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.

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.

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.

Preliminary Study on the Treatment Efficiency of Pasteurized Lime Thermal Alkaline Hydrolysis for Excess Activated Sludge and Reduction of Tetracycline Resistance Genes

Thermal alkaline hydrolysis is a common pretreatment method for the utilization of excess activated sludge(EAS).Owing to strict environment laws and need for better energy utilization,new methods were developed in this study to improve the efficiency of pretreatment method.Direct thermal hydrolysis(TH),pasteurized thermal hydrolysis(PTH),and alkaline pasteurized thermal hydrolysis(PTH+CaO and PTH+NaOH)methods were used to treat EAS.Each method was compared and analyzed in terms of dissolution in ammonium nitrogen(NH_(4)^(+)-N)and soluble COD(SCOD)in EAS.Furthermore,the removal of tetracycline resistance genes(TRGs)and class 1 transposon gene intI1 from EAS was investigated.The NH_(4)^(+)-N and SCOD concentrations in EAS treated by PTH were 1.24 and 2.58 times higher than those of TH.However,the removal efficiency of total TRGs and intI1 between the groups was comparable.The SCOD concentration of the PTH+NaOH group was 4.37 times higher than that of the PTH group,and the removal efficiency of total TRGs was increased by 9.52%compared with that by PTH.The NH_(4)^(+)-N and SCOD concentrations of the PTH+CaO group could reach 85.04%and 92.14%of the PTH+NaOH group,but the removal efficiency of total TRGs by PTH+CaO was 19.78%lower than that by PTH+NaOH.Thus,to reduce the financial cost in actual operation,lime(CaO)can be used instead of a strong alkali(NaOH),and pasteurized steam at 70℃ instead of conventional high-temperature heating to treat EAS.This study provides a reference for the development of alkaline hydrolysis under moderate temperatures along with the removal of TRGs in EAS.

Safety Evaluations of Long-Term and Excessive Intakes of Bifidobacterium longum CLA8013: A Placebo-Controlled, Randomized, Double-Blind Study

Heat-killed Bifidobacterium longum CLA8013 has been demonstrated to improve the frequency of defecation, straining, and pain during defecation in human placebo-controlled, double-blind, parallel-group studies. We conducted a randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety of both long-term and excessive intakes of heat-killed B. longum CLA8013, when used as a food with functional claims. In both tests, 30 healthy volunteers were divided into two groups: an active group that ingested heat-killed B. longum CLA8013 and a placebo group. In the long-term intake safety study, participants in the active group ingested 25 billion cells/day for 12 weeks. In the excessive intake safety study, participants in the active group ingested 125 billion cells/day for 4 weeks. Physical, hematological, biochemical, and urine examinations were conducted, and adverse events were evaluated in both studies. The studies revealed no abnormalities in any of the safety tests. In conclusion, no safety-related issues were identified with long-term or excessive intake of heat-killed B. longum CLA8013.

Pyloric Stenosis and Nonbilious Vomiting in Infants: Negative Base Excess and Hypercapnia—Two Opposing Points of One Scale a Comparative Case Series

Background: Blood pH and bicarbonate estimations are basal acid-base laboratory tests that are performed in infants with infantile hypertrophic pyloric stenosis (IHPS). This study aimed to define the clinical value of pCO2 and BE in infants suspected to have IHPS. Methods: We collected data from 80 “surgical” infants younger than 100 days with prolonged nonbilious vomiting who were suspected to have IHPS. In 65 infants, pyloric stenosis was confirmed, and 15 infants had nonsurgical conditions. Capillary blood was tested for standard acid-base parameters and lactate. The two groups were compared. Results: Eighty-eight percent of the IHPS infants had elevated standard bicarbonate levels (st bicarb) > 25 mmol/l, and 60% had BE > 3.5 mmol/l;12% of the infants showed hypercapnia (pCO2 ≥ 50 mmHg) associated with markedly increased standard bicarbonate and BE. Infants with nonsurgical vomiting were older at admission (p = 0.002), had a longer duration of vomiting (p < 0.001), were older (p = 0.002) and weighted more at admission (p = 0.004), had lower pCO2 (p = 0.021), lower st bicarb (p < 0.001) and lower BE (p = 0.001). In addition, nonsurgical infants showed a trend to anemia (p = 0.002). Conclusions: In infants with IHPS/nonbilious vomiting, acid-base analysis (ABA) is equivocal or inconclusive. These findings may be misleading and could result in a false clinical decision. Nonsurgical vomiting is associated with a lower degree of alkalosis, normocapnia to slight hypercapnia and a base deficit. However, even infants with IHPS may present with a negative BE. In infants with IHPS and severe alkalosis, hypercapnia carries a risk for respiratory depression. Monitoring the infant’s respiration allows for the early detection of respiratory deterioration.

Abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type

Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in the method were from the Physical Examination Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the 60 rheumatoid arthritis patients included were from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The disease activity score of patients with rheumatoid arthritis was evaluated using VAS score and DAS28 score,joint symptoms and spleen deficiency syndrome score were evaluated using graded quantification method,immune inflammation indicators were detected using relevant instruments,inflammatory cytokines were detected using ELISA method,macrophage markers were detected using FCM method,and pathway gene expression was detected using RT-qPCR;Evaluate the predictive effect of circ-CBLB and miR-486-5p on disease activity in rheumatoid arthritis using ROC curves.Results:(1)miR-486-5p,CD14^(+)CD86^(+),ESR,CRP,RF,Anti CCP Ab,IL-6,TNF in patients with rheumatoid arthritis-αThe levels of circ-CBLB,CD14^(+)CD163^(+),IL-4,and IL-10 were significantly higher than those of healthy individuals;(2)The expression level of circ-CBLB in patients with rheumatoid arthritis is positively correlated with CD14^(+)CD163^(+),and negatively correlated with miR-486-5p and CD14^(+)CD86^(+);The expression level of miR-486-5p is negatively correlated with CD14^(+)CD163^(+)and positively correlated with CD14^(+)CD86^(+);There is a negative correlation between CD14^(+)CD86^(+)and CD14^(+)CD163^(+);ESR is negatively correlated with circ-CBLB,and positively correlated with miR-486-5p,CD14^(+)CD86^(+),CRP;CRP is negatively correlated with circ-CBLB,CD14^(+)CD163^(+),and positively correlated with CD14^(+)CD86^(+),ESR;(3)The expression level of circ-CBLB in patients with rheumatoid arthritis is negatively correlated with joint tenderness,morning stiffness,lack of qi and lazy speech,and postprandial abdominal distension score;The expression level of miR-486-5p is positively correlated with the scores of joint tenderness and decreased appetite.(4)The ROC curve shows that in terms of circ-CBLB,ESR,CRP,VAS,and DAS28 AUC are 0.662(P=0.032),0.658(P=0.035),0.516(P=0.830),and 0.791(P=0.000),respectively.In terms of miR-486-5p,ESR,CRP,VAS,and DAS28 AUC were 0.566(P=0.385),0.511(P=0.883),0.592(P=0.223),and 0.727(P=0.003),respectively.Conclusion:The abnormal expression of circ CBLB and miR-486-5p in peripheral blood mononuclear cell of patients with rheumatoid arthritis of spleen deficiency and dampness excess type is related to inflammatory polarization markers,immune inflammation,disease activity,joint symptoms and spleen deficiency syndrome of rheumatoid arthritis,and the low expression of circ CBLB and high expression of miR-486-5p have certain predictive value for disease activity of rheumatoid arthritis.

小Excess与开流形的拓扑(英文)

本文中 ,我们应用比较几何的方法研究开流形的Excess与其拓扑之间的关系 .我们证明了对于一个曲率下有界的开流形 ,当它的Excess被其临界半径的某个函数所界定时 ,它就有有限拓扑型或微分同胚于n维z欧氏空间 .

Excess函数的应用(英文)

在本文中,我们研究了曲率有下界的开流形的拓扑,并推广了文[7]中的结果,证明了截曲率有下界的开流形如果它的excess函数被它的临界半径的某个函数所界定时,它就具有有限拓扑型或者微分同胚于Rn.

Treating both wastewater and excess sludge with an innovative process

The innovative process consists of biological unit for wastewater treatment and ozonation unit for excess sludge treatment. An aerobic membrane bioreactor(MBR) was used to remove organics and nitrogen, and an anaerobic reactor was added to the biological unit for the release of phosphorus contained at aerobic sludge to enhance the removal of phosphorus. For the excess sludge produced in the MBR, which was fed to ozone contact column and reacted with ozone, then the ozonated sludge was returned to the MBR for further biological treatment. Experimental results showed that this process could remove organics, nitrogen and phosphorus efficiently, and the removals for COD, NH 3-N, TN and TP were 93.17%, 97.57%, 82.77% and 79.5%, respectively. Batch test indicated that the specific nitrification rate and specific denitrification rate of the MBR were 1.03 mg NH 3-N/(gMLSS·h) and 0.56 mg NOx-N/(gMLSS·h), and denitrification seems to be the rate-limiting step. Under the test conditions, the sludge concentration in the MBR was kept at 5000—6000 mg/L, and the wasted sludge was ozonated at an ozone dosage of 0.10 kgO 3/kgSS. During the experimental period of two months, no excess sludge was wasted, and a zero withdrawal of excess sludge was implemented. Through economic analysis, it was found that an additional ozonation operating cost for treatment of both wastewater and excess sludge was only 0.045 RMB Yuan(USD 0.0054)/m 3 wastewater.

Releasing characteristics of phosphorus and other substances during thermal treatment of excess sludge

The releasing characteristics of phosphorus, nitrogen compounds, organics, and some metal cations during thermal treatment of excess sludge were investigated. It was found that during heating not only phosphorus, but also nitrogen compounds, organics, and some metal cations could be released in abundance. The maximum orthophosphate （ortho-P） release of about 90 mg/L in concentration was observed at 50℃ in 1 h. Except for volatile fatty acids （VFAs）, comparatively little total nitrogen （TN）, total organic carbon （TOC）, and metal cations were released at the same time. Such results might favor further process of phosphorus recovery. VFAs were considerably released only at 50℃. Acetic, butyric, and propionic acid were the most abundant components in turn and their releasing profiles exhibited good linear relationship with time （R2 = 0.9977, 0.9624, and 0.8908, respectively）. The concentrations of Mg^2＋ and K^＋ increased with time and temperature during thermal treatment, but Ca^2＋ decreased. The release of Mg^2＋ and K^＋ agreed well with TP release （R^2 = 0.9892 and 0.9476, respectively）. Temperature in the experimental range had very little impact on the linear relationships, especially of Mg^2＋. Moreover, the parameter of mixed liquor suspended solids （MLSS） was found to be an important factor for thermal sludge treatment as the released ortho-P and total phosphorus （TP） at 50℃ increased more than one-fold when MLSS was increased from 4000 to 8000 mg/L.

Effects of Exogenous Silicon on Photosynthetic Capacity and Antioxidant Enzyme Activities in Chloroplast of Cucumber Seedlings Under Excess Manganese

Effects of silicon on photosynthetic parameters and antioxidant enzymes of chloroplast in cucumber seedlings under excess Mn were studied. Compared with the control, excess Mn significantly inhibited net photosynthetic rate （Pn）, stomatal conductance, as well as the maximum yield of the photosystem II photochemical reactions （Fv/Fm） and the quantum yield of photosysytem II electron transport （Φ PSII）, application of Si reversed the negative effects of excess Mn. In the further investigation, it was obtained that application of Si significantly increased the activities of enzymes related with ascorbate-glutathione cycle including ascorbate peroxidase （APX）, dehydroascorbate reductase （DHAR） and glutathione reductase （GR） in cucumber chloroplast under excess Mn, this could be responsible for the lower accumulation of H2O2 and lower lipid peroxidation of chloroplast induced by Mn, and resulted in keeping higher photosynthesis.

A novel approach to treat combined domestic wastewater and excess sludge in MBR

Domestic wastewater was treated by combined anaerobic biofilm aerobic membrane bioreactor(MBR) process, and part biomass in MBR was withdrawn to treat with ozone, then the ozonated sludge was returned to anaerobic inlet. In aerobic MBR, MLSS and DO were controlled at 3000—3500 mg/L and 0 8 mg/L respectively. Comparing the experimental results of two stages, it was noticed that ozonation did not affect the removal efficiency for organics but had a significant influence on the removals of NH 3 N and TN. During the ozonation period of two months, no excess sludge was wasted, and a zero sludge yield was obtained.

Excess函数的性质及其应用

证明了Ric(M)≥-(n-1)完备非紧的n维黎曼流形M,若其上某一点的Excess函数有上界(常数)时,M就具有有限拓扑型或微分同胚于Rn.

Effect of Selenium Supplementation on Activity and mRNA Expression of Type 1 Deiodinase in Mice With Excessive Iodine Intake

Objective To investigate the effect of selenium supplementation on the selenium status and selenoenzyme, especially the activity and mRNA expression of type 1 deiodinase （D1） in mice with excessive iodine （EI） intake and to explore the mechanism of selenium intervention on iodine-induced abnormities. Methods Weanling female BALB/c mice were given tap water or 3 mg/L of iodine or supplemented with 0.5 mg/L or 1.0 mg/L of selenium in the presence of excessive iodine for 5 months. Selenium status, thyroid hormone level, hepatic and renal D 1 activity and mRNA expression were examined. Results Excessive iodine intake significantly decreased the selenium concentration in urine and liver, and the activity of glutathione peroxidase （GSH-Px） in liver. Meanwhile, serum total T4 （TT4） increased while serum total T3 （TT3） decreased. Hepatic D1 enzyme activity and mRNA expression were reduced by 33% and 86%, respectively. Renal D1 enzyme activity and mRNA were reduced by 30% and 55%, respectively. Selenium supplementation obviously increased selenium concentration, activity of GSH-Px and D1 as well as mRNA expression of D1. However, increasing the supplementation of Se from 0.5 to 1.0 mg/L did not further increase selenoenzyme activity and expression. Conclusion Relative selenium deficiency caused by excessive iodine plays an essential role in the mechanism of iodine-induced abnormalities. An appropriate dose of selenium supplementation exercises a beneficial intervention.

Environmental Implications of Excessive Selenium: A Review

Selenium is a naturally occurring trace element that is nutritionally required in smallamounts but it can become toxic at concentrations only twice those required. The narrow mar-gin between beneficial and harmful levels has important implications for human activities thatincrease the amount of selenium in the environment. Two of these activities, disposal of fbssilfuel wastes and agricultural irrigation of arid, seleniferous soils, have poisoned fish andwildlife, and threatened public health at several locations in the United States. Research stud-ies of these episodes have generated a data base that clearly illustrates the environmental hazardof excessive selenium. It is strongly bioaccumulated by aquatic organisms and even slight in-creases in waterborne concentrations can quickly result in toxic effects such as deformed em-bryos and reproductive failure in wildlife. The selenium data base has been very beneficial indeveloping hazard assessment procedures and establishing environmentally sound water qualitycriteria. The two faces of selenium, required nutrient and Potent toxin, make it a particularlyimportant trace element in the health of both animals and man. Because of this paradox, envi-ronmental selenium in relation to agriculture, fisheries, and wildlife wiIl continue to raise im-POrtant land and water management issues for decades to come. If these issues are dealt withusing prudence and the available environmental selenium data base, adverse irnpacts to naturalresources andspublic health can be avoided

Excess polonium-210 in the coastal atmosphere originating from marine biogenic material

The depositional fluxes of atmospheric polonium-210 were measured at one site in Xiamen from August 2001 to March 2002. With predominant marine air mass, the depositional fluxes of atmospheric polonium-210 ranged from 0.01 to 0.09 Bq/（m^2· d）, with an average of 0.04 Bq/（m^2 · d）. The seasonal pattern showed elevated polonium-210 fluxes in summer and autumn rather than in winter. Atmospheric depositional fluxes of polonium-210 showed a good correlation with beryllium-7 （r^2 =0. 85） and lead-210 fluxes （r^2 =0.71 ）, indicating their similar removal mechanism from atmosphere. The relationship between the polonium-210 depositional fluxes and the precipitation amount demonstrated that the precipitation dominates the polonium-210 removal from the atmosphere. The observed high activity ratios of polonium-210 to lead-210 indicated the occurrence of excess polonium-210 in coastal atmosphere, which may originate from marine surface waters either by indirect （foam）, or mare likely, direct （ air - sea exchange） input of marine bingenic material into the atmosphere. This source is even more important than the in situ decay of lead-210.

Role of insulin and insulin resistance in androgen excess disorders

Insulin has complex effects on cell growth,metabolism and differentiation,and these effects are mediated by a cell-surface bound receptor and eventually a cascade of intracellular signaling events.Among the several metabolic and growth-promoting effects of insulin,insulin resistance is defined as an attenuated effect of insulin on glucose metabolism,primarily the limited export of blood glucose into skeletal muscle and adipose tissue.On the other hand,not all the signaling pathways and insulin-responsive tissues are equally affected,and some effects other than the metabolic actions of insulin are overexpressed.Ovaries and the adrenal glands are two examples of tissues remaining sensitive to insulin actions where insulin may contribute to increased androgen secretion.Polycystic ovary syndrome(PCOS)is the most common form of androgen excess disorder(AED),and its pathogenesis is closely associated with insulin resistance.Patients with idiopathic hirsutism also exhibit insulin resistance,albeit lower than patients with PCOS.Although it is not as evident as in PCOS,patients with congenital adrenal hyperplasia may have insulin resistance,which may be further exacerbated with glucocorticoid overtreatment and obesity.Among patients with severe insulin resistance syndromes,irrespective of the type of disease,hyperinsulinemia promotes ovarian androgen synthesis independently of gonadotropins.It is highly debated in whom and how insulin resistance should be diagnosed and treated among patients with AEDs,including PCOS.It is not suitable to administer an insulin sensitizer relying on only some mathematical models used for estimating insulin resistance.Instead,the treatment decision should be based on the constellation of the signs,symptoms and presence of obesity;acanthosis nigricans;and some laboratory abnormalities such as impaired glucose tolerance and impaired fasting glucose.

Features of the Excess Adsorption Isotherms of High-Pressure Methane Adsorption on Coal and Simulation Model

Four coal samples of different ranks are selected to perform the adsorption measurement of high-pressure methane（CH4）.The highest equilibrium pressure of the measurement exceeds 20 MPa. Combined with the measuring results and theoretical analyses,the reasons for the peak or the maximum adsorption capacity appearing in the excess adsorption isotherms are explained.The rules of the peak occurrence are summarized.And then,based on the features of coal pore structure,the adsorption features of high-pressure gas,the microcosmic interaction relationship of coal surface and CH4 molecule,and the coalbed methane reservoir conditions,three theoretical assumptions on the coal adsorption high-pressure CH_4 are suggested.Thereafter,on the basis of these theoretical assumptions,the Ono-Kondo lattice model is processed for simplification and deformation. Subsequently,the equations modeling the excess adsorption isotherm of high-pressure CH_4 adsorption on coal are obtained.Through the verification on the measurement data,the fitting results indicate that it is feasible to use the Ono-Kondo lattice mode to model the excess adsorption isotherm of high-pressure CH_4 adsorption on coal.