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Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs.
We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period.
To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68).
Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.
Accurate measurements of food volume and density are often required as ‘gold standards’ for calibration of image-based dietary assessment and food database development. Currently, there is no specialised laboratory instrument for these measurements. We present the design of a new volume of density (VD) meter to bridge this technological gap.
Our design consists of a turntable, a load sensor, a set of cameras and lights installed on an arc-shaped stationary support, and a microcomputer. It acquires an array of food images, reconstructs a 3D volumetric model, weighs the food and calculates both food volume and density, all in an automatic process controlled by the microcomputer. To adapt to the complex shapes of foods, a new food surface model, derived from the electric field of charged particles, is developed for 3D point cloud reconstruction of either convex or concave food surfaces.
We conducted two experiments to evaluate the VD meter. The first experiment utilised computer-synthesised 3D objects with prescribed convex and concave surfaces of known volumes to investigate different food surface types. The second experiment was based on actual foods with different shapes, colours and textures. Our results indicated that, for synthesised objects, the measurement error of the electric field-based method was <1 %, significantly lower compared with traditional methods. For real-world foods, the measurement error depended on the types of food volumes (detailed discussion included). The largest error was approximately 5 %.
The VD meter provides a new electronic instrument to support advanced research in nutrition science.
For a wide range of insect species, the microbiota has potential roles in determining host developmental programme, immunity and reproductive biology. The tea geometrid moths Ectropis obliqua and E. grisescens are two closely related species that mainly feed on tea leaves. Although they can mate, infertile hybrids are produced. Therefore, these species provide a pair of model species for studying the molecular mechanisms of microbiotal involvement in host reproductive biology. In this study, we first identified and compared the compositions of microbiota between these sibling species, revealing higher microbiotal diversity for E. grisescens. The microbiota of E. obliqua mainly comprised the phyla Firmicutes, Proteobacteria and Cyanobacteria, whereas that of E. grisescens was dominated by Proteobacteria, Actinobacteria and Firmicutes. At the genus level, the dominant microbiota of E. grisescens included Wolbachia, Enterobacter and Pseudomonas and that of E. obliqua included Melissococcus, Staphylococcus and Enterobacter. Furthermore, we verified the rate of Wolbachia to infect 80 samples from eight different geographical populations, and the results supported that only E. grisescens harboured Wolbachia. Taken together, our findings indicate significantly different microbiotal compositions for E. obliqua and E. grisescens, with Wolbachia possibly being a curial factor influencing the reproductive isolation of these species. This study provides new insight into the mechanisms by which endosymbiotic bacteria, particularly Wolbachia, interact with sibling species.
From 21 January 2020 to 9 February 2020, three family clusters involving 31 patients with coronavirus disease 2019 were identified in Wenzhou, China. The epidemiological and clinical characteristics of the family cluster patients were analysed and compared with those of 43 contemporaneous sporadic cases. The three index cases transmitted the infection to 28 family members 2–10 days before illness onset. Overall, 28 of the 41 sporadic cases and three of 31 patients in the family clusters came back from Wuhan (65.12 vs. 9.68%, P< 0.001). In terms of epidemiological characters and clinical symptoms, no significant differences were observed between the family cluster and sporadic cases. However, the lymphocyte counts of sporadic cases were significantly lower than those of family cluster cases ((1.32 ± 0.55) × 109/l vs. (1.63 ± 0.70) × 109/l, P = 0.037), and the proportion of hypoalbuminaemia was higher in sporadic cases (18/43, 41.86%) than in the family clusters (6/31, 19.35%) (P < 0.05). Within the family cluster, the second- and third-generation cases had milder clinical manifestations, without severe conditions, compared with the index and first-generation cases, indicating that the virulence gradually decreased following passage through generations within the family clusters. Close surveillance, timely recognition and isolation of the suspected or latent patient is crucial in preventing family cluster infection.
Hydrogen production from water electrolysis with renewable energy input has been the focus of tremendous attention, as hydrogen is widely advocated as a clean energy carrier. In order to realize large-scale hydrogen generation from water splitting, it is essential to develop competent and robust electrocatalysts that will substantially decrease the overpotential requirement and improve energy efficiency. Recent advances in electrocatalyst design reveal that interfacial engineering is an effective approach in tuning the adsorption–desorption abilities of key catalytic intermediates on active sites, accelerating electron transfer, and stabilizing the active sites for long-term operation. Consequently, a large number of hybrid electrocatalysts consisting of metal/compound interfaces have been demonstrated to exhibit superior performance for electrocatalytic hydrogen evolution from water. This article highlights examples of these hybrid electrocatalysts, including noble metal and non-noble metal candidates interfaced with a variety of compounds. Specific emphasis is placed on the synthetic methods, reaction mechanisms, and electrocatalytic activities, which are envisioned to inspire the design and development of further improved electrocatalysts for hydrogen evolution from water splitting on an industrial scale.
The Antarctic subglacial drilling rig (ASDR) is designed to recover 105 mm-diameter ice cores up to 1400 m depth and 41.5 mm-diameter bedrock cores up to 2 m in length. In order to ensure safe and convenient drilling, drilling auxiliaries are designed to support fieldwork and servicing. These auxiliaries are subdivided into several systems for power supply, drill tripping in the borehole, ice core and chip processing, and drill servicing and maintenance. The required equipment also includes two generators, a drilling winch with a cable, logging winch with a cable, control desk, pipe handler with a fixed clamp, chip chamber vibrator, centrifuge, emergency devices and fitting and electrical tools. Additionally, several environmental protective measures such as a new liquid-tight casing with a thermal casing shoe and a bailing device for recovering drilling fluid from the borehole were designed. Most of the auxiliaries were tested during the summer of 2018–2019 near Zhongshan Station, East Antarctica while drilling to the bedrock to a depth of 198 m.
A new, modified version of the cable-suspended Ice and Bedrock Electromechanical Drill (IBED) was designed for drilling in firn, ice, debris-rich ice and rock. The upper part of the drill is almost the same for all drill variants and comprises four sections: cable termination, a slip-ring section, an antitorque system and an electronic pressure chamber. The lower part of the IBED comprises an auger core barrel, reamers, a core barrel for ice/debris-ice drilling and a conventional geological single-tube core barrel or custom-made double-tube core barrel. First, the short and full-scale field versions of the IBED were tested at an outdoor testing stand and a testing facility with a 12.5 m-deep ice well. Then, in the 2018–2019 summer season, the IBED was tested in the field at a site ~12 km south of Zhongshan Station, East Antarctica, and a ~6 cm bedrock core was recovered from a 198 m-deep borehole. A total of 18 d was required to penetrate the ice sheet. The retrieved core samples of blue ice, basal ice and bedrock provided valuable information regarding the Earth's paleo-environment.
To investigate homocysteine (Hcy) and folate levels, prevalence of hyperhomocysteinaemia (HHcy) and folate deficiency, which are affected by lifestyles in urban, agricultural and stock-raising populations.
This is a cross-sectional study.
Urban, agricultural and stock-raising regions in Emin, China.
Totally 1926 subjects – 885 (45·9 %) from urban, 861 (44·7 %) from agricultural and 180 (9·4 %) from stock-raising regions – were obtained using multistage stratified random sampling. Inclusion criteria encompassed inhabitants aged ≥15 years who resided at the current address for ≥6 months and agreed to participate in the study. Surveys on health behaviour questionnaires and physical examinations were conducted and blood samples collected.
The folate level of subjects from the stock-raising region was the lowest, followed by those from the agricultural region, and the highest in those from the urban region (3·48 v. 6·50 v. 7·12 ng/ml, P < 0·001), whereas mean Hcy showed no significant difference across regions. The OR for HHcy in stock-raising regions was 1·90 (95 % CI 1·11, 3·27) compared with the urban region after adjusting for all possible covariates. The OR for folate deficiency in stock-raising and agriculture regions was 11·51 (95 % CI 7·09, 18·67) and 1·91 (95 % CI 1·30, 2·82), respectively, compared with the urban region after adjusting for all possible covariates.
HHcy and folate deficiency are highly prevalent in stock-raisers, which is of important reference for HHcy control in Xinjiang, with a possibility of extension to others with approximate lifestyles.
Hypertension is a common comorbidity in COVID-19 patients. However, the association of hypertension with the severity and fatality of COVID-19 remain unclear. In the present meta-analysis, relevant studies reported the impacts of hypertension on SARS-CoV-2 infection were identified by searching PubMed, Elsevier Science Direct, Web of Science, Wiley Online Library, Embase and CNKI up to 20 March 2020. As the results shown, 12 publications with 2389 COVID-19 patients (674 severe cases) were included for the analysis of disease severity. The severity rate of COVID-19 in hypertensive patients was much higher than in non-hypertensive cases (37.58% vs 19.73%, pooled OR: 2.27, 95% CI: 1.80–2.86). Moreover, the pooled ORs of COVID-19 severity for hypertension vs. non-hypertension was 2.21 (95% CI: 1.58–3.10) and 2.32 (95% CI: 1.70–3.17) in age <50 years and ⩾50 years patients, respectively. Additionally, six studies with 151 deaths of 2116 COVID-19 cases were included for the analysis of disease fatality. The results showed that hypertensive patients carried a nearly 3.48-fold higher risk of dying from COVID-19 (95% CI: 1.72–7.08). Meanwhile, the pooled ORs of COVID-19 fatality for hypertension vs. non-hypertension was 6.43 (95% CI: 3.40–12.17) and 2.66 (95% CI: 1.27–5.57) in age <50 years and ⩾50 years patients, respectively. Neither considerable heterogeneity nor publication bias was observed in the present analysis. Therefore, our present results provided further evidence that hypertension could significantly increase the risks of severity and fatality of SARS-CoV-2 infection.
In this work, we propose a broadband, polarization-insensitive and wide incident angle stable metamaterial absorber (MA) based on the resistive film. The absorber consists of a three-layer structure with each layer of dielectric substrate printed with different shapes of resistive film. The multilayer structure not only extends the absorption bandwidth but also maintains high absorption under large wave incident angles. Numerical simulation shows that the absorptivity of a normal incident wave is above 90% in the frequency range 2.34–18.95 GHz, corresponding to a relative absorption bandwidth of 156%. Moreover, the whole MA structure has a total thickness of 11.3 mm, corresponding to 0.09 λ0 at its lowest absorption frequency. Due to the high symmetry of the structure, the absorber has good polarization insensitivity. In addition, for both transverse electric and transverse magnetic incidence, the proposed absorber achieves an absorptivity of more than 80% at incident angles of up to 45° and thus has good stability for wide incident angles. The absorption principle of the absorber is analyzed by the surface current and power loss density distribution. Parameter analysis is also performed for bandwidth optimization. Due to its advantages of wideband absorption with high efficiency, the proposed absorber has the potential to be applied to the energy-harvesting and electromagnetic stealth fields.
be the set of integers and the set of positive integers, respectively. For
be the number of representations of
. Using theta function identities we prove 13 transformation formulas for
The vortex sound interaction in acoustic resonance induced by vortex shedding from a cylinder in a flow duct is numerically studied based on a nonlinear physical model, which consists of three meshless sub-models describing the vortex shedding, sound generation and propagation within the duct. In addition, the acoustic particle velocity near the separation point of the shear layer is solved and added onto the Kutta condition of the vortex shedding, which takes the acoustic feedback effect into consideration and makes the vortex sound interaction bi-directional. The predicted results of resonant frequency and amplitude are found to be in conformity with previous experiment data, especially, a continuous description of the onset–sustain–cease of lock-in phenomenon is well captured. The lock-in phenomenon is depicted as a vigorous competition between the vortex shedding frequency
and the inherent frequency of the acoustic
. The mutual capturing behaviour of these two frequencies is dominated by
cannot always be locked onto
within the whole lock-in region, which is in marked contrast to the previous understanding. In this aspect, two lock-in regions, the synchronous region and the
-mode dominant region, are defined according to the relevance of
. The maximum resonant sound appears at the end of the synchronous region. The present model not only predicts the proper characteristics of frequency lock-in as observed in experiments, but also helps to provide a more detailed understanding of the underlying lock-in mechanism.
Oxidative stress is closely related to metabolic disorders, which can lead to various diseases. Nuclear factor E2-related factor 2 (Nrf2) is a central regulator of oxidative stress. Sodium butyrate (NaB) has been shown to alleviate oxidative stress and insulin resistance, yet how Nrf2 is involved in the action of NaB remains unclear. In the present study, rats were rendered obese by feeding a high-fat diet for 9 weeks. NaB (300 mg/kg), which was gavaged every 2 d for 7 weeks, significantly alleviated high-fat diet-induced oxidative stress and insulin resistance. Additionally, the insulin signalling pathway in the liver was activated by NaB, associated with significant activation of Nrf2, superoxide dismutase and glutathione. Furthermore, hepatic up-regulation of Nrf2 in NaB-treated rats was associated with reduced protein content of histone deacetylase 1 and increased histone H3 acetyl K9 (H3K9Ac) modification on the Nrf2 promoter. The actions of NaB were completely abolished when Nrf2 was knocked down in vitro. Taken together, NaB acts as a histone deacetylase inhibitor to up-regulate Nrf2 expression with enhanced H3K9Ac modification on its promoter. NaB-induced Nrf2 activation stimulates transcription of downstream antioxidant enzymes, thus contributing to the amelioration of high-fat diet-induced oxidative stress and insulin resistance.
This study aimed to determine whether increased carotenoids intake was associated with reduced risk of gestational diabetes mellitus (GDM). We performed a cross-sectional analysis using data from Tongji Maternal and Child Health Cohort study. The dietary carotenoids intake of 1978 pregnant women was assessed using a researcher-administered FFQ before undertaking an oral glucose tolerance test at 24–28 weeks. Multivariate logistic and linear regression analyses were used to obtain the effect estimates. Participants in the highest quartile of lycopene intake showed a lower risk of GDM (OR 0·50; 95 % CI 0·29, 0·86; Pfor trend = 0·007) compared with those in the lowest quartile; each 1 mg increase in lycopene consumption was associated with a 5 % (95 % CI 0·91, 0·99; Pfor trend = 0·020) decrease in GDM risk. No significant association was found between α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin intake and GDM risk. Multiple linear regression analysis suggested an inverse association between lycopene intake and fasting blood glucose (FBG) (Pfor trend < 0·001); each 1 mg increase in lycopene intake was associated with 0·005 (95 % CI 0·002, 0·007; Pfor trend < 0·001) mmol/l decrease in FBG. Interaction analysis indicated consistent effect on each age or pre-BMI subgroup; however, a stronger protective effect of lycopene intake against GDM was observed among primigravid women (OR 0·20; 95 % CI 0·07, 0·55 in the highest v. the lowest quartile of intake; Pfor interaction = 0·036). In conclusion, dietary lycopene intake was mainly assumed via reducing FBG to decrease GDM risk, and the protection was relatively increased among primigravid women.
Graphene oxide (GO) is a promising material in improving the corrosion resistance properties of metals. This improvement significantly relies on the microstructure and electrical properties of GO, which nevertheless is rarely studied. Here, multiscale GOs with different flake sizes and oxidation degrees were fabricated and incorporated into waterborne alkyd resin (AR). The physical and chemical structures of GO and AR/GO composites were characterized in detail. Multiscale GOs are successfully prepared, and the corrosion resistance of AR/GO coatings is measured by electrochemical workstation. Electrochemical experiments indicate that GOs with larger flake sizes have excellent barrier properties due to the shielding effect; GOs with appropriate oxidation degrees could effectively improve the dispersion of GO and avoid the conductive path of GO in the matrix, because oxidation degree of GO could influence the dispersion and electrical properties. The corrosion protection efficiency of AR/GO(GO: 120 μm, 1.5 wt%, sp2/sp3 = 2.61) is 98.14%, which is 2.26 times higher than AR. The multiscale effects of GO on the corrosion resistance property of AR coatings are quite general, thus providing guidelines for developing highly efficient corrosion resistant coatings for practical usage.
Firefighters are routinely exposed to various traumatic events and often experience a range of trauma-related symptoms. Although these repeated traumatic exposures rarely progress to the development of post-traumatic stress disorder, firefighters are still considered to be a vulnerable population with regard to trauma.
To investigate how the human brain responds to or compensates for the repeated experience of traumatic stress.
We included 98 healthy firefighters with repeated traumatic experiences but without any diagnosis of mental illness and 98 non-firefighter healthy individuals without any history of trauma. Functional connectivity within the fear circuitry, which consists of the dorsal anterior cingulate cortex, insula, amygdala, hippocampus and ventromedial prefrontal cortex (vmPFC), was examined using resting-state functional magnetic resonance imaging. Trauma-related symptoms were evaluated using the Impact of Event Scale – Revised.
The firefighter group had greater functional connectivity between the insula and several regions of the fear circuitry including the bilateral amygdalae, bilateral hippocampi and vmPFC as compared with healthy individuals. In the firefighter group, stronger insula–amygdala connectivity was associated with greater severity of trauma-related symptoms (β = 0.36, P = 0.005), whereas higher insula–vmPFC connectivity was related to milder symptoms in response to repeated trauma (β = −0.28, P = 0.01).
The current findings suggest an active involvement of insular functional connectivity in response to repeated traumatic stress. Functional connectivity of the insula in relation to the amygdala and vmPFC may be potential pathways that underlie the risk for and resilience to repeated traumatic stress, respectively.
To investigate the protein-sparing effect of α-lipoic acid (LA), experimental fish (initial body weight: 18·99 (sd 1·82) g) were fed on a 0, 600 or 1200 mg/kg α-LA diet for 56 d, and hepatocytes were treated with 20 μm compound C, the inhibitor of AMP kinase α (AMPKα), treated for 30 min before α-LA treatment for 24 h. LA significantly decreased lipid content of the whole body and other tissues (P<0·05), and it also promoted protein deposition in vivo (P<0·05). Further, dietary LA significantly decreased the TAG content of serum and increased the NEFA content of serum (P<0·05); however, there were no significant differences among all groups in the hepatopancreas and muscle (P>0·05). Consistent with results from the experiment in vitro, LA activated phosphorylation of AMPKα and notably increased the protein content of adipose TAG lipase in intraperitoneal fat, hepatopancreas and muscle in vivo (P<0·05). Meanwhile, LA significantly up-regulated the mRNA expression of genes involved in fatty acid β-oxidation in the same three areas, and LA also obviously down-regulated the mRNA expression of genes involved in amino acid catabolism in muscle (P<0·05). Besides, it was observed that LA significantly activated the mammalian target of rapamycin (mTOR) pathway in muscle of experimental fish (P<0·05). LA could promote lipolysis and fatty acid β-oxidation via increasing energy supply from lipid catabolism, and then, it could economise on the protein from energy production to increase protein deposition in grass carp. Besides, LA might directly promote protein synthesis through activating the mTOR pathway.