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Pulsed-xenon-ultraviolet light (PX-UVL) is increasingly used as a supplemental disinfection method in healthcare settings. We undertook a systematic search of the literature through several databases and conducted a meta-analysis to evaluate the efficacy of PX-UVL in reducing healthcare-associated infections. Eleven studies were included in the systematic review and nine in the meta-analysis. Pooled analysis of seven studies with before-after data indicated a statistically significant reduction of Clostridium difficile infection (CDI) rates with the use of the PX-UVL (incidence rate ratio (IRR): 0.73, 95% CI 0.57–0.94, I2 = 72%, P = 0.01), and four studies reported a reduction of risk of methicillin-resistant Staphylococcus aureus (MRSA) infections (IRR: 0.79, 95% CI 0.64–0.98, I2 = 35%, P = 0.03). However, a further four trials found no significant reduction in vancomycin-resistant enterococci (VRE) infection rates (IRR: 0.80, 95% CI 0.63–1.01, I2 = 60%, P = 0.06). The results for CDI and MRSA proved unstable on sensitivity analysis. Meta-regression analysis did not demonstrate any influence of study duration or intervention duration on CDI rates. We conclude that the use of PX-UVL, in addition to standard disinfection protocols, may help to reduce the incidence of CDI and MRSA but not VRE infection rates. However, the quality of evidence is not high, with unstable results and wide confidence intervals, and further high-quality studies are required to supplement the current evidence.
More than 80% of coronavirus disease 2019 (COVID-19) cases are mild or moderate. In this study, a risk model was developed for predicting rehabilitation duration (the time from hospital admission to discharge) of the mild-moderate COVID-19 cases and was used to conduct refined risk management for different risk populations.
A total of 90 consecutive patients with mild-moderate COVID-19 were enrolled. Large-scale datasets were extracted from clinical practices. Through the multivariable linear regression analysis, the model was based on significant risk factors and was developed for predicting the rehabilitation duration of mild-moderate cases of COVID-19. To assess the local epidemic situation, risk management was conducted by weighing the risk of populations at different risk.
Ten risk factors from 44 high-dimensional clinical datasets were significantly correlated to rehabilitation duration (P < 0.05). Among these factors, 5 risk predictors were incorporated into a risk model. Individual rehabilitation durations were effectively calculated. Weighing the local epidemic situation, threshold probability was classified for low risk, intermediate risk, and high risk. Using this classification, risk management was based on a treatment flowchart tailored for clinical decision-making.
The proposed novel model is a useful tool for individualized risk management of mild-moderate COVID-19 cases, and it may readily facilitate dynamic clinical decision-making for different risk populations.
Giant coronary aneurysms are the most severe complications of Kawasaki disease. There are few reports of outcomes from China. Most previous studies were based only on absolute aneurysmal dimensions. The aim of the present study was to catalog the outcomes of Kawasaki disease with giant coronary aneurysms in southwest China based on absolute dimensions and the z-score adjusted for body surface area.
Methods and results:
All patients diagnosed with giant coronary aneurysms (z-score ≥ 10 or absolute dimension ≥ 8 mm) between December, 2002 and December, 2018 were included. We retrospectively analysed patient characteristics and clinical data from 38 patients with giant coronary aneurysms. Over a median follow-up period of 30.5 months (range from 1.7 months to 22.3 years), including patients in chronic phase who had been diagnosed prior to 2002, eight patients had myocardial infarction, including two deaths and one patient with coronary artery bypass grafting. The 1-, 2-, and 5-year event-free rates were 0.63, 0.63, and 0.53 for thrombosis, respectively, and 0.86, 0.81, and 0.81 for major adverse cardiac events, respectively. The 1-, 2-, and 5-year regression-free rates were 0.94, 0.85, and 0.67, respectively. A total of 73.7% of patients remained active.
In the early stages of Kawasaki disease, patients with giant coronary aneurysms often experience major cardiovascular events; however, they are also likely to have normalisation of the coronary internal luminal diameter. With long-term anticoagulation, close cardiologic monitoring, and prompt thrombolytic therapy, most patients can achieve disease-free periods.
As distinctive spontaneous polarization and far-infrared radiation characteristics, the natural mineral tourmaline (TM) has the regulatory effect on crystallization behavior, which possesses potential application in biomimetic mineralization and bone regeneration. In this study, polyurethane (PU) and gelatin (GE) membranes with different adding proportion of TM nanoparticles were prepared via electrospinning. Additionally, the effect of TM nanoparticles on the mineralization process of hydrophobic PU and hydrophilic GE was investigated by immersing the composite TM/PU and TM/GE electrospun membranes in the 10× simulated body fluid (10SBF) at 37 °C for varying periods of time. SEM images confirmed the well-dispersed TM nanoparticles in the PU and GE electrospun fibers. The mineralization deposition was characterized by the SEM, EDS, XRD, and FTIR, and it indicated that two types of calcium phosphate deposits with different Ca/P molar ratios were obtained when TM/PU membranes and TM/GE membranes were incubated in 10SBF. Honeycomb-like hydroxyapatite crystals nucleated and grew faster on TM/PU and TM/GE membranes than the pure PU and GE membranes, respectively. Furthermore, with the increase of the added TM nanoparticles in the composite membranes, more calcium phosphate crystals were precipitated. These results showed that the added TM nanoparticles were able to improve the mineralization of polymer fibrous membranes, which is potential for the composite bone scaffold.
Biodegradable poly(lactide acid) (PLA) has been well-studied as a shape memory polymer in recent years, but the brittleness and relatively high Tg limit its applications. In this study, a series of PLA/poly(ethylene glycol) (PEG) blends were manufactured by using the solvent evaporation method. The thermal behaviors, morphology, hydrophilicity, and mechanical properties of the samples with different contents of PEG have been experimentally studied by differential scanning calorimetry, scanning electronic microscopy, water contact angle, dynamic mechanical analysis, and tensile test. Furthermore, the influence of PEG on the shape memory properties under different loading conditions including the stretch strain, recovery temperature, deformation temperature, and tensile rate were explored systematically. Experimental results reveal that introduction of appropriate contents of the plasticizer PEG into the PLA/PEG systems results in the significant improvement of morphology, hydrophilicity, and mechanical properties while the high shape memory properties are still retained.
Employing self-determination theory, in this study, we explore how workplace ostracism (being ignored and excluded by others) affects newcomer’s voice behavior. Through an empirical study with 353 matched supervisor–subordinate pairs from a large high-technology company, we find that workplace ostracism has negative influence on newcomer’s both promotive and prohibitive voice through the mediating effect of psychological needs satisfaction. In addition, narcissism moderates the effects of ostracism on psychological needs satisfaction. Theoretical and practical implications of these findings are discussed.
For the prevention and control of newly emergent or sudden infectious diseases, we built an on-site, modularized prevention and control system and tested the equipment by using the clustering analysis method. On the basis of this system, we propose a modular equipment allocation method and 4 applications of this method for different types of infectious disease prevention and control. This will help to improve the efficiency and productivity of anti-epidemic emergency forces and will provide strong technical support for implementing more universal and serialized equipment in China. (Disaster Med Public Health Preparedness. 2017;11:375–382)
The bioavailability of dietary ionised calcium is affected by intestinal basic environment. Calcium-binding peptides can form complexes with calcium to improve its absorption and bioavailability. The aim of this study was focused on isolation and characterisation of a calcium-binding peptide from whey protein hydrolysates. Whey protein was hydrolysed using Flavourzyme and Protamex with substrate to enzyme ratio of 25 : 1 (w/w) at 49 °C for 7 h. The calcium-binding peptide was isolated by DEAE anion-exchange chromatography, Sephadex G-25 gel filtration and reversed phase high-performance liquid chromatography (RP-HPLC). A purified peptide of molecular mass 204 Da with strong calcium binding ability was identified on chromatography/electrospray ionisation (LC/ESI) tandem mass spectrum to be Glu-Gly (EG) after analysis and alignment in database. The calcium binding capacity of EG reached 67·81 μg/mg, and the amount increased by 95% compared with whey protein hydrolysate complex. The UV and infrared spectrometer analysis demonstrated that the principal sites of calcium-binding corresponded to the carboxyl groups and carbonyl groups of glutamic acid. In addition, the amino group and peptide amino are also the related groups in the interaction between EG and calcium ion. Meanwhile, the sequestered calcium percentage experiment has proved that EG-Ca is significantly more stable than CaCl2 in human gastrointestinal tract in vitro. The findings suggest that the purified dipeptide has the potential to be used as ion-binding ingredient in dietary supplements.
The advancement of computational tools for material property predictions enables broad search of novel materials for various energy-related applications. However, challenges still exist in accurately predicting the mean free paths (MFPs) of electrons and phonons in a high-throughput frame for thermoelectric property predictions, which largely hinders the computation-driven search for novel materials. In this work, this need is eliminated under the small-grain-size limit, in which these MFPs are restricted by the grain sizes within a bulk material. A new criterion for ZT evaluation is proposed for general nanograined bulk materials and is demonstrated with representative oxides.
To explore (i) the prevalence of thyroid dysfunction in populations with adequate and excessive iodine intakes and (ii) the effect of iodine exposure on the prevalence of thyroid dysfunction.
Cross-sectional study was conducted in Hebei in 2010. The population was classified as having adequate or excessive iodine intake according to the iodine concentration in drinking water. Demographic information was collected by questionnaire. Levels of serum thyroid hormones, thyroid autoantibodies and iodine in drinking water and urine were measured.
Villages with adequate or excessive drinking water iodine in Hebei Province, People’s Republic of China.
A total of 854 men and women aged 20–50 years who had lived in the surveyed areas for over 5 years, including 348 from the adequate iodine area (AIA) and 506 from the excessive iodine area (EIA).
Median urinary iodine concentration was 185 μg/l in AIA and 1152 μg/l in EIA. The prevalence of thyroid dysfunction in AIA was 10·3 %, which included 1·1 % with hypothyroidism and 8·1 % with subclinical hypothyroidism; and 20·6 % in EIA, which included 3·6 % with hypothyroidism and 13·6 % with subclinical hypothyroidism. The positive rates of thyroglobulin antibody were 16·1 % in AIA and 11·9 % in EIA; the positive rates of thyroperoxidase antibody were 20·7 % in AIA and 16·4 % in EIA.
Excessive iodine intake may lead to increased prevalence of biochemical thyroid dysfunction, especially biochemical hypothyroidism. This is not related to an increase in prevalence of thyroid antibodies. Women are more susceptible to iodine excess.
In this paper, we demonstrate a thin film Cu–Ni–Nb alloy deposited directly on silicon, without a designated barrier, showing very high thermal stability at a temperature up to 700 °C for 1 h. Thin [Nb–Ni12]Cux films were sputter deposited and annealed, and their material and electrical properties were studied. The results can be explained by the “cluster-plus-glue atom” model for stable solid solutions, where [Nb–Ni12] cuboctahedral clusters are embedded in a Cu matrix. In this model, the clusters are congruent with the Cu minimizing atomic interactions allowing a good stability. The properties of the films were found to be affected by the Ni/Nb ratios. Especially, the (Nb1.2/13.2Ni12/13.2)0.3Cu99.7 film annealed at 500 °C for 1 h had the lowest electrical resistivity of about 2.7 μΩ cm. And even after 40 h annealing at 500 °C, it maintained a low resistivity of about 2.8 μΩ cm, demonstrating extremely high stabilities against silicide formation.
Resveratrol (Res), a polyphenol that is abundant in many medicinal plants and is a selective oestrogen receptor modulator, exhibits multiple biological activities. In the present study, we determined whether Res prevents oestrogen deficiency-induced osteopenia and whether Res administration decreases pathological changes in the endometrium and lumen of the uterus compared with oestradiol replacement therapy (ERT). A total of sixty 3–4-month-old female Wistar rats were randomly divided into a sham-operated group (Sham) and five ovariectomy (OVX) subgroups, i.e. OVX rats as a control group (OVX); OVX rats receiving oestradiol valerate (ERT, 0·8 mg/kg); and OVX rats receiving Res 20, 40 and 80 mg/kg. Daily oral administration was initiated at week 2 after OVX for 12 weeks. A dose–response difference was observed in the effects of Res on bone mineral density (BMD) and trabecular microarchitecture. Only at the highest dose, bone loss was almost equivalent to that observed in the ERT group. The dose–response effects of Res on the biochemical parameters (alkaline phosphatase, IL-6, TNF-α and transforming growth factor-β1 concentrations in the serum as well as urinary Ca and P excretion) and the expressions of receptor activator of nuclear factor κB ligand (RANKL) and the RANKL:osteoprotegerin protein ratio in the femur were also observed. Furthermore, the thickening of the endometrium and the infiltration of lymphocytes were prevented in all the three Res-treated groups compared with the ERT group. In conclusion, Res treatment not only improves BMD and trabecular microarchitecture but also does not affect the uterus and Res might be a potential remedy for the treatment of postmenopausal osteoporosis.
This paper presents a novel model of snake-like robots based on a spatial linkage mechanism. The reasonable structural parameters of the mechanism are obtained by performing a kinematic simulation. Then the kinematics of the spatial linkage mechanism is developed and the motor angles of the robot for performing lateral undulation are analyzed based on the Serpenoid curve. The torque of servomotors at each moment is also obtained. The experiments detailed in this paper confirm that the robot is of the ability to realize several motion modes, including lateral undulation, left and right turning motions, and uplifting of the head.
The diabetogenic impact of ethanol remains as a focal point of basic and clinical investigations. In this study, Wistar rats were subjected to daily intragastric ethanol administration (10 ml/kg body weight injection with 0 (control), 10, 20 and 33 % (v/v) ethanol in the injections, respectively) for 19 weeks. At the end of the administration, we found that the fasting plasma glucose level of the 33 % (v/v) ethanol-loaded group was 18 % higher than the control. Insulin sensitivity was decreased in a dose-dependent manner in all the ethanol-loaded groups (r − 0·842, P < 0·001) during intraperitoneal insulin tolerance test. Necrotic/haemorrhagic injury was detected in the pancreas and islet β-cell mass was significantly reduced in the 33 % (v/v) ethanol-loaded rats by immunohistochemical and morphometric analysis. At the molecular level, we detected a dose-dependent attenuation of phosphatidylinositol 3-kinase activity (r − 0·956, P < 0·001) and GLUT-4 expression (GLUT-4 mRNA, r − 0·899, P < 0·001; GLUT-4 protein, r − 0·964, P < 0·001) in skeletal muscle. These results demonstrated that drinking is a conditional aetiological factor for diabetes and excessive ethanol intake is negatively associated with both insulin sensitivity and β-cell mass. The whole-body insulin resistance might result from the ethanol-induced insulin signalling defects in muscle.
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