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To investigate whether preoperative skin cleaning of the chin, neck, and chest with chlorhexidine soap could reduce suture contamination by Cutibacterium acnes (C. acnes) in patients undergoing arthroscopic rotator cuff repair.This study included patients who underwent primary arthroscopic rotator cuff repair. Exclusion criteria included age18 years, previous shoulder surgery, history of shoulder infection, and allergy to chlorhexidine. Patients were randomized into three groups. Patients in the control group cleaned their skin with soap and water, as usual. Patients in the shoulder group cleaned their shoulders with chlorhexidine soap 3 days before surgery, whereas patients in the extended shoulder group additionally cleaned their chest, back, neck, and face with chlorhexidine soap. On the day of surgery, skin swab samples were obtained from the shoulder after surgical draping. After rotator cuff repair, sutures were cut from the anchor ends. Both traditional culture methods and polymerase chain reaction (PCR) were used.Ninety patients were enrolled (32 in the control group, 29 in the shoulder group, and 29 in the extended shoulder group) in the present study. The culture-positive rate from the posterior shoulder skin samples in the extended shoulder group (17.2%) was significantly lower than that in the control (40.6%) and shoulder (48.3%) groups (P = 0.036), whereas the culture-positive rates were not different among the three groups in other skin samples as well as the suture samples. The detection rates of C. acnes in suture samples were 12.5%, 13.8%, and 17.2% in the control, shoulder, and extended shoulder groups, respectively (P = 0.603).Extensive skin cleaning to the shoulder region with chlorhexidine helps reduce the shoulder cutaneous bacterial load, but the detection of C. acnes suture contamination in patients undergoing arthroscopic rotator cuff repair remained untouched regardless of the use of chlorhexidine soap in skin cleaning on the preoperative days.

The Global Registry of Acute Coronary Events (GRACE) score is a powerful tool used to predict in-hospital mortality after acute myocardial infarction (AMI) and does not include a glycometabolism-related index. We investigated whether the addition of the stress hyperglycemia ratio (SHR) provides incremental prognostic value in addition to the GRACE score.A retrospective cohort of 613 AMI patients was enrolled in the present analyses. The patients were stratified according to the primary endpoint (in-hospital mortality) and the tertiles of the SHR.During hospitalization, 40 patients reached the primary endpoint, and this was more frequently observed in the patients with a higher SHR. The SHR, but not admission blood glucose (ABG), adjusted for the GRACE score independently predicted in-hospital mortality (odds ratio 2.5861; 95% confidence interval, 1.3910-4.8080; P =0.0027). Adjustment of the GRACE score by the SHR improved the predictive ability for in-hospital death (an increase in the C-statistic value from 0.787 to 0.814; net reclassification improvement, 0.6717, 95% CI 0.3665-0.977, P0.01; integrated discrimination improvement 0.028, 95% CI 0.0066-0.0493, P= 0.01028). The likelihood ratio test showed that the SHR significantly improved the prognostic models including the GRACE score. Adding the SHR to the GRACE score presented a larger net benefit across the range of in-hospital mortality risk compared with the GRACE score alone.The SHR, but not ABG, is an independent predictor of in-hospital mortality after AMI even after adjusting for the GRACE score. The SHR improves the predictability and clinical usefulness of prognostic models containing the GRACE score.

The building sector, including building operations and materials, was responsible for the emission of ∼11.9 gigatons of global energy-related CO

CD44 exerts anti-senescence effects in many disease models. We examined senescence in tendinopathy and the effect of CD44 on senescence-associated secretory phenotypes (SASPs). Senescent markers were determined in human tendinopathic long head of bicep (LHB) and normal hamstring tendons. CD44 gene transfer in rat tendinopathic tenocytes stimulated with interleukin (IL)-1β and a rat Achilles tendinopathy model were performed using lentiviral vectors. Expression levels of p53, p21, and p16 and senescence-associated β-galactosidase (SA-β-gal) activity were positively correlated with the severity of human tendinopathy and were higher in rat and human tendinopathic tenocytes than in normal controls. CD44 overexpressed tenocyte transfectants exhibited reduced levels of IL-6, matrix metalloproteinases (MMPs), cyclooxygenase (COX)-2, p53, p21, p16, SA-β-gal, and phospho-nuclear factor (NF)-κB, whereas their collagen type I alpha 1 (COL1A1) and tenomodulin (tnmd) levels were increased when compared with control transfectants under IL-1β-stimulated conditions. In the animal model, CD44 overexpression lowered the ultrasound and histology scores and expression levels of the senescent and SASP markers COX-2 and phospho-NF-κB. Bromodeoxyuridine (BrdU)- and tnmd-positive cell numbers were increased in the LVCD44-transduced tendinopathic tendons. Senescence is positively correlated with tendinopathic severity, and CD44 overexpression may protect the tendinopathic tendons from SASPs via anti-inflammation and maintenance of extracellular matrix homeostasis.

© Copyright 2022. Sociedad Meteorológica Estadounidense (AMS). Para obtener permiso para reutilizar cualquier parte de este Trabajo, comuníquese con permisos@ametsoc. org . Cualquier uso del material en este Trabajo que se determine como "uso justo" según la Sección 107 de la Ley de derechos de autor de EE. UU. (17 Código de EE. UU. § 107) o que cumpla las condiciones especificadas en la Sección 108 de la Ley de derechos de autor de EE. ) no requiere el permiso de la AMS. La republicación, la reproducción sistemática, la publicación en forma electrónica, como en un sitio web o en una base de datos de búsqueda, u otros usos de este material, excepto los exentos de la declaración anterior, requieren un permiso por escrito o una licencia de la AMS. Todas las publicaciones periódicas y monográficas de AMS están registradas en el Centro de Autorización de Derechos de Autor (https://www.copyright.com ). Se proporcionan detalles adicionales en la declaración de política de derechos de autor de AMS, disponible en el sitio web de AMS ( https://www.ametsoc.org/PUBSCopyrightPolicy ) ., In 2021, both social and economic activities began to return towards the levels preceding the COVID-19 pandemic for some parts of the globe, with others still experiencing restrictions. Meanwhile, the climate has continued to respond to the ongoing increase in greenhouse gases and resulting warming. La Niña, a phenomenon which tends to depress global temperatures while changing rainfall patterns in many regions, prevailed for all but two months of the year. Despite this, 2021 was one of the six-warmest years on record as measured by global mean surface temperature with an anomaly of between +0.21° and +0.28°C above the 1991–2020 climatology., Lake surface water temperatures from satellite data have been generated within the GloboLakes project funded by the UK National Environment Research Council (NE/J023345/2), with extensions funded by the EU Copernicus Climate Change Service (C3S) programme...

The first phase of the Tropospheric Ozone Assessment Report (TOAR-I), an activity of the International Global Atmospheric Chemistry Project (IGAC), provided the first comprehensive view of surface ozone’s global distribution and trends, based on all available surface ozone observations. TOAR-I focused on a present-day period of 2010-2014, and calculated trends for a range of periods, but primarily focused on the most recent years of 2000-2014, plus long-term trends from the 1970s/1980s through 2014. Subsequent studies of ozone trends using data after the TOAR-I cut-off of 2014, have shown a wide range of trends, both positive and negative, at monitoring sites around the world. To keep up with the rapid changes of ozone at urban, rural and remote locations this study provides current world-wide ozone trends using observations through 2021, archived in the newly updated TOAR-II Database of Surface Observations. Focus is placed on two ozone metrics relevant to human health impacts: 1) the annual peak of the 6-month running mean of maximum daily 8-hour average ozone; this metric is used by Global Burden of Disease (GBD) to estimate mortality due to long-term ozone exposure; 2) the number of days per year that exceed 70 ppbv, based on the maximum daily 8-hour average ozone value; this value corresponds to the primary U.S. National Ambient Air Quality Standards for ozone and is relevant to short-term ozone exposure. Global maps will indicate the regions of the world where the potential for ozone impacts on human health are greatest (and least), and will show regions where ozone air quality is either improving or degrading. Despite our effort to use all available surface ozone observations, large data gaps exist across many regions of the world, especially in developing nations, and GBD maps generated by data fusion will be used to identify, and to estimate ozone levels in the data-poor regions.

This work presents a comprehensive regional trend analysis of surface ozone observations across the contiguous United States, using 25 years of data from 62 rural monitoring sites, and based on quantile regression and change point analysis. We highlight that the ozone exceedance events (based on the daily maximum 8-hour average and a threshold of 70 ppb) in recent years (2017-2021) are largely diminished compared to two decades ago (1995-2003) in the eastern US and across much of the western US. Ozone exceedance events in recent years are mainly observed in California during the fire season. Results based on thresholds of 60, 50 and 35 ppb will also be discussed.

With a few exceptions, most of the studies on tropospheric ozone (O3) variability following the restriction measures related to the spread of COVID-19 focused on emissions-prone or urban environments. In this work, we investigated the impact of the pandemic restriction measures on surface O3 at several high-altitude remote and rural sites across North America and Western Europe. O3 monthly anomalies, computed with respect to the baseline period 2000–2019, were calculated for 2020 and 2021, to explore the impact of the economic downturn in 2020 and the economic recovery in 2021. A total of 41 high-altitude sites were analyzed: 5 remote stations in western Europe, 19 rural sites in the western US, 4 sites in the western US downwind of highly polluted areas, 4 sites in the eastern US, plus 9 remote sites across the globe to provide a "global" picture for comparison. In 2020, most of European high-altitude sites showed persistent negative anomalies for spring (March-May, i.e., MAM; average of -1.8 ppb) and summer (June-August, i.e., JJA; -2.7 ppb), except for April (1.8 ppb). The pattern was similar in 2021 (-1.8 ppb for both MAM and JJA), except for June (1.8 ppb). The sites in the western US showed similar behavior, with negative anomalies in 2020 (-2.1 ppb for MAM and -0.5 ppb for JJA), and 2021 (-0.5 ppb for MAM). However, the JJA seasonal average was influenced by strong positive anomalies in July, due to the large spread of wildfires in the western US. The polluted rural sites in the western US showed a negative O3 anomaly for MAM 2020, and a slight recovery in 2021, resulting in a positive anomaly for MAM and alternating positive and negative anomalies in JJA. The eastern US sites were characterized by below baseline numbers for both MAM and JJA 2020, while in 2021 the negative values generated a "dipole" structure, with the western sites influenced by the presence of wildfires. Concerning the rest of the world, a global picture could not be drawn, as the sites, spanning a range of different environments, did not show consistent anomalies across the globe. A few sites did not experience any relevant variations (e.g., the Antarctic sites), while others showed signals of influence from the surrounding environment, or behaviors like those observed for European and US remote sites. We also attempted anomaly attribution by analyzing the behavior of several O3 precursors (e.g., surface and columnar CO, NO, and NO2) from the CAMS reanalysis, and the patterns of emissions reductions for 2019, 2020, and 2021.

The multitude of fixation options for radial neck fractures, such as pins, screws, biodegradable pins and screws, locking plates, and blade plates, has led to a lack of consensus on the optimal implant choice and associated biomechanical properties. This study aims to evaluate the biomechanical strength of various fixation constructs in axial, sagittal, and torsional loading directions. We included biomechanical studies comparing different interventions, such as cross/parallel screws, nonlocking plates with or without augmented screws, fixed angle devices (T or anatomic locking plates or blade plates), and cross pins. A systematic search of MEDLINE (Ovid), Embase, Scopus, and CINAHL EBSCO databases was conducted on September 26th, 2022. Data extraction was carried out by one author and verified by another. A network meta-analysis (NMA) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Primary outcomes encompassed axial, bending, and torsional stiffness, while the secondary outcome was bending load to failure. Effect sizes were calculated for continuous outcomes, and relative treatment ranking was measured using the surface under the cumulative ranking curve (SUCRA). Our analysis encompassed eight studies, incorporating 172 specimens. The findings indicated that fixed angle constructs, specifically the anatomic locking plate, demonstrated superior axial stiffness (mean difference [MD]: 23.59 N/mm; 95% CI 8.12–39.06) in comparison to the cross screw. Additionally, the blade plate construct excelled in bending stiffness (MD: 32.37 N/mm; 95% CI − 47.37 to 112.11) relative to the cross screw construct, while the cross-screw construct proved to be the most robust in terms of bending load failure. The parallel screw construct performed optimally in torsional stiffness (MD: 139.39 Nm/degree; 95% CI 0.79–277.98) when compared to the cross screw construct. Lastly, the nonlocking plate, locking T plate, and cross-pin constructs were found to be inferior in most respects to alternative interventions. The NMA indicated that fixed angle devices (blade plate and anatomic locking plate) and screw fixations may exhibit enhanced biomechanical strength in axial and bending directions, whereas cross screws demonstrated reduced torsional stability in comparison to parallel screws. It is imperative for clinicians to consider the application of these findings in constraining forces across various directions during early range of motion exercises, taking into account the distinct biomechanical properties of the respective implants.

Purpose Suture anchors are commonly used to repair rotator cuff tendons in arthroscopy surgery, and several anchor materials have been created to maximize pull-out strength and minimize iatrogenic damage. We hypothesized that all-suture anchors have biomechanical properties equivalent to those of conventional anchors. Our purpose is to compare the biomechanical properties of different anchors used for rotator cuff repair. Methods The Embase, PubMed, Cochrane, and Scopus databases were searched for biomechanical studies on various suture anchors. The search keywords included rotator cuff tears and suture anchors, and two authors conducted study a selection, risk of bias assessment, and data extraction. The failure load, stiffness, and displacement were calculated using the mean differences with 95% confidence intervals (CIs). Failure modes were estimated using summary odds ratios with 95% CIs. The surface under the cumulative ranking curve was used for the relative ranking probabilities. A sensitivity analysis was performed by excluding studies using synthetic bones. Results The polyetheretherketone (PEEK) (p p p = 0.006) and biocomposite anchors (p Conclusions All-suture anchors showed significantly higher failure loads than the biocomposite anchors and similar cyclic displacements to the biocomposite and PEEK anchors. There were no significant differences in stiffness between all-suture and conventional suture anchors. The relative ranking of biomechanical properties changed in sensitivity analysis, suggesting the potential effect of bone marrow density. Level of Evidence Level IV.

Current biomedical models fail to replicate the complexity of human biology. Consequently, almost 90% of drug candidates fail during clinical trials after decades of research and billions of investments in drug development. Despite their physiological similarities, animal models often misrepresent human responses, and instead, trigger ethical and societal debates regarding their use. The overall aim across regulatory entities worldwide is to replace, reduce, and refine the use of animal experimentation, a concept known as the Three Rs principle. In response, researchers develop experimental alternatives to improve the biological relevance of in vitro models through interdisciplinary approaches. This article highlights the emerging organ-on-a-chip technologies, also known as microphysiological systems, with a focus on models of the vasculature. The cardiovascular system transports all necessary substances, including drugs, throughout the body while in charge of thermal regulation and communication between other organ systems. In addition, we discuss the benefits, limitations, and challenges in the widespread use of new biomedical models. Coupled with patient-derived induced pluripotent stem cells, organ-on-a-chip technologies are the future of drug discovery, development, and personalized medicine.

Based on institutional theory, legitimacy theory and signaling theory, this article uses the difference-in-differences (DID) model to investigate the influence of the Guidance on Building a Green Financial System jointly issued by the People’s Bank of China (PBC) and six other ministries on ESG disclosure of A-share listed companies in the Shanghai Stock Exchange (SSE) and the Shenzhen Stock Exchange (SZSE) from 2014 to 2018. The results suggest that the publication of the Guidance positively contributes to the ESG disclosure quality (ESGdq) of listed companies. Further analysis shows that the positive effect of the Guidance on ESGdq is greater for listed companies in heavily polluting industries, state-owned and in regions with higher levels of economic development. Conclusions obtained through our research enrich the economic consequences of green finance policy, provide practical implications for enhancing corporate ESG disclosure, integrating ESG concepts into corporate strategies and governance systems.

Additional file 1: Appendix 1. Search strategy and results.

The aim of this guidance note is to provide recommendations on best statistical practices and to ensure consistent communication of statistical analysis and associated uncertainty across TOAR publications. The scope includes approaches for reporting trends, a discussion of strengths and weaknesses of commonly used techniques, and calibrated language for the communication of uncertainty. The focus of this guidance note is placed on trend analysis, which is expected to be the main statistical topic of interest across many TOAR-II focus working groups, but some of the recommendations and principles provided below are also valid for other applications. Recommendations are highlighted and numbered from R1 to R9.

Additional file 2: Appendix 2. Detail of the articles.

Species identification is pivotal in taxonomy, systematics, evolutionary biology and conservation biology. We collected bats that died of natural causes in Shihezi city, Xinjiang, China, and carried out morphological and genetic identification. Morphologically, all individuals were adults/subadults or juveniles of Pipistrellus pipistrellus. We found one haplotype for the mitochondrial gene ND1 and five for the mitochondrial gene cytochrome b (Cytb) among six specimens. Phylogenetically, all the Cytb sequences grouped with P. pipistrellus. We confirm this species’ occurrence in Xinjiang, China.

To develop a machine-learning model by integrating clinical and imaging modalities for predicting tumor response and survival of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE).140 HCC patients with TACE were retrospectively included from two centers. Tumor response were evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Response-related radiomics scores (Rad-scores) were constructed on T2-weighted images (TAmong 4 MRI sequences, TThe model combined MRI radiomics with clinical factors demonstrated favorable performance for predicting tumor response and clinical outcomes, thus may help personalized clinical management.

Global warming potential (GWP) has been widely used in the life cycle assessment (LCA) to quantify the climate impacts of energy technologies. Most LCAs are static analyses without considering the dynamics of greenhouse gas (GHG) emissions and changes in background GHG concentrations. This study presents a dynamic approach to analyze the life-cycle GWP of energy technologies in different timeframes and representative GHG concentration pathways. Results show that higher atmospheric GHG concentrations lead to higher life-cycle GWP for long-term analysis. The impacts of background GHG concentrations are more significant for technologies with large operational emissions or CH

The design of restaurant environment and atmosphere is an important key to influencing consumer satisfaction and purchase intention. In the fiercely competitive catering industry, how to make restaurants stand out and enhance their own competitiveness for sustainable operation is an important topic currently faced by catering operators. Operators not only need to understand and listen to the voices of customers, but also strive to create a good and appropriate sustainable environment, provide consumers with a comfortable dining experience process and environment, and improve the overall dining experience of consumers, and continue to innovate and improve. Changes to meet the sustainable needs of consumers and the market. This research will use the Delphi expert questionnaire method and the five-sense atmosphere theory to explore and construct a set of styles and indicators that are suitable for the sustainable music environment of Taiwanese coffee and light food restaurants. The index method of this study adopts the Delphi expert research method, and conducts three rounds of expert Delphi method for experts and scholars with professional knowledge such as scholars in the field of catering and music, restaurant industry, and the characteristics of repeated feedback of their opinions make the results convergent , and then use the stability analysis and the average of each aspect of the third round of questionnaires as screening criteria. Finally, the aspects and indicators suitable for the design of the sustainable music environment and atmosphere of the coffee restaurant are extracted. The biggest research contribution and value of this study lies in the construction of indicators that are suitable for the selection of sustainable atmosphere of Taiwanese restaurant music environment, so that it can provide a reference for restaurants to improve sustainable service quality. It can also provide academia as a reference for academic research on sustainable service quality in restaurants.

Waste plastic gasification for hydrogen production combined with carbon capture and storage is one technology option to address the plastic waste challenge. Here, we conducted a techno-economic analysis and life cycle assessment to assess this option. The minimum hydrogen selling price of a 2000 oven-dry metric ton/day mixed plastic waste plant with carbon capture and storage is US$2.26–2.94 kg−1 hydrogen, which can compete with fossil fuel hydrogen with carbon capture and storage (US$1.21–2.62 kg−1 hydrogen) and current electrolysis hydrogen (US$3.20–7.70 kg−1 hydrogen). An improvement analysis outlines the roadmap for reducing the average minimum hydrogen selling price from US$2.60 to US$1.46 kg−1 hydrogen, which can be further lowered to US$1.06 kg−1 hydrogen if carbon credits are close to the carbon capture and storage costs along with low feedstock cost. The life cycle assessment results show that hydrogen derived from mixed plastic waste has lower environmental impacts than single-stream plastics.

These files include the Supplementary Data and code for"Soil organic carbon change can reduce the climate benefits of biofuel produced from forest residues" in Nature Sustainability.

Purpose To investigate the functional outcomes for patients who used a novel home-based rehabilitative system during the postoperative period after anterior cruciate ligament (ACL) reconstructions. Methods Patients undergoing ACL reconstruction surgeries were prospectively enrolled. A home-based rehabilitation system, which is composed of a knee brace with a motion tracker, a mobile app, and a web portal, was applied. Patients could complete the rehabilitation exercise through the audio guidance and the real-time tracking system which displayed the achieved motions on the user interface of the app. Feedbacks from the patients, including the International Knee Documentation Committee (IKDC) scores, were collected and uploaded to the web portal. Each patient would meet a specialized physical therapist face-to-face once a month. At postoperative 6 months, every patient received a GNRB arthrometer examination and a Cybex isokinetic dynamometer examination. Results A total of 15 patients (10 males and 5 females) were enrolled and followed for at least 6 months. The mean time of return to full knee extension was 1.5 months. The mean difference in laxity measured by GNRB arthrometer at 134 N significantly improved at postoperative 6 months (1.8 ± 1.6 mm) compared to that measured preoperatively (3.4 ± 1.9 mm) (p = 0.024). The peak torques of flexor and extensor muscles measured by Cybex isokinetic dynamometer remained unchanged at postoperative 6 months (p = 0.733 and 0.394, respectively). The patients’ IKDC score became smaller at postoperative 1 month (p = 0.011) and significantly improved at postoperative 6 months (p = 0.002). Conclusion Using a home-based rehabilitative knee brace system after ACL reconstruction is a viable option as patients maintained their knee muscle strengths maintained their muscle strength and achieve similar or better knee range of motion six months postoperatively.

The Notch signaling pathway is a direct cell-cell communication system involved in a wide variety of biological processes, and its disruption is observed in several pathologies. The pathway is comprised of a ligand-expressing (sender) cell and a receptor-expressing (receiver) cell. The canonical ligands are members of the Delta/Serrate/Lag-1 (DSL) family of proteins. Their binding to a Notch receptor in a neighboring cell induces a conformational change in the receptor, which will undergo regulated intramembrane proteolysis (RIP), liberating the Notch intracellular domain (NICD). The NICD is translocated to the nucleus and promotes gene transcription. It has been demonstrated that the ligands can also undergo RIP and nuclear translocation, suggesting a function for the ligands in the sender cell and possible bidirectionality of the Notch pathway. Although the complete mechanism of ligand processing is not entirely understood, and its dependence on Notch receptors has not been ruled out. Also, ligands have autonomous functions beyond Notch activation. Here we review the concepts of reverse and bidirectional signalization of DSL proteins and discuss the characteristics that make them more than just ligands of the Notch pathway.

Observational records of meteorological and chemical variables are imprinted by an unknown combination of anthropogenic activity, natural forcings, and internal variability. With a 15-member initial-condition ensemble generated from the CESM2-WACCM6 chemistry-climate model for 1950-2014, we extract signals of anthropogenic (‘forced’) change from the noise of internally arising climate variability on observed tropospheric ozone trends. Positive trends in free tropospheric ozone measured at long-term surface observatories, by commercial aircraft, and retrieved from satellite instruments generally fall within the ensemble range. CESM2-WACCM6 tropospheric ozone trends are also bracketed by those in a larger ensemble constructed from five additional chemistry-climate models. Comparison of the multi-model ensemble with observed tropospheric column ozone trends in the northern tropics implies an underestimate in regional precursor emission growth over recent decades. Positive tropospheric ozone trends clearly emerge from 1950 to 2014, exceeding 0.2 DU yr-1 at 20-40N in all CESM2-WACCM6 ensemble members. Tropospheric ozone observations are often only available for recent decades, and we show that even a two-decade record length is insufficient to eliminate the role of internal variability, which can produce regional tropospheric ozone trends oppositely signed from ensemble mean (forced) changes. By identifying regions and seasons with strong anthropogenic change signals relative to internal variability, initial-condition ensembles can guide future observing systems seeking to detect anthropogenic change. For example, analysis of the CESM2-WACCM6 ensemble reveals year-round upper tropospheric ozone increases from 1995-2014, largest at 30S-40N during boreal summer. Lower tropospheric ozone increases most strongly in the winter hemisphere, but internal variability leads to trends of opposite sign (ensemble overlaps zero) north of 40N during boreal summer. This decoupling of ozone trends in the upper and lower troposphere suggests a growing prominence for tropospheric ozone as a greenhouse gas despite regional efforts to abate warm season ground-level ozone.

Data on long-term trends of ozone exposure and attributable mortality across urban-rural catchment areas worldwide are scarce, especially for low-income and middle-income countries. This study aims to estimate trends in ozone concentrations and attributable mortality for urban-rural catchment areas worldwide.In this modelling study, we used a health impact function to estimate ozone concentrations and ozone-attributable chronic respiratory disease mortality for urban areas worldwide, and their surrounding peri-urban, peri-rural, and rural areas. We estimated ozone-attributable respiratory health outcomes using a modified Global Burden of Diseases, Injuries, and Risk Factors 2019 Study approach. We evaluate long-term trends with linear regressions of annual ozone concentrations and ozone-attributable mortality against time in years, and examined the influence of each health impact function input parameter to temporal changes in ozone-attributable disease burden estimates for 12 946 cities worldwide by region, from 2000 to 2019.Ozone-attributable mortality worldwide increased by 46% from 2000 (290 400 deaths [95% CI 151 800-457 600]) to 2019 (423 100 deaths [95% CI 223 200-659 400]). The fraction of global ozone-attributable mortality occurring in peri-urban areas remained unchanged from 2000 to 2019 (56%), whereas urban areas gained in their share of global ozone-attributable burden (from 35% to 37%; 54 000 more deaths). Across all cities studied, average population-weighted mean ozone concentration increased by 11% (46 parts per billion [ppb] to 51 ppb). The number of cities with concentrations above the WHO peak season ozone standard (60 μg/mOzone exposure is increasing worldwide, contributing to disproportionate ozone mortality in peri-urban areas and increasing ozone exposure and attributable mortality in urban areas worldwide. Reducing ozone precursor emissions in areas affecting urban and peri-urban exposure can yield substantial public health benefits.NASA Health and Air Quality Applied Sciences Team, the National Institute for Occupational Safety and Health, and the NOAA Co-operative Agreement with the Cooperative Institute for Research in Environmental Sciences.

Introduction: The effect of using closed suction drainage system with the proximal femoral nail antirotation (PFNA) system fixation on outcomes in treating intertrochanteric fractures (ITFs) is still unknown. This prospective randomized controlled trial aimed to examine whether routine drainage is useful for PFNA fixation in ITFs. Methods: A total of 80 patients with acute ITFs were treated with closed or mini-open reduction with PFNA fixation at the National Cheng Kung University Hospital and 60 eligible patients were randomized for whether to receive suction drainage. In clinical outcomes, the visual analog scale (VAS), morphine equivalent dosage, injured thigh width, body temperature, wound condition and wound infection were measured on postoperative day 1, 2, 4, 10, and 90. In laboratory outcomes, we evaluated hemoglobin and hematocrit levels postoperatively at different time points. Blood transfusion and total blood loss (TBL) were measured by Mercuriali's formula in millimeter. Results: The results revealed that the amount of blood transfusion received by the drained group (543.3 mL) was more than that by the undrained group (367.8 mL; p = 0.0074), and similarly, TBL in the drained group (750.1 mL) was more than that in the undrained group (537.4 mL; p = 0.0067). Regarding clinical and laboratory outcomes, compared with the undrained group, the drained group had a higher VAS score on postoperative day 2 (p = 0.0216). No difference was observed between the 2 groups for morphine equivalent dosage, thigh swelling, wound infection and hematoma, hospitalization period, or total number of complications at every time point after index procedure. Conclusions: Blood transfusion requirement and TBL were higher in the drained group than in the undrained group of PFNA fixation for ITFs. In addition, the closed drainage system may have manifested no short-term benefit for wound condition postoperatively.

Background Degenerative signs on shoulder radiographs, including spur formation and narrow acromiohumeral intervals (AHIs), have been recognized as indicative of atrophic and fat-infiltrated rotator cuff muscles. Past studies have demonstrated that patients with poor quality muscles are prone to retraction of the supraspinatus tendon and failure to repair. However, the association between radiographic signs and tendon retraction has never been elucidated in previous literature. The present study aimed to investigate the association between the degenerative signs on shoulder radiographs and the severity of supraspinatus retraction. Methods Images of 67 individuals, who had undergone an arthroscopic rotator cuff repair, were retrospectively reviewed. The greater tuberosity (GT) morphology, subacromial spur, AHI, and acromial thickness were evaluated on the radiographs, whereas the retraction of the supraspinatus tendon was assessed via an MRI in accordance with the Patte classification. Simple regression analyses between the radiographic signs and Patte stages were performed, and factors reaching statistical significance were then included in the multiple ordinal logistic regression. Statistically significant predictors from the multiple regression analysis were constructed into combinations, for which the sensitivity and specificity were calculated. Results The GT morphology (P = .004), AHI (P = .083), subacromial spur (P = .008), and age (P = .004) were associated with supraspinatus retraction in the simple regression analyses. These four parameters were incorporated into the multiple ordinal logistic regression, where the GT spur (adjusted odds ratio 8.63, 95% confidence interval 2.16-34.53, P = .002) and AHI (AOR 0.79, 95% CI 0.63-0.98, P = .032) were demonstrated to be predictive of the Patte stage of supraspinatus retraction. The acromial spur implied a higher risk of severe retraction although this finding was not statistically significant (AOR 2.89, 95% CI 0.90-9.29, P = .075). The presence of concurrent GT spur and narrow AHI was highly specific (sensitivity 27.3% / specificity 91.1%) for advanced supraspinatus retraction. Conclusion The presence of a radiographic GT spur, narrow AHI, and subacromial spur indicated advanced retraction of the supraspinatus tendon. When patients with clinical suspicion of rotator cuff tear present with combinations of these radiographic signs, a prompt MRI examination and a referral to a shoulder specialist are recommended.

Purpose To compare the biomechanical properties of high-tensile strength tape and a high-tensile strength suture in subpectoral biceps tenodesis using a suture anchor in a porcine tendon model. Methods A total of 24 artificial composite (polymer and glass fiber) humeri and porcine flexor profundus tendons were used. Two types of suture materials, high-tensile strength sutures (group S) and high-tensile strength tapes (group T), were evaluated. After we inserted metallic suture anchors with either 2 sutures or tapes 5 cm from the superomedial corner of the greater tuberosity, a Krackow suture technique was used to secure the tendons. After a preload of 5 N for 2 minutes, a cyclic loading test from 5 to 70 N was conducted for 500 cycles. Finally, the specimen was loaded to failure at a rate of 1 mm/s. Results There were no significant between-group differences in elongation after cyclic loading and elongation at failure load for group S and group T (P = .977 and .630, respectively). The ultimate failure loads in group T (278.2 ± 54 N) were significantly greater than those in group S (249.4 ± 32 N) (P = .028). In contrast, the stiffness values in group T (28.5 ± 4.0 N/mm) were significantly lower than those in group S (32.3 ± 4.5 N) (P = .028). Ten specimens in group S and 8 specimens in group T failed, with tendons being cut through by the sutures, whereas the other 2 specimens in group S and 4 specimens in group T failed due to suture breakage. Conclusions Using high-tensile strength tapes in subpectoral biceps tenodesis using a suture anchor leads to significantly greater ultimate failure load as compared with using high-tensile strength sutures in a porcine model. Although lower levels of stiffness were found in high-tensile strength tape group, the difference in the means were not large between 2 groups. Clinical Relevance A strong suture–tendon structure may prevent clinical failure of a subpectoral biceps tenodesis using a suture anchor.

Objectives To predict kidney fibrosis in patients with chronic kidney disease using radiomics of two-dimensional ultrasound (B-mode) and Sound Touch Elastography (STE) images in combination with clinical features. Methods The Mindray Resona 7 ultrasonic diagnostic apparatus with SC5-1U convex array probe (bandwidth frequency of 1–5 MHz) was used to perform two-dimensional ultrasound and STE software. The severity of cortical tubulointerstitial fibrosis was divided into three grades: mild interstitial fibrosis and tubular atrophy (IFTA), fibrotic area < 25%; moderate IFTA, fibrotic area 26–50%; and severe IFTA, fibrotic area > 50%. After extracting radiomics from B-mode and STE images in these patients, we analyzed two classification schemes: mild versus moderate-to-severe IFTA, and mild-to-moderate versus severe IFTA. A nomogram was constructed based on multiple logistic regression analyses, combining clinical and radiomics. The performance of the nomogram for differentiation was evaluated using receiver operating characteristic (ROC), calibration, and decision curves. Results A total of 150 patients undergoing kidney biopsy were enrolled (mild IFTA: n = 74; moderate IFTA: n = 33; severe IFTA: n = 43) and randomized into training (n = 105) and validation cohorts (n = 45). To differentiate between mild and moderate-to-severe IFTA, a nomogram incorporating STE radiomics, albumin, and estimated glomerular filtration (eGFR) rate achieved an area under the ROC curve (AUC) of 0.91 (95% confidence interval [CI]: 0.85–0.97) and 0.85 (95% CI: 0.77–0.98) in the training and validation cohorts, respectively. Between mild-to-moderate and severe IFTA, the nomogram incorporating B-mode and STE radiomics features, age, and eGFR achieved an AUC of 0.93 (95% CI: 0.89–0.98) and 0.83 (95% CI: 0.70–0.95) in the training and validation cohorts, respectively. Finally, we performed a decision curve analysis and found that the nomogram using both radiomics and clinical features exhibited better predictability than any other model (DeLong test, p < 0.05 for the training and validation cohorts). Conclusion A nomogram based on two-dimensional ultrasound and STE radiomics and clinical features served as a non-invasive tool capable of differentiating kidney fibrosis of different severities. Key Points • Radiomics calculated based on the ultrasound imaging may be used to predict the severities of kidney fibrosis. • Radiomics may be used to identify clinical features associated with the progression of tubulointerstitial fibrosis in patients with CKD. • Non-invasive ultrasound imaging-based radiomics method with accuracy aids in detecting renal fibrosis with different IFTA severities.

Circularly polarized luminescent materials play an increasingly important role in display equipment and optical apparatuses. Herein, we design and synthesize a kind of luminescent liquid crystallin...

Detecting a tropospheric ozone trend from sparsely sampled ozonesonde profiles (typically once per week) is challenging due to the short-lived anomalies in the time series resulting from ozone's high temporal variability. To enhance trend detection, we have developed a sophisticated statistical approach that utilizes a geoadditive model to assess ozone variability across a time series of vertical profiles. Treating the profile time series as a set of individual time series on discrete pressure surfaces, a class of smoothing spline ANOVA (analysis of variance) models is used for the purpose of jointly modeling multiple correlated time series (on separate pressure surfaces) by their associated seasonal and interannual variabilities. This integrated fit method filters out the unstructured variation through a statistical regularization (i.e., a roughness penalty) by taking advantage of the additional correlated data points available on the pressure surfaces above and below the surface of interest. We have applied this technique to the trend analysis of the vertically correlated time series of tropospheric ozone observations from (1) IAGOS (In-service Aircraft for a Global Observing System) commercial aircraft profiles above Europe and China throughout 1994–2017 and (2) NOAA GML's (Global Monitoring Laboratory) ozonesonde records at Hilo, Hawaii, (1982–2018) and Trinidad Head, California (1998–2018). We illustrate the ability of this technique to detect a consistent trend estimate and its effectiveness in reducing the associated uncertainty in the profile data due to the low sampling frequency. We also conducted a sensitivity analysis of frequent IAGOS profiles above Europe (approximately 120 profiles per month) to determine how many profiles in a month are required for reliable long-term trend detection. When ignoring the vertical correlation, we found that a typical sampling strategy (i.e. four profiles per month) might result in 7 % of sampled trends falling outside the 2σ uncertainty interval derived from the full dataset with an associated 10 % of mean absolute percentage error. Based on a series of sensitivity studies, we determined optimal sampling frequencies for (1) basic trend detection and (2) accurate quantification of the trend. When applying the integrated fit method, we find that a typical sampling frequency of four profiles per month is adequate for basic trend detection; however, accurate quantification of the trend requires 14 profiles per month. Accurate trend quantification can be achieved with only 10 profiles per month if a regular sampling frequency is applied. In contrast, the standard separated fit method, which ignores the vertical correlation between pressure surfaces, requires 8 profiles per month for basic trend detection and 18 profiles per month for accurate trend quantification. While our method improves trend detection from sparse datasets, the key to substantially reducing the uncertainty is to increase the sampling frequency.

Purpose To compare the biomechanical properties of a high-tensile strength suture with the high-tensile strength tape for tendon graft fixation. Methods A total of 24 porcine tendons were used and were randomly divided into 2 groups. Two kinds of suture materials, a braided nonabsorbable high-strength suture (group S) and a high-tensile strength tape (group T), were used to complete 3 pairs of Krackow stitches on the tendons. Each specimen was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and finally loaded to failure. Elongation after cyclic loading, ultimate failure load, and the mode of failure were recorded. Results The elongation after cyclic loading between group S (26% ± 5%) and group T (24% ± 5%) were not significantly different (P = .378). The ultimate failure loads in group T (400 ± 38 N) were significantly greater than those in group S (358 ± 21 N) (P = .010). All specimens failed because of suture material breakage. Conclusions Compared with the braided nonabsorbable high-strength suture, the high-tensile strength tape had similar elongation values after cyclic loading, but significantly greater ultimate failure load in this porcine in vitro biomechanical model. Clinical Relevance A secure suture-tendon construct is especially important when a post-tie fixation technique is used because the mitigating construct may potentially lead to graft loosening and affect graft healing.

Neuropathic pain is an intractable medical condition with few or no options for effective treatment. Emerging evidence shows a strong structure-function relationship between dendritic spine dysgenesis and the presence of neuropathic pain. Postmortem tissue analyses can only imply dynamic structural changes associated with injury-induced pain. Here, we profiled thein vivodynamics of dendritic spines over time on the same superficial dorsal horn (lamina II) neurons before and after peripheral nerve injury-induced pain. We used a two-photon, whole-animal imaging paradigm that permitted repeat imaging of the same dendritic branches of these neurons in C57/Bl6 Thy1-YFP male mice. Our study demonstrates, for the first time, the ongoing, steady-state changes in dendritic spine dynamics in the dorsal horn associated with peripheral nerve injury and pain. Ultimately, the relationship between altered dendritic spine dynamics and neuropathic pain may serve as a structure-based opportunity to investigate mechanisms of pain following injury and disease.SIGNIFICANCE STATEMENTThis work is important because it demonstrates for the first time: (1) the powerful utility of intravital study of dendritic spine dynamics in the superficial dorsal horn; (2) that nerve injury-induced pain triggers changes in dendritic spine steady-state behavior in the spinal cord dorsal horn; and (3) this work opens the door to further investigationsin vivoof spinal cord dendritic spine dynamics in the context of injury and disease.

Objective. To evaluate the quality of methodologies used in previous systematic reviews (SRs) and compare efficacy of different acupuncture therapies for allergic rhinitis. Methods. Seven electronic databases were searched for systematic reviews (SRs) performed on different acupuncture therapies for allergic rhinitis from inception to 15 November 2019. The AMSTAR2 instrument was employed to assess the methodological quality of included SRs. Eligible randomized controlled trials (RCTs) were selected from the included systematic reviews. We also included recent RCTs published by 15 November 2019. Cochrane risk of bias tool was utilized to determine risk of bias of the included RCTs. Pairwise meta-analyses were performed using the random-effects model. Network meta-analysis of the included RCTs was carried out using frequentist framework. Results. We identified 2 SRs with low quality and 18 SRs with very low quality, both of which contained 33 eligible RCTs (n = 3769). Most of these studies had unclear risk of bias. On the basis of ranking probability, NMA analysis showed that acupuncture at the sphenopalatine ganglion acupoint (OR: 1.31, 95% CI 1.07 to 1.61) had the highest probability of improving global allergic rhinitis symptoms, followed by San-Fu-Tie (OR: 1.17, 95% CI 1.08 to 1.27), manual acupuncture (OR:1.15, 95% CI 1.07 to 1.24) compared with conventional western medicine treatment. Moreover, direct comparison of the follow-up period showed that the clinical outcomes of acupuncture and related therapies at three-month (OR:1.34, 95% CI 1.17 to 1.55), six-month (OR: 1.31, 95% CI 1.10 to 1.57), and twelve-month (OR: 1.30, 95%CI 1.11 to 1.53) follow-up were better than those of traditional western medicine. Conclusion. These results indicate that for patients with allergic rhinitis who are unresponsive to conventional western medicine or cannot tolerate the side effects, acupuncture at the sphenopalatine ganglion acupoint is an effective alternative therapy. Further studies are advocated to deeply explore methodological quality of SRs by incorporating high-quality RCTs.

To compare the biomechanical properties of the double simple suture (DSS) technique, Krackow suture (KS) technique, and double Krackow suture (DKS) technique in subpectoral biceps tenodesis using a double-loaded suture anchor in a porcine tendon model.A total of 30 artificial composite (polymer and glass fiber) humeri and porcine flexor profundus tendons with diameter of 4.5 mm were used. The sample size was determined based on the results of the pilot study. Metallic suture anchors with double-loaded No. 2 braided sutures were inserted at the subpectoral tenodesis site, 5 cm from the superomedial corner of the greater tuberosity. Three suture techniques were used to fix the tendons: a DSS used as the control, a KS, and a DKS, which is an alternative tendon graft fixation technique. A preload of 5 N was applied for 2 minutes, followed by cyclic loading for 500 cycles ranging from 5 to 70 N; next, a load-to-failure test at 1 mm/s was performed.The KS (283.5 ± 57 N) and DKS (270.4 ± 50 N) groups had significantly greater ultimate failure loads as compared with the DSS group (84.1 ± 6.4 N) (P.001). Meanwhile, the peak displacement at failure loads in the KS group (9.3 ± 2.2 mm) and DKS group (7.8 ± 1.7 mm) were significantly smaller than that of the DSS group (11.3 ± 2.9 mm) (P = .015). Stiffness in the DSS group (36.4 ± 3.0 N/mm), KS group (39.6 ± 2.5 N/mm), and DKS group (36.9 ± 4.6 N/mm) was not significantly different (P = .125). All DSS constructs and 6 KS constructs failed with tendons being cut through by the sutures, whereas the other 4 KS constructs and all DKS constructs failed resulting from suture breakage.In this subpectoral biceps tenodesis model, both the KS technique and the DKS technique had similar time 0 biomechanical properties that were better than those of the double simple suture technique.A sturdy suture-tendon structure could prevent clinical failure of a subpectoral biceps tenodesis using a suture anchor.

The current study investigated the dielectric and electrical properties of BaAl(2−2x)(Zn0.5Ti0.5)2xO4 ceramics, with x = 0, 0.4%, 0.8%, 1.2% and 1.6%, via impedance spectroscopy. The co-doping of Zn and Ti improved the temperature stability over −100 °C–700 °C of er and lowered tanδ due to the electron-pinned defect-dipoles. Effects of oxygen partial pressure on the electrical, dielectric and ferroelectric properties of x = 1.6% ceramic were studied as well. The bulk conductivity of the N2–H2-sintered and O2-sintered samples was attributed to the e ' and h • , respectively.

High-efficiency linearly polarized luminescence (LPL) materials are very important for display equipment and optical apparatus. Herein, we construct a free-standing film with a wavelength-tunable LPL property through the luminescent material. First, a highly efficient fluorescent reactive monomer (M6BP) based on α-cyanostilbene with stimuli-responsive behavior is successfully designed and synthesized. Then, the free-standing film is prepared by photo polymerizing the mixture of M6BP and liquid crystal (LC) monomer (C6M) in an antiparallel lab-made LC cell. The resultant film achieves a uniaxial orientation along the polyvinyl alcohol (PVA) substrate rubbing direction, which endows it with good LPL behavior. The dichroic ratio (N) and polarization ratio (ρ) values of the film are measured as 2.63 and 0.45, respectively. Owing to the existence of the pyridine group, the resultant film exhibits a reversible fluorescence switch with LPL property under trifluoroacetic acid (TFA)/triethylamine (TEA) vapors. Furthermore, a film with a special orientation pattern is obtained by photoalignment, and it is further successfully applied in the anti-counterfeiting field. This work provides a new method to fabricate optical devices with wavelength-tunable LPL property.

Luminescent materials with stimuli-responsive behavior have good prospects for application in displays, sensors, and other fields. In this research, a type of luminescent supramolecular polymer was fabricated, via hydrogen bonding, that shows stimuli-responsive behavior with different types of acid. Firstly, the acceptor material luminogen (4,4′-dibutanoxy tetraphenylethylene)-1-pyridine (PTPEC4) is synthesized. Then, the PTPEC4 is used to prepare luminescent supramolecular polymer PVA(PTPEC4)x by complexing the donor material poly(vinyl alcohol) (PVA) with different amounts of PTPEC4. The PVA(PTPEC4)x exhibits a lamellar structure at x ≥ 0.6, whereas a crystalline structure forms with x ≤ 0.4. Because of the protonation effect of the pyridine group in PTPEC4, PVA(PTPEC4)x not only exhibits solid-state emission behavior but also presents multicolor luminescence switching under different acid vapors. Moreover, because of the existence of the hydrogen bonds, PVA(PTPEC4)1.0 shows a reversible, spontaneous fluorescence switch under acid vapor with a pKa > 5.25. If the sample is fumed with acid vapor with pKa < 5.25, PVA(PTPEC4)1.0 only exhibits a larger luminescence red shift but cannot recover unless the sample is treated with triethylamine vapor. Furthermore, a rewritable paper with tunable multicolor emission and high contrast is prepared based on the fluorescence response and recovery behavior, which may be applied in optical memory systems.

A novel Vogesella strain, YM-1T, was recovered from human urine in PR China in 2017. Cells of strain YM-1T were Gram-stain-negative, rod-shaped, aerobic, motile, non-spore-forming and poly-β-hydroxybutyrate-accumulating. The strain contained C16:1ω6c/C 16:1ω7c, C16:0 and C18:0ω7c as major fatty acids; phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol and an unidentified phospholipid as major polar lipids; and ubiquinone-8 as the predominant respiratory quinone. Comparison of 16S rRNA gene sequences indicated that this strain had highest similarities to Vogesella perlucida DS-28T (98.8 %) and Vogesella mureinivorans 389T (98.1 %). The results of phylogenetic analysis based on the 16S rRNA gene sequences revealed that the novel strain was clustered and well separated with V. perlucida DS-28T and V. mureinivorans 389T within the genus Vogesella . The average nucleotide identity (ANI) and amino acid identity (AAI) analyses showed that this strain was not identified as V. perlucida DS-28T or V. mureinivorans 389T, with values well below the threshold limit for species demarcation (ANI

Exploration of noble-metal-free, highly-efficient and durable catalysts for Hydrogen evolution reaction (HER) remains a challenge. In this work, the development of carbon-coated cobalt-molybdenum-phosphide nanosheets supported on carbon cloth (Co-Mo-P@C) is successfully demonstrated. To obtain a better electrocatalystic performance, the different amount of glucose was added into the reaction system during hydrothermal process. Benefiting from the 2D structure, high electrical conductivity and sufficient active sites, the Co-Mo-P@C contained 0.5 mmol glucose exhibits relatively good catalytic activity for HER with low over poentials at −96 mV and −162 mV @ 10 mA cm−2 in acidic and alkaline medias respectively and the Tafel slope of 52.9 mV dec−1 and 34.3 mV dec−1. Additionally, the catalyst also shows good durability in the both electrolytes.