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The study aims were to present in vitro susceptibilities of clinical isolates from Gram-negative bacteria bloodstream infections (GNBSI) collected in China. GNBSI isolates were collected from 18 tertiary hospitals in 7 regions of China from 2018 to 2020. Minimum inhibitory concentrations were assessed using a Trek Diagnostic System. Susceptibility was determined using CLSI broth microdilution, and breakpoints were interpreted using CLSI M100 (2021). A total of 1,815 GNBSI strains were collected, with E. coli (42.4%) and Klebsiella pneumoniae (28.6%) being the most prevalent species, followed by P. aeruginosa (6.7%). Susceptibility analyses revealed low susceptibilities (<40%) of ESBL-producing E. coli and K. pneumonia to third-/fourth-generation cephalosporins, monobactamases, and fluoroquinolones. High susceptibilities to colistin (95.0%) and amikacin (81.3%) were found for K. pneumoniae, while Acinetobacter baumannii exhibited a high susceptibility (99.2%) to colistin but a low susceptibility to other antimicrobials (<27.5%). Isolates from ICUs displayed lower drug susceptibility rates of K. pneumoniae and A. baumannii than isolates from non-ICUs (all P < 0.05). Carbapenem-resistant and ESBL-producing K. pneumoniae detection was different across regions (both P < 0.05). E. coli and K. pneumoniae were major contributors to GNBSI, while A. baumannii exhibited severe drug resistance in isolates obtained from ICU departments.
C-type lectins (CTLs), a diverse family of pattern recognition receptors, are essential for immune recognition and pathogen clearance in invertebrates. TcCTL17 contains one carbohydrate recognition domain and three scavenger receptor Cys-rich domains. Spatial and temporal expression analysis revealed that TcCTL17 is highly expressed in early pupa, early adult stages, and the larval gut at 20 days. The recombinant TcCTL17 exhibited dose-dependent binding to lipopolysaccharides and peptidoglycans, Ca2+-dependent binding and agglutination of bacteria in vitro. Knocking down TcCTL17 before bacterial exposure reduced survival rates and increased bacterial loads in T. castaneum larvae, accompanied by decreased antimicrobial peptide expression and haemolymph phenoloxidase activity. Additionally, TcCTL17 RNA interference caused developmental abnormalities, affecting metamorphosis and fecundity, possibly by influencing the 20E, JH, and vitellogenin pathways. These findings underscore dual functions of TcCTL17 in immunity and development, making it a potential target for pest management.
Substantial changes resulting from the interaction of environmental and dietary factors contribute to an increased risk of obesity, while their specific associations with obesity remain unclear. We identified inflammation-related dietary patterns (DP) and explored their associations with obesity among urbanised Tibetan adults under significant environmental and dietary changes. Totally, 1826 subjects from the suburbs of Golmud City were enrolled in an open cohort study, of which 514 were followed up. Height, weight and waist circumference were used to define overweight and obesity. DP were derived using reduced rank regression with forty-one food groups as predictors and high-sensitivity C-reactive protein and prognostic nutritional index as inflammatory response variables. Altitude was classified as high or ultra-high. Two DP were extracted. DP-1 was characterised by having high consumptions of sugar-sweetened beverages, savoury snacks, and poultry and a low intake of tsamba. DP-2 had high intakes of poultry, pork, animal offal, and fruits and a low intake of butter tea. Participants in the highest tertiles (T3) of DP had increased risks of overweight and obesity (DP-1: OR = 1·37, 95 % CI 1·07, 1·77; DP-2: OR = 1·48, 95 % CI 1·18, 1·85) than those in the lowest tertiles (T1). Participants in T3 of DP-2 had an increased risk of central obesity (OR = 2·25, 95 % CI 1·49, 3·39) than those in T1. The positive association of DP-1 with overweight and obesity was only significant at high altitudes, while no similar effect was observed for DP-2. Inflammation-related DP were associated with increased risks of overweight and/or obesity.
This paper proposes an online robust self-learning terminal sliding mode control (RS-TSMC) with stability guarantee for balancing control of reaction wheel bicycle robots (RWBR) under model uncertainties and disturbances, which improves the balancing control performance of RWBR by optimising the constrained output of TSMC. The TSMC is designed for a second-order mathematical model of RWBR. Then robust adaptive dynamic programming based on an actor-critic algorithm is used to optimise the TSMC only by data sampled online. The system closed-loop stability and convergence of the neural network weights are guaranteed based on the Lyapunov analysis. The effectiveness of the proposed algorithm is demonstrated through simulations and experiments.
Our study aimed to develop and validate a nomogram to assess talaromycosis risk in hospitalized HIV-positive patients. Prediction models were built using data from a multicentre retrospective cohort study in China. On the basis of the inclusion and exclusion criteria, we collected data from 1564 hospitalized HIV-positive patients in four hospitals from 2010 to 2019. Inpatients were randomly assigned to the training or validation group at a 7:3 ratio. To identify the potential risk factors for talaromycosis in HIV-infected patients, univariate and multivariate logistic regression analyses were conducted. Through multivariate logistic regression, we determined ten variables that were independent risk factors for talaromycosis in HIV-infected individuals. A nomogram was developed following the findings of the multivariate logistic regression analysis. For user convenience, a web-based nomogram calculator was also created. The nomogram demonstrated excellent discrimination in both the training and validation groups [area under the ROC curve (AUC) = 0.883 vs. 0.889] and good calibration. The results of the clinical impact curve (CIC) analysis and decision curve analysis (DCA) confirmed the clinical utility of the model. Clinicians will benefit from this simple, practical, and quantitative strategy to predict talaromycosis risk in HIV-infected patients and can implement appropriate interventions accordingly.
Panulirus stimpsoni is restricted to southern China, Vietnam, and Japan but has been rarely reported in tropical Gulf of Thailand. In Malaysia, only six species were previously reported. This study (1) reports the seventh Malaysian species – a new record of P. stimpsoni with morphological and genetic data; (2) establishes a checklist of Malaysian Panulirus species. Surveys from 2021 to 2022 sampled lobsters across Malaysia by SCUBA or from fishermen. Seven species were identified and a modified key of Malaysian species was constructed. The COI gene was used for genetic identification and phylogenetic tree reconstruction with maximum likelihood (ML). The best model was GTR + I + G. The ML tree comprised Clades I and II with sequences clustering by species and strong support. Most Peninsular Malaysian lobsters were P. polyphagus while P. versicolor dominated Sabah. Information on P. stimpsoni's full fishery potential, distribution, ecology, and biology is limited. Further research is needed to ensure conservation and management as data are only available for six previously reported species. Further studies are required to discover sustainable use approaches for all Panulirus species, particularly P. stimpsoni, given limited ecological understanding.
This work investigates the spatio-temporal evolution of coherent structures in the wake of a generic high-speed train, based on a three-dimensional database from large eddy simulation. Spectral proper orthogonal decomposition (SPOD) is used to extract energy spectra and energy ranked empirical modes for both symmetric and antisymmetric components of the fluctuating flow field. The spectrum of the symmetric component shows overall higher energy and more pronounced low-rank behaviour compared with the antisymmetric one. The most dominant symmetric mode features periodic vortex shedding in the near wake, and wave-like structures with constant streamwise wavenumber in the far wake. The mode bispectrum further reveals the dominant role of self-interaction of the symmetric component, leading to first harmonic and subharmonic triads of the fundamental frequency, with remarkable deformation of the mean field. Then, the stability of the three-dimensional wake flow is analysed based on two-dimensional local linear stability analysis combined with a non-parallelism approximation approach. Temporal stability analysis is first performed for both the near-wake and the far-wake regions, showing a more unstable condition in the near-wake region. The absolute frequency of the near-wake eigenmode is determined based on spatio-temporal analysis, then tracked along the streamwise direction to find out the global mode growth rate and frequency, which indicate a marginally stable global mode oscillating at a frequency very close to the most dominant SPOD mode. The global mode wavemaker is then located, and the structural sensitivity is calculated based on the direct and adjoint modes derived from a local spatial analysis, with the maximum value localized within the recirculation region close to the train tail. Finally, the global mode shape is computed by tracking the most spatially unstable eigenmode in the far wake, and the alignment with the SPOD mode is computed as a function of streamwise location. By combining data-driven and theoretical approaches, the mechanisms of coherent structures in complex wake flows are well identified and isolated.
Isolated multi-MeV $\gamma$-rays with attosecond duration, high collimation and beam angular momentum (BAM) may find many interesting applications in nuclear physics, astrophysics, etc. Here, we propose a scheme to generate such $\gamma$-rays via nonlinear Thomson scattering of a rotating relativistic electron sheet driven by a few-cycle twisted laser pulse interacting with a micro-droplet target. Our model clarifies the laser intensity threshold and carrier-envelope phase effect on the generation of the isolated electron sheet. Three-dimensional numerical simulations demonstrate the $\gamma$-ray emission with 320 attoseconds duration and peak brilliance of $9.3\times 10^{24}$ photons s${}^{-1}$ mrad${}^{-2}$ mm${}^{-2}$ per 0.1$\%$ bandwidth at 4.3 MeV. The $\gamma$-ray beam carries a large BAM of $2.8 \times 10^{16}\mathrm{\hslash}$, which arises from the efficient BAM transfer from the rotating electron sheet, subsequently leading to a unique angular distribution. This work should promote the experimental investigation of nonlinear Thomson scattering of rotating electron sheets in large laser facilities.
Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus.
Aims
To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS.
Method
We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted.
Results
From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37–4.06) and decreased PTSS severity (standardised mean difference −0.29, 95% CI −0.50 to −0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59–5.00) and PTSS severity (standardised mean difference 0.53, 95% CI −0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors.
Conclusions
Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group.
The AIMTB rapid test assay is an emerging test, which adopted a fluorescence immunochromatographic assay to measure interferon-γ (IFN-γ) production following stimulation of effector memory T cells in whole blood by mycobacterial proteins. The aim of this article was to explore the ability of AIMTB rapid test assay in detecting Mycobacterium tuberculosis (MTB) infection compared with the widely applied QuantiFERON-TB Gold Plus (QFT-Plus) test among rural doctors in China. In total, 511 participants were included in the survey. The concordance between the QFT-Plus test and the AIMTB rapid test assay was 94.47% with a Cohen’s kappa coefficient (κ) of 0.84 (95% CI, 0.79–0.90). Improved concordance between the two tests was observed in males and in participants with 26 or more years of service as rural doctors. The quantitative values of the QFT-Plus test was higher in individuals with a result of QFT-Plus-/AIMTB+ as compared to those with a result of QFT-Plus-/AIMTB- (p < 0.001). Overall, our study found that there was an excellent consistency between the AIMTB rapid test assay and the QFT-Plus test in a Chinese population. As the AIMTB rapid test assay is fast and easy to operate, it has the potential to improve latent tuberculosis infection testing and treatment at the community level in resource-limited settings.
Previous research has suggested a potential link between folic acid (FA) supplementary therapy and gastric ulcers (GU). To investigate this relationship further, we conducted a Mendelian randomisation (MR) analysis using data from the UK Biobank. Our analysis primarily employed inverse-variance weighted (IVW) methods, including both fixed-effect and random-effect models. To ensure the robustness of our findings, additional methods such as the simple median, the weighted median and the penalised weighted median were also applied. The MR analysis aimed to explore the causal effect of FA supplementary therapy on GU. Seven SNP at genetic loci associated with FA supplementary therapy were identified. Both the random-effect and fixed-effect IVW models indicated that genetically predicted FA supplementary therapy significantly reduced the risk of GU (OR, 0·870; 95 % CI 0·826, 0·917, P < 0·001). This result was consistent across other methods, with similar outcomes observed using the simple median (OR, 0·835; 95 % CI 0·773, 0·901, P < 0·001), the weighted median (OR, 0·854; 95 % CI 0·794, 0·919, P < 0·001) and the penalised weighted median (OR, 0·849; 95 % CI 0·789, 0·914, P < 0·001). Leave-one-out sensitivity analysis confirmed that no individual SNP significantly drove the association between FA supplementary therapy and GU. This MR study provides genetic evidence that FA supplementary therapy may decrease the risk of GU.
One species-general life history (LH) principle posits that challenging childhood environments are coupled with a fast or faster LH strategy and associated behaviors, while secure and stable childhood environments foster behaviors conducive to a slow or slower LH strategy. This coupling between environments and LH strategies is based on the assumption that individuals’ internal traits and states are independent of their external surroundings. In reality, individuals respond to external environmental conditions in alignment with their intrinsic vitality, encompassing both physical and mental states. The present study investigated attachment as an internal mental state, examining its role in mediating and moderating the association between external environmental adversity and fast LH strategies. A sample of 1169 adolescents (51% girls) from 9 countries was tracked over 10 years, starting from age 8. The results confirm both mediation and moderation and, for moderation, secure attachment nullified and insecure attachment maintained the environment-LH coupling. These findings suggest that attachment could act as an internal regulator, disrupting the contingent coupling between environmental adversity and a faster pace of life, consequently decelerating human LH.
Studies on obesity and risk factors from a life-course perspective among residents in the Tibet Plateau with recent economic growth and increasing obesity are important and urgently needed. The birth cohort in this area provides a unique opportunity to examine the association between maternal dietary practice and neonatal obesity. The study aims to detect the prevalence of obesity among neonates, associated with maternal diet and other factors, supporting life-course strategies for obesity control. A cohort of pregnant women was enrolled in Tibet Plateau and followed till childbirth. Dietary practice during pregnancy was assessed using the Chinese FFQ – Tibet Plateau version, food items and other variables were associated with the risk for obesity of neonates followed by logistic regression, classification and regression trees (CART) and random forest. Of the total 1226 mother–neonate pairs, 40·5 % were Tibetan and 5·4 % of neonates with obesity. Consuming fruits as a protective factor for obesity of neonates with OR (95 % CI) = 0·61 (0·43, 0·87) from logistic regression; as well as OR = 0·20 (0·12, 0·35) for consuming fruits (≥ weekly) from CART. Removing fruit consumption to avoid overshadowing effects of other factors, the following were influential from CART: maternal education (more than middle school, OR = 0·22 (0·13, 0·37)) and consumption of Tibetan food (daily, OR = 3·44 (2·08, 5·69). Obesity among neonates is prevalent in the study population. Promoting healthy diets during pregnancy and strengthening maternal education should be part of the life-course strategies for obesity control.
We systematically study the dissipative anomaly in compressible magnetohydrodynamic (MHD) turbulence using direct numerical simulations, and show that the total dissipation remains finite as viscosity diminishes. The dimensionless dissipation rate $\mathcal {C}_{\varepsilon }$ fits well with the model $\mathcal {C}_{\varepsilon } = \mathcal {C}_{\varepsilon,\infty } + \mathcal {D}/R_L^-$ for all levels of flow compressibility considered here, where $R_L^-$ is the generalized large-scale Reynolds number. The asymptotic value $\mathcal {C}_{\varepsilon,\infty }$ describes the total energy transfer flux, and decreases with increase of the flow compressibility, indicating non-universality of the dimensionless dissipation rate in compressible MHD turbulence. After introducing an empirically modified dissipation rate, the data from compressible cases collapse to a form similar to the incompressible MHD case depending only on the modified Reynolds number.
Understanding settling motion of coral grains is important in terms of protection of coral reef systems and resotoration of the associated ecosystems. In this paper, a series of laboratory experiments was conducted to investigate the settling motion, using optical microscopy to measure shape parameters of coral grains and the particle-filtering-based object tracking to reconstruct the three-dimensional trajectory. Three characteristic descent regimes, namely, tumbling, chaotic and fluttering, are classified based on the three-dimensional trajectory, the spiral radius variation and the velocity spectrum. It is demonstrated that if one randomly picks up one coral grain, then the probabilities of occurrence of the three regimes are approximately $26\,\%$, $42\,\%$ and $32\,\%$, respectively. We have shown that first, the dimensionless settling velocity generally increases with the non-dimensional diameter and Corey shape factor and second, the drag coefficient generally decreases with the Reynolds number and Corey shape factor. Based on this, the applicability of existing models on predicting settling velocity and drag coefficient for coral grains is demonstrated further. Finally, we have proposed extended models for predicting the settling velocity. This study contributes to better understanding of settling motion and improves our predictive capacity of settling velocity for coral grains with complex geometry.
Path planning for the unmanned aerial vehicle (UAV) is to assist in finding the proper path, serving as a critical role in the intelligence of a UAV. In this paper, a path planning for UAV in three-dimensional environment (3D) based on enhanced gravitational search algorithm (EGSA) is put forward, taking the path length, yaw angle, pitch angle, and flight altitude as considerations of the path. Considering EGSA is easy to fall into local optimum and convergence insufficiency, two factors that are the memory of current optimal and random disturbance with chaotic levy flight are adopted during the update of particle velocity, improving the balance between exploration and exploitation for EGSA through different time-varying characteristics. With the identical cost function, EGSA is compared with seven peer algorithms, such as moth flame optimization algorithm, gravitational search algorithm, and five variants of gravitational search algorithm. The experimental results demonstrate that EGSA is superior to the seven comparison algorithms on CEC 2020 benchmark functions and the path planning method based on EGSA is more valuable than the other seven methods in diverse environments.
The stimulated Brillouin scattering phase conjugation mirror (SBS-PCM) based on liquid media is widely used in high-power laser systems due to its robust thermal load capacity, high energy conversion efficiency and improved beam quality. Nevertheless, with an increase in the pump repetition rate, thermally-induced blooming and optical breakdown can emerge, leading to distortions in the Stokes beam. In this study, we delved into the thermal effects in liquid SBS-PCMs employing hydrodynamic analysis, establishing a relationship between beam profile distortion and the thermal convection field. We calculated the temperature and convection velocity distribution based on the pump light parameters and recorded the corresponding beam profiles. The intensities of the beam profiles were modulated in alignment with the convection directions, reaching a velocity peak of 2.85 mm/s at a pump pulse repetition rate of 250 Hz. The residual sum of squares (RSS) was employed to quantify the extent of beam profile distortion relative to a Gaussian distribution. The RSS escalated to 7.8, in contrast to 0.7 of the pump light at a pump pulse repetition rate of 500 Hz. By suppressing thermal convection using a high-viscosity medium, we effectively mitigated beam distortion. The RSS was reduced to 0.7 at a pump pulse repetition rate of 500 Hz, coinciding with a twentyfold increase in viscosity, thereby enhancing the beam quality. By integrating hydrodynamic analysis, we elucidated and mitigated distortion with targeted solutions. Our research offers an interdisciplinary perspective on studying thermal effects and contributes to the application of SBS-PCMs in high-repetition-rate laser systems by unveiling the mechanism of photothermal effects.
This study aims to gain insight into each attribute as presented in the value of implantable medical devices, quantify attributes’ strength and their relative importance, and identify the determinants of stakeholders’ preferences.
Methods
A mixed-methods design was used to identify attributes and levels reflecting stakeholders’ preference toward the value of implantable medical devices. This design combined literature reviewing, expert’s consultation, one-on-one interactions with stakeholders, and a pilot testing. Based on the design, six attributes and their levels were settled. Among 144 hypothetical profiles, 30 optimal choice sets were developed, and healthcare professionals (decision-makers, health technology assessment experts, hospital administrators, medical doctors) and patients as stakeholders in China were surveyed. A total of 134 respondents participated in the survey. Results were analyzed by mixed logit model and conditional logit model.
Results
The results of the mixed logit model showed that all the six attributes had a significant impact on respondents’ choices on implantable medical devices. Respondents were willing to pay the highest for medical devices that provided improvements in clinical safety, followed by increased clinical effectiveness, technology for treating severe diseases, improved implement capacity, and innovative technology (without substitutes).
Conclusions
The findings of DCE will improve the current evaluation on the value of implantable medical devices in China and provide decision-makers with the relative importance of the criteria in pricing and reimbursement decision-making of implantable medical devices.
Early diagnosis of acute coronary syndrome is more and more important because of its mortality and morbidity. Hypertension is one of the pathogenesis of acute coronary syndrome, which often leads to stenosis and ischaemia. Ischaemia-modified albumin is sensitive for the occurrence of ischaemia, which attracted us in the significance of ischaemia-modified albumin in patients with chest pain, especially patients complicated with hypertension.
Methods:
In total, 200 patients with acute chest pain were included in the study. According to the diagnostic criteria, patients were divided into acute coronary syndrome group and non-ischaemic chest pain group. Cardiac biomarkers were measured with 30 minutes in emergency department, including cardiac troponin T, creatine kinase MB, and ischaemia-modified albumin. Receiver operating characteristic curve (ROC) analysis was used for the sensitivity and specificity of ischaemia-modified albumin in the early diagnosis of acute coronary syndrome. Comparisons between ischaemia-modified albumin and cardiac Troponin T were done between groups.
Results:
The demographics in two groups were not significantly different in most aspects. Compared with non-ischaemic chest pain group, serum levels of ischaemia-modified albumin and cardiac Troponin T were significantly higher in acute coronary syndrome group. ROC analysis showed that ischaemia-modified albumin had a good sensitivity and specificity in early diagnosis of acute coronary syndrome. The level of ischaemia-modified albumin in acute coronary syndrome patients with hypertension was higher than that in non-ischaemic chest pain patients.
Conclusions:
In patients complained with acute chest pain, the serum measurement of ischaemia-modified albumin is potential valuable for the early diagnosis of acute coronary syndrome, especially combined with ECG. The serum level of ischaemia-modified albumin in acute coronary syndrome patients is significantly associated with hypertension.