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Electrochemical (EC) carbon dioxide (CO2) reduction, where CO2 is converted to value-added products such as fuel precursors, plays a key role in helping the world's energy system reach net-zero carbon emissions. Simulations of EC cells provide valuable insight into their operation since detailed experimental results on short length and time scales are difficult to obtain. In this work, we construct a 1D simulation of a membrane-electrode-assembly EC cell for CO2 reduction, using a porous silver gas diffusion cathode. We run the simulation under different electrolyte conditions, showing how the cell performance is affected. We then perform a sensitivity analysis of all input parameters to the simulation, which has not been presented before in the literature. We show that the CO partial current density (i CO) is significantly affected by each input parameter of the simulation. i CO is most sensitive to EC kinetic parameters (i 0/α) of all EC reactions, with a 1% change in α resulting in up to 6% change in i CO. Since there is uncertainty associated with the value of each input parameter, this indicates that infidelity between experiment and simulation is likely, and thus, caution should be practiced when comparing experimental results to simulation results. Further, we show that the large range of conditions simulated in literature helps to explain the large variance in reported values of i 0 and α. The results of this paper demonstrate the potential of sensitivity analysis methods to quickly optimize aspects of cell performance (CO2 utilization, Faradaic efficiency, etc.).
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Holistic study of glacial lakes and glacial lake outburst floods (GLOFs) in the strategically important China-Nepal transportation corridors is imperative for regional connectivity and disaster risk reduction. This study focuses on four China-Nepal transportation corridors, namely Chentang-Kimathanka, Zhangmu-Kodari, Keyrung-Kathmandu and Taklakot-Hilsa from east to west in the Himalayan region. Within a remote integrated framework, we present the latest high-resolution inventory of glacial lakes, assess their decadal spatio-temporal changes (1992-2022), identify potentially dangerous glacial lakes, and apply hydrodynamic model to assess downstream impacts of possible GLOFs along the study area. The results show 2688 glacial lakes (≥0.001 km2) with a total area of 116.10 ± 8.53 km2 over the study area in 2022. Glacial lakes exhibited spatiotemporal heterogeneity in expansion, with overall expansion of 32 % during 30 years. Keyrung-Kathmandu corridor, among others, was assessed with high GLOF susceptibility. Furthermore, hydrodynamic modeling of four highly dangerous lakes in each transportation area reveals that GLOFs have cross-border effects, impacting â¼103 km of China-Nepal highway, 103 bridges, two major dry ports and 3301 buildings in both countries. Based on these findings, we emphasize the joint efforts of both countries for integrated disaster management for smooth connectivity between two countries and saving downstream population through joint cooperation from central to local government levels by initiating artificial lake lowering, developing cross-border early warning systems and cooperation. This study is valuable for presenting a synergistic study of glacial lakes and GLOF for informing decision- and policy-makers of both China and Nepal for a joint approach to disaster mitigation.
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Compared with hematoma evacuation craniotomy, decompressive craniectomy has a higher incidence of intracranial complications and no outcome benefit over craniotomy, which gives surgeons a safer decision-making options during surgery.
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BACKGROUND: The objective of this study was to utilize data from the Global Burden of Disease Study (GBD) 2019 to estimate the patterns and prevalence of mild traumatic brain injury (mTBI) from 1990 to 2019, with the intention of informing the development of efficacious intervention strategies. MATERIAL AND METHODS: Data from the GBD 2019 were examined to determine the prevalence, incidence, and rates of years lived with disability (YLDs) associated with mTBI across global geographic populations from 1990 to 2019. To assess temporal patterns, estimated annual percentage changes (EAPCs) and age-standardized rates were computed. Additionally, an age-period-cohort model (APC model) framework was employed to analyze potential trends in incidence based on age, period, and birth cohort. RESULTS: In 2019, there were a total of 12,268.5 thousand incident cases (95% uncertainty interval [UI] 992.66 to 1,602.07), 11,482.5 thousand prevalent cases (95% UI 107.59 to 123.52), and 1,366.9 thousand YLDs (95% UI 96.36 to 183.35) of mTBI worldwide. The age-standardized rates (ASRs) of incidence, prevalence, and YLDs exhibited a decline from 1990 to 2019. Across all age groups, males had higher prevalence, incidence and YLDs rates. Furthermore, middle-aged and elderly adults experienced a greater disease burden. The primary causes of the global mTBI burden in 2019 were falls and road injuries. According to the APC model, the age effect trend exhibited a similar pattern across individual sociodemographic index (SDI) groups, characterized by an initial increase, followed by a decrease and a subsequent increase. Regarding the period effect, each SDI group demonstrated variation, with the middle SDI group notably displaying a consistent increase. Furthermore, in terms of the birth effect, the middle-SDI group experienced the most substantial and continuous increase. CONCLUSION: The global incident cases and prevalent cases of mTBI increased significantly from 1990 to 2019, with a heavier burden observed in males, older adults, and in low SDI such as Afghanistan. More efforts are needed in the prevention and management of mTBI, such as reducing the incidence of falls among older people and building safer road transport facilities to reduce the burden of mTBI.
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Recently, various transition metal dichalcogenides (TMDs)/Ga2O3 heterostructures have emerged as excellent candidates for the development of broadband photodetection, exhibiting various merits such as broadband optical absorption, efficient interlayer carrier transfer, a relatively simple fabrication process, and potential for flexibility. In this work, vertically stacked MoSe2/Ga2O3, WS2/Ga2O3, and WSe2/Ga2O3 heterostructures were experimentally synthesized, all exhibiting broadband light absorption, spanning at least from 200 to 800 nm. The absorption coefficients of these TMDs/Ga2O3 heterostructures are significantly improved compared to those of individual Ga2O3 films. The superior performance can be attributed to the type-I band alignment and efficient interlayer carrier transfer, which result from various band offsets along with the different doping conditions of the TMD layers, leading to distinct photoluminescence (PL) emission properties. Through a detailed analysis of the excitation-power-dependent PL spectra, we offer an in-depth discussion of the interlayer carrier transfer mechanism in the TMDs/Ga2O3 heterostructures. Regarding interlayer coupling effects, the shift of the EF of TMD layers plays a crucial role in modulating their trion emission properties. These findings suggest that these three TMDs/Ga2O3 heterostructures have great potential in broadband photodetection, and our in-depth physical mechanism analysis lays a solid foundation for a new device design.
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AIM: To provide the direct evidence for the crucial role of trimethylamine N-oxide (TMAO) in vascular permeability and endothelial cell dysfunction under diabetic condition. METHODS: The role of TMAO on the in vitro biological effect of human retinal microvascular endothelial cells (HRMEC) under high glucose conditions was tested by a cell counting kit, wound healing, a transwell and a tube formation assay. The inflammation-related gene expression affected by TMAO was tested by real-time polymerase chain reaction (RT-PCR). The expression of the cell junction was measured by Western blotting (WB) and immunofluorescence staining. In addition, two groups of rat models, diabetic and non-diabetic, were fed with normal or 0.1% TMAO for 16wk, and their plasma levels of TMAO, vascular endothelial growth factor (VEGF), interleukin (IL)-6 and tumor necrosis factor (TNF)-α were tested. The vascular permeability of rat retinas was measured using FITC-Dextran, and the expression of zonula occludens (ZO)-1 and claudin-5 in rat retinas was detected by WB or immunofluorescence staining. RESULTS: TMAO administration significantly increased the cell proliferation, migration, and tube formation of primary HRMEC either in normal or high-glucose conditions. RT-PCR showed elevated inflammation-related gene expression of HRMEC under TMAO stimulation, while WB or immunofluorescence staining indicated decreased cell junction ZO-1 and occludin expression after high-glucose and TMAO treatment. Diabetic rats showed higher plasma levels of TMAO as well as retinal vascular leakage, which were even higher in TMAO-feeding diabetic rats. Furthermore, TMAO administration increased the rat plasma levels of VEGF, IL-6 and TNF-α while decreasing the retinal expression levels of ZO-1 and claudin-5. CONCLUSION: TMAO enhances the proliferation, migration, and tube formation of HRMEC, as well as destroys their vascular integrity and tight connection. It also regulates the expression of VEGF, IL-6, and TNF-α.
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The abundance of Fusobacterium nucleatum (F. nucleatum) is highly associated with the development and poor prognosis of colorectal cancer (CRC), which is regarded as a promising target for CRC. However, until now, the novel strategy to clear F. nucleatum in the colon and CRC has not been well proposed. Herein, a probiotic strain Enterococcus faecium (E. faecium, EF47) is verified to secrete various organic acids and bacteriocins to exert superior antimicrobial activity towards F. nucleatum. However, the oral delivery of EF47 is affected by the complex digestive tract environment, so we design the hyaluronic acid-inulin (HA-IN) coated EF47 for colon-targeted delivery to fight F. nucleatum. IN can protect EF47 from the harsh gastrointestinal tract environment and is degraded specifically in the colon, acting as prebiotics to further promote the proliferation of EF47. The exposed HA can also enhance the targeting effect to the tumor area via the interaction with the CD44 receptor on the tumor cells, which is confirmed to increase the adhesive ability in tumor tissues and inhibit the growth of F. nucleatum. Therefore, this colon-targeted delivery system provides a novel platform to realize high-activity and adhesive delivery of probiotics to assist the therapeutic efficiency of CRC.
Subject(s)
Colorectal Neoplasms , Enterococcus faecium , Fusobacterium Infections , Humans , Fusobacterium nucleatum , Colorectal Neoplasms/pathology , Hyaluronic Acid/pharmacology , Inulin , Fusobacterium Infections/complications , Fusobacterium Infections/microbiologyABSTRACT
PURPOSES: To investigate the incidence and factors influencing the occurrence of metamorphopsia in patients with simple rhegmatogenous retinal detachment (RRD) after surgery. METHODS: Relevant studies of metamorphopsia were identified by searching in PubMed, Embase, and Cochrane until August 2022. Meta-analysis of the incidence of metamorphopsia after rhegmatogenous retinal detachment surgery was performed using Review Manager 5.4 statistical software. RESULTS: A total of 12 studies reported 1133 participants with 469 patients with postoperative metamorphopsia. The meta-analysis showed a higher incidence of metamorphopsia in macular-off cases compared with macular-on RRD (RR = 2.88, 95% CI: 2.35 to 3.52). The use of perfluorocarbon liquid (PFCL) during pars plana vitrectomy (PPV) reduced the incidence of metamorphopsia (RR = 0.61, 95% CI: 0.41 to 0.92). There was no evidence of any important difference in metamorphopsia between participants in the PPV group and the scleral buckling (SB) group (RR = 1.04, 95% CI: 0.82 to 1.33). There was little or no difference in metamorphopsia between gas and silicon oil (SO) in the PPV group (RR = 0.89, 95% CI: 0.69 to 1.13). CONCLUSION: The incidence of postoperative metamorphopsia is higher in macular-off RRD, and PFCL should be a preferred choice to prevent postoperative metamorphopsia in macula-off RRD cases.
Subject(s)
Fluorocarbons , Retinal Detachment , Humans , Retinal Detachment/epidemiology , Retinal Detachment/surgery , Retinal Detachment/etiology , Incidence , Visual Acuity , Scleral Buckling/adverse effects , Vision Disorders/epidemiology , Vision Disorders/etiology , Vitrectomy/adverse effects , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases with atypical manifestations. The aim of this study was to utilize urine metabolomics to explore potential biomarkers for the diagnosis and prognosis of CSDH. METHODS: Seventy-seven healthy controls and ninety-two patients with CSDH were enrolled in our study. In total, 261 urine samples divided into the discovery group and validation group were analyzed by LC-MS. The statistical analysis and functional annotation were applied to discover potential biomarker panels and altered metabolic pathways. RESULTS: A total of 53 differential metabolites were identified in this study. And the urinary metabolic profiles showed apparent separation between patients and controls. Further functional annotation showed that the differential metabolites were associated with lipid metabolism, fatty acid metabolism, amino acid metabolism, biotin metabolism, steroid hormone biosynthesis, and pentose and glucuronate interconversions. Moreover, one panel of Capryloylglycine, cis-5-Octenoic acid, Ethisterone, and 5,6-DiHETE showed good predictive performance in the diagnosis of CSDH, with an AUC of 0.89 in discovery group and an AUC of 0.822 in validation group. Another five metabolites (Trilobinol, 3'-Hydroxyropivacaine, Ethisterone, Arginyl-Proline, 5-alpha-Dihydrotestosterone glucuronide) showed the levels of them returned to a healthy state after surgery, showing good possibility to monitor the recovery of CSDH patients. CONCLUSION AND CLINICAL RELEVANCE: The findings of the study revealed urine metabolomic differences between CSDH and controls. The potentially diagnostic and prognostic biomarker panels of urine metabolites were established, and functional analysis demonstrated deeper metabolic disorders of CSDH, which might conduce to improve early diagnose of CSDH clinically.
Subject(s)
Hematoma, Subdural, Chronic , Lomustine/analogs & derivatives , Humans , Hematoma, Subdural, Chronic/surgery , Chromatography, Liquid , Ethisterone , Liquid Chromatography-Mass Spectrometry , Tandem Mass Spectrometry , Biomarkers , MetabolomicsABSTRACT
BACKGROUND: Cataracts now account for the largest proportion of the global burden of blindness and vision loss. Understanding the changing trends in the global burden of cataracts over the past 30 years and the next 15 years is of clear significance for the prevention and control of cataracts in key populations. As far as we know, research on the future burden of cataracts is lacking. OBJECTIVE: This study aims to assess the global burden of cataracts over the past 30 years by using age-period-cohort modeling and to estimate trends in the next 15 years. METHODS: Data were obtained from the Global Burden of Disease Study 2019, the United Nations Development Programme, and the WHO (World Health Organization) Global Health Observatory data repository. The assessment of trends and disparities in the number and rate of disability-adjusted life years (DALYs) for cataracts from 1990 to 2019 was conducted. The association between the age-standardized DALY rate (ASDR) and the socio-demographic index (SDI), human development index (HDI), national levels of particulate matter <2.5 µm in diameter (PM2.5), and ambient ultraviolet radiation (UVR) was determined using linear regression analysis. Additionally, we used the Nordpred (Harald Fekjær and Bjørn Møller) age-period-cohort model to predict the cataract burden from 2020 to 2034. RESULTS: Globally, the number of DALYs due to cataract increased from 3,492,604 (95% uncertainty interval [UI] 2,481,846-4,719,629) in 1990 to 6,676,281 (95% UI 4,761,210-9,006,193) in 2019. The ASDRs due to cataract decreased from 93.17 (95% UI 66.14-125.32) in 1990 to 82.94 (95% UI 59.06-111.75) in 2019, with an average annual percentage change of -0.37 (95% CI -0.44 to -0.3; P<.001). Age, female sex, air pollution, smoking, high fasting plasma glucose levels, and a high body mass index were risk factors for the burden of cataracts. SDI and HDI were negatively correlated with ASDRs of cataracts, while PM2.5 and UVR were positively associated with them. Higher DALY rates were also associated with lower SDI (R2=0.1939; P<.001), lower HDI (R2=0.2828; P<.001), national PM2.5 concentration (R2=0.1874; P<.001), and ambient UVR levels (R2=0.2354; P<.001). The prediction model suggested that the number of DALYs due to cataract will continue to rise globally, while the cataract DALY rate will continue to decrease. CONCLUSIONS: While the ASDR of cataracts has decreased, there has been a notable increase in the number of DALYs over the past 30 years. Projections suggest that the global burden of cataracts will continue to rise over the next 15 years. To address this challenge, appropriate prevention and treatment policies must be implemented.
Subject(s)
Cataract , Global Burden of Disease , Humans , Female , Adolescent , Quality-Adjusted Life Years , Retrospective Studies , Ultraviolet Rays , Global Health , Cataract/epidemiology , Particulate MatterABSTRACT
OBJECTIVES: Air pollution has been suggested as an important risk factor for chronic obstructive pulmonary disease (COPD); however, evidence of interactive effects on COPD between different factors was sparse, especially for young adults. We aimed to assess the combined effects of ambient ozone (O3) and household air pollution on COPD in young individuals. METHODS: We conducted a population-based study of residents aged 15-50 years in the low-income and middle-income regions of western China. We used multivariable logistic regression models to examine the associations between long-term ozone exposure and COPD in young individuals. RESULTS: A total of 6537 young cases were identified among the participants, with a COPD prevalence rate of 7.8 (95% CI 7.2% to 8.5%), and most young COPD individuals were asymptomatic. Exposure to household air pollution was associated with COPD in young patients after adjustment for other confounding factors (OR 1.82, 95% CI 1.41 to 2.37). We also found positive associations of COPD with O3 per IQR increase of 20 ppb (OR 1.92, 95% CI 1.59 to 2.32). The individual effects of household air pollution and O3 were 1.68 (95% CI 1.18 to 2.46) and 1.55 (95% CI 0.99 to 2.43), respectively, while their joint effect was 3.28 (95% CI 2.35 to 4.69) with the relative excess risk due to interaction of 1.05 (95% CI 0.33 to 1.78). CONCLUSIONS: This study concludes that exposure to ambient O3 and household air pollution might be important risk factors for COPD among young adults, and simultaneous exposure to high levels of the two pollutants may intensify their individual effects.
Subject(s)
Air Pollutants , Air Pollution , Ozone , Pulmonary Disease, Chronic Obstructive , Young Adult , Humans , Middle Aged , Ozone/toxicity , Ozone/analysis , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/etiology , Risk Factors , Particulate Matter/adverse effects , Particulate Matter/analysis , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Nitrogen DioxideABSTRACT
Birefringence is at the heart of photonic applications. Layered van der Waals materials inherently support considerable out-of-plane birefringence. However, funnelling light into their small nanoscale area parallel to its out-of-plane optical axis remains challenging. Thus far, the lack of large in-plane birefringence has been a major roadblock hindering their applications. Here, we introduce the presence of broadband, low-loss, giant birefringence in a biaxial van der Waals materials Ta2NiS5, spanning an ultrawide-band from visible to mid-infrared wavelengths of 0.3-16 µm. The in-plane birefringence Δn ≈ 2 and 0.5 in the visible and mid-infrared ranges is one of the highest among van der Waals materials known to date. Meanwhile, the real-space propagating waveguide modes in Ta2NiS5 show strong in-plane anisotropy with a long propagation length (>20 µm) in the mid-infrared range. Our work may promote next-generation broadband and ultracompact integrated photonics based on van der Waals materials.
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AIM: To evaluate the trends and changes in the number and rates of disability-adjusted life years (DALYs) and prevalence of cataract in China between 1990 and 2019, and to predict the trends of cataract burden from 2020 to 2030. METHODS: The Global Burden of Diseases (GBD) database was employed to collect the data on DALYs and the prevalence of cataract in China, which was distinguished by age and sex during the past three decades from 1990 to 2019, and then changes in the number and rates of cataract from 2020 to 2030 were predicted. All data were analyzed by the R program (version 4.2.2) and GraphPad Prism 9.0 statistics software. RESULTS: The number of DALYs of cataract increased from 449 322.84 in 1990 to 1 087 987.61 in 2019, number of cataract cases increased from 5 607 600.94 in 1990 to 18 142 568.96 in 2019. The age-standardized DALY rates (ASDR) generally increased slightly [estimated annual percentage change (EAPC=0.1; 95%CI: -0.24 to 0.45), age-standardized prevalence rates (ASPR) also increased (EAPC=0.88; 95%CI: 0.6 to 1.15). Cataract burden increased with age and female gender. Among the causes of cataract, air pollution was the most important, followed by smoking, high fasting plasma glucose, and high body mass index (BMI). The burden of cataract is predicted to grow persistently from 2020 to 2030, the number of DALYs and prevalence for cataract will rise to 2 336 431 and 43 698 620 respectively by 2030, the ASDR is predicted to be 85/100 000 and ASPR will be 1586/100 000 in 2030, females will still be at greater risk of suffering from cataract than males. CONCLUSION: The burden of cataract in China kept rising from 1990 to 2019. Increasing age and female gender are risk factors for cataract. Air pollution, smoking, high fasting plasma glucose, and high BMI are associated with cataract. The burden of cataract in China will gradually increase from 2020 to 2030, the elderly women in particular need attention. Our results may be of help for providing reference strategies to reduce cataract burden in the near future.
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Hematopoietic stem cells (HSCs) sustain hematopoiesis during homeostasis and regeneration. However, their limited availability poses a challenge for protein analysis. Here, we present a protocol for performing high-sensitivity western blot on HSCs using two techniques that enhance HSC isolation from mice and boost sensitivity for low cell numbers. We describe steps for isolating murine bone marrow cells, antibody staining, and cell sorting and post-sort analysis. We then detail a western blot procedure suitable for low numbers of HSCs. For complete details on the use and execution of this protocol, please refer to Li et al (2022).1,2.
Subject(s)
Hematopoiesis , Hematopoietic Stem Cells , Animals , Mice , Hematopoietic Stem Cells/metabolism , Cell Separation , Bone Marrow Cells , Blotting, WesternABSTRACT
BACKGROUND: There is no general agreement on the preferential use of a fixed ratio (FR) of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 0.7 vs. the lower limit of normal (LLN) of FEV1/FVC to define airflow obstruction. Determining the impact of these different cut-off levels in people living at high altitudes has not been studied. We assessed the prevalence of airflow obstruction and its clinical characteristics in residents living at high altitude using a fixed ratio and the LLN of FEV1/FVC according to Global Lung Initiative 2012 (GLI) reference values. METHODS: Using a multistage stratified sampling method, 3702 participants (aged ≥ 15 years) living at an altitude of 3000-4700 m in Tibet were included. RESULTS: 11.4% and 7.7% of participants had airflow obstruction according to GLI-LLN and a fixed FEV1/FVC cut-off value, respectively. The participants in the FR-/LLN+ group were younger, predominantly female, more frequently exposed to household air pollution, and had a higher proportion of chronic obstructive pulmonary disease assessment test scores ≥ 10 than those in the FR-/LLN- group. They also had a significantly lower FEV1 and a higher frequency of small airway dysfunction. Compared with the participants of the FR+/LLN+ group, those in the FR-/LLN+ group showed no significant difference in the risk factors for airflow obstruction and respiratory symptoms, but had a lower prevalence of small airway dysfunction. CONCLUSIONS: Defining airflow obstruction according to LLN, instead of using an FR, identified younger individuals with more frequent clinical symptoms of airflow obstruction and small airway dysfunction.
Subject(s)
Altitude , Pulmonary Disease, Chronic Obstructive , Female , Humans , Male , Cross-Sectional Studies , Reference Values , LungABSTRACT
Chronic subdural hematoma (CSDH) is a common neurosurgical condition. Inflammation has been found to play an essential role in the formation of CSDHs, and the prognostic nutritional index (PNI), a nutritional and inflammatory baseline marker, plays a role in predicting the prognosis of many diseases. We aimed to identify the relationship between PNI and CSDH recurrence. This study retrospectively analyzed 261 CSDH patients who underwent burr hole evacuation in Beijing Tiantan Hospital from August 2013 to March 2018. The PNI was calculated as 5 ∗ lymphocyte count (109/L) + serum albumin concentration (g/L), and these markers were obtained from the peripheral blood test on the day of discharge from the hospital. Recurrence was defined as operated hematoma enlargement accompanied by newly emerging neurological disorders. The comparison of baseline characteristics demonstrated that patients with bilateral hematoma and low levels of albumin, lymphocytes, and PNI were more likely to be recurrent. After adjusting for age, sex, and other important variables, decreased PNI levels were associated with an increased risk of CSDH (OR, 0.803, 95% CI: 0.715-0.902, p = 0.001). The addition of PNI to conventional risk factors significantly improved the risk prediction of CSDH (net reclassification index: 71.12%, p = 0.001; integrated discrimination index: 10.94%, p = 0.006). A low PNI level is associated with an increased risk of CSDH recurrence. As an easily obtainable nutritional and inflammatory marker, PNI may play a significant role in predicting the recurrence of CSDH patients.
Subject(s)
Hematoma, Subdural, Chronic , Nutrition Assessment , Humans , Prognosis , Retrospective Studies , Hematoma, Subdural, Chronic/surgery , Recurrence , DrainageABSTRACT
Background: Exposure to particulate matter (PM) has been a major public health threat, but the potentially differential effects on asthma of PM remain largely unknown in high altitude settings. We evaluated the effects of ambient PM on asthma in high altitude settings. Methods: The study recruited a representative sample from high altitude settings using a multistage stratified sampling procedure. Asthma was defined by a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. The annual mean PM2.5 and PM10 concentrations were calculated for each grid cell at 1-km spatial resolution based on the geographical coordinates. Results: We analyzed data for participants (mean age 39.1 years, 51.4% female) and 183 (3.7%, 95% confidence interval (CI): 3.2-4.2) of the participants had asthma. Prevalence was higher in women (4.3%, 95% CI 3.5-5.1) than in men (3.1%, 2.4-3.8) and increasing with higher concentration of PM exposures. For an interquartile range (IQR) difference (8.77 µg/m3) in PM2.5 exposure, the adjusted odds ratio (OR) was 1.64 (95% CI 1.46-1.83, P < 0.001) for risk of asthma. For PM10, there was evidence for an association with risk of asthma (OR 2.34, 95% CI: 1.75-3.15, P < 0.001 per IQR of 43.26 µg/m3). Further analyses showed that household mold or damp exposure may aggravate PM exposure associated risks of asthma. Conclusions: This study identified that PM exposure could be a dominate environmental risk factor for asthma but largely unconsidered in the high-altitude areas. The association between PM exposure and asthma should be of interest for planners of national policies and encourage programs for prevention of asthma in residents living at high altitudes.
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Objective: Chronic subdural hematoma (CSDH) is a common disease in neurosurgery, which usually occurs in the elderly. Seizure is one of the postoperative complications in CSDH patients and can affect patient outcomes. There is currently no consensus on whether antiepileptic drugs should be prescribed prophylactically. The aim of this study was to evaluate independent risk factors for postoperative seizures and unfavorable outcomes in CSDH patients. Methods: We reviewed 1,244 CSDH patients who had undergone burr-hole craniotomy in this study. Patient clinical data, CT scan results, recurrence and outcome data were collected. We divided the patients into two groups based on whether they had a postoperative seizure. Percentages and χ2 tests were applied for categorical variables. Standard deviations and two-sided unpaired t-tests were applied for continuous variables. Stepwise logistic regression analyses were performed to identify the independent factors of postoperative seizures and unfavorable outcomes. Results: The incidence of seizures after CSDH surgery was 4.2% in this study. There was no significant difference in recurrence rate between seizure and non-seizure patients (p = 0.948), and the outcome of seizure patients was significantly poor (p < 0.001). There are more postoperative complications in seizure patients (p < 0.001). Logistic regression analysis showed that the independent risk factors for postoperative seizures included drinking history (p = 0.031), cardiac disease (p = 0.037), brain infarction (p = 0.001) and trabecular hematoma (p < 0.001). The use of urokinase is a protective factor for postoperative seizures (p = 0.028). Hypertension is an independent risk factor for unfavorable outcome in seizure patients (p = 0.038). Conclusion: Seizures after CSDH surgery were associated with postoperative complications, higher mortality and poorer clinical outcomes at follow-up. We believe that alcohol consumption, cardiac disease, brain infarction and trabecular hematoma are independent risk factors for seizures. The use of urokinase is a protective factor against seizures. Patients with postoperative seizures need more stringent management of their blood pressure. A prospective randomized study is necessary to determine which subgroups of CSDH patients would benefit from antiepileptic drugs prophylaxis.
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The detection of a fallen person (FPD) is a crucial task in guaranteeing individual safety. Although deep-learning models have shown potential in addressing this challenge, they face several obstacles, such as the inadequate utilization of global contextual information, poor feature extraction, and substantial computational requirements. These limitations have led to low detection accuracy, poor generalization, and slow inference speeds. To overcome these challenges, the present study proposed a new lightweight detection model named Global and Local You-Only-Look-Once Lite (GL-YOLO-Lite), which integrates both global and local contextual information by incorporating transformer and attention modules into the popular object-detection framework YOLOv5. Specifically, a stem module replaced the original inefficient focus module, and rep modules with re-parameterization technology were introduced. Furthermore, a lightweight detection head was developed to reduce the number of redundant channels in the model. Finally, we constructed a large-scale, well-formatted FPD dataset (FPDD). The proposed model employed a binary cross-entropy (BCE) function to calculate the classification and confidence losses. An experimental evaluation of the FPDD and Pascal VOC dataset demonstrated that GL-YOLO-Lite outperformed other state-of-the-art models with significant margins, achieving 2.4-18.9 mean average precision (mAP) on FPDD and 1.8-23.3 on the Pascal VOC dataset. Moreover, GL-YOLO-Lite maintained a real-time processing speed of 56.82 frames per second (FPS) on a Titan Xp and 16.45 FPS on a HiSilicon Kirin 980, demonstrating its effectiveness in real-world scenarios.
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Background: The geriatric nutritional risk index (GNRI) is a simple index for evaluating the nutrition status of elderly patients. Many investigations have demonstrated that this index is associated with the prognosis of several diseases. This study aims to identify the relationship between the GNRI and recovery in elderly mild traumatic brain injury (mTBI) patients. Methods: A total of 228 mTBI patients older than 65 years were included in this study. mTBI was defined as an injury to the brain with a loss of consciousness of 30 min or less, a duration of posttraumatic amnesia of <24 h, and an admission Glasgow Coma Scale (GCS) score of 13-15. The Glasgow Outcome Scale Extended (GOSE), an outcome scale assessing functional independence, work, social activities, and personal relationships, was applied to assess the recovery of the patients. The clinical outcome was divided into complete recovery (GOSE = 8) and incomplete recovery (GOSE ≤ 7) at 6 months after the injury. Multivariate logistic regression was applied to evaluate the association between the GNRI and recovery of elderly mTBI patients, with adjustment for age, sex, hypertension, diabetes, and other important factors. Results: The receiver operating curve (ROC) analysis demonstrated that the cutoff value of GNRI was 97.85, and the area under the curve (AUC) was 0.860. Compared to the patients with a high GNRI, the patients with a low GNRI were older, had a higher prevalence of anemia, acute subdural hematoma, and subarachnoid hemorrhage, had a higher age-adjusted Charlson Comorbidity Index value, and had lower levels of albumin, lymphocytes, and hemoglobin. Multivariable analysis showed that high GNRI was associated with a lower risk of 6-month incomplete recovery (OR, 0.770, 95% CI: 0.709-0.837, p < 0.001). Conclusion: The GNRI has utility as part of the objective risk assessment of incomplete 6-month functional recovery in elderly patients with mTBI.