Engineering the Dielectric Constants of Polymers: From Molecular to Mesoscopic Scales.

Polymers are essential components of modern-day materials and are widely used in various fields. The dielectric constant, a key physical parameter, plays a fundamental role in the light-, electricity-, and magnetism-related applications of polymers, such as dielectric and electrical insulation, battery and photovoltaic fabrication, sensing and electrical contact, and signal transmission and communication. Over the past few decades, numerous efforts have been devoted to engineering the intrinsic dielectric constant of polymers, particularly by tailoring the induced and orientational polarization modes and ferroelectric domain engineering. Investigations into these methods have guided the rational design and on-demand preparation of polymers with desired dielectric constants. This review article exhaustively summarizes the dielectric constant engineering of polymers from molecular to mesoscopic scales, with emphasis on application-driven design and on-demand polymer synthesis rooted in polymer chemistry principles. Additionally, it explores the key polymer applications that can benefit from dielectric constant regulation and outlines the future prospects of this field.

Assessment of a 50:50 mixture of two Bacillus subtilis strains as growth promoters for finishing pigs: productivity improvement and noxious gas reduction.

In this study, we aimed to assess the potential of a 50:50 mixture of two Bacillus subtilis strains in improving the productivity and health of finishing pigs and reducing noxious gases in their feces. These strains were found to abundantly secrete surfactin which has been shown to alleviate the effects of lipopolysaccharides in vitro. For the 10-wk experiment, 200 finishing pigs ([Landrace × Yorkshire] × Duroc) with an average body weight of 54.15 ±â€…1.70 kg were divided into four groups. Each group was fed with a basal diet supplemented with an equal amount of spores from the two B. subtilis strains at different levels: control group, no addition; treatment group 1, 0.5 × 109; treatment group 2, 1.0 × 109; treatment group 3, 1.5 × 109 cfu·kg-1 addition. During the 10-wk feeding period, dietary supplementation of 0.5 × 109, 1.0 × 109, and 1.5 × 109 cfu·kg-1 of the spore cells from these two strains resulted in a 0.9%, 1.9%, and 2.5% increase in body weight, respectively (linear P < 0.095). During the final 5 wk, the average daily gain (ADG) in weight was increased by the strains at amounts of 0.5 × 109, 1.0 × 109, and 1.5 × 109 cfu·kg-1 with a clear dosage effect (linear P < 0.05). However, neither the gain-to-feed ratio, the average daily feed intake, nor nutrient digestibility was affected by the supplementation. In blood, the endotoxin lipopolysaccharides, and two liver toxicity indicator enzymes; aspartate aminotransferase and lactate dehydrogenase were decreased (P < 0.05) in the 1.0 × 109 cfu·kg-1 spores-feeding group. Furthermore, four noxious gases were reduced by 8 to 20% in feces excreted by pigs fed with 1.5 × 109 cfu·kg-1 spores with a linear dosage effect (linear P < 0.001 to 0.05) during the final 5 wk. Our findings suggest that the mixture of B. subtilis strains may enhance the productivity of finishing pigs by reducing the risk of mild endotoxemia, rather than increasing digestibility or daily feed intake. Therefore, these Bacillus strains have the potential to act as growth promoters for pigs, leading to improved animal health and productivity. These results have significant implications for pig farmers seeking to optimize the health and growth of their animals.

In a previous study, we discovered two new strains of Bacillus subtilis that showed high surfactin secretion during growth in culture media. This surfactin proved effective in reducing endotoxin effects, particularly lipopolysaccharides, in vitro. To explore their potential as pig growth promoters, we administered 50:50 bacteria blend to 200 finishing pigs, dividing them into four groups for a 10-wk trial. Results showed that supplementing the pigs' diet with 0.5, 1.0, or 1.5 billion bacteria per kilogram led to weight gains of 0.9%, 1.9%, and 2.5%, respectively, with a dosage effect. The weight gain was notably higher during the final 5 wk. However, there were no significant differences in feed intake or nutrient digestibility. Blood analysis revealed reduced lipopolysaccharides and liver toxicity indicators, suggesting improved animal health. Moreover, the pigs that received the bacterial mixture showed reduced noxious gas levels in their feces with a dosage effect. These findings suggest that these new B. subtilis strains could serve as effective growth promoters for pigs by minimizing the risk of mild endotoxemia, leading to enhanced animal health and productivity. These results could have valuable implications for pig farmers seeking to optimize the health and growth of their animals.

Application of lesser trochanteric reduction fixator in the treatment of unstable intertrochanteric fractures.

BACKGROUND: Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures. AIM: To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures. METHODS: We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer. Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails, and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021. RESULTS: The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator, which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients. CONCLUSION: We fully realize the significance of trochanteric reduction and fixation, namely, reconstruction of structures under pressure, in the treatment of intertrochanteric fractures. As long as the general condition of patients is favorable and they are willing to undergo surgery, fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.

The Impact of Oversizing in Thoracic Endovascular Aortic Repair on Long-Term Outcomes in Uncomplicated Type B Aortic Dissection: A Single-Center Retrospective Study.

PURPOSE: The purpose of this study was to assess the impact of oversizing in thoracic endovascular aortic repair (TEVAR) on early and long-term survival and major adverse events in patients with uncomplicated type B aortic dissection (TBAD). METHODS: Between January 2010 and December 2018, 226 patients who were diagnosed with uncomplicated TBAD and received TEVAR were analyzed retrospectively. The patients were divided into ≤5% oversizing (n=153) and >5% oversizing (n=73) groups. Primary end points were all-cause and aortic-related mortalities. Secondary end points were procedure-related complications, including retrograde type A aortic dissection (RTAD), endoleak, distal stent-induced new entry (SINE), and late reintervention. All-cause and aortic-related mortalities were assessed using the Kaplan-Meier survival method, while procedure-related complications were evaluated using a competing risk model with all-cause death as a competing risk. RESULTS: Mean oversizing was 2.1%±1.5% in the ≤5% oversizing group and 9.6%±4.1% in the >5% oversizing group. Differences in the 30-day mortality and adverse events between the 2 groups were statistically insignificant. The freedom from all-cause mortality was comparable between the ≤5% oversizing group and the >5% oversizing group (≤5%: 93.3% at 5 years, >5%: 92.3% at 5 years, p=0.957). No significant difference was observed between both groups in the freedom from aortic-related mortality (≤5%: 95.0% at 5 years, >5%: 96.7% at 5 years, p=0.928). However, the competing risk analyses revealed that the cumulative incidence of RTAD was statistically significantly greater in the >5% oversizing group than in the ≤5% oversizing group (≤5%: 1(0.7%) at 5 years, >5%: 6(6.9%) at 5 years, p=0.007). All RTADs occurred within a year of TEVAR. The differences in the cumulative incidences of type I endoleak, distal SINE, and late reintervention were not significant between the 2 groups. CONCLUSION: The differences in the 5-year all-cause mortality and aortic-related mortality between patients with uncomplicated TBAD who received TEVAR with ≤5% oversizing and those who got TEVAR with >5% oversizing were insignificant. However, oversizing >5% was considerably associated with an increased risk of RTAD within a year of TEVAR, suggesting that oversizing ≤5% may be the appropriate size for TEVAR in patients with uncomplicated TBAD. CLINICAL IMPACT: For patients with uncomplicated TBAD, choosing oversizing ≤5% in endovascular treatment is beneficial to reduce the risk of postoperative retrograde type A aortic dissection. This finding provides a basis for stent size selection in endovascular repair. In addition, one year after TEVAR is the main time period for postoperative retrograde type A aortic dissection, and attention should be paid to the management and follow-up of this period.

Modulus-Modulated All-Organic Core-Shell Nanofiber with Remarkable Piezoelectricity for Energy Harvesting and Condition Monitoring.

The low piezoelectricity of piezoelectric polymers significantly restricts their applications. Introducing inorganic fillers can slightly improve the piezoelectricity of polymers, whereas it is usually at the cost of flexibility and durability. In this work, using a modulus-modulated core-shell structure strategy, all-organic nanofibers with remarkable piezoelectricity were designed and prepared by a coaxial electrospinning method. It was surprisingly found that the introduction of a nonpiezoelectric polymeric core (e.g., polycarbonate, PC) can result in 110% piezoelectric coefficient (d33) enhancement in a poly(vinylidenefluoride-co-trifluoroethylene) (PVDF-TrFE) nanofiber. Accordingly, the all-organic PVDF-TrFE@PC core-shell nanofiber exhibits record-high energy-harvesting performance (i.e., 126 V output voltage, 710 mW m-2 power density) among the reported organic piezoelectric materials. In addition, the excellent sensing capability of the core-shell nanofiber enabled us to develop a wireless vibration monitoring and analyzing system, which realizes the real-time vibration detection of a power transformer.

Risk factors for distal stent graft-induced new entry after endovascular repair in uncomplicated type B aortic dissection.

OBJECTIVE: We investigated the risk factors for distal stent graft-induced new entry (dSINE) after thoracic endovascular aortic repair for patients with uncomplicated type B aortic dissection (TBAD) and reported the outcomes of using a tapered stent graft and dSINE reintervention. METHODS: A total of 226 patients with uncomplicated TBAD who had undergone thoracic endovascular aortic repair between January 2010 and December 2018 were analyzed retrospectively. The global features of the thoracic aorta and the local features of the proximal and distal landing zones were evaluated and compared between the dSINE and non-dSINE groups. A multivariate Cox model was used to identify the independent risk factors for dSINE. The cumulative incidence of reintervention was estimated using competing risk models. RESULTS: After a median follow-up of 4.6 years, 16 patients (7.1%) had developed dSINE. Multivariable Cox regression analysis demonstrated that a type III aortic arch, decreased angle, increased distal oversizing, and increased distal mismatch ratio were significant risk factors for dSINE. Of the patients with tapered stent grafts, five with a ≤4-mm taper had developed dSINE. However, no dSINE was seen in the >4-mm taper group (P = .024). Reintervention was performed for 7 of the 16 patients with dSINE (43.8%). The mean time from the initial detection of dSINE to reintervention was 6.43 ± 4.62 months. The competing risk analyses showed that the cumulative incidence of reintervention in the dSINE group at 1, 3, and 5 years was 25.0%, 37.5%, and 43.5%, respectively. CONCLUSIONS: A type III aortic arch, excessive distal oversizing and mismatch ratio, and severe angulation were associated with dSINE in patients with uncomplicated TBAD. The use of a tapered stent graft with a >4-mm taper could help prevent dSINE in patients with a high taper ratio. Aggressive reintervention was associated with favorable long-term outcomes for patients with progressive dSINE.

Effect of postoperative ultrasound-guided internal superior laryngeal nerve block on sore throat after intubation of double-lumen bronchial tube: a randomized controlled double-blind trial.

BACKGROUND: Postoperative sore throat (POST) is one of the main adverse postoperative outcome after tracheal intubation using double-lumen endobronchial tubes (DLTs). The aim of this study was to investigate the effectiveness and safety of ultrasound (US)-guided block of the internal branch of the superior laryngeal nerve (iSLN) for alleviating POST after intubation of DLTs. METHODS: Patients undergoing thoracic surgery between August 2019 and August 2021 were randomized into two groups depending on whether they received US-guided iSLN block immediately after the operation. In the control group, the patients underwent a thoracic surgery under general anesthesia (GA) with DLTs without any special treatment, while the patients in the experimental group received US-guided iSLN block bilaterally with 2 ml of 0.25% ropivacaine on either side immediately after the operation. The primary outcome was the grading of sore throat at three-time points after the operation, i.e., immediate extubation, 2 h after extubation, and 24 h after extubation. Secondary outcomes included the rate of nausea and vomiting, hoarseness, dyspnea, and choking cough after swallowing saliva at 2 h after extubation. RESULTS: The incidence and severity of sore throat were significantly lower in the experimental group than the control group at all time intervals (all P < 0.01). The rate of nausea and vomiting, hoarseness, dyspnea, and choking cough after swallow saliva at 2 h after extubation had no statistical difference (all P > 0.05). CONCLUSIONS: The use of US-guided iSLN block can be effectively and safely applied to relieve POST after intubation of DLTs on thoracic surgery. TRIAL REGISTRATION: The study protocol was registered at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , NO. ChiCTR2000032188, 22/04/2020).

High Conduction Band Inorganic Layers for Distinct Enhancement of Electrical Energy Storage in Polymer Nanocomposites.

Dielectric polymer nanocomposites are considered as one of the most promising candidates for high-power-density electrical energy storage applications. Inorganic nanofillers with high insulation property are frequently introduced into fluoropolymer to improve its breakdown strength and energy storage capability. Normally, inorganic nanofillers are thought to introducing traps into polymer matrix to suppress leakage current. However, how these nanofillers effect the leakage current is still unclear. Meanwhile, high dopant (> 5 vol%) is prerequisite for distinctly improved energy storage performance, which severely deteriorates the processing and mechanical property of polymer nanocomposites, hence brings high technical complication and cost. Herein, boron nitride nanosheet (BNNS) layers are utilized for substantially improving the electrical energy storage capability of polyvinylidene fluoride (PVDF) nanocomposite. Results reveal that the high conduction band minimum of BNNS produces energy barrier at the interface of adjacent layers, preventing the electron in PVDF from passing through inorganic layers, leading to suppressed leakage current and superior breakdown strength. Accompanied by improved Young's modulus (from 1.2 GPa of PVDF to 1.6 GPa of nanocomposite), significantly boosted discharged energy density (14.3 J cm-3) and charge-discharge efficiency (75%) are realized in multilayered nanocomposites, which are 340 and 300% of PVDF (4.2 J cm-3, 25%). More importantly, thus remarkably boosted energy storage performance is accomplished by marginal BNNS. This work offers a new paradigm for developing dielectric nanocomposites with advanced energy storage performance.

Arterial enhancement fraction in evaluating the therapeutic effect and survival for hepatocellular carcinoma patients treated with DEB-TACE.

BACKGROUND: Arterial enhancement fraction (AEF), derived from triphasic CT scans, is considered to indirectly reflect the ratio of hepatic arterial perfusion to total perfusion. The purpose of this study was to retrospectively investigate the relationship between AEF and treatment response and survival in hepatocellular carcinoma (HCC) patients treated with drug-eluting bead (DEB) TACE. METHODS: AEF of primary lesion (AEFpre) and residual tumor (AEFpost) in 158 HCC patients were obtained from triphasic liver CT examinations pre- and post-treatment. Wilcoxon-signed rank test was used to compare the AEFpre and AEFpost for different response groups. Survival curves for overall survival (OS) in patients with different AEF were created by using Kaplan-Meier method. Cox regression analyses were used to determine the association between AEF and OS. RESULTS: There was no correlation between AEFpre and treatment response. After DEB-TACE, AEFpost was significantly lower than AEFpre either in the partial response group (38.9% vs. 52.7%, p <  0.001) or in the stable disease group (49.3% vs. 52.1%, p = 0.029). In the progression disease group, AEFpost was numerically higher than AEFpre (55.5% vs. 53.0%, p = 0.604). Cox regression analyses showed that risk of death increased in patients with AEFpre > 57.95% (HR = 1.66, p = 0.019) or AEFpost > 54.85% (HR = 2.47, p <  0.001), and the risk reduced in patients with any reduction in tumor AEF (decrease ratio ≥ 0) and with increased AEF but not exceeding the ratio of 0.102 (increase ratio <  0.102) (HR = 0.32, p <  0.001). CONCLUSIONS: The change in AEF of viable tumor is correlated with response of HCC to DEB-TACE. In addition, the AEF could be a helpful predictor in future studies on the embolization treatment for HCC.

Dielectric Manipulated Charge Dynamics in Contact Electrification.

Surface charge density has been demonstrated to be significantly impacted by the dielectric properties of tribomaterials. However, the ambiguous physical mechanism of dielectric manipulated charge behavior still restricts the construction of high-performance tribomaterials. Here, using the atomic force microscopy and Kelvin probe force microscopy, an in situ method was conducted to investigate the contact electrification and charge dynamics on a typical tribomaterial (i.e., BaTiO3/PVDF-TrFE nanocomposite) at nanoscale. Combined with the characterization of triboelectric device at macroscale, it is found that the number of transferred electrons increases with contact force/area and tends to reach saturation under increased friction cycles. The incorporated high permittivity BaTiO3 nanoparticles enhance the capacitance and electron trapping capability of the nanocomposites, efficiently inhibiting the lateral diffusion of electrons and improving the output performance of the triboelectric devices. Exponential decay of the surface potential is observed over monitoring time for all dielectric samples. At high BaTiO3 loadings, more electrons can drift into the bulk and combine with the induced charges on the back electrode, forming a large leakage current and accordingly accelerating the electron dissipation. Hence, the charge trapping/storing and dissipating, as well as the charge attracting properties, should be comprehensively considered in the design of high-performance tribomaterials.

Transcatheter chemoembolization plus percutaneous radiofrequency ablation versus laparoscopic radiofrequency ablation: improved outcome for inoperable hepatocellular carcinoma.

AIMS: To retrospectively compare the efficacy of transcatheter chemoembolization (TACE) plus percutaneous radiofrequency ablation (PRFA) (hereafter, TACE + PRFA) and laparoscopic radiofrequency ablation (LRFA) in the treatment of inoperable hepatocellular carcinoma (HCC). METHODS: From July 2014 to December 2017, 132 consecutive patients with inoperable HCC were treated with TACE + PRFA (n = 86) or LRFA (n = 46). Overall survival (OS) and recurrence-free survival (RFS) were analyzed using log-rank test and Cox regression analysis. Propensity score matched (PSM) analyses based on patient and tumor characteristics were also conducted. Additionally, we performed exploratory analyses to determine the effectiveness of TACE + PRFA and LRFA in clinically relevant subsets. RESULTS: The baseline characteristics of TACE + PRFA patients displayed relatively inferior liver status and a higher rate of BCLC-B disease. For unmatched patients, median OS (55.0 vs. 42.0 months; p = .019) and RFS (20.0 vs. 11.0 months; p < .001) were significantly longer in TACE + PRFA group than that in the LRFA group. After PSM, 39 matched pairs were identified. The difference in median OS (60.0 vs. 44.0 months; p = .009) and RFS (27.0 vs. 11.0 months; p < .001) between the two groups remained significant. Multivariate analysis in matched patients showed that treatment modality and response to initial treatment were significant predictors of OS and RFS, while recurrence after resection was an independent prognostic factor of OS. The benefits of TACE + PRFA were consistent across all the subgroups examined. The different treatments had shared a similar complication rate. CONCLUSIONS: Compared to LRFA, TACE + PRFA results in improved OS and RFS in patients not amenable to resection.

Transcranial sonography in differential diagnosis of Parkinson disease and other movement disorders.

BACKGROUND: Reports evaluating the efficacy of transcranial sonography (TCS) for the differential diagnosis of Parkinson disease (PD) and other movement disorders in China are scarce. Therefore, this study aimed to assess the application of TCS for the differential diagnosis of PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and essential tremor (ET) in Chinese individuals. METHODS: From 2017 to 2019, 500 inpatients treated at the Department of Dyskinesia, Beijing Tiantan Hospital, Capital Medical University underwent routine transcranial ultrasound examination. The cross-sections at the midbrain and thalamus levels were scanned, and the incidence rates of substantia nigra (SN) positivity and the incidence rates of lenticular hyperechoic area were recorded. The echo of the SN was manually measured. RESULTS: Of the 500 patients, 125 were excluded due to poor signal in temporal window sound transmission. Among the 375 individuals with good temporal window sound transmission, 200 were diagnosed with PD, 90 with ET, 50 with MSA, and 35 with PSP. The incidence rates of SN positivity differed significantly among the four patient groups (χ2 = 121.061, P < 0.001). Between-group comparisons were performed, and the PD group showed a higher SN positivity rate than the ET (χ2 = 94.898, P < 0.017), MSA (χ2 = 57.619, P < 0.017), and PSP (χ2 = 37.687, P < 0.017) groups. SN positivity showed a good diagnostic value for differentiating PD from the other three movement diseases, collectively or individually. The incidences of lenticular hyperechoic area significantly differed among the four patient groups (χ2 = 38.904, P < 0.001). Next, between-group comparisons were performed. The lenticular hyperechoic area was higher in the PD group than in the ET (χ2 = 6.714, P < 0.017) and MSA (χ2 = 18.680, P < 0.017) groups but lower than that in the PSP group (χ2 = 0.679, P > 0.017). CONCLUSION: SN positivity could effectively differentiate PD from ET, PSP, and MSA in a Chinese population.

Neural monitoring during ultrasound-guided radiofrequency ablation of thyroid nodules.

BACKGROUND: Intraoperative neurological monitoring is important in locating and assessing nerves during surgery. This study aimed to investigate the feasibility of neural monitoring during ultrasound-guided radiofrequency ablation (RFA) of thyroid nodules. METHODS: From February 2019 to August 2019, 16 patients (age, 42.8 ± 15.9 years; range, 17-74 years) with benign thyroid nodules who underwent ultrasound-guided RFA with neural monitoring in Zhongshan Hospital, Xiamen University, were included. A neuromonitoring system stimulated the vagus nerve to obtain electromyographic (EMG) signals and predict the function of recurrent laryngeal nerves (RLNs) during RFA. The hydrodissection technique was used to protect the RLN area. Thyroid nodules were treated with the moving-shot technique. The EMG signal value results were recorded and analyzed. All patients underwent laryngoscopic investigation 1 day after the procedure. RESULTS: Twenty vagus nerves were stimulated preprocedure and postprocedure, and the EMG signals were successfully recorded (100%). The mean initial (before ablation) and final (final ablation) vagus nerve amplitudes were 612.7 ± 130.4 µV (range, 455-882 µV) and 592.7 ± 127.3 µV (range, 410-817 µV), respectively. Based on the EMG signals, all 20 RLNs were judged to be in good condition, consistent with the postprocedure laryngoscopic results. The maximum lesion size and volume at 6 months after RFA were significantly lesser than those at baseline (p < 0.05). The volume reduction rate was 68.5% ± 21.5% (range, 13.0-97.3%). Cosmetic and symptom scores were significantly lower than those at baseline. No complications from neural monitoring occurred. CONCLUSIONS: Neural monitoring during ultrasound-guided RFA of thyroid nodules is feasible to predict RLN function.

The protective role of omentin-1 in IL-1ß-induced chondrocyte senescence.

Osteoarthritis is a common type of degenerative joint disease. Inflammation-related chondrocyte senescence plays a major role in the pathogenesis of osteoarthritis. Omentin-1 is a newly identified anti-inflammatory adipokine involved in lipid metabolism. In this study, we examined the biological function of omentin-1 in cultured chondrocytes. The presence of omentin-1 potently suppresses IL-1ß-induced cellular senescence as revealed by staining with senescence-associated beta-galactosidase (SA-ß-Gal). At the cellular level, omentin-1 attenuates IL-1ß-induced G1 phase cell-cycle arrest. Mechanistically, we demonstrate that omentin-1 reduced IL-1ß-induced expression of senescent factors including caveolin-1, p21, and PAI-1 as well as p53 acetylation through ameliorating SIRT1 reduction. Notably, silencing of SIRT1 abolishes IL-1ß-induced senescence along with the induction of p21 and PAI-1, suggesting that the action of omentin-1 in chondrocytes is dependent on SIRT1. Collectively, our results revealed the molecular mechanism through which the adipokine omentin-1 exerts a beneficial effect, thereby protecting chondrocytes from senescence. Thus, omentin-1 could have clinical implication in the treatment of osteoarthritis.

Why Are Native Hawaiians Underrepresented in Hawai'i's Older Adult Population? Exploring Social and Behavioral Factors of Longevity.

Native Hawaiians comprise 24.3% of Hawai'i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100-199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

[Evaluation of surgical outcomes using imaging study for patients with slow transit constipation complicated with outlet obstruction].

OBJECTIVE: To explore the clinical significance of multiple radiography of the pelvis in the evaluation of surgical outcomes for patients with slow transit constipation complicated with outlet obstruction. METHODS: Patients with slow transit constipation complicated with outlet obstruction were diagnosed by multiple radiography of the pelvis after screening using colon transit study. Surgery was performed according to the cause of the obstruction. Anorectal angle and the locations of perineum, pelvic peritoneum, and bladder were assessed by multiple radiography of the pelvis one month after surgery. The changes in locations of pelvic organs were assessed and the imaging appearance after the release of obstruction was observed. RESULTS: A total of 48 patients were included. Rectocele repair, partial mucosectomy with rectopexy, and hysteropexy were performed. All the patients were followed up with a mean length of 19(6-58) months. Excluding 2 patients who had no symptomatic improvement, the mean bowel movements was 1.9 times per day in the remaining 46 patients(95.8%). Preoperative anorectal angle at the squeezing phase was(128.09±13.82) degree and the difference between squeezing and resting phase was (11.14±12.58) degree, while the postoperative angle was (180.26±9.98) degree and the difference(20.01±13.11) degree(P<0.05). Preoperative location of the perineum at the squeezing phase was(-2.05±0.83) cm and the difference was(2.23±0.78) cm, while postoperative location was (-0.50±1.13) cm and the difference was (2.18±1.04) cm(P<0.05). Preoperative location of the pelvic peritoneum at the squeezing phase was(4.91±1.32) cm and the difference was (1.32±0.89) cm, while postoperative location was (2.62±2.53) cm and the difference was (3.28±0.68) cm (P<0.05). Preoperative bladder location at the squeezing phase in patients with urological symptoms was (3.92±2.51) cm and the difference was(1.39±1.27) cm, while postoperative location was (2.15±1.55) cm and the difference was (1.98±1.54) cm(P<0.05). CONCLUSION: Multiple imaging of the pelvis provides objective evidence in the evaluation of surgical outcomes for patients with chronic slow transit constipation complicated with outlet obstruction.

Longevity disparities in multiethnic Hawaii: an analysis of 2000 life tables.

OBJECTIVE: We examined differences among seven major ethnic groups in Hawaii in life expectancy at birth (e[0]) and mortality at broad age groups. METHODS: We constructed life tables for 2000 for Caucasian, Chinese, Filipino, Hawaiian, Japanese, Korean, and Samoan ethnic groups in Hawaii. We partitioned overall mortality into broad age groups: <15 (representing premature mortality), 15-65 (representing working age), and 66-84 and > or =85 (representing senescent mortality). RESULTS: The overall e(O) in Hawaii was 80.5 years, but the difference between the longest-living group (Chinese) and the shortest-living group (Samoan) was 13 years. Chinese had the lowest mortality rates in each age group except the > or =85 category. In this last age group, we observed anomalously low rates for some new immigrant groups (especially Samoan males) suggesting, as a cause, that elders in these immigrant groups may return to natal countries in their old age and die there. In the <15 age group, mortality rates for Samoans and Koreans were highest, especially for Korean girls, suggesting some continuance in the U.S. of a preference for boy children. Outside of these anomalies, ethnic differences in e(O) were likely explained by socioeconomic and behavioral variables known to affect mortality levels, which are closely associated with ethnicity in Hawaii. CONCLUSIONS: These findings confirm the need to disaggregate Asian and Pacific Islander data, to conduct ethnic-specific research, and to address socioeconomic disparities.

[Study of mental disorder due to brain damage].

OBJECTIVE: To study the incidence rate, pattern and affective factors of mental disorder due to brain damage. METHODS: According to CCMD-2-R, 388 subjects with traumatic brain damage in the Psychiatric Hospital of Huainan city within last 5 years were assessed by three psychiatrists 6 months to 1 year after brain injury. RESULTS: (1) 74.2% of the mental disordered due to brain injury have intellectual impairment, most of them is mild; (2) The intracranial hematoma, brain stem injury, brain injury extent, GCS, complicated mental disorder, and education have great effect on intellectual impairment; (3) There is an intimate relationship between the intellectual impairment and the brain stem injury, intracranial hematoma, GCS, brain injury extent, and unconsciousness time. There is an intimate relationship between the mental symptom and the brain injury extent, contusion and laceration of brain, frontal lobe injury, and intracranial hematoma. There is also an intimate relationship between the personality change and the frontal lobe injury, unfolding brain case treatment, and intracranial hematoma. CONCLUSION: To assess overall mental disorder should rely on the characteristics of craniocerebral injuries.

Ethnicity, birth weight, and maternal age in infant mortality: Hawaiian experience.

To investigate the role of ethnicity, birth weight, and maternal age in infant mortality, separately in neonatal and postneonatal phases, this study used linked birth and infant death certificates for a 10-year period, 1979-1988, in the State of Hawaii. Log-linear analysis was applied to the cross-classified tables generated from the two files. Birth weight was a strong factor both in neonatal and postneonatal phases, but ethnicity was a factor only in the latter phase. Maternal age was not significant in infant survival in either phase, but it was strongly associated with the other two factors. Among the nine major ethnic groups residing in the state, black and Hawaiian women were more likely to have infants dying during the postneonatal period. © 1993 Wiley-Liss, Inc.

The Demographic Position of the Koreans in China / 예방의학회지

No abstract available.