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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.
A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.
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%).
Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.
Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians.
We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation.
A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%.
With appropriate training, maternity hospital’s paediatricians can detect major CHD with high detection rates with an acceptable false positive rate.
To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.
A cross-sectional validation study.
Huashan Hospital, Shanghai, China.
A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.
Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.
Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.
Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.
Silicone Rubber (SR) filled with graphene nanoplatelets (GNPs) and carbon black (CB) is prepared for high performance flexible pressure sensor. Due to the synergetic effect of mixed GNPs and CB, the percolation threshold of GNPs/CB/SR is lower than that of CB/SR, which indicates the addition of GNPs is contributed to enhance the electrical conductivity of GNPs/CB/SR. Moreover, the GNPs/CB/SR has a higher electrical stability and weaker resistance creep than that of GNPs/SR. That is to say, the addition of CB can promote the electrical and mechanical performance of GNPs/CB/SR, simultaneously. The pressure sensor array based on GNPs/CB/SR with weight on different sensing element is tested, and the results show that the size of applied loading on the pressure-sensitivity array can be recognized accurately.
It is well known that c-Jun N-terminal kinase (JNK) plays pivotal roles in various mitotic events, but its function in mammalian oocyte meiosis remains unknown. In this study, we found that no specific JNK2 signal was detected in germinal vesicle stage. JNK2 was associated with the spindles especially the spindle poles and cytoplasmic microtubule organizing centers at prometaphase I, metaphase I, and metaphase II stages. JNK2 became diffusely distributed and associated with the midbody at telophase I stage. Injection of myc-tagged JNK2α1 mRNA into oocytes also revealed its localization on spindle poles. The association of JNK2 with spindle poles was further confirmed by colocalization with the centrosomal proteins, γ-tubulin and Plk1. Nocodazole treatment showed that JNK2 may interact with Plk1 to regulate the spindle assembly. Then we investigated the possible function of JNK2 by JNK2 antibody microinjection and JNK specific inhibitor SP600125 treatment. These two manipulations caused abnormal spindle formation and decreased the rate of first polar body (PB1) extrusion. In addition, inhibition of JNK2 resulted in impaired localization of Plk1. Taken together, our results suggest that JNK2 plays an important role in spindle assembly and PB1 extrusion during mouse oocyte meiotic maturation.
Seven isoenergetic semi-purified test diets containing graded levels of protein ranging from 20 to 50% were formulated using fish meal and casein as the protein sources. Test diets were fed to triplicate groups of Barbodes caldwelli juveniles with initial body weights of 1.26±0.02 g for eight weeks. The results indicated no significant effect of dietary protein levels on survival rate, relative weight of the viscera and relative weight of the liver in the juvenile fish. The weight gain and specific growth rate of the fish were found to be greater as dietary protein levels increased from 20 to 35%, but were not affected significantly as dietary protein level increased from 35 to 50%. Feed efficiencies did not differ significantly when fish were fed diets with protein levels from 30 to 50%, but were significantly higher than those of fish fed diets with protein levels of 20 and 25%. The protein efficiency ratio (PER) was negatively correlated with diet protein level (x) (PER=3.006−0.03251x, R=0.9366). There was no significant effect of dietary protein levels on carcass moisture, crude protein and ash. However, carcass lipid levels (L) decreased with an increase in dietary protein level (x) (L=8.2169−0.0458x, R=0.8551). There was no significant variation in hepatopancreas protease activity among the tests. Intestine protease activity and hepatopancreas amylase activity were increased to some extent, and then decreased as dietary protein levels continued to rise. The intestine amylase activity (IAA) of the juveniles was negatively correlated with dietary protein level (x) (IAA=84.625−0.9147x, R=0.8463). It was estimated that the suitable protein level for the B. caldwelli juvenile is 34% (the broken-line model was used to regress the relationship of the weight gain of the juvenile and dietary protein level).
Eupatorium adenophorum (crofton weed) is one of the most widespread invasive species in China. Its genetic diversity and population structure in China were analysed by amplified fragment length polymorphism (AFLP). Three primer pairs were selected for the analysis and 490 bands were produced from 62 E. adenophorum populations selected from five major geographic areas. A total of 328 of the bands showed polymorphism [percentage of polymorphic bands (PPB)=59.4%]. Diversity levels of populations were relatively high (mean expected heterozygosity=0.154, mean Shannon index=0.241). At the regional level, the AMOVA indicated that about 70.25% of variation in the data set was from genotypic variations within populations, whereas 8.04% of the variation was due to regional differences, and the remaining 21.71% to differences among populations within the provincial regions. Cluster analysis based on the unweighted pair-group method using the method of arithmetic averages (UPGMA) grouped the majority of E. adenophorum populations into four main clusters, which correspond to their geographic regions. It is concluded that E. adenophorum spread mainly by wind or water and its genetic diversity level in newly invaded areas was lower than that in formerly colonized areas.
Objective: To evaluate the role of transoesophageal echocardiography and problems related to safety during the surgical repair of congenital cardiac malformations in children. Methods: We examined the transoesophageal recordings made in 350 children with congenital cardiac diseases, aged from 2 months to 17 years and 9 months, with a median age of 2.7 years, tracings having been taken both before and after cardiopulmonary bypass. All patients had been scanned by transthoracic echocardiography before the operative procedures. Results: Preoperative transoesophageal echocardiography added additional findings, or changed the diagnoses made using transthoracic echocardiography, in 33 cases (9.4%), among which the findings had therapeutic significance in 23 cases (6.6%) that altered the planned surgical procedures. Residual problems or sequels were detected by postoperative transoesophageal echocardiography in 57 cases (16.3%), with 13 patients (3.7%) requiring instant intervention or return to bypass for modifications of the surgical procedures. We encountered no severe complications due to the performance of transoesophageal echocardiography. Mild complications occurred in only 2 patients (0.6%). Conclusions: Transoesophageal echocardiography is a useful tool with which to determine the strategies for treatment in the perioperative period, and to improve the quality of surgical procedures in children with congenital cardiac diseases. Complications were few, but still deserved careful attention to detail.