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Catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but this was fully attributable to a concurrent surveillance case definition revision. Post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.
In this study, Mg-substituted tricalcium phosphate (Mg-TCP) nanoparticles were synthesized by hydrothermal reactions of Mg-calcite mesocrystals from echinoderm skeletons. Following the biomineralization of echinoderms, Mg-calcite powder was synthesized via the solid-state transition of Mg-amorphous calcium carbonate prepared by a wet-chemical precipitation method, which can also be used to fabricate Mg-TCP. We illustrated that Mg-calcite with a certain level of Mg substitution led to the formation of Mg-TCP through the ion-exchange reactions in the hydrothermal system. Therefore, this study provides a new pathway for the synthesis of Mg-TCP nanoparticles.
Inter-system code double differencing is an effective method for improving the positioning accuracy of low-cost receivers in complex environments. Due to the adoption of Frequency Division Multiple Access (FDMA), Globalnaya Navigazionnaya Sputnikovaya Sistema (GLONASS) code observations are affected by the Inter-Frequency Code Biases (IFCBs), which makes it difficult to calculate the Differential Inter-System Code Biases (DISCBs) between GLONASS and the Code Division Multiple Access (CDMA) systems directly. In this contribution, the focus is on the performance of tightly combined Global Positioning System (GPS) and GLONASS code Double Difference (DD) positioning. After analysing the relationship between IFCBs and GLONASS channel numbers, an IFCB correction model and an inter-system code differencing model between GLONASS and GPS are proposed. Results show that even if there is no obvious relationship between IFCBs and channel numbers, the long-term stable IFCB values of each satellite can be obtained by using the proposed model. In addition, the GPS + GLONASS DISCB is also stable. Therefore, compared with the intra-system model, the inter-system model can benefit from prior IFCBs and DISCBs parameters and thus can significantly improve the positioning accuracy in obstructed environments.
In this paper, instabilities in the flow over a circular cylinder of diameter
with dual splitter plates attached to its rear surface are numerically investigated using the spectral element method. The key parameters are the splitter plate length
, the attachment angle
and the Reynolds number
. The presence of the plates was found to significantly modify the flow topology, leading to substantial changes in both the primary and secondary instabilities. The results showed that the three instability modes present in the bare circular cylinder wake still exist in the wake of the present configurations and that, in general, the occurrences of modes A and B are delayed, while the onset of mode QP is earlier in the presence of the splitter plates. Furthermore, two new synchronous modes, referred to as mode A
and mode B
, are found to develop in the wake. Mode A
is similar to mode A but with a quite long critical wavelength. Mode B
shares the same spatio-temporal symmetries as mode B but has a distinct spatial structure. With the exception of the case of
, mode A
persists for all configurations investigated here and always precedes the transition through mode A. The onset of mode B
. The characteristics of all the transition modes are analysed, and their similarities and differences are discussed in detail in comparison with the existing modes. In addition, the physical mechanism responsible for the instability mode B
is proposed. The weakly nonlinear feature of mode B
, as well as that of mode A
, is assessed by employing the Landau model. Finally, selected three-dimensional simulations are performed to confirm the existence of these two new modes and to investigate the nonlinear evolution of the three-dimensional modes.
Employing atomic-scale simulations, the response of a high-angle grain boundary (GB), the soft/hard GB, against external loading was systematically investigated. Under tensile loading close to the hard orientation, strain-induced dynamic recrystallization was observed to initiate through direct soft-to-hard grain reorientation, which was triggered by stress mismatch, inhibited by surface tension from the soft-hard GB, and proceeded by interface ledges. Such grain reorientation corresponds with expansion and contraction of the hard grain along and perpendicular to the loading direction, respectively, accompanied by local atomic shuffling, providing relatively large normal strain of 8.3% with activation energy of 0.04 eV per atom. Tensile strain and residual dislocations on the hard/soft GB facilitate the initiation of dynamic recrystallization by lowering the energy barrier and the critical stress for grain reorientation, respectively.
Reynolds-averaged Navier–Stokes (RANS) simulations with turbulence closure models continue to play important roles in industrial flow simulations. However, the commonly used linear eddy-viscosity models are intrinsically unable to handle flows with non-equilibrium turbulence (e.g. flows with massive separation). Reynolds stress models, on the other hand, are plagued by their lack of robustness. Recent studies in plane channel flows found that even substituting Reynolds stresses with errors below 0.5 % from direct numerical simulation databases into RANS equations leads to velocities with large errors (up to 35 %). While such an observation may have only marginal relevance to traditional Reynolds stress models, it is disturbing for the recently emerging data-driven models that treat the Reynolds stress as an explicit source term in the RANS equations, as it suggests that the RANS equations with such models can be ill-conditioned. So far, a rigorous analysis of the condition of such models is still lacking. As such, in this work we propose a metric based on local condition number function for a priori evaluation of the conditioning of the RANS equations. We further show that the ill-conditioning cannot be explained by the global matrix condition number of the discretized RANS equations. Comprehensive numerical tests are performed on turbulent channel flows at various Reynolds numbers and additionally on two complex flows, i.e. flow over periodic hills, and flow in a square duct. Results suggest that the proposed metric can adequately explain observations in previous studies, i.e. deteriorated model conditioning with increasing Reynolds number and better conditioning of the implicit treatment of the Reynolds stress compared to the explicit treatment. This metric can play critical roles in the future development of data-driven turbulence models by enforcing the conditioning as a requirement on these models.
The aim of this meta-analysis was to provide a comprehensive overview of human immunodeficiency virus (HIV)-1 subtypes and to investigate temporal and geographical trends of the HIV-1 epidemic among men who have sex with men (MSM) in China. Chinese and English articles published between January 2007 and December 2017 were systematically searched. Pooled HIV-1 prevalence was calculated, and its stability was analysed using sensitivity analysis. Subgroups were based on study time period, sampling area and prevalence. Publication bias was measured using Funnel plot and Egger's test. A total of 68 independent studies that included HIV-1 molecular investigations were eligible for meta-analysis. Circulating recombinant form (CRF) 01_AE (57.36%, 95% confidence interval (CI) 53.76–60.92) was confirmed as the most prevalent HIV-1 subtype among MSM in China. Subgroup analysis for time period found that CRF01_AE steadily increased prior to 2012 but decreased during 2012–2016. Further whereas CRF07_BC increased over time, B/B′ decreased over time. CRF55_01B has increased in recent years, with higher pooled estimated rate in Guangdong (12.22%, 95% CI 10.34–13.17) and Fujian (8.65%, 95% CI 4.98–13.17) provinces. The distribution of HIV-1 subtypes among MSM in China has changed across different regions and periods. HIV-1 strains in MSM are becoming more complex. Long-term molecular monitoring in this population remains necessary for HIV-1 epidemic control and prevention.
Wireless power transmission (WPT) systems with moveable mechanical parts have been acquired more and more attention during the past decade. However, due to the moveable feature of transmitting coil and receiving coil, misalignment issue lead to extra power loss, decrease in efficiency, increase in control complexity, and unwanted performance degradation of the whole system. Moreover, it happened frequently than those traditional planar coils systems. The motivation for this paper is trying to have a deep understanding of quantitative relationship between ball-shaped coils mutual inductance and misalignment. Based upon that, engineers would know more detail of the coils position and mutual inductance. So, optimized design might be achieved. On considering that, this paper presents a WPT system with a ball-shaped coil for robot joints. A mutual inductance calculation based on filament method aimed at ball-shaped coil is proposed. Based on these, nine different ball-shaped coil solutions are calculated. Then, model with a minimized change rate of mutual inductance against the angular misalignment is chosen as the optimized design. Circuit analysis of the WPT system with the series–series resonant topology is conducted to choose a proper working frequency and load. Finally, an experimental platform is established. It demonstrates the feasibility of the proposed calculation method and the feasibility of the WPT prototype.
Direct numerical simulation is conducted to uncover the response of a supersonic turbulent boundary layer to streamwise concave curvature and the related physical mechanisms at a Mach number of 2.95. Streamwise variations of mean flow properties, turbulence statistics and turbulent structures are analysed. A method to define the boundary layer thickness based on the principal strain rate is proposed, which is applicable for boundary layers subjected to wall-normal pressure and velocity gradients. While the wall friction grows with the wall turning, the friction velocity decreases. A logarithmic region with constant slope exists in the concave boundary layer. However, with smaller slope, it is located lower than that of the flat boundary layer. Streamwise varying trends of the velocity and the principal strain rate within different wall-normal regions are different. The turbulence level is promoted by the concave curvature. Due to the increased turbulence generation in the outer layer, secondary bumps are noted in the profiles of streamwise and spanwise turbulence intensity. Peak positions in profiles of wall-normal turbulence intensity and Reynolds shear stress are pushed outward because of the same reason. Attributed to the Görtler instability, the streamwise extended vortices within the hairpin packets are intensified and more vortices are generated. Through accumulations of these vortices with a similar sense of rotation, large-scale streamwise roll cells are formed. Originated from the very large-scale motions and by promoting the ejection, sweep and spanwise events, the formation of large-scale streamwise roll cells is the physical cause of the alterations of the mean properties and turbulence statistics. The roll cells further give rise to the vortex generation. The large number of hairpin vortices formed in the near-wall region lead to the improved wall-normal correlation of turbulence in the concave boundary layer.
Compared with traditional stainless steels, high nitrogen stainless steels (HNSS), have been widely used due to their high strength, toughness along with excellent corrosion resistance and low cost, formed by partial replacement of Ni (austenite-forming element) by N. The evolution of the microstructure of a Cr19Mn19Mo2N0.7 stainless steel is investigated after solution treatment at 1010, 1060, 1200 or 1250°C for 30min. A complex multilayer structure has been found under a negative pressure vacuum. A white ferritic layer at the surface is formed, and a subsurface layer with full austenitic structure and a bulk microstructure comprising of austenite and ferrite are detected. With increasing solution temperature, the surface layer thickness increases. The formation of the multilayer structure is attributed to an outward diffusion, a diffusive retardation and an abnormal accumulation of nitrogen during solution treatment.
National policies target healthcare-associated infections using medical claims and National Healthcare Safety Network surveillance data. We found low concordance between the 2 data sources in rates and rankings for surgical site infection following colon surgery in 155 hospitals, underscoring the limitations in evaluating hospital quality by claims data.
Heavy metal contamination in the paddy soils of China is a serious concern because of its health risk through transfer in food chains. A field experiment was conducted in 2014–2015 to investigate the long-term effects of different biochar amendments on cadmium (Cd) and arsenic (As) immobilisation in a contaminated paddy field in southern China. Two types of biochar, a rice-straw-derived biochar (RB) and a coconut-by-product-derived biochar (CB), were amended separately to determine their impacts on rice yield and their efficacy in reducing Cd and As in rice. The two-year field experiment showed that biochar amendments significantly improved the rice yields and that CB is superior to RB, especially in the first growth season. Using a large amount of biochar amendment (22.5tha–1) significantly increased soil pH and total organic carbon, and concomitantly decreased the Cd content in rice grains over the four growth seasons, regardless of biochar type and application rate. Arsenic levels in rice were similar to the control, and results from this study suggest that there was a sustainable effect of biochar on Cd sequestration in soil and reduction of Cd accumulation in rice for at least two years. Biochar amendment in soil could be considered as a sustainable, reliable and cost-effective option to remediate heavy metal contamination in paddy fields for long periods.
This article analyzes how creditors’ simultaneous debt and equity holdings affect firm investment policies. We find that firms with dual ownership are less likely to have capital expenditure restrictions in loan contracts, and the relation varies in predicted ways with the monitoring needs of borrowers and the monitoring capacity of dual owners. A less frequent use of capital expenditure restrictions, however, does not result in borrowers’ risk-shifting. Dual ownership firms are also more likely to be granted an unconditional waiver and do not significantly reduce debt issuance or investment expenditures after a financial covenant violation. Our results highlight how dual ownership can help mitigate shareholder–creditor conflicts.
The basic principle of high-entropy alloys (HEAs) is that high mixing entropies of solid-solution phases enhance the phase stability, which renders us a new strategy on alloy design. The current research of HEAs mostly emphasizes mechanical behavior at room and higher temperatures. Relatively fewer papers are focused on low-temperature behaviors, below room temperature. However, based on the published papers, we can find that the low-temperature properties of HEAs are generally excellent. The great potential for cryogenic applications could be expected on HEAs. In this article, we summarized and discussed the mechanical behaviors and deformation mechanisms, as well as stacking-fault energies, of HEAs at low temperatures. The comparison of low-temperature properties of HEAs and conventional alloys will be provided. Future research directions will be suggested at the end.
Sterol regulatory element binding protein 1 (SREBP1) has a central regulatory effect on milk fat synthesis. Lipopolysaccharides (LPS) can induce mastitis and cause milk fat depression in cows. SREBP1 is also known to be associated with inflammatory regulation. Thus, in the current study, we hypothesized that LPS-induced milk fat depression in dairy cow mammary epithelial cells (DCMECs) operates via decreased SREBP1 expression and activity. To examine the hypothesis, DCMECs were isolated and purified from dairy cow mammary tissue and treated with LPS (10 µg/ml). LPS treatment of DCMECs suppressed lipid-metabolism-related transcription factor SREBP1 mRNA expression, nuclear translocation and protein expression, leading to reduced triglyceride content. The transcription levels of acetyl-CoA carboxylase-1 and fatty acid synthetase were significantly down-regulated in DCMECs after LPS treatment, suggesting that acetyl-CoA carboxylase-1 and fatty acid synthetase involved in de novo milk fat synthesis was regulated by SREBP1. In summary, these results suggest that LPS induces milk fat depression in dairy cow mammary epithelial cells via decreased expression of SREBP1 in a time-dependent manner.
We previously reported four heterozygous missense mutations of MYH7, KCNQ1, MYLK2, and TMEM70 in a single three-generation Chinese family with dual Long QT and hypertrophic cardiomyopathy phenotypes for the first time. However, the clinical course among the family members was various, and the potential myocardial dysfunction has not been investigated.
The objective of this study was to investigate the echocardiographic and electrocardiographic characteristics in a genetic positive Chinese family with hypertrophic cardiomyopathy and further to explore the association between myocardial dysfunction and electric activity, and the identified mutations.
A comprehensive echocardiogram – standard two-dimensional Doppler echocardiography and three-dimensional speckle tracking echocardiography – and electrocardiogram were obtained for members in this family.
As previously reported, four missense mutations – MYH7-H1717Q, KCNQ1-R190W, MYLK2-K324E, and TMEM70-I147T – were identified in this family. The MYH7-H1717Q mutation carriers had significantly increased left ventricular mass indices, elevated E/e’ ratio, deteriorated global longitudinal stain, but enhanced global circumferential and radial strain compared with those in non-mutation patients (all p<0.05). The KCNQ1-R190W carriers showed significantly prolonged QTc intervals, and the MYLK2-K324E mutation carriers showed inverted T-waves (both p<0.05). However, the TMEM70-I147T mutation carriers had similar echocardiography and electrocardiographic data as non-mutation patients.
Three of the identified four mutations had potential pathogenic effects in this family: MYH7-H1717Q was associated with increased left ventricular thickness, elevated left ventricular filling pressure, and altered myocardial deformation; KCNQ1-R190W and MYLK2-K324E mutations were correlated with electrocardiographic abnormalities reflected in long QT phenotype and inverted T-waves, respectively.
Specific adipokines, such as adiponectin and resistin, are secreted from adipose tissue and are associated with the development of obesity. Supplementation of dietary SCFA can prevent and reverse high-fat-diet (HFD)-induced obesity. However, it is not clear whether SCFA ameliorate abnormal expression of adiponectin and resistin in the obese state. The aim of this study was to investigate the effects of SCFA on adiponectin and resistin’s expressions in diet-induced obese mice, as well as the potential mechanisms associated with DNA methylation. C57BL/6J male mice were fed for 16 weeks with five types of HFD (34·9 % fat by wt., 60 % kJ) – a control HFD and four HFD with acetate (HFD-A), propionate (HFD-P), butyrate (HFD-B) and their admixture (HFD-SCFA). Meanwhile, a low-fat diet (4·3 % fat by wt., 10 % kJ) was used as the control group. The reduced mRNA levels of adiponectin and resistin in the adipose tissue of the HFD-fed mice were significantly reversed by dietary supplementation of acetate, propionate, butyrate or their admixture to the HFD. Moreover, the expressional changes of adiponectin and resistin induced by SCFA were associated with alterations in DNA methylation at their promoters, which was mediated by reducing the expressions of enzyme-catalysed DNA methyltransferase (DNMT1, 3a, 3b) and the methyl-CpG-binding domain protein 2 (MBD2) and suppressing the binding of these enzymes to the promoters of adiponectin and resistin. Our results indicate that SCFA may correct aberrant expressions of adiponectin and resistin in obesity by epigenetic regulation.
The purpose of this study was to investigate whether hesitant or preoccupied people (state-oriented) have different goal content and motives compared to initiative or disengaged people (action-oriented). People rated the degree of autonomous versus controlled feelings for extrinsic or intrinsic types of goals. Results showed that action-oriented people had a higher autonomous motive than state-oriented people for intrinsic goals, but not for extrinsic goals. Moreover, action-oriented individuals were related to a more internalised goal content (intrinsic goal) than state-oriented individuals. Implications for goal internalisation are discussed.
In 2012, the Centers for Medicare and Medicaid Services expanded a 2008 program that eliminated additional Medicare payment for mediastinitis following coronary artery bypass graft (CABG) to include Medicaid. We aimed to evaluate the impact of this Medicaid program on mediastinitis rates reported by the National Healthcare Safety Network (NHSN) compared with the rates of a condition not targeted by the program, deep-space surgical site infection (SSI) after knee replacement.
Interrupted time series with comparison group.
We included surveillance data from nonfederal acute-care hospitals participating in the NHSN and reporting CABG or knee replacement outcomes from January 2009 through June 2017. We examined the Medicaid program’s impact on NHSN-reported infection rates, adjusting for secular trends. The data analysis used generalized estimating equations with robust sandwich variance estimators.
During the study period, 196 study hospitals reported 273,984 CABGs to the NHSN, resulting in 970 mediastinitis cases (0.35%), and 294 hospitals reported 555,395 knee replacements, with 1,751 resultant deep-space SSIs (0.32%). There was no significant change in incidence of either condition during the study. Mediastinitis models showed no effect of the 2012 Medicaid program on either secular trend during the postprogram versus preprogram periods (P=.70) or an immediate program effect (P=.83). Results were similar in sensitivity analyses when adjusting for hospital characteristics, restricting to hospitals with consistent NHSN reporting or incorporating a program implementation roll-in period. Knee replacement models also showed no program effect.
The 2012 Medicaid program to eliminate additional payments for mediastinitis following CABG had no impact on reported mediastinitis rates.