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This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation in infants with acute respiratory distress syndrome after congenital heart surgery.
Methods:
We retrospectively analysed the clinical data of 32 infants who were ventilated due to acute respiratory distress syndrome after congenital heart surgery between January, 2020 and January, 2022. We adopted high-frequency oscillation ventilation combined with intermittent mandatory ventilation as the rescue ventilation mode for infants who were failing conventional mechanical ventilation.
Results:
After rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation, the dynamic compliance (Cdyn), PaO2 and PaO2/FiO2 ratio of the infants improved compared with conventional mechanical ventilation (p < 0.05). Moreover, high-frequency oscillation ventilation combined with intermittent mandatory ventilation resulted in a significant decrease in arterial-alveolar oxygen difference (AaDO2), FiO2, and oxygenation index (p < 0.05). No significant effect on haemodynamic parameters was observed. Moreover, no serious complications occurred in the two groups.
Conclusion:
Rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation significantly improved oxygenation in infants who failed conventional mechanical ventilation for acute respiratory distress syndrome after congenital heart surgery. Thus, this strategy is considered safe and feasible. However, further studies must be conducted to confirm the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation as a rescue perioperative respiratory support strategy for CHD.
The selection of high-quality sperms is critical to intracytoplasmic sperm injection, which accounts for 70–80% of in vitro fertilization (IVF) treatments. So far, sperm screening is usually performed manually by clinicians. However, the performance of manual screening is limited in its objectivity, consistency, and efficiency. To overcome these limitations, we have developed a fast and noninvasive three-stage method to characterize morphology of freely swimming human sperms in bright-field microscopy images using deep learning models. Specifically, we use an object detection model to identify sperm heads, a classification model to select in-focus images, and a segmentation model to extract geometry of sperm heads and vacuoles. The models achieve an F1-score of 0.951 in sperm head detection, a z-position estimation error within ±1.5 μm in in-focus image selection, and a Dice score of 0.948 in sperm head segmentation, respectively. Customized lightweight architectures are used for the models to achieve real-time analysis of 200 frames per second. Comprehensive morphological parameters are calculated from sperm head geometry extracted by image segmentation. Overall, our method provides a reliable and efficient tool to assist clinicians in selecting high-quality sperms for successful IVF. It also demonstrates the effectiveness of deep learning in real-time analysis of live bright-field microscopy images.
We report an experimental study of the Prandtl-number effects in quasi-two-dimensional (quasi-2-D) Rayleigh–Bénard convection. The experiments were conducted in four rectangular convection cells over the Prandtl-number range of $11.7 \leqslant Pr \leqslant 650.7$ and over the Rayleigh-number range of $6.0\times 10^8 \leqslant Ra \leqslant 3.0\times 10^{10}$. Flow visualization reveals that, as $Pr$ increases from 11.7 to 145.7, thermal plumes pass through the central region much less frequently and their self-organized large-scale motion is more confined along the periphery of the convection cell. The large-scale flow is found to break down for higher $Pr$, resulting in a regime transition in the Reynolds number $Re$. For the $Pr$ range with a large-scale flow of system size, the $Re$ number, Nusselt number $Nu$ and local temperature fluctuations were investigated systematically. It is found that $Re$ scales as $Re \sim Ra^{0.58}Pr^{-0.82}$ in the present geometry, which suggests that it is in line with the behaviour in the 2-D configuration. On the other hand, the measured $Nu(Ra, Pr)$ relation $Nu \sim Ra^{0.289}Pr^{-0.02}$ tends to be compatible with the finding in a three-dimensional (3-D) system. For the temperature fluctuations in the cell centre and near the sidewall, they exhibit distinct $Ra$-dependent scalings that could not be accounted for with existing theories, but their $Pr$ dependences for $Pr \lesssim 50$ are in agreement with the predictions by Grossmann & Lohse (Phys. Fluids, vol. 16, 2004, pp. 4462–4472). These results enrich our understanding of quasi-2-D thermal convection, and its similarities and differences compared to 2-D and 3-D systems.
The aim of this study was to assess the current status of disease-related knowledge and to analyze the relationship among the general condition, illness perception, and psychological status of patients with coronavirus disease 2019 (COVID-19).
Methods:
A hospital-based cross-sectional study was conducted on 118 patients using convenience sampling. The general questionnaire, disease-related knowledge questionnaire of COVID-19, Illness Perception Questionnaire (IPQ), and Profile of Mood States (POMS) were used to measure the current status of participants.
Results:
The overall average score of the disease-related knowledge of patients with COVID-19 was (79.19 ± 14.25), the self-care situation was positively correlated with knowledge of prevention and control (r = 0.265; P = 0.004) and total score of disease-related knowledge (r = 0.206; P = 0.025); the degree of anxiety was negatively correlated with the knowledge of diagnosis and treatment (r = −0.182; P = 0.049). The score of disease-related knowledge was negatively correlated with negative cognition (volatility, consequences, emotional statements) and negative emotions (tension, fatigue, depression) (P < 0.05); positively correlated with positive cognition (disease coherence) and positive emotion (self-esteem) (P < 0.05).
Conclusions:
It was recommended that we should pay more attention to the elderly and low-income groups, and increase the knowledge about diagnosis and treatment of COVID-19 and self-care in the future health education for patients.
Conceptual design, as an early phase of the design process, is known to have the highest impact on determining the innovation level of design results. Although many tools exist to support designers in conceptual design, additional knowledge, especially knowledge related to emerging technologies, is still often needed. In this paper the authors aim to propose a data-driven creative concept generation and evaluation approach to support designers in incorporating emerging technologies in the new product early development stage. The approach is demonstrated by means of an illustrated example.
Panonychus citri (McGregor) is the most common pest in citrus-producing regions. Special low-toxicity acaricides, such as spirocyclic tetronic acids and mite growth inhibitors, have been used for a long time in China. However, pesticide resistance in mites is a growing problem due to the lack of new acaricide development. Wide-spectrum insecticides, such as amitraz have gained acceptance among fruit growers. An amitraz-resistant strain of P. citri was obtained by indoor screening to examine field resistance monitoring of mites to acaricides and to explore the resistant mechanism of mites against amitraz. The amitraz-resistant strain of P. citri had an LC50 value of 2361.45 mg l−1. The resistance ratio was 81.35 times higher in the resistant strain of P. citri compared with the sensitive strain. Crossing experiments between the sensitive and resistant strains of P. citri were conducted, resulting in a D value of 0.11 for F1 SS♀×RS♂ and 0.06 for F1 RS♀×SS♂. Reciprocal cross experiments showed that the dose–mortality curves for the F1 generations coincided, indicating that the resistance trait was not affected by cytoplasmic inheritance. The dose–expected response relationship was evaluated in the backcross generation and a significant difference was observed compared with the actual value. The above results indicate that the inheritance of resistance trait was incompletely dominant, governed by polygenes on the chromosome. Synergism studies demonstrated that cytochrome P450s and esterase may play important roles in the detoxification of amitraz. Based on differential gene analysis, 23 metabolism-related genes of P. citri were identified, consistent with the results of synergism studies. Real-time PCR verification implied that P450s, ABC transporters, and acetylcholinesterase might influence the detoxification of amitraz by P. citri. These results provide the genetic and molecular foundation for the management of pest mite resistance.
Amnestic mild cognitive impairment (aMCI) is characterized by delayed P300 latency and reduced grey matter (GM) volume, respectively. The relationship between the features in aMCI is unclear. This study was to investigate the relationship between the altered P300 latency and the GM volume in aMCI.
Methods
Thirty-four aMCI and 34 well-matched normal controls (NC) were studied using electroencephalogram during a visual oddball task and scanned with MRI. Both tests were finished in the same day.
Results
As compared with the NC group, the aMCI group exhibited delayed P300 latency in parietal cortex and reduced GM volumes in bilateral temporal pole and left hippocampus/parahippocampal gyrus. A remarkable negative correlation was found between delayed P300 latency and reduced left hippocampal volume only in the aMCI group. Interestingly, the mediating analysis found P300 latency significantly mediated the association between right supramarginal gyrus volume and information processing speed indicated by Stroop Color and Word Test A scores.
Conclusions
The association between delayed P300 latency and reduced left hippocampal volume in aMCI subjects suggests that reduced left hippocampal volume may be the potential structural basis of delayed P300 latency.
Lassa fever (LF) is increasingly recognised as an important rodent-borne viral haemorrhagic fever presenting a severe public health threat to sub-Saharan West Africa. In 2017–18, LF caused an unprecedented epidemic in Nigeria and the situation was worsening in 2018–19. This work aims to study the epidemiological features of epidemics in different Nigerian regions and quantify the association between reproduction number (R) and state rainfall. We quantify the infectivity of LF by the reproduction numbers estimated from four different growth models: the Richards, three-parameter logistic, Gompertz and Weibull growth models. LF surveillance data are used to fit the growth models and estimate the Rs and epidemic turning points (τ) in different regions at different time periods. Cochran's Q test is further applied to test the spatial heterogeneity of the LF epidemics. A linear random-effect regression model is adopted to quantify the association between R and state rainfall with various lag terms. Our estimated Rs for 2017–18 (1.33 with 95% CI 1.29–1.37) was significantly higher than those for 2016–17 (1.23 with 95% CI: (1.22, 1.24)) and 2018–19 (ranged from 1.08 to 1.36). We report spatial heterogeneity in the Rs for epidemics in different Nigerian regions. We find that a one-unit (mm) increase in average monthly rainfall over the past 7 months could cause a 0.62% (95% CI 0.20%–1.05%)) rise in R. There is significant spatial heterogeneity in the LF epidemics in different Nigerian regions. We report clear evidence of rainfall impacts on LF epidemics in Nigeria and quantify the impact.
Objective: Deficits in the semantic learning strategy were observed in subjects with amnestic mild cognitive impairment (aMCI) in our previous study. In the present study, we explored the contributions of executive function and brain structure changes to the decline in the semantic learning strategy in aMCI. Methods: A neuropsychological battery was used to test memory and executive function in 96 aMCI subjects and 90 age- and gender-matched healthy controls (HCs). The semantic clustering ratio on the verbal learning test was calculated to evaluate learning strategy. Medial temporal lobe atrophy (MTA) and white matter hyperintensities (WMH) were measured on MRI with the MTA and Fazekas visual rating scales, respectively. Results: Compared to HCs, aMCI subjects had poorer performance in terms of memory, executive function, and the semantic clustering ratio (P < .001). In aMCI subjects, no significant correlation between learning strategy and executive function was observed. aMCI subjects with obvious MTA demonstrated a lower semantic clustering ratio than those without MTA (P < .001). There was no significant difference in the learning strategies between subjects with high-grade WMH and subjects with low-grade WMH. Conclusion: aMCI subjects showed obvious impairment in the semantic learning strategy, which was attributable to MTA but independent of executive dysfunction and subcortical WMH. These findings need to be further validated in large cohorts with biomarkers identified using volumetric brain measurements. (JINS, 2019, 25, 706–717)
The influence of the nozzle aspect ratio ($AR=1$, 2 and 4), stroke length ($L_{0}=1.85$, 3.7 and 5.55) and Reynolds number ($Re=79$, 158, 316 and 632) on the behaviour of elliptic synthetic jets is studied experimentally. Laser-induced fluorescence and two-dimensional and stereoscopic particle image velocimetry are used to analyse the vortex dynamics and evolution mechanism. It is found that the fluid elements around the major axis of an elliptic vortex ring move downstream faster and tend to approach the centreline, while the fluid elements around the minor axis move downstream at a slower speed and away from the centreline, thereby resulting in the occurrence of the well-known axis-switching phenomenon for elliptic synthetic jets. During this process, a pair of arc-like vortices forms ahead of the primary vortex ring, and they are constituted by streamwise vortices in the leg part and spanwise vortices in the head part; two pairs of streamwise vortices form from the inside of the primary vortex ring and develop in the tails. The streamwise vortices are pushed away progressively from the centreline by the synthetic jet vortex rings that are formed during the subsequent periods. These additional vortical structures for non-circular synthetic jets show regular and periodic characteristics, which are quite different from the previous findings for non-circular jets. Their mutual interaction with the vortex ring causes significant changes in the topology of elliptic synthetic jets, which further results in the variation of the statistical characteristics. Increasing the aspect ratio, stroke length and Reynolds number will make the evolution of the synthetic jet become more unstable and complex. In addition, the entrainment rate of an elliptical synthetic jet is larger than that of a circular synthetic jet and it increases with the nozzle aspect ratio ($AR\leqslant 4$) and Reynolds number. It is indicated that the formation of streamwise vortices could enhance the entrainment rate. This finding provides substantial evidence for the potential application of elliptic synthetic jets for effective flow control.
A 336-cm-long sediment core spanning the last 130 ka was recovered from Lake Xingkai on the northeastern margin of the East Asian summer monsoon domain to reveal the linkage between lacustrine depositional processes and environmental changes. Bayesian end member modeling analysis was conducted to partition and interpret the grain-size distributions of Lake Xingkai sediments. Our results suggest that the sedimentary system is characterized by three end members (EMs). EM1 and EM2, with a modal value of 13 and 10 μm, respectively, indicate the variation of local hydraulic conditions. EM3, with a modal value of 5 μm, reflects the background atmospheric dust loading. High atmospheric dust concentration generally occurred during Marine Isotope Stage (MIS) 5d, MIS 4, and early MIS 3, when the climate in the Asian dust source region was cold and dry. In contrast, low dust concentration prevailed during MIS 2, likely due to the southward shift of the westerlies driven by maximum ice volume in the high latitudes.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
Methods:
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
Results:
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
Conclusion:
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
New samples of fusulinids collected in the Tengchong Block, western Yunnan, China, are systematically studied and presented here. The fusulinid fauna from the Xishancun section in the Shanmutang area is dominated by Chusenella and Nankinella, whereas that from the Shuangheyan area is composed mainly of Chusenella and Schwagerina. Both faunas are dated as Roadian–Capitanian (middle Permian). These new findings are integrated with fusulinid taxa reported earlier from the block to demonstrate the taxonomic features and paleogeographic significance of Permian fusulinids. The low generic diversity through early and middle Permian and the paucity of middle Permian neoschwagerinids and verbeekinids in the block confirm its Gondwana-affinity attributes. Moreover, the Permian fusulinids of the Tengchong Block are depauperate; i.e., consisting of a limited number of species with abundant individuals. This particular feature commonly suggests an inhospitable environment, and carbonates of varied facies containing these faunas in the Tengchong Block suggest a facies-independent factor as the reason, most likely the relatively low temperature of seawater.