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Objective: To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. Methods: Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010–2020. The prevalence rate (PR) of birth defects is the number of birth defects per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond). PMR is the number of perinatal deaths per 100 fetuses. PR and PMR with 95% confidence intervals (CI) were calculated using the log-binomial method. Chi-square trend tests (χ2trend) were used to determine trends in PR and PMR by year, maternal age, income, education level, parity, and gestational age of termination. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with perinatal deaths attributable to birth defects. Results: Our study included 1,619,376 fetuses, a total of 30,596 birth defects, and 18,212 perinatal deaths (including 16,561 stillbirths and 1651 early neonatal deaths) were identified. The PR of birth defects was 18.89‰ (95%CI: 18.68–19.11), and the total PMR was 1.12%(95%CI: 1.11–1.14). Birth defects accounted for 42.0% (7657 cases) of perinatal deaths, and the PMR of birth defects was 25.03%. From 2010 to 2020, the PMR of birth defects decreased from 37.03% to 2010 to 21.00% in 2020, showing a downward trend (χ2trend = 373.65, P < 0.01). Congenital heart defects caused the most perinatal deaths (2264 cases); the PMR was 23.15%. PMR is highest for encephalocele (86.79%). Birth defects accounted for 45.01% (7454 cases) of stillbirths, and 96.16% (7168 cases) were selective termination of pregnancy. Perinatal deaths attributable to birth defects were more common in rural than urban areas (31.65% vs. 18.60%, OR = 2.03, 95% CI: 1.92–2.14) and in females than males (27.92% vs. 22.68%, OR = 1.32, 95% CI: 1.25–1.39). PMR of birth defects showed downward trends with rising maternal age (χ2trend = 200.86, P < 0.01), income (χ2trend = 54.39, P < 0.01), maternal education level (χ2trend = 405.66, P < 0.01), parity (χ2trend = 85.11, P < 0.01) and gestational age of termination (χ2trend = 15297.28, P < 0.01). Conclusion: In summary, birth defects are an important cause of perinatal deaths. Rural areas, female fetuses, mothers with low maternal age, low income, low education level, low parity, and low gestational age of termination were risk factors for perinatal deaths attributable to birth defects. Future studies should examine the mechanisms. Our study is helpful for intervention programs to reduce the PMR of birth defects. [ABSTRACT FROM AUTHOR]

Background: To research the effect of China's many-child policy on the number of births and the prevalence of serious teratogenic and disabling defects (STDDs) in Hunan province. Methods: We performed an observational study based on the Birth Defect (BD) Surveillance System of Hunan Province and chose STDD case cards. From 2012–2022, we defined the following 4 periods: the one-child policy (OCP) (2012.01–2013.12), partial two-child policy (PTCP) (2014.1–2015.12), universal two-child policy (UTCP) (2016.1–2020.12), and the early stage of the three-child policy (ETCP) (2021.1–2022.12). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the association of policy changes with STDDs. Crame′rʹs V was calculated to estimate the effect sizes. Joinpoint regression analysis and annual percent change (APC) were used for each segment of the trend. Results: A total of 1,652,079 births were included in this analysis. Joinpoint regression analysis showed that the number of perinatal births increased from 2012 to 2017, with APC = 9.52 (95% CI: 7.2 to 11.8), and decreased from 2017 to 2022, with an APC = -10.04 (95% CI: -11.9 to -8.1). The number of mothers over 30 years old gradually increased, from 25.54% during the OCP period to 54.05% during the ETCP period (Ptrend < 0.001). With policy changes, the total prevalence of STDDs increased from 28.10 per 10,000 births during the period of OCP into 46.77 per 10,000 births during the ETCP period by 66.44%. The live birth prevalence of STDDs increased only during the ETCP period (PTCP: OR = 1.27, 95% CI: 0.99–1.24, p = 0.057, UTCP: OR = 1.22, 95% CI: 0.99–1.52, p = 0.067, ETCP: OR = 1.75, 95% CI: 1.37–2.24, p < 0.001). Over the past ten years, there was a decrease in the gestational age at diagnosis (*F = 772.520, p < 0.001), from 24.49 ± 5.65 weeks in 2012 to 20.77 ± 5.17 weeks in 2022. From 2012 to 2022, the percentage of deaths within 7 days decreased with APC = -18.85 (95% CI: -26.4— -10.5, P > 0.05). Conclusion: Many-child policies were associated with a moderate increase in fertility especially for women in urban areas and older women. However, they have lost the ability to control birth since 2017. The total prevalence of STDDs increased over the entire period, but the live birth prevalence increased only during the ETCP period. The gestational age at diagnosis decreased and the percentage of deaths within 7 days decreased. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to compare the treatment outcomes between suctioning flexible ureteroscopic lithotomy (SF-URL) with automatic control of renal pelvic pressure and minimally invasive percutaneous nephrolithotomy (MPCNL) for the management of 2–3-cm renal stones in patients with a solitary kidney. Materials and Methods: A total of 127 patients with a solitary kidney who underwent SF-URL (n = 57) or MPCNL (n = 70) for large renal stones (>2 cm) between June 2015 and October 2020 were consecutively analyzed. The stone characteristics, operative times, stone-free rate (SFR), hospital stays, and incidences of complications were compared. Results: There was a significantly shorter operative time with MPCNL than with SF-URL (43.4 ± 18.9 min vs. 61.8 ± 21.1 min, p = 0.012). SFR at 30 days were 80.7% (46/57) and 90.0% (63/70) for SF-URL and MPCNL, respectively (p > 0.05). The SFR at the 3-month follow-up was comparable in both groups (91.2% vs. 95.7%, p > 0.05). The hemoglobin decline value, hospital stay, serum cystatin C, and percentage of patients requiring blood transfusions in the SF-URL group were obviously better than those in the MPCNL group: (0.8 ± 0.4) versus (3.9 ± 2.7) g/dL (p = 0.007), (3.6 ± 1.5) versus (6.9 ± 3.1) days (p = 0.013), (1.02 ± 0.48) versus (2.54 ± 0.69) mg/L (p = 0.011), and 0 (0.0%) versus 7 (10.0%) (p = 0.016), respectively. The percentages of patients with thrombosis and perirenal hematoma in the MPCNL group were higher than those in the SF-URL group, but the difference was not statistically significant (p > 0.05). Conclusion: For the treatment of 2–3-cm renal stones in patients with a solitary kidney, both SF-URL and MPCNL are effective. MPCNL has the advantage of a shorter operation time. However, SF-URL is characterized by less bleeding, shorter hospital stay, and less damage to kidney function. [ABSTRACT FROM AUTHOR]

Purpose: We reported the different consequences of forgotten stents and share our managing experiences. Patients and Methods: From July 2011 to August 2019, eight patients (five men and three women) with forgotten encrusted ureteral stents were treated by different endoscopic procedures in our center. Plain-film radiography (kidney, ureter, and bladder [KUB]) and computed tomography were used to evaluate the position of stents, the site of encrustation, and the stone burden. Various sole or combined endoscopic techniques including percutaneous nephrolithotomy, retrograde ureteroscopic lithotripsy, and cystolitholapaxy were used to achieve stent removal. Results: The average age of the patients was 50.9 years (range: 25–72 years). The mean indwelling time of the stents was 32.9 months (range: 12–83 months). Mean stent stone burden was 15 mm × 10 mm. Three patients had stent stone burden larger than 20 mm. Three patients had a preoperative positive urine culture before treatment. The stent was fragmented in two patients. The ureteral stents and related stones were successfully removed without any complications by a sole or combined endoscopic techniques with stone-free status achieved in all patients. There is no complications occurred. Conclusion: Forgotten stents can lead to complicated urinary tract calculi, stent encrustation, urinary tract infection, vesicoureteric reflux, and even ureteral polyps. Various sole or combined endourological techniques can be used to manage the forgotten encrusted ureteral stents. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of underweight, overweight and obesity as defined by pre-pregnancy body mass index (BMI) and the relationship between pre-pregnancy BMI and pregnancy and perinatal outcomes in women based on a retrospective cohort. Women registered via the Free Pre-pregnancy Health Check (FPHC) program from 2017 to 2019 in Hunan Province, China, were included to the study cohort. The data regarding maternal characteristics, pregnancy outcomes, and infant characteristics were retrieved from the surveillance system of the FPHC program. Logistic regressions were performed to calculate odds ratios (ORs) and adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) to assess the associations between pre-pregnancy BMIs and the outcomes. Among a total of 398,368 women, 54,238 (13.62%) were underweight (BMI < 18.5 kg/m2), 51,251 (12.87%) were overweight (24.0 kg/m2 ≤ BMI < 28.0 kg/m2), and 10,399 (2.61%) were obese (BMI ≥ 28.0 kg/m2). Underweight occurred more commonly in the 20–24 years old (17.98%), Han Chinese (13.89), college-educated (16.09%), rural (13.74%), and teacher/public servant/office clerk (16.09%) groups. Obesity occurred more often in the older than 35-year-old (4.48%), minority (3.64%), primary school or below (4.98%), urban (3.06%), and housewife (3.14%) groups (P < 0.001). Compared with the normal BMI group, underweight was associated with increased risk of low birth weight (LBW) (AOR = 1.25) and small-for-gestational age (SGA) (AOR = 1.11), but protected against gestational hypertensive disorder (GHD) (AOR = 0.85), gestational diabetes mellitus (GDM) (AOR = 0.69), macrosomia (AOR = 0.67), post-term pregnancy (AOR = 0.76), and cesarean-section (AOR = 0.81). Overweight and obesity were associated with increased risk of GHD (AOR = 1.28, 2.47), GDM (AOR = 1.63, 3.02), preterm birth (AOR = 1.18, 1.47), macrosomia (AOR = 1.51, 2.11), large-for-gestational age (LGA) (AOR = 1.19, 1.35), post-term pregnancy (AOR = 1.39, 1.66), and cesarean- section (AOR = 1.60, 2.05). Pre-pregnancy underweight is relatively common in Hunan Province, China. Pre-pregnancy underweight to some extent is associated with better maternal outcomes, but it has certain adverse effects on neonatal outcomes. Pre-pregnancy overweight, especially obesity, has a substantial adverse effect on pregnancy and perinatal outcomes. [ABSTRACT FROM AUTHOR]

Aim: To investigate the epidemiology of chromosomal abnormalities (CA) in fetuses of all pregnancies based on a provincial‐wide birth defects‐monitoring system, which could provide scientific basis for making relatively policy and research. Methods: Chromosomal abnormalities cases were collected from all hospitals in Hunan Province, China, between 2016 and 2019. The prevalence of CAs was calculated to examine associations among infant sex, maternal age and region. The rates of prenatal diagnosis and termination of pregnancy (TOP) involving CA or associated anomalies were calculated as rates or proportions. Results: From 2016 to 2019, a total of 2 883 890 perinatal infants (28 weeks of gestation to postpartum 7 days) underwent prenatal screening and diagnostic tests, and 3181 fetuses were diagnosed as CA, with the prevalence of 11.03/10 000. The average prevalence of CAs was higher for male than female fetuses (11.33/10 000 vs 10.06/10 000) (OR = 1.13, 95% CI: 1.05–1.21), which was higher in urban areas than rural areas (23.03/10 000 vs 7.13/10 000) (OR = 3.23, 95% CI: 3.02–3.47), and the prevalence increased linearly with maternal age (Xtrend2 = 1821.844, P = 0.000). Among the fetuses with CAs, 3097 (97.36%) were diagnosed prenatally, and 3046 (98.35%) underwent TOP. The majority of CA were numerical abnormalities (90.18%). The main types of numerical autosomal abnormalities were trisomy 21 (6.69/10 000, 59.57%), trisomy 18 (1.13/10 000, 10.04%) and trisomy 13 (0.21/10 000, 1.88%). The main types of numerical gonosomal abnormalities were Klinefelter syndrome (0.68/10 000, 6.02%), Turner syndrome (0.49/10 000, 4.39%), Triple X syndrome (0.26/10 000, 2.29%) and 47,XYY syndrome (0.21/10 000, 1.91%). The three associated anomalies with the highest proportions were congenital heart defects (CHD) (41.06%), cleft palate or/and cleft lip (10.89%) and congenital talipes equinovarus (8.94%). Conclusion: The prevalence of CA was lower than that reported. Chromosome detection should be further promoted including test contest and coverage, especially for urban areas, older mothers and fetuses with CHD, cleft palate or/and cleft lip or congenital talipes equinovarus. [ABSTRACT FROM AUTHOR]

A 3D porous carbon foam (CF) loaded with Fe3O4/graphene oxide (GO) has been successfully fabricated. As expected, the saturated adsorption capacity of the resulting Fe3O4/GO–CF composite toward As(III) can reach up to 111 mg g−1, superior to those of most of the reported Fe-containing adsorbents. Additionally, the obtained Fe3O4/GO–CF exhibits excellent As(III) removal performance after five absorption–regeneration cycles with more than 70% of removal efficiency. The exceptional arsenic removal performance can be ascribed to its unique 3D porous network structure as well as fully exposed sorption sites originating from Fe3O4 particles. Finally, the macroscopic size and magnetic feature of the Fe3O4/GO–CF monolith are favorable for facile separation after adsorption. Therefore, the hierarchically porous Fe3O4/GO–CF monolith is highly expected to find many potential applications in arsenic-contaminated water remediation. [ABSTRACT FROM AUTHOR]

Objective: To introduce a novel technique for intelligently monitoring and controlling renal pelvic pressure (RPP) in minimally invasive percutaneous nephrolithotomy (MPCNL) and to investigate its reliability and stability. Materials and Methods: A total of 63 kidney stone patients (41 males and 22 females) were enrolled in the study. The average stone size was 3.7 ± 1.1 cm. The average age was 41.6 ± 15.6 years old. All patients underwent MPCNL under combined spinal and epidural anesthesia in prone position. A ureteral catheter connected to an invasive blood pressure monitor was retrogradely placed to measure renal pelvic outlet pressure. The MPCNL was performed with the aid of the patented device, including an irrigation and suctioning platform and a pressure-measuring suctioning sheath. On the platform, the RPP control value was set at –5 mm Hg, and the RPP warning value was set at 20 mm Hg. RPP was measured during the irrigation and suctioning period (ISP), and therapeutic period (TP) when the infusion flow was set at 300, 400, and 500 mL/min, respectively, for 5 min. Results: Sixty-three patients successfully underwent the procedure without serious complications. The mean operative time was 67 min (range 31–127 min). Three patients had residual stones >2 mm in size. No statistical significance was observed between the renal pelvic outlet pressure, platform RPP values, and RPP control values for the 300, 400, and 500 mL/min groups during the ISP and TP (p > 0.05). Conclusion: The patented devices including the platform and the sheath can reliably and stably monitor and control RPP in real time and within a safe range during MPCNL. [ABSTRACT FROM AUTHOR]

U 3 Si 2 attracted much attention as candidate nuclear fuel for some favorable properties such as higher uranium density and thermal conductivity than that of UO 2. Until now, the oxidation and hydrolysis mechanism of U 3 Si 2 have not been fully explained. In this paper, we fabricated U 3 Si 2 by arc-melting method and characterized surface morphology and structure by SEM and XRD, respectively. The initial oxidation process of U 3 Si 2 was studied by in-situ XPS analysis. The results showed that the oxidized product of U 3 Si 2 were firstly uranium oxides and then uranium silicate. By XPS peak fitting process, the percentage of oxides were obtained and showed that the oxides percentage increased roughly obeyed the exponential law. [ABSTRACT FROM AUTHOR]

Background. There has been significant research on the genetic and environmental factors of congenital heart defects (CHDs), but few causes of teratogenicity, especially teratogenic mechanisms, can be clearly identified. Metabolomics has a potential advantage in researching the relationship between external factors and CHD. Objective. To find and identify the urinary potential biomarkers of pregnancy (including in the second and third trimesters) for fetuses with CHD based on modified gas chromatograph-mass spectrometer (GC-MS), which could reveal the possibility of high-risk factors for CHD and lay the foundation for early intervention, treatment, and prevention. Methods. Using a case-control design, we measured the urinary potential biomarkers of maternal urine metabolomics based on GC-MS in a population-based sample of women whose infants were diagnosed with CHD (70 case subjects) or were healthy (70 control subjects). SIMCA-P 13.0 software, principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), Wilcoxon-Mann-Whitney test, and logistics regression were used to find significant potential biomarkers. Result. The 3D score graph of the OPLS-DA showed that the CHD and control groups were fully separated. The fitting parameters were R2x=0.78 and R2y=0.69, and the forecast rate was Q2=0.61, indicating a high forecast ability. According to the ranking of VIPs from the OPLS-DA models, we found 34 potential metabolic markers with a VIP > 1, and after two pairwise rank sum tests, we found 20 significant potential biomarkers, which were further used in multifactor logistic regressions. Significant substances, including 4-hydroxybenzeneacetic acid (OR=4.74, 95% CI: 1.06-21.06), 5-trimethylsilyloxy-n-valeric acid (OR=15.78, 95% CI: 2.33-106.67), propanedioic acid (OR=5.37, 95% CI: 1.87-15.45), hydracrylic acid (OR=6.23, 95% CI: 1.07-36.21), and uric acid (OR=5.23, 95% CI: 1.23-22.32), were associated with CHD. Conclusion. The major potential biomarkers in maternal urine associated with CHD were 4-hydroxybenzeneacetic acid, 5-trimethylsilyloxy-n-valeric acid, propanedioic acid, hydracrylic acid, and uric acid, respectively. These results indicated that the short chain fatty acids (SCFAs) and aromatic amino acid metabolism may be relevant with CHD. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Environmental concern associated with excess fluoride has intrigued the unceasing exploration of new multifunctional hybrid materials to mitigate any undesirable consequence to human health. Herein, a novel hybrid monolith has been successfully fabricated via a facile in-situ growth strategy for highly efficient defluoridation from contaminated waters, in which homogeneously dispersed UiO-66 particles are perfectly anchored on three dimensional (3D) porous carbon foam (CF). Benefiting from fully exposed active sites, excellent pore accessibility and efficient mass transport, the integrated UiO-66/CF hybrid monolith exhibits fast adsorption kinetics, and outstanding uptake capacity toward fluoride as high as 295 mg g−1, which greatly outperforms the previously reported adsorbents. Furthermore, the fluoride removal efficiency of the spent monolith can reach up to 70% after four cycles, accompanied by facile separation nature and outstanding water stability. More significantly, the resulting UiO-66/CF packed column (0.36 g) can continuously treat 400 mL of F− solution with 6.2 mg L−1 before the breakthrough point occurs, highlight its potential feasibility for fluoride removal in the practical applicability. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Composition-tunable bimetallic Fe/Mg-MIL-88B(n) nanospindles was synthesized. • Arsenate uptake capacity up to 303.6 mg/g is achieved in the optimized Fe/Mg-MIL-88B(0.5). • Regenerative ability and stability of Fe/Mg-MIL-88B absorbents were evaluated. • Sorption mechanism of arsenate on the Fe/Mg-MIL-88B(0.5) was studied. Abstract The rational design of metal–organic frameworks with tailored components and structural features is crucial for achieving the desired functions and expanding the emerging applications. Herein, water-stable bimetallic Fe/Mg metal–organic frameworks (Fe/Mg-MIL-88B) have been successfully fabricated through a facile and effective one-step strategy to access the exceptional arsenic decontamination. Notably, the obtained bimetallic Fe/Mg-MIL-88B architectures are demonstrated to possess a well-defined spindle-like morphology. Interestingly, the Fe/Mg molar ratios within the resultant Fe/Mg-MIL-88B frameworks can be flexibly modulated on demand, leading to the variation of the structural features associated with length/diameter ratio and unit cell parameters along with surface areas. Thanks to the unique structural and compositional merits as well as the synergetic contribution from two active metal centres, the fabricated Fe/Mg-MIL-88B nanospindles exhibit enhanced decontaminant performance toward arsenate in terms of ultrafast sorption kinetics and high sorption capacities, compared to the monometallic Fe-MIL-88B. Impressively, an extraordinary arsenate uptake capacity up to 303.6 mg/g is achieved in the optimized Fe/Mg-MIL-88B with Fe/Mg feeding ratio of 0.5, which is substantially superior to most of the reported arsenic absorbents. More significantly, these Fe/Mg-MIL-88B absorbents possess exceptional regenerative ability and stability during multiple sorption/desorption cycles, as reflected by the negligible drop in arsenic removal efficiency and excellent maintenance of the crystalline structure and morphology integrity. All these satisfactory results prefigure that the designed bimetallic Fe/Mg-MIL-88B absorbents hold a great promise for the in-depth purification of arsenic-contaminated water. [ABSTRACT FROM AUTHOR]

Objective: To investigate the usage of intelligently pressure-controlled flexible ureteroscopy (URS) in managing upper urinary tract calculi in patients with a solitary kidney.Methods: Forty patients with a solitary kidney and upper urinary tract calculus were included in this study. All the patients underwent suctioning URS with intelligent control of renal pelvic pressure by connecting pressure-measuring suctioning ureteral access sheath to an irrigation and suctioning platform. Treatment outcome and perioperative data were collected.Results: The mean operative time was 25.2 ± 14.5 minutes. The mean hospital stay was 4.7 ± 1.4 days. The stone-free rate at 4 weeks after surgery was 87.5%, and it was 92.5% at 12 weeks after surgery. Two patients (5%) experienced complications of fever postoperatively. There were no complications of elevated serum creatinine, severe bleeding, sepsis, stone street, ureteral mucosa stripping, and ureteral stenosis.Conclusion: It is safe and efficient to use the intelligently pressure-controlled flexible URS in treating upper urinary tract calculi for patients with a solitary kidney with advantages of high lithotripsy efficacy and low complication rate. [ABSTRACT FROM AUTHOR]

Background Gentamicin has been determined to be active against a wide range of bacterial infections and has been commonly used as a preoperative antibiotic for inflatable penile prosthesis (IPP) implantation. However, the best dosing regimen to produce the safest optimal prophylactic effect remains to be determined. Aim To compare low- and high-dose gentamicin as prophylaxis during IPP implantation. Methods We retrospectively analyzed two groups of patients who underwent IPP placement from April 14, 2012 through April 13, 2016. Group 1 was composed of 490 patients who underwent IPP placement from April 14, 2012 through April 13, 2014 and received a low dose of preoperative gentamicin at 80 mg every 8 hours for 1 day. Group 2 was composed of 407 patients who underwent IPP placement from April 14, 2014 through April 13, 2016 and received a single high dose of preoperative gentamicin at 5 mg/kg. We compared the infection rates of IPP and any gentamicin-related toxicities. The same surgeon performed all procedures. All patients received additional vancomycin 1 g before incision and at 12 hours postoperatively. Outcome Demographic data and IPP infection rate were compared and potential toxicities from the higher dose of gentamicin were closely monitored. Results There were no significant differences in mean age, mean body mass index, and mean interval for IPP placement and IPP infection between the two groups. No toxicity was seen with the higher gentamicin dose. Six cases in group 1 (five de novo cases and one redo case, infection rate = 1.22%) and three cases in group 2 (two de novo cases and one redo case, infection rate = 0.74%) were found to have IPP infection. The infection rate in group 2 appeared to be lower than that in group 1, although a significant statistical difference was not achieved ( P = .057). Clinical Implications These findings would help guide urologists in choosing an optimal preoperative gentamicin dose for IPP surgery. Strengths and Limitations This is the first study to report on the usage of high-dose preoperative gentamicin for IPP surgery but with limitations as a retrospective study. Conclusions Although not achieving a statistical difference, there was a trend for patients receiving a higher dose of preoperative gentamicin to have a lower IPP infection rate. No toxicity was encountered from the 5-mg/kg gentamicin dose. We recommend following prophylactic high-dose gentamicin guidelines. Xie D, Gheiler V, Lopez I, et al. Experience With Prophylactic Gentamicin During Penile Prosthesis Surgery: A Retrospective Comparison of Two Different Doses. J Sex Med 2017;14:1160–1164. [ABSTRACT FROM AUTHOR]

Objective: To evaluate perinatal outcomes and congenital heart defect (CHD) prognosis in a non-selected population. Methods: The population-based surveillance data used in this assessment of CHDs were based on birth defect surveillance data collected from 2010–2012 in Liuyang City, China. Infants living with CHDs were followed up for 5 years to determine their prognosis. Prevalence, prenatal diagnosis, perinatal outcomes, and total and type-specific prognosis data were assessed using SPSS 18.0. Results: In total, 190 CHD cases were identified among the 53313 included perinatal infants (PIs), indicating a CHD prevalence of 35.64 per 10000 PIs in this non-selected population. The five most frequently identified types of CHDs were ventricular septal defects (VSDs, 38.95%), atrial septal defects (ASDs, 15.79%), cardiomegaly (7.89%), tetralogy of Fallot (TOF, 5.79%), and atrioventricular septal defects (AVSDs, 5.26%). Of the 190 CHD cases, 110 (57.89%) were diagnosed prenatally, 30 (15.79%) were diagnosed with associated malformations, and 69 (36.32%) resulted in termination of pregnancy (TOP). Moreover, 15 (7.89%) PIs died within 7 days after delivery, and 42 (22.10%) died within 1 year. In contrast, 79 (41.58%) were still alive after 5 years. When TOP cases were included, the 5-year survival rate of PIs with prenatally detected CHDs was lower than that of PIs with postnatally detected CHDs (25.45% vs. 63.75%). The CHD subtype associated with the highest rate of infant (less than 1 year old) mortality was transposition of the great arteries (100%). The subtypes associated with higher 5-year survival rates were patent ductus arteriosus (80%), ASD (63.33%), VSD (52.70%) and AVSD (50%). Conclusions: The rates of prenatal CHD detection and TOP were high in this study population, and the 5-year survival rate of PIs with CHDs was low. The government should strengthen efforts to educate pediatricians regarding this issue and provide financial assistance to improve the prognosis of infants living with CHDs, especially during the first year of life. [ABSTRACT FROM AUTHOR]

Single crystals of UFe 0.6 Sb 2 grown by Sb flux method have been investigated by means of X-ray diffraction, magnetic susceptibility, electrical resistivity and specific heat. UFe 0.6 Sb 2 crystallizes in the tetragonal HfCuSi 2 -type structure (space group P4/nmm). UFe 0.6 Sb 2 undergoes a ferromagnetic transition at T C = 28 K with an easy axis along the c-axis. The resistivity resembles heavy fermion semiconducting-like behavior and implies three pseudogaps are formed in both directions. One pseudogap formed in the range of 9–30 K originates from states of impurity due to the partial occupancies of the Fe sites, and it can be closed by applying high magnetic field. The magnetic field, however, has little effects on the other two pseudogaps. A large electronic specific heat coefficient γ = 233 mJ/mol·K 2 reveals this compound is a strong electron correlation material. [ABSTRACT FROM AUTHOR]

Objective: To describe the epidemiology of birth defects (BDs) in perinatal infants in Hunan Province, China, between 2005 and 2014. Methods: The BD surveillance data of perinatal infants (for stillbirth, dead fetus or live birth between 28 weeks of gestation and 7 days after birth) were collected from 52 registered hospitals of Hunan between 2005 and 2014. The prevalence rates of BDs with 95% confidence interval (CI) and crude odds ratio (ORs) were calculated to examine the associations of infant gender, maternal age, and region (urban vs rural) with BDs. Results: From 2005 to 2014, there were a total of 925413 perinatal infants of which 17753 had BDs, with the average prevalence of 191.84 per 10000 PIs (perinatal infants), showing a significant uptrend. The risks of BDs are higher in urban areas versus rural areas (OR = 1.20), in male infants versus female infants (OR = 1.19), and in mothers above age 35 versus those below age 35 (OR = 1.24). The main five types of BDs are Congenital heart defects (CHD), Other malformation of external ear (OMEE), Polydactyly, Congenital malformation of kidney (CMK), and Congenital talipes equinovarus (CTE). From 2005 to 2014, the prevalence rates (per 10000 PIs) of CHD and CMK increased significantly from 22.56 to 74 (OR = 3.29, 95%CI: 2.65–4.11) and from 7.61 to 14.62 (OR = 1.92, 95%CI:1.30–2.84), respectively; the prevalence rates of congenital hydrocephalus and neural tube defects (NTDs) decreased significantly from 11.8 to 5.29 (OR = 0.45, 95%CI: 0.31–0.65) and from 7.87 to 1.74 (OR = 0.22, 95%CI: 0.13–0.38), respectively. Conclusions: The prevalence rates of specific BDs in perinatal infants in Hunan have changed in the last decade. Urban pregnant women, male perinatal infants, and mothers above age 35 present different prevalence rates of BDs. Wider use of new diagnosis technology, improving the ability of monitoring, strengthening the publicity and education are important to reduce the prevalence of BDs. [ABSTRACT FROM AUTHOR]

Purpose: Lower urinary tract symptoms (LUTS) in young men are becoming a more recognized urologic issue that can arise from many causes, each with their own management strategy. The purpose of this study was to determine the rates and types of voiding dysfunction causing LUTS in men under 40 years. Methods: Videourodynamic studies (VUDS) of 87 men 40 years of age or less with LUTS for greater than 6 months, performed between July 2004 and June 2012 at Weill Cornell Medical College, were retrospectively analyzed. Patients with culture-proven bacterial prostatitis, symptoms for less than 6 months, a history of neurologic disease, or previous urological surgery affecting voiding function were excluded from the analysis. Results: The mean age of the patients was 31.84 ± 5.78. There were 37 patients that presented with more than one urinary symptom (42.5 %). The most frequent complaints included: urinary frequency ( N = 42, 48.28 %), difficulty with urination ( N = 41, 47.13 %), and urinary urgency ( N = 21, 24.14 %). The most common urodynamic abnormality was bladder outlet obstruction (BOO) ( N = 37, 42.53 %), dysfunctional voiding ( N = 25, 28.74 %), detrusor underactivity ( N = 10, 11.49 %), and detrusor overactivity ( N = 7, 8.05 %). There were no differences seen in AUA symptom and quality of life scores across diagnosis groups. Conclusions: Lower urinary tract symptoms can present in younger men with a variety of types of voiding dysfunction. This study uses VUDS to show that the most common types of voiding dysfunction in this population with chronic LUTS are BOO followed by dysfunctional voiding. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether diet-induced diabetes mellitus (DM) in mice would reproduce the major features of human erectile dysfunction (ED) because DM is a significant risk factor in the development of ED.Methods: In total, 150 C57BL6 (bl6) mice were divided into six groups of 25 mice each. Of these 150 mice, 125 were fed a high-fat (45% of total calories) diet for the final 4 (group 2), 8 (group 3), 12 (group 4), 16 (group 5), or 22 (group 6) weeks. Group 1 was fed a normal diet. The mice were 22 to 25 weeks old at study termination. The corporal tissues were harvested and studied for endothelium-dependent and endothelium-independent vasoreactivity, endothelial and smooth muscle cell content by immunohistochemistry, nitric oxide synthase expression by nicotinamide adenine dinucleotide-diaphorase staining, and apoptosis by terminal deoxynucleotidyl transferase biotin-D-UTP nick-end labeling staining.Results: The blood glucose levels were greater in groups 2 to 6 compared with those in group 1. The vasoreactivity, endothelial cell content, and smooth muscle/collagen ratio were lower and apoptosis were greater in the DM mice (P = 0.0001, P = 0.10, P = 0.0002, P <0.001, and P <0.001, respectively). Significantly decreased nitric oxide synthase expression and significantly increased apoptosis (P <0.0001 each) was found in the high-fat diet mice.Conclusions: Corporal tissue from mice with diet-induced DM demonstrated many of the major functional, structural, and biochemical changes found in humans with ED. This model should serve as a valuable tool for advancing our understanding of the role DM plays in the pathogenesis of ED. [ABSTRACT FROM AUTHOR]

• Hot Isostatic Pressing bonding is performed on W/316L joints using Cu interlayer. • Neither intermetallic compounds nor brittle phases form at the interfaces. • The average tensile strength of W/316L joint is as high as 480 MPa. • Mechanical properties are improved by Cu interlayer solid solution strengthening. The microstructure and mechanical properties of W and steel joints with a Cu interlayer, bonded by hot isostatic pressing (HIP) diffusion under 1050 °C for 0.5–2 h with 150 MPa, were investigated. The results show that a reliable bonding between W and steel could be obtained by HIP using Cu interlayer. Metallographic analysis revealed excellent bonding at all of the joining interfaces through elements inter-diffusion across the W/Cu, Cu/steel interface. Neither intermetallic compounds nor other brittle phases occurred in the bonded region. The diffusion layer thickness across the W/Cu, Cu/steel interface and tensile strength increased with increasing holding time. The tensile strength of the joints was as high as 480 MPa. The surface fracture analyses revealed a plastic fracture occurred in the middle of Cu interlayer far apart from diffusion zone. The hardness distribution across the joining interfaces demonstrated W/Cu, Cu/steel interfaces could be enhanced by solid solution hardening. Soft Cu interlayer could effectively reduce residual stress and improve the mechanical properties through solid solution strengthening of diffusion zone at interface. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence and epidemiology of congenital polydactyly and syndactyly in Hunan Province, China, 2016–2020. Methods: Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. Prevalence of birth defects (polydactyly or syndactyly) is the number of cases per 1000 births (unit: ‰). Prevalence and 95% confidence intervals (CI) were calculated by the log-binomial method. Chi-square trend tests (χ2trend) were used to determine trends in prevalence by year. Crude odds ratios (ORs) were calculated to examine the association of each demographic characteristic with polydactyly and syndactyly. Results: Our study included 847,755 births, and 14,459 birth defects were identified, including 1,888 polydactyly and 626 syndactyly cases, accounting for 13.06% and 4.33% of birth defects, respectively. The prevalences of total birth defects, polydactyly, and syndactyly were 17.06‰ (95%CI: 16.78–17.33), 2.23‰ (95%CI: 2.13–2.33), and 0.74‰ (95%CI: 0.68–0.80), respectively. Most polydactyly (96.77%) and syndactyly (95.69%) were diagnosed postnatally (within 7 days). From 2016 to 2020, the prevalences of polydactyly were 1.94‰, 2.07‰, 2.20‰, 2.54‰, and 2.48‰, respectively, showing an upward trend (χ2trend = 19.48, P < 0.01); The prevalences of syndactyly were 0.62‰, 0.66‰, 0.77‰, 0.81‰, and 0.89‰, respectively, showing an upward trend (χ2trend = 10.81, P = 0.03). Hand polydactyly (2.26‰ vs. 1.33‰, OR = 1.69, 95%CI: 1.52–1.87) and hand syndactyly (0.43‰ vs. 0.28‰, OR = 1.42, 95%CI: 1.14–1.76) were more common in males than females. Polydactyly (2.67‰ vs. 1.93‰, OR = 1.38, 95%CI: 1.26–1.51) and syndactyly (0.91‰ vs. 0.62‰, OR = 1.47, 95%CI: 1.26–1.72) were more common in urban areas than in rural areas. Compared to maternal age 25–29, hand polydactyly was more common in maternal age < 20 (2.48‰ vs. 1.74‰, OR = 1.43, 95%CI: 1.01–2.02) or ≥ 35 (2.25‰ vs. 1.74‰, OR = 1.30, 95%CI: 1.12–1.50). Conclusion: In summary, we have described the prevalence and epidemiology of polydactyly and syndactyly from hospital-based surveillance in Hunan Province, China, 2016–2020. Our findings make some original contributions to the field, which may be valuable for future research. [ABSTRACT FROM AUTHOR]

To define the relationship between sex, residence, maternal age, and a broad range of birth defects by conducting a comprehensive cross-analysis based on up-to-date data. Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010–2020. Prevalences of birth defects (number of cases per 10,000 fetuses (births and deaths at 28 weeks of gestation and beyond)) with 95% confidence intervals (CI) were calculated by sex, residence, maternal age, year, and 23 specific defects. Cross-analysis of sex, residence, and maternal age was conducted, and crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with birth defects. A total of 1,619,376 fetuses and 30,596 birth defects were identified. The prevalence of birth defects was 188.94/10,000 (95% CI 186.82–191.05). Birth defects were more frequent in males than females (210.46 vs. 163.03/10,000, OR = 1.30, 95% CI 1.27–1.33), in urban areas than in rural areas (223.61 vs. 162.90/10,000, OR = 1.38, 95% CI 1.35–1.41), and in mothers ≥ 35 than mothers 25–29 (206.35 vs. 187.79/10,000, OR = 1.10, 95% CI 1.06–1.14). Cross-analysis showed that the prevalence of birth defects was higher in urban females than in rural males (194.53 vs. 182.25/10,000), the difference in prevalence between males and females was more significant for maternal age < 20 compared to other age groups (OR = 1.64, 95% CI 1.37–1.95), and the prevalence difference between urban and rural areas is more significant for maternal age 25–34 compared to other age groups (OR = 1.49, 95% CI 1.43–1.57). Cleft palates were more frequent in males, and nine specific defects were more frequent in females. Five specific defects were more frequent in rural areas, and eight were more frequent in urban areas. Compared to mothers 25–29, five specific defects were more frequent in mothers < 20, seven specific defects were more frequent in mothers 20–24, two specific defects were more frequent in mothers 30–34, and ten specific defects were more frequent in mothers ≥ 35. Our data indicate that sex, residence, and maternal age differences in the prevalences of birth defects and most specific defects are common. We have found some new epidemiological characteristics of birth defects using cross-analysis, such as residence is the determining factor for the prevalence of birth defects, the difference in prevalence between males and females was more significant for maternal age < 20 compared to other age groups, the prevalence difference between urban and rural areas is more significant for maternal age 25–34 compared to other age groups. And differences in the epidemiological characteristics of some specific defects from previous studies. Future studies should examine mechanisms. Our findings contributed to clinical counseling and advancing research on the risk factors for birth defects. [ABSTRACT FROM AUTHOR]

Heavy metal contamination has been demonstrated to possess the severe threats toward the whole ecosystems and public security even at trace levels. Therefore, it is essential to exploit an ultrasensitive technique to determine the levels of heavy metal ions. In this work, hierarchical MgFe-layered double hydroxide (MgFe-LDH) microspheres have been successfully immobilized on the graphene nanosheets surface via a facile one-step hydrothermal route. Benefiting from the synergistic effects associated with high specific surface area, strong affinity of hierarchical MgFe-LDH architecture toward heavy metal ions, good electrical conductivity and effective electron transfer efficiency of graphene, the resulting composite (denoted as MgFe-LDH/graphene) is explored as an electrochemical sensor for simultaneous detection of Pb(II) and Cd(II) in aqueous medium. As a consequence, MgFe-LDH/graphene modified electrode exhibits low detection limit of 5.9 nM for Cd(II) and 2.7 nM for Pb(II), which are dramatically lower than the respective values of 3 ppb (27 nM) and 10 ppb (48 nM) in domestic water permitted by the World Health Organization (WHO). Meaningfully, the proposed electrochemical sensor shows specific recognition capability to Pb(II) and Cd(II), excellent reproducibility in repetitive measurements as well as feasibility in real water analysis. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the epidemiological characteristics of cleft lip and/or palate (CL/P) and CL/P-related perinatal deaths, provide some information for intervention programs to reduce the incidence of CL/P and provide clues for future researchers. Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. Incidences of CL/P [number of cases per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond)] with 95% confidence intervals (CI) were calculated by residence, gender, maternal age, year, and major types [cleft lip only (CL), cleft palate only (CP), and cleft lip with palate (CLP)]. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with CL/P. Pearson chi-square tests (χ2) were used to examine the association of each maternal characteristic with CL/P-related perinatal deaths. A total of 847,755 fetuses were registered, and 14,459 birth defects were identified, including 685 CL/P (accounted for 4.74% of all birth defects). CL, CP, and CLP accounted for 24.67% (169 cases), 36.79% (252 cases), and 38.54% (264 cases) of all CL/P, respectively. The incidence of CL/P was 0.81‰ (95%CI 0.75–0.87). The incidence of CL was 0.20‰ (95%CI 0.17–0.23) (169 cases), of CP was 0.30‰ (95%CI 0.26–0.33) (252 cases), and of CLP was 0.31‰ (95%CI 0.27–0.35) (264 cases). CL was more common in males than females (0.24‰ vs. 0.15‰, OR = 1.62, 95%CI 1.18–2.22). CP was more common in urban than rural (0.36‰ vs. 0.25‰, OR = 1.43, 95%CI 1.12–1.83), and less common in males than females (0.22‰ vs. 0.38‰, OR = 0.59, 95%CI 0.46–0.75). CLP was more common in males than females (0.35‰ vs. 0.26‰, OR = 1.36, 95%CI 1.06–1.74). Compared to mothers 25–29 years old, mothers < 20 years old were risk factors for CLP (OR = 3.62, 95%CI 2.07–6.33) and CL/P (OR = 1.80, 95%CI 1.13–2.86), and mothers ≥ 35 years old was a risk factor for CLP (OR = 1.43, 95%CI 1.01–2.02). CL/P-related perinatal deaths accounted for 24.96% (171/685) of all CL/P, of which 90.64% (155/171) were terminations of pregnancy. Rural residents, low income, low maternal age, and early prenatal diagnosis are risk factors for perinatal death. In conclusion, we found that CP was more common in urban areas and females, CL and CLP were more common in males, and CL/P was more common in mothers < 20 or ≥ 35 years old. In addition, most CL/P-related perinatal deaths were terminations of pregnancy. CL/P-related perinatal deaths were more common in rural areas, and the proportion of CL/P-related perinatal deaths decreased with the increase in maternal age, parity, and per-capita annual income. Several mechanisms have been proposed to explain these phenomena. Our study is the first systematic research on CL/P and CL/P-related perinatal deaths based on birth defects surveillance. It is significant for intervention programs to prevent CL/P and CL/P-related perinatal deaths. As well, more epidemiological characteristics of CL/P (such as the location of CL/P) and approaches to reduce CL/P-related perinatal deaths need to be studied in the future. [ABSTRACT FROM AUTHOR]

Presents a correction to the article "Cholesterol Feeding Reduces Vascular Endothelial Growth Factor Signaling in Rabbit Corporal Tissues," that was previously published in the 2005 issue of "The Journal of Sexual Medicine."

Objectives: At present, there is no report on the application of Guy's stone (GS) score in minimally invasive percutaneous nephrolithotomy (MPCNL). We therefore investigate the clinical effect of MPCNL by using a patented irrigation and clearance system according to the GS. Methods: A total of 222 consecutive patients were divided into 2 groups that were treated with MPCNL using the patented system or standard PCNL using Electro Medical System (EMS) ultrasound/ ballistic trajectory lithotripsy and clearance system, respectively (124 patients in patented system group, 98 patients in EMS system group). The stone complexity and severity of complications were stratified by GS and Modified Clavien grading system in this study, respectively. The success and complication rates between MPCNL and PCNL were compared. Results: The patented system group had a significantly higher success rate (GS3: 95 vs. 43% and GS4: 67 vs. 31%) and a significantly less complications rate (GS3: 12 vs. 27% and GS4: 21 vs. 46%) in GS3 and GS4 compared with the EMS system group. Also, the patented system had significant lower complication rates in Clavien grades II-IV than that of the EMS system. Conclusion: The MPCNL using the patented irrigation and clearance system was more efficient in dealing with renal stones of high complexity (GS3-4). [ABSTRACT FROM AUTHOR]

Introduction: In order to better control renal pelvic pressure (RPP), reduce surgical complications and increase operative efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL), we designed an MPCNL with intelligent monitoring and control of RPP and sought to explore its clinical efficacy and characteristics. Subject and Methods: This study included 60 patients with renal staghorn calculi. A 5F ureteral catheter was connected to an invasive blood pressure monitor for monitoring and control of RPP. A 12F renoscope was inserted through a percutaneous tract for lithotripsy using a laser, with the help of an intelligent system to monitor RPP continuously, which includes an irrigation and suctioning platform and an integrated intraluminal pressure sensory PCNL suctioning sheath. Before the lithotripsy, intraluminal pressure control value and perfusion flow were set on the platform. Results: RPP was maintained at a range of -12 to 2 mm Hg. The mean operative time was 120 min. The mean intraoperative bleeding amount was 100 ml. Fifty-two of the 60 patients the stones were cleared by one surgery. Conclusions: In our suctioning MPCNL with the intelligent control of RPP, the intraoperative RPP could be accurately controlled within the preset safety range. The stone clearance rate was high. [ABSTRACT FROM AUTHOR]

Background: Existing evidence highlights that exposure to secondhand smoke (SHS) is a risk factor for pregnant women's health and is possibly affected by individual characteristics. This study aimed to explore the effect of individual socioeconomic status (SES) on SHS exposure among pregnant women in the third trimester and the interaction effect of age.Methods: A total of 678 nonsmoking pregnant women with a median age of 29.0 years from 14 communities in a medium-sized city were recruited for this survey. Exposure to SHS was defined as the self-reported smoking habit of a spouse/partner. Individual SES characteristics consisted of marital status, educational attainment, employment and per capita monthly income.Results: There were 238 (35.1%) participants who suffered from SHS exposure. Compared to the pregnant women who were employed, those who were unemployed were more likely to suffer from SHS exposure (OR = 1.572, 95% CI: 1.013-2.441). Participants who had a high school or technical secondary school education were more likely to be exposed to SHS than those with a college education or above (OR = 1.601, 95% CI: 1.029-2.449). Advanced age was a protective factor for participants with a college education or above (OR = 0.939, 95% CI: 0.884-0.997), but age increased the risk of SHS exposure among women who had unstable marriages (OR = 1.256, 95% CI: 1.019-1.549).Conclusion: Exposure to SHS was very common among pregnant women in the third trimester. Pregnant women with a low SES and an older age should be considered a key population for the implementation of public health interventions. [ABSTRACT FROM AUTHOR]

This work comprehensively investigated how the characteristics of boron (B) precursors affect the catalytic activity of microscale zero-valent iron (mZVI) towards peracetic acid (PAA) activation for micropollutant degradation. Three boron precursors were introduced into mZVI by ball milling with their physical-chemical properties carefully characterized, and their ability to activate PAA comprehensively evaluated via sulfamethoxazole (SMX) oxidation efficiency. It's found that B 2 O 3 -ZVI demonstrated the highest capability to activate PAA for SMX degradation, with k obs 2 ∼ 3 times higher than Na 2 B 4 O 7 -ZVI and H 3 BO 3 -ZVI. Specially, B precursors regulate the ability of mZVI to activate PAA via the following two aspects: (1) affecting the formation and content of FeB to accelerate Fe(II) regeneration; (2) increasing the hydrophilicity of the iron particles and the affinity of B-ZVI for binding PAA to different extent. This study highlights the important role of boron precursors in tuning engineered mZVI to initiate Fenton-like process for water purification. [Display omitted] ● Three B-ZVIs effectively activate PAA with successful detoxification and boosted removal of SMX. ● SMX removal depends on the primary contribution of HO• and limited involvement of RO•. ● B 2 O 3 -ZVI has the highest ability to activate PAA for SMX removal with good application potential. ● B precursors affect the formation of FeB on B-ZVI to accelerate Fe(II) regeneration. ● B precursors vary the hydrophilicity of B-ZVI and their affinity for binding PAA. [ABSTRACT FROM AUTHOR]

Objective: To determine an efficient method for treating upper ureteral impacted stones, we compared the outcome of minimally invasive percutaneous nephrolithotomy with the aid of our patented system and transurethral ureteroscopy. Materials and Methods: A total of 182 patients with complicated impacted upper ureteral stones above the level of L4 were randomly divided into 2 groups. Group 1 included 91 patients who were treated with minimally invasive percutaneous nephrolithotomy with the aid of a patented system. Group 2 included 91 patients who were treated with ureteroscopy. The patients underwent postoperative shock wave lithotripsy, when necessary. The operative time, stone clearance rate, operative complication markers (amount of intraoperative bleeding and postoperative fever rate), and cost of treatment were compared. Results: A significantly shorter operative time, greater rate of stone clearance, lower need for postoperative shock wave lithotripsy, and lower rate of postoperative fever was found in group 1 than in group 2 (P <.05). However, the cost of treatment and amount of intraoperative bleeding were significantly greater. Conclusion: We believe minimally invasive percutaneous nephrolithotomy with the aid of the patented system could be the first choice in treating complicated impacted upper ureteral stones above the level of L4. [ABSTRACT FROM AUTHOR]

Objectives. To compare the differences of epidemiology analysis in population birth defects (BDs) between the rural and urban areas of Hunan Province in China. Methods. The data of population-based BDs in Liuyang county (rural) and Shifeng district (urban) in Hunan Province for 2014–2018 were analyzed. BD prevalence rates, percentage change, and annual percentage change (APC) by sex and age were calculated to evaluate time trends. Risk factors associated with BDs were assessed using simple and multiple logistic regression analyses. Results. The BD prevalence rate per 10,000 perinatal infants (PIs) was 220.54 (95% CI: 211.26-230.13) in Liuyang and 181.14 (95% CI: 161.18-202.87) in Shifeng. Significant decreasing trends in BD prevalence rates were noted in the female PIs (APC = − 9.31 , P = 0.044) and the total BD prevalence rate in Shifeng (APC = − 14.14 , P = 0.039). Risk factors for BDs were as follows: rural area, male PIs, PIs with gestational age < 37 weeks, PIs with birth weight < 2500 g , and migrant pregnancies. Conclusions. We should focus on rural areas, reduce the prevalence of premature and low birth weight infants, and provide maternal healthcare services for migrant pregnancies for BD prevention from the perspective of population-based BD surveillance. [ABSTRACT FROM AUTHOR]

• A new picture for the coexistence of FM & SC in UGe 2 is established, in terms of the two-fluid model. • The collective spin-flop behavior of itinerant quasiparticles. • A sudden delocalization of part of 5f electrons near 1.2 GPa for the appearance of SC. The microscopic origin of heavy fermions is a central concept in correlated matter where the hybridization between localized spins and conduction electrons gives rise to exotic itinerant quasiparticles with enhanced effective masses. Although the two-fluid model provides a phenomenological description, the coexistence of localized and itinerant characters remains highly debated. Here we report the coexisting two fluids in a prime ferromagnet, UGe 2 , in which an unconventional superconductivity occurs in a limited pressure range. Except for localized moments, itinerant quasiparticles give an additional magnetic moment, resulting in a first-order-like transition with increasing magnetic field at high pressures. Our findings suggest a collective spin-flip behavior of itinerant quasiparticles, instead of the previously reported metamagnetic transition. Moreover, we record the pressure evolution of the two fluids, revealing a sudden delocalization of part of 5f electrons at P X ≈ 1.2 GPa. The valence instability with strong fluctuations sheds new light on the appearance of superconductivity adjoining ferromagnetism. [ABSTRACT FROM AUTHOR]

Background. This facility-based study analyzed the epidemiology and incidence of maternal near miss (MNM) and mortality by hospital level as part of Hunan Province's efforts to raise the quality of hospital care for women. Methods. We used data for MNM and mortality cases for 2012–2018 from 17 hospitals (12 resource-poor facilities, five resource-rich facilities) that receive referrals for obstetric complications in Hunan Province. Data were drawn from China's National Maternal Near Miss Surveillance System and collected using the World Health Organization near miss tool. We calculated the ratio of severe maternal outcomes (SMO) (i.e., MNM and maternal death (MD) cases), mortality index (MI), and MNM to mortality ratio (MNM : MD), and epidemiological factors, organ dysfunction, and maternal complications stratified by hospital level. The chi-square tests to examine differences between groups and total ratios and 95% CI were calculated. Results. There were 518 SMO cases (489 MNM and 29 MD) among 279407 live births (LBs) and 1299 SMO cases (1262 MNM and 37 MD) among 232386 LBs in resource-poor and resource-rich facilities. The total MNM ratio in resource-poor and resource-rich hospitals was 1.75 (95% CI: 1.60–1.91) and 5.43 (95% CI: 5.14–5.74) per 1000 LBs, respectively. There were differences in SMO cases between resource-poor and resource-rich hospitals in maternal age, education, parity, antenatal visits, and history of cesarean sections. In MNM cases, coagulation dysfunction was the main organ dysfunction (resource-poor hospitals: 59.10%; resource-rich hospitals: 79.32%), and the main maternal complications were obstetric hemorrhage (resource-poor hospitals: 71.98%) and hepatopathy (resource-rich hospitals: 69.49%). For MD cases, the main maternal complications were neurologic dysfunction (resource-poor hospitals: 41.38%) and coagulation dysfunction (resource-rich hospitals: 42.55%). Anemia was the main maternal complication for SMO cases in both resource-poor (69.69%) and resource-rich (68.59%) hospitals. Conclusions. MNM and MD are higher in resource-rich hospitals compared with resource-poor hospitals. The obstetric emergency capacity of resource-rich hospitals is higher than that of resource-poor hospitals. Future government policies should consider upgrading the obstetric emergency treatment capacity in resource-poor hospitals or to redistinguish the social functions of different medical institutions. [ABSTRACT FROM AUTHOR]

To prevent mother-to-child transmission (MTCT) of syphilis, Hunan Province launched a free syphilis screening and treatment programme in 2011. Thus far, the programme has been implemented for 6 years. This study aimed to assess progress toward the elimination of MTCT of syphilis in Hunan Province from 2011–2016. Estimates of syphilis-related adverse pregnancy outcomes (APOs) were based on the health service delivery model developed by the WHO, which were then translated into disability-adjusted life years (DALYs). Default values in the model were replaced by a Chinese version. The progress of this programme was assessed through the reduction of estimated DALYs with and without screening and treatment services. The results showed that the estimated number of syphilis-related APOs in Hunan Province from 2011 to 2016 was 3,840, more than 70% of which occurred among women who had at least one antenatal care visit but were not screened or treated for syphilis during pregnancy. The public health burden resulting from maternal syphilis-related APOs was 192,528 DALYs over six years, and with the current screening and treatment coverage, approximately 163,794 expected DALYs (46%) were averted. Our estimates indicate that in Hunan Province, syphilis in pregnancy continues to be an important cause of APOs, which can lead to substantial perinatal morbidity and mortality. Approximately half of the expected public health burden resulting from syphilis-related APOs was averted by the current screening and treatment services, which suggests progress toward the elimination of MTCT of syphilis in Hunan Province. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application of intelligent pressure control devices (medical irrigation and suctioning platform with pressure feedback function, and suctioning ureteral access sheath with pressure-measuring function) in flexible ureteroscopy for monitoring and control of renal pelvic pressure.Materials and Methods: Nine pigs with a total of 18 kidneys were randomly divided into 3 groups according to varied renal perfusion flow rates: group A, 50 mL/min; group B, 100 mL/min; and group C, 150 mL/min. A ureteral catheter connected to an invasive blood pressure monitor was retrogradely placed to the upper renal calyx to measure upper calyceal pressure; the suctioning sheath was connected to a 3-channel tubing and was connected to an invasive blood pressure monitor; and the platform and renal pelvic outlet pressure was measured. Perfusion flow, intraluminal pressure control, and warning values were preset on the platform. A flexible ureteroscope was inserted into the upper, mid, and lower renal calyces, and to the front end of the sheath, respectively, each location was irrigated for 5 minutes, and pressure was measured every second.Results: No statistical significance was found between monitor renal pelvic outlet pressure and platform renal pelvic outlet pressure for each group, or between platform renal pelvic outlet pressure and upper renal caliceal pressure for each group at different locations when varied irrigation flow rates were used, or among groups for platform renal pelvic outlet pressure at various irrigation flow rates.Conclusion: The intelligent devices used in the flexible ureteroscopy can reliably and stably monitor and control the renal pelvic pressure within a safety range. [ABSTRACT FROM AUTHOR]

We report on the facile, reliable fabrication of novel magnetic cucurbit[6]uril/graphene oxide (CB[6]/GO/Fe 3 O 4 ) composite by using an in-situ co-precipitation method, for which the formation process and possible formation mechanism were also investigated. Moreover, the composite was used as an adsorbent for the removal of uranium(VI) from aqueous solution. Herein, GO nanosheets were chosen as a substrate to immobilize CB[6] and Fe 3 O 4 . During the co-precipitation of Fe 3 O 4 nanoparticles on surface of GO nanosheets, CB[6] molecules was fixed through hydrogen bonding simultaneously. The as-prepared composite exhibited a high efficiency of magnetic separability, competitive adsorption performance and acceptable reusability and stability for U(VI) removal, indicating a potential application in uranium-bearing wastewater treatment. [ABSTRACT FROM AUTHOR]

Highlights: [•] The surface morphology of U/Si (111) with different annealing temperature is given. [•] A new phase of USi1.67 was found when annealing the sample at 870K. [•] A new superstructure is found for U–Si system. [•] Electronic structure of U–Si system is studied by UPS. [Copyright &y& Elsevier]

Objective: To determine an efficient method for treating upper ureteral impacted stones, we compared the outcome of minimally invasive percutaneous nephrolithotomy with the aid of our patented system and transurethral ureteroscopy. Materials and Methods: A total of 182 patients with complicated impacted upper ureteral stones above the level of L4 were randomly divided into 2 groups. Group 1 included 91 patients who were treated with minimally invasive percutaneous nephrolithotomy with the aid of a patented system. Group 2 included 91 patients who were treated with ureteroscopy. The patients underwent postoperative shock wave lithotripsy, when necessary. The operative time, stone clearance rate, operative complication markers (amount of intraoperative bleeding and postoperative fever rate), and cost of treatment were compared. Results: A significantly shorter operative time, greater rate of stone clearance, lower need for postoperative shock wave lithotripsy, and lower rate of postoperative fever was found in group 1 than in group 2 (P <.05). However, the cost of treatment and amount of intraoperative bleeding were significantly greater. Conclusion: We believe minimally invasive percutaneous nephrolithotomy with the aid of the patented system could be the first choice in treating complicated impacted upper ureteral stones above the level of L4. [ABSTRACT FROM AUTHOR]

Objective: To assess preoperative parameters that may be predictive of pathologic stage T2a disease in low-risk prostate cancer patients. Methods: Data from a cohort of 1,495 consecutive men with low-risk prostate cancer who underwent a radical prostatectomy between 1993 and 2009 were evaluated. Preoperative parameter assessment focused on age, race, clinical stage, diagnostic PSA level, biopsy tumor laterality and diagnostic Gleason score. Preoperative parameters were analyzed by univariate and multivariate methods. Kaplan-Meier method was used to evaluate the biochemical disease-free survival. Results: Among the 1,495 men, 236 (15.8%) had pT2a disease. In univariate analysis, biopsy tumor unilaterality (p < 0.001), diagnostic PSA ≤4 ng/ml (p < 0.001) and non-African-American race (p = 0.009) were significant variables. In multivariate analysis, biopsy tumor laterality (OR 0.377; p < 0.001), diagnostic PSA ≤4 ng/ml (OR 0.621; p = 0.002) and race (OR 0.583; p = 0.029) were independent predictors. Low-risk patients with pT2a disease showed a better PSA recurrence-free survival rate, compared with men with >pT2a diseases (p = 0.012). Conclusions: Biopsy tumor unilaterality, diagnostic PSA ≤4 ng/ml and race are independent predictors of pT2a in low-risk prostate cancer. These three preclinical variables may be a useful reference to begin the selection process for focal therapy in men with low-risk prostate cancer. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

AbstractPurpose:To investigate the clinical effect of minimally invasive percutaneous nephrolithotomy (MPCNL) using a patented irrigation and clearance system.Patients and Methods:From August 2008 to August 2009, 60 patients with renal stones ≥2.0 cm were randomly assigned to two groups. Group 1 included 30 patients who were treated by MPCNL through a patented 16F sheath with the aid of a patented irrigation and clearance system combined with a high power holmium laser. Group 2 included 30 patients who were treated by a third generation EMS ultrasound/ballistic trajectory lithotripsy and clearance system through a standard 24F sheath. The differences in (1) average time needed for stone clearance; (2) percentage of cases in which one surgery resulted in freedom from stones; (3) mean renal pelvic pressure; and (4) mean amount of intraoperative bleeding were compared.Results:Compared with the EMS ballistic trajectory/ultrasound lithotripsy and clearance system, the MPCNL irrigation and clearance system had a significantly higher percentage of stone-free outcomes after one surgery and a lower amount of introperative bleeding (P<0.05). There was no difference in mean stone-clearance time and mean renal pelvic pressure (P>0.05). When comparing the cases with one percutaneous tract in the patented system group with the cases with one percutaneous tract in the EMS system group, the findings were similar.Conclusion:The patented MPCNL irrigation and clearance system is safe and highly efficient in managing renal stones. [ABSTRACT FROM AUTHOR]

Abstract: A simple and fast method for the simultaneous analysis of thiobencarb, deltamethrin and 19 organochlorine pesticide residues in fish by gas chromatography–mass spectrometry was investigated in this study. Samples are extracted with acetonitrile. Most of lipids in the extract are eliminated by low-temperature cleanup, prior to solid-phase extraction cleanup. The lipids extracted from the fish samples were easily removed without any significant losses of the pesticides. Aminopropyl (NH2) cartridge was effective to eliminate the remaining interference. Spiked experiments were carried out to determine the recovery, precision and limits of detection (LODs) of the method. The method detection limits ranged from 0.5μgkg−1 to 20μgkg−1, whilst recoveries of the pesticides were in the range of 81.3–113.7% with relative standard deviations ⩽13.5% at a spiked concentration of 0.05mgkg−1, 0.02mgkg−1 and 0.1mgkg−1. The newly developed method is demonstrated to give efficient recoveries and LODs for detecting pesticide multiresidues in fish. [Copyright &y& Elsevier]

Abstract: We describe a case of successful vegetectomy of the aortic valves for early infective endocarditis. An aortic vegetectomy was performed as an alternative to valve replacement for a 54-year-old man with three vegetations and mild regurgitation in aortic valve due to infective endocarditis. Postoperative clinical course was without signs of recurrent infection after follow-up of 19 months, and transesophageal echocardiography demonstrated aortic valve competence. We would suggest that vegetectomy with valve sparing may be a viable option in the context of early infective endocarditis involved aortic valve in selected patients. [Copyright &y& Elsevier]

• The present study identified gender-related metabolic disturbances in patients with ASD. • The sex differences in metabolite levels may be associated with the implication of sex hormone. • The creatinine:creatine ratio may be a potential predictor of ASD in female subjects. Autism spectrum disorders (ASD) are a highly heterogeneous group of neurodevelopmental disorders that are more commonly diagnosed in boys than in girls. The reasons for gender differences in ASD are unknown and no definitive current evidence can explain male predominance. Therefore, in search for laboratory biomarkers responsible for ASD, a comprehensive metabolomics study was performed by metabolic profiling of urine samples in 51 ASD subjects and 51 age- and sex-matched children with typical development. Orthogonal partial least-squares discriminant analysis (OPLS-DA) models with poor quality failed to perform the analysis based on gender in the ASD and control groups. OPLS-DA models based on single-sex samples, especially in female subjects, had better clustering between the ASD and control groups with an increase in the R2 and Q2 values compared with those in the whole group. Significantly increased levels of adenine, 2-Methylguanosine, creatinine, and 7alpha-hydroxytestololactone and a decrease in creatine were observed in the female ASD subjects. In particular, 7alpha-hydroxytestololactone, which has a structure similar to that of testolactone, was positively correlated with adenine (Pearson correlation coefficient, r = 0.738, p < 0.01), creatinine (r = 0.826, p < 0.01), and 2-Methylguanosine (r = 0.757, p < 0.01) and negatively correlated with creatine (r=-0.413, p < 0.05). A receiver operating characteristic curve analysis using the creatinine:creatine ratio yielded an area under the curve of 0.913 (95% CI: 0.806–1). These metabolites may be sex-related or sex-sensitive to an extent and can be valuable for identification of the molecular pathways involved in the gender bias in manifestation of ASD. The creatinine:creatine ratio has a potential to be a good predictor of ASD in the female subjects. [ABSTRACT FROM AUTHOR]

Background: Drowning is still the primary cause of death in children under 5 years old, however, little is known about the drowning of Hunan province children. This study identifies the previously unpublished incidence and characteristics of fatal drowning in children of Hunan Province, and provide a basis for formulating strategies for children's survival, development and protection.Methods: Data were collected through sampling with the multistage stratified cluster. The case group included all fatal frowning children under 5 years old in 13 districts between October 2015 and September 2016. The control group was matched 1:1.The epidemic features and influencing factors of fatal drowning were analyzed retrospectively according to descriptive analysis, conditional univariate and multivariate logistic regression analysis.Results: For children aged 0-4 years, the fatal drowning was 16.1/100000 in Hunan Province. Drowning rates were higher for boys than girls. The proportion of rural areas is much higher than that of urban areas. The 1-2 years age-group was the highest of all age groups. Fatal drowning mainly occurred in summer. The three leading drowning locations were pond, ditch and well. Playing close to the water were the leading activities that preceded fatal drowning. Multivariate logistic regression analysis showed that: children with primary caregiver education in high school and above (OR = 0.05) have a lower risk of fatal drowning; children with full-time care (OR = 0.17) have a lower risk; children who received unintentional drowning safety education (OR = 0.23) have a lower risk of fatal drowning. Children who were always swimming or playing near the water in the past 6 months (OR = 3.13) have a higher risk of fatal drowning.Conclusion: The fatal drowning among children under 5 years is the result of the interaction of multiple factors. A significant number of child deaths could have been prevented if parents and other close relatives had been more concerned about the safety of their children. We should develop health education plans for villagers to warn them of the dangers of drowning and preventive measures. [ABSTRACT FROM AUTHOR]