Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

Excess pore pressure behavior and evolution in deep coalbed methane reservoirs

Deep coalbed methane(DCBM),an unconventional gas reservoir,has undergone significant advancements in recent years,sparking a growing interest in assessing pore pressure dynamics within these reservoirs.While some production data analysis techniques have been adapted from conventional oil and gas wells,there remains a gap in the understanding of pore pressure generation and evolution,particularly in wells subjected to large-scale hydraulic fracturing.To address this gap,a novel technique called excess pore pressure analysis(EPPA)has been introduced to the coal seam gas industry for the first time to our knowledge,which employs dual-phase flow principles based on consolidation theory.This technique focuses on the generation and dissipation for excess pore-water pressure(EPWP)and excess pore-gas pressure(EPGP)in stimulated deep coal reservoirs.Equations have been developed respectively and numerical solutions have been provided using the finite element method(FEM).Application of this model to a representative field example reveals that excess pore pressure arises from rapid loading,with overburden weight transferred under undrained condition due to intense hydraulic fracturing,which significantly redistributes the weight-bearing role from the solid coal structure to the injected fluid and liberated gas within artificial pores over a brief timespan.Furthermore,field application indicates that the dissipation of EPWP and EPGP can be actually considered as the process of well production,where methane and water are extracted from deep coalbed methane wells,leading to consolidation for the artificial reservoirs.Moreover,history matching results demonstrate that the excess-pressure model established in this study provides a better explanation for the declining trends observed in both gas and water production curves,compared to conventional practices in coalbed methane reservoir engineering and petroleum engineering.This research not only enhances the understanding of DCBM reservoir behavior but also offers insights applicable to production analysis in other unconventional resources reliant on hydraulic fracturing.

Dynamic response mechanism and precursor characteristics of gneiss rockburst under different initial burial depths

To investigate the influence mechanism of geostress on rockburst characteristics,three groups of gneiss rockburst experiments were conducted under different initial geostress conditions.A high-speed photography system and acoustic emission(AE)monitoring system were used to monitor the entire rockburst process in real time.The experimental results show that when the initial burial depth increases from 928 m to 1320 m,the proportion of large fracture scale in rockburst increases by 154.54%,and the AE energy increases by 565.63%,reflecting that the degree and severity of rockburst increase with the increase of burial depth.And then,two mechanisms are proposed to explain this effect,including(i)the increase of initial geostress improves the energy storage capacity of gneiss,and then,the excess energy which can be converted into kinetic energy of debris ejection increases,consequently,a more pronounced violent ejection phenomenon is observed at rockburst;(ii)the increase of initial geostress causes more sufficient plate cracks of gneiss after unloading ofσh,which provides a basis for more severe ejection of rockburst.What’s more,a precursor with clear physical meaning for rockburst is proposed under the framework of dynamic response process of crack evolution.Finally,potential value in long term rockburst warning of the precursor obtained in this study is shown via the comparison of conventional precursor.

Density of excess modes below the first phonon mode in four-dimensional glasses

Glasses are known to possess low-frequency excess modes beyond the Debye prediction.For decades,it has been assumed that evolution of low-frequency density of excess modes D(ω) with frequency ω follows a power-law scaling:D(ω)~ω~γ.However,it remains debated on the value of γ at low frequencies below the first phonon-like mode in finitesize glasses.Early simulation studies reported γ=4 at low frequencies in two-(2D),three-(3D),and four-dimensional(4D)glasses,whereas recent observations in 2D and 3D glasses suggested γ=3.5 in a lower-frequency regime.It is uncertain whether the low-frequency scaling of D(ω)~ω^(3.5) could be generalized to 4D glasses.Here,we conduct numerical simulation studies of excess modes at frequencies below the first phonon-like mode in 4D model glasses.It is found that the system size dependence of D(ω) below the first phonon-like mode varies with spatial dimensions:D(ω) increases in2D glasses but decreases in 3D and 4D glasses as the system size increases.Furthermore,we demonstrate that the ω^(3.5)scaling,rather than the ω~4 scaling,works in the lowest-frequency regime accessed in 4D glasses,regardless of interaction potentials and system sizes examined.Therefore,our findings in 4D glasses,combined with previous results in 2D and 3D glasses,suggest a common low-frequency scaling of D(ω)~ ω^3.5) below the first phonon-like mode across different spatial dimensions,which would inspire further theoretical studies.

Oxygen and hydrogen isotope characteristics of different water bodies in the Burqin River Basin of the Altay Mountains,China

Characterization of the spatial and temporal variability of stable isotopes in surface water is essential for interpreting hydrological processes.In this study,we collected the water samples of river water,groundwater,and reservoir water in the Burqin River Basin of the Altay Mountains,China in 2021,and characterized the oxygen and hydrogen isotope variations in different water bodies via instrumental analytics and modeling.Results showed significant seasonal variations in stable isotope ratios of oxygen and hydrogen(δ18O andδ2H,respectively)and significant differences inδ18O andδ2H among different water bodies.Higherδ18O andδ2H values were mainly found in river water,while groundwater and reservoir water had lower isotope ratios.River water and groundwater showed differentδ18O-δ2H relationships with the local meteoric water line,implying that river water and groundwater are controlled by evaporative enrichment and multi-source recharge processes.The evaporative enrichment experienced by reservoir water was less significant and largely influenced by topography,recharge sources,local moisture cycling,and anthropogenic factors.Higher deuterium excess(d-excess)value of 14.34‰for river water probably represented the isotopic signature of combined contributions from direct precipitation,snow and glacial meltwater,and groundwater recharge.The average annual d-excess values of groundwater(10.60‰)and reservoir water(11.49‰)were similar to the value of global precipitation(10.00‰).The findings contribute to understanding the hydroclimatic information reflected in the month-by-month variations in stable isotopes in different water bodies and provide a reference for the study of hydrological processes and climate change in the Altay Mountains,China.

Ultrasound unveiling:Decoding venous congestion in heart failure for precision management of fluid status

This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of Cardiology.We here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart failure.While the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic decisions.In particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal interactions.Integrating specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.

Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of Cardiology.In this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart failure.Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and X-rays.However,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis.Doppler flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

Transportation Network Density,Domestic Market Integration and Excess Sensitivity of Household Consumption

From the perspective of domestic market integration,this paper systematically examines the impact of transportation infrastructure conditions on excess sensitivity of household consumption based on the China Family Panel Survey(CFPS)and multi-level matching panel data of transportation network density.The results show that the fast-growing development of the transportation infrastructure network has a significant alleviating effect on excess sensitivity of household consumption along the route,and the conclusion is still robust after the use of the multi-dimensional instrumental variable method and a series of robustness tests.According to the heterogeneity tests,in terms of the alleviating effect of transportation infrastructure,railroads rank the first,highways the second,substandard roads the third,waterways the fourth,and roads of other grades at the bottom.The mechanism test reveals that the improvement of domestic market integration is an important channel for transportation infrastructure to alleviate excess sensitivity of household consumption.This paper confirms that improving the transportation infrustructure system is conducive to the construction of a unified national market,alleviating excess sensitivity of consumption and stimulating consumption.This paper provides suggestions for implementing the strategy of boosting domestic demand,and helps the government understand households'consumption decision-making from a broader perspective.This study also provides a theoretical basis for the economic spillover effect of transportation infrastructure.

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

Application of Non-Fuel Power Generation Technology in Steel Industry

Through continuous equipment technology transformation and full utilization of Ma Steel's abundant gas,the boiler no longer relies on fuel oil for stable combustion during boiler startup,sliding parameter shutdown,and RB,thus achieving safe and stable operation of the boiler under any abnormal working conditions,and achieving good economic and social benefits.

ARCADE 2 Spatial Roar, What Theory of Relation Reveals

The theory of Relation provides an explanation for the Arcade 2 excess. It assumes that the isotropic radio emission measured by the Arcade 2 Collaboration, which is 5 - 6 times brighter than the expected contributions from known extra-galactic sources, is the residue of an immense primitive energy of ordinary matter released by a relativistic bang almost 100 million years after the big bang, which gave the mass-energy the missing gravity to activate contraction. This relativistic bang, via a Lorentz energy transformation, would have released enormous energy held to be the source of the powerful radio noise detected by the NASA researchers. This transformation would have simultaneously triggered the formation of the first stars from dense gas and the reionization of less dense neutral gas. This departs from the idea that continuous reionization began after the formation of the first stars. We emphasize the importance of primordial magnetic fields, which would have generated significant density fluctuations during recombination and acted as a direct seed for cosmic structures. The first stars and galaxies were bathed in strong magnetic fields that gave rise to the radio microwave din (boom) discovered by Arcade 2. These intense magnetic fields alter the trajectory of charged particles zooming near the speed of light, triggering the space roar and emitting radiation that forms a synchrotron radio background. The theory of Relation offers an alternative to the Lambda-CDM cosmological model, which has become the standard model of the big bang, which leads straight to the vacuum catastrophe.

A Case Report on Treating Progressive Supranuclear Palsy with a Combination of Chinese and Western Medicine

A case of progressive supranuclear palsy in a 66-year-old woman is presented.The patient complained of“progressive stiffness of both lower limbs for five years,accompanied by choking and coughing for more than 1 year,”and was diagnosed with paralysis in traditional Chinese medicine(TCM),which was characterized by a deficiency of liver and kidney,and phlegm and blood stasis blocking the collaterals.Western medicine diagnosed it as progressive supranuclear palsy.The patient was diagnosed with“Parkinson’s disease”several times in the past and was given“polybasic hydrazide”and“amantadine hydrochloride tablets,”etc.The patient did not have significant symptomatic relief,so she sought further treatment with a combination of traditional Chinese and Western medicine.Based on the concept of deficiency and excess,this disease is categorized as a paralytic disease in Chinese medicine,and the onset of the disease is closely related to the deficiency of the body after a long period of illness,with wind,phlegm,blood stasis,and deficiency as the main pathogenetic mechanism.The treatment is based on the combination of disease and evidence,with traditional Chinese medicine and acupuncture as the main treatments,supplemented by intermediate-frequency pulsed electrical stimulation,transcranial repetitive magnetic stimulation,medicated canisters,wax therapy,traditional Chinese medicine guasha,and acupoint injections.Western medicine is based on symptomatic treatment,and the patient’s symptoms were relieved significantly after the combination of Chinese and Western medicine.

Orthodontic-surgical treatment for severe skeletal class Ⅱ malocclusion with vertical maxillary excess and four premolars extraction: A case report

BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.

Managing excess PbI_(2)for efficient perovskite solar cells

Perovskite solar cells(PSCs)have attracted much attention due to their low cost,high efficiency and easy processing.Recently,You et al.achieved a record efficiency of 26.1%(certified 25.6%)in PSCs with excellent stability[1].Excess PbI_(2) in perovskite films was converted into inactive(PbI_(2))2RbCl to avoid its detrimental effect to device stability,while maintaining its positive effect to device efficiency.

Point-of-care ultrasound in diagnosis and management of congestive nephropathy

Congestive nephropathy is kidney dysfunction caused by the impact of elevated venous pressures on renal hemodynamics.As a part of cardiorenal syndrome,the diagnosis is usually made based on history and physical examination,with findings such as jugular venous distension,a third heart sound,and vital signs as supporting findings.More recently,however,these once though objective measures have come under scrutiny for their accuracy.At the same time,bedside ultrasound has increased in popularity and is routinely being used by clinicians to take some of the guess work out of making the diagnosis of volume overload and venous congestion.In this mini-review,we will discuss some of the traditional methods used to measure venous congestion,describe the role of point-of-care ultrasound and how it can ameliorate a clinician’s evaluation,and offer a description of venous excess ultrasound score,a relatively novel scoring technique used to objectively quantify congestion.While there is a paucity of published large scale clinical trials evaluating the potential benefit of ultrasonography in venous congestion compared to gold standard invasive measurements,more study is underway to solidify the role of this objective measure in daily clinical practice.

Transcending boundaries:Unleashing the potential of multi-organ point-of-care ultrasound in acute kidney injury

Acute kidney injury(AKI)is a clinical syndrome characterized by a rapid increase in serum creatinine levels or a decrease in urine output or both.In spite of thorough history-taking,physical examination,and laboratory analysis,there are limitations in the diagnostic process and clinical monitoring of AKI.Point-of-care ultrasonography(POCUS),a limited ultrasound study performed by clinicians at the bedside,has emerged as a valuable tool in different clinical settings.In this discussion,we explore the potential of POCUS performed by nephrologists to address specific questions encountered in the diagnosis and management of AKI patients.POCUS not only aids in excluding hydronephrosis but also provides real-time insights into hemodynamics,enabling formulation of individualized treatment plans.Further studies are required to assess the impact of multi-organ POCUS on pragmatic patient outcomes related to AKI,as well as its potential in risk stratification and identification of different levels of AKI severity and pathophysiological signatures.

Combining nitrogen effects and metabolomics to reveal the response mechanisms to nitrogen stress and the potential for nitrogen reduction in maize

The physiological and metabolic differences in maize under different nitrogen(N)levels are the basis of reasonable N management,which is vital in improving fertilizer utilization and reducing environmental pollution.In this paper,on the premise of defining the N fertilizer efficiency and yield under different long-term N fertilization treatments,the corresponding differential metabolites and their metabolic pathways were analyzed by untargeted metabolomics in maize.N stress,including deficiency and excess,affects the balance of carbon(C)metabolism and N metabolism by regulating C metabolites(sugar alcohols and tricarboxylic acid(TCA)cycle intermediates)and N metabolites(various amino acids and their derivatives).L-alanine,L-phenylalanine,L-histidine,and L-glutamine decreased under N deficiency,and L-valine,proline,and L-histidine increased under N excess.In addition to sugar alcohols and the above amino acids in C and N metabolism,differential secondary metabolites,flavonoids(e.g.,kaempferol,luteolin,rutin,and diosmetin),and hormones(e.g.,indoleacetic acid,trans-zeatin,and jasmonic acid)were initially considered as indicators for N stress diagnosis under this experimental conditions.This study also indicated that the leaf metabolic levels of N2(120 kg ha–1 N)and N3(180 kg ha–1 N)were similar,consistent with the differences in their physiological indexes and yields over 12 years.This study verified the feasibility of reducing N fertilization from 180 kg ha–1(locally recommended)to 120 kg ha–1 at the metabolic level,which provided a mechanistic basis for reducing N fertilization without reducing yield,further improving the N utilization rate and protecting the ecological environment.

Electrical resistivity change of saturated sand during reliquefaction under hammering loading

The electrical resistivity method was verified as an optional technique to monitor the change of mesostructure of saturated soils.To investigate the change laws of resistivity and analyze the reliquefaction meso-mechanism during the consecutive liquefaction process,five successive impact liquefaction tests were performed in a one-dimensional cubical chamber.The resistivity variation and excess pore water pressure(EPWP)were measured.The results indicate that the excess pore water pressure experienced four stages:quick increase stage,slow dissipation stage,rapid dissipation stage,and stability stage.Meanwhile,a swift decrease of resistivity emerged before the start of the rapid dissipation stage of EPWP,and then an increasing trend of resistivity is demonstrated with the densification of soil.It is proved that the vertical pore connectivity of liquefied sand is better than its random deposit state,based on a comparative study of porosity calculated from the settlement and resistivity of sand after each test.

Adsorption of methane onto mudstones under supercritical conditions: Mechanisms, physical properties and thermodynamic parameters

Since the mechanisms of methane-mudstone interactions are important for estimating shale gas reserves,methane adsorption under supercritical conditions of 30 MPa pressure and 303.15,333.15,363.15 K temperatures was studied to measure the excess methane adsorption in two mudstone samples from Yanchang Formation,Ordos Basin.Excess adsorption features inflection points where the amount of adsorbed gas changes from increasing to decreasing concentrations.Three methods(fixed,slope,and freely fitted density)were applied to calculate the adsorbed-phase density(rad),which was then used to fit the measured excess adsorption.Two criteria,the goodness-of-fit and whether the fitting can obtain reasonable absolute adsorption,were applied to determine the most accurate model.Results indicated that the supercritical Dubinin-Radushkevich(SDR)model with freely fitted rad was the most reasonable model.The volume of adsorbed methane at 363.15 K is close to the micropore(d<2 nm)volume of the corresponding mudstone.Considering the actual geological conditions,the adsorbed gas should be predominantly stored in micropores.Thermodynamic parameters reveal that the methane adsorption on mudstone is a physisorption process that is jointly controlled by the heterogeneity of,and interaction forces between the methane molecule and,the rock surface.

Pore pressure built-up in hydrate-bearing sediments during phase transition: A poromechanical approach

Due to the density contrast between the hydrate and methane gas,the pore pressure is accumulated in the sediment during the decomposition process of methane hydrate.This accumulation of pore pressure decreases the magnitude of effective stress,further triggering potential geological disasters such as landslide.This paper establishes a theoretical framework to investigate the evolution of fluid pressure in the hydrate-bearing sediments during the decomposition process.This model consists of two parts:an unsaturated thermo-poromechanical constitutive law as well as a phase equilibrium equation.Compared with the existing studies,the present work incorporates the effect of pore volume change into the pressure built-up model.In addition,the capillary effect is considered,which plays a nontrivial role in fine-grained sediments.Based on this model,the evolution of fluid pressure is investigated in undrained conditions.It is shown that four mechanisms mainly contribute to the pressure built-up:the density contrast between decomposing hydrate and producing fluid,the variation of pore volume,the compaction of hydrate due to variation of capillary pressure,and the thermal deformation of pore constituents induced by temperature change.Among these mechanisms,the density contrast dominates the pore pressure accumulation.Under the combined effect of these contributions,the evolution of fluid pressure exhibits a strong nonlinearity during the decomposition process and can reach up to dozens of mega Pascal.Nevertheless,this high-level pressure built-up results in a significant tensile strain,yielding potential fracturing of the sediment.