Search

Pancreaticoduodenectomy is a highly morbid operation with significant resource utilization. Using a national cohort, we examined the interhospital variation in pancreaticoduodenectomy hospitalization cost in the United States. Adults undergoing elective pancreaticoduodenectomy in the setting of pancreatic cancer were tabulated from the 2016–2020 Nationwide Readmissions Database. A 2-level mixed-effects model was developed to evaluate the interhospital variation in pancreaticoduodenectomy hospitalization costs. Institutions within the top decile of risk-adjusted expenditures were defined as high-cost hospitals. Multivariable regression models were fitted to examine the association between high-cost hospital status and outcomes of interest. To account for the effects of complications on expenditures, a subgroup analysis comprising of patients with no adverse events was conducted. The study included an estimated 24,779 patients with a median hospitalization cost of $38,800. After mixed-effects modeling, 40.9% of the cost variation was attributable to hospital, rather than patient, factors. Multivariable regression models revealed an association between high-cost hospital status and greater odds of complications and longer length of stay. Among patients without an adverse event, interhospital cost variation remained significant at 61.0%, and treatment at high-cost hospitals was similarly linked to longer length of stay. Our study identified significant interhospital variation in pancreaticoduodenectomy hospitalization costs in the United States. Although high-cost hospital status was associated with increased odds of complications, variation remained significant even among patients without an adverse event. These results suggest the important role of hospital practices as contributors to expenditures. Further efforts to identify drivers of costs and standardize pancreatic surgical care are warranted. [ABSTRACT FROM AUTHOR]

The two-dimensional molybdenum carbide (Mo 2 CT x) has a similar electronic structure to platinum, which has the potential to be one of non-precious metals catalysts for hydrogen evolution reaction (HER). However, the preparation of Mo 2 CT x by conventional HF and LiF–HCl etching method inevitably introduces the –F and –Cl terminations on the surface, which adversely affect activity and stability. In this study, the LiCl–KCl–Li 3 N molten salt was used to treat Mo 2 CT x at 600 °C and atmospheric pressure and introduce nitrogen heteroatoms. After treated in LiCl–KCl–Li 3 N molten salt, the HER performance of nitrogen-doped Mo 2 CT x is improved compared with that of un-doped Mo 2 CT x , which should be attributed to the optimization of the electronic structure of N–Mo 2 CT x and lower hydrogen adsorption energy barrier. This simple molten salt method provides a way to modify non-precious metal HER catalyst and introduce nitrogen heteroatoms. The LiCl–KCl–Li 3 N molten salt was used to treat Mo 2 CT x at 600 °C and atmospheric pressure and introduce nitrogen heteroatoms. After treatment in LiCl–KCl–Li 3 N molten salt, the HER performance of nitrogen-doped Mo 2 CT x is improved compared with that of un-doped Mo 2 CT x , which should be attributed to the optimization of the electronic structure of N–Mo 2 CT x and lower hydrogen adsorption energy barrier. [Display omitted] • N-modified Mo 2 CT x MXene was prepared via molten salt modification strategy. • The N doping optimizes the electronic structure of Mo 2 CT x. • The improved catalytic performance and stability for Mo 2 CT x. • The molten salt method is simple, efficient, cost-effective, and environmentally friendly for modification. [ABSTRACT FROM AUTHOR]

• Using the FAAR model, this study assessed the mediating effect of family function and family resilience in the relationship between stressors and family adaptation: stressors reduce levels of family function and family resilience, and consequently reduce family adaptation. • Interventions that enhance family function and family resilience may help minimize the impact of stressors on family adaptation among stroke patients. The mechanisms underlying how stressors affect family adaptation are unclear. This study determined the relationship between stressors and family adaptation among stroke patients, particularly the parallel mediating role of family function and family resilience. The study was conducted in the neurology ward of a tertiary hospital in China. A total of 335 stroke inpatients were interviewed face-to-face from August 2020 to March 2021. A questionnaire was administered that included demographic characteristics, the Family Inventory of Life Events and Changes, Family Apgar Index Scale, Family Hardiness Index Scale, and Family Adaptation Scale. The demographic data and correlations among the research variables were analyzed. A bootstrap method using the SPSS PROCESS macro was employed to test a mediation model. Family adaptation was negatively related to stressors (r = -0.291, p < 0.01) and positively related to family function (r = 0.531, p < 0.01) and family resilience (r = 0.393, p < 0.01). Furthermore, family function and family resilience played parallel mediating roles between stressors and family adaptation. This study elaborated how stressors interacted with family adaptation through the mediation of family function and family resilience. The findings suggest that enhancement of family function and family resilience may help to improve family adaptation among stroke patients. [ABSTRACT FROM AUTHOR]

Oversampling is a popular yet useful method to fulfill the binary classification of imbalanced data, however many existing results of oversampling are very likely to generate redundant/unsafe/noise samples due primarily to the inadequate consideration of the data distribution. To address this issue, we propose a novel oversampling approach, namely Switching Synthesizing-Incorporated and Cluster-Based Synthetic Oversampling (SSI-CBSO). The core idea of SSI-CBSO is four-fold: (1) noise samples are removed by using K nearest neighbor strategy and Fuzzy C-Means clustering is adopted for the filtered data in the minority class; (2) the number of samples that need to be synthesized is adaptively assigned to each cluster concerning the inter-class distance and the intra-cluster similarity; (3) to better reflect the data distribution, a new method in terms of the concept of the hypersphere is put forward to measure the cluster density in a high dimensional; and (4) a new principle based on the Mahalanobis distance is provided for a better selection of the target sample. Then, a switching synthesizing strategy is established to guarantee the safety of the synthesized samples. Finally, experiments on 13 binary imbalanced data sets by using five evaluation metrics with four classifiers verify that our proposed SSI-CBSO approach can obtain desirable results. [ABSTRACT FROM AUTHOR]

Employing a mixed methods approach, this study investigated the mediating effect of negative emotion intensity on the relationship between trait emotional intelligence (trait EI) and the emotion regulation strategies of cognitive reappraisal and expressive suppression in an L2 learning context. Questionnaires were administered among 391 EFL learners to measure their trait EI, English learning-related negative emotion intensity, and the selection of cognitive reappraisal and expressive suppression. The mediation analysis revealed that negative emotion intensity mediated the relationship between trait EI and cognitive reappraisal. However, the mediating effect of negative emotion intensity was not significant on the relationship between trait EI and expressive suppression. Semi-structured interviews revealed factors that explained the trait EI – negative emotion intensity – cognitive reappraisal nexus, including available cognitive resources and learning engagement. Pedagogical implications were provided to enhance the learners' selection of cognitive reappraisal and decrease their tendency to use expressive suppression. • Negative emotion intensity mediated the relationship between trait EI and cognitive reappraisal. • Negative emotion intensity did not mediate the relationship between trait EI and expressive suppression. • Cognitive resources and engagement influenced the trait EI – negative emotion intensity – cognitive reappraisal nexus. [ABSTRACT FROM AUTHOR]

• The present study intended to explore potential causes for high prehospital delay rate and low thrombolysis rate in Chinese patients with AIS. • The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is used to determine the ranking order of prehospital delay risk. • We established the risk assessment questionnaire of prehospital delay, which can be used for optimizing the management of AIS patients. Although recent advances have been made in the treatment of acute stroke, only a few patients have received reperfusion therapy. Studies on prehospital delay in patients with stroke have revealed a wide range of associated factors in different countries. However, a unified risk management system for stroke remains unavailable. There are no published risk management systems to manage prehospital delay in stroke patients across China. This study aimed to identify key risk factors that affect the prehospital delay risk prediction of acute ischemic stroke (AIS) patients and develop a crux of recommendations using the identified risk factors. Prehospital delay predictors were collected through literature and expert interviews. We also developed a risk assessment questionnaire via two rounds of expert inquiry. From October 2017 to July 2019, 447 patients admitted for AIS and 202 relevant medical personnel from the Heilongjiang province of China were recruited. The risk factors were analyzed using the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) to extract those that significantly impacted prehospital delay. A total of seven key risk factors were extracted from the 22 factors that were evaluated. Of these factors, five were associated with the patient delay stage and two with the transportation delay stage. A multi-dimensional and whole-process risk management mechanism should be established for AIS patients. These patients should be advised to improve their risk coping ability and relevant departments should formulate complete medical treatment procedures and medical systems to ameliorate prehospital delay effectively. [ABSTRACT FROM AUTHOR]

• Cr and Mn improved the low-temperature catalytic activity and SO 2 resistance. • Cr and Mn doping improved the rate of the catalytic reaction. • The reaction followed the Eley–Rideal and Langmuir–Hinshelwood mechanisms. • The catalyst significantly inhibited the accumulation of bisulfate or sulfate. A series of Cr α Mn β CeTiO x catalysts were prepared using one-pot precipitation method and evaluated for the selective catalytic reduction (SCR) of NO with ammonia. Among the catalysts prepared, the Cr 0.006 Mn 0.05 CeTiO x catalyst exhibited the highest low-temperature activity and widest activity window (＞90% NO conversion at 160–425 °C) as well as outstanding sulfur resistance. The catalysts were characterized using XRD, NH 3 /NO/SO 2 + O 2 -TPD, XPS, in situ DRIFT, and so on. The amorphous Cr 0.006 Mn 0.05 CeTiO x catalyst had a larger specific surface area, high ammonia adsorption and strong acidity, resulting in an improved catalytic activity. A high ratio of surface adsorption oxygen and Ce3+ promoted the formation of NO 2 , a key intermediate gas in the fast SCR reaction. Furthermore, in situ DRIFT showed that the SCR reaction followed the Eley Rideal and Langmuir Hinshelwood mechanisms. Moreover, the synergetic effect of Cr and Mn inhibited the accumulation of hydrogen sulfate or sulfate considerably. [ABSTRACT FROM AUTHOR]

• A simple method is provided for converting waste biomass into N-doped biochar. • The as prepared catalyst with similar ORR performance than that of Pt/C. • Different types of ZAB are assembled to power homemade electronics. • The button cell shows outstanding performance than commercial PR 48 (Panasonic). Oxygen reduction reaction (ORR) is a cathode reaction for Zn-air battery (ZAB), however, it limits the large scale utilization of ZAB for its nature of a slow dynamic process. Therefore, it is of great practical significance to improve ORR performance when waste biomass materials are turned into cathode materials for ZAB. Herein, we report a simple and expandable green strategy, that can convert waste biomass materials (rotten wood (RW)) into N-doped carbon material (NRW-1000) with excellent ORR ability in a one-step process. In this strategy, NH 4 Cl is selected as activator and N source, thus realizing the biomass carbonization, activation and N doping process at the same time. The NRW-1000 prepared by this strategy was endowed with a half-wave of 0.87 V (vs. RHE), which is the same as Pt/C (0.87 V). To test the practicality of NRW-1000, different types of ZAB were assembled to power homemade electronics. Remarkably, the button ZAB based on NRW-1000 showed even more impressive energy density (58.52 mW cm−2) than that of the commercial PR 48 (Panasonic) (30.73 mW cm−2). Our work provides a solution to the current energy crisis by recycling waste into electrochemical catalysts. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • Study on the mechanism of aptamer-based fluorescent DNA biosensors. • Antibiotic detection is facilitated by the construction of aptamer-based fluorescent DNA biosensors using both label-free and labeled methods. • Signal amplification are harnessed to pursuit the heightened sensitivity of the antibiotic detection. The inappropriate employment of antibiotics across diverse industries has engendered profound apprehensions concerning their cumulative presence within human bodies and food commodities. Consequently, many nations have instituted stringent measures limiting the admissible quantities of antibiotics in food items. Nonetheless, conventional techniques employed for antibiotic detection prove protracted and laborious, prompting a dire necessity for facile, expeditious, and uncomplicated detection methodologies. In this regard, aptamer-based fluorescent DNA biosensors (AFBs) have emerged as a sanguine panacea to surmount the limitations of traditional detection modalities. These ingenious biosensors harness the binding prowess of aptamers, singular strands of DNA/RNA, to selectively adhere to specific target antibiotics. Notably, the AFBs demonstrate unparalleled selectivity, affinity, and sensitivity in detecting antibiotics. This comprehensive review meticulously expounds upon the strides achieved in AFBs for antibiotic detection, particularly emphasizing the labeling modality and the innovative free-label approach. It also elucidates the design principles behind a diverse array of AFBs. Additionally, a succinct survey of signal amplification strategies deployed within these biosensors is provided. The central objective of this review is to apprise researchers from diverse disciplines of the contemporary trends in AFBs for antibiotic detection. By doing so, it aspires to instigate a concerted endeavor toward the development of heightened sensitivity and pioneering AFBs, thereby contributing to the perpetual advancement of antibiotic detection methodologies. [ABSTRACT FROM AUTHOR]

Recently, with the ongoing development of the express industry, the consumption of waste plastic express bags has been increasing year by year, which has brought considerable pressure on municipal waste management. At the same time, in China, where coal is the main energy resource, the upgrading of low-rank coal is a more reliable and prospective way. An effective method for waste treatment and resource upgrading by synergistic co-liquefaction of waste plastic express bags and low-rank coal in a supercritical water-ethanol system has been developed. The effects of different experimental factors (temperature, residence time, plastic-coal ratio, water-ethanol ratio) on the conversion ratio and synergistic effect of co-liquefaction were investigated. The results showed that elevated temperature, lower water-ethanol ratio as well as suitable residence time, and plastic-coal ratio of 1:1 were conducive to the conversion ratio. Temperature ≥375 °C and suitable plastic-coal ratio (1:1) had a significant positive synergistic effect on the conversion ratio, whereas the other conditions exhibited no or negative synergistic effect on the conversion ratio. The maximum conversion ratio and positive synergistic efficiency were 85.11% and 12.25% at 425 °C, 60 min, water-ethanol ratio of 1:1, and plastic-coal ratio of 1:1, respectively. It was observed after FT-IR and elemental analysis based on the solid residue that the oxygen-containing functional groups in the residue disappeared, the oxygen content decreased, the carbon content increased, and the higher heating value (HHV) increased significantly, and the residue could be further used (such as gasification or pyrolysis) without the need for landfill. The GC-MS results of the oil products suggested that the oil products contained high content of hydrocarbons and phenols, as well as esters, alcohols, and other compounds. The hydrocarbons and phenols mainly derived from the decomposition of long chains in plastics and the decomposition of aromatic structures in coal, and the hydrocarbon and phenolic contents produced at 400 °C were 27.74% and 32.62%, respectively. Thus, the oil product can be used further as a chemical raw material. It cannot be ignored that the ethanol medium after reaction can also be further recycled by rotary evaporation. The synergistic co-liquefaction of waste plastic express bags and low-rank coal based on supercritical water-ethanol system is a promising method for waste treatment and resource upgrading. [Display omitted] • A synergistic co-liquefaction for waste express bags and low-rank coal was developed. • Ethanol can improve the synergistic efficiency of co-liquefaction. • The maximum conversion ratio of co-liquefaction reached 85.11% at 425 °C, 60 min. • Oil products from co-liquefaction contained hydrocarbons and phenolic compounds. [ABSTRACT FROM AUTHOR]

With the warming trend and the increasing frequency of extreme weather events, accurate crop yield estimation is becoming urgent. Crop yield estimation mainly consists of two methods: crop model simulation and remote sensing observations. Crop models can achieve accurate simulations of crop growth at field scales. However, in regional applications, they are limited by the spatial heterogeneity of certain input parameters. Remote sensing observations can obtain crop status over large areas quickly and conveniently, while lacking knowledge of crop growth processes. By combining the advantages of crop models and remote sensing, crop yield estimation with spatiotemporal continuity can be achieved using data assimilation methods. The research progress of the three elements of data assimilation system has been quantitatively reviewed in this paper. And the relevant literature was quantitatively screened and reviewed to provide a systematic overview of the application of data assimilation in crop yield estimation. In this study, the scientific background of the data assimilation system for crop yield estimations was described, and basic principles of data assimilation were introduced. A second part of this review screened and reviewed the relevant literature quantitatively. The answers to problems on: the most widely used crop model, the assimilation algorithm, and the assimilation variables were reported. Finally, a synthesis of the emerging directions and challenges of data assimilation systems for crop yield estimation were discussed. The results show that: a) the sequential assimilation method is the most widely used algorithm in the field of data assimilation, especially EnKF. b) WOFOST, DSSAT, AquaCrop and SAFY are the most common models in the research of data assimilation for yield estimation. c) In terms of assimilation variables, LAI (leaf area index), SM (soil moisture), and VIs (vegetation indexes) are relatively common assimilation variables. Research progress of data assimilation system for crop yield estimation is summarized from the aspects of algorithm improvement, model coupling research, multi-source remote sensing data assimilation and multiple assimilation variables. This review quantitatively examined and contrasted the research progress of data assimilation systems providing researchers with a more comprehensive background. It also suggests ideas and references for higher resolution, more accurate and reliable yield estimation for future research. [Display omitted] • Data assimilation is a vital tool to estimate and forecast regional crop yield. • The 143 papers on crop yield estimation by data assimilation published during 2000–2021 were searched and reviewed. • The paper focused on current models, algorithms, variables, spatial resolution and period of assimilation. • The progress of multisource and multivariable research was discussed. • The challenges and future directions were expounded. [ABSTRACT FROM AUTHOR]

[Display omitted] • Gained FeSiCr-based SMCs with a CeO 2 ·SiO 2 composite layer by selective oxidation between substrate and CeO 2 insulation layer. • The CeO 2 insulation layer promotes selective oxidation of Si in substrate during sintering in water vapor environment. • CeO 2 ·SiO 2 composite insulation layer demonstrated a 22.9% reduction in core loss than using the CeO 2 insulating layer alone. • CeO 2 ·SiO 2 composite insulation layer mitigated core loss while maintaining high magnetic conductivity in FeSiCr-based SMCs. This study introduces an approach to fabricating soft magnetic composites (SMCs) that effectively address core loss while maintaining high magnetic conductivity. During the sintering process in a water vapor environment, the CeO 2 insulation layer facilitates the selective oxidation of Si while simultaneously impeding the outward diffusion of Fe and Cr. Consequently, a CeO 2 ·SiO 2 composite insulation layer forms within the FeSiCr-based SMCs. The FeSiCr-based SMCs with the CeO 2 ·SiO 2 composite insulation layer achieve a saturation magnetization of 153.1 emu/g, which is 10.9% lower than that of FeSi 3.7 Cr 4.5 compacts, and exhibits a deterioration rate lower than previously reported values. Moreover, the permeability of the FeSiCr-based SMCs remains highly stable, demonstrating outstanding insulation characteristics. The total core loss and core loss separation results further corroborate that incorporating a CeO 2 ·SiO 2 composite insulation layer leads to a more pronounced reduction in interparticle eddy current loss than using a CeO 2 insulating layer alone. This performance enhancement can be attributed to the selective oxidation of a rare metal oxide insulation layer on a ferromagnetic metal particle substrate, a technique applied to SMCs for the first time. These findings hold significant implications for the design of high-performance SMCs in miniaturized and lightweight electromagnetic devices. [ABSTRACT FROM AUTHOR]

It is well established that fluid geochemistry in fault zones could provide reliable indicators for fault activity. Along these lines, in this work, Rn and CO 2 fluxes were measured for soil gases along the Xiaojiang Fault Zone (XFZ), SW China. The relationship among the soil gas Rn and CO 2 fluxes, hydrochemistry of hot springs, and fault activity were thoroughly examined based on the analytical results and regional geology. The water samples from the hot springs in the study area were the primary types of Ca·Mg-HCO 3 , Ca·Mg-HCO 3 ·SO 4 , and Ca-SO 4. It was believed that these types were probably affected by the interactions between the groundwater and carbonate rocks. Based on the weak correlation between the soil gas Rn and the CO 2 fluxes, the existence of distinct sources was suggested. The manifestation of a relatively high temperature and ion concentration of the hot spring water samples, as well as the relatively high soil gas Rn and CO 2 fluxes, led to a concentrated distribution in the northern and southern segments of the XFZ, which was consistent with the spatial distribution of the seismic activities and fault slip rate. The intense fault activity in the southern and northern segments could also enhance the permeability and accelerate both the water-rock interactions and soil gas emission within the fault zone. An assessment of the earthquake potential and radioactivity protection is considered of outmost significance for the southern and northern segments of the XFZ. • Feature and genesis of fluids emitted from the XFZ were systematically analyzed. • Hydrochemistry and soil gas Rn are potential indicators to evaluate fault activity. • Attention should be paid to seismicity and radiation risk in two ends of the XFZ. [ABSTRACT FROM AUTHOR]

• Silencing of E6 - 2 resulted in delayed fruit ripening. • E6 - 2 influences total carotenoids and lycopene accumulation in fruit ripening. • E6 - 2 affects ethylene sensitivity and multiple metabolisms. • MADS-RIN directly activates the expression of E6 - 2. Tomato fruit ripening is a complicated and well-coordinated process with numerous metabolic changes resulted from endogenous hormone and genetic regulators. Although the regulation of MADS-box transcription factor (MADS-RIN) controlling fruit ripening has been widely reported, its mechanisms underlying need to be further improved. Here, we characterized a novel tomato E6-like gene, E6 - 2 , whose transcripts showed a high accumulation in fruit ripening stages (Breaker, Breaker+4 and Breaker+7), but a low level was observed in Never ripe (Nr) and ripening inhibitor (rin) mutants. MADS-RIN directly activates the expression of E6 - 2 in vivo. Additionally, a remarkable reduction of E6 - 2 was observed in wild-type (WT) tomato fruits at the MG stage treated with 1-MCP. RNAi-mediated silencing of E6 - 2 resulted in delayed fruit ripening, reduced accumulation of the total carotenoid and lycopene, reduced content of ethylene production, and increased contents of the total pectin, cellulose, starch and soluble sugar. Moreover, the expression of carotenoid biosynthesis genes (PSY1 , PDS and ZDS), ripening-related genes (CNR , PG and ERF4), ethylene biosynthesis genes (ACS2 , ACO1 and ACO3), ethylene-responsive genes (E4 and E8) and cell wall metabolism genes (TBG4 , PL , EXP1 and XTH5) were inhibited in E6 - 2 -RNAi lines. These results indicate that E6 - 2 plays an important role in regulating tomato fruit ripening targeted by RIN. [ABSTRACT FROM AUTHOR]