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Disabilities in physical activity and functional independence affect the early rehabilitation of stroke survivors. Moreover, a good instrument for assessing activity disability allows accurate assessment of physical disability and assists in prognosis determination.
Objective:
To compare three assessment tools for physical activity in acute-phase stroke survivors.
Methods:
We conducted this prospective observational study at an affiliated hospital of a Medical University in Shanghai, China, from June 2018 to November 2019. We administered three instruments to all patients during post-stroke days 5–7, including the Modified Barthel Index (MBI), Instrumental Activities of Daily Living (IADL), and modified Rankin scale (mRs). We analyzed correlations among the aforementioned scales and the National Institutes of Health Stroke Scale (NIHSS) using Spearman’s rank-order correlations test. Univariate analyses were performed using the Mann–Whitney U test. We used a binary logistic regression model to assess the association between the NIHSS (30 days) and patient-related variables. Finally, we used receiver operating characteristic (ROC) curves to assess the predictive value of the multivariate regression models.
Results:
There was a high correlation among the three instruments; furthermore, the MBI had a higher correlation with the NIHSS (days 5–7). The NIHSS (day 30) was correlated with thrombolysis. ROC analysis revealed that the mRs-measured disability level had the highest predictive value of short-term stroke severity (30 days).
Conclusion:
The MBI was the best scale for measuring disability in physical activity, whereas the mRs showed better accuracy in short-term prediction of stroke severity.
Distinguished by a marked combination of high strength and high fracture toughness, 18Ni-300 maraging steel (MS) is widely used for intricate tool and die applications. MS is also amenable to the powder bed fusion additive manufacturing process, providing unique opportunities to make small features and incorporate cooling channels in molds. In this study, tensile test samples were fabricated using selective laser melting to investigate the effects of built height and orientations on the evolution of the microstructure and the mechanical properties of the samples. The microstructure of the as-fabricated samples consists of the primary α-martensite phase and fine cellular microstructure (~0.66–0.83 μm) with the retained austenite γ-phase aggregated at the boundaries of the cells, resulting in an enhanced mechanical performance compared with traditional counterparts under the same condition (without post-heat treatments). Random grain orientations with weak textures are revealed in all samples. The XY-built samples display better tensile performance when compared to the Z-built samples due to the fine grain sizes and the retained γ phase. The bottom of the Z-built sample exhibits a higher hardness than other parts of the sample, which could be attributed to its finer cellular structure.
In this paper, in situ Al4C3 and carbon nanotubes (CNTs) hybrid-reinforced aluminum matrix composites were prepared by a two-step ball milling (TSBM), consisting of a 24-h long-time ball milling (LTBM) and a 6-h short-time ball milling (STBM). During LTBM, most of the CNTs were seriously damaged, and many amorphous carbon atoms derived from these damaged defects would react with Al powder to form in situ Al4C3 nanorods. Subsequently, 1 wt% CNTs were added into the composite powders for STBM to uniformly disperse CNTs into the composite powders. Compared with that of the composite prepared by one-step ball milling, the comprehensive mechanical properties of the composite prepared by the TSBM are improved obviously due to the synergistic effects of in situ Al4C3 and CNTs, and the tensile strength and elongation reached 258 MPa and 19.5%, respectively. The strengthening mechanisms of TSBM composite include fine-grained strengthening, dispersion strengthening by in situ Al4C3, and load transfer from matrix to CNTs.
In this paper we study general aggregation of stochastic arrangement increasing random variables, including both the generalized linear combination and the standard aggregation as special cases. In terms of monotonicity, supermodularity, and convexity of the kernel function, we develop several sufficient conditions for the increasing convex order on the generalized aggregations. Some applications in reliability and risks are also presented.
By using high purity aluminum powders and multi-walled carbon nanotubes (MWCNTs) as raw materials, MWCNTs/Al composites were fabricated with ball milling, followed by cold pressing, vacuum sintering, and hot extrusion. It was found that when the sintering temperature was 863 K, MWCNTs/Al composite sintered for 4 h showed good comprehensive properties, and its tensile strength and elongation reached to 156 MPa and 21%, respectively. The comprehensive mechanical properties of the composites became better with raising sintering temperature when the sintering time was 4 h. When the sintering temperature raised to 923 K, the tensile strength of the composite reached to 167 MPa which is three times more than that of annealed high purity aluminum, mainly due to the higher density and better interface bonding resulted from higher sintering temperature. CNTs' pulling out were observed obviously in the fractured surfaces, and load transfer may be the main strengthening mechanism.
We study the convergence of an Ulm-like Cayley transform method for solving inverse eigenvalue problems which avoids solving approximate Jacobian equations. Under the nonsingularity assumption of the relative generalized Jacobian matrices at the solution, a convergence analysis covering both the distinct and multiple eigenvalues cases is provided and the quadratical convergence is proved. Moreover, numerical experiments are given in the last section to illustrate our results.
The Centers for Disease Control and Prevention (CDC) has developed an approach to ventilator-associated events (VAE) surveillance. Using these methods, this study was performed to investigate VAE incidences and to test whether VAEs are associated with poorer outcomes in China.
DESIGN
A 4-month, prospective multicenter surveillance study between April and July 2013.
SETTING
Our study included 15 adult intensive care units (ICUs) of 15 hospitals in China.
PATIENTS
Patients admitted to ICUs during the study period
METHODS
Patients on mechanical ventilation (MV) were monitored for VAEs: ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), and possible or probable ventilator-associated pneumonia (VAP). Patients with and without VACs were compared with regard to duration of MV, ICU length of stay (LOS), overall hospital LOS, and mortality rate.
RESULTS
During the study period, 2,356 of the 5,256 patients admitted to ICUs received MV for 8,438 ventilator days. Of these patients, 636 were on MV >2 days. VACs were identified in 94 cases (4.0%; 11.1 cases per 1,000 ventilator days), including 31 patients with IVACs and 16 with possible VAP but none with probable VAP. Compared with patients without VACs, patients with VACs had longer ICU LOS (by 6.2 days), longer duration on MV (by 7.7 days), and higher hospital mortality rate (50.0% vs 27.3%). The mortality rate attributable to VACs was 11.7%. Compared with those with VACs alone, patients with IVACs had longer duration on MV and increased ICU LOS but no higher mortality rates.
CONCLUSIONS
In China, surveillance of VACs and IVACs is able to identify MV patients with poorer outcomes. However, surveillance of possible and probable VAP can be problematic.
Infect. Control Hosp. Epidemiol. 2015;36(12):1388–1395
X-ray powder diffraction data, unit-cell parameters, and space group for beta-methyl vinyl phosphate (MAP), C29H27N2O10P, are reported [a = 17.293(4) Å, b = 6.142(6) Å, c = 14.464(8) Å, α = γ = 90°, β = 112.048(0)°, unit-cell volume V = 1424.19 Å3, Z = 2, and space group P21]. All measured lines were indexed and are consistent with the P21 space group. No detectable impurity was observed.
This article reviews current progress in research in ferroelectric switching
phenomena using in situ electron microscopy. We focus on
state-of-the-art instrumentation, analytical methods, experimental procedures,
and image contrast mechanisms. Particular emphasis is on ferroelectric domain
and domain wall structures that determine ferroelectric behaviors. The
applicability of in situ microscopy to studying a wide range of
switching phenomena, such as domain nucleation, domain wall motion, and domain
wall pinning by various types of defects, in ferroelectric thin films is
demonstrated. The underlying physics of these dynamic processes is also
discussed.