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Objectives: Central-line–associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that a care bundle is effective in reducing CLABSI rates; however, the data on long-term sustainability and cost savings of bundled care are limited. Methods: From January 2011 to December 2020, a prospective surveillance was performed to monitor CLABSI at a university hospital in northern Taiwan. To reduce the CLABSI rate, a hospital-wide bundled care program for CLABSI prevention was implemented in 2013. We evaluated the long-term effect of the care bundle on CLABSI incidence and length of stay in the ICU. Results: During the study period, the overall CLABSI incidence decreased from 8.22 per 1,000 catheter days before the care bundle was implemented to 6.33 per 1,000 catheter days in 2020 (P for trend <.01). The most common pathogens causing CLABSI were gut organisms (1,420 of 2,363, 60.1%), followed by environmental organisms (734 of 2,363, 31.1%) and skin organisms (177 of 2,363, 7.5%). The decreasing trend was statistically significant in the incidence of CLABSI caused by skin organisms (P for trend < .01), but not in the incidence of CLABSI caused by environmental organisms (P for trend = .86) or gut organisms (P for trend = .06). In the multivariable analysis, implementation of this care bundle was independently associated with a decrease in the CLABSI rate (RR, 0.77; 95% CI, 0.66–0.88). Compared with patients without CLABSI, patients with CLABSI had a longer average ICU length of stay (27 vs 17 days). Conclusions: A sustainable reduction in the incidence of CLABSI caused by common commensals could be achieved through a cost-saving bundled care program.
Objectives: Candidemia has become one of the leading causes of healthcare-associated bloodstream infection, particularly in the intensive care unit. The management of candidemia remains challenging. We reassessed the protective effectiveness of a comprehensive care bundle on the management of candidemia and the effects of compliance with each element on the outcomes of patients. Methods: This network meta-analysis was conducted using the frequentist method. The participants included adult patients both infected with candidemia and who received bundle care. The primary outcome was the all-cause mortality among the patients included. Results: Studies in which a care bundle was created for patients with candidemia were identified, and 5 eligible studies with 5,808 participants were enrolled for further analysis. The random-effects model of the overall odds ratio (OR) revealed a significant reduction in the risk of all-cause mortality compared with that of the controls (OR, 0.599; 95% CI, 0.378–0.949; P = .025), as well as a reduction in the risk of developing persistent candidemia compared with the controls (OR, 0.483; 95% CI, 0.245–0.952; P = .008). In addition, no single element reached a protective effectiveness to improve the clinical outcome. Conclusions: This meta-analysis demonstrated that the combination of core elements in the care bundle resulted in protective effects, in that the all-cause mortality rates and incidence rates were effectively reduced among patients with persistent candidemia.
Visual place recognition (VPR) in condition-varying environments is still an open problem. Popular solutions are convolutional neural network (CNN)-based image descriptors, which have been shown to outperform traditional image descriptors based on hand-crafted visual features. However, there are two drawbacks of current CNN-based descriptors: (a) their high dimension and (b) lack of generalization, leading to low efficiency and poor performance in real robotic applications. In this paper, we propose to use a convolutional autoencoder (CAE) to tackle this problem. We employ a high-level layer of a pre-trained CNN to generate features and train a CAE to map the features to a low-dimensional space to improve the condition invariance property of the descriptor and reduce its dimension at the same time. We verify our method in four challenging real-world datasets involving significant illumination changes, and our method is shown to be superior to the state-of-the-art. The code of our work is publicly available at https://github.com/MedlarTea/CAE-VPR.
Major depressive disorder (MDD) is a common neuropsychiatry disorder with high prevalence and recurrence rate, but the misdiagnosis rate is inevitable due to the shortage of objective laboratory-based diagnostic criteria. This study is focused on the disturbance of lipid metabolism, providing potential biomarkers for diagnosing.
Lipid metabolism-related molecules in plasma of 42 drug-naïve MDD patients and 49 healthy people were measured by liquid chromatography-mass spectrometry. Further to evaluate the diagnostic values of changed metabolites, these molecules were evaluated by the receiver operating characteristic curve. Based on the significant role of phosphatidylcholine (PC) disturbance in depression, oxidization of PCs, oxidation of 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (OxPAPC), IL-8 and caspase-3 in hippocampus, and serum of chronic lipopolysaccharide (cLPS) depression mice were detected by ELISA.
Compared with healthy control, MDD patients expressed higher 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (16:0-16:0 PC, DPPC), 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (16:0-20:4 PC, PAPC), 1-palmitoyl-2-stearoyl-sn-glycero-3-phosphocholine (16:0-18:0 PC), glycocholic acid, taurocholic acid, glycoursodeoxycholic acid, and chenodeoxycholic acid glycine conjugate, and lower 1-heptadecanoyl-2-hydroxy-sn-glycero-3-phosphocholine (LPC 20:0). The 16:0-20:4 PC showed the great diagnostic value for MDD with an area under the curve (AUC) of 0.9519, and combination of 16:0 PC, 16:0-18:0 PC, and 16:0-20:4 PC exhibited the highest diagnostic value with AUC of 0.9602. OxPAPC was certified increase in hippocampus and serum of cLPS depression mice, which further supported PCs disorder participated in depression.
This research offers 16:0-20:4 PC as the latent diagnostic indicator for MDD and hints the important role of PCs in depression.
Se is an essential trace element associated with animal growth and antioxidant and metabolic processes. However, whether Se, especially organic Se with higher bioavailability, can alleviate the adverse effects of low salinity stress on marine economic crustacean species has not been investigated. Accordingly, juvenile Pacific white shrimp (Litopenaeus vannamei) were reared in two culture conditions (low and standard salinity) fed diets supplemented with increasing levels of l-selenomethionine (0·41, 0·84 and 1·14 mg/kg Se) for 56 d, resulting in four treatments: 0·41 mg/kg under standard seawater (salinity 31) and 0·41, 0·84 and 1·14 mg/kg Se under low salinity (salinity 3). The diet containing 0·84 mg/kg Se significantly improved the survival and weight gain of shrimp under low salinity stress and enhanced the antioxidant capacity of the hepatopancreas. The increased numbers of B and R cells may be a passive change in hepatopancreas histology in the 1·14 mg/kg Se group. Transcriptomic analysis found that l-selenomethionine was involved in the regulatory pathways of energy metabolism, retinol metabolism and steroid hormones. In conclusion, dietary supplementation with 0·84 mg/kg Se (twice the recommended level) effectively alleviated the effects of low salinity stress on L. vannamei by regulating antioxidant capacity, hormone regulation and energy metabolism.
With the increasing use of health economic evaluation (HEE) in decision-making and health resource allocation and management policy design has seen an increase in HEE studies on screening programs in China l. In addition to the quantity of HEE, the quality may be of particular concern as it influences the reliability of HEE evidence adopted in policy formulation. This study sought to assess the reporting quality of HEE on screening programs over the last 20 years in China and identify potential predictors and relevant recommendations to improve the quality of study reporting.
A search of HEE studies published in PubMed, Embase, CNKI and WANFANG from 2000 to 2021 was performed. Two reviewers independently extracted data and assessed the quality if reporting using the 24 item Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. The CHEERS score for each study was converted into standardized 0-1 point scale. General liner regression was used to identify predictors associated with the reporting quality.
One hundred and thirty-three studies met the inclusion criteria. The mean standardized score for the included studies was 0.56 (title), 0.64 (abstract), 0.74 (introduction), 0.58 (methods), 0.40 (results), 0.70 (discussion), and 0.54 (other section). The number and reporting quality of articles published each year showed an overall upward trend. A greater proportion of studies were published in Chinese journal (69.2%), modelling-based (54.9%), conducted by universities/research institutions (45.9%), focused on non-infectious disease (84.2%), using cost-effectiveness analysis method (50.4%), published in non-specialty journal (60.2%), and declaring the funding support (76.7%). Items related to study perspective, discount rate, measurement of effectiveness, currency and price, analytical methods, uncertainty, heterogeneity and conflicts were under-reported. Published year, journal type, first author affiliation and economic evaluation type predicted higher score in regression analyses (p<0.05).
Overall, the quantity and quality of HEE on screening programs in China is improving, although there is a need to improve the use of on specific reporting items in the CHEERS criteria. The use of suitable evaluation guidelines will make the decision-making process more scientific.
The carbonate-hosted Pb–Zn deposits in the Sichuan–Yunnan–Guizhou (SYG) triangle region are important Indosinian deposits in South China. The Tianbaoshan deposit is a typical large Pb–Zn deposit in the SYG area and occurs as pipe-like type, hosted by Sinian dolostone. It contains ∼26 Mt Zn–Pb ore (7.76–10.09 % Zn, 1.28–1.50 % Pb and 93.6 g t−1 Ag) and >0.1 Mt Cu ore (2.55 % Cu). In this study, the detailed mineral textures, mineral chemical and sulphur isotopic compositions of the various sulphides have been analysed to constrain the abnormal enrichment mechanism and mineralization relationship. Four mineralization stages have been recognized: Stage 1, minor early pyrite (Py1) with relics and infill of intergranular dolomite or quartz grains; Stage 2, Cu mineralization with coarse-grained, elliptical crystal chalcopyrite (Cp1); (3) Stage 3, Zn mineralization with dark fine-grained sphalerite (Sph1) and light coarse-grained sphalerite (Sph2); and (4) Stage 4, as represented by a quartz–calcite assemblage with galena, minor pyrite (Py2) and chalcopyrite (Cp2). The petrography of the sulphide minerals (Py1, Cp1, Sph1 and Sph2) demonstrates a mutual inclusion relationship. The nature of this relationship from core to rim and their similar sulphur isotope values (5.5–8.3 ‰) indicates a single sulphur source, suggesting that the different mineralization types are the result of different stages of a continuous hydrothermal system. Sphalerite geothermometer study suggests that sphalerite in the Tianbaoshan deposit formed in a low-temperature (<200 °C) hydrothermal system. The low concentrations of Mn and In, low In/Ge ratios and high Fe/Cd ratios in the sphalerite are consistent with those of Mississippi Valley-type (MVT) deposits, but different from those of magmatism-related deposits (e.g. epithermal, skarn and VMS deposits). The positive δ34S values for Py1 (5.1–7.9 ‰), Cp1 (5.1–7.2 ‰), Sph1 (4.7–7.4 ‰), Sph2 (3.9–8.7 ‰), Py2 (4.4–9.3 ‰) and Cp2 (5.0–6.8 ‰) indicate a sulphur source from thermochemical reduction of coeval seawater sulphate. Widely developed dissolved textures (caverns and breccias) with massive sulphide infillings and deformed host rock remnants suggest that replacement of host dolostones by ore fluids was volumetrically significant and the ore formed nearly simultaneously with the cavities. The Tianbaoshan deposit is a typical MVT deposit, which resulted from mixing of a H2S-rich fluid and a metal-rich fluid, with thermochemical sulphate reduction occurring before ore precipitation rather than during ore precipitation.
The low maturation rate of oocytes is an important reason for female infertility and failure of assisted pregnancy. The germinal vesicle breakdown (GVBD) is a landmark event of oocyte maturation. In our previous studies, we found that zona pellucida 3 (ZP3) was strongly concentrated in the nuclear region of germinal vesicle (GV) oocytes and interacted with aryl hydrocarbon receptor-interacting protein-like 1 (AIPL1) and lamin A to promote GVBD. In the current study, we found that lamin A is mainly concentrated in the nuclear membrane. When ZP3 is knocked down, lamin A will be partially transferred to the nucleus of oocytes. The prelamin A is increased in both the nuclear membrane and nucleus, while phosphorylated lamin A (p-lamin A) is significantly reduced. AIPL1 was also proved to accumulate in the GV region of oocytes, and ZP3 deletion can significantly inhibit the aggregation of AIPL1 in the nuclear region. Similar to ZP3 knockdown, the absence of AIPL1 resulted in a decrease in the occurrence of GVBD, an increase in the amount of prelamin A, and a significant decrease in p-lamin A in oocytes developed in vitro. Finally, we propose the hypothesis that ZP3 can stabilize farnesylated prelamin A on the nuclear membrane of AIPL1, and promote its further processing into mature lamin A, therefore promoting the occurrence of GVBD. This study may be an important supplement for the mechanism of oocyte meiotic resumption and provide new diagnostic targets and treatment clues for infertility patients with oocyte maturation disorder.
We review the literature on how fathers contribute to their children’s development from early childhood to adolescence. First, we set the stage by giving a brief profile of who fathers are in the United States. Second, we summarize the theoretical and methodological approaches used to conceptualize and assess the role of fathers in caregiving. Third, we synthesize the empirical literature on the important correlates of father involvement and provide a critical analysis of the ways father involvement in caregiving is related to children’s cognitive, language, and social-emotional development. Lastly, we discuss implications to inform best practices and policies pertaining to this research and end with future directions.
Genetic mutations of fused in sarcoma (FUS) causing amyotrophic lateral sclerosis (ALS) may disrupt mRNA splicing events. For example, the FUS c.1394-2delA variant was reported in two western ALS patients, but its molecular mechanism is unclear. In this study, we aim to investigate FUS splice site mutations in Chinese ALS patients.
Sanger sequencing was used to identify FUS splicing mutations in Chinese ALS patients. We combined a deep learning tool (SpliceAI), RNA sequencing, and RT-PCR/RT-qPCR to analyze the effect of FUS c.1394-2delA mutation on RNA splicing and expression. AlphaFold was used to predict the protein structure of mutant FUS. In transfected cell lines, we used immunofluorescence to assess cytoplasmic mislocalization of mutant FUS protein.
We identified a de novo FUS splice acceptor site mutation (c.1394-2delA, p. Gly466Valfs*14) in one Chinese sporadic ALS patient, which is linked to exon 14 skipping, and upregulated total FUS mRNA expression. The FUS splice site mutation was predicted to be translated into a truncated protein product at C-terminal. In vitro studies revealed that the FUS mutation increased cytoplasmic mislocalization in both HEK293T and SH-SY5Y cells.
We identified a de novo FUS splicing mutation (c.1394-2delA, p. Gly466Valfs*14) in 1 out of 233 Chinese ALS patients. It caused abnormal RNA splicing, upregulated gene expression, truncated FUS translation, and cytosolic mislocalization. Our findings suggested that FUS splice site mutation is rare in Chinese ALS patients and extended our knowledge of molecular mechanisms of the FUS c.1394-2delA mutation.
Excavation at Mogou, a Bronze Age cemetery containing over 1700 burials and 6000 individuals, has revealed a diverse range of multiple burials. Building on this dataset, the Mogou Multidisciplinary Investigation Project aims to explore connections between kinship, burial space and social organisation in Bronze Age north-west China.
Bipolar disorder is a chronic mental disorder related to cognitive deficits. Low serum vitamin D levels are significantly associated with compromised cognition in neuropsychiatric disorders. Although patients with bipolar disorder frequently exhibit hypovitaminosis D, the association between vitamin D and cognition in bipolar disorder, and their neuroaxonal integrity, is unclear.
To investigate the interaction effects between vitamin D and neurofilament light chain (NfL) levels on cognitive domains in bipolar disorder.
Serum vitamin D and NfL levels were determined in 100 euthymic patients with bipolar disorder in a cross-sectional study. Cognitive function was measured with the Brief Assessment of Cognition in Affective Disorders. We stratified by age groups and used general linear models to identify associations between vitamin D and NfL levels and their interaction effects on cognitive domains.
The mean vitamin D and NfL levels were 16.46 ng/nL and 11.10 pg/mL, respectively; 72% of patients were vitamin D deficient. In the older group, more frequent hospital admissions and lower physical activity were identified in the group with versus without vitamin D deficiency. The age-modified interaction effect of vitamin D and NfL was associated with composite neurocognitive scores and verbal fluency in both age groups, and with processing speed domain in the younger group.
We observed a high vitamin D deficiency prevalence in bipolar disorder. We identified the interaction of vitamin D and NfL on cognitive domains, and the effect was modified by age. Longitudinal or randomised controlled studies enrolling patients with various illness durations and mood statuses are required to validate our findings.
Social functioning is crucial for daily living and is an essential indicator of dementia in patients with Parkinson's disease. The pattern of social functioning in patients with Parkinson's disease without dementia (i.e. those who are cognitively intact or have mild cognitive impairment (PD-MCI)) and its determinants are unclear.
In exploring the heterogeneity of social functioning among patients with Parkinson's disease-associated dementia, we determined the optimal cut-off score of the Parkinson's Disease Social Functioning Scale (PDSFS) for patients with PD-MCI, and the variables influencing patients’ social functioning.
A total of 302 participants underwent the Mini-Mental State Examination (MMSE) and PDSFS; 120 patients with Parkinson's disease completed the measurements (MMSE, Activities of Daily Living Scale and Neuropsychiatric Inventory). Group comparisons, receiver operating characteristic curves, Spearman correlation and multiple and hierarchical regression analyses were conducted.
The PD-MCI group scored the lowest on the PDSFS (F = 10.10, P < 0.001). The PDSFS cut-off score was 53 (area under the curve 0.700, sensitivity 0.800, specificity 0.534). The MMSE (β = 0.293, P = 0.002), Activities of Daily Living Scale (β = 0.189, P = 0.028) and Neuropsychiatric Inventory (β = −0.216, P = 0.005) scores predicted the PDSFS score. Further, there was an interaction effect between the Activities of Daily Living Scale and Neuropsychiatric Inventory scores on the PDSFS score (β = 0.305, P < 0.001).
We determined a PDSFS cut-off score for detecting PD-MCI and found that patients with PD-MCI have social dysfunction. Future research should focus on the effects of neuropsychiatry symptoms and activities of daily living on social functioning, and tailor the intervention programme for patients with Parkinson's disease.
Though early intervention can improve outcomes for children with motor disabilities, delays in diagnosis can impact the success of intervention programs. Prior work indicates that spontaneous kicking patterns can be used to model typical infant motor development to assist in the early detection of motor delays. However, abnormalities in spontaneous movements are not well defined or readily observable through traditional functional assessments. In this research, a method is introduced for the early detection of delays through the assessment of spontaneous kicking data gathered using a wearable sensing suit. We present formulations of kinematic features identified in the clinical space, identify which features are significant predictors of infant age, and establish normative values. Finally, we offer an analysis of preterm (PT) infant data compared to normative values derived from term infants. Term and PT infants ranging in age from 1 to 10 months were studied. We found that frequency, duration, acceleration, inter-joint coordination, and maximum joint excursion metrics had a significant correlation with age. From these features, models of typical kicking development were created using data from term, typically developing infants. When compared to normative trends, PT infants display differing developmental trends.
Particle-resolved direct numerical simulations are employed to investigate the particle–particle drag force in the bidisperse gas–particle suspensions where the particles are smooth and the single-particle velocity distribution function is Maxwellian. The particle Reynolds number ranges from 6.7 to 123.8, and in this range the particle inertia is high enough that the lubrication force is not essential. It is found that the relation derived by the kinetic theory of granular flow (KTGF) highly overestimates the particle–particle drag force. This is because the pre-collision velocities of colliding particles are not completely uncorrelated with each other. From the time sequence of collision events, it is observed that the particle pair that has just collided will probably collide again after a short time due to the restriction of the particle motion in dense suspensions. Since the post-collision velocities of the first collision cannot relax entirely in such a short time, the relative velocity before the subsequent collision is statistically smaller than the domain-averaged relative velocity. Consequently, the particle–particle drag force is over-predicted when the domain-averaged relative velocity is used. For this reason, this work assumes that the particle–particle drag force is determined by the relative velocity within a local region near large particles. When the local region is set to be the spherical shells centred on the centres of large particles and with an outer radius of a mean free path of small particles, the KTGF-based relation can reasonably predict the particle–particle drag force.
Biped robots with dynamic motion control have shown strong robustness in complex environments. However, many motion planning methods rely on models, which have difficulty dynamically modifying the walking cycle, height, and other gait parameters to cope with environmental changes. In this study, a heuristic model-free gait template planning method with dynamic motion control is proposed. The gait trajectory can be generated by inputting the desired speed, walking cycle, and support height without a model. Then, the stable walking of the biped robot can be realized by foothold adjustment and whole-body dynamics model control. The gait template can be changed in real time to achieve gait flexibility of the biped robot. Finally, the effectiveness of the method is verified by simulations and experiments of the biped robot BHR-B2. The research presented here helps improve the gait transition ability of biped robots in dynamic locomotion.
Aorto-right-atrial fistula is an uncommon condition with an unclear pathogenesis. We present the case of a 3-year-old girl with a giant omphalocele repaired days after birth and incidentally discovered with a celiacomesenteric trunk-to-right atrium fistula. Three-dimensional reconstruction CT unveiled its anatomical pattern, and the fistula was successfully closed using a Amplatzer vascular plug II percutaneously.