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WSeTe/PtTe 2 vdW heterojunctions are constructed and their mechanical, electronic, and optical properties are deeply studied. On this basis, the strain-controlled high on–off-ratio mechanical switching and high-performance solar cell devices are proposed. [Display omitted] • WSeTe/PtTe 2 heterojunction is constructed and various physical properties are investigated. • They have are type-II semiconductors, with exceptional mechanical property. • Their types of band alignment and band gap size can be tuned flexibly by physical field. • High-performance mechanical switching and solar cell devices are proposed. Janus WSeTe and PtTe 2 monolayers have attracted much attention due to their outstanding electronic properties. To explore their combined advantages and to find new physics, we construct WSeTe/PtTe 2 vdW heterojunctions and use the most stable configurations A4 and B1 to explore their various physical properties and device applications. It is found that both A4 and B1 hold exceptional mechanical properties. They are type-II semiconductors, and types of band alignment and band gap size can be tuned flexibly by external electric field and vertical strain. Based on such a property, we design a strain-controlled high on–off-ratio mechanical switching device. They also show an excellent light response and high photoelectric power conversion efficiency (PCE), which can be tuned greatly by the external electric field and vertical strain as well. For example, light adsorption in visible and infrared region can be improved greatly by the compressive strain. Particularly, we find for B1 in the intrinsic state or with a small tensile strain of 0.3 Å, or for A4 with small electric field of −0.3 V/Å, they all hold type-II band alignment and have very high PCE and large visible light absorption, based on these results, we propose high-performance solar cell devices. [ABSTRACT FROM AUTHOR]

A better understanding of how the vertical profile of suspended sediment concentration (SSC) is influenced by multiple factors is required to better understand the hydrodynamics and sediment dynamics of estuaries. Based on in situ measurements obtained during a spring-neap cycle in the estuarine turbidity maximum (ETM) of the Changjiang Estuary in January 2015, we investigate the intratidal evolution and controlling mechanisms of SSC profiles. The results show that during the dry season the ETM was characterized by periodic salinity stratification, low SSC, suspended sediments with reduced grain size, and low sediment availability for resuspension. Three types of SSC profiles were identified, i.e., profiles with two-layer, linear and quasi-uniform structures. The shapes of the SSC profiles varied with time and generally deviated from the equilibrium profile due to the highly variable hydrodynamic and sediment conditions. During ebbs of spring and intermediate tides, the SSC profiles generally evolved from a two-layer to a quasi-uniform structure via a linear structure. Analysis shows that the linear and quasi-uniform profiles occurred under the combination of vertically well-mixed salinity, negligible resuspension, low settling velocity associated with very fine grains, and shallow water depth. Such an evolution pattern can be well reproduced using a one-dimensional numerical model, with the diffusion coefficient being parabolically distributed in the water column and the four factors mentioned above. The findings reported here imply a high variability of SSC profiles in estuarine environments. • Three typical types of SSC profiles were observed in the partially and periodically stratified estuary. • SSC profiles often deviated from equilibrium due to highly variable estuarine conditions. • Prerequisites for the formation of linear and quasi-uniform SSC profiles were identified. • Typical evolution patterns of SSC profiles were reproduced using a 1D numerical model. [ABSTRACT FROM AUTHOR]

Background: Canine sudden acquired retinal degeneration syndrome (SARDS) causes blindness for which there are no proven effective treatments. We aimed to clarify the time to vision loss, treatment response/side effects, and prognosis for life in dogs with SARDS. Methods: An online questionnaire was administered to owners of dogs with a historical diagnosis of SARDS. Mortality data were compared with a published purebred reference population. Select parameters were analyzed statistically using general linear model with least square means, two‐sample t tests, and chi‐squared or Fisher's exact tests. Results: Responses from owners that stated that their dog visited an ophthalmologist and had electroretinography performed (n = 434) were analyzed. The majority of owners (65.4%) reported the time from vision disturbance to complete vision loss as <2 weeks; 19.4% reported >4 weeks. Onset of systemic clinical signs to complete vision loss was >4 weeks in 44.5% of responses. A higher proportion of owners reported some vision recovery with combination treatment (14.4%) compared with monotherapy (3.2%, P =.0004). Side effects of treatment were commonly reported. Dogs with SARDS did not have a shorter lifespan than the reference population but had higher incidence of kidney disease (P =.0001) and respiratory disease (P =.0004) at death. Conclusions: Dogs with SARDS have a rapid onset of vision loss. In the owner's opinion, treatment is unlikely to restore vision and is associated with systemic side effects. The potential for systemic pathologies that arise after SARDS diagnosis warrants further study. [ABSTRACT FROM AUTHOR]

Background Patients with CF treated for pulmonary exacerbations (PEx) may experience faster subsequent declines in FEV 1 . Additionally, incomplete recovery to baseline FEV 1 occurs frequently following PEx treatment. Whether accelerated declines in FEV 1 are preceded by poor PEx recovery has not been studied. Methods Using 2004 to 2011 CF Foundation Patient Registry data, we randomly selected one PEx among patients ≥ 6 years of age with no organ transplantations, ≥ 12 months of data before and after the PEx, and ≥ 1 FEV 1 recorded within the 6 months before and 3 months after the PEx. We defined poor PEx recovery as the best FEV 1 in the 3 months after the PEx < 90% of the best FEV 1 in the 6 months before the PEx. We calculated mean (95% CI) hazard ratios (HR) of having > 5% predicted/year FEV 1 decline and poor PEx recovery using multi-state Markov models. Results From 13,954 PEx, FEV 1 declines of > 5% predicted/year were more likely to precede poor spirometric recovery, HR 1.17 (1.08, 1.26), in Markov models adjusted for age and sex. Non-Responders were less likely to have a subsequent fast FEV 1 decline, HR 0.41 (0.37, 0.46), than patients who recovered to > 90% of baseline FEV 1 following PEx treatment. Conclusions Accelerated declines in FEV 1 are more likely to precede a PEx with poor recovery than to occur in the following year. Preventing or halting declines in FEV 1 may also have the benefit of preventing PEx episodes. [ABSTRACT FROM AUTHOR]

Two-dimensional materials with suitable band gaps and high carrier mobility are considered to be ideal for fabricating next-generation microelectronics devices. In this paper, the C 3 Al crystal structure, electronic and mechanical properties are systematically investigated based on a first-principles method. We find that C 3 Al is an auxetic semiconductor material with wide band gap and high carrier mobility. Electrons have good transport properties but holes are almost completely scattered in the zigzag direction. C 3 Al is one of the few materials with negative Poisson's ratio effect. In addition, the electronic properties of C 3 Al can transform from semiconductor to metal by tuning straining and stacking. The bare-edge and H-terminated C 3 Al nanoribbons shows an enriched set of electronic properties of semiconductors, half-semiconductor, bipolar magnetic semiconductors, non-magnetic metals, magnetic metals, and half-metals. These results not only provide a theoretically novel and promising crystal configuration, but also further explore the potential of the material for applications in biosensing, strain sensors, transistors, and various nano-optical devices. • The C 3 Al has excellent performance in terms of structural and thermodynamic stability. • C 3 Al is an auxetic semiconductor material with wide band gap and high carrier mobility. • The electronic properties of C 3 Al can transform from semiconductor to metal by tuning strain and stacking. • The bare-edge and H-terminated C 3 Al nanoribbons show an enriched set of electronic properties. [ABSTRACT FROM AUTHOR]

In many estuaries, current velocity, suspended sediment concentration (SSC), and water depth have notable flood-ebb asymmetries in magnitude or duration. Such asymmetries can make marked impact on estuarine sediment transport and require in-depth analysis of the underlying mechanism. Based on field measurement over a neap-spring cycle in the Changjiang Estuary in January 2015, net suspended sediment transport modulated by multiple asymmetries were analyzed. The results showed that there were notable flood-ebb asymmetries in the current velocity, current duration, SSC, and water depth. The former two were ebb-dominated, while the latter two were flood-dominated. The net suspended sediment transport was landward and exhibited remarkable tidal fluctuation in magnitude. Ebb-dominated velocity and duration asymmetries favored seaward transport, but flood-dominated SSC and water depth asymmetries promoted landward transport. The relative contribution of these asymmetries to the net sediment transport was different and closely related to their asymmetry intensities. The magnitude of net sediment transport was highly modulated by the combined effects of these asymmetries. Further analyses revealed that the ebb-dominated asymmetries in velocity and duration were controlled by river flow, tidal wave deformation, and compensation flow of Stokes drift. The flood-dominated water depth asymmetry was related to the progressive tidal wave. The flood-dominated SSC asymmetry was mainly attributed to the lower SSCs in early ebbs, notable sediment supply limitation in late ebbs, wind wave height asymmetry, and gravitational circulation. Additionally, it is worth noting that the progressive tidal wave can yield strong current asymmetry, notable water depth asymmetry, and obvious wind wave height asymmetry during strong wind periods. • Multiple important flood-ebb asymmetries coexist in a tidal cycle in natural estuaries. • Net sediment transports are highly modulated by the combination of multiple asymmetries. • Flood- and ebb-dominated asymmetries play opposite roles in net sediment transport. • Compensation flow of Stokes drift has important influence on current asymmetry. • Variation in sediment availability for resuspension can yield notable SSC asymmetry. [ABSTRACT FROM AUTHOR]

Context Although Pseudomonas aeruginosa is the most common virulent respiratory pathogen in cystic fibrosis (CF), the longitudinal development of P aeruginosa infection and its effect on antibody responses and lung disease progression in children with CF remain unclear. Objective To prospectively examine the epidemiology of P aeruginosa infection and its impact on CF pulmonary morbidity. Design, Setting, and Patients We prospectively evaluated 56 CF patients at 2 CF centers in Madison and Milwaukee, Wis, from birth up to age 16 years between April 15, 1985, and April 15, 2004, with diagnoses made through the Wisconsin CF Neonatal Screening Project. Main Outcome Measures Timing of nonmucoid P aeruginosa and mucoid P aeruginosa acquisition was assessed by first positive result. Longitudinal development from no P aeruginosa to nonmucoid P aeruginosa and from nonmucoid P aeruginosa to mucoid P aeruginosa was examined. Outcome measurements included antibody titers, respiratory symptoms, quantitative chest radiography, and pulmonary function tests. Results Sixteen patients (29%) acquired nonmucoid P aeruginosa in the first 6 months of life. The age-specific prevalence of mucoid P aeruginosa increased markedly from age 4 to 16 years. Nonmucoid and mucoid P aeruginosa were acquired at median ages of 1.0 and 13.0 years, respectively. In contrast with the short transition time from no P aeruginosa to nonmucoid P aeruginosa, the transition time from nonmucoid to mucoid P aeruginosa was relatively long (median, 10.9 years) and could be slightly extended by brief/low anti-P aeruginosa antibiotic treatment. Antibody titers increased with both transitions, but the deterioration in cough scores, chest radiograph scores, and pulmonary function correlated best with transition from nonmucoid to mucoid P aeruginosa. Conclusions Early prevention and detection of nonmucoid and mucoid P aeruginosa are critical because of early acquisition and prevalence. There is a window of opportunit... [ABSTRACT FROM AUTHOR]

By uniformly introducing pyrazine defects on monolayer C 3 N, the porous 2D C 7 N 2 (p2D-C 7 N 2) crystals were obtained. Based on first-principles calculations, we systematically investigate the mechanical, electronic, and magnetic properties of p2D-C 7 N 2 crystals. The p2D-C 7 N 2 crystals have excellent performance in terms of structural and thermodynamic stability. Furthermore, we systemically study the electronic and magnetic properties of various nanoribbons by cutting from a monolayer p2D-C 7 N 2 crystals along the typical crystallographic orientations. All the nanoribbons are magnetic metals. The C 7 N 2 nanoribbons exhibit sensitive responses to edge modifications using H and O atoms. We find that the edge modifications can induce the spin semiconductor phase, non-magnetic metal phase, half-semiconductor phase, and half-metal phase. These results can open up the two-dimensional material frontier to some extent and can also provide some theoretical support for the potential application and development of nanoelectronic devices based on C 7 N 2. • The holey 2D C 7 N 2 sheet has excellent performance in terms of structural and thermodynamic stability. • The holey 2D C 7 N 2 has the intrinsic ferromagnetic state magnetic order. • All the original C 7 N 2 nanoribbons are magnetic metals. • The edge modifications by H and O atoms in the C 7 N 2 nanoribbons can induce the different phase. [ABSTRACT FROM AUTHOR]

IOTA (International Ovarian Tumor Analysis) Simple Rules classifies adnexal masses as benign, malignant, or indeterminate based on sonographic features. We seek to determine if IOTA inappropriately directed women to surgery, or more aggressive surgery, than their final diagnosis warranted. This is a retrospective study of sonographically detected adnexal masses with known clinical outcomes from two institutions (n = 528). Surgically managed patients (n = 172) were categorized based on pathology and compared using Chi-square and t-test for categorical and continuous variables respectively. A logistic regression was used to predict characteristics that predicted surgery or imaging follow up of indeterminate masses. Of the 528 masses imaged, 29% (n = 155) underwent surgery for benign pathology. Only 1.9% (n = 10) underwent surgery after classification as malignant by IOTA for what was ultimately a benign mass. Surgical complications occurred in 10 cases (5.8%), all benign. Fifteen (3.2%) patients went into surgically induced menopause for benign masses, one of which was inaccurately classified by IOTA as malignant. Of the 41 IOTA indeterminate masses, the presence of soft tissue nodules on ultrasound was the only statistically significant predictor of the patient being triaged directly to surgery (OR 1.79, p = 0.04). Our findings support that the IOTA ultrasound classification system can provide clinical guidance without incurring unnecessary surgeries or surgical complications. [ABSTRACT FROM AUTHOR]

One-dimensional nanotubes have become an indispensable ideal candidate material for nano-device applications due to their excellent and unique electronic, mechanical, and thermal properties. By the first-principles method of density functional theory, we have theoretically investigated the structural stability, electronic properties, carrier mobility, and Poisson's ratio of C 3 N single-walled nanotubes (C 3 NSWNT). We find that C 3 NSWNT is stable and the ground state of the system is non-magnetic. The electronic properties and carrier mobilities of C 3 NSWNT can be adjusted by diameter and edge engineering. The electron mobility of (n,n) armchair C 3 NSWNT (A-C 3 NSWNT) is lower than that of (n,0) zigzag C 3 NSWNT (Z-C 3 NSWNT), but the hole mobility of (n,n) A-C 3 NSWNT is higher than that of (n,0) Z-C 3 NSWNT. Moreover, both A-C 3 NSWNT and Z-C 3 NSWNT can transfer from semiconductor to metal by tuning the electric field, and Z-C 3 NSWNT is more sensitive to the applied electric field than A-C 3 NSWNT due to smaller energy gap. But only A-C 3 NSWNT can transfer from semiconductor to metal by tuning strain, and be more suitable to the application in nano electromechanical switching devices. These research results may provide some theoretical support for the potential application and development of nanoelectronic devices based on C 3 NSWNT. • The pentagonal C 3 N nanotube is stable both in kinetics and thermodynamics. • The electronic properties and carrier mobilities of C 3 N nanotube can be adjusted by diameter and edge engineering. • An applied external electric field can transform the both armchair and Zigzag C 3 N nanotubes from semiconductor to metal. • Only armchair C 3 N nanotube can transfer from semiconductor to metal by strain. [ABSTRACT FROM AUTHOR]

[Display omitted] • CrI 3 /As vdWHs are investigated deeply on why magnetic stability is substantially enhanced. • Curie temperature T C = 75.9 K, enhanced by 73.3 % compared with CrI 3 , can be achieved. • Compression strain can lead to T C up to 111.3 K due to particular magnetic coupling. • Such vdWHs also features the excellent mechanical and property. CrI 3 monolayer has attracted much attention, but it holds a very low magnetic stability, with Curie temperature (T C) of 45 K, seriously limiting the practical applications. To find solutions for this issue, we construct CrI 3 /As vdW heterstructures (vdWHs). Calculations show that such vdWHs are half-semiconductor with excellent mechanical property and T C of 75.9 K, improved by 73.3 % compared with CrI 3 monolayer. Due to a weak orbital hybridization and coupling occurring between As layer and I in atom-layer upon vdW interactions, the potential well of interfacial I in atom-layer would become shallower, which make electron flow out from I in atoms and magnetic moments increased for Cr and I in atoms, in turn, the ferromagnetic (FM) coupling in Cr-I in -Cr superexchange magnetic coupling channel is strengthened. Particularly, the magnetic stability can be significantly raised by compression strain, leading T C up to 111.3 K, which is caused by super-exchange interactions of both Cr-I in -Cr and Cr-As-Cr channels, and magnetic proximity effects increased further. For light absorption, the red-shifted absorption edge relative to CrI 3 monolayer and high absorption peak appearing in visible and infrared region allow heterstructures absorbing solar energy in a wider range. Such a phenomenon can be further strengthened by compression strain. [ABSTRACT FROM AUTHOR]

[Display omitted] By using the special structure of the eggshell and its interaction with Co 3 O 4 , the performance of the catalyst in the catalytic oxidation of benzene is improved. And schematic diagram of reaction mechanism for catalytic benzene oxidation over Co 3 O 4 /Eggshell is speculated. Moreover, eggshell as carrier is environmentally friendly and low-cost, which can achieve more promising application. • Low-cost, environmentally friendly carrier - application of eggshell. • The activity of Co 3 O 4 /Eggshell materials is remarkably improved as compared to commercially pure Co 3 O 4 nanoparticles. • The reaction mechanism of benzene catalytic oxidation is revealed by in-situ FTIR analysis. Transition metal oxides have excellent catalytic activities for the oxidation of VOCs, in which it is necessary to find new catalysts/supports with cheap and environmentally-friendly properties. Herein, Co 3 O 4 nanoparticles decorated eggshell catalysts were firstly synthesized via impregnation method, where the waste eggshell is used as an effective hard template and an excellent support with porous structure. A series of Co 3 O 4 /Eggshell catalysts were synthesized by changing the different concentration of precursors (different Co 3 O 4 loadings), which were defined as Co 3 O 4 /Eggshell-1 (33.1 %), Co 3 O 4 /Eggshell-2 (16.7 %) and Co 3 O 4 /Eggshell-3 (9.1 %) catalysts. Among of them, the Co 3 O 4 /Eggshell-2 exhibited the best activity with the temperature T 90 % = 256 ℃, which is about 90 °C lower than Co 3 O 4 /oyster shell-2 (benzene catalytic oxidation). And the catalytic activity of Co 3 O 4 /Eggshell is remarkably improved as compared to commercially pure Co 3 O 4 nanoparticles and commercially CaCO 3. The excellent activity can be attributed to the unique structure of the eggshell and the interaction of CaCO 3 and Co 3 O 4. In addition, the catalyst has also showed long-term stability. Moreover, the reaction mechanism of benzene catalytic oxidation was further revealed by in-situ FTIR studies. [ABSTRACT FROM AUTHOR]

This study investigated the effects of low-temperature curing environment, moisture content of concrete, and surface roughness of concrete on the interfacial bond performance of concrete – epoxy mortar composite specimens. The mechanical and microstructural properties of concrete – epoxy mortar composite specimens were studied systematically via splitting tensile strength test, direct shear strength test, and scanning electron microscopy test, and the failure modes were observed. Further, the factors that remarkably affect the mechanical properties of the concrete–epoxy mortar composite specimen were investigated by analysing the images obtained using grey correlation analysis. The results indicated that the compressive strength of epoxy mortar, interfacial splitting tensile strength, and shear strength of composite specimens decreased gradually with the decrease in curing temperature. The splitting tensile strength and shear strength at the interface of the composite specimens first increased and then decreased with increasing surface roughness of the concrete. However, these parameters gradually decreased with the increase in moisture content. Moreover, based on the results of grey correlation analysis the three factors, the curing temperature had the most influence on these two strengths, followed by surface roughness and then moisture content. In this case, the surface roughness and moisture content have a comparable degree of influence. The relationship between shear strength and splitting tensile strength was investigated and a good linear relationship was found between these two parameters. The microstructure performance analysis show that as the curing temperature decreased, pores appeared around the foundation concrete. Consequently, the aggregate structure became loose, and the overall denseness was remarkably reduced. As the moisture content of the concrete increased, the pores and cracks at the interface increased, and the width of the interface transition zone became larger. • The mechanical and microstructural properties of concrete–epoxy mortar composite specimens were studied systematically. • The interfacial splitting tensile strength, and shear strength decreased gradually with the decrease in curing temperature. • The splitting tensile strength and shear strength first increased and then decreased with increasing surface roughness. • The results of the SEM showed that as the curing temperature decreased the overall denseness was significantly reduced as the curing temperature decreased. [ABSTRACT FROM AUTHOR]

In this work, bio-inspired Au nanoparticles (NPs) were loaded through an ionic-liquid-enhanced-immobilization method onto TS-1 support, leading to efficient Au/TS-1 catalysts for gas-phase propylene epoxidation in the presence of O2 and H2. Specifically, the mesoporous TS-1 was synthesized by a hydrothermal method using nanosized TS-1 (size of ∼ 220 nm) as seeds, and the support was then etched with acid (HCl or HNO3). Both the pristine TS-1 and Au/TS-1 catalysts were fully characterized to understand the effects of preparation conditions on the catalytic performance in propylene epoxidation. Interestingly, it was found that the amount of Lewis acid sites in the seed-induced TS-1 was greater than that on the control sample formed without seed; more importantly, the size of the loaded Au NPs can be regulated by changing the amount of Lewis acid site. Furthermore, we have demonstrated that the post-treatment of TS-1 with appropriate acid sites could enhance the propylene conversion and propylene oxide (PO) selectivity. [ABSTRACT FROM AUTHOR]

The article presents the study on the direct observation approach implemented for the evaluation of the clinical skills of residents in competency-based education and training on ambulatory block rotation.

Background Screening for gastric cancer is known to be associated with reduced mortality in populations with high prevalence. However, many countries with high prevalence do not screen, with high costs being a significant reason for this. Aims To describe, develop, and assess the potential for a low-cost gastroscope for early cancer screening and patient risk stratification. Methods Our interdisciplinary team used both off-the-shelf and fabricated components to create multiple gastroscope prototypes (GP) in iterative fashion based off clinician feedback. Clinician endoscopists were surveyed using Likert scales regarding device potential, video quality, and handling when testing on a GI training device. Video quality comparison to clinically standard high-definition white light endoscopy (HD-WLE) was done using the absolute categorical ratings (ACR) method. Results A candidate cost-effective GP with clinical potential was developed. Although initial versions were scored as inferior via ACR on all views tested when compared to HD-WLE (p < 0.001), participants agreed the concept may be beneficial (M = 4.52/5, SD = 0.72). In testing improved versions, participants agreed the device had the ability to identify discrete (M = 4.62/5, SD = 0.51) and subtle lesions (M = 4/5, SD = 0.7) but most felt video quality, although improved, was still less than HD-WLE. Sufficiency of maneuverability of device to visualize gastric views was rated as equivocal (M = 2.69/5, SD = 1.25). Conclusion The presented low-cost gastroscopic devices have potential for clinical application. With further device development and refinement including the possible addition of technologies in telemedicine and artificial intelligence, we hope the GP can help expand gastric cancer screening for populations in need. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents results of in situ measurements of fracture evolution within the excavation damaged zone (EDZ) surrounding the tunnel boring machine (TBM) excavated headrace tunnel No. 3 of Jinping II hydropower station, China. Fractures were measured by borehole images obtained with a digital panoramic borehole camera throughout the processes of tunnel excavation and support installation. Boreholes for the digital camera were pre-drilled perpendicular to the tunnel axis from a pre-excavated branch tunnel, and a series of digital images of the borehole walls were made as the TBM passed. Digital processing revealed the lithology, pre-existing fractures and characters of rock core discing of the surrounding rock mass. Processes of fracture initiation, propagation, and closure were observed, and width, occurrence and zoning of EDZ were measured. The relationship between fracture evolution and TBM construction progress is described in detail. Based on true triaxial tests and theoretical analysis of unloading conditions of deep rock masses, the occurrence of tunnelling induced new fractures at the EDZ is discussed with respect to in situ measurement results. The results provide valuable data for EDZ analysis, future designs and the construction of deeply buried tunnels using TBM. [Copyright &y& Elsevier]

Abstract: Rockbursts occurred frequently during the excavation of several parallel tunnels in the Jinping II hydropower station under a maximum overburden of 2525m over an average length of 17.5km. In order to investigate the nucleation and evolution mechanism of rockbursts, a comprehensive monitoring campaign consisting of a digital borehole camera, cross-hole acoustic apparatus, and sliding micrometer was undertaken for in situ measurements in two specially excavated test tunnels B and F. This paper presents the comprehensive monitoring methods applied, and results of numerical analysis applied to a typical rockburst that fortuitously occurred during the testing period. Precursory characteristics preceding rockbursts are: (a) abundant crack initiation, propagation and coalescence, (b) deformation of surrounding rock mass involving an accelerated deformation stage, quiescence stage and reaccelerated deformation stage, and (c) decrease of the characteristic elastic wave velocity of the rock mass. The nucleation and evolution of rockbursts discussed consist of four stages: a) stress adjustment, b) energy accumulation, c) crack initiation, propagation and coalescence, and d) fractured rock collapse and ejection. The results provide a direct case history to assist the prediction and support of rockburst disasters, and contribute to field excavation of deeply buried tunnels. [Copyright &y& Elsevier]

Abstract: Background: With the rapid implementation of cystic fibrosis (CF) newborn screening (NBS), quality improvement (QI) has become essential to identify and prevent errors. Using Process Failure Modes and Effects Analysis (PFMEA), we adapted this method to determine if it could be applied to discover and rank high priority QI opportunities. Methods: Site visits to three programmes were conducted, and PFMEA exercises were accomplished in Colorado, Massachusetts and Wisconsin with 23 experienced professionals. During each of these comprehensive sessions, participants identified and ranked potential failures based on severity, occurrence and detection to calculate risk priority number (RPN) values. Results: A total of 96 failure modes were generated and ranked in a list of the 20 riskiest problems that show no significant discordances by site, although there were differences by profession of the rater, particularly nurses. Conclusions: Our results illustrate that the PFMEA method applies well to CF NBS and that steps requiring communication and information transfer are perceived to be the highest risks. The number of identified failures makes and their potential impact demonstrate considerable overall risk and a need for ongoing QI. [Copyright &y& Elsevier]

Abstract: Background: A comparison of the longitudinal progression of lung disease in cystic fibrosis patients identified through newborn screening (NBS) in cohorts located in two different countries has never been performed and was the primary objective of this study. Methods: The study included 56 patients in Brittany diagnosed through NBS between 1989 and 1994 and 69 similar patients in Wisconsin between 1985 and 1994. The onset and progression of lung disease was radiographically quantified using the Wisconsin Chest X-ray (WCXR) scoring system. A single pediatric pulmonologist blinded to all identifiers scored the films. Results: Generalized estimating equation analyses adjusted for age, genotype, sex, pancreatic insufficiency, and meconium ileus showed worse WCXR scores in Brittany patients compared to Wisconsin patients (average score difference=4.48; p <0.001). Percent predicted FEV1 was also worse among Brittany patients (p <0.001). Conclusions: The finding of milder radiographically-quantified lung disease using the WCXR scoring system, as well as better FEV1 values, may be explained by variations in nutrition, environmental exposures, or healthcare delivery. [Copyright &y& Elsevier]

Classical estuary circulation theory states that in the longitudinal direction of an estuary there exists a single circulation with landward, near-bottom, and seaward, near-surface flows; however, the situation becomes complicated with the presence of a river mouth bar. Here we conducted tidal-cycle observations in the South Passage of the Yangtze Estuary during both the wet and dry seasons of 2018 (July and December, respectively). The simultaneous current velocity, temperature, and salinity profile data were obtained from anchored boats and base tripods at three stations along the channel in the mouth bar area. The results reveal two distinct longitudinal residual circulation patterns: a classic circulation which is formed on the seaward slope of the mouth bar during the wet season, and a double circulation system which is composed of two circulation cells over the landward and seaward slopes of the mouth bar during the dry season. The Simpson number (Si), mixing parameter (M), and salinity data were used to quantify the mixing intensity, which shows that horizontal baroclinic pressure gradient is the dominant factor in the formation of the longitudinal residual circulation. Furthermore, the double circulation pattern during the dry season is related to the mouth bar bathymetry, which affects saltwater intrusion. The double circulations can significantly influence the spatial and temporal evolution of the stagnation point in the estuarine channel, which in turn modifies the distribution patterns of suspended sediment concentration in the maximum turbidity zone. Evidently, the changes in the mouth bar sandbar bathymetry in response to human activities and river basin hydrographic conditions indirectly affect the occurrence and scale of the double circulations. [ABSTRACT FROM AUTHOR]

Purpose: This report represents a subanalysis of data from a primary study and addresses a gap in understanding the similarities and differences of symptom reporting between children with advanced cancer and their parents. The objectives of this subanalysis were to (1) compare reports of symptom prevalence, symptom burden, and symptom frequency, severity, and distress between groups of children and adolescents and their parents, and (2) describe concordance of symptom reports within individual child–parent dyads. Design and Methods: Forty‐six children with relapsed, refractory, or progressive cancer and their parents from five pediatric cancer centers prospectively reported symptoms every 2 weeks for up to 61 weeks. The abbreviated Pediatric Quality of Life and Evaluation of Symptoms Technology—Memorial Symptom Assessment Scales were used to measure symptom prevalence, frequency, severity, and distress. Results: Children and parents reported pain, fatigue, nausea, and sleeping difficulties as the most frequently occurring symptoms. With the exception of shortness of breath, parents reported symptom prevalence more often than children. The differences in parent reports were statistically significant for fatigue, nausea, lack of appetite, feeling nervous, and sadness. Parents reported higher symptom burden scores compared to children for all individual symptoms except shortness of breath. Children reported higher scores for 19 of 32 possible symptom frequency, severity, and distress ratings. Children's scores were higher for frequency and severity, while parents' scores were higher for distress. Sleeping difficulties, pain, nausea, and diarrhea demonstrated the highest concordance, while feeling nervous, sadness, irritability, and fatigue yielded the lowest concordance between children's and parents' symptom reports. Practice Implications: Eliciting the symptom experience from the child, when appropriate, rather than a parent proxy is best practice given evidence supporting the overestimation of symptom prevalence by parents and underestimation of symptom frequency and severity for some symptoms. When proxy raters must be used, pediatric nurses should educate proxy raters regarding symptom assessment, and assess and tend to symptoms that may not exhibit visual cues. Pediatric nurses should conduct a comprehensive symptom assessment and evaluate beyond the presence of symptoms and include an assessment of frequency, severity, and distress for physical and psychological symptoms to optimize symptom management strategies. [ABSTRACT FROM AUTHOR]

The vertical density gradients of salinity and suspended sediment concentration (SSC) cause stratification in estuaries, which play a vital role in the turbulence structure, water mixing, and sediment transport. To investigate the effect of stratification, especially SSC-induced stratification, on maintaining the estuarine turbidity maximum (ETM), we conducted in situ measurements on sediment dynamics at the upper and central ETM sites in the South Passage of Changjiang Estuary in July 2018. The gradient Richardson number was estimated as a proxy for the stratification that is attributable to salinity or/and SSC. We found that salinity-induced stratification was observed mainly on the surface and in the middle layers, whereas SSC-induced stratification occurred mainly in the near-bottom layers. Furthermore, at the central ETM, the baroclinic effect was enhanced during the neap tide when the salinity-induced stratification was stronger than that during the spring tide. In the early phase of floods with minimum velocity during the neap tide, salinity-induced stratification suppressed the turbulence and vertical diffusion of sediments. Moreover, the flocculation enhanced the settling process within the water column. Consequently, high concentrations of fine-grained sediments formed near the bottom and promoted SSC-induced stratification, thereby leading to the continuous accumulation and trapping of sediments. In conclusion, the interactions among the "salinity- and SSC-induced stratification" processes served as crucial constraints of the temporal and spatial variations of the ETM in the Changjiang Estuary. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of Mind Over Matter: Healthy Bowels, Healthy Bladder, a small-group intervention, on urinary and bowel incontinence symptoms among older women with incontinence.Methods: In this individually randomized group treatment trial, women aged 50 years and older with urinary, bowel incontinence, or both, were randomly allocated at baseline to participate in Mind Over Matter: Healthy Bowels, Healthy Bladder immediately (treatment group) or after final data collection (waitlist control group). The primary outcome was urinary incontinence (UI) improvement on the Patient Global Impression of Improvement at 4 months. Validated instruments assessed incontinence, self-efficacy, depression, and barriers to care-seeking. Intent-to-treat analyses compared differences between groups. Target sample size, based on an anticipated improvement rate of 45% in treated women vs 11% in the control group, 90% power, type I error of 0.05, with anticipated attrition of 25%, was 110.Results: Among 121 women randomized (62 treatment group; 59 control group), 116 (95%) completed the 4-month assessment. Most participants were non-Hispanic white (97%), with a mean age of 75 years (SD 9.2, range 51-98); 66% had attended some college. There were no significant between-group differences at baseline. At 4 months, 71% of treated women vs 23% of women in the control group reported improved UI on Patient Global Impression of Improvement (P<.001); 39% vs 5% were much improved (P<.001). Regarding bowel incontinence, 55% of treated women vs 27% of women in the control group improved on Patient Global Impression of Improvement (P<.005), with 35% vs 11% reporting much improvement (P<.005). Treated women improved significantly more than women in the control group on all validated instruments of incontinence severity, quality of life, and self-efficacy. Care-seeking rates were similar between groups.Conclusion: Participation in a small-group intervention improves symptoms of both urinary and bowel incontinence in older women. Mind Over Matter is a feasible model with potential to bring effective behavioral solutions to the community.Clinical Trial Registration: ClinicalTrials.gov, NCT03140852. [ABSTRACT FROM AUTHOR]

Abstract Many rivers are facing human-induced system regime shifts that have great environmental, ecological and social implications, necessitating an increasing need to quantify the human influence on sediment properties and their impacts on the source-to-sink system of marginal seas. The Huanghe and Changjiang Rivers have experienced a dramatic reduction in sediment flux in recent decades, typifying the human influence on sediment properties of global large rivers. Sediment samples from the two rivers were analyzed to obtain grain size, magnetic and geochemical data. The results show a large difference in sediment properties between pre- and post-dam periods. We applied a discrepancy factor to re-examine the magnetic and geochemical tracers that were previously used in the two rivers. The discrepancy factors of most magnetic and geochemical tracers in the mud-sized sediments of the two rivers increased by an average of about 109% after dam construction. This suggests that human-induced changes in sediment properties have greatly improved the discriminatory ability between the sediments from the two rivers. The results also raise the uncertainty of using previous tracers to distinguish between sediments from the two rivers after damming. Furthermore, significant changes in sediment properties that happened in a relatively short time may provide future geological time markers for sedimentary records with a temporal resolution of 100–101 years. For marine environments, an approach for identifying sediment sources based on multiple independent optimum tracers is also proposed, with composite magnetic (SIRM vs. HIRM) and geochemical (Na 2 O vs. Zn) tracers being considered. The results of this work can advance our knowledge of how human activities alter river systems, and identify a sustainable development model under system regime shifts for areas of high-intensity human activity. Graphical abstract Unlabelled Image Highlights • Large differences in sediment properties exist between pre- and post-dam periods. • An approach of using multiple independent optimum tracers is proposed. • Human activities increased the differences between the sediments from the two rivers. • Amplified endmember differences may provide a future geological time marker. [ABSTRACT FROM AUTHOR]

Extreme flood events can significantly disturb hydro-sediment dynamics and affect turbidity maximum zone (TMZ) distributions, which are crucial to estuary evolution. This study used field data and eight Sentinel-2A/B MSI, GF-1/6 WFV, and Landsat-8 OLI satellite images to examine the behavior of the TMZ in the North Passage (NP) and South Passage (SP) of the Yangtze Estuary under the influence of the 2020 extreme flood event. Images covered average annual, usual flood, and extreme flood (river discharge above 70,000 m3/s) conditions between 2018 and 2020. The surface suspended sediment concentration (SSSC) of the Yangtze Estuary was retrieved and verified by the in-situ measured turbidity. Relative SSSC (RSSSC), the ratio of retrieved SSSC to region-averaged SSSC, was then calculated to determine the TMZ (RSSSC>1). The results show that the relation between the SSSC measured in the TMZ core of the SP and river discharge at Datong Gauging Station demonstrated an anticlockwise hysteresis, which can be divided into three stages. In the second stage, the observed SSSCs during the extreme flood were 0.18– 0.68 kg/m3, 0.10– 0.17 kg/m3 higher than before. SSSCs after the extreme flood were lower than those with similar discharge before it in this stage. The TMZ boundary location is correlated logarithmically with river discharge, and the upper boundary moves more seaward than the lower boundary. They moved 6– 20 and − 4– 11 km seaward in the NP and migrated 4– 13 and − 7– 9 km seaward in the SP during the extreme flood, respectively, compared with average annual and usual flood conditions. These findings further clarify TMZ characteristics in extreme floods and can be used as a reference for ecological and waterway projects considering the impacts of extreme flood events. • The surface SSC-discharge curve follows an anticlockwise hysteresis pattern. • The surface SSCs after the extreme floods are lower than before. • The turbidity maximum zone location is logarithmically related to river discharge. [ABSTRACT FROM AUTHOR]

A double-layer transverse oscillating grid for a flume was designed and manufactured, in order to generate approximately isotropic homogeneous turbulence, and allowing the effect of suspended sediment stratification on turbulence characteristics to be studied experimentally. In the experiment, the diachronic variations in turbulence and suspended sediment concentration were measured synchronously using an Acoustic Doppler Velocimeter and a multichannel optical fibre suspended sediment concentration meter. The effect of suspended sediment stratification on turbulence was analyzed in relation to changes in turbulence characteristics, such as root mean square velocity and turbulence intensity. The experimental results confirm that suspended sediment stratification can suppress turbulence and weaken turbulence intensity, and the degree of turbulence suppression is related to the suspended sediment concentration gradient and turbulence intensity. By analogy with the dimensionless Richardson number that characterizes stratification in common ocean models, we define a dimensionless stratification parameter that characterizes the degree of stratification related to turbulence in an oscillating grid. The analysis shows that the turbulence suppression rate is closely related to the stratification parameter in sediment-laden flows. The correlation between turbulence suppression rate and stratification parameter may be obtained using a fitting technique. • The oscillating grid flume generates approximately isotropic homogeneous turbulence. • Suspended sediment stratification suppress turbulence and weaken turbulence intensity. • Turbulence suppression is related to concentration gradient and turbulence intensity. • The correlation between turbulence variation and stratification parameter is obtained. [ABSTRACT FROM AUTHOR]

Among all marine hazards, storm surges cause the most severe damage, and East Asia is one of the regions in the world most affected by tropical cyclones (TCs). With the increase in global mean temperature, the future changes of tropical cyclone (TC) activities are of great concern in East Asian countries. However, due to the inconsistency among different TC datasets, there is no uniform understanding of the spatial and temporal distribution and trends of TC activities in the eastern sea area of China (ESAC). In this study, all TC wind fields affecting ESAC during 1949–2019 were calculated using the Fujita-Takahashi formula, and a new TC dataset with a spatial resolution of 0.1° × 0.1° was thus obtained. Based on this dataset, the spatial-temporal variations of TC activity were analyzed. Three stages (1949–1967, 1968–1993, 1994–2019) of TC activities in ESAC can be identified using Mann Kendall Trend Test, which is closely related to El Niño-Southern Oscillation, sunspot activity, and Pacific Decadal Oscillation. A comparison of the accumulative number and duration of TCs in the three stages shows increasing trend toward the coasts and an northward. To address the issue of shelf storm deposition records on ESAC, we compared the published storm depositional records retrieved from several cores with typhoon impact data from the same sites based on the dataset of this study. We found that the preservation potential of the storm deposition record on ESAC ranged from 8% to 33%, with a high preservation potential in shallow water. These findings reveal the distribution and variability of TC impacts, which can be used to provide a scientific basis for disaster prevention and mitigation planning and adjustment of key coastal protection zones, as well as to evaluate the value of marine sedimentary records better. We have established a new and more comprehensive dataset (0.1° × 0.1°) to analyze the spatial-temporal distribution of tropical cyclone(TC) activity on the seas. Also due to the latitudinal and longitudinal effects of TC effect, the coastal cities in northern China may suffer from more severe storm surge disasters in the future. We also included sedimentary records to help us understand more ancient TC activity. [Display omitted] • We provide a new high-resolution (0.1° x 0.1°) and more detailed dataset of tropical cyclones.. • Coastal cities in northern China are likely to suffer from more severe storm surge disasters in the future. • The tropical cyclone dataset coupled with the sedimentary record can provide a better understanding of paleostorm activity. [ABSTRACT FROM AUTHOR]

Some patients experience reduced bone mineral density (BMD) despite bisphosphonate therapy. We performed a retrospective chart review study to detect factors associated with decreased BMD in men prescribed alendronate. Two investigators reviewed eligible medical records and used a standardized form to record potential characteristics predicting men's response to alendronate. We analyzed patient characteristics associated with annualized change in hip and spine BMD (D-BMD). Among 115 eligible men, 19 (17 %) experienced significantly decreased BMD at the hip or spine, defined as a change exceeding precision error. Eleven men (10 %) fractured during therapy. Spine D-BMD was positively associated with adherence to alendronate ( R = 0.23, p = 0.02) and inversely associated with baseline body weight ( R = −0.21, p = 0.03). Hip D-BMD was positively associated with annualized weight change ( R = 0.19, p = 0.0498) and negatively associated with patient age and number of concomitant medications ( R = −0.21, p = 0.03; R = −0.20, p = 0.03, respectively). In stepwise linear models, spine D-BMD was associated positively with alendronate adherence and multivitamin use and negatively with baseline body weight. Hip D-BMD was negatively associated with age. Fracture during treatment was associated with fracture prior to therapy ( p = 0.03). In this small study of men prescribed alendronate, BMD response showed a positive association with adherence to therapy, weight gain, and use of a multivitamin. By contrast, older age, higher baseline body weight, and higher number of medications were each associated with a decrease in BMD. Larger studies are needed to confirm and extend these findings. [ABSTRACT FROM AUTHOR]

Reclamation in estuaries can greatly change the channel geometry and hydrodynamic conditions and these changes may have significant impacts on spatial and temporal distribution of the turbidity maximum zone. This study focuses on the effects of a large area of reclamation built in 2007–2018 and the behavior of the turbidity maximum zone along the North Channel of the Yangtze Estuary. Data were collected of bathymetry in the North Channel, tidal elevations at Sheshan Station, river discharge at Datong Station and turbidity, retrieved from six Landsat remote sensing images in the dry season from 2006 to 2019. In-situ measured data on flow velocity and suspended sediment concentration were obtained in the dry season of 2003 and 2018. Analysis of the data revealed that reclamations, which led to narrowing (0.86–2.74 km) and fixing of the channel, caused erosion of 0.19–3.72 m in the deep channel and deposition on the tidal flats. Furthermore, it was found that the length of the turbidity maximum zone decreased: its landward boundary shifted 5 km seaward during spring tide and 17 km seaward during neap tide in the dry season. The position of the seaward boundary wandered within a range of 3 km, being further downstream during neap tide than that during spring tide. A conceptual model of changes in the borders of the turbidity maximum zone in response to reclamation is proposed. After the reclamation works, the deeper and narrower channel intensified ebb-dominance of the flow velocity. The coarsening of bed sediment weakened resuspension and decreased the bottom tidally averaged suspended sediment concentration. These changes led to a significant decline in the depth-mean of tidally averaged suspended sediment concentration and caused the seaward movement of the landward boundary of the turbidity maximum zone. • The landward boundary of the turbidity maximum zone has moved seawards. • Ebb dominance is enhanced in the deep channel via channel narrowing and deepening. • Coarsening of surface sediments has weakened resuspension. [ABSTRACT FROM AUTHOR]

A MIDAS-400 customized data acquisition system has been used for the high-resolution sediment dynamic measurements over the Dafeng intertidal flats of northern Jiangsu during 6 tidal cycles from July 3 to July 10, 2003. The bed shear stress and bedload transport rates, in response to wave-current interactions, are calculated, which indicate that wind waves enhance the bottom shear stress and bedload transport rates. At the station for measurements, bedload transport was directed to seaward, with a sediment discharge of 30-150 kg·m-1 per tidal cycle. The surficial sediment samples were collected from a grid with 10 m spatial intervals over a rectangle 2 × 104 m² experimental area, near the MIDAS-400 during the spring tide of July 4, 2003, and the neap tide of July 9, 2003. In addition, leveling survey was undertaken to obtain the detailed topography of the sampling area. Grain-size trend analysis of the sediment samples shows that the bedload transport patterns are complex, mainly controlled by the hydrodynamics and local geomorphology (e.g. tidal creeks) over the intertidal flats. Furthermore, the grain-size trends pattern during the neap tide rather than during the spring tide is consistent with the calculated bedload transport, and the grain-size trend vectors for the spring tide are larger than those for [ABSTRACT FROM AUTHOR]

Abstract: Background: Although there are more than 1000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, most of them are uncommon and only limited information exists regarding genotype–pulmonary phenotype relationships. Methods: We determined and classified the CFTR mutations using denaturing high-performance liquid chromatography and developed new, quantitative methods to categorize pulmonary phenotypes. Results: Two novel alleles were discovered, namely G1047R and 1525-2A→G, which were accompanied by F508del and G551D mutations, respectively. Assessment of numerous options revealed that CF pulmonary phenotype categorization in children cannot be accomplished with clinical or pulmonary function data but is facilitated by longitudinal quantitative chest radiology. It was most useful to categorize pulmonary disease status by evaluating the typical pattern of abnormalities in patients homozygous for the F508del mutation, and then compare patients with minor mutations to this typical CF pulmonary phenotype. By this method, both patients with novel mutations have pulmonary phenotypes typical of F508del homozygotes. However, patients with class IV mutations (e.g., R347P) or with pancreatic sufficiency showed serial chest radiographs that were atypically mild. Conclusions: Longitudinal quantitative chest radiography provides a new strategy for CF pulmonary phenotype categorization that should be useful for genotype–phenotype delineation in individual patients and in both epidemiologic studies and clinical trials involving groups of children with CF. [Copyright &y& Elsevier]

Context: Although Pseudomonas aeruginosa is the most common virulent respiratory pathogen in cystic fibrosis (CF), the longitudinal development of P aeruginosa infection and its effect on antibody responses and lung disease progression in children with CF remain unclear.Objective: To prospectively examine the epidemiology of P aeruginosa infection and its impact on CF pulmonary morbidity.Design, Setting, and Patients: We prospectively evaluated 56 CF patients at 2 CF centers in Madison and Milwaukee, Wis, from birth up to age 16 years between April 15, 1985, and April 15, 2004, with diagnoses made through the Wisconsin CF Neonatal Screening Project.Main Outcome Measures: Timing of nonmucoid P aeruginosa and mucoid P aeruginosa acquisition was assessed by first positive result. Longitudinal development from no P aeruginosa to nonmucoid P aeruginosa and from nonmucoid P aeruginosa to mucoid P aeruginosa was examined. Outcome measurements included antibody titers, respiratory symptoms, quantitative chest radiography, and pulmonary function tests.Results: Sixteen patients (29%) acquired nonmucoid P aeruginosa in the first 6 months of life. The age-specific prevalence of mucoid P aeruginosa increased markedly from age 4 to 16 years. Nonmucoid and mucoid P aeruginosa were acquired at median ages of 1.0 and 13.0 years, respectively. In contrast with the short transition time from no P aeruginosa to nonmucoid P aeruginosa, the transition time from nonmucoid to mucoid P aeruginosa was relatively long (median, 10.9 years) and could be slightly extended by brief/low anti-P aeruginosa antibiotic treatment. Antibody titers increased with both transitions, but the deterioration in cough scores, chest radiograph scores, and pulmonary function correlated best with transition from nonmucoid to mucoid P aeruginosa.Conclusions: Early prevention and detection of nonmucoid and mucoid P aeruginosa are critical because of early acquisition and prevalence. There is a window of opportunity for suppression and possible eradication (by aggressive anti-P aeruginosa treatment) of initial nonmucoid P aeruginosa. Mucoid P aeruginosa plays a much greater role in CF lung disease progression than nonmucoid P aeruginosa. Antibody titers, cough scores, and chest radiographs are early signs of nonmucoid P aeruginosa and especially mucoid P aeruginosa stages. [ABSTRACT FROM AUTHOR]

Climate change and human activity have exerted significant influences on the sediment load and channel morphology of the Changjiang River system, China. However, our knowledge of their influence on flood regime on the centennial to millennial timescales remains limited, and this is mainly because of the difficulty in directly determining the long-term hydrological variability of the Changjiang River over the period before hydrological gauges were established. Based on multiproxy analysis that combines chronological, sedimentological, and geochemical analysis of a 4.8-m-long sediment core retrieved from the subaqueous delta of the Changjiang River, this study establishes a flood history for the Changjiang River during the late Holocene. Our palaeoflood reconstruction revealed 14 multi-decadal periods of extreme floods (19–66 BCE, 25–80, 255–350, 415–475, 550–710, 740–835, 970–990, 1080–1130, 1170–1235, 1275–1390, 1440–1500, 1560–1730, 1810–1830, and 1950–2011 CE). These flood units match well with the observed large floods, documentary records of floods, and sedimentary flood deposits, confirming that the coarse units in the sequence are flood-derived and are regionally representative. Comparing with regional and global palaeoclimate records indicates that major flood events of the Changjiang are strongly modulated by the Asian summer monsoon and the El Niño–Southern Oscillation (ENSO), but that anthropogenic impacts (e.g. artificial channelization and land clearance) have also greatly amplified the flooding frequency over the past 600 yr. • We report a history of extreme flood events on the Chanjiang River over the past 2000 yr. • Periods of increased extreme flood activity in the Changjiang River typically coincide with El Niño periods and weak EASM phases. • Human modifications have greatly amplified flood activities in the Changjiang River over the past 600 yr. [ABSTRACT FROM AUTHOR]

Advances in nanotechnology provide plenty of exciting solutions to environmental issues affecting air, soil as well as water. To solve the water pollution problem caused by organics and microorganisms, development of a simple, environment-friendly, and cheap method for the synthesis of nanomaterials is of paramount importance. Herein, we prepared a novel nanocomposite (named Eggshell/Ag) using waste eggshell as a support and Cacumen platycladi extract as reducing and stabilizing agents in aqueous solutions at room temperature. Biogenic-stabilized Ag nanoparticles (Ag NPs) with an average diameter of 60 nm were well-dispersed on the surface of eggshells, exhibiting dual-functional properties of organics catalytic degradation and bacterial growth inhibition. Through five repeated assays, it was established that the reduction efficiency of the nanocomposite for 4-nitrophenol (4-NP) was high. The reduction could be completed rapidly at room temperature. Moreover, significant inhibition zones were observed for Staphylococcus aureus (S. aureus) agar plates and Escherichia coli (E. coli). Meanwhile, the minimum inhibition concentrations (MIC) were determined to be 0.08 and 0.04 mg mL−1, respectively, while the minimum bactericidal concentration (MBC) was measured as 0.64 mg mL−1. The biogenic Eggshell/Ag nanocomposites are promising candidates for a series of applications in the fields of biomedicine, environment as well as energy. Unlabelled Image • The green Eggshell/Ag are synthesized with eggshells as template and Cacumen platycladi as reducing and stabilizing agents. • The biogenic Eggshell/Ag exhibited dual-functional properties for organics catalytic degradation and bacterial inhibition. • The biogenic Eggshell/Ag are expected as superior candidates in water disinfection and sustainable development. [ABSTRACT FROM AUTHOR]

The link between tropical cyclone (TC) activity in the South China Sea (SCS) and global climate change is commonly debated and there is a clear need for long-term geological records of TC activity if we are to clarify this connection. Multi-millennial, high-resolution paleo-storm records from the SCS are rare in the region and this causes difficulties for those exploring potential climate drivers of TC variability over centennial to millennial timescales and reduces our ability to fully assess the risks associated with future TC activity. This paper presents an age-constrained, mud-dominated sedimentary sequence from a coastal lagoon on Hainan Island, China. Multiproxy analyses incorporating chronological, lithological, sedimentological, and geochemical evidence were used to infer storm deposits preserved within the sequence and to reconstruct a time series of storm activity in the SCS during the mid-to-late Holocene. This long sedimentary record shows that TCs were highly active over the periods 5500 to 3500 and 1700 to 0 cal yrs. BP, and these periods contrast with a relatively quiet period 3500–1700 cal yrs. BP. An apparent inverse correlation between TC reconstructions from the SCS and those from the Korean Peninsula and Japan implies an oscillating pattern across the SCS and western North Pacific (WNP) over centennial to millennial timescales. A comparison between the sedimentary and paleoclimatic records implies that the El Niño–Southern Oscillation was not the only mechanism responsible for typhoon variability over the past 7500 cal yrs. BP, suggesting that other factors such as the thermal state of the western Pacific warm pool likely also had a strong influence on both SCS and WNP TC variability. • Sedimentological evidence from Hainan Island was used to reconstruct typhoon activity in the SCS over the mid–late Holocene. • There exists a well-defined seesaw pattern in storm activity across the WNP basin during the study period. • Periods of increased (reduced) storm activity in the SCS typically coincide with La Niña (El Niño) periods and warm (cold) phases of the WPWP during the mid-late Holocene. [ABSTRACT FROM AUTHOR]

Background Effective symptom assessment and management for children with advanced cancer undergoing hematopoietic stem cell transplantation (HSCT) is critical to minimize suffering. Most literature specific to children receiving HSCT is based upon medical record reviews and parent report, and to a lesser extent, patient self-report. Objectives The purpose of this study was to describe symptom frequency, severity and level of distress in children and adolescents undergoing HSCT using patient self-report via electronic data collection. Methods A modified Memorial Symptom Assessment Scale (MSAS) was electronically administered to children with advanced cancer every two weeks. Clinical data was collected at corresponding time points. A sub-analysis was conducted for the cohort of children with advanced cancer who received autologous or allogeneic HSCT. Results Forty-seven children with advanced cancer were enrolled and completed 563 surveys during the course of the study. Eleven of these 47 children received HSCT and completed 201/563 surveys. The median age of children in the HSCT cohort was 12.7 years, 73% were female, and most children had a hematologic (45%) or solid tumor (45%) malignancy. Ninety-six percent of surveys administered to children receiving HSCT were completed, and 64% of surveys were completed at home. Pain (35%), nausea (30%), sleeping difficulty (29%) and fatigue (22%) were the most commonly reported symptoms in children receiving HSCT. Children in the HSCT cohort had higher total and physical subscale mean MSAS scores, and higher pain, nausea, fatigue, and lack of appetite mean scores compared to children with advanced cancer not receiving HSCT (p <.05). Children receiving HSCT experienced more distress from pain, fatigue, nausea, lack of appetite, diarrhea and constipation when these symptoms were present compared to children with advanced cancer not receiving HSCT (p <.05). Conclusion Children with advanced cancer receiving HSCT may have increased symptom burden with higher levels of distress as compared to those who do not receive HSCT. Increased understanding of the symptom experience for children with advanced cancer undergoing HSCT may promote timely assessment and treatment of distressing symptoms. [ABSTRACT FROM AUTHOR]