Objective To investigate the referral rate, prevalence and aetiology of neonatal hearing loss. Methods A total of 11,894 infants were screened by two-stage transient evoked otoacoustic emission testing. Those who failed were diagnosed by distortion product otoacoustic emission, 1000 Hz probe tone tympanometry and auditory brainstem response. The results of these tests were analysed by statistical software SPSS16.0. Results The initial referral rate was 17.36%. The rescreening referral rate was 21.29%. The referral rate of initial screening in maternity wards (15.37%) was lower than in neonatal intensive care unit wards (22%) (chi-square [x 2 ], P , 0.05). There were 68 cases (106 ears) diagnosed with hearing loss (incidence 0.571%). Of these, 31 cases were conductive, 16 cases were sensorineural, and 21 cases were mixed hearing loss. The prevalence of hearing loss was 12.92% (38/294) in the bilateral referred group and 5.00% (30/600) in the unilateral referred group. The moderate/severe hearing loss was 33.33% (10/30) and 86.84% (66/76), respectively (x 2

sources into fuels and value-added chemicals. [1−3] However, non-ideal catalytic activity primarily caused by the sluggish kinetics has long posed a crucial challenge in restricting the efficiency of electrocatalytic reactions. [4,5] Based on this, enormous research is devoted to enhancing the intrinsic activity of pre-existing active sites. For example, facet control can selectively expose the high-energy facets of catalysts to promote the adsorption of electrolytes, providing higher catalytic performance. [6] However, catalysts with high-energy facets are generally thermodynamic unstable and their preparations remain greatly challenging. Strain regulation can adjust the local coordination environment of active sites, [7] but its application is restricted by the stability of the modified structure with huge strain. Additionally, alloying with metals/nonmetals is also an effective strategy to decrease the reaction barrier for electrocatalytic reactions, [8] while the thermodynamic miscibility among the different elements is a necessary prerequisite. [9] In essence, the reaction kinetics is effectively triggered to promote the catalytic performance by these design approaches, which is ascribed to appropriate electronic structures. [10,11] Nevertheless, as for the existing catalytic materials, a rational design to tailor the optimal electronic structures is currently lacking, which is highly desired.Here, we propose a design principle, namely "dual self-built gating" to greatly boost the hydrogen evolution reaction (HER) performance of catalysts. Taking ReS 2 and WS 2 as an example, the dual self-built gating originated from in-plane ReS 2 -WS 2 covalent bonds and out-plane ReS 2 /WS 2 interlayer interaction induces electrons to directionally transfer from WS 2 to ReS 2 , [12,13] resulting in charge redistribution at the interface. In this case, owing to the tailored electronic structures, dual selfbuilt gating can balance the adsorption of intermediates and the desorption of hydrogen synergistically, leading to a dramatic improvement in reaction kinetics. As demonstrated by density functional theory (DFT) calculations, the dual gating region shows a Gibbs free energy close to zero (0.03 eV), suggesting that the charge redistribution at the interface enhances the intrinsic activity of active sites. More interestingly, on account of the adjustable carrier density, we also confirm the Optimizing the intrinsic activity of active sites is an appealing strategy for accelerating the kinetics of the catalytic process. Here, a design principle, namely "dual self-built gating", is proposed to tailor the electronic structures of catalysts. Catalytic improvement is confirmed in a model catalyst with a ReS 2 -WS 2 /WS 2 hybridized heterostructure. As demonstrated in experimental and theoretical results, the dual gating can bidirectionally guide electron transfer and redistribute at the interface, endowing the model catalyst with an electron-rich region. The tailored electronic structures balance the adsorption of intermediate...

ContestThe relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and liver stiffness and bone mineral density (BMD) remains unclear.ObjectivesWe aimed to investigate the association between MAFLD and liver stiffness and BMD in the United States population.MethodsA cross-sectional study among 2031 participants over 50 years old in the National Health and Nutrition Examination Survey (NHANES) 2017-2018 was performed. All patients underwent vibration controlled transient elastography (VCTE) and dual-energy x-ray absorptiometry (DXA). The linear and logistic regression model were used to analyze the association between the MAFLD and liver stiffness and osteoporosis, with adjustments for known covariates. Furthermore, the sensitive analyses were conducted to explore the relationship between MAFLD and liver stiffness and whole osteoporosis (include femoral and lumbar osteoporosis).ResultsMAFLD was prevalent in the study population, with a prevalence of 50.9% for men and 40.7% for women. The multiple linear models demonstrated positive associations between MAFLD and liver stiffness and total femur BMD, femur neck BMD, trochanter BMD, intertrochanter BMD. In multiple logistic regression models, both MAFLD and significant liver fibrosis were negatively associated with femoral osteoporosis (OR=0.41, 95% CI: 0.27 to 0.63; OR=0.67, 95% CI: 0.33-1.37, respectively). Nonetheless, when BMI was adjusted, the association between MAFLD and liver stiffness and osteoporosis became insignificant. Besides, as showed in the sensitive analyses, the relationship between MAFLD and liver stiffness and whole osteoporosis were stable.ConclusionsThese results suggest that MAFLD and liver stiffness were associated with higher femoral and lumbar bone mineral density in individuals aged over 50 years. But the results may be confounded by BMI.

Th2 cytokines play a pivotal role in the pathogenesis of allergic rhinitis. To investigate the effect of p38 mitogen-activated protein kinase (MAPK) on the production of Th2 cytokines such as IL-4 and IL-5 in allergic rhinitis, a model of allergic rhinitis was established in SD rats. The expression level of p38 MAPK mRNA in PBMCs was detected by means of real time quantitative RT-PCR. The p38 MAPK activity in PBMCs was detected by Western blotting. PBMCs were cultured with various concentrations of p38 MAPK inhibitor SB 239063 or without the treatment, and then IL-4, IL-5 levels of the supernatant were determined by using sandwich ELISA. The results showed that mRNA expression and activity of p38 MAPK in PBMCs were significantly higher in allergic rhinitis rats than in control rats (P<0.05). The p38 MAPK inhibitor SB 239063 decreased the production of IL-4 and IL-5 in a dose-dependent manner. It is concluded that p38 MAPK plays an important role in the pathogenesis of allergic rhinitis which is associated with Th2 cytokines release.