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.

Bridge engineering design drawings basic elements contain a large amount of important information such as structural dimensions and material indexes. Basic element detection is seen as the basis for digitizing drawings. Aiming at the problem of low detection accuracy of existing drawing basic elements, an improved basic elements detection algorithm for bridge engineering design drawings based on YOLOv5 is proposed. Firstly, coordinate attention is introduced into the feature extraction network to enhance the feature extraction capability of the algorithm and alleviate the problem of difficult recognition of texture features inside grayscale images. Then, targeting objectives across different scales, the standard 3 × 3 convolution in the feature pyramid network is replaced with switchable atrous convolution, and the atrous rate is adaptively selected for convolution computation to expand the sensory field. Finally, experiments are conducted on the bridge engineering design drawings basic elements detection dataset, and the experimental results show that when the Intersection over Union is 0.5, the proposed algorithm achieves a mean average precision of 93.6%, which is 3.4% higher compared to the original YOLOv5 algorithm, and it can satisfy the accuracy requirement of bridge engineering design drawings basic elements detection.

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.

Escherichia albertii is an emerging foodborne enteropathogen associated with infectious diarrhoea in humans. In February 2023, an outbreak of acute gastroenteric cases was reported in a junior high school located in Hangzhou, Zhejiang province, China. Twenty-two investigated patients presented diarrhoea (22/22, 100%), abdominal pain (21/22, 95.5%), nausea (6/22, 27.3%), and vomiting (3/22, 13.6%). E. albertii strains were successfully isolated from anal swabs collected from six patients. Each isolate was classified as sequence type ST2686, harboured eae-β gene, and carried both cdtB-I and cdtB-II subtypes, being serotyped as EAOg32:EAHg4 serotype. A comprehensive whole-genome phylogenetic analysis revealed that the six isolates formed a distinct cluster, separate from other strains. These isolates exhibited minimal genetic variation, differing from one another by 0 to 1 single nucleotide polymorphism, suggesting a common origin from a single clone. To the best of our knowledge, this represented the first reported outbreak of gastroenteritis attributed to E. albertii outside of Japan on a global scale.

In this study, we investigated the influence of fiber parameters on stimulated Raman scattering (SRS) and identified a unique pattern of SRS evolution in the counter tandem pumping configuration. Our findings revealed that the SRS threshold in counter-pumping is predominantly determined by the length of the output delivery fiber rather than the gain fiber. By employing the counter tandem pumping scheme and optimizing the fiber parameters, a 10 kW fiber laser was achieved with beam quality M2 of 1.92. No mode instability or severe SRS limitation was observed. To our knowledge, this study achieved the highest beam quality in over 10 kW fiber lasers based on conventional double-clad Yb-doped fiber.

Gestational diabetes mellitus (GDM) is a frequent complication of pregnancy. The specific mechanisms underlying GDM have not yet been fully elucidated. Contemporary research indicates a potential association between liver enzyme irregularities and an increased risk of metabolic disorders, including diabetes. The alanine aminotransferase (ALT) level is recognized as a sensitive marker of liver injury. An increase in ALT levels is hypothesized to be linked to the pathogenesis of insulin resistance and diabetes. Nonetheless, the definitive causal link between ALT levels and GDM still needs to be determined. This investigation utilized two-sample Mendelian randomization (MR) to examine the genetic causation between alanine aminotransferase (ALT) and GDM. We acquired alanine aminotransferase (ALT)-related GWAS summary data from the UK Biobank, Million Veteran Program, Rotterdam Study, and Lifeline Study. Gestational diabetes data were obtained from the FinnGen Consortium. We employed various MR analysis techniques, including inverse-variance weighted (IVW), MR Egger, weighted median, simple, and weighted weighting. In addition to MR-Egger intercepts, Cochrane’s Q test was also used to assess heterogeneity in the MR data, and the MR-PRESSO test was used to assess horizontal pleiotropy. To assess the association’s sensitivity, a leave-one-out approach was employed. The IVW results confirmed the independent risk factor for GDM development, as indicated by the ALT level (p = .011). As shown by leave-one-out analysis, horizontal pleiotrophy did not significantly skew the causative link (p > .05). Our dual-sample MR analysis provides substantiated evidence of a genetic causal relationship between alanine aminotransferase (ALT) levels and gestational diabetes.

Intracytoplasmic sperm injection (ICSI) is a technique that directly injects a single sperm into the cytoplasm of mature oocytes. Here, we explored the safety of single-sperm cryopreservation applied in ICSI. This retrospective study enrolled 186 couples undergoing ICSI-assisted pregnancy. Subjects were allocated to the fresh sperm (group A)/single-sperm cryopreservation (group B) groups based on sperm type, with their clinical baseline/pathological data documented. We used ICSI-compliant sperm for subsequent in vitro fertilization and followed up on all subjects. The recovery rate/cryosurvival rate/sperm motility of both groups, the pregnancy/outcome of women receiving embryo transfer, and the delivery mode/neonatal-related information of women with successful deliveries were recorded. The clinical pregnancy rate, cumulative clinical pregnancy rate, abortion rate, ectopic pregnancy rate, premature delivery rate, live birth delivery rate, neonatal birth defect rate, and average birth weight were analyzed. The two groups showed no significant differences in age, body mass index, ovulation induction regimen, sex hormone [anti-Müllerian hormone (AMH)/follicle-stimulating hormone (FSH)/luteinizing hormone (LH)] levels, or oocyte retrieval cycles. The sperm recovery rate (51.72%-100.00%) and resuscitation rate (62.09% ± 16.67%) in group B were higher; the sperm motility in the two groups demonstrated no significant difference and met the ICSI requirements. Group B exhibited an increased fertilization rate, decreased abortion rate, and increased safety versus group A. Compared with fresh sperm, the application of single-sperm cryopreservation in ICSI sensibly improved the fertilization rate and reduced the abortion rate, showing higher safety.

Exploiting the fact that hypertension is diagnosed when a person’s blood pressure reading exceeds a medically specified threshold (90 mmHg for diastolic blood pressure or 140 mmHg for systolic blood pressure), this study estimates the effect of a first-ever hypertension diagnosis on Chinese adults’ alcohol consumption using a two-dimensional regression discontinuity design. Analyzing data on 10,787 adults from the China Health and Nutrition Survey, our estimation reveals that hypertension diagnoses based on diastolic blood pressure readings exert a number of desirable effects. Hypertensive adults’ drinking frequency and the incidence of excessive drinking among them were reduced by 1.2 times/week and 17.9 percentage points, respectively, about three years after the diagnosis. Meanwhile, their beer and Chinese spirits (Baijiu) intakes were reduced by 518.6 ml/week and 194.8 ml/week, respectively. Interestingly, we also found modest evidence that hypertension diagnoses based on diastolic blood pressure readings increase Chinese adults’ wine intake, suggesting a substitution pattern upon hypertension diagnoses. In contrast, based on systolic blood pressure readings, no significant effects of hypertension diagnoses on alcohol consumption were found.

Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People’s Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.

The chemistry of Al transformation has been well documented, though little is known about the mechanisms of structural perturbation of Al precipitates by carbonates at a molecular level. The purpose of the present study was to investigate the structural perturbation of Al precipitates formed under the influence of carbonates. Initial carbonate/Al molar ratios (MRs) used were 0, 0.1, and 0.5 after aging for 32 days, then the samples were analyzed by X-ray absorption near edge structure spectroscopy (XANES), X-ray diffraction (XRD), Fourier-transform infrared absorption spectroscopy (FTIR), and chemical analysis. The XRD data were in accord with the FTIR results, which revealed that as the carbonate/Al MR was increased from 0 to 0.1, carbonate preferentially retarded the formation of gibbsite and had relatively little effect on the formation of bayerite. As the carbonate/Al MR was increased to 0.5, however, the crystallization of both gibbsite and bayerite was completely inhibited. The impact of carbonate on the nature of Al precipitates was also evident in the increase of adsorbed water and inorganic C contents with increasing carbonate/Al MR. The Al K- and L- edge XANES data provide the first evidence illustrating the change in the coordination number of Al from 6-fold to mixed 6- and 4-fold coordination in the structural network of short-range ordered (SRO) Al precipitates formed under the increasing perturbation of carbonate. The fluorescence yield spectra of the O K-edge show that the intensity of the peak at 534.5 eV assigned to σ* transitions of Al-O and O-H bonding decreased with increasing carbonate/Al MR. The XANES data, along with the evidence from XRD, FTIR, and chemical analysis showed clearly that carbonate caused the alteration of the coordination nature of the Al-O bonding through perturbation of the atomic bonding and structural configuration of Al hydroxides by complexation with Al in the SRO network of Al precipitates. The surface reactivity of an Al-O bond is related to its covalency and coordination geometry. The present findings were, therefore, of fundamental significance in understanding the low-temperature geochemistry of Al and its impacts on the transformation, transport, and fate of nutrients and pollutants in the ecosystem.

Aging plays a crucial role in the mechanisms of the impacts of genetic and environmental factors on blood pressure and serum lipids. However, to our knowledge, how the influence of genetic and environmental factors on the correlation between blood pressure and serum lipids changes with age remains to be determined. In this study, data from the Chinese National Twin Registry (CNTR) were used. Resting blood pressure, including systolic and diastolic blood pressure (SBP and DBP), and fasting serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) were measured in 2378 participants (1189 twin pairs). Univariate and bivariate structural equation models examined the genetic and environmental influences on blood pressure and serum lipids among three age groups. All phenotypes showed moderate to high heritability (0.37–0.59) and moderate unique environmental variance (0.30–0.44). The heritability of all phenotypes showed a decreasing trend with age. Among all phenotypes, SBP and DBP showed a significant monotonic decreasing trend. For phenotype-phenotype pairs, the phenotypic correlation (Rph) of each pair ranged from −0.04 to 0.23, and the additive genetic correlation (Ra) ranged from 0.00 to 0.36. For TC&SBP, TC&DBP, TG&SBP and TGs&DBP, both the Rph and Ra declined with age, and the Ra difference between the young group and the older adult group is statistically significant (p < .05). The unique environmental correlation (Re) of each pair did not follow any pattern with age and remained relatively stable with age. In summary, we observed that the heritability of blood pressure was affected by age. Moreover, blood pressure and serum lipids shared common genetic backgrounds, and age had an impact on the phenotypic correlation and genetic correlations.

Transverse stimulated Raman scattering (TSRS) in potassium dihydrogen phosphate (KDP) and deuterated potassium dihydrogen phosphate (DKDP) plates for large-aperture, inertial confinement fusion (ICF)-class laser systems is a well-recognized limitation giving rise to parasitic energy conversion and laser-induced damage. The onset of TSRS is manifested in plates exposed to the ultraviolet section of the beam. TSRS amplification is a coherent process that grows exponentially and is distributed nonuniformly in the crystal and at the crystal surfaces. To understand the growth and spatial distribution of TSRS energy in various configurations, a modeling approach has been developed to simulate the operational conditions relevant to ICF-class laser systems. Specific aspects explored in this work include (i) the behavior of TSRS in large-aperture crystal plates suitable for third-harmonic generation and use as wave plates for polarization control in current-generation ICF-class laser system configurations; (ii) methods, and their limitations, of TSRS suppression and (iii) optimal geometries to guide future designs.

We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00–60·00) at baseline (2007–2008) and followed up during 2013–2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.

Wireless capsule endoscopes (WCEs) are pill-sized camera-embedded devices that can provide visualization of the gastrointestinal (GI) tract by capturing and transmitting images to an external receiver. Determination of the exact location of the WCE is crucial for the accurate navigation of the WCE through external guidance, tracking of the GI abnormality, and the treatment of the detected disease. Despite the enormous progress in the real-time tracking of the WCE, a well-calibrated analytical model is still missing for the accurate localization of WCEs by the measurements from different onboard sensing units. In this paper, a well-calibrated analytical model for the magnetic localization of the WCE was established by optimizing the magnetic moment in the magnetic dipole model. The Jacobian-based iterative method was employed to solve the position of the WCE. An error model was established and experimentally verified for the analysis and prediction of the localization errors caused by inaccurate measurements from the magnetic field sensor. The assessment of the real-time localization of the WCE was performed via experimental trials using an external permanent magnet (EPM) mounted on a robotic manipulator and a WCE equipped with a 3-axis magnetic field sensor and an inertial measurement unit (IMU). The localization errors were measured under different translational and rotational motion modes and working spaces. The results showed that the selection of workspace (distance relative to the EPM) could lead to different positioning errors. The proposed magnetic localization method holds great potential for the real-time localization of WCEs when performing complex motions during GI diagnosis.

In this work, a confined-doped fiber with the core/inner-cladding diameter of 40/250 μm and a relative doping ratio of 0.75 is fabricated through a modified chemical vapor deposition method combined with the chelate gas deposition technique, and subsequently applied in a tandem-pumped fiber amplifier for high-power operation and transverse mode instability (TMI) mitigation. Notably, the impacts of the seed laser power and mode purity are preliminarily investigated through comparative experiments. It is found that the TMI threshold could be significantly affected by the seed laser mode purity. The possible mechanism behind this phenomenon is proposed and revealed through comprehensive comparative experiments and theoretical analysis. Finally, a maximum output power of 7.49 kW is obtained with the beam quality factor of approximately 1.83, which is the highest output power ever reported in a forward tandem-pumped confined-doped fiber amplifier. This work could provide a good reference and practical solution to improve the TMI threshold and realize high-power high-brightness fiber lasers.

Planting patterns have significant effects on rice growth. Nonetheless, little is known about differences in annual crop yield and resource utilization among mechanized rice planting patterns in a rice–wheat cropping system. Field experiments were conducted from 2014 to 2017 using three treatments: pot seedling transplanting for rice and row sowing for wheat (PST-RS), carpet seedling transplanting for rice and row sowing for wheat (CST-RS) and row sowing for both crops (RS-RS). The results showed that, compared with RS-RS, PST-RS and CST-RS prolonged annual crop growth duration by 25–26 and 13–15 days, increased effective accumulated temperature by 399 and 212°C days and increased cumulative solar radiation by 454 and 228 MJ/m2 because of the earlier sowing of rice by 28 and 16 days in PST-RS and CST-RS, respectively. Compared with RS-RS, the annual crop yield of PST-RS and CST-RS increased by 3.1–3.8 and 2.0–2.6 t/ha, respectively, because of the increase in the number of spikelets/kernels per hectare, aboveground biomass, mean leaf area index and grain–leaf ratio. In addition, temperature production efficiency, solar radiation production efficiency and solar radiation use efficiency were higher in PST-RS, followed by CST-RS and RS-RS. These results suggest that mechanized rice planting patterns such as PST-RS increase annual crop production in rice–wheat cropping systems by increasing yield and solar energy utilization.

Previous studies have reported inconsistent associations between low-carbohydrate diets (LCD) and plasma lipid profile. Also, there is little evidence on the role of the quality and food sources of macronutrients in LCD in cardiometabolic health. We investigated the cross-sectional associations between LCD and plasma cardiometabolic risk markers in a nationwide representative sample of the US population. Diet was measured through two 24-h recalls. Overall, healthy (emphasising unsaturated fat, plant protein and less low-quality carbohydrates) and unhealthy (emphasising saturated fat, animal protein and less high-quality carbohydrate) LCD scores were developed according to the percentage of energy as total and subtypes of carbohydrate, protein and fat. Linear regression was used to estimate the percentage difference of plasma marker concentrations by LCD scores. A total of 34 785 participants aged 18–85 years were included. After adjusting for covariates including BMI, healthy LCD was associated with lower levels of insulin, homoeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP) and TAG, and higher levels of HDL-cholesterol, with the percentage differences (comparing extreme quartile of LCD score) of −5·91, −6·16, −9·13, −9·71 and 7·60 (all P trend < 0·001), respectively. Conversely, unhealthy LCD was associated with higher levels of insulin, HOMA-IR, CRP and LDL-cholesterol (all P trend < 0·001). Our results suggest that healthy LCD may have positive, whereas unhealthy LCD may have negative impacts on CRP and metabolic and lipid profiles. These findings underscore the need to carefully consider the quality and subtypes of macronutrients in future LCD studies.

Triglycerol-3-phosphate acyltransferases (GPATs) are the key enzymes in the first step of the synthesis of triacylglycerol (TAG). In mammals, there are four isoforms of GPATs. GPAT1 and GPAT2 are localised in the outer mitochondrial membrane, while GPAT3 and GPAT4 are localised in the endoplasmic reticulum. Previous research has emphasised that GPAT plays a critical effect on the development of metabolic syndromes, such as liver steatosis, obesity, and insulin resistance. In this review, we will critically evaluate the regulatory effects of GPATs isoforms in metabolic syndrome. In addition, we also discuss perspectives on clinical intervention strategies for the neurometabolic disease.