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The implementation effect of the 24-hour Supervise-Correct-Improve (SCI) supervision model was investigated in COVID-19 isolation ward in putting on and taking off process of personal protective equipment. As shown in results, the error rate of taking off process was significantly reduced (P < 0.001) by applying the 24h “SCI” mode. Staffs over 40 years old and workers were more likely to make mistakes. Through uninterrupted supervision and protection, application of this mode is proved to be effective.
Three-dimensional flow fields of a rectangular synthetic jet with aspect ratio of 3 and its interaction with a laminar cross-flow are measured using time-resolved tomographic particle image velocimetry. The synthetic-jet to free-stream velocity ratio is fixed at 1, and two orifice orientations, normal to (spanwise configuration) and aligned with (streamwise configuration) the cross-flow direction, respectively, are investigated. The flow scenarios are composed of a tilted vortex ring, a secondary trailing vortex and a tertiary near-wall vortex. Compared to previous results for circular cases, the legs of the trailing structures are found to be jointed in the spanwise direction by two shear-layer vortices at different wall-normal heights. In addition, the near-wall vortex is a crescent-shaped spanwise vortex. For the first time, as the peculiar process of non-circular vortex rings in quiescent condition, axis switching is validated to exist in the cross-flow. Associated with axis switching, the spanwise case exhibits interaction between the leeward vortex of the vortex ring and the downstream shear-layer vortex, which causes slower penetration and recovery of vortex ring tilting, but faster jet transition. Furthermore, the trailing structures and vortex ring are weakened, leading to lower peaks of the velocity deficit and overshoot in the jet region than those for the streamwise case. On the other hand, the spanwise case can induce a stronger near-wall vortex, which transfers more momentum and initial disturbance into the boundary layer. Consequently, the spanwise case yields larger velocity gradient and velocity fluctuation peak inside the boundary layer with a lower shape factor, suggesting greater efficiency of promoting boundary-layer transition.
This study investigated the effect of Bacillus subtilis DSM 29784 (Ba) and enzymes (xylanase and β-glucanases; Enz), alone or in combination (BE) as antibiotic replacements, on the growth performance, digestive enzyme activity, immune response, and intestinal barrier of broiler chickens. In total, 1200 1-d-old broilers were randomly assigned to five dietary treatments, each with six replicate pens of 40 birds for 63 d as follows: A) basal diet (control), supplemented with B) 1×109 colony-forming units (cfu)/kg Ba, C) 300 mg/kg Enz, D) 1×109 cfu/kg Ba and 300 mg/kg Enz, and E) 250 mg/kg enramycin (ER). Ba, Enz, and BE, similar to ER, decreased the feed conversion rate, maintained intestinal integrity with a higher villus height-to-crypt depth ratio, and increased the numbers of goblet cells. The BE group exhibited higher expression of claudin-1 and Mucin-2 than the other four groups. BE supplementation significantly increased the α-diversity and β-diversity of the intestinal microbiota and markedly enhanced lipase activity in the duodenal mucosa. Serum endotoxin was significantly decreased in the BE group. Compared to those in the control group, increased superoxide dismutase and glutathione peroxidase activities were observed in the jejunal mucosa of Ba and BE groups, respectively. In conclusion, the results suggested that dietary treatment with Ba, Enz, or BE has beneficial effects on growth performance and anti-oxidative capacity, and BE had better effects than Ba or Enz alone on digestive enzyme activity and the intestinal microbiota. Ba or Enz could be used as an alternative to antibiotics for broiler chickens.
A 2-year fertilization experiment was conducted to study the effect of different ratios of organic (pig) manure on wheat yield and nitrogen use efficiency (NUE). The four treatments were no nitrogen (N) (CK); 100% chemical fertilizer N (urea; T1); 70% chemical fertilizer N + 30% organic manure N (T2) and 50% chemical fertilizer N + 50% organic manure N (T3), with the same amount of applied nitrogen (120 kg/ha). The results showed the maximum grain yield (3049 kg/ha), crop nitrogen uptake (216 kg/ha), NUE (65.4%) and accumulated nitrate nitrogen (NO3−-N in 0–200 cm, 142 kg/ha) were observed in the T1 among all treatments in the first year. However, the largest grain yield (5074 kg/ha), crop nitrogen uptake (244 kg/ha) and NUE (82.5%) were under T2 treatment in the second year. Furthermore, T2 had the maximum NO3−-N content in 0–100 cm layer (116 kg/ha), especially 0–40 cm layer, and the lowest NO3−-N content in 100–200 cm (58.8 kg/ha). However, 50% organic manure N in T3 increased apparent nitrogen loss by 39.0% compared to that in T2. Therefore, 30% organic manure N application was more conducive for enhancing wheat yield and NUE and promoting environmental safety after 1-year fertilization time.
The evolution of melt ponds on Arctic sea ice in summer is one of the main factors that affect sea-ice albedo and hence the polar climate system. Due to the different spectral properties of open water, melt pond and sea ice, the melt pond fraction (MPF) can be retrieved using a fully constrained least-squares algorithm, which shows a high accuracy with root mean square error ~0.06 based on the validation experiment using WorldView-2 image. In this study, the evolution of ponds on first-year and multiyear ice in the Canadian Arctic Archipelago was compared based on Sentinel-2 and Landsat 8 images. The relationships of pond coverage with air temperature and albedo were analysed. The results show that the pond coverage on first-year ice changed dramatically with seasonal maximum of 54%, whereas that on multiyear ice changed relatively flat with only 30% during the entire melting period. During the stage of pond formation, the ponds expanded rapidly when the temperature increased to over 0°C for three consecutive days. Sea-ice albedo shows a significantly negative correlation (R = −1) with the MPF in melt season and increases gradually with the refreezing of ponds and sea ice.
Hubei province in China has had the most confirmed coronavirus disease 2019 (COVID-19) cases and has reported sustained transmission of the disease. Although Lu'an city is adjacent to Hubei province, its community transmission was blocked at the early stage, and the impact of the epidemic was limited. Therefore, we summarised the overall characteristics of the entire epidemic course in Lu'an to help cities with a few imported cases better contain the epidemic. A total of 69 confirmed COVID-19 cases and 11 asymptomatic carriers were identified in Lu'an during the epidemic from 12 January to 21 February 2020. Fifty-two (65.0%) cases were male, and the median age was 40 years. On admission, 56.5% of cases had a fever as the initial symptom, and pneumonia was present in 89.9% of cases. The mean serial interval and the mean duration of hospitalisation were 6.5 days (95% CI: 4.8–8.2) and 18.2 days (95% CI: 16.8–19.5), respectively. A total of 16 clusters involving 60 cases (17 first-generation cases and 43 secondary cases) were reported during the epidemic. We observed that only 18.9% (7/37) index cases resulted in community transmission during the epidemic in Lu'an, indicating that the scale of the epidemic was limited to a low level in Lu'an city. An asymptomatic carrier caused the largest cluster, involving 13 cases. Spread of COVID-19 by asymptomatic carriers represents an enormous challenge for countries responding to the pandemic.
The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) to identify malnutrition risk in patients with liver disease. However, little is known about the application of the RFH-NPT to screen for the risk of malnutrition in China, where patients primarily suffer from hepatitis virus-related cirrhosis. A total of 155 cirrhosis patients without liver cancer or uncontrolled co-morbid illness were enrolled in this prospective study. We administered the Nutritional Risk Screening 2002 (NRS-2002), RFH-NPT, Malnutrition Universal Screening Tool (MUST) and Liver Disease Undernutrition Screening Tool (LDUST) to the patients within 24 h after admission and performed follow-up observations for 1·5 years. The RFH-NPT and NRS-2002 had higher sensitivities (64·8 and 52·4 %) and specificities (60 and 70 %) than the other tools with regard to screening for malnutrition risk in cirrhotic patients. The prevalence of nutritional risk was higher under the use of the RFH-NPT against the NRS-2002 (63 v. 51 %). The RFH-NPT tended more easily to detect malnutrition risk in patients with advanced Child–Pugh classes (B and C) and lower Model for End-stage Liver Disease scores (<15) compared with NRS-2002. RFH-NPT score was an independent predictive factor for mortality. Patients identified as being at high malnutrition risk with the RFH-NPT had a higher mortality rate than those at low risk; the same result was not obtained with the NRS-2002. Therefore, we suggest that using the RFH-NPT improves the ability of clinicians to predict malnutrition risk in patients with cirrhosis primarily caused by hepatitis virus infection at an earlier stage.
Isolated congenital tricuspid regurgitation other than Ebstein’s anomaly was rare especially for children. The objective of this study was to investigate the clinical characteristics and to assess the results of tricuspid valvuloplasty for children with isolated tricuspid regurgitation.
From January 2010 to June 2019, 10 consecutive patients with isolated tricuspid regurgitation who were unresponsive to drug therapy underwent tricuspid valvuloplasty in our hospital. Patients’ clinical data were analysed retrospectively.
Mean age at operation was 48.5 ± 31.0 (range: 9–106) months and mean weight at operation was 16.1 ± 6.9 (range: 8.6–33.0) kg. All patients presented severe isolated tricuspid regurgitation. According to pathological lesions, the main causes accounted for chordae tendinea rupture (3/10), leaflet cleft (2/10), mal-connected chordal tendinea to leaflets (2/10), elongated chordae (1/10) and chordae absent (1/10), and severe anterior leaflet dysplasia (1/10). Individualised tricuspid valvuloplasty was adapted to all of them successfully. Post-operative echocardiography showed no tricuspid regurgitation in two patients and mild regurgitation in eight patients. The cardiothoracic ratios on their chest roentgenograms decreased from 0.59 ± 0.05 to 0.54 ± 0.05. At the latest follow-up (50.4 ± 47.2 months), echocardiography showed that mild to moderate tricuspid regurgitation in seven patients, moderate tricuspid regurgitation in three patients, and no patient with severe tricuspid regurgitation. All patients were in NYHA functional class I.
For patients with isolated tricuspid regurgitation who were not well responsive to drug therapy, individualised tricuspid valve repair can achieve an excellent result.
Although altimeters have been widely used to monitor the spatiotemporal variation of sea-ice thickness, they are unable to separate sea-ice freeboard from snow depth. We use a floating GPS deployed on sea ice to derive the freeboard and snow depth near China's Zhongshan Station. Our results show that the standalone floating GPS can monitor freeboard with a precision of 4.2 cm. If time-varying dynamic ocean topography provided by, for example, a bottom pressure gauge is available, then the precision of GPS-derived freeboard can improve to 1.3 cm. The daily snow depth inverted by GPS interferometric reflectometry captures three precipitation events during our experiment, showing that the floating GPS can monitor the variation in snow depth and observe the freeboard variation at the same time. By studying the relationship between freeboard, snow depth and sea-ice thickness, we find that sea-ice thickness will be greatly underestimated by the negative single-point freeboard under the assumption of hydrostatic equilibrium. As a supplement to existing technologies, the GPS-derived freeboard and snow depth can be used both to evaluate the altimeter observations directly and to improve our understanding of the real-time variation of freeboard and snow depth in the experimental area.
Major depressive disorder is characterized by a high risk of relapse. We aimed to compare the prophylactic effects of different antidepressant medicines (ADMs).
PubMed, Cochrane Central Register of Controlled Trials, Embase and the Web of Science were searched on 4 July 2019. A pooled analysis of parametric survival curves was performed using a Bayesian framework. The main outcomes were hazard ratios (HRs), relapse-free survival and mean relapse-free months.
Forty randomized controlled trials were included. The 1-year relapse-free survival for ADM (76%) was significantly better than that for placebo (56%). Most of the relapse difference (86.5%) occurred in the first 6 months. Most HRs were not constant over time. Proof of benefit after 6 months of follow-up was not established partially because of small differences between the drug and placebo after 6 months. Almost all studies used an ‘enriched’ randomized discontinuation design, which may explain the high relapse rates in the first 6 months after randomization.
The superiority of ADM v. placebo was mainly attributed to the difference in relapse rates that occurred in the first 6 months. Our analysis provided evidence that the prophylactic efficacy was not constant over time. A beneficial effect was observed, but the prevention of new episodes after 6 months was questionable. These findings may have implications for clinical practice.
We present a 3D reconstruction method using brightness and camera motion estimation for registering local colon structure in colonoscopy. The proposed method is based on reverse projection from 2D fold contours to 3D space, motion estimation from 3D reconstructed points between neighboring frames, and model registration to reconstruct the fold structure. On the synthetic colon, the average percentages of the reconstructed depth error and circumference error are about 14.2% and 15.2%, respectively. The accuracy is enough for the navigation and control in capsule robot. This work demonstrates that the proposed method is superior to the methods using single-frame-based brightness intensity.
Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.
The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Previous studies of amyloid diseases reported that the aggregating proteins share a similar conserved peptide sequence which can form the cross-β-sheet-containing nanostructures like nanofilaments. The template-assisted self-assembly (TASA) of peptides on inorganic substrates with different hydrophilicity could be an alternative approach to shed light on the fibrillization mechanism of proteins/peptides in vivo. To figure out the effect of interfaces on amyloid aggregation, we herein employed in situ atomic force microscopy (AFM) to investigate the self-assembling of a Parkinson disease-related core peptide sequence (TGV-9) on a hydrophobic liquid–solid interface via real-time observation of the dynamic fibrillization process. The results show that TGV-9 forms one-dimensional nanostructures on the surface of highly ordered pyrolytic graphite (HOPG) with three preferred growth orientations, which are consistent with the atomic lattice of HOPG, indicating an epitaxial growth or TASA. Conversely, the nanostructures formed in bulk solution can be free-standing nanofilaments, and the fibrillization mechanism is different from that on HOPG. These results could not only deepen the understanding of the protein/peptide aggregation mechanism but also benefit for the early diagnosis and clinic treatment of related diseases.
Chlamydia spp. are a group of obligate intracellular pathogens causing a number of diseases in animals and humans. Avian chlamydiosis (AC), caused by Chlamydia psittaci (C. psittaci) as well as new emerging C. avium, C. gallinacea and C. ibidis, have been described in nearly 500 avian species worldwidely. The Crested Ibis (Nipponia nippon) is a world endangered avian species with limited population and vulnerable for various infections. To get a better understanding of the prevalence of Chlamydia spp. in the endangered Crested Ibis, faecal samples were collected and analysed. The results confirmed that 20.20% (20/99) of the faecal samples were positive for Chlamydiaceae and were identified as C. ibidis with co-existence of C. psittaci in one of the 20 positive samples. In addition, ompA sequence of C. psittaci obtained in this study was classified into the provisional genotype Matt116, while that of C. ibidis showed high genetic diversity, sharing only 77% identity with C. ibidis reference strain 10-1398/6. We report for the first time the presence of C. ibidis and C. psittaci in the Crested Ibis, which may indicate a potential threat to the endangered birds and should be aware of the future protection practice.