Background: Healthcare-associated central line associated bloodstream infection (HA-CLABSI) surveillance is important for monitoring healthcare-associated infections (HAIs) and evaluating effectiveness of infection prevention (IP) measures. However, implementing it is a laborious and time-consuming approach. Exclusive focus on central lines neglects HAI risk due to peripheral vascular catheters. This study aimed to assess whether HA-CLABSI incidence could be inferred from HA-bloodstream infection (BSI) trends and explore shift to HA-BSI surveillance. Methods: The study was performed in a Singaporean tertiary care hospital. Electronic medical records review was performed to determine whether positive blood cultures met Centers for Disease Control/National Health Safety Network (CDC/NHSN) definitions for HA-CLABSI and HA-BSI. Incident episodes of HA-BSI were included (excluding positive cultures repeated within 14 days). Incident organisms were explored to identify common causative pathogens (excluding same organisms isolated from cultures repeated within 14 days). CLABSI and BSI occurring ≥72hrs after admission were considered healthcare-associated. Patients under oncology or hematology service were considered immunocompromised. Incidence rates (IR) per 10,000 patient-days, patient characteristics and causative pathogens were compared between both indicators. Results: From January 2022 to October 2023, mean IR for HA-CLABSI was 0.63 (n=68) and for HA-BSI was 10.06 (n=1094). Median age of patients with HA-CLABSI was 66 years and HA-BSI was 68 years. HA-CLABSI and HA-BSI were more common in males (60.86% & 58.68%). Median duration between admission to HA-CLABSI was 20 days and to HA-BSI was 12 days. Median duration between central line insertion to HA-CLABSI was 16 days. Of 1094, 631 (57.7%) patients had vascular catheter(s) (i.e., IV cannula, port-a-cath, peripherally-inserted central catheter or central line) inserted at time of HA-BSI diagnosis, of whom 46 (7.3%) patients had CLABSI ±2days from positive blood culture. There was no significant correlation between monthly aggregate data from these indicators (Spearman’s correlation coefficient= 0.36, p-value=0.1). Predominant organisms causing HA-CLABSI and HA-BSI were gram negative bacteria (GNB, 40% & 57.21%), gram positive bacteria (24.71% & 22.23%), and fungi. Common GNB in CLABSI patients were Pseudomonas spp. and Stenotrophomonas maltophilia (8.24%), followed by Serratia marcescens and Klebsiella pneumoniae (5.88%). The frequent GNB in HA-BSI patients were Escherichia coli (15.4%), Klebsiella pneumonia (12.68%), and Pseudomonas spp. (6.69%). Common multi-drug resistant organisms were vancomycin-resistant Enterococcus faecium (10.59% & 3.69%) and methicillin-resistant Staphylococcus aureus (10.59% & 3.07%). Conclusion: HA-BSI did not correlate with HA-CLABSI. HA-BSI reflects heterogenous population outcomes. For utilization as surveillance indicator, further assessment on exclusion criteria is required to improve specificity.

Syphilis remains a serious public health problem in mainland China that requires attention, modelling to describe and predict its prevalence patterns can help the government to develop more scientific interventions. The seasonal autoregressive integrated moving average (SARIMA) model, long short-term memory network (LSTM) model, hybrid SARIMA-LSTM model, and hybrid SARIMA-nonlinear auto-regressive models with exogenous inputs (SARIMA-NARX) model were used to simulate the time series data of the syphilis incidence from January 2004 to November 2023 respectively. Compared to the SARIMA, LSTM, and SARIMA-LSTM models, the median absolute deviation (MAD) value of the SARIMA-NARX model decreases by 352.69%, 4.98%, and 3.73%, respectively. The mean absolute percentage error (MAPE) value decreases by 73.7%, 23.46%, and 13.06%, respectively. The root mean square error (RMSE) value decreases by 68.02%, 26.68%, and 23.78%, respectively. The mean absolute error (MAE) value decreases by 70.90%, 23.00%, and 21.80%, respectively. The hybrid SARIMA-NARX and SARIMA-LSTM methods predict syphilis cases more accurately than the basic SARIMA and LSTM methods, so that can be used for governments to develop long-term syphilis prevention and control programs. In addition, the predicted cases still maintain a fairly high level of incidence, so there is an urgent need to develop more comprehensive prevention strategies.

Motivated by practical applications of inspection and maintenance, we have developed a wall-climbing robot with passive compliant mechanisms that can autonomously adapt to curved surfaces. At first, this paper presents two failure modes of the traditional wall-climbing robot on the variable curvature wall surface and further introduces the designed passive compliant wall-climbing robot in detail. Then, the motion mechanism of the passive compliant wall-climbing robot on the curved surface is analyzed from stable adsorption conditions, parameter design process, and force analysis. At last, a series of experiments have been carried out on load capability and curved surface adaptability based on a developed principle prototype. The experimental results indicated that the wall-climbing robot with passive compliant mechanisms can effectively promote both adsorption stability and adaptability to variable curvatures.

Let G be a finite group and $\mathrm {Irr}(G)$ the set of all irreducible complex characters of G. Define the codegree of $\chi \in \mathrm {Irr}(G)$ as $\mathrm {cod}(\chi ):={|G:\mathrm {ker}(\chi ) |}/{\chi (1)}$ and let $\mathrm {cod}(G):=\{\mathrm {cod}(\chi ) \mid \chi \in \mathrm {Irr}(G)\}$ be the codegree set of G. Let $\mathrm {A}_n$ be an alternating group of degree $n \ge 5$. We show that $\mathrm {A}_n$ is determined up to isomorphism by $\operatorname {cod}(\mathrm {A}_n)$.

In the absence of the necessary valley topography, karst depressions are sometimes used to construct conventional impoundments in order to contain tailings. Leakage is a primary concern for such impoundments. The purpose of the current study was to determine the characteristics and barrier performance of laterite mantling karst depressions, using, as an example, the Wujiwatang (WJWT) tailings impoundment, located in the Gejiu mining area, southwestern China. The geotechnical-hydrogeological properties, geochemistry, mineral compositions, and particle shapes of the laterite were investigated by geotechnical techniques, chemical analysis, X-ray diffraction (XRD), and scanning electron microscopy (SEM). The results showed that the laterite contained poorly sorted particles that covered a wide spectrum of grain sizes (<5 mm to <50 nm), and was unexpectedly categorized as silty clay or silt with a high liquid limit. The continuous gradation and small D90 value helped the laterite achieve saturated hydraulic conductivities in the range of <10–6 cm/s required for impoundment liners. The laterite beneath the tailings impoundment was finer-grained and had a lower permeability than that of the laterite on the depression walls within the same depression. Geochemically and mineralogically, the laterite was classified as true laterite and its major mineralogical constituents were gibbsite and goethite with chlorite occurring in trace amounts. The laterite was dominated by subspherolitic–spherolitic cohesionless grains (concretions) made up of Al, Fe, Ti, and Mn oxides and hydroxides. The laterite did not have plasticity indices in the clay range. Fortunately, slopewash prior to tailings containment selectively transported the finer oxide concretions to the depression floor, creating a natural low-permeability barrier for the WJWT tailings impoundment. This is undoubtedly important for the planning and design of future karst depression-type tailings impoundments around the world.

In order to establish a compact all-optical Thomson scattering source, experimental studies were conducted on the 45 TW Ti: sapphire laser facility. By including a steel wafer, mixed gas, and plasma mirror into a double-exit jet, several mechanisms, such as shock-assisted ionization injection, ionization injection, and driving laser reflection, were integrated into one source. So, the source of complexity was remarkably reduced. Electron bunches with central energy fluctuating from 90 to 160 MeV can be produced. Plasma mirrors were used to reflect the driving laser. The scattering of the reflected laser on the electron bunches led to the generation of X-ray photons. Through comparing the X-ray spots under different experimental conditions, it is confirmed that the X-ray photons are generated by Thomson scattering. For further application, the energy spectra and source size of the Thomson scattering source were measured. The unfolded spectrum contains a large amount of low-energy photons besides a peak near 67 keV. Through importing the electron energy spectrum into the Monte Carlo simulation code, the different contributions of the photons with small and large emitting angles can be used to explain the origin of the unfolded spectrum. The maximum photon energy extended to about 500 keV. The total photon production was 107/pulse. The FWHM source size was about 12 μm.

Energy loss of protons with 90 and 100 keV energies penetrating through a hydrogen plasma target has been measured, where the electron density of the plasma is about 1016 cm−3 and the electron temperature is about 1-2 eV. It is found that the energy loss of protons in the plasma is obviously larger than that in cold gas and the experimental results based on the Bethe model calculations can be demonstrated by the variation of effective charge of protons in the hydrogen plasma. The effective charge remains 1 for 100 keV protons, while the value for 90 keV protons decreases to be about 0.92. Moreover, two empirical formulae are employed to extract the effective charge.

Schistosomiasis, a parasite infectious disease caused by Schistosoma japonicum, often leads to egg granuloma and fibrosis due to the inflammatory reaction triggered by egg antigens released in the host liver. This study focuses on the role of the egg antigens CP1412 protein of S. japonicum (SjCP1412) with RNase activity in promoting liver fibrosis. In this study, the recombinant egg ribonuclease SjCP1412, which had RNase activity, was successfully prepared. By analysing the serum of the population, it has been proven that the anti-SjCP1412 IgG in the serum of patients with advanced schistosomiasis was moderately correlated with liver fibrosis, and SjCP1412 may be an important antigen associated with liver fibrosis in schistosomiasis. In vitro, the rSjCP1412 protein induced the human liver cancer cell line Hep G2 and liver sinusoidal endothelial cells apoptosis and necrosis and the release of proinflammatory damage-associated molecular patterns (DAMPs). In mice infected with schistosomes, rSjCP1412 immunization or antibody neutralization of SjCP1412 activity significantly reduced cell apoptosis and necroptosis in liver tissue, thereby reducing inflammation and liver fibrosis. In summary, the SjCP1412 protein plays a crucial role in promoting liver fibrosis during schistosomiasis through mediating the liver cells apoptosis and necroptosis to release DAMPs inducing an inflammatory reaction. Blocking SjCP1412 activity could inhibit its proapoptotic and necrotic effects and alleviate hepatic fibrosis. These findings suggest that SjCP1412 may be served as a promising drug target for managing liver fibrosis in schistosomiasis japonica.

The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.

In Beijing, the capital of China, routine measles mass vaccination has been in place for decades with high coverage; and since the 2000s, catch-up vaccination programmes have been implemented for migrant workers coming to the city. However, measles epidemics in Beijing persisted. Here, we explored the contributing factors of persistent measles transmission in Beijing using an epidemic model in conjunction with a particle filter. Model inputs included data on birth, death, migration, and vaccination. We formulated a series of hypotheses covering the impact of migrant influx, early waning of maternal immunity, and increased mixing among infants; we compared the plausibility of the hypotheses based on model fit to age-grouped, weekly measles incidence data from January 2005 to December 2014, and out-of-fit prediction during 2015–2019. Our best models showed close agreement with the data, and the out-of-fit prediction generally captured the trend of measles incidence from 2015 to 2019. We found that large influx of migrants with considerably higher susceptibility likely contributed to the persistent measles transmission in Beijing. Our findings suggest that stronger catch-up vaccination programmes for migrants may help eliminate measles transmission in Beijing.

This paper studies the synchronization control of the blanket remote maintenance robot (BRMR) of the China fusion engineering test reactor (CFETR). First, the general state space mathematical model of BRMR was established by using a physical-based method. Second, based on the receding horizon optimization of model predictive control (MPC) and cross-coupling error reduction in cross-coupling control (CCC), the innovative MPC-CCC controller was proposed to realize the single-system and multisystem error convergence and high accuracy transportation of blanket through the high accuracy synchronization control of BRMR. Third, to verify the control effectiveness of the MPC-CCC controller, two types of simulations and experiments were implied compared with the original proportional-integral (PI) controller in Mover. Results showed that simulation and experiments were highly consistent. It is found that the use of an MPC-CCC controller can result in up to a 70% reduction in displacement error and up to a 59% reduction in synchronization error compared to the PI controller. And the accuracy of the MPC-CCC controller satisfies the real requirement of the maintenance process of the blanket. This work provides the theoretical basis and practical experience for the highly stable, safe, and efficient maintenance of blankets in the future.

A model-free adaptive robust control based on time delay estimation (TDE) is proposed for robot in the presence of disturbance and input saturation. TDE is utilized to estimate the complicated nonlinear terms of the robot including unknown dynamics and disturbance, and a TDE error observer is developed to estimate the inevitable TDE error. When the input torque of the robot exceeds the upper or lower limit of the input saturation, an auxiliary system and a saturation deviation boundary adaptive law are employed to mitigate the negative impact of input saturation on the position tracking. Finally, the robust control law is obtained by backstepping. The stability of the closed-loop system is proved by Lyapunov functions, and the validity of the proposed method is demonstrated by comparative simulations and experiments. Compared with the model-based controllers and other model-free controllers, the proposed method does not necessitate the accurate dynamic model of the complicated system and with lower computation. Moreover, it can guarantee the desired position tracking performance of the robot even subject to disturbance and input saturation simultaneously.

Placental trophoblastic cells play important roles in placental development and fetal health. However, the mechanism of trophoblastic cell fusion is still not entirely clear. The level of Tspan5 in the embryo culture medium was detected using enzyme-linked immunosorbent assay (ELISA). Fusion of BeWo cells was observed by immunofluorescence. Cell fusion-related factors and EMT-related factors were identified by qRT-PCR and western blotting. Notch protein repressor DAPT was used to verify the role of Tspan5 in BeWo cells. The expression of Tspan5 was significantly increased in embryo culture medium. The fusion of BeWo cells was observed after treatment with forskolin (FSK). Cell fusion-related factors (i.e. β-hCG and syncytin 1/2) and Tspan5 were significantly increased after FSK treatment. In addition, FSK treatment promoted EMT-related protein expression in BeWo cells. Knockdown of Tspan5 inhibited cell fusion and EMT-related protein levels. Notch-1 and Jagged-1 protein levels were significantly upregulated, and the EMT process was activated by overexpression of Tspan5 in FSK-treated BeWo cells. Interestingly, blocking the Notch pathway by the repressor DAPT had the opposite results. These results indicated that Tspan5 could promote the EMT process by activating the Notch pathway, thereby causing cell fusion. These findings contribute to a better understanding of trophoblast cell syncytialization and embryonic development. Tspan5 may be used as a therapeutic target for normal placental development.

Design is a highly nonlinear chaotic dynamic process with many possible solutions, which requires enormous knowledge for designers. This paper investigates how environment-based design (EBD) methodology can help designers use only necessary knowledge for their creativity based on three methods: information search, knowledge acquisition and knowledge application. The methods are applied in an aircraft pylon design, which is evaluated by two aerospace design specialists. The paper discussed the different roles of EBD for novice and expert designers in regard to overcoming emotion and knowledge barriers to achieving designer creativity.

The association between time-restricted eating (TRE) and the risk of non-alcoholic fatty liver disease (NAFLD) is less studied. Moreover, whether the association is independent of physical exercise or diet quality or quantity is uncertain. In this nationwide cross-sectional study of 3813 participants, the timing of food intakes was recorded by 24-h recalls; NAFLD was defined through vibration-controlled transient elastography in the absence of other causes of chronic liver disease. OR and 95 % CI were estimated using logistic regression. Participants with daily eating window of ≤ 8 h had lower odds of NAFLD (OR = 0·70, 95 % CI: 0·52, 0·93), compared with those with ≥ 10 h window. Early (05.00–15.00) and late TRE (11.00–21.00) showed inverse associations with NAFLD prevalence without statistical heterogeneity (Pheterogeneity = 0·649) with OR of 0·73 (95 % CI: 0·36, 1·47) and 0·61 (95 % CI: 0·44, 0·84), respectively. Such inverse association seemed stronger in participants with lower energy intake (OR = 0·58, 95 % CI: 0·38, 0·89, Pinteraction = 0·020). There are no statistical differences in the TRE-NAFLD associations according to physical activity (Pinteraction = 0·390) or diet quality (Pinteraction = 0·110). TRE might be associated with lower likelihood of NAFLD. Such inverse association is independent of physical activity and diet quality and appears stronger in individuals consuming lower energy. Given the potential misclassification of TRE based on one- or two-day recall in the analysis, epidemiological studies with validated methods for measuring the habitual timing of dietary intake are warranted.

Let G be a finite group and $\mathrm {Irr}(G)$ the set of all irreducible complex characters of G. Define the codegree of $\chi \in \mathrm {Irr}(G)$ as $\mathrm {cod}(\chi ):={|G:\mathrm {ker}(\chi ) |}/{\chi (1)}$ and denote by $\mathrm {cod}(G):=\{\mathrm {cod}(\chi ) \mid \chi \in \mathrm {Irr}(G)\}$ the codegree set of G. Let H be one of the $26$ sporadic simple groups. We show that H is determined up to isomorphism by cod$(H)$.

Objectives: Influenza vaccination is encouraged for all healthcare workers (HCWs) to reduce the risk of acquiring the infection and onward transmission to colleagues and patients during the influenza season. Thus, vaccination was introduced at Singapore General Hospital (SGH) in 2007 and has been offered to all HCWs at no cost. The HCW influenza vaccination program is conducted annually in October and biannually during years with vaccine mismatch. However, influenza vaccine uptake remained low among HCWs. We sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on influenza vaccine uptake among HCWs. Methods: At SGH, 2 methods of vaccine delivery are offered: centralized (1-month drop-in system during office hours) and decentralized (administered by vaccination teams in offices or ward staff in inpatient locations). In the 4-year study period between 2018 and 2021, 6 influenza vaccination exercise campaigns were conducted during 8 influenza seasons. During each exercise, ~9,000 HCWs were eligible for vaccination. Results: Prior to the COVID-19 pandemic, vaccine uptake in the Southern Hemisphere was 77.6% (6,964 of 8,977) in 2018 and 84.2% (7,296 of 8,670) in 2019. During the COVID-19 pandemic in 2020, vaccine uptake in the Southern Hemisphere increased by 10% to 94.1% (8,361 of 8,889). In the Northern Hemisphere, vaccine uptake was 79.2% (7,114 of 8,977) in 2018, and this increased by 17.9% to 97.1% (8,926 of 9,194) during the COVID-19 pandemic in 2020. During the 2021 Southern Hemisphere influenza season, no vaccination program was conducted because the risk of influenza was considered low due to the closure of international borders and the implementation of public health measures. In addition, priority was given to COVID-19 vaccination efforts. Conclusions: Increased uptake of the influenza vaccination was observed during the COVID-19 pandemic. Anxiety created by the respiratory disease pandemic and debate surrounding vaccines likely contributed to increased awareness and uptake in influenza vaccine among HCWs.

Computer-aided design (CAD) plays an essential role in creative idea generation on 2D screens during the design process. In most CAD scenarios, virtual object translation is an essential operation, and it is commonly used when designers simulate their innovative solutions. The degrees of freedom (DoF) of virtual object translation modes have been found to directly impact users’ task performance and psychological aspects in simulated environments. Little is known in the existing literature about the sense of agency (SoA), which is a critical psychological aspect emphasizing the feeling of control, in translation modes on 2D screens during the design process. Hence, this study aims to assess users’ SoA in virtual object translation modes on mouse-based, touch-based, and handheld augmented reality (AR) interfaces through subjective and objective measures, such as self-report, task performance, and electroencephalogram (EEG) data. Based on our findings in this study, users perceived a greater feeling of control in 1DoF translation mode, which may help them come up with more creative ideas, than in 3DoF translation mode in the design process; additionally, the handheld AR interface offers less control feel, which may have a negative impact on design quality and creativity, as compared with mouse- and touch-based interfaces. This research contributes to the current literature by analyzing the association between virtual object translation modes and SoA, as well as the relationship between different 2D interfaces and SoA in CAD. As a result of these findings, we propose several design considerations for virtual object translation on 2D screens, which may enable designers to perceive a desirable feeling of control during the design process.