Search

The COVID-19 pandemic has exerted unprecedented impacts on the world. Since its onset, China has established a network of fever clinics as an effective strategy to aggressively isolate and screen possible patients with COVID-19 symptoms. This study presents two fever clinic maps that visualize the uneven responses to the COVID-19 pandemic at the city level in mainland China. The maps highlight more resources in the southwest, northwest, east, and south China, and paucity in the far west parts of southwest and northwest China and in the north and northeast China.

Geographic access to cancer care is known to significantly impact utilization and outcomes. Longer travel times have negative impacts for patients requiring highly specialized care, such as for rare cancers, and for those in rural areas. Scant population-based research informs geographic access to care for rare cancers and whether rurality impacts that access.Using Medicare data (2014-2015), we identified prevalent cancers and cancer-directed surgeries, chemotherapy, and radiation. We classified cancers as rare (incidence6/100,000/year) or common (incidence ≥6/100,000/year) using previously published thresholds and categorized rurality from ZIP code of beneficiary residence. We estimated travel time between beneficiaries and providers for each service based on ZIP code. Descriptive statistics summarized travel time by rare versus common cancers, service type, and rurality.We included 1,169,761 Medicare beneficiaries (21.9% in nonmetropolitan areas), 87,399; 7.5% had rare cancers, with 9,133,003 cancer-directed services. Travel times for cancer services ranged from approximately 29 minutes (25th percentile) to 68 minutes (75th percentile). Travel times were similar for rare and common cancers overall (median: 45 vs 43 minutes) but differed by service type; 13.4% of surgeries were2 hours away for rare cancers, compared to 8.3% for common cancers. Increasing rurality disproportionately increased travel time to surgical care for rare compared to common cancers.Travel times to cancer services are longest for surgery, especially among rural residents, yet not markedly longer overall between rare versus common cancers. Understanding geographic access to cancer care for patients with rare cancers is important to delivering specialized care.

Background Delays between breast cancer diagnosis and surgery are associated with worsened survival. Delays are more common in urban-residing patients, although factors specific to surgical delays among rural and urban patients are not well understood. Methods We used a 100% sample of fee-for-service Medicare claims during 2007–2014 to identify 238,491 women diagnosed with early-stage breast cancer undergoing initial surgery and assessed whether they experienced biopsy-to-surgery intervals > 90 days. We employed multilevel regression to identify associations between delays and patient, regional, and surgeon characteristics, both in combined analyses and stratified by rurality of patient residence. Results Delays were more prevalent among urban patients (2.5%) than rural patients (1.9%). Rural patients with medium- or high-volume surgeons had lower odds of delay than patients with low-volume surgeons (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.58–0.88; OR = 0.74, 95% CI = 0.61–0.90). Rural patients whose surgeon operated at ≥ 3 hospitals were more likely to experience delays (OR = 1.29, 95% CI = 1.01–1.64, Ref: 1 hospital). Patient driving times ≥ 1 h were associated with delays among urban patients only. Age, black race, Hispanic ethnicity, multimorbidity, and academic/specialty hospital status were associated with delays. Conclusions Sociodemographic, geographic, surgeon, and facility factors have distinct associations with > 90-day delays to initial breast cancer surgery. Interventions to improve timeliness of breast cancer surgery may have disparate impacts on vulnerable populations by rural-urban status.

Calcium-based sulfur-fixing agent, as the main sulfur-fixing product, is widely used in power plant boiler systems. In order to further study the thermodynamic properties and reaction characteristics of calcium-based sulfur fixing agent and its products, the method of combining power plant experiment with theory was used. The electronic structure, thermodynamic properties and density of states of quicklime, limestone, calcium sulfate (CaSO4) and calcium sulphoaluminate have been calculated based on the first-principles ultra-soft pseudopotential plane wave method of density functional theory. The generalized gradient approximation algorithm is used to optimize the structure of various minerals to achieve the most stable state. The results show that the enthalpy, entropy, specific heat capacity at constant pressure and Gibbs free energy of calcium sulfonate vary greatly from 25-1000 K, while the change of calcium oxide (CaO) is small, and that of calcium carbonate (CaCO3) and CaSO4 are between them. It shows that calcium sulphoaluminate has strong stability and more energy is needed to destroy the molecular structure of calcium sulphoaluminate. The CaO is the most unstable and requires less energy to react. The CaCO3 and CaSO4 are in between. The variation range of CaSO4 is greater than that of CaCO3, indicating that the stability of CaSO4 is higher than that of CaCO3. The experimental results show that the desulfurization efficiency of generating calcium sulphoaluminate is much higher than that of only generating CaSO4, indicating that calcium sulphoaluminate is very stable, which is consistent with the calculated results.

Combined effects of obstacles and fine water mist on a methane-air explosion of a semi-closed pipe were investigated experimentally. In this study, the diameter of the water mist, the location, and the number of obstacles was considered. The results demonstrated that 5 µm water mist present a significant suppression affected while 45 µm shows a slight promotion effected on a gas explosion of the condition without obstacles. In the presence of an obstacle, however, the inhibitory effect of 5 µm water veils of mist dropped significantly during flame propagation, and the effect of 45 µm water veils of mist changed from the enhancement of inhibition, and its inhibitory effect was significant. The inhibitory effect of 45 µm water veils of mist on gas explosion weakened firstly and then enhanced with the increasing distance between obstacle location from the ignition location as well as in several obstacles.

Gd2O3 nanoparticles modified g-C3N4 photocatalytic composites were synthesized by a simple one-step hydrothermal method. The structure, morphology, optical properties of the prepared photocatalyst were characterized by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), field emission transmission electron microscopy (FETEM) and X-ray photoelectron spectroscopy (XPS). The result demonstrates that gadolinium is mainly dispersed on the surface of g-C3N4 in the form of Gd2O3, and does not destroy the lattice structure of g-C3N4. Besides, the gadolinium can cause the red shift of the absorption edge of light, narrow the band gap, and increase the separation efficiency of the photogenerated electron and hole of g-C3N4. Especially, the specific surface area of g-C3N4 can be significantly increased. Furthermore, g-C3N4/Gd-0.05 displays the highest photodegradation performance when it is used for degradation of methyl orange (MO), methylene blue (MB) and Rhodamine B (RhB). The photodegradation rate of g-C3N4/Gd-0.05 composites is 72.4% for MO, 95.5% for RhB, 100% for MB after 120 min under visible light (λ > 420 nm) irradiation. Narrow band gap promotes the separation of photogenerated electron and hole, which enhances the photocatalytic activity of g-C3N4. It is noted that g-C3N4/Gd-0.05 exhibits excellent photocatalytic stability by the photocurrent and the cyclic photodegradation of MO.

Purpose Spatial behavior of patients in utilizing health care reflects their travel burden or mobility, accessibility for medical service, and subsequently outcomes from treatment. This paper derives the best-fitting distance decay function to capture the spatial behaviors of cancer patients in the Northeast region of the U.S., and examines and explains the spatial variability of such behaviors across sub-regions. Principal results (1) 46.8%, 85.5%, and 99.6% of cancer care received was within a driving time of 30, 60, and 180 min, respectively. (2) The exponential distance decay function is the best in capturing the travel behavior of cancer patients in the region and across most sub-regions. (3) The friction coefficient in the distance decay function is negatively correlated with the mean travel time. (4) The best-fitting function forms are associated with network structures. (5) The variation of the friction coefficient across sub-regions is related to factors such as urbanicity, economic development level, and market competition intensity. Major conclusions The distance decay function offers an analytic metric to capture a full spectrum of travel behavior, and thus a more comprehensive measure than average travel time. Examining the geographic variation of travel behavior needs a reliable analysis unit such as organically defined “cancer service areas,” which capture relevant health care market structure and thus are more meaningful than commonly-used geopolitical or census area units.

Lung cancer, a malignant tumor, is associated with high morbidity and mortality worldwide. We studied the influence and mechanism of CBR3-AS1 on lung cancer cell proliferation, migration, and infiltration. The expression of CBR3-AS1 and miRNA-337-3p were higher and lower (P< 0.05), respectively, in lung cancer tissues than in paracancerous tissues. After inhibiting the expression of CBR3-AS1, the OD value of A549 cells, cloning formation numbers, migrating and invasive numbers, N-cadherin protein expression levels were lower. The G0-G1 cell cycle periods was longer. The S cell cycle periods was shorter. The E-cadherin protein expression levels higher (P< 0.05 in all cases). CBR3-AS1 negatively regulated miRNA-337-3p expression in A549 cells (P< 0.05). After inhibiting the expression of CBR3-AS1 and miRNA-337-3p, the OD value of A549 cells was lower, cloning formation numbers, migrating and invasive numbers, N-cadherin protein expression levels were lower. The G0-G1 cell cycle periods was longer. The S cell cycle periods was shorter. The E-cadherin protein expression levels was higher (P< 0.05 in all cases). CBR3-AS1 expression was increased in lung cancer tissues, and interference with CBR3-AS1 expression could inhibit the proliferation, migration, and infiltration of lung cancer A549 cells by negatively regulating miRNA-337-3p.

The composition of low calorific value synthesis gas varies greatly depending on the raw material and processing technology, which makes the combustion extremely complicated. The three mechanisms of the GRI-Mech 3.0, Li-Model, and FFCM-Mech are used to numerically simulate CH4/CO/H2/N2 air premixed combustion by using ANSYS CHEMKIN-PRO. The numerical simulation is the calculation of laminar flame velocity and adiabatic flame temperature at an initial temperature of 298 K, an equivalence ratio of 0.6–1.4, and an initial pressure of 0.1–0.5 MPa, discussing through thermodynamics and chemical kinetics. The formation of NOX, H, and OH radicals by fuel composition was analyzed. The result shows that the concentrations of H, O, and OH radicals have a positive effect on laminar flame velocity. The combustion reaction of H2 is higher than that of CH4 and CO; with the increase of N2 content, the priority is higher. The thermal diffusivity of flame under different equivalence ratios is affected by inert gas, which affects adiabatic combustion temperature and laminar combustion velocity. In thermal kinetics and chemical kinetics, CH4 has more influence on combustion temperature than CO, while laminar flame velocity is relatively low. Under the change of initial pressure, the laminar combustion flux increases to the initial pressure and the laminar combustion velocity decreases to the increase in pressure. Reactions H + O2 = O + OH, HO2 + H = 2OH, and CH3 + HO2 = OH + CH3O are mainly due to change in the concentration of O, H, and OH radicals.