Parental detection of neonatal jaundice using a low-cost colour card: a multicentre prospective study.

BACKGROUND: Since most infants are usually discharged before age 48-72 hours, peak bilirubin levels will almost always occur after discharge. Parents may be the first to observe the onset of jaundice after discharge, but visual assessment is unreliable. The jaundice colour card (JCard) is a low-cost icterometer designed for the assessment of neonatal jaundice. The objective of this study was to evaluate parental use of JCard to detect jaundice in neonates. METHODS: We conducted a multicentre, prospective, observational cohort study in nine sites across China. A total of 1161 newborns ≥35 weeks of gestation were enrolled in the study. Measurements of total serum bilirubin (TSB) levels were based on clinical indications. The JCard measurements by parents and paediatricians were compared with the TSB. RESULTS: JCard values of parents and paediatricians were correlated with TSB (r=0.754 and 0.788, respectively). The parents' and paediatricians' JCard values 9 had sensitivities of 95.2% vs 97.6% and specificities of 84.5% vs 71.7% for identifying neonates with TSB ≥153.9 µmol/L. The parents' and paediatricians' JCard values 15 had sensitivities of 79.9% vs 89.0% and specificities of 66.7% vs 64.9% for identifying neonates with TSB ≥256.5 µmol/L. Areas under the receiver operating characteristic curves of parents for identifying TSB ≥119.7, ≥153.9, ≥205.2, and ≥256.5 µmol/L were 0.967, 0.960, 0.915, and 0.813, respectively, and those of paediatricians were 0.966, 0.961, 0.926 and 0.840, respectively. The intraclass correlation coefficient was 0.933 between parents and paediatricians. CONCLUSION: The JCard can be used to classify different levels of bilirubin, but it is less accurate with high bilirubin levels. The JCard diagnostic performance of parents was slightly lower than that of paediatricians.

Financial constraints, government subsidies, and corporate innovation.

To investigate the relationships between financial constraints, government subsidies, and corporate innovation, a semi-logarithmic fixed-effect panel model and mediation effect test were applied, based on the data of Chinese listed companies from 2007 to 2017. We find that (1) financial constraints suppress corporate innovation. (2) Government subsidies are targeted at bailing out firms facing financial constraints. (3) Government subsidies promote corporate innovation (4) Government subsidies partially offset the suppression of financial constraints on innovation. We contribute to the fields of public finance, corporate finance, and corporate innovation by: (1) justifying the government subsidies target strategy as a bailout of corporate financial constraints, (2) verifying the corporate-innovation promotion of government subsidies, thus justifying the efficiency of government subsidies, and (3) showing that different types of innovation benefit differently from subsidies, thus justifying subsidies as a structural innovation engine.

Phosphomolybdate assembly as a low-cost catalyst for the reduction of toxic Cr(vi) in aqueous solution.

Highly reduced phosphomolybdate hybrid compounds have been hydrothermally prepared and structurally defined. X-ray single-crystal analysis revealed that these phosphomolybdates had the following formulae: (H2bpp)6{Fe[Mo6O12(OH)3(HPO4)2(H2PO4)2]2}2·11H2O (1), (H2bpp)6{Zn[Mo6O12(OH)3(HPO4)2(H2PO4)2]2}2·11H2O (2), and (H2bpp)5.5{Mn[Mo6O12(OH)3(HPO4)2(H2PO4)2]2}2·2H2O (3) (bpp = 1,3-bi(4-pyridyl)propane). In the inorganic moiety, all Mo centers are in the +5 reduced form, representing a unique, fully reduced cluster in the polyanionic family. As a counter cation, the flexible bpp surrounds the anionic cluster to form hybrid 'core-shell' supramolecular assemblies. These hybrids are stable and insoluble in water, which can change a catalytic reaction from homogeneous to heterogeneous. Experiments showed that the three supramolecular hybrids exhibit ideally reversible multi-electron transfer behavior, and hybrid 1 is active as a heterogeneous molecular catalyst to reduce toxic Cr(vi) to nontoxic Cr(iii) at low temperature in a short period of time. Hybrid 1 serves as an electron shuttle to promote the redox reaction between Cr(vi) and HCOOH. The activation energy of the reaction is effectively decreased after the reactants are adsorbed on the solid crystal surface, and the activation energy is calculated to be 78.5 kJ·mol-1. The well-organized structures of polyoxometalates help to explain the catalytic mechanism at the molecular level.

Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

OBJECTIVE: This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. METHODS: Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. RESULTS: A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. CONCLUSION: Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be conducted.