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A multicenter study of sharps injuries (SIs) and other blood or body fluid (OBBF) exposures was conducted among 33,156 healthcare workers (HCWs) from 175 hospitals in Anhui, China. In total, 12,178 HCWs (36.7%) had experienced at least 1 SI in the previous 12 months and 8,116 HCWs (24.5%) had experienced at least 1 OBBF exposure during the previous 12 months.
High fiber intake is associated with reduced mortality risk in both general and chronic kidney disease populations. However, in dialysis patients such data is limited. Therefore, the association between dietary fiber intake (DFI) and the risk of all-cause and cardiovascular disease (CVD) mortality was examined in this study. A total of 1044 maintenance hemodialysis (MHD) patients from eight outpatient dialysis centers in China were included in this study. Data on DFI was collected using 24-h dietary recalls for three days in a week and was normalized to actual dry weight. The study outcomes included all-cause and CVD mortality. Over a median of 46 months of follow-up, 354 deaths were recorded, of which 210 (59%) were due to CVD. On assessing DFI as tertiles, the CVD mortality risk was significantly lower in patients in tertile 2-3 (≥0.13g/kg/d; hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.51-0.97) compared to those in tertile 1 (<0.13g/kg/d). A similar, but non-significant trend was found for the association between DFI (tertile 2-3 vs. tertile 1; HR: 0.83; 95%CI: 0.64-1.07) and all-cause mortality. In summary, higher DFI was associated with lower CVD mortality risk among Chinese patients of MHD. This study emphasized the significance of dietary fiber intake in MHD patients, and provided information that is critical for the improvement of dietary guidelines for dialysis patients.
Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
The hardware-in-the-loop docking simulators are significant ground test equipment for aerospace projects. The fidelity of docking simulation highly depends on the accuracy performance. This paper investigates the kinematic accuracy for the developed docking simulator. A novel kinematic calibration method which can reduce the number of parameters for error modeling is presented. The principle of parameters separation is studied. A simplified error model is derived based on Taylor series. This method can contribute to the simplification of the error model, fewer measurements, and easier convergence during the parameters identification. The calibration experiment validates this method for further accuracy enhancement.
Nanocrystalline metals possess high strength and outstanding resistance to irradiation damage. However, the high-density grain boundaries in nanocrystalline metals lead to low plasticity and poor thermal stability. In recent years, interface engineering has gradually become an important way to improve the comprehensive properties of nanocrystalline metals. In this paper, the interface structure, deformation mechanism, and physical properties of Cu–Nb nanolayered composites fabricated by physical vapor deposition and accumulative roll bonding are reviewed. Both Cu–Nb nanolayered composites possess semi-coherent interfaces. The nanolayered composites could achieve excellent resistance to irradiation damage since the interfaces are good sinks for the irradiation point defects. In addition, nanolayered metallic composites with abundant heterogeneous interfaces have better thermal stability compared to nanocrystalline metallic materials. Moreover, the interactions between dislocations and interfaces can be adjusted effectively through controlling the atomistic interface structure and alignment of slip systems across the interface, so as to achieve high strength and high plastic deformation ability simultaneously.
To reveal the thermal shock resistance of double-layer thermal barrier coatings (TBCs), two types of TBCs were prepared via atmospheric plasma spraying, i.e., Gd2Zr2O7/yttria-stabilized zirconia (GZ/YSZ) TBCs and La2Zr2O7 (LZ)/YSZ TBCs, respectively. Subsequently, thermal cycling tests of the two TBCs were conducted at 1100 °C and their thermal shock resistance and failure mechanism were comparatively investigated through experiments and the finite element method. The results showed that the thermal shock failure of the two TBCs occurred inside the top ceramic coating. However, the GZ/YSZ TBCs had longer thermal cycling life. It was the mechanical properties of the top ceramic coating, and the thermal stresses arising from the thermal mismatch between the top ceramic coating and the substrate that determined the thermal cycling life of the two TBCs together. Compared with the LZ layer in the LZ/YSZ TBCs, the GZ layer in the GZ/YSZ TBCs had smaller elastic modulus, larger fracture toughness, and smaller thermal stresses, which led to the higher crack propagation resistance and less spallation tendency of the GZ/YSZ TBCs. Therefore, the GZ/YSZ TBCs exhibited superior thermal shock resistance to the LZ/YSZ TBCs.
In the preparation of café latte, spectacular layer formation can occur between the espresso shot in a glass of milk and the milk itself. Xue et al. (Nat. Commun., vol. 8, 2017, pp. 1–6) showed that the injection velocity of espresso determines the depth of coffee–milk mixture. After a while, when a stable stratification forms in the mixture, the layering process can be modelled as a double diffusive convection system with a stably stratified coffee–milk mixture cooled from the side. More specifically, we perform (two-dimensional) direct numerical simulations of laterally cooled double diffusive convection for a wide parameter range, where the convective flow is driven by a lateral temperature gradient while stabilized by a vertical concentration gradient. Depending on the strength of stabilization as compared to the thermal driving, the system exhibits different flow regimes. When the thermal driving force dominates over the stabilizing force, the flow behaves like vertical convection in which a large-scale circulation develops. However, with increasing strength of the stabilizing force, a meta-stable layered regime emerges. Initially, several vertically-stacked convection rolls develop, and these well-mixed layers are separated by sharp interfaces with large concentration gradients. The initial thickness of these emerging layers can be estimated by balancing the work exerted by thermal driving and the required potential energy to bring fluid out of its equilibrium position in the stably stratified fluid. In the layered regime, we further observe successive layer merging, and eventually only a single convection roll remains. We elucidate the following merging mechanism: as weakened circulation leads to accumulation of hot fluid adjacent to the hot sidewall, larger buoyancy forces associated with hotter fluid eventually break the layer interface. Then two layers merge into a larger layer, and circulation establishes again within the merged structure.
Soft robots can perform effectively inspecting than rigid robots in some special environments such as nuclear pipelines and high-voltage cables. This article presents a versatile quadruped soft rod-climbing robot (SR-CR) that consists of four bending actuators and a telescopic actuator. The bending actuator is composed of flexible bellows with multiple folding air chambers, elastic telescopic layer (ETL), and strain-limiting layer (SLL). The telescopic actuator provides the energy for the robot to climb forward. The SR-CR is activated by a control strategy that alternates the body deformation and feet pneumatic clenched for stable climbing. The robot can climb rods at 90°, with the maximum speed of up to 2.33 mm/s (0.018 body length/s). At 0.83 HZ, the maximum moving speed of the robot in climbing horizontally parallel rods can reach 18.43 mm/s. In addition, the SR-CR can also achieve multiple impressive functions, including turning around a corner at a rate of 7 mm/s (0.054 body length/s), carrying a payload of 3.7 times its self-weight on horizontal rods at a speed of 9 mm/s (0.069 body length/s).
A Fast Ice Prediction System (FIPS) was constructed and is the first regional land-fast sea-ice forecasting system for the Antarctic. FIPS had two components: (1) near-real-time information on the ice-covered area from MODIS and SAR imagery that revealed, tidal cracks, ridged and rafted ice regions; (2) a high-resolution 1-D thermodynamic snow and ice model (HIGHTSI) that was extended to perform a 2-D simulation on snow and ice evolution using atmospheric forcing from ECMWF: either using ERA-Interim reanalysis (in hindcast mode) or HERS operational 10-day predictions (in forecast mode). A hindcast experiment for the 2015 season was in good agreement with field observations, with a mean bias of 0.14 ± 0.07 m and a correlation coefficient of 0.98 for modeled ice thickness. The errors are largely caused by a cold bias in the atmospheric forcing. The thick snow cover during the 2015 season led to modeled formation of extensive snow ice and superimposed ice. The first FIPS operational service was performed during the 2017/18 season. The system predicted a realistic ice thickness and onset of snow surface melt as well as the area of internal ice melt. The model results on the snow and ice properties were considered by the captain of R/V Xuelong when optimizing a low-risk route for on-ice transportation through fast ice to the coastal Zhongshan Station.
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.
Dolostones are widely developed in the middle Permian rocks of East Yunnan, China, mainly in the shoal-facies Maokou Formation. The previously reported dolostone formation mechanisms cannot explain the distribution and geochemical characteristics of these dolostones, in particular their strontium, magnesium and oxygen isotope signatures. To help predict the distribution of dolostone reservoirs and reduce the exploration risk and cost, this study proposes a new model of dolomitization: open thermal convection dolomitization. In this new dolomitization model, Mg2+ in dolomitizing fluids originates mostly from seawater, with a minor component coming from deep hydrothermal fluids. Elevated heat flux (in this case due to the nearby Emei mantle plume) causes spatial temperature variations in the fluid along the circulation flow pathways, resulting in fast and pervasive dolomitization of limestone. The proposed model not only explains the characteristics and distribution of dolostones in the study area but also serves as a reference for predicting the distribution of dolostones in other areas subjected to thermal convection.
The surface topology of biomaterial has a definite effect on the growth behavior of nerve cells for peripheral nerve regeneration. In this study, the silk fibroin (SF) film with different anisotropic microgroove/ridge was constructed by micropatterning technology. The effects of topologies width on the directional growth of dorsal root ganglion (DRG) neurons were evaluated. The results showed that the topological structure of the SF film with higher SF concentration was more clear and complete. The microtopography of the SF film with a concentration of 15% and a groove width of around 30 μm could effectively guide the directional growth of the nerve fibers of DRG. And nerve fibers could obviously form nerve fiber bundles which may have a certain pavement effect on the recovery of nerve function. The study indicated that the SF film with a specific width of the topological structure may have potential applications in the field of directional nerve regeneration.
For the guarantee of the long-distance transport of the bunches of China Initiative Accelerator Driven System (CIADS), a new scheme is proposed that extra magnetic field is used in the accelerator-target coupling section before the windowless target to minimize the self-modulation (SM) mechanism. Particle-in-cell simulations are carried out to study the influence of the solenoidal magnetic field on the self-modulation mechanism when long proton bunches move in the background plasmas. The long proton bunches used in the simulations are similar to these in the linear accelerator of CIADS. It is found that the presence of the solenoidal magnetic field will significantly inhibit the self-modulation process. For the strong magnetic field, the longitudinal separation and transverse focusing of the long bunches disappear. We attribute these phenomena to the reason that the strong solenoidal magnetic field restricts the transverse movement of plasma electrons. Thus, there are not enough electrons around the bunch to compensate the space charge effect. Moreover, without transverse current, the longitudinal pinched effect disappears, and the long bunch can not be separated into small pulses anymore.
The Arsenic (+3 oxidation state) methyltransferase (AS3MT) gene has been identified as a top risk gene for schizophrenia in several large-scale genome-wide association studies. A variable number tandem repeat (VNTR) of this gene is the most significant expression quantitative trait locus, but its role in brain activity in vivo is still unknown.
We first performed a functional magnetic resonance imaging (fMRI) scan of 101 healthy subjects during a memory span task, trained all subjects on an adaptive memory span task for 1 month, and finally performed another fMRI scan after the training. After excluding subjects with excessive head movements for one or more scanning sessions, data from 93 subjects were included in the final analyses.
The VNTR was significantly associated with both baseline brain activation and training-induced changes in multiple regions including the prefrontal cortex and the anterior and posterior cingulate cortex. Additionally, it was associated with baseline brain activation in the striatum and the parietal cortex. All these results were corrected based on the family-wise error rate method across the whole brain at the peak level.
This study sheds light on the role of AS3MT gene variants in neural plasticity related to memory span training.
Primary liver cancer is the third leading cause of cancer-related death worldwide. Most patients are diagnosed at late stages with poor prognosis; thus, identification of modifiable risk factors for primary prevention of liver cancer is urgently needed. The well-established risk factors of liver cancer include chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), heavy alcohol consumption, metabolic diseases such as obesity and diabetes, and aflatoxin exposure. However, a large proportion of cancer cases worldwide cannot be explained by current known risk factors. Dietary factors have been suspected as important, but dietary aetiology of liver cancer remains poorly understood. In this review, we summarised and evaluated the observational studies of diet including single nutrients, food and food groups, as well as dietary patterns with the risk of developing liver cancer. Although there are large knowledge gaps between diet and liver cancer risk, current epidemiological evidence supports an important role of diet in liver cancer development. For example, exposure to aflatoxin, heavy alcohol drinking and possibly dairy product (not including yogurt) intake increase, while intake of coffee, fish and tea, light-to-moderate alcohol drinking and several healthy dietary patterns (e.g. Alternative Healthy Eating Index) may decrease liver cancer risk. Future studies with large sample size and accurate diet measurement are warranted and need to consider issues such as the possible aetiological heterogeneity between liver cancer subtypes, the influence of chronic HBV or HCV infection, the high-risk populations (e.g. cirrhosis) and a potential interplay with host gut microbiota or genetic variations.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
The aim of this study was to investigate the combined effect of n-3 fatty acids (EPA and DHA, at an EPA:DHA ratio of 150:500) and phytosterol esters (PS) on non-alcoholic fatty liver disease (NAFLD) patients. We conducted a randomised, double-blind, placebo-controlled trial. Ninety-six NAFLD subjects were randomly assigned to the following groups: the PS group (receiving 3·3 g/d PS); the FO group (receiving 450 mg EPA + 1500 mg DHA/d); the PS + FO combination group (receiving 3·3 g/d PS and 450 mg EPA + 1500 mg DHA/d) and the PO group (a placebo group). The baseline clinical characteristics of the four groups were similar. The primary outcome was liver:spleen attenuation ratio (L:S ratio). The percentage increase in liver–spleen attenuation (≤1) in the PS + FO group was 36 % (P = 0·083), higher than those in the other three groups (PS group, 11 %, P = 0·519; FO group, 18 %, P = 0·071; PO group, 15 %, P = 0·436). Compared with baseline, transforming growth factor-β (TGF-β) was significantly decreased in the three study groups at the end of the trial (PS, P = 0·000; FO, P = 0·002; PS + FO, P = 0·001) and TNF-α was significantly decreased in the FO group (P = 0·036), PS + FO group (P = 0·005) and PO group (P = 0·032) at the end of the intervention. Notably, TGF-β was reduced significantly more in the PS + FO group than in the PO group (P = 0·032). The TAG and total cholesterol levels of the PS + FO group were reduced by 11·57 and 9·55 %, respectively. In conclusion, co-supplementation of PS and EPA + DHA could increase the effectiveness of treatment for hepatic steatosis.
To determine whether a potassium dihydrogen phosphate (KDP) surface mitigated by micro-milling would potentially threaten downstream optics, we calculated the light-field modulation based on angular spectrum diffraction theory, and performed a laser damage test on downstream fused silica. The results showed that the downstream light intensification caused by a Gaussian mitigation pit of 800 μm width and 10 μm depth reached a peak value near the KDP rear surface, decreased sharply afterward, and eventually kept stable with the increase in downstream distance. The solved peak value of light intensification exceeded 6 in a range 8–19 mm downstream from the KDP rear surface, which is the most dangerous for downstream optics. Laser damage sites were then induced on the fused silica surface in subsequent laser damage tests. When the distance downstream was greater than 44 mm with a downstream light intensification of less than 3, there were no potential damage threats to downstream optics. The study proves that a mitigated KDP surface can cause laser damage to downstream optical components, to which attention should be paid in an actual application. Through this work, we find that the current manufacturing process and the mitigation index still need to be improved. The research methods and calculation models are also of great reference significance for related studies like optics mitigation and laser damage.