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Introduction: Although acute gastroenteritis is an extremely common childhood illness, there is a paucity of literature characterizing the associated pain and its management. Our primary objective was to quantify the pain experienced by children with acute gastroenteritis in the 24-hours prior to emergency department (ED) presentation. Secondary objectives included describing maximum pain, analgesic use, discharge recommendations, and factors that influenced analgesic use in the ED. Methods: Study participants were recruited into this prospective cohort study by the Alberta Provincial Pediatric EnTeric Infection TEam between January 2014 and September 2017. This study was conducted at two Canadian pediatric EDs; the Alberta Children's Hospital (Calgary) and the Stollery Children's Hospital (Edmonton). Eligibility criteria included < 18 years of age, acute gastroenteritis (□ 3 episodes of diarrhea or vomiting in the previous 24 hours), and symptom duration □ 7 days. The primary study outcome, caregiver-reported maximum pain in the 24-hours prior to presentation, was assessed using the 11-point Verbal Numerical Rating Scale. Results: We recruited 2136 patients, median age 20.8 months (IQR 10.4, 47.4); 45.8% (979/2136) female. In the 24-hours prior to enrolment, 28.6% (610/2136) of caregivers reported that their child experienced moderate (4-6) and 46.2% (986/2136) severe (7-10) pain in the preceding 24-hours. During the emergency visit, 31.1% (664/2136) described pain as moderate and 26.7% (571/2136) as severe. In the ED, analgesia was provided to 21.2% (452/2131) of children. The most commonly administered analgesics in the ED were ibuprofen (68.1%, 308/452) and acetaminophen (43.4%, 196/452); at home, acetaminophen was most commonly administered (77.7%, 700/901), followed by ibuprofen (37.5%, 338/901). Factors associated with analgesia use in the ED were greater pain scores during the visit, having a primary-care physician, shorter illness duration, fewer diarrheal episodes, presence of fever and hospitalization. Conclusion: Although children presenting to the ED with acute gastroenteritis experience moderate to severe pain, both prior to and during their emergency visit, analgesic use is limited. Future research should focus on appropriate pain management through the development of effective and safe pain treatment plans.
We study the shape and motion of gas bubbles in a liquid flowing through a horizontal or slightly inclined thin annulus. Experimental data show that in the horizontal annulus, bubbles develop a unique ‘tadpole-like’ shape with a semi-circular cap and a highly stretched tail. As the annulus is inclined, the bubble tail tends to vanish, resulting in a significant decrease of bubble length. To model the bubble evolution, the thin annulus is conceptualised as a ‘Hele-Shaw’ cell in a curvilinear space. The three-dimensional flow within the cell is represented by a gap-averaged, two-dimensional model, which achieved a close match to the experimental data. The numerical model is further used to investigate the effects of gap thickness and pipe diameter on the bubble behaviour. The mechanism for the semi-circular cap formation is interpreted based on an analogous irrotational flow field around a circular cylinder, based on which a theoretical solution to the bubble velocity is derived. The bubble motion and cap geometry is mainly controlled by the gravitational component perpendicular to the flow direction. The bubble elongation in the horizontal annulus is caused by the buoyancy that moves the bubble to the top of the annulus. However, as the annulus is inclined, the gravitational component parallel to the flow direction becomes important, causing bubble separation at the tail and reduction in bubble length.
Four complete platysiagid fish specimens are described from the Luoping Biota, Anisian (Middle Triassic), Yunnan Province, southwest China. They are small fishes with bones and scales covered with ganoine. All characters observed, such as nasals meeting in the midline, a keystone-like dermosphenotic, absence of post-rostral bone, two infraorbitals between dermosphenotic and jugal, large antorbital, and two postcleithra, suggest that the new materials belong to a single, new Platysiagum species, P. sinensis sp. nov. Three genera are ascribed to Platysiagidae: Platysiagum, Helmolepis and Caelatichthys. However, most specimens of the first two genera are imprints or fragmentary. The new, well-preserved specimens from the Luoping Biota provide more detailed anatomical information than before, and thus help amend the concept of the Platysiagidae. The Family Platysiagidae was previously classed in the Perleidiformes. Phylogenetic analysis indicates that the Platysiagidae is a member of basal Neopterygii, and its origin seems to predate that of Perleidiformes. Moreover, platysiagid fishes are known from the Middle Triassic of the western Tethys region. The newly found specimens of platysiagids from Luoping provide additional evidence that both eastern and western sides of the Tethys Ocean were biogeographically more connected than previously thought.
Rice planthopper (RPH) populations of Nilaparvata lugens and Sogatella furcifera periodically have erupted across Asia. Predicting RPH population dynamics and identifying their source areas are crucial for the management of these migratory pests in China, but the origins of the migrants to temperate and subtropical regions in China remains unclear. In particular, their early migration to China in March and April have not yet been explored due to a lack of research data available from potential source areas, Central Vietnam and Laos. In this study, we examined the population dynamics and migratory paths of N. lugens and S. furcifera in Vietnam and South China in 2012 and 2013. Trajectory modeling showed that in March and April in 2012 and 2013, RPH emigrated from source areas in Central Vietnam where rice was maturing to the Red River Delta and South China. Early migrants originated from Southern Central Vietnam (14–16°N), but later most were from Northern Central Vietnam (16–19°N). Analysis of meteorological and light-trap data from Hepu in April (1977–2013) using generalized linear models showed that immigration increased with precipitation in Southern Central Vietnam in January, but declined with precipitation in Northern Central Vietnam in January. These results determined that the RPH originate from overwintering areas in Central Vietnam, but not from southernmost areas of Vietnam. Winter precipitation, rather than temperature was the most important factor determining the number of RPH migrants. Based on their similar population dynamics and low population densities in Central Vietnam, we further speculated that RPH migrate to track ephemeral food resources whilst simultaneously avoiding predators. Migrations do not seem to be initiated by interspecific competition, overcrowding or host deterioration. Nevertheless, S. furcifera establishes populations earlier than N. lugens South China, perhaps to compensate for interspecific competition. We provide new information that could assist with forecasting outbreaks and implementing control measures against these migratory pests.
An outbreak of acute hepatitis recently occurred in a nursing home in Zhejiang Province, China. The objectives of this study were to confirm the outbreak and identify the aetiology, source and transmission patterns. All residents and staff in or near the nursing home during the period from 1 October 2014 to 21 May 2015 were investigated regarding hygiene and for epidemiological information including water and food (eating meat especially pork products). Serum and stool specimens were collected for detection of hepatitis E virus (HEV) antibodies using ELISA and RNA using RT–PCR. Samples that were RNA positive were genotyped. Of 185 senior residents and 24 staff in the nursing home, there were 37 laboratory-confirmed cases during the outbreak. Of these cases, 12 patients (three deaths) were symptomatic with jaundice, a common clinical symptom for hepatitis E infection. HEV strains were isolated from three cases and they formed a single cluster within genotype 4d. A case-control study was conducted to investigate potential risk factors for the outbreak and the results revealed that cases more often washed their dishes and rinsed their mouths using tap water than the controls (P < 0·05). Based on hygiene investigation and meteorological information, it is likely that HEV-infected sewage and faeces contaminated the water network on rainy days. Collectively, these results suggest that the outbreak of HEV genotype 4 infection was most likely caused by contaminated tap water rather than food.
The valley of the Baxie River, situated in the western region of the Loess Plateau in central China, contains a loess profile 15 m thick, which can be considered representative of loess-paleosol sequences formed over the last 17 ka. Both thermoluminescence (TL) determinations on fine-grained sediment (4–11 μm) and 14C determinations on various organic fractions of paleosols from the profile have provided an extremely useful chronological framework for these sequences. These sequences indicate a weakened summer monsoon during the last glacial maximum followed by a strengthening of the summer monsoon, beginning ca. 13 ka cal bp. An abrupt change to a weakened summer monsoon regime lasted from ca. 10.9 to 10.2 ka cal bp. The Asian summer monsoon circulation, recording the Holocene optimum, then increased and lasted from ca. 10.2 to 6 ka cal bp. The organic component of samples taken down the profile has δ13C values ranging from −21 to −24‰ with respect to the PDB standard. The more positive δ13C values suggest that the proportion of C4-type plants in river valleys of the Loess Plateau increased as Asian summer monsoon influence weakened, and C3-type vegetation increased as the summer monsoon influence strengthened. Magnetic susceptibility and organic content were low during loess deposition, also reflecting weakening of summer monsoon. Two 14C determinations on the humin fraction of the organic component near the top of the lower paleosol and the base of the upper paleosol complex gave ages of 10.2 and 10.9 ka cal BP, respectively. These ages mark the beginning and termination of a brief event involving increased dust influx under weakened summer monsoon conditions.
Development of partial inter-specific hybrid (PIH) rice is a promising approach for exploiting inter-specific heterosis between Oryza glaberrima and Oryza sativa. In the present study, the relationship between genetic distance (GD) of parental lines and yield performance of the PIHs was assessed using partial diallel crosses between three indica male sterile lines and 14 introgression lines (ILs) with different fragments of O. glaberrima genes. Twenty two out of the 42 PIHs expressed positive heterobeltiosis (i.e., the Fl hybrid showed superiority over the better parent in the target trait) for panicle number, spikelet number, thousand grain weight and grain yield/plant. The proportion of O. glaberrima genome in the ILs ranged from 0·03 to 0·41, as revealed by 16 informative simple sequence repeat markers. Significant positive correlations were found between the proportion of O. glaberrima genome of the ILs and the GD between the ILs and the three different female parents. Heterosis of spikelet number per panicle in the hybrids was positively proportional with the O. glaberrima genome content of the parental ILs, while that of fertile grain percentage was negatively proportional to the O. glaberrima genome proportion. On average, the PIHs with higher grain yield and highest heterobeltiosis were obtained from the ILs carrying between 0·15 and 0·30 of O. glaberrima genome. The results indicated that a small proportion (<0·15) of the O. glaberrima genome in the ILs might limit heterosis expression of spikelet number per panicle, while a very large proportion (>0·30) of the O. glaberrima genome decreased the grain filling percentage in the PIHs, thus an intermediate range of O. glaberrima genome proportion should be more suitable for breeding heterotic PIHs. The exploitation of inter-specific heterosis between O. glaberrima and O. sativa has potential value for heterotic breeding in rice.
The formation of injectable implants in the presence of cells or solutes has previously been conceptualized to be based on the selectivity of bioorthogonal chemical reactions. As an alternative approach, hydrogel network synthesis by enzymatic reactions with a typically high inherent substrate specificity and low toxicity have been repeatedly proposed, e.g. using commercial mushroom tyrosinase (MTyr), which specifically catalyzes phenol oxidation. In this study, it should be explored whether MTyr is compatible with therapeutic peptides that may be delivered from such hydrogels in the future. Based on the specificity of MTyr to phenol residues, no modification of peptides lacking the amino acid tyrosine would be expected. One example of such peptides is gramicidin S (GS), a potent antimicrobial peptide. However, when GS was incubated with commercial MTyr, peptide degradation occurred as observed by HPLC analysis. Several fragments of the peptide were detected by MALDI-TOF. Contamination of MTyr with peptidases was proven as the source of undesired peptide cleavage, which needs to be considered when preparing enzymatically crosslinked hydrogels for biomedical applications.
Atom probe is a powerful technique for studying the composition of nano-precipitates, but their morphology within the reconstructed data is distorted due to the so-called local magnification effect. A new technique has been developed to mitigate this limitation by characterizing the distribution of the surrounding matrix atoms, rather than those contained within the nano-precipitates themselves. A comprehensive chemical analysis enables further information on size and chemistry to be obtained. The method enables new insight into the morphology and chemistry of niobium carbonitride nano-precipitates within ferrite for a series of Nb-microalloyed ultra-thin cast strip steels. The results are supported by complementary high-resolution transmission electron microscopy.
An experiment was conducted to investigate the effect of arginine on feed intake regulation. One hundred and twenty six 1-day-old male White Pekin ducks (Anas platyrhynchos domestica) were randomly were allotted to one of two dietary treatments. The birds were fed diets containing 0.71% (deficient) or 1.27% (sufficient) arginine for 3 weeks. At 21 days of age, feed intake was determined and hypothalamic protein profiles were analyzed using isobaric tags for relative and absolute quantification technique. The birds fed with arginine-deficient diet had a lower final live BW and cumulative feed intake (P<0.01) than those fed with arginine-sufficient diet. A total of 16 proteins were identified in the hypothalamus with >1.5-fold expressional changes between arginine-deficient and -sufficient dietary treatments. Nine of these proteins were upregulated and seven of them were downregulated. The identified proteins could be regrouped into six categories: protein processing, carbohydrate metabolism and energy production, transporter, cytoskeleton, immunity and neuronal development. Dietary arginine deficiency decreased expression of proteins involved in energy production (glycine amidinotransferase, aldolase B fructose-bisphosphate, aconitase, transaldolase, 6-phosphofructokinase type C-like) and oxygen transportation (haemoglobin subunit α expression). The proteomic alterations described here provides valuable insights into the interactions of arginine with appetite.
Long-term functionality and stability of neural interfaces with complex geometries is one of the major challenges for chronic clinic applications due to lack of effective encapsulation. We present an encapsulation method that combines atomic layer deposited Al2O3 and Parylene C for encapsulation of biomedical implantable devices, focusing on its application on Utah electrode array based neural interfaces. The alumina and Parylene C bi-layer encapsulated wired Utah electrode array showed relatively stable impedance during the 960 equivalent soaking days at 37 °C in phosphate buffered solution. For the bi-layer coated wireless neural interfaces, the power-up frequency was constantly ∼ 910 MHz and the RF signal strength was stably around -73 dBm during equivalent soaking time of 1044 days at 37 °C (still under soak testing).
This study analysed the spatio-temporal distribution and propagation of hand-foot-and-mouth disease (HFMD) in Shenzhen from 2008 to 2010. Specifically, we examined the epidemiological data, temporal distribution and spatial distribution, and then the relationship between meteorological, social factors and the number of reported HFMD cases was analysed using Spearman's rank correlation. Finally, a geographically weighted regression model was constructed for the number of reported HFMD cases in 2009. It was found that three independent variables, i.e. the number of reported HFMD cases in 2008 and, annual average temperature and precipitation, had different spatial impacts on the number of reported HFMD cases in 2009. In addition, these variables accounted for the propagation mechanism of HFMD in the centre and east of Shenzhen, where the high incidence rate areas are located. These results will be of great help in understanding the spatio-temporal distribution of HFMD and developing approaches to prevent this disease.
The nanoscale physical properties of newly electrospun polyamide nanofibrillar matrices < 1 year old versus those that were > 3 year old were investigated with transmission electron microscopy, selected area electron diffraction, contact angle measurements, and Raman spectroscopy. Significant differences in crystallinity, hydrophobicity, and chemistry were found and correspondingly different cell responses by cerebellar granular neurons were observed. The properties of the aged nanofibrillar scaffolds evoked a response for neuron burrowing into a more 3-dimensional environment in addition to better facilitation of neurite outgrowth. The nanophysical properties of tissue scaffolds have been recently shown to directly and indirectly regulate cellular responses. As physical properties can evolve over time, the present investigation addresses the issue of tissue scaffold shelf life, with possible changes in directive signals to cells.