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Straightplasma channels are widely used to guide relativistic intense laser pulses over several Rayleigh lengths for laser wakefield acceleration. Recently, a curved plasma channel with gradually varied curvature was suggested to guide a fresh intense laser pulse and merge it into a straight channel for staged wakefield acceleration [Phys. Rev. Lett. 120, 154801 (2018)]. In this work, we report the generation of such a curved plasma channel from a discharged capillary. Both longitudinal and transverse density distributions of the plasma inside the channel were diagnosed by analyzing the discharging spectroscopy. Effects of the gas-filling mode, back pressure and discharging voltage on the plasma density distribution inside the specially designed capillary are studied. Experiments show that a longitudinally uniform and transversely parabolic plasma channel with a maximum channel depth of 47.5 μm and length of 3 cm can be produced, which is temporally stable enough for laser guiding. Using such a plasma channel, a laser pulse with duration of 30 fs has been successfully guided along the channel with the propagation direction bent by 10.4°.
Recently, the collisionless pitch-angle scattering for relativistic runaway electrons (REs) in toroidal geometries such as tokamaks was discovered through a full orbit simulation approach (Liu et al., Nucl. Fusion, vol. 56, 2016, p. 064002), and it was then theoretically investigated that a new expression for the magnetic moment, including the second-order corrections, could essentially reproduce the so-called collisionless pitch-angle scattering process (Liu et al., Nucl. Fusion, vol. 58, 2018, p. 106018). In this paper, with synchrotron radiation, extensive numerical verification of the validity of the high-order guiding-centre theory is given for simulations involving REs by incorporating such an expression for the magnetic moment into our particle tracing code. A high-order guiding-centre simulation approach with synchrotron radiation (HGSA) is applied. Synchrotron radiation plays an essential role in the life cycle of REs. The energy of REs first increases and then becomes saturated until the electric field acceleration is balanced by the radiation dissipation. Unfortunately, the process cannot be simulated accurately with the standard guiding-centre model, i.e. the first-order guiding-centre model. Remarkably, it is found that the HGSA can effectively produce the fundamental process of REs. Since the time scale of the energy saturation of REs is close to seconds, the computational cost becomes significant. In order to save costs, it is necessary to estimate the time of energy saturation. An analytical estimate is derived for the time it takes for synchrotron drag to balance an accelerating electric field and the provided formula has been numerically verified. Test calculations reveal that HGSA is favourable for exploiting the dynamics of REs in tokamak plasmas.
T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms.
Methods
We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model.
Results
We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23–0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34–0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23–0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias.
Conclusions
CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.
This study explored the effects of condition notification based on virtual reality technology on the anxiety levels of parents of children with simple CHD.
Methods:
The subjects of the study were the parents of 60 children with simple CHD who were treated in our centre. The state anxiety scale was used to assess the anxiety status of the parents of the children before and after the condition notification in different ways (based on virtual reality explanations and written explanations).
Results:
In this study, a total of 55 parents of children with CHD successfully completed the survey. At the time of admission, there was no significant difference in the state anxiety scale scores of the parents between the two groups. The anxiety status of the virtual reality group was relieved after the condition notification assisted by virtual reality technology, and there was a significant difference compared with the control group.
Conclusion:
Condition notification based on virtual reality technology can effectively alleviate the anxiety of parents of children with simple CHD, which is worthy of clinical application.
This study aimed to explore the effects of eye masks on the sleep quality and pain of school-age children with CHD after surgery.
Methods:
Forty school-age children with CHD who underwent open-heart surgery in the Cardiac Surgery Department of a provincial hospital in China from January 2020 to December 2020 were selected. The children were randomly divided into the experimental group (n = 20) and the control group (n = 20). Children in the control group were given routine sleep care, and the children in the experimental group were given a sleep intervention with eye masks for three nights following the removal of tracheal intubation. The Pittsburgh Sleep Quality Index was used to evaluate the sleep quality of the children. The Children’s Pain Behaviour Scale was used to evaluate the pain of the children.
Results:
After three nights of receiving the eye masks intervention, the sleep quality scores of the children in the experimental group were significantly lower than those of the control group, the difference was statistically significant (p < 0.05) and the sleep quality of the children in the experimental group was higher. The pain scores of the children in the experimental group were significantly lower than those of the children in the control group, the difference was statistically significant (p < 0.05), and the children in the experimental group suffered less post-operative pain.
Conclusion:
Eye masks are a simple, safe and economical intervention, that is beneficial for improving the post-operative sleep quality and relieving post-operative pain in school-age children with congenital heart disease.
To evaluate the relationship between religious beliefs and mental state, care burden, and quality of life in parents of infantile patients with CHD.
Methods:
A cross-sectional study was conducted at a provincial hospital in Fujian, China. In this study, 114 parents of infant patients with CHD were successfully enrolled. Data were collected using the Duke University Religion Index, Hospital Anxiety and Depression Scale, Zarit Caregiver Burden Interview, and 36-Item Short-Form Health Survey.
Results:
The organisational religious activity, non-organisational religious activity, and intrinsic religiosity of parents were significantly related to the care burden and quality of life, and the two dimensions of non-organisational religious activity and intrinsic religiosity of parents were significantly related to their anxiety symptoms. No association was found between parents’ religious beliefs and their depressive symptoms. Among Buddhist parents, non-organisational religious activity and intrinsic religiosity reduced the care burden and improved quality of life. Among Christian parents, organisational religious activity and non-organisational religious activity were found to reduce the care burden, while organisational religious activity and intrinsic religiosity were found to improve quality of life. There was no correlation between the sub-dimensions of religious beliefs and a negative impact on the care process in Muslim parents.
Conclusion:
Religious beliefs have a protective effect on the parents of infant patients with CHD. They help relieve parents’ anxiety, reduce their care burden, and improve their quality of life. In addition, different religious beliefs have different dimensions of influence on caregivers.
To explore the feasibility and superiority of applying the WeChat platform in a midterm follow-up of surgical repair for ventricular septal defects in infants.
Methods:
Eighty-six infants with VSD who underwent surgical repair were divided into an outpatient follow-up group and a WeChat follow-up group. The clinical data, including complications, economic cost, time spent, loss to follow-up rate, and parents’ satisfaction at the 3-month and 1-year follow-ups, were recorded and analysed.
Results:
There was no significant difference in the incidence of post-operative complications between the two groups. Although the loss to follow-up rate in the WFU group was lower than that of the OFU group, the difference was not statistically significant. The economic cost and time spent in the 3 months and 1 year after discharge in the WFU group were significantly lower than those in the OFU group. One year after discharge, the PSQ-18 score of the WFU group was significantly higher than that of the OFU group.
Conclusion:
Compared with outpatient follow-up, the WeChat platform at the midterm follow-up after surgical repair of VSDs in infants has the advantages of saving time and economic costs and improves parents’ satisfaction.
To investigate the safety and feasibility of midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
Methods:
A retrospective analysis was performed on 55 patients who underwent transcatheter device closure of atrial septal defects from October, 2019 to May, 2020. All patients received intravenous midazolam and local anesthesia with lidocaine to maintain sedation. A group of previous patients with unpublished data who underwent the same procedure with general anesthesia was set as the control group. The relevant clinical parameters, the Ramsay sedation scores, the numerical rating scale, and the post-operative satisfaction questionnaire were recorded and analyzed.
Results:
In the midazolam group, the success rate of atrial septal defect closure was 98.2%. Hemodynamic stability was observed during the procedure. None of the patients needed additional endotracheal intubation for general anesthesia. Compared with the control group, the midazolam group had no statistically significant differences in the Ramsay sedation score and numerical rating scale scores. Patients in the midazolam group experienced more post-operative satisfaction than those in the control group.
Conclusions:
Conscious sedation using midazolam is a safe and effective anesthetic technique for transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect.
Methods:
A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed.
Results:
There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group.
Conclusion:
The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.
The study of enclaves in granitic plutons provides fundamental information on the petrogenesis of their host rocks. Here we combine U–Pb zircon ages, petrography, geochemistry and Nd–Hf isotope composition to investigate the origin of dioritic–granodioritic enclaves and their host granodiorites and biotite granites in the Xuehuading–Panshanchong area, which is a pivotal site to study the Palaeozoic intracontinental orogenic processes of the South China Block. Obtained ages indicate that the host rocks were formed in early Silurian time (c. 432 Ma). The enclaves are fine grained, but with mineral assemblages similar to their hosts and contain amphibole, biotite and plagioclase. All rocks have fractionated rare earth element patterns ((La/Yb)N = 2.86–8.16), except for one biotite granite that has a concave rare earth element pattern ((La/Yb)N = 1.50). Most rocks are depleted in Ta–Nb–Ti, and have negative Eu anomalies and ϵNd(t) (–8.86 to –5.75) and zircon ϵHf(t) (–13.30 to –4.11, except for one, –39.08). We interpret that the enclaves were formed at the borders of magma-ascending conduits, where the mafic mineral crystallization was enhanced by rapid cooling. Conversely, the biotite granites were produced by fractional crystallization from a related granodiorite magma. The sample with a concave rare earth element pattern may have been influenced by hydrothermal fluid–melt interaction. Geochemical modelling suggests that the granodiorites were likely generated by disequilibrium melting of heterogeneous amphibolites in the middle–lower crust. Considering the geological data for the Palaeozoic magmatic rocks in the South China Block, we propose that the Xuehuading–Panshanchong magmatism was likely triggered by piecemeal removal of the thickened lithospheric root and subsequent thermal upwelling of mantle, without a mantle-derived magma contribution to the granites.
Having enterprises engaged in environmentally friendly behavior is an important part of reducing negative environmental impacts. This study makes a quantitative analysis against the backdrop of China's transitional economic system. The results show that politically-connected enterprises significantly reduce environmental expenditure, but this only holds for state-owned enterprises; private enterprises with political connections spend significantly more. Analysis of the efficiency of environmental expenditure indicates that, for private enterprises, environmental spending is used as a way to maintain political connections, with rent-seeking as the likely motivation. Politically-connected private enterprises have not reduced their emissions to the same extent as state-owned enterprises, despite increased expenditure. Given the scale of environmental degradation in China during a period of massive economic and social upheaval, the results of this analysis provide a quantitative case for policy change: governments should shift focus to the results that environmental spending produces.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
In inertial confinement fusion experiments that involve short-laser pulses such as fast ignition (FI), diagnosis of neutrons is usually very challenging because high-intensity γ rays generated by short-laser pulses would mask the much weaker neutron signal. In this paper, fast-response scintillators with low afterglow and gated microchannel plate photomultiplier tubes are combined to build neutron time-of-flight (nTOF) spectrometers for such experiments. Direct-drive implosion experiments of deuterium-gas-filled capsules were performed at the Shenguang-II Upgrade (SG-II-UP) laser facility to study the compressed fuel areal density (〈ρR〉) and evaluate the performance of such nTOF diagnostics. Two newly developed quenched liquid scintillator detectors and a gated ultrafast plastic scintillator detector were used to measure the secondary DT neutrons and primary DD neutrons, respectively. The secondary neutron signals were clearly discriminated from the γ rays from (n, γ) reactions, and the compressed fuel areal density obtained with the yield-ratio method agrees well with the simulations. Additionally, a small scintillator decay tail and a clear DD neutron signal were observed in an integrated FI experiment as a result of the low afterglow of the oxygen-quenched liquid scintillator.
We previously reported four heterozygous missense mutations of MYH7, KCNQ1, MYLK2, and TMEM70 in a single three-generation Chinese family with dual Long QT and hypertrophic cardiomyopathy phenotypes for the first time. However, the clinical course among the family members was various, and the potential myocardial dysfunction has not been investigated.
Objectives
The objective of this study was to investigate the echocardiographic and electrocardiographic characteristics in a genetic positive Chinese family with hypertrophic cardiomyopathy and further to explore the association between myocardial dysfunction and electric activity, and the identified mutations.
Methods
A comprehensive echocardiogram – standard two-dimensional Doppler echocardiography and three-dimensional speckle tracking echocardiography – and electrocardiogram were obtained for members in this family.
Results
As previously reported, four missense mutations – MYH7-H1717Q, KCNQ1-R190W, MYLK2-K324E, and TMEM70-I147T – were identified in this family. The MYH7-H1717Q mutation carriers had significantly increased left ventricular mass indices, elevated E/e’ ratio, deteriorated global longitudinal stain, but enhanced global circumferential and radial strain compared with those in non-mutation patients (all p<0.05). The KCNQ1-R190W carriers showed significantly prolonged QTc intervals, and the MYLK2-K324E mutation carriers showed inverted T-waves (both p<0.05). However, the TMEM70-I147T mutation carriers had similar echocardiography and electrocardiographic data as non-mutation patients.
Conclusions
Three of the identified four mutations had potential pathogenic effects in this family: MYH7-H1717Q was associated with increased left ventricular thickness, elevated left ventricular filling pressure, and altered myocardial deformation; KCNQ1-R190W and MYLK2-K324E mutations were correlated with electrocardiographic abnormalities reflected in long QT phenotype and inverted T-waves, respectively.
To produce pulses with good flat-top quality, pulse-forming lines (PFLs) have been widely used in the field of Tesla-type pulse generators. To shorten the physical length of the PFL, a double-width PFL (DWPFL) is proposed that doubles the output pulse width while maintaining flat-top quality. A repetitively 10 GW Tesla-type long-pulse generator producing pulses with flat-top width of about 110 ns was developed with a coaxial DWPFL to produce high-current electron beams. Electron beams of about 10 GW with flat-top widths of about 110 ns were obtained on a planar vacuum diode load. With this pulse generator and a C-band high-power microwave system, microwaves of ~2.2 GW power and full-width at half-maximum of 101 ns were generated. The experiment demonstrates the feasibility and ideal output waveform quality of the DWPFL.
The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.
Methods and results
In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.
Conclusions
A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.
Spatial-temporal variations in the extent of the seasonal snow cover of the upper reaches of the Yellow River were studied sytematically, using NOAA, Landsat, MSS and TM images, supported by ground-truth data. Effects of changing areal extent of snow cover on river flow were also examined. Spring-runoff forecasting models were developed, based on ridge regression methods and Grey theory, employing satellite snow-cover and actual hydrometeorological data to forecast inflow to the Longyang Gorge reservoir for ten-day periods between April and early June. Forecast precision is within ±15% of the actual observation. Separating snow-cover data by elevation zone improves the accuracy of forecast over lumping snow cover over the entire basin.
A 50-yr resolution reconstruction of climate and environment variability during the period 43–14 ka was developed using 26 high-precision U/Th dates and 390 oxygen isotope (δ18O) data of a stalagmite (SJ1) collected from Songjia Cave in central China, which is close to the northwestern boundary of the Asian summer monsoon (ASM). The δ18O record in SJ1 displays significant millennial-scale changes that correlate well in timing and duration with Dansgaard/Oeschger (D/O) events 5–10 and Heinrich event 4 (H4) identified in high-latitude regions of the Northern Hemisphere. Four 230Th dates constrain the H4 event precisely to the period of 39.7 to 38.3 ka. Notable centennial variations of the ASM activity could be observed within the H4 event. The magnitude and duration of D/O event 4.1 recorded in SJ1 are similar to those archived in east China but different from those documented in southwest China, suggesting that the manifestation of this event may be regionally different. The timing, duration and structure of D/O events 5–10 and Heinrich event 4 suggest that temperature changes in both hemispheres have exerted significant influences on the ASM variations in central China.