New Insight into the Electronic Effect for Cu Porphyrin Catalysts in Electrocatalytic of CO2 into CH4.

Perturbation of the copper (Cu) active site by electron manipulation is a crucial factor in determining the activity and selectivity of electrochemical carbon dioxide (CO2 ) reduction reaction (e-CO2 RR) in Cu-based molecular catalysts. However, much ambiguity is present concerning their electronic structure-function relationships. Here, three molecular Cu-based porphyrin catalysts with different electron densities at the Cu active site, Cu tetrakis(4-methoxyphenyl)porphyrin (Cu─T(OMe)PP), Cu tetraphenylporphyrin (Cu─THPP), and Cu tetrakis(4-bromophenyl)porphyrin (Cu─TBrPP), are prepared. Although all three catalysts exhibit e-CO2 RR activity and the same reaction pathway, their performance is significantly affected by the electronic structure of the Cu site. Theoretical and experimental investigations verify that the conjugated effect of ─OCH3 and ─Br groups lowers the highest occupied molecular orbital (HOMO)-lowest unoccupied molecular orbitals (LUMO) gap of Cu─T(OMe)PP and Cu─TBrPP, promoting faster electron transfer between Cu and CO2 , thereby improving their e-CO2 RR activity. Moreover, the high inductive effect of ─Br group reduces the electron density of Cu active site of Cu─TBrPP, facilitating the hydrolysis of the bound H2 O and thus creating a preferable local microenvironment, further enhancing the catalytic performance. This work provides new insights into the relationships between the substituent group characteristics with e-CO2 RR performance and is highly instructive for the design of efficient Cu-based e-CO2 RR electrocatalysts.

The Synthesis of Amino-Acid-Anchored Two-Dimensional Silicoaluminophosphates and Congo Red Adsorption Application.

Two-dimensional (2D) materials with nanometer thickness have the advantage of a large specific surface area and excellent surface accessibility. They have great potential for adsorption, catalysis, and many other applications. 2D zeolitic silicoaluminophosphates (SAPOs) can be synthesized through a dual structure directing agent (SDA) strategy. But the materials have been primarily used in their organic-free form. In this work, we demonstrate that the same synthesis strategy is effective for developing amino-acid-anchored 2D SAPOs through a one-step synthesis. Because of the addition of amino acids, the surficial amino and carboxylic groups serve as active sites for adsorption and catalysis. Congo red adsorption is used to evaluate the potential of using the organic functional groups as active adsorption sites. The 2D SAPO materials have demonstrated excellent Congo red removal efficiency with close to complete removal for certain concentrations. The effects of the amino acid concentration and hydrothermal synthesis time on material morphology development will be discussed. Thorough characterization by SEM, TEM, FTIR, XRD, and nitrogen adsorption has been done to reveal the properties of the amino-acid-anchored 2D SAPOs.

Construction of Low-Coordination Cu-C2 Single-Atoms Electrocatalyst Facilitating the Efficient Electrochemical CO2 Reduction to Methane.

Constructing Cu single-atoms (SAs) catalysts is considered as one of the most effective strategies to enhance the performance of electrochemical reduction of CO2 (e-CO2 RR) towards CH4 , however there are challenges with activity, selectivity, and a cumbersome fabrication process. Herein, by virtue of the meta-position structure of alkynyl in 1,3,5-triethynylbenzene and the interaction between Cu and -C≡C-, a Cu SAs electrocatalyst (Cu-SAs/HGDY), containing low-coordination Cu-C2 active sites, was synthesized through a simple and efficient one-step method. Notably, this represents the first achievement of preparing Cu SAs catalysts with Cu-C2 coordination structure, which exhibited high CO2 -to-CH4 selectivity (72.1 %) with a high CH4 partial current density of 230.7 mA cm-2 , and a turnover frequency as high as 2756 h-1 , dramatically outperforming currently reported catalysts. Comprehensive experiments and calculations verified the low-coordination Cu-C2 structure not only endowed the Cu SAs center more positive electricity but also promoted the formation of H•, which contributed to the outstanding e-CO2 RR to CH4 electrocatalytic performance of Cu-SAs/HGDY. Our work provides a novel H⋅-transferring mechanism for e-CO2 RR to CH4 and offers a protocol for the preparation of two-coordinated Cu SAs catalysts.

Construction of Synergistic Ni3 S2 -MoS2 Nanoheterojunctions on Ni Foam as Bifunctional Electrocatalyst for Hydrogen Evolution Integrated with Biomass Valorization.

The intrinsic sluggish kinetics of the oxygen evolution reaction (OER) limit the improvement of hydrogen evolution reaction (HER) performance, and substituting the anodic oxidation of biomass materials is an alternative approach, given its lower oxidation potential and higher added value compared to those of OER. In this study, a Ni3 S2 -MoS2 nanoheterojunction catalyst with strong electronic interactions is prepared. It exhibits high efficiency for both the HER and the electrooxidation of 5-hydroxymethylfurfural (HMF). In a two-electrode cell with Ni3 S2 -MoS2 serving as both the anode and cathode, the potential is only 1.44 V at a current density of 10 mA cm-2 , which is much lower than that of pure water splitting. Density functional theory calculations confirm that the strong chemisorption of H and HMF at the interface leads to outstanding electrocatalytic activity. The findings not only provide a strategy for developing efficient electrocatalysts, but also provide an approach for the continuous production of high value-added products and H2 .

High-Performance Zeolitic Hollow-Fiber Membranes by a Viscosity-Confined Dry Gel Conversion Process for Gas Separation.

Zeolite membranes show great potential for gas and hydrocarbon separations, but high manufacturing cost has been one of the main hurdles in their industrial application. Here we demonstrate a method termed viscosity-confined dry gel conversion (VCDGC) for zeolite hollow fiber membrane fabrication. We demonstrate in detail the VCDGC synthesis of small-pore CHA zeolite membranes. Extensive permeation measurements reveal that dry gel-processed CHA zeolite hollow fiber membranes have excellent gas and hydrocarbon separation characteristics well exceeding or comparable to current membranes. Medium-pore MFI membranes are also fabricated, and their favorable hydrocarbon separation characteristics indicate the versatility and reliability of the VCDGC method.

Entropy-Based Effect Evaluation of Delineators in Tunnels on Drivers' Gaze Behavior.

Driving safety in tunnels has always been an issue of great concern. Establishing delineators to improve drivers' instantaneous cognition of the surrounding environment in tunnels can effectively enhance driver safety. Through a simulation study, this paper explored how delineators affect drivers' gaze behavior (including fixation and scanpath) in tunnels. In addition to analyzing typical parameters, such as fixation position and fixation duration in areas of interest (AOIs), by modeling drivers' switching process as Markov chains and calculating Shannon's entropy of the fit Markov model, this paper quantified the complexity of individual switching patterns between AOIs under different delineator configurations and with different road alignments. A total of 25 subjects participated in this research. The results show that setting delineators in tunnels can attract drivers' attention and make them focus on the pavement. When driving in tunnels equipped with delineators, especially tunnels with both wall delineators and pavement delineators, the participants exhibited a smaller transition entropy H t and stationary entropy H s , which can greatly reduce drivers' visual fatigue. Compared with left curve and right curve, participants obtained higher H t and H s values in the straight section.

Lumbar muscle volume in postmenopausal women with osteoporotic compression fractures: quantitative measurement using MRI.

OBJECTIVE: To investigate the relationship between paraspinal and psoas muscle volumes and acute osteoporotic or low-bone-mass compression fractures of the lumbar spine in postmenopausal women. METHODS: Patient data were retrieved retrospectively for postmenopausal women with L-spine magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry showing osteoporosis/low bone mass. Group 1 comprised eight women aged 60-80 years with MRI showing a single acute compression fracture. The age-matched group 2a (N = 12) and younger group 2b (N = 12) comprised of women whose MRIs showed no fractures. Cross-sectional MRIs of the paraspinal and psoas muscles and intramuscular fat volume for each muscle group were measured. Operator repeatability and reproducibility were obtained. RESULTS: Group 1 showed significantly smaller lean muscle volume for all muscle groups at L5/S1. Intramuscular fat volume was also smaller in most muscle groups in group 1, though only reaching statistical significance at variable muscle groups and levels. Measurements show both good intrarater repeatability and interrater reproducibility of lean muscle volume estimations (intraclass correlation coefficient (ICC), 0.999 for rater A and 0.997 for rater B; Cronbach's alpha 0.995) and intramuscular fat volume estimations (ICC, 0.995 for rater A and 0.982 for rater B; Cronbach's alpha was 0.981). CONCLUSIONS: This study provides the first quantitative evidence that compression fractures in postmenopausal women with underlying osteoporosis/low bone mass are associated with less paraspinal and psoas muscle volumes. Further longitudinal studies with larger cohorts are needed to verify this relationship. KEY POINTS: • The risk of osteoporotic compression fractures is higher in older women with smaller paraspinal muscle volume. • Older women show smaller paraspinal muscle volume and more intramuscular fat compared to younger controls.

Continuous Zeolite MFI Membranes Fabricated from 2D MFI Nanosheets on Ceramic Hollow Fibers.

High-quality 2D MFI nanosheet coatings were prepared on α-alumina hollow fiber supports by vacuum filtration and then transformed into molecular sieving membranes by two sequential hydrothermal treatments. This processing method eliminates the need for specially engineered silica-based support materials that have so far been necessary to allow the formation of functional membranes from 2D MFI nanosheets. The sequential steps enhance adhesion of the membrane on the fiber support, fill in nanoscale gaps between the 2D nanosheets, and preserve the desirable (0k0) out-of-plane orientation without the need of any support engineering or modification. The membrane exhibits high performance for separation of n-butane from i-butane, and for other technologically important hydrocarbon separations. The present findings have strong implications on strategies for obtaining thin, highly selective zeolite membranes from 2D zeolites in a technologically scalable manner.

Chiral Silver-Lanthanide Metal-Organic Frameworks Comprised of One-Dimensional Triple Right-Handed Helical Chains Based on [Ln7(µ3-OH)8]13+ Clusters.

Three new isostructural chiral silver-lanthanide heterometal-organic frameworks [Ag3Ln7(µ3-OH)8(bpdc)6(NO3)3(H2O)6](NO3)·2H2O [Ln = Eu (1), Tb (2, Sm (3); H2bpdc = 2,2'-bipyridine-3,3'-dicarboxylic acid] based on heptanuclear lanthanide clusters [Ln7(µ3-OH)8]13+ comprised of one-dimensional triple right-handed helical chains were hydrothermally synthesized. Various means such as UV-vis spectroscopy, IR spectroscopy, elemental analysis, powder X-ray diffraction, and thermogravimetric/differential thermal analysis were used to characterize the compounds, wherein compound 3 was crystallographically characterized. In the structure of compound 3, eight µ3-OH- groups link seven Sm3+ ions, forming a heptanuclear cluster, [Sm7(µ3-OH)8]13+, and the adjacent [Sm7(µ3-OH)8]13+ clusters are linked by the carboxylic groups of bpdc2- ligands, leading to the formation of a one-dimensional triple right-handed helical chain. The adjacent triple right-handed helical chains are further joined together by coordinating the pyridyl N atoms of the bpdc2- ligands with Ag+, resulting in a chiral three-dimensional silver(I)-lanthanide(III) heterometal-organic framework with one-dimensional channels wherein NO3- anions and crystal lattice H2O molecules are trapped. The compounds were studied systematically with respect to their photoluminescence properties and energy-transfer mechanism, and it was found that H2bpdc (the energy level for the triplet states of the ligand H2bpdc is 21505 cm-1) can sensitize Eu3+ luminescence more effectively than Tb3+ and Sm3+ luminescence because of effective energy transfer from bpdc2- to Eu3+ under excitation in compound 1.

Synthesis, Structure, and Photoluminescence of Color-Tunable and White-Light-Emitting Lanthanide Metal-Organic Open Frameworks Composed of AlMo6(OH)6O183- Polyanion and Nicotinate.

A series of isostructural compounds Na(HL)(CH3COO)Ln(Al(OH)6Mo6O18)(H2O)6·10H2O [L = nicotinate; Ln = Eu (1), Tb (2)] and Na(HL)(CH3COO)EumTbnLa1-m-n(AlMo6(OH)6O18)(H2O)6·10H2O (3-8, L = nicotinate), wherein Anderson-type polyanions AlMo6(OH)6O183- as basic inorganic building blocks are connected by Eu(CH3COO)(HL)(H2O)3]24+ and [Na2(H2O)8]2+ cations, resulting in formation of three-dimensional lanthanide metal-organic open frameworks, were synthesized successfully with AlCl3·6H2O, Na2MoO4·2H2O, nicotinic acid, and lanthanide nitrates as starting materials. The compounds were characterized by UV-vis, IR, elemental analysis, powder XRD, and TG-DTA measurements. The single-crystal structures of compounds 1 and 2 show that the two compounds display three-dimensional open frameworks with 1D channels along the b and c axes. Investigation of the energy transfer mechanism indicated that the organic nicotinate ligand can transfer energy efficiently to Tb3+ rather than Eu3+. The influence of the POM moiety on the fluorescence of the compounds is also studied. Compounds 1-8 exhibit tunable luminescence color, and emitting of white light was realized through adjusting the molar ratio of Eu:Tb:La within the compounds.

Structural analysis and insertion study reveal the ideal sites for surface displaying foreign peptides on a betanodavirus-like particle.

Betanodavirus infection causes fatal disease of viral nervous necrosis in many cultured marine and freshwater fish worldwide and the virus-like particles (VLP) are effective vaccines against betanodavirus. But vaccine and viral vector designs of betanodavirus VLP based on their structures remain lacking. Here, the three-dimensional structure of orange-spotted grouper nervous necrosis virus (OGNNV) VLP (RBS) at 3.9 Å reveals the organization of capsid proteins (CP). Based on the structural results, seven putative important sites were selected to genetically insert a 6× histidine (His)-tag for VLP formation screen, resulting in four His-tagged VLP (HV) at positions N-terminus, Ala220, Pro292 and C-terminus. The His-tags of N-terminal HV (NHV) were concealed inside virions while those of 220HV and C-terminal HV (CHV) were displayed at the outer surface. NHV, 220HV and CHV maintained the same cell entry ability as RBS in the Asian sea bass (SB) cell line, indicating that their similar surface structures can be recognized by the cellular entry receptor(s). For application of vaccine design, chromatography-purified CHV could provoke NNV-specific antibody responses as strong as those of RBS in a sea bass immunization assay. Furthermore, in carrying capacity assays, N-terminus and Ala220 can only carry short peptides and C-terminus can even accommodate large protein such as GFP to generate fluorescent VLP (CGV). For application of a viral vector, CGV could be real-time visualized to enter SB cells in invasion study. All the results confirmed that the C-terminus of CP is a suitable site to accommodate foreign peptides for vaccine design and viral vector development.

[Application of modified Frosch approach for Schatzker typeâ ¡tibial plateau fractures with posterolateral column].

OBJECTIVE: To explore clnical efficacy of modified Frosch approach for Schatzker typeⅡtibial plateau fracture with posterolateral column. METHODS: From January 2019 to September 2020, totally 11 patients with Schatzker typeⅡtibial plateau fractures with posterolateral column were treated, including 7 males and 4 females, aged from 21 to 49 years old. Modified Frosch approach was adopted for lateral decubitus position, and posterolateral fractures were fixed with support plates or posterolateral screws. Anterolateral fixation with conventional tibial plateau lateral locking plate. Tibial plateau varus angle and posterior inclination angle were measured by X-ray immediately and 12 months after operation, as well as knee motion at 12 months after operation. Knee function at 12 months after operation was evaluated by knee score of Hospital for Special Surgery(HSS). RESULTS: Eleven patients were followed up for 12 to 15 months. Varus angle and inclination angle at immediately after operation ranged from 76° to 86° and 6° to 10°, respectively, and 79° to 88° and 6° to 10°, respectively at 12 months after operation. The range of extension of knee ranged from 0° to 5°, and flexion was 106° to 137° at 12 months after operation. Postoperative HSS knee score at 12 months ranged from 74 to 94 scores, 8 patients were excellent and 3 good. CONCLUSION: Modified Frosch approach is an effective surgical method for Schatzker typeⅡtibial plateau fracture with posterolateral column. A single incision is used to complete fracture exposure and fixation at two sites, avoiding use of combined incisions, and could obtain good postoperative knee joint function. During operation, popliteal fossa structure should be familiar, and the common peroneal nerve should be protected to avoid injury.

Relationship between leaf vein traits of three dominant Quercus species and ecological factors in the Qinling Mountains, China.

We investigated the inter- and intra-species differences of leaf vein traits of three dominant Quercus species, Q. wutaishanica, Q. aliena var. acutiserrata, and Q. variabilis of Niubeiling (subtropical humid climate) and Taohuagou (warm temperate semi-humid climate), located in the eastern and western Qinling Mountains. The nine examined leaf vein traits included primary leaf vein width, secondary leaf vein width, mean fine vein width, primary vein density, fine vein density, vein areole diameter, areole density, 3D fine vein surface area, and fine vein volume. We further elucidated the influencing mechanisms and regulatory pathways of biotic and abiotic factors on leaf vein traits. The results showed that species identity had significant effects on eight out of nine leaf vein traits except 3D fine vein surface area, while habitat had significant effects on primary leaf vein width, secondary leaf vein width, vein areole diameter, fine vein density, and areole density. Altitude had significant effects on primary vein density, mean fine vein width, vein areole diameter, fine vein density and areole density. Habitat, tree species identity, and altitude had significantly interactive effects on primary leaf vein density, 3D fine vein surface area, and fine vein volume. There were significant differences in primary leaf vein width, mean fine vein width, areole density, 3D fine vein surface area, fine vein volume, primary vein density of Q. wutaishanica between the two studied habitats, but the differences were only found in secondary leaf vein width and areole density of Q. aliena var. acutiserrata and Q. variabilis. The examined leaf vein traits were influenced both by biotic and abiotic factors, with varying effect sizes. Among the biotic factors, petiole length, leaf length and width ratio had strong effect on leaf vein traits. Among the abiotic factors, climatic and soil factors had high effect size on vein traits, with the former being higher than the latter. Leaf vein traits were affected directly by biotic factors, but indirectly by abiotic factors (soil and climatic factors) via regulating biotic factors (leaf stoichiometry and leaf phenotypic traits).

Regulation of depressive-like behaviours by palmitoylation: Role of AKAP150 in the basolateral amygdala.

BACKGROUND AND PURPOSE: Protein palmitoylation is involved in learning and memory, and in emotional disorders. Yet, the underlying mechanisms in these processes remain unclear. Herein, we describe that A-kinase anchoring protein 150 (AKAP150) is essential and sufficient for depressive-like behaviours in mice via a palmitoylation-dependent mechanism. EXPERIMENTAL APPROACH: Depressive-like behaviours in mice were induced by chronic restraint stress (CRS) and chronic unpredictable mild stress (CUMS). Palmitoylated proteins in the basolateral amygdala (BLA) were assessed by an acyl-biotin exchange assay. Genetic and pharmacological approaches were used to investigate the role of the DHHC2-mediated AKAP150 palmitoylation signalling pathway in depressive-like behaviours. Electrophysiological recording, western blotting and co-immunoprecipitation were performed to define the mechanistic pathway. KEY RESULTS: Chronic stress successfully induced depressive-like behaviours in mice and enhanced AKAP150 palmitoylation in the BLA, and a palmitoylation inhibitor was enough to reverse these changes. Blocking the AKAP150-PKA interaction with the peptide Ht-31 abolished the CRS-induced AKAP150 palmitoylation signalling pathway. DHHC2 expression and palmitoylation levels were both increased after chronic stress. DHHC2 knockdown prevented CRS-induced depressive-like behaviours, as well as attenuating AKAP150 signalling and synaptic transmission in the BLA in CRS-treated mice. CONCLUSION AND IMPLICATIONS: These results delineate that DHHC2 modulates chronic stress-induced depressive-like behaviours and synaptic transmission in the BLA via the AKAP150 palmitoylation signalling pathway, and this pathway may be considered as a promising novel therapeutic target for major depressive disorder.

The Mediating Role of Attitudes Towards Dementia on the Relationship Between Dementia Knowledge and Behaviors Towards Persons with Dementia: A Cross-Sectional Study.

Purpose: To examine the mediating effect of attitudes towards dementia on the relationship between dementia knowledge and behaviors towards persons with dementia. Participants and Methods: A cross-sectional survey was conducted with 313 adults (age ≤ 20 years). Participants were recruited using non-probability convenience sampling from medical clinics, community centers, and supermarkets located in the Wanhua District of Taipei City. Data were collected with the following self-report questionnaires: a demographic survey, validated instruments for dementia knowledge and attitudes towards dementia (assessed using the Alzheimer's Disease Knowledge Scale and the Approaches to Dementia Questionnaire, respectively), and a researcher-developed survey on unfriendly behaviors towards persons with dementia. Results: Pearson's correlation and multiple linear regression analysis indicated that higher scores for dementia knowledge and more positive attitudes about dementia were significantly associated with lower levels of unfriendly behaviors towards persons living with dementia. Mediation analysis using a robust bootstrap test with 5000 samples indicated that attitudes toward dementia had a partial mediating effect on the relationship between dementia knowledge and unfriendly behaviors. Conclusion: Our findings suggest that increasing public awareness and knowledge about dementia could help the general population develop better attitudes towards dementia, which could subsequently help improve behaviors towards persons living with dementia.

Comparison of species composition and community characteristics of Quercus forests on south and north slopes of Taibai Mountain, China.

We examined species composition, community characteristics, diversity, and community similarity of five Quercus communities composed of three Quercus species (Q. variabilis, Q. aliena var. acutiserrata, Q. wutaishanica) on the altitudinal gradient on the south and north slopes of Taibai Mountain. The results showed that there was an altitudinal transition pattern from Q. variabilis pure forest to Q. variabilis-Q. aliena var. acutiserrata mixed forest, Q. aliena var. acutiserrata pure forest, Q. aliena var. acutiserrata-Q. wutaishanica mixed forest and Q. wutaishanica pure forest on the south and north slopes of Taibai Mountain. The main companion species of Quercus community on the north slope were Pinus armandii, Castanea seguinii, and Sorbus alnifolia, and were Pinus tabuliformis, C. seguinii, Carpinus cordata, and Q. spinosa on the south slope. Species richness, woody plant density, and Quercus species dominance on the north slope of Taibai Mountain were higher than those on the south slope. α diversity of tree layer in Quercus community on the south and north slopes of Taibai Mountain increased first, then decreased and then increased with altitude. α diversity of tree layer was higher in mixed forests than pure forests. α diversity of shrub layer was higher than that of tree layer and herb layer in Quercus community on south and north slopes. ß diversity fluctuated greatly along the altitudinal gradient on the south and north slopes, indicating that species composition changed greatly with altitude. Results of redundancy analysis showed that mean warmest month temperature, altitude and tree height accounted for 79.0% of the community diversity on the north slope, and that soil water content, tree height, canopy density and mean annual temperature accounted for 79.6% of the community diversity on the south slope. Overall, Quercus dominance was higher on the north slope of Taibai Mountain, and the substitution distribution pattern of Quercus species was clearer than that on the south slope. Environmental factors related to temperature and precipitation jointly affected α diversity of Quercus communities.

DHHC2 regulates fear memory formation, LTP, and AKAP150 signaling in the hippocampus.

Palmitoyl acyltransferases (PATs) have been suggested to be involved in learning and memory. However, the underlying mechanisms have not yet been fully elucidated. Here, we found that the activity of DHHC2 was upregulated in the hippocampus after fear conditioning, and DHHC2 knockdown impaired fear induced memory and long-term potentiation (LTP). Additionally, the activity of DHHC2 and its synaptic expression were increased after high frequency stimulation (HFS) or glycine treatment. Importantly, fear learning selectively augmented the palmitoylation level of AKAP150, not PSD-95, and this effect was abolished by DHHC2 knockdown. Furthermore, 2-bromopalmitic acid (2-BP), a palmitoylation inhibitor, attenuated the increased palmitoylation level of AKAP150 and the interaction between AKAP150 and PSD-95 induced by HFS. Lastly, DHHC2 knockdown reduced the phosphorylation level of GluA1 at Ser845, and also induced an impairment of LTP in the hippocampus. Our results suggest that DHHC2 plays a critical role in regulating fear memory via AKAP150 signaling.

[Application of artificial neural network model to predict the health risk of dyslipidemia in individuals].

OBJECTIVE: To establish models to predict the risk of dyslipidemia in individuals, and then to explore and evaluate new prediction models. METHODS: The epidemiological survey data of 8914 community residents was selected and divided into a trained group (6686 cases) and a test group (2228 cases). Artificial neural network (ANN) and Logistic regression analysis were used to establish prediction models, and then the results were evaluated by receiver operating characteristic (ROC) curve. RESULTS: The specificity (64.79%) of AAN model forecasting the results of test group was lower, but the sensitivity (94.86%), Youden's index (59.65%) and consistency rate (81.23%) of AAN model was higher than the Logistic regression predicted model (specificity = 77.49%, sensitivity = 53.51%, Youden' s index = 31.00% and consistency rate = 81.23%, respectively). Moreover, the area under ROC curve of ANN prediction model (Az = 0.824 +/- 0.009) was significantly bigger than the Logistic regression prediction model (Az = 0. 655 +/- 0.012). CONCLUSION: The discrimination performance of ANN model is better than Logistic regression in the prediction of health risk of dyslipidemia in individuals.

The Impact of Global Budgeting on the Efficiency of Healthcare under a Single-Payer System in Taiwan.

Since 1995, a national health insurance (NHI) program has been in operation in Taiwan, which provides uniform comprehensive coverage. Forced by severe financial deficit, global budgeting reimbursement was adopted in the healthcare sector to control healthcare expenditures in 2002. A two-stage data envelopment analysis (DEA) approach was used to measure the efficiency of hospital resource allocation among stakeholders in Taiwan's NHI system, and to further explore the changes in resource allocation after the introduction of a global budgeting payment scheme. The dataset was collected from the annual statistical reports of Taiwan's Ministry of Health and Welfare (MOHW) and was used to estimate the efficiency of resource allocation in hospital-based healthcare services under global budgeting. In terms of efficiency during the period from 2003 to 2009, one-third of decision-making units (DMUs) improved their productivity in stage I, and seven out of the total of eighteen DMUs saw falls in financial efficiency in stage II. After global budgeting was implemented, there were significant positive impacts on the efficiency of hospital resource allocation in Taiwan. The two-stage DEA model for analyzing the effects of the global budgeting reimbursement system on productivity and financial efficiency represents a key decision-making tool for hospital administrators and policymakers.

Determining the stability of minimally displaced lateral humeral condyle fractures in children: ultrasound is better than arthrography.

BACKGROUND: Evaluating of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound imaging of the elbow is increasingly being used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children with minimally displaced fractures. The aims of this study were to assess the correlations between ultrasound and arthrography findings for predicting the integrity of the cartilage hinge and to describe the utility of ultrasound in determining the need for pre-treatment. METHODS: Thirty-nine patients with minimally displaced lateral humeral condyle fractures who underwent ultrasound and arthrography examinations before surgery from May 2018 to December 2019 were included in this study. Ultrasound and arthrography predictors of the cartilage hinge status were independently measured. The ultrasound and arthrography results were compared. RESULTS: The mean displacement of the fractures was 3.1 mm (range, 2.0~5.0 mm). Arthrography showed incomplete fractures in 24 patients (61.5%) and complete fractures in 15 patients (38.5%). Ultrasound showed incomplete fractures in 25 patients (64.1%) and complete fractures in 14 patients (35.9%). The ultrasound and arthrography results of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 that were predicted to have an intact articular surface and 13 that were predicted to have an incongruity articular surface. There was no correlation between the displacement and the fracture appearing complete on the ultrasound scan. The Pearson coefficient between ultrasound and arthrography for assessing the integrity of the articular surface was 0.837. CONCLUSIONS: Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status in children with minimally displaced lateral humeral condyle fractures. LEVEL OF EVIDENCE: Prospective study; level II.