Summary
Tranexamic acid is an effective treatment to reduce blood loss. We performed a retrospective observational study to evaluate safety in unilateral total knee arthroplasty. We utilised Taiwan's ...national health insurance database to identify relevant patients and to retrieve information on peri‐operative blood transfusions and tranexamic acid administration within 60 days of follow‐up. We examined changes in the rate of transfusions and adverse events with respect to tranexamic acid administration using logistic regression. We observed a total of 226,719 knee arthroplasty cases during 2010–2019. Transfusion and tranexamic acid administration rates were 38.9% (88,258) and 42.9% (97,237), respectively. Tranexamic acid was associated with a 50% decrease in blood transfusions (RR: 0.50, 95%CI: 0.48–0.51). After propensity‐score matching, tranexamic acid was not associated with pulmonary embolism; deep vein thromboembolism; artery vein thromboembolism; acute myocardial infarction; ischaemic stroke; or in‐hospital mortality, but was significantly associated with acute kidney injury. Patients with existing chronic kidney disease suffered a high absolute risk of kidney injury irrespective of tranexamic acid administration (832 per 10,000, 95%CI 797–869). Tranexamic acid was also associated with surgical site infection. There was strong interaction between blood transfusion; tranexamic aid administration; and development of surgical site infection. In conclusion, tranexamic acid use was associated with decreased blood transfusion and was not associated with thromboembolic events. However, careful consideration is required before use in patients with pre‐existing renal disease. Further, our observed interaction between patients given tranexamic acid who subsequently require transfusion requires careful consideration with respect to enhanced prophylaxis against surgical site infection.
State-of-the-art silicon interposer technology of chip-on-wafer-on-substrate (CoWoS) containing the second-generation high bandwidth memory (HBM) has been applied for the first time in fabricating ...high-performance wafer-level system-in-package. An ultralarge Si interposer up to 1200 mm 2 made by a two-mask stitching process is used to form the basis of the second-generation CoWoS (CoWoS-2) to accommodate chips of logic and memory and achieve the highest possible performance. Yield challenges associated with the high warpage of such a large heterogeneous system are resolved to achieve high package yield. Compared to alternative interposer integration approaches such as chip-on-substrate, CoWoS offers more competitive design rule which results in better power consumption, transmission loss, and eye diagram. CoWoS-2 has positioned itself as a flexible 3-D IC platform for logic-memory heterogeneous integration between logic system-on-chip and HBM for various high-performance computing applications.
Chiral separation is a crucial step in many chemical synthesis processes, particularly for pharmaceuticals. Here we present a novel method for the realization of both separating and trapping of ...enantiomers using the dielectric photonic crystal (PhC) slabs, which possess quasi-fourfold degenerate Bloch modes (overlapping double degenerate transverse-electric-like and transverse-magnetic-like modes). Based on the designed structure, a large gradient of optical chirality appears near the PhC slab, leading to the extreme enhancement of chiral optical forces about 3 orders of magnitude larger than those obtained with circularly polarized lights. In this case, our method provides a reference for realizing all-optical enantiopure syntheses.
We present a search for lepton-flavor-violating τ decays into three leptons (electrons or muons) using 782 fb−1 of data collected with the Belle detector at the KEKB asymmetric-energy e+e− collider. ...No evidence for these decays is observed and we set 90% confidence level upper limits on the branching fractions between 1.5×10−8 and 2.7×10−8.
Two experiments were conducted to study the effects of stocking density on growth performance, carcass yield, and foot pad lesions of White Pekin ducks from hatch to 14 d of age (experiment 1) and ...from 14 to 42 d of age (experiment 2), respectively. All ducks were reared in raised plastic wire-floor pens with a pen size of 30 m2, and males and females were mixed at a ratio of 1:1 in each pen of both experiments. In experiment 1, a total of 10,200 ducks that were 1 d old were allotted to 20 pens according to the stocking densities of 13, 15, 17, 19, and 21 birds/m2 (or 8.4, 9.7, 10.9, 11.9, and 13.0 kg of actually achieved BW/m2), respectively, with 4 replicates per treatment. In experiment 2, a total of 3,150 ducks that were 14 d old were allotted to 15 pens according to the stocking densities of 5, 6, 7, 8, and 9 birds/m2 (or 17.0, 20.3, 23.6, 26.9, and 29.9 kg of actually achieved BW/m2), respectively, with 3 replicates per treatment. The stocking density had significant effects on final BW and weight gain of starter and growing ducks (P < 0.05), but not on feed/gain and mortality in both periods (P > 0.05). The final BW and weight gain of starter and growing ducks all decreased with increasing density (P < 0.05). Final BW and weight gain of starter ducks were reduced significantly as stocking density increased from 17 to 21 birds/m2 (P < 0.05). In addition, final BW and weight gain of growing ducks decreased significantly when stocking density was 9 birds/m2 (P < 0.05). On the other hand, increasing stocking density did not markedly influence the carcass, breast meat, leg meat, abdominal fat, and foot pad lesions of growing ducks (P > 0.05).
Purpose We identified the profile of lower urinary tract changes in ketamine users in the community. In addition, we identified the relative risks of dose, frequency of ingestion and duration of ...ketamine use for changes in lower urinary tract function. Materials and Methods A mobile medical assessment service was established at specific youth centers, and subjects who were known to social workers and who had a history of ketamine use were invited to participate in health screening. Lower urinary tract function was evaluated using the Pelvic Pain, Urgency and Frequency questionnaire, and uroflowmetry and ultrasonography. Results Use of ketamine more than 3 times weekly was significantly associated with lower voided volumes. Pelvic Pain, Urgency and Frequency questionnaire scores were significantly higher for ketamine use for more than 24 months compared to use for short durations (7.82 vs 6.00). The scores on the symptom and bother subscales of the Pelvic Pain, Urgency and Frequency questionnaire decreased progressively with increased duration of abstinence. For individuals after 1 year of abstinence the Pelvic Pain, Urgency and Frequency questionnaire scores were significantly lower and voided volumes were higher than those for active users. Conclusions Ketamine users with at least a 2-year habit of 3 or more hits per week have altered bladder function that can be recognized and that causes bother. These early functional changes have the potential to normalize after 1 year of ketamine abstinence. This study provides a basis for the development of health promotion material that can be used in the community by welfare workers seeking to encourage drug cessation.
Summary
Porcine deltacoronavirus (PDCoV) is a recently identified coronavirus in the genus Deltacoronavirus that can cause enteric disease with clinical signs including diarrhoea, vomiting, ...dehydration and mortality in neonatal piglets. Although evidence of the prevalence of PDCoV in China is accumulating, little published information about Chinese PDCoV isolates is available. In this study, we investigated the presence of PDCoV in 49 faecal/intestinal samples from piglets with diarrhoea on different farms in Hebei province. Five samples (10.2%) were positive for PDCoV, but no coinfection of PDCoV with other enteropathogens was observed. A PDCoV strain named HB‐BD was successfully isolated from the intestinal contents of a diarrhoeic piglet and serially propagated in swine testicular (ST) cells for >40 passages. The complete genome of the HB‐BD strain was sequenced and analysed. Genomic analysis showed that the HB‐BD strain had a closer relationship with Chinese strains than those from other countries and was grouped within the Chinese PDCoV cluster. The results of this study will be valuable for further research of PDCoV genetic evolution and development of effective diagnostic reagents, assays and potential vaccines against newly emerged PDCoV strains.
Streptococcus suis (S. suis) can be classified into 33 serotypes based on the structure of capsular polysaccharides. Recent research indicated that a new surface protein designated as Sao (surface ...antigen one) reacts with 30 serotypes of convalescent‐phase sera during S. suis infections, which makes Sao a good potential antigen for developing S. suis vaccines. The objectives of this study were to produce recombinant Sao‐L protein (rSao‐L) from a strain of S. suis serotype 2 by a prokaryotic expression system in bioreactors and to use rSao‐L as the antigen for a S. suis vaccine in mouse and swine models. The antibody titres in mice and pigs immunized with rSao‐L were significantly (P < 0.05) increased. After challenge with live S. suis serotype 1 bacteria, the anatomical lesions in pigs immunized with rSao‐L were reduced by 60%. These data indicated that immunization with rSao‐L can confer cross‐serotype protection against S. suis. Moreover, percentages of CD8⁺ and CD4⁺/CD8⁺ double‐positive T cells in immunized pigs were significantly higher than those of the control group (P < 0.01). Using bioreactors to produce rSao‐L as the antigen for S. suis vaccines may broaden protective efficacy and reduce production costs.
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