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Severe trauma can lead to amputation of limbs. There is no golden standard or comprehensive evaluation indicator for amputation. It is difficult for the primary rescue organization to focus on the most essential indicators and to determine whether to perform amputation or take proper operation.
For medical staff in first-line medical teams for disaster relief or in a common primary hospital, what indicators should they focus on to keep the patient’s limbs when they receive wounded patients with severe trauma?
A retrospective case-control study was performed based on the patients with severe trauma from January 2013 through December 2018 in the emergency department of Southwest Hospital (Shapingba District, Chongqing, China), a Level I trauma center. A total of 165 cases were divided into amputation group (n = 79) and non-amputation control group (n = 86), which had severe skin and muscle injury but without amputation. The causes of trauma and the special cases were analyzed. Binary logistic regression models were used to find the essential indicators for amputation.
Neurovascular injury with delayed treatment was the most decisive indicator leading to amputation, and time phase was also important for limb salvage. Preliminary treatment of disaster victims and patients with severe trauma should focus on neurovascular status and timely delivery.
Previous studies in schizophrenia revealed abnormalities in the cortico-cerebellar-thalamo-cortical circuit (CCTCC) pathway, suggesting the necessity for defining thalamic subdivisions in understanding alterations of brain connectivity.
To parcellate the thalamus into several subdivisions using a data-driven method, and to evaluate the role of each subdivision in the alterations of CCTCC functional connectivity in patients with schizophrenia.
There were 54 patients with schizophrenia and 42 healthy controls included in this study. First, the thalamic structural and functional connections computed, based on diffusion magnetic resonance imaging (MRI, white matter tractography) and resting-state functional MRI, were clustered to parcellate thalamus. Next, functional connectivity of each thalamus subdivision was investigated, and the alterations in thalamic functional connectivity for patients with schizophrenia were inspected.
Based on the data-driven parcellation method, six thalamic subdivisions were defined. Loss of connectivity was observed between several thalamic subdivisions (superior-anterior, ventromedial and dorsolateral part of the thalamus) and the sensorimotor system, anterior cingulate cortex and cerebellum in patients with schizophrenia. A gradual pattern of dysconnectivity was observed across the thalamic subdivisions. Additionally, the altered connectivity negatively correlated with symptom scores and duration of illness in individuals with schizophrenia.
The findings of the study revealed a wide range of thalamic functional dysconnectivity in the CCTCC pathway, increasing our understanding of the relationship between the CCTCC pathway and symptoms associated with schizophrenia, and further indicating a potential alteration pattern in the thalamic nuclei in people with schizophrenia.
Ring artifacts are undesirable and complicate the analysis and interpretation of microstructures in synchrotron X-ray microtomography. Here, we propose a new method to improve the image quality of an object by removing the ring artifacts and investigate the efficiency of this process with tomographic images of a dried Tenebrio molitor. In this method, before the tomographic reconstruction, ring artifacts were identified and located in the sinograms as line artifacts. Then, the identified line artifacts were corrected as single point noise via image processing of the original projections. Eventually, the corresponding line artifacts were removed, resulting in reduced ring artifacts in the reconstructed tomographic images. Simulations verified the efficiency of the proposed method. This method was successfully applied for the structural analysis of the insect T. molitor, showing superior performance in reducing ring artifacts in the tomographic image without noticeable loss of structural information.
This study aimed to investigate the impacts of dietary threonine on intestinal immunity and inflammation in juvenile grass carp. Six iso-nitrogenous semi-purified diets containing graded levels of threonine (3·99–21·66 g threonine/kg) were formulated and fed to fishes for 8 weeks, and then challenged with Aeromonas hydrophila for 14 d. Results showed that, compared with optimum threonine supplementation, threonine deficiency (1) decreased the ability of fish against enteritis, intestinal lysozyme activities (except in the distal intestine), acid phosphatase activities, complement 3 (C3) and C4 contents and IgM contents (except in the proximal intestine (PI)), and it down-regulated the transcript abundances of liver-expressed antimicrobial peptide (LEAP)-2A, LEAP-2B, hepcidin, IgZ, IgM and β-defensin1 (except in the PI) (P<0·05); (2) could up-regulate intestinal pro-inflammatory cytokines TNF-α, IL-1β, IL-6, IL-8 and IL-17D mRNA levels partly related to NF-κB signalling; (3) could down-regulate intestinal anti-inflammatory cytokine transforming growth factor (TGF)-β1, TGF-β2, IL-4/13A (not IL-4/13B) and IL-10 mRNA levels partly by target of rapamycin signalling. Finally, on the basis of the specific growth rate, against the enteritis morbidity and IgM contents, the optimum threonine requirements were estimated to be 14·53 g threonine/kg diet (4·48 g threonine/100 g protein), 15.05 g threonine/kg diet (4·64 g threonine/100 g protein) and 15·17 g threonine/kg diet (4·68 g threonine/100 g protein), respectively.
The Tibetan Plateau interior area (TPIA), often termed the Qangtang Plateau, is distinguished by many dome-like mountains higher than 6000 ma.s.l. These mountains provide favourable conditions for the development of ice caps and glaciers of extreme continental/subpolar type. According to historical topographic maps (1959–80) and recent Landsat images (2004–11), continuous retreat was observed and the glacierized part of this area decreased by 9.5% (0.27% a–1) with respect to the total glacier area of 8036.4 km2 in the 1970s. Glaciers in the Zhari Namco basin have experienced the highest area shrinkage, with a reduction rate of 0.72% a–1, while the smallest reduction occurred in Bangong Co (0.12% a–1) and Dogai Coying basins (0.11% a–1). A regional gradient of area loss was found, with a larger decrease in the south and a smaller decrease in the north of the plateau. Comparisons indicate glaciers have experienced smaller shrinkage in the TPIA than in surrounding regions. Glacier shrinkage in the TPIA is mainly attributed to an increase in air temperature, while precipitation, glacier size and positive difference of glaciation also played an important role.
The second Chinese glacier inventory was compiled based on 218 Landsat TM/ETM+ scenes acquired mainly during 2006–10. The widely used band ratio segmentation method was applied as the first step in delineating glacier outlines, and then intensive manual improvements were performed. The Shuttle Radar Topography Mission digital elevation model was used to derive altitudinal attributes of glaciers. The boundaries of some glaciers measured by real-time kinematic differential GPS or digitized from high-resolution images were used as references to validate the accuracy of the methods used to delineate glaciers, which resulted in positioning errors of ±10 m for manually improved clean-ice outlines and ±30 m for manually digitized outlines of debris-covered parts. The glacier area error of the compiled inventory, evaluated using these two positioning accuracies, was ±3.2%. The compiled parts of the new inventory have a total area of 43 087 km2, in which 1723 glaciers were covered by debris, with a total debris-covered area of 1494 km2. The area of uncompiled glaciers from the digitized first Chinese glacier inventory is ∼8753 km2, mainly distributed in the southeastern Tibetan Plateau, where no images of acceptable quality for glacier outline delineation can be found during 2006–10.
In this work, temperature-dependent optical properties of a series of AlN thin films with different thickness are studied by spectroscopic ellipsometry (SE) ranging from 300 to 825K. The fitted refractive index at 300K is in good agreement with the reported by others, which confirms the high accuracy of the optical model used in this work. The degradation of the absorption properties and the decrease of the bandgap become more pronounced with temperature increases above 475K. A larger change of bandgap at elevated temperature is observed for the thinner AlN epi-layer (300nm) than the thicker ones (404nm). This can be attributed to the poor surface morphologies and crystal qualities in the thinner AlN epi-layer.
The present study investigated the effects of dietary vitamin A on immune function in the proximal intestine (PI), mid intestine (MI) and distal intestine (DI) of young grass carp (Ctenopharyngodon idella). Fish were fed graded levels of dietary vitamin A for 10 weeks, and then a challenge test using an injection of Aeromonas hydrophila was conducted for 14 d. The results showed that, compared with the optimum vitamin A level, vitamin A deficiency significantly decreased fish growth performance, increased enteritis morbidity, decreased intestinal innate humoral immune response and aggravated intestinal inflammation. However, liver-expressed antimicrobial peptide 2A/B mRNA in the DI and IL-6, IL-17D, IL-10, transforming growth factor (TGF)-β1 and TGF-β2 mRNA in the PI were not affected by vitamin A levels. Meanwhile, vitamin A deficiency disturbed inflammatory cytokines in the PI, MI and DI, which might be partly linked to p38 mitogen-activated protein kinase (p38MAPK) signalling and NF-κB canonical signalling pathway (IκB kinase β (IKKβ), IKKγ, inhibitor of κBα, NF-κB p65 and c-Rel) rather than NF-κB non-canonical signalling pathway (NF-κB p52 and IKKα). However, the signalling molecules NF-κB p65 and p38MAPK did not participate in regulating cytokines in the PI. These results suggested that vitamin A deficiency decreased fish growth and impaired intestinal immune function, and that different immune responses in the PI, MI and DI were mediated partly by NF-κB canonical signalling and p38MAPK signalling pathways. On the basis of percentage of weight gain, to protect fish against enteritis morbidity and acid phosphatase activity, the optimum dietary vitamin A levels were estimated to be 0·664, 0·707 and 0·722 mg /kg, respectively.
Facilitated by recent establishment of terrestrial networks and satellite constellations of Automatic Identification System (AIS) receivers, ship trajectories are becoming increasingly available and the size of recorded trajectories is getting larger. Large sets of trajectories create problems of storing, transmitting and processing data. Using appropriate methods, an accurate representation of the original trajectories can be obtained by compressing redundant information, while maintaining the main characteristic elements. In this paper, a new scheme and the implementation of the Douglas-Peucker (DP) algorithm are presented, which can simplify AIS trajectories by extracting characteristic points. As for the simplification threshold, the solo parameter of the DP algorithm, a new AIS-based minimum ship domain evaluation method is proposed and acts as criteria for simplification threshold determination. Finally, a validation is made to examine the effectiveness of the DP simplification algorithm and the rationality of the simplification threshold. The result indicates that the DP algorithm can simplify AIS trajectories effectively; the simplification threshold is scientific and reasonable.
This study investigated the effects of glycinin on the growth, intestinal oxidative status, tight junction components, cytokines and apoptosis signalling factors of fish. The results showed that an 80 g/kg diet of glycinin exposure for 42 d caused poor growth performance and depressed intestinal growth and function of juvenile Jian carp (Cyprinus carpio var. Jian). Meanwhile, dietary glycinin exposure induced increases in lipid peroxidation and protein oxidation; it caused reductions in superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx) activities; and it increased MnSOD, CuZnSOD, GPx1b and GPx4a mRNA levels, suggesting an adaptive mechanism against stress in the intestines of fish. However, dietary glycinin exposure decreased both the activity and mRNA levels of nine isoforms of glutathione-S-transferase (GST) (α, μ, π, ρ, θ, κ, mGST1, mGST2 and mGST3), indicating toxicity to this enzyme activity and corresponding isoform gene expressions. In addition, glycinin exposure caused partial disruption of intestinal cell–cell tight junction components, disturbances of cytokines and induced apoptosis signalling in the distal intestines>mid intestines>proximal intestines of fish. Glycinin exposure also disturbed the mRNA levels of intestinal-related signalling factors Nrf2, Keap1a, Keap1b, eleven isoforms of protein kinase C and target of rapamycin/4E-BP. Interestingly, glutamine was observed to partially block those negative influences. In conclusion, this study indicates that dietary glycinin exposure causes intestinal oxidative damage and disruption of intestinal physical barriers and functions and reduces fish growth, but glutamine can reverse those negative effects in fish. This study provides some information on the mechanism of glycinin-induced negative effects.
Converging evidence has revealed both functional and structural abnormalities in adolescents with early-onset conduct disorder (EO-CD). The neurological abnormalities underlying EO-CD may be different from that of adolescent-onset conduct disorder (AO-CD) patients. However, the cortical structure in AO-CD patients remains largely unknown. The aim of the present study was to investigate the cortical alterations in AO-CD patients.
We investigated T1-weighted brain images from AO-CD patients and age-, gender- and intelligence quotient-matched controls. Cortical structures including thickness, folding and surface area were measured using the surface-based morphometric method. Furthermore, we assessed impulsivity and antisocial symptoms using the Barratt Impulsiveness Scale (BIS) and the Antisocial Process Screening Device (APSD).
Compared with the controls, we found significant cortical thinning in the paralimbic system in AO-CD patients. For the first time, we observed cortical thinning in the precuneus/posterior cingulate cortex (PCC) in AO-CD patients which has not been reported in EO-CD patients. Prominent folding abnormalities were found in the paralimbic structures and frontal cortex while diminished surface areas were shown in the precentral and inferior temporal cortex. Furthermore, cortical thickness of the paralimbic structures was found to be negatively correlated with impulsivity and antisocial behaviors measured by the BIS and APSD, respectively.
The present study indicates that AO-CD is characterized by cortical structural abnormalities in the paralimbic system, and, in particular, we highlight the potential role of deficient structures including the precuneus and PCC in the etiology of AO-CD.
We here present electronic structures and chiroptical responses of gold-based bimetallic nanoclusters protected by chiral thiolate ligand, glutathione (GSH), and compare them with those of monometallic counterparts. The nanoclusters examined are AuPd and AuAg bimetallic systems. The effect of Pd or Ag doping on the chiroptical responses of optically active Au nanoclusters as well as the importance of the bimetallic core configurations are discussed. Briefly, we find that GS-protected AuPd or AuAg nanoclusters exhibit quite different Cotton effects from those of the monometallic nanoclusters in metal-based electronic transition regions. In the AuPd system, all bimetallic nanoclusters exhibit featureless absorption profiles, but their circular dichroism (CD) signals are structured, offering a greater advantage in detecting a foreign atom doping in the nanocluster system. In the AuAg system, the nanocluster compounds exhibit relatively weaker CD responses than those of the corresponding Au compounds. This CD decrease can be explained in terms of the increased geometrical isomers that are formed by statistical distribution of Ag heteroatoms in the nanocluster, since an increased number of possible configurations gives an average in the CD response with positive and negative bands of different optical isomers.
The method of fundamentalsolutions (MFS)is known as aneffective boundary meshless method. However, the formulation of the MFS results in a dense and extremely ill-conditioned matrix. In this paper we investigate the MFS for solving large-scale problems for the nonhomogeneous modified Helmholtz equation. The key idea is to exploit the exponential decay of the fundamental solution of the modified Helmholtz equation, and consider a sparse or diagonal matrix instead of the original dense matrix. Hence, the homogeneous solution can be obtained efficiently and accurately. A standard two-step solution process which consists of evaluating the particular solution and the homogeneous solution is applied. Polyharmonic spline radial basis functions are employed to evaluate the particular solution. Five numerical examples in irregular domains and a large number of boundary collocation points are presented to show the simplicity and effectiveness of our approach for solving large-scale problems.
In recent years wearable devices have attracted significant attention. Flexibility and stretchability are required for comfortable wear of such devices. In this paper, we report flexible and stretchable touch sensors with two different patterns (interdigitated and diamond-shaped capacitors). The touch sensors were made of screen-printed silver nanowire electrodes embedded in polydimethylsiloxane. For each pattern, the simulation-based design was conducted to choose optimal dimensions for the highest touch sensitivity. The sensor performances were characterized as-fabricated and under deformation (e.g., bending and stretching). While the interdigitated touch sensors were easier to fabricate, the diamond-shaped ones showed higher touch sensitivity under as-fabricated, stretching or even bending conditions. For both types of sensors, the touch sensitivity remained nearly constant under stretching up to 15%, but varied under bending. They also showed robust performances under cyclic loading and against oxidation.
To investigate the effect of pre-emptive parecoxib sodium, given in addition to routine analgesic treatment, on post-operative cognitive function in elderly patients.
Seventy elderly patients were included, who were 65–82 years of age, 48–75 kg of weight, and ASA grade I-II. Preoperative mini mental state examination (MMSE) score was ≥21 points. Patients were randomly divided into two groups: control group (group C) and parecoxib sodium group (group P). Before induction of general anesthesia, 40 mg of parecoxib sodium was injected intravenously in group P and the same volume of saline was injected in group C. Patient-controlled intravenous analgesia (PCIA) containing fentanyl and tramadol was used for post-operative pain control. A 3 ml blood sample was obtained from the peripheral vein one day before surgery, 1, 4, 24, and 72 h after surgery, and plasma cortisol, IL-6 and S100β concentrations were measured. Cognitive function was evaluated by measuring the MMSE score and a neurological test battery within 72 h after surgery. The occurrence of post-operative cognitive dysfunction (POCD), the dosage of fentanyl and tramadol used in PCIA, and the rate of additional fentanyl administration were recorded.
Compared to group C, post-operative plasma cortisol concentration decreased, the amount of fentanyl and tramadol used in PCIA was reduced, the rate of additional fentanyl administration decreased, and the rate of POCD was reduced in group P (P < 0.05).
Pre-emptive analgesia with 40 mg of parecoxib sodium can reduce the incidence of POCD in elderly patients.
To obtain better performance on unstructured environments, such as in agriculture, forestry, and high-altitude operations, more and more researchers and engineers incline to study classes of biologically inspired robots. Since the natural inchworm can move well in various types of terrain, inchworm-like robots can exhibit excellent mobility. This paper describes a novel inchworm-type robot with simple structure developed for the application for climbing on trees or poles with a certain range of diameters. Modularization is adopted in the robot configuration. The robot is a serial mechanism connected by four joint modules and two grippers located at the front and rear end, respectively. Each joint is driven by servos, and each gripper is controlled by a linear motor. The simplified mechanism model is established, and then is used for its kinematic analysis based on screw theory. The dynamics of the robot are also analyzed by using Lagrange equations. The simulation of the robot gait imitating the locomotion of real inchworm is finally presented.
This paper discusses a planar 2-DOF (degrees of freedom) parallel kinematic machine with actuation redundancy. Its inverse dynamic model is constructed by utilizing the Newton–Euler method based on the kinematic analysis. However, the dynamic model cannot be solved directly because the number of equations is less than the number of unknowns, which is due to the redundant force. In order to solve this problem, the relationship between the deformations of the links and the position errors of the moving platform are further explored. Then a novel method, which aims at minimizing the position errors of the machine, is proposed to optimize the redundant force. It also enables to solve the dynamic model. Finally, the dynamic performance analyses of this machine and its non-redundant counterpart are provided by numerical examples. Besides, another optimization method proposed for minimizing the constraint forces is also applied for comparison. The results show the effectiveness of the novel methods in improving the position precision of the machine.
We identify large discontinuous changes, known as jumps, in daily stock prices and explore the role of jumps in cross-sectional stock return predictability. Our results show that small and illiquid stocks have higher jump returns to the extent that cross-sectional differences in jumps fully account for the size and illiquidity effects. Based on value-weighted portfolios, jumps also account for the value premium. On the other hand, jumps are not the cause of momentum or net share issue effects. The findings of our study shed new light on stock return dynamics and present challenges to conventional explanations of stock return predictability.
The discovery of c. 1.77 Ga A-type granite in the Tarim Craton (TC) provides the first evidence that supports an extensional event related to fragmentation of the Columbia supercontinent in the late Palaeoproterozoic. We present laser-ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) zircon U–Pb ages, Lu–Hf isotopic data and the whole-rock geochemical and Nd isotopic data of A-type granites in the Dunhuang area in the SE Tarim Craton. Zircon U–Pb dating for three granite samples indicate that they were emplaced at c. 1.77 Ga. Zircons from these granites have εHf(t) values ranging from –5.9 to 8.7, corresponding to two-stage model ages of 1.9–2.7 Ga. These granites exhibit the following petrological geochemical characteristics that are typical of A-type granite: (a) high content of SiO2 and alkalis (i.e. high K2O + Na2O with K2O/Na2O > 1), enrichment of high-field-strength elements (HFSE) and rare Earth elements (REE) (except for Eu) and extreme depletion of Ba, Sr, P, Ti and Eu; (b) 10000×Ga/Al ratios in the Dunhuang granites of 3.5–4.4, with an average value of 3.79 which is similar to the global average of 3.75 for A-type granites; (c) the presence of characteristic minerals such as amphibole, sphene and perthite; and (d) zirconium saturation temperature results indicate that the Dunhuang granites have high initial magmatic temperatures in the range 887–950°C, similar to those of typical of A-type granites. Whole-rock εNd(t) values range from –2.5 to –6.2 and TDM model ages from 2.3 to 2.7 Ga. Nd–Hf isotopic and whole-rock geochemical data indicate that these granites were most likely derived from the late Archean crustal source in a post-collisional/post-orogenic extensional tectonic environment. The late Palaeoproterozoic A-type granites in the TC could be correlated with those of the North China Craton (NCC), India and the Canadian Shield, thus demonstrating extensional tectonics and break-up of the Columbia supercontinent.