Electrochromic Smart Window Based on Transition-Metal Phthalocyanine Derivatives.

Phthalocyanines have been widely investigated as electrochromic materials because of their large conjugated structure. However, they have shown limited applicability due to their complex electrochromism mechanism and low solubility in common organic solvents. Replacement of central metal ions in phthalocyanines affects their stability and is responsible for various electrochromic phenomena, such as color change. Herein, the relationship between the electron d-orbital arrangement in the outermost layer of transition metals and the electrochromic stability of phthalocyanine derivatives has been investigated. An enhanced solubility of phthalocyanines in organic solvents was obtained through the introduction of quaternary tert-butyl substitution. Electrochromic devices fabricated with transition-metal phthalocyanine derivatives showed high response speeds and good stability. The fast color-switching feature between blue/green and blue/purple makes it a promising candidate for smart windows and adaptive camouflage applications.

[Xq;Yq translocation in a patient with premature ovarian insufficiency].

OBJECTIVE: To explore the genetic basis for a patient with premature ovarian insufficiency. METHODS: Chromosomal G-banding and C-banding, single nucleotide polymorphism array (SNP-array), fluorescence in situ hybridization (FISH) and Y chromosome microdeletion assay were used for the analysis. RESULTS: With the combined techniques, the patient was found to carry a Xq;Yq translocation, with a karyotype of 46,X,der(X)t(X;Y)(q25;q12).ish der(X)(Tel XYp+,Tel XYq+,Yq12+). CONCLUSION: Unbalanced Xq;Yq translocation probably underlay the premature ovarian insufficiency in this patient.

Surgeon- and hospital-level variation in wait times for scheduled non-urgent surgery in Ontario, Canada: A cross-sectional population-based study.

BACKGROUND: Canadian health systems fare poorly in providing timely access to elective surgical care, which is crucial for quality, trust, and satisfaction. METHODS: We conducted a cross-sectional analysis of surgical wait times for adults receiving non-urgent cataract surgery, knee arthroplasty, hip arthroplasty, gallbladder surgery, and non-cancer uterine surgery in Ontario, Canada, between 2013 and 2019. We obtained data from the Wait Times Information System (WTIS) database. Inter- and intra-hospital and surgeon variations in wait time were described graphically with caterpillar plots. We used non-nested 3-level hierarchical random effects models to estimate variation partition coefficients, quantifying the proportion of wait time variance attributable to surgeons and hospitals. RESULTS: A total of 942,605 procedures at 107 healthcare facilities, conducted by 1,834 surgeons, were included in the analysis. We observed significant intra- and inter-provider variations in wait times across all five surgical procedures. Inter-facility median wait time varied between six-fold for gallbladder surgery and 15-fold for knee arthroplasty. Inter-surgeon variation was more pronounced, ranging from a 17-fold median wait time difference for cataract surgery to a 216-fold difference for non-cancer uterine surgery. The proportion of variation in wait times attributable to facilities ranged from 6.2% for gallbladder surgery to 23.0% for cataract surgery. In comparison, surgeon-related variation ranged from 16.0% for non-cancer uterine surgery to 28.0% for cataract surgery. IMPLICATIONS: There is extreme variability in surgical wait times for five common, high-volume, non-urgent surgical procedures. Strategies to address surgical wait times must address the variation between service providers through better coordination of supply and demand. Approaches such as single-entry models could improve surgical system performance.

Social determinants of access to timely elective surgery in Ontario, Canada: a cross-sectional population level study.

BACKGROUND: Equitable access to surgical care has clinical and policy implications. We assess the association between social disadvantage and wait times for elective surgical procedures in Ontario. METHODS: We conducted a cross-sectional analysis using administrative data sets of adults receiving nonurgent inguinal hernia repair, cholecystectomy, hip arthroplasty, knee arthroplasty, arthroscopy, benign uterine surgery and cataract surgery from April 2013 to December 2019. We assessed the relation between exceeding target wait times and the highest versus lowest quintile of marginalization dimensions by use of generalized estimating equations logistic regression. RESULTS: Of the 1 385 673 procedures included, 174 633 (12.6%) exceeded the target wait time. Adjusted analysis for cataract surgery found significantly increased odds of exceeding wait times for residential instability (adjusted odd ratio [OR] 1.16, 95% confidence interval [CI] 1.11-1.21) and recent immigration (adjusted OR 1.12, 95% CI 1.07-1.18). The highest deprivation quintile was associated with 18% (adjusted OR 1.18, 95% CI 1.12-1.24) and 20% (adjusted OR 1.20, 95% CI 1.12-1.28) increased odds of exceeding wait times for knee and hip arthroplasty, respectively. Residence in areas where higher proportions of residents self-identify as being part of a visible minority group was independently associated with reduced odds of exceeding target wait times for hip arthroplasty (adjusted OR 0.82, 95% CI 0.75-0.91), cholecystectomy (adjusted OR 0.68, 95% CI 0.59-0.79) and hernia repair (adjusted OR 0.65, 95% CI 0.56-0.77) with an opposite effect in benign uterine surgery (adjusted OR 1.28, 95% CI 1.17-1.40). INTERPRETATION: Social disadvantage had a small and inconsistent impact on receiving care within wait time targets. Future research should consider these differences as they relate to resource distribution and the organization of clinical service delivery.

[Case-control study of risk factors of obstetrical brachial plexus palsy].

OBJECTIVE: To study the risk factors of obstetrical brachial plexus palsy (OBPP). METHODS: Forty-six newborn infants with OBPP were recruited between January 1997 and December 2009 from Technical Appraisement Center for Medical Malpractice of Shandong province as OBPP group. In the control group, 138 newborn infants delivered in the same time, same hospital and same gender were collected, with a ratio of 1:3. All the cases were analyzed retrospectively. The newborn, maternal, childbirth data and working experience of midwives were analyzed by univariate and multivariate logistic regression analysis. RESULTS: (1) External pelvimetries of the two groups were normal. All were singleton newborns by vaginal deliveries with cephalic presentation. Twenty-two newborns had left unilateral palsies, and the other 24 had right unilateral palsies. The numbers of the whole, upper and fore arm type were 17, 26 and 3, respectively. The maternal age, gravidity, parity and gestational weeks were higher in OBPP group than in the control group (P < 0.05). (2) The maternal antepartum body mass index (BMI) [(29.5 ± 2.4) kg/m(2)], height of the uterus [(34.9 ± 2.4) cm] and abdominal circumference [(105 ± 6) cm] in OBPP group were higher than those in the control group [(26.1 ± 2.5) kg/m(2), (33.7 ± 2.2) cm and (99 ± 5) cm, respectively] (P < 0.05). The newborn birth weight in OBPP group [(4390 ± 489) g] was significantly higher than the control group [(3404 ± 360) g] (P < 0.01). The working experience of midwives in OBPP group [(5.2 ± 2.3) years] was less than the control group [(8.9 ± 5.4) years] (P < 0.01). (3) There was a higher proportion of instrumental delivery (28.3% vs. 3.6%), uterine atony (28.3% vs. 6.5%), prolonged second stage (8.7% vs. 0.7%) and fetal malposition (10.9% vs. 2.9%) in the OBPP group than in the control group (P < 0.05). (4) Univariate logistic analysis showed that the P values of maternal age, antepartum BMI, height of uterus, abdominal circumference, newborn birth weight, gravidity, second stage duration, instrumental delivery, fetal malposition, uterine atony and working experience of midwives were all less than 0.10. And the working experience of midwives was a protective factor. (5) The factors listed above were taken as variables, selected stepwise regression for multivariate logistic regression analysis. Boundary value was 0.10. It showed that the antepartum BMI (OR = 1.733) and newborn birth weight (OR = 1.004) were related to OBPP (P < 0.10). The significance of maternal antepartum BMI was higher than birth weight. CONCLUSIONS: The maternal antepartum BMI is the most important risk factor for OBPP, and the newborn birth weight is the other risk factor. The working experience of midwives is a protective factor.