Speed Measurement Feasibility by Eddy Current Effect in the High-Speed MFL Testing

It is known that eddy current effect has a great influence on magnetic flux leakage testing(MFL).Usually,contacttype encoder wheels are used to measure MFL testing speed to evaluate the effect and further compensate testing signals.This speed measurement method is complicated,and inevitable abrasion and occasional slippage will reduce the measurement accuracy.In order to solve this problem,based on eddy current effect due to the relative movement,a speed measurement method is proposed,which is contactless and simple.In the high-speed MFL testing,eddy current induced in the specimen will cause an obvious modification to the applied field.This modified field,which is measured by Hall sensor,can be utilized to reflect the moving speed.Firstly,the measurement principle is illustrated based on Faraday’s law.Then,dynamic finite element simulations are conducted to investigate the modified magnetic field distribution.Finally,laboratory experiments are performed to validate the feasibility of the proposed method.The results show that Bmz(r1)and Bmx(r2)have a linear relation with moving speed,which could be used as an alternative measurement parameter.

Respiratory Support in Severely or CriticallyⅢICU Patients With COVID-19 in Wuhan,China

Summary:This case series aimed to describe the clinical characteristics of severely or critically ill patients with COVID-19 and compare the clinical characteristics of patients who received invasive respiratory support with those of patients who received noninvasive respiratory support.We included all confirmed severe or critical illness cases of COVID-19 admitted to the Intensive Care Unit(ICU)of Zhongnan Hospital of Wuhan University,a COVID-19-designated hospital,from January 8 to March 12,2020.Cases were analyzed for cpidemiological,demographic,clinical,APACHE II,SOFA,radiological features and laboratory data.Outcomes of all patients were followed up as of March 12,2020.This newly emerging virus had caused 55 confirmed severe or critical illness cases in ICU of a COVID-19-designated hospital.Most of the infected patients were men;more than half had underlying diseases,including hypertension,coronary artery disease and diabetes.The median age was 63 years old.Common symptoms at onset of ilness were fever,fatigue and dry cough.Five(9.1%)hospitalized patients were presumed to have been infected in the hospital,and 4(7.3%)health care workers were infected in their work.Of the 55 confirmed severe or critical ilncss cases,10(18.2%)patients died during the follow-up period as of March 12 with the median follow-up period of 28 days(interquartile range 1635).Nine patients received VV-ECMO for severe respiratory failure and 4(44.4%)patients died.Moreover,28 patients received invasive respiratory support and 14(50.0%)patients died.In this single-center study,55 severely or critically ill ICU patients were confirmed to have COVID-19 in Wuhan and the overall mortality was 29.1%。Totally 28(50.9%)of severely or critically ill ICU patients received invasive respiratory support and 14(50.0%)died during the follow-up period.

Clinical and Microbiological Characteristics of Patients with Complicated Intra-abdominal Infections in Intensive Care Unit

In order to investigate the clinical and microbiological characteristics of patients with complicated intra-abdominal infections(cIAIs)in intensive care unit(ICU),the clinical data of 612 cIAIs patients from January 2016 to December 2018 were retrospectively collected.Clinical characteristics,distribution of pathogens and drug resistance were statistically analyzed.It was found that patients with community-acquired intra-abdominal infections(CA-IAIs)made up a majority of cIAIs patients.The positive rate of abdominal drainage fluid culture was 55.56%.Gramnegative bacteria accounted for the majority,the most commonly isolated bacteria of which were Escherichia coli(20.96%),Klebsiella pneumoniae(10.20%)and Pseudomonas aeruginosa(5.57%).The most commonly isolated gram-positive bacteria were Enterococcus(16.88%)and Methicillinresistant staphylococcus aureus(MRSA,3.90%).Enterobacter isolates showed high resistance rate to most cephalosporins and low resistance rate to piperacillin/tazobactam and carbapenems.Extended spectrum beta-lactamase(ESBL)screen positive isolates from CA-IAIs patients showed an increasing trend in past three years.Enterococcus and MRSA showed high resistance rate to clindamycin,quinolone,erythromycin and tetracycline,while they showed high sensitivity rate to linezolid,tegacycline,teicoplanin and vancomycin.Our results indicate that isolated bacteria from abdominal drainage fluid show high resistance rates to commonly used antibiotics in ICU patients with cIAIs.The curative effects on diseases should be monitored continuously when antibiotics are used.Meanwhile,we should always keep eyes on drug-resistant bacteria,especially when the treatment efficacy is not good.

<i>Biradiolites</i>from the Yigeziya Formation of the Southwestern Tarim Basin

Two Biradiolites species described from the Yigeziya Formation of the southwestern Tarim Basin are revised. The Maastrichtian Biradiolites boldjuanensis is small and pipe-like species that is usually preserved as clusters or bouquets. Although it was considered to be endemic to Central Asia, similar specimens are abundant in Maastrichtian of other Tethyan regions. Biradiolites minor specimens have no relationship with the genus Biradiolites because their ventral and posterior bands are protruding ridges and interband is depressed broad groove. This species is comparable with the Campanian-Maastrichtian eastern Arabian species Glabrobournonia arabica, by the character of smooth outer shell layer in right valve, and simple radial bands and ridges on margin of each shell flank, but it differs from the latter species in size and the shape of left valve. This study will be a supportive tool for the establishment and reconstruction of the palaeogeographic connection between Central Asia and other Tethyan regions.

The brackish-water bivalve Waagenoperna from the Lower Jurassic Badaowan Formation of the Junggar Basin and its palaeoenvironmental and palaeogeographic significance

The brackish-water bivalve Waagenoperna Tokuyama, 1959 is reported from the Lower Jurassic Badaowan Formation at four localities, along the southern margin and western margin of the Junggar Basin. Taphonomic features recorded in the field indicate that it occurs in autochthonous or parautochthonous assemblages. The autecology of Waagenoperna therefore yields information on the palaeoenvironment of the area. The restriction of Waagenoperna to marine and brackish-water settings suggests that the sea water once reached these areas during the Sinemurian. This paper discusses the palaeogeographic implications and suggests an ingression of the sea water from the west to the western and southern part of the Junggar Basin. Additionally, the two Waagenoperna species collected from the Haojiagou section in the Junggar Basin are taxonomically documented.

Jurassic integrative stratigraphy,biotas,and paleogeographical evolution of the Qinghai-Tibetan Plateau and its surrounding areas

The Qinghai-Tibetan Plateau experienced a unique geological evolution during the Jurassic,driven by the termination of the Palaeotethys and the reduction of the Neotethys.The Indian Plate separated from the northern margin of Gondwana and drifted northward from the Southern Hemisphere.Given that the timing of strata serves as the basis for reconstructing geological history,the present work aimed to develop a new multiple stratigraphic and chronologic framework for the Jurassic strata of the Qinghai-Tibetan Plateau region via a synthesis of the material on lithostratigraphy,palaeontology,iso-radiometric dating,magnetostratigraphy,and other techniques with an emphasis on recent progress and findings.The new framework included the Jurassic System from the four major subdivisions of the plateau:the Baryan Har,Qiangtang,Lhasa-Gandise,and Southern Xizang(Himalaya).Ultimately,a more complete,refined biostratigraphic sequence was proposed,comprising the most common fossils in the plateau and those that are stratigraphically significant for the Jurassic stratigraphy,including ammonites,bivalves,brachiopods,foraminifera,radiolarians,and dinoflagellate cysts for the marine strata,and pollen and spores,and charophytes for the terrestrial sediments.This biostratigraphic framework was correlated with the Jurassic international standard zonation of the Geological Time Scale 2020 via standard or representative species or genera of ammonites.Based on this framework,we constructed a lateral correlation of the Jurassic strata between different basins of the plateau.The palaeontologic correlation in the present work shows that the Lhasa-Gandise Block had a closer relationship with the Qiangtang Block than with the Southern Xizang Himalaya during the Jurassic Period.Meanwhile,the Lhasa-Gandise Block and Qiangtang Block shared similar marine fauna features of the north marginal East Tethys.This contrasts the opinion suggesting that the Yarlung Zangbo Tethys was a small back-arc basin.A combination of stratigraphical,palaeontological,and sedimentological analyses implies that the Bangong Co-Nujiang Tethys may have begun rifting in the Late Triassic,evolving to the birth at the late Early Jurassic with the formation of ocean crust.However,this resulted in failure after it grew into the climax at the end of the Middle Jurassic when the Qiangtang Block began subducting under the Lhasa-Gandise Block.In the Early Cretaceous,the two blocks finally merged.

Cretaceous integrative stratigraphy,biotas,and paleogeographical evolution of the Qinghai-Tibetan Plateau and its surrounding areas

The Cretaceous Period is a vital time interval in deciphering the evolutionary history of the Neo-Tethys Ocean and the convergence of different plates and blocks across the Qinghai-Tibetan Plateau.A detailed stratigraphic framework and paleogeographic patterns are the basis for understanding the evolution of the Neo-Tethys Ocean and the formation of the QinghaiTibetan Plateau.Here,the Cretaceous stratigraphy,biota,paleogeography,and major geological events in the Qinghai-Tibetan Plateau are analyzed to establish an integrative stratigraphic framework,reconstruct the paleogeography during the Cretaceous Period,and decode the history of the major geological events.The Cretaceous rocks of the Qinghai-Tibetan Plateau and its surrounding area are predominantly marine deposits,with a small amount of interbedded marine-terrestrial and terrestrial conponents.The Indus-Yarlung Tsangpo Suture Zone was responsible for the deposition of deep marine sediments dominated by ophiolite suites and radiolarian silicalite.To the south,the Tethys Himalayas and Indus Basin received marine sediments of varying depths and lithology;to the north,the Xigaze and Ladakh forearc basins are also filled with marine sediments.The Lhasa Block,Karakorum Block,western Tarim Basin,and West Burma block consist of shallow marine,interbedded marine-terrestrial,and terrestrial sediments.The Qiangtang Basin and other areas are dominated by terrestrial sedimentation.The Cretaceous strata of the Qinghai-Tibetan Plateau and its surrounding areas are widely distributed and diversified,with abundant foraminifera,calcareous nannofossils,radiolarians,ammonites,bivalves,and palynomorphs.On the basis of integrated lithostratigraphic,biostratigraphic,geochronologic,and chemostratigraphic analyses,we proposed herein a comprehensive stratigraphic framework for the Cretaceous Period of the eastern Neo-Tethys.By analyzing the Cretaceous biota of different biogeographic zones from eastern Neo-Tethys and its surrounding areas,we reconstructed the paleobiogeography of different periods of eastern NeoTethys.The Cretaceous paleogeographic evolution of the Qinghai-Tibetan Plateau and its surrounding areas can be divided into three phases:(1)gradual breakup of the Indian Plate from the Australia-Antarctica continent and the early collision phase of the Lhasa-Qiangtang blocks(145-125 Ma);(2)northward drift of the Indian Plate and the collision phase of the Lhasa-Qiangtang blocks(125-100 Ma);(3)rapid northward drift of the Indian Plate,formation of the Tarim-Tajik-Karakorum Bay,and early uplift of the Gangdise Mountains(100-66 Ma).The Indus-Tethys Himalayan biota underwent a transition from the cold-water type in the high latitudes of the southern hemisphere to the warm-water type near the equator from the Early Cretaceous to the MidCretaceous.The biodiversity and abundance of the eastern Neo-Tethys Ocean increased gradually in the Early Cretaceous,peaking in the Mid-Cretaceous,and decreased sharply during the late Late Cretaceous(late Maastrichtian).Along with the northward drift of the Indian Plate and subduction of the Neo-Tethys,the eastern Neo-Tethys and its surrounding areas experienced a series of major geological events,including the formation of the large igneous province,oceanic anoxia events,and mass extinction,etc.

A National Multicenter Survey on Management of Pain, Agitation, and Delirium in Intensive Care Units in China

Background： The management of pain, agitation, and deliriunl （PAD） in Intensive Care Unit （ICU） is beneficial for patients and makes it widely applied in clinical practice. Previous studies showed that the clinical practice of PAD in ICU was improving： yet relatively little intbrmation is available in China. This study aimed to investigate the practice of PAD in ICUs in China. Methods： A multicenter, nationwide survey was conducted using a clinician-directed questionnaire from September 19 to December 18, 2016. The questionnaire focused on the assessment and naanagement of PAD by the clinicians in ICUs. The practice of PAD was compared among the lbur regions of China （North, Southeast, Northwest, and Southwest）. The data were expressed as percentage and fi＇equency. The Chi-square test, Fisher＇s exact test, and line-row Chi-square test were used. Results： Of the 1011 valid questionnaire lbrms, the response rtite was 80.37%. The clinicians came from 704 hospitals across 158 cities of China. The rate of PAD assessment was 75.77%, 90.21%, and 66.77%, respectively. The rates of PAD scores were 45.8%, 68.94%, and 34.03%, respectively. The visual analog scale, Richmond agitation-sedation scale, and conlktsion assessment method lbr the ICU were the first choices of scales for PAl） assessment. Fentanyl, midazolam, and dexmedetomidine were the first choices of agents for analgesic, sedation, and delirium treatment. While choosing analgesics and sedatives, the clinicians put the pharmacological characteristics of drugs in the first place （66.07% and 76.36%）. Daily interruption for sedation was carried out by 67.26% clinicians. Most of the clinicians （87.24%） used analgesics while using sedatives. Of the 738 （73%） clinicians titrating the sedatives oil the basis of the proposed target sedation level, 268 （26.61%） clinicians just depended on their clinical experience. Totally, 519 （51.34%） clinicians never used other nondrug strategies tbr PAD. The working time of clinicians was an important thctor in the management of analgesia and sedation rather than their titles and educational background. The ratios of pain score and sedation score in the Southwest China were the highest and the North China were the lowest. The ratios of delirium assessment and score were the same in the four regions of China. Moreover, the first choices of scales for PAD in the four regions were the same. However, the top three choices of agents in PAD treatment in the four regions were not the same. Conclusions： The practice of PAD in China lbllows the international guidelines; however, the pain assessment should be improved. The PAD practice is a little different across the four regions of China： however, the trend is consistent. Trial Registration： The study is registered at http：//www.clinicaltrials.gov （No. ChiCTR-OOC-16000014, www.chictr, org.cn/index.aspx.）.

Assessment of respiratory support decision and the outcome of invasive mechanical ventilation in severe COVID-19 with ARDS

Background:The coronavirus disease 2019(COVID-19)is an ongoing pandemic.Invasive mechanical ventilation(IMV)is essential for the management of COVID-19 with acute respiratory distress syndrome(ARDS).We aimed to assess the impact of compliance with a respiratory decision support system on the outcomes of patients with COVID-19-associated ARDS who required IMV.Methods:In this retrospective,single-center,case series study,patients with COVID-19-associated ARDS who required IMV at Zhongnan Hospital of Wuhan University,China,from January 8th,2020,to March 24th,2020,with the final follow-up date of April 20th,2020,were included.Demographic,clinical,laboratory,imaging,and management information were collected and analyzed.Compliance with the respiratory support decision system was documented,and its relationship with 28-day mortality was evaluated.Results:The study included 46 COVID-19-associated ARDS patients who required IMV.The median age of the 46 patients was 68.5 years,and 31 were men.The partial pressure of arterial oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))ratio at intensive care unit(ICU)admission was 104 mmHg.The median total length of IMV was 12.0(interquartile range[IQR]:6.0–27.3)days,and the median respiratory support decision score was 11.0(IQR:7.8–16.0).To 28 days after ICU admission,18(39.1%)patients died.Survivors had a significantly higher respiratory support decision score than non-survivors(15.0[10.3–17.0]vs.8.5(6.0–10.3),P=0.001).Using receiver operating characteristic(ROC)curve to assess the discrimination of respiratory support decision score to 28-day mortality,the area under the curve(AUC)was 0.796(95%confidence interval[CI]:0.657–0.934,P=0.001)and the cut-offwas 11.5(sensitivity=0.679,specificity=0.889).Patients with a higher score(>11.5)were more likely to survive at 28 days after ICU admission(log-rank test,P<0.001).Conclusions:For severe COVID-19-associated ARDS with IMV,following the respiratory support decision and assessing completion would improve the progress of ventilation.With a decision score of>11.5,the mortality at 28 days after ICU admission showed an obvious decrease.

Cost-effectiveness analysis of second-line chemotherapy strategies for patients with advanced non-squamous non-small cell lung cancer

Lung cancer is the most widespread type of cancer and the primary cause of cancer-related death in the world.In this study,we aimed to analyze the cost-effectiveness of second-line chemotherapy strategies based on gemcitabine,pemetrexed,and docetaxel for advanced non-squamous non-small cell lung cancer patients in China.A Markov model based on three states,progression-free survival,progressed survival and death,was constructed to simulate the progression of the disease in a 6-year horizon.Sensitivity analysis was performed to evaluate the robustness of the model.The primary outcome of the model was the incremental cost-effectiveness ratio at a willingness-to-pay threshold of 3×per capita GDP of China in 2018($29383).The baseline model results showed that the quality-adjusted life years over the course of the disease associated with second-line chemotherapy strategies were 0.233,0.417 and 0.272 for gemcitabine,pemetrexed and docetaxel,respectively,and the corresponding total costs were$5321.02,$12143.94,and$9479.42.Gemcitabine,pemetrexed and docetaxel resulted in the incremental cost-effectiveness ratios of$37081.09 and$106625.64 per quality-adjusted life year gained.The incremental cost-effectiveness ratio of pemetrexed and docetaxel compared with gemcitabine exceeded the willingness-to-pay threshold.One-way sensitivity analysis showed that the utility value of gemcitabine in the progressed survival state was the most influential parameter.