Advancing Pediatric Hemodialysis Care through the Novel Intervention in Children’s Healthcare (NICH) Program

Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.

长期秸秆还田对白浆土物理性质及水稻产量的影响

【目的】明确长期秸秆还田对白浆土土壤物理性质及水稻产量的影响。【方法】开展秸秆还田长期定位试验。试验设置4个处理,分别为对照(CK),单施秸秆(S),秸秆+化肥(SNPK),单施化肥(NPK)。在2005年后连年处理,并于试验处理前和2010年、2015年试验处理期间调查土壤容重、硬度、孔隙、三相组成以及水稻产量。【结果】白浆土长期秸秆还田有利于水稻产量提高,10年产量平均,秸秆还田配施肥料处理水稻产量比对照和秸秆单独还田处理增产275.70%和133.23%,比单施化肥处理增产14.17%。秸秆还田处理水稻产量在还田第5—10年平均产量比第1—5年有增加趋势;长期秸秆还田可以改善土壤物理性质,降低土壤容重、硬度,还田10年后,秸秆还田配施化肥处理土壤容重低于化肥单施、秸秆单施及对照处理,SNPK处理0—20、20—30 cm土层土壤容重与对照相比分别降低6.34%和10.00%,与还田5年后同类处理相比仍呈下降趋势;秸秆还田配施化肥处理土壤硬度10年后在10、20、30 cm土层与处理前相比分别降低为26.87%、5.68%和4.62%,在20—30 cm土层与对照相比差异显著,还田10年与5年后相比有下降趋势,其他处理变化不明显;还田5年后,秸秆还田配施化肥处理在0—20、20—30、30—40 cm土层土壤固相比例与对照相比分别下降8.82%、8.36%和3.65%,还田10年后分别下降10.87%、10.61%和4.67%,10年后要比5年后下降幅度大,秸秆还田配施化肥比秸秆单施和化肥单施处理下降幅度大;长期秸秆还田可以增加土壤有效孔隙的数量,在处理间和年限间差异极显著,还田10年后,在0—20、20—30、30—40 cm土层秸秆还田配施化肥土壤有效孔隙比对照增加28.86%、63.85%和23.40%,在20—30 cm和30—40 cm土层比化肥单施增加12.55%和62.96%,在0—20、20—30、30—40cm土层比秸秆单施增加19.68%、56.52%和24.46%;与还田5年后相比,土壤有效孔隙度均呈现增加的趋势。【结论】长期秸秆还田可以改善白浆土不良物理性状,降低白浆层的容重、硬度,增加土壤总孔隙度和有效孔隙的比例,提高水稻产量。秸秆还田年限越长改善土壤不良物理性质效果越明显。单独进行秸秆还田改善土壤效果不明显,秸秆还田配施肥料处理效果明显;在不同处理上,秸秆还田配施化肥处理既有改土效果,又可提高水稻产量,而单施化肥和单独秸秆还田均达不到此类效果。

土层置换犁消除豆田残留除草剂药害的效果

为探索消除豆田残留除草剂对后作药害的新途径,本研究采用生物鉴定的方法,以甜菜为指示植物查明了豆田残留除草剂主要分布在0～10cm土层中,向下层逐渐减少,20cm以下土层为安全土层。自主设计的土层置换犁实现了将0～20cm土层和20～40cm土层位置转换,即所谓的土层置换。应用该犁在有残留除草剂污染的豆茬上实施土层置换改土作业后,连续2年调查作物产量结果显示,土层置换区比对照区甜菜、马铃薯等作物长势好、杂草数量少;改土后种植甜菜,第1年、第2年分别比未改土的对照增产468.9%和805.7%;种植马铃薯分别增产177.1%和31.0%;种植玉米(第2年)增产2.0%。种植连作大豆(第2年)增产6.5%。同时在未受到残留除草剂污染的土壤上实施土层置换作业后,第1年种植马铃薯和甜菜分别比对照减产3.1%和5.6%、第2年种植马铃薯和玉米,分别增产27.0%和5.2%。研究结果可为修复残留除草剂污染土壤、消除作物连作障碍和促进种植业结构提供技术支撑。

三江平原低湿地水田土壤理化特性及暗管排水效果

低湿土壤渍涝问题是限制农业生产的瓶颈问题,为改良低湿土壤渍涝问题,该文研究低湿地水田草甸沼泽土土壤特性,并探讨利用暗管排水进行低湿地排水及种植水稻的效果。结果表明,草甸沼泽土土壤质地黏重、各层土壤黏粒质量分数在40%以上;有效孔隙低,在6.40%~7.81%之间,通气、透水性差,母质层几乎不透气、透水,土体容气度为5.55%~16.08%;含水率高,自然状态达到40%以上;土壤容重低,耕层为0.93 g/cm3,母质层1.30 g/cm3;硬度低,液性指数在0.38~0.61之间,整体处于可塑状态,机械承载力差;草甸沼泽土上设置暗管可以改善土壤的透水性,随距暗管距离不同,土壤排水效果有差异,距离暗管越近,土壤排水效果越好,水分降低的越明显;同样排水晒田后,暗管处理土壤表层状态呈干裂状态,对照(无暗管排水区)则仍呈湿润状态;从水稻产量看,有暗管的处理水稻产量比无暗管处理增产8.06%。研究可为低湿地水田合理利用及改良提供依据。

稻壳深施改良苏打碱土理化性质长期效应

盐渍土是中国重要耕地土壤,由于土壤中盐基离子含量高,影响植物生育,为此改良盐渍土意义重大。该研究以黑龙江省苏打碱土为供试土壤,采用土层置换犁将稻壳埋于20~30cm土层中,以单独的机械耕作不埋稻壳为对照,田间作业8 a后再次调查土壤理化性质,研究结果:土壤有机碳、速效氮、磷、钾含量与对照比有增加趋势,各层土壤pH值降低0.37~0.41,Na^+降低40.68~212.35 mg/kg;土壤固相率约40%,与对照比下降了3.68%~8.86%,土壤总孔隙度增加到57.38%~60.58%之间,有效孔隙比例大,占总孔隙的22.7%~26.8%,对照有效孔隙占总孔隙的19.0%~23.7%;土壤通气、透水性分别是对照的10~121 5倍和118~173 5倍,0~30 cm土层水库容量高于对照18.58 mm;速效水库容高于对照10.71 mm;稻壳深施持续后效长,改善苏打碱土比单一机械耕作有效,是适合盐渍土改良的一项技术,而且可以通过机械手段得以实现。

《国际功能、残疾和健康分类》：对物理和康复医学进行统一概念描述的模式

需要发展一个当代为国际上广泛接受的物理和康复医学(PRM)的概念描述。建立这种新的概念依赖于统一的概念模型和《国际功能、残疾和健康分类》(ICF)的分类体系。这种基于ICF的康复概念描述是将康复作为一种健康策略。欧盟医学专家委员会(UEMS)的康复专家正在致力于将ICF作为物理和康复医学的统一概念的模型,并依据此建立基于ICF的概念描述并给PRM下定义。根据此项目标,作者通过与欧盟物理和康复医学专业实践委员会成员的合作,对于属于医学专业的PRM作了一个简明的定义。物理和康复医学是基于功能评估的医学专业,包含健康状况的诊断和治疗,实施、应用生物医学并结合其它更为广泛的干预方法,使残疾人或者可能经历残疾的人达到功能最佳化的目标。

Fabrication of titanium-based alloys with bioactive surface oxide layer as biomedical implants:Opportunity and challenges

Titanium and its alloys have long been used as implant materials due to their outstanding mechanical properties and apparent biocompatibility.Despite this,the search for better alloys has continued to be active by researchers and industries alike,as there are still pressing issues that require attention.These include(1)a large mismatch in the elastic modulus of the implant material,which causes a stress shielding problem;(2)the release of harmful ions from Ti alloys after long-term use;(3)a low bioactivity of the Ti alloy surface,which prolongs the healing process.More research has been directed toward finding new generation Ti alloys composed of more biocompatible phases and modifying the surface of Ti alloys from naturally bio-inert to bioactive in order to circumvent the problems.This review examines recent work reported on the fabrication of Ti alloys,and based on the survey,major characteristics highlighted the importance of elastic modulus and the use of non-toxic metal elements to improve biocompatibility.In terms of surface modification of Ti alloys,numerous studies have found that a nano-scaled surface oxide layer grown on the surface is always beneficial to improving the bioactivity of Ti alloys for rapid recovery after implantation.This comprehensive review focuses on the appropriate phase and composition for new Ti alloys intended for use as biomedical implants,emphasizing both fabrication and surface modification methods.

Geometrical, microstructural and mechanical characterization of pulse laser welded thin sheet 5052-H32 aluminium alloy for aerospace applications

Pulse laser welding of 0.6 mm-thick AA5052-H32 was performed to determine the optimum set of parameters including laser pulse current,pulse frequency and pulse duration that meets the AWS D17.1 specifications for aerospace industry.The microstructure and mechanical properties of the weldments were also investigated.Relationships between the parameters and weld bead geometry were found.High quality weld joints without solidification crack that met AWS D17.1 requirements were obtained at(I)high pulse energy(25 J)and high average peak power(4.2 kW)and(II)low pulse energy(17.6 J)and low average peak power(2.8 kW).The weld joint formed at lower heat energy input exhibited finer dendritic grain structure.Mg vapourisation and hard phase compound(Al0.5Fe3Si0.5)formation decreased in the weld joint formed at lower heat energy input.Consequently,the tensile strength of the weldment formed at lower heat energy input(168 MPa)is by a factor of 1.15 higher but showed^29%decrease in hardness(111 HV0.1)at the joint when being compared with the weldment formed at higher heat energy input.Appropriate parameters selection is critical to obtaining 0.6 mm-thick AA5052-H32 pulse laser weld joints that meet AWS D17.1 requirements for aircraft structures.

Mechanical and degradation behaviour of biodegradable magnesium-zinc/hydroxyapatite composite with different powder mixing

Magnesium-based biomaterials have recently gained great attention as promising candidates for the new generation of biodegradable implants.This study investigated the mechanical performance and biodegradation behaviour of magnesium-zinc/hydroxyapatite(Mg-Zn/HA)composites fabricated by different powder mixing techniques.A single step mixing process involved mechanical alloying or mechanical milling techniques,while double step processing involved a combination of both mechanical alloying and mechanical milling.Optimum mechanical properties of the composite were observed when the powders were prepared using single step processing via mechanical alloying technique.However,Mg-Zn/HA composite fabricated through single step processing via mechanical milling technique was found to have the most desirable low degradation rate coupled with highest bioactivity.The composite achieved the lowest degradation rate of 0.039×10^−3 mm/year as measured by immersion test and 0.0230 mm/year as measured by electrochemical polarization.Ca:P ratio of the composite also slightly more than enough to aid the initial bone mineralization,that is 1:1.76,as the required Ca:P ratio for initial bone mineralization is between 1:1 and 1:1.67.

Effect of SrCO_3 addition on the dynamic compressive strength of ZTA

Ceramic parts usually experience dynamic load in armor applications. Therefore, studying the dynamic behaviors of ceramics is important. Limited data are available on the dynamic behaviors of ceramics; thus, it is helpful to predict the dynamic strength of ceramics on the basis of their mechanical properties. In this paper, the addition of SrCO3 into zirconia-toughened alumina（ZTA） was demonstrated to improve the fracture toughness of ZTA due to the formation of the SrAl12O19（SA6） phase. The porosity of ZTA was found to be increased by the addition of SrCO3. These newly formed pores served as the nucleation sites of cracks under dynamic load; these cracks eventually coalesced to form damaged zones in the samples. Although the KIC values of the samples were improved, the dynamic strength was not enhanced because of the increase in porosity; in fact, the dynamic strength of ZTA ceramics decreased with the addition of SrCO3.

A Short Review on Copper Calcium Titanate(CCTO) Electroceramic;Synthesis,Dielectric Properties,Film Deposition,and Sensing Application

Electroceramic calcium copper titanates(CaCu3Ti4O12,CCTO),with high dielectric permittivities（e） of approximately 105 and 104,respectively,for single crystal and bulk materials,are produced for a number of wellestablished and emerging applications such as resonator,capacitor,and sensor.These applications take advantage of the unique properties achieved through the structure and properties of CCTO.This review comprehensively focuses on the primary processing routes,effect of impurity,dielectric permittivity,and deposition technique used for the processing of electroceramics along with their chemical composition and micro and nanostructures.Emphasis is given to versatile and basic approaches that allow one to control the microstructural features that ultimately determine the properties of the CCTO ceramic.Despite the intensive research in this area,none of the studies available in the literature provides all the possible relevant information about CCTO fabrication,structure,the factors influencing its dielectric properties,CCTO immobilization,and sensing applications.

Regulatory RNAs,microRNA,long-non coding RNA and circular RNA roles in colorectal cancer stem cells

The properties of cancer stem cells(CSCs),such as self-renewal,drug resistance,and metastasis,have been indicated to be responsible for the poor prognosis of patients with colon cancers.The epigenetic regulatory network plays a crucial role in CSC properties.Regulatory non-coding RNA(ncRNA),including microRNAs,long noncoding RNAs,and circular RNAs,have an important influence on cell physiopathology.They modulate cells by regulating gene expression in different ways.This review discusses the basic characteristics and the physiological functions of colorectal cancer(CRC)stem cells.Elucidation of these ncRNAs will help us understand the pathological mechanism of CRC progression,and they could become a new target for cancer treatment.

Phytochemical analysis and anti-oxidant activities of Albuca bracteata Jacq.and Albuca setosa Jacq bulb extracts used for the management of diabetes in the Eastern Cape,South Africa

Objective:The bulb of Albuca bracteata Jacq.,and Albuca setosa commonly used in Eastern Cape Province of South Africa for the treatment of several types of disease conditions including diabetes,was investigated for their phytochemical contents and antioxidant activities.Methods:The antioxidant activity was determined by evaluating the effect of various solvent extracts(acetone,methanol,ethanol and water) on 2,2 – diphenyl-2-picrylhydrazyl(DPPH) scavenging activity,2,20– azino-bis(3-ethylbenzthiazoline-6-sulfonic acid diammonium salt(ABTS),ferric reducing power,hydrogen peroxide and nitric oxide scavenging activity while the various extracts were also analysed for phytochemical their contents.Results:The results obtained indicate that polyphenols,proanthocyanidins,saponins and alkaloids are present in higher concentrations.The composition of phenols(117 mg/g),flavonols(26.28 mg/g),proanthocyanidins(84.85 mg/g) and flavonoids(5.36 mg/g) were significantly higher in the acetone extract while saponin and alkaloids contents were higher in the aqueous extract.Antioxidant studies of the extracts for nitric oxide,hydrogen peroxide,ABTS and DPPH showed high antioxidant potential in a concentration-dependent manner that was not significantly different from Vitamin C,BHT and Rutin used as standard references.The methanol extract showed higher ferric reducing potential compared to the aqueous extract but was significantly different from Vitamin C,BHT and Rutin.Conclusion:This implies that the bulb of Albuca bracteata may serve as a natural source of antioxidants,which together with the numerous phytochemicals present,could account for its folkloric use as a medicinal plant.

Airborne Acoustic Transmission and Terrain Topography at SAINTGITS Amphitheatre:An Analysis of Outdoor Auditory Perception and Comparison of Contour Plots

The arrangement of natural and physical features on the earth’s surface are a few among the countless items that govern the airborne acoustic transmission at boundary layers.In particular,if the acoustic waves are attributes of live concerts at open-air theatres,without losing the sheen and quality,the audience should certainly receive the unbroken depth of the performance.Hence,at all times,it is advisable to analyse the auditory receptiveness,particularly in all intended recreational spaces.The current pandemic circumstances and the mandated COVID-19 prevention protocols encourage gatherings in naturally ventilated outdoor regions than confined indoors.This work predicts and quantifies the acoustic experience at the naturally carved amphitheatre at SAINTGITS,an autonomous institution at the down South-West of the Indian Subcontinent.The entire recreational space at SAINTGITS AMPHI was separately modelled as a Base case and Advanced case,and were analysed using the acoustic modelling module of EASE Focus,a renowned simulation freeware,which is in strict adherence with the International standards.The variation in loudness received at the nearest and farthest ends of the amphitheatre was between 67 to 80 dB.Though the Zero frequency SPL(Z-weighting)exhibited the loudness in the range of 81 to 85 dB and could maintain a safer auditory level for any human ear,it was confined to a hemispherical region near the sound source.A vertical beam angle of−4.0°was found to be effective throughout.The procedures and analyses will certainly help the future organizers and stakeholders to effectively plan the resources to reap rich acoustic experience at terrain-centric locales.The surface topography and contours were plotted with another set of freeware,the CADMAPPER and the QUIKGRID,to compare terrain gradient with the known data.Furthermore,this interdisciplinary research exhibits the extensive simulation capability of both EASE Focus and QUIKGRID and demonstrates the modelling versatility and deliverable potential of these freeware to benefit the budding architects and researchers.

Room temperature operation of all-solid-state battery using a closo-type complex hydride solid electrolyte and a LiCoO_(2) cathode by interfacial modification

We report on an all-solid-state battery that employs a closo-type complex hydride solid electrolyte and a LiCoO2 cathode.Interfacial modification between the solid electrolyte and cathode with a LiNbO3 buffer layer enables reversible charge-discharge cycling with a cell voltage of 3.9V (vs.Li^+/Li) at room temperature.Electrochemical analyses clarify that the given modification effectively suppresses side reactions at the cathode/solid electrolyte interface.The interfacial resistance is lowered by ca.10 times with a 5 nm thick LiNbO3 buffer layer compared to that without a buffer layer,so that a discharge capacity of 109 mAh g^-1 is achieved.These results suggest that interfacial modification can be a viable approach to the development of high-voltage all-solid-state batteries using closo-type complex hydride solid electrolytes and oxide cathodes.

Characterization of mechanical and corrosion properties of cryorolled Al 1100 alloy:Effect of annealing and solution treatment

Effect of annealing and solution treatment prior to cryorolling on the formation of initial structure influencing microstructure formation from nano to micron scale and resultant mechanical and corrosion properties in Al 1100 alloy has been studied in detail.Before subjecting to 50%cryorolling,samples were pre-annealed at 250℃ for 2 h and pre-solution treated at 540℃ for 1 h.X-ray diffraction and HRTEM techniques were used to understand the crystallite size,lattice strain and dislocation configuration in the processed alloy.The results indicate that the pre-annealed sample has the highest grain aspect ratio(4.43),the smallest crystallite size(37.53 nm),the highest lattice strain(9.12×10^(−3))and the highest dislocation density(45.16×10^(13) m^(−2))among the tested sample.The pre-annealed sample shows a significant improvement of 43.44%,24.64%and 20.33%in hardness,ultimate tensile strength and yield strength.Both pre-annealed and pre-solution treated samples show improved corrosion resistance when compared to cryorolled samples without any pre-treatment,with the pre-annealed sample showing the best corrosion resistance.

The efficiency and accuracy of probability diagram, spatial statistic and fractal methods in the identification of shear zone gold mineralization: a case study of the Saqqez gold ore district,NW Iran

In this study,geochemical anomaly separation was carried out with methods based on the distribution model,which includes probability diagram(MPD),fractal(concentration-area technique),and U-statistic methods.The main objective is to evaluate the efficiency and accuracy of the methods in separation of anomalies on the shear zone gold mineralization.For this purpose,samples were taken from the secondary lithogeochemical environment(stream sediment samples)on the gold mineralization in Saqqez,NW of Iran.Interpretation of the histograms and diagrams showed that the MPD is capable of identifying two phases of mineralization.The fractal method could separate only one phase of change based on the fractal dimension with high concentration areas of the Au element.The spatial analysis showed two mixed subpopulations after U=0 and another subpopulation with very high U values.The MPD analysis followed spatial analysis,which shows the detail of the variations.Six mineralized zones detected from local geochemical exploration results were used for validating the methods mentioned above.The MPD method was able to identify the anomalous areas higher than 90%,whereas the two other methods identified 60%(maximum)of the anomalous areas.The raw data without any estimation for the concentration was used by the MPD method using aminimum of calculations to determine the threshold values.Therefore,the MPD method is more robust than the other methods.The spatial analysis identified the detail soft hegeological and mineralization events that were affected in the study area.MPD is recommended as the best,and the spatial U-analysis is the next reliable method to be used.The fractal method could show more detail of the events and variations in the area with asymmetrical grid net and a higher density of sampling or at the detailed exploration stage.

Maqui Aristotelia chilensis （Mol.） Stuntz]-the Amazing Chilean Tree： A Review

A. chilensis （Elaeocarpaceae） is commonly known as maqui, a species widely distributed in Chile. The plant participates in the structure of the Chilean temperate rainforest, currently being found mainly as fragmented forest. Maqui has been listed as the plant with the highest content of phenols when compared with other berries. Multiplication by both, seeds and vegetative has been obtained, opening the possibility to cultivate the plant. Leaves ofmaqui have been traditionally used in the native herbal medicine to treat diverse ailments. Studies indicate the presence of indolic alkaloids, flavonoids, cyaniding glucosides, delfidine, malvidine, petunidine, cumarines and triterpenes. Recent studies support therapeutic properties of maqui leaves, concluding that extracts obtained with polar solvents showed stabilizing capacity of free radicals and antioxidant capacity of plasma in humans. Other works show that fruits could be useful as antioxidant and cardioprotective source. The high contents of anthocyanins and polyglycosylated derivatives make berries of maqui an interesting p｜ant for food and pharmaceutical uses. A. chilensis polyphenols molecular mechanism of action and toxicity can be attributed to functional perturbation of cell membrane lipid bilayers. This review summarizes the research up to date, from propagation methods to chemical properties, indicating weak and lacking aspects.

Synthesis of biodegradable Mg-Zn alloy by mechanical alloying: Statistical prediction of elastic modulus and mass loss using fractional factorial design

Biodegradable Mg-Zn alloy was synthesized using mechanical alloying where a statistical model was developed using fractional factorial design to predict elastic modulus and mass loss of the bulk alloy.The effects of mechanical alloying parameters(i.e.,milling time,milling speed,ball-to-powder mass ratio and Zn content)and their interactions were investigated involving 4 numerical factors with 2 replicates,thus 16 runs of two-level fractional factorial design.Results of analysis of variance(ANOVA),regression analysis and R2 test indicated good accuracy of the model.The statistical model determined that the elastic modulus of biodegradable Mg-Zn alloy was between 40.18 and 47.88 GPa,which was improved and resembled that of natural bone(30-57 GPa).Corrosion resistance(mass loss of pure Mg,33.74 mg)was enhanced with addition of 3%-10%Zn(between 9.32 and 15.38 mg).The most significant independent variable was Zn content,and only the interaction of milling time and ball-to-powder mass ratio was significant as P-value was less than 0.05.Interestingly,mechanical properties(represented by elastic modulus)and corrosion resistance(represented by mass loss)of biodegradable Mg-Zn alloy can be statistically predicted according to the developed models.