Failure probability analysis of high fill levee considering multiple uncertainties and correlated failure modes.

Such complex causative factors in current failure probability models are represented by simply random uncertainty and completely independent or correlation of failure modes, which can often limit the model utility. In this study, we developed a methodology to construct failure probability models for high fill levees, incorporating the identification of uncertainties and an analysis of failure modes. Based on quantification of stochastic-grey-fuzzy uncertainties, probability analysis involved with overtopping, instability and seepage failure modes was implemented combined with probability and non-probability methods. Given that the interaction among failure modes typically exhibits nonlinear behavior, rather than linear correlation or complete independence, a simple methodology for the binary Copula function was established and implemented in MATLAB. This methodology was applied to the high fill segments of a long-distance water transfer project characterized by high population density. It shows that the failure probability of a single failure mode is overestimated when uncertainties are not considered, because of the randomness and fuzziness of some parameters and the greyness of information. Meanwhile, it is found that the magnitude of failure probability related to levee breach is overestimated without respect to failure modes correlation, especially when the probabilities of seepage and instability are both significant and closely aligned.

Moderate Salinity Stress Affects Rice Quality by Influencing Expression of Amylose- and Protein-Content-Associated Genes.

Salinity is an environmental stress that severely impacts rice grain yield and quality. However, limited information is available on the molecular mechanism by which salinity reduces grain quality. In this study, we investigated the milling, appearance, eating and cooking, and nutritional quality among three japonica rice cultivars grown either under moderate salinity with an electrical conductivity of 4 dS/m or under non-saline conditions in a paddy field in Dongying, Shandong, China. Moderate salinity affected rice appearance quality predominantly by increasing chalkiness rate and chalkiness degree and affected rice eating and cooking and nutritional quality predominantly by decreasing amylose content and increasing protein content. We compared the expression levels of genes determining grain chalkiness, amylose content, and protein content in developing seeds (0, 5, 10, 15, and 20 days after flowering) of plants grown under saline or non-saline conditions. The chalkiness-related gene Chalk5 was up-regulated and WHITE-CORE RATE 1 was repressed. The genes Nuclear factor Y and Wx, which determine amylose content, were downregulated, while protein-content-associated genes OsAAP6 and OsGluA2 were upregulated by salinity in the developing seeds. These findings suggest some target genes that may be utilized to improve the grain quality under salinity stress conditions via gene-pyramiding breeding approaches.

Sewage network operational risks based on InfoWorks ICM with nodal flow diurnal patterns under NPIs for COVID-19.

Non-Pharmaceutical Interventions (NPIs) have been widely employed globally over the past three years to control the rapid spread of coronavirus disease 2019 (COVID-19). These measures have imposed restrictions on urban residents' activities and significantly influenced sewage discharge characteristics within sewage network, particularly in densely populated cities in China. This study focused on the nodal flow diurnal patterns and sewage network operational risks before and after epidemic lockdown in Beijing from March to May in 2022. Nodal flow diurnal patterns on weekdays and weekends before and after NPIs were analyzed using measured data through statistical and mathematical methods. A sewage network model was established to simulate and analyze the operational risks based on InfoWorks ICM before and after epidemic lockdown. The main conclusions were as follows: (1) In predominantly residential areas, the total wastewater volume increased by approximately 28.76 % to 33.52 % after the implementation of strict NPIs. The morning and midday "M" peaks on normalized weekdays transformed into "N" peaks, and the morning peak time was delayed by 0.5 to 1 hour after the lockdown; (2) Following NPIs, More than 90 % of manholes' average water levels rose to varying degrees, approximately 50 % of pipe lengths exhibited a full flow state; (3) When the lockdown was in place during a hot summer day, sewage overflow phenomena were observed in 4.6 % and 9.6 % of manholes, respectively, with per capita daily drainage equivalent reaching 40-50 %. These findings hold significant implications for the proactive planning and operational management of water industry infrastructure during major emergencies.

Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study. / ä¸åŒç»´æŒå‰‚é‡æž¸æ©¼é ¸å’–å•¡å› å¯¹è¾ åŠ©é€šæ°”æ—©äº§å„¿çš„ç–—æ•ˆè¯„ä¼°ï¼šä¸€é¡¹åˆæ­¥å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment. METHODS: A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group. RESULTS: Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05). CONCLUSIONS: This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

General movement assessment is correlated with neonatal behavior neurological assessment/cerebral magnetic resonance imaging in preterm infants.

ABSTRACT: To explore the relationship between general movements (GMs) and neonatal behavior neurological assessment (NBNA)/cerebral magnetic resonance imaging (MRI) in preterm infants.Forty preterm infants were examined with GMs assessment before gestational age of 40 weeks; NBNA was performed at the age of 40 weeks; cerebral MRI was performed at the age of 42 weeks.Our experiment showed that preterm infants with poor GMs scores are more likely to have low NBNA scores (P = .001); preterm infants with abnormal cerebral MRI are more likely to have low NBNA scores (P = .002); preterm infants with poor GMs scores are more likely to have abnormal cerebral MRI (P = .012).GM assessment is correlated with NBNA and MRI results in preterm infants for neurological development.

A multicenter retrospective study on survival rate and complications of very preterm infants. / æžæ—©äº§å„¿å­˜æ´»çŽ‡å’Œå¹¶å‘ç—‡çš„å¤šä¸­å¿ƒå›žé¡¾æ€§ç ”ç©¶.

OBJECTIVES: To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications. METHODS: The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants. RESULTS: A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25+6 weeks, 26-26+6 weeks, 27-27+6 weeks, 28-28+6 weeks, 29-29+6 weeks, 30-30+6 weeks, and 31-31+6 weeks had a survival rate of 32.5%, 60.6%, 68.0%, 82.9%, 90.1%, 92.3%, and 94.8% respectively. The survival rate tended to increase with the gestational age (P<0.05) and the survival rate without serious complications in each gestational age group was 7.5%, 18.1%, 34.5%, 52.2%, 66.7%, 75.7%, and 81.8% respectively, suggesting that the survival rate without serious complications increased with the gestational age (P<0.05). The multivariate logistic regression analysis showed that high gestational age, high birth weight, and prenatal use of glucocorticoids were protective factors against death in very preterm infants (P<0.05), and 1-minute Apgar score ≤3 was a risk factor for death in very preterm infants (P<0.05); high gestational age and high birth weight were protective factors against serious complications in very preterm infants who survived (P<0.05), while 5-minute Apgar score ≤3 and maternal chorioamnionitis were risk factors for serious complications in very preterm infants who survived (P<0.05). CONCLUSIONS: The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.

The RNA demethylase ALKBH5 promotes osteoblast differentiation by modulating Runx2 mRNA stability.

AlkB homolog 5 (ALKBH5) has been reported as a key m6A demethylase that is involved in development and diseases; however, the function of ALKBH5 in osteogenesis remains unknown. In this study, we report that ALKBH5 mRNA and protein expression were upregulated during osteoblast differentiation and that ALKBH5 knockdown suppressed osteoblast differentiation, mineralization, and the expression of osteogenic biomarkers. Conversely, ALKBH5 overexpression promoted osteogenesis. Moreover, the expression of wild-type ALKBH5, but not the m6A-modified active site mutant ALKBH5, could rescue ALKBH5 knockdown-induced osteogenesis inhibition. Furthermore, knockdown of ALKBH5 significantly impaired the mRNA stability of the transcription factor Runx2, which plays a key role in osteoblast differentiation. Taken together, our results suggest that ALKBH5 promotes osteogenesis through modulating Runx2 mRNA stability.

Mechanisms and Empirical Modeling of Evaporation from Hardened Surfaces in Urban Areas.

Urban evaporation, as an essential part of local water vapor resources in urban areas, has often been underestimated. One possible reason is that the evaporation of urban hardened surfaces is seldom considered and poorly understood in urban evaporation estimation. This study focused on the mechanisms and calculation of evaporation on hardened surfaces in urban areas. Experimental monitoring was used to monitor the processes and characteristics of evaporation on hardened surfaces. Mathematical models based on water quantity constraints were built to calculate evaporation of hardened surfaces. The results showed that: The interception abilities for rainwater and rainfall days of impervious hardened surfaces determine their evaporated water amount, which means no water, no evaporation for the impervious surfaces. The greater evaporation of artificial sprinkling on roads happened in fewer days of rainfall and frost. The evaporation of pervious hardened ground is continuous compared to the impervious surface. Its soil moisture in the sub-layer of permeable concrete decreases periodically with a period of one day. The evaporation of hardened surfaces occupies 16-29% of the total amount of evaporation in the built-up areas in cities. Therefore, the hardened surface evaporation has great significance on the urban hydrological cycle and urban water balance.

Flood economic assessment of structural measure based on integrated flood risk management: A case study in Beijing.

Flood disasters have appeared more frequently in recent years because of climate change and urbanization, and Integrated Flood Risk Management (IFRM) has emerged as an effective method to reduce damage from these floods. This research studies IFRM methods in three aspects: flood risk identification of high-risk areas, flood risk assessment to quantify economic losses, and flood risk management to identify structural measures with the greatest engineering benefits. These methods were applied to Beijing as a case study, and the results showed that the Zuoan-Road area was a high-risk area with economic losses ranging from 0.7 million to 35.9 million euros over different return periods. There are five structural measures in Zuoan-Road area, with engineering benefits ranging from 0.97 to 1.60 over different return periods, and the one with the greatest engineering benefits had a fifty-year return period. The results of this research can be used to support urban flood risk management in Beijing.

Estimated Cost-effectiveness of Newborn Screening for Congenital Cytomegalovirus Infection in China Using a Markov Model.

Importance: Congenital cytomegalovirus infection (cCMVi) is one of the most common infections associated with childhood hearing loss. Prevention and mitigation of cCMVi-related hearing loss will require an increase in newborn screening, which is not yet available in China. Objective: To estimate the cost-effectiveness of newborn screening strategies for cCMVi from the perspective of the Chinese health care system. Design, Setting, and Participants: A decision tree for a simulated cohort population of 15 000 000 live births was developed to compare the costs and health effects of 3 mutually exclusive interventions: (1) no screening, (2) targeted screening using CMV polymerase chain reaction assay for newborns who fail a universal hearing screening, and (3) universal screening for CMV among all newborns. Markov diagrams were used to evaluate the lifetime horizon (76 years). Main Outcomes and Measures: Cost, hearing-related health outcomes, and incremental cost-effectiveness ratios (ICERs) were estimated based on a direct medical costs perspective. Costs and ICERs were reported in 2018 US dollars. Results: Incidence of cCMVi among newborns was reported to be approximately 0.7% in China. Targeted screening was less costly but also less effective than universal screening, identifying 41% of cases needing antiviral treatment and preventing nearly half of less severe or profound hearing loss. To avoid 1 CMV-related severe or profound hearing loss, 13 and 16 newborns need to be treated by targeted and universal screening, respectively. The ICERs of targeted and universal screening vs no screening were $79 and $2087 per quality-adjusted life-year gained, respectively, at the discounted rate of 3.5%. Both screening options were cost-effective for the Chinese health care system based on the willingness-to-pay threshold of 3 × gross domestic product per capita. The sensitivity analysis showed that the prevalence of cCMVi, as well as diagnosis and treatment costs, were key factors that may be associated with decision-making. Conclusions and Relevance: To achieve cost-effectiveness and best health outcomes, universal screening could be considered for the Chinese population. While the results are specific to China, the model may easily be adapted for other countries.

Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants.

BACKGROUND AND AIM: Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. METHODS: This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1-24 mL/(kg · day), 25-49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. RESULTS: Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1-24 ml/(kg · day), 139 (14.4%) received 25-49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). CONCLUSIONS: A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03453502 . Registration date: March 5, 2018. This study was retrospectively registered.

[An investigation of severe neonatal hyperbilirubinemia in 13 hospitals of Jiangsu Province, China].

OBJECTIVE: To investigate the incidence of severe neonatal hyperbilirubinemia and the management on the treatment and follow-up of this disease in Jiangsu Province, China. METHODS: The neonates with severe hyperbilirubinemia who were admitted to 13 hospitals in Jiangsu Province from January to December, 2018, were enrolled as subjects. A retrospective analysis was performed on their mediacal data and follow-up data. RESULTS: In 2018, 740 neonates with severe hyperbilirubinemia were reported from the 13 hospitals in Jiangsu Province, accounting for 2.70% (740/27 386) of the total number of neonates admitted to the department of neonatology. Among these neonates, 620 (83.8%) had severe hyperbilirubinemia, 106 (14.3%) had extremely severe hyperbilirubinemia, and 14 (1.9%) had hazardous hyperbilirubinemia. Four neonates (0.5%) were diagnosed with acute bilirubin encephalopathy. A total of 484 neonates (65.4%) were readmitted due to severe hyperbilirubinemia after discharge from the delivery institution, with a median age of 7 days, among whom 214 (44.2%) were followed up for jaundice at the outpatient service before readmission, with a median age of 6 days at the first time of outpatient examination. During hospitalization, 211 neonates (28.5%) underwent cranial MRI examinations, among whom 85 (40.3%) had high T1WI signal in the bilateral basal ganglia and the globus pallidus; 238 neonates (32.2%) underwent brainstem auditory evoked potential examinations, among whom 14 (5.9%) passed only at one side and 7 (2.9%) failed at both sides. The 17 neonates with acute bilirubin encephalopathy or hazardous hyperbilirubinemia were followed up. Except one neonate was lost to follow-up, and there were no abnormal neurological symptoms in the other neonates. CONCLUSIONS: Neonates with severe hyperbilirubinemia account for a relatively high proportion of the total number of neonates in the department of neonatology. Jaundice monitoring and management after discharge from delivery institutions need to be strengthened. For neonates with severe hyperbilirubinemia, relevant examinations should be carried out more comprehensively during hospitalization and these neonates should be followed up comprehensively and systematically after discharge.

OsABAR1, a novel GRAM domain-containing protein, confers drought and salt tolerance via an ABA-dependent pathway in rice.

Glucosyltransferases-like GTPase activators and Myotubularin (GRAM) domain-containing proteins are important for plant development and responses to biotic stresses. However, the effects of GRAM proteins on abiotic stress responses remain unclear. In this study, we identified a novel GRAM protein-encoding gene, OsABAR1, and characterized its regulatory functions related to rice drought and salt tolerance. The OsABAR1 protein was localized in the cytoplasm and nucleus. Among all examined organs, the OsABAR1 transcript level was highest in the roots. Moreover, OsABAR1 expression was up-regulated by drought and salinity stresses. The OsABAR1-overexpressing (OsABAR1-OX) lines exhibited enhanced tolerance to drought and salinity, whereas the knock-out lines (Osabar1) had the opposite phenotypes. We further analyzed the involvement of OsABAR1 in the abscisic acid (ABA) signaling pathway. The OsABAR1 expression level was up-regulated by ABA. In turn, OsABAR1 regulated the expression of ABA metabolic genes and responsive genes. Furthermore, OsABAR1-OX seedlings were hypersensitive to exogenous ABA, whereas Osabar1 seedlings were hyposensitive. These results imply that OsABAR1 is a positive regulator of the ABA pathway and confirm that OsABAR1 improves rice drought and salt tolerance via an ABA-dependent pathway. This study is the first to clarify the regulatory roles of GRAM proteins in rice responses to abiotic stresses.

Analysis of cytokines and trace elements in children with febrile seizures.

BACKGROUND: Febrile seizure (FS) is a common neurological condition in children and affects 2-5% of cases of fever. FS occurs with temperature >38 °C without symptoms of central nervous system infection, severe electrolyte imbalance, or clear cause. METHODS: From June 2018 to December 2019, 65 children with FS, and 60 children with acute upper respiratory tract infections without seizures who were admitted to the pediatric department, and 60 healthy children as the control group were selected for the study. The serum iron (SI), serum calcium (SC), interleukin (IL)-6, IL-10 and procalcitonin (PCT) levels in the two groups of children were detected. The FS group was further divided into simple FS (SFS) and complex FS (CFS). RESULTS: The duration of fever in the FS group was significantly longer than in the control group (P<0.05). The SC and SI levels of the FS group were significantly lower than those in the control group (P<0.05). The SC and SI levels of the CFS group were also lower than those of the SFS group (P<0.05), and the IL-6 levels of the CFS group were significantly higher than in the SFS group (P<0.05). CONCLUSIONS: A decrease in the levels of SI, and SC and an increase of IL-6 were closely related to the occurrence of FS, suggesting that clinical attention should be paid to monitoring changes of SI, SC and IL-6 levels in children with FS. As the levels of SI and SC decrease, the frequency of possible seizures may increase. Care should be taken to correct electrolyte disorders in time.

Characterization of phytochrome C functions in the control of de-etiolation and agronomic traits in rice.

Although phytochrome A (phyA) and phyB have been functionally characterized, functions of phyC in rice growth and development have remained elusive because of the functional dependency of phyC on the phyB protein. In this study, we introduced PHYB(C364A), in which the chromophore attachment site cysteine 364 was converted to alanine, into the phyAphyB double mutant (aabb) and the phyAphyBphyC triple mutant (aabbcc) to produce PHYB(C364A)/aabb lines and PHYB(C364A)/aabbcc lines, respectively. PHYB(C364A)/aabbcc lines were insensitive to red light (R) and far-red light (FR), suggesting that PHYB(C364A) protein was biologically inactive. Functions of phyC were characterized using the PHYB(C364A)/aabb lines, without the functional interference of phyA or phyB. Phytochrome C responded to R and FR to trigger de-etiolation in the very-low-fluence response and low-fluence response in the PHYB(C364A)/aabb lines. Compared with the aabb mutant, seedlings of PHYB(C364A)/aabb lines showed higher chlorophyll content and reduced leaf angle. The PHYB(C364A)/aabb lines also showed a delayed heading date under long-day conditions. Phytochrome C-regulated agronomic traits were measured at the mature stage. The PHYB(C364A)/aabb lines showed significantly increased plant height, panicle length, grain number per main panicle, seed-setting rate, grain size, and grain weight, compared with those of the aabb mutant. Taken together, the present findings confirm that phyC perceives R and FR, and plays an important role in photomorphogenesis and yield determination in rice.

MicroRNA-211-5p Enhances Analgesic Effect of Dexmedetomidine on Inflammatory Visceral Pain in Rats by Suppressing ERK Signaling.

Dexmedetomidine (DEX) is a high-selectivity α2 adrenergic receptor agonist. The present study aimed to characterize the analgesic effects of DEX on TNBS-induced chronic inflammatory visceral pain (CIVP) in rats and to evaluate whether its antinociceptive effect is regulated by microRNAs (miRNAs) and the ERK pathway. TNBS with or without DEX was administered to 60 male Sprague-Dawley rats. These rats were randomly classified into four groups: control, TNBS, vehicle, and DEX groups. Pain behaviors were assessed by the abdominal withdrawal reflex (AWR), thermal withdrawal latency (TWL), and mechanical withdrawal threshold (MWT). qPCR, ELISA, and western blotting results showed increased serum IL-1ß, TNF-α, and IL-6 levels. RNA microarray and qPCR results indicated that miR-211 was downregulated by CIVP induction but upregulated by DEX administration. ERK signaling was decreased in the TNBS+miR-211 group and increased in the DEX + miR-211 group, indicating that miR-211 targeted the 3'-UTR of the ERK gene. Moreover, ectopic expression of miR-211 in these two groups ameliorated pain behaviors and reduced proinflammatory cytokine production. Therefore, DEX exhibited an analgesic effect on CIVP in rats through a miR-211-mediated MEK/ERK/CREB pathway, suppressing visceral hypersensitivity.

Impact of extent of resection on survival in high-risk neuroblastoma: A systematic review and meta-analysis.

BACKGROUND: Despite the development of new treatment options, the prognosis of high-risk neuroblastoma patients is still poor. Many studies designed to elaborate the association between the extent of resection (EOR) and outcome have reported conflicting results. We performed a meta-analysis to assess whether greater EOR is associated with improved overall survival (OS) and event-free survival (EFS) in patients with high-risk neuroblastoma. METHODS: Embase, PubMed, Cochrane library, and conference proceedings were searched between March 10 and October 1, 2017. Studies of pediatric patients with newly diagnosed high-risk neuroblastoma comparing various EOR and presenting objective overall or event-free survival data were included. Primary outcomes were relative risk (RR) for mortality at 3 and 5 years. Secondary outcomes were 3-year and 5-year EFS rates. RESULTS: 19 retrospective studies including a total of 2358 cases were identified. Compared with subtotal resection (STR), patients who underwent gross total resection (GTR) had significantly decreased mortality at 3 years (RR, 0.69; 95% CI, 0.58-0.82; P < 0.001; I2 = 27%) and 5 years (RR, 0.70; 95% CI, 0.60-0.82; P < 0.001; I2 = 38%). A similar decrease was revealed in the 3-year risk for mortality for STR compared with biopsy (RR, 0.71; 95% CI, 0.53-0.95; P = 0.02; I2 = 0%). When comparing any resection with biopsy, resection group also showed a decreased risk for mortality at 3 years (RR, 0.66; 95% CI, 0.53-0.83; P < 0.001; I2 = 8%) and 5 years (RR, 0.67; 95% CI, 0.50-0.91; P = 0.009; I2 = 61%). With respect to the risk ratio for EFS, there were no significant differences in any comparisons. CONCLUSION: This literature highlights the importance of "extent of resection" in treating high-risk neuroblastoma, and when feasible, the currently available evidences in favor of the use of GTR for high-risk neuroblastoma for reducing 3- and 5-year mortality. LEVEL OF EVIDENCE: 3A.

An Effect Analysis of Comprehensive Treatment of Groundwater Over-Exploitation in Cheng'an County, Hebei Province, China.

The comprehensive treatment project of groundwater over-exploitation in Hebei Province has been implemented for more than a year, and the effect of exploitation restriction is in urgent need of evaluation. This paper deals with Cheng'an County of Hebei Province as the research subject. Based on collected hydro-meteorological, socioeconomic, groundwater, and other related data, together with typical regional experimental research, this study generates the effective precipitation-groundwater exploitation (P-W) curve and accompanying research methods, and calculates the quantity of groundwater exploitation restriction. It analyzes the target completion status of groundwater exploitation restriction through water conservancy measures and agricultural practices of the groundwater over-exploitation comprehensive treatment project that was implemented in Cheng'an County in 2014. The paper evaluates the treatment effect of groundwater over-exploitation, as well as provides technical support for the effect evaluation of groundwater exploitation restriction of agricultural irrigation in Cheng'an County and relevant areas.

Poly(ester urea)-Based Adhesives: Improved Deployment and Adhesion by Incorporation of Poly(propylene glycol) Segments.

The adhesive nature of mussels arises from the catechol moiety in the 3,4-dihydroxyphenylalanine (DOPA) amino acid, one of the many proteins that contribute to the unique adhesion properties of mussels. Inspired by these properties, many biomimetic adhesives have been developed over the past few years in an attempt to replace adhesives such as fibrin, cyanoacrylate, and epoxy glues. In the present work, we synthesized ethanol soluble but water insoluble catechol functionalized poly(ester urea) random copolymers that help facilitate delivery and adhesion in wet environments. Poly(propylene glycol) units incorporated into the polymer backbone impart ethanol solubility to these polymers, making them clinically relevant. A catechol to cross-linker ratio of 10:1 with a curing time of 4 h exceeded the performance of commercial fibrin glue (4.8 ± 1.4 kPa) with adhesion strength of 10.6 ± 2.1 kPa. These adhesion strengths are significant with the consideration that the adhesion studies were performed under wet conditions.

Caddisfly Inspired Phosphorylated Poly(ester urea)-Based Degradable Bone Adhesives.

Bone and tissue adhesives are essential in surgeries for wound healing, hemostasis, tissue reconstruction, and drug delivery. However, there are very few degradable materials with high adhesion strengths that degrade into bioresorbable byproducts. Caddisfly adhesive silk is interesting due to the presence of phosphoserines, which are thought to afford adhesive properties. In this work, phosphoserine-valine poly(ester urea) copolymers with 2% and 5% phosphoserine content were synthesized to mimic caddisfly adhesive silk. Significantly, the materials are ethanol soluble and water insoluble, making them clinically relevant. Their physical properties were quantified, and the adhesion properties were studied on aluminum and bovine bone substrates before and after cross-linking with Ca(2+) ions. The adhesive strength of the phosphorylated copolymer on a bone substrate after cross-linking with Ca(2+) was 439 ± 203 kPa, comparable to commercially available PMMA bone cement (530 ± 133 kPa).