Two risk assessment models for predicting white matter injury in extremely preterm infants.

BACKGROUND: Extremely preterm infants (EPIs) are at high-risk of white matter injury (WMI), leading to long-term neurodevelopmental impairments. We aimed to develop nomograms for WMI. METHODS: The study included patients from 31 provinces, spanning ten years. 6074 patients before 2018 were randomly divided into a training and internal validation group (7:3). The external validation group comprised 1492 patients from 2019. Predictors were identified using the least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression and nomograms were constructed. Models' performance was evaluated using receiver operating characteristic (ROC), decision curve analysis (DCA) and calibration curves. RESULTS: The prenatal nomogram included multiple gestation, premature rupture of membranes (PROM), chorioamnionitis, prenatal glucocorticoids, hypertensive disorder complicating pregnancy (HDCP) and Apgar 1 min, with area under the curve (AUC) of 0.805, 0.816 and 0.799 in the training, internal validation and external validation group, respectively. Days of mechanical ventilation (MV), shock, patent ductus arteriosus (PDA) ligation, intraventricular hemorrhage (IVH) grade III-IV, septicemia, hypothermia and necrotizing enterocolitis (NEC) stage II-III were identified as postpartum predictors. The AUCs were 0.791, 0.813 and 0.823 in the three groups, respectively. DCA and calibration curves showed good clinical utility and consistency. CONCLUSION: The two nomograms provide clinicians with precise and efficient tools for prediction of WMI. IMPACT: This study is a large-sample multicenter study, spanning 10 years. The two nomograms are convenient for identifying high-risk infants early, allowing for reducing poor prognosis.

Nomogram Model for Cardiac Surgery-Associated Acute Kidney Injury Based on Clinical Characteristics Combined with Plasma suPAR.

Objective: Analyze risk factors for cardiac surgery-associated acute kidney injury (CSA-AKI) in adults and establish a nomogram model for CSA-AKI based on plasma soluble urokinase-type plasminogen activator receptor (suPAR) and clinical characteristics. Methods: In a study of 170 patients undergoing cardiac surgery with cardiopulmonary bypass, enzyme-linked immunosorbent assay (ELISA) measured plasma suPAR levels. Multivariable logistic regression analysis identified risk factors associated with CSA-AKI. Subsequently, the CSA-AKI nomogram model was developed using R software. Predictive performance was evaluated using a receiver operating characteristic (ROC) curve and the area under the curve (AUC). Internal validation was performed through the Bootstrap method with 1000 repeated samples. Additionally, decision curve analysis (DCA) assessed the clinical applicability of the model. Results: Multivariable logistic regression analysis revealed that being male, age ≥ 50 years, operation time ≥ 290 minutes, postoperative plasma suPAR at 2 hours, and preoperative left ventricular ejection fraction (LVEF) were independent risk factors for CSA-AKI. Employing these variables as predictive factors, a nomogram model was constructed, an ROC curve was generated, and the AUC was computed as 0.817 (95% CI 0.726-0.907). The calibration curve indicated the accuracy of the model, and the results of DCA demonstrated that the model could benefit the majority of patients. Conclusion: Being male, age ≥ 50 years, operation time ≥ 290 minutes, low preoperative LVEF, and elevated plasma suPAR at 2 hours are independent risk factors for CSA-AKI. The nomogram model established based on these risk factors has high accuracy and clinical value, serving as a predictive tool for assessing the risk of CSA-AKI.

Achieving high-capacity aqueous supercapacitors via anion-doped construction of dual redox centers in NixCo1-xSeO3.

In asymmetric supercapacitors, transition metal selenates are promising electrodes, but their capacity are limited by a single redox center. To further enhance the performance of transition metal selenates, NixCo1-xSeO3 (NCSeO) doped with N and Cl was prepared on nickel-plated carbon cloth (NCSeO-NCl-NiCC). During electrochemical reactions, NCSeO can be converted to M(OH)2 (M = Ni/Co) and OH- is replaced by N and Cl. Two redox centers, M(OH)2/MOOH and M(OH)xN2-x/NO3-, are formed during charging and discharging, which is attributed to the increased capacity of the NCSeO-NCl-NiCC electrode. On NCSeO, the substitution of Cl facilitates the regulation of the electronic structure and enhances the stability of N-doping. The optimised electrode exhibits a high capacity of 417 mA h g-1 at 1 A g-1 and an impressive rate capability of 235 mA h g-1 at 50 A g-1. Asymmetric supercapacitors with this design have an ultra-high energy density of 73.6 W h kg-1, as well as an excellent rate and cycling performance with a capacitance retention of 97.8% after 20 000 cycles at a current density of 20 A g-1.

The association of stress perception on anxiety, depression and sleep quality in parents of children with burns: The moderating effect of social support.

OBJECTIVE: Few studies have explored the mental health status of parents of children with burns and the moderating effect of social support on them. METHODS: A survey was performed with parents of 112 burn-injured children at a burn center in China. Their perceived stress, anxiety, depression, sleep quality, and social support were measured by the Chinese Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale. RESULTS: ➀ The prevalence of anxiety (46.43%), depression (52.67%) and poor sleep quality (43.75%) of parents indicated that they experienced emotional and sleep disorders;➁ The perceived stress was positively correlated with sleep quality, anxiety and depression（P＜0.01), and negatively correlated with perceived social support (p＜0.05); ➂ Social support had a significant moderating effect on their perceived stress and anxiety, depression, but not on their sleep quality. With high social support, parental perceived stress had a significant positive association on anxiety and depression, while with low perceived social support, parental perceived stress had no significant association on anxiety and depression. CONCLUSION: Parents of burned children had increased stress, obvious symptoms of anxiety and depression, and poor sleep quality. Social support had a significant buffering effect on them under low pressure, and high pressure will hinder the buffering effect of social support on stress. Therefore, the ideal services to improve mental health should be provided for them to face different levels of stress.

Rod-like Ni-CoS2@NC@C: Structural design, heteroatom doping and carbon confinement engineering to synergistically boost sodium storage performance.

Currently, conversion-type transition metal sulfides have been extensively favored as the anodes for sodium-ion batteries due to their excellent redox reversibility and high theoretical capacity; however, they generally suffer from large volume expansion and structural instability during repeatedly Na+ de/intercalation. Herein, spatially dual-confined Ni-doped CoS2@NC@C microrods (Ni-CoS2@NC@C) are developed via structural design, heteroatom doping and carbon confinement to boost sodium storage performance of the material. The morphology of one-dimensional-structured microrods effectively enlarges the electrode/electrolyte contact area, while the confinement of dual-carbon layers greatly alleviates the volume change-induced stress, pulverization, agglomeration of the material during charging and discharging. Moreover, the introduction of Ni improves the electrical conductivity of the material by modulating the electronic structure and enlarges the interlayer distance to accelerate Na+ diffusion. Accordingly, the as-prepared Ni-CoS2@NC@C exhibits superb electrochemical properties, delivering the satisfactory cycling performance of 526.6 mA h g-1 after 250 cycles at 1 A g-1, excellent rate performance of 410.9 mA h g-1 at 5 A g-1 and superior long cycling life of 502.5 mA h g-1 after 1,500 cycles at 5 A g-1. This study provides an innovative idea to improve sodium storage performance of conversion-type transition metal sulfides through the comprehensive strategy of structural design, heteroatom doping and carbon confinement.

Path-dependent morphology of CH4 hydrates and their dissociation studied with high-pressure microfluidics.

Methane hydrates (MHs) have been considered a promising future energy source due to their vast resource volume and high energy density. Understanding the behavior of MH formation and dissociation at the pore-scale and the effect of MH distribution on the gas-liquid two phase flow is of critical importance for designing effective production strategies from natural gas hydrate (NGH) reservoirs. In this study, we devised a novel high-pressure microfluidic chip apparatus that is capable of direct observation of MH formation and dissociation behavior at the pore-scale. MH nucleation and growth behavior at 10.0 MPa and dissociation via thermal stimulation with gas bubble generation and evolution were examined. Our experimental results reveal that two different MH formation mechanisms co-exist in pores: (a) porous-type MH with a rough surface formed from CH4 gas bubbles at the gas-liquid interface and (b) crystal-type MH formed from dissolved CH4 gas. The growth and movement of crystal-type MH can trigger the sudden nucleation of porous-type MH. Spatially, MHs preferentially grow along the gas-liquid interface in pores. MH dissociation under thermal stimulation practically generates gas bubbles with diameters of 20.0-200.0 µm. Based on a custom-designed image analysis technique, three distinct stages of gas bubble evolution were identified during MH dissociation via thermal stimulation: (a) single gas bubble growth with an expanding water layer at an initial slow dissociation rate, (b) rapid generation of clusters of gas bubbles at a fast dissociation rate, and (c) gas bubble coalescence with uniform distribution in the pore space. The novel apparatus designed and the image analysis technique developed in this study allow us to directly capture the dynamic evolution of the gas-liquid interface during MH formation and dissociation at the pore-scale. The results provide direct first-hand visual evidence of the growth of MHs in pores and valuable insights into gas-liquid two-phase flow behavior during fluid production from NGHs.

An oriented tube array porous carbon anode prepared using a self-blowing mold of salt templates for high-rate potassium storage.

Porous carbon materials with oriented porosity are very useful in ion batteries, but their high cost and complex fabrication hinder their wide application. In this paper, we used cheap and water-soluble NaHCO3 grains to prepare unique porous carbon with an orderly arranged tube array via one-step carbonization. During the preparation process, a novel self-blowing mold of salt templates was discovered for the first time, and the resulting numerous high-speed gas jets can act as gas state templates to induce the formation of the oriented porous carbon into a mesoscale tube array with rich micropores. Besides, the amount of CO functional groups has been enhanced greatly by the chemical activation of H2O and CO2 derived from the decomposition of NaHCO3, which can improve the reversible specific capacity of the electrode by forming a C-O-K compound with potassium. Thanks to the coupling effect of the hierarchical porous structure with an orderly tube array and rich CO functional groups, the obtained porous carbon materials exhibited excellent kinetics and impressive rate capability as the anode of potassium-ion batteries (PIBs) with high capacities of 209 mA h g-1 at 10 A g-1 and 156 mA h g-1 at 30 A g-1. This work not only provides a facile, green, sustainable approach to fabricating novel carbon materials, but also demonstrates the promising prospect of oriented porous carbon in exploring advanced electrode materials for PIBs.

Multifunctional Iron Selenate Sheath of Fe-Based Anode Achieving High-Rate Capacity-Durability Combination of Aqueous Hybrid Energy Storage Devices.

The introduction of battery-type cathode has been commonly considered a preferred approach to boost the energy density of aqueous hybrid energy storage devices (AHESDs) in alkalic systems, but AHESDs with both high energy density and power density are rare due to the great challenge in designing battery-type anode materials with high rate and durability comparable to capacitive-type carbon anodes. In this paper, a well-hydrated iron selenate (FeSeO) sheath is constructed around FeOOH nanorods by a facile electrochemical activation, demonstrating the unique multifunction in fasting charge diffusion, promoting the dissociation of H2O, and inhibiting the irreversible phase transition of FeOOH to inert γ-Fe2O3, which endow the hydrated sheath coated Fe-based anodes with an impressive rate capability and superior durability. Thanks to the comprehensive performance of this Fe-based anode, the assembled AHESD delivered a high energy density of 117 Wh kg-1 with the extraordinary durability of almost 100% capacity retention after 40 000 cycles. Even at an ultrahigh power density of 27 000 W kg-1, an impressive energy density of 65 Wh kg-1 can be achieved, which rivals previously reported energy-storage devices.