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Results The study population included 6,628 adult patients with CKD who were aged 20 to 90 years. 941 KFRT events and 1,653 deaths occurred during follow-up. The adjusted HR for progression to KFRT was 1.19 (95% CI, 1.08-1.31) per 7.8μg/m3 greater PM2.5, an amount spanning the interquartile range. There was evidence of a dose-response relationship (adjusted HRs of 1.16 [95% CI, 0.90-1.51], 1.19 [95% CI, 0.94-1.52], and 1.42 [95% CI, 1.12-1.80] for low, medium, and high PM2.5 levels). There was no significant association between PM2.5 and all-cause mortality (adjusted HR, 1.01 [95% CI, 0.95-1.08]). Limitations Misclassification of PM2.5 exposure assessment and the potential for residual confounding. Conclusions Our findings suggest that long-term exposure to PM2.5 is associated with increased risk for progression to KFRT in patients with CKD.Social media is a ubiquitous part of society and used by many healthcare professionals, including radiologists. This article prepared by the 2019-2020 Radiology Research Alliance Social Media Task Force presents different uses and benefits of an online professional social media profile. Physician and healthcare-specific issues along with popular platforms such as LinkedIn, Facebook, Twitter, Instagram, and YouTube are used to explore topics including education, branding, research, mentorship, promotion, and leadership.Objective To compare the efficacy of two methods of outpatient cervical ripening (CR) an intracervical Foley catheter and a prostaglandin E2 (PGE)2 slow-release vaginal insert. Methods All records of women receiving outpatient CR at a tertiary care hospital from January 2017 to June 2018 were retrospectively reviewed. We compared time from insertion of first CR agent until delivery between groups using a Cox proportional hazards (CPH) model. Exclusion criteria included age less then 18 years, multiple gestation, or contraindication to either CR method. Secondary outcomes included time from removal of agent and time from admission until delivery, additional CR used, uterine tachysystole, labour and delivery complications, type of delivery, and adverse neonatal outcomes. Results A total of 153 patients were included (82 Foley; 71 PGE2). Baseline characteristics were comparable except for lower dilation in the PGE2 group (16% vs. 38% less then 1cm dilated; P less then 0.05). In the CPH model, time from insertion to delivery was not different between PGE2 and Foley catheter groups (median 27 vs. 33 h), controlling for parity, gestational age, initial dilation, and use of oxytocin (HR 1.13, 95% confidence interval 0.77-1.68). learn more Patients in the PGE2 group were more likely to experience uterine tachysystole (9% vs. 0%; P less then 0.01) and require another method of CR (34% vs. 1%; P less then 0.001). There were no differences in neonatal or maternal adverse outcomes between groups. Conclusion Our results suggest that outpatient Foley catheter and PGE2 CR are comparable in time from insertion to delivery; however, PGE2 inserts are associated with higher rates of tachysystole and the need for second CR method. A prospective study is warranted to further investigate these findings.Background Tranexamic acid reduces blood loss in patients with bleeding diatheses and is used in a number of gynaecologic and non-gynaecologic conditions. Case We discuss the case of a 27-year-old woman with type 1 von Willebrand disease, who presented with a two-year history of severe mittelschmerz secondary to recurrent hemorrhagic cysts. The patient refused oral contraception and reported that traditional analgesia did not significantly alleviate symptoms. We theorized that the underlying von Willebrand disease compounded the degree of hemorrhage into her recurrent cysts. As such, a trial of mid-cycle tranexamic acid was offered, which drastically improved her symptoms. Conclusion We report that the use of mid-cycle tranexamic acid in patients with recurrent haemorrhagic cysts can lower ovulation-associated pain.This paper proposes a new necessary and sufficient condition for the robust stability of output feedback controlled fractional-order systems with structured uncertainties in all system coefficient matrices by using μ-analysis and the Kronecker product. The robust stability problems are converted to the judgment of the singularity of the matrices with uncertainties. Furthermore, the explicit robustness bounds of preserving the asymptotical stability of such systems are established based on the above condition. Finally, the proposed results are illustrated by two numerical examples.The vibration signal of faulty rotating machinery tends to be a mixture of repetitive transients, discrete frequency components and noise. How to accurately extract the repetitive transients is a critical issue for machinery fault diagnosis. Inspired by reweighted L1 (ReL1) minimization for sparsity enhancement, a reweighted generalized minimax-concave (ReGMC) sparse regularization method is proposed to extract the repetitive transients. We utilize the generalized minimax-concave (GMC) penalty to regularize the weighted sparse representation model to overcome the underestimation deficiency of L1 norm penalty. Moreover, a new reweight strategy which is different from the reweight strategy in ReL1 for sparsity enhancement is proposed according to the statistical characteristic, i.e., squared envelope spectrum kurtosis. Then ReGMC is proposed by solving a series of weighted GMC minimization problems. ReGMC is utilized to process a simulated signal and the vibration signals of a hot-milling transmission gearbox and a run-to-failure bearing with incipient fault. The ReGMC analysis results and the comparison studies show that ReGMC can effectively extract the repetitive transients while suppressing the discrete frequency components and noise, and behaves better than GMC, improved lasso, and spectral kurtosis.DC microgrids are gaining more and more popularity and are becoming a more viable alternative to AC microgrids (MGs) due to their advantages in terms of simpler power converter stages, flexible control algorithms and the absence of synchronization and reactive power. However, DC-MGs are prone to instability issues associated with the presence of nonlinear loads such as constant power loads (CPL) known by their incremental negative impedance (INI), which may lead to voltage collapse of the main DC Bus. In this paper, H∞-based controller of a source side buck converter is designed to avoid the instability issues caused by the load-side converter acting as a CPL. Besides, the proposed controller allows a perfect rejection of all perturbations that may arise from parameter variations, input voltage and CPL current fluctuations. The design process of H∞-based controller is based on the Golver Doyle Optimization Algorithm (GDOA), which requires an augmented system extracted from the small-signal model of the DC/DC converter including the mathematical model of parameter variations and overall external perturbations. The​ H∞ based controller involves the use of weight functions in order to get the desired performances. The proposed controller is easy to implement and lead to reducing the implementation cost and avoid the use of current measurement that may have some disadvantages. The derived controller is validated by simulation performed in Psim software and experimental setup.Background Measles is a highly infectious illness requiring herd immunity of 95% to interrupt transmission. China has not reached elimination goals despite high vaccination coverage. We estimated the population susceptibility against measles in Tianjin, China and to tailor awareness raising activities in the measles elimination plan. Methods Age-specific measles seroprevalence was evaluated by Enzyme-Linked Immunosorbent Assay (ELISA) on 12,164 individual aged 0-44 years in 2009-2018. Measles IgG avidity testing was performed to confirm the relationship of the waning immunity after vaccination and secondary vaccination failures (SVF) on 324 confirmed measles cases in 2013-2018. Results 11,108 samples (91.32%) tested positive for measles IgG, 239 (1.96%) tested as equivocal and 817 (6.72%) were negative. The age distribution of measles cases in Tianjin followed a U-shaped curve and was highest for those at less then 8 months and again at 20-39 years which correlated closely with the age distribution of measles susceptibility based on measles IgG antibody status (r = 0.72, P less then 0.001). The seropositivity rate and antibody geometric mean concentration (GMC) for the 2018 study population were significantly lower (χ2 = 7.45, P = 0.006 and t = 12.01, P less then 0.001) compared to 2009. The multivariate stepwise logistic regression analysis showed that age and region were the risk factors for both measles seropositivity rate and GMC after vaccination. The proportion of high avidity cases increased with age, being significantly higher in 75.31% of cases in patients aged 30-34 years (χ2 = 18.04, P = 0.003). Conclusions High immunization coverage in children alone will not be adequate to realizing sufficient levels of population herd immunity, particularly given that the potential susceptibility window in adult. Implementation of supplemental immunization activity (SIA) targeted to appropriate group aged 30-34 years is recommended.Aluminum-adjuvanted vaccines are freeze-sensitive products that require attentive cold chain adherence. Freeze/thaw events can be tested using "The World Health Organization Shake Test", a qualitative test whereby a vial from the batch suspected to have been frozen is checked to infer whether the whole batch has been frozen. In this paper, we present a noninvasive and quantitative method to detect whether a vial of liquid vaccine has experienced freeze/thaw using the water proton transverse relaxation rate by Nuclear Magnetic Resonance relaxometry (wNMR relaxometry). Importantly, wNMR relaxometry does not compromise the vial's integrity so the analyzed vial can be used for vaccination if it meets the quality specifications. Vial-to-vial variability in freezing susceptibility within a single carton of vaccine vials was also detected, both by visual observation and concurrently by wNMR relaxometry. This variability brings into question the practice of using one or a few vials in a batch of vaccines to infer about the quality of the whole batch.Objective To evaluate whether the social media strategy developed for the campaign Stop HPV - stop cervical cancer was successful at engaging target groups in communication regarding HPV vaccination. Introduction In 2009, the Human Papillomavirus (HPV) vaccine became part of the Danish childhood vaccination program to protect Danish girls from cervical cancer. In 2015, after a period of massive media coverage questioning the safety of the HPV vaccination, a rapid decline in HPV vaccination coverage was observed. An information campaign was therefore launched in May 2017 to address HPV vaccination hesitancy. THE SOCIAL MEDIA STRATEGY 'Heart-brain communication' combined facts and emotions through varied content. Community management guidelines were worked out to ensure that there was positive dialogue. Key Point Indicators (KPI) for Engagement Rate (ER) and Click Through Rate (CTR) were chosen to uphold engagement and traffic from Facebook to the website. The KPIs were used to measure effectiveness. Results In January 2019, the social media campaign had reached 8,020,000 people with an average of 127 comments per post.