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Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
Compared with commercial polyolefin membranes, polyacrylonitrile (PAN) membrane prepared by electrostatic spinning has higher porosity, electrolyte uptake, thermal stability, and lithium-ion conductivity, etc. However, poor mechanical performance has largely limited the application of electrospun PAN separators. In this study, PAN/polyimide (PI) composite membrane is prepared by electrostatic spinning to improve the mechanical and electrochemical performances. Scanning electron microscopy, thermal analysis method, and electrochemical methods were used for evaluation of the electrospun composite membrane. The results show that the composite membrane possesses good thermal stability and exhibits better mechanical performance than pristine PAN membrane (increasing by 1.1 times in tension strength). The addition of PI can increase porosity and fluid absorption rate obviously. In addition, the composite membrane has high ionic conductivity (18.77 × 10−4 S/cm), wide electrochemical window (about 4.0 V), and excellent cycling performance. It can retain a discharge specific capacity of 153 mA h/g even after 50 cycles at 0.5 C. The electrospun PAN/PI membrane may be a promising candidate for lithium-ion battery separators.
Sulphur isotopes can be used as a powerful tool to trace fluid evolution and explore the formation of chimneys. To clarify the in situ S isotopic variations of sulphides at the micro-scale, we analyzed a sulphide chimney collected from the hydrothermal field in the East Pacific Rise 1–2° S using a sensitive high-mass-resolution ion micro-probe for stable isotopes (SHRIMP SI). Three mineral zones can be identified in the chimney: an external outer wall of porous anhydrite and colloform pyrite, an internal middle zone of sub-euhedral pyrite and massive chalcopyrite, and an inner zone of massive pyrite. The δ34SV-CDT values of the sulphides fall within the range 1.83–7.51 ‰ (avg. 4.05 ‰, n = 16), and S isotopic values increase from the core (3.09 ‰, n = 3) to the middle (3.78 ‰, n = 11) to the edge (6.99 ‰, n = 2). These results illustrate mineral crystallization processes and the mixing between seawater-derived S and magmatic–hydrothermal fluids during the growth of the chimney. The zones from the edge to the core are characterized by crystal morphologies of colloform/anhedral pyrite to massive pyrite with decreasing δ34S values, revealing multi-stage mineral deposition and sulphur isotopic fractionation. In contrast to the increase in δ34S values from the core to the edge in one profile (profile A), anomalously low δ34S values in fine-grained pyrite relative to chalcopyrite in another profile (profile B) in the middle zone result from S isotopic exchange between seawater SO42− and fluid H2S due to different fluid–seawater mixing, possibly caused by variations in permeability and porosity across the chimney.
The pathophysiology of cognitive impairment in patients with the major depressive disorder (MDD) may involve neuroinflammation mediated by cytokines.
The aim of this study was to examine the serum interleukin-6 (IL-6) levels, sustained attention, and their association in patients with MDD.
Thirty patients with MDD and 30 healthy controls were enrolled in this case-control study. Sustained attention was measured using the Rapid Visual Information Processing (RVP) task in the Cambridge Neuropsychological Tests Automated Battery. The serum IL-6 levels of all subjects were assessed by sandwich enzyme-linked immunosorbent assays.
There were significant differences in the log10RVP total hits, log10RVP total misses, and log10RVP mean latency between patients with MDD and healthy controls (F = 6.04, p = 0.017; F = 19.77, p < 0.0001; F = 14.42, p < 0.0001, respectively). The serum levels of Log10IL-6 were significantly higher in patients with MDD than in healthy controls (F = 192.27, p < 0.0001). The log10IL-6 levels were also positively correlated with the log10RVP mean latency in patients with MDD (r = 0.45, p = 0.013). A further stepwise multivariate regression analysis indicated that the log10IL-6 levels were significantly associated with the log10RVP mean latency in patients with MDD (β = 0.31, t = 2.41, p = 0.025).
Our data suggested that increased IL-6 levels were associated with the psychopathology of MDD, and that abnormal IL-6 levels were implicated in the impairment of sustained attention in patients with MDD.
Isolation of multidrug-resistant gram-negative bacteria (MDR-GNB) from patients in the community has been increasingly observed. A prediction model for MDR-GNB colonization and infection risk stratification on hospital admission is needed to improve patient care.
A 2-stage, prospective study was performed with 995 and 998 emergency department patients enrolled, respectively. MDR-GNB colonization was defined as isolates resistant to 3 or more classes of antibiotics, identified in either the surveillance or early (≤48 hours) clinical cultures.
A score-assigned MDR-GNB colonization prediction model was developed and validated using clinical and microbiological data from 995 patients enrolled in the first stage of the study; 122 of these patients (12.3%) were MDR-GNB colonized. We identified 5 independent predictors: age>70 years (odds ratio [OR], 1.84 [95% confidence interval (CI), 1.06–3.17]; 1 point), assigned point value in the model), residence in a long-term-care facility (OR, 3.64 [95% CI, 1.57–8.43); 3 points), history of cerebrovascular accidents (OR, 2.23 [95% CI, 1.24–4.01]; 2 points), hospitalization within 1 month (OR, 2.63 [95% CI, 1.39–4.96]; 2 points), and recent antibiotic exposure (OR, 2.18 [95% CI, 1.16–4.11]; 2 points). The model displayed good discrimination in the derivation and validation sets (area under ROC curve, 0.75 and 0.80, respectively) with the best cutoffs of<4 and ≥4 points for low- and high-risk MDR-GNB colonization, respectively. When applied to 998 patients in the second stage of the study, the model successfully stratified the risk of MDR-GNB infection during hospitalization between low- and high-risk groups (probability, 0.02 vs 0.12, respectively; log-rank test, P<.001).
A model was developed to optimize both the decision to initiate antimicrobial therapy and the infection control interventions to mitigate threats from MDR-GNB.
The musk deer (Moschus berezovskii) is an economically important species from which musk is extracted and used in perfumes and medicines. Cestodes (parasitic flatworms) of the genus Moniezia are important parasites that infect this endangered species and can cause high mortality in young deer. In 1982, Moniezia (S.) sichuanensis sp. nov. was described from a specimen obtained from wild musk deer. The new species was distinct from the other described species of Moniezia by the sawtooth-shaped interproglottidal glands, the thick vagina and the absence of a cirrus spine. In the present study, 12 cestodes collected from musk deer were examined morphologically and confirmed to be M. sichuanensis. Molecular characterization was performed by amplifying and comparing the internal transcribed spacer 1 (ITS1) and 5.8S rRNA gene (ITS1–5.8S) of ribosomal DNA with available sequences from other Moniezia species. The amplified sequences ranged from 761 to 764 bp and similarity ranged from 98.7–100%, compared to 67.8–92.4% with other Moniezia spp. Construction of a phylogenetic tree using the neighbour-joining method indicated that all 12 ITS1–5.8S sequences formed a single clade, confirming M. sichuanensis as a separate species. This study provides novel molecular insight into M. sichuanensis that could prove useful for future diagnosis and control of monieziasis in musk deer.
The hydrobaric effect on photoactivity of titanium dioxide (TiO2) fabricated by cathodic deposition in an aqueous solution was evaluated in this study. When the applied pressure was increased to 35 MPa, the water-splitting performance was improved by almost fourfold of the performance of the TiO2 prepared at atmospheric pressure. The surface states effect was significant in the deposited TiO2, which was exploited to affect the charges recombination of TiO2, and thereby enhance the resultant photoelectrochemical water-splitting performance. The hydrobaric cathodic deposition could be extended to fabrication of other metal oxides to eliminate the negative influence from the high-temperature process.
The integration of synchrotron and high-pressure techniques has significantly advanced research in materials science, giving rise to many important discoveries in physics, chemistry, environmental science, and many other fields of physical and engineering sciences. The relevant frontier work in multiple disciplines is reviewed. The selected studies include high-pressure superconductivity, lattice dynamics of materials, plastic deformation of nanomaterials, polyamorphic transitions and devitrification in metallic glass, rheology of minerals, and high-pressure chemistry probing.
The long-term outcome of never-treated patients with schizophrenia is
To compare the 14-year outcomes of never-treated and treated patients
with schizophrenia and to establish predictors for never being
All participants with schizophrenia (n = 510) in Xinjin,
Chengdu, China were identified in an epidemiological investigation of 123
572 people and followed up from 1994 to 2008.
The results showed that there were 30.6%, 25.0% and 20.4% of patients who
received no antipsychotic medication in 1994, 2004 and 2008 respectively.
Compared with treated patients, those who were never treated in 2008 were
significantly older, had significantly fewer family members, had higher
rates of homelessness, death from other causes, being unmarried, living
alone, being without a caregiver and poor family attitudes. Partial and
complete remission in treated patients (57.3%) was significantly higher
than that in the never-treated group (29.8%). Predictors of being in the
never-treated group in 2008 encompassed baseline never-treated status,
being without a caregiver and poor mental health status in 1994.
Many patients with schizophrenia still do not receive antipsychotic
medication in rural areas of China. The 14-year follow-up showed that
outcomes for the untreated group were worse. Community-based mental
healthcare, health insurance and family intervention are crucial for
earlier diagnosis, treatment and rehabilitation in the community.
This study modified the surfaces of three kinds of TiNi-based shape memory alloys (SMAs) by dry electrical discharge machining (EDM) in nitrogen (N2) and acetylene (C2H2) gas mixture. The effects of composition of the dielectric medium and work-piece on the machining performance and surface characteristics were investigated. Increasing the ratio of acetylene gas in gas mixture was beneficial for improving the material removal rate (MRR). However, adding a large amount of acetylene gas resulted in unstable discharge. A recast layer, comprising nitrides and carbides, which well adhered on the EDMed surface exhibited high hardness. Among Ti50Ni50, Ti50Ni49.5Cr0.5, and Ti40.5Ni49.5Zr10 SMA as a work-piece, Ti40.5Ni49.5Zr10 SMA has the lowest MRR owing to it possessed the highest melting temperature and thermal conductivity. The recast layer on Ti40.5Ni49.5Zr10 SMA, comprising zirconium nitride, exhibited the highest hardness and adhesion among all the SMAs. However, the high-hardness recast layer deteriorated the shape recovery of the SMA.
The distribution of the Critically Endangered tree Manglietia longipedunculata, of which there are only 11 known wild individuals, is restricted to the Nankunshan Nature Reserve in South China. The species is threatened with extinction because of its small number of individuals and the impediments to its reproduction (a combination of protogyny, a short period of stigma receptivity, and a lack of efficient pollinators). To reduce the risk of extinction we conducted two conservation translocation trials: one to augment the sole extant population, and the other 202 km north of the current range. The latter trial was a conservation introduction in which the goals were to increase the population and to buffer against the effects of climate change. We used emerged and grafted seedlings as translocation materials. We compared the survival, growth, and eco-physiological properties of emerged and grafted seedlings at the two sites. The survival rate and growth were higher for grafted seedlings than for emerged seedlings at both sites. Eco-physiological data indicated that grafted seedlings at both sites were as efficient or more so in light and water usage than wild individuals, whereas emerged seedlings were less efficient. Grafted seedlings attained the flowering stage sooner than emerged seedlings. Our study suggests that grafting can facilitate the augmentation and establishment of new populations of M. longipedunculata and perhaps of new populations of other threatened species facing reproductive difficulties and climate change.
Angiopoietin-like protein 3 (ANGPTL3) is a secreted protein that regulates lipid, glucose and energy metabolism. This study was conducted to better understand the effect of ANGPTL3 on important economic traits in cattle. First, transcript profiles for ANGPTL3 were measured in nine different Jiaxian cattle tissues. Second, polymorphisms were identified in the complete coding region and promoter region of the bovine ANGPTL3 gene in 707 cattle samples. Finally, an association study was carried out utilizing these single nucleotide polymorphisms (SNPs) to determine the effect of these SNPs on the growth and meat quality traits. Quantitative real-time PCR analysis showed that ANGPTL3 was mainly expressed in the liver. The promoter of the bovine ANGPTL3 contained several putative transcription factor binding sites (SF1, HNF-1, LXRα, NFκβ, HNF-3 and C/EBP). In total, four SNPs of the bovine ANGPTL3 gene were identified by direct sequencing. SNP1 (rs469906272: g.−38T>C) was identified in the promoter, SNP2 (rs451104723:g.104A>T) and SNP3 (rs482516226: g.509A>G) were identified in exon 1, and SNP4 (rs477165942: g.8661T>C) was identified in exon 6. Changes in predicted protein structures due to non-synonymous SNPs were analyzed. Haplotype frequencies and linkage disequilibrium were also investigated. Analysis of four SNPs in cattle from different native Chinese breeds (Nanyang (NY) and Jiaxian (JX)) and commercial breeds (Angus (AG), Hereford (HF), Limousin (LM), Luxi (LX), Simmental (ST) and Jinnan (JN)) revealed a significant association with growth traits (including: BW and hipbone width) and meat quality traits (including: Warner–Bratzler shear force and ribeye area). Therefore, implementation of these four mutations in selection indices in the beef industry may be beneficial in selecting individuals with superior growth and meat quality traits.
To provide a counter electrode with lower-cost and simple production method for dye-sensitized solar cells (DSSCs), we developed polyaniline/graphene nanoplatelet/multi-walled carbon nanotube (PANi/GNP/MWCNT) composite films growing on glass substrates by using chemical/electrochemical deposition method and on fluorine-doped tin oxide (FTO)/glass substrates by using electrochemical deposition method respectively. A proper weight ratio of PANi/GNP/MWCNT (1/0.0030/0.0045) composite film depositing on FTO substrate as counter electrode with sheet resistance of 8.25±0.13 Ω/sq for DSSCs yielded power conversion efficiency (PCE) up to 7.45±0.08%, which has potential to replace the conventional Pt cell (7.62±0.07%). In addition, we also fabricated the DSSCs composed of a proper weight ratio of PANi/GNP/MWCNTs (1/0.0045/0.0060) composite film depositing on glass substrate as counter electrode. The sheet resistance of resulting composite film was 59.34±12.34 Ω/sq. These solar cells with FTO-free counter electrode exhibited a PCE of 2.90±0.09%.
This study investigated the microstructure and machining characteristics of a Zr38.5Ti16.5Cu15.25Ni9.75Be20 bulk metallic glass (Zr-BMG) alloy machined using electro-discharge machining (EDM). After EDM, the hardening effect near the outer surface of the electro-discharge machined (EDMed) Zr-BMG alloy originated from the surface carbides of the recast layer, ZrC and TiC. The thickness of the recast layer, crater size, and the surface roughness increased with greater pulse energy. Furthermore, the EDM can generate a porous recast layer and convert the Zr-BMG alloy surface into a carbide surface, which is a potential method to fabricate biomaterials. Experimental results also show that the material removal rate of this alloy in the EDM process was significantly related to the pulse current IP and pulse duration τP. Many electro-discharge craters and recast materials were observed on the surface of the EDMed Zr-BMG alloy. The surface roughness of the EDMed Zr-BMG alloy was found to obey the empirical equation of Ra = β(IP × τP)α.
Neurosyphilis (NS) may present with neuropsychiatric disorders characterized by cognitive impairment, personality disorders, and confusion, among others. Very few studies have focused on neuropsychiatric disorders secondary to NS in elderly people.
A retrospective chart review was performed to characterize the psychiatric findings, clinical signs and symptoms, laboratory findings, and brain magnetic resonance imaging results of ten elderly inpatients with NS.
In these ten patients, the most common presenting symptoms included a wide variety of psychiatric manifestations. The serum rapid plasma regain (RPR) and Treponema pallidum particle agglutination assay (TPPA) of the ten patients were positive, with positive CSF TPPA and RPR rates of 100% and 60%, respectively. In addition, 90% of the patients demonstrated abnormal imaging, including cerebral atrophy, infarct ischemic stroke, and hydrocephalus.
Our findings support the importance of serological tests for syphilis as a routine component of the evaluation of patients with clinically evident neurological or psychiatric symptoms. If the serology is positive, all of the patients should be examined with a lumbar puncture. Moreover, psychiatric illnesses secondary to NS in the elderly also deserve medical attention.
Congenital anomalies of the coronary arteries are present in 0.2–1.4% of the general population. These anomalies represent one of the most confusing issues in the field of cardiology and challenges for interventional cardiologists and cardiac surgeons if the anomalies are unrecognised. Double right coronary artery is one of the rarest coronary arteries. Previously, the probability of developing atherosclerotic changes in patients with a double right coronary artery was considered to be equal to that in those without it. In reality, however, a high prevalence of atherosclerotic coronary artery disease was found in patients with a double right coronary artery originating from a single ostium after our comprehensive literature search through the PubMed database. Owing to the fact that double right coronary artery is both a congenital and potentially atherosclerotic coronary artery disease at diagnosis, coronary intervention or cardiac operation is more complicated than previously believed. Individuals with a double right coronary artery may be unaware of its presence until an accidental finding during coronary angiography or cardiac operation and are at risk for unsuspected complications of atherosclerotic coronary artery disease or during cardiac operation. Therefore, it is important to obtain information on the anatomic variants of this congenital coronary anomaly in patients who are undergoing either coronary intervention, aortic root operation or myocardial revascularisation. To our knowledge, this is the first comprehensive article to discuss the anomalies and their clinical implications.
It is well known that extracellular signal-regulated kinase 8 (ERK8) plays pivotal roles in various mitotic events. But its physiological roles in oocyte meiotic maturation remain unclear. In this study, we found that although no specific ERK8 signal was detected in oocyte at the germinal vesicle stage, ERK8 began to migrate to the periphery of chromosomes shortly after germinal vesicle breakdown. At prometaphase I, metaphase I (MI), anaphase I, telophase I, and metaphase II (MII) stages, ERK8 was stably detected at the spindles. By taxol treatment, we clarified that the ERK8 signal was stained on the spindle fibers as well as microtubule asters in MI and MII oocytes. In fertilized eggs, the ERK8 signal was not observed in the two pronuclei stages. At prometaphase, metaphase, and anaphase of the first mitosis, ERK8 was detected on the mitotic spindle. ERK8 knock down by antibody microinjection and specific siRNA caused abnormal spindles, failed chromosome congression, and decreased first polar body extrusion. Taken together, our results suggest that ERK8 plays an important role in spindle organization during mouse oocyte meiotic maturation and early embryo cleavage.
Few studies have evaluated the relationship between the consumption of dietary folate and one-carbon metabolism-related nutrients and breast cancer risk defined by oestrogen receptor (ER) and progesterone receptor (PR) status. The objective of the present study was to examine the associations between dietary folate, vitamin B6, vitamin B12, and methionine intake and the risk of breast cancer by ER and PR status among Chinese women in Guangdong. A hospital-based case–control study was conducted from June 2007 to August 2008, with 438 cases and 438 age (5-year interval)- and residence (rural/urban)-matched controls. Dietary intake information was assessed using a validated FFQ administered through a face-to-face interview. Unconditional logistic regression models were used to calculate multivariate-adjusted OR and 95 % CI. A significant inverse association was found between dietary folate and vitamin B6 intake and breast cancer risk. The adjusted OR of the highest v. the lowest quartile were 0·32 (95 % CI 0·21, 0·49; Ptrend < 0·001) for dietary folate and 0·46 (95 % CI 0·30, 0·69; Ptrend < 0·001) for vitamin B6. No associations were observed for vitamin B12 and methionine intake. A significant inverse association between dietary folate intake and breast cancer risk was observed in all subtypes of ER and PR status. These findings suggest that dietary folate and vitamin B6 intakes were inversely associated with breast cancer risk. The inverse association did not differ by ER and/or PR status.
High-quality GaP, GaP@GaN and GaN@GaP nanowires were grown by a convenient vapor deposition technique. The wire-like and two-layers structures of GaP@GaN and GaN@GaP core-shell nanowires were clearly resolved using X-ray powder diffraction and high-resolution transmission electron microscopy (HRTEM) and their growth directions were identified. Photoluminescence intensity of GaP@GaN nanowires increased as temperature increased. The result was interpreted by the piezoelectric effect induced from lattice mismatch between two semiconductor layers. An unexpected peak at 386 cm-1 was found in the Raman spectra of GaN@GaP and assigned to a surface phonon mode due to the interface. Detailed synthetic conditions and possible growth mechanisms of those nanowires were proposed.