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The aim of the audit is to ascertain how well hyperprolactinemia is being monitored and managed across all acute adult inpatient wards in a mental health NHS Trust, for patients on regular antipsychotic mediation. The objectives of the audit are to: 1) Assess whether prolactin is being monitored according to local guidelines for patients on regular antipsychotic medication, 2) Determine whether hyperprolactinemia is being identified and managed according to appropriate guidelines, 3) Assess the standard of documentation around the decisions made.
Methods
Data were collected retrospectively from the electronic notes and records for 78 patients, who were discharged from 8 acute wards in February 2021. For checking prolactin test results, the relevant reporting systems were accessed. Two data collection forms were used, which separated patients between those already taking antipsychotics prior to their admission and those who were newly initiated on an antipsychotic.
Patients who were prescribed at least one regular antipsychotic were included. Patients with pre-existing medical conditions that cause hyperprolactinaemia, ongoing pregnancy or breastfeeding were excluded. The monitoring for and management of hyperprolactinaemia was assessed against NICE and local guidance.
Results
From the reviewed data, 41 patients were prescribed at least one regular antipsychotic drug during their admission. 32 patients were already established on an antipsychotic prior to their admission and 9 individuals were started on their first antipsychotic. Hyperprolactinaemia was identified in 9 patients. 19 patients had no prolactin assay performed during their whole admission.
44.4% of antipsychotic naïve patients had a baseline prolactin level taken prior to starting an antipsychotic. 9.1% of patients with hyperprolactinaemia had their symptoms assessed by a clinician. 27.3% of patients with hyperprolactinaemia had actions discussed and undertaken to address this.
Conclusion
This audit identified that patients are at risk of suffering from hyperprolactinaemia and are being insufficiently monitored. The symptoms of hyperprolactinaemia are not adequately screened or assessed for. This may increase the side effect burden and decrease medication adherence among patients. There is a need to increase the awareness among clinicians about the importance of regular prolactin monitoring to improve patient outcomes.
The subduction model of the Neo-Tethys during the Early Cretaceous has always been a controversial topic, and the scarcity of Early Cretaceous magmatic rocks in the southern part of the Gangdese batholith is the main cause of this debate. To address this issue, this article presents new zircon U–Pb chronology, zircon Hf isotope, whole-rock geochemistry and Sr–Nd isotope data for the Early Cretaceous quartz diorite dykes with adakite affinity in Liuqiong, Gongga. Zircon U–Pb dating of three samples yielded ages of c. 141–137 Ma, indicating that the Liuqiong quartz diorite was emplaced in the Early Cretaceous. The whole-rock geochemical analysis shows that the Liuqiong quartz diorite is enriched in large-ion lithophile elements (LILEs) and light rare-earth elements (LREEs) and is depleted in high-field-strength elements (HFSEs), which are related to slab subduction. Additionally, the Liuqiong quartz diorite has high SiO2, Al2O3 and Sr contents, high Sr/Y ratios and low heavy rare-earth element (HREE) and Y contents, which are compatible with typical adakite signatures. The initial 87Sr/86Sr values of the Liuqiong adakite range from 0.705617 to 0.705853, and the whole-rock ϵNd(t) values vary between +5.78 and +6.24. The zircon ϵHf(t) values vary from +11.5 to +16.4. Our results show that the Liuqiong adakite magma was derived from partial melting of the Neo-Tethyan oceanic plate (mid-ocean ridge basalt (MORB) + sediment + fluid), with some degree of subsequent peridotite interaction within the overlying mantle wedge. Combining regional data, we favour the interpretation that the Neo-Tethyan oceanic crust was subducted at a low angle beneath the Gangdese during the Early Cretaceous.
Due to the lack of research between the inner layers in the structure of colonic mucous and the metabolism of fatty acid in the constipation model, we aim to determine the changes in the mucous phenotype of the colonic glycocalyx and the microbial community structure following treatment with Rhubarb extract in our research. The constipation and treatment models are generated using adult male C57BL/6N mice. We perform light microscopy and transmission electron microscopy (TEM) to detect a Muc2-rich inner mucus layer attached to mice colon under different conditions. In addition, 16S rDNA sequencing is performed to examine the intestinal flora. According to TEM images, we demonstrate that Rhubarb can promote mucin secretion and find direct evidence of dendritic structure-linked mucus structures with its assembly into a lamellar network in a pore size distribution in the isolated colon section. Moreover, the diversity of intestinal flora has noticeable changes in constipated mice. The present study characterizes a dendritic structure and persistent cross-links have significant changes accompanied by the alteration of intestinal flora in feces in models of constipation and pretreatment with Rhubarb extract.
Many waterflooding oil fields, injecting water into an oil-bearing reservoir for pressure maintenance, are in their middle to late stages of development. To explore the geological conditions and improve oilfield recovery of the most important well group of the Hu 136 block, located on the border areas of three provinces (Henan, Shandong, and Hebei), Zhongyuan Oilfield, Sinopec, central China, a 14C cross-well tracer monitoring technology was developed and applied in monitoring the development status and recognize the heterogeneity of oil reservoirs. The tracer response in the production well was tracked, and the water drive speed, swept volume of the injection fluid were obtained. Finally, the reservoir heterogeneity characteristics, such as the dilution coefficient, porosity, permeability, and average pore-throat radius, were fitted according to the mathematical model of the heterogeneous multi-layer inter-well theory. The 14C-AMS technique developed in this work is expected to be a potential analytical method for evaluating underground reservoir characteristics and providing crucial scientific guidance for the mid to late oil field recovery process.
Energy homeostasis is essential for organisms to maintain fluctuation in energy accumulation, mobilization. Lipids as the main energy reserve in insects, their metabolism is under the control of many physiological program. This study aimed to determine whether the adipokinetic hormone receptor (AKHR) was involved in the lipid mobilization in the Spodoptera litura. A full-length cDNA encoding AKHR was isolated from S. litura. The SlAKHR protein has a conserved seven-transmembrane domain which is the character of a putative G protein receptor. Expression profile investigation revealed that SlAKHR mRNA was highly expressed in immatural stage and abundant in fat body in newly emerged female adults. Knockdown of SlAKHR expression was achieved through RNAi by injecting double-stranded RNA (dsRNA) into the 6th instar larvae. The content of triacylgycerol (TAG) in the fat body increased significantly after the SlAKHR gene was knockdown. And decrease of TAG releasing to hemolymph with increase of free fatty acid (FFA) in hemolymph were observed when the SlAKHR gene was knowned-down. In addition, lipid droplets increased in fat body was also found. These results suggested that SlAKHR is critical for insects to regulate lipids metabolism.
We present an experimental and numerical study of turbulent thermal convection in the presence of an effective horizontal buoyancy that generates extra shear at the boundary. Geometrical confinements are also applied by varying the streamwise and spanwise aspect ratios of the convection cell to condense the plumes. With these, we systematically explore the effects of plume and shear on heat transfer. It is found that a streamwise confinement results in increased plume coverage but decreased shear compared with spanwise confinement. The fact that streamwise confinement leads to a higher vertical heat transfer efficiency than the spanwise confined case suggests that the increase of plume coverage is the dominant effect responsible for the enhanced heat transfer. Our results highlight the potential applications of coherent structure manipulation in efficient passive heat transfer control and thermal engineering. We also analyse the energetics of the present system and derive the expression of mixing efficiency accordingly. The mixing efficiency is found to increase with both the buoyancy ratio and streamwise dimension.
How can authoritarian regimes effectively control information to maintain regime legitimacy in times of crisis? We argue that media framing constitutes a subtle and sophisticated information control strategy in authoritarian regimes and plays a critical role in steering public opinion and cultivating an image of competent government during a tremendous crisis. Using structural topic models (STM), we conduct a textual analysis of more than 4,600 news reports produced by seven Chinese media outlets during the COVID-19 pandemic. We find that Chinese media, instructed by the propaganda authorities, used a heroism frame to feature frontline medics’ sacrifices when saving others in need and resorted to a contrast frame to highlight the poor performance of the United States in the fight against COVID-19. We also show that both state and commercial media outlets used these two frames, though the tone of commercial media coverage was generally more moderate than the state media version.
Big data has been reported widely to facilitate epidemic prevention and control in health care during the coronavirus disease 2019 (COVID-19) pandemic. However, there is still a lack of practical experience in applying it to hospital prevention and control. This study is devoted to the practical experience of design and implementation as well as the preliminary results of an innovative big data-driven COVID-19 risk personnel screening management system in a hospital. Our screening system integrates data sources in four dimensions, which includes Health Quick Response (QR) code, abroad travelling history, transportation close contact personnel and key surveillance personnel. Its screening targets cover all patients, care partner and staff who come to the hospital. As of November 2021, nearly 690 000 people and 5.79 million person-time had used automated COVID-19 risk screening and monitoring. A total of 10 376 person-time (0.18%) with abnormal QR code were identified, 242 person-time with abroad travelling history were identified, 925 person-time were marked based on the data of key surveillance personnel, no transportation history personnel been reported and no COVID-19 nosocomial infection occurred in the hospital. Through the application of this system, the hospital's expenditure on manpower and material resources for epidemic prevention and control has also been significantly reduced. Collectively, this study has proved to be an effective and efficient model for the use of digital health technology in response to the COVID-19 pandemic. Based on the data from multiple sources, this system has an irreplaceable role in identifying close contacts or suspicious person, and can significantly reduce the social burden caused by COVID-19, especially the human resources and economic costs of hospital prevention and control. It may provide guidance for clinical epidemic prevention and control in hospitals, as well as for future public health emergencies.
Prospective cohort studies linking organ meat consumption and nonalcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between organ meat consumption and risk of NAFLD in a general Chinese adult population. This prospective cohort study included a total of 15,568 adults who were free of liver disease, cardiovascular disease, and cancer at baseline. Dietary information was collected at baseline using a validated food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between organ meat consumption and risk of NAFLD. During a median of 4.2 years of follow-up, we identified 3,604 incident NAFLD cases. After adjusting for demographic characteristics, lifestyle factors, vegetable, fruit, soft drink, seafood, and red meat consumption, the multivariable hazard ratios (95% confidence intervals) for incident NAFLD across consumption of organ meat were 1.00 (reference) for almost never, 1.04 (0.94, 1.15) for tertile 1, 1.08 (0.99, 1.19) for tertile 2, and 1.11 (1.01, 1.22) for tertile 3, respectively (P for trend <0.05). Such association did not differ substantially in the sensitivity analysis. Our study indicates that organ meat consumption was related to a modestly higher risk of NAFLD among Chinese adults. Further investigations are needed to confirm this finding.
Athetis lepigone Möschler (Lepidoptera, Noctuidae) is a common maize pest in Europe and Asia. However, there is no long-term effective management strategy is available yet to suppress its population. Adults rely heavily on olfactory cues to locate their optimal host plants and oviposition sites. Pheromone-binding proteins (PBPs) are believed to be responsible for recognizing and transporting different odorant molecules to interact with receptor membrane proteins. In this study, the ligand-binding specificities of two AlepPBPs (AlepPBP2 and AlepPBP3) for sex pheromone components and host plant (maize) volatiles were measured by fluorescence ligand-binding assay. The results demonstrated that AlepPBP2 had a high affinity with two pheromones [(Z)-7-dodecenyl acetate, Ki = 1.11 ± 0.1 μM, (Z)-9-tetradecenyl acetate, Ki = 1.32 ± 0.15 μM] and ten plant volatiles, including (-)-limonene, α-pinene, myrcene, linalool, benzaldehyde, nonanal, 2-hexanone, 3-hexanone, 2-heptanone and 6-methyl-5-hepten-2-one. In contrast, we found that none of these chemicals could bind to AlepPBP3. Our results clearly show no significant differences in the functional characterization of the binding properties between AlepPBP2 and AlepPBP3 to sex pheromones and host plant volatiles. Furthermore, molecular docking was employed for further detail on some crucial amino acid residues involved in the ligand-binding of AlepPBP2. These findings will provide valuable information about the potential protein binding sites necessary for protein-ligand interactions which appear as attractive targets for the development of novel technologies and management strategies for insect pests.
This study investigates the dynamics of low-viscosity nanodroplets impacting surfaces with static contact angles from θ = 73° to 180° via molecular dynamics (MD) simulations. Two typical morphologies of impacting nanodroplets are observed at the maximum spreading state, a Hertz-ball-like in a low-Weber-number range and a thin-film-like in a high-Weber-number range. Only inertial and capillary forces dominate the impact for the former, whereas viscous force also becomes dominant for the latter. Regardless of morphologies at the maximum spreading state, the ratio of spreading time to contact time always remains constant on an ideal superhydrophobic surface with θ = 180°. With the help of different kinematic approximations of the spreading time and scaling laws of the contact time, scaling laws of the maximum spreading factor ${\beta _{max}}\sim W{e^{1/5}}$ in the low-Weber-number range (capillary regime) and ${\beta _{max}}\sim W{e^{2/3}}R{e^{ - 1/3}}$ (or ${\beta _{max}}\sim W{e^{1/2}}O{h^{1/3}}$) in the high-Weber-number range (cross-over regime) are obtained. Here, We, Re, and Oh are the Weber number, Reynolds number, and Ohnesorge number, respectively. Although the scaling laws are proposed only for the ideal superhydrophobic surface, they are tested valid for θ over 73° owing to the ignorable zero-velocity spreading effect. Furthermore, combining the two scaling laws leads to an impact number, $W{e^{3/10}}O{h^{1/3}} = 2.1$. This impact number can be used to determine whether viscous force is ignorable for impacting nanodroplets, thereby distinguishing the capillary regime from the cross-over regime.
The wheat aphid Sitobion miscanthi (CWA) is an important harmful pest in wheat fields. Insecticide application is the main method to effectively control wheat aphids. However, CWA has developed resistance to some insecticides due to its extensive application, and understanding resistance mechanisms is crucial for the management of CWA. In our study, a new P450 gene, CYP4CJ6, was identified from CWA and showed a positive response to imidacloprid and thiamethoxam. Transcription of CYP4CJ6 was significantly induced by both imidacloprid and thiamethoxam, and overexpression of CYP4CJ6 in the imidacloprid-resistant strain was also observed. The sensitivity of CWA to these two insecticides was increased after the knockdown of CYP4CJ6. These results indicated that CYP4CJ6 could be associated with CWA resistance to imidacloprid and thiamethoxam. Subsequently, the posttranscriptional regulatory mechanism was assessed, and miR-316 was confirmed to participate in the posttranscriptional regulation of CYP4CJ6. These results are crucial for clarifying the roles of P450 in the resistance of CWA to insecticides.
It is recently found that viscoelastic pipe flows can be linearly unstable, leading to the possibility of a supercritical transition route, in contrast to Newtonian pipe flows. Such an instability is referred to as the centre mode, which was studied numerically by Chaudhary et al. (J. Fluid Mech., vol. 908, 2021, p. A11) based on an Oldroyd-B model. In this paper, we are interested in expanding the parameter space investigated and exploring the asymptotic scalings related to this centre instability in the Oldroyd-B viscoelastic pipe flow. It is found from the asymptotic analysis that the centre mode exhibits a three-layered asymptotic structure in the radial direction, a wall layer, a main layer and a central layer, which are driven by pure viscosity, axial and/or radial pressure gradient, and a combined effect of viscosity and elasticity, respectively. Depending on the relations of the control parameters, two regimes, the long-wavelength and short-wavelength centre instabilities, emerge, for which the central-layer thicknesses are of different orders of magnitude. Our large-Reynolds-number asymptotic predictions are compared to the numerical solutions of the original eigenvalue system, and favourable agreement is achieved, especially when the parameters approach their individual limits. In addition to revealing the dominant factors and their balances, the asymptotic analysis describes the instability system by reducing the number of control parameters, and furthermore explaining the collapse of the numerical results for different re-scalings.
Extensive magmatism in NE China, eastern Central Asian Orogenic Belt, has produced multi-stage granitic plutons and accompanying W mineralization. The Narenwula complex in the southwestern Great Xing’an Range provides important insights into the petrogenesis, geodynamic processes and relationship with W mineralization. The complex comprises granodiorites, monzogranites and granite porphyry. Mafic microgranular enclaves are common in the granodiorites, and have similar zircon U–Pb ages as their host rocks (258.5–253.9 Ma), whereas the W-bearing granitoids yield emplacement ages of 149.8–148.1 Ma. Permian granodiorites are I-type granites that are enriched in large-ion lithophile elements and light rare earth elements, and depleted in high field strength elements and heavy rare earth elements. Both the mafic microgranular enclaves and granodiorites have nearly identical zircon Hf isotopic compositions. The results suggest that the mafic microgranular enclaves and granodiorites formed by the mixing of mafic and felsic magmas. W-bearing granitoids are highly fractionated A-type granites, enriched in Rb, Th, U and Pb, and depleted in Ba, Sr, P, Ti and Eu. They have higher W concentrations and Rb/Sr ratios, and lower Nb/Ta, Zr/Hf and K/Rb ratios than the W-barren granodiorites. These data and negative ϵHf(t) values (–6.0 to –2.1) suggest that they were derived from the partial melting of ancient lower crust and subsequently underwent extreme fractional crystallization. Based on the regional geology, we propose that the granodiorites were generated in a volcanic arc setting related to the subduction of the Palaeo-Asian Ocean, whereas the W-bearing granitoids and associated deposits formed in a post-orogenic extensional setting controlled by the Mongol–Okhotsk Ocean and Palaeo-Pacific Ocean tectonic regimes.
There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America.
Methods
Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors.
Results
A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v. 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively.
Conclusions
The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.
Laser–plasma accelerators (LPAs) have great potential to realize a compact X-ray free-electron laser (FEL), which is limited by the beam properties currently. Two-color high-intensity X-ray FEL provides a powerful tool for probing ultrafast dynamic systems. In this paper, we present a simple and feasible method to generate a two-color X-ray FEL pulse based on an LPA beam. In this scheme, time-dependent mismatch along the bunch is generated and manipulated by the designed lattice system, enabling FEL lasing at different wavelength within two undulator sections. The time separation between the two pulses can be precisely adjusted by varying the time-delay chicane. Numerical simulations show that two-color soft X-ray FELs with gigawatt-level peak power and femtosecond duration can be generated, which confirm the validity and feasibility of the scheme.
The present study investigated the effect of black soldier fly (Hermetia illucens) larvae meal (BSF) on haemolymph biochemical indicators, muscle metabolites as well as the lipid and glucose metabolism of Pacific white shrimp Litopenaeus vannamei. Four diets were formulated in which the control diet contained 25 % of fishmeal (FM) and 10 % (BSF10), 20 % (BSF20), and 30 % (BSF30) of FM protein were replaced with BSF. Four hundred and eighty shrimp (0·88 ± 0·00 g) were distributed to four groups of three replicates and fed for 7 weeks. Results showed that growth performance of shrimp fed BSF30 significantly decreased compared with those fed FM, but there was no significant difference in survival among groups. The whole shrimp crude lipid content, haemolymph TAG and total cholesterol were decreased with the increasing BSF inclusion. The results of metabolomics showed that the metabolite patterns of shrimp fed different diets were altered, with significant changes in metabolites related to lipid metabolism, glucose metabolism as well as TCA cycle. The mRNA expressions of hk, pfk, pk, pepck, ampk, mcd, cpt-1 and scd1 in hepatopancreas were downregulated in shrimp fed BSF30, but mRNA expression of acc1 was upregulated. Unlike BSF30, the mRNA expressions of fas, cpt-1, fbp and 6pgd in hepatopancreas were upregulated in shrimp fed BSF20. This study indicates that BSF20 diet promoted lipid synthesis and lipolysis, while BSF30 diet weakened β-oxidation and glycolysis as well as affected the unsaturated fatty acids synthesis, which may affect the growth performance and body composition of shrimp.
We investigate the dynamic couplings between particles and fluid in turbulent Rayleigh–Bénard (RB) convection laden with isothermal inertial particles. Direct numerical simulations combined with the Lagrangian point-particle mode were carried out in the range of Rayleigh number $1\times 10^6 \le {Ra}\le 1 \times 10^8$ at Prandtl number ${Pr}=0.678$ for three Stokes numbers ${St_f}=1 \times 10^{-3}$, $8 \times 10^{-3}$ and $2.5 \times 10^{-2}$. It is found that the global heat transfer and the strength of turbulent momentum transfer are altered a small amount for the small Stokes number and large Stokes number as the coupling between the two phases is weak, whereas they are enhanced a large amount for the medium Stokes number due to strong coupling of the two phases. We then derived the exact relation of kinetic energy dissipation in the particle-laden RB convection to study the budget balance of induced and dissipated kinetic energy. The strength of the dynamic coupling can be clearly revealed from the percentage of particle-induced kinetic energy over the total induced kinetic energy. We further derived the power law relation of the averaged particles settling rate versus the Rayleigh number, i.e. $S_p/(d_p/H)^2{\sim} Ra^{1/2}$, which is in remarkable agreement with our simulation. We found that the settling and preferential concentration of particles are strongly correlated with the coupling mechanisms.
The effects of chordwise deformation and the half-amplitude asymmetry on the hydrodynamic performance and vortex dynamics of batoid fish have been numerically investigated, in which the two parameters were represented by the wavenumber ($W$) and the ratio of the half-amplitude above the longitudinal axis to that below ($HAR$). Fin kinematics were prescribed based on biological data. Simulations were conducted using the immersed boundary method. It was found that moderate chordwise deformation enhances the thrust, saves the power and increases the efficiency. A large $HAR$ can also increase thrust performance. By using the derivative-moment transformation theory at several subdomains to capture the local vortical structures and a force decomposition, it was shown that, at high Strouhal numbers ($St$), the tip vortex is the main source of thrust, whereas the leading-edge vortex (LEV) and trailing-edge vortex weaken the thrust generation. However, at lower $St$, the LEV would enhance the thrust. The least deformation ($W=0$) leads to the largest effective angle of attack, and thus the strongest vortices. However, moderate deformation ($W=0.4$) has an optimal balance between the performance enhancement and the opposite effect of different local structures. The performance enhancement of $HAR$ was also due to the increase of the vortical contributions. This work provides a new insight into the role of vortices and the force enhancement mechanism in aquatic swimming.
Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.
Methods:
A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.
Results:
A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).
Conclusions:
Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.