Background. Better understanding of complications and outcomes of adults hospitalized with respiratory syncytial virus (RSV) infection is necessary. Methods. A retrospective cohort study was ...conducted on all adults (≥18 years) admitted to 3 acute care general hospitals in Hong Kong with virologically confirmed RSV infection during 2009–2011 (N = 607). Adults hospitalized for seasonal influenza during the period were used for comparison (n = 547). Both infections were prospectively diagnosed following a standard protocol. Independent reviews of chest radiographs were performed by radiologists. Main outcome measures were all-cause death, respiratory failure requiring ventilatory support, and hospitalization duration. Cox proportional hazards models were used for analyses. Results. The mean age of RSV patients was 75 (SD, 16) years; 87% had underlying conditions. Lower respiratory and cardiovascular complications were diagnosed in 71.9% (pneumonia, 42.3%; acute bronchitis, 21.9%; chronic obstructive pulmonary disease/asthma exacerbation, 27.3%) and 14.3% of patients, respectively; 12.5% had bacterial superinfections. Supplemental oxygen and ventilatory support were required in 67.9% and 11.1%, respectively. Crude all-cause mortality was 9.1% and 11.9% within 30 days and 60 days, respectively; mean length of stay of survivors was 12 (SD, 13) days. Advanced age, radiographic pneumonia, requirement for ventilation, bacterial superinfection, and elevated urea level and white blood cell count were independently associated with poorer survival. Systemic corticosteroid use was associated with longer hospitalization and secondary infections. The overall outcomes of survival and length of stay were not significantly different from those in influenza. Conclusions. RSV can cause severe lower respiratory complications in older adults, resulting in respiratory failure, prolonged hospitalization, and high mortality similar to seasonal influenza. Corticosteroids did not seem to improve outcomes. The unmet need for antiviral therapy and vaccination against RSV in adults should be promptly addressed.
We present the fourth in a series of catalogs of gamma-ray bursts (GRBs) observed with Fermi's Gamma-ray Burst Monitor (Fermi-GBM). It extends the six year catalog by four more years, now covering ...the 10 year time period from trigger enabling on 2008 July 12 to 2018 July 11. During this time period GBM triggered almost twice a day on transient events, 2356 of which we identified as cosmic GRBs. Additional trigger events were due to solar flare events, magnetar burst activities, and terrestrial gamma-ray flashes. The intention of the GBM GRB catalog series is to provide updated information to the community on the most important observables of the GBM-detected GRBs. For each GRB the location and main characteristics of the prompt emission, the duration, peak flux, and fluence are derived. The latter two quantities are calculated for the 50-300 keV energy band, where the maximum energy release of GRBs in the instrument reference system is observed and also for a broader energy band from 10-1000 keV, exploiting the full energy range of GBM's low-energy detectors. Furthermore, information is given on the settings of the triggering criteria and exceptional operational conditions during years 7 to 10 in the mission. This fourth catalog is an official product of the Fermi-GBM science team, and the data files containing the complete results are available from the High-Energy Astrophysics Science Archive Research Center.
Summary Survivors of childhood cancer treated with anthracycline chemotherapy or chest radiation are at an increased risk of developing congestive heart failure. In this population, congestive heart ...failure is well recognised as a progressive disorder, with a variable period of asymptomatic cardiomyopathy that precedes signs and symptoms. As a result, several clinical practice guidelines have been developed independently to help with detection and treatment of asymptomatic cardiomyopathy. These guidelines differ with regards to definitions of at-risk populations, surveillance modality and frequency, and recommendations for interventions. Differences between these guidelines could hinder the effective implementation of these recommendations. We report on the results of an international collaboration to harmonise existing cardiomyopathy surveillance recommendations using an evidence-based approach that relied on standardised definitions for outcomes of interest and transparent presentation of the quality of the evidence. The resultant recommendations were graded according to the quality of the evidence and the potential benefit gained from early detection and intervention.
► Farmers tend to concede in land acquisitions for public interests; but to struggle in those for individual interests. ► New conflicts arise as local governments negotiate with farmers in land ...acquisition for individual interests. ► The contradictions and inconsistencies in the law that governs land acquisitions are the main reasons for these conflicts. ► Illegal land conversion has inflicted serious damage on farmers and resulted in land conflicts. ► Due to illegal land conversion, the black land market is triggered which spreads unchecked.
Conflicts over land have arisen frequently in China during rapid urbanization and have caused adverse impacts. Different from previous researches on land conflict analyzing its causes, types, consequences, methods of assessment and management, this paper develops a new analytic framework from a behavioral perspective based on game theory. The framework concerns the logic and strategy of conflicts of legal land acquisition, and that of illegal land conversion. The paper has established three innovative models: (1) the dynamic model for conflicts of legal land acquisition, (2) the game model of illegal land acquisition and (3) the game model of the black land market. These models are to explain how disputes and conflicts evolve and illustrate the logic and strategy of conflicts between local governments and farmers. Based on the Nash equilibrium of these models, the paper offers some important insights for policy direction in land acquisition and conflict management.
Summary
This meta‐analysis aimed to evaluate the association between childhood and adolescent obesity and depression. We systematically searched PubMed, PsycInfo, EMBASE and Science Direct for ...studies that compared prevalence of depression and depressive symptoms in normal weight and obese children and adolescents. Observational studies were included if they reported body mass index and assessed depression by validated instruments or diagnostic interviews. Quality assessment was performed using the Newcastle–Ottawa scale. We used the random‐effect model to calculate the pooled odds ratios, standard mean differences (SMDs) and subgroup analysis. Findings for a total of 51,272 participants were pooled across 18 studies and examined. Our analyses demonstrated a positive association between childhood and adolescent obesity and depression (pooled odds ratio = 1.34, 95% confidence interval CI: 1.1–1.64, p = 0.005) and more severe depressive symptoms (SMD = 0.23, 95% CI: 0.025–0.44, p = 0.028) in the obese groups. Overweight subjects were not more likely to have either depression (pooled odds ratio = 1.16, 95% CI: 0.93–1.44, p = 0.19) or depressive symptoms (SMD = 0, 95% CI: −0.101 to 0.102, p = 0.997). Non‐Western and female obese subjects were significantly more likely to have depression and severe depressive symptoms (p < 0.05). In conclusion, obese children and adolescents are more likely to suffer from depression and depressive symptoms, with women and non‐Western people at higher risk.
In 2015, the China State Council in its 13th Five-Year Plan for Economic and Social Development strategically initiated the Guangdong-Hong Kong-Macau Greater Bay Area, with emphasis on strengthening ...its role in economic development and its powerful synergy with the all-important The Belt and Road Initiative (BRI) in the country and globally. The Greater Bay Area is a unique mega city region situated at the Pearl River Delta, covering the 11 9 mainland cities +2 special administrative regions (Hong Kong and Macau) cities. However, few studies examined the bay area under a unique institutional and economic context. This study aims to examine regional integration and spatial connection that affect the growth and success of the megacity region using network analysis. Particularly, it analyzed the centrality of human movements, traffic flow and railway network through visualization of the results from Tencent (QQ) Location Big Data, railway service and census data. The study reveals that the vital contributor to the formation and success of the Greater Bay Area is its rapid growth of transport infrastructure and capacities, particularly high-speed railway, promoting free flowing of the key factors. Strong spatial and transport connection critically harness regional integration and boosting viable development of the Greater Bay Area. Guangzhou-Shenzhen-Hong Kong has shaped a triangle structure. The findings provide planning recommendation and policy implications for city planners and policy makers for regional governance and cooperation in mainland China, Hong Kong and worldwide.
•The Greater Bay Area strengthening economic development, with 9 mainland cities + 2 special administrative regions;•Spatial connection of human movements, traffic flow, and transport network denote the degree of regional integration;•Transport infrastructure promote factors freely flowing and contribute to the formation and success of a megacity region;•Integrated infrastructure network raises the Greater Bay Area to the world-class megacity region;•One-hour rail transit forms the megacity region and enhances the flows between the east and west bay area.
Abstract
We present the systematic spectral analyses of gamma-ray bursts (GRBs) detected by the Fermi Gamma-Ray Burst Monitor during its first ten years of operation. This catalog contains two types ...of spectra: time-integrated spectral fits and spectral fits at the brightest time bin, from 2297 GRBs, resulting in a compendium of over 18,000 spectra. The four different spectral models used for fitting the spectra were selected based on their empirical importance to the shape of many GRBs. We describe in detail our procedure and criteria for the analyses, and present the bulk results in the form of parameter distributions both in the observer frame and in the GRB rest frame. 941 GRBs from the first four years have been refitted using the same methodology as that of the 1356 GRBs in years five through ten. The data files containing the complete results are available from the High-Energy Astrophysics Science Archive Research Center.
ABSTRACT With an instantaneous view of 70% of the sky, the Fermi Gamma-ray Burst Monitor (GBM) is an excellent partner in the search for electromagnetic counterparts to gravitational-wave (GW) ...events. GBM observations at the time of the Laser Interferometer Gravitational-wave Observatory (LIGO) event GW150914 reveal the presence of a weak transient above 50 keV, 0.4 s after the GW event, with a false-alarm probability of 0.0022 (2.9 ). This weak transient lasting 1 s was not detected by any other instrument and does not appear to be connected with other previously known astrophysical, solar, terrestrial, or magnetospheric activity. Its localization is ill-constrained but consistent with the direction of GW150914. The duration and spectrum of the transient event are consistent with a weak short gamma-ray burst (GRB) arriving at a large angle to the direction in which Fermi was pointing where the GBM detector response is not optimal. If the GBM transient is associated with GW150914, then this electromagnetic signal from a stellar mass black hole binary merger is unexpected. We calculate a luminosity in hard X-ray emission between 1 keV and 10 MeV of 1.8 − 1.0 + 1.5 × 10 49 erg s−1. Future joint observations of GW events by LIGO/Virgo and Fermi GBM could reveal whether the weak transient reported here is a plausible counterpart to GW150914 or a chance coincidence, and will further probe the connection between compact binary mergers and short GRBs.
Green building incentives are widely implemented. Under each incentive, governments and developers have different payoffs and dominant strategies that affect incentive effectiveness. Existing studies ...have examined incentive effectiveness through different methods but have failed to reveal the decision-making mechanisms of governments and developers in a dynamic process of a game. As governments and developers have bounded rationality, and their strategies may change from time to time, this study employed evolutionary game theory to model the evolutionary behaviours of two players, thus providing a quantitative method to illustrate the effectiveness of incentives and the strategy changes of the players. This study concluded that four types of interactions between governments and developers affect incentive effectiveness, namely, 1) governments' dominant strategies depend on developers' choices; 2) developers' dominant strategies rely on governments' choices; 3) two parties' dominant strategies are independent; 4) their dominant strategies are interdependent. Under these interactions, the price premium of green building and the level and affordability of incentives were found to be the critical factors for the decision makings of the leading players. Policy recommendations were proposed accordingly. This study adopted a mathematical approach to investigate the conflicts of interests between governments and developers. It also provided a general model which can fit various contexts. In addition, the research introduced a valuable angle of government payoffs. Results can advance policymakers' understanding of green building incentives, help policymakers predict developers' behaviours and the incentive effectiveness in the long run and justify the design or improvement of multinational incentives.
•This paper concluded four types of interactions between governments and developers.•Critical factors for the decision-makings of the leading players were identified.•This paper provided a general model which can fit various contexts.•Policy implications are suitable for multinational policies.
An optimal single-photon source should deterministically deliver one, and only one, photon at a time, with no trade-off between the source’s efficiency and the photon indistinguishability. However, ...all reported solid-state sources of indistinguishable single photons had to rely on polarization filtering, which reduced the efficiency by 50%, fundamentally limiting the scaling of photonic quantum technologies. Here, we overcome this long-standing challenge by coherently driving quantum dots deterministically coupled to polarization-selective Purcell microcavities. We present two examples: narrowband, elliptical micropillars and broadband, elliptical Bragg gratings. A polarization-orthogonal excitation–collection scheme is designed to minimize the polarization filtering loss under resonant excitation. We demonstrate a polarized single-photon efficiency of 0.60 ± 0.02 (0.56 ± 0.02), a single-photon purity of 0.975 ± 0.005 (0.991 ± 0.003) and an indistinguishability of 0.975 ± 0.006 (0.951 ± 0.005) for the micropillar (Bragg grating) device. Our work provides promising solutions for truly optimal single-photon sources combining near-unity indistinguishability and near-unity system efficiency simultaneously.
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