Off-hour admission and mortality risk for 28 specific diseases: A systematic review and meta-analysis of 251 cohorts

Background: A considerable amount of studies have examined the relationship between off-hours (weekends and nights) admission and mortality risk for various diseases, but the results remain equivocal. Methods and Results: Through a search of EMBASE, PUBMED, Web of Science, and Cochrane Database of Systematic Reviews, we identified cohort studies that evaluated the association between off-hour admission and mortality risk for disease. In a random effects meta-analysis of 140 identified articles (251 cohorts), off-hour admission was strongly associated with increased mortality for aortic aneurysm (odds ratio [OR], 1.52; 95% confidence interval, 1.30-1.77), breast cancer (1.50, 1.21-1.86), leukemia (1.45, 1.17-1.79), respiratory neoplasm (1.32, 1.20-1.26), pancreatic cancer (1.32, 1.12-1.56), malignant neoplasm of genitourinary organs (1.27, 1.08-1.49), colorectal cancer (1.26, 1.07-1.49), pulmonary embolism (1.20, 1.13-1.28), arrhythmia and cardiac arrest (1.19, 1.09-1.29), and lymphoma (1.19, 1.06-1.34). Weaker (OR<1.19) but statistically significant association was noted for renal failure, traumatic brain injury, heart failure, intracerebral hemorrhage, subarachnoid hemorrhage, stroke, gastrointestinal bleeding, myocardial infarction, chronic obstructive pulmonary disease, and bloodstream infections. No association was found for hip fracture, pneumonia, intestinal obstruction, aspiration pneumonia, peptic ulcer, trauma, diverticulitis, and neonatal mortality. Overall, Off-hour admission was associated with increased mortality for 28 diseases combined (OR, 1.11; 95% confidence interval, 1.10-1.13).Conclusions: Off-hour admission is associated with increased mortality risk, and the associations varied substantially for different diseases. Specialists, nurses, as well as hospital administrators and health policy makers can take these findings into consideration to improve the quality and continuity of medical services

Experimental investigation on expansion characteristics and strength of carbonating reactive magnesia solidified clay

The carbonated reactive magnesia (CRM) method is superior in energy conservation, carbon capture, and rapid solidification in soil improvement. It has been revealed that CRM method could cause apparent volumetric expansion during carbonation, which may cause apparent compaction impact on the surrounding soils when used for soft foundation improvement. However, this expansion hasn't been discussed systematically. In this study, the evolutions of expansion stress (σEx) and volumetric expansion (ΔV) during carbonation process were successfully monitored. Two factors, including reactive MgO content (Cm) and net confining pressure (Pnc), were investigated. The internal relations between σEx, ΔV, and unconfined compressive strength (UCS) together with the influences of Cm and Pnc on them were discussed. Besides, the intrinsic mechanisms were discussed based on density variations, pore structures, and microstructures. According to the findings, σEx and ΔV invariably exhibited a three-stage behavior consisting of stability-rapid increase-stability. By increasing Cm or Pnc, the σEx, UCS, and density were all significantly increased, while the volume increment was obviously reduced. For the completely confined specimen, the σEx and UCS were found to approach 3 MPa and 9 MPa, respectively. The increase in Cm promoted the crystallization of hydrated magnesium carbonates (HMCs), leading to lower porosity in solidified soils. Increasing Pnc also improved the crystallization of HMCs and modified pore structures, causing further increases in σEx and UCS

Ice-nucleating particles from multiple aerosol sources in the urban environment of Beijing under mixed-phase cloud conditions

Ice crystals occurring in mixed-phase clouds play a vital role in global precipitation and energy balance because of the unstable equilibrium between coexistent liquid droplets and ice crystals, which affects cloud lifetime and radiative properties, as well as precipitation formation. Satellite observations proved that immersion freezing, i.e., ice formation on particles immersed within aqueous droplets, is the dominant ice nucleation (IN) pathway in mixed-phase clouds. However, the impact of anthropogenic emissions on atmospheric IN in the urban environment remains ambiguous. In this study, we present in situ observations of ambient ice-nucleating particle number concentration (NINP) measured at mixed-phase cloud conditions (−30 ∘C, relative humidity with respect to liquid water RHw= 104 %) and the physicochemical properties of ambient aerosol, including chemical composition and size distribution, at an urban site in Beijing during the traditional Chinese Spring Festival. The impact of multiple aerosol sources such as firework emissions, local traffic emissions, mineral dust, and urban secondary aerosols on NINP is investigated. The results show that NINP during the dust event reaches up to 160 # L−1 (where “#” represents number of particles), with an activation fraction (AF) of 0.0036 % ± 0.0011 %. During the rest of the observation, NINP is on the order of 10−1 to 10 # L−1, with an average AF between 0.0001 % and 0.0002 %. No obvious dependence of NINP on the number concentration of particles larger than 500 nm (N500) or black carbon (BC) mass concentration (mBC) is found throughout the field observation. The results indicate a substantial NINP increase during the dust event, although the observation took place at an urban site with high background aerosol concentration. Meanwhile, the presence of atmospheric BC from firework and traffic emissions, along with urban aerosols formed via secondary transformation during heavily polluted periods, does not influence the observed INP concentration. Our study corroborates previous laboratory and field findings that anthropogenic BC emission has a negligible effect on NINP and that NINP is unaffected by heavy pollution in the urban environment under mixed-phase cloud conditions.</p

The signs of computer tomography combined with artificial intelligence can indicate the correlation between status of consciousness and primary brainstem hemorrhage of patients

BackgroundFor patients of primary brainstem hemorrhage (PBH), it is crucial to find a method that can quickly and accurately predict the correlation between status of consciousness and PBH.ObjectiveTo analyze the value of computer tomography (CT) signs in combination with artificial intelligence (AI) technique in predicting the correlation between status of consciousness and PBH.MethodsA total of 120 patients with PBH were enrolled from August 2011 to March 2021 according to the criteria. Patients were divided into three groups [consciousness, minimally conscious state (MCS) and coma] based on the status of consciousness. Then, first, Mann–Whitney U test and Spearman rank correlation test were used on the factors: gender, age, stages of intracerebral hemorrhage, CT signs with AI or radiology physicians, hemorrhage involving the midbrain or ventricular system. We collected hemorrhage volumes and mean CT values with AI. Second, those significant factors were screened out by the Mann–Whitney U test and those highly or moderately correlated by Spearman’s rank correlation test, and a further ordinal multinomial logistic regression analysis was performed to find independent predictors of the status of consciousness. At last, receiver operating characteristic (ROC) curves were drawn to calculate the hemorrhage volume for predictively assessing the status of consciousness.ResultsPreliminary meaningful variables include hemorrhage involving the midbrain or ventricular system, hemorrhage volume, grade of hematoma shape and density, and CT value from Mann–Whitney U test and Spearman rank correlation test. It is further shown by ordinal multinomial logistic regression analysis that hemorrhage volume and hemorrhage involving the ventricular system are two major predictors of the status of consciousness. It showed from ROC that the hemorrhage volumes of &lt;3.040 mL, 3.040 ~ 6.225 mL and &gt;6.225 mL correspond to consciousness, MCS or coma, respectively. If the hemorrhage volume is the same, hemorrhage involving the ventricular system should be correlated with more severe disorders of consciousness (DOC).ConclusionCT signs combined with AI can predict the correlation between status of consciousness and PBH. Hemorrhage volume and hemorrhage involving the ventricular system are two independent factors, with hemorrhage volume in particular reaching quantitative predictions

Childhood Influenza Vaccination and Its Determinants during 2020-2021 Flu Seasons in China: A Cross-Sectional Survey.

Young children aged 6−59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020−2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77−3.54), safety (OR: 1.60; 95%CI: 1.29−1.99), and effectiveness (OR: 1.54; 95%CI: 1.23−1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00−1.77), family members, or friends (OR: 1.30; 95%CI: 1.14−1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions

Novel albumin-binding multifunctional probe for synergistic enhancement of FL/MR dual-modal imaging and photothermal therapy

The fluorescence/magnetic resonance (FL/MR) dual-modal imaging could provide accurate tumor visualization to guide photothermal therapy (PTT) of cancer, which has attracted widespread attention from scientists. However, facile and effective strategies to synergistically enhance fluorescence intensity, MR contrast and photothermal efficacy have rarely been reported. This study presents a novel multifunctional probe Gd-EB-ICG (GI) for FL/MR dual-modal imaging-guided PTT of cancer. GIs can self-assemble with endogenous albumin to form drug-albumin complexes (GIAs), which exhibit excellent biocompatibility. Albumin can protect GIAs from the recognition and clearance by the mononuclear phagocytic system (MPS). High plasma concentration and long half-life allow GIAs to accumulate continuously in the tumor area through EPR effect and specific uptake of tumor. Because of the prolonged rotational correlation time (τR) of Gd chelates, GIAs exhibited superior MR contrast performance over GIs with more than 3 times enhancement of longitudinal relaxation efficiency (r1). The fluorescence quantum yield and photothermal conversion efficiency of GIAs was also significantly improved due to the constrained geometry, disrupted aggregation and enhanced photothermal stability. This simple and feasible strategy successfully resulted in a synergistic effect for FL/MR dual-modal imaging and photothermal therapy, which can cast a new light for the clinical translation of multifunctional probes

Dense Feature Aggregation and Pruning for RGBT Tracking

How to perform effective information fusion of different modalities is a core factor in boosting the performance of RGBT tracking. This paper presents a novel deep fusion algorithm based on the representations from an end-to-end trained convolutional neural network. To deploy the complementarity of features of all layers, we propose a recursive strategy to densely aggregate these features that yield robust representations of target objects in each modality. In different modalities, we propose to prune the densely aggregated features of all modalities in a collaborative way. In a specific, we employ the operations of global average pooling and weighted random selection to perform channel scoring and selection, which could remove redundant and noisy features to achieve more robust feature representation. Experimental results on two RGBT tracking benchmark datasets suggest that our tracker achieves clear state-of-the-art against other RGB and RGBT tracking methods.Comment: arXiv admin note: text overlap with arXiv:1811.0985

Chk1 Inhibition Ameliorates Alzheimer's Disease Pathogenesis and Cognitive Dysfunction Through CIP2A/PP2A Signaling

Alzheimer's disease (AD) is the most common neurodegenerative disease with limited therapeutic strategies. Cell cycle checkpoint protein kinase 1 (Chk1) is a Ser/Thr protein kinase which is activated in response to DNA damage, the latter which is an early event in AD. However, whether DNA damage-induced Chk1 activation participates in the development of AD and Chk1 inhibition ameliorates AD-like pathogenesis remain unclarified. Here, we demonstrate that Chk1 activity and the levels of protein phosphatase 2A (PP2A) inhibitory protein CIP2A are elevated in AD human brains, APP/PS1 transgenic mice, and primary neurons with A beta treatment. Chk1 overexpression induces CIP2A upregulation, PP2A inhibition, tau and APP hyperphosphorylation, synaptic impairments, and cognitive memory deficit in mice. Moreover, Chk1 inhibitor (GDC0575) effectively increases PP2A activity, decreases tau phosphorylation, and inhibits A beta overproduction in AD cell models. GDC0575 also reverses AD-like cognitive deficits and prevents neuron loss and synaptic impairments in APP/PS1 mice. In conclusion, our study uncovers a mechanism by which DNA damage-induced Chk1 activation promotes CIP2A-mediated tau and APP hyperphosphorylation and cognitive dysfunction in Alzheimer's disease and highlights the therapeutic potential of Chk1 inhibitors in AD