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Several investigations have been carried out to explore the genetic association of TLR4 codon variants, specifically Asp299Gly and Thr399Ile, and susceptibility to sepsis, but the results have been contradictory. The present study aimed to conduct a meta‐analysis to draw a definitive conclusion regarding the role of TLR4 genetic variants (Asp299Gly and Thr399Ile) in sepsis. A thorough literature search was conducted using the PubMed, Scopus, and Science Direct databases. The inclusion and exclusion criteria were established to ensure the accuracy of the data. The Comprehensive Meta‐Analysis Software v4 was utilized to perform the meta‐analysis and related analyses. A total of 13 studies were analyzed, including 2328 sepsis cases and 2495 healthy controls for the TLR4 Asp299Gly variant. Eight studies provided genotype data for the rs4986791 polymorphism. The Asp299Gly variant showed a marginal protective effect in the allele (p = 0.08, odds ratio = 0.71) and dominant (p = 0.09, odds ratio = 0.71) genetic models, although it was not statistically significant. The trial sequential analysis indicated that further case–control studies are necessary to draw definitive conclusions about the TLR4 polymorphisms in sepsis. The TLR4 Asp299Gly variant may have a protective effect against sepsis. However, additional research with larger sample sizes across diverse populations is required to validate this finding. [ABSTRACT FROM AUTHOR]

A series of novel intumescent flame retardant (IFR) based on melamine, neopentyl glycol, and aluminum diethylphosphinate were prepared and tested. In addition, the synergistic effect of the novel IFR and zinc borate (ZB) on the flame retardancy of LLDPE composites was investigated. The structures of novel IFR and ZB were characterized by X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy. The limiting oxygen index (LOI) increased from 19.3% for the pure LLDPE to 27% for the 25 wt% IFR/5 wt% ZB composites and the composites achieved the desired V-0 rating in the UL-94 test. Thermogravimetric analysis showed that the addition of IFR/ZB reduced the pyrolysis rate of the LLDPE composites at high temperatures and increased the amount of the char residues, and the char residue of LLDPE-5 reached 12.1 wt% at 700[degrees]C. Cone calorimetry (CCT) data showed that the peak of total heat release, heat release rate, and fire growth index were comparatively reduced, indicating that the addition of IFR/ZB decreased the fire hazard of LLDPE composites. The formation of a compact and thermally stable char layer on the surfaces of LLDPE composites was revealed from the scanning electrone microscopy images and digital photographs of the char residue after the CCT tests. KEYWORDS composites, flame retardant, polyethylene, synthesis, thermal properties, 1 | INTRODUCTION Polyethylene (PE) is a typical thermoplastic that currently has the highest production volume among the five general-purpose plastics. Polyethylene is used in a wide range of applications [...]

Purpose: Although pediatric epidural analgesia is a well-established technique used perioperatively. It is unclear whether a lumbar or caudal epidural is suitable for osteogenesis imperfecta (OI) patients, which may be associated with brittle bones and spine deformity. We conducted a retrospective study to investigate and compare the efficacy of the two continuous epidural techniques in pediatric patients undergoing lower extremity osteotomy surgery using a propensity score-matched analysis (PSMA). Patients and Methods: A total of 274 patients were included. Patients' age, weight, and height were adjusted using PSMA. 90 patients were matched for further analysis, with 45 patients in the lumbar epidural group (Group L) and 45 patients in the caudal epidural group (Group C). Pain scores were categorized into three grades: mild (0– 3), moderate (4– 6), and severe (7– 10), and compared between the two groups. Additionally, operation time, operation site, blood loss, scoliosis, oral analgesic medications, and catheter or nerve-related complications were compared. Results: There were no significant differences in operation time, operation site, scoliosis, and blood loss between the two groups. The percentage of moderate to severe pain during movement was significantly higher in Group L than in Group C, with 37.5% versus 17.5% on the second-day post-operation (P=0.039). However, no statistically significant difference was observed on other days. Additionally, there was no significant difference in oral medication consumption and complications between the two groups. Conclusion: Both lumbar and caudal epidural analgesia can be effectively used postoperatively, and a caudal epidural should be considered where performing a lumbar epidural is challenging in OI pediatric patients. Plain Language Summary: Osteogenesis imperfecta (OI) is a rare genetic disorder that affects the body's connective tissues, particularly the bones and ligaments. It is caused by abnormalities in type I collagen, which leads to skeletal fragility known as "brittle bones". This fragility can cause various issues, including an increased risk of fractures from minor trauma, limb deformities, and unusual fractures such as vertebral compressions. OI patients may also experience spinal manifestations such as scoliosis and kyphosis. Lumbar epidural analgesia has been found to be effective in providing pain relief for surgeries that involve the lower extremities. Additionally, caudal epidural analgesia has also demonstrated its effectiveness in providing postoperative analgesia for surgeries that affect the lower limbs. However, there is still debate about the safety of epidural analgesia in patients with skeletal dysplasias, especially those with OI. Despite this uncertainty, our center, which was supported by the Rare Diseases Public Welfare Organization, has successfully used epidural analgesia since 2015 in the southern part of China for OI surgeries. We conducted a retrospective study to share our experiences of nine years of practice and compare lumbar epidural with caudal epidural using a propensity score matching to balance basic demographics. We also compared the presence of scoliosis. Our findings suggest that both lumbar and caudal epidural analgesia can be safely used in OI patients. In cases where lumbar punctures may pose challenges due to potential spine deformities, the caudal route can be an alternative. [ABSTRACT FROM AUTHOR]

Most systems experience both random shocks (hard failure) and performance degradation (soft failure) during service span, and the dependence of the two competing failure processes has become a key issue. In this study, a novel dependent competing failure processes (DCFPs) model with a varying degradation rate is proposed. The comprehensive impact of random shocks, especially the effect of cumulative shock, is reasonably considered. Specifically, a shock will cause an abrupt degradation damage, and when the cumulative shock reaches a predefined threshold, the degradation rate will change. An analytical reliability solution is derived under the concept of first hitting time (FHT). Besides, a one‐step maximum likelihood estimation method is established by constructing a comprehensive likelihood function. Finally, the reasonability of the closed form reliability solution and the feasibility and effectiveness of the proposed DCFPs modeling methodology are demonstrated by a comparative simulation study. [ABSTRACT FROM AUTHOR]