Pilot Study to Determine the Effectiveness of a Home Health Nursing Simulation.

Demand for home care has increased due to the expansion of preventive care, people living longer with chronic conditions, and the need for healthcare services as the baby boom population ages. Nurses must be prepared to meet the needs of patients and families in the home setting. Home care nursing simulations have been utilized as a teaching-learning strategy in baccalaureate nursing education, yet less is known about their use with practicing home care nurses and associate degree nursing students. The purpose of this pilot study using simulation was to prepare practicing nurses and student nurses to respond using nursing skills and clinical judgment. The convenience sample consisted of associate degree nursing students (n = 9), practicing home healthcare nurses (n = 8), and nursing faculty (n = 2). The Simulation Effectiveness Tool - Modified (SET-M) Survey (Leighton et al., 2015) was utilized for data collection. Participants perceived the home healthcare simulation to be an effective practice experience with high overall agreement for Pre-briefing, Scenario-Confidence, Scenario-Learning, and Debriefing. The findings of this study provide data to support partnerships to provide home care simulation experiences for associate degree nursing students and practicing home care nurses.

Health screenings in college health centers: Variations in practice.

Objective: The purpose of this study was to examine the routine screening of female students in college health centers for six priority health-related behaviors and experiences (tobacco use, alcohol use, eating disorders [EDs], obesity, anxiety and depression, intimate partner violence/sexual violence [IPV/SV]), and to identify variations in practice. Participants: A nationally representative sample of 1,221 healthcare providers (HCPs), including nurse practitioners, physicians, and physician assistants, from 471 U.S. college health centers. Methods: HCPs completed surveys (on-line or paper) and reported on routine screening of female college students. Results: HCPs reported consistently high rates (75-85%) of screening for tobacco use, alcohol use, and anxiety/depression. Rates of screening for IPV/SV, obesity and EDs were much lower. Nurse practitioners reported the highest IPV/SV screening rates. Conclusions: College health centers present unique opportunities for screening, case-finding and intervening to reduce long-term sequelae. Providers are well-positioned to lead initiatives to improve screening practices.

The effectiveness of digital twins in promoting precision health across the entire population: a systematic review.

Digital twins represent a promising technology within the domain of precision healthcare, offering significant prospects for individualized medical interventions. Existing systematic reviews, however, mainly focus on the technological dimensions of digital twins, with a limited exploration of their impact on health-related outcomes. Therefore, this systematic review aims to explore the efficacy of digital twins in improving precision healthcare at the population level. The literature search for this study encompassed PubMed, Embase, Web of Science, Cochrane Library, CINAHL, SinoMed, CNKI, and Wanfang Database to retrieve potentially relevant records. Patient health-related outcomes were synthesized employing quantitative content analysis, whereas the Joanna Briggs Institute (JBI) scales were used to evaluate the quality and potential bias inherent in each selected study. Following established inclusion and exclusion criteria, 12 studies were screened from an initial 1321 records for further analysis. These studies included patients with various conditions, including cancers, type 2 diabetes, multiple sclerosis, heart failure, qi deficiency, post-hepatectomy liver failure, and dental issues. The review coded three types of interventions: personalized health management, precision individual therapy effects, and predicting individual risk, leading to a total of 45 outcomes being measured. The collective effectiveness of these outcomes at the population level was calculated at 80% (36 out of 45). No studies exhibited unacceptable differences in quality. Overall, employing digital twins in precision health demonstrates practical advantages, warranting its expanded use to facilitate the transition from the development phase to broad application.PROSPERO registry: CRD42024507256.

Student Health Services at Historically Black Colleges and Universities and Predominantly Black Institutions in the United States.

Introduction: Student health services are associated with improved health outcomes and academic success, particularly among under-resourced college populations. This study compared student health services at Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs) and identified factors associated with the availability of comprehensive health services (CHS). Methods: We conducted a secondary analysis of 2022 data from the Integrated Postsecondary Education Data System (IPEDS), the Minority Serving Institutions (MSIs) Directory, and the websites of HBCUs and PBIs (n=167). Bivariate and multivariate logistic regression analyses were undertaken to identify institutional variables associated with providing CHS. Institutional variables included college type (public vs. private), MSI category (HBCU vs. PBI), undergraduate enrollment, location, and proportion of Pell grant recipients. Results: Approximately 13% of HBCUs and 26% of PBIs offered no student health services; 65% of HBCUs and 39% of PBIs offered on-campus CHS with prescribing providers. Four-year HBCUs were five times more likely than 4-year PBIs to have CHS (p=0.014). Institutions with more Pell Grant recipients were less likely to offer CHS. Conclusions: Access to health care is an important social determinant of health, academic persistence, and achievement for college students. HBCUs were significantly more likely than PBIs to offer CHS. HBCUs are more likely than PBIs to have resources from federal funding, donors, and endowments that may support the development of student health centers and services. Increased funding for PBI health centers could improve access and promote health equity among the most vulnerable student populations.

Original Research: Exploring U.S. Nurses' Perceived Duty to Care During the COVID-19 Pandemic.

BACKGROUND: Duty to care is both an integral concept in health care and a fundamental nursing obligation. But nurses' perceptions of duty to care can be moderated by their experiences in the practice setting. Research examining nurses' perceptions of their duty to care during the COVID-19 pandemic could shed light on how the pandemic is affecting the nursing workforce. PURPOSE: This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale (NDCS), and to compare the high-scoring nurses with the low-scoring nurses. METHODS: This quantitative study used a descriptive, cross-sectional design. It was conducted among licensed RNs enrolled at two accredited nursing programs in the Northeast region of the United States. Data were collected via a demographics questionnaire and the NDCS. A two-step cluster procedure was used to categorize participants into two groups: those with high perceived duty to care (HPDC) and those with low perceived duty to care (LPDC). Independent t tests were performed to compare NDCS results between the two groups. RESULTS: Nearly two-thirds (61%) of the participants had total NDCS scores indicating an HPDC, while 39% had scores indicating an LPDC. Of the NDCS's four subscales, perceived obligation and perceived risk were the most important in separating participants into the low- and high-scoring groups. CONCLUSIONS: This study adds to the literature about the components that affected nurses' perceived duty to care and willingness to report to work during the early months of the pandemic. Just as nurses have a duty to care, health care organizations have an obligation to provide a safe working environment so that nurses can fulfill that duty without sacrificing personal safety. The study findings may guide health care leaders, systems, and organizations regarding how to create safer work environments that support the nurse's duty to care during disasters.

Anomalous stable hydrogen-oxygen isotope characteristics and water vapor sources of autumn precipitation in the Weihe River basin, Northwest China.

The extreme changes in autumn rain have significant impacts on the ecological environment of Weihe River basin. Based on 117 autumn rain samples and corresponding meteorological data from 2015 to 2021 at Yangling located in the middle of Weihe River basin, we investigated the stable hydrogen and oxygen isotope composition and water vapor sources of precipitation. The results showed that, (1) extreme changes in autumn rainfall in the study area occurred frequently in recent years, which could be divided into extreme-high autumn precipitation year (HAP, 2021), general autumn precipitation year (GAP, 2015-2017, 2019-2020) and extreme-low autumn precipitation year (LAP, 2018) based on the autumn rain index (ARI); (2) the stable isotopes of different types of precipitation differed significantly, with a pattern of LAP>GAP>HAP for both δ2H and δ18O values. the variations of d-excess values and the slopes and intercepts of the meteoric water lines of autumn rain showed opposite trends. The main factor controlling autumn rain anomaly was not the local meteorological parameters, but the El Nino-Southern Oscillation and the Indian Ocean dipole events, which could explain 99% and 93% of the autumn rain isotopic variations, respectively. These coupling phenomena affected water vapor transport intensity of the marine air mass to the northwest inland, which determined autumn rainfall amount and the stable hydrogen-oxygen isotope composition. Our results would be helpful for improving the understanding of autumn rain anomalies in West China, and provide basic data and theoretical support for regional hydrological model building, would thereby better serve water resources management and disaster prevention and reduction.

A Novel Sparse Linear Mixed Model for Multi-Source Mixed-Frequency Data Fusion in Telemedicine.

Digital health and telemonitoring have resulted in a wealth of information to be collected to monitor, manage, and improve human health. The multi-source mixed-frequency health data overwhelm the modeling capacity of existing statistical and machine learning models, due to many challenging properties. Although predictive analytics for big health data plays an important role in telemonitoring, there is a lack of rigorous prediction model that can automatically predicts patients' health conditions, e.g., Disease Severity Indicators (DSIs), from multi-source mixed-frequency data. Sleep disorder is a prevalent cardiac syndrome that is characterized by abnormal respiratory patterns during sleep. Although wearable devices are available to administrate sleep studies at home, the manual scoring process to generate the DSI remains a bottleneck in automated monitoring and diagnosis of sleep disorder. To address the multi-fold challenges for precise prediction of the DSI from high-dimensional multi-source mixed-frequency data in sleep disorder, we propose a sparse linear mixed model that combines the modified Cholesky decomposition with group lasso penalties to enable joint group selection of fixed effects and random effects. A novel Expectation Maximization (EM) algorithm integrated with an efficient Majorization Maximization (MM) algorithm is developed for model estimation of the proposed sparse linear mixed model with group variable selection. The proposed method was applied to the SHHS data for telemonitoring and diagnosis of sleep disorder and found that a few significant feature groups that are consistent with prior medical studies on sleep disorder. The proposed method also outperformed a few benchmark methods with the highest prediction accuracy.

Undergraduate nursing students' attitudes towards incarcerated persons and their perceptions of clinical experiences.

BACKGROUND: In 2019, an estimated 6.3 million persons were under the supervision of the United States adult correctional systems and one in 40 adult persons were under correctional supervision. At year-end of 2019, nearly seven in ten persons under correctional supervision were supervised in the community. A nurse's attitudes and beliefs about incarcerated persons may influence their behavior. PURPOSE: The purpose of this study was to examine nursing student's attitudes towards incarcerated persons and their perceptions of a clinical experience at a correctional facility. METHODS: Data from 137 nursing students were collected through a cross-sectional, electronic survey. The Attitude Towards Prisoners Scale (Melvin et al., 1985) was used. A post hoc analysis of perceptions of their clinical experience at a correctional facility was explored. RESULTS: The mean scores of 93 and 94 (potential range of scores 0 to 144) suggest positive attitudes towards incarcerated persons exist, yet few nursing students report an interest in correctional nursing as a career. Although few (n = 5) students had a correctional nursing clinical experience, most perceived it as an effective clinical learning setting. CONCLUSION: With high rates of incarceration, the researchers recommend that baccalaureate nursing programs include educational teaching strategies that focus on incarceration, incarceration stigma, and explore clinical learning experiences.

A Multi-Center Structural Equation Modeling Approach to Investigate Interpersonal Violence Screening for Public Health Promotion.

Background: Interpersonal violence is a significant public health issue. Routine health screening is a cost-effective strategy that may reduce harmful physical and mental consequences. However, existing research finds consistently low rates of violence screening offered by healthcare providers, e.g., nurses, nurse practitioners, physicians. There is a critical need for research that helps understand how providers' screening behaviors are impacted by individual-level and organizational-level factors to promote the uptake of routine screening for interpersonal violence. Two recent studies, i.e., The Health Care Providers study and Nurse Practitioners Violence Screening study, involved quantitative data collected to measure providers' screening behavior and multi-level factors impacting violence screening. Methods: The current analysis includes a combination of multi-center data collected from The Health Care Providers and Nurse Practitioners Violence Screening studies, respectively. The total sample is 389 providers across the United States. The proposed research develops a system-level multi-center structural equation model framework to rigorously integrate data from the two studies and examine providers' screening behavior for interpersonal violence based upon Theory of Planned Behavior from a quantitative perspective. Results & Conclusions: We successfully examine the efficacy of the Theory of Planned Behavior proposed by Ajzen to predict healthcare providers' screening behavior for interpersonal violence. Organizational factors, e.g., availability of policy for interpersonal violence screening, organizational priority given to violence screening relative to other priorities, and if providers within the health center are interested in improving care quality, were significantly associated with providers' screening behavior. The knowledge and insights generated from our study may facilitate the design and optimization of health professional training and practice environment, and lead to improved women's health and quality of care.

[Hydrochemistry and Its Controlling Factors and Water Quality Assessment of Shallow Groundwater in the Weihe and Jinghe River Catchments].

The Weihe and Jinghe Rivers catchments are important tributaries of the Yellow River, where it is of great significance to evaluate groundwater hydrochemistry and quality for ecological protection and sustainable development. Piper diagrams, Gibbs, Na-normalized molar ratios, and ion correlation methods were used to analyze the chemical composition of groundwater in these two catchments. Furthermore, the WQI method, Wilcox diagrams, USSL diagrams, and Doneen diagrams were used to evaluate the suitability of groundwater quality for drinking and irrigation. The results showed that the Weihe and Jinghe River catchments are dominated by fresh and weakly alkaline water. Groundwater ion concentration in the Weihe River are higher than in Jinghe River except for Na+, and the major groundwater types are HCO3-Ca-Mg(accounted for 50%), and HCO3-Ca-Mg and HCO3-Na-K (accounted for 32.5%), respectively. The hydrochemistry of the Weihe and Jinghe River catchments is mainly controlled by rock weathering, primarily silicate weathering. Moreover, the groundwater chemistry in the research area is affected by mining and chemical fertilizer application for agriculture. Furthermore, the hydrochemistry of the Weihe River catchment is affected by cation exchange, although this was not obvious in some regions of the Jinghe River catchment. The overall groundwater quality of the two catchments was good, with the Jinghe River water quality being better than in the Weihe River catchment. Based on SSP, SAR, and PI, the groundwater in some parts of the study area cannot be directly used for irrigation as this would result in salinization and, thus, inhibit plant growth. Overall, the groundwater quality in the south of the study area is better than in the north, and is better in the Jinghe River catchment than in the Weihe River catchment according to these three indicators. This study provides a basis for the sustainable development of two catchments, providing baseline data for groundwater quality management.

Positional Isomeric Effects on the Optical Properties, Multivalent Glycosidase Inhibition Effect, and Hypoglycemic Effect of Perylene Bisimide-deoxynojirimycin Conjugates.

Although multivalent glycosidase inhibitors have shown enhanced glycosidase inhibition activities, further applications and research directions need to be developed in the future. In this paper, two positional isomeric perylene bisimide derivatives (PBI-4DNJ-1 and PBI-4DNJ-2) with 1-deoxynojirimycin conjugated were synthesized. Furthermore, PBI-4DNJ-1 and PBI-4DNJ-2 showed positional isomeric effects on the optical properties, self-assembly behaviors, glycosidase inhibition activities, and hypoglycemic effects. Importantly, PBI-4DNJ-1 exhibited potent hypoglycemic effects in mice with 41.33 ± 2.84 and 37.45 ± 3.94% decreases in blood glucose at 15 and 30 min, respectively. The molecular docking results showed that the active fragment of PBI-4DNJ-1 has the highest binding energy (9.649 kcal/mol) and the highest total hydrogen bond energy (62.83 kJ/mol), which were related to the positional isomeric effect on the hypoglycemic effect in mice. This work introduced a new means to develop antihyperglycemic agents in the field of multivalent glycomimetics.

[Hydrochemical and Isotopic Characteristics in the Shallow Groundwater of the Fenhe River Basin and Indicative Significance].

The Fenhe River basin is the second largest tributary of the Yellow River. Piper diagrams, Gibbs, PCA, correlation analysis and forward derivation modeling were used to analyze the distribution characteristics and the controlling factors of the groundwater chemistry and stable isotopes in the Fenhe River basin, which revealed the water cycle and water quality evolution process. The results indicated that the groundwater is a weakly alkaline, micro-hard water, the dominant anions and cations are HCO3- and Ca2+, the major groundwater types are Mg-Ca-HCO3 and Mg-Ca-Cl-SO4, the groundwater quality is good, and more than 94% of the samples belong to classes Ⅰ-Ⅲ. The average values of δD and δ18O of the Fenhe River groundwater are -70.2‰ and -9.6‰, which are similar to the isotope values of the precipitation from July to September, indicating that the groundwater may have originated from this period and that the groundwater recharge mode (dominant flow and piston flow) has a spatial variation. Rock weathering is the dominant source of ions in the groundwater, with an average contribution of 87%, while the contributions of atmospheric input and human activity are 8% and 5%, respectively. For rock weathering, silicate, evaporate, and carbonate rock contribute equally to the groundwater solutes, accounting for 32%, 28%, and 26%, respectively. The results of this study provide the basis for promoting the sustainable development and utilization of groundwater resources in the Fenhe River basin.

9-Hydroxy-6,7-dimethoxydalbergiquinol suppresses hydrogen peroxide-induced senescence in human dermal fibroblasts through induction of sirtuin-1 expression

Objective:To investigate the potential anti-aging mechanism of 9-hydroxy-6,7-dimethoxydalbergiquinol (HDDQ) on hydrogen peroxide (H2O2)-induced oxidative stress in human dermal fibroblasts (HDFs). Methods:The effect of HDDQ on cell viability was assessed by MTT assay, and the effects of HDDQ on senescence-like phenotypes were determined by senescence-associated β-galactosidase (SA-β-gal) staining, Western blotting analysis, and a cell proliferation assay. The expression level and activity of sirtuin-1 (SIRT1) induced by HDDQ were also measured. Results:HDDQ reversed senescence-like phenotypes in the oxidant-challenged model, through reducing SA-β-gal activity and promoting cell growth. Meanwhile, decreases in ac-p53, p21Cip1/WAF1, and p16Ink4a and an increase in pRb were observed. HDDQ induced the expression of SIRT1 in a concentration- and time-dependent manner. Moreover, HDDQ inhibited H2O2-induced phosphorylation of Akt by SIRT1 up-regulation and reduced SA-β-gal staining. Conclusions:HDDQ inhibits H2O2-induced premature senescence and upregulation of SIRT1 expression plays a vital role in the inhibition of the senescence phenotype in HDFs.

[Analysis of Hydrogen and Oxygen Stable Isotope Characteristics and Vapor Sources of Precipitation in the Guanzhong Plain].

To improve the understanding of hydrogen and oxygen stable isotope characteristics and vapor sources in the Guanzhong Plain, we collected 98 precipitation samples and corresponding meteorological data between 2015 and 2018 in Yangling, Shanxi Province, which is located in the central area of the Guanzhong Plain. The composition characteristics of the local hydrogen and oxygen stable isotopes of precipitation (δ2H, δ18O, and δ17O) and their environmental controls were analyzed, and the local meteoric water line (LMWL) and the meteoric water line of the triple oxygen isotopes were established. Three indicators (δ18O, d-excess, and 17O-excess) were used to explore the possible vapor sources of local precipitation and to quantify the contributions of ocean-source and inland-source water vapor to the precipitation. The results showed that there were obvious seasonal changes in the hydrogen and oxygen stable isotopes of precipitation in the Yangling area:water isotopes were depleted in the wet season (May to October) and enriched in the dry season (November to April of the next year). Both the slope (7.7) and intercept (9.1) of the LMWL were lower than those of the global meteoric water line (GMWL), indicating that the annual precipitation in the research area experienced variable degrees of secondary evaporation under cloud cover. The slope of the meteoric water line of the triple oxygen isotopes is 0.528, which is between that of seawater equilibrium fractionation (0.529) and water vapor diffusion into dry air (0.518), consistent with the fact that the Guanzhong area is located on the migration path of marine air mass to inland arid regions. Comprehensive analysis of δ18O, d-excess, and 17O-excess confirmed that the precipitation in the study area is jointly contributed to by the warm and humid air mass from the southeast monsoon and the dry and cold air mass from the westerly wind. Of these, approximately 55%-79% of the precipitation water vapor comes from the ocean, mainly in June to August, and about 21%-45% of the water vapor comes from inland and local evaporation, mainly from October to April. The water vapor sources of precipitation in May and September are complex and may intermittently originate from ocean and inland water vapor.

U.S. nurse practitioners' HIV screening behaviors and health center characteristics.

ABSTRACT: One of the most effective strategies to end the human immunodeficiency virus (HIV) epidemic is HIV screening technologies. Routine HIV screening reaches the first-time tester, people with undiagnosed HIV, and those persons who are in need of frequent retesting due to their ongoing risk. This secondary analysis examined nurse practitioners' (NPs) rates of offering routine HIV screening and health center HIV screening characteristics. A convenience sample of NPs completed either a paper and pencil or an online survey in February 2016. Nurse practitioners responded to several questions about their behaviors and the health center characteristics where they work related to HIV screening. Many NPs (31%) never offer routine HIV screening to patients. Efforts are needed to implement structural changes to increase HIV screening rates among NPs and the health centers where they work. Nurse practitioners, health centers, and the health center policies must align to address the HIV epidemic and implement national HIV screening recommendations.

[Effects of extraction methods on soil water isotope and plant water source segmentation.] / æå–æ–¹æ³•å¯¹åœŸå£¤æ°´åŒä½ç´ å’Œæ¤ç‰©æ°´æºåˆ†å‰²çš„å½±å“.

We used two types of soil with different physicochemical properties (loam and sand), oven-dried them, and then added the known isotopic composition mineral water that was reference water to compose the soil-water mixture with different soil water contents (loam: 0.15, 0.20, 0.30 g·g-1; sand: 0.10 g·g-1). After that, we set up different equilibrium time (loam: 3, 6, 12, 24, 48, 72, 96 h; sand: 96 h) to ensure that the dry soil particles were well mixed with the added water. The soil water was extracted by mechanical centrifugation and cryogenic vacuum extraction after equilibrium, and their isotope composition was analyzed. Results showed that the isotopic values of soil water extracted by mechanical centrifugation method had no significant difference in same water content with different equilibration times, but were more enriched compared with the reference water isotopic value. The maximum enrichment for hydrogen and oxygen isotope was 7.38‰ and 1.24‰, respectively. In contrast, cryogenic vacuum extraction method resulted in more depleted soil water isotopes than reference water, with the maximum depletion for hydrogen and oxygen isotope being 6.27‰ and 1.03‰, respectively. Moreover, the degree of depletion increased with the increases of equilibrium time (less than 24 h) at low water content, and became stable after 24 h. With the increases of soil water content, the isotopic composition of the extracted soil water was less affected by the two extraction methods. The water isotope value of loam that had high clay content, was more sensitive to the extraction method than the sandy soil that had low clay content. The difference of isotopic composition caused by extraction methods did not affect the plant water source segmentation.

A Cross-Study Analysis for Reproducible Sub-classification of Traumatic Brain Injury.

Objective: To identify reproducible sub-classes of traumatic brain injury (TBI) that correlate with patient outcomes. Methods: Two TBI datasets from the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System were utilized, Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot and Citicoline Brain Injury Treatment Trial (COBRIT). Patients included in these analyses had closed head injuries with Glasgow Comas Scale (GCS) scores of 13-15 at arrival at the Emergency Department (ED). Sparse hiearchical clustering was applied to identify TBI sub-classes within each dataset. The reproducibility of the sub-classes was evaluated by investigating similarities in clinical variable profiles and patient outcomes in each sub-class between the two datasets, as well as by using a statistical metric called in-group proportion (IGP). Results: Seven TBI sub-classes were identified in the first dataset. There were between-class differences in patient outcomes at 90 days (Glasgow Outcome Scale Extended (GOSE): p < 0.001) and 180 days (Trail Making Test (TMT): p = 0.03). Four of seven sub-classes were reproducible in the second dataset with very high IGPs (94, 100, 99, 97%). Seven TBI sub-classes were also identified in the second dataset. There were significant between-class differences in patient outcomes at 180 days (GOSE: p = 0.024; Brief Symptom Inventory (BSI) p = 0.007; TMT: p < 0.001). Three of seven sub-classes were reproducible in the second dataset with very high IGPs (100% for all). Conclusions: Reproducible TBI sub-classes were identified across two independent datasets, suggesting that these sub-classes exist in a general population. Differences in patient outcomes according to sub-class assignment suggest that this sub-classification could be used to guide post-TBI prognosis.

Sub-classifying patients with mild traumatic brain injury: A clustering approach based on baseline clinical characteristics and 90-day and 180-day outcomes.

BACKGROUND: The current classification of traumatic brain injury (TBI) into "mild", "moderate", or "severe" does not adequately account for the patient heterogeneity that still exists within each of these categories. The objective of this study was to identify "sub-groups" of mild TBI (mTBI) patients based on data available at the time of the initial post-TBI patient evaluation and to determine if the sub-grouping correlates with patient outcomes at 90 and 180 days post-TBI. METHODS: Data from patients in the TRACK-TBI Pilot dataset who had a Glasgow Coma Scale (GCS) score of 13 to 15 at arrival to the Emergency Department and a closed head injury were included. Considering 53 clinical variables that are typically available during the initial evaluation of the patient with mild TBI, sparse heirarchial clustering with cluster quality assessment was used to identify the optimal number of patient sub-groups. Patient sub-groups were then compared for ten outcomes measured at 90 or 180 days post-TBI. RESULTS: Amongst the 485 patients with mTBI, optimal clustering was based on the inclusion of 12 clinical variables that divided the patients into 5 mild TBI sub-groups. Clinical variables driving the sub-clustering included: gender, employment status, marital status, TBI due to falling, brain CT scan result, systolic blood pressure, diastolic blood pressure, administration of IV fluids in the Emergency Department, alcohol use, tobacco use, history of neurologic disease, and history of psychiatric disease. These 5 mild TBI sub-groups differed in their 90 day and 180 day outcomes within several domains including global outcomes, persistence of TBI-related symptoms, and neuropsychological impairment. CONCLUSIONS: Sub-groups of patients with mTBI can be identified according to clinical variables that are relatively easy to obtain at the time of initial patient evaluation. A patient's sub-group assignment is associated with multidimensional patient outcomes at 90 and 180 days. These findings support the notion that there are clinically meaningful subgroups of patients amongst those currently classified as having mTBI.

[Profile Distribution of Soil Organic and Inorganic Carbon Under Different Land Use Types in the Loess Plateau of Northern Shaanxi].

Carbon storage in the Loess Plateau is affected by land use. In order to assess the differences in soil organic carbon (SOC) and soil inorganic carbon (SIC) under different land use patterns in deep soil profiles, we investigated the distribution characteristics of SOC and SIC at 0-20.0 m soil depth at three locations in the northern Shaanxi province (i.e., an economical plantation in Mizhi, a reforestation area in Shenmu, and a wind break and sand fixation forest district in Yuyang). The results showed that the order for SOC content was:pruning jujube tree (2.00 g·kg-1) > jujube tree (1.54 g·kg-1) > Caragana (0.97 g·kg-1) > degraded artificial grassland (0.81 g·kg-1) > pine forests (0.70 g·kg-1) > natural grass field (0.45 g·kg-1), which indicated significant differences between SOC content and land use types (P<0.05). Similarly, the order of SIC content was:pruning jujube tree (11.66 g·kg-1) > jujube tree (11.59 g·kg-1) > Caragana (9.62 g·kg-1) > degraded artificial grassland (8.07 g·kg-1) > pine forests (4.32 g·kg-1) > natural grass field (0.47 g·kg-1). There were no significant differences between SIC content and soil profiles under the economical plantation of Mizhi and the reforestation area of Shenmu. There were significant differences for SIC content between an artificial economic forest, an area returning farmland to a forest (grass) profile, and a windbreak and sand fixation forest (P<0.05). The SIC densities for pruning jujube tree, jujube tree, Caragana, degraded artificial grassland, pine forest, and natural grass field were 6.19, 7.71, 10.70, 10.78, 5.91, and 1.03 times that of its corresponding SOC density, respectively. It has been concluded that the soil carbon storage was significantly different for different land use patterns, and the SIC content was much higher than the SOC content in the soil profile.

Effect of weaning age on growth performance, feed efficiency, nutrient digestibility and blood-biochemical parameters in Droughtmaster crossbred beef calves.

OBJECTIVE: The objective of this study was to determine the effect of weaning age on intake, performance, nutrition metabolism and serum parameters of beef calves. METHODS: Sixty Droughtmaster crossbred calves were assigned to 5 groups with 12 calves in each group. The calves in control group remained with the dams till the 22-week age, while the calves weaned at 28 d (4 wk), 42 d (6 wk), 56 d (8 wk), and 70 d (10 wk) of age were sent to group 4 wk, group 6 wk, group 8 wk, and group 10 wk, respectively, and then were fed on milk replacer till the 22-week age. Feed intake and body weight and size were record and blood metabolites were measured. And 24 calves of them (6 in each group) were picked randomly for digestion and metabolism trail. Feed, feces and urine sample were taken and measured. RESULTS: Dry matter intake of calves in group 4 wk was significantly lower than those in the remaining groups from wk 17 to 22 (p<0.05). Feed efficiency of the calves was higher in groups 4 wk and 6 wk than those in groups 8 wk and 10 wk from 11 to 13 wk (p<0.05), and calves had higher feed efficiency in group 4 wk, group 6 wk, and group 8 wk than those in group 10 wk from wk 14 to wk 22. Calves in group 4 wk and 6 wk had lower body weight than group 8 wk and group 10 wk and control group at 10-week age (p<0.05) and 13-week age (p<0.05), and calves in group 6 wk had no significant difference in body weight with control group, group 8 wk and 10 wk (p>0.05) but was higher than that of group 4 wk (p<0.05). Calves in group 6 wk had higher final body weight and total gain than group 4 wk, but no difference of total gain with that of groups 8 wk, 10 wk, and control group. And weaning calves at 6-week age brought higher feed efficiency and average daily gain from wk 14 to wk 22, and higher dry matter and organic matter digestibility at 21 wk. CONCLUSION: It is concluded that the weaning of calves at 6 weeks of age gave positive results.