Identifying how leaf habit subdivisions link to the fast–slow and avoidance–tolerance trait tradeoffs can provide new insight into divergence in ecophysiological strategies among plant functional groups. Here, we te...Identifying how leaf habit subdivisions link to the fast–slow and avoidance–tolerance trait tradeoffs can provide new insight into divergence in ecophysiological strategies among plant functional groups. Here, we tested a hypothesis that the differentiation across deciduous, semi-deciduous and evergreen woody species contributes to physiological trait tradeoffs in a dry-hot valley savanna. We investigated 11 photosynthetic, morphological and hydraulic traits of 24 species including 8 deciduous, 10 semi-deciduous and 6 evergreen species. Deciduous species were grouped in the fast and avoidance side associated with high values of maximum photosynthetic rates,stomatal conductance and leaf size, while evergreen species were grouped in the slow and tolerance side associated with high photosynthetic water use efficiency, leaf mass per area, sapwood density, Huber value, leaf water potential at turgor loss point and water potential causing 50% loss of stem hydraulic conductance. Semideciduous species generally had intermediate trait values and represented different physiological characteristics when compared to deciduous and evergreen species. The physiological trait tradeoffs showed a close linkage to the differentiation of these three leaf habits. Our findings clearly reveal trait tradeoffs related to fast–slow and avoidance–tolerance strategies among diverse savanna plants, suggesting a syndrome in multiple ecophysiology strategies across different leaf habits.展开更多
Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mecha...Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.展开更多
BACKGROUND Data examining the impact of sex on liver transplant(LT)outcomes are limited.It is clear that further research into sex-related differences in transplant patients is necessary to identify areas for improvem...BACKGROUND Data examining the impact of sex on liver transplant(LT)outcomes are limited.It is clear that further research into sex-related differences in transplant patients is necessary to identify areas for improvement.Elucidation of these differences may help to identify specific areas of focus to improve on the organ matching process,as well as the peri-and post-operative care of these patients.AIM To utilize data from a high-volume Eurotransplant center to compare characteristics of male and female patients undergoing liver transplant and assess association between sex-specific variables with short-and long-term post-transplant outcomes.METHODS A retrospective review of the University of Essen’s transplant database was performed with collection of baseline patient characteristics,transplant-related data,and short-term outcomes.Comparisons of these data were made with Shapiro-Wilk,Mann-Whitney U,χ2 and Bonferroni tests applied where appropriate.A P value of<0.05 was accepted as statistically significant.RESULTS Of the total 779 LT recipients,261(33.5%)were female.Female patients suffered higher incidences of acute liver failure and lower incidences of alcohol-related or viremic liver disease(P=0.001).Female patients were more likely to have received an organ from a female donor with a higher donor risk index score,and as a high urgency offer(all P<0.05).Baseline characteristics of male and female recipients were also significantly different.In multivariate hazard regression analysis,recipient lab-Model for End-Stage Liver Disease score and donor cause of death were associated with long-term outcomes in females.Pre-operative diagnosis of hepatocellular carcinoma,age at time of listing,duration of surgery,and units transfused during surgery,were associated with long-term outcomes in males.Severity of complications was associated with long-term outcomes in both groups.Overall survival was similar in both males and females;however,when stratified by age,females<50 years of age had the best survival.CONCLUSION Female and male LT recipients have different baseline and transplant-related characteristics,with sex-specific variables which are associated with long-term outcomes.Female recipients<50 years of age demonstrated the best long-term outcomes.Pre-and post-transplant practices should be individualized based on sex-specific variables to optimize long-term outcomes.展开更多
BACKGROUND There is no data evaluating the impact of Medicaid expansion on kidney tran-splants(KT)in Oklahoma.AIM To investigate the impact of Medicaid expansion on KT patients in Oklahoma.METHODS The UNOS database wa...BACKGROUND There is no data evaluating the impact of Medicaid expansion on kidney tran-splants(KT)in Oklahoma.AIM To investigate the impact of Medicaid expansion on KT patients in Oklahoma.METHODS The UNOS database was utilized to evaluate data pertaining to adult KT reci-pients in Oklahoma in the pre-and post-Medicaid eras.Bivariate analysis,Kaplan Meier analysis was used to estimate,and cox proportional models were utilized.RESULTS There were 2758 pre-and 141 recipients in the post-Medicaid expansion era.Post-expansion patients were more often non-United States citizens(2.3%vs 5.7%),American Indian,Alaskan,or Pacific Islander(7.8%vs 9.2%),Hispanic(7.4%vs 12.8%),or Asian(2.5%vs 8.5%)(P<0.0001).Waitlist time was shorter in the post-expansion era(410 vs 253 d)(P=0.0011).Living donor rates,pre-emptive transplants,re-do transplants,delayed graft function rates,kidney donor profile index values,panel reactive antibodies levels,and insurance types were similar.Patients with public insurance were more frail.Despite increased early(<6 months)rejection rates,1-year patient and graft survival were similar.In Cox proportional hazards model,male sex,American Indian,Alaskan or Pacific Islander race,public insurance,and frailty category were independent risk factors for death at 1 year.Medicaid expansion was not associated with graft failure or patient survival(adjusted hazard ratio:1.07;95%CI:0.26-4.41).CONCLUSION Medicaid expansion in Oklahoma is associated with increased KT access for non-White/non-Black and non-United States citizen patients with shorter wait times.1-year graft and patient survival rates were similar before and after expansion.Medicaid expansion itself was not independently associated with graft or patient survival outcomes.Ongoing research is necessary to determine the long-term effects of Medicaid expansion.展开更多
Differential interferometric synthetic aperture radar(DIn SAR), a satellite-based remote sensing technique, has potential application for measuring mine subsidence on a regional scale with high spatial and temporal re...Differential interferometric synthetic aperture radar(DIn SAR), a satellite-based remote sensing technique, has potential application for measuring mine subsidence on a regional scale with high spatial and temporal resolutions. However, the characteristics of synthetic aperture radar(SAR) data and the effectiveness of DIn SAR for subsidence monitoring depend on the radar band(wavelength). This study evaluates the effectiveness of DIn SAR for monitoring subsidence due to longwall mining in central Utah using L-band(24 cm wavelength) SAR data from the advanced land observing satellite(ALOS)and X-band(3 cm wavelength) SAR data from the Terra SAR-X mission. In the Wasatch Plateau region of central Utah, which is characterized by steep terrain and variable ground cover conditions, areas affected by longwall mine subsidence are identifiable using both L-band and X-band DIn SAR.Generally, using L-band data, subsidence magnitudes are measurable. Compared to X-band, L-band data are less affected by signal saturation due to large deformation gradients and by temporal decorrelation due to changes in the surface conditions over time. The L-band data tend to be stable over relatively long periods(months). Short wavelength X-band data are strongly affected by signal saturation and temporal decorrelation, but regions of subsidence are typically identifiable over short periods(days). Additionally,though subsidence magnitudes are difficult to precisely measure in the central Utah region using X-band data, they can often be reasonably estimated.展开更多
This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(...This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(XRD)-based DIP method effectively analyzed the mineral composition contents and spatial distributions of granite. During the particle flow code(PFC2D) model calibration phase, the numerical simulation exhibited that the uniaxial compressive strength(UCS) value, elastic modulus(E), and failure pattern of the granite specimen in the UCS test were comparable to the experiment. By establishing 351 sets of numerical models and exploring the impacts of mineral composition on the mechanical properties of granite, it indicated that there was no negative correlation between quartz and feldspar for UCS, tensile strength(σ_(t)), and E. In contrast, mica had a significant negative correlation for UCS, σ_(t), and E. The presence of quartz increased the brittleness of granite, whereas the presence of mica and feldspar increased its ductility in UCS and direct tensile strength(DTS) tests. Varying contents of major mineral compositions in granite showed minor influence on the number of cracks in both UCS and DTS tests.展开更多
Non-spherical particles exist widely in natural and industrial fluid systems and the motions of nonspherical particles are significantly different from that of spherical particles.In this paper,a simplified model of n...Non-spherical particles exist widely in natural and industrial fluid systems and the motions of nonspherical particles are significantly different from that of spherical particles.In this paper,a simplified model of non-spherical particles considering particle drag correction,lift,and rotation was established.Based on the Eulerian-Lagrangian simulation,the dispersion characteristics of spherical and nonspherical particles with different Stokes numbers in a high-speed turbulent jet were analyzed and compared considering the effect of particle rotation.The results show that,the differences in particle dispersion and radial velocity fluctuation between non-spherical particles and spherical particles in the jet are significant,especially when Stokes number is large.Moreover,the effects of different type of forces on the dispersion of non-spherical particles and spherical particles were compared in detail,which revealed that the change of the Magnus force caused by the increase in the angular velocity of non-spherical particles plays a dominant role in the differences of particle dispersion.展开更多
Age and diabetes have long been known to induce an oxidative reaction between glucose and collagen,leading to the accumulation of advanced glycation end-products(AGEs)cross-links in collagenous tissues.More recently,A...Age and diabetes have long been known to induce an oxidative reaction between glucose and collagen,leading to the accumulation of advanced glycation end-products(AGEs)cross-links in collagenous tissues.More recently,AGEs content has been related to loss of bone quality,independent of bone mass,and increased fracture risk with aging and diabetes.Loss of bone quality is mostly attributed to changes in material properties,structural organization,or cellular remodeling.Though all these factors play a role in bone fragility disease,some common recurring patterns can be found between diabetic and age-related bone fragility.The main pattern we will discuss in this viewpoint is the increase of fibrillar collagen stiffness and loss of collagen-induced plasticity with AGE accumulation.This study focused on recent related experimental studies and discusses the correlation between fluorescent AGEs content at the molecular and fibrillar scales,collagen deformation mechanisms at the nanoscale,and resistance to bone fracture at the macroscale.展开更多
Quantitative analysis of mine-wide subsidence at the kilometer scale and details of stress distribution about an advancing longwall face are estimated using an adaptation of the finite element method. The method is we...Quantitative analysis of mine-wide subsidence at the kilometer scale and details of stress distribution about an advancing longwall face are estimated using an adaptation of the finite element method. The method is well suited to the tasks at hand. For greater realism, variability of strata properties is taken into account as are the effects of joints and cleats on elastic moduli and strengths. Evolution of pillar stress and entry closure remote from the face is readily quantified in a series of analyses that simulate face advance. Computed results compare favorably with the evolution of closure measurements about an instrumented pillar in a two-entry headgate. The appropriateness of the finite element method is confirmed. This method is based on first principles that avoid empirical schemes of uncertain applicability and numerical models ‘‘calibrated" by fitting computer output to mine measurements.展开更多
The microstructures of fault rocks from the Wasatch fault zone in Utah (USA) have been studied using a polarizing microscope,a scanning electron microscope (SEM) and an ultrahigh-voltage electron microscope (HVHM...The microstructures of fault rocks from the Wasatch fault zone in Utah (USA) have been studied using a polarizing microscope,a scanning electron microscope (SEM) and an ultrahigh-voltage electron microscope (HVHM).This fault zone may be recognized as one a with long history of seismic activity according to the microstructural characteristics such as type, deformation characteristics,melting structure and surface textures of the fault rocks.However,the main fault now present seems not to have been noticeably active since the late Pleistocene (Q<sub>3</sub>),as shown by the eroded-surface texture on the quartz fragments in the fault gouge.Meanwhile,those faults supposed to be strongly active in modern times are branching faults much closer to the basin side and are covered by the Holocene sediments in the basin.展开更多
Sergei Winogradsky illuminated revolutionary concepts and produced a tool to visualize complex microbial communities and their metabolisms over time:columns displaying aquatic consortia with variety of niches.We worke...Sergei Winogradsky illuminated revolutionary concepts and produced a tool to visualize complex microbial communities and their metabolisms over time:columns displaying aquatic consortia with variety of niches.We worked with museums in Utah to create Winogradsky columns that would highlight aesthetic properties of the Great Salt Lake(GSL)ecosystem,which has a salinity gradient from the freshwater wetlands to salt saturation.One column,constructed using haloarchaea-rich hypersaline brine and oolitic sand of the lake’s north arm,was enriched with nutrients,and resulted in the desired pink hue over time.After a seven-year maturation period,we examined the microbial taxa present in the water through 16 S/18 S rRNA and Internal Transcribed Spacer(ITS)gene sequencing.A pigment analysis revealed an abundance of bacteriochlorophyll a.The presence of this pigment coupled with the DNA sequencing results,suggest that the haloarchaea that dominate the GSL brine,were not responsible for the pink coloration,but instead Gammaproteobacteria,especially Halorhodospira species.Among the eukaryotes,the lack of phytoplankton and the abundance of fungi were noteworthy observations.These data likely relate to the reduction of oxygen in a non-aerated sealed system over time.Our second exhibit had the goal of educating museum goers about the varying salinities of Great Salt Lake.Here we employed three distinct columns of water and sediment from this salinity gradient.Observations of these columns overtime gave us information about invertebrate communities in addition to the microbial consortia.Both installations taught us about comparing an artificial environment in a museum setting to the natural ecosystem.Taken together,we present the data collected and lessons learned from using Winogradsky columns in public spaces for teaching about an important saline lake.展开更多
Recent studies have revealed concerning declines in bird populations in Europe and other parts of the world.In understudied but biodiverse regions,especially those that are located along key migratory flyways,there is...Recent studies have revealed concerning declines in bird populations in Europe and other parts of the world.In understudied but biodiverse regions,especially those that are located along key migratory flyways,there is an unmet need to evaluate the status of resident and migratory birdlife for avian conservation ecology.This is especially urgent at a time when recent regional studies have highlighted the scale of the decline of the European and Palearctic avifauna.Rapidly growing community science datasets may help bridge the gaps in our understanding of long-term regional avifaunal trends.In this study,we used eBird data submitted by observers in Türkiye to undertake the first long-term assessment of the state of the country’s birds from 2001 to 2022.We evaluated population trends based on presence-absence data of species to determine if any birds have significantly increased or decreased in the country so far this century.We provide a list of trends for 418 bird species that had large enough sample sizes of eBird observations from Türkiye,and highlight which species have significantly declined or increased.We found that 63 species have significantly declined in detection while 120 have significantly increased during the study period.Our findings provide a baseline for the future monitoring of Türkiye’s birds and help contextualize population changes of birds in Türkiye against those occurring at the continental(Palearctic)scale.Additionally,we include movement classifications for all of the bird species in this study.We also provide a framework to effectively use eBird data to assess long-term avifaunal changes at the country-level in other understudied regions.Finally,we highlight ways in which eBirders in Türkiye and elsewhere can strengthen the quality and value of community ornithology data for population assessments and avian conservation ecology.展开更多
The absorption by neutral hydrogen in the intergalactic medium(IGM)produces the Lya forest in the spectra of quasars.The Lya forest absorbers have a broad distribution of neutral hydrogen column density N_(HⅠ) and Do...The absorption by neutral hydrogen in the intergalactic medium(IGM)produces the Lya forest in the spectra of quasars.The Lya forest absorbers have a broad distribution of neutral hydrogen column density N_(HⅠ) and Doppler b parameter.The narrowest Lya absorption lines(of lowest b)with neutral hydrogen column density above~10^(13)cm^(-2) are dominated by thermal broadening,which can be used to constrain the thermal state of the IGM.Here we constrain the temperature-density relation T=T0(ρ/■)γ^(-1) of the IGM at 1.6<z<3.6 by using N_(HⅠ) and b parameters measured from 24 high-resolution and high-signal-to-noise quasar spectra and by employing an analytic model to model the N_(HⅠ) -dependent low-b cutoff in the b distribution.In each N_(HⅠ) bin,the b cutoff is estimated using two methods,one non-parametric method from computing the cumulative b distribution and a parametric method from fitting the full b distribution.We find that the IGM temperature T0 at the mean gas densityρshows a peak of~1.5×10^(4) K at z~2.7-2.9.At redshift higher than this,the indexγapproximately remains constant,and it starts to increase toward lower redshifts.The evolution in both parameters is in good agreement with constraints from completely different approaches,which signals that HeⅡreionization completes around z~3.展开更多
Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate ho...Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.展开更多
In this paper we study the function , for z∈C. We derive a functional equation that relates G(z) and G(1−z) for all z∈C, and we prove: 1) that G and the Riemann zeta function ζ have exactly the same zeros in the cr...In this paper we study the function , for z∈C. We derive a functional equation that relates G(z) and G(1−z) for all z∈C, and we prove: 1) that G and the Riemann zeta function ζ have exactly the same zeros in the critical region D:= {z∈C:ℜz∈(0,1)};2) the Riemann hypothesis, i.e., that all of the zeros of G in D are located on the critical line := {z∈D:ℜz =1/2};and that 3) all the zeros of the Riemann zeta function located on the critical line are simple.展开更多
In the research article“Optical Detection of Distal Lung Enzyme Activity in Human Inflammatory Lung Disease”[1],the data availability statement was inadvertently omitted by the publisher.This has now been corrected ...In the research article“Optical Detection of Distal Lung Enzyme Activity in Human Inflammatory Lung Disease”[1],the data availability statement was inadvertently omitted by the publisher.This has now been corrected in the PDF and HTML(full text).展开更多
Background: Abdominoplasty has consistently been one of the top cosmetic procedures performed each year with a high patient satisfaction rate. Excision of the excess abdominal skin has been shown to reduce low back pa...Background: Abdominoplasty has consistently been one of the top cosmetic procedures performed each year with a high patient satisfaction rate. Excision of the excess abdominal skin has been shown to reduce low back pain and improve posture. The effects of the excess skin removal would, theoretically, be demonstrated through changes in gait. This study aimed to measure kinematic differences during gait to obtain objective measures for abdominoplasty. Methods: Subjects were recruited from a large, academic plastic surgery clinic. Patients were included if they were 18 years of age, able to walk without an assistive device or any hindrance by any existing medical condition, and were scheduled for abdominoplasty. Kinematic measurements were taken before and after surgery using a plug-in-gait marker set, cameras, and a treadmill. Pre- and postoperative measurements were compared and a post-hoc power analysis was created. Results: Nine total patients were included in the study. Joint angles before and after surgery demonstrated moderate differences. However, analysis revealed few significant differences for spatiotemporal or kinematic variables. The power analysis demonstrated an inadequate number of patients to detect significance. Conclusions: Despite the literature describing subjective and objective improvements following abdominoplasty, we were unable to validate this. Overall, there were noticeable differences in joint angles pre- and postoperatively, though the study is too underpowered to reach statistical significance. This preliminary data shows that if the study was powered through a larger cohort, then more generalizable conclusions could be drawn.展开更多
Boron is an important industrial raw material often sourced from minerals containing different compounds that cocrystallize,which makes it difficult to separate the mineral phases through conventional beneficiation.Th...Boron is an important industrial raw material often sourced from minerals containing different compounds that cocrystallize,which makes it difficult to separate the mineral phases through conventional beneficiation.This study proposed a new treatment called flash reduction-melting separation(FRMS)for boron-bearing iron concentrates.In this method,the concentrates were first flash-reduced at the temperature under which the particles melt,and the slag and the reduced iron phases disengaged at the particle scale.Good reduc-tion and melting effects were achieved above 1550℃.The B_(2)O_(3) content in the separated slag was over 18wt%,and the B content in the iron was less than 0.03wt%.The proposed FRMS method was tested to investigate the effects of factors such as ore particle size and tem-perature on the reduction and melting steps with and without pre-reducing the raw concentrate.The mineral phase transformation and morphology evolution in the ore particles during FRMS were also comprehensively analyzed.展开更多
With the increase in IoT(Internet of Things)devices comes an inherent challenge of security.In the world today,privacy is the prime concern of every individual.Preserving one’s privacy and keeping anonymity throughou...With the increase in IoT(Internet of Things)devices comes an inherent challenge of security.In the world today,privacy is the prime concern of every individual.Preserving one’s privacy and keeping anonymity throughout the system is a desired functionality that does not come without inevitable trade-offs like scalability and increased complexity and is always exceedingly difficult to manage.The challenge is keeping confidentiality and continuing to make the person innominate throughout the system.To address this,we present our proposed architecture where we manage IoT devices using blockchain technology.Our proposed architecture works on and off blockchain integrated with the closed-circuit television(CCTV)security camera fixed at the rental property.In this framework,the CCTV security camera feed is redirected towards the owner and renter based on the smart contract conditions.One entity(owner or renter)can see the CCTV security camera feed at one time.There is no third-party dependence except for the CCTV security camera deployment phase.Our contributions include the proposition of framework architecture,a novel smart contract algorithm,and the modification to the ring signatures leveraging an existing cryptographic technique.Analyses are made based on different systems’security and key management areas.In an empirical study,our proposed algorithm performed better in key generation,proof generation,and verification times.By comparing similar existing schemes,we have shown the proposed architectures’advantages.Until now,we have developed this system for a specific area in the real world.However,this system is scalable and applicable to other areas like healthcare monitoring systems,which is part of our future work.展开更多
BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinica...BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinical course of AP.It could worsen symptoms and potentially lead to additional complications.However,clinical evidence regarding the specific association between APFC and early readmission in AP remains scarce.Understanding the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare costs.AIM To evaluate the association between APFC and 30-day readmission in patients with AP.METHODS This retrospective cohort study is based on the Nationwide Readmission Database for 2016-2019.Patients with a primary diagnosis of AP were identified.Participants were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was performed.The primary outcome was early readmission rates.Secondary outcomes included the incidence of inpatient complications and healthcare utilization.Unadjusted analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission risks.RESULTS A total of 673059 patients with the principal diagnosis of AP were included.Of these,5.1%had APFC on initial admission.After propensity score matching,each cohort consisted of 33914 patients.Those with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APFC group also had higher readmission charges($28282 vs$22865,P<0.001).The presence of APFC increased the risk of readmission twofold(aHR 2.52,95%confidence interval:2.40-2.65,P<0.001).The independent risk factors for 30-day readmission included female gender,Elixhauser Comorbidity Index≥3,chronic pulmonary diseases,chronic renal disease,protein-calorie malnutrition,substance use disorder,depression,portal and splenic venous thrombosis,and certain endoscopic procedures.CONCLUSION Developing APFC during index hospitalization for AP is linked to higher readmission rates,more inpatient complications,longer LOS,and increased healthcare costs.Knowing predictors of readmission can help target high-risk patients,reducing healthcare burdens.展开更多
基金funded by the National Natural Science Foundation of China (31901285, 32171507, 31870385, 32301308)the CAS“Light of West China”programs to DY and JLZ+3 种基金the Yunnan Fundamental Research Projects (202001AU070128, 202401AT070230)the 14th Five-Year Plan of the Xishuangbanna Tropical Botanical Garden,Chinese Academy of Sciences (XTBG-1450101)German Vargas G. was supported by the NOAA Climate and Global Change Postdoctoral Fellowship Programadministered by UCAR's Cooperative Programs for the Advancement of Earth System Science (CPAESS) under the NOAA Science Collaboration Program award#NA21OAR4310383。
文摘Identifying how leaf habit subdivisions link to the fast–slow and avoidance–tolerance trait tradeoffs can provide new insight into divergence in ecophysiological strategies among plant functional groups. Here, we tested a hypothesis that the differentiation across deciduous, semi-deciduous and evergreen woody species contributes to physiological trait tradeoffs in a dry-hot valley savanna. We investigated 11 photosynthetic, morphological and hydraulic traits of 24 species including 8 deciduous, 10 semi-deciduous and 6 evergreen species. Deciduous species were grouped in the fast and avoidance side associated with high values of maximum photosynthetic rates,stomatal conductance and leaf size, while evergreen species were grouped in the slow and tolerance side associated with high photosynthetic water use efficiency, leaf mass per area, sapwood density, Huber value, leaf water potential at turgor loss point and water potential causing 50% loss of stem hydraulic conductance. Semideciduous species generally had intermediate trait values and represented different physiological characteristics when compared to deciduous and evergreen species. The physiological trait tradeoffs showed a close linkage to the differentiation of these three leaf habits. Our findings clearly reveal trait tradeoffs related to fast–slow and avoidance–tolerance strategies among diverse savanna plants, suggesting a syndrome in multiple ecophysiology strategies across different leaf habits.
文摘Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.
文摘BACKGROUND Data examining the impact of sex on liver transplant(LT)outcomes are limited.It is clear that further research into sex-related differences in transplant patients is necessary to identify areas for improvement.Elucidation of these differences may help to identify specific areas of focus to improve on the organ matching process,as well as the peri-and post-operative care of these patients.AIM To utilize data from a high-volume Eurotransplant center to compare characteristics of male and female patients undergoing liver transplant and assess association between sex-specific variables with short-and long-term post-transplant outcomes.METHODS A retrospective review of the University of Essen’s transplant database was performed with collection of baseline patient characteristics,transplant-related data,and short-term outcomes.Comparisons of these data were made with Shapiro-Wilk,Mann-Whitney U,χ2 and Bonferroni tests applied where appropriate.A P value of<0.05 was accepted as statistically significant.RESULTS Of the total 779 LT recipients,261(33.5%)were female.Female patients suffered higher incidences of acute liver failure and lower incidences of alcohol-related or viremic liver disease(P=0.001).Female patients were more likely to have received an organ from a female donor with a higher donor risk index score,and as a high urgency offer(all P<0.05).Baseline characteristics of male and female recipients were also significantly different.In multivariate hazard regression analysis,recipient lab-Model for End-Stage Liver Disease score and donor cause of death were associated with long-term outcomes in females.Pre-operative diagnosis of hepatocellular carcinoma,age at time of listing,duration of surgery,and units transfused during surgery,were associated with long-term outcomes in males.Severity of complications was associated with long-term outcomes in both groups.Overall survival was similar in both males and females;however,when stratified by age,females<50 years of age had the best survival.CONCLUSION Female and male LT recipients have different baseline and transplant-related characteristics,with sex-specific variables which are associated with long-term outcomes.Female recipients<50 years of age demonstrated the best long-term outcomes.Pre-and post-transplant practices should be individualized based on sex-specific variables to optimize long-term outcomes.
文摘BACKGROUND There is no data evaluating the impact of Medicaid expansion on kidney tran-splants(KT)in Oklahoma.AIM To investigate the impact of Medicaid expansion on KT patients in Oklahoma.METHODS The UNOS database was utilized to evaluate data pertaining to adult KT reci-pients in Oklahoma in the pre-and post-Medicaid eras.Bivariate analysis,Kaplan Meier analysis was used to estimate,and cox proportional models were utilized.RESULTS There were 2758 pre-and 141 recipients in the post-Medicaid expansion era.Post-expansion patients were more often non-United States citizens(2.3%vs 5.7%),American Indian,Alaskan,or Pacific Islander(7.8%vs 9.2%),Hispanic(7.4%vs 12.8%),or Asian(2.5%vs 8.5%)(P<0.0001).Waitlist time was shorter in the post-expansion era(410 vs 253 d)(P=0.0011).Living donor rates,pre-emptive transplants,re-do transplants,delayed graft function rates,kidney donor profile index values,panel reactive antibodies levels,and insurance types were similar.Patients with public insurance were more frail.Despite increased early(<6 months)rejection rates,1-year patient and graft survival were similar.In Cox proportional hazards model,male sex,American Indian,Alaskan or Pacific Islander race,public insurance,and frailty category were independent risk factors for death at 1 year.Medicaid expansion was not associated with graft failure or patient survival(adjusted hazard ratio:1.07;95%CI:0.26-4.41).CONCLUSION Medicaid expansion in Oklahoma is associated with increased KT access for non-White/non-Black and non-United States citizen patients with shorter wait times.1-year graft and patient survival rates were similar before and after expansion.Medicaid expansion itself was not independently associated with graft or patient survival outcomes.Ongoing research is necessary to determine the long-term effects of Medicaid expansion.
基金Funding for this research was provided by the National Institute for Occupational Health and Safety(NIOSH)
文摘Differential interferometric synthetic aperture radar(DIn SAR), a satellite-based remote sensing technique, has potential application for measuring mine subsidence on a regional scale with high spatial and temporal resolutions. However, the characteristics of synthetic aperture radar(SAR) data and the effectiveness of DIn SAR for subsidence monitoring depend on the radar band(wavelength). This study evaluates the effectiveness of DIn SAR for monitoring subsidence due to longwall mining in central Utah using L-band(24 cm wavelength) SAR data from the advanced land observing satellite(ALOS)and X-band(3 cm wavelength) SAR data from the Terra SAR-X mission. In the Wasatch Plateau region of central Utah, which is characterized by steep terrain and variable ground cover conditions, areas affected by longwall mine subsidence are identifiable using both L-band and X-band DIn SAR.Generally, using L-band data, subsidence magnitudes are measurable. Compared to X-band, L-band data are less affected by signal saturation due to large deformation gradients and by temporal decorrelation due to changes in the surface conditions over time. The L-band data tend to be stable over relatively long periods(months). Short wavelength X-band data are strongly affected by signal saturation and temporal decorrelation, but regions of subsidence are typically identifiable over short periods(days). Additionally,though subsidence magnitudes are difficult to precisely measure in the central Utah region using X-band data, they can often be reasonably estimated.
基金This research was supported by the Department of Mining Engineering at the University of Utah.In addition,the lead author wishes to acknowledge the financial support received from the Talent Introduction Project,part of the Elite Program of Shandong University of Science and Technology(No.0104060540171).
文摘This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(XRD)-based DIP method effectively analyzed the mineral composition contents and spatial distributions of granite. During the particle flow code(PFC2D) model calibration phase, the numerical simulation exhibited that the uniaxial compressive strength(UCS) value, elastic modulus(E), and failure pattern of the granite specimen in the UCS test were comparable to the experiment. By establishing 351 sets of numerical models and exploring the impacts of mineral composition on the mechanical properties of granite, it indicated that there was no negative correlation between quartz and feldspar for UCS, tensile strength(σ_(t)), and E. In contrast, mica had a significant negative correlation for UCS, σ_(t), and E. The presence of quartz increased the brittleness of granite, whereas the presence of mica and feldspar increased its ductility in UCS and direct tensile strength(DTS) tests. Varying contents of major mineral compositions in granite showed minor influence on the number of cracks in both UCS and DTS tests.
基金supported by National Science and Technology Major Project of China(2019-I-0022-0021)Seed fund of Shanxi Research Institute for Clean Energy,Tsinghua Universitythe National Natural Science Foundation of China(51761125011)。
文摘Non-spherical particles exist widely in natural and industrial fluid systems and the motions of nonspherical particles are significantly different from that of spherical particles.In this paper,a simplified model of non-spherical particles considering particle drag correction,lift,and rotation was established.Based on the Eulerian-Lagrangian simulation,the dispersion characteristics of spherical and nonspherical particles with different Stokes numbers in a high-speed turbulent jet were analyzed and compared considering the effect of particle rotation.The results show that,the differences in particle dispersion and radial velocity fluctuation between non-spherical particles and spherical particles in the jet are significant,especially when Stokes number is large.Moreover,the effects of different type of forces on the dispersion of non-spherical particles and spherical particles were compared in detail,which revealed that the change of the Magnus force caused by the increase in the angular velocity of non-spherical particles plays a dominant role in the differences of particle dispersion.
基金supported by the National Institutes of Health under Award Number 1R21AR077881.
文摘Age and diabetes have long been known to induce an oxidative reaction between glucose and collagen,leading to the accumulation of advanced glycation end-products(AGEs)cross-links in collagenous tissues.More recently,AGEs content has been related to loss of bone quality,independent of bone mass,and increased fracture risk with aging and diabetes.Loss of bone quality is mostly attributed to changes in material properties,structural organization,or cellular remodeling.Though all these factors play a role in bone fragility disease,some common recurring patterns can be found between diabetic and age-related bone fragility.The main pattern we will discuss in this viewpoint is the increase of fibrillar collagen stiffness and loss of collagen-induced plasticity with AGE accumulation.This study focused on recent related experimental studies and discusses the correlation between fluorescent AGEs content at the molecular and fibrillar scales,collagen deformation mechanisms at the nanoscale,and resistance to bone fracture at the macroscale.
基金Financial support by the National Institute of Safety and Health under Contract 200-2016-90240, MIS Analysis and DINSAR Measurements-Tools for Improving Mine Ground Control Safety is gratefully acknowledged
文摘Quantitative analysis of mine-wide subsidence at the kilometer scale and details of stress distribution about an advancing longwall face are estimated using an adaptation of the finite element method. The method is well suited to the tasks at hand. For greater realism, variability of strata properties is taken into account as are the effects of joints and cleats on elastic moduli and strengths. Evolution of pillar stress and entry closure remote from the face is readily quantified in a series of analyses that simulate face advance. Computed results compare favorably with the evolution of closure measurements about an instrumented pillar in a two-entry headgate. The appropriateness of the finite element method is confirmed. This method is based on first principles that avoid empirical schemes of uncertain applicability and numerical models ‘‘calibrated" by fitting computer output to mine measurements.
文摘The microstructures of fault rocks from the Wasatch fault zone in Utah (USA) have been studied using a polarizing microscope,a scanning electron microscope (SEM) and an ultrahigh-voltage electron microscope (HVHM).This fault zone may be recognized as one a with long history of seismic activity according to the microstructural characteristics such as type, deformation characteristics,melting structure and surface textures of the fault rocks.However,the main fault now present seems not to have been noticeably active since the late Pleistocene (Q<sub>3</sub>),as shown by the eroded-surface texture on the quartz fragments in the fault gouge.Meanwhile,those faults supposed to be strongly active in modern times are branching faults much closer to the basin side and are covered by the Holocene sediments in the basin.
基金Supported by the NASA Utah Space Grant Consortium and Preston Chiaro。
文摘Sergei Winogradsky illuminated revolutionary concepts and produced a tool to visualize complex microbial communities and their metabolisms over time:columns displaying aquatic consortia with variety of niches.We worked with museums in Utah to create Winogradsky columns that would highlight aesthetic properties of the Great Salt Lake(GSL)ecosystem,which has a salinity gradient from the freshwater wetlands to salt saturation.One column,constructed using haloarchaea-rich hypersaline brine and oolitic sand of the lake’s north arm,was enriched with nutrients,and resulted in the desired pink hue over time.After a seven-year maturation period,we examined the microbial taxa present in the water through 16 S/18 S rRNA and Internal Transcribed Spacer(ITS)gene sequencing.A pigment analysis revealed an abundance of bacteriochlorophyll a.The presence of this pigment coupled with the DNA sequencing results,suggest that the haloarchaea that dominate the GSL brine,were not responsible for the pink coloration,but instead Gammaproteobacteria,especially Halorhodospira species.Among the eukaryotes,the lack of phytoplankton and the abundance of fungi were noteworthy observations.These data likely relate to the reduction of oxygen in a non-aerated sealed system over time.Our second exhibit had the goal of educating museum goers about the varying salinities of Great Salt Lake.Here we employed three distinct columns of water and sediment from this salinity gradient.Observations of these columns overtime gave us information about invertebrate communities in addition to the microbial consortia.Both installations taught us about comparing an artificial environment in a museum setting to the natural ecosystem.Taken together,we present the data collected and lessons learned from using Winogradsky columns in public spaces for teaching about an important saline lake.
文摘Recent studies have revealed concerning declines in bird populations in Europe and other parts of the world.In understudied but biodiverse regions,especially those that are located along key migratory flyways,there is an unmet need to evaluate the status of resident and migratory birdlife for avian conservation ecology.This is especially urgent at a time when recent regional studies have highlighted the scale of the decline of the European and Palearctic avifauna.Rapidly growing community science datasets may help bridge the gaps in our understanding of long-term regional avifaunal trends.In this study,we used eBird data submitted by observers in Türkiye to undertake the first long-term assessment of the state of the country’s birds from 2001 to 2022.We evaluated population trends based on presence-absence data of species to determine if any birds have significantly increased or decreased in the country so far this century.We provide a list of trends for 418 bird species that had large enough sample sizes of eBird observations from Türkiye,and highlight which species have significantly declined or increased.We found that 63 species have significantly declined in detection while 120 have significantly increased during the study period.Our findings provide a baseline for the future monitoring of Türkiye’s birds and help contextualize population changes of birds in Türkiye against those occurring at the continental(Palearctic)scale.Additionally,we include movement classifications for all of the bird species in this study.We also provide a framework to effectively use eBird data to assess long-term avifaunal changes at the country-level in other understudied regions.Finally,we highlight ways in which eBirders in Türkiye and elsewhere can strengthen the quality and value of community ornithology data for population assessments and avian conservation ecology.
基金supported by the National Key R&D Program of China (Grant No.2018YFA0404503)the support of China Scholarship Council (No.201804910563)+2 种基金the hospitality of the Department of Physics and Astronomy at the University of Utah during her visitsupported by NSF grant AST-2007499The support and resources from the Center for High Performance Computing at the University of Utah。
文摘The absorption by neutral hydrogen in the intergalactic medium(IGM)produces the Lya forest in the spectra of quasars.The Lya forest absorbers have a broad distribution of neutral hydrogen column density N_(HⅠ) and Doppler b parameter.The narrowest Lya absorption lines(of lowest b)with neutral hydrogen column density above~10^(13)cm^(-2) are dominated by thermal broadening,which can be used to constrain the thermal state of the IGM.Here we constrain the temperature-density relation T=T0(ρ/■)γ^(-1) of the IGM at 1.6<z<3.6 by using N_(HⅠ) and b parameters measured from 24 high-resolution and high-signal-to-noise quasar spectra and by employing an analytic model to model the N_(HⅠ) -dependent low-b cutoff in the b distribution.In each N_(HⅠ) bin,the b cutoff is estimated using two methods,one non-parametric method from computing the cumulative b distribution and a parametric method from fitting the full b distribution.We find that the IGM temperature T0 at the mean gas densityρshows a peak of~1.5×10^(4) K at z~2.7-2.9.At redshift higher than this,the indexγapproximately remains constant,and it starts to increase toward lower redshifts.The evolution in both parameters is in good agreement with constraints from completely different approaches,which signals that HeⅡreionization completes around z~3.
基金Michael C Schubert was funded by the Department of Defense under the Neurosensory and Rehabilitation Research Award Program (Grant award#W81XWH-15-1-0442)Lee Dibble was funded by the Telemedicine and Advanced Technology Research Center(TATRC) through the Army Medical Department Advanced Medical Technology Initiative (AAMTI)Brian J.Loyd was supported in part by the Foundation for Physical Therapy Research New Investigator Fellowship Training Initiative (NIFTI).
文摘Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.
文摘In this paper we study the function , for z∈C. We derive a functional equation that relates G(z) and G(1−z) for all z∈C, and we prove: 1) that G and the Riemann zeta function ζ have exactly the same zeros in the critical region D:= {z∈C:ℜz∈(0,1)};2) the Riemann hypothesis, i.e., that all of the zeros of G in D are located on the critical line := {z∈D:ℜz =1/2};and that 3) all the zeros of the Riemann zeta function located on the critical line are simple.
文摘In the research article“Optical Detection of Distal Lung Enzyme Activity in Human Inflammatory Lung Disease”[1],the data availability statement was inadvertently omitted by the publisher.This has now been corrected in the PDF and HTML(full text).
文摘Background: Abdominoplasty has consistently been one of the top cosmetic procedures performed each year with a high patient satisfaction rate. Excision of the excess abdominal skin has been shown to reduce low back pain and improve posture. The effects of the excess skin removal would, theoretically, be demonstrated through changes in gait. This study aimed to measure kinematic differences during gait to obtain objective measures for abdominoplasty. Methods: Subjects were recruited from a large, academic plastic surgery clinic. Patients were included if they were 18 years of age, able to walk without an assistive device or any hindrance by any existing medical condition, and were scheduled for abdominoplasty. Kinematic measurements were taken before and after surgery using a plug-in-gait marker set, cameras, and a treadmill. Pre- and postoperative measurements were compared and a post-hoc power analysis was created. Results: Nine total patients were included in the study. Joint angles before and after surgery demonstrated moderate differences. However, analysis revealed few significant differences for spatiotemporal or kinematic variables. The power analysis demonstrated an inadequate number of patients to detect significance. Conclusions: Despite the literature describing subjective and objective improvements following abdominoplasty, we were unable to validate this. Overall, there were noticeable differences in joint angles pre- and postoperatively, though the study is too underpowered to reach statistical significance. This preliminary data shows that if the study was powered through a larger cohort, then more generalizable conclusions could be drawn.
基金supported by the Science and Technology Special Plan Project from China Minmetals Group (No.2020ZXA01)the International Exchange and Growth Program for Young Teachers (No.QNXM20220061)the National Key Research and Development Program of China (No.2022YFC2906100).
文摘Boron is an important industrial raw material often sourced from minerals containing different compounds that cocrystallize,which makes it difficult to separate the mineral phases through conventional beneficiation.This study proposed a new treatment called flash reduction-melting separation(FRMS)for boron-bearing iron concentrates.In this method,the concentrates were first flash-reduced at the temperature under which the particles melt,and the slag and the reduced iron phases disengaged at the particle scale.Good reduc-tion and melting effects were achieved above 1550℃.The B_(2)O_(3) content in the separated slag was over 18wt%,and the B content in the iron was less than 0.03wt%.The proposed FRMS method was tested to investigate the effects of factors such as ore particle size and tem-perature on the reduction and melting steps with and without pre-reducing the raw concentrate.The mineral phase transformation and morphology evolution in the ore particles during FRMS were also comprehensively analyzed.
基金This work was supported by Institute of Information&Communications Technology Planning&Evaluation(IITP)under the Artificial Intelligence Convergence Innovation Human Resources Development(IITP-2023-RS-2023-00255968)Grantthe ITRC(Information Technology Research Center)Support Program(IITP-2021-0-02051)funded by theKorea government(MSIT).
文摘With the increase in IoT(Internet of Things)devices comes an inherent challenge of security.In the world today,privacy is the prime concern of every individual.Preserving one’s privacy and keeping anonymity throughout the system is a desired functionality that does not come without inevitable trade-offs like scalability and increased complexity and is always exceedingly difficult to manage.The challenge is keeping confidentiality and continuing to make the person innominate throughout the system.To address this,we present our proposed architecture where we manage IoT devices using blockchain technology.Our proposed architecture works on and off blockchain integrated with the closed-circuit television(CCTV)security camera fixed at the rental property.In this framework,the CCTV security camera feed is redirected towards the owner and renter based on the smart contract conditions.One entity(owner or renter)can see the CCTV security camera feed at one time.There is no third-party dependence except for the CCTV security camera deployment phase.Our contributions include the proposition of framework architecture,a novel smart contract algorithm,and the modification to the ring signatures leveraging an existing cryptographic technique.Analyses are made based on different systems’security and key management areas.In an empirical study,our proposed algorithm performed better in key generation,proof generation,and verification times.By comparing similar existing schemes,we have shown the proposed architectures’advantages.Until now,we have developed this system for a specific area in the real world.However,this system is scalable and applicable to other areas like healthcare monitoring systems,which is part of our future work.
文摘BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinical course of AP.It could worsen symptoms and potentially lead to additional complications.However,clinical evidence regarding the specific association between APFC and early readmission in AP remains scarce.Understanding the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare costs.AIM To evaluate the association between APFC and 30-day readmission in patients with AP.METHODS This retrospective cohort study is based on the Nationwide Readmission Database for 2016-2019.Patients with a primary diagnosis of AP were identified.Participants were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was performed.The primary outcome was early readmission rates.Secondary outcomes included the incidence of inpatient complications and healthcare utilization.Unadjusted analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission risks.RESULTS A total of 673059 patients with the principal diagnosis of AP were included.Of these,5.1%had APFC on initial admission.After propensity score matching,each cohort consisted of 33914 patients.Those with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APFC group also had higher readmission charges($28282 vs$22865,P<0.001).The presence of APFC increased the risk of readmission twofold(aHR 2.52,95%confidence interval:2.40-2.65,P<0.001).The independent risk factors for 30-day readmission included female gender,Elixhauser Comorbidity Index≥3,chronic pulmonary diseases,chronic renal disease,protein-calorie malnutrition,substance use disorder,depression,portal and splenic venous thrombosis,and certain endoscopic procedures.CONCLUSION Developing APFC during index hospitalization for AP is linked to higher readmission rates,more inpatient complications,longer LOS,and increased healthcare costs.Knowing predictors of readmission can help target high-risk patients,reducing healthcare burdens.