High Utilization Rate Research Articles

Construction of AgBr/BiOBr S-scheme heterojunction using ion exchange strategy for high-efficiency reduction of CO2 to CO under visible light

CO2 reduction via photocatalytic is regarded as the excellent strategy to resolve the severe environmental crisis and energy crisis caused by the accelerated utilization of fossil energy like natural gas, oil, and coal. The Ag ion and the Br ion in BiOBr are creatively used in the ion exchange strategy to form AgBr on the surface of BiOBr, and an S-scheme BiOBr/AgBr heterojunction with close interface contact is constructed. The visible light utilization rate and CO2 conversion rate of the obtained heterojunction are both remarkably improved. The reduction rate of CO2 over the catalyst was tested under visible light using pure water as the liquid environment. As obtained results displayed that the transformation efficiency of BA-1 to CO from CO2 in the visible light was 12.43 μ mol g-1h−1, which is about 3 times that the pristine BiOBr. The intermediates during the reaction were studied using in situ DRIFTS. The process by which CO2 was degraded was speculated based on in situ DRIFTS spectra. In addition, TPR, EIS, and PL measurements indicate that BA-1 has a high solar utilization rate and strong photo-generated carrier transfer and separation capability. This work showed a novel direction for preparation of efficient photocatalyst for CO2 reduction.

Investigating the use of playgrounds by tweens: a systematic observation study

ABSTRACT Playgrounds provide a developmental framework for social and physical interactions of children. School playgrounds have been extensively investigated but little research has focused specifically on tweens’ (9–12-year-olds) use of school playground equipment. In this study, we investigated play categories, play equipment use, and play activities of tweens. On four Danish school playgrounds, 991 children were observed by trained observers using The System for Observing Play and Leisure Activity in Youth (SOPLAY). Prevalence of play categories and utilization of play equipment were calculated using SPSS, and activity descriptions were analyzed using thematic analysis. Results showed that physical play and talkative play accounted for 80% of tweens’ play on play equipment and that swings had the highest utilization rate while ball game play equipment had the highest average of users. The highest utilization rate was found on swings and ball game equipment for boys and climbing equipment for girls. Activities were described as hanging out, games with rules, challenging play, and innovative play. Incorporating play equipment that meets the needs of tweens is important to retain their interest in social and physical play. If we want to enhance school playground use by tweens, we must consider physical and talkative play options.

S1397 Hospital Utilization and Survival Analysis in a Model of Outpatient Paracentesis by Interventional Radiology

Introduction: There has been a significant change in outpatient cirrhosis care, as paracentesis is currently performed by interventional radiologists (IR) rather than gastroenterologists/hepatologists or internists. In this model of care, patients’ access could be limited by scheduling availability, and there is no evaluation of their renal function or adjustment of their medications at the time of paracentesis. This study was aimed to analyze hospital utilization and cirrhosis complications within six months of index outpatient paracentesis by IR and to identify potential areas of improvement in care. Methods: This is a retrospective study of patients with cirrhosis and ascites who underwent outpatient paracentesis by IR from October 2015 to October 2018 at a tertiary academic medical center. We collected demographics, data on cirrhosis etiology/complications, laboratory tests, provider notes, outpatient paracenteses dates, emergency department (ED) visits, hospitalizations, and ICU admissions within the following six months post-index paracentesis. Overall survival was analyzed using product-limited survival estimates (Kaplan-Meier). The log-rank test was used to test for differences by cause. Kaplan-Meier survival curves were plotted for overall and stratified survival. Cox regression analyses examined survival by cause while controlling for age and MELD score. Hazard ratios are reported. (Figure) Results: Within 6 months from index paracentesis, 44 patients (64.7%) underwent repeat IR outpatient paracentesis (total 187 paracenteses, 4.25 paracenteses/patient); 42 (61.7%) had ER visits (total 118 ER visits, 2.8/patient), 40 (58.5%) had hospital admissions (total 88 admissions, 2.2/patient) and 11 had ICU admission. On multivariate analysis, the predictive factors for mortality were older age (p=0.04) and MELD score (p=0.082). Baseline MELD was predictive of acute kidney injury (p=0.0184), UGI bleed (p=0.0096), and ICU admission (p=0.0064). The mean overall survival was 35.6 (SD +/- 2.68) months. Mean survival stratified by cause was 36.2 (SD +/- 3.78) months for patients with cirrhosis due to alcohol use, and 41.7 (SD +/- 4.1) months for cirrhosis due to hepatitis B or C. (Table) Conclusion: In this contemporary cohort of patients with cirrhosis undergoing IR outpatient paracentesis, we found a high rate of short-term cirrhosis complications and hospital utilization, while TIPS consideration was very low. Further data is needed to identify specific gaps in care and to analyze long-term survival.Figure 1.: (a) Survival curve using Kaplan-Meier estimator with the cause of cirrhosis as strata. (b) Survival curve for each cause at the average age (60.5) and average MELD score (17.7) Table 1. - demonstrates baseline demographics such as age, gender, and cause of cirrhosis, the most common reasons for readmissions with a 6-month mortality rate, and TIPS status Age n (%) Less than 60 32 (46.37) 60 or more 37 (53.62) Average 60.47 Gender n (%) Male 49 (71.01) Female 20 (28.98) Cause of Cirrhosis n (%) Alcohol 37 (53.62) Hepatitis B and/or C 15 (21.74) Other 17 (24.64) Most common reasons for admissions % Hepatic encephalopathy 39.7% Acute Kidney Injury 38.2% Upper gastrointestinal (UGI) bleed 14.7% Spontaneous bacterial peritonitis (SBP) 14.7% 6-month mortality rate 6.9% TIPS n (%) TIPS performed 4 (0.09) No documentation of TIPS consideration 31 (70.4)

S57 Opioid Use Patterns in Patients With Chronic Pancreatitis and Concomitant Mental Illness: A Propensity-Matched Cohort Analysis

Introduction: Chronic pancreatitis (CP) is commonly associated with pain that can be difficult to manage. This can result in high rates of healthcare utilization and chronic opioid use. Many patients with CP have concomitant mental health disorders (MHDs) which may be associated with greater disease burden. Genetic links between CP-associated pain and MHDs have been described. Given the current opioid epidemic trend, it is critical to assess whether concomitant MHDs affect opioid usage patterns in patients with CP. The aim of this study was to identify whether patients with coexisting CP and mental illness have higher opioid usage compared to their counterparts without any diagnosed mental illness. Methods: This was a large cohort study using TriNetX, which links anonymized inpatient and outpatient electronic health record data from more than 80,000,000 patients. We created two cohorts: patients with chronic pancreatitis from 2010-2020 with and without co-existing mental health disorders. The cohorts underwent 1:1 propensity matching based on age, sex, race, ethnicity, and alcohol and nicotine dependence. The primary outcome was a new diagnosis of opioid use disorder at 3 years after the first diagnosis of CP. Secondary outcomes at 3 years included any opioid use, long-term opioid use, opioid overdose, and all-cause mortality. Results: After matching, two cohorts of 48,960 patients remained for analysis. All covariates were well-matched. In the MHD cohort, 51.6% had mood /affective disorders (F30-39), 49.5% had anxiety (F40-48), and 5.9% had non-mood psychotic (F20-29). At 3 years, the MHD cohort had a near 5-fold increase in the rate of opioid use disorder (7.1% vs 1.6%, OR =4.8, 95% CI 4.4-5.2). The MHD cohort also had significantly higher rates of any opiate use,(OR 1.5, 95% CI 1.4-1.5), long-term opioid use (OR 2.2, 95% CI 2.1-2.3), opioid overdose (OR 4.2, 95% CI 3.7-4.6), and all-cause mortality (OR 1.3, 95% CI 1.2-1.3) (Table). Conclusion: In propensity-matched cohorts, patients with CP and concomitant MHDs had higher rates of opioid use disorder, long-term use, overdose, and all-cause mortality compared with those without MHDs. As CP-related pain has been shown to be augmented in patients with MHDs – specifically depression – identifying this opioid risk is critical in the management of these patients. Table 1. - Measures of Association. CP w/ MHD: chronic pancreatitis with mental health disorder cohort, CP w/o MHD: chronic pancreatitis without mental health disorder cohort Outcome Patients with outcome (% risk), CP w/ MHD Patients with outcome (% risk), CP w/o MHD Odds Ratio (OR) 95% Confidence Interval (CI) p-value Opioid use disorder (dependence or abuse) 3,467 (7.1%) 767 (1.6%) 4.8 4.4-5.2 < 0.0001 Opiate use (ever) 13,846 (28.3%) 10,310 (21.1%) 1.5 1.4-1.5 < 0.0001 Adverse opiate event 592 (1.2%) 158 (0.3%) 3.8 1.4-1.5 < 0.0001 Opiate overdose 1,809 (3.7%) 448 (0.9%) 4.2 3.7-4.6 < 0.0001 Long-term opiate analgesic use 9,896 (20.2%) 5,046 (10.3%) 2.2 2.1-2.3 < 0.0001 All-cause mortality 6,958 (14.4%) 5,702 (11.8%) 1.3 1.2-1.3 < 0.0001

Research progress of FRP in steel and masonry bridge structures reinforcement

Fiber reinforced polymer (FRP) has been widely used in the reinforcement of concrete bridge structures, and it still has a good application prospect in the reinforcement of steel and masonry bridge structures. In order to summarize the research results of FRP in the reinforcement of steel and masonry structures, broaden the ideas of FRP strengthening bridges in China and promote its wide application in the field of bridge structure reinforcement, it is summarized from the aspects of anti-fatigue reinforcement, anti-buckling reinforcement, bearing capacity reinforcement and seismic reinforcement according to the different reinforcement mechanisms. The shortcomings of the existing studies were analyzed, some problems and ideas that can be further studied were put forward. Analysis result shows that the prestressed FRP reinforcement technology has a good application prospect because of its high material strength utilization rate. Generally, the method of prestressing FRP is used to strengthen the bridge steel members with fatigue cracks, and FRP and filler materials are used to form an external reinforcement system to improve the buckling resistance of steel members. FRP reinforcement can improve the bearing capacity and seismic performance of masonry structures. Follow-up studies should be continued to develop standardized prestressed FRP reinforcement and anchorage system with long-term reliable performance, further promote the engineering application of prestressed FRP reinforced steel structures and establish the specification system of FRP reinforced masonry bridges. The durability of FRP reinforced bridges under complex environment and coupling of various factors should be deeply studied.

Low-temperature vacuum deposition of green phosphorescent OLED devices using close-space sublimation of spirobifluorene hosts

Commercial organic light-emitting diode (OLED) displays are mainly produced by line-of-sight vacuum thermal evaporation (VTE) methods that operate at high temperatures with low material utilization, exerting thermal stress on shadow masks and driving up costs. Further advancement of OLED displays towards higher resolutions at reduced cost demands more efficient deposition sources and OLED materials that can be reliably evaporated at low temperatures. In this study, we utilized close-space sublimation (CSS), an area deposition technique with a high material utilization rate, to lower the evaporation temperature of materials and deposition time drastically. By employing a spirobifluorene-based host that has a matching CSS profile with common iridium-based dopants, we have successfully reduced the evaporation temperature of the emitting layer (EML) to as low as 120 °C in CSS, less than half of the temperature required in VTE, and shortened the deposition time from minutes to seconds. The CSS-deposited green phosphorescent OLEDs exhibited comparable efficiencies with their VTE-deposited counterparts and demonstrated promising lifetimes.

Research progress of FRP in steel and masonry bridge structures reinforcement

Fiber reinforced polymer (FRP) has been widely used in the reinforcement of concrete bridge structures, and it still has a good application prospect in the reinforcement of steel and masonry bridge structures. In order to summarize the research results of FRP in the reinforcement of steel and masonry structures, broaden the ideas of FRP strengthening bridges in China and promote its wide application in the field of bridge structure reinforcement, it is summarized from the aspects of anti-fatigue reinforcement, anti-buckling reinforcement, bearing capacity reinforcement and seismic reinforcement according to the different reinforcement mechanisms. The shortcomings of the existing studies were analyzed, some problems and ideas that can be further studied were put forward. Analysis result shows that the prestressed FRP reinforcement technology has a good application prospect because of its high material strength utilization rate. Generally, the method of prestressing FRP is used to strengthen the bridge steel members with fatigue cracks, and FRP and filler materials are used to form an external reinforcement system to improve the buckling resistance of steel members. FRP reinforcement can improve the bearing capacity and seismic performance of masonry structures. Follow-up studies should be continued to develop standardized prestressed FRP reinforcement and anchorage system with long-term reliable performance, further promote the engineering application of prestressed FRP reinforced steel structures and establish the specification system of FRP reinforced masonry bridges. The durability of FRP reinforced bridges under complex environment and coupling of various factors should be deeply studied.

Optimization of Load Balancing and Task Scheduling in Cloud Computing Environments Using Artificial Neural Networks-Based Binary Particle Swarm Optimization (BPSO)

As more people utilize the cloud, more employment opportunities become available. With constraints such as a limited make-span, a high utilization rate of available resources, minimal execution costs, and a rapid turnaround time for scheduling, this becomes an NP-hard optimization issue. The number of solutions/combinations increases exponentially with the magnitude of the challenge, such as the number of tasks and the number of computing resources, making the task scheduling problem NP-hard. As a result, achieving the optimum scheduling of user tasks is difficult. An intelligent resource allocation system can significantly cut down the costs and waste of resources. For instance, binary particle swarm optimization (BPSO) was created to combat ineffective heuristic approaches. However, the optimal solution will not be produced if these algorithms are not paired with additional heuristic or meta-heuristic algorithms. Due to the high temporal complexity of these algorithms, they are less useful in real-world settings. For the NP problem, the binary variation of PSO is presented for workload scheduling and balancing in cloud computing. Considering the updating and optimization constraints stated in this research, our objective function determines if heterogeneous virtual machines (VMs) Phave the most significant difference in completion time. In conjunction with load balancing, we developed a method for updating the placements of particles. According to the experiment results, the proposed method surpasses existing metaheuristic and heuristic algorithms regarding work scheduling and load balancing. This level of success has been attainable because of the application of Artificial Neural Networks (ANN). ANN has demonstrated promising outcomes in resource distribution. ANN is more accurate and faster than multilayer perceptron networks at predicting targets.

Power Tracking Control of Marine Boiler-Turbine System Based on Fractional Order Model Predictive Control Algorithm

The marine boiler-turbine system is the core part for the steam-powered ships with complicated dynamics. To improve the power tracking performance and fulfill the requirement of high utilization rate of fossil energy, the control performance of the system should be improved. In this paper, a nonlinear model predictive control method is proposed for the boiler-turbine system with fractional order cost functions. Firstly, a nonlinear model of the boiler-turbine system is introduced. Secondly, a nonlinear extended predictive self adaptive control(EPSAC) method is designed to the system. Then, integer order cost function is replaced with a fractional order cost function to improve the control performance, and also the configuration of the cost function is simplified. Finally, the superiority of the proposed method is proved accordring to the comparison experiments between the fractional order model predictive control and the traditional model predictive control.

Small public space vitality analysis and evaluation based on human trajectory modeling using video data

Small public spaces are important for citizens to live and socialize with a high utilization rate. The vitality of small public space plays an important role in evaluating space quality and attraction and provides reference for urban governance issues such as vitality evaluation of public space, quality optimization, and site micro-renewal. Previous studies of vitality based on low-throughput surveys or big data with low positioning accuracy are not suitable for the high-efficiency study of small public space. In this study, a systematic framework of vitality quantification in small public spaces is built on fine-grained human trajectories extracted from videos for more efficient and refined human-oriented vitality evaluation. A multi-indicator vitality quantification method is first proposed to comprehensively represent human vitality, including number of people, duration of stay, motion speed, trajectory diversity and trajectory complexity. Furthermore, a video dataset of small public space along with our sub-index-assisted expert assessing scheme is proposed to evaluate our vitality quantification framework. Finally, we analyze the correlation between quantitative vitality indicators and the expert-assessing vitality through multiple linear regression and obtain the optimal vitality quantification model. The experimental results indicate that our dataset is reliable and the vitality quantification model constructed with our quantitative indicators can better characterize urban vitality than the previous model based on number of people and staying time.

Co and N co-doped hierarchical porous carbon as peroxymonosulfate activator for phenol degradation via nonradical pathway mechanism

Developing catalysts with high metal utilization rates for activation of peroxymonosulfate (PMS) has attracted extensive attention. Herein, Co and N co-doped hierarchical porous carbon (Co/HOPNC) was synthesized successfully for peroxymonosulfate (PMS) activation to degrade phenol. Transmission Electron Microscope (TEM) confirmed that this hierarchical porous carbon indeed offered a site for the highly dispersed with low doping amount of Co. The 1.5 % Co/HOPNC exhibited the optimal removal efficiency and admirable adaptability to pH, temperature and different co-existing ions, which was credited to the highly dispersing Co atoms. Furthermore, the leaching of Co showed a neglectable impact on catalytic efficiency, revealing metal leaching was indeed inhibited. Remarkably, singlet oxygen (1O2) and high-valence Co-oxo species were verified as major contributors to enhance the catalytic activity. This finding gives a unique insight in PMS activation mechanism triggered nonradical pathways of hierarchical porous carbon materials. Moreover, the 1.5 % Co/HOPNC displayed an outstanding effect on phenol degradation in actual wastewater which expressed great potential in practical applications.

Increasing access to immediate postpartum contraceptive implants: a prospective clinical trial among patients with opioid use disorder

Objective To evaluate the effects of increased access to immediate postpartum contraceptive implants (IPI) on repeat pregnancy and contraceptive use rates among patients with opioid use disorder (OUD). Materials and Methods Between 2016 and 2018, 194 postpartum patients with OUD were offered the option of IPI placement at an institution with limited immediate postpartum long-acting reversible contraception availability and followed for one-year postpartum. Differences in pregnancy rates between participants who did and did not choose IPI were examined using logistic regression with inverse probability of treatment weighting from propensity scores accounting for differences between the two groups. Results Among 194 participants, 96 (49.5%) chose an IPI and 98 (50.5%) chose an alternative method or no contraception (non-IPI). Among IPI participants, 76 (80.9%) continued to use their implant at one-year postpartum. Overall, 19 participants had a repeat pregnancy and 11 (57.9%) were unintended. In multivariable analyses, repeat pregnancy was more likely among those who did not choose IPI (OR 9.90; 95% CI 3.58–27.03) than those who did. Participants with OUD and who used alcohol (11.66; 1.38, 98.20) or cocaine (2.72; 1.23, 5.99) during pregnancy were more likely to choose IPI. Participants who were married (0.28; 0.09, 0.89), engaged in OUD treatment prior to pregnancy (0.48; 0.25, 0.93), and happier when they found out about their pregnancy (0.87; 0.77, 0.98) were less likely to choose IPI. Conclusion Offering patients with OUD the option of IPI is associated with high utilisation and continuation rates, and low rates of repeat pregnancy within one-year postpartum.

Long-term burden of respiratory complications associated with extreme prematurity: An analysis of US Medicaid claims.

Infants born extremely premature (EP) (<28 weeks gestational age) are at high risk of complications, particularly bronchopulmonary dysplasia (BPD), which can develop into chronic lung disease (CLD). The burden of respiratory complications in EP infants up to 2 years corrected age (CA) was evaluated using real-world data from the US Medicaid program. Data recorded between 1997 and 2018 on EP infants without major congenital malformations were collected from Medicaid records of six states. EP infants were divided into three cohorts: BPD, CLD, and without BPD or CLD. The incidence of respiratory conditions, respiratory medication use, and healthcare resource utilization were compared between the BPD cohort and CLD cohort versus the cohort without BPD or CLD, using unadjusted and adjusted generalized linear models. A total of 4462EP infants were identified (17.4% of all premature infants in the database). Of these, BPD and CLD were diagnosed in 61.9% and 72.1%, respectively, and 14.5% were diagnosed with neither BPD nor CLD. Compared with infants without BPD or CLD, infants with BPD or CLD had more complications and a longer length of birth hospitalization stay. Respiratory distress syndrome was the most frequently reported complication (94.6%, 92.5%, and 82.3% of EP infants in the BPD, CLD, and without BPD or CLD cohorts, respectively). After the birth hospitalization, respiratory conditions, respiratory medication use, and incidence rates of rehospitalizations, emergency room visits, and outpatient visits were higher for infants with BPD or CLD. Rehospitalization occurred in 50.5%, 51.6%, and 27.3% of EP infants with BPD, CLD, or without BPD or CLD, respectively; most hospitalizations occurred for respiratory-related reasons. In this analysis of a large population of EP infants up to 2 years CA, respiratory conditions were prevalent after the birth hospitalization and were associated with high rates of medication and healthcare resource utilization.

Symmetry and Its Application in Metal Additive Manufacturing (MAM)

Additive manufacturing (AM) is proving to be a promising new and economical technique for the manufacture of metal parts. This technique basically consists of depositing material in a more or less precise way until a solid is built. This stage of material deposition allows the acquisition of a part with a quasi-final geometry (considered a Near Net Shape process) with a very high raw material utilization rate. There is a wide variety of different manufacturing techniques for the production of components in metallic materials. Although significant research work has been carried out in recent years, resulting in the wide dissemination of results and presentation of reviews on the subject, this paper seeks to cover the applications of symmetry, and its techniques and principles, to the additive manufacturing of metals.

Field application of non-blasting mechanized mining using high-frequency impact hammer in deep hard rock mine

A non-blasting mechanized mining experiment was carried out with a high-frequency impact hammer, and the daily mining performance was recorded to explore the applicability of the high-frequency impact hammer in deep hard rock mines. Before the field application, the scope of the excavation damage zone was monitored, and rock samples were obtained from the ore body to be mined to carry out a series of laboratory experiments. Field application results show that the overall excavation efficiency reaches 50.6 t/h, and the efficiency of pillar excavation after excavating stress relief slot reaches 158.2 t/h. The results indicate that the non-blasting mechanized mining using high-frequency impact hammer has a good application in deep hard rock mines, and the stress relief slot is conducive to mechanical excavation. In addition, the high-frequency impact hammer also exhibits the advantages of high utilization rate of labor hours, small lumpiness of spalling ore, little dust, and little excavation damage. Finally, according to the field application and laboratory experiment results, a non-blasting mechanized mining method for hard rock mines based on high-frequency impact hammer is proposed.

Cobalt dual-atom clusters with strong chemiluminescent response for analyzing pathogenic bacteria by using cell wall bind domain as recognizer

As new type of catalysts, dual or multiple atomic clusters have displayed extremely high atom utilization rate and superior catalytic activity. In the present work, a metal binuclear atom pair with unique cobalt coordination environment of Co2-O8 were prepared on the supports of MOFs MIL-53(Al), and named as Co dual-atom clusters (CoDACs). Fascinatingly, CoDACs with desirable water dispersibility display very high catalytic efficiency for redox-based chemiluminescent (CL) reaction by generating abundant reactive oxygen species. The catalysts boosted the CL signal of luminol-H2O2 system for 1192 times as their concentration were 1.0 μg mL-1, thus can be applied as superior CL probes for tracing biorecognition events. To verify their application potential, CoDACs were used to establish a CL method for analyzing methicillin-resistant Staphylococcus aureus (MRSA) strains by adopting cell wall bind domain of bacteriophage P108 as a recognizer. The method displays a dynamic range of 6.1 × 102 - 6.1 × 107 CFU mL-1 and a detection limit of 220 CFU mL-1. The results for analysis of MRSA in biological, drug and food samples manifest their reliability for real application. To our best knowledge, it is the first study focusing on DACs as efficient catalysts for CL reaction.

The effect of opioid analgesics, benzodiazepines, gabapentinoids, and opioid agonist treatment on mortality risk among opioid-dependent people.

BackgroundAs dispensings for benzodiazepines and gabapentinoids have increased in recent years, risk of increased mortality has been identified, particularly when used with opioids. There is limited research examining use of these medicines among people with opioid dependence and whether mortality risk varies according to opioid agonist treatment (OAT) status. This study characterizes patterns of opioid analgesic utilization and concomitant use of benzodiazepines, gabapentinoids and OAT among people with opioid dependence initiating opioid analgesics. It also assesses mortality risk associated with exposure to these medicines. MethodsRetrospective cohort study in New South Wales, Australia, including 28,891 people with documented opioid dependence initiating opioid analgesics between July 2003 and December 2018. Linked administrative records provided data on prescription dispensings, sociodemographics, clinical characteristics, OAT and mortality. Generalised estimating equation models estimated incidence rate ratios (IRR) comparing periods in and out of OAT for the number of opioid analgesic dispensings. Periods of concomitant use of opioid analgesics, benzodiazepines, gabapentinoids, and OAT were identified. Cox models assessed associations between concomitant medicines use with mortality risk. ResultsAt the time of opioid analgesic initiation, 43.7% of the cohort were in OAT. The most commonly initiated opioid was codeine (67.8%). In the 90 days prior to the index opioid dispensing, benzodiazepines were more frequently dispensed than gabapentinoids, but rates varied over time. Between 2004 and 2018, benzodiazepine dispensings decreased (41.7% to 21.1%) while gabapentinoid dispensings increased (0.2% to 7.9%). Incidence of opioid analgesic dispensings was higher during periods out of OAT compared to in OAT (5.8 v. 2.3 per person-year; IRR 0.39, 95% CI 0.38, 0.41). Analyses investigating associations between medicine exposure and mortality are ongoing. ConclusionPeople with opioid dependence had high rates of recent benzodiazepine utilization and current OAT enrollment at the time of opioid analgesic initiation. OAT was associated with a significant reduction in opioid analgesic prescribing.

Forward-and-reverse multidirectional turning: A novel material removal approach for improving energy efficiency, processing efficiency and quality

To address the issue of high energy consumption and low utilization rate in conventional turning, a concept of forward-and-reverse multidirectional turning (MDT) and the MDT approach are proposed to reduce energy consumption in idling and to improve processing efficiency and surface quality. The material removal performance of the MDT from aspects of energy consumption, processing efficiency, chip morphology and surface quality is discussed to understand its features and advantages compared with unidirectional turning (UDT). In three application scenarios, the processing efficiency is increased by 6.40%, 8.45%, and 7.76%, and energy consumption is reduced by 10.88%, 7.25%, and 9.52%, using the MDT, respectively. Additionally, the MDT has better control ability of the chip removal, benefitting for improving the processing stability. The surface quality of the workpiece processed by the MDT is generally better than that by UDT. This study provides a novel high performance processing approach for the machining,which contributes to promoting the efficient and high-quality development of mechanical manufacturing industry.

Recent progress on the long‐term stability of hydrogen evolution reaction electrocatalysts

AbstractDeveloping new methodologies to produce clean and renewable energy resources is pivotal for carbon‐neutral initiatives. Hydrogen (H2) is considered as an ideal energy resource due to its nontoxic, pollution‐free, high utilization rate, and high calorific combustion value. Electrolysis of water driven by the electricity generated from renewable and clean energy sources (e.g., solar energy, wind energy) to produce hydrogen attracts great efforts for hydrogen production with high purity. Recently, the breakthrough of the catalyst activity limit for the hydrogen evolution reaction (HER) catalysts has received extensive attention. Comparatively, fewer reviews have focused on the long‐term stability of HER catalysts, which is indeed decisive for large‐scale electrolytic industrialization. Therefore, a systematic summary concentrated on the durability of HER electrocatalysts would provide a fundamental understanding of the electrocatalytic performance for practical applications and offer new opportunities for the rational design of the highly performed HER electrocatalysts. This review summarizes the research progress toward the HER stability of precious metals, transition metals, and metal‐free electrocatalysts in the past few years. It discusses the challenges in the stability of HER electrocatalysts and the future perspectives. We anticipate that it would provide a valuable basis for designing robust HER electrocatalysts.image

Evaluation of the appropriate use of chest CT-Scans in the diagnosis of hospitalized patients in shiraz teaching hospitals, Southern Iran

PurposeDuring recent years, overuse of medical imaging especially computed tomography has become a serious concern. We evaluated the suitable usage of chest computed tomography (CT)-scan, in patients hospitalized in emergency and medical wards of two teaching hospitals of Shiraz University of Medical Science.MethodsMedical records of 216 patients admitted in two major teaching hospitals (Namazi and Shahid Faghihi), who had undergone chest radiography and at least one type of chest CT were investigated. The clinical and paraclinical manifestations were independently presented to three pulmonologists and their opinion regarding the necessity and type of CT prescription were documented. Also, the patient’s history was presented to an expert chest radiologist and asked to rate the appropriateness of chest CT according to American colleague of radiologist (ACR) criteria.ResultsIn 127 cases (59%), at least 2 out of 3 pulmonologists had the same opinion on the necessity of performing CT scan regardless of CT scan type, in 89 cases (41%) the same CT type and in 38 (17.5%) cases other CT type was supposed. Based on ACR criteria, of total prescribed CTs, 49.5% were “usually not appropriate” and 31.5% of cases were “usually appropriate”. Among 109 pulmonary CT angiography, 54 (49.5%) was usually not appropriate base on ACR criteria, which was the most frequent inappropriate requested CT type.ConclusionConsidering the high rates of inappropriate utilization of chest CT scan in our teaching hospitals, implementation of the standard guideline at a different level and consulting with a pulmonologist, may prevent unnecessary chest CTs prescription and reduce harm to patients and the health system.