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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.
Honeybees cannot synthesize arachidonic acid (ARA) themselves, only obtain it from food. Most pollen is deficient or contains a small amount of ARA. The necessity of supplementary ARA in bees’ diet has not been studied. The objective of this study was to investigate the effects of dietary ARA levels on the growth and immunity of Apis mellifera ligustica. A total of 25 honeybee colonies were randomly assigned to five dietary groups which were fed basic diets supplemented with 0, 2, 4, 6, and 8% of ARA. The diet with 4% ARA improved the body weight of newly emerged worker bees compared with the control group. Supplement of ARA in honeybee diets changed the fatty acid composition of honeybee body. SFA and MUFA contents of bees’ body declined, and PUFA content rised in the ARA group. Compared with the control group, the supplement of ARA in honeybee diets increased the contents of ARA, C22:6n-3 (DHA) and C18:3n-6 in bees’ body significantly, but decreased the contents of C16:1 and C18:3n-3. The diet supplied with 4% ARA reduced the mortality rate of honeybee infected with Escherichia coli. The activity of immune enzymes (phenoloxidase, antitrypsin, and lysozyme) and the mRNA expression levels of immune genes (defensin-2, toll, myd88, and dorsal) were improved by ARA diets to varying degrees depending on the ARA levels, especially 4% ARA. These results suggested that dietary ARA could improve the growth, survival, and immune functions of honeybees. Supplement of ARA in bees’ diet would be valuable for the fitness of honeybees.
Although many organizations encourage employees to voice, employees may be reluctant to voice directly because they are afraid that their supervisors will perceive it as challenging their face (i.e., the positive image or social value of an individual). Alternatively, employees could deliver improvements or express concerns to their supervisors using indirect and implicit approaches, which we refer to as ‘implicit voice delivery’. Applying face theory, we examine the antecedents and outcomes as well as two boundary conditions of implicit voice delivery in organizations with two studies. In Study 1, we define the construct and develop a measure of implicit voice delivery. In Study 2, we test our proposed model with supervisor-subordinate dyadic data from a time-lagged survey. Results demonstrate that concern for other people's face drives employees to express their voices implicitly and that this relationship is stronger when supervisors’ concern for their own face is high rather than low. In addition, implicit voice delivery is associated with supervisors’ favorable response in terms of voice endorsement. Furthermore, the effect on voice endorsement is stronger when the supervisor is more able to infer meaning from implicit messages. Theoretical contribution and managerial implications are discussed.
This article studies the promulgation of law in Qin and Western Han China (221 b.c.e.–9 c.e.) based primarily on excavated legal and administrative texts. It shows that a new law was handed down from the emperor to the relevant offices on the day of enactment. The article argues that, to an extent, the subject matter and function of a law determined for whom it was passed and promulgated. Depending upon the location, rank, and official duties of the offices, the laws known and used could be quite different. Although it was required that documents of imperial decisions be forwarded swiftly and safely by courier at the prescribed speed, delays in forwarding such documents to distant local offices were probably common in Qin and Western Han China. Evidence indicates that district- and prefecture-level officials publicized laws that needed to be made known by the common people, by reading them aloud in local gatherings, for example, or posting them in conspicuous places. The article further argues that a law came into effect in offices on the day it arrived at local courts or on the day it was enacted in the central court, depending on the existence of related extant laws. It concludes that a new law in Qin and Western Han China was ex post facto, as it reached backwards to a past action and retroactively attached liabilities to the action at the point when it was performed.
Several Drosophila species (Diptera: Drosophilidae) have become serious economic pests of berry and soft-skinned stone fruits around the world. Prominent examples are Drosophila suzukii (Matsumura), D. melanogaster (Meigen), D. hydei (Sturtevant), and D. immigrans (Sturtevant). Information on the biology and ecology of Drosophila is important for a better understanding of these important fruit pests and, ultimately, for fruit protection. In this study, the gut bacteriomes of these four Drosophila species were surveyed and the differences among bacterial communities were characterised. The 16S rRNA genes of gut microbes were sequenced by Illumina MiSeq technology (Illumina, San Diego, California, United States of America), followed by α-diversity and β-diversity analyses. The results show that bacteria of the family Enterobacteriaceae (Kluyvera and Providencia; phylum Proteobacteria) dominated all four Drosophila species. Specific dominant gut bacterial communities were found in each Drosophila species. The dominant families in D. melanogaster and D. suzukii were Enterobacteriaceae, Comamonadaceae, and Acetobacteraceae. In the intestine of D. hydei, Enterobacteriaceae had a proportion of 56.99%, followed by Acetobacteraceae, Spiroplasmataceae, and Bacillales Incertae Sedis XII. In D. immigrans, besides Enterobacteriaceae, Alcaligenaceae, Flavobacteriaceae, Xanthomonadaceae, Comamonadaceae, and Sphingobacteriaceae also had high relative abundance. These data expand current knowledge about the putative function related to gut microbes – for example, the metabolism of carbohydrates, amino acids, inorganic ions, lipids, and secondary metabolites. This knowledge provides a basis for further metatranscriptomic and metaproteomic investigations.
As a neuroprogressive illness, depression is accompanied by brain structural abnormality that extends to many brain regions. However, the progressive structural alteration pattern remains unknown.
To elaborate the progressive structural alteration of depression according to illness duration, we recruited 195 never-treated first-episode patients with depression and 130 healthy controls (HCs) undergoing T1-weighted MRI scans. Voxel-based morphometry method was adopted to measure gray matter volume (GMV) for each participant. Patients were first divided into three stages according to the length of illness duration, then we explored stage-specific GMV alterations and the causal effect relationship between them using causal structural covariance network (CaSCN) analysis.
Overall, patients with depression presented stage-specific GMV alterations compared with HCs. Regions including the hippocampus, the thalamus and the ventral medial prefrontal cortex (vmPFC) presented GMV alteration at onset of illness. Then as the illness advanced, others regions began to present GMV alterations. These results suggested that GMV alteration originated from the hippocampus, the thalamus and vmPFC then expanded to other brain regions. The results of CaSCN analysis revealed that the hippocampus and the vmPFC corporately exerted causal effect on regions such as nucleus accumbens, the precuneus and the cerebellum. In addition, GMV alteration in the hippocampus was also potentially causally related to that in the dorsolateral frontal gyrus.
Consistent with the neuroprogressive hypothesis, our results reveal progressive morphological alteration originating from the vmPFC and the hippocampus and further elucidate possible details about disease progression of depression.
Chronic inflammation exerts pleiotropic effects in the aetiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40–69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HR) as well as 95 % CI for the risk of incident COPD. During a median follow-up of 8·96 years (interquartile range 8·29–9·53 years), 9016 new-onset events of COPD were documented. We found that the regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0·80 (95 % CI, 0·75, 0·85; P < 0·001). When subgroup analyses were performed by smoking status, the adjusted HR for the association of regular glucosamine use with incident COPD were 0·84 (0·73, 0·96), 0·84 (0·77, 0·92) and 0·71 (0·62, 0·80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (Pfor interaction = 0·078). Incident COPD could be reduced by 14 % to 84 % through a combination of regular glucosamine use and smoking cessation.
To explore the characteristics of the mitochondrial genome (mitogenome) of the squeaking silkmoths Rhodinia, a genus of wild silkmoths in the family Saturniidae of Lepidoptera, and reveal phylogenetic relationships, the mitogenome of Rhodinia fugax Butler was determined. This wild silkmoth spins a green cocoon that has potential significance in sericulture, and exhibits a unique feature that its larvae can squeak loudly when touched. The mitogenome of R. fugax is a circular molecule of 15,334 bp long and comprises 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes, and an A + T-rich region, consistent with previous observations of Saturniidae species. The 370-bp A + T-rich region of R. fugax contains no tandem repeat elements and harbors several features common to the Bombycidea insects, but microsatellite AT repeat sequence preceded by the ATTTA motif is not present. Mitogenome-based phylogenetic analysis shows that R. fugax belongs to Attacini, instead of Saturniini. This study presents the first mitogenome for Rhodinia genus.
Detailed balance of a chemical reaction network can be defined in several different ways. Here we investigate the relationship among four types of detailed balance conditions: deterministic, stochastic, local, and zero-order local detailed balance. We show that the four types of detailed balance are equivalent when different reactions lead to different species changes and are not equivalent when some different reactions lead to the same species change. Under the condition of local detailed balance, we further show that the system has a global potential defined over the whole space, which plays a central role in the large deviation theory and the Freidlin–Wentzell-type metastability theory of chemical reaction networks. Finally, we provide a new sufficient condition for stochastic detailed balance, which is applied to construct a class of high-dimensional chemical reaction networks that both satisfies stochastic detailed balance and displays multistability.
Almost all hospitals are equipped with air-conditioning systems to provide a comfortable environment for patients and staff. However, the accumulation of dust and moisture within these systems increases the risk of transmission of microbes and have on occasion been associated with outbreaks of infection. Nevertheless, the impact of air-conditioning on the transmission of microorganisms leading to infection remains largely uncertain. We conducted a scoping review to screen systematically the evidence for such an association in the face of the coronavirus disease 2019 epidemic. PubMed, Embase and Web of Science databases were explored for relevant studies addressing microbial contamination of the air, their transmission and association with infectious diseases. The review process yielded 21 publications, 17 of which were cross-sectional studies, three were cohort studies and one case−control study. Our analysis showed that, compared with naturally ventilated areas, microbial loads were significantly lower in air-conditioned areas, but the incidence of infections increased if not properly managed. The use of high-efficiency particulate air (HEPA) filtration not only decreased transmission of airborne bioaerosols and various microorganisms, but also reduced the risk of infections. By contrast, contaminated air-conditioning systems in hospital rooms were associated with a higher risk of patient infection. Cleaning and maintenance of such systems to recommended standards should be performed regularly and where appropriate, the installation of HEPA filters can effectively mitigate microbial contamination in the public areas of hospitals.
When a mixture of viscous oil and non-colloidal particles displaces air between two parallel plates, the shear-induced migration of particles leads to the gradual accumulation of particles on the advancing oil–air interface. This particle accumulation results in the fingering of an otherwise stable fluid–fluid interface. While previous works have focused on the resultant instability, one unexplored yet striking feature of the experiments is the self-similarity in the concentration profile of the accumulating particles. In this paper, we rationalise this self-similar behaviour by deriving a depth-averaged particle transport equation based on the suspension balance model, following the theoretical framework of Ramachandran (J. Fluid Mech., vol. 734, 2013, pp. 219–252). The solutions to the particle transport equation are shown to be self-similar with slight deviations, and in excellent agreement with experimental observations. Our results demonstrate that the combination of the shear-induced migration, the advancing fluid–fluid interface and Taylor dispersion yield the self-similar and gradual accumulation of particles.
Pneumatic launch systems for Unmanned Aerial Vehicles (UAVs), including mechanical and pneumatic systems, are complex and non-linear. They are subjected to system parameters during launch, which leads to difficulty in engineering research analysis. For example, the mismatch between the UAV parameters and the parameter design indices of the launch system as well as the unclear design indices of the launching speed and overload of UAVs have a great impact on launch safety. Considering this situation, some studies are presented in this paper. Taking the pneumatic launch system as a research object, a pneumatic launcher dynamic simulation model is built based on co-simulation considering the coupling characteristics of the mechanical structure and transmission system. Its accuracy was verified by laboratory test results. Based on this model, the paper shows the effects of the key parameters, including the mass of the UAV, cylinder volume, pressure and moment of inertia of the pulley block, on the performance of the dynamic characteristics of the launch process. Then, a method for matching the parameter characteristics between the UAV and launch system based on batch simulation is proposed. The set of matching parameter values of the UAV and launch system that satisfy the launch take-off safety criteria are calculated. Finally, the influence of the system parameters of the launch process on the launch performance was analysed in detail, and the design optimised. Meaningful conclusions were obtained. The analysis method and its results can provide a reference for engineering and theoretical research and development of pneumatic launch systems.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
Three-scalar subgrid-scale (SGS) mixing in turbulent coaxial jets is investigated experimentally. The flow consists of a centre jet, an annulus and a co-flow. The SGS mixing process and its dependence on the velocity and length scale ratios of the annulus flow to the centre jet are investigated. For small SGS scalar variance the scalars are well mixed and the initial three-scalar mixing configuration is lost. For large SGS variance, the scalars are highly segregated with a bimodal scalar filtered joint density function (f.j.d.f.) at a range of radial locations. Two competing factors, the SGS variance and the scalar length scale, play an important role for the bimodal f.j.d.f. For the higher velocity ratio cases, the peak value of the SGS variance is higher, thereby resulting in stronger bimodality. For the lower velocity ratio cases, the wider mean SGS variance profiles and the smaller scalar length scale cause bimodal f.j.d.f.s over a wider range of physical locations. The scalar dissipation rate structures have similarities to those of mixture fraction and temperature in turbulent non-premixed/partially premixed flames. The observed SGS mixing characteristics present a challenging test for SGS mixing models as well as provides an understanding of the physics for developing improved models. The results also provide a basis for investigating multiscalar SGS mixing in turbulent reactive flows.
This paper reports a new phenomenon in the near-free-surface region of open channel flows (OCFs): namely that higher relative population densities of spanwise vortices are observed than are seen at equivalent positions in turbulent boundary layers. The presence of additional retrograde spanwise vortices in OCFs throughout the region $y/h>0.2$ (where $y$ is the distance to the wall and $h$ is the water depth) prompts us to re-examine the wall-normal extent that the free-surface effect can reach, which is classically expected to be limited within the surface and blockage layers. Finally, possible mechanisms for the phenomenon of additional spanwise vortices in OCFs are provided.
It has long been hypothesized that personality plays a causative role in incidence and outcome of breast cancer (BC), but epidemiological evidence of association between personality and BC is inconsistent.
We used two-sample Mendelian randomization analysis to estimate the impact of personality on the risk and survival of BC. In total, 109 single nucleotide polymorphisms (SNPs) were utilized as instruments of neuroticism from a large-scale Genome-Wide Association Studies (GWAS), and five SNPs were utilized as instruments of extraversion from Genetic of Personality Consortium and 23andMe. Genetic association with the risk and survival of overall and individual subtype BC were obtained from the Breast Cancer Association Consortium.
Neuroticism is significantly associated with the risk of overall BC [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.01–1.11; p = 0.015] and the risk of luminal A BC (OR 1.09; 95% CI 1.03–1.16; p = 0.004). Extraversion is not associated with the risk of BC. None of neuroticism or extraversion is associated with the survival of BC.
Neuroticism was associated with a modest increased risk of BC and particularly luminal A BC.
A ship's perception of risk is an important basis for collision avoidance. To improve such perception, several risk measurement parameters on the ship domain are determined, including the approach factor, the time to domain violation (TDV) and the possible collision domain. Then, a risk hierarchy prewarning (RHP) model based on the violation detection of a ship domain is proposed, in which a two-level alarm scheme is adopted accordingly. A low-intensity alarm will be activated by reaching the minimum approach factor and the TDV threshold, and a high-intensity alarm will be activated by the factor of the possible collision domain and the TDV threshold. Subsequently, a novel guard zone in ARPA radar utilising the RHP model has been developed to establish a ship's risk perception system for officers on watch at sea. The model proposed in this paper can not only enhance the veracity of risk assessment around our own ship, but also be used as a decision support system for collision avoidance.
As a new management reform adapting the development of the times, electronic human resource management (E-HRM) covers all possible integration mechanisms and contents between HRM and Information Technologies. E-HRM promotes employees' subject status with the network characteristics of openness and cooperation. Taking the theory of work adjustment as the instruction, this research studies the adaptive process induced by reconstructing the sense of matching when employees experience the reform, along with the influence of E-HRM on employee's initiative behavior from the perspective of job crafting. In total, 706 employees and their supervisors were investigated with matched questionnaire survey. The results show that: (1) E-HRM can stimulate employees' personal initiative behavior; (2) task crating, relational crafting and cognitive crafting as three dimensions of employees' job crafting, mediate the effect of E-HRM on personal initiative behavior and (3) the self-development motivation of employees' internet use plays a positive moderating role, steering self-oriented job crafting in the positive direction which conforms to the organizations' expectation.