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The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Evidence has suggested that honey intake has a beneficial impact on glycaemic control in patients with type 2 diabetes. Whether these findings apply to adults with prediabetes is yet unclear. The aim of the present study was to examine whether honey intake is associated with a lower prevalence of prediabetes. A cross-sectional study was performed in 18 281 participants (mean age 39·6 (sd 11·1) years; men, 51·5 %). Dietary intake was assessed through a validated 100-item FFQ. Prediabetes was defined according to the American Diabetes Association criteria: impaired fasting glucose, impaired glucose tolerance or raised glycosylated Hb. Multivariable logistic regression models were used to estimate the association between honey consumption and prediabetes. As compared with those who almost never consumed honey, the multivariable OR of prediabetes were 0·94 (95 % CI 0·86, 1·02) for ≤3 times/week, 0·77 (95 % CI 0·63, 0·94) for 4–6 times/week and 0·85 (95 % CI 0·73, 0·99) for ≥1 time/d (Pfor trend < 0·01). These associations did not differ substantially in sensitivity analysis. Higher honey consumption was associated with a decreased prevalence of prediabetes. More large prospective cohort studies are needed to investigate this association.
This article explores the emerging use of the proportionality concept in the contract law of the Anglo-common law world, first to understand its internal logic, and secondly, to situate its invocation within private law theory. What are judges doing when they appeal to “proportionality”?, and what does this say about the ideology of adjudication? I draw insights from the use of proportionality in other domains, in particular public law, to uncover its internal rationality as a means-ends rationality review coupled with a process of balancing competing considerations, which I illustrate with reference to the illegality, penalty, and cost of cure doctrines. I argue that proportionality reflects a method of pragmatic justification, expressing an aspiration towards a structured and transparent mode of argumentation that is anti-formal and anti-ideological, focusing from the bottom-up on contextual considerations, and occupying a distinct space against existing theories in private law driven, for instance, by “top-down”? rights-based ideologies or critical and communitarian perspectives.
The aim of this study is to characterize the injury profiles and outcomes of victims of a tornado in Jiangsu Province, China.
This study retrospectively investigated the clinical records of 144 patients treated at a teaching hospital due to a tornado. Each patient’s demographic data, diagnosis, injury types, causes of injury, infection status, and outcomes were all reviewed.
Of the 144 patients, 64 (44.4%) were male, and 80 (55.6%) were female. The patients’ ages ranged from 2 months to 94 years; 91 (63.19%) were admitted within the first 12 h after the disaster. The most frequently injured sites were the body surfaces (24.48%), followed by the limbs and pelvis (21.79%) and chest (20.3%). Soft-tissue injuries and fractures were the most frequent injuries. Traumatic brain injuries were the main causes of death. Tornado-related injuries were primarily caused by flying/falling bricks, wood, and glass. Twenty-three (15.9%) patients suffered from infections, which consisted mainly of skin/soft tissue infections and pneumonia.
Destructive tornadoes often cause heavy casualties with little warning. Medical aid agencies must be prepared to accommodate the massive numbers of injured patients after a catastrophe. Proper triage and prompt treatment of injured victims may decrease mortality. (Disaster Med Public Health Preparedness. 2019;xx:xxx-xxx).
While the concept of the ‘relational contract’ has been invoked in the courts with greater visibility and regularity in recent years, the doctrinal import of relational contract theory remains for the most part unclear to contract and commercial lawyers. This paper offers a broad framework for understanding the different ways through which relational theory might have an impact on contract doctrine going forward, and evaluates the promises and perils of doing so.
In order to improve the dispersibility of halloysite nanotubes (HNTs) in polytetrafluoroethylene (PTFE), the modification of HNT surfaces was studied with three types of modifiers (polymethyl methacrylate [PMMA], sodium dodecyl sulfate [SDS] and carboxylic acid). The modified HNTs were characterized by Fourier-transform infrared (FTIR) spectrometry, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and contact angle measurements. The HNTs were used to reinforce the mechanical properties of PTFE. The mechanical results indicated that the tensile strength of the modified HNT-filled PTFE nanocomposites (F-HNT/PTFE) improved to an acceptable degree and Young's modulus increased significantly. The tribological results showed that the wear rate of F-HNT/PTFE decreased by 21–82 and 9–40 times compared to pure PTFE and the pristine F-HNT/PTFE, respectively.
The detailed kinetics study of erythrocyte deformability is useful for the early diagnosis of blood diseases and for monitoring the blood rheology. Present solutions for a three-dimensional (3D) reconstruction of erythrocytes has a limited potential. This study aimed to use erythrocyte transmission electron images (ETIs) to evaluate the morphological relationship between adjacent ETIs and generate erythrocytes 3D model. First, ultrathin serial sections of skeletal muscle tissue were obtained using an ultramicrotome. Further, the set of ETIs in a capillary were captured by transmission electron microscopy. The images were aligned by translations and rotations using custom software to optimize the morphological relationship between adjacent ETIs. These coordinate transformations exploit the unique principal axis of inertia of each image to define the body coordinate system and hence provide the means to accurately reconnect the adjacent ETIs. The sum of the distances between the corresponding points on the boundary of adjacent ETIs was minimized and, further, was optimized by using physiological relationship between the adjacent ETIs. The analysis allowed to define precise virtual relationship between the adjacent erythrocytes. Finally, extracted erythrocytes’ cross-section images allowed to generate 3D model of the erythrocytes.
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.
Halloysite nanotubes (HNTs)/polytetrafluoroethylene (PTFE) nanocomposites were prepared by the cold compression moulding method. The effects of addition of HNTs (HNTs ‘filling’) on the performances of PTFE were explored using X-ray diffraction, Fourier Transform infrared spectroscopy, scanning electron microscopy and thermogravimetric analysis which showed that HNTs were well dispersed in the PTFE matrix by means of physical mixing at lower contents of 2–5 wt.%; the introduction of HNTs into PTFE could improve the heat stability of the PTFE. Furthermore, the mechanical and tribological performances of the nanocomposites were measured to examine the filling effect. The tensile strength of the HNTs/PTFE nanocomposites at 2–5 wt.% HNTs content increased by ~3.5% while their wear rates decreased by 55–90% relative to pure PTFE, clear proof of the filling effect of HNTs with a high aspect ratio.
Previous studies have supported the theory that there is a positive association between ferritin and carotid atherosclerosis in Western people. Diet plays an important role in determining serum ferritin concentration. Asian dietary patterns are different from Western dietary patterns, implying that there may be a difference in the association of ferritin with carotid atherosclerosis between Asian and Western people. However, few studies focus on the association between ferritin and carotid atherosclerosis among Asians. The aim of this study was to investigate how serum ferritin levels are associated with carotid atherosclerosis in an Asian adult population. A cross-sectional assessment was performed in 8302 adults in Tianjin, China. Carotid intima-media thickness (IMT) and plaques were assessed using ultrasonography, and serum ferritin was measured using the protein chip-chemiluminescence method. Multiple logistic regression analysis was used to examine the association between quartiles of serum ferritin concentration and carotid atherosclerosis. In the present study, the overall prevalence of IMT and carotid plaques in participants is 29·2 and 22·7 %, respectively. In women, after adjustments for potentially confounding factors, the OR of IMT and carotid plaques by increasing serum ferritin quartiles were 1·00, 1·39 (95 % CI 0·98–1·99), 1·39 (95 % CI 0·99–1·97), 1·81 (95 % CI 1·30–2·55) (Pfor trend<0·001) and 1·00, 1·24 (95 % CI 0·89–1·73), 1·18 (95 % CI 0·85–1·65), 1·59 (95 % CI 1·15–2·20) (Pfor trend<0·01), respectively. However, no association was found between serum ferritin and carotid atherosclerosis in men. The study demonstrated that increased serum ferritin levels are independently associated with IMT and carotid plaques in Asian women but not in Asian men.
In this paper, the recent studies of laboratory astrophysics with strong magnetic fields in China have been reviewed. On the Shenguang-II laser facility of the National Laboratory on High-Power Lasers and Physics, a laser-driven strong magnetic field up to 200 T has been achieved. The experiment was performed to model the interaction of solar wind with dayside magnetosphere. Also the low beta plasma magnetic reconnection (MR) has been studied. Theoretically, the model has been developed to deal with the atomic structures and processes in strong magnetic field. Also the study of shock wave generation in the magnetized counter-streaming plasmas is introduced.
Intracytoplasmic sperm injection (ICSI) is a technique commonly used in clinical and research settings. In mouse oocytes, conventional ICSI has a poor survival rate caused by a high level of lysis. Cytochalasin B (CB) is a toxic microfilament-inhibiting agent that is known to relax the cytoskeleton and enhance the flexibility of oocytes. CB has been used widely in nuclear transfer experiments to improve the success rate of the micromanipulation, however information describing the use of CB in ICSI is limited. Here, we demonstrated that the addition of 5 μg/ml CB to the manipulation medium of ICSI procedure significantly improved the survival rate of the ICSI embryos (80.74% vs. 89.50%, p < 0.05), and that there was no harm for the in vitro or in vivo development. The birth rates and birth weights were not significantly different between the CB-treated and -untreated groups. Interestingly, the microfilaments of the ICSI embryos were almost undetectable immediately after CB treatment; however, they gradually re-appeared and had fully recovered to the normal level 2 h later. Moreover, CB did not disturb spindle rotation, second polar body formation or pronuclei migration, and had no effect on the microtubules. We thus conclude that ICSI manipulation in CB-containing medium results in significantly improved survival rate of mouse ICSI embryos, and that short-term treatment with CB during ICSI manipulation does not have adverse effects on the development of ICSI embryos.
Habitat change has major effects on wildlife and it is important to understand how wild animals respond to changing habitats. Dashanbao National Nature Reserve, in north-east Yunnan, China, which was established for the protection of the black-necked crane Grus nigricollis, other wintering waterbirds and the upland wetland ecosystem, recently began converting farmland to grassland and woodland. With respect to this policy we studied habitat selection by black-necked cranes in the Reserve from November 2006 to April 2007. Farmland, grassland, marsh and water were used by black-necked cranes but no cranes occurred in man-made woodland. Black-necked cranes showed the least preference for grassland and no significant differences were detected in the species’ preference for the other three habitats. However, black-necked cranes exhibited different behavioural responses to the four habitats: farmland and grassland were their main foraging sites. Principle component analysis verified that a foraging-related component was the first factor determining habitat selection. Cranes used habitat close to their roosts with short grass, shallow water and less disturbance by human activity. Our results indicate that the policy of converting farmland and grassland to woodland is not beneficial for conservation of the crane. For effective conservation of the black-necked crane scientific habitat management that takes into account habitat selection by the species is required, with the retention of some farmland and restoration of wetlands.
This paper presents a new method to simulate the
properties of Frequency Selective Surface (FSS) composed of planar H-shaped
fractals structure exhibiting multiple band gaps of electromagnetic waves.
The FSS sample can be easily fabricated as that of the Printed Circuit Board
(PCB). The electromagnetic characteristics of this H-shaped fractal
structure were studied mainly by numerical simulation based on Finite
Integration Technique (FIT). The simulation results present a direct image of
surface currents when certain frequency electromagnetic waves incident on
the surface of the sample, which is in a considerably good agreement with
the experimental results. Based on the comparison of simulated and
experimental result it is suggested that the planar H-shaped fractals
structure has quasi-periodic multiple band gaps and the size can be
significantly smaller than the relevant electromagnetic band gap wavelength.
The application of selective resonant tunneling model is extended
from d + t fusion to other light nucleus fusion reactions, such as d +
d fusion and d + 3He. In contrast to traditional formulas,
the new formula for the cross-section needs only a few parameters to
fit the experimental data in the energy range of interest. The features
of the astrophysical S-function are derived in terms of this model. The
physics of resonant tunneling is discussed.
During an investigation of mycoparasitic fungi on sclerotia of Sclerotinia sclerotiorum in China, a new fungal species was consistently encountered and isolated from natural soils taken from soybean fields of Shandong and Jiangsu Provinces. The fungus is featured by its sphaeroid conidia with 1–2 transverse septa, but mostly (>65%) with only one septum at the base. It resembles Monacrosporium indicum, M. sphaeroides and M. sinense, but can be distinguished from the first two species by lack of basal hila and large vacuoles on its conidia, respectively, and from M. sinense by its typically two-celled and broadly turbinate to napiform conidia. Colonization frequencies on S. sclerotiorum sclerotia by the new species were 10% and 33.3% in the two field soils, respectively, when the sclerotia were introduced into soils and coincubated at 22–24 °C for 4 wk. Reinoculation tests by placing surface-sterilized sclerotia onto the tested isolate colony for 2 wk and then surface-sterilized again resulted in 23.3% sclerotia colonized. Microscopic observations indicated that the fungus coiled around hyphae of Rhizoctonia solani and grew along and appressed to hyphae of Fusarium solani f.sp. pisi, S. sclerotiorum and Phytophthora cactorum when dual-cultured in slides. Tests on agar plates demonstrated that the fungus formed adhesive networks and was an active predator of Panagrellus redivivus. This study indicated the diverse mechanisms for the fungus to survive in soil. For expression of its mycoparasitic and nematode-trapping capacities, the fungus is named as Monacrosporium janus.
Muscular ventricular septal defects were diagnosed by echocardiography in 97 neonates within 7 days of birth. In 82 of the neonates (84.5%), the defect was solitary, while 15 had multiple defects. The solitary defects was located at mid-septal, apical, anterior and inlet locations in 42 (51.2%), 21 (25.6%), 14 (17.1%) and 5 (6.1%) neonates, respectively. Multiple defects occurred in the apical, anterior and mid-septal areas. The diameter of the solitary defects ranged from 1 to 6 mm (2.3 ± 0.8 mm), while the multiple lesions were 1 to 4 mm in diameter (2.1 2.3 ± 0.8 mm 0.8 mm) in 28 instances in which they could measured. It proved possible to follow 79 of the patients for period of 10 to 13 months. The defects closed spontaneously in 56 (84.8%) of 66 patients with a single defect, and in 7 (53.8%) of 13 of those with multiple defects (P<0.05). For the solitary defects, the position and size were factors determining the likelihood and speed of closure. Defects located at the apical septum, or defects larger than 4 mm in diameter, closed slowly and at a later stage. Echocardiography is an useful technique in establishing of natural history of muscular ventricular septal defects encountered in neonates.
Results are presented on the influence of the size of diamond powders and the laser power on the main Raman line. These results show conclusively that there is a consistent and systematic, reversible, downshift with both decrease of powder size, and increase of power. The shift can be explained by local heating of about 500 °C in the extreme case. Its significance applies to interpretation of the alleged “downshifting” of the 1332 cm−1 line in all diamond research. In the future, the grain size, the thermal contact, and the beam power must be carefully monitored in reporting and interpreting any frequency shifts.
The tolerance of the oocyte plasma membrane (oolemma) to electrical pulses (TEP) was investigated for oocytes, zygotes, and embryos at the early and late 2-cell stage. The oocyte survival rate after two electrical pulses (1.4KV/cm for 640μs each) was used as an indicator of the TEP of the oolemma. Survival rate of mid-pronuclear zygotes (94.3%±2.3%) was significantly (p < 0.05) higher than that of recently ovulated (2.1%±1.9%) and in vivo aged (25.1%±2.6%) oocytes; survival rate of in vivo aged oocytes was also significantly higher than that of recently ovulated oocytes. Soon after fertilisation, the survival rate of the oocytes markedly increased, up to 94% at the mid-pronuclear stage. Survival ratedropped thereafter. These results suggest that the characteristics of the oocyte plasma membrane (oolemma) change after fertilisation.
This study reviews the results of the surgical management of 154 cases of ruptured aneurysm of the sinus of Valsalva. Of the patients0 73% were male, with an average age of 28 years. An associated ventricular septal defect was found in 40% and 23% had aortic valvar regurgitation. The aneurysms originated from the right coronary sinus in 79% and from the non-coronary sinus in the remainders. The aneurysms ruptured into the right ventricle in 73%, into the right atrium in 27% and into the left ventricle in less than 1%. Operative mortality was 4.5%. Long-term follow-up was achieved in 80% of patients, with a mean duration of 5.7 years and a range from two months to 29 years. Preoperative aortic regurgitation and preoperative functional class (NYHA III or IV) were both predictive of a worse long-term outcome. The optimal surgical approach was closure of the distal end of the fistula by direct suture together with reinforcement of the aortic sinus with a Dacron patch.