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This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation in infants with acute respiratory distress syndrome after congenital heart surgery.
Methods:
We retrospectively analysed the clinical data of 32 infants who were ventilated due to acute respiratory distress syndrome after congenital heart surgery between January, 2020 and January, 2022. We adopted high-frequency oscillation ventilation combined with intermittent mandatory ventilation as the rescue ventilation mode for infants who were failing conventional mechanical ventilation.
Results:
After rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation, the dynamic compliance (Cdyn), PaO2 and PaO2/FiO2 ratio of the infants improved compared with conventional mechanical ventilation (p < 0.05). Moreover, high-frequency oscillation ventilation combined with intermittent mandatory ventilation resulted in a significant decrease in arterial-alveolar oxygen difference (AaDO2), FiO2, and oxygenation index (p < 0.05). No significant effect on haemodynamic parameters was observed. Moreover, no serious complications occurred in the two groups.
Conclusion:
Rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation significantly improved oxygenation in infants who failed conventional mechanical ventilation for acute respiratory distress syndrome after congenital heart surgery. Thus, this strategy is considered safe and feasible. However, further studies must be conducted to confirm the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation as a rescue perioperative respiratory support strategy for CHD.
The current study examined the effects of a 16-week creative expression program on brain activity during a story creating task and resting-state functional network connectivity in mild cognitive impairment (MCI) adults.
Method:
Thirty-six MCI adults were allocated to either the creative expression program (CrExp, n = 18) or control group (CG,n = 18). Before and after intervention, all participants were scanned with functional magnetic resonance imaging (fMRI) during story creating task performance and a resting state. The two-group comparison was calculated between the blood oxygenation level-dependent (BOLD) signal changes for each cluster to investigate the differences in fMRI activation and functional connectivity (FC) between two groups.
Results:
Task activation analyses showed an increase in the right anterior cingulate gyrus (ACG), right medial frontal gyrus (MFG), right lentiform nucleus (LN), left hippocampus (HIP), left middle occipital gyrus (MOG), and left cerebellum posterior lobe (CPL) (p < 0.05). Story creating performance improvements were associated with greater activation in the left HIP region. Resting-state functional connectivity (FC) between left HIP and certain other brain areas shown a significant interaction of creative expression group versus control group. Moreover, connectivity between the right angular gyrus (ANG), right inferior temporal gyrus (ITG), right superior occipital gyrus (SOG), left ANG, and left MFG were related to improved cognitive performance (p < 0.05).
Conclusion:
These data extend current knowledge by indicating that the creative expression program can improve cognitive activation in MCI, and these enhancements may be related to the neurocognitive network plasticity changes induced by creative expression training.
We aimed to investigate the relationship between the neutrophil to lymphocyte ratio (NLR) and nutritional parameters in chronic kidney disease (CKD) patients. In this cross-sectional study, 187 non-dialysis CKD patients were enrolled. Daily dietary energy intake (DEI) and daily dietary protein intake (DPI) were assessed by 3-d dietary records. Protein-energy wasting (PEW) was defined as Subjective Global Assessment (SGA) class B and C. Spearman correlation analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The median NLR was 2·51 (1·83, 3·83). Patients with CKD stage 5 had the highest NLR level. A total of 19·3 % (n 36) of patients suffered from PEW. The NLR was positively correlated with SGA and serum P, and the NLR was negatively correlated with BMI, waist and hip circumference, triceps skinfold thickness, mid-arm muscle circumference, DPI and Hb. Multivariate logistic regression analysis adjusted for DPI, DEI, serum creatinine, blood urea nitrogen, uric acid and Hb showed that a high NLR was an independent risk factor for PEW (OR = 1·393, 95 % CI 1·078, 1·800, P = 0·011). ROC analysis showed that an NLR ≥ 2·62 had the ability to identify PEW among CKD patients, with a sensitivity of 77·8 %, a specificity of 62·3 % and an AUC of 0·71 (95 % CI 0·63, 0·81, P < 0·001). The NLR was closely associated with nutritional status. NLR may be an indicator of PEW in CKD patients.
The aim of our study was to determine the distribution of hepatitis B virus (HBV) genotypes and subgenotypes in ethnic minorities in Yunnan province to provide evidence supporting the theoretical basis for hepatitis B prevention and control. We obtained serum samples and demographic data from 765 individuals reported by Yunnan province who had either acute or chronic HBV infection and were from one of 20 ethnic minority populations: Achang, Bai, Brown, Tibetan, Dai, Deang, Dulong, Hani, Hui, Jingpo, Lahu, Yi, Lisu Miao, Naxi, Nu, Pumi, Wa, Yao, or Zhuang people. We sequenced the HBV DNA and determined the genotypes and subgenotypes of the isolated HBVs. We mapped the genotype and subgenotype distribution by ethnic minority population and conducted descriptive analyses. There were four genotypes among the 20 ethnic groups: genotype B (21.3% of samples), C (76.6%), D (1.8%) and I (0.3%). The most common subgenotype was C1. There were no genotype differences by gender (P = 0.954) or age (P = 0.274), but there were differences by region (P < 0.001). There were differences in genotype distribution (P < 0.001) and subgenotype distribution (P = 0.011) by ethnic group. Genotype D was most prominent in Tibet and most HBV isolates were C/D recombinant viruses. The only two genotype I virus isolates were in Zhuang people. Susceptibility and geographic patterns may influence HBV prevalence in different ethnic populations, but additional research is needed for such a determination.
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.
The North Qilian Orogenic Belt is surrounded by the Tarim Craton to the NW and the North China Craton to the NE. The Precambrian continental crust remnants that are distributed in the North Qilian Orogenic Belt are termed the North Qilian Block (NQB), and their tectonic evolution has profound implications for the evolution of the Columbia Supercontinent. Here we present major- and trace-element and Sr–Nd–Hf isotope data for (meta-) basalts from the Beidahe Group (BDHG) and Zhulongguan Group (ZLGG) in the western North Qilian Orogenic Belt, to investigate the tectonic evolution of the NQB during the Proterozoic Eon. The protoliths of Palaeoproterozoic amphibole gneisses and plagioclase amphibolites from the BDHG are calc-alkaline series basalts. These metabasalts show island-arc-basalt affinities with variable Nd and Hf isotopes (ϵNd(t) = −5.0–0.6 and 2.7–4.3; ϵHf(t) = −14.2–2.0 and 6.9–8.8) and were generated by partial melting of the asthenospheric mantle that was metasomatized by aqueous fluid and sediment melt in a continental-arc setting. The early Mesoproterozoic ZLGG basalts show features of shoshonite-series basalts and are geochemically similar to ocean-island basalts. These basalts show variable (87Sr/86Sr)i, ϵNd(t) and ϵHf(t) values of 0.70464–0.70699, −1–2.6 and −1.5–5.7, and are products of mantle plume magmatism that participated with subducted oceanic crust in an intracontinental rift setting. This study suggests that the NQB underwent tectonic evolution from palaeo-oceanic subduction to intracontinental rifting during the Palaeoproterozoic–Mesoproterozoic eras. Furthermore, the above tectonomagmatic events were in response to convergence–splitting events of the Columbia Supercontinent during the Palaeoproterozoic–Mesoproterozoic eras.
People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia).
Methods
PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex.
Results
Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3–406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5–417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4–1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60–2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7–50.4)].
Conclusions
The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.
The present study investigated the association between fibre degradation and the concentration of dissolved molecular hydrogen (H2) in the rumen. Napier grass (NG) silage and corn stover (CS) silage were compared as forages with contrasting structures and degradation patterns. In the first experiment, CS silage had greater 48-h DM, neutral-detergent fibre (NDF) and acid-detergent fibre degradation, and total gas and methane (CH4) volumes, and lower 48-h H2 volume than NG silage in 48-h in vitro incubations. In the second experiment, twenty-four growing beef bulls were fed diets including 55 % (DM basis) NG or CS silages. Bulls fed the CS diet had greater DM intake (DMI), average daily gain, total-tract digestibility of OM and NDF, ruminal dissolved methane (dCH4) concentration and gene copies of protozoa, methanogens, Ruminococcus albus and R. flavefaciens, and had lower ruminal dH2 concentration, and molar proportions of valerate and isovalerate, in comparison with those fed the NG diet. There was a negative correlation between dH2 concentration and NDF digestibility in bulls fed the CS diet, and a lack of relationship between dH2 concentration and NDF digestibility with the NG diet. In summary, the fibre of CS silage was more easily degraded by rumen microorganisms than that of NG silage. Increased dCH4 concentration with the CS diet presumably led to the decreased ruminal dH2 concentration, which may be helpful for fibre degradation and growth of fibrolytic micro-organisms in the rumen.
Road scene understanding is a critical component in an autonomous driving system. Although the deep learning-based road scene segmentation can achieve very high accuracy, its complexity is also very high for developing real-time applications. It is challenging to design a neural net with high accuracy and low computational complexity. To address this issue, we investigate the advantages and disadvantages of several popular convolutional neural network (CNN) architectures in terms of speed, storage, and segmentation accuracy. We start from the fully convolutional network with VGG, and then we study ResNet and DenseNet. Through detailed experiments, we pick up the favorable components from the existing architectures and at the end, we construct a light-weight network architecture based on the DenseNet. Our proposed network, called DSNet, demonstrates a real-time testing (inferencing) ability (on the popular GPU platform) and it maintains an accuracy comparable with most previous systems. We test our system on several datasets including the challenging Cityscapes dataset (resolution of 1024 × 512) with an Mean Intersection over Union (mIoU) of about 69.1% and runtime of 0.0147 s/image on a single GTX 1080Ti. We also design a more accurate model but at the price of a slower speed, which has an mIoU of about 72.6% on the CamVid dataset.
Compared with commercial polyolefin membranes, polyacrylonitrile (PAN) membrane prepared by electrostatic spinning has higher porosity, electrolyte uptake, thermal stability, and lithium-ion conductivity, etc. However, poor mechanical performance has largely limited the application of electrospun PAN separators. In this study, PAN/polyimide (PI) composite membrane is prepared by electrostatic spinning to improve the mechanical and electrochemical performances. Scanning electron microscopy, thermal analysis method, and electrochemical methods were used for evaluation of the electrospun composite membrane. The results show that the composite membrane possesses good thermal stability and exhibits better mechanical performance than pristine PAN membrane (increasing by 1.1 times in tension strength). The addition of PI can increase porosity and fluid absorption rate obviously. In addition, the composite membrane has high ionic conductivity (18.77 × 10−4 S/cm), wide electrochemical window (about 4.0 V), and excellent cycling performance. It can retain a discharge specific capacity of 153 mA h/g even after 50 cycles at 0.5 C. The electrospun PAN/PI membrane may be a promising candidate for lithium-ion battery separators.
Microbial-induced calcite precipitation (MICP) has gained much attention in soil improvement studies, where it can enhance the physical properties of sandy soil. Small-scale sand cylinder tests were conducted to investigate the formation and failure of calcium carbonate precipitation bonding between individual sand particles. Bonding formation by precipitation was examined by scanning electron microscopy. Energy-dispersive X-ray spectroscopy analysis verified the existence of calcium, carbon, and oxygen, which could form CaCO3 after MICP-treatment. Focused-ion-beam milling was applied to study the interior structure of calcium carbonate precipitation during the MICP process.
The Shen-Guang II Upgrade (SG-II-U) laser facility consists of eight high-power nanosecond laser beams and one short-pulse picosecond petawatt laser. It is designed for the study of inertial confinement fusion (ICF), especially for conducting fast ignition (FI) research in China and other basic science experiments. To perform FI successfully with hohlraum targets containing a golden cone, the long-pulse beam and cylindrical hohlraum as well as the short-pulse beam and cone target alignment must satisfy tight specifications (30 and $20~\unicode[STIX]{x03BC}\text{m}$ rms for each case). To explore new ICF ignition targets with six laser entrance holes (LEHs), a rotation sensor was adapted to meet the requirements of a three-dimensional target and correct beam alignment. In this paper, the strategy for aligning the nanosecond beam based on target alignment sensor (TAS) is introduced and improved to meet requirements of the picosecond lasers and the new six LEHs hohlraum targets in the SG-II-U facility. The expected performance of the alignment system is presented, and the alignment error is also discussed.
In high power laser facility for inertial confinement fusion research, final optics assembly (FOA) plays a critical role in the frequency conversion, beam focusing, color separation, beam sampling and debris shielding. The design and performance of FOA in SG-II Upgrade laser facility are mainly introduced here. Due to the limited space and short focal length, a coaxial aspheric wedged focus lens is designed and applied in the FOA configuration. Then the ghost image analysis, the focus characteristic analysis, the B integral control design and the optomechanical design are carried out in the FOA design phase. In order to ensure the FOA performance, two key technologies are developed including measurement and adjustment technique of the wedged focus lens and the stray light management technique based on ground glass. Experimental results show that the design specifications including laser fluence, frequency conversion efficiency and perforation efficiency of the focus spot have been achieved, which meet the requirements of physical experiments well.
Babesiosis is an emerging tick-transmitted zoonosis prevalent in large parts of the world. This study was designed to determine the rates of Babesia microti infection among small rodents in Yunnan province, where human cases of babesiosis have been reported. Currently, distribution of Babesia in its endemic regions is largely unknown. In this study, we cataloged 1672 small wild rodents, comprising 4 orders, from nine areas in western Yunnan province between 2009 and 2011. Babesia microti DNA was detected by polymerase chain reaction in 4·3% (72/1672) of the rodents analyzed. The most frequently infected rodent species included Apodemus chevrieri and Niviventer fulvescens. Rodents from forests and shrublands had significantly higher Babesia infection rates. Genetic comparisons revealed that Babesia was most similar to the Kobe- and Otsu-type strains identified in Japan. A variety of rodent species might be involved in the enzootic maintenance and transmission of B. microti, supporting the need for further serological investigations in humans.
The semilocal convergence of a third-order Newton-like method for solving nonlinear equations is considered. Under a weak condition (the so-called γ-condition) on the derivative of the nonlinear operator, we establish a new semilocal convergence theorem for the Newton-like method and also provide an error estimate. Some numerical examples show the applicability and efficiency of our result, in comparison to other semilocal convergence theorems.
We consider the nonlinear and ill-posed inverse problem where the Robin coefficient in the Laplace equation is to be estimated using the measured data from the accessible part of the boundary. Two regularisation methods are considered — viz. L2 and H1 regularisation. The regularised problem is transformed to a nonlinear least squares problem; and a suitable regularisation parameter is chosen via the normalised cumulative periodogram (NCP) curve of the residual vector under the assumption of white noise, where information on the noise level is not required. Numerical results show that the proposed method is efficient and competitive.
The Lorentz factor (Γ) is an important parameter related to the relativistic jet physics. We study the evolution patterns of Γ within gamma-ray burst (GRB) and active galactic nuclear jets for individual GRB 090168, GRB 140508A, and 3C 454.3. By estimating the Γ values for well-separated pulses in GRBs 090618 and 140508A with an empirical relation derived from typical GRBs, we find that the Γ evolution pattern in the two GRBs are different. The increasing-to-coasting evolution pattern of Γ in GRB 090618 likely indicates that the GRB fireball is still being accelerated in the prompt phase. The clear decrease evolution pattern of Γ in GRB 140508A suggests the deceleration of the fireball components. By deriving the Γ value through fitting their spectral energy distribution in different flares of 3C 454.3, a pattern of Γ-tracking-γ-ray flux is clearly found, likely indicating that the observed gamma-ray flares are being due to the Doppler boosting effect to the jet emission.
The long-term outcome of never-treated patients with schizophrenia is
unclear.
Aims
To compare the 14-year outcomes of never-treated and treated patients
with schizophrenia and to establish predictors for never being
treated.
Method
All participants with schizophrenia (n = 510) in Xinjin,
Chengdu, China were identified in an epidemiological investigation of 123
572 people and followed up from 1994 to 2008.
Results
The results showed that there were 30.6%, 25.0% and 20.4% of patients who
received no antipsychotic medication in 1994, 2004 and 2008 respectively.
Compared with treated patients, those who were never treated in 2008 were
significantly older, had significantly fewer family members, had higher
rates of homelessness, death from other causes, being unmarried, living
alone, being without a caregiver and poor family attitudes. Partial and
complete remission in treated patients (57.3%) was significantly higher
than that in the never-treated group (29.8%). Predictors of being in the
never-treated group in 2008 encompassed baseline never-treated status,
being without a caregiver and poor mental health status in 1994.
Conclusions
Many patients with schizophrenia still do not receive antipsychotic
medication in rural areas of China. The 14-year follow-up showed that
outcomes for the untreated group were worse. Community-based mental
healthcare, health insurance and family intervention are crucial for
earlier diagnosis, treatment and rehabilitation in the community.
In this paper, preconditioned iterative methods for solving two-dimensional space-fractional diffusion equations are considered. The fractional diffusion equation is discretized by a second-order finite difference scheme, namely, the Crank-Nicolson weighted and shifted Grünwald difference (CN-WSGD) scheme proposed in [W. Tian, H. Zhou and W. Deng, A class of second order difference approximation for solving space fractional diffusion equations, Math. Comp., 84 (2015) 1703-1727]. For the discretized linear systems, we first propose preconditioned iterative methods to solve them. Then we apply the D’Yakonov ADI scheme to split the linear systems and solve the obtained splitting systems by iterative methods. Two preconditioned iterative methods, the preconditioned generalized minimal residual (preconditioned GMRES) method and the preconditioned conjugate gradient normal residual (preconditioned CGNR) method, are proposed to solve relevant linear systems. By fully exploiting the structure of the coefficient matrix, we design two special kinds of preconditioners, which are easily constructed and are able to accelerate convergence of iterative solvers. Numerical results show the efficiency of our preconditioners.