Dysfunction of CCT3-associated network signals for the critical state during progression of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors and is a serious threat to human health; thus, early diagnosis and adequate treatment are essential. However, there are still great challenges in identifying the tipping point and detecting early warning signals of early HCC. In this study, we aimed to identify the tipping point (critical state) of and key molecules involved in hepatocarcinogenesis based on time series transcriptome expression data of HCC patients. The phase from veHCC (very early HCC) to eHCC (early HCC) was identified as the critical state in HCC progression, with 143 genes identified as key candidate molecules by combining the DDRTree (dimensionality reduction via graph structure learning) and DNB (dynamic network biomarker) methods. Then, we ranked the candidate genes to verify their mRNA levels using the diethylnitrosamine (DEN)-induced HCC mouse model and identified five early warning signals, namely, CCT3, DSTYK, EIF3E, IARS2 and TXNRD1; these signals can be regarded as the potential early warning signals for the critical state of HCC. We identified CCT3 as an independent prognostic factor for HCC, and functions of CCT3 involving in the "MYCtargets_V1" and "E2F-Targets" are closely related to the progression of HCC. The predictive method combining the DDRTree and DNB methods can not only identify the key critical state before cancer but also determine candidate molecules of critical state, thus providing new insight into the early diagnosis and preemptive treatment of HCC.

Targeting Large-Conductance Calcium-Activated Potassium Channels to Ameliorate Lipopolysaccharide-Induced Depressive-Like Behavior in Mice.

Neuroinflammation plays crucial role in the development and progression of depression. Large conductance calcium- and voltage-dependent potassium (BK) channels mediate the activation of microglia. Herein, we investigated whether BK channels could serve as a target for the treatment of inflammation-associated depression. Lipopolysaccharide (LPS, 0.83 mg/kg) was injected intraperitoneally (i.p.) to induce neuroinflammation and depressive-like behavior in 6-8 week ICR mice. Adeno-associated virus (AAV) constructs (AAV9-Iba1p-BK shRNA-EGFP (BK shRNA-AAV) or AAV9-Iba1p-NC shRNA-EGFP (NC shRNA-AAV)) were unilaterally injected intracerebroventricularly to selectively knock down BK channels in microglia. The tail suspension test (TST) and forced-swim test (FST) were used to evaluate depressive-like behavior in mice 24 h after LPS challenge. The morphology of microglia, expression of BK channels, levels of cytokines, and expression and activity of indoleamine 2,3-dioxygenase (IDO) were measured by immunohistochemistry, western blot, quantitative real time PCR, and enzyme-linked immunosorbent assay (ELISA), respectively. Either paxilline (i.p.), a specific BK channel blocker, or BK shRNA-AAV effectively inhibited the activation of microglia, reduced the production of IL-1ß in the hippocampus and suppressed the expression and activity of IDO in the hippocampus and prefrontal cortex, resulting in the amelioration of depressive-like behavior in mice. These data suggest for the first time that BK channels are involved in LPS-induced depressive-like behaviors. Thus, microglia BK channels may be a potential drug target for the depression treatment.

Clinical and radiographic outcomes of lateral sinus floor elevation with simultaneous hydrophilic implants placement: A retrospective study of 2-5 years.

AIMS: To investigate the clinical and radiographic outcomes of a chemically modified sandblasted large-grit acid-etched implant (hydrophilic) in lateral sinus floor elevation (LSFE), compared with a conventional one (hydrophobic). MATERIALS AND METHODS: A retrospective study design was adopted. Patients who received LSFE with simultaneous implant placement were recruited. According to different types of implant surfaces, patients were divided into two groups (the hydrophilic group and the hydrophobic group). Implant survival rate (SR), endo-sinus bone stability on the radiographs, mean probing depths, percentage of bleeding on probing, marginal bone loss, and patient satisfaction were evaluated. RESULTS: A total of 106 patients with 180 implants (hydrophilic:101, hydrophobic:79) in 119 maxillary sinuses were included. The follow-up period ranged from 2 to 5 years. Three hydrophobic implants and one hydrophilic implant in four different patients failed. The SR of the hydrophilic group was higher than that of the hydrophobic group but without a significant difference (p > .05). The change and change rate of endo-sinus bone height (ΔESBH and RΔESBH) and bone volume (ΔESBV and RΔESBV) in the hydrophilic group were less than those in the hydrophobic group, with a significant difference at 6 months after implantation. No other significant difference was found between the two groups. CONCLUSION: Within the limitations of this study, both hydrophilic and hydrophobic implants were suitable for LSFE with predictable clinical outcomes. Meanwhile, hydrophilic implants could contribute to the grafted endo-sinus bone stability during healing time.

Immediate loaded fixed complete dentures supported by implants in patients with a history of periodontitis: A retrospective cohort study of 2 to 7 years.

STATEMENT OF PROBLEM: The outcome of implant-supported fixed complete dentures in edentulous patients with a history of periodontitis is unclear. PURPOSE: The purpose of this retrospective clinical study was to assess the clinical outcomes of immediate loaded fixed complete dentures in individuals with a history of periodontitis and to analyze risk factors related to implant failure. MATERIAL AND METHODS: A total of 642 implants (146 prostheses) in 119 patients were included. The follow-up period ranged from 2 to 7 years. Implant survival rates, marginal bone loss, mechanical complications, biologic complications, and patient satisfaction were evaluated. The Pearson chi-square test, independent samples t test, and multivariate generalized estimating equation were performed for statistical analysis (α=.05). RESULTS: Eleven implants in 9 patients failed, leading to overall survival rates of 98.3% at the implant level and 92.4% at the patient level. The mean ±standard deviation marginal bone loss was 0.62 ±0.86 mm, and marginal bone loss did not differ significantly between axial and tilted implants (P>.05). Mechanical complications were detected in 55 (37.7%) definitive prostheses; biologic complications were detected in 318 (49.5%) implants. Smokers had a significantly lower survival rate than nonsmokers (odds ratio: 6.880, P=.013). Bruxers had a significantly higher incidence of mechanical complications than nonbruxers (P<.001). CONCLUSIONS: The immediate loaded fixed complete denture supported by implants is a suitable treatment option for edentulous patients with a history of periodontitis, with high survival implant rates. Smoking is a risk factor for implant failure. Bruxism may increase the incidence of mechanical complications with implant-supported fixed complete dentures, and the overall biologic complication incidence is comparatively high.

Attitudes and perspectives of 534 Chinese pediatricians toward internet hospitals.

Background: Internet hospitals introduced in China have effectively reduced service time and space, promoted high-quality pediatric medical resources to grassroots areas, solved the contradiction between supply and demand of pediatric medical resources, and met patients' increasing multi-level and diversified medical service needs. However, pediatricians' attitudes toward and satisfaction with the use of internet hospitals remain unknown. Objective: This study aimed to investigate pediatricians' knowledge of, use of, and satisfaction with internet hospitals in order to identify major issues in internet hospital development, and to understand pediatricians' attitudes and opinions on the construction, development, and use of internet hospitals. Materials and methods: A total of 625 pediatricians in 17 public tertiary hospitals in Shanghai were surveyed from November 1-30, 2021. Five hundred and thirty four pediatricians completed the survey, and the response rate was 85.44%. Pediatricians' baseline demographic data were collected and information about their use of and satisfaction with internet hospitals. Results: About 70.22% (375/534) of pediatricians knew about internet hospitals and about 54.68% (292/534) use internet hospitals for patient consultation, diagnosis, and treatment. Utilized services mainly focused on online consultation (271/292, 92.81%), online follow-up consultation (174/292, 59.59%), and health sciences (111/292, 38.01%). Online services were provided by 69.18% (202/292) of pediatricians for less than 1 h a day, and 75.00% (219/292) responded to fewer than five patient consultations online every day. Pediatricians' overall satisfaction with internet hospitals was low (3.59 ± 0.92 points), user experience, systems functions, operation processes, service prices, and performance rewards of internet hospitals were main influencing factors. Pediatricians are enthusiastic about further development of internet hospitals, with 87.83% (469/534) willing to provide services on the internet hospital platform. Conclusion: Most pediatricians view internet hospitals favorably and are eager to contribute to the development of online diagnosis and treatment services. The development of internet hospitals will be more strongly supported by improving pediatricians' satisfaction and mobilizing their enthusiasm and initiative to participate in internet medical services.

Room-temperature formation of alloy ZnxCd13-xSe13 magic-size clusters via cation exchange in diamine solution.

Magic-size clusters (MSCs) are molecular materials with unique properties at the border between molecules and solids, providing important insights into the nanocrystal formation process. However, the synthesis of multicomponent alloy MSCs in a single-ensemble form remains challenging due to their tiny size and difficult doping control. Herein, for the first time, we successfully synthesized alloy ZnxCd13-xSe13 MSCs (x = 1-12) with a unique sharp absorption peak at 352 nm by cation exchange between Cd2+ ions and pre-synthesized (ZnSe)13 MSCs in a diamine solution at room temperature. The experimental results show that the use of diamines is crucial to the formation of stable ZnxCd13-xSe13 MSCs, which may be attributed to two amine groups that can coordinate to the surface of MSCs simultaneously. Limited by the robust interaction between diamine ligands and MSCs, the partial cation exchange results in the formation of alloy ZnxCd13-xSe13 MSCs. In contrast, complete cation exchange occurs in a monoamine solution, giving (CdSe)34 MSCs. Besides, a lower reaction temperature and a higher concentration of diamine favor the formation of ZnxCd13-xSe13 MSCs. Our study provides an important basis for further understanding of the transformation of MSCs and a new approach to the controllable synthesis of alloyed MSCs.

Cleaning effects of decontamination methods on clinically failed TiUnite implants and their impacts on surface roughness and chemistry: An in vitro pilot study.

PURPOSE: To evaluate the in vitro cleaning effects of different decontamination methods and their impacts on surface characteristics using clinically failed TiUnite implants (Nobel Biocare, Kloten, Switzerland). MATERIALS AND METHODS: Thirty clinically failed TiUnite implants were treated using different decontamination methods. Group 1 (control group) received physiological saline irrigation; Group 2 underwent erythritol powder air polishing (AIRFLOW Master Piezon, EMS Dental, Nyon, Switzerland); Group 3 was treated with erythritol powder air polishing with ethylenediaminetetraacetic acid brushing (FileRite PRC, Pulpdent, Watertown, MA, USA); Group 4 received ultrasonic scaling with polyetheretherketone tips (EMS Dental); Group 5 underwent ultrasonic scaling with polyetheretherketone tips with ethylenediaminetetraacetic acid; and Group 6 was treated with a combination of ultrasonic scaling with polyetheretherketone tips, erythritol powder air polishing and ethylenediaminetetraacetic acid. Surface cleaning effects, quantified by relative contaminated area reduction and visual analogue scale score, as well as surface roughness and chemistry, were assessed after decontamination. The cleaning effects of each decontamination method were also compared between TiUnite and SLA (sandblasted, large-grit acid-etched; Straumann, Basel, Switzerland) implants. RESULTS: Group 6 showed the highest relative contaminated area reduction (stereoscopic microscopy 83.92%, scanning electron microscopy 96.40%), visual analogue scale score (2.83) and reduction in surface roughness (thread bottom -0.78 µm, tip -1.35 µm), as well as an almost maximal decrease in the proportion of carbon (thread bottom -12.33%, tip -8.77%) and increase in that of titanium (thread bottom 13.71%, tip 10.73%). Polyetheretherketone remnants were observed in Groups 4 and 5 but appeared to be reduced in Group 6. When comparing the outcomes with those for SLA implants, no significant differences were found. CONCLUSION: Within the limitations of the present study, the combination of ultrasonic scaling with polyetheretherketone tips, erythritol powder air polishing and ethylenediaminetetraacetic brushing achieved reasonable cleaning effects. The original surface modification did not seem to have any impact on the decontamination results for any of the methods examined.

A novel approach for audible acoustic quick response codes.

Compared to image-based quick response (QR) codes, acoustic QR codes have some advantages. However, an acoustic QR scanner cannot recognize an acoustic QR code at a distance of more than two meters from an acoustic QR announcer. To this end, we propose a new sort of acoustic QR code, called an audible acoustic QR code (AAQRC), which employs humanly audible sound to carry users' information directly. First, a user's string of characters is translated into a string of pitches. Then, the related algorithms convert the string of pitches into a playable audio file. As a result, an AAQRC is generated, consisting of the audio itself. AAQRC recognition is the opposite process of AAQRC generation. Compared with the existing approach for acoustic QR codes, the new method can recognize acoustic QR codes at a longer distance, even if there are obstacles between the AAQRC announcer and AAQRC scanner.

IL-1 Receptor Antagonist Protects the Osteogenesis Capability of Gingival-Derived Stem/Progenitor Cells under Inflammatory Microenvironment Induced by Porphyromonas gingivalis Lipopolysaccharides.

Mesenchymal stem cells (MSCs) have been considered to be a future treatment option for periodontitis due to their excellent regenerative capability. However, it is still a challenge to protect MSCs' biological properties from multiple bacterial toxins in local inflammatory environment. The present study is aimed at investigating the treatment effect of interleukin-1 receptor antagonist (IL-1ra) on cell proliferation, migration, and osteogenic differentiation of gingival-derived mesenchymal stem cells (GMSCs) under an inflammatory microenvironment induced by Porphyromonas gingivalis lipopolysaccharides (P. gingivalis-LPS). GMSCs derived from Sprague-Dawley (SD) rats' free gingival tissues were treated with P. gingivalis-LPS (10 µg/mL) to create in vitro inflammatory environment. Different concentrations of IL-1ra (0.01-1 µg/mL) were used to antagonize the negative effect of LPS. Cell behaviors including proliferation, cloning formation unit (CFU), cell migration, osteogenic differentiation, mineral deposition, and cytokine production were assessed to investigate the protection effect of IL-1ra on GMSCs under inflammation. The toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) pathway activated by LPS was evaluated by real-time quantitative polymerase chain reaction (RT-PCR) and western blot. In response to P. gingivalis-LPS treatment, cell numbers, cloning formation rate, cell migration rate, proinflammatory cytokine production, and osteogenic differentiation-associated protein/mRNA expressions as well as mineralized nodules were suppressed in a time-dependent manner. These negative effects were effectively attenuated by IL-1ra administration in a time- and dose-dependent manner. In addition, mRNA expressions of TLR4 and IkBα decreased dramatically when IL-1ra was added into LPS-induced medium. IL-1ra also reversed the LPS-induced TLR4/NF-κB activation as indicated by western blot. The present study revealed that IL-1ra decreased inflammatory cytokine production in a supernatant, so as to protect GMSCs' osteogenesis capacity and other biological properties under P. gingivalis-LPS-induced inflammatory environment. This might be explained by IL-1ra downregulating TLR4-mediated NF-κB signaling pathway activation.

Changes in the surface topography and element proportion of clinically failed SLA implants after in vitro debridement by different methods.

OBJECTIVE: To evaluate the surface topography and element proportion changes in clinically failed implants after different modalities in vitro debridement and to compare the cleaning effect of different method combinations. MATERIAL AND METHODS: Thirty clinical failed implants were treated by different debridement methods in vitro as follows: Group 1: physiologic saline irrigation; Group 2: glycine powder air polishing; Group 3: glycine powder air polishing + ethylenediaminetetraacetic acid (EDTA); Group 4: polyetheretherketone (PEEK) tip ultrasonic scaling; and Group 5: PEEK tip ultrasonic scaling + EDTA. The relative contaminated area reduction (RCAR), visual analogue scale (VAS, the higher value means, the better cleaning effect) and surface roughness were assessed using scanning electron microscopy (SEM), stereoscopic microscopy (SM) and white light interferometry (WLI). Surface chemistry was determined by energy dispersive spectroscopy (EDS). RESULTS: Group 4 and Group 5 showed higher RCARs (82.90%, 82.89%), VAS scores (2.61, 2.33) and roughness reductions (-0.85 µm, -1.80 µm). Group 3 attained the highest decrease of C% (carbon, -26.67%), O% (oxygen, -13.71%) and N% (nitrogen, -5.66%), and the highest increase of Ti% (titanium, 49.67%). PEEK remnants were detected on the implant surface of Groups 4 and 5. CONCLUSION: Within the limitation of the present in vitro design, PEEK tip ultrasonic scaling was more effective in eliminating visible contamination, while glycine powder air polishing combined with EDTA treatment was more conducive to expose the original surface element distribution. Both methods have their own advantages in decontamination, but none of them could reconstruct the surface as the pristine implant.

Numerical Modeling Design for the Hybrid Additive Manufacturing of Laser Directed Energy Deposition and Shot Peening Forming Fe-Cr-Ni-B-Si Alloy.

Hybrid additive manufacturing is of great significance to make up for the deficiency of the metal forming process; it has been one of the main trends of additive manufacturing in recent years. The hybrid process of laser directed energy deposition (laser DED) and shot peening is a new technology combining the principles of surface strengthening and additive manufacturing, whose difficulty is to reduce the interaction between the two processes. In this paper, a new model with a discrete phase and fluid-solid interaction method is established, and the location of the shot peening point in the hybrid process is optimized. The distributions of the temperature field and powder trajectory were researched and experiments were carried out with the optimized parameters to verify simulation results. It was found that the temperature field and the powder trajectory partly change, and the optimized injection point is located in the stress relaxation zone of the material. The densities and surface residual stresses of samples were improved, and the density increased by 8.83%. The surface stress changed from tensile stress to compressive stress, and the introduced compressive stress by shot peening was 2.26 times the tensile stress produced by laser directed energy deposition.

The effectiveness and safety of Tanreqing Injection combined with ganciclovir on the treatment of respiratory syncytial virus pneumonia in children: A protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Based on the Theory of Traditional Chinese Medicine, this study systematically evaluated the effectiveness and safety of Chinese medicine preparation Tanreqing injection combined with ganciclovir on the treatment of respiratory syncytial virus pneumonia in children, and provided new ideas and methods for the treatment of respiratory syncytial virus pneumonia (RSVP) in children. At the same time, it also studies the effectiveness and safety of the combination of Chinese and Western medicine on the treatment of related diseases from the direction of evidence-based medicine. METHODS: The relevant literature was searched by the computer in the electronic network databases, the retrieved databases include Chinese database and English database, English database includes PubMed, Cochrane Library, Embase and Web of Science. Chinese database includes: CNKI, SinoMed, WangFang Date, VIP and other networks electronic full-text database, conducting a randomized controlled trial of Tanreqing Injection combined with ganciclovir (study group) and ganciclovir alone (control group) on the treatment of RSVP in children and the retrieval time limit is set from the establishment of each database to July 1, 2020. According to the inclusion and exclusion criteria, the literature is independently searched and screened by 2 researchers, and conducting the full-text retrieval and evaluation of the research to be included, and extracting the information and checking it after reading the full-text; In case of disagreement, a third researcher will be invited to participate, and the decision is made after discussion by the 3 researchers. They were using the bias risk assessment tool provided by the Cochrane Handbook for Systematic Reviews of Interventions 3.0.2 to evaluate the selected literature. They were using RevMan 5.3 statistical software to conduct statistical analysis. RESULTS: This study will be carried out in full accordance with the steps of systematic review as required in the Cochrane Handbook for Systematic Reviews of Interventions. All research results will be published publicly in international academic journals with peer review. CONCLUSION: After the meta-analysis of Tanreqing injection combined with ganciclovir on the treatment of RSVP in children, this paper will give a scientific and objective judgment on the effectiveness and safety of the combined use of Chinese and Western medicine on the treatment of RSVP in children, to provide evidence-based medical evidence for the clinical application, effectiveness and safety of Chinese and Western medicine combined on the treatment of RSVP in children. PROSPERO REGISTRATION NUMBER: OSF platform, registration number: j2bz5.

A novel grey decision-DE optimized internal model controller for vibration control of nonlinear uncertain aeroelastic blade system.

In this paper, a novel grey decision-differential evolution (GD-DE) optimized internal model controller is proposed for the control of nonlinear aeroelastic blade system (ABS) under time-varying uncertainties and control saturations. Two-port internal model control structure is presented for saturation compensation. The filter parameter of the controller is optimally tuned by proposed GD-DE algorithm, which is designed based on the grey decision incidence theory and differential evolution algorithm. The superiority of GD-DE optimized tuning technique is verified, compared to conventional IMC tuning method and other evolutionary algorithm based techniques. The robustness is analysed by comprehensive simulations from time-invariant uncertainties to large periodic or random time-varying uncertainties. The realistic condition with input/output disturbances is also involved. Simulation results show that the proposed controller outperforms existing adaptive IMC controller and other advanced controllers with greatly improved dynamic performance, stronger robustness and better saturation compensation on various conditions.

Synthesis of Hierarchical Porous Ni1.5Co1.5S4/g-C3N4 Composite for Supercapacitor with Excellent Cycle Stability.

In this work, the hierarchical porous Ni1.5Co1.5S4/g-C3N4 composite was prepared by growing Ni1.5Co1.5S4 nanoparticles on graphitic carbon nitride (g-C3N4) nanosheets via a hydrothermal route. Due to the self-assembly of larger size g-C3N4 nanosheets as a skeleton, the prepared nanocomposite possesses a unique hierarchical porous structure that can provide short ions diffusion and fast electron transport. As a result, the Ni1.5Co1.5S4/g-C3N4 composite exhibits a high specific capacitance of 1827 F g-1 at a current density of 1 A g-1, which is 1.53 times that of pure Ni1.5Co1.5S4 (1191 F g-1). In particular, the Ni1.5Co1.5S4/g-C3N4//activated carbon (AC) asymmetric supercapacitor delivers a high energy density of 49.0 Wh kg-1 at a power density of 799.0 W kg-1. Moreover, the assembled device shows outstanding cycle stability with 95.5% capacitance retention after 8000 cycles at a high current density of 10 A g-1. The attractive performance indicates that the easily synthesized and low-cost Ni1.5Co1.5S4/g-C3N4 composite would be a promising electrode material for supercapacitor application.

CRISPR-Cas13a Inhibits HIV-1 Infection.

CRISPR-Cas provides bacteria and archaea with immunity against invading phages and foreign plasmid DNA and has been successfully adapted for gene editing in a variety of species. The class 2 type VI CRISPR-Cas effector Cas13a targets and cleaves RNA, providing protection against RNA phages. Here we report the repurposing of CRISPR-Cas13a to inhibit human immunodeficiency virus type 1 (HIV-1) infection through targeting HIV-1 RNA and diminishing viral gene expression. We observed strong inhibition of HIV-1 infection by CRISPR-Cas13a in human cells. We showed that CRISPR-Cas13a not only diminishes the level of newly synthesized viral RNA, either from the transfected plasmid DNA or from the viral DNA, which is integrated into cellular DNA, but it also targets and destroys the viral RNA that enters cells within viral capsid, leading to strong inhibition of HIV-1 infection. Together, our results suggest that CRISPR-Cas13a provides a potential novel tool to treat viral diseases in humans.

Electroluminescence from light-emitting devices based on erbium-doped ZnO/n-Si heterostructures: Enhancement effect of fluorine co-doping.

We report on erbium (Er) related electroluminescence (EL) in the visible and near infrared (NIR) regions from the light-emitting device (LED) based on the Er-doped ZnO (ZnO:Er)/n-Si isotype heterostructure formed by sputtering ZnO:Er film on n-Si/n+-Si epitaxial wafer. Herein, the ZnO:Er film exhibits n-type in electrical conduction. The aforementioned LED is electroluminescent only under sufficiently high forward bias with the negative voltage connecting to n+-Si substrate. Such forward bias enables the electrons from n-Si to enter into the ultra-thin SiOx (x ≤ 2) layer inherently existing between the ZnO:Er film and n-Si via Poole-Frenkel conduction mechanism and, subsequently, to drift into the ZnO:Er film thus becoming hot electrons, which impact-excite the Er3+ ions to emit characteristic visible and NIR light. Furthermore, the Er-related EL from the aforementioned LED can be significantly enhanced through adopting the strategy of co-doping F- ions into the ZnO host, which brings about twofold primary effects. Firstly, due to the atomic size compensation between F- and Er3+ ions, the ZnO crystal grains become larger to accommodate much more optically active Er3+ ions. Secondly, the partial substitution of F- ions for O2- ions around the Er3+ ion reduces the symmetry of pseudo-octahedral crystal field of Er3+ ion, thus increasing the probabilities of intra-4f transitions of Er3+ ions. We believe that this work sheds light on developing efficient silicon-based LEDs using the Er-doped oxide semiconductors.

Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China.

BACKGROUND: China has implemented numerous pilots to shift its hospital payment mechanism from the traditional retrospective cost-based system to prospective diagnosis-related-group (DRG) -based system. This study investigated the impact of the DRG payment reform with global budget in Zhongshan, China. METHODS: A total of 2895 patients diagnosed with acute myocardial infarction (AMI) were selected from local two largest tertiary hospitals, among which 727 were discharged prior to the payment reform and 2168 afterwards. Difference-in-difference (DID) regression models were used to evaluate the policy effects on patients' percutaneous coronary intervention (PCI) use, hospital expenditures, in-hospital mortality, and readmission rates within 30 days after discharge. RESULTS: Patients' PCI use and hospital expenditures increased quickly after the payment reform. With patients with no local insurance scheme as reference, PCI use for local insured patients decreased significantly by 4.55 percent (95 percent confidence interval [CI]: 0.23, 0.72), meanwhile the total hospital expenses decreased significantly by US$986.10 (b=-0.15, P=0.0037) after reform. No changes were observed with patients' hospital mortality and readmission rates in our study. CONCLUSION: The innovative DRG-based payment reform in Zhongshan suggested a positive effect on AMI patient's cost containment but negative effect on encouraging resource use. It had no impacts on patients' care quality. Cost shifting consequence from the insured to the uninsured was observed. More evidence of the impacts of the DRG-based payment in China's health scenario is needed before it is generalized nationwide.

Rapid Fabrication of High-Performance CaO-Based Integral Ceramic Mould by Stereolithography and Non-Aqueous Gelcasting.

A high-performance CaO-based integral ceramic mould was fabricated for investment casting by stereolithography (SLA) and non-aqueous gelcasting. The rheology of tert-butyl alcohol (TBA)-based CaO slurries and the effect of gelation parameters on the gelation time and strength of the green body were investigated to obtain a high-quality green body of the CaO-based integral ceramic mould. Then the pre-sintering and sintering processes were optimized to avoid cracks, reduce the sintering shrinkage, and improve the strength of CaO-based ceramic mould. The results showed that the CaO-based slurry with 56 vol % solid loading and 3 wt % dispersant content exhibited high stability and good flowability. The optimized gelation parameters were determined to be a monomer content of 20 wt %, a ratio of crosslinker to monomer of 0.06, an initiator content of 1 wt % and a gelation temperature of 40 °C. A reasonable sintering regime was identified to avoid cracks and guarantee a low shrinkage of 0.6%, a room temperature bending strength of 14.12 MPa and a high temperature (1200 °C) strength of 8.22 MPa. The CaO-based integral ceramic mould fabricated in this study has many advantages including excellent thermal stability, reaction-resistance to molten active alloys, ease of dissolution, and enhanced efficiency and economy in comparison to SiO2 or Al2O3 ceramic moulds.

Tailoring the Mechanical Properties of Laser Cladding-Deposited Ferrous Alloys with a Mixture of 410L Alloy and Fe⁻Cr⁻B⁻Si⁻Mo Alloy Powders.

The effects of different ratios of 410L alloy and Fe⁻Cr⁻B⁻Si⁻Mo alloy powders on the microstructure and mechanical properties of laser cladding-deposited ferrous alloys were investigated. The experimental results revealed that the 410L alloy had good strength and excellent ductility due to its microstructure consisting of large elongated ferrite dendrites surrounded by a small number of martensite grains, while the Fe⁻Cr⁻B⁻Si⁻Mo alloy had high strength and poor ductility because of its eutectic microstructure composed of ferrite and Fe2B/Cr2B. As the concentration of Fe⁻Cr⁻B⁻Si⁻Mo alloy powder added to the 410L alloy powder increased, the ferrite grains became finer and the volume fraction of the eutectic increased, which eventually improved the strength and reduced the plasticity. Then, 410L + 12.5% Fe⁻Cr⁻B⁻Si⁻Mo alloy powder was successfully deposited onto AISI 1060 steel substrate via laser cladding deposition, and the mechanical properties met those of the substrate, which verified that tailoring the mechanical properties of the laser cladding-deposited alloys with a mixture of 410L and Fe⁻Cr⁻B⁻Si⁻Mo alloy powders for steel repairing applications is a feasible solution.

Long-term spatiotemporal variations of aerosol optical depth over Yellow and Bohai Sea.

In this study, MODerate resolution Imaging Spectroradiometer (MODIS) Collection 6.1 (C6.1) level-2 Dark Target (DT) Aerosol Optical Depth (AOD) observations at 550 nm (AOD550) for the highest quality flag assurance (QA = 3) were obtained to analyze spatiotemporal variations of aerosol optical properties over the Yellow and the Bohai Sea from 2002 to 2017. Spectral AOD observations at 470 nm (AOD470) and 660 nm (AOD660) were obtained to calculate Angstrom Exponent (AE470-660) and classify the aerosol types including clean continental (CC), clean maritime (CM) biomass and urban industrial (BUI), dust (D), and mixed (MXD) aerosol types. Results showed a very distinct spatial pattern of AOD distribution over the Bohai Sea which looks suspicious, i.e., high aerosol loadings (AOD > 0.8) throughout the entire time period, whereas relative low AOD distribution was observed over the adjacent land pixels especially in autumn and winter, which suggested that the DT algorithm might be influenced by a large number of sediments located in the Bohai Sea. Significant differences in spatial distributions were found in different seasons in terms of area coverage as a maximum number of pixels were available during autumn, and regional high and low aerosol loadings were observed during autumn and summer, respectively. Trend analysis from 2002 to 2017 showed that AOD was increased up to 0.04 over the Bohai Sea and decreased up to 0.04 over the Yellow Sea, and this trend varies from month to month. Aerosol classification showed significant contributions of BUI and CC over the region, and contributions of CM, DUST, and MXD aerosols over the Yellow Sea were relatively high compared to the Bohai Sea.