Analysis of harm data in clinical trials needs further attention. A severity classification system and a total harm score can be used to quantify harm after glaucoma surgery. Graphical tools can also help interpret complication data.

Analysis of harm data in clinical trials needs further attention. A severity classification system and a total harm score can be used to quantify harm after glaucoma surgery. Graphical tools can also help interpret complication data.

We report the clinical outcomes of patients who had primary lens implantation in the capsular bag and subsequently a supplementary trifocal lens implanted in the ciliary sulcus (duet procedure) to create reversible trifocality.

Retrospective interventional case series.

This single-center clinical study included 25 patients who had undergone either refractive lens exchange for presbyopia correction or cataract surgery. All had lens removal by phacoemulsification and duet procedure to achieve reversible trifocality. Preoperatively and 3 months postoperatively, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were assessed, as well as uncorrected near visual acuity (UNVA), distance corrected near visual acuity (DCNVA), and corrected near visual acuity (CNVA). At the postoperative examination, uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), and corrected intermediate visual acuity (CIVA), defocus curve testing, and dylar bag fixated trifocal intraocular lenses. The duet procedure offers the advantage of an exit strategy in cases with a future loss of function or side effects associated with the optics.

Low ionized calcium (I

) is prevalent and prognostic in critical care, but poorly detected by either total calcium (T

) or albumin-corrected T

(cT

). We recently derived models of I

(Pred-I

) and low I

(Prob

) in critical care that adjust T

for binding to albumin and small anions-represented by the anion gap’s components. On internal validation, they outperformed cT

in diagnosing low I

. Two other new anion gap-based models of I

, derived in renal patients, have not been validated. This study tested the external validity of these 4 new models in the Medical Information Mart for Intensive Care III (MIMIC-III) database.

We identified 4105 patients in MIMIC-III with I

measured on an arterial blood gas panel within 20min of chemistry panel measurements of T

, albumin, sodium, chloride, and total carbon dioxide. The 4 models and cT

were assessed by their diagnostic discrimination for low I

(<1.10mmol/l) and high I

(>1.32mmol/l), and by the agreement between predicted and observed values.

Pred-I

and Prob

had the best discrimination and agreement.

Pred-I

and Prob

were externally validated in MIMIC-III. They can help clinicians efficiently decide when to order direct I

testing in critical care.

Pred-ICa and ProbHYPO were externally validated in MIMIC-III. They can help clinicians efficiently decide when to order direct ICa testing in critical care.Social contacts play an important role in the development and survival of social animals. Social isolation (SI) at adolescence often induces abnormalities in many kinds of behaviors. This study assessed whether five weeks of continuous SI at adulthood could alter social behaviors and whether dorsal raphe nucleus (DR) to medial prefrontal cortex (mPFC) 5-HT neural projections were involved in this alteration in C57BL/6J adult male mice. The present study found that five weeks chronic social isolation (CSI) at adulthood increased mounting and sniffing behaviors in resident-intruder test, and lengthened duration staying in interaction zone of stranger cage in the three-chamber social preference test. CSI also reduced the release of 5-HT in the mPFC detected by 5-HT 1.0 sensor and measured by in vivo fiber photometry test. Meanwhile, the c-Fos expression indicated that CSI reduced the activity of serotonergic neurons. Chemogenetic activation of DR-mPFC 5-HTergic projection reduced sniffing of CSI mice in the resident-intruder test, but didn’t significantly affect mounting behavior. It also decreased the interaction time during the three-chamber social preference test. Thus, 5-HT neural projections from the DR to the mPFC are involved in changes of social exploration behaviors induced by CSI at adulthood.Denitrifying sulfur conversion-assisted enhanced biological phosphorus removal (DS-EBPR) was recently developed for saline wastewater treatment. However, the main functional bacteria and the interrelationship of functional bacteria of the DS-EBPR have not been defined and identified so far. This study used metagenomics and multivariate statistics to deduce the functional microbial community and distribution of functional genes associated with the critical metabolic pathways of carbon (C), nitrogen (N), phosphorus (P) and sulfur (S), particularly regarding how they would behave under the alternating anaerobic-anoxic conditions inside a long-term DS-EBPR system. An analysis of the metagenomics and metabolic functions identified 11 major microbial species which were classifiable into four groups sulfate reducing bacteria (SRB, 0.8-2.2%), sulfur oxidizing bacteria (SOB, 31.9-37.7%), denitrifying phosphate accumulating organisms (DPAOs, 10.0-15.8%) and glycogen accumulating organisms (GAOs, 3.7-7.7%). The four groups of microorganisms performed their respective metabolisms synergistically. In terms of distribution of functional genes, SRB (Desulfococcus and Desulfobacter) and SOB (Chromatiaceae and Thiobacillus) are not only encoded by the related sulfur conversion genes (sqr, dsrAB, aprAB and sat), but also encoded by the necessary ppx and ppk1 gene for P removal that they can be considered as the potential S-related PAOs. Between the anaerobic and anoxic conditions, the metagenome-based microbial community remained structurally similar, but the functional genes, which encode various key enzymes for the P, N, and S pathways, changed in abundance. This study contributes to our understanding on the interactions and competition between the SRB, SOB, DPAOs, and GAOs in a DS-EBPR system.

Household air pollution (HAP) from cooking with solid fuels has been associated with adverse respiratory effects, but most studies use surveys of fuel use to define HAP exposure, rather than on actual air pollution exposure measurements.

To examine associations between household and personal fine particulate matter (PM

) and black carbon (BC) measures and respiratory symptoms.

As part of the Prospective Urban and Rural Epidemiology Air Pollution study, we analyzed 48-h household and personal PM

and BC measurements for 870 individuals using different cooking fuels from 62 communities in 8 countries (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Self-reported respiratory symptoms were collected after monitoring. Associations between PM

and BC exposures and respiratory symptoms were examined using logistic regression models, controlling for individual, household, and community covariates.

The median (interquartile range) of household and personal PM

was 73.5 (119.1)d documented strong associations with respiratory symptoms.This study analyzed an ozone pollution episode that occurred in the summer of 2020 in Zhengzhou, the provincial capital of Henan, China, and quantified the contribution of local and surrounding area anthropogenic emissions to this episode based on the Weather Research and Forecasting with Chemistry (WRF/Chem) model. Simulation results showed that the WRF/Chem model is well suited to simulate the ozone concentrations in this area. In addition, four simulation scenarios (removing the emissions from the northern Zhengzhou, southwestern Zhengzhou, Zhengzhou local and southeastern Zhengzhou) were conducted to explore the specific contributions of local emissions and emissions from surrounding areas within Henan to this ozone pollution episode. We found that contributions from the northern, local, southwestern, and southeastern regions were 6.1%, 5.9%, 1.7%, and 1.5%, respectively. The northern and local emissions of Zhengzhou (only emissions from Zhengzhou) were prominent contributors within the simulation areas. In other words, during this episode, most of the ozone pollution in Zhengzhou appeared to be transported in from regions outside Henan Province.Solid fuel is the most widely used energy source for cooking and heating in the rural households in developing countries. In this study, emissions from 13 fuel-stove combinations were studied in two typical rural villages in the Fenhe Basin, Shanxi Province, China. This study gathered data on the emission characteristics of particles with an aerodynamic diameter of ≤2.5 μm (PM2.5), organic carbon (OC), elemental carbon (EC), and 21 parent and oxygenated polycyclic aromatic hydrocarbons (pPAHs and oPAHs, respectively); the mechanism of gas formation was also determined. The PM2.5 EFs of biomass burning ranged from 4.11 ± 2.12 to 138 ± 47.2 g/kg, which was higher than that of coal combustion (1.57 ± 0.89 to 4.11 ± 0.63 g/kg). Notably, the average PM2.5 EFs of biomass burning in a traditional stove and elevated kang were 50.9 ± 13.8 and 23.0 ± 3.99 g/kg, respectively, suggesting that the elevated kang had superior emission mitigation. Wood pellet burning in a biomass furnace yielded lower PM2.5 EFs than firewood burning in the biomass furnace, which demonstrated wood pellet combustion’s superior emission reduction effect. The relative contribution of OC4 to OC subfractions may be useable as tools for identifying the sources of coal and biomass burning. Regarding PAHs, biomass with abundant lignin pyrolysis produced numerous hydroxyl radicals that were conducive to the release of greater proportions of oPAHs. By contrast, pPAHs had greater relative contributions in coal combustion. Regarding gaseous pollutants, its formation mechanism varied with combustion phase. Emission differences between the two phases were mainly determined by the relative contributions of volatile C/N and char. Clarifying the pollutant formation mechanism can better guide the implementation of emission control from household solid fuel combustion.The alternation of dry and wet is an important environmental factor affecting the emission of nitrous oxide from soil. However, the consistent or opposite effects on NH3 and N2O emissions caused by adding exogenous urea in this process have not been fully considered. Here, we controlled the initial (slow drying) and final (adding water) water-filled pore space (WFPS) at 70%, 60%, or 50% through microculture experiment to simulate a process of slow drying-fertilization and rapid wetting of the soil from rice harvest to dryland crop fertilization. Through measuring soil chemical properties and the abundance and composition of related microbial communities during drying process, we studied the pathways of influence of drying and rewetting on the emission of N2O and NH3 after urea application. During the progressive drying process (WFPS decreasing from 70% to 60% and 50%), soil N2O and NH3 emissions decreased by 49.77%-72.13% and 17.89%-42.19%, respectively. After rapid rewetting (WFPS increasing from 60% to 70%, 50%-60% and 70%), N2O emissions showed a slight increase, while NH3 volatilization continued to decrease.