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Severe trauma can lead to amputation of limbs. There is no golden standard or comprehensive evaluation indicator for amputation. It is difficult for the primary rescue organization to focus on the most essential indicators and to determine whether to perform amputation or take proper operation.
For medical staff in first-line medical teams for disaster relief or in a common primary hospital, what indicators should they focus on to keep the patient’s limbs when they receive wounded patients with severe trauma?
A retrospective case-control study was performed based on the patients with severe trauma from January 2013 through December 2018 in the emergency department of Southwest Hospital (Shapingba District, Chongqing, China), a Level I trauma center. A total of 165 cases were divided into amputation group (n = 79) and non-amputation control group (n = 86), which had severe skin and muscle injury but without amputation. The causes of trauma and the special cases were analyzed. Binary logistic regression models were used to find the essential indicators for amputation.
Neurovascular injury with delayed treatment was the most decisive indicator leading to amputation, and time phase was also important for limb salvage. Preliminary treatment of disaster victims and patients with severe trauma should focus on neurovascular status and timely delivery.
The trace elements in quartz, Al and Ti, contain considerable information about mineral genesis, and determining their concentrations is of great importance in geology. Electron probe microanalysis has the advantages of non-destructive testing and high spatial resolution; however, it is a challenge to improve the accuracy and precision of trace element detection using this method. The important factors affecting accuracy include the fragility of quartz lattices at high beam currents and the methods used to determine the background. In this paper, the peaks of Al-Kα and Ti-Kα, and their backgrounds, were found to exhibit intensity variations at high beam currents and small beam diameters; therefore, it is necessary to select a large beam diameter (up to 20 µm) to avoid variations in intensity at high currents (500 nA). For background determination of Al, a multipoint background method is proposed to determine the background value, which greatly improves the accuracy of the results. For Ti, the choice of background measurement does not affect the result. In addition, it is verified that the background obtained from other quartz samples can be used as the background of an unknown quartz sample, which reduces the analysis time and minimizes sample damage.
INTRODUCTION: Gangliogliomas (GGs) are neuroepithelial tumours of the central nervous system (CNS) composed of mature ganglion cells or a mixed population of ganglion and glial cells. Microarray data of low grade gliomas (LGG) including GGs revealed overexpression of the Dlx2 gene, a homeobox gene essential for interneuron migration and differentiation. We hypothesized that GGs are arrested in development, and began to explore the role of the Dlx2 gene. BRAF rearrangements and BRAF V600E point mutations have been reported in pediatric LGG. METHODS: DLX2 expression was examined in GGs using immunofluorescence (IF) and immunohistochemistry (IHC) labelling of formalin fixed paraffin embedded (FFPE) tissue sections, along with staining of glial and neuronal markers. BRAF mutations were detected using a commercial antibody and/or sequence verification of the DNA extracted from the FFPE blocks. RESULTS: In the Discovery cohort 10/30 were DLX2+ (33.3%) and in the Validation cohort 15/40 were DLX2+ (37.5%). Of these 15 cases, 15 were GFAP+ (100%), 15 were synaptophysin and/or NeuN+ (100%), and 13 were OLIG2+ (86.7%); 6 had a BRAF V600E mutation (40.0%). For the Validation cohort of 40 GGs, 28 were OLIG2+ (70.0%); 13/28 co-expressed DLX2 (46.4%). 18/40 cases had a BRAF V600 mutation(17 V600E, 1 V600G; 45.0%) and 6/18 were DLX2+ (33.3%). CONCLUSIONS: DLX2 is expressed in GGs in both neuronal and glial marker expressing tumour cells. Our results support that GGs arise from CNS progenitors arrested at the neuronal-glial cell fate “decision” point.
Auto-alignment is a basic technique for high-power laser systems. Special techniques have been developed for laser systems because of their differing structures. This paper describes a new sensor for auto-alignment in a laser system, which can also serve as a reference in certain applications. The authors prove that all of the beam transfer information (position and pointing) can theoretically be monitored and recorded by the sensor. Furthermore, auto-alignment with a single lens sensor is demonstrated on a simple beam line, and the results indicate that effective auto-alignment is achieved.
Pre-Quaternary terrestrial climate variability is less well understood than that during the Quaternary. The continuous eolian Red Clay sequence underlying the well-known Quaternary loess-paleosol sequence on the Chinese Loess Plateau (CLP) provides an opportunity to study pre-Quaternary terrestrial climate variability in East Asia. Here, we present new mineral magnetic records for a recently found Red Clay succession from Shilou area on the eastern CLP, and demonstrate a marked East Asian climate shift across the Miocene-Pliocene boundary (MPB). Pedogenic fine-grained magnetite populations, ranging from superparamagnetic (SP)/single domain (SD) up to small pseudo-single domain (PSD) sizes (i.e., from <30 nm up to ~1000 nm), dominate the magnetic properties. Importantly, our mineral magnetic results indicate that both pedogenic formation of SP grains and transformation of SP grains to SD and small PSD grains accelerated across the MPB in the Shilou Red Clay, which are indicative of enhanced pedogenesis. We relate this enhanced pedogenesis to increased soil moisture availability on the CLP, associated with stronger Asian Summer Monsoon precipitation during an overall period of global cooling. Our study thus provides new insights into the Miocene-Pliocene climate transition in East Asia.
Previous studies have yielded conflicting results on the associations of maternal Fe intake with birth outcomes. This study aimed to investigate the associations between maternal Fe intake (total Fe from diet and supplements, dietary total Fe, haeme Fe, non-haeme Fe and Fe supplements use) and adverse birth outcomes in Shaanxi Province of Northwest China. In all, 7375 women were recruited using a stratified multistage random sampling method at 0–12 months (median 3; 10th–90th percentile 0–7) after delivery. Diets were collected by a validated FFQ and maternal characteristics were obtained via a standard questionnaire. The highest tertile of haeme Fe intake compared with the lowest tertile was negatively associated with low birth weight (LBW) (OR 0·68; 95 % CI 0·49, 0·94), small for gestational age (SGA) (OR 0·76; 95 % CI 0·62, 0·94) and birth defects (OR 0·55; 95 % CI 0·32, 0·89). Maternal haeme Fe intake was associated with a lower risk of intra-uterine growth retardation (IUGR) (medium tertile v. lowest tertile: OR 0·78; 95 % CI 0·61, 0·95; highest tertile v. lowest tertile: OR 0·76; 95 % CI 0·59, 0·93; Ptrend=0·045). The OR of LBW associated with Fe supplements use were as follows: during pregnancy: 0·72 (95 % CI 0·50, 0·95); in the second trimester: 0·67 (95 % CI 0·42, 0·98); in the third trimester: 0·47 (95 % CI 0·24, 0·93). We observed no associations of total Fe, dietary total Fe or non-haeme Fe intake with birth outcomes. The results suggest that maternal haeme Fe intake is associated with a reduced risk of LBW, SGA, IUGR and birth defects, and Fe supplements use during pregnancy reduces LBW risk.
Brief cognitive–behavioural therapy (CBT) is an emerging treatment for
schizophrenia in community settings; however, further trials are needed,
especially in non-Western countries.
To test the effects of brief CBT for Chinese patients with schizophrenia
in the community (trial registration: ChiCTR-TRC-13003709).
A total of 220 patients with schizophrenia from four districts of Beijing
were randomly assigned to either brief CBT plus treatment as usual (TAU)
or TAU alone. Patients were assessed at baseline, post-treatment and at
6- and 12-month follow-ups by raters masked to group allocation.
At the post-treatment assessment and the 12-month follow-up, patients who
received brief CBT showed greater improvement in overall symptoms,
general psychopathology, insight and social functioning. In total, 37.3%
of those in the brief CBT plus TAU group experienced a clinically
significant response, compared with only 19.1% of those in the TAU alone
group (P = 0.003).
Brief CBT has a positive effect on Chinese patients with schizophrenia in
An effective multiplex real-time polymerase chain reaction (PCR) assay for the simultaneous detection of three major pathogens, Nosema bombycis Nägeli (Microsporidia: Nosematidae), Bombyx mori nucleopolyhedrovirus (Baculoviridae: genus Alphabaculovirus) (NPV), and Bombyx mori densovirus (Parvoviridae: genus Iteravirus) (DNV), in silkworms (Bombyx mori (Linnaeus); Lepidoptera: Bombycidae) was developed in this study. Polymerase chain reaction and real-time PCR tests and basic local alignment search tool searches revealed that the primers and probes used in this study had high specificities for their target species. The ability of each primer/probe set to detect pure pathogen DNA was determined using a plasmid dilution panel, in which under optimal conditions the multiplex real-time PCR assay showed high efficiency in the detection of three mixed target plasmids with a detection limit of 8.5×103 copies for N. bombycis and Bombyx mori NPV (BmNPV) and 8.5×104 copies for Bombyx mori DNV (BmDNV). When the ability to detect these three pathogens was examined in artificially inoculated silkworms, our method presented a number of advantages over traditional microscopy, including specificity, sensitivity, and high-throughput capabilities. Under the optimal volume ratio for the three primer/probe sets (3:2:2=N. bombycis:BmNPV:BmDNV), the multiplex real-time PCR assay showed early detection of BmNPV and BmDNV by day 1 post inoculation using DNA templates of the three pathogens in various combinations from individually infected silkworms; the early detection of N. bombycis was possible by day 3 post inoculation using the DNA isolated from the midgut of N. bombycis-infected silkworms.
This paper is concerned with numerical approximations of a nonlocal heat equation define on an infinite domain. Two classes of artificial boundary conditions (ABCs) are designed, namely, nonlocal analog Dirichlet-to-Neumann-type ABCs (global in time) and high-order Padé approximate ABCs (local in time). These ABCs reformulate the original problem into an initial-boundary-value (IBV) problem on a bounded domain. For the global ABCs, we adopt a fast evolution to enhance computational efficiency and reduce memory storage. High order fully discrete schemes, both second-order in time and space, are given to discretize two reduced problems. Extensive numerical experiments are carried out to show the accuracy and efficiency of the proposed methods.
To describe nutrient intakes, characterize dietary patterns and analyse their associations with sociodemographic characteristics among pregnant women in Shaanxi, China.
Population-based cross-sectional survey.
Twenty counties and ten districts in Shaanxi Province of Northwest China, 2013.
Women (n 7462) were recruited using a stratified multistage random sampling method to report diets during pregnancy, at 0–12 months (median 3 months; 10th–90th percentile, 0–7 months) after delivery.
Pregnant women had higher intakes of fat, niacin and vitamin E than the nutrient reference values, while most micronutrients such as vitamin A, folate, Ca and Zn were reportedly low. Women in the highest education, occupation and household income groups had higher nutrient intakes than those in the lowest groups. Nutrient intake differences also existed by geographic area, residence and maternal age at delivery. Three dietary patterns were identified: balanced pattern, vegetarian pattern and snacks pattern. Participants with high balanced pattern scores tended to be better educated, wealthier, 25–29 years old at delivery, working outside and living in urban areas and central Shaanxi. Women with high scores on the vegetarian pattern and snacks pattern tended to be in low balanced pattern score groups, and had lower nutrient intakes than those in the high balanced pattern score groups.
The study suggested that pregnant women in Shaanxi, China had low intakes of most nutrients such as vitamin A, folate and Ca. Dietary patterns and most nutrient intakes varied by sociodemographic characteristics. Targeted programmes are needed to improve dietary intakes and dietary patterns among sociodemographically disadvantaged groups.
The surface microstructure of shot peened (TiB + TiC)/Ti–6Al–4V is investigated using Rietveld whole pattern fitting method. The domain size and microstrain of them are obtained. By comparing the calculated results between them, it can be found that the microstructure variations of Ti–6Al–4V are more severe than those of (TiB + TiC)/Ti–6Al–4V, which is due to the effect of reinforcements' resistance to the deformation of the surface layer. The distribution of average domain size and microstrain of (TiB + TiC)/Ti–6Al–4V at varying depths are calculated, and the results are discussed in detail. Moreover, the probability distribution of the domain size at different depths is obtained using the lognormal distribution model. Based on the discussion, the results obtained from Rietveld whole pattern fitting method agree with the results calculated using the Voigt method, which reveals that the Rietveld method is an effective method of characterizing the surface microstructure of titanium matrix composites after shot peening treatments.
This paper presents a method to improve the speed and accuracy rate for space robot visual target recognition based on illumination and affine invariant feature extraction. The method takes illumination changes, strong nonlinear light due to refraction and reflection, target affine transformation and occlusion into consideration, all of which occur on the cabin target surface and affect the target recognition accuracy seriously. In this paper, a method is proposed to capture a same target at multi-viewpoints to establish feature library for high recognition accuracy and speed at any viewpoint. By using an analysis of the light intensity and gray level transformation, we obtain the corrected image which reduce the influence of illumination change. Then the affine moment invariants features of the correction images at multi-viewpoints were extracted and the average feature datum were stored in the library. To verify the validity of the method, a robot vision system provided images, followed by image preprocessing, dynamic local threshold segmentation and feature extraction. These methods were verified on a target recognition system of space robot built for this research. The experimental results showed that the methods were feasible and effective.
Recently, Fickenscher et al.  have shown that, in a core-multi-shell structure where a GaAs quantum well is embedded into an AlGaAs shell wrapped around a  oriented GaAs nanowire, the electron and hole ground states are strongly confined to the corners of the hexagonally symmetric quantum well. Thus this confinement defines quantum wires which run along the length of the nanowires along its corners. Here we review single nanowire photoluminescence measurements which show the significant confinement energy of the excitons. For well widths larger than 5 nm, optical transitions between electron and hole excited states can be seen in excitation spectra, while for widths less than 5 nm only the ground state optical transitions are observed. For well widths smaller than 5 nm, high resolution spatially resolved photoluminescence measurements show directly the appearance of localized states. Single nanowire spectra from the 4 nm QWT sample display ultranarrow emission lines on the high energy side of the luminescence band. Spatially-resolved PL images show that these quantum dots are localized randomly along the length of the wire.
A crucial problem is the risk that a manipulator arm would be damaged by twisting or bending during and after contacting a target satellite. This paper presents a solution to minimize the risk of damage to the arm and thereby enhance contact performance. First, a hand-eye servo controller is proposed as a method for accurately tracking and capturing a target satellite. Next, a motion planning strategy is employed to obtain the best-fit contacting moments. Also, an impedance control law is implemented to increase protection during operation and to ensure more accurate compliance. Finally, to overcome the challenge of verifying algorithms for a space manipulator while on the ground, a novel experimental system with a 6-DOF (degree of freedom) manipulator on a chaser field robot is presented and implemented to capture a target field robot; the proposed methods are then validated using the experimental platform.
Schizophrenia (SZ) is a common severe psychiatric disorder and a complex polygenic inherited disease that has not yet been fully interpreted. Heredity was proven to play an important role in the development of SZ. The association between the NOTCH4 gene rs3131296 polymorphism and SZ was reported to reach significance at the genome-wide level; therefore, it is necessary to replicate this association in other different populations.
To evaluate the association of the NOTCH4 gene rs3131296 polymorphism with the risk for SZ, and to explore whether a significant association could be replicated in different ethnic groups of China, we conducted this case–control study on 282 SZ cases (188 Han and 94 Zhuang) and 282 controls (188 Han and 94 Zhuang) among the Chinese Zhuang and Han populations.
The results showed no statistically significant difference in the genotype or allele frequencies of the NOTCH4 gene variant rs3131296 between SZ patients and healthy controls in either the Zhuang or Han samples (p > 0.05). In addition, no significant difference was found in genotype or allele frequencies of the NOTCH4 gene variant rs3131296 between cases and controls in the combined samples including Zhuang and Han samples.
Our study failed to replicate the significant association between the NOTCH4 gene rs3131296 polymorphism and the risk for SZ.
This paper describes an MHD simulation of an observed Sigmoid in AR 11283 from its formation to eruption. The Non-linear Force Free MHD model (Jiang and Feng, 2012) and the data-driven active region evolution model (Wu et al., 2006; Jiang et al. 2013) together with the SDO/HMI magnetograms are used. We show the successful simulation results of the eruption of a flux-rope structure.