The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.

The sediments of closed-basin lakes on the margin of the East Asian summer monsoon (EASM) are valuable archives of past changes in hydroclimate and dust activity and thus potentially can help us to understand future climate changes. We present high-resolution, well-dated records of the grain size and carbonate mineralogy from Lake Bayanchagan, northern China, spanning the last 11.5 ka. Grain-size endmember (EM) analysis distinguished four EMs, each linked to different sediment transport processes. EM1 (0.4–0.6 μm) and EM3 (14–102 μm) reflect the strength of regional dust activity, whereas EM2 (1.3–31 μm) represents variations in local hydrodynamic conditions related to lake-level changes and EM4 (68–500 μm) is associated with local dust activity. Our results show that a high lake level and weakened dust activity occurred during 10–5.8 ka, as indicated by increased EM2 and decreased EM3, respectively. After 5.8 ka, EM2 decreased as the three other EMs increased, and dolomite appeared in the sediments while calcite decreased—indicating both a decline in lake level and strengthened dust activity. The fluctuations in lake level and dust activity are in good agreement with precipitation variations reconstructed from other records, which are in turn correlated to movement of the EASM rainfall belt, in response to temperature changes.

This study presents a novel 4-DOF two-limb gripper mechanism with a simple design that offers high adaptability for different objects. The mechanism integrates a three-finger end effector and employs a 2-DOF driving system in both serial kinematic chains mounted on the base, addressing performance problems caused by moving actuators. First, the architecture of the gripper mechanism is described, and its mobility is verified. Next, the inverse and forward kinematic problems are solved, and the Jacobian matrix is derived to analyze the singularity conditions. The inverse and forward singularity surfaces are plotted. The workspace is investigated using a search method, and two indices, manipulability and dexterity, are studied. The proposed manipulator’s parameters are optimized for improved dexterity. The novel gripper mechanism has high potential for grasping different types of parts within a large workspace, making it a valuable addition to the field of robotics.

A steady granular flow experiment was performed in a confined annular shear cell to examine how the wall friction coefficient $\mu _w$ degrades from the intrinsic sliding friction coefficient $f$ between the grains and the container wall. Two existing models are invoked to examine the decay trend of $\mu _w/f$ in view of the ratio of shear velocity to the square root of granular temperature $\chi$ (Artoni & Richard, Phys. Rev. Lett., vol. 115, 2015, 158001) and the ratio of grain angular and slip velocities $\varOmega$ (Yang & Huang, Granul. Matt., vol. 18, issue 4, 2016, p. 77), respectively. As both models correlate $\mu _w/f$ to different flow properties, a hidden relation is speculated between $\chi$ and $\varOmega$, or equivalently, between the granular temperature and the grain rotation speed. We used experiment data to confirm and reveal this hidden relation. From there, a unified $\mu _w/f-\chi$ model is proposed with physical meanings for the model coefficients and to show general agreement with the measured trend. Hence we may conclude that both the fluctuations in grain translations and their mean rotation are the crucial yet equivalent mechanisms to degrade $\mu _w/f$.

Polymers maintain colloidal stability by adsorbing onto the surface of sepiolite particles, and changes in temperature and salinity can affect this process. We chose three typical polymers to investigate their interactions with sepiolite under high-salinity (15 wt.% NaCl) conditions at >180°C. Sepiolite samples were characterized using infrared testing, X-ray diffraction testing, contact angle testing, thermogravimetric testing, filtration loss testing and rheological testing. The experimental results showed that the desorption of the polymers under high-temperature and high-salinity conditions reduces the stability and filtration control of the suspension significantly. Adding polymers to sepiolite suspensions can maintain good stability even after thermal ageing at 240°C. In terms of drilling fluid regulation, sepiolite can play a role in regulating rheological properties, and the interactions between various polymers and sepiolite can be utilized to maintain the stable colloidal state of the drilling fluid. Studying the adsorption behaviour of various types of polymers on the surface of sepiolite under high-temperature and high-salinity conditions has important implications for the design and selection of sepiolite drilling fluid treatment agents.

Routine blood examination is an easy way to examine infectious diseases. This study is aimed to develop a model to diagnose serious bacterial infections (SBI) in ICU neonates based on routine blood parameters. This was a cross-sectional study, and data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III). SBI was defined as suffering from one of the following: pyelonephritis, bacteraemia, bacterial meningitis, sepsis, pneumonia, cellulitis, and osteomyelitis. Variables with statistical significance in the univariate logistic regression analysis and log systemic immune–inflammatory index (SII) were used to develop the model. The area under the curve (AUC) was calculated to assess the performance of the model. A total of 1,880 participants were finally included for analysis. Weight, haemoglobin, mean corpuscular volume, white blood cell, monocyte, premature delivery, and log SII were selected to develop the model. The developed model showed a good performance to diagnose SBI for ICU neonates, with an AUC of 0.812 (95% confidence interval (CI): 0.737–0.888). A nomogram was developed to make this model visualise. In conclusion, our model based on routine blood parameters performed well in the diagnosis of neonatal SBI, which may be helpful for clinicians to improve treatment recommendations.

The discharged capillary plasma channel has been extensively studied as a high-gradient particle acceleration and transmission medium. A novel measurement method of plasma channel density profiles has been employed, where the role of plasma channels guiding the advantages of lasers has shown strong appeal. Here, we have studied the high-order transverse plasma density profile distribution using a channel-guided laser, and made detailed measurements of its evolution under various parameters. The paraxial wave equation in a plasma channel with high-order density profile components is analyzed, and the approximate propagation process based on the Gaussian profile laser is obtained on this basis, which agrees well with the simulation under phase conditions. In the experiments, by measuring the integrated transverse laser intensities at the outlet of the channels, the radial quartic density profiles of the plasma channels have been obtained. By precisely synchronizing the detection laser pulses and the plasma channels at various moments, the reconstructed density profile shows an evolution from the radial quartic profile to the quasi-parabolic profile, and the high-order component is indicated as an exponential decline tendency over time. Factors affecting the evolution rate were investigated by varying the incentive source and capillary parameters. It can be found that the discharge voltages and currents are positive factors quickening the evolution, while the electron-ion heating, capillary radii and pressures are negative ones. One plausible explanation is that quartic profile contributions may be linked to plasma heating. This work helps one to understand the mechanisms of the formation, the evolutions of the guiding channel electron-density profiles and their dependences on the external controllable parameters. It provides support and reflection for physical research on discharged capillary plasma and optimizing plasma channels in various applications.

Placental trophoblastic cells play important roles in placental development and fetal health. However, the mechanism of trophoblastic cell fusion is still not entirely clear. The level of Tspan5 in the embryo culture medium was detected using enzyme-linked immunosorbent assay (ELISA). Fusion of BeWo cells was observed by immunofluorescence. Cell fusion-related factors and EMT-related factors were identified by qRT-PCR and western blotting. Notch protein repressor DAPT was used to verify the role of Tspan5 in BeWo cells. The expression of Tspan5 was significantly increased in embryo culture medium. The fusion of BeWo cells was observed after treatment with forskolin (FSK). Cell fusion-related factors (i.e. β-hCG and syncytin 1/2) and Tspan5 were significantly increased after FSK treatment. In addition, FSK treatment promoted EMT-related protein expression in BeWo cells. Knockdown of Tspan5 inhibited cell fusion and EMT-related protein levels. Notch-1 and Jagged-1 protein levels were significantly upregulated, and the EMT process was activated by overexpression of Tspan5 in FSK-treated BeWo cells. Interestingly, blocking the Notch pathway by the repressor DAPT had the opposite results. These results indicated that Tspan5 could promote the EMT process by activating the Notch pathway, thereby causing cell fusion. These findings contribute to a better understanding of trophoblast cell syncytialization and embryonic development. Tspan5 may be used as a therapeutic target for normal placental development.

Over the years, numerous observational studies have substantiated that various dietary choices have opposing effects on CVD. However, the causal effect has not yet been established. Thus, we conducted a Mendelian randomisation (MR) analysis to reveal the causal impact of dietary habits on CVD. Genetic variants strongly associated with 20 dietary habits were selected from publicly available genome-wide association studies conducted on the UK Biobank cohort (n 449 210). Summary-level data on CVD were obtained from different consortia (n 159 836–977 323). The inverse-variance weighted method (IVW) was the primary outcome, while MR-Egger, weighted median and MR Pleiotropy RESidual Sum and Outlier were used to assess heterogeneity and pleiotropy. We found compelling evidence of a protective causal effect of genetic predisposition towards cheese consumption on myocardial infarction (IVW OR = 0·67; 95 % CI = 0·544, 0·826; P = 1·784 × 10−4) and heart failure (IVW OR = 0·646; 95 % CI = 0·513, 0·814; P = 2·135 × 10−4). Poultry intake was found to be a detrimental factor for hypertension (IVW OR = 4·306; 95 % CI = 2·158, 8·589; P = 3·416 × 10−5), while dried fruit intake was protective against hypertension (IVW OR = 0·473; 95 % CI = 0·348, 0·642; P = 1·683 × 10−6). Importantly, no evidence of pleiotropy was detected. MR estimates provide robust evidence for a causal relationship between genetic predisposition to 20 dietary habits and CVD risk, suggesting that well-planned diets may help prevent and reduce the risk of CVD.

With the development of high-volume manufacturing for very-large-scale integrated circuits, the purity of the light source in the extreme ultraviolet lithography (EUVL) system needs to fulfil extreme requirements in order to avoid thermal effect, optical distortion and critical dimension errors caused by out-of-band radiations. This paper reviews the key technologies and developments of the spectral purity systems for both a free-standing system and a built-in system integrated with the collector. The main challenges and developing trends are also discussed, with a view towards practical applications for further improvement. Designing and manufacturing spectral purity systems for EUVL is not a single task; rather, it requires systematic considerations for all relevant modules. Moreover, the requirement of spectral purity filters drives the innovation in filtering technologies, optical micromachining and advanced metrology.

In this work, we present a high-power, high-repetition-rate, all-fiber femtosecond laser system operating at 1.5 $\unicode{x3bc}$m. This all-fiber laser system can deliver femtosecond pulses at a fundamental repetition rate of 10.6 GHz with an average output power of 106.4 W – the highest average power reported so far from an all-fiber femtosecond laser at 1.5 $\unicode{x3bc}$m, to the best of our knowledge. By utilizing the soliton-effect-based pulse compression effect with optimized pre-chirping dispersion, the amplified pulses are compressed to 239 fs in an all-fiber configuration. Empowered by such a high-power ultrafast fiber laser system, we further explore the nonlinear interaction among transverse modes LP01, LP11 and LP21 that are expected to potentially exist in fiber laser systems using large-mode-area fibers. The intermodal modulational instability is theoretically investigated and subsequently identified in our experiments. Such a high-power all-fiber ultrafast laser without bulky free-space optics is anticipated to be a promising laser source for applications that specifically require compact and robust operation.

This study aimed to screen factors related to live birth outcomes of women with first frozen embryo transfer (FET). The enrolled women were divided into training and validation cohorts. The least absolute shrinkage and selection operator (Lasso) regression algorithm of machine learning and the multiple regression model were then used to screen factors relevant to live birth failure (LBF) for the training dataset. A nomogram risk prediction model was established on the basis of the screened factors, and the consistency index (C-index) and calibration curve were derived for evaluating the model. The validation cohort was utilized to validate the nomogram model further. In total, 2083 women who accepted the first FET in our hospital were included and 44 factors were initially screened in this study. On the basis of the training cohort, the screened risk factors via multiple regression analysis with odds ratio (OR) values were female age (OR: 3.092, 95%CI: 1.065–4.852), body mass index (BMI; OR: 1.106, 95%CI: 1.015–1.546), caesarean section (OR: 1.909, 95%CI: 1.318–2.814), number of high-quality embryos (OR: 0.698, 95%CI: 0.599–0.812), and endometrial thickness (OR: 0.957, CI: 0.904–0.980). The nomogram model was generated based on five predictors. Furthermore, favourable results with C-indexes and calibration curves close to ideal curves indicated the accurate predictive ability of the nomogram. Female age, BMI, caesarean section, number of high-quality embryos, and endometrial thickness were independent predictors for LBF. The five factors of the risk assessment model may help to identify LBF with high accuracy in women who accept FET.

People's willingness to forgive corrupt government officials has intrigued many researchers. According to a prominent explanation, citizens tolerate corrupt officials in exchange for their ability to deliver public benefits, such as promoting economic development. We contextualize this corruption–competence tradeoff thesis by assessing individuals' evaluations of local officials in China. We conduct a nationwide vignette experiment with 5527 citizens, and find that the corruption–competence tradeoff exists and is hierarchical. Respondents prefer competent but corrupt low-level officials over those who are honest but incompetent, but this relative preference vanishes when they evaluate high-level local officials. Our interviews reveal that proximity to citizens and position in the power hierarchy primarily drive citizens' sophisticated assessments of officials at different levels.

The phase summation effect in sum-frequency mixing process is utilized to avoid a nonlinearity obstacle in the power scaling of single-frequency visible or ultraviolet lasers. Two single-frequency fundamental lasers are spectrally broadened by phase modulation to suppress stimulated Brillouin scattering in fiber amplifier and achieve higher power. After sum-frequency mixing in a nonlinear optical crystal, the upconverted laser returns to single frequency due to phase summation, when the phase modulations on two fundamental lasers have a similar amplitude but opposite sign. The method was experimentally proved in a Raman fiber amplifier-based laser system, which generated a power-scalable sideband-free single-frequency 590 nm laser. The proposal manifests the importance of phase operation in wave-mixing processes for precision laser technology.

Spherical robots (SRs) have the characteristics of nonholonomic constraints, underactuation, nonchain, and strong coupling, which increase the difficulty of modeling and motion control compared with traditional robots. In this study, we develop an adaptive motion control scheme for a nonholonomic SR, in which an omnidirectional dynamic model is carried out by using the Euler–Lagrange method to describe the omnidirectional motion of the SR more accurately. Furthermore, to facilitate the design of the motion controller, the dynamic model is simplified to obtain the state space expression of the SR. Aiming at the problem of poor control effect caused by the change of system model parameters which are influenced by dynamic model reduction, an adaptive motion control law of SR is designed based on MRAC. And the coefficient adjustment of the controller is obtained by the Lyapunov method, with the guaranteed stability of the closed-loop system. Finally, the controller designed in this thesis is compared with four controllers including linear quadratic regulator, Fuzzy PID, PSO-ADRC, and hierarchical SMC. The experimental comparison proves that the control scheme proposed in this study still has good control ability when the motion parameters are disturbed.

Objectives: Over the past 2 years, many infection prevention and control (IPC) resources have been diverted to manage the COVID-19 pandemic. Its impact on the incidence of antimicrobial-resistant organisms has not been adequately studied. We investigated the impact of the pandemic on the incidence of carbapenem-resistant Enterobacterales (CRE) in Singapore. Methods: We extracted data on unique CRE isolates (clinical and/or surveillance cultures) and patient days for 6 public hospitals in Singapore from the carbapenemase-producing Enterobacteriaceae (CaPES) study group database, and we calculated the monthly incidence of CRE (per 10,000 patient days). Interrupted time-series (ITS) analysis was conducted with the pre–COVID-19 period defined as before February 2020, and the COVID-19 period defined as after February 2020. Statistical analyses were performed using Stata version 15 software. Results: From January 2017 to March 2021, 6,770 CRE isolates and 9,126,704 patient days were documented. The trend in CRE monthly incidence increased significantly during the pre–COVID-19 period (0.060; 95% CI, 0.033–0.094; P < .001) but decreased during the COVID-19 period (−0.183; 95% CI, −0.390 to 0.023; P = .080) without stepwise change in the incidence (−1.496; 95% CI, −3.477 to 0.485; P = .135). The trend in monthly incidence rate of CRE clinical cultures increased significantly during the pre–COVID-19 period (0.046; 95% CI, 0.028–0.064; P < .001) and decreased significantly during COVID-19 period (−0.148; 95% CI, −0.249 to −0.048; P = .048) with no stepwise change in the incidence (−0.063; 95% CI, −0.803 to 0.677; P = .864). The trend in monthly incidence rate of CRE surveillance cultures decreased during the pre–COVID-19 period (−0.020; 95% CI, −0.062 to 0.022; P = .341) and the COVID-19 period (−0.067; 95% CI, −0.291to 0.158; P = .552) without stepwise change in the incidence (−1.327; 95% CI, −3.535 to 0.881; P = .233). Conclusions: The rate of CRE in clinical cultures decreased during COVID-19 but not the rate in surveillance cultures. Further studies are warranted to study the impact of COVID-19 on CREs.

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Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.