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.

There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the ‘Unhealthy’ cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the ‘Healthy’ cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the ‘Unhealthy’ cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49–3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the ‘Unhealthy’ cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68–6·06), respectively), relative to Chinese ethnicity. In conclusion, this study identified two dietary patterns in children, labelled as the ‘Unhealthy’ and ‘Healthy’ clusters. Mothers’ educational attainment and ethnicity were two correlates that were associated with the children’s assignments to the clusters. These findings can assist in informing health promotion programmes targeted at Asian children.

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.

In the alloy materials, their mechanical properties mightly rely on the compositions and concentrations of chemical elements. Therefore, looking for the optimum elemental concentration and composition is still a critical issue to design high-performance alloy materials. Traditional alloy designing method via “trial and error” or domain experts’ experiences is barely possible to solve the issue. Here, we propose a “composition-oriented” method combined machine learning to design the Cu–Zn alloys with the high strengths, high ductility, and low friction coefficient. The method of separate training for each attribute label is used to study the effects of elemental concentrations on the mechanical properties of Cu–Zn alloys. Moreover, the elemental concentrations of new Cu–Zn alloys with the good mechanical properties are predicted by machine learning. The current results reveal the vital importance of the “composition-oriented” design method via machine learning for the development of high-performance alloys in a broad range of elemental compositions.

Ketosis is a metabolic disease of dairy cows often characterized by high concentrations of ketone bodies and fatty acids, but low milk protein and milk production. The Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) and the mechanistic target of rapamycin (mTOR) signaling pathways are central for the regulation of milk protein synthesis. The effect of high levels of fatty acids on these pathways and β-casein synthesis are unknown in dairy cows with clinical ketosis. Mammary gland tissue and blood samples were collected from healthy (n = 15) and clinically-ketotic (n = 15) cows. In addition, bovine mammary epithelial cells (BMEC) were treated with fatty acids, methionine (Met) or prolactin (PRL), respectively. In vivo, the serum concentration of fatty acids was greater (P > 0.05) and the percentage of milk protein (P > 0.05) was lower in cows with clinical ketosis. The JAK2-STAT5 and mTOR signaling pathways were inhibited and the abundance of β-casein was lower in mammary tissue of cows with clinical ketosis (P > 0.05). In vitro, high levels of fatty acids inhibited the JAK2-STAT5 and mTOR signaling pathways (P > 0.05) and further decreased the β-casein synthesis (P > 0.05) in BMEC. Methionine or PRL treatment, as positive regulators, activated the JAK2-STAT5 and mTOR signaling pathways to increase the β-casein synthesis. Importantly, the high concentration of fatty acids attenuated the positive effect of Met or PRL on mTOR, JAK2-STAT5 pathways and the abundance of β-casein (P > 0.05). Overall, these data indicate that the high concentrations of fatty acids that reach the mammary cells during clinical ketosis inhibit mTOR and JAK2-STAT5 signaling pathways, and further suppress β-casein synthesis.

To solve the poor cyclability of faradic supercapacitors (SCs), the authors reported a unique porous carbon (PC) coating with “gap shell” structure on carbon fiber cloth (CFC)/NiS2 materials. This gap shell PC coating was fabricated by combining atomic layer deposition (ALD) Al2O3 and molecular layer deposition alucone, followed by carbonization and etching. The as-prepared CFC/NiS2/PC composites were directly used as binder-free electrodes for SCs. Benefited from its novel nanostructure, the CFC/NiS2/PC electrode shows a large specific capacitance of 1034.6 F/g at 1 A/g and considerable rate capability of 67% capacitance, retaining ratio within 1–20 A/g. The cyclability of the CFC/NiS2/PC electrode is enhanced by 50% relative to the mere CFC/NiS2 after 2000 cycles, which is attributed to the gap and electrically conductive PC coating. Hence, this work provides a promising approach to design gap shell layer for improved cyclability of faradic SCs and other practical applications in energy storage electronics.

l-Carnitine is essential for mitochondrial β-oxidation and has been used as a lipid-lowering feed additive in humans and farmed animals. d-Carnitine is an optical isomer of l-carnitine and dl-carnitine has been widely used in animal feeds. However, the functional differences between l- and d-carnitine are difficult to study because of the endogenous l-carnitine background. In the present study, we developed a low-carnitine Nile tilapia model by treating fish with a carnitine synthesis inhibitor, and used this model to investigate the functional differences between l- and d-carnitine in nutrient metabolism in fish. l- or d-carnitine (0·4 g/kg diet) was fed to the low-carnitine tilapia for 6 weeks. l-Carnitine feeding increased the acyl-carnitine concentration from 3522 to 10 822 ng/g and alleviated the lipid deposition from 15·89 to 11·97 % in the liver of low-carnitine tilapia. However, as compared with l-carnitine group, d-carnitine feeding reduced the acyl-carnitine concentration from 10 822 to 5482 ng/g, and increased lipid deposition from 11·97 to 20·21 % and the mRNA expression of the genes involved in β-oxidation and detoxification in the liver. d-Carnitine feeding also induced hepatic inflammation, oxidative stress and apoptosis. A metabolomic investigation further showed that d-carnitine feeding increased glycolysis, protein metabolism and activity of the tricarboxylic acid cycle and oxidative phosphorylation. Thus, l-carnitine can be physiologically utilised in fish, whereas d-carnitine is metabolised as a xenobiotic and induces lipotoxicity. d-Carnitine-fed fish demonstrates increases in peroxisomal β-oxidation, glycolysis and amino acid degradation to maintain energy homeostasis. Therefore, d-carnitine is not recommended for use in farmed animals.

Although the streaked optical pyrometer (SOP) system has been widely adopted in shock temperature measurements, its reliability has always been of concern. Here, two calibrated Planckian radiators with different color temperatures were used to calibrate and verify the SOP system by comparing the two calibration standards using both multi-channel and single-channel methods. A high-color-temperature standard lamp and a multi-channel filter were specifically designed for the measurement system. To verify the reliability of the SOP system, the relative deviation between the measured data and the standard value of less than 5% was calibrated out, which demonstrates the reliability of the SOP system. Furthermore, a method to analyze the uncertainty and sensitivity of the SOP system is proposed. A series of laser-induced shock experiments were conducted at the ‘Shenguang-II’ laser facility to verify the reliability of the SOP system for temperature measurements at tens of thousands of kelvin. The measured temperature of the quartz in our experiments agreed fairly well with previous works, which serves as evidence for the reliability of the SOP system.

A bottom-feed omni-directional CP (circularly polarized) antenna array is proposed in this letter. The antenna array is composed of four elements (two printed ZPS (zero-phase-shift) line loops and two half-wavelength dipoles). The four elements are fed with the same phase and amplitude. The ZPS line loops provide the horizontal polarization while the dipoles provide the vertical polarization. Therefore, omni-directional circular polarization is formed in the far field. The feeding network consists of a 1–4 T-shaped power divider formed by parallel strip lines. In order to balance the amplitude of the feeding coaxial cable, the structure is used in the bottom to transfer parallel strip line to micro-strip line. Besides, the loops and the dipoles are placed on the different side of the network to guarantee the omni-directional radiation property. The measured impedance bandwidth of the fabricated antenna is 0.13 GHz (2.40–2.53 GHz) and the measured maximum CP gain at 2.45 GHz is 4.8 dBic.

Novel NiMoO4-integrated electrode materials were successfully prepared by solvothermal method using Na2MoO4·2H2O and NiSO4·6H2O as main raw materials, water, and ethanol as solvents. The morphology, phase, and structure of the as-prepared materials were characterized by SEM, XRD, Raman, and FT-IR. The electrochemical properties of the materials in supercapacitors were investigated by cyclic voltammetry, constant current charge–discharge, and electrochemical impedance spectroscopy techniques. The effects of volume ratio of water to ethanol (W/E) in solvent on the properties of the product were studied. The results show that the pure phase monoclinic crystal NiMoO4 product can be obtained when the W/E is 2:1. The diameter and length are 0.1–0.3 µm and approximately 3 µm, respectively. As an active material for supercapacitor, the NiMoO4 nanorods material delivered a discharge specific capacitance of 672, 498, and 396 F/g at a current density of 4, 7, and 10 A/g, respectively. The discharge specific capacitance slightly decreased from 815 to 588 F/g with a retention of 72% after 1000 cycles at a current density of 1 A/g. With these superior capacitance properties, the novel NiMoO4 integrated electrode materials could be considered as promising material for supercapacitors.

Carbon nanotubes (CNTs) were added to carbon nanofibers (CNFs) as additives to improve their electrochemical properties. In the present work, CNFs were prepared by using pressurized gyration with polyacrylonitrile as the precursor. The microstructure and electrochemical properties of samples were investigated by scanning electron microscopy and electrochemical workstation, respectively. The results showed that the network structure formed in the fiber, and the fiber diameter decreased with the increase of working pressure. The integral area of cyclic voltammetry curve reached the maximum and the charge/discharge time of constant current charge/discharge curve reached the longest in the case of the CNT concentration is 0.50 wt% and working pressure is 0.2 MPa. At the same time, it exhibited the best electrochemical performance with a specific capacitance of 79 F/g at a current density of 100 mA/g. Compared with the specific capacitance of pure CNFs, the specific capacitance of CNFs with the concentration of CNTs 0.50 wt% increased by about 40%.

Astrophysical collisionless shocks are amazing phenomena in space and astrophysical plasmas, where supersonic flows generate electromagnetic fields through instabilities and particles can be accelerated to high energy cosmic rays. Until now, understanding these micro-processes is still a challenge despite rich astrophysical observation data have been obtained. Laboratory astrophysics, a new route to study the astrophysics, allows us to investigate them at similar extreme physical conditions in laboratory. Here we will review the recent progress of the collisionless shock experiments performed at SG-II laser facility in China. The evolution of the electrostatic shocks and Weibel-type/filamentation instabilities are observed. Inspired by the configurations of the counter-streaming plasma flows, we also carry out a novel plasma collider to generate energetic neutrons relevant to the astrophysical nuclear reactions.

Northeastern China is a region of high tick abundance, multiple tick-borne pathogens and likely human infections. The spectrum of diseases caused by tick-borne pathogens has not been objectively evaluated in this region for clinical management and for comparison with other regions globally where tick-transmitted diseases are common. Based on clinical symptoms, PCR, indirect immunofluorescent assay and (or) blood smear, we identified and described tick-borne diseases from patients with recent tick bite seen at Mudanjiang Forestry Central Hospital. From May 2010 to September 2011, 42% (75/180) of patients were diagnosed with a specific tick-borne disease, including Lyme borreliosis, tick-borne encephalitis, human granulocytic anaplasmosis, human babesiosis and spotted fever group rickettsiosis. When we compared clinical and laboratory features to identify factors that might discriminate tick-transmitted infections from those lacking that evidence, we revealed that erythema migrans and neurological manifestations were statistically significantly differently presented between those with and without documented aetiologies (P < 0.001, P = 0.003). Twelve patients (6.7%, 12/180) were co-infected with two tick-borne pathogens. We demonstrated the poor ability of clinicians to identify the specific tick-borne disease. In addition, it is necessary to develop specific laboratory assays for optimal diagnosis of tick-borne diseases.

We present laboratory measurement and theoretical analysis of silicon K-shell lines in plasmas produced by Shenguang II laser facility, and discuss the application of line ratios to diagnose the electron density and temperature of laser plasmas. Two types of shots were carried out to interpret silicon plasma spectra under two conditions, and the spectra from 6.6 Å to 6.85 Å were measured. The radiative-collisional code based on the flexible atomic code (RCF) is used to identify the lines, and it also well simulates the experimental spectra. Satellite lines, which are populated by dielectron capture and large radiative decay rate, influence the spectrum profile significantly. Because of the blending of lines, the traditional $G$ value and $R$ value are not applicable in diagnosing electron temperature and density of plasma. We take the contribution of satellite lines into the calculation of line ratios of He-$\unicode[STIX]{x1D6FC}$ lines, and discuss their relations with the electron temperature and density.

Relic archeological settlement is used to indicate the development of agriculture. We extracted 8865 relic archeological settlements from the Atlas of Chinese Cultural Relics to analyze how the spatiotemporal distribution of archaeological settlements was influenced by temperature changes and social factors during the last millennium. During the Liao dynasty (AD 916–1125) and Jin dynasty (AD 1115–1234) in the Medieval Warm Period (MWP), a large number of settlements indicated the development of agriculture as far north as 47°N. The warm climate of the MWP provided sufficient heat resources to promote the implication of positive policies of the Liao and Jin dynasties to develop agriculture and settlements. By contrast, during the dynasties of Yuan (AD 1279–1368), Ming (AD 1368–1644), and Qing (AD 1644–1911) in the Little Ice Age (LIA), the number of settlements declined drastically, and the northern boundary of the settlement distribution retreated by 3–4 degrees of latitude to modern Liaoning Province. Although the southward retreat of the settlements and related agriculture occurred in the cold climate of the LIA, it could not be completely explained by the drop in temperature. Social factors including nomadic customs, ethnic policies, and postal road systems played more important roles to the northern boundaries of the settlement distributions during the Yuan, Ming, and Qing dynasties.