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Based on an accurate numerical solution of the kinetic equation using well-resolved spatial and velocity grids, the separation of rarefied gas flow in a microchannel with double rectangular bends is investigated over a wide range of Knudsen and Reynolds numbers. Rarefaction effects are found to play different roles in flow separation (vortex formation) at the concave and convex corners. Flow separations near the concave and convex corners are only observed for a Knudsen number up to
, respectively. With further increase of the Knudsen number, flow separation disappears. Due to the velocity slip at the solid walls, the concave (convex) vortex is suppressed (enhanced), which leads to the late (early) onset of separation of rarefied gas flows with respect to the Reynolds number. The critical Reynolds numbers for the emergence of concave and convex vortices are found to be as low as
, respectively. The slip velocity near the concave (convex) corner is found to increase (decrease) when the Knudsen number increases. An adverse pressure gradient appears near the concave corner for all the examined Knudsen numbers, while for the convex corner it only occurs when the Knudsen number is less than
. Due to the secondary flow and adverse pressure gradient near the rectangular bends, the mass flow rate ratio between the bent and straight channels of the same length is a non-monotonic function of the Knudsen number. Our results clarify the diversified and often contradictory observations reported in the literature about flow rate enhancement and vortex formation in bent microchannels.
A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital.
The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient’s characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method.
DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector.
For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients’ medical records, and to reorganize the DMAT dispatch system.
This paper describes the study protocol, which aims to evaluate the effectiveness of a multifaceted intervention package called ‘Enhanced Primary Healthcare’ (EnPHC) on the process of care and intermediate clinical outcomes among patients with Type 2 diabetes mellitus (T2DM) and hypertension. Other outcome measures include patients’ experience and healthcare providers’ job satisfaction.
In 2014, almost two-thirds of Malaysia’s adult population aged 18 years or older had T2DM, hypertension or hypercholesterolaemia. An analysis of health system performance from 2016 to 2018 revealed that the control and management of diabetes and hypertension in Malaysia was suboptimal with almost half of the patients not diagnosed and just one-quarter of patients with diabetes appropriately treated. EnPHC framework aims to improve diagnosis and effective management of T2DM, hypertension or hypercholesterolaemia and their risk factors by increasing prevention, optimising management and improving surveillance of diagnosed patients.
This is a quasi-experimental controlled study which involves 20 intervention and 20 control clinics in two different states in Malaysia, namely Johor and Selangor. The clinics in the two states were matched and randomly allocated to ‘intervention’ and ‘control’ arms. The EnPHC framework targets different levels from community to primary healthcare clinics and integrated referral networks.
Data are collected via a retrospective chart review (RCR), patient exit survey, healthcare provider survey and an intervention checklist. The data collected are entered into tablet computers which have installed in them an offline survey application. Interrupted time series and difference-in-differences (DiD) analyses will be conducted to report outcomes.
The effects of macronutrient intake on obesity are controversial. This research aims to investigate the associations between macronutrient intake and new-onset overweight/obesity. The relationship between the consumption of carbohydrate and total fat and obesity was assessed by the multivariable Cox model in this 11-year cohort, which included 6612 adults (3291 men and 3321 women) who were free of overweight and obesity at baseline. The dietary intake was recorded using a 24-h recall method for three consecutive days. Moreover, substitution models were developed to distinguish the effects of macronutrient composition alteration from energy intake modification. During 7·5 person years (interquartile range 4·3, 10·8) of follow-up, 1807 participants became overweight or obese. After adjusting for risk factors, the hazard ratio (HR) of overweight/obesity in extreme quintiles of fat was 1·48 (quintile 5 v. quintile 1, 95 % CI 1·16, 1·89; Ptrend = 0·02) in women. Additionally, replacing 5 % of energy from carbohydrate with equivalent energy from fat was associated with an estimated 4·3 % (HR 1·043, 95 % CI 1·007, 1·081) increase in overweight/obesity in women. Moreover, dietary carbohydrate was inversely associated with overweight/obesity (quintile 5 v. quintile 1, HR 0·70, 95 % CI 0·55, 0·89; Ptrend = 0·02) in women. Total fat was related to a higher risk of overweight/obesity, whereas high carbohydrate intake was related to a lower risk of overweight/obesity in women, which was not observed in men.
Underground Nuclear Astrophysics in China (JUNA) will take the advantage of the ultra-low background in Jinping underground lab. High current accelerator with an ECR source and detectors were commissioned. JUNA plans to study directly a number of nuclear reactions important to hydrostatic stellar evolution at their relevant stellar energies. At the first period, JUNA aims at the direct measurements of 25Mg(p,γ)26 Al, 19F(p,α) 16 O, 13C(α, n) 16O and 12C(α,γ) 16O near the Gamow window. The current progress of JUNA will be given.
We incorporate deep learning (DL) into tiled aperture coherent beam combining (CBC) systems for the first time, to the best of our knowledge. By using a well-trained convolutional neural network DL model, which has been constructed at a non-focal-plane to avoid the data collision problem, the relative phase of each beamlet could be accurately estimated, and then the phase error in the CBC system could be compensated directly by a servo phase control system. The feasibility and extensibility of the phase control method have been demonstrated by simulating the coherent combining of different hexagonal arrays. This DL-based phase control method offers a new way of eliminating dynamic phase noise in tiled aperture CBC systems, and it could provide a valuable reference on alleviating the long-standing problem that the phase control bandwidth decreases as the number of array elements increases.
The formation of low-angle grain boundaries (LABs) in the rejoined platforms of a Ni-based single crystal superalloy under different directional solidification rates was investigated by the experimental investigation and the ProCAST simulation. The results showed that the growth morphology and orientation evolution of dendrites in the platforms were different under the withdrawal rates in the range of 60–100 μm/s and then resulted in different types of LABs. At lower withdrawal rates, the longitudinal LABs were common in the rejoined platforms. Both the sliver defects and the orientation deviation of original primary dendrites from two independent growth paths could cause the longitudinal LABs in the platforms. At higher withdrawal rates, the dendrite growth patterns were more complex and the secondary branches with lateral growth tended to deviate from their original orientation, eventually leading to the formation of some transverse LABs. Finally, some suggestions to prevent the formation of different LABs are provided.
Herbicide-resistant weeds pose a considerable threat to agriculture, but their resistance mechanisms are poorly understood. Differential gene expression analysis of a weed subjected to herbicide treatment is a key step toward more mechanistic studies. Such an analysis, often involving quantitative real-time PCR (qPCR), requires suitable reference genes as internal controls. In this study, we identified optimal reference genes in the noxious weed, Japanese foxtail. This weed has evolved resistance to acetyl-coenzyme A carboxylase (ACCase) inhibitors. We analyzed the stability of eight commonly used candidate reference genes (glyceraldehyde-3-phosphate dehydrogenase [GAPDH]; ubiquitin [UBQ]; capsine phosphatase [CAP]; beta-tubulin [TUB]; eukaryotic initiation factor 4a [EIF4A]; elongation factor-1 alpha [EF1]; 18S ribosomal RNA [18S]; 25S ribosomal RNA [25S]) from root, stem, and leaf tissue of plants that were either resistant or sensitive to ACCase inhibitors, with or without herbicide stress, using qPCR. The results were further ranked and analyzed using geNorm, NormFinder, and BestKeeper software. These analyses identified EF1 and UBQ in roots, EF1, TUB, CAP, and 18S in stems, and EF1, GAPDH, and 18S in leaves as suitable references for qPCR normalization. We have identified a set of reference genes that can be used to study herbicide resistance mechanisms in Japanese foxtail.
The effects of boron and zirconium contents from 0 to 0.049 wt% on the casting fluidity, as-cast microstructure and mechanical properties of IN718C superalloy are systematically investigated. The results show that as the B or Zr content increases, the fluidity firstly increases and then decreases. The optimum fluidity is obtained at the pouring temperature of 1470 °C when the content of B is 0.0059 wt% or Zr is 0.042 wt%, respectively. The addition of Zr can lead to the formation of blocky laves phase, but B has no influence on microstructure morphology. Furthermore, the addition of B or Zr can effectively improve the tensile and stress life properties as well as casting fluidity of IN718C superalloy. As compared with IN718C master alloys, the tensile strength can increase 6.2–8.6% and stress life can be improved by 1.3 times when B content is 0.0059 wt%. In addition, when the alloy contains 0.042 wt% Zr, the tensile strength can increase 5.6–7% and stress life can increase 1.076 times than that of the master alloy.
The effects of W, Re, Cr, and Mo on microstructural stability, such as the morphology of γ′ phase and the topologically close-packed (TCP) phase precipitation are systematically investigated in eleven kinds of Ni-based single crystal superalloys containing certain amounts of Co, Al, and Ta. After heat treatment, all the designed alloys show different sizes of γ′ phases with typical cuboidal morphology occupying 75% of the total volume. With increasing Re content, the size of γ′ decreases obviously, while the size of γ′ decreases slightly with increasing Cr and Mo contents. Increasing W does not affect the size of γ′. As a result of thermal exposure at 1000 °C for 1000 h, some acicular, rod-like, and blocky TCP phases are precipitated in most alloys. It is noted that Mo and Re can strongly promote the precipitation of TCP phase, but W has no obvious effect on TCP phase precipitation. In addition, transmission electron microscope analysis indicates that these TCP phases are σ phase, μ phase, and R phase.
The relation between climate change and historical rhythms has long been discussed. However, this type of study still faces the lack of high-resolution data concerning long-term socio-economic processes. In this study, we collected 1586 items of direct and proffered evidence from 29 Chinese history books. We used semantic analysis to reconstruct a quantitative series of the social vicissitudes of the past 2000 yr with a 10-yr resolution to express the phase transition of the social vicissitudes of the dynasties in China. Our reconstruction demonstrates that social vicissitudes have clear cyclical features on multiple time scales. Analysis of the association of social rise and fall with climate change indicates that temperature displayed more significant effects on social vicissitudes in the long term, while precipitation displayed more significant effects on the social vicissitudes in the short term. There are great overlaps between social and climatic variables around the predominant or periodic bands. Social rise mostly occurred in the centennial-scale warm periods, whereas social decline mostly occurred in the centennial-scale cold periods. Under warm-wet conditions, social rise occurred over 57% of the time; under cold-dry conditions, the social decline occurred over 66% of the time.
I deficiency is a worldwide public health problem. Median urinary I concentration in school-aged children has been used globally as a proxy for all populations. This study aims to determine whether median urinary I concentration of school-aged children is an appropriate indicator of I nutritional status in different adult populations. This is a secondary data analysis of two national I Deficiency Disorder surveys (2011, 2014) and two regional surveys (in coastal areas, 2009, and in high-risk areas, 2009–2014). Population groups included in these surveys were school-aged children (8–10 years), pregnant women, lactating women, women of childbearing age and adults (men and women, 18–45 years). All participants were self-reported healthy without history of thyroid diseases or were not using thyroid medicines. The median urinary I concentration of school-aged children was matched with that of the other population at the county level. The matched populations had similar iodised salt supply, food and water I, food composition and I content in salt. Weak or moderate correlation of median urinary I concentrations was observed between school-aged children and pregnant women and between children and lactating women. However, the agreement was stronger between children and women of childbearing age and between children and adult men and women. The results could be affected by cut-off values, data aggregation level and sample size. Using median urinary I concentration of school-aged children tends to overestimate that of pregnant women and lactating women. Median urinary I concentration of school-aged children can be used for assessing I nutrition in the adult population.
Disaster can strike people in any community at any time anywhere in the world. Disasters occur with high frequency, take on multiple forms, and exert wide influence, typically causing property damage, injuries, and death. As the world’s largest developing country, China incurs great costs when a disaster hits. After the Wenchuan earthquake in 2008, the Chinese government focused its attention on the construction of an emergency response system, the creation of disaster prevention and mitigation systems, and the development of a disaster medicine program. Here, we describe the current status of disaster medicine in China, focusing on the following four aspects: the Emergency Management System, Education & Training, Rescue Practices, and Research. We also discuss the future of disaster medicine in China. (Disaster Med Public Health Preparedness. 2018;12:157–165)
The present study aimed to explore the associations between food away-from-home (FAFH) consumption and body weight outcomes among Chinese adults.
FAFH was defined as food prepared at restaurants and the percentage of energy from FAFH was calculated. Measured BMI and waist circumference (WC) were used as body weight outcomes. Quantile regression models for BMI and WC were performed separately by gender.
Information on demographic, socio-economic, diet and health parameters at individual, household and community levels was collected in twelve provinces of China.
A cross-sectional sample of 7738 non-pregnant individuals aged 18–60 years from the China Health and Nutrition Survey 2011 was analysed.
For males, quantile regression models showed that percentage of energy from FAFH was associated with an increase in BMI of 0·01, 0·01, 0·01, 0·02, 0·02 and 0·03 kg/m2 at the 5th, 25th, 50th, 75th, 90th and 95th quantile, and an increase in WC of 0·04, 0·06, 0·06, 0·04, 0·06, 0·05 and 0·07 cm at the 5th, 10th, 25th, 50th, 75th, 90th and 95th quantile. For females, percentage of energy from FAFH was associated with 0·01, 0·01, 0·01 and 0·02 kg/m2 increase in BMI at the 10th, 25th, 90th and 95th quantile, and with 0·05, 0·04, 0·03 and 0·03 cm increase in WC at the 5th, 10th, 25th and 75th quantile.
Our findings suggest that FAFH consumption is relatively more important for BMI and WC among males rather than females in China. Public health initiatives are needed to encourage Chinese adults to make healthy food choices when eating out.
The effect of Co on element segregation and microstructure is investigated in the third generation Ni-based single crystal superalloys with 4, 8.5, and 11.5 wt% Co addition. The results show that the increase of Co content leads to a severe element segregation in as-cast microstructure. After heat treatment, the size of γ′ phase is slightly reduced with Co content increase. During the thermal exposure, the γ′ phase coarsens gradually but its coarsening rate decreases with increasing Co content. In addition, some acicular and blocky topologically close-packed (TCP) phases are precipitated in 4% Co and 8.5% Co alloys. However, no TCP phase can be found in 11.5% Co alloy. Finally, it may be concluded that although a higher Co content is harmful for the element segregation, it is beneficial to maintain the cuboidal morphology of γ′ phase, decrease its coarsening rate, and impede the precipitation of TCP phase.
Conventional retrogression and re-aging (RRA) treatment could not be put to good use for combination property of Al–Zn–Mg–Cu alloys. The new RRA treatment fitted for spray formed Al–Zn–Mg–Cu alloy was investigated by transmission electron microscope, tensile, and conductivity tests. The results show that the pre-aging treatment with under aging of 120 °C for 16 h is beneficial for the redissolution of matrix precipitates during retrogression treatment. With the retrogression of 200 °C for 8 min, grain boundary precipitates are discrete and the corrosion resistance of the alloy is drastically increased. After re-aging (120 °C for 24 h) the strength of the alloy is increased again. According to the above-mentioned new RRA treatment, the ultimate tensile strength, yield strength, elongation, and conductivity of the alloy are 791 MPa, 736 MPa, 8.5%, and 39.5% IACS respectively, which is higher than that after conventional RRA treatment.
Enhancement of heat transport across a fluid layer is of fundamental interest as well as great technological importance. For decades, Rayleigh–Bénard convection has been a paradigm for the study of convective heat transport, and how to improve its overall heat-transfer efficiency is still an open question. Here, we report an experimental and numerical study that reveals a novel mechanism that leads to much enhanced heat transport. When vertical partitions are inserted into a convection cell with thin gaps left open between the partition walls and the cooling/heating plates, it is found that the convective flow becomes self-organized and more coherent, leading to an unprecedented heat-transport enhancement. In particular, our experiments show that with six partition walls inserted, the heat flux can be increased by approximately 30 %. Numerical simulations show a remarkable heat-flux enhancement of up to 2.3 times (with 28 partition walls) that without any partitions.
Early identification of patients with bipolar disorder during their first depressive episode is beneficial to the outcome of the disorder and treatment, but traditionally this has been a great challenge to clinicians. Recently, brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the pathophysiology of bipolar disorder and major depressive disorder (MDD), but it is not clear whether BDNF levels can be used to predict bipolar disorder among patients in their first major depressive episode.
To explore whether BDNF levels can differentiate between MDD and bipolar disorder in the first depressive episode.
A total of 203 patients with a first major depressive episode as well as 167 healthy controls were recruited. After 3 years of bi-annual follow-up, 164 patients with a major depressive episode completed the study, and of these, 21 were identified as having bipolar disorder and 143 patients were diagnosed as having MDD. BDNF gene expression and plasma levels at baseline were compared among the bipolar disorder, MDD and healthy control groups. Logistic regression and decision tree methods were applied to determine the best model for predicting bipolar disorder at the first depressive episode.
At baseline, patients in the bipolar disorder and MDD groups showed lower BDNF mRNA levels (P<0.001 and P = 0.02 respectively) and plasma levels (P = 0.002 and P = 0.01 respectively) compared with healthy controls. Similarly, BDNF levels in the bipolar disorder group were lower than those in the MDD group. These results showed that the best model for predicting bipolar disorder during a first depressive episode was a combination of BDNF mRNA levels with plasma BDNF levels (receiver operating characteristics (ROC) = 0.80, logistic regression; ROC = 0.84, decision tree).
Our findings suggest that BDNF levels may serve as a potential differential diagnostic biomarker for bipolar disorder in a patient's first depressive episode.