With the aim of gathering temporal trends on bacterial epidemiology and resistance from multiple laboratories in China, the CHINET surveillance system was organized in 2005. Antimicrobial ...susceptibility testing was carried out according to a unified protocol using the Kirby-Bauer method or automated systems. Results were analyzed according to Clinical and Laboratory Standards Institute (CLSI) 2014 definitions. Between 2005 and 2014, the number of bacterial isolates ranged between 22 774 and 84 572 annually. Rates of extended-spectrum β-lactamase production among Escherichia coli isolates were stable, between 51.7 and 55.8%. Resistance of E. coli and Klebsiella pneumoniae to amikacin, ciprofloxacin, piperacillin/tazobactam and cefoperazone/sulbactam decreased with time. Carbapenem resistance among K. pneumoniae isolates increased from 2.4 to 13.4%. Resistance of Pseudomonas aeruginosa strains against all of antimicrobial agents tested including imipenem and meropenem decreased with time. On the contrary, resistance of Acinetobacter baumannii strains to carbapenems increased from 31 to 66.7%. A marked decrease of methicillin resistance from 69% in 2005 to 44.6% in 2014 was observed for Staphylococcus aureus. Carbapenem resistance rates in K. pneumoniae and A. baumannii in China are high. Our results indicate the importance of bacterial surveillance studies.
Topological materials with exotic quantum properties are promising candidates for quantum spin electronics. Different classes of topological materials, including Weyl semimetal, topological ...superconductor, topological insulator and Axion insulator, etc., can be connected to each other via quantum phase transition. For example, it is believed that a trivial band insulator can be twisted into topological phase by increasing spin-orbital coupling or changing the parameters of crystal lattice. With the results of LDA calculation and measurement by angle-resolved photoemission spectroscopy (ARPES), we demonstrate in this work that the electronic structure of SrSn2As2 single crystal has the texture of band inversion near the critical point. The results indicate the possibility of realizing topological quantum phase transition in SrSn2As2 single crystal and obtaining different exotic quantum states.
As one of the most important engineering materials, aluminum alloys have been widely applied in many fields. However, the requirement of enhancing their mechanical properties without sacrificing the ...ductility is always a challenge in the development of aluminum alloys. Thanks to the excellent physical and mechanical properties, graphene nanoflakes (GNFs) have been applied as promising reinforcing elements in various engineering materials, including polymers and ceramics. However, the investigation of GNFs as reinforcement phase in metals or alloys, especially in aluminum alloys, is still very limited. In this study, the aluminum alloy reinforced by GNFs was successfully prepared via powder metallurgy approach. The GNFs were mixed with aluminum alloy powders through ball milling and followed by hot isostatic pressing. The green body was then hot extruded to obtain the final GNFs reinforced aluminum alloy nanocomposite. The scanning electron microscopy and transmission electron microscope analysis show that GNFs were well dispersed in the aluminum alloy matrix and no chemical reactions were observed at the interfaces between the GNFs and aluminum alloy matrix. The mechanical properties׳ testing results show that with increasing filling content of GNFs, both tensile and yield strengths were remarkably increased without losing the ductility performance. These results not only provided a pathway to achieve the goal of preparing high strength aluminum alloys with excellent ductilitybut they also shed light on the development of other metal alloys reinforced by GNFs.
This work reports a precise measurement of the reactor antineutrino flux using 2.2 million inverse beta decay (IBD) events collected with the Daya Bay near detectors in 1230 days. The dominant ...uncertainty on the neutron detection efficiency is reduced by 56% with respect to the previous measurement through a comprehensive neutron calibration and detailed data and simulation analysis. The new average IBD yield is determined to be (5.91±0.09)×10−43 cm2/fission with total uncertainty improved by 29%. The corresponding mean fission fractions from the four main fission isotopes U235, U238, Pu239, and Pu241 are 0.564, 0.076, 0.304, and 0.056, respectively. The ratio of measured to predicted antineutrino yield is found to be 0.952±0.014±0.023 (1.001±0.015±0.027) for the Huber-Mueller (ILL-Vogel) model, where the first and second uncertainty are experimental and theoretical model uncertainty, respectively. This measurement confirms the discrepancy between the world average of reactor antineutrino flux and the Huber-Mueller model.
Epileptic encephalopathies are severe epilepsy disorders with strong genetic bases. We performed targeted next‐generation sequencing (NGS) in 70 patients with epileptic encephalopathies. The likely ...pathogenicity of variants in candidate genes was evaluated by American College of Medical Genetics and Genomics (ACMG) scoring taken together with the accepted clinical presentation. Thirty‐three candidate variants were detected after population filtration and computational prediction. According to ACMG, 21 candidate variants, including 18 de novo variants, were assessed to be pathogenic/likely pathogenic with clinical concordance. Twelve variants were initially assessed as uncertain significance by ACMG, among which 3 were considered causative and 3 others were considered possibly causative after analysis of clinical concordance. In total, 24 variants were identified as putatively causative, among which 19 were novel findings. SCN1A mutations were identified in 50% of patients with Dravet syndrome. TSC1/TSC2 mutations were detected in 66.7% of patients with tuberous sclerosis. STXBP1 mutations were the main findings in patients with West syndrome. Mutations in SCN2A, KCNT1, KCNQ2 and CLCN4 were identified in patients with epileptic infantile with migrating focal seizures; among them, KCNQ2 and CLCN4 were first identified as potential causative genes. Only one CHD2 mutation was detected in patients with Lennox‐Gastaut syndrome. This study highlighted the utility of targeted NGS in genetic diagnoses of epileptic encephalopathies and a comprehensive evaluation of the pathogenicity of variants based on ACMG scoring and assessment of clinical concordance. Epileptic encephalopathies differ in genetic causes, and the genotype‐phenotype correlations would provide insights into the underlying pathogenic mechanisms.
We identified 24 causative mutations (19 novel) in a cohort of 70 EE patients and delineated new phenotype associated with CLCN4 and KCNQ2.
Summary
Background
Inflammation plays a vital role in liver cirrhosis progression and prognosis.
Aim
To investigate the prognostic significance of inflammatory response markers in decompensated ...cirrhotic patients without acute‐on‐chronic liver failure (ACLF).
Methods
Independent predictors were identified using multivariate Cox model and then assembled into a nomogram to predict survival. Concordance index (C‐index) and time‐dependent receiver operating characteristics (td‐ROC) analysis were adopted to evaluate and compare the performance of nomogram, model for end‐stage liver disease (MELD) scores, MELD‐Na and Chronic Liver Failure‐consortium score for acute decompensated (CLIF‐C ADs).
Results
A total of 902 decompensated cirrhotic patients with different aetiologies were enrolled, with 6‐month, 1‐year and 3‐year mortality of 18.6%, 24.4% and 34.8%, respectively. The cut‐off values for neutrophil‐to‐lymphocyte ratio (NLR) and lymphocyte‐to‐monocyte ratio (LMR) determined by X‐tile program were 5.7 and 1.1 respectively. Patients with NLR>5.7 or LMR≤1.1 had significantly higher mortality (P < 0.001). Independent factors derived from multivariable Cox analysis of development cohort to predict mortality were age, NLR and LMR (hazard ratio (HR): 1.064, 95% confidence interval (CI): 1.045–1.084, P < 0.001; HR: 1.124, 95%CI: 1.091–1.158, P < 0.001; HR: 0.794, 95%CI: 0.702–0.898, P < 0.001, respectively). The C‐indexes of nomogram were higher than that of MELD score, MELD‐Na and CLIF‐C ADs for predicting survival. The tdROC and decision curves showed that nomogram was superior to MELD score, MELD‐Na and CLIF‐C ADs. Similar results were observed in validation cohort.
Conclusion
The proposed nomogram with neutrophil‐to‐lymphocyte ratio and lymphocyte‐to‐monocyte ratio resulted in accurate prognostic prediction for decompensated cirrhotic patients without ACLF.
Linked ContentThis article is linked to Forest and Cai and Shi et al papers. To view these articles visit https://doi.org/10.1111/apt.14183 and https://doi.org/10.1111/apt.14208.
Background
Hepatic vein tumour thrombus (HVTT) is a major determinant of survival outcomes for patients with hepatocellular carcinoma (HCC). An Eastern Hepatobiliary Surgery Hospital (EHBH)‐HVTT ...model was established to predict the prognosis of patients with HCC and HVTT after liver resection, in order to identify optimal candidates for liver resection.
Methods
Patients with HCC and HVTT from 15 hospitals in China were included. The EHBH‐HVTT model with contour plot was developed using a non‐linear model in the training cohort, and subsequently validated in internal and external cohorts.
Results
Of 850 patients who met the inclusion criteria, there were 292 patients who had liver resection and 198 who did not in the training cohort, and 124 and 236 in the internal and external validation cohorts respectively. Contour plots for the EHBH‐HVTT model were established to predict overall survival (OS) rates of patients visually, based on tumour diameter, number of tumours and portal vein tumour thrombus. This differentiated patients into low‐ and high‐risk groups with distinct long‐term prognoses in the liver resection cohort (median OS 34·7 versus 12·0 months; P < 0·001), internal validation cohort (32·8 versus 10·4 months; P = 0·002) and external validation cohort (15·2 versus 6·5 months; P = 0·006). On subgroup analysis, the model showed the same efficacy in differentiating patients with HVTT in peripheral and major hepatic veins, the inferior vena cava, or in patients with coexisting portal vein tumour thrombus.
Conclusion
The EHBH‐HVTT model was accurate in predicting prognosis in patients with HCC and HVTT after liver resection. It identified optimal candidates for liver resection among patients with HCC and HVTT, including tumour thrombus in the inferior vena cava, or coexisting portal vein tumour thrombus.
Antecedentes
La trombosis tumoral de la vena hepática (hepatic vein tumour thrombus, HVTT) es un determinante importante de los resultados de supervivencia en pacientes con carcinoma hepatocelular (hepatocellular carcinoma, HCC). Se desarrolló el modelo llamado Eastern Hepatobiliary Surgery Hospital (EHBH)‐HVTT para predecir el pronóstico de los pacientes con HCC y HVTT después de la resección hepática (liver resection, LR), con el fin de identificar los candidatos óptimos para LR entre estos pacientes.
Métodos
Se incluyeron pacientes con HCC y HVTT de 15 hospitales en China. El modelo EHBH‐HVTT con gráfico de contorno se desarrolló utilizando un modelo no lineal en la cohorte de entrenamiento, siendo posteriormente validado en cohortes internas y externas.
Resultados
De 850 pacientes que cumplieron con los criterios de inclusión, hubo 292 pacientes en el grupo LR y 198 pacientes en el grupo no LR en la cohorte de entrenamiento, y 124 y 236 en las cohortes de validación interna y externa. Los gráficos de contorno del modelo EHBH‐HVTT se establecieron para predecir visualmente las tasas de supervivencia global (overall survival, OS) de los pacientes, en función del diámetro del tumor, número de tumores y del trombo tumoral de la vena porta (portal vein tumour thrombus, PVTT). Esto diferenciaba a los pacientes en los grupos de alto y bajo riesgo, con distinto pronóstico a largo plazo en las 3 cohortes (34,7 versus 12,0 meses, 32,8 versus 10,4 meses y 15,2 versus 6,5 meses, P < 0,001). En el análisis de subgrupos, el modelo mostró la misma eficacia en la diferenciación de pacientes con HVTT, con trombo tumoral en la vena cava inferior (inferior vena cava tumour thrombus, IVCTT) o en pacientes con PVTT coexistente.
Conclusión
El modelo EHBH‐HVTT fue preciso para la predicción del pronóstico en pacientes con HCC y HVTT después de la LR. Identificó candidatos óptimos para LR en pacientes con HCC y HVTT, incluyendo IVCTT o PVTT coexistente.
The Eastern Hepatobiliary Surgery Hospital–hepatic vein tumour thrombus (EHBH‐HVTT) model was accurate in predicting prognosis in patients with hepatocellular carcinoma (HCC) and HVTT after liver resection. It identified optimal candidates for liver resection among patients with HCC and HVTT, including inferior vena cava tumour thrombus, or coexisting portal vein tumour thrombus (PVTT).
predicts prognosis
This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at ...Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.
Single-phase equiatomic CoCrFeMnNi high-entropy alloy (HEA) specimens with three different grain sizes (0.65 μm, 2.1 μm and 105 μm) were processed by cold rolling and annealing treatment. Tensile ...properties were investigated over a broad temperature range from 77 K to 873 K. Superior strength-ductility balance can be achieved by refining grain size and decreasing temperature. The Hall-Petch relationship was well fitted, and the fitting parameters have a negative relation with temperature. The thermal and athermal contributions to the yield strength were revealed. This work has unveiled the superior mechanical property of HEAs at cryogenic temperatures.
•The Hall-Petch relationships for CoCrFeMnNi high-entropy alloys (HEAs) were well fitted in large temperature range.•The Hall-Petch slope and friction stress of the CoCrFeMnNi HEAs have a negative relation with temperature.•Athermal contribution and grain size (d) follow a Hall-Petch relation, while thermal part is related to temperature and d.•Superior strength and ductility for CoCrFeMnNi HEAs were achieved by refining grain size and decreasing temperature.
Superflares, which are strong explosions on stars, have been well studied with the progress of spacetime-domain astronomy. In this work, we present the study of superflares on solar-type stars using ...Transiting Exoplanet Survey Satellite (TESS) data. Thirteen sectors of observations during the first year of the TESS mission covered the southern hemisphere of the sky, containing 25,734 solar-type stars. We verified 1216 superflares on 400 solar-type stars through automatic search and visual inspection with 2 minute cadence data. Our result suggests a higher superflare frequency distribution than the result from Kepler. This may be because the majority of TESS solar-type stars in our data set are rapidly rotating stars. The power-law index γ of the superflare frequency distribution ( ) is constrained to be γ = 2.16 0.10, which is a little larger than that of solar flares but consistent with the results from Kepler. Because only seven superflares of Sun-like stars are detected, we cannot give a robust superflare occurrence frequency. Four stars were accompanied by unconfirmed hot planet candidates. Therefore, superflares may possibly be caused by stellar magnetic activities instead of planet-star interactions. We also find an extraordinary star, TIC43472154, which exhibits about 200 superflares per year. In addition, the correlation between the energy and duration of superflares ( ) is analyzed. We derive the power-law index to be β = 0.42 0.01, which is a little larger than β = 1/3 from the prediction according to magnetic reconnection theory.
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