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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Life cycle assessment (LCA) reports are commonly used for sustainability documentation, but extracting useful information from them is challenging and requires expert oversight. Designers frequently face technical obstacles and time constraints when interpreting LCA documents. As AI-driven tools become increasingly integrated into design workflows, there is an opportunity to improve access to sustainability data. This study used a mixed-methods approach to develop life cycle design heuristics to help non-LCA experts acquire relevant design knowledge from LCA reports. Developed through in-depth interviews with LCA experts (n = 9), these heuristics revealed five prominent categories of information: (1) scope of analysis, (2) priority components, (3) eco hotspots, (4) key metrics, and (5) design strategies. The utility of these heuristics was tested in a need-finding study with designers (n = 17), who annotated an LCA report using the heuristics. Findings suggest a need for additional support to help designers contextualize quantitative metrics (e.g., carbon footprints) and suggest relevant design strategies. A follow-up reflective interview study with LCA experts gathered feedback on the heuristics. These heuristics offer designers a framework for engaging with sustainability data, supporting product redesign, and a foundation for AI-assisted knowledge extraction to integrate life cycle information into design workflows efficiently.
This study investigated the factors influencing the mental health of rural doctors in Hebei Province, to provide a basis for improving the mental health of rural doctors and enhancing the level of primary health care.
Background:
The aim of this study was to understand the mental health of rural doctors in Hebei Province, identify the factors that influence it, and propose ways to improve their psychological status and the level of medical service of rural doctors.
Methods:
Rural doctors from 11 cities in Hebei Province were randomly selected, and their basic characteristics and mental health status were surveyed via a structured questionnaire and the Symptom Checklist-90 (SCL-90). The differences between the SCL-90 scores of rural doctors in Hebei Province and the Chinese population norm, as well as the proportion of doctors with mental health problems, were compared. Logistic regression was used to analyse the factors that affect the mental health of rural doctors.
Results:
A total of 2593 valid questionnaires were received. The results of the study revealed several findings: the younger the rural doctors, the greater the incidence of mental health problems (OR = 0.792); female rural doctors were more likely to experience mental health issues than their male counterparts (OR = 0.789); rural doctors with disabilities and chronic diseases faced a significantly greater risk of mental health problems compared to healthy rural doctors (OR = 2.268); rural doctors with longer working hours have a greater incidence of mental health problems; and rural doctors with higher education backgrounds have a higher prevalence of somatization (OR = 1.203).
Conclusion:
Rural doctors who are younger, male, have been in medical service longer, have a chronic illness or disability, and have a high degree of education are at greater risk of developing mental health problems. Attention should be given to the mental health of the rural doctor population to improve primary health care services.
We present a method for narrowing nonparametric bounds on treatment effects by adjusting for potentially large numbers of covariates, using generalized random forests. In many experimental or quasi-experimental studies, outcomes of interest are only observed for subjects who select (or are selected) to engage in the activity generating the outcome. Outcome data are thus endogenously missing for units who do not engage, and random or conditionally random treatment assignment before such choices is insufficient to identify treatment effects. Nonparametric partial identification bounds address endogenous missingness without having to make disputable parametric assumptions. Basic bounding approaches often yield bounds that are wide and minimally informative. Our approach can tighten such bounds while permitting agnosticism about the data-generating process and honest inference. A simulation study and replication exercise demonstrate the benefits.
Clinical high risk for psychosis (CHR) is often managed with antipsychotic medications, but their effects on neurocognitive performance and clinical outcomes remain insufficiently explored. This study investigates the association between aripiprazole and olanzapine use and cognitive and clinical outcomes in CHR individuals, compared to those receiving no antipsychotic treatment.
Methods
A retrospective analysis was conducted on 127 participants from the Shanghai At Risk for Psychosis (SHARP) cohort, categorized into three groups: aripiprazole, olanzapine, and no antipsychotic treatment. Neurocognitive performance was evaluated using the MATRICS Consensus Cognitive Battery (MCCB), while clinical symptoms were assessed through the Structured Interview for Prodromal Syndromes (SIPS) at baseline, 8 weeks, and one year.
Results
The non-medicated group demonstrated greater improvements in cognitive performance, clinical symptoms, and functional outcomes compared to the medicated groups. Among the antipsychotic groups, aripiprazole was associated with better visual learning outcomes than olanzapine. Improvements in neurocognition correlated significantly with clinical symptom relief and overall functional gains at follow-up assessments.
Conclusions
These findings suggest potential associations between antipsychotic use and cognitive outcomes in CHR populations while recognizing that observed differences may reflect baseline illness severity rather than medication effects alone. Aripiprazole may offer specific advantages over olanzapine, underscoring the importance of individualized risk-benefit evaluations in treatment planning. Randomized controlled trials are needed to establish causality.
The sulphur microbial diet (SMD), a dietary pattern associated with forty-three sulphur-metabolising bacteria, may influence gut microbiota composition and contribute to ageing process through gut-produced hydrogen sulfide (H2S). We aimed to explore the association between SMD and biological age (BA) acceleration, using the cross-sectional study that included 71 579 individuals from the UK Biobank. The SMD score was calculated by multiplying β-coefficients by corresponding serving sizes and summing them, based on dietary data collected using the Oxford WebQ, a 24-hour dietary assessment tool. BA was assessed using Klemerae–Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age refers to the age acceleration (AgeAccel), termed ‘KDMAccel’ and ‘PhenoAgeAccel’. Generalised linear regression was performed. Mediation analyses were used to investigate underlying mediators including BMI and serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio. Following adjustment for multiple variables, a positive association was observed between consuming a dietary pattern with a higher SMD score and both KDMAccel (βQ4 v. Q1 = 0·35, 95 % CI = 0·27, 0·44, P < 0·001) and PhenoAgeAccel (βQ4 v. Q1 = 0·32, 95 % CI = 0·23, 0·41, P < 0·001). Each 1-SD increase in SMD score was positively associated with the acceleration of BA by 7·90 % for KDMAccel (P < 0·001) and 7·80 % for PhenoAgeAccel (P < 0·001). BMI and AST/ALT mediated the association. The stratified analysis revealed stronger accelerated ageing impacts in males and smokers. Our study indicated a higher SMD score is associated with elevated markers of biological ageing, supporting the potential utility of gut microbiota-targeted dietary interventions in attenuating the ageing process.
Prehistoric humans seem to have preferred inhabiting small river basins, which were closer in distance to most settlements compared to larger rivers. The Holocene landscape evolution is considered to have played a pivotal role in shaping the spatiotemporal patterns of these settlements. In this study, we conducted comprehensive research on the relationship between landscape evolution and settlement distribution within the Huangshui River basin, which is a representative small river in Central China with numerous early settlements, including a prehistoric city known as the Wangjinglou site (WJL). Using geoarchaeological investigations, optically stimulated luminescence dating, pollen analysis, and grain-size analysis, we analyzed the characteristics of the Holocene environment. The results indicate the presence of two distinct geomorphic systems, namely the red clay hills and the river valley. The red clay hills, formed in the Neogene, represent remnants of the Songshan piedmont alluvial fan that was eroded by rivers. There are three grades of terraces within the river valley. T3 is a strath terrace and formed around 8.0 ka. Both T2 and T1 are fill terraces, which were developed around 4.0 ka and during the historical period, respectively. The sedimentary features and pollen analysis indicate the existence of an ancient lake-swamp on the platform during 11.0–9.0 ka. This waterbody gradually shrank during 9.0–8.0 ka, and ultimately disappeared after 8.0 ka. Since then, the development of large-scale areas of water ceased on the higher geomorphic units. River floods also cannot reach the top of these high geomorphic units, where numerous prehistoric settlements are located, including the Xia–Shang cities of the WJL site. Our research demonstrates that landscape stability supported the long-term and sustainable development of ancient cultures and facilitated the establishment of the WJL ancient cities in the region.
Remote center-of-motion (RCM) manipulators are a key issue in minimally invasive surgeries (MIS). The existing RCM parallel mechanisms (PMs) can only generate RCM motion based on the invariant RCM. To provide mobility for RCM, this paper designed a new family of RCM PMs with movable RCM that features a double-stage topological structure. Drawing mainly on configuration evolution and Lie-group, a general approach is proposed to design double-stage PMs with movable RCM. Feasible limbs for 2R1T RCM motion are enumerated and used to construct the secondary PM. Type synthesis of the primary PMs that realize movable RCM is accomplished based on the method presented. Different connection styles between the two stages that ensure the geometrical conditions of RCM motion are designed. Using different connection styles, double-stage PMs with movable RCM are constructed. These new RCM PMs can realize precise positioning of RCM by taking advantage of the primary PMs, which indicates their potential application prospects in MIS.
Compacted bentonite, used as an engineering barrier for permanent containment of high-level radioactive waste, is susceptible to mineral evolution resulting in compromise of the expected barrier performance due to alkaline–thermal chemical interaction in the near-field. To elucidate the mineral-evolution mechanisms within bentonite and the transformation of the nuclide adsorption properties during that period, experimental evolution of bentonite was conducted in a NaOH solution with a pH of 14 at temperatures ranging from 60 to 120°C. The results showed that temperature significantly affects the stability of minerals in bentonite under alkali conditions. The dissolution rate of fine-grained cristobalite in bentonite exceeds that of smectite, with the phase-transition products of smectite being temperature-dependent. As the temperature rises, smectite experiences a three-stage transformation: initially, at 60°C, the lattice structure thins due to the collapse of the octahedral sheets; at 80°C, the lattice disintegrates and reorganizes into a loose framework akin to albite; and by 100°C, it further reorganizes into a denser framework resembling analcime. The adsorption properties of bentonite exhibit a peak inflection point at 80°C, where the dissolution of the smectite lattice eliminates interlayer pores and exposes numerous polar or negatively charged sites which results in a decrease in specific surface area and an increase in cation exchange capacity and adsorption capacity of Eu3+. This research provides insights into the intricate evolution of bentonite minerals and the associated changes in radionuclide adsorption capacity, contributing to a better understanding of the stability of bentonite barriers and the effective long-term containment of nuclear waste.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
We present the generation of high-repetition-rate strong-field terahertz (THz) pulses from a thin 4-N,N-dimethylamino-4’-N’-methyl-stilbazolium 2,4,6-trimethylbenzenesulfonate (DSTMS) organic crystal pumped by an ytterbium-doped yttrium aluminum garnet laser. The generated THz pulse energy reaches 932.8 nJ at 1 kHz repetition rate, with a conversion efficiency of 0.19% and a peak electric field of 819 kV/cm. At a repetition rate of 10 kHz, it is able to maintain a peak electric field of 236 kV/cm and an average THz power of 0.77 mW. The high-repetition-rate, strong-field THz source provides a convenient tool for the study of THz matter manipulation and THz spectroscopy.
The axisymmetric nozzle mechanism is the core part for thrust vectoring of aero engine, which contains complex rigid-flexible coupled multibody system with joints clearance and significantly reduces the efficiency in modeling and calculation, therefore the kinematics and dynamics analysis of axisymmetric vectoring nozzle mechanism based on deep neural network is proposed. The deep neural network model of the axisymmetric vector nozzle is established according to the limited training data from the physical dynamic model and then used to predict the kinematics and dynamics response of the axisymmetric vector nozzle. This study analyses the effects of joint clearance on the kinematics and dynamics of the axisymmetric vector nozzle mechanism by a data-driven model. It is found that the angular acceleration of the expanding blade and the driving force are mostly affected by joint clearance followed by the angle, angular velocity and position of the expanding blade. Larger joint clearance results in more pronounced fluctuations of the dynamic response of the mechanism, which is due to the greater relative velocity and contact force between the bushing and the pin. Since axisymmetric vector nozzles are highly complex nonlinear systems, traditional numerical methods of dynamics are extremely time-consuming. Our work indicates that the data-driven approach greatly reduces the computational cost while maintaining accuracy, and can be used for rapid evaluation and iterative computation of complex multibody dynamics of engine nozzle mechanism.
Growing evidence indicates a link between diet and depression risk. We aimed to examine the association between an inflammatory diet index and depression utilising extensive data from UK biobank cohort. The energy-adjusted dietary inflammation index (E-DII) was calculated to quantify the potential of daily diet, with twenty-seven food parameters utilised. The E-DII scores were classified into two categories (low v. high) based on median value. To mitigate bias and ensure comparability of participant characteristics, propensity score matching was employed. To ascertain the robustness of these associations, sensitivity analyses were conducted. Subgroup analyses were performed to evaluate the consistency of these associations within different subpopulations. Totally, 152 853 participants entered the primary analyses with a mean age of 56·11 (sd 7·98) years. Employing both univariate and multivariate logistic regression models, adjustments were made for varying degrees of confounding factors (socio-demographics, lifestyle factors, common chronic medical conditions including type 2 diabetes and hypertension). Results consistently revealed a noteworthy positive correlation between E-DII and depression. In the context of propensity score matching, participants displaying higher E-DII scores exhibited an increased likelihood of experiencing incident depression (OR = 1·12, 95 % CI: 1·05, 1·19; P = 0·000316). Subgroup analysis results demonstrated variations in these associations across diverse subpopulations. The E-value for the point-estimate OR calculated from the propensity score matching dataset was 1·48. Excluding individuals diagnosed with type 2 diabetes or hypertension, the findings consistently aligned with the positive association in the primary analysis. These findings suggested that consumption of a diet with higher pro-inflammatory potential might associated with an increase of future depression risk.
Milk fat synthesis is tightly regulated by hormones and growth factors. Leptin is a versatile peptide hormone that exerts pleiotropic effects on metabolic pathways. In this study, we evaluated the expression and function of leptin and its long form receptor OB-Rb in dairy cow mammary tissues from different physiological stages and in cultured mammary epithelial cells. The results showed that the expression of leptin and OB-Rb were significantly higher in the mammary tissues of lactating cows as compared with dry cows, suggesting that they are related to milk component synthesis. In cultured dairy cow mammary epithelial cells, leptin treatment significantly increased OB-Rb expression and intracellular triacylglycerol content. Transcriptome analysis identified the difference in gene expression between leptin treated cells and control cells, and 317 differentially expressed genes were identified. Gene ontology and pathway mapping showed that lipid metabolism-related gene expression increased and signal transduction pathway-related genes were the most significantly enriched. Mechanistic studies showed that leptin stimulation enhanced sterol regulatory element-binding protein 1 expression via activating the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) signaling pathway, which in turn up-regulated the expression of genes related to milk fat synthesis. Moreover, we found that fatty acid synthesis precursors, acetate and β-hydroxybutyrate, could positively regulate the expression of leptin and OB-Rb in bovine mammary epithelial cells, thereby potentially increasing milk fat synthesis. Our study provided novel evidence in the regulation of leptin on milk fat production in mammary glands of dairy cows, as well as experimental basis for artificial regulation of milk fat
This study aimed to evaluate the association between vegetable intake and major depressive disorder (MDD) through cross-sectional analysis and bidirectional two-sample Mendelian randomisation (MR).
Design:
Cross-sectional analysis was conducted on National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 and the corresponding Food Patterns Equivalents Database (FPED). Genome-wide association study (GWAS) data were obtained from UK Biobank and Psychiatric Genomics Consortium (PGC) dataset. Logistic regression analysis was performed after calculating the weights of the samples. Inverse variance weighted, MR-Egger and weighted median methods were used to evaluate the causal effects.
Setting:
A Patient Health Questionnaire-9 score ≥ 10 was considered to indicate MDD. Low vegetable intake was defined as < 2 cups of vegetables per day.
Participants:
30 861 U.S. adults from NHANES. The GWAS data sample size related to vegetable intake were comprised 448 651 and 435 435 cases respectively, while the GWAS data sample size associated with MDD encompassed 500 199 cases.
Results:
There were 23 249 (75·33 %) participants with low vegetable intake. The relationship between vegetable intake and MDD was nonlinear. In the multivariate model adjusted for sex, age, education, marital status, poverty income ratio, ethnicity and BMI, participants with low vegetable intake were associated with an increased risk of MDD (OR = 1·53, 95 % CI (1·32, 1·77), P < 0·001). Bidirectional MR showed no causal effects between vegetable intake and MDD.
Conclusions:
Cross-sectional analysis identified a significant relationship between vegetable intake and MDD, whereas the results from bidirectional two-sample MR did not support a causal role.
This research communication screened and identified differentiated expressed genes in bovine mammary epithelial cells (BMECs) upon prolactin (PRL) stimulation. PRL of 5 μg/ml increased β-casein synthesis in BMECs with milk protein synthesis capacity. RNA sequencing (RNA-seq) was used to screen differentially expressed genes (DEGs). A total of 375 DEGs (165 up-regulated and 210 down-regulated) were identified between PRL-stimulated group and the control group. Gene ontology enrichment analysis showed that the up-regulated genes were primarily associated with cell functions, metabolic processes, and biological regulatory processes. Pathway enrichment analysis showed that the up-regulated genes were mainly enriched in JAK-STAT, Rap1, Ras and Notch signaling pathways, which are widely involved in cell proliferation, differentiation and milk component synthesis. This study provides an initial understanding of the changes in gene expression in BMECs with PRL-stimulation, as determined by RNA-seq transcriptomic analysis, thereby enhancing our knowledge of the molecular regulation of lactation metabolism.
Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
Gentiana straminea Maxim. (Gentianaceae) is an important traditional Tibetan herb that is mainly distributed on the Qinghai-Tibetan Plateau. Despite its agricultural and pharmacological importance, there remains a paucity of microsatellite markers, particularly expressed sequence tag-simple sequence repeat (EST-SSR) markers, available for this local endemic species. In this study, based on previous Illumina transcriptome data of G. straminea, a total of 96 EST-SSR markers were initially designed and tested. Thirty-two of 96 loci (33.33%) were successfully amplified and verified for validation. Among them, 10 were polymorphic and had clear bands. The polymorphism information content values were 0.09–0.799, the number of alleles per locus ranged from 3 to 14, and the levels of observed and expected heterozygosity were 0.078–0.722 and 0.238–0.884, respectively, which suggested a high level of information. Moreover, cross-amplification was successful for 10 loci in two other related species, Gentiana macrophylla Pallas and Gentiana dahurica Fischer. These EST-SSR markers provide a valuable tool for investigating the genetic diversity related to quantitative traits and population genetic studies on G. straminea and related species in sect. Cruciata Gaudin.
Double-cone ignition [Zhang et al., Phil. Trans. R. Soc. A 378, 20200015 (2020)] was proposed recently as a novel path for direct-drive inertial confinement fusion using high-power lasers. In this scheme, plasma jets with both high density and high velocity are required for collisions. Here we report preliminary experimental results obtained at the Shenguang-II upgrade laser facility, employing a CHCl shell in a gold cone irradiated with a two-ramp laser pulse. The CHCl shell was pre-compressed by the first laser ramp to a density of 3.75 g/cm3 along the isentropic path. Subsequently, the target was further compressed and accelerated by the second laser ramp in the cone. According to the simulations, the plasma jet reached a density of up to 15 g/cm3, while measurements indicated a velocity of 126.8 ± 17.1 km/s. The good agreements between experimental data and simulations are documented.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.