Mobile technology:Usage and perspective of patients and caregivers presenting to a tertiary care emergency department

BACKGROUND:Developments in information technology(IT)have driven a push in healthcare innovation in the emergency department(ED).Many of these applications rely on mobile technology(MT)such as smartphones but not everyone is comfortable with MT usage.Our study aims to characterize the technology usage behavior of users in the ED so as to guide the implementation of IT interventions in the ED.METHODS:A cross-sectional survey was conducted in the emergency department of a tertiary hospital.Patients and their caregivers aged 21 and above were recruited.The survey collected demographic information,technology usage patterns,and participant reported comfort level in the usage of MT.We performed descriptive statistics and multivariate logistic regression to identify factors differentially associated with comfort in usage of MT.RESULTS:A total of 498 participants were recruited,and 299(60%)were patients.English was the most commonly written and read language(66.9%)and 64.2%reported a comfort level of 3/5 or more in using MT.Factors that were associated with being comfortable in using MT include having a tertiary education,being able to read and write English,as well as being a frequent user of IT.Caregivers were more likely to display these characteristics.CONCLUSION:A large proportion of ED patients are not comfortable in the usage of MT.Factors that predicted comfort level in the usage of MT were common amongst caregivers.Future interventions should take this into consideration in the design of MT interventions.

Combination of High Yield Strength and Improved Ductility of 21Cr Lean Duplex Stainless Steel by Tailoring Cold Deformation and Low-Temperature Short-Term Aging

Proper matching of cold-rolled deformation and low-temperature short-term aging can simultaneously enhance the strength and ductility of the lean duplex stainless steel. To investigate this, the microstructure evolution of cold-rolled and aging steels was observed by using scanning electron microscopy, transmission electron microscopy and electron backscattered diffraction. Additionally, the phase volume fraction was measured using X-ray diffraction. In this study, it was observed that the elongation of 21Cr lean duplex stainless steel significantly increased to 16.7% after undergoing moderate cold deformation (~ 40% reduction) and subsequent aging treatment at 550 ℃ for 30 min. Remarkably, the material still maintained a high yield strength of 1045 MPa. Such an excellent mechanical property was attributed to a unique microstructure combination of fine α'-martensite, twins, coarsened austenite resulting from partial martensite reverse transformation, and two-phase fine layered structure. The result of this study may open up new horizons for the alloy development in order to overcome the low ductility of cold-rolled high-strength lean duplex stainless steel.

Geochemical Characteristics and Geological Significance of Meta-Volcanic Rocks of the Bainaimiao Group, Sonid Right Banner, Inner Mongolia, China

The Bainaimiao Group, which crops out in the Sonid Right Banner area of Inner Mongolia, China, comprises mainly metamorphosed volcano-sedimentary rocks. This group can be divided into two formations: a lower formation characterized by intermediate-felsic volcanic rocks, and an upper formation of intermediate-mafic volcanic rocks. Zircon dating indicates that biotite leptynite from the lower formation and chlorite-sericite schist from the upper formation crystallized at 499±2 and 478±2 Ma, respectively, corresponding to different volcanic events. Meta-volcanic rocks of the Bainaimiao Group belong to the calcalkaline series, and the SiO2 concentrations suggest that their protoliths were mainly basalts and rhyolites. Greenschist rocks of the group are enriched in light rare earth elements(LREEs) relative to heavy rare earth elements(HREEs), with(La/Yb)N ratios of 3.08–10.9. In addition, they are enriched in large-ion lithophile elements, including Rb, Ba and K, and depleted in the high-field-strength elements Nb, Ta and Ti. The felsic meta-volcanic rocks also exhibit relative enrichments in LREEs compared with HREEs, with high(La/Yb)N ratios of 2.92–9.89, and are enriched in Rb, Ba, Zr and Hf, and depleted in Sr, Nb and Ta. These geochemical characteristics indicate that the meta-basic volcanic rocks were originated from partial melting of sub-arc mantle wedge that had been previously metasomatized by subducted-slab-derived fluids, whereas the meta-felsic volcanic rocks were generated by partial melting of continental crust. These results suggest that the meta-volcanic rocks of the Bainaimiao Group are the products of oceanic plate subduction magmatism along an active continental margin, which can be attributed to Early Paleozoic subduction of the PaleoAsian Ocean plate beneath the northern margin of the North China Craton.

The zinc finger transcription factor,KLF2,protects against COVID-19 associated endothelial dysfunction

Coronavirus disease 2019(COVID-19)is regarded as an endothelial disease(endothelialitis)with its patho-mechanism being incompletely understood.Emerging evidence has demonstrated that endothelial dysfunction precipitates COVID-19 and its accompanying multi-organ injuries.Thus,pharmacotherapies targeting endothelial dysfunction have potential to ameliorate COVID-19 and its cardiovascular complications.The objective of the present study is to evaluate whether kruppel-like factor 2(KLF2),a master regulator of vascular homeostasis,represents a therapeutic target for C0VID-19-induced endothelial dysfunction.Here,we demonstrate that the expression of KLF2 was reduced and monocyte adhesion was increased in endothelial cells treated with COVID-19 patient serum due to elevated levels of pro-adhesive molecules,ICAM1 and VCAM1.IL-1β and TNF-α;two cytokines elevated in cytokine release syndrome in COVID-19 patients,decreased KLF2 gene expression.Pharmacologic(atorvastatin and tannic acid)and genetic(adenoviral overexpression)approaches to augment KLF2 levels attenuated COVID-19-serum-induced increase in endothelial inflammation and monocyte adhesion.Next-generation RNA-sequencing data showed that atorvastatin treatment leads to a cardiovascular protective transcriptome associated with improved endothelial function(vasodilation,antiinflammation,antioxidant status,anti-thrombosis/-coagulation,anti-fibrosis,and reduced angiogenesis).Finally,knockdown of KLF2 partially reversed the ameliorative effect of atorvastatin on COVID-19-serum-induced endothelial inflammation and monocyte adhesion.Collectively,the present study implicates loss of KLF2 as an important molecular event in the development of COVID-19-induced vascular disease and suggests that efforts to augment KLF2 levels may be therapeutically beneficial.