Double Superconducting Dome of Quasi Two-Dimensional TaS2 in Non-Centrosymmetric van der Waals Heterostructure.

Two-dimensional van der Waals heterostructures (2D-vdWHs) based on transition metal dichalcogenides (TMDs) provide unparalleled control over electronic properties. However, the interlayer coupling is challenged by the interfacial misalignment and defects, which hinders a comprehensive understanding of the intertwined electronic orders, especially superconductivity and charge density wave (CDW). Here, by using pressure to regulate the interlayer coupling of non-centrosymmetric 6R-TaS2 vdWHs, we observe an unprecedented phase diagram in TMDs. This phase diagram encompasses successive suppression of the original CDW states from alternating H-layer and T-layer configurations, the emergence and disappearance of a new CDW-like state, and a double superconducting dome induced by different interlayer coupling effects. These results not only illuminate the crucial role of interlayer coupling in shaping the complex phase diagram of TMD systems but also pave a new avenue for the creation of a novel family of bulk heterostructures with customized 2D properties.

Characteristics, reasons and patterns of Road Traffic Injuries presenting in emergency department of a tertiary care public hospital in Karachi.

Objectives: To determine the main characteristics, reasons and patterns of road traffic injuries (RTIs) in a tertiary care public hospital of Karachi. Methods: It was a hospital based cross sectional study conducted in a public tertiary care hospital emergency department with a sample size 425 selected conveniently. Participants included the consenting victims or caretaking attendants of road traffic injuries (RTIs) from 25th May to 28th June in 2019. A structured questionnaire was developed after literature review and was translated into "Urdu" language. The questionnaire collected detailed information on socio-demographic characteristics, possible reasons of RTI's such as condition of vehicle, over speeding and breaking traffic rules. Data was analyzed by using software SPSS version 20. Results: Almost half of RTI victims (43.1%) belonged to the age group 18-29. Majority of the victims were males (86.6%). The most common vehicle involved was motorbike (87.50%) followed by Rickshaw (6.8%) and Car (2.4%). Majority of RTIs occurred on main road (75.30%). The most common sites of injuries were lower limb (64%), upper limb (37.60%) and head (32.2%). The severe injuries were significantly more likely to happen in events in which direct collision with other vehicle/thing was involved, road conditions were wet and pedestrian were crossing the road. Conclusion: Motorbikes were involved in majority of RTIs. Main reasons of RTIs included irresponsible road behaviors including over-speeding, careless road crossing, breaking the signal and riding on wet roads which lead to moderate to severe injuries in almost two thirds of participants.

Adult ADHD screening scores and hospitalization due to pedestrian injuries: a case-control study.

BACKGROUND: The aim of this study was to investigate the association between adult ADHD screening scores and hospitalization due to pedestrian injuries in a sample of Iranian pedestrians. METHODS: Through a case-control study, a case population of 177 pedestrians injured by the vehicles in road traffic crashes were compared with 177 controls who lacked a record of intentional or unintentional injuries enrolled from various wards of Imam Reza University Hospital which is a specialty teaching hospital located in the same city with similar referral level. The cases and controls had an age range of 18-65 years and were matched on gender and age. ADHD symptom profile was assessed using the Persian Self-report Screening Version of the Conner's Adult ADHD Rating Scales (CAARS-S:SV). The association of ADHD screening score and pedestrian injuries was investigated using multiple binary logistic regression to investigate the independent effect of ADHD index score on belonging to case group. Both crude and adjusted odds ratios were reported. RESULTS: Men comprised 86.4% of the study subjects. The crude odds ratios for all the four ADHD subscales to be associated with pedestrian injuries were 1.05, 1.08, and 1.04 for the subscales A (attention deficit), B (hyperactivity/impulsiveness) and ADHD index respectively. However, the association for subscale A was not statistically significant with a borderline p-value. The final multivariate analysis showed that variables associated with pedestrian injuries in the road traffic crashes were ADHD Index score (OR = 1.06, 95% CI: 1.01-1.12); economic status (including household income and expenditure capacity); educational level and total walking time per 24 h. CONCLUSIONS: Adult ADHD screening score can predict pedestrian injuries leading to hospitalization independently from sex, age, economic status, educational level and pedestrian exposure to traffic environment (average walking time).

Robotic transanal minimally invasive surgery (TAMIS) for local excision of rectal lesions with the da Vinci Xi (dVXi): technical considerations and video vignette.

Robotic transanal minimally invasive surgery (TAMIS) (RT) represents a compelling new alternative capable of overcoming the limitations of conventional TAMIS for the local excision of rectal lesions. We describe our RT technique using the dVXi™ (Intuitive Surgical, Sunnyvale, CA, USA) which we have used to efficiently and completely excise eight cases of rectal lesions which were not endoscopically resectable. We also include a video vignette of the procedure. With the patient in the prone jackknife position, we insert a GelPOINT™ Path Transanal Access Platform (Applied Medical, Rancho Santa Margarita, CA, USA) in combination with the dVXi and AirSeal™ insufflation system (Conmed, Niagara. Falls, ON, Canada). Our technique aims to be ergonomically efficient to minimise docking difficulties and to reduce instrument clash in the limited space, whilst maximising the capabilities of the dVXi for RT. At 3-month endoscopic follow-up, no evidence of recurrence was detected in any of the eight patients. RT is safe, feasible and has advantages over conventional laparoscopic TAMIS (LT). Our described technique addresses some of the long-standing challenges of LT and the novel RT. The immediate challenge to its widespread use remains the cost, expertise and availability.

The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis.

BACKGROUND: Regional trade agreements are major international policy instruments that shape macro-economic and political systems. There is widespread debate as to whether and how these agreements pose risks to public health. Here we perform a comprehensive systematic review of quantitative studies of the health impact of trade and investment agreements. We identified studies from searches in PubMed, Web of Science, EMBASE, and Global Health Online. Research articles were eligible for inclusion if they were quantitative studies of the health impacts of trade and investment agreements or policy. We systematically reviewed study findings, evaluated quality using the Quality Assessment Tool from the Effective Public Health Practice Project, and performed network citation analysis to study disciplinary siloes. RESULTS: Seventeen quantitative studies met our inclusion criteria. There was consistent evidence that implementing trade agreements was associated with increased consumption of processed foods and sugar-sweetened beverages. Granting import licenses for patented drugs was associated with increased access to pharmaceuticals. Implementing trade agreements and associated policies was also correlated with higher cardiovascular disease incidence and higher Body Mass Index (BMI), whilst correlations with tobacco consumption, under-five mortality, maternal mortality, and life expectancy were inconclusive. Overall, the quality of studies is weak or moderately weak, and co-citation analysis revealed a relative isolation of public health from economics. CONCLUSION: We identified limitations in existing studies which preclude definitive conclusions of the health impacts of regional trade and investment agreements. Few address unobserved confounding, and many possible consequences and mechanisms linking trade and investment agreements to health remain poorly understood. Results from our co-citation analysis suggest scope for greater interdisciplinary collaboration. Notwithstanding these limitations, our results find evidence that trade agreements pose some significant health risks. Health protections in trade and investment treaties may mitigate these impacts.

Robotic transanal surgery (RTAS) with utilization of a next-generation single-port system: a cadaveric feasibility study.

PURPOSE: Transanal surgery remains both an innovative approach to rectal pathology and a demonstrated technical challenge. Improved technology using a single-port system robotic platform (SPS) offers a promising option for this surgery. METHODS: SPS robotic system was utilized to perform submucosal, full-thickness and cylindrical excision on four cadavers. Operative performance and surgeon fatigue were measured. RESULTS: On all types of resections, the SPS system performed well. There were no piecemeal or fragmented resections. Closure was judged to be good to excellent in all cases. Surgeon assessment of setup and performance of the SPS was excellent in all cases. CONCLUSIONS: SPS robotic transanal surgery represents an exciting new option for transanal surgery.

Do Deep Regional Trade Agreements Improve Residents' Health? A Cross-Country Study.

The development trend of deepening regional trade agreements (RTAs) is becoming more prominent, traditional RTAs based on border terms continue to shift to deep RTAs based on the high level of border terms and a series of post-border terms, but the relationship between deep RTAs and residents' health has not drawn much attention. Based on Gallup World Poll data from 2009 to 2017 covering 786,040 respondents in 143 countries, this study empirically examined the impact of deep RTAs on the health of residents as well as its influence mechanisms by using the combination of fixed effects and stepwise regression. The results show that deep RTAs have a significantly positive impact on residents' health, which means that an increase in the depth of RTAs can improve residents' health. However, the impact of deep RTAs on residents' health is heterogeneous, caused by the different terms of RTAs, the different income levels of different countries, and the different types of residents. Meanwhile, deep RTAs mainly improve the health of residents through employment effects and environmental effects. This study highlights the importance of deep RTAs for improving the health of residents and provides new ideas for governments to assist in the formulation of policies that can effectively improve their residents' health.

Spatial Distribution of Road Traffic Accident at Hawassa City Administration, Ethiopia.

BACKGROUND: Globally, road traffic accidents (RTAs) are the leading killer of young people and are projected to be the 7th leading cause of death by 2030. This study is aimed at analyzing the spatial distribution of road traffic accident and identifying hotspot areas across Kebeles (smallest administrative division in Ethiopia) of Hawassa city administration in Ethiopia. METHOD: Secondary data on daily traffic accident record from October 2013 to June 2018 was obtained from Hawassa city administration police department. The spatial clustering and hotspots identification were carried through Moran's I and Getis-Ord Gi* statistics. Data analysis was conducted using GeoDa 1.16.0.0 and ArcGIS 10.2 softwares. RESULTS: Drivers within age group of 18-30 years, who were hired by private business owners and who had no driving license committed the highest number of traffic accidents. The majority of traffic accidents were caused due to careless driving, failure to give priority for pedestrian, high speed and driver failure to give priority for each other. In addition, about 82.01% of traffic accidents were recorded on asphalts road and 11.51% by gravel road. Spatial clustering of road traffic accidents for accidents occurred on gravel road and in sunny weather conditions found to be significant. Different hotspot areas were identified for gravel type of road and sunny weather condition. CONCLUSION: The concerned government bodies involved in policymaking are recommended to give special attention to young driver who were hired by private business owners. Interventions to mitigate the occurrence of traffic accident would take in to account the identified hotspot areas.

Cerebral Hemodynamic Correlates of Transcutaneous Auricular Vagal Nerve Stimulation in Consciousness Restoration: An Open-Label Pilot Study.

This study aimed to preliminarily illustrate the cerebral hemodynamic correlates of transcutaneous auricular vagal nerve stimulation (taVNS) in consciousness restoration. Arterial spin labeling (ASL) was adopted with functional magnetic resonance imaging (fMRI) to measure cerebral blood flow (CBF) changes before and after taVNS in 10 qualified patients with disorders of consciousness (DOC). Before taVNS, five patients responded to auditory stimuli (RtAS), and five did not respond to auditory stimuli (nRtAS). The RtAS DOC patients obtained favorable prognoses after the 4-week taVNS treatment, whereas the nRtAS ones did not. Simultaneously, taVNS increased CBF of multiple brain regions in the RtAS DOC patients, but hardly in the nRtAS ones. In conclusion, the preserved auditory function might be the prior key factor of the taVNS responders in DOC patients, and taVNS might alleviate RtAS DOC by activating the salience network, the limbic system, and the interoceptive system.

Reactions of the Lipid Hydroperoxides With Aminic Antioxidants: The Influence of Stereoelectronic and Resonance Effects on Hydrogen Atom Transfer.

Aminic radical-trapping antioxidants (RTAs), as one of the most important antioxidants, have not received sufficient attention yet. But, an increasing number of aminic RTAs have been identified as ferroptosis inhibitors in recent years, which can potentially mediate many pathological states including inflammation, cancer, neurodegenerative disease, as well as ocular and kidney degeneration. This highlights the importance of aminic RTAs in the field of medicine. Herein, we systematically explored the radical scavenging mechanism of aminic RTAs with a quantum chemical method, particularly emphasizing the role of stereoelectronic factors and resonance factors on the transfer of H-atom and the stability to one-electron oxidation. These theoretical results elucidate the diversity of free radical scavenging mechanisms for aminic RTAs, and has significant implications for the rational design of new aminic RTAs.

Applying crash data to injury claims - an investigation of determinant factors in severe motor vehicle accidents.

An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents. A multiple linear regression is carried out to identify the crash factors that significantly influence expected compensation costs and compared to ordered and multinomial logit models. The model offers encouraging results given the inherent variation expected in vehicular incidents and the subjectivity influencing compensation payout judgments, attaining an adjusted-R2 fit of 20.6% when uninfluential factors are removed. It is found that relative speed at time of impact and dark conditions increase the expected costs, while rear-end incidents, incident sustained in van-based trucks and incidents sustained while turning result in lower expected compensations. The number of airbags available in the vehicle is also a significant factor. The scalar-outcome approach used in this research offers an alternative methodology to the discrete-outcome models that dominate traffic safety analyses. The results also raise queries on the future development of claims reserving (capital allocations earmarked for future expected claims payments) as advanced driver assistant systems (ADASs) seek to eradicate the most frequent types of crash factors upon which insurance mathematics base their assumptions.

Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran.

OBJECTIVE: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. METHODS: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. RESULTS: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. CONCLUSION: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.