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To explore the progress that the Veterans Health Administration has made to minimize the impact of the penicillin (PCN) allergy label, we determined the proportion of Veterans who reported a PCN-class allergy at the time of hospitalization and described antibiotic use in hospitalizations with and without a PCN-class allergy.
Design:
Cross-sectional study.
Participants:
National sample of 6,541,299 acute care admissions between 2011 and 2022.
Methods:
We calculated the prevalence of PCN-class allergies on admission and used Poisson regression to compare patterns of antibiotic use between hospitalizations with and without a PCN-class allergy.
Results:
The prevalence of PCN-class allergies on admission decreased from 12.99% to 11.20%. Use of cefazolin and non-pseudomonal third-generation cephalosporins increased regardless of PCN-class allergy status (“PCN-class allergy only” +11.46%, “No antibiotic allergy” +4.92%). The prevalence ratio (PR) for antibiotic use in hospitalizations with a PCN-class allergy compared to hospitalizations without antibiotic allergies, decreased for anti-Methicillin Resistant Staphylococcus aureus agents (1.26 [1.25, 1.28] to 1.15 [1.13, 1.17]), carbapenems (1.59 [1.54, 1.65] to 1.47 [1.41, 1.53]), and aztreonam (23.89 [22.45, 25.43] to 17.57 [15.90, 19.42]); and increased for fluoroquinolones (1.58 [1.56, 1.60] to 2.15 [2.09, 2.20]).
Conclusions:
Prevalence of PCN-class allergies is declining and narrow-spectrum βL use is rising among hospitalized Veterans. Prescribing differences are decreasing between hospitalizations with and without a reported PCN-class allergy, except for aminoglycosides, clindamycin, and fluoroquinolones. These findings can serve to identify areas of focus for future analyses or interventions related to the impact of the PCN allergy label on antibiotic selection.
Deep learning (DL) has been widely used in bearing fault diagnosis. In particular, convolutional neural networks (CNNs) improve diagnosis accuracy by extracting excellent fault features. However, CNN lacks an explicit learning mechanism to distinguish between different fault characteristics in the input signal to the diagnosis results. This article presents a new end-to-end depth framework called multi-head self-attention convolution neural network (MSA-CNN) for bearing fault diagnosis. Firstly, we adopt a data pre-processing method that directly converts one-dimensional (1D) original signals into two-dimensional (2D) grayscale images, which is simple to implement and preserves the complete information of the original signal. Secondly, multi-head self-attention (MSA) is first constructed to aggregate the global information and adaptively assign weights to the input signal's features. Thirdly, the CNN with small-scale kernels extracted detailed local features. Finally, the learned high-level representations are fed into the full connect (FC) layer for fault diagnosis. The performance of the MSA-CNN is validated on different datasets. The results show that the proposed MSA-CNN can significantly improve fault diagnosis accuracy compared with the other state-of-the-art methods and has excellent noise immunity performance.
The current LiDAR-inertial odometry is prone to cumulative Z-axis error when it runs for a long time. This error can easily lead to the failure to detect the loop-closing in the correct scenario. In this paper, a ground-constrained LiDAR-inertial SLAM is proposed to solve this problem. Reasonable constraints on the ground motion of the mobile robot are incorporated to limit the Z-axis drift error. At the same time, considering the influence of initial positioning error on navigation, a keyframe selection strategy is designed to effectively improve the flatness and accuracy of positioning and the efficiency of loop detection. If GNSS is available, the GNSS factor is added to eliminate the cumulative error of the trajectory. Finally, a large number of experiments are carried out on the self-developed robot platform to verify the effectiveness of the algorithm. The results show that this method can effectively improve location accuracy in outdoor environments, especially in environments of feature degradation and large scale.
A walking robot consisting of double Stewarts parallel legs was designed by our research team in the past time, which was mainly used for the transportation of the wounded after the disaster. In order to promote stability of control locomotion and ensure invariably horizontal state of the robot platform in the process of motion, the central pattern generator (CPG) based on particle swarm optimization (PSO) is presented to optimize the kinematic model. The purpose of optimization is to solve the hysteresis problem of displacement variation among the electric cylinders. Moreover, the dynamic model of the robot is established, which can provide mechanical basis for the feedback of control signal and make the robot move stably. The simulation results show that the displacement hysteresis problem of the electric cylinders is solved well. Meanwhile, compared with simulation results based on GA-CPG method, it is demonstrated that the robot motion planned using PSO-CPG method has better motion stability and can avoid the impact of legs landing during the transition phase of the motion cycle. The experimental results show that the platform on the robot can maintain an invariably horizontal state, and the locomotion is more stable. It verifies the feasibility of PSO-CPG model and the correctness of the dynamic model of the parallel mobile rescue robot.
The dynamics of compound drops impacting on a flat substrate is numerically investigated using a ternary-fluid diffuse-interface method, with the aim of assessing the effect of a density difference between the inner and outer droplets (denoted by $\lambda$) on the evolution of the interfaces. With the help of numerical simulations, we find that, at the intermediate stage of drop impact, the inner droplet exhibits a self-similar deformation at $\lambda =1$ and relatively high Weber number, and experiences more or less a uniform acceleration for various $\lambda$. In particular, the acceleration magnitude at $\lambda \ne 1$ can be correlated with the acceleration at $\lambda =1$ and the Atwood number. When the inner droplet is denser than the outer one, a lamella occurs at the spreading front of the inner droplet. We present a scaling analysis of the thickness of the lamella, and the resultant theoretical prediction is in good agreement with numerical results. At the maximal spreading of the compound drop, a bulging structure is formed around the symmetry axis due to the presence of the inner droplet, thereby effectively reducing the liquid supply to the spreading front and leading to a decrease of maximal spreading ratio $\beta _{max}$ as compared with a pure drop. We proposed a corrected Weber number $We^*_\lambda$ by taking account of the combined effects of $\lambda$, volume fraction of the inner droplet, Weber number and morphology of the compound drop. Integrating $We^*_\lambda$ with the universal model of $\beta _{max}$ for impacting pure drops, we successfully build up a new model for predicting the maximal spreading ratio of impacting compound drops with various $\lambda$.
To explore the effect of yield stress on the secondary breakup of gel drops, experimental and theoretical investigations are carried out by employing a high-speed camera. A unique hemline-type breakup, as a modified behaviour of sheet-thinning breakup, occurs when the air velocity increases to a high region. The edges of the drops constantly deform into thin membranes when the high-velocity air skims over the gel drops. These membranes vibrate vertically, and breaking points occur at high amplitudes, causing the formation of reticular fragments. The results of linear stability analysis indicated that the yield stress of the gel drops has an influence on the formation and breakup of the gel membranes. The breakup regime map and breakup times are also studied.
We study the role of state controlling shareholders in corporate payout policy. The State Capital Operation Program in China requires parent central state-owned enterprises (CSOEs) to contribute part of their consolidated income to a new fiscal fund. We find that listed CSOEs, partially controlled by parent CSOEs, experience significant reductions in dividend payouts as the income-contribution ratio increases. The dividend reductions are concurrent with increases in intragroup resource transfers—listed CSOEs’ loans to, and commercial trades with, group peers. The program yields adverse consequences for listed CSOEs’ investment and employment, yet being mitigated by group-level dividend reductions.
The sequential occurrence of three layers of smooth muscle layers (SML) in human embryos and fetus is not known. Here, we investigated the process of gut SML development in human embryos and fetuses and compared the morphology of SML in fetuses and neonates. The H&E, Masson trichrome staining, and Immunohistochemistry were conducted on 6–12 gestation week human embryos and fetuses and on normal neonatal intestine. We showed that no lumen was seen in 6–7th gestation week embryonic gut, neither gut wall nor SML was developed in this period. In 8–9th gestation week embryonic and fetal gut, primitive inner circular SML (IC-SML) was identified in a narrow and discontinuous gut lumen with some vacuoles. In 10th gestation week fetal gut, the outer longitudinal SML (OL-SML) in gut wall was clearly identifiable, both the inner and outer SML expressed α-SMA. In 11–12th gestation week fetal gut, in addition to the IC-SML and OL-SML, the muscularis mucosae started to develop as revealed by α-SMA immune-reactivity beneath the developing mucosal epithelial layer. Comparing with the gut of fetuses of 11–12th week of gestation, the muscularis mucosae, IC-SML, and OL-SML of neonatal intestine displayed different morphology, including branching into glands of lamina propria in mucosa and increased thickness. In conclusions, in the human developing gut between week-8 to week-12 of gestation, the IC-SML develops and forms at week-8, followed by the formation of OL-SML at week-10, and the muscularis mucosae develops and forms last at week-12.
Intestinal atresia (IA), a common cause of neonatal intestinal obstruction, is a developmental defect, which disrupts the luminal continuity of the intestine. Here, we investigated (i) the process of lumen formation in human embryos; and (ii) how a defective lumen formation led to IA. We performed histological and histochemical study on 6–10 gestation week human embryos and on IA septal regions. To investigate the topology of embryonic intestine development, we conducted 3D reconstruction. We showed that a 6–7th gestation week embryonic gut has no lumen, but filled with mesenchyme cells and vacuoles of a monolayer of epithelial cells. A narrow gut lumen was formed by gestation week-9, the gut was filled with numerous vacuoles of different sizes, some vacuoles were merging with the developing embryonic gut wall. At gestation week-10, a prominent lumen was developed, only few vacuoles were present and were merging with the intestine wall. At IA septal regions, vacuoles were located in the submucous layer, covered by a single layer of epithelium without glandular structure, and surrounded with fibrous tissue. The mucosal epithelium was developed with lamina propria and basement membrane, but the submucosa and the longitudinal smooth muscle layers were not properly developed. Hence, the vacuoles in IA septum could represent a remnant of vacuoles of embryonic gut. In conclusion, the fusion of vacuoles with the developing intestine wall associates with the disappearance of vacuoles and gut lumen formation in human embryos, and perturbation of these developmental events could lead to IA.
We investigate the dynamics of a self-rewetting drop placed on a substrate with a constant temperature gradient via three-dimensional numerical simulations using a conservative level-set approach to track the interface of the drop. The surface tension of a so-called self-rewetting fluid exhibits a parabolic dependence on temperature with a well-defined minimum. Two distinct drop behaviours, namely deformation and elongation, are observed when it is placed at the location of the minimum surface tension. The drop spreads slightly and reaches a pseudo-steady state in the deformation regime, while it continuously spreads until breakup in the elongation regime. Theoretical models based on the forces exerted on the drop have been developed to predict the critical condition at which the drop undergoes the transition between the two regimes, and the predictions are in good agreement with the numerical results. We also investigate the effect of the initial position of the drop with respect to the location of the minimum surface tension on the spreading and migration dynamics. It is found that, at early times, the migration of the drop obeys an exponential function with time, but it diverges at the later stage due to an increase in the drop deformation.
Glutathione S-transferases (GSTs) are a detoxifying enzyme family that is essential for parasite blood-feeding and survival, and represent potential targets for hookworm vaccine development. Multiple GST-encoding complementary DNAs (cDNAs) have been cloned from Ancylostoma caninum and Necator americanus, but there are no reports about the cloning of this enzyme from Ancylostoma ceylanicum, the animal-derived zoonotic hookworm. To study the molecular nature and tissue localization of GST of A. ceylanicum (Ace-GST), we designed primers based on the GST gene sequence of A. ceylanicum in GenBank, amplified the Ace-GST cDNA by reverse transcription polymerase chain reaction, and analysed its homology and genetic evolution relationship. The amplified product was cloned into the pET-32a vector and transformed into Escherichia coli BL21 (DE3) for expression. To prepare anti-GST polyclonal antibodies, the recombinant protein was purified and used to immunize Kunming mice. The level of immunoglobulin G (IgG) antibody in the serum of immunized mice was detected by indirect enzyme-linked immunosorbent assay, and the Ace-GST localization in adult worm was determined using the immunofluorescence method. The results showed that the full-length cDNA encoding Ace-GST was 468 bp, which had the highest homology with Ac-GST-1 (60.1%) and clustered into one branch (v-class) with Ac-GST-1 and Na-GST-1 in a phylogenetic tree. Mice immunized with recombinant Ace-GST showed specific IgG antibody response. Immunolocalization revealed that natural Ace-GST is mainly located in the epidermis, muscle and intestine of the adult. These results may lay a foundation for further studies on the biological function of Ace-GST.
We numerically investigate the mechanism resulting in fate change of a hydrophobic sphere impacting onto a confined pool, that is, at the same impact speed, it does not submerge in a wide pool but does in a narrow pool. We find that the reflection of the impact-induced gravity-capillary waves from the pool boundary is responsible for this phenomenon. In particular, the return of the wave to the symmetry axis may coincide with the rising of the impacting sphere to the water surface, which corresponds to the critical conditions of the fate change. Moreover, for the spheres at the onset of submersion in a wide pool, our analysis suggests that this scenario also accounts for an interesting observation in the numerical simulations. That is, the effective pool size $S_{c}$, beyond which the submersion of impacting spheres is no longer affected by the pool size $S$, is mainly dependent on the sphere diameter, no matter whether the surface waves are the capillary or gravity waves. For $S<S_{c}$, two important pool sizes ($S_{w,1}$ and $S_{w,2}$, and $S_{w,2}\geqslant S_{w,1}$) are identified at the same impact speed, and the sphere submersion takes place at $S_{w,1}\leqslant S\leqslant S_{w,2}$. Based on the flow features identified in simulations, a scaling law is proposed to correlate the Weber number and Bond number with $S_{w}$. The theoretical prediction is shown to agree well with the numerical results.
The aim of the present study was to explore the influence of tea consumption on diabetes mellitus in the Chinese population. This multi-centre, cross-sectional study was conducted in eight sites from south, east, north, west and middle regions in China by enrolling 12 017 subjects aged 20–70 years. Socio-demographic and general information was collected by a standardised questionnaire. A standard procedure was used to measure anthropometric characteristics and to obtain blood samples. The diagnosis of diabetes was determined using a standard 75-g oral glucose tolerance test. In the final analysis, 10 825 participants were included and multiple logistic models and interaction effect analysis were applied for assessing the association between tea drinking with diabetes. Compared with non-tea drinkers, the multivariable-adjusted OR for newly diagnosed diabetes were 0·80 (95 % CI 0·67, 0·97), 0·88 (95 % CI 0·71, 1·09) and 0·86 (95 % CI 0·67, 1·11) for daily tea drinkers, occasional tea drinkers and seldom tea drinkers, respectively. Furthermore, drinking tea daily was related to decreased risk of diabetes in females by 32 %, elderly (>45 years) by 24 % and obese (BMI > 30 kg/m2) by 34 %. Moreover, drinking dark tea was associated with reduced risk of diabetes by 45 % (OR 0·55; 95 % CI 0·42, 0·72; P < 0·01). The results imply that drinking tea daily was negatively related to risk of diabetes in female, elderly and obese people. In addition, drinking dark tea was associated with decreased risk of type 2 diabetes mellitus.
We report direct numerical simulation results that clearly elucidate the mechanism that leads to curvature dependence of drag enhancement (DE) in viscoelastic turbulent Taylor–Couette flow. Change in the angular momentum transport and its inherent link to transitions in vortical flow structures have been explored to depict the influence of the curvature of the flow geometry on DE. Specifically, it has been demonstrated that a transition in vortical structures with increasing radius ratio leads to weakening and elimination of the small-scale Görtler vortices and development and better organization (occupying the entire gap) of large-scale Taylor vortices as also evinced by the patterns of angular momentum current. The commensurate change in DE and its underlying mechanism are examined by contributions of convective flux and polymeric stress to the angular momentum current. The present finding paves the way for capturing highly localized elastic turbulence structures in direct numerical simulation by increasing geometry curvature in traditional turbulent curvilinear flows.
Laser pulses of 200 ps with extremely high intensities and high energies are sufficient to satisfy the demand of shock ignition, which is an alternative path to ignition in inertial confinement fusion (ICF). This paper reports a type of Brillouin scheme to obtain high-intensity 200-ps laser pulses, where the pulse durations are a challenge for conventional pulsed laser amplification systems. In the amplification process, excited Brillouin acoustic waves fulfill the nonlinear optical effect through which the high energy of a long pump pulse is entirely transferred to a 200-ps laser pulse. This method was introduced and achieved within the SG-III prototype system in China. Compared favorably with the intensity of $2~\text{GW}/\text{cm}^{2}$ in existing ICF laser drivers, a 6.96-$\text{GW}/\text{cm}^{2}$ pulse with a width of 170 ps was obtained in our experiment. The practical scalability of the results to larger ICF laser drivers is discussed.
Liquid films can be entrained when the dewetting velocity attains a threshold, and this dynamical wetting transition has been well studied in the situation of plane substrates. We investigate the forced dewetting in a capillary tube using diffuse-interface simulations and lubrication analysis, focusing on the onset of wetting transition and subsequent interface evolution. Results show that the meniscus remains stable when the displacing rate is below a threshold, beyond which film entrainment occurs and eventually leads to the formation of Taylor bubbles separated by liquid slugs, as has also been observed in the recent experiments of Zhao et al. (Phys. Rev. Lett., vol. 120, 2018, 084501). We derive an analytical solution of the critical capillary number, and demonstrate that the wetting transition is accompanied by a vanishing apparent contact angle and an abrupt drop of the contact-line velocity. Both the bubble and slug lengths are found to depend on the capillary number and the wettability of the wall. A theoretical formula for the bubble length is also proposed and compares favourably with numerical and experimental results.
Carbon nanotubes (CNTs) were added to carbon nanofibers (CNFs) as additives to improve their electrochemical properties. In the present work, CNFs were prepared by using pressurized gyration with polyacrylonitrile as the precursor. The microstructure and electrochemical properties of samples were investigated by scanning electron microscopy and electrochemical workstation, respectively. The results showed that the network structure formed in the fiber, and the fiber diameter decreased with the increase of working pressure. The integral area of cyclic voltammetry curve reached the maximum and the charge/discharge time of constant current charge/discharge curve reached the longest in the case of the CNT concentration is 0.50 wt% and working pressure is 0.2 MPa. At the same time, it exhibited the best electrochemical performance with a specific capacitance of 79 F/g at a current density of 100 mA/g. Compared with the specific capacitance of pure CNFs, the specific capacitance of CNFs with the concentration of CNTs 0.50 wt% increased by about 40%.
Dipetalonema gracile is a common parasite in squirrel monkeys (Saimiri sciureus), which can cause malnutrition and progressive wasting of the host, and lead to death in the case of massive infection. This study aimed to identify a suspected D. gracile worm from a dead squirrel monkey by means of molecular biology, and to amplify its complete mitochondrial genome by polymerase chain reaction (PCR) and sequence analysis. The results identified the worm as D. gracile, and the full length of its complete mitochondrial genome was 13,584 bp, which contained 22 tRNA genes, 12 protein-coding genes, two rRNA genes, one AT-rich region and one small non-coding region. The nucleotide composition included A (16.89%), G (20.19%), T (56.22%) and C (6.70%), among which A + T = 73.11%. The 12 protein-coding genes used TTG and ATT as start codons, and TAG and TAA as stop codons. Among the 22 tRNA genes, only trnS1AGN and trnS2UCN exhibited the TΨC-loop structure, while the other 20 tRNAs showed the TV-loop structure. The rrnL (986 bp) and rrnS (685 bp) genes were single-stranded and conserved in secondary structure. This study has enriched the mitochondrial gene database of Dipetalonema and laid a scientific basis for further study on classification, and genetic and evolutionary relationships of Dipetalonema nematodes.
We numerically investigate the mechanism leading to the entrapment of spheres at the gas–liquid interface after impact. Upon impact onto a liquid pool, a hydrophobic sphere is seen to follow one of the three regimes identified in the experiment (Lee & Kim, Langmuir, vol. 24, 2008, pp. 142–145): sinking, bouncing or being entrapped at the interface. It is important to understand the role of wettability in this process of flow–structure interaction with dynamic wetting, and in particular, to what extent the wettability can determine whether the sphere is entrapped at the interface. For this purpose, a diffuse-interface immersed boundary method is adopted in the numerical simulations. We expand the parameter space considered previously, provide the phase diagrams and identify the key phenomena in the impact dynamics. Then, we propose the scaling models to interpret the critical conditions for the occurrence of sphere entrapment, accounting for the wettability of the sphere. The models are shown to provide a good correlation among the impact inertia of the drop, the surface tension, the wettability and the density ratio of the sphere to the liquid.