear a risk effect on the fourth day. Notably, the fraction of hospital outpatients attributable to low RH was 5.22% (95% CI: 1.92%, 8.33%) and high RH was 4.07% (95% CI: 1.13%, 7.30%) in the backward perspective. Additionally, male and students apparent to be more sensitive to the effects of low RH. Conclusion This study suggests that both high and low RH are potential trigger for AR hospital outpatients in Hefei, China. Our studies might offer valuable messages to health practitioners and useful direction to decisions-makers respectively.

We report on improvements of mode-locked soliton pulse energy and peak power in a thulium-doped fiber laser. At the pump power of 370 mW, conventional soliton can be first generated using nonlinear polarization rotation technology. By increasing the pump power to 550 mW and appropriately adjusting cavity polarization state, the conventional soliton pulse can be converted into the Gaussian pulse. Due to dispersion management, excess accumulation of nonlinear phase shifts in the cavity can be avoided. In this case, the pulse energy and peak power can be increased from 77 pJ to 1.38 nJ and from 106.9 W to 2.67 kW, respectively. These improvements indicate that the Gaussian pulse operation can effectively enhance the pulse energy and peak power of the thulium-doped fiber laser.

We propose and demonstrate a high repetition-rate passively mode-locking Tm-doped fiber laser. Mode-locking operation is achieved by using a conventional nonlinear polarization rotation (NPR) structure. Fundamental frequency soliton laser is obtained with the repetition-rate of 5.05 MHz and the pulse width of 54.7 ps. 3-dB bandwidth and signal and noise ratio (SNR) are 3.1 nm and 53.03 dB, respectively. In order to improve repetition-rate of the mode-locking pulse, a narrow band filter is adopted. In this case, maximum repetition-rate of the output pulse can be up to 7.75 GHz (1534 orders). Pulse width and 3-dB bandwidth of mode-locking laser are compressed to 67.2 ps and 0.2 nm, respectively, and SNR is 19.71 dB. In addition, the laser center wavelength can be tuned from 1882 nm to 1925 nm by adjusting the filter.

Purpose We conducted the meta-analysis to respectively evaluate the risk of prenatal antibiotics use during specific trimesters (first, second, and third trimester) on childhood asthma or wheeze and to explore whether the association was biased by potential confounding. Methods The quality of included articles was assessed according to Newcastle–Ottawa Quality Assessment Scale and the Strengthening the Reporting of Observational Studies in Epidemiology. A random effects model was used to calculate pooled risk ratios and corresponding 95% confidence interval (CI), and publication bias was tested by Egger statistical test. Results Eight studies were included finally. We found a crude positive association of prenatal antibiotics use during each pregnancy trimester and risk of childhood asthma or wheeze with RRs of 1.28 (95% CI, 1.09–1.51) for the first trimester of pregnancy, 1.25 (95% CI, 1.02–1.52) for the second trimester, and 1.25 (95% CI, 1.05–1.49) for the third trimester. However, when considering potential factors of maternal infections and presence of siblings, the relationship for each trimester was insignificant. Conclusions This systemic review and meta-analysis proposed a crude positive association between prenatal antibiotic use in every specific trimester and risk of childhood asthma or wheeze. However, adjustment for confounders decreased the relative risk estimates, supporting the concept that these associations are, at least in part, because of confounding by indication.

We propose and demonstrate a multi-wavelength actively mode-locked fiber laser around $2.07~\mu \text{m}$ . A holmium-doped fiber is used as the gain medium which is pumped by a 1.93- $\mu \text{m}$ fiber laser. The multi-wavelength laser is achieved by employing a fiber Lyot filter in cavity, and actively mode-locking is achieved by driving a sinusoidal radio frequency signal on the electro-optic modulator. Stable actively mode-locked pulses can be obtained with up to 10.078-GHz repetition rate. The shortest measured pulse width is 16 ps. The wavelength channels can be accurately tuned under a fixed pump power by adjusting the polarization controllers and the BIAS voltage. Up to 27 channels can be obtained under a stable mode-locked operation. However, the increase of output channels leads to a significant increase in the threshold, and the maximum output channels have a strong dependence on the repetition rate.

Background Many studies have shown an association of childhood respiratory diseases with short-term temperature variability such as diurnal temperature range (DTR) and temperature change between two neighboring days (TCN). However, the impact of temperature variability on allergic rhinitis (AR) has not been investigated so far. This study sought to evaluate the short-term effect of temperature variability (i.e., TCN and DTR) on AR, as well as to identify vulnerable subpopulations. Method We collected daily data on emergency room visits and outpatients for AR and weather variables in Hefei, China during 2014–2016. A distributed lag non-linear model that controlled for long-term trend and seasonality, mean temperature, relative humidity, day of week was used to fit the associations of AR with DTR and TCN. Stratified analyses by age, sex and occupation were also performed. Results During the study period, there were a total of 53,538 cases and the average values of DTR and TCN were 8.4 °C (range: 1.0 °C to 21.2 °C) and 0 °C (range: − 12.2 °C to 5.9 °C), respectively. While we did not observe an adverse effect of DTR on AR, TCN was significantly associated with increased risk of AR. Specifically, a large temperature drop between two adjacent days (3.8 °C, 5th percentile of TCN) has a delayed and short-lasting effect on AR, with the estimated relative risk of 1.02 (95% confidence interval: 1.01 to 1.04) at lag 12. Moreover, boys and children older than 15 years seemed to be more vulnerable to the effect of TCN. Conclusions This study provided evidence of an adverse effect of large temperature drops between two adjacent days on childhood AR. Attention paid to boys and older children may help prevent AR attacks.

We report on the switchable generation of a dissipative soliton (DS) pulse and a noise-like pulse (NLP) in an all-fiberized Tm-doped fiber laser in the normal-dispersion region. Mode-locking operation is achieved through a nonlinear polarization rotation component, and the cavity dispersion is compensated using ultra-high numerical aperture (UHNA4) fiber that is easy to integrate and low in cost. At a pump threshold of 510 mW, DS operation can first be achieved without additional filter. The 3 dB spectrum bandwidth of the DS pulse is greater than 50 nm, and the duration of the de-chirped pulse is 193 fs. By increasing the pump power to 880 mW, the mode-locking state can evolve into NLP operation with proper cavity polarization state. The 3 dB spectrum bandwidth and duration of de-chirped coherence spike are 105.6 nm and 121 fs, respectively. Meanwhile, ultra-broadband NLP (over 150 nm considering 3 dB spectrum width) can also be observed with the appropriate cavity parameters. All the proposed pulse patterns present good capacity for achieving narrow pulse width and withstanding high pulse energy.

An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in Wuhan, China, with cases now confirmed in multiple countries. The clinical course of patients remains to be fully characterized, clinical presentation ranges from asymptomatic infection to acute respiratory distress syndrome and acute renal failure, and no pharmacological therapies of proven efficacy yet exist. We report a case of SARS-CoV-2 infection in a renal transplant recipient with excellent outcome. This case states the importance of close monitoring of the concentration of cyclosporine in patients treated with lopinavir/ritonavir; the routine treatment of corticosteroid can be continued. This is a rare report of SARS-CoV-2 infection in a renal transplant recipient. Further data are needed to achieve better understanding of the impact of immunosuppressive therapy on the clinical presentation, severity, and outcome of SARS-CoV-2 infections in solid organ transplant recipients.

Background The relationship between ambient temperature, humidity and hand, foot, and mouth disease (HFMD) has been highlighted in East and Southeast Asia, which showed multiple different results. Therefore, our goal is to conduct a meta-analysis to further clarify this relationship and to quantify the size of these effects as well as the susceptible populations. Methods PubMed, Web of science, and Cochrane library were searched up to November 22, 2017 for articles analyzing the relationships between ambient temperature, humidity and incidence of HFMD. We assessed sources of heterogeneity by study design (temperature measure and exposed time resolution), population vulnerability (national income level and regional climate) and evaluated pooled effect estimates for the subgroups identified in the heterogeneity analysis. Results We identified 11 studies with 19 estimates of the relationship between ambient temperature, humidity and incidence of HFMD. It was found that per 1 °C increase in the temperature and per 1% increase in the relative humidity were both significantly associated with increased incidence of HFMD (temperature: IRR, 1.05; 95% CI, 1.02–1.08; relative humidity: IRR, 1.01; 95% CI, 1.00–1.02). Subgroup analysis showed that people living in subtropical and middle income areas had a higher risk of incidence of HFMD. Conclusions Ambient temperature and humidity may increase the incidence of HFMD in Asia-Pacific regions. Further studies are needed to clarify the relationship between ambient temperature, humidity and incidence of HFMD in various settings with distinct climate, socioeconomic, and demographic features.

BackgroundAcute bronchitis (AB) is one of the principal causes of childhood morbidity. Increasing number of studies has shown that air pollution is an important environmental contributor of respiratory disease. However, evidence so far is scarce regarding the effects of air pollution on childhood AB, and it also remains unclear how the risk of AB will change by season and age.MethodsData on hospital visits for AB in children, air pollution and meteorological factors from 1 January 2015 to 31 December 2016 were collected in Hefei, China. Time-series analysis was applied to assess the short-term effects of traffic-related air pollution on childhood AB outpatient visits. A Poisson generalised linear regression model combined with a distributed lag non-linear model was used to estimate the relationships, controlling for long-term trends, seasonal patterns, meteorological factors and other possible confounders.ResultsWe found that an IQR increase in concentrations of nitrogen dioxide, particulate matter ConclusionA significant association of traffic-related air pollution and increased department visits for childhood AB was observed, notably in school-age children and during the cold season.

A 2-D thermal-electric coupling model has been developed, which enables us to evaluate the current distribution of monolithically integrated light-emitting diode (MI-LED). Based on the experimental IR images, the current distributions have been evaluated for the MI-LEDs on two types’ heat sinks. For the MI-LED on poor thermal conductive chip-on-board heat sink, although there is a large junction temperature variation of 40 °C all over the chip, the current only varies from −16% to 11% due to the high parasitic series resistance and the topological design of MI-LED. The experiments show that the impact of the heat-crowding-induced uneven current distribution on the wall-plug efficiency is negligible at a power density of 1 W/mm2. The average junction temperature is still the dominant issue. With a high thermal conductive copper heat sink, the average junction temperature could be suppressed below 50 °C, and there is no obvious heat crowding and uneven current distribution observed.

Objectives To determine the relationship between diurnal temperature range (DTR) and outpatient visits for childhood acute bronchitis (AB) in Hefei, China, to analyze whether DTR effect was delayed, and to explore the susceptible populations. Study design An ecological study. Methods A Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyze the relationship between DTR and childhood AB from Hefei, China during 2010–2013, after adjusting for long-term trend and seasonality, mean temperature and relative humidity. Results An adverse effect of DTR on childhood AB was observed, and the impact of DTR was greatest at three days lag, with a 1.0% (95% confidence interval = 0.5–1.6%) increase of AB cases per 1 °C increment of DTR. Female children and children aged 0–4 years appeared to be more vulnerable to DTR effect than other children. Conclusions Our study suggests that large DTR may increase the incidence of childhood AB in Hefei, particularly for those who are female and young. Caregivers and health practitioners should be made aware of the potential threat posed by large DTR.

We report on the experimental observation of wavelength-switchable stretched pulse and bound-state pulse in a dispersion-managed Tm-doped laser. At a pump power of 572 mW, a stretched pulse with a pulse duration of 389 fs can be first obtained at 1961 nm. By increasing the pump power and appropriately adjusting the cavity polarization state, the mode-locking wavelength can be switched from 1961 nm to 1980 nm caused by the birefringence filtering effect based on nonlinear polarization rotation, and the corresponding pulse duration is 371 fs. Meanwhile, loosely bound states of two pulses and three pules at 1980 nm can be observed with appropriate cavity parameters.

In this paper, we report a thulium-doped fiber based on nonlinear polarization rotation technology. Increasing the pump power to 600mW and adjusting the polarization controllers, Gaussian pulse with high pulse energy can be achieved. The pulse duration of de-chirped pulse is 553 fs. Due to dispersion management, excessive nonlinear phase shift accumulation can be avoided. The maximum output power of the resonant cavity is 86.3mW, and the corresponding pulse energy is 2.96nJ.

The stretched pulse has narrower pulse duration and high pulse energy than conventional soliton, so that the stretched pulse can improve the potential application values of 2 μm mode-locked fiber laser in remote sensing, mid-infrared source, material processing and other applications. In this paper, the dispersion management method is adopted to accurately manage the dispersion in the cavity using a commercial ultra-high numerical aperture fiber and a common single-mode fiber. Based on the nonlinear polarization rotation technology to achieve mode-locking, when the pump power is set to 645 mW, the polarization controller is adjusted to achieve stretched pulse output with a de-chirped pulse duration of 581 fs. The center wavelength is 1939.26 nm and the 3-dB bandwidth is 21.8 nm. The repetition rate is 28.9 MHz and the signal to noise ratio is 54.21 dB. At the maximum pump power, the direct output power of the resonant cavity is 9.98 mW, and the corresponding single pulse energy is 0.34 nJ.

Background: Hand, foot and mouth disease (HFMD) is one of the major infectious diseases among children and remains a health threat, especially among Asian countries. Many epidemiologic studies suggested significant association of air temperature and humidity with childhood HFMD; however, evidence on the temperature effects on childhood HFMD in temperate cities is limited, and the interactive effects of temperature and humidity have not been studied yet.Methods: Daily counts of HFMD in children younger than 15 years of age and daily meteorologic variables during 2010 to 2012 were obtained in Hefei, China. A distributed lag nonlinear model was applied to estimate the potential nonlinear association between temperature and childhood HFMD. The interactive effects between temperature and humidity on childhood HFMD were also investigated.Results: Temperature rise was associated with higher risk of childhood HFMD. Within the incubation period of HFMD, temperature rise appeared to have the acute effects on childhood HFMD, and a 5 degrees C increase of temperature at lag 0-6 days was associated with 24.8% (95% confidence interval: 11.94%-39.10%) increase of childhood HFMD. Females and children of 0-4 years of agewere more vulnerable to temperature rise. Notably, there were obvious combined effects between temperature and humidity on childhood HFMD-the risk of childhood HFMD elevated at higher temperature and humidity level.Conclusions: This study provides evidence that temperature and humidity may jointly affect childhood HFMD, and such interactive impact needs to be considered when evaluating the temperature-childhood HFMD relationship.

Diurnal temperature range (DTR) and temperature change between neighboring days (TCN) are important meteorological indicators closely associated with global climate change. However, up to date, there have been no studies addressing the impacts of both DTR and TCN on emergency hospital admissions for schizophrenia. We conducted a time-series analysis to assess the relationship between temperature variability and daily schizophrenia onset in Hefei, an inland city in southeast China. Daily meteorological data and emergency hospital admissions for schizophrenia from 2005 to 2014 in Hefei were collected. After stratifying by season of birth, Poisson generalized linear regression combined with distributed lag nonlinear model (DLNM) was used to examine the relationship between temperature variability and schizophrenia, adjusting for long-term trend and seasonality, mean temperature, and relative humidity. Our analysis revealed that extreme temperature variability may increase the risk for schizophrenia onset among patients born in spring, while no such association was found in patients born in summer and autumn. In patients born in spring, the relative risks of extremely high DTR comparing the 95th and 99th percentiles with the reference (50th, 10 °C) at 3-day lag were 1.078 (95 % confidence interval (CI) 1.025-1.135) and 1.159 (95 % CI 1.050-1.279), respectively. For TCN effects, only comparing 99th percentile with reference (50th, 0.7 °C) was significantly associated with emergency hospital admissions for schizophrenia (relative risk (RR) 1.111, 95 % CI 1.002-1.231). This study suggested that exposure to extreme temperature variability in short-term may trigger later days of schizophrenia onset for patients born in spring, which may have important implications for developing intervention strategies to prevent large temperature variability exposure.

Background Several studies have suggested that asthma is associated with an increased risk of stroke. However, the results are inconsistent. The aim of this study is to investigate the relation of asthma and the risk of stroke through a systematic review and meta-analysis of published research. Methods Pertinent studies were identified by a search of the PubMed and the Web of Science databases to June 2015. Study-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using fixed-effect or random-effect models when appropriate. Associations were tested in subgroups representing different participants and study characteristics. Publication bias was assessed with Egger's test. Results Five articles comprising 524,637 participants and 6031 stroke cases were eligible for inclusion. Asthma was associated significantly with increased risk of stroke, and the pooled HR was 1.32 (95% CI: 1.13, 1.54, I 2 = 80.4%). Subgroup analyses revealed that the association between asthma and stroke risk was stronger among female patients (HR = 1.42, 95% CI: 1.15-1.76) and prospective cohort study design (HR = 1.52, 95% CI: 1.21-1.91). Conclusion Asthma is associated with a significantly increased risk of stroke. This finding may have clinical and public health importance.

A simplified packaging process was successfully developed for a wafer-level light emitting diode (WL-LED) chip aiming at very-high power solid-state lighting (SSL) applications. Compared with the traditional chip-on-board (COB) technology, WL-LED chip not only greatly simplifies the packaging process but also enables the lighting source more compact. The fabricated blue WL-LED SSL source with a record-high light output power of 305 W exhibits $\sim 30$ % wall plug efficiency at an input electrical power of 1026 W.

Background Short-term exposure to high level of ambient particulate matters (PM) concentrations has been linked with increased hospital admissions (HA) for schizophrenia. However, evidence is inconclusive about the added effect of multi-day exposure to high-level PM concentration on schizophrenia. This study aims to evaluate the durational effect of PM air pollution wave on schizophrenia. Method Data on daily HA for schizophrenia, PM (PM2.5 and PM10) and meteorological variables over the period of 2014–2017 was collected in Jining, Shandong, China. Air pollution wave of PM was defined as ≥2 or ≥3 or ≥4 consecutive days with PM concentration ≥90th or ≥92.5th or ≥95th or ≥97.5th percentiles, respectively. A time-series Poisson regression model with duration as the variable of interest was used to evaluate the associations of PM air pollution wave with HA for schizophrenia. Results A total of 14650 hospital admissions for schizophrenia were identified. Under various air pollution wave definitions, both PM2.5 and PM10 had significant adverse effects on schizophrenia HA. PM2.5 wave defined as ≥2 consecutive days with concentration ≥90th, ≥92.5th, ≥95th and ≥97.5th percentile was associated with 4.8% (2.0%–7.6%), 4.9% (1.9%–7.9%), 5.5% (2.0%–9.2%), and 7.6% (2.9%–12.6%) increase of HA for schizophrenia at lag 6. PM2.5 waves defined as ≥3 consecutive days with concentration ≥90th, ≥92.5th, ≥95th and ≥97.5th percentile respectively corresponded to 5.0% (2.3%–7.8%), 5.1% (1.9%–8.4%), 6.9% (3.0%–10.8%) and 12.0% (5.3%–19.1%) increases in HA for schizophrenia at lag 6. The most significant associations were observed on the sixth day in different lag models. Conclusions PM air pollution wave was associated with increased risk of hospital admissions for schizophrenia, with stronger associations among married and female patients.

We present the generation and optimization of square-wave noise-like pulses (NLPs) in a mode-locked Tm-doped fiber laser. Mode-locking operation around the 2-μm band is achieved by a nonlinear amplifying loop mirror. To optimize the output performance, the figure-eight cavity is modified by employing a polarization-dependent isolator in a unidirectional loop, and the cavity length is only 17.2 m. First, by employing a cavity with pure anomalous dispersion, a conventional soliton can evolve into a square-wave NLP by properly setting the pump power and polarization controllers. The pulse energy of the fundamental-frequency operation can be varied from 2.29 to 3.4 nJ. Using an ultrahigh-numerical-aperture fiber to reduce the net dispersion to −1.033 ps2, the 3-dB bandwidth of the spectrum is broadened to 14.78 nm, and the duration of the autocorrelation spike is only 421 fs. The maximum single-pulse energy can increase up to 4.97 nJ. Due to dispersion management mechanism, the threshold and output power are also significantly improved.

We integrally demonstrate 2 μm mode-locked pulses performances in all-fiber net anomalous dispersion cavity. Stable mode-locking operations with the center wavelength around 1950-1980 nm can be achieved by using the nonlinear polarization rotation structure and properly designing the dispersion management component. Conventional soliton is firstly obtained with a total anomalous dispersion cavity. Due to the contribution of commercial ultra-high numerical aperture fibers, net dispersion is reduced to -0.077 ps2. So that stretched pulse with 19.4 nm optical bandwidth is obtained and the de-chirped pulse-width can reach 312 fs using extra-cavity compression. Under pump power greater than 890 mW, stretched pulse can evolve into noise-like pulse with 41.3 nm bandwidth. The envelope and peak of such broadband pulse can be compressed with up to 2.2 ps and 145 fs, respectively. The single pulse energy of largely chirped stretched and noise-like pulse can reach 1.785 nJ and 1.53 nJ, respectively. Furthermore, extra-cavity compression can also contribute to a significant increase of peak power.

We have experimentally obtained dispersion-managed solitons with sidebands in a passively mode-locked thulium-doped fiber laser. The stable single soliton with sidebands can be converted into two soliton pulses at the pump power of 867 mW with appropriate settings of the polarization controllers (PCs). By increasing the pump power and cautiously adjusting the PCs, the three, four, and five soliton pulses with nonuniform intensity operate with stability in the cavity due to the global soliton interaction caused by unstable continuous waves. Furthermore, the soliton bunch can be observed at the pump power of 1 W. The position of solitons in the soliton bunch is random with a fixed separation that is controllable by changing the linear phase delay. Our work gives insight into the dynamics of multipulse dispersion-managed solitons in a 2-μm mode-locked fiber laser.

Background Existing body of knowledge suggests that antibiotic use during pregnancy was inconsistently associated with childhood wheeze/asthma. The aim of this study was to determine whether exposure to antibiotic during pregnancy could increase the risk for childhood wheeze/asthma using a comprehensive meta-analysis. Methods PubMed, MEDLINE, and China National Knowledge Infrastructure (CNKI) were systematically searched for studies up to September 10, 2014, and additional studies were found by searching reference lists of relevant articles. For this meta-analysis, cohort studies and case–control studies assessing the association between antibiotic use during pregnancy and risk of childhood wheeze/asthma were included. Extracted data were mainly pooled using random-effects model. Study quality was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). Results Ten studies were identified in final analysis. Pooling analysis of these studies showed an OR of 1.20 (95% CI, 1.13–1.27) for wheeze/asthma. After excluding case–control studies and prospective studies without achieving high scores on the NOS, the pooled OR was 1.18 (95% CI, 1.11–1.26). We found the risk of antibiotic use and pooled ORs of wheeze/asthma were 1.09 (95% CI, 0.92–1.29) for the first trimester, 1.14 (95% CI, 1.01–1.29) for the second trimester, and 1.33 (95% CI, 1.11–1.60) for the third trimester, respectively. Conclusions This meta-analysis suggests that antibiotic exposure during pregnancy may increase the risk of wheeze/asthma in childhood. Besides, the risk of developing wheeze/asthma in childhood was marked during last two trimesters of pregnancy. Future studies of large-size and prospective cohorts which adequately address concerns for confounder bias are needed to examine the relationship between antibiotic use and risk of childhood asthma.

Objective To investigate the relationship between ambient temperature and hospital admissions for schizophrenia in Hefei, China. Study design An ecological design was used to explore the effect of ambient temperature on hospital admissions for schizophrenia. Methods Daily data on hospital admissions for schizophrenia and meteorological data for the warm season (May–October) in 2005–2014 were obtained from Anhui Mental Health Centre and Hefei Bureau of Meteorology, respectively. Poisson generalised linear regression model combined with a distributed lag non-linear model was used to analyse the effects of temperature on admissions for schizophrenia. Stratified analyses according to individual characteristics, such as age and sex, were also conducted. Results A significant relationship was found between ambient temperature and admissions for schizophrenia. High temperature appeared to have a delayed effect on admissions for schizophrenia, and a temperature of 28°C (75th percentile) at lag 0–4 days was associated with a 7% (95% confidence interval: 4–11%) increase in admissions for schizophrenia. Stratified analyses showed that male patients, patients aged 21–60 years and married patients were more vulnerable to high temperature, and the temperature effects for those groups occurred at a lag of 1 day. Conclusion High temperature poses significant risks for schizophrenia in subtropical regions. Future preventive measures for reducing the occurrence of schizophrenia should be considered for susceptible populations.

We report on the experimental generation of various self-organized structures of bound states in a near zero-dispersion mode-locked fiber laser. When the pump power is fixed at 492 mW, appropriately adjusting polarization controllers, the switching of the cavity feedback results in the evolution from the single pulse to the dispersion-managed soliton (i.e., stretched-pulse) pair. With the increase of pump power, bound states composed of more than two pulses can also be observed. Our results of the self-organized structures might enlarge the data-carrying capacity of current fiber-optical communication systems and benefit the investigation of nonlinear dynamics of bound states in fiber lasers at 2 μm.

Based on the optimised high-voltage network design and the resistance matching technique, a wafer-level light emitting diode (WL-LED) with a light output power of 157 W has been successfully demonstrated for the first time. The external quantum efficiency of the fabricated WL-LED was measured to be 24% at a driving current of 4 A.

Background Although studies have well documented increased mortality risk during extreme heat and heatwaves, few have examined their impacts on emergency ambulance dispatches under different temperature metrics. Additionally, evidence on the attributable risk of emergency ambulance dispatches due to extreme heat and heatwaves is scarce around the world. Methods A distributed lag nonlinear model (DLNM) was applied to quantify the impact of extreme heat and heatwaves on emergency ambulance dispatches in Huainan, China, during 2011–2013. Several local extreme heat and heatwave definitions were tested by using percentile of daily mean temperature (i.e., 95th, 97.5th and 99th) and duration (i.e., ≥ 2 consecutive days and ≥ 3 consecutive days). The fraction of emergency ambulance dispatches attributable to extreme heat and heatwaves was also quantitatively estimated. Results Both extreme heat and heatwaves were significantly associated with increases in emergency ambulance dispatches, and their effects appeared to be acute. For extreme heat effects, the relative risks (RRs) of emergency ambulance dispatches at lag0 steadily increased from 95th percentile of daily mean temperature (1.03, 95% confidence interval (CI): 1.01–1.05) to 99th percentile (1.07, 95% CI: 1.05–1.10). For heatwave effects, we observed that RRs of emergency ambulance dispatches at lag0 fluctuated between 1.03 and 1.05 across different heatwave definitions. Notably, the fraction of emergency ambulance dispatches attributable to extreme heat decreased with higher percentile of daily mean temperature, dropping from 2.24% (95% CI: 1.41%–2.99%) at 95th percentile to 0.69% (95% CI: 0.45%–0.92%) at 99th percentile. Likewise, we found that heatwaves with higher intensity and (or) longer duration accounted for lower fraction of emergency ambulance dispatches, varying between 0.51%–1.52%. Conclusions Our findings may have important implications for the development of local heat warming systems and public health interventions to lessen the impact of extreme heat events on population health.

Background Diurnal temperature range (DTR), as an important index of climate change, has been increasingly used to evaluate the impacts of temperature variability on human health. However, little is known about the effects of DTR on schizophrenia. Objective The present study aims to examine the relationship between DTR and schizophrenia admissions, and further, to explore whether the association varied by individual characteristics and study periods. Methods A Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) was applied to analyze daily DTR and schizophrenia data from Hefei, China during 2005 to 2014, after adjusting for long-term and seasonal trends, mean temperature, relative humidity and other confounding factors. Results An acute adverse effect of extremely high DTR on schizophrenia was observed, with a 2.7% (95% CI: 1.007–1.047) increase of daily schizophrenia admissions after exposure to extremely high DTR (95th percentile vs. 50th percentile). The risk for schizophrenia onset due to large DTR exposure increased from the first five years (2005–2009) to the second five years (2010–2014). Additionally, the patient aged 15–29 and 50–64 years, male patients, patients born in spring/autumn, and married patients appeared to be more vulnerable to DTR effect. However, there was no significant association between moderately high DTR (75th percentile) and schizophrenia. Conclusions This study suggests that extremely high DTR is a potential trigger for schizophrenia admissions in Hefei, China. Our findings may provide valuable information to decisions-makers and guidance to health practitioners.

A high-power phosphor-converted white LED with 3058 lm is reported. The high-power white LED was manufactured by utilising a single-blue LED chip with a cerium-doped yttrium aluminium garnet phosphor crystal film, and the LED chip consists of 16 LED cells that are connected in series, the chip dimensions are of 4.5 x 4.5 mm(2). The electrical and optical characteristics of the LED were measured up to a 500 mA injection current under direct operation conditions. Results show that the luminous flux and luminous efficacy at 500 mA reach to 3058 lm and 128 lm/W, respectively.

A temperature sensing system based on a multi-wavelength Brillouin fiber laser (MBFL) is proposed and demonstrated. Two beams of Stokes light are generated in a temperature sensitive fiber and a reference fiber, respectively. Stokes light from temperature sensitive fiber can generate frequency shift with temperature changing, and two beams can produce a microwave signal by beat frequency. Therefore, change of temperature can be accurately measured according to variation of the central frequency of the beat frequency microwave signals. A 3.2 km long dispersion shifted fiber (DSF) is used as temperature sensitive fiber pumped by a Brillouin pump with power of 1.5 W, then more than 20 Stokes light wavelengths can be observed. By using the 18th order Stokes light pair, temperature sensitivity can be 19.93 MHz∕°C. The uncertainty of the temperature measurement is ± 0.125°C.

Background There is conflicting evidence about the association between bisphenol A (BPA) exposure and childhood asthma risk. We aimed to review the epidemiological literature on the relationship between prenatal or postnatal exposure to BPA and the risk of childhood asthma/wheeze. Methods The PubMed database was systematically searched, and additional studies were found by searching reference lists of relevant articles. Results Six studies fulfilled the eligibility criteria. Three studies found that prenatal BPA exposure is associated with an increased risk of childhood wheeze, while another study reported a reduced risk of wheeze. Regarding the postnatal BPA exposure, three studies demonstrated an increased risk of childhood asthma/wheeze. Conclusions The mean prenatal BPA was associated with the risk of childhood wheeze/asthma. Besides, the influence of BPA exposure during the second trimester of pregnancy on the prevalence of childhood wheeze was marked. Further studies are urgently needed to explore the underlying mechanism about adverse effect of BPA exposure on childhood wheeze/asthma.

Objectives The short-term temperature variation has been shown to be significantly associated with human health. However, little is known about whether temperature change between neighbouring days (TCN) and diurnal temperature range (DTR) have any effect on childhood hand, foot and mouth disease (HFMD). This study aims to explore whether temperature variability has any effect on childhood HFMD. Study design Ecological study. Methods The association between meteorological variables and HFMD cases in Huainan, China, from January 1st 2012 to December 31st 2014 was analysed using Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) after controlling for long-term trend and seasonality, mean temperature and relative humidity. Results An adverse effect of TCN on childhood HFMD was observed, and the impact of TCN was the greatest at five days lag, with a 10% (95% CI: 4%–15%) increase of daily number of HFMD cases per 3 °C (10th percentile) decrease of TCN. Male children, children aged 0–5 years, scattered children and children in high-risk areas appeared to be more vulnerable to the TCN effect than others. However, there was no significant association between DTR and childhood HFMD. Conclusions Our findings indicate that TCN drops may increase the incidence of childhood HFMD in Huainan, highlighting the importance of protecting children from forthcoming TCN drops, particularly for those who are male, young, scattered and from high-risk areas.

A very high power wafer level light emitting diode (WL-LED) has been successfully fabricated on 2 inches InGaN/GaN epi-wafer based on high voltage design. The maximum light output power (LOP) was measured to be 157W with an external quantum efficiency (EQE) of 24%.

The metal stem of the totally replaced hip carries load and resists fatigue, but it is electrochemically corroded. Metallic atoms act as haptens, induce type 1 T-helper cells/Th1-type immune responses and enhance periprosthetic osteolysis. Stiff metal implants, which do not have the same elasticity as the surrounding bone, cause stress shielding. Cyclic loading and lack of ligamentous support lead to mechanical and ischemia reperfusion injury and particle formation from bone, polymethylmethacrylate, and porous implant surfaces, which accelerate third-body polyethylene wear. Surgical injury and micromotion induce the formation of a fibrous capsule interface. Type-B lining cells produce lubricin and surface-active phospholipids to promote solid-to-solid lubrication but may loosen the implant from bone. The pumping action of the cyclically loaded joint and synovial fluid pressure waves dissect the implant-host interface and transports polyethylene particles and pro-inflammatory mediators to the interface. Hyaluronan induces formation of a synovial lining like layer. Because of its localization close to bone, foreign body inflammation at the interface stimulates osteoclastogenesis and peri-implant bone loss. Metal-on-metal and ceramic-on-ceramic pairs might minimize third body wear, but can lead to high-impact load of the acetabulum. Diamond coating of a metal-on-polyethylene couple might solve both of these problems. The basic biomaterial solutions allow good mechanical performance and relatively long life in-service, but surface modifications (porous coating, hydroxyapatite, diamond, bioglass, and others) may facilitate performance of the implant and improve the biomaterial and body interfaces.

In this letter, a double-gate AlGaN/GaN high electron mobility transistor operated in a synchronized switching mode is demonstrated, and improved dynamic performances are obtained. The additional gate sits on top of the conventional gate and stretches 2/4 μm to the source/drain electrodes, respectively. A positive voltage pulse is applied to the top gate and is synchronized with the ON-OFF switching pulse applied to the conventional gate. Such a double-gate driving method significantly improves the dynamic performances of the device. Moreover, it allows us to investigate the dynamic on-resistance in the drift region in detail.

Normally-off AlGaN/GaN metal-oxide-semiconductor high electron mobility transistors (MOS-HEMTs) on Si substrate were fabricated with the fluorine-based treatment technique. By employing a 20nm-thick Al2O3 gate dielectric deposited by atomic layer deposition, the fabricated MOS-HEMT exhibits a large positive threshold voltage of + 3.5V, a maximum gate input voltage of 15V, a maximum saturate drain current of 5.3A and an off-state breakdown voltage of 402V. The high threshold voltage and the large input voltage swing is expected to improve the electromagnetic interference immunity and safety of AlGaN/GaN MOS-HEMT power switches.

A directional residue prediction method is proposed, in which motion-aligned neighbouring residues are used in the directional prediction for residues in an inter-block. Corresponding motion estimation strategies are also designed. Experiments show that the bit rate saving can be up to 20% with a negligible decoding complexity increase.