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To assess helical tomotherapy (TOMO) current clinical application and practice in mainland China.
Materials and methods:
Data were collected for all TOMO units clinically operational in mainland China by 30 April 2016, including (a) the distribution of installation and staffing levels; (b) types of cancers treated; (c) utilisation efficiency; (d) quality assurance; (e) maintenance; (f) optional features; and (g) satisfaction levels. The data were collected as a census and analysed qualitatively and quantitatively.
As of 30 April 2016, 23 TOMO units were used clinically by 22 hospitals in mainland China. In the same period, 22,558 cancer patients were treated. For TOMO units with more than a year of clinical utilisation, a median of 378 cases were treated annually per machine. The median daily operation was 10·5 hours, and treatment headcount was 38·3 patients. The median service outage rate was 2·6%, and the most common cause was malfunction of the multi-leaf collimator. In terms of overall satisfaction levels, 3 hospitals were very satisfied, 16 were satisfied and 3 considered their satisfaction level as average.
The overall operation of TOMO is good, but there are some problems due to running at full capacity, lack of clinical efficacy research and insufficient quality assurance regulations.
Connected and Autonomous Vehicles (CAVs) have been researched extensively for solving traffic issues and for realising the concept of an intelligent transport system. A well-developed positioning system is critical for CAVs to achieve these aims. The system should provide high accuracy, mobility, continuity, flexibility and scalability. However, high-performance equipment is too expensive for the commercial use of CAVs; therefore, the use of a low-cost Global Navigation Satellite System (GNSS) receiver to achieve real-time, high-accuracy and ubiquitous positioning performance will be a future trend. This research used RTKLIB software to develop a low-cost GNSS receiver positioning system and assessed the developed positioning system according to the requirements of CAV applications. Kinematic tests were conducted to evaluate the positioning performance of the low-cost receiver in a CAV driving environment based on the accuracy requirements of CAVs. The results showed that the low-cost receiver satisfied the “Where in Lane” accuracy level (0·5 m) and achieved a similar positioning performance in rural, interurban, urban and motorway areas.
South-east Asian apple snails, Pila spp., have been declining since the introduction of globally invasive, confamilial South American Pomacea spp., yet Pila ecology remains poorly studied, with most occurrence records unconfirmed. Pila scutata, a previously widespread species, presumed native to the Malay peninsula and assessed as Least Concern in the IUCN Red List, was formerly harvested for food, and may have experienced anthropogenic translocations. We surveyed the Malay peninsula (specifically Peninsular Malaysia and Singapore) to investigate the current distribution and genetic diversity of P. scutata. Six populations were found in Singapore, but only one in Peninsular Malaysia. Mitochondrial COI and 16S sequencing revealed that the Malaysian population shared a single haplotype of both genes with the Singapore populations (500 km distant). This low genetic diversity could stem from a recent anthropogenic introduction, which brings into question the true native range of P. scutata and, coupled with poorly resolved taxonomy of the genus, necessitates a reassessment of its IUCN Red List status. Introduced populations pose a dilemma, and the lack of genetic diversity is of concern in light of Pila decline throughout South-east Asia. Our results highlight that conservation management of P. scutata and its congeners must therefore be better informed by greater taxonomic resolution and more comprehensive investigations of their ecology, both in native and introduced ranges.
The addition of vegetable to carbohydrate-based meals was shown to contribute to glycaemic management. The aim of this study was to investigate the impact of homogenisation on vegetables added to rice meals in terms of acute glycaemic responses (GR). In a randomised crossover trial, sixteen healthy volunteers completed thirteen test sessions, which included two sessions for glucose control, two for rice and nine for different vegetable-rice mixed meals: cooked pak choi and cooked rice (CP+R); cooked cauliflower and cooked rice (CC+R); cooked eggplant and cooked rice (CE+R); and their homogenised counterparts, both raw or cooked. Postprandial GR tests, in vitro carbohydrate digestion and chemical analyses were carried out for each test meal. Compared with pure rice, CE+R, CP+R and CC+R meals achieved significantly lower glycaemic indexes (GI) of 67, 71 and 73, whereas their homogenised counterparts failed to show significant difference with rice. The hydrolysis indexes (HI) of CE+R, CP+R and CC+R were 69·6, 83·8 and 80·6 % of the HI of the rice control. CE had the greatest effect on lowering the GI, the incremental area under the blood glucose curve from 0 to 120 min, the peak glucose value, the maximum amplitude of glucose excursion in 0–120 min (MAGE0–120), the HI and rapid available starch. Both in vitro and in vivo tests demonstrated that incorporating non-homogenised cooked vegetables into a rice meal could slow the carbohydrate digestion and improve postprandial GR. Texture properties of vegetable may play an important role in underlying glycaemic control mechanisms.
Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain.
To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning.
A prospective survey study.
An academic medical center.
The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison.
According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2).
The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.
Two phases of diabase-sill-forming magmatism are recorded within the Badu anticline where magmas were emplaced into upper Palaeozoic carbonates and clastic rocks of the Youjiang fold-and-thrust belt in the SW South China Block, China. Zircons from these diabase units yield weighted mean U–Pb ages of 249.2±2.0 Ma and 187.1±3.3 Ma, and magmatic oxygen fugacity values from ‒20 to ‒6 (average of ‒12, equating to FMQ +5) and ‒20 to ‒10 (average of ‒15, equating to FMQ +2), respectively. These data indicate that the sills were emplaced during Early Triassic and Early Jurassic times. The discovery of c. 250 Ma mafic magmatism in this area was probably related to post-flood-basalt extension associated with the Emeishan mantle plume or rollback of the subducting Palaeo-Tethys slab. The c. 190 Ma diabase sills indicate that the southwestern South China Block records Early Jurassic mafic magmatism and lithospheric extension that was likely associated with a transition from post-collisional to within-plate tectonic regimes. The emplacement of diabase intrusions at depth may have driven hydrothermal systems, enabling the mobilization of elements from sedimentary rocks and causing the formation of a giant epigenetic metallogenic domain. The results indicate that high-oxygen-fugacity materials within basement rocks caused crustal contamination of the magmas, contributing to the wide range of oxygen fugacity conditions recorded by the Au-bearing Badu diabase. In addition, data from inherited xenocrystic zircons within the Badu diabase and detrital zircons from basement rocks suggest that the Neoproterozoic Jiangshao suture extends to the south of the Badu anticline.
Some critical limitations of prior research on organizational controls stem from the scant theory identifying the coexistence of contradictions and interrelations between differing organizational controls and exploring how the contradictory but interrelated controls affect innovation modes. To address this gap, this research links Hitt’s internal control system framework and the ambidexterity perspective by building on their focus on the interplay and tensions between different organizational controls. Using survey data from 182 Chinese firms in innovation-intensive industries, the results show that besides the independent use of strategic control, both the combined and balance use of strategic and financial controls are important for internal innovation. For firms specializing in cooperative innovation, however, financial control is more effective, and the combined use of strategic and financial controls has negative effect on cooperative innovation. These findings contribute to our understanding of organizational control itself and its connection to the ambidexterity perspective and innovation theory.
Over the past three decades, China has shown tremendous interest in the “Singapore model” through its sending of tens of thousands of cadres to Singapore for executive training and graduate education. Although this phenomenon has been studied, no attention has been drawn to the perspectives of those mid-level cadres who took part in the training and what those perspectives might imply. Utilizing a unique dataset of over 1,350 mid-level cadres graduating from the “Mayors’ Class” in Singapore from 1995 to 2016 and follow-up surveys and interviews, this article intends to fill this gap. We found that the most appealing characteristics of the “Singapore model” for these mid-level officials lay in practical governance lessons and their potential transferability rather than in ideologies. This finding challenges conventional wisdom that the most plausible rationale of China's learning from Singapore is political. We also examine Xi Jinping's view of Singapore and its relevance to China's latest national agendas in building a “learning nation” and strengthening the CCP's resilience through anti-corruption and intra-party regeneration. The conclusion places the China–Singapore case within the context of the changing trend of transnational knowledge transfer in the non-Western world.
We designed a resorcinol-formaldehyde (RF) sol–gel ink for direct ink writing of the microlattices. To improve the formability, the fresh microlattices were strengthened by surface catalysis with HCl atmosphere. After supercritical drying and carbonization, the sample’s specific surface area was 631 m2/g and the average pore size was 3.81 nm. Both RF aerogel and carbonized RF aerogel samples had millimeter-scale pore, micron-scale pore, and nanoscale skeleton. The pore and skeleton could provide high surface area and diffusion channels, which were beneficial to the adsorption performances. The carbonized RF aerogel sample fully adsorbed Dulbecco’s modified eagle medium in 250 min, which exhibited a good capacity of quick adsorption and indicated the potential application for cell supports.
This paper presents a new approach for studying temporal sequences across ordinal variables. It involves three complementary approaches (frequency tables, transitional graphs, and dependency tables), as well as an established adaptation based on Bayesian dynamical systems, inferring a general system of change. The frequency tables count pairs of values in two variables and transitional graphs depict changes, showing which variable tends to attain high values first. The dependency tables investigate which values of one variable are prerequisites for values in another, as a more direct test of causal hypotheses. We illustrate the proposed approaches by analyzing the V-Dem dataset, and show that changes in electoral democracy are preceded by changes in freedom of expression and access to alternative information.
We report a novel tip-type field emission (FE) emitter by synthesizing the few-layer graphene (FLG) flakes on tip of nichrome (8020) wire (ϕ≈80 μm) by microwave plasma enhanced chemical vapor deposition(PECVD). These resultant random arrays of free-standing FLG flakes are aligned vertically to the substrate surface in a high-density and stacked to each other to form several larger “flower-like” agglomerates in spherical shapes. The FE performance of the tip-type FLG flakes emitter shows a low threshold field of 0.55 V/μm, a large field enhancement factor of 9455 ± 46, a large field emission current density of 22.18 A/cm2 at 2.70 V/μm, and an excellent field emission stability at high emission current densities (6.93 A/cm2). It can be used in variety of applications that include cathode-ray tube monitors, X-ray sources, electron microscopes, and other vacuum electronic applications.
This paper presents a new approach to simulate the propagation of elastic and cohesive cracks under mode-I loading based on the vector form intrinsic finite element method. The proposed approach can handle crack propagation without requiring global stiffness matrices and extra weak stiffness elements. The structure is simulated by mass particles whose motions are governed by the Newton's second law. Elastic and cohesive crack propagation are simulated by proposed VFIFE-J-integral and VFIFE-FCM methods, respectively. The VFIFE-J-integral method is based on vector form intrinsic finite element (VFIFE) and J-integral methods to calculate the stress intensity factors at the crack tips, and the VFIFE-FCM method combines VFIFE and fictitious crack models (FCM). When the stress state at the crack tip meets the fracture criterion, the mass particle at the crack tip is separated into two particles. The crack then extends in the plate until the plate splits into two parts. The proposed VFIFE-J-integral method was validated by elastic crack simulation of a notched plate, and the VFIFE-FCM method by cohesive crack propagation of a three point bending beam. As assembly of the global stiffness matrix is avoided and each mass particle motion is calculated independently, the proposed method is easy and efficient. Numerical comparisons demonstrate that the present results predicted by the VFIFE method are in agreement with previous analytical, numerical and experimental works.
Nutritional status of 380 hospitalised children aged from 1 month to 5 years with liver disease was evaluated in a single paediatric centre. The total prevalence of stunting (height-for-age Z (HAZ) < −2), underweight (weight-for-age Z (WAZ) < −2) and wasting (weight-for-height Z < −2) was 9·8, 9·0 and 7·9 %, respectively. The overall nutritional risk (−2 ≤ Z < −1) of stunting, underweight and wasting was 11·8, 12·9 and 12·6 %. The prevalence of undernutrition was significantly higher in children with cholestasis than children without cholestasis (stunting, 17·5 %/4·4 %, P < 0·001, and underweight, 14·9 %/4·9 %, P < 0·001). HAZ and WAZ scores were significantly higher in children without cholestasis than children with cholestasis (0·58 (sd 1·59)/−0·68 (sd 1·99), P < 0·001, and 0·37 (sd 1·35)/−0·47 (sd 1·75), P < 0·001). Further multivariate logistic regression analysis strengthened the evidence that cholestasis was significantly associated with undernutrition of stunting (OR = 4·18, P = 0·002) and underweight (OR = 3·26, P = 0·008), and suggested that the prevalence of stunting caused by infection was lower than other aetiologies in hospitalised children with liver disease (OR = 0·10, P = 0·002). We concluded that a high prevalence of malnutrition and risk of undernutrition presents in hospitalised young children with liver disease, especially in children with cholestasis. Nutrition assessment is recommended for hospitalised children with liver disease.
The Middle and early Late Triassic of southern China is well known for a remarkable diversity of marine vertebrates, particularly reptiles, including an abundance of intriguing new forms (e.g., Jiang et al., 2005; Hu et al., 2011; Li et al., 2016). Here we describe a new diapsid from Yunnan Province. It possesses an elongate neck that exhibits a remarkable similarity to that of many Protorosauria, yet in other respects the skull and postcranium are much less derived.
The new taxon is part of the so-called Panxian-Luoping Fauna and the deposits correspond to the Upper Member of the Guanling Formation, comprising thin to medium bedded, gray to dark-gray laminated marly limestone and limestone, with several layers of bentonite intercalated in the fossil level at Panxian (Wan, 2002; Motani et al., 2008; Jiang et al., 2009). Their age is Pelsonian (middle Anisian, Middle Triassic) as is indicated by the conodont Nicoraella kockeli Zone (Sun et al., 2006; Zhang et al., 2009). A recent U-Pb study indicates the absolute age of these middle Anisian beds to be close to 244 Ma (Wang et al., 2014).
A group of traditional pottery workshops in Sichuan Province, China, produce a unique coal-clay composite ceramic that is fired using a similarly unique kiln design and two-stage firing procedure not seen in any other ceramic tradition. Here we report on field and laboratory efforts to better understand this unusual ceramic material and technology, the functional advantages as cookware, braziers, and large storage vessels that include high strength and high thermal shock resistance, and the cultural context that supported the creativity and experimentation needed to develop such an innovative technology.
Fluazifop-P-butyl, a selective graminicide, has been widely used to control annual grass weeds for more than three decades in Taiwan, and a resistant (R) biotype of goosegrass has consequently appeared. In this study, liquid chromatography/tandem mass spectrometry (LC/MS/MS) was applied to analyze metabolites of fluazifop-P-butyl in a R biotype of goosegrass. Six signals, including mass-to-charge ratios (m/z) 512, 432, 423, 415, 314, and 160, in positive scanning mode, and four signals, including m/z 788, 623, 593, and 162, in negative scanning mode, were found in the metabolites of the R and S biotypes, respectively. All of the signals of these metabolites in the R biotype showed higher intensity than those of the S biotype, except for m/z 162. Based on the molecular weights of the fragments (MS2 signal) from the molecules (MS1 signal) and comparison with the Metabolite Link Metabolomics database, MassBank database, and related references, one reduced form of fluazifop acid, i.e., 2-[4-(5- trifluoromethyl-2-pyridyloxy) phenoxy] propanol (MW 313); two types of intermediates of MW 163, i.e., 5-trifluoromethyl-2-pyridone and 5-trifluoromethyl-2-hydroxypyridine (or 2-hydroxy-5-trifluoromethyl pyridine); and five possible conjugated compounds containing a common core fragment (MW 255) from fluazifop acid were identified. In addition, another compound, likely degraded from one of the five conjugated compounds, was also detected. Accordingly, the metabolic pathway of fluazifop-P-butyl in goosegrass is described in this study. An enzyme kinetic study on glutathione S-transferase showed that the R biotype has higher affinities to the substrates reduced glutathione (GSH) and 1-chloro-2, 4-dinitrobenzene, with S/R Km ratios of 3.0 and 2.4, respectively. No difference in Vmax was found, revealing that the S biotype has a strong ability to bind GSH and herbicide or target molecules and showed susceptibility to fluazifop.