Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.

We study the melting process of a solid under microgravity, driven solely by lateral vibrations that are perpendicular to the applied temperature gradient due to the absence of gravity-induced convection. Using direct numerical simulations with the phase-field method, we examine two-dimensional vibration-induced melting in a square cavity over four orders of magnitude of vibrational Rayleigh numbers, $10^5\le Ra_{{vib}}\le 10^9$. Our results show that as melting progresses, the flow structure transitions from a periodic-circulation regime with diffusion-dominated heat transfer to a columnar regime with vibroconvection. The mean height of the liquid–solid interface follows a power-law dependency with time, $\bar {\xi } \sim \tilde t^{1/(2-2\alpha )}$, where $\alpha = 0$ in the periodic-circulation regime and $\alpha = 1/2$ in the columnar regime. We further observe that within the columnar regime, the morphological evolution of the liquid–solid interface is influenced by the interaction of columnar thermal plumes in the central regions and the peripheral flow near the sidewalls. Specifically, we offer a comprehensive analysis of the plume merging behaviour, which is governed by the aspect ratio ($\bar {\xi }$) of the liquid layer and the intensity of vibration, quantified by the effective vibrational Rayleigh number $Ra_{vib}^{eff}$. We identify the relationship between the number of columnar plumes $K_m$ and $Ra_{vib}^{eff}$, finding that $K_m \sim \bar {\xi }^{-1} (Ra_{vib}^{eff})^{\gamma }$ with the fitting scaling exponent $\gamma = 0.150 \pm 0.025$. We subsequently quantify the characteristics of the interface roughness amplitude evolution in microgravity vibroconvection. Our results indicate that the roughness amplitude exhibits a power-law dependence on the mean height of the liquid layer. Drawing from the Stefan boundary condition, we theoretically deduce this dependence under the assumption of a non-uniform heat flux distribution at the interface, where the theory is corroborated by our numerical simulations.

To meet the development needs of aeroengines for high thrust-to-weight ratios and fuel-air ratios, a high temperature rise triple-swirler main combustor was designed with a total fuel-air ratio of 0.037, utilising advanced technologies including staged combustion, multi-point injection and multi-inclined hole cooling. Fluent software was used to conduct numerical simulations under both takeoff and idle conditions, thereby obtaining the distribution characteristics of the velocity and temperature fields within the combustor, as well as the generation of pollutants. The simulation results indicate that under takeoff conditions, the high temperature rise triple-swirler combustor achieves a total pressure loss coefficient of less than 6% and a combustion efficiency exceeding 99%. Under takeoff conditions, the OTDF and RTDF values are 0.144 and 0.0738, respectively. The mole fraction of NOx emissions is 3,700ppm, while the mole fraction of soot emissions is 2.55×10−5ppm. Under idle conditions, the triple-swirler combustor maintains a total pressure loss coefficient of less than 6% and a combustion efficiency greater than 99.9%. The OTDF and RTDF values are 0.131 and 0.0624, respectively. The mole fractions of CO and UHC emissions are both 0×10−32ppm at the calculation limit of Fluent software.

Maura Dykstra's 2022 monograph Uncertainty in the Empire of Routine: The Administrative Revolution of the Eighteenth-Century Qing State (Harvard Asia Center, 2022) has attracted controversy in the academic community. This paper analyses the book's use of documents from the Ba County Archive, held in the SIchuan Provincial Archive. While reviewing the monograph's arguments drawn from these materials, the paper also introduces the Ba Archives and the methodologies that may be employed to interpret them.

Tea can improve the progression of some metabolic diseases through anti-inflammatory and antioxidant effects, but its impact on non-alcoholic fatty liver disease (NAFLD) is still controversial. The aim of this paper is to identify the relationship between tea and NAFLD by Mendelian randomisation (MR) and complete clinical validation using National Health and Nutrition Examination Survey (NHANES) database. MR used data from Genome Wide Association Study, with inverse-variance weighted (IVW) as principal analytical methods. The reliability of the results was verified by a series of sensitivity and heterogeneity tests. Subsequently, clinical validation was conducted using NHANES (2005–2018), involving 22 257 participants, grouped by the type of tea. Green tea drinkers were categorised into four groups (Q1–Q4) by quartiles of green tea intake, from lowest to highest (similar for black tea drinkers and other tea drinkers). Models were constructed by logistic regression to estimate the role of tea consumption (Q1–4) on NAFLD. Finally, using fibrosis-4 index (FIB-4) to evaluate the severity of hepatic fibrosis, the effect of tea consumption (Q1–4) on the degree of hepatic fibrosis was investigated by linear regression. IVW method (OR = 0·43, 95 % CI: 0·21, 0·85, P = 0·01) and weighted median method (OR = 0·35, 95 % CI: 0·14, 0·91, P = 0·03) revealed there was a causal relationship between tea and NAFLD. An array of sensitivity analyses validated the reliability of results. Analysis of NHANES indicated tea drinker present a slightly lower prevalence of NAFLD than non-tea drinker (green tea drinkers: 47·6 %, black tea drinkers: 46·3 %, other tea drinker: 43·2 %, non-tea drinkers: 48·1 %, P < 0·05). After adjusting for confounders, compared with the lowest black tea consumption (Q1), the population with the highest black tea consumption (Q4) was independently related to lower presence of NAFLD (Q4: OR = 0·69, 95 % CI: 0·50, 0·93, P < 0·05), such association remained stable in the overweight subgroup. As further analysed, Q4 also displayed a significant negative correlation with the level of hepatic fibrosis in patients with NAFLD (β = –0·073, 95 % CI: –0·126, −0·020, P < 0·01).Tea reduces the morbidity of NAFLD and ameliorates hepatic fibrosis degree in those already suffering from the disease.

Thanks to its real-time computation efficiency, deep reinforcement learning (DRL) has been widely applied in motion planning for mobile robots. In DRL-based methods, a DRL model computes an action for a robot based on the states of its surrounding obstacles, including other robots that may communicate with it. These methods always assume that the environment is attack-free and the obtained obstacles’ states are reliable. However, in the real world, a robot may suffer from obstacle localization attacks (OLAs), such as sensor attacks, communication attacks, and remote-control attacks, which cause the robot to retrieve inaccurate positions of the surrounding obstacles. In this paper, we propose a robust motion planning method ObsGAN-DRL, integrating a generative adversarial network (GAN) into DRL models to mitigate OLAs in the environment. First, ObsGAN-DRL learns a generator based on the GAN model to compute the approximation of obstacles’ accurate positions in benign and attack scenarios. Therefore, no detectors are required for ObsGAN-DRL. Second, by using the approximation positions of the surrounding obstacles, ObsGAN-DRL can leverage the state-of-the-art DRL methods to compute collision-free motion commands (e.g., velocity) efficiently. Comprehensive experiments show that ObsGAN-DRL can mitigate OLAs effectively and guarantee safety. We also demonstrate the generalization of ObsGAN-DRL.

Recent studies suggest an association between greater dietary inflammatory index (DII) and higher biological ageing. As α-Klotho has been considered as a longevity protein, we examined whether α-Klotho plays a role in the association between DII and ageing. We included 3054 participants from the National Health and Nutrition Examination Survey. The associations of DII with biological and phenotypic age were assessed by multivariable linear regression, and the mediating role of α-Klotho was evaluated by mediation analyses. Participants’ mean age was 58·0 years (sd 11·0), with a median DII score of 1·85 and interquartile range from 0·44 to 2·79. After adjusting for age, sex, race/ethnicity, BMI, education, marital status, poverty income ratio, serum cotinine, alcohol, physical activity, a higher DII was associated with both older biological age and phenotypic age, with per DII score increment being associated with a 1·01-year increase in biological age (1·01 (95 % CI: 1·005, 1·02)) and 1·01-year increase in phenotypic age (1·01 (1·001, 1·02)). Negative associations of DII with α-Klotho (β = –1·01 pg/ml, 95 % CI: –1·02, –1·006) and α-Klotho with biological age (β= –1·07 years, 95 % CI: –1·13, –1·02) and phenotypic age (β= –1·03 years, 95 % CI: –1·05, –1·01) were found. Furthermore, α-Klotho mediated 10·13 % (P < 0·001) and 9·61 % (P < 0·001) of the association of DII with biological and phenotypic age, respectively. Higher DII was associated with older biological and phenotypic age, and the potential detrimental effects could be partly mediated through α-Klotho.

We report the unified constitutive law of vibroconvective turbulence in microgravity, i.e. $Nu \sim a^{-1} Re_{os}^\beta$ where the Nusselt number $Nu$ measures the global heat transport, $a$ is the dimensionless vibration amplitude, $Re_{os}$ is the oscillational Reynolds number and $\beta$ is the universal exponent. We find that the dynamics of boundary layers plays an essential role in vibroconvective heat transport and the $Nu$-scaling exponent $\beta$ is determined by the competition between the thermal boundary layer (TBL) and vibration-induced oscillating boundary layer (OBL). Then a physical model is proposed to explain the change of scaling exponent from $\beta =2$ in the TBL-dominant regime to $\beta = 4/3$ in the OBL-dominant regime. Our finding elucidates the emergence of universal constitutive laws in vibroconvective turbulence, and opens up a new avenue for generating a controllable effective heat transport under microgravity or even microfluidic environment in which the gravity effect is nearly absent.

Gentiana straminea Maxim. (Gentianaceae) is an important traditional Tibetan herb that is mainly distributed on the Qinghai-Tibetan Plateau. Despite its agricultural and pharmacological importance, there remains a paucity of microsatellite markers, particularly expressed sequence tag-simple sequence repeat (EST-SSR) markers, available for this local endemic species. In this study, based on previous Illumina transcriptome data of G. straminea, a total of 96 EST-SSR markers were initially designed and tested. Thirty-two of 96 loci (33.33%) were successfully amplified and verified for validation. Among them, 10 were polymorphic and had clear bands. The polymorphism information content values were 0.09–0.799, the number of alleles per locus ranged from 3 to 14, and the levels of observed and expected heterozygosity were 0.078–0.722 and 0.238–0.884, respectively, which suggested a high level of information. Moreover, cross-amplification was successful for 10 loci in two other related species, Gentiana macrophylla Pallas and Gentiana dahurica Fischer. These EST-SSR markers provide a valuable tool for investigating the genetic diversity related to quantitative traits and population genetic studies on G. straminea and related species in sect. Cruciata Gaudin.

Gradual typing integrates static and dynamic typing by introducing a dynamic type and a consistency relation. A problem of gradual type systems is that dynamic types can easily hide erroneous data flows since consistency relations are not transitive. Therefore, a more rigorous static check is required to reveal these hidden data flows statically. However, in order to preserve the expressiveness of gradually typed languages, static checks for gradually typed languages cannot simply reject programs with potentially erroneous data flows. By contrast, a more reasonable request is to show how these data flows can affect the execution of the program. In this paper, we propose and formalize Static Blame, a framework that can reveal hidden data flows for gradually typed programs and establish the correspondence between static-time data flows and runtime behavior. With this correspondence, we build a classification of potential errors detected from hidden data flows and formally characterize the possible impact of potential errors in each category on program execution, without simply rejecting the whole program. We implemented Static Blame on Grift, an academic gradually typed language, and evaluated the effectiveness of Static Blame by mutation analysis to verify our theoretical results. Our findings revealed that Static Blame exhibits a notable level of precision and recall in detecting type-related bugs. Furthermore, we conducted a manual classification to elucidate the reasons behind instances of failure. We also evaluated the performance of Static Blame, showing a quadratic growth in run time as program size increases.

Accurately predicting neurosyphilis prior to a lumbar puncture (LP) is critical for the prompt management of neurosyphilis. However, a valid and reliable model for this purpose is still lacking. This study aimed to develop a nomogram for the accurate identification of neurosyphilis in patients with syphilis. The training cohort included 9,504 syphilis patients who underwent initial neurosyphilis evaluation between 2009 and 2020, while the validation cohort comprised 526 patients whose data were prospectively collected from January 2021 to September 2021. Neurosyphilis was observed in 35.8% (3,400/9,504) of the training cohort and 37.6% (198/526) of the validation cohort. The nomogram incorporated factors such as age, male gender, neurological and psychiatric symptoms, serum RPR, a mucous plaque of the larynx and nose, a history of other STD infections, and co-diabetes. The model exhibited good performance with concordance indexes of 0.84 (95% CI, 0.83–0.85) and 0.82 (95% CI, 0.78–0.86) in the training and validation cohorts, respectively, along with well-fitted calibration curves. This study developed a precise nomogram to predict neurosyphilis risk in syphilis patients, with potential implications for early detection prior to an LP.

Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p<0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients’ practice toward rabies prevention is essential for rabies elimination by 2030.

Buckminsterfullerene (C60) is one of the most important carbon-based nanoparticles (CNPs). Industrial-scale production of C60 has reached the level of tons; release to the environment has been confirmed (Tremblay, 2002; Qiao et al., 2007). The present study was devoted to study of the effect of clay minerals on the migration process of C60. Molecular dynamics (MD) simulations were used to study the interaction of CNPS with clay minerals through study of the adsorption of C60 on various surfaces of kaolinite and pyrophyllite in vacuum and aqueous environments. Two kinds of surfaces, hydrophobic siloxane surfaces and hydrophilic hydroxyl surfaces, were investigated. C60 is mainly adsorbed onto the vacancy of the six-membered ring, composed of SiO4 tetrahedra or AlO6 octahedra, on clay-mineral surfaces. A single adsorption layer consisting of C60 molecules with an ordered hexagonal arrangement is presented for all surfaces in vacuum. In aqueous environments, however, the monolayer appears on the siloxane surfaces only, while a cluster of C60 molecules is formed on the hydroxyl surfaces. Free energies prove that the attachment of two C60 molecules is stronger than the adsorption of C60 onto the hydroxyl surface in water, which is the reason for unfavorable formation of C60 monolayer. On the other hand, the adsorption free energy is more negative on the hydrophobic siloxane surface, explaining the monolayer formation. The existence of water, which forms hydration layers on the surfaces of clay minerals, produces energy barriers, and reduces the adsorption affinity to some extent. Because clay minerals act as geosorbents in the environment, the present study is significant in terms of understanding the migration and fate of CNPS in nature.

The adsorption properties of clay minerals (e.g. montmorillonite and palygorskite) have been improved through chemical treatment methods. However, the addition of extra chemicals is often not friendly to the environment and powdered clay-mineral adsorbents are inconvenient for some applications. To overcome these drawbacks in the present study, granular montmorillonite-palygorskite adsorbents (GMPA) were successfully prepared using Na-alginate and thermal treatments to improve heavy metal removal from water. The properties of GMPA samples under different calcination temperatures were examined using thermogravimetric (TG) analysis, scanning electron microscopy (SEM), X-ray diffraction (XRD), and specific surface area (BET). The results indicated that loss of mass by GMPA relative to the untreated montmorillonite-palygorskite was due to the loss of water, adsorbed Na-alginate, and mineral decomposition during thermal treatment. Changes in the morphology and crystallinity were significant at calcination temperatures from 500°C to 1000°C. The layered morphology totally disappeared after calcination at 1000°C, while transformation of the montmorillonite and palygorskite to a non-crystalline material was almost complete at 800°C and new crystalline phases appeared. Calcination temperature had a significant influence on the specific surface areas and pore volumes of GMPA. Both the changes in texture and chemical structure affected Pb2+ and Cu2+ removal. The GMPA sample produced at a 600°C calcination temperature was the most promising adsorbent for heavy metal removal from water.

Multilayer dielectric gratings (MLDGs) are crucial for pulse compression in picosecond–petawatt laser systems. Bulged nodular defects, embedded in coating stacks during multilayer deposition, influence the lithographic process and performance of the final MLDG products. In this study, the integration of nanosecond laser conditioning (NLC) into different manufacturing stages of MLDGs was proposed for the first time on multilayer dielectric films (MLDFs) and final grating products to improve laser-induced damage performance. The results suggest that the remaining nodular ejection pits introduced by the two protocols exhibit a high nanosecond laser damage resistance, which remains stable when the irradiated laser fluence is more than twice the nanosecond-laser-induced damage threshold (nanosecond-LIDT) of the unconditioned MLDGs. Furthermore, the picosecond-LIDT of the nodular ejection pit conditioned on the MLDFs was approximately 40% higher than that of the nodular defects, and the loss of the grating structure surrounding the nodular defects was avoided. Therefore, NLC is an effective strategy for improving the laser damage resistance of MLDGs.