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Klebsiella pneumoniae are common pathogens causing bloodstream infection (BSI) that increasingly express carbapenem resistance worldwide. To date, no study has precisely investigated the impact of carbapenem resistance in K. pneumoniae (CRKP) BSI on mortality.
Methods:
This retrospective study included 87 patients with CRKP BSI and 321 patients with carbapenem-susceptible K. pneumoniae (CSKP) BSI from 2015 to 2020. Propensity score analyses with stabilized inverse probability of treatment weighting (IPTW-S) was applied to balance covariates. The hazard ratio for 30-day mortality associated with carbapenem resistance was estimated using Cox regression and Kaplan-Meier curves.
Results:
The 30-day crude mortality rates were 43.7% in patients with CRKP BSI and 17.8% in patients with CSKP BSI (P < .001). Age ≥55 years, underlying hematological malignancies and hemodialysis were independently associated with mortality in CRKP BSI. A skin or soft-tissue infection source, urinary catheter, and underlying chronic obstructive pulmonary disease were predictors of mortality in CSKP BSI. The group characteristics were well balanced after IPTW-S. The adjusted hazard ratio for 30-day mortality for CRKP BSI was 1.607 (interquartile range, 0.814–3.171).
Conclusions:
Carbapenem resistance was not associated with a significant increase in 30-day mortality in KP BSI; patient and disease factors were primary determinants of outcomes.
We aimed to evaluate the reliable rate of normal/balanced embryos for reciprocal translocation and Robertsonian translocation carriers and to provide convincing evidence for clinical staff to conduct genetic counselling regarding common structural rearrangements to alleviate patient anxiety. The characteristics of 39,459 embryos that were sourced from unpublished data and literature were analyzed. The samples consisted of 17,536 embryo karyotypes that were not published and 21,923 embryo karyotypes obtained from the literature. Using the PubMed, Cochrane Library, Web of Science, and Embase databases, specific keywords were used to screen the literature for reciprocal translocation and Robertsonian translocation. The ratio of normal/balanced embryos in the overall data was calculated and analyzed, and we grouped the results according to gender to confirm if there were gender differences. We also divided the data into the cleavage stage and blastocyst stage according to the biopsy period to verify if there was a difference in the ratio of normal/balanced embryos. By combining the unpublished data and data derived from the literature, the average rates of normal/balanced embryos for reciprocal translocation and Robertsonian translocation carriers were observed to be 26.96% (7953/29,495) and 41.59% (4144/9964), respectively. Reciprocal translocation and Robertson translocation exhibited higher rates in male carriers than they did in female carriers (49.60% vs. 37.44%; 29.84% vs. 27.67%). Additionally, the data for both translocations exhibited differences in the normal/balanced embryo ratios between the cleavage and blastocyst stages of carriers for both Robertsonian translocation and reciprocal translocation (36.07% vs 43.43%; 24.88% vs 27.67%). The differences between the two location types were statistically significant (P < 0.05). The normal/balanced ratio of embryos in carriers of reciprocal and RobT was higher than the theoretical ratio, and the values ranged from 26.96% to 41.59%. Moreover, the male carriers possessed a higher number of embryos that were normal or balanced. The ratio of normal/balanced embryos in the blastocyst stage was higher than that in the cleavage stage. The results of this study provide a reliable suggestion for future clinic genetic consulting regarding the rate of normal/balanced embryos of reciprocal translocation and Robertsonian translocation carriers.
The concentration of suspended particulate organic carbon (POC) and its carbon isotopic composition (δ13CPOC) were analysed in this study with the aim of exploring the sources and factors influencing levels of POC in the surface water around the Antarctic Peninsula. The scanning electron microscopy results suggest that diatom particles formed the main component of suspended particulate matter, indicating that POC was mainly from in situ primary production. The high concentrations of chlorophyll a and POC in sea water mainly occurred in nearshore and sea-ice edge regions, which might be controlled by nutrient and reactive iron inputs stemming from sea-ice melting. The δ13CPOC in the study area is significantly lower than that in low-latitude waters, with a range of -31.8‰ to -22.8‰ (mean -28.9‰), which was controlled by the high CO2 concentration in the Southern Ocean and might be influenced by phytoplankton growth rates and assemblages. This study helps us to understand material cycling in the Antarctic region under the conditions of global climate change.
To investigate the spiritual care needs and their attributes among Chinese elders hospitalized for severe chronic heart failure (CHF) based on the Kano model, in order to provide a reference for improving the quality and satisfaction of spiritual care.
Methods
An observational design was implemented, and the STROBE Checklist was used to ensure quality reporting of the study. The demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, and the Kano model–based Nurse Spiritual Therapeutics Attributes Scale were used. A convenience sample of 451 patients were selected from 2 hospitals. Descriptive statistics, and Kano model were used to analyze the data.
Results
The total score of spiritual care needs was 29.95 ± 7.51. Among the 12 items, 3 items were attractive attributes, all of which were located in Reserving Zone IV; 5 items were one-dimensional attributes, of which 3 were located in Predominance Zone I and 2 were located in Improving Zone II; 2 items were must-be attributes, all of which were located in Improving Zone II; and 2 items were indifference attributes, all of which were located in Secondary Improving Zone III.
Significance of results
The spiritual care needs among Chinese elders hospitalized for severe CHF were moderate. The must-be and one-dimensional attributes mainly focus on “creating a good atmosphere” and “sharing self-perception” dimensions, while attractive attributes mainly focus on “sharing self-perception” and “helping thinking” dimensions. It is suggested that hospital authority should develop and innovate attractive attributes on the basis of maintaining and perfecting must-be and one-dimensional attributes, and objectively analyze and optimize indifference attributes.
As an attractive collector medium for hypervelocity particles, combined with outstanding physical properties and suitable compositional characteristics, SiO2 aerogel has been deployed on outer space missions and laser shock-loaded collection experiments. In this paper, impact experiments were conducted to understand the penetration process of irregular grains, irregular Al2O3 grains with two different sizes and speeds (~110 μm@7 km/s, ~251 μm@2.3 km/s) at various density silica aerogels. By classifying the shapes of projectile residues and tracks, the morphology of tracks was analyzed. It was observed that there were several kinds of typical tracks in the penetration of irregular grains, accompanied by residues with the shapes of near-sphere, polyhedron, streamlined body wedge, and rotator. The rotational behavior was demonstrated by the final status of one flake projectile as direct evidence. In addition, there was no obvious relationship between the track length and experimental parameters, which may be caused by the uncertain interaction between aerogels and irregular particles. In addition, it confirmed the existence of fragmentation, melting situation by observing the shape of the impact entrance hole. At the same time, optical coherence tomography was used to observe the detail of tracks clearly, which provided a method to characterize the tracks nondestructively.
Upper Ordovician strata exposed from the Baiyanhuashan section is the most representative Late Ordovician unit in the northwestern margin of the North China Craton (NCC). In total, 1,215 conodont specimens were obtained from 24 samples through the Wulanhudong and Baiyanhuashan formations at the Baiyanhuashan section. Thirty-six species belonging to 17 genera, including Tasmanognathus coronatus new species, are present. Based on this material, three conodont biozones—the Belodina confluens Biozone, the Yaoxianognathus neimengguensis Biozone, and the Yaoxianognathus yaoxianensis Biozone—have been documented, suggesting that the Baiyanhuashan conodont fauna has a stratigraphic range spanning the early to middle Katian. The Baiyanhuashan conodont fauna includes species both endemic to North China and widespread in tropical zones, allowing a reassessment of the previous correlations of the Katian conodont zonal successions proposed for North China with those established for shallow-water carbonate platforms at low latitudes.
Let
$\mathcal{C}$
be a fusion category over an algebraically closed field
$\mathbb{k}$
of arbitrary characteristic. Two numerical invariants of
$\mathcal{C}$
, that is, the Casimir number and the determinant of
$\mathcal{C}$
are considered in this paper. These two numbers are both positive integers and admit the property that the Grothendieck algebra
$(\mathcal{C})\otimes_{\mathbb{Z}}K$
over any field K is semisimple if and only if any of these numbers is not zero in K. This shows that these two numbers have the same prime factors. If moreover
$\mathcal{C}$
is pivotal, it gives a numerical criterion that
$\mathcal{C}$
is nondegenerate if and only if any of these numbers is not zero in
$\mathbb{k}$
. For the case that
$\mathcal{C}$
is a spherical fusion category over the field
$\mathbb{C}$
of complex numbers, these two numbers and the Frobenius–Schur exponent of
$\mathcal{C}$
share the same prime factors. This may be thought of as another version of the Cauchy theorem for spherical fusion categories.
We designed a resorcinol-formaldehyde (RF) sol–gel ink for direct ink writing of the microlattices. To improve the formability, the fresh microlattices were strengthened by surface catalysis with HCl atmosphere. After supercritical drying and carbonization, the sample’s specific surface area was 631 m2/g and the average pore size was 3.81 nm. Both RF aerogel and carbonized RF aerogel samples had millimeter-scale pore, micron-scale pore, and nanoscale skeleton. The pore and skeleton could provide high surface area and diffusion channels, which were beneficial to the adsorption performances. The carbonized RF aerogel sample fully adsorbed Dulbecco’s modified eagle medium in 250 min, which exhibited a good capacity of quick adsorption and indicated the potential application for cell supports.
Parameter uncertainties which may lead to divergence of traditional Kalman filters during Mars entry are investigated in this paper. To achieve high precision navigation, a Derivative-free Nonlinear version of an Extended Recursive Three-Step Filter (DNERTSF) is introduced, which suits nonlinear systems with arbitrary parameter uncertainties. A DNERTSF can estimate the state and the parameters simultaneously, and Jacobian and Hessian calculations are not necessary for this filter. Considering the uncertainties in atmosphere density, ballistic coefficient and lift-to-drag ratio, a numerical simulation of Mars entry navigation is carried out. Compared with the standard Unscented Kalman Filter (UKF), DNERTSF can effectively reduce the adverse effects of parameter uncertainties and achieve a high navigation accuracy performance, keeping position and velocity estimation errors at a very low level. In all, the DNERTSF in this paper shows good advantages for Mars entry navigation, providing a possible application for a future Mars pinpoint landing.
This paper deals with the Green ring $\mathcal{G}(\mathcal{C})$ of a finite tensor category $\mathcal{C}$ with finitely many isomorphism classes of indecomposable objects over an algebraically closed field. The first part of this paper deals with the question of when the Green ring $\mathcal{G}(\mathcal{C})$, or the Green algebra $\mathcal{G}(\mathcal{C})\otimes_{\mathbb {Z}}$K over a field K, is Jacobson semisimple (namely, has zero Jacobson radical). It turns out that $\mathcal{G}(\mathcal{C})\otimes_{\mathbb {Z}}$K is Jacobson semisimple if and only if the Casimir number of $\mathcal{C}$ is not zero in K. For the Green ring $\mathcal{G}(\mathcal{C})$ itself, $\mathcal{G}(\mathcal{C})$ is Jacobson semisimple if and only if the Casimir number of $\mathcal{C}$ is not zero. The second part of this paper focuses on the case where $\mathcal{C}=\text{Rep}(\mathbb {k}G)$ for a cyclic group G of order p over a field $\mathbb {k}$ of characteristic p. In this case, the Casimir number of $\mathcal{C}$ is computable and is shown to be 2p2. This leads to a complete description of the Jacobson radical of the Green algebra $\mathcal{G}(\mathcal{C})\otimes_{\mathbb {Z}}$K over any field K.
PHT-splines are a type of polynomial splines over hierarchical T-meshes which posses perfect local refinement property. This property makes PHT-splines useful in geometric modeling and iso-geometric analysis. Current implementation of PHT-splines stores the basis functions in Bézier forms, which saves some computational costs but consumes a lot of memories. In this paper, we propose a de Boor like algorithm to evaluate PHT-splines provided that only the information about the control coefficients and the hierarchical mesh structure is given. The basic idea is to represent a PHT-spline locally in a tensor product B-spline, and then apply the de-Boor algorithm to evaluate the PHT-spline at a certain parameter pair. We perform analysis about computational complexity and memory costs. The results show that our algorithm takes about the same order of computational costs while requires much less amount of memory compared with the Bézier representations. We give an example to illustrate the effectiveness of our algorithm.
Super-black carbon aerogel sleeves (CAS) with different reflectivities and a clear aperture had been made, by the sol–gel polycondensation of resorcinol (R) and formaldehyde (F) under the catalysis of sodium carbonate (C), and was used to eliminate stray light. We explained that the subwavelength structure is the main factor that leads to the low reflectivity of CA and constructed a simple optical system to measure the exit power from CAS in different directions. We proved that different CASs have different matting effects, and all of these CASs have better matting effects than that of monolithic graphite that has higher reflectivity. To show the fine angular resolution ability of CAS, we measured the faculae from the reflected light of a compact disc and found that the CAS with a clear aperture of 1.0 mm is the best. The super-black CAS could be used in precision optical instruments and to eliminate stray light in the optical.
The temporal dynamics of ciliate community structure in a southern Chinese shrimp aquaculture facility were investigated during the period June–September 2012. A total of 53 species belonging to 37 genera and 17 orders were recorded based on analyses of eight samples. Ciliate abundance peaked between 16 August and 14 September 2012, while the maximum number of species occurred on 26 June 2012. Clear temporal patterns were observed in the ciliate community structure. The patterns of succession of the 10 most abundant species were consistent with the results of a Canonical Analysis of Principal coordinates (CAP) analysis. Correlation analyses showed that these patterns of succession were related to temporal changes in environmental variables. In summary, the results demonstrate that the ciliate community responds predictably to environmental variations and recovers from shrimp cultivation.
Accurate navigation systems are required for future pinpoint Mars landing missions. A radio ranging augmented Inertial Measurement Unit (IMU) integrated navigation system concept is considered for the Mars entry navigation. The uncertain system parameters associated with the Three Degree-Of-Freedom (3-DOF) dynamic model, and the measurement systematic errors are considered. In order to improve entry navigation accuracy, this paper presents the Multiple Model Adaptive Rank Estimation (MMARE) filter of radio beacons/IMU integrated navigation system. 3-DOF simulation results show that the performances of the proposed navigation filter method, 70·39 m estimated altitude error and 15·74 m/s estimated velocity error, fulfill the need of future pinpoint Mars landing missions.
Data on grain size and heavy mineral composition for surface sediments on the Prydz Bay continental shelf was analysed to identify sediment features and provenance. The grain size composition of surface sediments indicate spatial variations in the glaciomarine environment and the key factors influencing sedimentation, which on the shelf include topography/water depth, currents and icebergs. The study area was divided into two sections by Q-type factor analysis: section I included Prydz Channel, Amery Basin and Svenner Channel, and section II included Four Ladies Bank, Fram Bank and the area in front of the Amery Ice Shelf. Sedimentation in section I is mainly controlled by currents and topography/water depth. However, in section II, icebergs/floating ice masses, the Amery Ice Shelf and currents have prominent effects on sedimentation. The heavy mineral composition indicates that surface sediments on the eastern side of the bay, including Four Ladies Bank, are primarily derived from Princess Elizabeth Land. Sediments in the area in front of the Amery Ice Shelf, Svenner Channel, Amery Basin and Prydz Channel have a mixed source from the eastern regions around the bay, including the Prince Charles Mountains and Princess Elizabeth Land. The contribution from Mac. Robertson Land to sediment at Fram Bank is limited.
Inertia strongly influences the dynamic performance of parallel manipulators, and ignorance of inertia is apt to result in negative phenomena such as vibrations, overshoot, and slow response. This study analyzes the inertia-decoupling characteristic of Stewart platform. Because the inertia matrix of the Stewart platform is usually non-diagonal, inertia coupling occurs between its legs. Herein, decoupling to inertia is implemented, and independent control channels are determined. The influence of decoupled inertia on the control system is analyzed using the Adams simulation software, and the inertia index of the Stewart platform is proposed. Experiments are conducted on a prototype of the Stewart platform to verify the eigenvalue characteristic of decoupled inertia. The distribution of inertia index in the operational workspace is provided, and the influence of dimensional parameters on inertia index is discussed. Finally, dimensional optimization is realized with a set of optimized dimensions for good dynamic performance.
Mutational and NMR methods were used to investigate features
of sequence, structure, and dynamics that are associated with
the ability of a pseudoknot to stimulate a −1 frameshift.
In vitro frameshift assays were performed on retroviral
gag-pro frameshift-stimulating pseudoknots and their
derivatives, a pseudoknot from the gene 32 mRNA of
bacteriophage T2 that is not naturally associated with
frameshifting, and hybrids of these pseudoknots. Results show
that the gag-pro pseudoknot from human endogenous
retrovirus-K10 (HERV) stimulates a −1 frameshift with
an efficiency similar to that of the closely related retrovirus
MMTV. The bacteriophage T2 mRNA pseudoknot was found to be a
poor stimulator of frameshifting, supporting a hypothesis that
the retroviral pseudoknots have distinctive properties that
make them efficient frameshift stimulators. A hybrid, designed
by combining features of the bacteriophage and retroviral
pseudoknots, was found to stimulate frameshifting while retaining
significant structural similarity to the nonframeshifting
bacteriophage pseudoknot. Mutational analyses of the retroviral
and hybrid pseudoknots were used to evaluate the effects of
an unpaired (wedged) adenosine at the junction of the pseudoknot
stems, changing the base pairs near the junction of the two
stems, and changing the identity of the loop 2 nucleotide nearest
the junction of the stems. Pseudoknots both with and without
the wedged adenosine can stimulate frameshifting, though the
identities of the nucleotides near the stem1/stem2 junction
do influence efficiency. NMR data showed that the bacteriophage
and hybrid pseudoknots are similar in their local structure
at the junction of the stems, indicating that pseudoknots that
are similar in this structural feature can differ radically
in their ability to stimulate frameshifting. NMR methods were
used to compare the internal motions of the bacteriophage T2
pseudoknot and representative frameshifting pseudoknots. The
stems of the investigated pseudoknots are similarly well ordered
on the time scales to which nitrogen-15 relaxation data are
sensitive; however, solvent exchange rates for protons at the
junction of the two stems of the nonframeshifting bacteriophage
pseudoknot are significantly slower than the analogous protons
in the representative frameshifting pseudoknots.
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