An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.

Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.

Soft magnetic metal amorphous nanocomposite alloys are produced through rapid solidification and thermal annealing yielding nanocrystals embedded within an amorphous precursor. Similar free energies in Co-rich and FeNi-based alloy systems result in multiple nanocrystalline phases being formed during devitrification. Studies of multi-phase crystallization processes have been reported for Co-rich alloys but relatively few have investigated FeNi-based systems. A detailed characterization of compositional partitioning and microstructure of an optimally annealed FeNi-based MANC (Fe70Ni30)80Nb4Si2B14 alloy is presented through complementary high-resolution transmission electron microscopy (HRTEM) and atom probe tomography (APT). HRTEM demonstrates orientation relationships between FCC and BCC nanocrystals, suggesting heterogeneous nucleation of nanocrystals in the amorphous matrix or a cooperative mechanism of nucleation between BCC and FCC nanocrystallites. APT results show evidence for (i) the segregation of Fe and Ni between nanocrystals of different phases, (ii) B partitioning to the amorphous phase, and (iii) an Nb-enriched shell surrounding nanocrystals.

The first formal bone tool in the Central Altai of Russia was found in an Early Upper Palaeolithic assemblage at the Kara-Bom open-air site. Here the authors report the results of AMS dating, use-wear analysis, 3D-modelling and zooarchaeological and collagen fingerprinting analysis, which reveal important new insights into the osseous technology of the Kara-Bomian tradition.

Introduction: As the availability of Computed Tomography Pulmonary Angiography (CTPA) to rule out pulmonary embolism (PE) increases, so too does its utilization, and consequent overutilization. A variety of evidence-based algorithms and decision rules using clinical criteria and D-Dimer testing have been proposed as instruments to allow physicians to safely rule out a PE in low-risk patients. However, studies have shown mixed results with respect to both physician uptake of these decision rules and their impact on improving ordering practices among physicians. The objective of this study is to describe the prevalence of D-Dimer utilization among ED physicians and its impact on positive yield rates of CTPAs in a community setting. Methods: Data was collected on all CTPA studies ordered by ED physicians at two very high-volume community hospitals and an affiliated urgent care centre during the 2-year period between January 1, 2016 and December 31, 2017. For each CTPA, we determined if 1) a D-Dimer had been ordered prior to CTPA, if 2) the D-Dimer was positive, and if 3) the CTPA was positive for a PE. Using a chi-square test, we compared the diagnostic yield for those patients who had a D-Dimer prior to their CTPA and those who did not. Results: A total of 2,811 CTPAs were included in the analysis. Of these, 964 CTPAs (34.3%) were ordered without a D-Dimer. Of those 1,847 patients who underwent D-Dimer testing prior to the CTPA, 343 (18.7%) underwent a CTPA despite a negative D-Dimer. When compared as a group, those CTPAs preceded by a D-Dimer showed no significant difference in positive yields when compared to those CTPAs ordered without a prior D-Dimer (9.9% versus 11.3%, p = 0.26). Conclusion: The findings of this study present a complicated picture of the impact of D-Dimer utilization on CTPA ordering patterns. There is evidence of suboptimal uptake of routine D-Dimer ordering, and adherence to guidelines in terms of forgoing CTPAs in low-risk patients with negative D-Dimers. While this study design leaves unanswered the question of how many CTPAs were avoided as a result of a negative D-Dimer, the finding of a similar positive yield among those patients who had a D-Dimer ordered versus those who did not is interesting, and illustrative of the issues arising from the high false-positive rates associated with D-Dimer screening.

At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case–control and one nested case–cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.

The present study was designed to detect three single nucleotide polymorphisms (SNPs) located on 22q11 that was thought as being of particularly importance for genetic research into schizophrenia. We recruited a total of 176 Chinese family trios of Han descent, consisting of mothers, fathers and affected offspring with schizophrenia for the genetic analysis. The transmission disequilibrium test (TDT) showed that of three SNPs, rs10314 in the 3′-untranslated region of the CLDN5 locus was associated with schizophrenia (χ2 = 4.75, P = 0.029). The other two SNPs, rs1548359 present in the CDC45L locus centromeric of rs10314 and rs739371 in the 5′-flanking region of the CLDN5 locus, did not show such an association. The global chi-square (χ2) test showed that the 3-SNP haplotype system was not associated with schizophrenia although the 1-df test for individual haplotypes showed that the rs1548359(C)-rs10314(G)-rs739371(C) haplotype was excessively non-transmitted (χ2 = 5.32, P = 0.02). Because the claudin proteins are a major component for barrier-forming tight junctions that could play a crucial role in response to changing natural, physiological and pathological conditions, the CLDN5 association with schizophrenia may be an important clue leading to look into a meeting point of genetic and environmental factors.

This paper proposes a fault-tolerant control (FTC) method based on fast fault observer (FFO) to solve the problem of actuator gain loss fault and stuck fault for hypersonic vehicles. Firstly, an input-output feedback linearisation model is presented that considers parametric uncertainties, control input saturation, disturbances and actuator faults. Secondly, the above factors are defined as an integrated fault item, and an improved fast fault observer is designed to estimate the integrated fault in real time. Finally, the fault-tolerant controller is constructed based on the sliding mode and fault estimation. In case of unknown faults, the effects of gain loss fault or stuck fault happen on elevators and the engine can be quickly processed, Also, the asymptotically stable tracking of the flight output reference command is completed to achieve fault-tolerant control. The final simulation experiment verifies the effectiveness of the proposed method.

Tuberculosis (TB) is the leading cause of death among infectious diseases. China has a high burden of TB and accounted for almost 13% of the world's cases of multi-drug resistant (MDR) TB. Spinal TB is one reason for the resurgence of TB in China. Few large case studies of MDR spinal TB in China have been conducted. The aim of this research was to observe the epidemiological characteristics of inpatients with MDR spinal TB in six provinces and cities of China from 1999–2015. This is a multicentre retrospective observational study. Patients' information was collected from the control disease centre and infectious disease database of hospitals in six provinces and cities in China. A total of 3137 patients with spinal TB and 272 patients with MDR spinal TB were analysed. The result showed that MDR spinal TB remains a public health concern and commonly affects patients 15–30 years of age (34.19%). The most common lesions involved the thoracolumbar spine (35.66%). Local pain was the most common symptom (98.53%). Logistic analysis showed that for spinal TB patients, reside in rural district (OR 1.79), advanced in years (OR 1.92) and high education degree (OR 2.22) were independent risk factors for the development of MDR spinal TB. Women were associated with a lower risk of MDR spinal TB (OR 0.48). The most common first-line and second-line resistant drug was isoniazid (68.75%) and levofloxacin (29.04%), respectively. The use of molecular diagnosis resulted in noteworthy clinical advances, including earlier initiation of MDR spinal TB treatment, improved infection control and better clinical outcome. Chemotherapy and surgery can yield satisfactory outcomes with timely diagnosis and long-term treatment. These results enable a better understanding of the MDR spinal TB in China among the general public.

The large-scale cold crucible induction melter (CCIM) with productivity of 12 kg/h was created for melting borosilicate glass containing 20 mass. % of high-level liquid wastes (HLLW) simulators. Tests were carried out to study the effect on the CCIM operating parameters during sedimentation of metallic silver, at the content of 3.8 mass. % Ag2O in glass. Post-test analyses of the glass shows the sedimentation of silver in the bottom layers of the molten pool. Experiments have confirmed that the presence of noble metals in the form of undissolved sediments in the bottom layers of furnace leads to a changes in the properties of the melt, the aggravation of its drain conditions, an increase in the thermal conductivity of the skull and heat losses during melting.

We consider the size spectrum of entrained bubbles under strong free-surface turbulence (SFST). We investigate the entrainment bubble-size spectrum per unit (mean) interface area, ${\mathcal{N}}_{a}^{E}(r)$ , with dimension length $^{-3}$ , and develop a physical/mechanistic model for ${\mathcal{N}}_{a}^{E}(r)$ through energy arguments. The model obtains two distinct regimes of ${\mathcal{N}}_{a}^{E}(r)$ , separated by bubble-size scale $r_{0}$ . For bubble radius $r>r_{0}$ , the effects of gravity $g$ dominate those of the surface tension force $\unicode[STIX]{x1D70E}/\unicode[STIX]{x1D70C}$ , and ${\mathcal{N}}_{a}^{E}(r)\propto g^{-1}\unicode[STIX]{x1D716}^{2/3}r^{-10/3}$ , where $\unicode[STIX]{x1D716}$ is the turbulence dissipation rate. For $r<r_{0}$ , surface tension is more important and ${\mathcal{N}}_{a}^{E}(r)\propto (\unicode[STIX]{x1D70E}/\unicode[STIX]{x1D70C})^{-1}\unicode[STIX]{x1D716}^{2/3}r^{-4/3}$ . From the model, we show that $r_{0}\approx r_{c}=1/2\sqrt{\unicode[STIX]{x1D70E}/\unicode[STIX]{x1D70C}g}$ , the capillary length scale, and not the generally assumed Hinze scale $r_{H}$ . For an air–water interface and Earth gravity, $r_{c}\approx$ 1.5 mm. The model provides an $\unicode[STIX]{x1D716}$ – $r$ entrainment regime map that identifies a critical dissipation rate $\unicode[STIX]{x1D716}_{cr}$ (constant for given $g$ and $\unicode[STIX]{x1D70E}/\unicode[STIX]{x1D70C}$ ) above which there is appreciable air entrainment, thus separating SFST and weak FST. We confirm the theoretical model and its predictions using two-phase, high-fidelity direct numerical simulations of a canonical FST flow using the conservative volume-of-fluid method: the respective power laws of ${\mathcal{N}}_{a}^{E}(r)\propto r^{-10/3}$ and $r^{-4/3}$ for $r>r_{0}$ and $r<r_{0}$ ; the value $r_{0}=r_{c}$ ; the scaling ${\mathcal{N}}_{a}^{E}(r)\propto \unicode[STIX]{x1D716}^{2/3}$ ; and the predictions of the $\unicode[STIX]{x1D716}$ – $r$ entrainment regime map.

We investigate two-phase free-surface turbulence (FST) associated with an underlying shear flow under the condition of strong turbulence (SFST) characterized by large Froude ( $Fr$ ) and Weber ( $We$ ) numbers. We perform direct numerical simulations of three-dimensional viscous flows with air and water phases. In contrast to weak FST (WFST) with small free-surface distortions and anisotropic underlying turbulence with distinct inner/outer surface layers, we find SFST to be characterized by large surface deformation and breaking accompanied by substantial air entrainment. The interface inner/outer surface layers disappear under SFST, resulting in nearly isotropic turbulence with ${\sim}k^{-5/3}$ scaling of turbulence kinetic energy near the interface (where $k$ is wavenumber). The SFST air entrainment is observed to occur over a range of scales following a power law of slope $-10/3$ . We derive this using a simple energy argument. The bubble size spectrum in the volume follows this power law (and slope) initially, but deviates from this in time due to a combination of ongoing broad-scale entrainment and bubble fragmentation by turbulence. For varying $Fr$ and $We$ , we find that air entrainment is suppressed below critical values $Fr_{cr}$ and $We_{cr}$ . When $Fr^{2}>Fr_{cr}^{2}$ and $We>We_{cr}$ , the entrainment rate scales as $Fr^{2}$ when gravity dominates surface tension in the bubble formation process, while the entrainment rate scales linearly with $We$ when surface tension dominates.