Introduction: In this paper we examine the relationship between vaccination against COVID-19 and both the death rate from COVID-19 and the rate of COVID-19 spread. Our goal is determine if vaccination is associated with reduced death and/or spread of disease at the local level. Methods: This analysis was conducted at the county level in the state of Pennsylvania, United States of America, with data that were collected during the first half of 2022 from the state of Pennsylvania’s Covid Dashboard ([COVID-19 Data for Pennsylvania (pa.gov)](https://www.health.pa.gov/topics/disease/coronavirus/pages/cases.aspx) . Result s: Given that, during this time period, the vaccines being used were not geared specifically toward the common variants at that time, we found no statistically significant relationship between disease spread and vaccination rate at the county level. That said, we did find a highly statistically significant relationship between death rate and vaccination rate (p-value = 0.006). Specifically, a 1% increase in vaccination rate was found to correspond to a 0.751% decrease in death rate (95% confidence interval (0.236%, 1.266%)). Conclusions: These results support previous findings from across the world that Covid vaccination is highly efficacious in preventing death from the disease. Even during a time when vaccine design was not optimally matched with the prevailing strains, vaccination was found to reduce death rate. Hence, improving global vaccine availability is vitally important, in order to achieve necessary outcomes.

Transfusion-related acute lung injury under general anesthesia successfully treated with extracorporeal membrane oxygenation: A case report

A document by Adam Kisling. Click on the document to view its contents.

Background: The purpose of this article is armed to provide some experience and insight for the clinical treatment of primary mediastinal yolk sac tumor (PMYST) basing on our case report and relevant literature review. Case report and literature review: A 15-year-old boy was diagnosed as PMYST with the volume about 13*12*8cm. The

This paper studies the problem of optimal control with state constraints for mean-field type stochastic systems, which is governed by fully coupled forward-backward stochastic differential equations(FBSDE) with Teugels martingales. In this system, the coefficients contain not only the state processes but also its marginal distribution, and the cost function is of mean-field type as well. We use an equivalent backward formulation to deal with the terminal state constraint, and then we obtain a stochastic maximum principle by Ekeland’s variational principle. In addition, we discuss a stochastic LQ control problem with state constraints.

Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by elevated pulmonary pressure, right ventricular failure (RVF) and ultimately death. Aggressive treatment of RVF is considered the most important therapeutic strategy. In this study, betaine injection was prepared and characterized by various techniques. The therapeutic efficacy of gavage (I.G.), nebulized inhalation (Inh.) and intravenous (I.V.) injections was evaluated comprehensively in terms of pharmacokinetics, tissue distribution and pharmacodynamics using three different methods of administration. The results of pharmacokinetic demonstrated that Inh. betaine injection significantly prolonged the half-life of the drug, increased its internal circulation time and increased Inh. administration significantly improved the pharmacokinetics of betaine compared to I.G. and I.V. administration. Combined with biodistribution experiments verified that betaine formulation could accumulate in lung tissue via Inh. The results of pharmacodynamic further confirmed that right ventricular systolic pressure (RVSP), mean pulmonary artery pressure (mPAP) and right ventricular hypertrophy index (RVHI) were increased in the model group and that betaine prepared by Inh. was able to suppress this increase to levels similar to those observed in the control group. Consequently, Inh. administration would be a promising strategy for the treatment of PAH-induced RVF.

Salt dilution is a well-established streamflow measurement method in creeks, which works particularly well downstream of turbulent flow sections as mixing of the salt tracer is enhanced. Usually salt dilution measurements are performed manually, which considerably limits the observations of rare peak flow events. However, these events are particularly important for constructing robust rating curves and avoiding large uncertainties in the extrapolation of river discharge values. An additional challenge is the variability of the river cross-section, especially after larger discharge events, leading to non-stationary rating curves. Therefore, discharge measurements well distributed over time are needed to both construct a reliable streamflow-water level relationship and to detect changes caused by erosion and deposition processes. To overcome these two issues, we used an automated streamflow measuring systems at three different sites in the Alps for event-based discharge measurements. This system allowed us to measure close to the highest peak flows at all three sites in the observation period (2020-2021) and to detect abrupt changes in the rating curve. Based on a very large data set of almost 300 measurements, we were able to evaluate the reliability of the system and to identify the main sources of uncertainty in the experimental setup. One key aspect was the site selection for the downstream electrical conductivity sensors as measurement location strongly controls the signal-to-noise ratio (SNR) in the recorded breakthrough curves.

The stereoselective preparation of fullerene bis-adducts through nontethered methods remains difficult due to the significant amount of regioisomers produced. The trans-4 aziridino[60]fullerenes, C60(NC6H4R)n (n = 1 or 2, R = OMe, OEt, OBu), were selectively synthesized even without a catalyst by reacting octabromofullerene with the corresponding aniline. Nuclear magnetic resonance spectroscopy, UV-vis spectroscopy, and X-ray structural analysis provided convincing characterization of the compounds. A possible reaction process was proposed to clarify the synthesis of highly regioselective trans-4-bisaziridino[60]fullerenes. The possible use of these aziridino[60]fullerene derivatives as propellant stabilizers was also explored.

Objective: To understand the extent to which adolescent awareness of and attitudes about anaemia and anaemia prevention can be changed by nutrition messages received at school. Design: Mixed-methods pre–post intervention study Setting: Three Government schools in Bagalkot, Belagavi and Raichur districts of Karnataka, India Population or Sample: Students of grade six and seven and teachers involved in implementing the intervention. Methods: An education intervention was co-developed by school teachers and nutrition experts using locally adapted resource materials that consisted of lectures, role play and practical demonstrations. Seven half-hour educational sessions were delivered by school teachers over seven weeks to 455 students. Pre- and post-intervention tests measured changes in adolescents’ knowledge about anaemia. In-depth interviews with teachers and focus groups with students explored reactions to the intervention. Main outcome measures: Knowledge score related to anaemia Results: The percentage of children with correct scores increased by 7.3 - 49.0 percentage points for the tested questions after implementation of the intervention. The mean knowledge score increased by 3.67±0.17(p<0.01). During interviews, teachers and students highlighted high acceptance of the intervention and materials, an increase in awareness, a positive attitude towards changing behaviour around diet, an increase in the demand for iron folic acid supplements and improved sharing of messages learned with peers and families. Challenges expressed included need for further training, time limitations and hesitancy in teaching about menstruation and pregnancy. Conclusions: Educational interventions carried out for adolescents by teachers in schools are effective in improving awareness and attitude related to anaemia.

This investigation proposes a dynamic event-triggered-based anti-disturbance control technique for the uncertain linear parameter varying (LPV) systems subject to multiple disturbances. The disturbances are comprised of two parts including the unavailable modeled disturbances and the available unmodeled disturbances. First, an observer is constructed to capture the unavailable modeled disturbances. Then, a dynamic event-triggered-based feedback controller is proposed. Further, under the developed event-triggered controller, sufficient conditions are presented for the uncertain LPV systems to achieve the multiple disturbances suppression and communication transmission resources saving. In the end, the reasonability of the raised dynamic event-triggered based anti-disturbance control scheme is verified by an example of a turbofan.

Mapping fluvial hydromorphology is an important part of defining river habitat. Mapping via field sampling or hydraulic modelling is however time consuming, and mapping hydromorphology directly from remote sensing data may offer an efficient solution. Here we present a system for automated classification of fluvial hydromorphology based on a deep learning classification scheme applied to aerial orthophotos. Using selected rivers in Norway, we show how surface flow patterns (smooth or rippled surfaces versus standing waves) can be classified in imagery using a trained convolutional neural network. We show how integration of these classified surface flow patterns with information on channel gradient, obtained from airborne topographic LiDAR data, can be used to compartmentalize the rivers into hydromorphological units that represent the dominant flow features. Automated classifications were consistent with those produced manually. They were found to be discharge-dependent, showing the temporally dynamic aspect of hydromorphology. The proposed system is quick, flexible, generalizable, and free from researcher-subjectivity. The deep learning approach used here can be customized to provide more detailed information on flow features, such as delineating between standing waves and advective diffusion of air bubbles/foam, to provide a more refined classification of surface flow patterns, and the classification approach can be further advanced by inclusion of additional remote sensing methods that provide further information on hydromorphological features.

Background Cyclin D has been shown to play an essential role in acute lymphoblastic leukemia (ALL) initiation and progression, providing rationale for targeting the CDK4/6-cyclin D complex that regulates cell cycle progression. Procedure The Children’s Oncology Group AINV18P1 phase 1 trial evaluated the CDK4/6 inhibitor, palbociclib, in combination with standard four-drug reinduction chemotherapy in children and young adults with relapsed/refractory B- and T-cell lymphoblastic leukemia (ALL) and lymphoma. Palbociclib (50 mg/m 2/dose) was administered orally once daily for 21 consecutive days, first as a single agent (days 1-3) and subsequently combined with reinduction chemotherapy. This two-part study was designed to determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) followed by an expansion pharmacokinetic (PK) cohort. Results Twelve heavily pretreated patients enrolled, all of whom were evaluable for toxicity. One dose-limiting hematologic toxicity (DLT) occurred at the starting dose of 50 mg/m 2/dose orally for 21 days. No additional DLTs were observed in the dose determination or PK expansion cohorts and overall rates of grade 3/4 non-hematologic toxicities were comparable to those observed with the chemotherapy platform alone. Five complete responses were observed, two among four patients with T-ALL and three among seven patients with B-ALL. Pharmacokinetic studies showed similar profiles with both liquid and capsule formulations of palbociclib. Conclusions Palbociclib in combination with reinduction chemotherapy was well tolerated with a RP2D of 50 mg/m 2/day for 21 days. Complete responses were observed among heavily pretreated patients.

A coupled inductor based on dual switches buck-boost converter is proposed in the article, which can be used in renewable energy applications. Wide conversion ratio can be realized by regulating turns ratio of the coupled inductor and the duty cycle. The topology has a quadratic- like voltage gain, and the low voltage stress and current stress. Combing the passive clamping circuit to recover leakage energy, the voltage spikes of power switches are suppressed, improving the efficiency. Moreover, it has the merits of continuous input current and common ground. To demonstrate the superior performances of the presented converter, the principle of operation and steady-state analysis are presented in detail. At last, a 100 W experimental prototype was designed to verify the correctness of the theoretical analysis, with a maximum efficiency of 95.7% in step-up mode and 96.8 % in step-down mode.

Objectives In a COVID-19 sero-surveillance cohort study with predominantly healthy and vaccinated individuals, the objectives were (i) to investigate longitudinally the factors associated with the quantitative dynamics of anti-spike IgG antibody levels, (ii) to evaluate whether the antibody levels were associated with protection from SARS-CoV-2 infection and (iii) to assess whether the association was different in the pre-Omicron compared with the Omicron period. Methods The QuantiVac Euroimmun ELISA test was used to quantify anti-S1 IgG levels. The entire study period (16 months), the 11-month pre-Omicron period and the cross-sectional analysis prior to the Omicron surge included 3219, 2310 and 895 reactive serum samples from 949, 919 and 895 study participants, respectively. Mixed-effect linear, mixed-effect time-to-event and logistic regression models were used to achieve the objectives. Results Age and time since infection or vaccination were the only factors associated with a decline of anti-S1 IgG levels. Antibody levels were significantly associated with protection from SARS-CoV-2 infection, and the association was higher for the Omicron than for the Alpha and Delta variants. In a prediction model, it was estimated that >8000 BAU/mL anti-S1 IgG was required to reduce the risk of infection with Omicron variants by 20% to 30% for 90 days. Conclusions Anti-S1 IgG antibody levels are associated with protection from infection. The levels in the pre-Omicron periods were less significant than during the Omicron surge, which in turn required very high levels for protection in a statistical model.

This paper proposes for the first time the preparation of a series of amino acid ionic liquids (AAILs) via one-step hydrolysis of cheap lactams for the capture of CO2. The structures of the prepared AAILs are confirmed using NMR, FTIR, and ESIMS, and their physical properties are also determined. It is found that these AAILs are reversible CO2 absorbents with very high absorption capacities (0.15 to 0.18 g·g1 at 313.2 K and 1.0 bar), better than almost all task-specific ionic liquids reported in literatures. The absorption mechanism is also elucidated to be a combination of 1:1 and 2:1 stoichiometric reaction of AAILs with CO2 from NMR, FTIR, reaction equilibrium thermodynamical modelling (RETM) and quantum calculations. The AAILs have the advantages of simple synthesis, high yield, and using available cheap raw materials. It is believed that this kind of AAILs have great potentials to be used as efficient CO2 absorbents.

The application of heterogeneous catalysts in dimethyl carbonate (DMC) synthesis from methanol is hindered by low activation efficiency of methanol to methoxy intermediates (CH3O*), which is the key intermediate for DMC generation. Herein, a catalyst of alkali metal K anchored on the CuO/ZnO oxide is rationally designed for offering Lewis acid-base pairs as dual active centers to improve the activation efficiency of methanol. Characterizations of CO2-TPD, NH3-TPD, XPS, and DRIFTS revealed that the addition of Lewis base K observably boosted the dissociation of methanol and combined with Lewis acid CuO/ZnO oxide to adsorb the formed CH3O* stably, thus synergistically promoted the transesterification. Finally, the CuO/ZnO-9%K2O catalyst exhibited the optimal catalytic activity, achieving a high yield of 74.4% with an excellent selectivity of 98.9% for DMC at a low temperature of 90 °C. The strategy of constructing Lewis acid-base pairs provides a reference for the design of heterogeneous catalysts.

Bladed mixers are widely used for processing granular materials where significant mechanical energy is required to produce the desired blend. Some mechanical energy is dissipated within the granular medium, generating heat during this process. However, our knowledge of the heat generation mechanisms without external thermal loads is still lacking. This study uses an overhead stirrer to mix granular materials and investigate heat generation by monitoring the temperature changes in the granular bed. Additionally, first-order kinetic equations are used to extrapolate the experimental data to a thermal equilibrium where the heat generation and heat loss rates are equal. Lead, steel, and glass particles are used under various operating conditions. It is observed that metallic particles heat up faster owing to their lower heat capacity. Also, increasing the rotation speed, fill ratio and particle size result in a greater temperature increase. Moreover, flat blades induce more heat generation compared to tilted blades.

Childhood interstitial lung disease (chILD) is a heterogeneous group of diffuse lung diseases (DLD) that can be challenging to diagnose. With relative rarity of individual entities, data are limited on disease prevalence, care patterns, and healthcare utilization. The objective of this study was to evaluate chILD prevalence and review diagnostic and clinical care patterns at our center. A single-center, retrospective cohort study was conducted of patients receiving care at the Children’s Hospital of Philadelphia (CHOP) between January 1, 2019, and December 31, 2021. Through query of selected ICD-10 billing codes relevant for chILD/DLD, a total of 306 patients were identified receiving care during this period. Respiratory symptom onset was documented to have developed before two years of age for 40% of cases. The most common diagnostic categories included those with oncologic disease (21.2%), bronchiolitis obliterans (10.1%), and connective tissue disease (9.5%). Genetic testing was performed in 49% of cases, while 36% underwent lung biopsy. Hospitalization at CHOP had occurred for 80.4% of patients, with 45.1% ever hospitalized in an intensive care unit. One-third of children had required chronic supplemental oxygen. Seven (2.3%) patients died during this three-year period. Collectively, these data demonstrate the scope of chILD and extent of health care utilization at a large volume tertiary care center. This approach to cohort identification and EMR-driven data collection in chILD provides new opportunities for cohort analysis and will inform the feasibility of future studies.