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BackgroundThe COVID-19 pandemic has shined a harsh light on a critical deficiency in our health care system: our inability to access important information about patients’ values, goals, and preferences in the electronic health record (EHR). At Memorial Sloan Kettering Cancer Center (MSK), we have integrated and systematized health-related values discussions led by oncology nurses for newly diagnosed cancer patients as part of routine comprehensive cancer care. Such conversations include not only the patient’s wishes for care at the end of life but also more holistic personal values, including sources of strength, concerns, hopes, and their definition of an acceptable quality of life. In addition, health care providers use a structured template to document their discussions of patient goals of care. ObjectiveTo provide ready access to key information about the patient as a person with individual values, goals, and preferences, we undertook the creation of the Patient Values Tab in our center’s EHR to display this information in a single, central location. Here, we describe the interprofessional, interdisciplinary, iterative process and user-centered design methodology that we applied to build this novel functionality as well as our initial implementation experience and plans for evaluation. MethodsWe first convened a working group of experts from multiple departments, including medical oncology, health informatics, information systems, nursing informatics, nursing education, and supportive care, and a user experience designer. We conducted in-depth, semistructured, audiorecorded interviews of over 100 key stakeholders. The working group sought consensus on the tab’s main content, homing in on high-priority areas identified by the stakeholders. The core content was mapped to various EHR data sources. We established a set of high-level design principles to guide our process. Our user experience designer then created wireframes of the tab design. The designer conducted usability testing with physicians, nurses, and other health professionals. Data validation testing was conducted. ResultsWe have already deployed the Patient Values Tab to a pilot sample of users in the MSK Gastrointestinal Medical Oncology Service, including physicians, advanced practice providers, nurses, and administrative staff. We have early evidence of the positive impact of this EHR innovation. Audit logs show increasing use. Many of the initial user comments have been enthusiastically positive, while others have provided constructive suggestions for additional tab refinements with respect to format and content. ConclusionsIt is our challenge and obligation to enrich the EHR with information about the patient as a person. Realization of this capability is a pressing public health need requiring the collaboration of technological experts with a broad range of clinical leaders, users, patients, and families to achieve solutions that are both principled and practical. Our new Patient Values Tab represents a step forward in this important direction.

We chose DPP-BDT-DPP {DPP=diketopyrrolopyrrole, BDT=4,8-di-[2-(2-ethylhexyl)-thienyl]benzo[1,2- b:4,5- b′]dithiophene} as a model backbone and varied the anchoring groups [C5H11, COOCH3, and SiCH3(OSiCH3)2] terminated on the N-substituted alkyl-chain spacer of the DPP units to study the effect of anchoring terminals on the morphology of blend film and on the device performances of bulk heterojunction solar cells. By replacing the nonpolar C5H11 anchoring terminal with the polar COOCH3 anchoring terminal leads to an enhancement in the short-circuit current density ( Jsc) (4.62 vs. 9.32 mA cm−2), whereas the value of Jsc sharply decreases to 0.45 mA cm−2 if the C5H11 anchoring terminal is replaced by a SiCH3(OSiCH3)2 group. The changes in Jsc are associated with changes in the π-π stacking distance (3.39→3.34 Å vs. 3.39→3.45 Å) and the phase size (50→20 nm vs. 50→>250 nm) through alteration of the anchoring group from C5H11 to COOCH3 versus from C5H11 to SiCH3(OSiCH3)2. Interestingly, the anchoring terminals bring about drastic changes in molecular orientations, which result in different out-of-plane hole transport. This is the first time this effect has been systemically demonstrated to improve photocurrent generation by manipulating the dipolar anchoring groups terminated on the alkyl-chain spacer. [ABSTRACT FROM AUTHOR]

The sorption of Pb and Cd from aqueous solutions by spent Agaricus bisporus was investigated. The effects of contact time, pH, ionic medium, initial metal concentration, other metal ions presence and ligands were studied in batch experiments at 25°C. Maximum sorption for both metals was found to occur at an initial pH of around 5.5. The equilibrium process was well described by the Langmuir isotherm model, with maximum sorption capacities of 0.2345 and 0.1273 mmol g−1 for Pb and Cd respectively. Kinetic data followed the pseudo-second-order kinetic model. The presence of NaCl and NaClO4 caused a reduction in Cd sorption, while Pb sorption was not remarkably affected. The presence of other metals did not affect Pb removal, while the Cd removal was much reduced. HCl or EDTA solutions were able to desorb Cd from the spent Agaricus bisporus (SAB) completely, while an approximately 60% and 15% desorption yield was obtained for Pb when HCl 0.01 mol L−1 or EDTA 0.001 mol L−1 were used, respectively. The results of FTIR, SEM and EDX analysis indicated that other mechanisms, such as surface complexation and electrostatic interactions, must be involved in the metal sorption in addition to ion exchange. © 2012 Canadian Society for Chemical Engineering [ABSTRACT FROM AUTHOR]

Tamarix chinensis, with its important ecological significance, is a vital dominant plant in the Yellow River Delta of China. To understand its genetic structure and population dynamics, five populations of T. chinensis, consisting of 140 individuals, were analyzed in this study using inter simple sequence repeat markers. Seventy-eight polymerase chain reaction fragments were scored, of which 62 were polymorphic. The mean percentage of polymorphic loci ( P), the mean Nei's gene diversity ( h), and the mean Shannon's information index ( I) were 79.5%, 0.239, and 0.363, respectively. These indexes indicated that a moderate level of genetic diversity existed in T. chinensis populations of the Yellow River Delta. Both analysis of molecular variance (AMOVA) ( Φ = 0.169) and Popgene ( G = 0.159) analyses revealed the low level of genetic differences among the five populations of T. chinensis. The results implied that relatively frequent gene flow existed among populations. However, slightly uneven genetic diversity was also found among populations. Unweighted pair group method with arithmetic mean and principal component analysis showed that populations with similar soil salinity had a close relationship, rather than populations with closer geographical distance. A significant negative correlation between genetic diversity and soil salinity of the five populations ( r = −0.958, p < 0.01) showed that soil salinity played an important role in shaping the population genetic structure of T. chinensis in the Yellow River Delta, China. [ABSTRACT FROM AUTHOR]

• ERα mRNA transcript was greater in the chicken ovarian tissues at 160 d than 90 d of age. • Histone H3K27 acetylation of chicken ERα promoter increased in ovarian tissues of 160 d than 90 d. • p300 mRNA transcript and protein increased in chicken ovarian tissues of 160 d than 90 d. Estrogen receptor alpha (ERα) is a ligand-activated transcription factor that regulates cellular responses to estrogens and transcription processes of target genes. In this study, changes in DNA methylation and histone modifications in the promoter region and Exon 1 of the ERα gene were analyzed to ascertain epigenetic changes associated with increased ERα mRNA abundance during reproductive maturation from 90 (egg production not yet initiated) to 160 (after egg production was initiated) d of age (d post-hatching) in chicken ovaries. The results indicate there was no difference in CpG methylation at the promoter and Exon 1 except at the region analyzed with primer pairs F2 and R2, where percentage of methylated CpG of Sites 2 and 8 after reproductive maturation was greater compared with before reproductive maturation. By using the chromatin immunuoprecipitation (ChIP) assay combined with SYBR green quantitative PCR, effects of histone modifications were evaluated, including histone H3K4 di + tri methylation, H3K9 phosphorylation and trimethylation, H3K36 methylation and H3K27 acetylation on chicken ERα mRNA transcript abundance. The results indicated that there was a greater histone H3K27 acetylation and lesser H3K36 trimethylation associated with increased abundance of ERα mRNA transcript in chicken ovaries after reproductive maturation (90 compared with 160 d of age). In consistent with this finding, the relative abundance of transcriptional coactivator p300 mRNA transcript and protein in the ovaries was markedly greater in reproductively mature than immature chickens. Findings provide insights into the epigenetic regulations of the chicken ERα gene expression that is required for chicken ovarian development. [ABSTRACT FROM AUTHOR]

For promoting the recycling of industrially discarded luffa resources and preventing environmental pollution caused by the incineration of luffa waste, abundant luffa scraps and environmentally friendly polyester fibers were used as raw materials to produce luffa fiber sound absorbing composites by the clean hot-pressing technology. Results revealed that the polyester fiber surface becomes rougher, with a large number of porous structures, affording a three-dimensional network after hot-pressing. Within the range of the test design, the sound absorption coefficient of the samples increased with increasing density, thickness, and distance of the back air gap. With the increase in the thickness from 2 cm to 6 cm, the average sound absorption coefficient of the material increased from 0.442 to 0.684, and the maximum sound absorption coefficient increased from 0.907 (4000 Hz) to 0.991 (1000 Hz). At back air gap distances of 0 cm, 1 cm, and 2 cm, their average sound absorption coefficients were 0.602, 0.606, and 0.645, respectively. At a density of 0.09 g/cm3, a thickness of 4 cm, and a back air gap distance of 2 cm, the average sound absorption coefficient of the luffa fiber composite reached 0.645, revealing a high-efficiency sound absorbing material. In addition to exhibiting a good sound absorption performance, the luffa fiber composite exhibited a soft surface and good buffer performance. Moreover, compared to other plant fiber composites, the luffa fiber composite exhibited better performance for hygroscopic and moisture dissipation. Raw materials as well as the processing of the novel sound absorbing material comprising luffa and polyester fibers. Image 1 • The composite overcomes the inhomogeneity of luffa scraps and remains highly porous. • Polyester fibers combined with luffa fibers, affording a three-dimensional network. • Pores and folds were generated on the polyester fiber surface after hot-pressing. • The average sound absorption coefficient of the composite reached 0.645. • The composite performs well on buffering, hygroscopicity and moisture dissipation. [ABSTRACT FROM AUTHOR]

In this study, we were concerned with the physical properties of carbon‐fiber‐ and pine‐cone‐fiber‐reinforced high‐density polyethylene prepared by compression molding. The resulting composites were characterized by scanning electron microscopy, X‐ray diffraction, Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis, differential scanning calorimetry, and mechanical testing. The results indicate that the manufacturing properties of the composites were improved with the addition of carbon fibers. The FTIR results showed that the carbon‐fiber reinforcement of the composites was mainly achieved through physical effects. An appropriate content of carbon‐fiber addition improved the interface combination between the fibers and matrix; carbon fibers improve the water absorption of the material, and the relative crystallinity of the composite increased with increasing carbon‐fiber addition. With increasing carbon‐fiber content, the thermal decomposition temperature of the composites increased, and the thermal stability of the composites improved. © 2018 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019, 136, 47304. [ABSTRACT FROM AUTHOR]

This study aimed to assess the feasibility of GP73 as a diagnostic marker for liver inflammation and fibrosis in chronic HBV patients with normal or slightly raised ALT (<2 ULN) and to develop models based on GP73 and other biochemical parameters to improve diagnostic accuracy. Serum GP73 levels were analyzed in 220 chronic HBV patients with normal or slightly raised ALT who underwent liver biopsy. The results showed that the area under the receiver operating characteristic (ROC) curve (AUC) was 0.806 for predicting significant liver inflammation (≥G2), while it was 0.742 for predicting significant fibrosis (≥S2). These results suggest that GP73 has higher diagnostic value for liver inflammation than liver fibrosis. Combining GP73, AST and ALB, as a diagnostic model for predicting significant liver inflammation, resulted in superior diagnostic performance over GP73 alone (AUC value increased from 0.806 to 0.854, z = 2.299, P = 0.021). By applying this diagnostic model, over 80% of chronic HBV patients with normal or slightly raised ALT will be correctly identified and hence avoid delay in diagnosis and treatment. In conclusion, GP73 would be an additional serum marker for predicting liver inflammation and fibrosis in chronic HBV patients with normal or slightly raised ALT. [ABSTRACT FROM AUTHOR]

Acoustic emission (AE) technology provides a novel approach for studying the damage and fracture behavior of wood‐plastic composites (WPCs) during their application process. This method allows rapid and precise analysis of the mechanical properties of materials, which is a significant advancement for the emerging WPC industry. Hence, a blend of waste floor sanding powder (FSP) and rice husk (RH) reinforced recycled high‐density polyethylene (Re‐HDPE) was prepared by the extrusion method. The AE technique, scanning electron microscopy, and finite element method (FEM) were used to analyze the damage and fracture behavior of the composite materials under a three‐point bending test. The results indicated that the bearing capacity of RH/Re‐HDPE composites was slightly higher than that of FSP/Re‐HDPE composites. The AE technique can better illustrate the damage evolution and fracture process of composites and determine the damage degree and mode. Matrix cracking and deformation were more pronounced in the FSP/Re‐HDPE composites. Fiber breakage and delamination were more prominent in the RH/Re‐HDPE composites. In addition, repeated loading caused irreversible damage to the composite. The increase in temperature led to the attenuation of the AE signal and a decrease in matrix strength. However, when the temperature reached a certain point, the cumulative AE ringing count increased again because the higher temperature improved the fiber–matrix interface strength, which partially canceled out the negative effect. In addition, Abaqus was used for simulation analysis, and the running results coincided with the experimental value. Highlights: RH/Re‐HDPE and FSP/Re‐HDPE are sustainability and low‐cost composites.AE can determine the degree and mode of damage of WPC at different temperatures.The AE curves of RH/Re‐HDPE and FSP/Re‐HDPE all pass through four stages.Heating reduced the matrix strength and improved the interface strength of WPC.The results of FEM were consistent with the experimental results. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported that abnormal interlimb coordination is a typical characteristic of motor developmental delay (MDD) during human movement, which can be visually manifested as abnormal motor postures. Clinically, the scale assessments are usually used to evaluate interlimb coordination, but they rely heavily on the subjective judgements of therapists and lack quantitative analysis. In addition, although abnormal interlimb coordination of MDD have been studied, it is still unclear how this abnormality is manifested in physiology-related kinematic features. Objectives: This study aimed to evaluate how abnormal interlimb coordination of MDD during infant crawling was manifested in the stability of joints and limbs, activation levels of synergies and intrasubject consistency from the kinematic synergies of tangential velocities of joints perspective. Methods: Tangential velocities of bilateral shoulder, elbow, wrist, hip, knee and ankle over time were computed from recorded three-dimensional joint trajectories in 40 infants with MDD [16 infants at risk of developmental delay, 11 infants at high risk of developmental delay, 13 infants with confirmed developmental delay (CDD group)] and 20 typically developing infants during hands-and-knees crawling. Kinematic synergies and corresponding activation coefficients were derived from those joint velocities using the non-negative matrix factorization algorithm. The variability accounted for yielded by those synergies and activation coefficients, and the synergy weightings in those synergies were used to measure the stability of joints and limbs. To quantify the activation levels of those synergies, the full width at half maximum and center of activity of activation coefficients were calculated. In addition, the intrasubject consistency was measured by the cosine similarity of those synergies and activation coefficients. Results: Interlimb coordination patterns during infant crawling were the combinations of four types of single-limb movements, which represent the dominance of each of the four limbs. MDD mainly reduced the stability of joints and limbs, and induced the abnormal activation levels of those synergies. Meanwhile, MDD generally reduced the intrasubject consistency, especially in CDD group. Conclusions: These features have the potential for quantitatively evaluating abnormal interlimb coordination in assisting the clinical diagnosis and motor rehabilitation of MDD. [ABSTRACT FROM AUTHOR]