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To address the shortcomings of existing methods for rotorcraft searching, positioning, tracking and landing on a ship at sea, a dual-channel LIDAR searching, positioning, tracking and landing system (DCLSPTLS) is proposed in this paper, which utilises the multi-pulse laser echoes accumulation method and the physical phenomenon that the laser reflectivity of the ship deck in the near-infrared band is four orders of magnitude higher than that of the sea surface. The DCLSPTLS searching and positioning model, tracking model and landing model are established, respectively. The searching and positioning model can provide estimates of the azimuth angle, the distance of the ship relative to the rotorcraft and the ship's course. With the above parameters as inputs, the total tracking time and the direction of the rotorcraft tracking speed can be obtained by using the tracking model. The landing model can calculate the pitch and the roll angles of the ship's deck relative to the rotorcraft by using the least squares method and the laser irradiation coordinates. The simulation shows that the DCLSPTLS can realise the functions of rotorcraft searching, positioning, tracking and landing by using the above parameters. To verify the effectiveness of the DCLSPTLS, a functional test is performed using a rotorcraft and a model ship on a lake. The test results are consistent with the results of the simulation.
It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
Fibronectin type III domain-containing protein 5 (FNDC5) is a transmembrane protein and the precursor of irisin, which serves as a systemic exerkine/myokine with multiple origins. Since its discovery in 2012, this hormone-like polypeptide has rapidly evolved to a component significantly involved in a gamut of metabolic dysregulations and various liver diseases. After a decade of extensive investigation on FNDC5/irisin, we are still surrounded by lots of open questions regarding its diagnostic and therapeutic values. In this review, we first concentrated on the structure–function relationship of FNDC5/irisin. Next, we comprehensively summarised the current knowledge and research findings regarding pathogenic roles/therapeutic applications of FNDC5/irisin in the context of non-alcoholic fatty liver disease, fibrosis, liver injury due to multiple detrimental insults, hepatic malignancy and intrahepatic cholestasis of pregnancy. Moreover, the prominent molecules involved in the underlying mechanisms and signalling pathways were highlighted. As a result, emerging evidence reveals FNDC5/irisin may act as a proxy for diagnosing liver disease pathology, a sensitive biomarker for assessing damage severity, a predisposing factor for surveilling illness progression and a treatment option with protective/preventive impact, all of which are highly dependent on disease grading and contextually pathological features.
The Lancang-Mekong River Basin (LMRB) is Asia's most important transboundary river. The precipitation-dependent agriculture and the world's largest inland fishery in the basin feed more than 70 million people. Floods are the main natural disasters which pose a serious threat to the local agriculture and human life. In the future, climate change will affect the streamflow and lead to changes in flood events. Based on the GMDF and GCM data, the SPI and the VIC model were used to assess the impact of climate change on streamflow and flood events during the historical (1985–2016) and future periods (2020–2050) in the LMRB. The results show that the LMRB will become more humid in the future and annual precipitation will change from about -2 to 6 per cent under RCP4.5 and RCP8.5. In the future, this basin should experience a higher flood risk, with more flood events and a relative increase in the flood peak and frequency reaching up to +15 and +58 per cent, respectively. This study contributes to improve our understanding of the role of climate change on streamflow and flood events and provides a scientific reference for the development of local water resources management in the LMRB.
The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced ‘dose’ of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.
Thioredoxin-interacting protein (TXNIP) plays a key role in diabetes development and prognosis through its role in pancreatic β-cell dysfunction and death as well as in upregulating the inflammatory response in hyperglycemia. DNA methylation (DNAm) of TXNIP (TXNIP-cg19693031) is associated with the prevalence and incidence of type 2 diabetes (T2D); however, its role in inflammation and its relationship with T2D remain unclear. We aimed to investigate the epigenetic associations of TXNIP-cg19693031 with a panel of inflammatory biomarkers and to examine whether these inflammatory biomarkers modify the association between TXNIP-cg19693031 methylation and diabetes in 218 middle-aged male twins from the Emory Twin Study. We confirmed the association of TXNIP-cg19693031 DNAm with T2D, as well as with HbA1c, insulin and fasting glucose. We found that hypomethylation at TXNIP-cg19693031 is strongly associated with both type 2 diabetes and higher levels of inflammatory biomarkers (VCAM-1, ICAM-1, MMP-2, sRAGE and P-selectin); however, the relationship between TXNIP-cg19693031 and T2D is independent of the levels of these inflammatory biomarkers. Our results suggest that DNA methylation of TXNIP is linked with multiple biological processes, through which the TXNIP may have broad influence on chronic disease risk.
This chapter seeks to resolve the puzzle of people’s low accuracy in perceptions of local network properties versus their much higher accuracy in perceiving global network structures. We argue that this puzzle is more apparent than real because humans rely on layers of relational schemata—mental structures dictating how social agents ought to be structurally connected—to mentally organize their social contacts. In other words, differences in accuracy reflect differences in the schemata used by the individual to mentally represent social network information at varying levels (e.g., dyadic level, triadic level, and community level). Individuals vary in their schemata repertoire, and their tendencies to adopt certain schemata in a given situation or context, so the specific set of schemata that individuals activate varies in its sufficiency and appropriateness for fully representing the network structure. We define these individual differences as network representation capacities, and review and compare four prominent approaches to quantifying them: the error paradigm, the free-recall paradigm, the structural learning paradigm and the statistical learning paradigm. We conclude by inviting researchers to reconsider the relations between cognition and egocentric networks, as well as the role of network analysis in analyzing, describing and prescribing social relational behavior.
The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.
Several studies supported the usefulness of “the surprise question” in terms of 1-year mortality of patients. “The surprise question” requires a “Yes” or “No” answer to the question “Would I be surprised if this patient died in [specific time frame].” However, the 1-year time frame is often too long for advanced cancer patients seen by palliative care personnel. “The surprise question” with shorter time frames is needed for decision making. We examined the accuracy of “the surprise question” for 7-day, 21-day, and 42-day survival in hospitalized patients admitted to palliative care units (PCUs).
This was a prospective multicenter cohort study of 130 adult patients with advanced cancer admitted to 7 hospital-based PCUs in South Korea. The accuracy of “the surprise question” was compared with that of the temporal question for clinician's prediction of survival.
We analyzed 130 inpatients who died in PCUs during the study period. The median survival was 21.0 days. The sensitivity, specificity, and overall accuracy for the 7-day “the surprise question” were 46.7, 88.7, and 83.9%, respectively. The sensitivity, specificity, and overall accuracy for the 7-day temporal question were 6.7, 98.3, and 87.7%, respectively. The c-indices of the 7-day “the surprise question” and 7-day temporal question were 0.662 (95% CI: 0.539–0.785) and 0.521 (95% CI: 0.464–0.579), respectively. The c-indices of the 42-day “the surprise question” and 42-day temporal question were 0.554 (95% CI: 0.509–0.599) and 0.616 (95% CI: 0.569–0.663), respectively.
Significance of results
Surprisingly, “the surprise questions” and temporal questions had similar accuracies. The high specificities for the 7-day “the surprise question” and 7- and 21-day temporal question suggest they may be useful to rule in death if positive.
Saetaspongia so far cannot be confidently assigned to any class-level crown group. Clarifying its phylogenetic position requires new information provided by more detailed studies of previously described and/or new material. Some sponge fossils with the typical skeletal architecture of Saetaspongia have recently been recognized in the Cambrian (Stage 4) Balang Biota of Guizhou, China, including S. jianhensis new species and S. cf. S. densa. The new taxon is characterized by the following features: spicules are fine monaxons and are inclined to be loosely to densely arranged into plumose arrays; skeleton is composed primarily of one major plumose bundle, with an uncertain number (perhaps two) of small plumose arrays; and primary skeleton is occasionally interspersed with some irregularly oriented individual spicules. An additional specimen consisting of large monaxons, with plumose structures and overlying irregular coarse monaxons, closely fits the description and illustrations of previously described S. cf. S. densa. By combining information from previous studies and the present research, fossil evidence indicates that the plumose architecture is a critical feature diagnostic of Saetaspongia and that there are no hexactine-based spicules in this genus. The new material from the Balang Biota further supports the notion that Saetaspongia has a protomonaxonid rather than a hexactinellid affinity. Fossil evidence suggests that Saetaspongia had a wide biogeographic distribution during the early Cambrian and the stratigraphic distribution of this genus extends up to Stage 4.
Precise auditory perception at a subcortical level (neural representation and encoding of sound) has been suggested as a form of implicit L2 aptitude in naturalistic settings. Emerging evidence suggests that such implicit aptitude explains some variance in L2 speech perception and production among adult learners with different first language backgrounds and immersion experience. By examining 46 Chinese learners of English, the current study longitudinally investigated the extent to which explicit and implicit auditory processing ability could predict L2 segmental and prosody acquisition over a 5-month early immersion. According to the results, participants’ L2 gains were associated with more explicit and integrative auditory processing ability (remembering and reproducing music sequences), while the role of implicit, preconscious perception appeared to be negligible at the initial stage of postpubertal L2 speech learning.
Seaweeds have numerous biologically active ingredients, such as polysaccharides, polyphenols and carotenoids, that are beneficial to human health. Although these benefits might be related to the synthesis, secretion or reabsorption of uric acid, no studies have explored the relationship between seaweeds consumption and hyperuricaemia (HUA) in the general population. The aim of this study was to investigate whether seaweeds consumption is related to HUA in a large-scale adult population. A cross-sectional study was conducted with 32 365 adults (17 328 men and 15 037 women) in Tianjin, People’s Republic of China. Frequency of seaweeds consumption was assessed by a validated self-administered FFQ. HUA was defined as serum uric acid levels >420 μmol/L in men and >350 μmol/L in women. The association between seaweeds consumption and HUA was assessed by multiple logistic regression analysis. Restricted cubic spline functions were used for non-linearity tests. The prevalence of HUA in men and women was 21·17 % and 5·93 %, respectively. After adjustments for potential confounding factors, the OR (95 % CI) for HUA across seaweed consumption (g/1000 kcal per d) were 1·00 (reference) for level 1, 0·91 (95 % CI 0·81, 1·02) for level 2; 0·90 (95 % CI 0·81, 1·01) for level 3; 0·86 (95 % CI 0·78, 0·97) for level 4 in men and 0·90 (95 % CI 0·73, 1·10) for level 2; 0·82 (95 % CI 0·67, 1·00) for level 3; 0·84 (95 % CI 0·68, 1·03) for level 4 in women, respectively. A negative correlation between seaweeds consumption and HUA in males but not in females was observed. Further studies are needed to explore the causal relationship.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
The study was conducted using data from 5 adult ICUs of a referral hospital.
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
A fever clinic within a hospital plays a vital role in pandemic control because it serves as an outpost for pandemic discovery, monitoring and handling. As the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan was gradually brought under control, the fever clinic in the West Campus of Wuhan Union Hospital introduced a new model for construction and management of temporary mobile isolation wards. A traditional battlefield hospital model was combined with pandemic control regulations, to build a complex of mobile isolation wards that used adaptive design and construction for medical operational, medical waste management and water drainage systems. The mobile isolation wards allowed for the sharing of medical resources with the fever clinic. This increased the capacity and efficiency of receiving, screening, triaging and isolation and observation of patients with fever. The innovative mobile isolation wards also controlled new sudden outbreaks of COVID-19. We document the adaptive design and construction model of the novel complex of mobile isolation wards and explain its characteristics, functions and use.
In this study, we propose a hypothesis that domain-general auditory processing, a perceptual anchor of L1 acquisition, can serve as the foundation of successful post-pubertal L2 learning. This hypothesis was tested with 139 post-pubertal L2 immersion learners by linking individual differences in auditory discrimination across multiple acoustic dimensions to the segmental, prosodic, lexical, and morphosyntactic dimensions of L2 proficiency. Overall, auditory processing was a primary determinant of a range of participants’ proficiency scores, even after biographical factors (experience, age) were controlled for. The link between audition and proficiency was especially clear for L2 learners who had passed beyond the initial phase of immersion (length of residence > 1 year). The findings suggest that greater auditory processing skill benefits post-pubertal L2 learners immersed in naturalistic settings for a sufficient period of time by allowing them to better utilize received input, which results in greater language gains and leads to more advanced L2 proficiency in the long run (similar to L1 acquisition).
A series of new synthetic armored cables were developed and tested to ensure that they were suitable for use with the RECoverable Autonomous Sonde (RECAS), which is a newly designed freezing-in thermal ice probe. The final version of the cable consists of two concentric conductors that can be used as the power and signal lines. Two polyfluoroalkoxy jackets are used for electrical insulation (one for insulation between conductors, and the other for insulation of the outer conductor). The outer insulation layer is coated by polyurethane jacket to seal the connections between the cable and electrical units. The 0.65 mm thick strength member is made from aramid fibers woven together. To hold these aramid fibers in place, a sheathing layer was produced from a polyamide fabric cover net. The outer diameter of the final version of the cable is ~6.1 mm. The permissible bending radius is as low as 17–20 mm. The maximal breaking force under straight tension is ~12.2 kN. The cable weight is only ~0.061 kg m−1. The mechanical and electrical properties and environmental suitability of the cable were determined through laboratory testing and joint testing with the probe.
To examine the association between physician–patient treatments shared decision making (SDM), patient satisfaction, and adoption of a new health technology.
A cross-sectional study was conducted from July 2016 to October 2016 in Fujian Province and Shanghai, in Eastern China. A total of 542 physicians and 619 patients in eleven hospitals were surveyed. Patients and their treating physicians completed self-reported questionnaires on patient–physician SDM, satisfaction with treatment decision making and adoption of a new health technology. Correlation analysis, multivariate logistic regression and multivariate linear regression were performed.
The majority (68.20 percent) of patients preferred SDM. Involvement of patients in SDM was positively associated with their satisfaction with treatment decision making (p < .001) and adoption of a new health technology (p < .05). Better concordance between their preference and actual SDM was positively associated with patients' adoption behavior (p < .05), but no statistically significant association was found between concordance and satisfaction.
SDM was the most important predictor of patients' satisfaction with decision making and adoption of a new health technology. Therefore, better communication between physicians and patients is recommended to improve their SDM, increase patient satisfaction and to assist with the adoption of new technologies. Training healthcare provider and teaching communication skills in working with patients in the initial stage of technology diffusion is required.
The Yangtze Block in South China constitutes an important Precambrian landmass in the present East Asian continent. The Neoproterozoic sedimentary successions of the Hengdan Group in the NW Yangtze Block record essential information for deciphering the Neoproterozoic tectonics along the NW margin. However, its depositional age, provenance and tectonic properties remain uncertain. Here, a combined analysis of detrital zircon U–Pb dating and geochemistry is performed on representative samples from the Hengdan Group. Concordant dating results of samples from the bottom and upper parts constrain the maximum depositional age at c. 720 Ma. Detrital zircon age patterns of samples reveal a uniformly pronounced age peak at c. 915–720 Ma, which is consistent with the magmatic pulses in domains at the NW end of the Yangtze Block. In addition, these samples display left-sloping post-Archaean Australian shale (PAAS)-normalized rare-earth element patterns and variable trace element patterns, resembling sediments accumulated in a basin related to an active continental margin geodynamic setting. Provenance analysis reveals that the main sources featured intermediate to felsic components, which experienced rapid erosion and sedimentation. These integrated new investigations, along with previous compilations, indicate that the Hengdan Group might have been deposited in a fore-arc basin controlled by subduction beneath the Bikou Terrane. Thus, such interpretation further supports proposals for subduction-related tectonics along the western margin of the Yangtze Block during the early Neoproterozoic.
In this study, we propose a hypothesis that domain-general auditory processing, a perceptual–cognitive anchor of first language (L1) acquisition, can serve as an important deciding factor for successful postpubertal second language (L2) pronunciation learning. To examine this hypothesis, samples of spontaneous speech were elicited from a total of 30 L1 Chinese L2 English learners at two points (outset and endpoint) during an 8-month study-abroad period in the United Kingdom. The participants were tested on three different components of auditory processing ability (formant, pitch, and duration discrimination) using behavioral instruments. The auditory processing scores were then linked to the segmental, prosodic, and fluency dimensions of their L2 pronunciation proficiency development throughout the project. Overall, most learners’ speech became smoother, faster, and more fluent (fewer pauses, faster articulation rate, and more optimal perceived tempo). Certain learners with high-level auditory processing ability (more precise formant discrimination) appeared to further attain more correct pronunciation of individual sounds and words (greater segmental and word stress accuracy), leading to more advanced L2 phonological skills (fluent and accurate). The findings suggest that auditory processing abilities can be a root of language learning throughout the life span and may apply to the initial- to midphase of naturalistic L2 pronunciation learning in adulthood.
This study aimed to identify clinical features for prognosing mortality risk using machine-learning methods in patients with coronavirus disease 2019 (COVID-19). A retrospective study of the inpatients with COVID-19 admitted from 15 January to 15 March 2020 in Wuhan is reported. The data of symptoms, comorbidity, demographic, vital sign, CT scans results and laboratory test results on admission were collected. Machine-learning methods (Random Forest and XGboost) were used to rank clinical features for mortality risk. Multivariate logistic regression models were applied to identify clinical features with statistical significance. The predictors of mortality were lactate dehydrogenase (LDH), C-reactive protein (CRP) and age based on 500 bootstrapped samples. A multivariate logistic regression model was formed to predict mortality 292 in-sample patients with area under the receiver operating characteristics (AUROC) of 0.9521, which was better than CURB-65 (AUROC of 0.8501) and the machine-learning-based model (AUROC of 0.4530). An out-sample data set of 13 patients was further tested to show our model (AUROC of 0.6061) was also better than CURB-65 (AUROC of 0.4608) and the machine-learning-based model (AUROC of 0.2292). LDH, CRP and age can be used to identify severe patients with COVID-19 on hospital admission.