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Objective. To explore whether acupuncture and moxibustion can prevent disease progression of advanced gastric cancer patients completing second-line chemotherapy and, if so, the related mechanism. Method. Progression-free survival (PFS) and overall survival (OS) were main outcome measures. The real-time quantitative PCR was used to detect the expression of genes including T-bet, IFN-γ, GATA3, and IL-4 in peripheral blood mononuclear cells (PBMCs). IL-4, IL-6, Ca199, CRP, and IFN-γ in plasma levels were checked. Results. 170 patients were randomly assigned in a 3 : 2 ratio to receive either acupuncture and moxibustion or sham acupuncture until progression. 135 patients were included in the primary analysis. Both PFS and OS in treatment group were proven to be better than control group. Acupuncture and moxibustion promoted typical Th1 cells drifting, as confirmed by increased T-bet/IFN-γ and decreased GATA3/IL-4 in mRNA levels from PBMCs, as well as upregulating IFN-γ and downregulating IL-4 in plasma levels. IL-6, Ca199, and CRP in plasma levels were also reduced by acupuncture and moxibustion. Conclusions. Acupuncture and moxibustion can prolong PFS and OS of advanced gastric cancer patients completing second-line chemotherapy by reversing Th1/Th2 shift and attenuating inflammatory responses.

Background: Public health measures (such as wearing masks, physical distancing, and isolation) have significantly reduced the spread of the coronavirus disease-2019 (COVID-19), but the impact of public health measures on other respiratory infectious diseases is unclear.Objective: To assess the correlation between public health measures and the incidence of respiratory infectious diseases in China during the COVID-19 pandemic.Methods: We collected the data from the National Health and Construction Commission in China on the number of patients with six respiratory infectious diseases (measles, tuberculosis, pertussis, scarlet fever, influenza, and mumps) from 2017 to 2020 and assessed the correlation between public health measures and the incidence of respiratory infectious diseases. Finally, we used the data of the six respiratory infectious diseases in 2021 to verify our results.Results: We found public health measures significantly reduced the incidence of measles (p = 0.002), tuberculosis (p = 0.002), pertussis (p = 0.004), scarlet fever (p = 0.002), influenza (p = 0.034), and mumps (p = 0.002) in 2020, and prevented seasonal peaks. Moreover, the effects of public health measures were most marked during the peak seasons for these infections. Of the six respiratory infectious diseases considered, tuberculosis was least affected by public health measures.Conclusion: Public health measures were very effective in reducing the incidence of respiratory infectious diseases, especially when the respiratory infectious diseases would normally have been at their peak.

Antimicrobial stewardship programmes (ASPs) have often been recommended as a viable solution to minimise the incidence of Clostridium difficile infection (CDI), which can be life-threatening. This study aimed to evaluate whether ASP interventions have contributed to reducing CDI rates.A retrospective review of ASP interventions issued from January 2013 to April 2014 was performed using data from the ASP database of Singapore General Hospital, a 1600-bed tertiary-care hospital in Singapore. A total of 283 interventions satisfied the inclusion criteria, of which commonly audited antibiotics were piperacillin/tazobactam (41.3%) and carbapenems (54.8%). Comparisons were made at 30days post-intervention between those with accepted or rejected interventions. The primary outcome was CDI incidence; secondary outcomes included length of hospitalisation post-intervention, 30-day mortality and CDI recurrence rate.Whilst the median duration of antibiotic therapy was reduced by 2days (6days vs. 4 days; P0.001), acceptance of ASP interventions did not alter primary CDI incidence at 30days (P=0.644) post-intervention. However, reduced CDI recurrence rates were observed for patients positive for CDI in the accepted patient group compared with the rejected group (0% vs. 37.5%; P=0.03), with no difference in CDI 30-day mortality between the two groups.Intervention acceptance did not contribute to a significant reduction in CDI incidence but may be associated with lower recurrence rates, although further studies are required.

Increasing resistance to polymyxin, a last-line antibiotic, is a growing public health concern worldwide. The primary objective of this study was to identify predictors for the isolation of polymyxin-resistant (PR) carbapenem-resistant Enterobacteriaceae (CRE) among hospitalized patients. The secondary objective was to describe the clinical outcomes of patients with PR-CRE infections. A retrospective case–control study including patients admitted to Singapore General Hospital between June 2012 and June 2016 was conducted. Cases were defined as patients who had clinical cultures from which a PR-CRE was isolated. Controls were randomly selected from patients with polymyxin-susceptible (PS) CRE admitted during the same period, and frequency-matched to site of isolation. We included 37 PR cases and 111 PS controls. Polymyxin resistance was detected predominantly in Enterobacter spp. (54.1%) and Klebsiella pneumoniae (43.2%). Multilocus sequence typing showed little clonal relatedness among the isolates. mcr-1 was detected in two PR-CRE isolates. Multivariable analyses showed that PR-CRE isolation was associated with prior polymyxins (adjusted odds ratio (OR), 21.31; 95% confidence interval (CI), 3.04–150.96) and carbapenem exposures (OR 3.74; CI 1.13–12.44), when adjusted for time at risk and bacteria species. In PR-CRE patients with infections, the 30-day all-cause in-hospital mortality was 50.0% as compared to 38.1% in patients with PS-CRE (P = 0.346). Prior polymyxin and carbapenem exposures were independent risk factors for isolation of PR-CRE. Outcomes of PR-CRE and PS-CRE infections were similar in this study.

The dynamic evolution and density distribution of laser-produced plasmas (LPP) of Al in air at atmospheric pressure were investigated using optical interferometry and optical emission spectroscopy, respectively. Interferograms were obtained in Mach–Zehnder interferometry with a laser pulse energy of 35 mJ and delay times from 200 ns to 6.9 µs. From the shift in interference fringes within this time interval and Taylor–Sedow theory, the expansion profiles of the shock wave were found to be hemispherical and approached planar propagation. The expansion and evolution of the plasma plume were also studied by exploiting the phase shift and refractive index obtained from the interferograms using the fast Fourier transformation and Abel transformation. Three-dimensional spatial expansion profiles of the plasma plume and shock wave were presented. In addition, two-dimensional electron density distributions of the Al plasmas were obtained from the spatial dependence of the refractive index of plasma, and compared with the results of optical emission spectroscopy. The results from the two diagnostic methods and their advantages and disadvantages are discussed. This work exploits two diagnostic methods to study the dynamic evolution and the density distribution of the LPP in air at atmospheric pressure and provides an important base reference for developing LPP applications in many fields.

Population pharmacokinetic studies have suggested that high polymyxin B (PMB) doses (&ge, 30,000 IU/kg/day) can improve bacterial kill in carbapenem-resistant Gram-negative bacteria (CR-GNB). We aim to describe the efficacy and nephrotoxicity of patients with CR-GNB infections prescribed high-dose PMB. A single-centre cohort study was conducted from 2013 to 2016 on septic patients with CR-GNB infection and prescribed high-dose PMB (~30,000 IU/kg/day) for &ge, 72 h. Study outcomes included 30-day mortality and acute kidney injury (AKI) development. Factors associated with AKI were identified using multivariable regression. Forty-three patients with 58 CR-GNB received high-dose PMB, 57/58 (98.3%) CR-GNB were susceptible to PMB. The median daily dose and duration of high-dose PMB were 32,051 IU/kg/day (IQR, 29,340&ndash, 34,884 IU/kg/day) and 14 days (IQR, 7&ndash, 28 days), respectively. Thirty-day mortality was observed in 7 (16.3%) patients. AKI was observed in 25 (58.1%) patients with a median onset of 8 days (IQR, 6&ndash, 13 days). Higher daily PMB dose (aOR,1.01, 95% CI, 1.00&ndash, 1.02) and higher number of concurrent nephrotoxins (aOR, 2.14, 95% CI, 1.03&ndash, 4.45) were independently associated with AKI. We observed that a sizable proportion developed AKI in CR-GNB patients described high-dose PMB, hence, the potential benefits must be weighed against increased AKI risk. Concurrent nephrotoxins should be avoided to reduce nephrotoxicity.

Tze-Peng Lim,1,2 Reyna Wang,1 Gang Quan Poh,3 Tse-Hsien Koh,4 Thean-Yen Tan,5 Winnie Lee,1 Jocelyn Qi-Min Teo,1 Yiying Cai,1 Thuan-Tong Tan,6 Pui Lai Rachel Ee,3 Andrea L Kwa1,3,7 1Department of Pharmacy, Singapore General Hospital, Singapore, Singapore; 2SingHealth Duke-NUS Medicine Academic Clinical Programme, Singapore, Singapore; 3Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore; 4Department of Microbiology, Singapore General Hospital, Singapore, Singapore; 5Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore; 6Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore; 7Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore Objectives: Treatment for nosocomial bloodstream infections (BSI) caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) is challenging. Rising antimicrobial resistance, especially in extended spectrum beta-lactamase production, inadvertently increases empiric carbapenem consumption. Three antipseudomonal carbapenems (imipenem, meropenem [MER], and doripenem [DOR]) are available commercially against MDR GNB in Singapore. The study aims to determine the most optimal empiric carbapenem dosing regimens (CDR) and evaluate their cost-effectiveness for GNB-BSI in the face of increasing MDR GNB. Methods: Carbapenem minimum inhibitory concentrations (MICs) were generated for non-repeat GNB-BSI obtained in 2013–2014 from two hospitals. Monte Carlo simulations were used to assess the cumulative fraction of response (CFR) of various CDRs using the percentage of time above MIC for 40% (%T>MIC of 40%) as the pharmacokinetic (PK)–pharmacodynamic (PD) parameter for efficacy. Carbapenem costs were based on patient antibiotic costs. Antibiotic cost-effectiveness was calculated as total daily drug cost/CFR. Results: A total of 1,140 bloodstream isolates were collected. They comprised 116 Acinetobacter baumannii, 237 Pseudomonas aeruginosa, and 787 Enterobacteriaceae. All CDRs achieved ~40, ~80, and ≥90% CFRs against A. baumannii, P. aeruginosa, and Enterobacteriaceae, respectively. Against P. aeruginosa, MER 2g every 8h infused over 3h and DOR 1g every 8h infused over 4h achieved CFRs 84 and 81%, respectively. Against Enterobacteriaceae, the cost of MER 2g every 8h infused over 3h was the lowest among the three carbapenems at $0.40/percentage of CFR. Conclusion: This study demonstrates the utility of PK–PD modeling to formulate the optimal selection of a cost-effective empiric CDR in antibiotics guidelines and formulary inclusion. The findings support the selection of high MER doses of prolonged infusions as empiric coverage for GNB-BSI in our institutions. Keywords: empiric carbapenem regimens, multidrug resistant, Gram-negative bacteria, bloodstream infections

A new three-party quantum key agreement protocol based on seven-qubit states is proposed. In this protocol, each participant adopts different encryption methods to transmit a secret key of the same length. Subsequently, the participants utilize joint measurement to gain the ultimate shared secret key. No participant can determine the ultimate shared key by himself/herself. In addition, the proposed three-party quantum key agreement protocol could resist several well-known attacks. Compared with typical quantum key agreement protocols, our proposed three-party quantum key agreement protocol is more efficient.

High Temperature Gas Cooled Reactor (HTGR) could work as heat source for petrochemical industry. In this article, the preliminary feasibility of a 600 MW modular HTGR (HTR-PM600) working as heat source for a typical hypothetical Chinese petrochemical factory is discussed and it is found that the joint of HTR-PM600 and petrochemical industry is achievable. In detail, the heat and water balance analysis of the petrochemical factory is given. Furthermore, the direct cost of heat supplied by HTR-PM600 is calculated and corresponding economy is estimated. The results show that though there are several challenges, the application of process heat of HTGR to petrochemical industry is practical in sense of both technology and economy.

Objectives In patients with a history of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE), the need for CP-CRE targeted treatment in subsequent sepsis episodes is unclear. This study aimed to characterise the incidence of subsequent CP-CRE infective episodes in individuals with prior CP-CRE colonisation and/or infection, and identify predictors for these subsequent CP-CRE infections. Methods All adult inpatients with CP-CRE detected from any site between June 2012 and May 2014 at a tertiary-care hospital were prospectively followed for two years to assess for any subsequent CP-CRE infections. Potential factors to which patients were exposed during the follow-up period were collected from medical records and analysed. Results A total of 171 patients were enrolled. Of 151 patients who entered the follow-up period, 16 (10.6%) developed a subsequent CP-CRE infection. The median time to a subsequent infective episode was 24.5 days (12–105 days). The type of carbapenemase was highly conserved within index and subsequent paired episodes (16 of 17 pairs). Patients with first CP-CRE isolated from intra-abdominal or respiratory sources were ≥7 times more likely to develop a subsequent infection, while most rectal carriers remain colonised. For carriers (n = 133), Klebsiella spp. (OR 4.7) and OXA carbapenemase (OR 9.4) were significant predictors of subsequent infection. In patients with initial infection (n = 18), end-stage renal failure requiring dialysis (OR 22.0) was the only predisposing factor. Conclusion The incidence of subsequent infections in patients with prior colonisation was low. Consideration for CP-CRE targeted therapy is recommended in patients on dialysis and previous CP-CRE infections involving the bloodstream and/or respiratory tract.

Wilhelmy plate method measures and calculates dynamic contact angle based on force balance equation of the test plate (or fiber). The equation doesn’t consider the resistance force which may result in a measurement error at high testing speed or for plate with non-negligible thickness. In this work, the influences of two ignored resistance forces, i.e. head resistance force and viscous friction, on dynamic contact angle were investigated both theoretically and experimentally. An auxiliary optical facility was designed and added to the tensiometer in order to get dynamic contact angle by direct optical method to verify the validity of the force balance method’s result. A series of experiments for silicone oils with various viscosities on quartz plates with different thicknesses were done and proved that the two above forces cannot be ignored when Ca got larger or the plate got thicker. A new force balance equation was established, in which the fitting results of both head resistance force coefficient and viscous friction coefficient were nearly constant for all the testing twelve systems. By using new equation, the accuracy of dynamic contact angle testing results were obviously improved especially at high Ca .

In the last decade, considerable advancements have been made to identify the pharmacokinetic/pharmacodynamic (PK/PD) index that defines the antimicrobial activity of polymyxins. Dose-fractionation studies performed in hollow-fiber models found that altering the dosing schedule had little impact on the killing or suppression of resistance emergence, alluding to AUC/MIC as the pharmacodynamic index that best describes polymyxin’s activity. For in vivo efficacy, the PK/PD index that was the most predictive of the antibacterial effect of colistin against P. aeruginosa and A. baumannii was ƒAUC/MIC.

The original article [1] contains an error whereby the author, Pui Lai Rachel Ee’s name is incorrectly presented.

The aim of the present study is to investigate the possible effects of chronic administration of myricetin, a natural flavonoid, on chronic stress-induced learning and memory deficits in mice. The mice were restrained daily 4 h/day for 21 days in well-ventilated plexiglass tubes without access to food and water. These animals were injected with myricetin or vehicle 40 min before each restraint stress over a period of 21 days. Then, spatial learning and memory of the mice were evaluated by the Morris water maze task. We did not observe a significant difference in the escape latency in mice subjected to repeated restraint stress, which indicates that learning ability was not affected by restraint stress. However, the spatial memory ability was significantly impaired in the repeatedly restrained mice. Myricetin administration specifically increased the time spent in the target quadrant in mice exposed to chronic stress in the probe trial as tested in the Morris water maze task. Further studies showed that myricetin treatment decreased plasma adrenocorticotrophic hormone levels of those mice subjected to repeated restraint stress. The effect of myricetin on the levels of brain-derived neurotrophic factor (BDNF) in hippocampus was also investigated. The result showed that myricetin normalized the decreased BDNF levels in mice subjected to repeated restraint stress. These findings provide more evidence that chronic administration of myricetin improves spatial memory in repeatedly restrained mice and BDNF signaling in the hippocampus may be involved in the protective effects of myricetin.

Background In the conventional ascending replacement for acute type A aortic dissection, the distal aortic anastomosis is frequently performed at the dissected site, and postoperative residual dissection in the arch and downstream aorta still occurs in most patients. We used open placement of a fenestrated stent graft during this operation. Methods During the conventional ascending replacement in 41 patients with acute type A aortic dissection, a fenestrated stent graft was inserted into the arch and the proximal descending aorta through the distal ascending transection. The distal ascending transection incorporating the proximal end of the fenestrated stent graft was directly anastomosed to the Dacron (DuPont, Wilmington, DE) tube graft. Survivors were examined by computed tomography angiography. Results The cardiopulmonary bypass time was 134.46 ± 19.03 minutes, aortic cross-clamp time was 46.38 ± 8.57 minutes, and selective cerebral perfusion and lower body arrest time was 12.50 ± 2.19 minutes. There was 1 in-hospital death but no difficult bleeding from the distal aortic anastomosis. On postoperative computed tomography, the false lumen closed, with complete thrombus formation around the inserted fenestrated stent graft found in all survivors (100%), at the diaphragmatic level in 28 patients (70%), and at the superior mesenteric arterial level in 3 (8%). Conclusions An open fenestrated stent graft placement provided extensive primary repair of the thoracic aorta and a strong distal aortic stump during the conventional ascending aorta replacement for acute type A aortic dissection but did not increase the risk or technical difficulty of the operation.

This paper proposes a multi-mode pulse-width modulation (PWM) AC/DC controller, which was implemented on a 40-V 0.8-μm one-poly two-metal (1P2M) CMOS process. It can change the operation mode by using an inner logic controller to improve the conversion efficiency under all load conditions. The necessary protection circuits are integrated on chip to reduce the number and size of the discrete components. The area of the chip is as small as 1410 X 730 um2. The standby power is lower than 100mW, and the conversion efficiency is higher than 85%. Test results have met the most stringent power consumption standards of “Energy Star VI”. The Design has achieved the industrial mass production, used in portable electronic device adapter.

Luxia Zhang and colleagues discuss the development of big data in Chinese healthcare and the opportunities for its use in medical research

In this paper, a reinforce concrete inner supporting of tunnel working well is taken as the research object. Based on the result of field monitoring and numerical simulation, the change rules of axial force of inner-supporting are analyzed. By the method of field monitoring, the force condition of reinforced concrete inner-supporting can be understand. By the method of numerical simulation, the finite element model of reinforced concrete inner-supporting can be modeled by ABAQUS. The results show that, the error of measured values and design values is caused by the sensitivity of vibrating wire sensor, temperature and the shrinkage of concrete. This paper can provide a reference for similar measurement projects, whose measured values much larger than design values.

In this article, a fifth-order dispersive nonlinear Schrödinger equation is investigated, which describes the propagation of ultrashort optical pulses, up to the attosecond duration, in an optical fibre. Rogue wave solutions are derived by virtue of the generalised Darboux transformation. Rogue wave structures and interaction are discussed through (i) the analyses on the higher-order rogue waves, the cubic, quartic, quintic, group-velocity, and phase-parameter effects; (ii) a higher-order rogue wave consisting of the first-order rogue waves via the interaction; (iii) characteristics of the rogue waves which are summarised, including the maximum/minimum values of the rogue waves and the number of the first-order rogue waves for composing the higher-order rogue wave; and (iv) spatial-temporal patterns which are illustrated and compared with those of the ‘self-focusing’ nonlinear Schrödinger equation. We find that the quintic terms increase the time of appearance for the first-order rogue waves which form the higher-order rogue wave, and that the quintic terms affect the interaction among the first-order rogue waves, which elongates the distance of appearance for the higher-order rogue wave.

Firstly, this paper analyzes the main factors affecting the benefit distribution of the dairy-product supply chain, and establishes the model of dairy-product supply chain benefit distribution based on game theory, and analyzes Nash’s negotiation Solution under the condition of asymmetry. Then, this paper researches Shapley value method based on risk factors, and use this method to analyze the final scheme of the model of benefit distribution. Finally, an empirical analysis is carried out. The numerical example shows that this method is effective and efficient. And the solution obtained by this model can improve the enthusiasm of dairy enterprises or consumers to participate in the supply chain trust cooperation.

The paper proposed a controller combined fuzzy logic with linear quadratic regulator (LQR). This controller was able to adjust the swing angle precisely during the lifting of gantry crane. It resolved the problem that the LQR controller mostly depending on the accuracy of the mathematical model. First, the paper analyzed the design method of the LQR, then an improved method combing with fuzzy logic was put forward in detail and a further simulation experiment was carried on the MATLAB. The result shows that compared with LQR, the Fuzzy-LQR method can drive the crane to destination in a shorter time and reduced the swing angle by a third.

Starting from the necessity of building refined oil emergency reserve monitoring system, in the aspects of system construction principle, the overall system architecture and the system construction has carried on the elaboration, proposed the construction scheme and reasonable reference.

This paper presents a new control method for three-phase voltage source rectifier to achieve a good system output response. The design process of fuzzy immune PI controller was described in detail. Moreover, a simulation model was built by the matlab toolbox to prove that rectifiers based on immune fuzzy PI controller have better performance in respond speed, stability and robustness ability, compared with rectifiers based on conventional PI controller.

At present, there are lots of calculation methods of acid dew point of flue gas; formula of acid dew point in the thermal calculation from the former U.S.S.R has been widely applied in China. But this formula still has some problems, such as the desulphurization ability of different fuels, classification of sulfur content in fuel and the factors of SO2 transferred into SO3.In order to solve these problems,the formula of the acid dew point in the thermal calculation from the former U.S.S.R is adjusted. It was found that the precision of A.G.O kkes formula is the highest by comparing several formulas. So the last will be the compilation of the new formula and A.G.O kkes formula, the former Soviet union formula and the calculation of burning lean coal,bituminous coal and lignite typical instance of 600 MW,it was found that the precision of new formula calculation has improved.

As a clean, renewable energy, rational use of biomss can effectively solve the problem of energy shortage and environmental pollution. Co-combustion and Co-gasification of biomass and coal are important ways of biomass utilization. Co-pyrolysis reaction is one of the most important processes in the co-combustion and co-gasification. In order to study the different mix ways of coal and wood chips affections on the co-pyrolysis process, TGA was used to study the co-pyrolysis characters of wood chips and coal mixed by different methods with mass ratio 1:1. it is founded out that there is certain interaction between wood chips and coal by the comparison of TGA curves and calculation curves. There is promoting affection at the high temperature if wood chips and coal had been mixed up. There is inhibiting affection if wood chips and coal are tiering distributed.

Unbalance of dc-link capacitor voltage is an key technical problem of multi-level inverter, this paper presents a novel method to solve it. According to the the new approach, a balancing capacitor is in turn connected in parallel with each dc-link capacitor in a sampling time, exacting charges from the capacitors with higher voltage and putting them into the capacitors with lower voltage.Thus the charges of all dc-link capacitors are refreshed constantly and the voltages can be kept balanced on the whole. This method only needs to add a simple hardware circuit and will not increase the complexity of modulation algorithm. In addition, the method is universal forN-level. Simulation experiments under several different conditions were made and the results verified the validity of the proposed approach.

This paper presents a method for calculating the fatigue life of helicopter composite material blade with residual strength theory. Builded the residual strength model, analyzed the influence of loading sequence, tensile -- compressed between the conversion and failure probability, adopt corresponding treatment plan. Using the model of residual strength, selected 19 typical flight condition, using the "rain flow counting method" load matrix, finally get the helicopter load spectrum. The composite blade dangerous section are calculated (root maximum strain), combined with every moment and centrifugal force, the flight state determined blade the stress spectrum, then according to the blade model and material characteristic parameters were calculated, results show that the residual strength decreases with the increase of flight time, and the failure probability increased with the flight time increasing. By comparison, the calculation results and full size is consistent with the experimental results, which shows the calculation is reliable.

Coastal cities have to face many kinds of natural hazards, which always interact with each other, leading to many losses. And rapid development makes city system too complicated to manage for reducing casualties and economic loss. In order to solve the problems in multi-hazard risk management of coastal cities, this paper attemptted to build a new framework based on historical data and hazard-chain theory, and studied the disaster network with the center of typhoon and earthquake. The framework contains a four-dimensional network composed of factor, hazard, event and vulnerability, and related by risk evaluation, chain probability and losses estimation models. The risk analysis for the network was proposed for estimate the influence over the city, aimed at more effective suggestions of planning and disaster reduction.

Radiation from laser-produced plasmas was examined as a potential wavelength calibration source for spectrographs in the extreme ultraviolet (EUV) region. Specifically, the EUV emission of chromium (Cr) plasmas was acquired via spatio-temporally resolved emission spectroscopy. With the aid of Cowan and flexible atomic code (FAC) structure calculations, and a comparative analysis with the simulated spectra, emission peaks in the 6.5–15.0 nm range were identified as 3p–4d, 5d and 3p–4s transition lines from Cr5+–Cr10+ ions. A normalized Boltzmann distribution among the excited states and a steady-state collisional-radiative model were assumed for the spectral simulations, and used to estimate the electron temperature and density in the plasma. The results indicate that several relatively isolated emission lines of highly charged ions would be useful for EUV wavelength calibration.

A novel design scheme of performance parameter automatic measurement system for residual current fire monitoring detector control circuit board based on virtual instrument technology was introduced. Hardware of the system was composed of measurement platform, industrial computer, data acquisition card and signal conditioning circuit, etc. The software developed on the LabVIEW platform takes charge of the high speed data acquisition, as well as the data processing, displaying and saving. Using the latest progress of computer control technology, network technology, communication technology and data acquisition and software technology, the system satisfied the needs of performance parameter measurement for residual current fire monitoring detector control circuit board. The overall structure of the measurement system, the structure of software, analysis process and LabVIEW program realization were introduced in detail. Practical application shows that the intelligent measurement system features with high precision, strong disturbance attenuation, high efficiency, easy to operate and maintain, and can improve the design and performance of products, which can be widely used. The system provides an effective way to design the performance parameter measurement system for residual current fire monitoring detector control circuit board.

Background In patients with history of carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CPCRE), the need for CPCRE targeted treatment in subsequent sepsis episodes is unclear. We determine the likelihood of CPCRE infection (CI) in patients previously colonized (PC) or infected (PI) with CPCRE and relatedness of both episodes. Methods Adult inpatients with CPCRE isolated from any site in June 2012–May 2014 at a tertiary-care hospital were prospectively followed for 2 years to assess for subsequent CI. Bacteria isolates from paired episodes were subjected to Illumina HiSeq2500 and multilocus sequence typing. Results Six of 25 (24%) PI and 11 of 152 (7%) PC patients had subsequent CI—overall incidence was 9.6%. KP was most commonly implicated. While bacteria species differed in four cases, the carbapenemase type was conserved in all but one. Those with initial bacteremia, intra-abdominal (IA) or lung infection (n = 6) were five times more likely to develop CI. Only 33% of PI vs. 62% of PC patients had subsequent infections of the same clonal group. For PC, KP (OR 9.3) and OXA carbapenemase (OR 12.8) significantly predicted for subsequent CI. In PI, chronic renal failure requiring dialysis (OR 70.2) and KPC enzyme (OR 14) were predisposing factors. In-hospital mortality was observed in six cases. Initial Subsequent Time (Days) Site Bacteria Gene Site Bacteria Gene U KP OXA-48 B KP OXA-48 26 IA EC KPC-2 L KP OXA-1; KPC-2 17 B KP KPC-2, ;OXA-1 B KP KPC-2; OXA-1 8 S KP OXA-48 S KP OXA-48 146 L KP KPC-2 B KP KPC-2; OXA-1 91 U KP KPC-2 S KP KPC-2 45 ECO KPC-2 R KP OXA-1 IA KP OXA-1 6 L KP KPC-2 B KP KPC-2 82 L KP OXA-1; KPC-2 U KP KPC-2 23 R ECO KPC-2 IA ECO KPC 16 R KP NDM-1; OXA-1; OXA-181; S KP NDM-1; OXA-181; 13 S EC OXA-1; OXA-48 S ECO OXA-1; OXA-181 93 IA KP KPC-2 B ECO OXA-181 311 R KP KPC-2 U KP KPC-2; OXA-181 250 R KP KPC-2; OXA-1; OXA-9 L KP KPC 6 R KP OXA-1; OXA-181 B ECO OXA-181 5 R KP KPC-2; OXA-1 S KP KPC 367 B, blood; IA, intra-abdominal; L, lung; R, rectal; S, skin soft tissue; U, urine; EC, Enterobacter cloacae; ECO, Escherichia coli; KP, Klebsiella pneumoniae Conclusion Incidence of CI in carriers is low. Patients with IA and respiratory CI in the preceding 93 days are candidates for CPCRE treatment; empiric therapy should be active against the carbapenemase identified in the index episode. Disclosures All authors No reported disclosures.

Aim of Study: Colorectal cancer (CRC), now the third most common cancer across the world, is known to aggregate in families. Recently, genome-wide association studies have identified two single nucleotide polymorphisms (SNP) associated with CRC in Caucasians. Materials and Methods: To validate whether the same variations conferred risk to CRC in the Han Chinese population, we genotyped 760 individuals (380 controls and 380 cases samples) recruited from the Han Chinese origin. Results: We found rs11987193 in 8p12 (P = 0.0472 after correction, OR = 0.751) was significantly associated with CRC but rs12080929 in 1p33 (P = 0.0650 after correction, OR = 0.750) was not. Conclusion: Our findings supported that rs11987193 is a susceptibility locus for CRC, and gene DUSP4 was possible to play a role in the pathology of CRC.

Recently, the superior approach with transaction of the superior vena cava was introduced for the repair of supracardiac anomalies in adults. We developed a bidirectional right-angle venous cannula and placed it within the innominate vein to make the modified superior approach with the superior caval transection suitable for neonates and tiny infants. We applied this modified superior approach for the repair of infracardiac forms of total anomalous pulmonary venous drainage. doi: 10.1111/jocs.12472 (J Card Surg 2015;30:278–280)

This paper proposed a kind of low voltage stress Z-source inverter topology. In the topology, the inductors of Z-source can be connected alternatively in parallel during the time of shoot-through and in series during the other time. Thus the network can obtain a high boost factor with a small shoot-through duty ratio and can decrease the voltage stress across the switch divices greatly. The principle of the topology was analyzed in detail and the simulation experiments was made as well. Simulation results verified the validity of the topology.

This paper evaluates the results of two recent studies of advanced amine-based, post-combustion CO2 capture plant designs. The first study was conducted by the IEA Greenhouse Gas R&D Programme (IEA GHG), while the second study was conducted by Parsons for the US DOEs National Energy Technology Laboratory (NETL). Fluors improved monoethanolamine (MEA) process, known as the Econamine FG PlusSM technology, is utilised for both studies. Cost and performance estimates for both pulverized coal and natural gas-fired combined cycle plants are summarized. Differences between the design bases and assumptions for the two studies are discussed. The Econamine FG PlusSM technology, as an improved process in amine-based post-combustion CO2 capture described in this paper is leading to lower increases in the cost of electricity (COE). Both the DOE/Parsons and IEA GHG studies show that the increase is now down to 42 to 43% from as high as 60 to 70% indicated from previous studies for PC plants with CO2 capture.

The development of biomass and coal co-gasification technology not only helps to alleviate the energyshortage crisis, but also reduces the pollution of fossil fuels to ecological environment. Co-gasification of biomass and coal can overcome in a certain extent tar emerge in biomass gasification, alkali chloride corrosion, low reaction temperature etc, can increase the calorific value of the gasified gas, can also improve the gasification characteristics. However, due to the biomass compositions differences and the gasification technologies differences, there are the different studies results of co-gasification of biomass and coal. This paper summarized and analyzed the biomass and coal co-gasification study literatures, it is conclude that the biomass compositions can enhance the coal gasification reaction if the biomass compositions intensive mixed with the coal compositions. If not, the biomass gasification and the coal gasification would react separately. This conclusion provides a theoretical basis of the biomass and coal co-gasification and accelerates the biomass gasification technologies development.

The technology of diesel particulate filter (DPF) is one of the most effective ways to control particulate emission of diesel engine. In this paper, a DPF was installed on a high-pressure common rail diesel engine, which meets China Stage III emission standard (GB17691-2005), to investigate the filtration efficiency of DPF, and its effects on exhaust back pressure, fuel economy, and emissions characteristics of diesel engine by test bench. Results showed that after DPF was installed on the engine, the PM was reduced by more than 90%, while specific fuel consumption and exhaust back pressure were increased by about 5% and 10kPa, respectively.

In this paper, two kinds of micro-emulsified biodiesel containing 5.6% and10% water are prepared. The effects of micro-emulsified biodiesel on engine’s power, combustion and emission characteristics are investigated in a DI diesel engine. The results show that under the rated speed and full load operating conditions, the maximum pressure rise rate and peak heat release rate for micro-emulsified biodiesel increase dramatically, while the ignition delay is prolonged and the combustion duration becomes shorter. Compared to base diesel, the HC, CO and smoke emissions from the engine fueled with biodiesel decrease sharply, except for a 9% increased NOx at large loads. However, micro-biodiesel could significantly reduce the NOx and smoke emissions, except for the higher HC and CO emissions at low and medium loads. When fuelled with 10%MB, the NOx and smoke emissions are 9% and 90% lower than that of diesel, respectively. Results reported here suggest that the application of micro-emulsified biodiesel in diesel engines has a potential to improve combustion process and reduce NOx, PM emissions simultaneously.

With transfer matrix, the dissonant property of the standing-wave tube with tapered section (STTS) is studied. The 181 dB extremely nonlinear pure standing wave is obtained in the STTS excited at its first resonance frequency. On the basis of that, a comparative experimental study on the saturation properties of the extremely nonlinear standing waves in the STTS, in the standing-wave tube with uniform section (STUS) and in the standing-wave tube with abrupt section (STAS) is carried out. It is found that the STTS can suppress the harmonics and meanwhile reduce energy loss of the standing wave more effectively. Moreover, for the STTS excited at its high-order resonance frequencies, it is found experimentally that the order of the wave distortion and the energy loss of the standing waves do not agree with that of its high-order resonance frequencies.

Background Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. Methods A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. Results In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%), C. tropicalis (29.9%), and C. albicans (23.8%) were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0–0.007, p = 0.04). Fluconazole resistance was detected primarily in C. tropicalis (16.7%) and C. glabrata (7.2%). fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01), neutropenia (p

Polymyxins have emerged as a last-resort treatment of extensively drug-resistant (XDR) Gram-negative Bacillus (GNB) infections, which present a growing threat. Individualized polymyxin-based antibiotic combinations selected on the basis of the results of in vitro combination testing may be required to optimize therapy. A retrospective cohort study of hospitalized patients receiving polymyxins for XDR GNB infections from 2009 to 2014 was conducted to compare the treatment outcomes between patients receiving polymyxin monotherapy (MT), nonvalidated polymyxin combination therapy (NVCT), and in vitro combination testing-validated polymyxin combination therapy (VCT). The primary and secondary outcomes were infection-related mortality and microbiological eradication, respectively. Adverse drug reactions (ADRs) between treatment groups were assessed. A total of 291 patients (patients receiving MT, n = 58; patients receiving NVCT, n = 203; patients receiving VCT, n = 30) were included. The overall infection-related mortality rate was 23.0% (67 patients). In the multivariable analysis, treatment of XDR GNB infections with MT (adjusted odds ratio [aOR], 8.49; 95% confidence interval [CI], 1.56 to 46.05) and NVCT (aOR, 5.75; 95% CI, 1.25 to 25.73) was associated with an increased risk of infection-related mortality compared to that with treatment with VCT. A higher Acute Physiological and Chronic Health Evaluation II (APACHE II) score (aOR, 1.14; 95% CI 1.07 to 1.21) and a higher Charlson comorbidity index (aOR, 1.28; 95% CI, 1.11 to 1.47) were also independently associated with an increased risk of infection-related mortality. No increase in the incidence of ADRs was observed in the VCT group. The use of an individualized antibiotic combination which was selected on the basis of the results of in vitro combination testing was associated with significantly lower rates of infection-related mortality in patients with XDR GNB infections. Future prospective randomized studies will be required to validate these findings.