Specific convulsions and brain damage in children hospitalized for Omicron BA.5 infection: an observational study using two cohorts.

BACKGROUND: SARS-CoV-2 continues to mutate over time, and reports on children infected with Omicron BA.5 are limited. We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care. METHODS: We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30, 2022. Specific convulsions and body temperatures were compared between the two cohorts. We analyzed potential associations between convulsions and vaccination, and additionally evaluated the brain damage among severe Omicron-infected children. RESULTS: Convulsion rates (97.5% vs. 4.3%, P < 0.001) and frequencies (median: 2.0 vs. 1.6, P < 0.001) significantly differed between Omicron-infected and non-Omicron-infected febrile children. The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions (median: 39.5 vs. 38.2 and 38.6 °C, both P < 0.001). In the three Omicron-subgroups, the temperature during convulsions was proportional to the percentage of patients and significantly differed ( P < 0.001), while not in the three non-Omicron-subgroups ( P = 0.244). The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children (average: 1.8 vs. 2.1, P < 0.001). The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated ( P < 0.001). Fifteen of the 112 severe Omicron cases had brain damage. CONCLUSIONS: Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children. We additionally found evidence of brain damage caused by infection with omicron BA.5. Vaccination and prompt fever reduction may relieve symptoms.

Durable superhydrophobic coatings for prevention of rain attenuation of 5G/weather radomes.

Superhydrophobic coatings are expected to solve the rain attenuation issue of 5G radomes. However, it is very challenging to design and construct such superhydrophobic coatings with good impalement resistance, mechanical robustness, and weather resistance, which remains as one of the main bottlenecks hindering their practical applications. Here, we report the design of superhydrophobic coatings with all these merits mentioned above by spray-coating a suspension of adhesive/fluorinated silica core/shell microspheres onto substrates. The core/shell microspheres are formed by phase separation of the adhesive and adhesion between the adhesive and fluorinated silica nanoparticles. The coatings have an approximately isotropic three-tier hierarchical micro-/micro-/nanostructure, a dense but rough surface at the nanoscale, and chemically inert composition with low surface energy. Consequently, the coatings show excellent impalement resistance, mechanical robustness and weather resistance compared with previous studies, and the mechanisms are revealed. Furthermore, we realize large-scale preparation, extension, and practical application of the coatings for efficiently preventing rain attenuation of 5G/weather radomes. By taking these advantages, we believe that the superhydrophobic coatings have great application potential and market prospect. The findings here will boost preparation and real-world applications of superhydrophobic coatings.

The Effect of Mobile Payment on Payment Waiting Time for Outpatients With Medical Insurance: Historically Controlled Study.

BACKGROUND: Waiting for a long time to make payments in outpatient wards and long queues of insured patients at the checkout window are common in many hospitals across China. To alleviate the problem of long queues for payment, many hospitals in China have established various mobile apps that those without health insurance can use. However, medically insured outpatients are still required to pay manually at the checkout window. Therefore, it is urgent to use information technology to innovate and optimize the outpatient service process, implement mobile payment for medically insured outpatients, and shorten the waiting time for outpatients, especially in the context of the COVID-19 epidemic. Furthermore, smartphone-based mobile payment for outpatients with health insurance could be superior to on-site cashier billing. OBJECTIVE: This study aimed to investigate the impact of smartphone-based mobile payment in relation to different aspects, such as waiting time, satisfaction with patients' waiting time, payment experience, the proportion of those dissatisfied with payment, total outpatient satisfaction, and outpatient volume, and compare mobile payment with on-site payment. METHODS: This was a historically controlled study. This study analyzed the outpatients' waiting time to make a medical insurance payment, their satisfaction with the waiting time and payment experience, the proportion of those dissatisfied with payment, and the outpatient volume of patients at Guangzhou Women and Children's Medical Center 1 year before and after the implementation of mobile payment for medical insurance in January 2021. An independent sample 2-tailed t test was used to compare waiting time, satisfaction with waiting time, and overall satisfaction. Paired sample 2-tailed t test was used to compare monthly outpatient visits. The chi-square test was used to compare the percentages of patients dissatisfied with payment. RESULTS: After the implementation of mobile payment for medical insurance outpatients, the patients' payment waiting time was significantly shortened (mean 45.28, SD 10.35 min vs mean 1.02, SD 0.25 min; t9014=53.396; P<.001), and satisfaction with waiting time and payment experience were significantly improved (mean 82.08, SD 3.17 vs mean 90.36, SD 3.45; t9014=-118.65; P<.001). Dissatisfaction with payment significantly decreased (10.27%, SD 2.18% vs 1.19% vs SD 0.30%; P<.001). The total satisfaction of outpatients significantly improved (mean 86.91, SD 3.23 vs mean 89.98, SD 3.31; t9014=-44.57; P<.001), and the outpatient volume increased (248,105.58, SD 89,280.76 vs 303,194.75, SD 53,773.12; t11=2.414; P=.03). Furthermore, payment efficiency improved, and the number of the on-site cashiers substantially decreased. CONCLUSIONS: Mobile payment for health insurance significantly shortened patients' payment waiting time; improved patient satisfaction on waiting time and payment experience and overall satisfaction; reduced the proportion of patients who were dissatisfied with payment and the cashier at the hospital; and increased monthly outpatient volume. This approach was effective and thus worthy of promoting.

Direct and Indirect Paths between Parental Marital Conflict and Children's Sibling Conflict in Chinese Families.

Links between parental marital conflict and children's sibling conflict have been well examined; however, the underlying mechanism of this link needs to be further studied. This study investigated the mediating role of parental intervention styles (i.e. child-centered strategies, control strategies, and nonintervention strategies) and children's control behavior toward their sibling between parental marital conflict and children's sibling conflict. We recruited 689 Chinese children (53.7% girls) aged 8-13 years to participate in the study. Results indicated that parental marital conflict, control strategies, nonintervention strategies, and children's control behavior toward sibling were positively associated with sibling conflict among children. Child-centered strategies were negatively correlated with children's sibling conflict. Furthermore, control and nonintervention strategies of parents and control behavior of children toward sibling simultaneously partially mediated between parental marital and child-sibling conflict. The mediating role of child-centered strategies was not significant. These findings suggest that parental strategies of control and nonintervention and children's control behavior toward their sibling may increase the risk of sibling conflict among children after repeated exposure to parental marital conflict. In contrast, child-centered strategies may be a protective factor for children regarding sibling conflict. Current findings confirm the combined effects of parent and child behavior on child-sibling conflict. They also help parents deal with sibling conflict among their children and promote more positive relationships among siblings.

Adoption of M-Learning in Business English Course and Its Relationship to Learning Style Preferences: An Empirical Investigation.

Learning around the world has been changed with the rapid development in technology which promotes the students to be more flexible and interactive with each other which has been encouraged by the mobile learning environment. Therefore, the current study intends to analyze the impact of inquiry learning, reflective thinking on problem-solving skills, and critical thinking skills with the mediation of peer communication. To carry out the study, data was collected from 378 college students in China by using survey forms. The analysis of the data and validation of the proposed hypotheses were conducted using Smart-PLS and structural equation modeling (SEM) technique. The results revealed that inquiry learning and reflective thinking affect problem-solving skills. However, inquiry learning and reflective thinking did not affect critical thinking skills. Moreover, the study found that peer communication mediated the relationship between reflective thinking, problem-solving skills, and between reflective thinking and critical thinking skills. However, peer communication did not mediate the relationship among inquiry learning as independent variable and problem-solving skills and critical thinking skills as dependent. The study has theoretically contributed by examining the impact of online learning styles on higher-order thinking skill (HOTS) in the M-learning environment. Also, the study greatly advances the literature by investigating the mediating role of peer communication. Practically, the colleges can improve the students HOTS by devising policies and educational programs focusing on learning styles.

Multi-Time Scale Trading Simulation of Source Grid Load Storage Based on Continuous Trading Mechanism for China.

The proportion of new energy in power systems is increasing yearly. How to deal with the adverse impact of new energy output uncertainty on its participation in trading from the mechanism level is an urgent problem in China that must be solved. A source grid load storage (SGLS) continuous trading mechanism and a multi-time scale trading simulation method are proposed which meet the needs of Chinese new energy consumption and satisfies the trading needs of Chinese power market players. Firstly, the connection mechanism of mid-long term, day-ahead, and intra-day SGLS interactive trading is established, and the meaning and ways of continuous development are defined. Secondly, the clearing model of SGLS trading based on the continuous trading mechanism is established to provide mathematical models and strategic methods for various resources to participate in SGLS trading. Then, the multi-time scale trading simulation of SGLS based on the continuous trading mechanism is carried out to obtain the trading strategies of different trading subjects. The example results show that compared with the trading mechanism based on deviation assessment, the one-day trading cost is reduced by 4.20% and the consumption rate of new energy is increased by 6.53%. It can be seen that the mid-long term-day-ahead-day SGLS interactive trading connection mechanism has advantages in reducing trading costs and improving the consumption rate of new energy. It can flexibly deal with the trading scenario of domestic new energy consumption and new energy reverse peak shaving, which has an effect on the adverse impact of trading and operation deviation caused by source load uncertainty on trading.

Big Data Analysis and Prediction System Based on Improved Convolutional Neural Network.

This paper presents a big data analysis and prediction system based on convolutional neural networks. Continuous template matching technology is used to analyze the distributed data structure of big data, and the information fusion processing of cloud service combination big data is combined with matching related detection methods, frequent item detection, and association rule feature extraction of high-dimensional fusion data. A clustering method is adopted to realize the classification and mining of cloud service portfolio big data. The hardware equipment of the car to detect the surrounding environment is complicated, and the combination of the convolutional neural network and the camera to detect the surrounding environment has become a research hotspot. However, simply using the convolutional neural network to process the camera data to control the turning angle of the car has the problems of long training time and low accuracy. An improved convolutional neural network is proposed. The experimental results show that the accuracy of data mining by this method is 12.43% and 21.76% higher than that of traditional methods, and the number of iteration steps is shorter, indicating that the timeliness of mining is higher. This network structure can effectively improve the training speed of the network and improve the accuracy of the network. It is proven that the convolutional neural network has faster training speed and higher accuracy.

Study on the Mechanism of Solid-Phase Oxidant Action in Tribochemical Mechanical Polishing of SiC Single Crystal Substrate.

Na2CO3-1.5 H2O2, KClO3, KMnO4, KIO3, and NaOH were selected for dry polishing tests with a 6H-SiC single crystal substrate on a polyurethane polishing pad. The research results showed that all the solid-phase oxidants, except NaOH, could decompose to produce oxygen under the frictional action. After polishing with the five solid-phase oxidants, oxygen was found on the surface of SiC, indicating that all five solid-phase oxidants can have complex tribochemical reactions with SiC. Their reaction products are mainly SiO2 and (SiO2)x. Under the action of friction, due to the high flash point temperature of the polishing interface, the oxygen generated by the decomposition of the solid-phase oxidant could oxidize the surface of SiC and generate a SiO2 oxide layer on the surface of SiC. On the other hand, SiC reacted with H2O and generated a SiO2 oxide layer on the surface of SiC. After polishing with NaOH, the SiO2 oxide layer and soluble Na2SiO3 could be generated on the SiC surface; therefore, the surface material removal rate (MRR) was the highest, and the surface roughness was the largest, after polishing. The lowest MRR was achieved after the dry polishing of SiC with KClO3.

Metformin attenuates diabetic neuropathic pain via AMPK/NF-κB signaling pathway in dorsal root ganglion of diabetic rats.

Neuropathic pain is a common complication of diabetes mellitus with poorly relieved by conventional analgesics. Metformin, a first-line drug for type 2 diabetes, reduces blood glucose by activating adenosine monophosphate protein kinase (AMPK) signalling system. However, the effect of Metformin on diabetic neuropathic pain is still unknown. In the present study, we showed that Metformin was capable of attenuating diabetes induced mechanical allodynia, and the analgesia effect could be blocked by Compound C (an AMPK inhibitor). Importantly, Metformin enhanced the phosphorylation level of AMPK in L4-6 DRGs of diabetic rats but not affect the expression of total AMPK. Intrathecal injection of AICAR (an AMPK agonist) could activate AMPK and alleviate the mechanical allodynia of diabetic rats. Additionally, phosphorylated AMPK and NF-κB was co-localized in small and medium neurons of L4-6 DRGs. Interestingly, the regulation of NF-κB in diabetic rats was obviously reduced when AMPK was activated by AICAR. Notably, Metformin could decrease NF-κB expression in L4-6 DRGs of diabetic rats, but the decrease was blocked by Compound C. In conclusion, Metformin alleviates diabetic mechanical allodynia via activation of AMPK signaling pathway in L4-6 DRGs of diabetic rats, which might be mediated by the downregulation of NF-κB, and this providing certain basis for Metformin to become a potential drug in the clinical treatment of diabetic neuropathic pain.

Metformin Attenuates Bone Cancer Pain by Reducing TRPV1 and ASIC3 Expression.

Bone cancer pain (BCP) is a common pathologic pain associated with destruction of bone and pathological reconstruction of nervous system. Current treatment strategies in clinical is inadequate and have unacceptable side effects due to the unclear pathology mechanism. In the present study, we showed that transplantation of Walker 256 cells aggravated mechanical allodynia of BCP rats (**p < 0.01 vs. Sham), and the expression of ASIC3 (Acid-sensitive ion channel 3) and TRPV1 was obviously enhanced in L4-6 dorsal root ganglions (DRGs) of BCP rats (**p < 0.01 vs. Sham). ASIC3 and TRPV1 was mainly expressed in CGRP and IB4 positive neurons of L4-6 DRGs. While, TRPV1 but not ASIC3 was markedly upregulated in L4-6 spinal dorsal horn (SDH) of BCP rats (**p < 0.01 vs. Sham). Importantly, intrathecal injection of CPZ (a TRPV1 inhibitor) or Amiloride (an ASICs antagonist) markedly increased the paw withdraw threshold (PWT) of BCP rats response to Von Frey filaments (**p < 0.01 vs. BCP + NS). What's more, intraperitoneally injection of Metformin or Vinorelbine markedly elevated the PWT of BCP rats, but reduced the expression of TRPV1 and ASIC3 in L4-6 DRGs and decreased the TRPV1 expression in SDH (*p < 0.05, **p < 0.01 vs. BCP + NS). Collectively, these results suggest an effective analgesic effect of Metformin on mechanical allodynia of BCP rats, which may be mediated by the downregulation of ASIC3 and TRPV1.

Fucoxanthin Prevents 6-OHDA-Induced Neurotoxicity by Targeting Keap1.

As the most abundant marine carotenoid extracted from seaweeds, fucoxanthin (FUC) is considered to have excellent neuroprotective activity. However, the target of FUC for its neuroprotective properties remains largely unclear. Oxidative stress is one of the initiating factors causing neuronal cell loss and necrosis, and it is also an important inducement of Parkinson's disease (PD). In the present study, the neuroprotective effect of FUC was assessed using a 6-hydroxydopamine- (6-OHDA-) induced neurotoxicity model. FUC suppressed 6-OHDA-induced accumulation of intracellular ROS, the disruption of mitochondrial membrane potential, and cell apoptosis through the Nrf2-ARE pathway. Keap1 as a repressor of Nrf2 can regulate the activity of Nrf2. Here, the biolayer interferometry (BLI) assay demonstrated that FUC specifically targeted Keap1 and inhibited the interaction between Keap1 and Nrf2. FUC bound to the hydrophobic region of Keap1 pocket and formed hydrogen bonding interactions with Arg415 and Tyr525. Besides, it also dose-dependently upregulated the expressions of antioxidant enzymes, such as nicotinamide heme oxygenase-1, glutamate-cysteine ligase modifier subunit, and glutamate-cysteine ligase catalytic subunit, in 6-OHDA-induced PC12 cells. In 6-OHDA-exposed zebrafish, FUC pretreatment significantly increased the total swimming distance of zebrafish larvae and improved the granular region of the brain tissue damage. These results suggested that FUC could protect the neuronal cells against 6-OHDA-induced injury via targeting Keap1.

Clinical characteristics of coronavirus disease 2019 (COVID-19) in patients out of Wuhan from China: a case control study.

BACKGROUND: A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. To examine the clinical characteristics of COVID-19 in infected patients out of Wuhan, from China. METHODS: Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27 and February 8, 2020, in Baoji city, Shannxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected; cases were divided into two groups according to the severity of infection (mild or severe). RESULTS: Nine (9/13) COVID-19 patients exhibited mild disease severity, and defined as second-generation human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P > 0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms; however, there was no statistical difference between mild and severe cases in this regard (all P > 0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19 infection, with statistically significant differences between those with severe disease and mild infection (all P < 0.05). Twelve of 13 COVID-19 patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P < 0.05). CONCLUSION: Most cases of COVID-19 infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19 varied. Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19 disease lacked typical characteristics such as fever and changes in CT imaging features.

Exploring the Structure of Sibling Relationships Among Preschool Children in China and Developing a Questionnaire.

OBJECTIVE: The objective of this study was to examine the structure of sibling relationships among preschool children in China and develop a questionnaire. METHODS: The concept of sibling relationships among preschool children in China was established through literature review, open interviews, and expert review, and the initial project was designed. Using the questionnaire survey method, with 651 mothers of preschool children as the research objects, we performed item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability and validity tests on the initial questionnaire. RESULTS: The questionnaire for the sibling relationships among preschool children in China had 18 questions covering dimensions of sibling interaction, sibling acceptance, sibling warmth, and sibling rivalry. The questionnaire fitting indexes were better (χ2/df = 1.829, CFI = 0.930, TLI = 0.917, RMSEA = 0.055, SRMR = 0.053). The internal consistency coefficient between the total questionnaire and each dimension was 0.759-0.8548, and the total questionnaire significantly correlated with each dimension (r = 0.229-0.792) and the total score of parental self-efficacy (r = -0.106 to 0.338). CONCLUSION: The Sibling Relationship Questionnaire for Chinese Preschool Children (Parental Version) exhibited good reliability and validity, making it an effective tool for the evaluation of sibling relationships among preschool children.

The Use of Smartphone-Based Triage to Reduce the Rate of Outpatient Error Registration: Cross-Sectional Study.

BACKGROUND: In many clinics, patients now have the option to make Web-based appointments but doing so according to their own judgment may lead to wrong registration and delayed medical services. We hypothesized that smartphone-based triage in outpatient services is superior to Web-based self-appointment registration guided by the medical staff. OBJECTIVE: This study aimed to investigate smartphone-based triage in outpatient services compared with Web-based self-appointment registration and to provide a reference for improving outpatient care under appointment registration. METHODS: The following parameters in Guangzhou Women and Children's Medical Center were analyzed: wrong registration rate, the degree of patient satisfaction, outpatient visits 6 months before and after smartphone-based triage, queries after smartphone-based triage, number of successful registrations, inquiry content, and top 10 recommended diseases and top 10 recommended departments after queries. RESULTS: Smartphone-based triage showed significant effects on average daily queries, which accounted for 16.15% (1956/12,112) to 29.46% (3643/12,366) of daily outpatient visits. The average daily successful registration after queries accounted for 56.14% (1101/1961) to 60.92% (1437/2359) of daily queries and 9.33% (1130/12,112) to 16.83% (2081/12,366) of daily outpatient visits. The wrong registration rate after smartphone-based triage was reduced from 0.68% (12,810/1,895,829) to 0.12% (2379/2,017,921) (P<.001), and the degree of patient satisfaction was improved. Monthly outpatient visits were increased by 0.98% (3192/325,710) to 13.09% (42,939/328,032) compared with the same period the preceding year (P=.02). CONCLUSIONS: Smartphone-based triage significantly reduces the wrong registration rate caused by patient Web-based appointment registration and improves the degree of patient satisfaction. Thus, it is worth promoting.

Effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume in a tertiary hospital in China.

BACKGROUND: In China, a long waiting time for registration is a common occurrence in many tertiary hospitals. This study aimed to analyze the effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume at the Guangzhou Women and Children's Medical Center. METHODS: This was a cross-sectional study. This study investigated the effects of a comprehensive reservation service for non-emergency registration in Guangzhou Women and Children's Medical Center in China starting in October 2015. In total, 2194 patients completed a satisfaction survey administered by the Guangdong Situation Research Center. The content of the questionnaire consisted of six aspects: general impression, service attitude, service quality, hospital environment, price perception and medical ethics. A Likert 5-point rating scale was used in the questionnaire; answers were classified as "very satisfied", "relatively satisfied", "neutral", "unsatisfied" and "very unsatisfied". The method of application was paper-based. T-tests were used to compare the sample means, and chi-square tests were used to compare the rates. A multiple-test procedure was performed to evaluate the differences in the reservation rates during a 12-month period. RESULTS: After the implementation of the comprehensive reservation service for non-emergency registration in our hospital, which has an annual outpatient volume of approximately 4 million, the monthly appointment registration rate increased from (34.95 ± 2.91)% to(89.13 ± 3.12)%,P < 0.01. The patient waiting time was significantly reduced (P < 0.01), and the proportion of patients who believed that the waiting time required improvement was decreased significantly (P < 0.01). Moreover, the third-party evaluation result of outpatient satisfaction significantly improved (P < 0.01). The total hospital outpatient volume decreased(P < 0.01). The outpatient volume of the Department of General Pediatrics decreased. CONCLUSION: The implementation of the comprehensive reservation service for non-emergency registration in the hospital shortened patient waiting time and improved patient satisfaction, and the outpatient volume was effectively controlled. These results indicated that this program obtained the desired results in a Grade 3A hospital in China.

Processing of Painful Pictures in Individuals With High and Low Rejection Sensitivity: Evidence From Event-Related Potentials.

An increasing number of studies have investigated the relation between the processing of painful stimuli and rejection. Little was known, however, about the impact of the rejection sensitivity (RS) on the processing of painful pictures. This study addressed this issue using high temporal resolution event-related potential techniques. Thirty high RS (20 women and 10 men who scored in the top 20th percentile of the Rejection Sensitivity Questionnaire scores) and 30 low RS (20 women and 10 men who scored in the bottom 20th percentile) volunteers participated in the experiment. All volunteers performed a discrimination task of painful pictures in which they were asked to judge whether target pictures were painful or not. Behaviorally, participants exhibited shorter reaction times for painful than nonpainful pictures. For the P100 component, low RS participants showed stronger brain activities for painful than nonpainful pictures, suggesting vigilance toward painful pictures. High RS participants, however, exhibited no P100 amplitude differences between painful and nonpainful pictures, indicating an analgesia phenomenon. Furthermore, we found that there were larger amplitudes in the late late positive complex component for painful compared with nonpainful pictures, regardless of participants' RS. This suggested a person's further assessment for painful pictures. In short, our findings demonstrated that the level of RS influenced the pain processing at a very early stage of processing.

Effects of blending sequences and molecular structures of the compatibilizers on the morphology and properties of PLLA/ABS blends.

The effects of molecular structures of the compatibilizers and blending sequences on the morphology and properties of the immiscible poly(l-lactide)/acrylonitrile-butadiene-styrene (PLLA/ABS) blend are investigated herein. The comb-like polymers (RC), which are constituted by a poly(methyl methacrylate) (PMMA) backbone and side chains and a few epoxy groups distributed randomly along the backbone, are found to be better compatibilizers for improving the morphology and mechanical properties of the PLLA/ABS blend, compared to linear polymers (RL) constituted by a PMMA backbone and epoxy groups along the backbone. In addition, the blending sequence, which dictates the extent of grafting reaction between carboxyl end groups of PLLA and epoxy groups in the RL and RC compatibilizers, is found to influence the diffusion and location of the in situ formed RL-g-PLLA and RC-g-PLLA polymers in the blend system. By blending RL or RC polymers with ABS phase firstly, the epoxy groups are diluted by ABS phase; thus, during the second step, blending with PLLA phase, lightly grafted polymers are formed. This method is found to be the best sequence to compatibilize the PLLA/ABS system. When the PLLA phase is mixed with the compatibilizers firstly, the highly grafted polymers are prone to be trapped in the PLLA phase, because the PMMA segments are shielded by the densely grafted PLLA segments from interacting efficiently with the ABS phase, and thus the morphology and mechanical properties of the blend deteriorate accordingly.

Accuracy Comparison Between Age-Adapted SOFA and SIRS in Predicting in-Hospital Mortality of Infected Children at China's PICU.

OBJECTIVES: Sepsis-3 consensus suggests "the need to develop similar updated definitions for pediatric populations." Sequential organ failure assessment (SOFA) and systemic inflammatory response syndrome (SIRS) criteria are two systems widely used to define the status of infection. However, it is still unclear whether SOFA is more accurate than SIRS in predicting children mortality in low- and middle-income countries. Thus, we validated the accuracy of age-adapted SOFA and SIRS in predicating the poor prognosis of infected children in China's pediatric intensive care unit (PICU). METHODS: We performed a retrospective and observational cohort study of children admitted for infection to PICU in the hospital between January 1, 2009 and December 31, 2017. The indexes within 24 h after intensive care unit (ICU) admission were analyzed according to age-adapted SOFA and SIRS, and all data were sourced from the hospital's electronic health record database. The prognosis was illustrated with primary outcome and secondary outcome. Primary outcome referred to in-hospital mortality, and secondary outcome to in-hospital mortality or ICU length of stay ≥ 7 days. The predictive power of age-adapted SOFA and SIRS was compared using crude and adjusted area under the receiver operating characteristic curve (AUROC). RESULTS: Of 1,831 PICU-admitted children due to infection, 164 (9.0%) experienced primary outcome, and 948 (51.8%) secondary outcome. Of 164 deaths, 65.9% were males (median age of 7.53 months, range of 2.67-41.00 months). Children who scored ≥ 2 in age-adapted SOFA or met two SIRS criteria accounted for 92.5% and 73.3%, respectively. In addition, age-adapted SOFA score of ≥2 predicted adverse outcome more accurately than pediatric SIRS (adjusted AUROC, 0.753; 0.713-0.796 vs. 0.674; 0.631-0.702; P < 0.001). CONCLUSION: Compared with SIRS criteria, age-adapted SOFA score of ≥ 2 enjoys a more accuracy in predicting in-hospital mortality of PICU-admitted children, and a higher sensitivity in identifying children with severe infection.

A new cross-platform architecture for epi-info software suite.

BACKGROUND: The Epi-Info software suite, built and maintained by the Centers for Disease Control and Prevention (CDC), is widely used by epidemiologists and public health researchers to collect and analyze public health data, especially in the event of outbreaks such as Ebola and Zika. As it exists today, Epi-Info Desktop runs only on the Windows platform, and the larger Epi-Info Suite of products consists of separate codebases for several different devices and use-cases. Software portability has become increasingly important over the past few years as it offers a number of obvious benefits. These include reduced development time, reduced cost, and simplified system architecture. Thus, there is a blatant need for continued research. Specifically, it is critical to fully understand any underlying negative performance issues which arise from platform-agnostic systems. Such understanding should allow for improved design, and thus result in substantial mitigation of reduced performance. In this paper, we present a viable cross-platform architecture for Epi-Info which solves many of these problems. RESULTS: We have successfully generated executables for Linux, Mac, and Windows from a single code-base, and we have shown that performance need not be completely sacrificed when building a cross-platform application. This has been accomplished by using Electron as a wrapper for an AngularJS app, a Python analytics module, and a local, browser-based NoSQL database. CONCLUSIONS: Promising results warrant future research. Specifically, the design allows for cross-platform form-design, data-collection, offline/online modes, scalable storage, automatic local-to-remote data sync, and fast analytics which rival more traditional approaches.