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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 hemorrhagic 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 (60.4 ± 12.83 years; 66.8% 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 identify those who need additional nutritional managements.
The aim of this study was to present the clinical characteristics and dynamic changes in laboratory parameters of the coronavirus disease 2019 (COVID-19) in Guangzhou, and explore the probable early warning indicators of disease progression.
We enrolled all the patients diagnosed with COVID-19 in the Guangzhou No. 8 People’s Hospital. The patients’ demographic and epidemiologic data were collected, including chief complaints, lab results, and imaging examination findings.
The characteristics of the patients in Guangzhou are different from those in Wuhan. The patients were younger in age, predominately female, and their condition was not commonly combined with other diseases. A total of 75% of patients suffered fever on admission, followed by cough occurring in 62% patients. Comparing the mild/normal and severe/critical patients, being male, of older age, combined with hypertension, abnormal blood routine test results, raised creatine kinase, glutamic oxaloacetic transaminase, lactate dehydrogenase, C-reactive protein, procalcitonin, D-dimer, fibrinogen, activated partial thromboplastin time, and positive proteinuria were early warning indicators of severe disease.
The patients outside epidemic areas showed different characteristics from those in Wuhan. The abnormal laboratory parameters were markedly changed 4 weeks after admission, and also were different between the mild and severe patients. More evidence is needed to confirm highly specific and sensitive potential early warning indicators of severe disease.
Mainland China has not adopted the UN Commission on International Trade Law (UNCITRAL) Model Law, nor has it permitted ad hoc arbitration. Yet, arbitration in China is developing rapidly. According to the data released by the Ministry of Justice on March 2019, at the end of 2018 there were 255 arbitration commissions established with more than 60,000 staff members in mainland China.1 The caseload of 2018 is 540,000, which was a 127 percent increase compared to that in 2017.2 The stakes involved in 2018 are around 700 billion RMB.3 Since the promulgation of the Chinese Arbitration Law (CAL) in 1994, domestic arbitral commissions have handled over 2.6 million cases involving more than seventy countries/regions.4 Additionally, judicial review of arbitration in China has undergone changes over the last decades. The Chinese Arbitration Law has gone through heated discussions of amendment, and the Supreme People’s Court’s (SPC) judicial interpretations have contributed significantly to the development of Chinese arbitration. With the acceleration of open-up policy and the implementation of the Belt and Road Initiative (BRI), China endeavors to elevate its international image by providing fair, transparent, and efficient judicial services for international dispute resolution. Judicial attitude toward arbitration becomes more open minded than ever before. In earlier days, foreign investors had little information on the prospects of enforceability of arbitral awards in mainland China. The uncertainty inevitably affected their decisions on whether to choose arbitration as a dispute resolution mechanism when doing business with Chinese counterparts.
Three-dimensional flow fields of a rectangular synthetic jet with aspect ratio of 3 and its interaction with a laminar cross-flow are measured using time-resolved tomographic particle image velocimetry. The synthetic-jet to free-stream velocity ratio is fixed at 1, and two orifice orientations, normal to (spanwise configuration) and aligned with (streamwise configuration) the cross-flow direction, respectively, are investigated. The flow scenarios are composed of a tilted vortex ring, a secondary trailing vortex and a tertiary near-wall vortex. Compared to previous results for circular cases, the legs of the trailing structures are found to be jointed in the spanwise direction by two shear-layer vortices at different wall-normal heights. In addition, the near-wall vortex is a crescent-shaped spanwise vortex. For the first time, as the peculiar process of non-circular vortex rings in quiescent condition, axis switching is validated to exist in the cross-flow. Associated with axis switching, the spanwise case exhibits interaction between the leeward vortex of the vortex ring and the downstream shear-layer vortex, which causes slower penetration and recovery of vortex ring tilting, but faster jet transition. Furthermore, the trailing structures and vortex ring are weakened, leading to lower peaks of the velocity deficit and overshoot in the jet region than those for the streamwise case. On the other hand, the spanwise case can induce a stronger near-wall vortex, which transfers more momentum and initial disturbance into the boundary layer. Consequently, the spanwise case yields larger velocity gradient and velocity fluctuation peak inside the boundary layer with a lower shape factor, suggesting greater efficiency of promoting boundary-layer transition.
Isolated congenital tricuspid regurgitation other than Ebstein’s anomaly was rare especially for children. The objective of this study was to investigate the clinical characteristics and to assess the results of tricuspid valvuloplasty for children with isolated tricuspid regurgitation.
From January 2010 to June 2019, 10 consecutive patients with isolated tricuspid regurgitation who were unresponsive to drug therapy underwent tricuspid valvuloplasty in our hospital. Patients’ clinical data were analysed retrospectively.
Mean age at operation was 48.5 ± 31.0 (range: 9–106) months and mean weight at operation was 16.1 ± 6.9 (range: 8.6–33.0) kg. All patients presented severe isolated tricuspid regurgitation. According to pathological lesions, the main causes accounted for chordae tendinea rupture (3/10), leaflet cleft (2/10), mal-connected chordal tendinea to leaflets (2/10), elongated chordae (1/10) and chordae absent (1/10), and severe anterior leaflet dysplasia (1/10). Individualised tricuspid valvuloplasty was adapted to all of them successfully. Post-operative echocardiography showed no tricuspid regurgitation in two patients and mild regurgitation in eight patients. The cardiothoracic ratios on their chest roentgenograms decreased from 0.59 ± 0.05 to 0.54 ± 0.05. At the latest follow-up (50.4 ± 47.2 months), echocardiography showed that mild to moderate tricuspid regurgitation in seven patients, moderate tricuspid regurgitation in three patients, and no patient with severe tricuspid regurgitation. All patients were in NYHA functional class I.
For patients with isolated tricuspid regurgitation who were not well responsive to drug therapy, individualised tricuspid valve repair can achieve an excellent result.
We present a 3D reconstruction method using brightness and camera motion estimation for registering local colon structure in colonoscopy. The proposed method is based on reverse projection from 2D fold contours to 3D space, motion estimation from 3D reconstructed points between neighboring frames, and model registration to reconstruct the fold structure. On the synthetic colon, the average percentages of the reconstructed depth error and circumference error are about 14.2% and 15.2%, respectively. The accuracy is enough for the navigation and control in capsule robot. This work demonstrates that the proposed method is superior to the methods using single-frame-based brightness intensity.
The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Qi and Chapman [‘Two closed forms for the Bernoulli polynomials’, J. Number Theory159 (2016), 89–100] gave a closed form expression for the Bernoulli polynomials as polynomials with coefficients involving Stirling numbers of the second kind. We extend the formula to the degenerate Bernoulli polynomials, replacing the Stirling numbers by degenerate Stirling numbers of the second kind.
The star formation history (SFH) of galaxies allow us to investigate when galaxies formed their stars and assembled their mass. We can constrain the SFH with high level of precision from galaxies with resolved stellar populations, since we are able to discriminate between stars of different ages from the spectrum they emit. However, the relative importance of secular evolution (nature) over nurture is not yet clear, and separating the effects of interaction-driven evolution in the observed galaxy properties is not trivial. The aim of this study is to use MaNGA (Mapping Nearby Galaxies at APO) Integral Field Unit (IFU) data, in combination with multi-wavelength data, to constrain the SFH of nearby isolated galaxies. We present here the new techniques we are developing to constrain the SFH with high level of precision from Spectral Energy Distribution (SED) fitting. This study is part of a China-Chile collaboration program where we are applying these new techniques to investigate how galaxies formed and evolve in different environments.
Employing atomic-scale simulations, the response of a high-angle grain boundary (GB), the soft/hard GB, against external loading was systematically investigated. Under tensile loading close to the hard orientation, strain-induced dynamic recrystallization was observed to initiate through direct soft-to-hard grain reorientation, which was triggered by stress mismatch, inhibited by surface tension from the soft-hard GB, and proceeded by interface ledges. Such grain reorientation corresponds with expansion and contraction of the hard grain along and perpendicular to the loading direction, respectively, accompanied by local atomic shuffling, providing relatively large normal strain of 8.3% with activation energy of 0.04 eV per atom. Tensile strain and residual dislocations on the hard/soft GB facilitate the initiation of dynamic recrystallization by lowering the energy barrier and the critical stress for grain reorientation, respectively.
Laser-induced acoustic desorption (LIAD) enables the desorption of nonvolatile and/or thermally labile neutral compounds, such as asphaltenes, saturated hydrocarbons in base-oil fractions and biomolecules, from a metal surface into a mass spectrometer. This is a “gentle” evaporation technique and causes minimal fragmentation to the desorbed neutral molecules, including oligonucleotides and polypeptides. LIAD can be coupled with a wide range of ionization methods to facilitate analysis of the desorbed analytes by using many different types of mass spectrometers, including Fourier transform ion cyclotron resonance, linear quadrupole ion trap and quadrupole time-of-flight instruments. The development and improvement of LIAD remains an active research area with diverse goals such as better desorption efficiencies, minimized analyte fragmentation and greater versatility. This article details the theory, experimental methods, applications, and future directions of LIAD in combination with mass spectrometry.
The immobilization of cytochrome c (cyt c) on tea polyphenol functionalized and reduced graphene oxide (TPG) was carried out by a simple adsorption process. Intriguingly, TPG with large surface area exhibited excellent adsorption behaviors and good biocompatibility. The adsorbed materials were characterized by various methods including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). And the effects of adsorption behavior of cyt c were discussed in detail. The results showed the adsorption behavior was dependent on the pH value and showed a high adsorption capacity as high as 1.414 × 104 mg/g and was friendly to normal cells (mouse fibroblast cell line, L929). In conclusion, we proposed the introduction of TPG as novel material and used the adsorption method to immobilize cyt c, which would provide a novel material and simple method for the enrichment of protein.
Blue compact dwarf galaxies(BCDs) are galaxies undergoing violent burst of star formation in compact regions. They are often thought of being an evolutionary stage of dwarf galaxies and thus can provide a unique window to study the formation and evolution of dwarf galaxies. We selected a sample of 48 BCDs from the SDSS-IV MaNGA survey (MPL-7) and separated the starburst(SB) components from their underlying hosts with a new algorithm. Combining the structural properties of the BCDs, we further explore the physical connections between the SB components and theirs hosts.
Sulphur isotopes can be used as a powerful tool to trace fluid evolution and explore the formation of chimneys. To clarify the in situ S isotopic variations of sulphides at the micro-scale, we analyzed a sulphide chimney collected from the hydrothermal field in the East Pacific Rise 1–2° S using a sensitive high-mass-resolution ion micro-probe for stable isotopes (SHRIMP SI). Three mineral zones can be identified in the chimney: an external outer wall of porous anhydrite and colloform pyrite, an internal middle zone of sub-euhedral pyrite and massive chalcopyrite, and an inner zone of massive pyrite. The δ34SV-CDT values of the sulphides fall within the range 1.83–7.51 ‰ (avg. 4.05 ‰, n = 16), and S isotopic values increase from the core (3.09 ‰, n = 3) to the middle (3.78 ‰, n = 11) to the edge (6.99 ‰, n = 2). These results illustrate mineral crystallization processes and the mixing between seawater-derived S and magmatic–hydrothermal fluids during the growth of the chimney. The zones from the edge to the core are characterized by crystal morphologies of colloform/anhedral pyrite to massive pyrite with decreasing δ34S values, revealing multi-stage mineral deposition and sulphur isotopic fractionation. In contrast to the increase in δ34S values from the core to the edge in one profile (profile A), anomalously low δ34S values in fine-grained pyrite relative to chalcopyrite in another profile (profile B) in the middle zone result from S isotopic exchange between seawater SO42− and fluid H2S due to different fluid–seawater mixing, possibly caused by variations in permeability and porosity across the chimney.
Replacing precious and nondurable platinum-based catalysts by economical and commercially available materials is a key issue addressed in contemporary fuel cell technology. Carbon-based nanomaterials display great potential to improve fuel tolerance and reduce the cost and stress on metal scalability. However, their relatively low catalytic activity limits the development and application of these catalysts. In this study, we have synthesized a nitrogen-doped carbon electrocatalyst from metal–organic frameworks and carbon nanotube composites, taking advantage of the existing N in the organic linker in the MOFs with more N added through ammonia treatment. The morphology and composition of synthesized catalysts were characterized by SEM, TEM, XPS, and Raman. The derived catalyst exhibited superior catalytic activity than that of commercial Pt-based catalysts. The N enriched carbon catalyst with high surface area, a graphitic carbon skeleton, and a hierarchical porous structure facilitated the mass and charge transfer during electrolysis.
The Megamaser Cosmology Project (MCP) measures the Hubble Constant by determining geometric distances to circumnuclear 22 GHz H2O megamasers in galaxies at low redshift (z < 0.05) but well into the Hubble flow. In combination with the recent, exquisite observations of the Cosmic Microwave Background by WMAP and Planck, these measurements provide a direct test of the standard cosmological model and constrain the equation of state of dark energy. The MCP is a multi-year project that has recently completed observations and is currently working on final analysis. Based on distance measurements to the first four published megamasers in the sample, the MCP currently determines H0 = 69.3 ± 4.2 km s−1 Mpc−1. The project is finalizing analysis for five additional galaxies. When complete, we expect to achieve a ~4% measurement. Given the tension between the Planck prediction of H0 in the context of the standard cosmological model and astrophysical measurements based on standard candles, the MCP provides a critical and independent geometric measurement that does not rely on external calibrations or a distance ladder.
We quantify what drives the rise in medical expenditures over the life-cycle using a stochastic dynamic overlapping generations model of health investment. Three motives for health investment are considered. First, health delivers a flow of utility each period (the consumption motive). Second, better health enables people to allocate more time to productive or pleasurable activities (the investment motive). Third, better health improves survival prospects (the survival motive). We find that, overall, the consumption motive plays a dominant role, whereas the investment motive is more important than the consumption and survival motives until the forties. The survival motive is quantitatively less important when compared to the other two motives. We also conduct a series of counter-factual policy experiments to investigate how government policies impacting health insurance coverage, Social Security, and health care technological progress affect the behavior of medical expenditures, and social welfare.
The discovery of the ancient city of Loulan in Xinjiang, China, at the beginning of the 20th century was of great significance for understanding the evolution of culture and civilization in Inner Asia. However, due to the lack of systematic chronological studies, the history of this ancient city remains unclear, particularly the date of its construction and abandonment. Here, we present the results of the first systematic radiocarbon (14C) dating carried out on artifacts from ancient Loulan. Our results show that human activity began as early as 350 cal BC, flourished during the interval from the 1st to 4th centuries AD, and completely disappeared around 600 AD. Most of the buildings in the city were constructed during the Eastern Han Dynasty rather than in Wei/Jin Dynasty, as previously indicated by excavated documents and letters (Hedin 1898; Xiao 2006). The development and flourishing of Loulan coincided with the interval of high ice accumulation and meltwater supply from surrounding mountains. The city began to decline and was finally abandoned following an abrupt decrease in ice accumulation and meltwater supply (Yao et al. 1996; Lauterbach et al. 2014), suggesting that natural climate change was the major factor responsible for the abandonment of Loulan.
With the 3D data of SDSS-IV MaNGA (Bundy et al. 2015) spectra and multi-wavelength SED modeling, we expect to have a better understanding of the distribution of dust, gas and star formation of galaxy mergers. For a case study of the merging galaxy Mrk848, we use both UV-to-IR broadband SED and the MaNGA integral field spectroscopy to obtain its star formation histories at the tail and core regions. From the SED fitting and full spectral fitting, we find that the star formation in the tail regions are affected by the interaction earlier than the core regions. The core regions show apparently two times of star formation and a strong burst within 500Myr, indicating the recent star formation is triggered by the interaction. The star formation histories derived from these two methods are basically consistent.
Digital maps have a large potential to support safety-related Advanced Driver Assistance Systems (ADAS) by providing detailed road and environment information. However, one critical attribute – road accident hotspot – is not available from existing digital maps, and is also difficult to derive from practical surveying. This paper provides a Geographical Information Systems (GIS)-based approach for the production of digital hotspot maps, based on a historical accident dataset and geospatial methods in a GIS. In this approach, firstly the Kernel Density Estimation (KDE) method was used to identify hotspot distribution; secondly the Percent Volume Contour (PVC) method was coupled with KDE to extract hotspot patterns; and finally the map layers of hotspot patterns were integrated with classical navigation maps. Following a description for geospatial hotspot production, the derivation of hotspot property data is also discussed. In order to prove this approach, a small-area case study was carried out in the City Centre of Nottingham. The presented results demonstrate that this approach is useful and effective for solving the hotspot creation problem for ADAS, but other future works will be required to improve data effectiveness.