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In the midst of a global pandemic, hospitals around the world are working to meet the demand for patients ill with COVID-19 caused by the novel coronavirus first identified in Wuhan, China. As the crisis unfolds, several countries have reported lower numbers as well as less morbidity and mortality for pediatric patients. Thus, pediatric centers find themselves pivoting from preparing for a patient surge to finding ways to support the regional response for adults. This report describes the response from two west coast freestanding academic children’s hospitals that were among the first cities in the United States impacted during this pandemic.
To develop an equation that can estimate the 24-h urinary Na excretion by using casual spot urine specimen for older hypertensive participants in rural Ningxia and further to compare with the INTERSALT method, Kawasaki method and Tanaka method.
Older hypertensive participants in rural Ningxia provided their casual spot urine samples and 24-h urine samples between January 2015 and February 2017. Sex-specific equation was developed using linear forward stepwise regression analysis. Model fit was assessed using adjusted R2. Approximately half of all participants were randomly selected to validate the equation. Mean differences, intraclass correlation coefficients and Bland–Altman plots were used to evaluate the performance of all methods.
Pingluo County and Qingtongxia County in Ningxia Hui Autonomous Region, China.
Older hypertensive participants in rural Ningxia.
Totally, 807 of 1120 invited participants provided qualified 24-h urine samples and spot urine samples. There was no statistical difference comparing the laboratory-based method against the new method and the INTERSALT method, while Kawasaki method had the largest bias with a mean difference of 40·81 g/d (95 % CI 39·27, 42·35 g/d). Bland–Altman plots showed similar pattern of the results.
The INTERSALT method and the new equation have the potential to estimate the 24-h urinary Na excretion in this study population. However, the extrapolation of the results to other population needs to be careful. Future research is required to establish a more reliable method to estimate 24-h urinary Na excretion.
Longitudinal studies predictably experience non-random attrition over time. Among older adults, risk factors for attrition may be similar to risk factors for outcomes such as cognitive decline and dementia, potentially biasing study results.
To characterize participants lost to follow-up which can be useful in the study design and interpretation of results.
In a longitudinal aging population study with 10 years of annual follow-up, we characterized the attrited participants (77%) compared to those who remained in the study. We used multivariable logistic regression models to identify attrition predictors. We then implemented four machine learning approaches to predict attrition status from one wave to the next and compared the results of all five approaches.
Multivariable logistic regression identified those more likely to drop out as older, male, not living with another study participant, having lower cognitive test scores and higher clinical dementia ratings, lower functional ability, fewer subjective memory complaints, no physical activity, reported hobbies, or engagement in social activities, worse self-rated health, and leaving the house less often. The four machine learning approaches using areas under the receiver operating characteristic curves produced similar discrimination results to the multivariable logistic regression model.
Attrition was most likely to occur in participants who were older, male, inactive, socially isolated, and cognitively impaired. Ignoring attrition would bias study results especially when the missing data might be related to the outcome (e.g. cognitive impairment or dementia). We discuss possible solutions including oversampling and other statistical modeling approaches.
Despite mounting evidence that non-injury-related factors have an important role in recovery from injury; specific variables associated with surgery outcomes are poorly understood. This lack of knowledge complicates efforts to improve the care of work-related hand injury (WRHI) patients. However, substantial research and investigation have still not clarified these underlying relationships, which merit further attention.
The purpose of this study was to evaluate the Health-Related Quality of Life (HRQL) outcome for WRHI patients after the impact of event and to investigate the moderated mediation analysis associated with their decision trust and regret.
A cross sectional study design was used to investigate the impact of event and the associated HRQL in 53 WRHI patients following severe and major hand injury. All consenting patients completed the Impact of Event Scale Revised, the Symptom Checklist-90-Revised, Decisional Trust scale, Decisional Regret scale and Short Form-36.
In the result of mediation analysis, patients affected HRQL via decisional trust and decisional regret, respectively. In addition, our data suggest that certain decisional trust and decisional regret (partial) characteristics significantly moderate this association. These findings may aid in the development of clinical interventions to enhance HRQL for WRHI patients. Overall, it is important for clinicians to consider the notion that more decisional trust or less decisional regret may sometimes, but not always, be better.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This paper employs an input–output based approach to analyse the convective velocities and transport of fluctuations in turbulent channel flows. The convective velocity for a fluctuating quantity associated with streamwise–spanwise wavelength pairs at each wall-normal location is obtained through the maximization of the power spectral density associated with the linearized Navier–Stokes equations with a turbulent mean profile and delta-correlated Gaussian forcing. We first demonstrate that the mean convective velocities computed in this manner agree well with those reported previously in the literature. We then exploit the analytical framework to probe the underlying mechanisms contributing to the local convective velocity at different wall-normal locations by isolating the contributions of each streamwise–spanwise wavelength pair (flow scale). The resulting analysis suggests that the behaviour of the convective velocity in the near-wall region is influenced by large-scale structures further away from the wall. These structures resemble Townsend’s attached eddies in the cross-plane, yet show incomplete similarity in the streamwise direction. We then investigate the role of each linear term in the momentum equation to isolate the contribution of the pressure, mean shear, and viscous effects to the deviation of the convective velocity from the mean at each flow scale. Our analysis highlights the role of the viscous effects, particularly in regards to large channel spanning structures whose influence extends to the near-wall region. The results of this work suggest the promise of an input–output approach for analysing convective velocity across a range of flow scales using only the mean velocity profile.
Take-away milk tea (TAMT) is popular among young generation, and the numbers of retails of TAMT have increased dramatically in recent years in many cities in China. Non-dairy cream is one of the major ingredients of TAMT. Concerns have been raised whether trans-fat originated from non-dairy cream may have an influence on cardio-metabolic traits. We evaluated the associations between daily intake of TAMT with plasma lipid profiles among young Chinese adults, who are the major customers of TAMT retailers.
Materials and Methods
The study population was from the phase 1 sample (104 adults) of the Carbohydrate Alternatives and Metabolic Phenotypes study. Those lacking blood samples or with a body mass index less than 18.5 kg/m2 were excluded, therefore, a total of 88 subjects with an average age of 22.8 years were included in the analysis. A food frequency questionnaire with 27 items was used to collect the dietary intake. Generalized linear regression was used to evaluate the associations between TAMT intake and cholesterol levels.
The estimated mean (± SE) of TAMT intake was 14.4 ± 3.4 ml/day, with apparent differences between males (8.8 ± 2.7 ml/day) and females (17.7 ± 5.1 ml/day). The mean of total cholesterol of the participants was 4.1 ± 0.1 mmol/L. After adjusted for age, sex, education attainment, smoking status, alcohol drink habit, and physical activity level, daily TAMT intake was positively associated with total cholesterol (beta ± SE = 0.0053 ± 0.0020, P = 0.011). The association was not substantially changed with further adjustment of body fat percentage (beta ± SE = 0.0053 ± 0.0020, P = 0.010). Similar associations were observed for high/low density lipoprotein cholesterols. When analysis was performed by sex, the association was only observed among females (beta ± SE = 0.0049 ± 0.0022, P = 0.031), but not in males (beta ± SE = 0.0022 ± 0.0060, P = 0.703).
In young adult Chinese, we observed an association between TAMT intake with plasma cholesterol level, independent of body adiposity.
To solve the poor cyclability of faradic supercapacitors (SCs), the authors reported a unique porous carbon (PC) coating with “gap shell” structure on carbon fiber cloth (CFC)/NiS2 materials. This gap shell PC coating was fabricated by combining atomic layer deposition (ALD) Al2O3 and molecular layer deposition alucone, followed by carbonization and etching. The as-prepared CFC/NiS2/PC composites were directly used as binder-free electrodes for SCs. Benefited from its novel nanostructure, the CFC/NiS2/PC electrode shows a large specific capacitance of 1034.6 F/g at 1 A/g and considerable rate capability of 67% capacitance, retaining ratio within 1–20 A/g. The cyclability of the CFC/NiS2/PC electrode is enhanced by 50% relative to the mere CFC/NiS2 after 2000 cycles, which is attributed to the gap and electrically conductive PC coating. Hence, this work provides a promising approach to design gap shell layer for improved cyclability of faradic SCs and other practical applications in energy storage electronics.
Previous studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet might contribute to managing risk factors of non-alcoholic fatty liver disease (NAFLD), but evidence is limited. We examined the association of DASH diet score (DASH-DS) with NAFLD, as well as the intermediary effects of serum retinol-binding protein-4 (RBP4), serum high-sensitivity C-reactive protein (hs-CRP), serum TAG, homeostasis model assessment of insulin resistance (HOMA-IR) and BMI.
We performed a cross-sectional analysis of a population-based cohort study. Dietary data and lifestyle factors were assessed by face-to-face interviews and the DASH-DS was then calculated. We assessed serum RBP4, hs-CRP and TAG and calculated HOMA-IR. The presence and degree of NAFLD were determined by abdominal sonography.
Guangzhou Nutrition and Health Study participants, aged 40–75 years at baseline (n 3051).
After adjusting for potential covariates, we found an inverse association between DASH-DS and the presence of NAFLD (Ptrend = 0·009). The OR (95 % CI) of NAFLD for quintiles 2–5 were 0·78 (0·62, 0·98), 0·74 (0·59, 0·94), 0·69 (0·55, 0·86) and 0·77 (0·61, 0·97), respectively. Path analyses indicated that a higher DASH-DS was associated with lower serum RBP4, hs-CRP, TAG, HOMA-IR and BMI, which were positively associated with the degree of NAFLD.
Adherence to the DASH diet was independently associated with a marked lower prevalence of NAFLD in Chinese adults, especially in women and those without abdominal obesity, and might be mediated by reducing RBP4, hs-CRP, TAG, HOMA-IR and BMI.
The present study aimed to evaluate the validity and reproducibility of a thirteen-item FFQ regarding identification of dietary conditions in a rural population in China.
A reproducibility study repeated the first FFQ (FFQ1) approximately 4 weeks later (FFQ2). A validity study evaluated the mean of three consecutive 24 h diet recalls as the reference measure.
Residents of a rural area in Henan Province, which is located in the central region of China.
A total of 295 individuals participated in the reproducibility study. In addition, 123 people agreed to participate in the validity study. Spearman’s correlation coefficients between the two FFQ ranged from 0·06 (vegetables) to 0·58 (eggs). Spearman’s correlation coefficients between the two methods of collection ranged from 0·01 for cereal to 0·49 for staple foods. The mean of the intraclass correlation coefficients of the two FFQ (FFQ1 v. FFQ2) was 0·19. Bland–Altman analysis indicated good agreement for most food groups across the range of intake for the two studies.
The study demonstrated that our FFQ design could be used as a representative tool to conduct a dietary evaluation of a rural population.
Altered heart rate variability (HRV), an index of autonomic nervous system function, has been reported in generalized anxiety disorder (GAD), but the results have been mixed. Thus, the present study, using a large sample size and better methodology, aims to examine whether GAD is associated with impaired HRV, both at rest and in response to posture challenges.
In total, 1832 participants were recruited in this study, consisting of 682 patients with GAD (including 326 drug- and comorbidity-free GAD patients) and 1150 healthy controls. Short-term HRV was measured during the supine-standing-supine test (5-min per position). Propensity score matching (PSM), a relatively novel method, was used to control for potential confounders.
After PSM algorithm, drug- and comorbidity-free GAD patients had reductions in resting (baseline) high-frequency power (HF), an index for parasympathetic modulation, and increases in the low-frequency/HF ratio (LF/HF), an index for sympathovagal balance as compared to matched controls. Furthermore, the responses of HF and LF/HF to posture changes were all attenuated when compared with matched controls. Effect sizes, given by Cohen's d, for resting HF and HF reactivity were 0.42 and 0.36–0.42, respectively.
GAD is associated with altered sympathovagal balance, characterized by attenuation in both resting vagal modulation and vagal reactivity, with an almost medium effect size (Cohen's d ≈ 0.4), regardless of medication use or comorbidity status.
The modification of halloysite nanotubes (HNTs) as fillers is very effective at improving the performance of polymers. A novel modification of HNTs through grafting dodecylamine onto their surfaces was conducted here. Owing to the improvement in dispersibility of HNTs in polytetrafluoroethylene (PTFE), the mechanical properties and wear resistance (in particular) of the dodecylamine-modified HNT-filled PTFE composite were enhanced significantly.
Shin-Horng Chen, Director, International Division, Chung-Hua Institution for Economic Research,
Pei-Chang Wen, Research Fellow, International Division, Chung-Hua Institution for Economic Research,
Meng-Chun Liu, Deputy, Director, International Division, Chung-Hua Institution for Economic Research
As neighbouring countries, economic relationships between ASEAN and Taiwan have been intensified primarily through de facto economic integration of trade and investment, instead of de jure integration, such as free trade agreements (FTAs). Not until in 2013 when Taiwan signed its FTA with Singapore (known as ASTEP) — its very first trade agreement ever with an ASEAN member. However, long before that, trade and direct investment between the two sides have intertwined to enhance mutual economic relationships. Particularly, it was direct investment in ASEAN made by numerous Taiwanese SMEs starting from the mid-1980s that triggered and pushed forward this economic integration (CIER 1995). In Taiwan, many tend to refer to this integration as the “investment-induced trade”. However, it can involve a process of “deep integration” (WTO 2011; Baldwin 2013a, p. 26) in a crossborder manner.
In addition, global value chains (GVCs) (Gereffi and Frederick 2010; Gereffi, Humphrey and Sturgeon 2005; Gereffi and Memedovic 2003) and otherwise known as global production networks (GPNs) (Chen 2002; Coe et al. 2004; Ernst 2005, 2006; Sturgeon and Lee 2005; UNCTAD 2005) are keys to such integration. It is well-documented that in East Asia, SMEs have made significant contribution to de facto regional economic integration via their participation in GVCs and/ or GPNs (ESCAP 2009; Lim and Kimura 2009; Harvie 2010; Chen 2002; OECD 2007), which in turn has become an important source of national economic growth. A typical example at issue refers to the GPNs, led by a few brand marketers in ICT (information and communications technology) hardware and software (Chen 2002; Yang and Coe 2009), involving such countries as Taiwan, Malaysia, Thailand, China, India and the Philippines. Furthermore, the WTO (2011) and a few scholars (Baldwin 2013a, 2013b; Low 2013) have suggested that GVCs/GPNs and FTAs often lead to “deep integration”, through intertwining relationships among trade, investment, service and intellectual property; a phenomenon termed the “trade-investmentservice- intellectual property (IP) nexus” (Baldwin 2013a, p. 26).
Set against the above context, this study sets out to examine the evolution of Taiwan's economic links with ASEAN. Indeed, GVCs/ GPNs are major elements underlying the economic links between ASEAN and Taiwan. To discuss this issue, we examine the macro data of direct investment and bilateral trade, from the Taiwanese perspective.
Cellulitis is a common infection of the skin and soft tissue. Susceptibility to cellulitis is related to microorganism virulence, the host immunity status and environmental factors. This retrospective study from 2001 to 2013 investigated relationships between the monthly incidence rate of cellulitis and meteorological factors using data from the Taiwanese Health Insurance Dataset and the Taiwanese Central Weather Bureau. Meteorological data included temperature, hours of sunshine, relative humidity, total rainfall and total number of rainy days. In otal, 195 841 patients were diagnosed with cellulitis and the incidence rate was strongly correlated with temperature (γS = 0.84, P < 0.001), total sunshine hours (γS = 0.65, P < 0.001) and total rainfall (γS = 0.53, P < 0.001). The incidence rate of cellulitis increased by 3.47/100 000 cases for every 1° elevation in environmental temperature. Our results may assist clinicians in educating the public of the increased risk of cellulitis during warm seasons and possible predisposing environmental factors for infection.
The excessive use of plastic, especially polystyrene (PS), has caused serious environmental pollution. The efficient utilization of plastics and the conversion of plastics into value-added carbon materials are the concerns of researchers. Herein, we propose novel “pyrolysis–deposition” method to convert one popular plastic substance, PS, into ordered mesoporous carbons (OMCs). During the synthesis process, PS is pyrolyzed into small organic gases under high temperature, which is then adsorbed through capillary adsorption into the mesoporous of SBA-15 in the presence of catalyst. The obtained OMCs have high specific surface area, uniform pore size, and ordered pore structure. The OMCs exhibit specific capacitance of 118 F/g at a current density of 0.2 A/g and electrochemical stability of 87.2% at a current density of 2 A/g after 5000 cycles. The pyrolysis–deposition strategy provides a new idea to convert waste plastics into high-performance carbon materials for electrochemical applications.
A kind of novel Ni–P gradient coating/stannate conversion film was deposited on AZ91D magnesium alloy (AZ91D alloy) by an integrative method involved stannate conversion and electroless plating. The results indicated that using sodium hypophosphite concentrations varied as 5, 10, 22, 46, and 60 g/L in the bath, the electroless Ni–P gradient coating with typical cell morphologies was successfully prepared, and the structures transited from crystalline → microcrystalline → amorphous were obtained as increasing P content from 3.31 to 12.58 wt%. Furthermore, the corrosion morphologies, polarization curves, and the electrochemical impedance spectroscopy result indicated that the corrosion resistance of AZ91D alloy substrate was significantly improved and the corrosion resistance of Ni–P gradient coating was superior than that of stannate conversion film, which might be attributed to the gradient structure and rising P content with unique function.
Direct determination of barrier height (ΦBH) value between Ir and single crystal (001) hydrogen-terminated diamond with lightly boron doped has been performed using x-ray photoelectron spectroscopy technique. 70 nm Ir islands were formed on hydrogen-terminated diamond surface using anodic aluminum oxide. The ΦBH value for Ir/hydrogen-terminated diamond was −0.43 ± 0.14 eV, indicating that Ir was a suitable metal for ohmic contact with hydrogen-terminated diamond. The band diagram of Ir/hydrogen-terminated diamond was obtained. The experimental ΦBH was compared with the theoretical ΦBH in this work.