Epidemiological and clinical characteristics of hospitalized unintentional injuries among children in central China from 2017-2023.

Objectives: To examine the epidemiological and clinical characteristics of hospitalized unintentional injuries among children in Central China and theoretically propose preventive and control measures. Methods: We conducted a retrospective study of children aged 0-18 years with unintentional injuries who were admitted to a tertiary hospital in Central China from January 2017 to December 2023. We examined various aspects of the unintentional injuries, including age, gender, urban-rural distribution, external causes, trends, location of injury, cost, and length of stay. Results: A total of 20,166 children with hospitalized unintentional injuries were enrolled. The median age with IQR was 2.8 (1.6, 5.1) years, with majority of the patients (57.0%) were aged 1-3 years, while the fewest were aged 11-18 years. The male-to-female ratio was 1.8:1, and the urban-to-rural ratio was 1.1:1. The most common external causes were foreign bodies (41.7%), exposure to inanimate mechanical forces (25.1%), and falls (22.1%). The most frequently injured body parts were head (72.5%). The total number of unintentional injuries exhibited an increasing trend from 2017-2022, and a decreasing trend from 2022-2023. The urban-rural distribution reversed after 2020. The overall hospitalization cost was 20,810,870.4 USD, with an median cost of 758.7 (556.4, 1,186.2) USD per person. Conclusion: Unintentional injuries imposed a heavy burden on society and families. However, the number of cases and the urban-rural distribution showed significant trend changes from 2017-2023. The external causes varied by age group, gender, and region, while prevention and control measures should be developed accordingly.

Incidence, outcome, and prognostic factors of prolonged mechanical ventilation among children in Chinese mainland: a multi-center survey.

Objective: To evaluate the incidence, outcome, and prognostic factors of prolonged mechanical ventilation (PMV) in children in Mainland China. Methods: A prospective study was conducted in 11 pediatric intensive care units (PICUs) from May 1, 2021, to April 30, 2022. All pediatric patients on mechanical ventilation meeting the criteria for PMV were included in the study. Results: Out of 5,292 patients receiving mechanical ventilation, 278 children met the criteria for PMV (5.3%). After excluding case with incomplete data or lost to follow-up, the study included 250 patients. Among them, 115 were successfully weaned from mechanical ventilation, 90 died, and 45 were still on mechanical ventilation. The 6-month survival rate was 64%. The primary associated conditions of PMV were lower airway diseases (36%), central nervous system diseases (32%), and neuromuscular diseases (14%). The stepwise multiple logistic regression analysis indicated that the utilization of vasoactive agents and an elevated pediatric logistic organ dysfunction-2 (PELOD-2) score on the day of PMV diagnosis were significantly associated with an increased of PMV death. Specifically, the odds ratio (OR) for vasoactive agent use was 2.86; (95% CI: 0.15-0.84; P = 0.018), and for the PELOD-2 score, it was 1.37; 95% CI: 1.17-1.61; P < .001). Conversely, early rehabilitation intervention was negatively associated with the risk of PMV death (OR = 0.45; 95% CI: 0.22-0.93; P = .032). Furthermore, the tracheotomy timing emerged as an independent predictor of failure to wean from PMV, with an OR of 1.08, (95% CI: 1.01-1.16; P = .030). Conclusions: The study revealed a 5.3% incidence of PMV in children requiring mechanical ventilation in China. The use of vasoactive agents and a higher PELOD-2 score at PMV diagnosis were significantly associated with an increased risk of PMV death, whereas early rehabilitation intervention was identified as crucial for improving patient outcomes. The timing of tracheostomy was identified as a high-risk factor for failure to wean from mechanical ventilation.

[Clinical characteristics of children on prolonged mechanical ventilation due to different primary diseases]. / ä¸åŒåŽŸå‘ç— å¯¼è‡´é•¿æœŸæœºæ¢°é€šæ°”æ‚£å„¿çš„ä¸´åºŠç‰¹å¾åˆ†æž.

OBJECTIVES: To investigate the differences in clinical characteristics among children on prolonged mechanical ventilation (PMV) due to different primary diseases. METHODS: A retrospective analysis was performed on the clinical data of 59 pediatric patients requiring PMV from July 2017 to September 2022. According to the primary disease, they were divided into respiratory disease (RD) group, central nervous system (CNS) group, neuromuscular disease (NMD) group, and other disease group. The four groups were compared in terms of general information, treatment, and outcome. RESULTS: There were significant differences among the four groups in age, body weight, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, Pediatric Risk of Mortality III (PRISM Ⅲ) score, analgesic and sedative treatment, nutrition supply, rehabilitation treatment, tracheotomy, successful ventilator weaning, and outcomes (P<0.05). Compared with the RD group, the CNS group and the other disease group had a significantly higher age and a significantly higher proportion of children receiving rehabilitation treatment, and the CNS group had a significantly higher proportion of children receiving tracheotomy (P<0.008). Compared with the other disease group, the CNS group and the NMD group had significantly lower PELOD-2 and PRISM III scores, and the CNS group had a significantly higher proportion of children with successful ventilator weaning and a significantly higher proportion of children who were improved and discharged (P<0.008). CONCLUSIONS: There are differences in clinical characteristics among children receiving PMV due to different etiologies. Most children in the RD group have a younger age, and children in the CNS group have a relatively good prognosis.

Elimination of Intragrain Defect to Enhance the Performance of FAPbI3 Perovskite Solar Cells by Ionic Liquid.

Ionic liquids have been widely used to improve the efficiency and stability of perovskite solar cells (PSCs), and are generally believed to passivate defects on the grain boundaries of perovskites. However, few studies have focused on the relevant effects of ionic liquids on intragrain defects in perovskites which have been shown to be critical for the performance of PSCs. In this work, the effect of ionic liquid 1-hexyl-3-methylimidazolium iodide (HMII) on intragrain defects of formamidinium lead iodide (FAPbI3) perovskite is investigated. Abundant {111}c intragrain planar defects in pure FAPbI3 grains are found to be significantly reduced by the addition of the ionic liquid HMII, shown by using ultra-low-dose selected area electron diffraction. As a result, longer charge carrier lifetimes, higher photoluminescence quantum yield, better charge carrier transport properties, lower Urbach energy, and current-voltage hysteresis are achieved, and the champion power conversion efficiency of 24.09% is demonstrated. These observations suggest that ionic liquids significantly improve device performance resulting from the elimination of {111}c intragrain planar defects.

Ordered Perovskite Structure with Functional Units for High Performance and Stable Solar Cells.

Ion migration is one of the most critical challenges that affects the stability of metal-halide perovskite solar cells (PSCs). However, the current arsenal of available strategies for solving this issue is limited. Here, novel perovskite active layers following the concept of ordered structures with functional units (OSFU) to intrinsically suppress ion migration, in which a three-dimensional (3D) perovskite layer is deposited by vapor deposition for light absorption and a 2D layer is deposited by solution process for ion inhibition, are constructed. As a promising result, the activation energy of ion migration increases from 0.36 eV for the conventional perovskite to 0.54 eV for the OSFU perovskite. These devices exhibit substantially enhanced operational stability in comparison with the conventional ones, retaining >85% of their initial efficiencies after 1200 h under ISOS-L-1. Moreover, the OSFU devices show negligible fatigue behavior with a robust performance under light/dark cycling aging test (ISOS-LC-1 protocol), which demonstrates the promising application of functional motif theory in this field.

Doping with KBr to Achieve High-Performance CsPbBr3 Semitransparent Perovskite Solar Cells.

Wide-bandgap semitransparent perovskite photovoltaics are emerging as one of the ideal candidates for building-integrated photovoltaics (BIPV). However, surface defects in inorganic CsPbBr3 perovskite prepared by vapor deposition severely limit the optoelectronic performance of perovskite solar cells. To address this issue, a strategy of doping a trace amount of KBr into perovskite by vapor deposition is adopted, effectively improving the quality of the film, reducing surface defect concentration, and enhancing the transportation and extraction of charge carriers. Simultaneously, fully physical vapor deposition technology is employed to fabricate perovskite solar cells with an average visible light transmittance of 44%. These devices exhibited an ultrahigh open-circuit voltage of 1.55 V and a superior power conversion efficiency (PCE) of 7.28%, demonstrating excellent moisture and heat resistance. Moreover, the corresponding 5 cm × 5 cm modules achieve a PCE of 5.35% with great thermal insulation capability. This work provides an approach for fabricating highly efficient all-inorganic perovskite solar cells with high average visible light transmittance, demonstrating new insights into their application in building-integrated photovoltaics.

LiTFSI-Free Hole Transport Materials for Robust Perovskite Solar Cells and Modules with High Efficiencies.

Lithium bis(trifluoromethane) sulfonamide (LiTFSI) and oxygen-doped organic semiconductors have been frequently used to achieve record power conversion efficiencies of perovskite solar cells (PSCs). However, this conventional doping process is time-consuming and leads to poor device stability due to the incorporation of Li ions. Herein, aiming to accelerate the doping process and remove the Li ions, we report an alternative p-doping process by mixing a new small-molecule organic semiconductor, N2,N2,N7,N7-tetrakis (4-methoxyphenyl)-9-(4-(octyloxy) phenyl)-9H carbazole-2,7-diamine (labeled OH44) and its preoxidized form OH44+(TFSI-). With this method, a champion efficiency of 21.8% has been achieved for small-area PSCs, which is superior to the state-of-the-art EH44 and comparable with LiTFSI and oxygen-doped spiro-OMeTAD. Moreover, the stability of OH44-based PSCs is improved compared with those of EH44, maintaining more than 85% of its initial efficiency after aging in an ambient condition without encapsulation for 1000 h. In addition, we achieved efficiencies of 14.7 and 12.6% for the solar modules measured with a metal mask of 12.0 and 48.0 cm2, respectively, which demonstrated the scalability of this method.

Eliminating Non-Corner-Sharing Octahedral for Efficient and Stable Perovskite Solar Cells.

The metal halide (BX6)4- octahedron, where B represents a metal cation and X represents a halide anion, is regarded as the fundamental structural and functional unit of metal halide perovskites. However, the influence of the way the (BX6)4- octahedra connect to each other has on the structural stability and optoelectronic properties of metal halide perovskite is still unclear. Here, the octahedral connectivity, including corner-, edge-, and face-sharing, of various CsxFA1-xPbI3 (0 ≤ x ≤ 0.3) perovskite films is tuned and reliably characterized through compositional and additive engineering, and with ultralow-dose transmission electron microscopy. It is found that the overall solar cell device performance, the charge carrier lifetime, the open-circuit voltage, and the current density-voltage hysteresis are all improved when the films consist of corner-sharing octahedra, and non-corner sharing phases are suppressed, even in films with the same chemical composition. Additionally, it is found that the structural, optoelectronic, and device performance stabilities are similarly enhanced when non-corner-sharing connectivities are suppressed. This approach, combining macroscopic device tests and microscopic material characterization, provides a powerful tool enabling a thorough understanding of the impact of octahedral connectivity on device performance, and opens a new parameter space for designing high-performance photovoltaic metal halide perovskite devices.

Molecular typing of Mycoplasma pneumoniae and its correlation with macrolide resistance in children in Henan of China.

BACKGROUND/PURPOSE: As a major causative pathogen of community-acquired pneumonia, Mycoplasma pneumoniae (M. pneumoniae) can cause both upper and lower respiratory tract inflammation as well as extrapulmonary syndromes, especially in infants and the elderly. The emergence of macrolide-resistance has significant effects on the treatment of relevant diseases in children. This study aimed to analyze the genotypes and the macrolide resistance-associated mutations in M. pneumoniae sampled from the pediatric patients in Henan, China. METHODS: A segment of gene on the 23S rRNA was amplified and sequenced to detect the mutations related to macrolide resistance. Molecular typing was performed by the method named multiple locus variable-number tandem repeat analysis (MLVA) for macrolide-susceptible and macrolide-resistant specimens. RESULTS: Among the M. pneumoniae-positive samples, 95.7% (111/116) had macrolide-resistant mutation, and all of them consisted of the A2063G mutation. There were only two MLVA types identified in this study, type 4-5-7-2 (51/92, 55.4%) and type 3-5-6-2 (41/92, 44.6%). CONCLUSION: There was no correlation between MLVA types and macrolide resistance (P â€‹> â€‹0.05).

Photoexcitation-induced passivation of SnO2 thin film for efficient perovskite solar cells.

A high-quality tin oxide electron transport layer (ETL) is a key common factor to achieve high-performance perovskite solar cells (PSCs). However, the conventional annealing technique to prepare high-quality ETLs by continuous heating under near-equilibrium conditions requires high temperatures and a long fabrication time. Alternatively, we present a non-equilibrium, photoexcitation-induced passivation technique that uses multiple ultrashort laser pulses. The ultrafast photoexcitation and following electron-electron and electron-phonon scattering processes induce ultrafast annealing to efficiently passivate surface and bulk defects, and improve the crystallinity of SnO2, resulting in suppressing the carrier recombination and facilitating the charge transport between the ETL and perovskite interface. By rapidly scanning the laser beam, the annealing time is reduced to several minutes, which is much more efficient compared with conventional thermal annealing. To demonstrate the university and scalability of this technique, typical antisolvent and antisolvent-free processed hybrid organic-inorganic metal halide PSCs have been fabricated and achieved the power conversion efficiency (PCE) of 24.14% and 22.75% respectively, and a 12-square-centimeter module antisolvent-free processed perovskite solar module achieves a PCE of 20.26%, with significantly enhanced performance both in PCE and stability. This study establishes a new approach towards the commercialization of efficient low-temperature manufacturing of PSCs.

Cost and health-related quality of life for children hospitalized with respiratory syncytial virus in Central China.

BACKGROUND: The economic burden of respiratory syncytial virus (RSV) infection and its impact on health-related quality of life (HRQoL) are not well-understood in China. This study assessed total cost and HRQoL for children hospitalized with RSV in Central China. METHODS: Based on a prospective case series study in Henan Province in 2020-2021, inpatients aged 0-59 months with RSV-related acute respiratory infections (ARIs) were included into analysis. Total cost included direct medical cost (sum of medical cost before and during hospitalization), direct non-medical cost, and indirect cost. Direct medical cost during hospitalization data were extracted from the hospital information system. Other costs and HRQoL status were obtained from a telephone survey conducted in the caregivers of the enrolled patients. RESULTS: Among 261 RSV-infected inpatients, caregivers of 170 non-severe cases (65.1%, 170/261) were successfully interviewed. Direct medical cost per episode was 1055.3 US dollars (US$) (95% CI: 998.2-1112.5 US$). Direct non-medical cost and indirect cost per episode were 83.6 US$ (95% CI: 77.5-89.7 US$) and 162.4 US$ (95% CI: 127.9-197.0 US$), respectively. Quality adjusted life years (QALY) loss for non-severe RSV hospitalization was 8.9 × 10-3 (95% CI: 7.9 × 10-3 -9.9 × 10-3 ). The majority of inpatients were <1 year of age comprising significantly higher cost and more QALY loss than older children. CONCLUSIONS: RSV-associated hospitalization poses high economic and health burden in Central China particularly for children <1 year old. Our findings are crucial for determining the priority of interventions and allocation of health resources.

Grain Boundary Elimination via Recrystallization-Assisted Vapor Deposition for Efficient and Stable Perovskite Solar Cells and Modules.

Vapor deposition is a promising technology for the mass production of perovskite solar cells. However, the efficiencies of solar cells and modules based on vapor-deposited perovskites are significantly lower than those fabricated using the solution method. Emerging evidence suggests that large defects are generated during vapor deposition owing to a specific top-down crystallization mechanism. Herein, a hybrid vapor deposition method combined with solvent-assisted recrystallization for fabricating high-quality large-area perovskite films with low defect densities is presented. It is demonstrated that an intermediate phase can be formed at the grain boundaries, which induces the secondary growth of small grains into large ones. Consequently, perovskite films with substantially reduced grain boundaries and defect densities are fabricated. Results of temperature-dependent charge-carrier dynamics show that the proposed method successfully suppresses all recombination reactions. Champion efficiencies of 21.9% for small-area (0.16 cm2 ) cells and 19.9% for large-area (10.0 cm2 ) solar modules under AM 1.5 G irradiation are achieved. Moreover, the modules exhibit high operational stability, i.e., they retain >92% of their initial efficiencies after 200 h of continuous operation.

Monolithically-grained perovskite solar cell with Mortise-Tenon structure for charge extraction balance.

Although the power conversion efficiency values of perovskite solar cells continue to be refreshed, it is still far from the theoretical Shockley-Queisser limit. Two major issues need to be addressed, including disorder crystallization of perovskite and unbalanced interface charge extraction, which limit further improvements in device efficiency. Herein, we develop a thermally polymerized additive as the polymer template in the perovskite film, which can form monolithic perovskite grain and a unique "Mortise-Tenon" structure after spin-coating hole-transport layer. Importantly, the suppressed non-radiative recombination and balanced interface charge extraction benefit from high-quality perovskite crystals and Mortise-Tenon structure, resulting in enhanced open-circuit voltage and fill-factor of the device. The PSCs achieve certified efficiency of 24.55% and maintain >95% initial efficiency over 1100 h in accordance with the ISOS-L-2 protocol, as well as excellent endurance according to the ISOS-D-3 accelerated aging test.

Antibody signatures in hospitalized hand, foot and mouth disease patients with acute enterovirus A71 infection.

Enterovirus A71 (EV-A71) infection is a major cause of severe hand, foot and mouth disease (HFMD) in young children. The characteristics of EV-A71 neutralizing antibodies in HFMD patients are not well understood. In this study, we identified and cloned EV-A71-neutralizing antibodies by single cell RNA and B cell receptor sequencing of peripheral blood mononuclear cells. From 145 plasmablasts, we identified two IgG1 monoclonal antibodies (mAbs) and six IgM mAbs that neutralized EV-A71. Four of the IgM mAbs harbor germline variable sequences and neutralize EV-A71 potently. Two genetically similar IgM antibodies from two patients have recurrent heavy chain variable domain gene usage and similar complementarity-determining region 3 sequences. We mapped the residues of EV-A71 critical for neutralization through selection of virus variants resistant to antibody neutralization in the presence of neutralizing mAbs. The residues critical for neutralization are conserved among EV-A71 genotypes. Epitopes for the two genetically similar antibodies overlap with the SCARB2 binding site of EV-A71. We used escape variants to measure the epitope-specific antibody response in acute phase serum samples from EV-A71 infected HFMD patients. We found that these epitopes are immunogenic and contributed to the neutralizing antibody response against the virus. Our findings advance understanding of antibody response to EV-A71 infection in young children and have translational potential: the IgM mAbs could potentially be used for prevention or treatment of EV-A71 infections.

Printable High-Efficiency and Stable FAPbBr3 Perovskite Solar Cells for Multifunctional Building-Integrated Photovoltaics.

Perovskite solar cells (PSCs) show great promise for next-generation building-integrated photovoltaic (BIPV) applications because of their abundance of raw materials, adjustable transparency, and cost-effective printable processing. Owing to the complex perovskite nucleation and growth control, the fabrication of large-area perovskite films for high-performance printed PSCs is still under active investigation. Herein, the study proposes an intermediate-phase-transition-assisted one-step blade coating for an intrinsic transparent formamidinium lead bromide (FAPbBr3 ) perovskite film. The intermediate complex optimizes the crystal growth path of FAPbBr3 , resulting in a large-area, homogeneous, and dense absorber film. A champion efficiency of 10.86% with high open-circuit voltage up to 1.57 V is obtained with a simplified device architecture of glass/FTO/SnO2 /FAPbBr3 /carbon. Moreover, the unencapsulated devices maintain 90% of their initial power conversion efficiency after aging at 75 °C for 1000 h in ambient air, and 96% after maximum power point tracking for 500 h. The printed semitransparent PSCs, with average visible light transmittance over 45%, demonstrate high efficiencies for both small devices (8.6%) and 10 × 10 cm2 modules (5.55%). Finally, the ability to customize the color, transparency, and thermal insulation properties of FAPbBr3 PSCs makes them high prospects as multifunctional BIPVs.

Protic Amine Carboxylic Acid Ionic Liquids Additives Regulate α-FAPbI3 Phase Transition for High Efficiency Perovskite Solar Cells.

The α-phase formamidinium lead tri-iodide (α-FAPbI3 ) has become the most promising photovoltaic absorber for perovskite solar cells (PSCs) due to its outstanding semiconductor properties and astonishing high efficiency. However, the incomplete crystallization and phase transition of α-FAPbI3 substantially undermine the performance and stability of PSCs. In this work, a series of the protic amine carboxylic acid ion liquids are introduced as the precursor additives to efficiently regulate the crystal growth and phase transition processes of α-FAPbI3 . The MA2 Pb3 I8 ·2DMSO phase is inhibited in annealing process, which remarkably optimizes the phase transition process of α-FAPbI3 . It is noted that the functional groups of carboxyl and ammonium passivate the undercoordinated lead ions, halide vacancies, and organic vacancies, eliminating the deleterious nonradiative recombination. Consequently, the small-area devices incorporated with 2% methylammonium butyrate (MAB) and 1.5% n-butylammonium formate (BAFa) in perovskite show champion efficiencies of 25.10% and 24.52%, respectively. Furthermore, the large-area modules (5 cm × 5 cm) achieve PCEs of 21.26% and 19.27% for MAB and BAFa additives, indicating the great potential for commercializing large-area PSCs.

Low-Cost Fabrication of Efficient Perovskite Photovoltaics Using Low-Purity Lead Iodide via Powder Engineering.

Low cost is the eternal theme for any commercial production. Numerous efforts have been explored to realize low-cost, high-efficiency perovskite solar cells (PSCs), such as replacing the traditional spin-coating method with an economical printing strategy, simplifying the device structure, reducing the number of functional layers, etc. However, there are few reports on the use of low-cost precursors. Herein, we enable the low-cost fabrication of efficient PSCs based on a very cheaper low-purity PbI2 via powder engineering. The low-purity PbI2 is blended with formamidinium iodide followed by dissolving in a 2-methoxyethanol solvent, and then, the high-quality FAPbI3 powders are formed via an inverse temperature crystallization process and solvent washing after several simple processes to reduce the impurities. As a result, the devices fabricated using the as-synthesized black powders based on the low-purity PbI2 exhibit a champion power conversion efficiency (PCE) of 23.9% and retained ∼95% of the initial PCE after ∼400 h of storage in the conditions of 25 ± 5 °C and 25 ± 5 RH% without encapsulation. In addition, the upscaling fabrication of a 5 cm × 5 cm solar minimodule also demonstrates an impressive efficiency of 19.5%. Our findings demonstrate an economic strategy for the commercialization of PSCs from the perspective of low-cost production.

Low-Cost Hydroxyacid Potassium Synergists as an Efficient In Situ Defect Passivator for High Performance Tin-Oxide-Based Perovskite Solar Cells.

Perovskite solar cells (PSCs) based on SnO2 electron transport layers have attracted extensive research due to their compelling photovoltaic performance. Herein, we presented an in situ passivation of SnO2 with low-cost hydroxyacid potassium synergist during deposition to optimize the interface carrier extraction and transport for high power conversion efficiency (PCE) and stabilities of PSCs. The orbital overlap of the carboxyl oxygen with the Sn atom alongwith the homogenous nano-particle deposition effectively suppresses the interfacial defects and releases the internal residual strains in the perovskite. Accordingly, a PCE of 24.91 % with a fill factor (FF) up to 0.852 is obtained for in situ passivated devices, which is one of the highest values for SnO2 -based PSCs. Moreover, the unencapsulated device maintained 80 % of its initial PCE at 80 °C over 600 h, 100 % PCE at ambient conditions for 1300 h, and 98 % after one week maximum power point tracking (MPPT) under continuous AM1.5G illumination.

Enhanced Carrier Diffusion Enables Efficient Back-Contact Perovskite Photovoltaics.

Back-contact architectures offer a promising route to improve the record efficiencies of perovskite solar cells (PSCs) by eliminating parasitic light absorption. However, the performance of back-contact PSCs is limited by inadequate carrier diffusion in perovskite. Here, we report that perovskite films with a preferred out-of-plane orientation show improved carrier dynamic properties. With the addition of guanidine thiocyanate, the films exhibit carrier lifetimes and mobilities increased by 3-5 times, leading to diffusion lengths exceeding 7 µm. The enhanced carrier diffusion results from substantial suppression of nonradiative recombination and improves charge collection. Devices using such films achieve reproducible efficiencies reaching 11.2 %, among the best performances for back-contact PSCs. Our findings demonstrate the impact of carrier dynamics on back-contact PSCs and provide the basis for a new route to high-performance back-contact perovskite optoelectronic devices at low cost.