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Regional anesthesia is a popular method for surgical anesthesia in clavicular surgery. Selective blocking of the cervical 3, 4, and 5 nerve roots shows promise in clavicle surgery, with its fast onset, good anesthesia and less complications, necessitating evaluation of its impact on diaphragmatic function. The purpose of this study is to examine the safety of C3, 4, and 5 nerve root block for its application in clavicle surgery. We conducted a pragmatic, randomized trial to evaluate the effect of C3, 4, and 5 nerve root block as compared with interscalene with intermediate cervical plexus block in diaphragmatic motion. This study involved forty patients undergoing right clavicle surgery. Patients were assigned in a 1:1 ratio to either a C345 nerve root block (administered with 2, 3, and 5 ml of 0.5% ropivacaine) or an interscalene with intermediate cervical plexus block (ISB + ICPB, each receiving 10 ml of 0.5% ropivacaine). Diaphragmatic kinetics were quantitatively assessed using sonographic techniques. The primary outcome was the incidence of complete hemi-diaphragmatic paralysis, observed at 30 min post-blockade. Secondary outcomes included the rate of complete hemi-diaphragmatic paralysis at 15 min and the degree of diaphragmatic motion restoration at 2, 4, 6, and 8 h post-blockade, onset time of block, motor block score in upper extremity, and adverse events. Results showed that only one patient (5%) in the C345 group vs. fifteen (75%) in the ISB + ICPB group experienced complete hemi-diaphragmatic paralysis at 30 min during deep breathing (P = 0.001). No patients in the C345 group, compared to five (25%) in the ISB + ICPB group exhibited paradoxical movement at 30 min during voluntary sniffing (P = 0.0471). Additionally, the C345 group demonstrated significantly greater diaphragmatic motion and upper limb strength restoration at all measured intervals post-blockade. Moreover, faster onset time and less adverse events were observed in the C345 group vs. in the ISB + ICPB group. Benefit from low volume of local anesthetics, the C345 nerve root block not only significantly reduces the incidence of complete hemi-diaphragmatic paralysis but also facilitates better recovery from diaphragmatic paralysis compared to the ISB + ICPB. It can be inferred that C345 is a more beneficial anesthesia method for early recovery of clavicular patients. Trial registration number : ChiCTR2300078283 04/12/2023.

Although lipophilic shellfish toxins (LSTs) pose a significant threat to the health of seafood consumers, their systematic investigation and risk assessment remain scarce. The goals of this study were as follows: (1) analyze LST levels in commercially available shellfish in Zhejiang province, China, and determine factors influencing LST distribution; (2) assess the acute dietary risk of exposure to LSTs for local consumers during the red tide period; (3) explore potential health risks of LSTs in humans; and (4) study the acute risks of simultaneous dietary exposure to LSTs and paralytic shellfish toxins (PSTs). A total of 546 shellfish samples were collected. LSTs were detected in 89 samples (16.3%) at concentrations below the regulatory limits. Mussels were the main shellfish species contaminated with LSTs. Spatial variations were observed in the yessotoxin group. Acute exposure to LSTs based on multiple scenarios was low. The minimum tolerable exposure durations for LSTs calculated using the mean and the 95th percentile of consumption data were 19.7 and 4.9 years, respectively. Our findings showed that Zhejiang province residents are at a low risk of combined exposure to LSTs and PSTs; however, the risk may be higher for children under 6 years of age in the extreme scenario.

Background: Patients with acute tubular necrosis (ATN) not only have severe renal failure, but also have many comorbidities, which can be life-threatening and require timely treatment. Identifying the influencing factors of ATN and taking appropriate interventions can effectively shorten the duration of the disease to reduce mortality and improve patient prognosis. Methods: Mortality prediction models were constructed by using the random survival forest (RSF) algorithm and the Cox regression. Next, the performance of both models was assessed by the out-of-bag (OOB) error rate, the integrated brier score, the prediction error curve, and area under the curve (AUC) at 30, 60 and 90 days. Finally, the optimal prediction model was selected and the decision curve analysis and nomogram were established. Results : RSF model was constructed under the optimal combination of parameters (mtry = 10, nodesize = 88). Vasopressors, international normalized ratio (INR)_min, chloride_max, base excess_min, bicarbonate_max, anion gap_min, and metastatic solid tumor were identified as risk factors that had strong influence on mortality in ATN patients. Uni-variate and multivariate regression analyses were used to establish the Cox regression model. Nor-epinephrine, vasopressors, INR_min, severe liver disease, and metastatic solid tumor were identified as important risk factors. The discrimination and calibration ability of both predictive models were demonstrated by the OOB error rate and the integrated brier score. However, the prediction error curve of Cox regression model was consistently lower than that of RSF model, indicating that Cox regression model was more stable and reliable. Then, Cox regression model was also more accurate in predicting mortality of ATN patients based on the AUC at different time points (30, 60 and 90 days). The analysis of decision curve analysis shows that the net benefit range of Cox regression model at different time points is large, indicating that the model has good clinical effectiveness. Finally, a nomogram predicting the risk of death was created based on Cox model. Conclusion: The Cox regression model is superior to the RSF algorithm model in predicting mortality of patients with ATN. Moreover, the model has certain clinical utility, which can provide clinicians with some reference basis in the treatment of ATN and contribute to improve patient prognosis.

Prenatal alcohol exposure causes fetal alcohol spectrum disorders (FASD), primarily through alcohol-induced apoptosis. This study explores the link between ethanol-induced neuronal apoptosis and neural network electrical activity in developing rat retinal ganglion cells, and examines dopamine's protective effects and influence on this activity. The study employed a combination of immunohistochemical techniques, terminal deoxynucleotidyl transferase dUTP nick-end labeling assay, and electrophysiological recordings to assess neuronal apoptosis and neural network activity in the developing rat retinal ganglion cell layer. Ethanol exposure was administered to model prenatal alcohol exposure, and dopamine was applied to evaluate its protective effects. Ethanol exposure was found to disrupt the spatiotemporal properties of synchronized spontaneous neural network electrical activity and partially induce neuronal apoptosis. Conversely, dopamine treatment increased the frequency of neural network electrical activity and attenuated ethanol-induced apoptosis. The findings suggest that ethanol disrupts neural network activity and induces apoptosis in the developing nervous system, while dopamine exerts a protective effect by modulating neural network activity and reducing apoptosis. These results contribute to understanding the mechanisms underlying FASD and offer potential therapeutic avenues for prevention and treatment.

The intake of paralytic shellfish toxins (PSTs) may adversely affect human health. Therefore, this study aimed to show the prevalence of PSTs from commercially available shellfish in Zhejiang Province, China, during the period of frequent red tides, investigate the factors affecting the distribution of PSTs, and assess the risk of PST intake following the consumption of bivalve shellfish among the Zhejiang population. A total of 546 shellfish samples were collected, 7.0% of which had detectable PSTs at concentrations below the regulatory limit. Temporal, spatial, and interspecific variations in the occurrence of PSTs were observed in some cases. The dietary exposure to PSTs among the general population of consumers only was low. However, young children in the extreme scenario (the 95th percentile of daily shellfish consumption combined with the maximum PST concentration), defined as 89–194% of the recommended acute reference doses, were possibly at risk of exposure. Notably, Arcidae and mussels were the major sources of exposure to toxins. From the public health perspective, PSTs from commercially available shellfish do not pose a serious health risk; however, more attention should be paid to acute health risks, especially for young children, during periods of frequent red tides.

With the IoT technology as the entry point, this paper designs the general plan for the IoT-based forest fire warning & monitoring system of Jizhou District, through the analysis of the application of IoT technology in the forest fire prevention of Tianjin; builds the workflow of the IoT-based forest fire warning system; and put forward the suggestions and countermeasures for the development of forest fire warning system in Jizhou District, thus providing theoretical basis and realistic foundation for improving the efficiency of Tianjin forest disaster prevention and mitigation.

The backflow and back-pressure propagation induced in a pulse detonation combustor (PDC) are the main factor in causing the thrust losses of a pulse detonation engine. In order to suppression the backflow propagation of a PDC, the aero-dynamic suppression strategy was implemented in this work. A total of ten isolators composed of different geometries were designed. A single-pulse detonation experiment was conducted by using the stoichiometric ethylene/enriched-oxygen mixture. It is shown that when the back-pressure has propagated about 0.86 the length of PDC, the propagation speeds and the pecks of the back-pressure in the isolator, which composed of the Venturi tube (V) and a long tube with 1.5 times diameter of the PDC, can be reduced by 10% and 20%, respectively, comparing with the base isolator. Comparing with the isolators that without the Tesla valve (T), the propagation speed of the back-pressure in the cases with the Tesla valve can be additionally reduced above 27.3%. Comparing with the isolators that without the slit (S), the peaks of the back-pressure in the cases with the slit can be decreased about 25%. The average decay rate of the back-pressure peaks can be highly increased if the cone (C) is introduced. It is found that the CVST-type isolator is the optimal. Comparing with the base isolator, the backpressure propagated in the CVST-type isolator can decrease about 50% and 40.5% of propagation speed and pressure peaks, respectively, and can increase the average decay rate of the back-pressure peaks by a factor of two. 脉冲爆震燃烧室(pulse detonation combustor, PDC)反压反流的前传是导致脉冲爆震发动机推力损失的主要因素。为抑制PDC反流的传播, 采用气动抑制策略, 设计出不同结构组合而成的10种隔离段, 使用恰当比的乙烯/富氧空气混合物开展了单次脉冲爆震的实验研究。结果表明: 当反压传播距离约为0.86倍PDC长度时, 相比于基准隔离段, Venturi管(V)与1.5倍PDC直径的直管组合的隔离段由于能够提供更大的膨胀空间, 其反压的传播速度与峰值可分别降低约10%与20%;相对于无Tesla阀(T)的隔离段, 在安装了Tesla阀的隔离段中, 反压传播速度可再降低27.3%以上; 相对于无泄压小孔(S)的隔离段, 安装了泄压小孔的隔离段可降低25%的反压峰值; 中心锥(C)的引入可大幅提高反压传播过程中的平均衰减率。在10种隔离段中, CVST型组合隔离段结构具有最佳的反压抑制能力。相比于基准隔离段, 反压在CVST隔离段中的传播速度降低了约50%, 峰值降低了约40.5%, 平均峰值衰减率提升了1倍左右。

Nickel (Ni) is a silver-white metal with high antioxidative properties, often existing in a bivalent form in the environment. Despite being the fifth most abundant metal on Earth, anthropogenic activities, including industrial processes, have elevated Ni levels in environmental media. This study investigated Ni contamination in various food groups in Zhejiang Province, China, mainly focusing on Ni levels in beans, vegetables, aquatic foods, meat products, cereal products, and fruits. A total of 2628 samples were collected and analyzed. Beans exhibited the highest Ni content in all samples. The overall detection rate of Ni was 86.5%, with variation among food categories. For plant-origin foods, legumes had the highest Ni concentration while for animal-origin foods, shellfish showed the highest median Ni concentration. The results indicate generally acceptable Ni exposure levels among Zhejiang residents, except for children aged 0–6. Beans were identified as the primary contributor to high Ni exposure risk. The paper suggests monitoring Ni contamination in food, especially for vulnerable populations, and provides insights into exposure risks in different age groups.

The backflow and back-pressure propagation induced in a pulse detonation combustor (PDC) are the main factor in causing the thrust losses of a pulse detonation engine. In order to suppression the backflow propagation of a PDC, the aero-dynamic suppression strategy was implemented in this work. A total of ten isolators composed of different geometries were designed. A single-pulse detonation experiment was conducted by using the stoichiometric ethylene/enriched-oxygen mixture. It is shown that when the back-pressure has propagated about 0.86 the length of PDC, the propagation speeds and the pecks of the back-pressure in the isolator, which composed of the Venturi tube (V) and a long tube with 1.5 times diameter of the PDC, can be reduced by 10% and 20%, respectively, comparing with the base isolator. Comparing with the isolators that without the Tesla valve (T), the propagation speed of the back-pressure in the cases with the Tesla valve can be additionally reduced above 27.3%. Comparing with the isolators tha

V231.2; 脉冲爆震燃烧室(pulse detonation combustor,PDC)反压反流的前传是导致脉冲爆震发动机推力损失的主要因素.为抑制PDC反流的传播,采用气动抑制策略,设计出不同结构组合而成的10 种隔离段,使用恰当比的乙烯/富氧空气混合物开展了单次脉冲爆震的实验研究.结果表明:当反压传播距离约为0.86 倍PDC长度时,相比于基准隔离段,Venturi管(V)与1.5 倍PDC直径的直管组合的隔离段由于能够提供更大的膨胀空间,其反压的传播速度与峰值可分别降低约10%与20%;相对于无Tesla阀(T)的隔离段,在安装了Tesla阀的隔离段中,反压传播速度可再降低27.3%以上;相对于无泄压小孔(S)的隔离段,安装了泄压小孔的隔离段可降低25%的反压峰值;中心锥(C)的引入可大幅提高反压传播过程中的平均衰减率.在10 种隔离段中,CVST型组合隔离段结构具有最佳的反压抑制能力.相比于基准隔离段,反压在CVST隔离段中的传播速度降低了约50%,峰值降低了约40.5%,平均峰值衰减率提升了1 倍左右.