Small Percentage Change Research Articles

Hydrothermal transforming phase structure and chemical composition of V2O5 for elevating electrochemical property of zinc ion batteries

V2O5 was hydrothermally modified in NaOH or KOH solutions at 180 °C for 24 h. The NaOH-modified powders had a nanorod-like structure with a crystal structure matching Na2V6O16·nH2O. The TG/DTA results of Na2V6O16·nH2O powders show a mass reduction of 4.24 % at 300 °C, corresponding to n of 1.496. KOH-modified powders have large rods and irregular structures with a crystal structure matching KV3O8. Its TG/DTA spectrum shows a very small percentage change, just 0.37 % at 600 °C. Cyclic voltammetry (CV) curves of a Na2V6O16·nH2O cathode in a 2 M ZnSO4 electrolyte exhibit higher oxidation and reduction current densities than those of pure V2O5 and KV3O8 electrodes.The best capacity of a Na2V6O16·nH2O electrode is 296.10 mAh g-1 at a current density of 50 mA g−1, which is higher than those of pure V2O5 (102.90 mAh g-1) and KV3O8 (91.07 mAh g-1) electrodes. EDS and XPS results reveal that the charge and discharge states involve de-insertion and insertion of Zn2+ ions out of/into the electrodes. Computational analysis of Zn intercalation into V2O5, Na2V6O16·nH2O, and KV3O8 structures displays increasing electron density on neighboring V atoms, which explains the increasing V4+/V5+ ratio in the discharged state as evidenced by XPS spectra.

Sm2O3 doping-adjusted radiation shielding properties and optical stability under sunlight irradiation of B2O3–Na2O–Sm2O3–Fe2O3 glass

In this work, we prepared sodium borate glass doped with different amounts of iron oxide (Fe2O3) and samarium oxide (Sm2O3). The effects of replacing Fe2O3 with Sm2O3 on the absorbance, optical band gap, Urbach energy, and radiation shielding parameters were studied. With further additions of Sm2O3, the optical band gap values increased from 2.50 to 2.67 eV, while Urbach energy values decreased from 0.49 to 0.42 eV. Further, we explored the effect of sunlight on the absorbance, optical band gaps, and Urbach energy at 90 min of irradiation time. With further exposure to sunlight, the values of the optical band gaps decreased and Urbach energy increased as the exposure time increased from 0 to 90 min. Moreover, the percent of change in absorbance, optical band gap, Urbach energy, refractive index, nonlinear refractive index and third order susceptibility for the glass samples containing the highest concentration of Sm2O3 is insignificant (<10%). The small percentage changes in absorbance, optical band gap, and Urbach energy show that the glasses are stable when exposed to sunlight. On the other hand, the inclusion of higher concentrations of Sm2O3 leads to improved radiation shielding capabilities, as seen by the increased values of the mass attenuation coefficient and half-value layer. Herein, the investigated glasses are both more transparent and more effective at shielding radiation; they're prime candidates for use in this field.

Lateral abdominal muscle thickness and contractile function in women with and without stress urinary incontinence.

Stress urinary incontinence (SUI) primarily results from the weakness of pelvic floor muscles, working synergistically with the abdominal muscles. The current study aimed to compare thickness and contractile function of lateral abdominal muscles in women with and without SUI. Thirty-nine women with SUI (SUI group; age: 38.87±8.96 years, body mass index (BMI): 24.03 (5.94) kg/m2) and 42 healthy women (control group; age: 36.21±11.46 years, BMI: 23.90 (5.85) kg/m2) were included. Transverse abdominis (TrA) and internal oblique (IO) muscle thickness at rest and during abdominal drawing-in maneuver (ADIM) were measured with ultrasound imaging in B-mode using a Logiq S7/Expert device and a 9-11 MHz linear transducer. Percentage change in thickness and contractile function of these muscles were also calculated. No significant differences in the thickness of TrA and IO muscles at rest and during ADIM between the groups were found (p>0.05). The percent change in thickness and contractile function of both right and left side TrA muscles and the right side IO muscle were lower in SUI group than control group (p<0.05). The percentage change in thickness and the contractile function of the left side IO muscle did not change (p>0.05). Women with SUI had a smaller percentage change in thickness and contractile function of TrA and IO muscle than women without SUI. However, there was no difference in the morphological features of these muscles between the groups. Considering the lateral abdominal muscle, training may be important for management of SUI.

State-Level Cardiovascular Mortality Rates Among Hispanic, Non-Hispanic Black, and Non-Hispanic White Populations, 1990 to 2019

Cardiovascular disease (CVD) is the leading cause of death in the US, with considerable variation by both state and race and ethnicity group. Consistent, comparable measures of mortality by specific CVD cause at the state level and by race and ethnicity have not previously been available and are necessary for supporting policy decisions aimed at reducing health inequities. To quantify and describe levels and trends of mortality due to overall CVD and its component causes for 3 mutually exclusive race and ethnicity groups and by state. This cross-sectional study used Census data, population surveys, and US vital registration records to estimate cause-specific cardiovascular mortality by state and by the following race and ethnicity groups, defined by the US Office of Management and Budget: Hispanic of any race, non-Hispanic Black (hereafter, Black), and non-Hispanic White (hereafter, White). Data were analyzed from January 2020 to September 2022. State of residence at time of death; Hispanic ethnicity and Black or White race. CVD death counts and mortality rates. An estimated 25 397 029 persons died of cardiovascular diseases from 1990 to 2019. The mean (SD) age of individuals was 78.20 (14.01); 13 087 290 individuals (51.53%) were female and 12 309 739 (48.47%) were male; 2 921 650 (11.50%) were Black, 1 159 498 (4.57%) were Hispanic, and 21 315 880 (83.93%) were White. Age-standardized CVD mortality per 100 000 persons in 2019 was 194.4 (95% uncertainty interval [UI], 172.7 to 207.4), 107.7 (95% UI, 92.9 to 121.4), and 153.8 (95% UI, 133.8 to 163.8) among Black, Hispanic, and White populations, respectively. The median (IQR) percentage change across states was smaller for 2010 to 2019 compared with 1990 to 2000 for both White female and White male populations (-6.8 [-10.1 to -4.3] vs -10.2 [-12.9 to -5.9] and -4.6 [-8.6 to -2.5] vs -16.5 [-19.3 to -15.4]). For the Black and Hispanic groups, the percentage change (IQR) was larger for the female populations for the latter time period (-15.1 [-18.9 to -11.7] vs -12.6 [-19.6 to -7.8] and -23.5 [-29.2 to -18.5] vs -8.2 [-17.8 to 5.96]). The converse was observed among male individuals in both groups, with smaller percentage change (IQR) values in 2010 to 2019 compared with 1990 to 2000 (-13.1 [-18.7 to -8.6] vs -18.6 [-25.5 to -14.7] among the Black male population and -20.4 [-25.6 to -15.6] vs -21.5 [-31.1 to -5.7] among the Hispanic male population). There was substantial variability at the state level for death due to total CVD and component causes in 2019 and changes in CVD mortality from 1990 through 2019. The findings of this study indicate that CVD mortality varied widely by state and race and ethnicity group. Changes over the time period were not consistent for all groups and varied by cardiovascular subcause. These results highlight ongoing health disparities in cardiovascular mortality.

Trends in neck of femur fracture incidence in EU15+ Countries from 1990-2017

BackgroundNeck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no comparison across countries has been reported. MethodsNOFF age-standardised incidence rates (ASIR) per 100,000 population were extracted from the GBD database for European Union (EU) 15+ countries over the period 1990 to 2017. Joinpoint regression analysis of the data identified trends in ASIR and associated estimated annual percentage changes (EAPC). These were analysed by specified timeframe, country and gender. ResultsOf the 19 EU15+ countries, 11 (58%) had overall increases in NOFF ASIRs in 2017 compared to 1990. The median ASIRs were 240/100,000 and 322/100,000 for males and females, respectively, in 1990. By 2017, this had increased to 259/100,000 and 325/100,000, respectively. Females consistently had relatively higher NOFF ASIRs with a median gender fracture gap of 62/100,000 in 2017. Males had a higher percentage change in increasing ASIRs, with a smaller percentage change in decreasing ASIRs for all included countries. The highest national ASIRs was observed in Australia, followed by Finland and Belgium. Conversely the Mediterranean countries demonstrated the lowest ASIRs, closely followed by the USA. ConclusionDespite significant advances in primary and secondary hip fracture prevention strategies over the 28-year study period, significant increases in NOFF ASIRs among most EU15+ countries were observed, especially with respect to gender.

12 Trends in Neck of Femur Fracture Incidence in EU15+ Countries From 1990–2017

Abstract Background Neck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no comparison across countries has been reported. Method NOFF age-standardised incidence rates (ASIR) per 100,000 population were extracted from the GBD database for European Union (EU) 15+ countries over the period 1990 to 2017. Joinpoint regression analysis of the data identified trends in ASIR and associated estimated annual percentage changes (EAPC). These were analysed by specified timeframe, country, and gender. Results Of the 19 EU15+ countries, 11 (58%) had overall increases in NOFF ASIRs in 2017 compared to 1990. The median ASIRs were 240/100,000 and 322/100,000 for males and females, respectively, in 1990. By 2017, this had increased to 259/100,000 and 325/100,000, respectively. Females consistently had relatively higher NOFF ASIRs with a median gender fracture gap of 62/100,000 in 2017. Males had a higher percentage change in increasing ASIRs, with a smaller percentage change in decreasing ASIRs for all included countries. The highest national ASIRs was observed in Australia, followed by Finland and Belgium. Conversely the Mediterranean countries demonstrated the lowest ASIRs, closely followed by the USA. Conclusions Despite significant advances in primary and secondary hip fracture prevention strategies over the 28-year study period, significant increases in NOFF ASIRs among most EU15+ countries were observed, especially with respect to gender.

Association of Total, Added, and Natural Phosphorus Intakes with Biomarkers of Health Status and Mortality in Healthy Adults in the United States.

The Western diet is high in dietary phosphorus, partially due to added phosphorus, (i.e., phosphates) predominantly present in processed food products. Elevated serum phosphate levels, otherwise known as hyperphosphatemia, have been associated with changes in health status, of note detrimental effects on cardiovascular and renal health. However, the extent to which highly absorbed added phosphorus contributes to these changes is relatively unknown, due to its poor characterization among food composition databases. Industry-provided data on phosphorus source ingredients and ranges of added phosphorus present in food categories to enable a more accurate estimation of the total, added, and natural phosphorus intakes in the U.S. population. Using regression analyses, we then assessed relationships between estimated total, added, and natural phosphorus intakes on biomarkers of health status and mortality in individuals enrolled in the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 2001–2016 datasets. Total, added, and natural phosphorus intakes were associated with several biomarkers of health status. Added phosphorus intake was consistently inversely associated with HDL cholesterol in both men and women, whereas naturally occurring phosphorus intake was inversely correlated with the risk of elevated blood pressure. However, in most cases, the predicted impact of increases in phosphorus intake would result in small percentage changes in biomarkers. No meaningful associations between phosphorus and mortality were found, but indications of a correlation between mortality with quintiles of naturally occurring phosphorus were present, depending on covariate sets used. The disparate results for natural and added phosphorus intakes within the current study provide increased support for updating current food composition databases to more accurately account for dietary phosphorus intake as total, naturally occurring, and added phosphorus.

Economic effects of shifting airport activity in the Los Angeles metro region

We estimate the economic effects of a reallocation of passenger traffic from congested Los Angeles International Airport (LAX) to Ontario International Airport (ONT). We find that the relative market shares of the two airports are a function of time and distance, relative fares, and absolute frequencies. Given increasing congestion and population growth patterns, there appears to be potential for expanded operations at Ontario, with resulting economic and environmental benefits. We define the potential market as those travelers choosing LAX despite being closer in travel time and distance to ONT, based on specific postal codes. Using estimates of the value of time, vehicle and aircraft operating costs, and emissions, we calculate the potential effects of shifting both for the average individual passenger and for 10 percent of the potential market from LAX to ONT. These estimated shifts would require only a relatively small percentage change in flight operations. We estimate the value of time and cost savings for both private and ride-sharing services at between $6 million and $11 million annually for a 10 percent shift, depending on whether parking fee differentials are included. The parking fee differentials represent just over half the estimated savings for private vehicle travelers, and to some degree may reflect locational rents rather than resource costs to the overall economy. We also estimate potential reductions in CO2 emissions of more than 4200 tons annually for a 10 percent shift, as well as meaningful reductions in hydrocarbons, CO, and NOx.

Normal values of the resistivity index of the pericallosal artery with and without compression of the anterior fontanelle.

Resistivity index (RI) of the pericallosal artery as is commonly measured during head ultrasound (US) examination in neonates. Some studies have shown that RI measured with gentle compression of the fontanelle provides additional information in cases of neonatal brain anomalies. The purpose of this study was to establish normal RI values with and without compression in a large population of neonates with normal cranial ultrasound as a function of gestational age. The authors of this retrospective study reviewed the RI of 323 infants with normal gray-scale cranial US and with a gestational age ranging 26-42weeks. We conducted the exams both with and without compression of the anterior fontanelle and we studied changes in RI depending on gestational age, gender and type of delivery. Infants with a gestational age of more than 35weeks tended to have a lower RI (P=0.011). The compression of the anterior fontanelle emphasized the change in RI with increasing gestational age, with higher gestational ages having a lower RI (P<0.001). The results concerning the percentage change between baseline RI and RI with compression showed that infants with higher gestational ages have a smaller percentage change in RI (P=0.002). We established the normal values for RI from 26weeks to 42weeks of gestation. The results of the study show the importance of taking the gestational age into consideration when evaluating the RI.

Influence of Adaptive Statistical Iterative Reconstruction on coronary plaque analysis in coronary computed tomography angiography

PurposeThe purpose of this study was to study the effect of iterative reconstruction (IR) software on quantitative plaque measurements in coronary computed tomography angiography (CCTA). MethodsThirty patients with a three clinical risk factors for coronary artery disease (CAD) had one CCTA performed. Images were reconstructed using FBP, 30% and 60% adaptive statistical IR (ASIR). Coronary plaque analysis was performed as per patient and per vessel (LM, LAD, CX and RCA) measurements. Lumen and vessel volumes and plaque burden measurements were based on automatic detected contours in each reconstruction. Lumen and plaque intensity measurements and HU based plaque characterization were based on corrected contours copied to each reconstruction. ResultsNo significant changes between FBP and 30% ASIR were found except for lumen- (−2.53 HU) and plaque intensities (−1.28 HU). Between FBP and 60% ASIR the change in total volume showed an increase of 0.94%, 4.36% and 2.01% for lumen, plaque and vessel, respectively. The change in total plaque burden between FBP and 60% ASIR was 0.76%. Lumen and plaque intensities decreased between FBP and 60% ASIR with −9.90 HU and −1.97 HU, respectively. The total plaque component volume changes were all small with a maximum change of −1.13% of necrotic core between FBP and 60% ASIR. ConclusionsQuantitative plaque measurements only showed modest differences between FBP and the 60% ASIR level. Differences were increased lumen-, vessel- and plaque volumes, decreased lumen- and plaque intensities and a small percentage change in the individual plaque component volumes.

The Multifocal On- and Off-Responses in the Human Diabetic Retina.

The characteristics of the on- and off-responses in the human diabetic retina by a “long-duration” multifocal electroretinogram (mfERG) paradigm were investigated. Changes in the retinal antagonistic interaction were also evaluated in the early stage of diabetes mellitus (DM). Twenty type II diabetic patients with no or mild non-proliferative diabetic retinopathy (NPDR) and twenty-one age-matched healthy controls were recruited for “long-duration” mfERG measurements. A 61-hexagon mfERG stimulus was displayed under two chromatic conditions (white/black and blue/black) at matched luminance. The amplitudes and implicit times of the on-response components (N1, P1 and N2) and off-response (P2) components were analysed. The blue stimulation generally triggered greater mfERG amplitudes in P1, N2 and P2 (p<0.05) than those from white stimulation in both control and diabetic groups. The diabetic group showed significantly greater N2 amplitude than the controls under white stimulation in mid-retinal regions (Rings 2 and 4) (p<0.05). When the stimulus was changed from white to blue, the diabetic group showed a smaller percentage change in N2 amplitude than the controls in peripheral retinal region (Ring 5) (p<0.02). When a stimulus is changed from white (broad-band spectral stimulation) to blue (narrow-band spectral stimulation), a decrease in the involvement of lateral antagonism would be expected. The larger amplitude of the on-response component (N2) in the diabetic patients suggested an imbalance of lateral antagonism, and the lesser percentage change of N2 amplitude in the diabetic group may indicate an impairment of the cross-talk at the middle retinal level in early stages of DM.

Enhanced electrocaloric effect in Ba0.85Ca0.15Zr0.1Ti0.9–xSnxO3 ferroelectric ceramics

ABSTRACTThe present work deals with the study of effect of Sn addition (0%–6% by mole) on the electrocaloric (EC) performance of Ba0.85Ca0.15Zr0.1Ti0.9O3 (BCZT) ceramics. Maxwell's relations in conjunction with data from experimental observations were used for the indirect caloric measurements. Small percentage change with Sn addition is found to increase the EC performance of BCZT ceramics. A peak adiabatic temperature change of 0.84 K (353 K) was predicted for 0–32 kV/cm electric field, significantly higher than pristine BCZT ceramics. A simultaneous increase in specific entropy change was also observed.

Walking the Wall

Walking the Wall

Comparative Response of SC CAKI-1 Renal Tumor to Treatment with Doxorubicin HCl and Doxorubicin Orotate

Background: Doxorubicin (DOX) is an effective treatment for many cancers across the age spectrum, but its therapeutic potential is limited because of dose-dependent relation to both progressive and irreversible cardiomyopathy leading to congestive heart failure. While decreases in cardiotoxicity have been reported with liposomal doxorubicin, the long-term cardiac effects are not known. Orotate salts of cytotoxic drugs have been shown to confer antitumor effects with a better safety profile than unconverted drug, and therefore may offer an improved approach to cancer treatment. Materials and Methods: Male, athymic NCr-nu/nu mice with subcutaneously implanted CAKI-1 human renal tumor xenografts were treated with DOX and its orotate salt (DOX-O) to evaluate antitumor activity, measured by median tumor mass doubling time and tumor weight. Nontumored male, athymic NCr-nu/nu mice were treated with DOX, DOX-O and liposomal doxorubicin formulations to determine DOX concentration in liver and heart; and to evaluate their effect on body weight. Non-tumored female, athymic NCr-nu/nu mice were treated with daunorubicin and daunorubicin orotate to evaluate tolerance. Results: DOX and DOX-O exhibited significant, similar levels of antitumor activity. Mice treated with DOX-O had a lower percentage body weight loss. In the animals treated with DOX, DOX-O, or liposomal doxorubicin, liposomal doxorubicin was associated with the lowest percentage of body weight loss, but the highest concentration of DOX in heart. In daunorubicin tolerance experiments, animals showed a better tolerance for daunorubicin orotate as measured by a smaller percentage change in body weight. Conclusions: DOX-O is effective as an antitumor therapy and may offer a less toxic alternative to DOX for maintaining therapy. The lower percentage of body weight loss in animals treated with DOX-O and daunorubicin orotate is a measure of improved tolerance and may translate into better patient outcomes.

Ultrasensitive response motifs: basic amplifiers in molecular signalling networks

Multi-component signal transduction pathways and gene regulatory circuits underpin integrated cellular responses to perturbations. A recurring set of network motifs serve as the basic building blocks of these molecular signalling networks. This review focuses on ultrasensitive response motifs (URMs) that amplify small percentage changes in the input signal into larger percentage changes in the output response. URMs generally possess a sigmoid input–output relationship that is steeper than the Michaelis–Menten type of response and is often approximated by the Hill function. Six types of URMs can be commonly found in intracellular molecular networks and each has a distinct kinetic mechanism for signal amplification. These URMs are: (i) positive cooperative binding, (ii) homo-multimerization, (iii) multistep signalling, (iv) molecular titration, (v) zero-order covalent modification cycle and (vi) positive feedback. Multiple URMs can be combined to generate highly switch-like responses. Serving as basic signal amplifiers, these URMs are essential for molecular circuits to produce complex nonlinear dynamics, including multistability, robust adaptation and oscillation. These dynamic properties are in turn responsible for higher-level cellular behaviours, such as cell fate determination, homeostasis and biological rhythm.

Forearm skin tissue dielectric constant measured at 300 MHz: effect of changes in skin vascular volume and blood flow

Skin tissue dielectric constant (TDC) values measured via the open-ended coaxial probe method are useful non-invasive indices of local skin tissue water. However, the effect of skin blood flow (SBF) or skin blood volume (SBV) on TDC values is unknown. To determine the magnitude of such effects, we decreased forearm SBV via vertical arm raising for 5 min (test 1) and increased SBV by bicep cuff compression to 50 mmHg for 5 min (test 2) in 20 healthy supine subjects (10 men). TDC values were measured to a depth of 1·5 mm on anterior forearm, and SBF was measured with laser-Doppler system simultaneously on forearm and finger. Results indicate that decreasing vascular volume (test 1) was associated with a small but statistically significant reduction in TDC (3·0 ± 4·3%, P = 0·003) and increasing vascular volume (test 2) was associated with a slight but statistically significant increase in TDC (3·5 ± 3·0%, P<0·001). SBF changes depended on test and measurement site. For forearm, test 1 significantly increased SBF (102·6 ± 156·2%, P<0·001) and test 2 significantly decreased it (39·5 ± 13·1%, P<0·001). In finger, SBF was significantly reduced by both tests: in test 1 by 55·3 ± 32·1%, P<0·001 and in test 2 by 53·3 ± 27·6%, P<0·001. We conclude that the small percentage changes in TDC values (3·0-3·5%) over the wide range of induced SBV and SBF changes suggest a minor effect on clinically determined TDC values because of SBV or SBF changes or differences when comparing TDC longitudinally over time or among individuals of different groups in a research setting.

An Expanding Market: Asian Mothers-to-be

Abstract Nowadays many fashion marketers search for specific niches in emerging countries in the hope of identifying needs to fulfil. For any potential niche, they scrutinize demographic and psychographic variables to determine preferences in style and elements of the buying decision process. This study classifies Asian mothers-to-be as a specific target market. It highlights criteria considered important throughout the purchasing process for maternity-wear. Because body size/shape changes rapidly during pregnancy, it identifies the needs for particular garments during precise periods of pregnancy. Additionally the uniqueness of the Asian culture influences maternity-wear preferences. This paper provides insights on: when and what type of maternity-wear is wanted/needed; what type of marketing channels purchasers rely on; where they purchase new garments or obtain previously owned garments; and which variables are important to the purchasing decision: price, brand, quality, etc. We confirm Asian mothers-t...

Climate changes at Lake Shkodra (Albania): the last 4500 years

Lake Shkodra is a wide basin located at the Albania/Montenegro border. Few kms of steep mountain slopes separate the lake from the Adriatic Sea, Three parallel overlapping cores down to the depth of 7.26 m have been used for palaeomagnetic, tephra, isotope, diatom, pollen, and microcharcoal analyses. The chronological framing of the record, spanning approximately the last 4500 years, has been assessed using 3 210Pb, 4 14C AMS dates al and 4 well-known tephra layers. The presence of such characteristic Italian volcanic ashes provides a relatively good chronology for the second half of the Holocene.The δ18Oc record indicates the presence of two prominent wet phases: one centered at ca. 4300 cal yr BP, and one at ca. 2400-2000 yr cal BP. The physiognomy of the vegetation did not suffer very much from the hydrological changes suggested by oxygen isotopes, recording small percentage changes of AP from 4500 to ca 900 cal yr BP. However, since ca. 900 cal yr BP human impact became apparent with significant decrease in AP% and in total pollen concentration. Despite being quite homogeneous, the well preserved ostracod assemblage records both the Medieval Warm Period and the Little Ice Age.

Tracheal suctioning without disconnection in intubated ventilated neonates

Assisted mechanical ventilation is a necessity in the neonatal population for a variety of respiratory and surgical conditions. However, there are a number of potential hazards associated with this life saving intervention. New suctioning techniques have been introduced into clinical practice which aim to prevent or reduce these untoward effects. To assess the effects of endotracheal suctioning without disconnection in intubated ventilated neonates. The review has drawn on the search strategy for the Cochrane Neonatal Review Group. A comprehensive search of Cochrane databases, MEDLINE and CINAHL, and the Society forPediatric Research abstracts was undertaken by the review authors (July 2011). All trials that utilised random or quasi-random patient allocation and in which suctioning with or without disconnection from the ventilator was compared. Standard methods of the Cochrane Neonatal Group were used. Each review author separately reviewed trials for eligibility and quality and extracted data; they then compared and resolved differences. Analysis was performed using the fixed-effect model and outcomes were reported using relative risk (RR) for categorical data and mean difference (MD) for outcomes measured on a continuous scale. Four trials (252 infants) were included in this review. The trials employed a cross-over design in which suctioning with or without disconnection was compared. Suctioning without disconnection resulted in a reduction in episodes of hypoxia (typical RR 0.48, CI 95% 0.31 to 0.74; 3 studies; 241 participants). There were also fewer infants who experienced episodes where the transcutaneous partial pressure of oxygen (TcPO(2)) decreased by > 10% (typical RR 0.39, 95% CI 0.19 to 0.82; 1 study; 11 participants). Suctioning without disconnection resulted in a smaller percentage change in heart rate (weighted mean difference (WMD) 6.77, 95% CI 4.01 to 9.52; 4 studies; 239 participants) and a reduction in the number of infants experiencing a decrease in heart rate by > 10% (typical RR 0.61, CI 0.40 to 0.93; 3 studies; 52 participants).The number of infants having bradycardic episodes was also reduced during closed suctioning (typical RR 0.38, CI 95% 0.15 to 0.92; 3 studies; 241 participants). There is some evidence to suggest suctioning without disconnection from the ventilator improves the short term outcomes; however the evidence is not strong enough to recommend this practice as the only method of endotracheal suctioning. Future research utilising larger trials needs to address the implications of the different techniques on ventilator associated pneumonia, pulmonary morbidities and neurodevelopment. Infants less than 28 weeks also need to be included in the trials.

Particulate Air Pollution and Socioeconomic Position in Rural and Urban Areas of the Northeastern United States

Although differential exposure by socioeconomic position (SEP) to hazardous waste and lead is well demonstrated, there is less evidence for particulate air pollution (PM), which is associated with risk of death and illness. This study determined the relationship of ambient PM and SEP across several spatial scales. Geographic information system-based, spatio-temporal models were used to predict PM in the Northeastern United States. Predicted concentrations were related to census tract SEP and racial composition using generalized additive models. Lower SEP was associated with small, significant increases in PM. Annual PM(10) decreased between 0.09 and 0.93 micrograms per cubic meter and PM(2.5) between 0.02 and 0.94 micrograms per cubic meter for interquartile range increases in income. Decrements in PM with SEP increased with spatial scale, indicating that between-city spatial gradients were greater than within-city differences. The PM-SEP relation in urban tracts was not substantially modified by racial composition. Lower compared with higher SEP populations were exposed to higher ambient PM in the Northeastern United States. Given the small percentage change in annual PM(2.5) and PM(10), SEP was not likely a major source of confounding in epidemiological studies of PM, especially those conducted within a single urban/metropolitan area.