广泛耐药革兰阴性菌感染的实验诊断、抗菌治疗及医院感染控制:中国专家共识

广泛耐药革兰阴性杆菌(XDR-GNB),是指除1~2类抗菌药物(主要指多黏菌素和替加环素)外,几乎对所有类别抗菌药物均不敏感的革兰阴性杆菌。XDR-GNB常见于肠杆菌科细菌、鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌等。近年来,中国XDR-GNB的发生率呈不断上升趋势,由于缺乏有效的治疗药物,XDR-GNB感染成为公共卫生安全的一大威胁。我国有关感染的临床、微生物学及临床药理学专家们就XDR-GNB感染的实验室诊断、临床诊疗和医院感染控制等问题深入讨论,形成此共识。其中细菌药敏试验的抗菌药物品种及结果判定标准遵循美国临床和实验室标准化协会(CLSI)、欧洲抗菌药物敏感性试验委员会(EUCAST)或美国食品与药物监督管理局(FDA)的指南。研究提示长疗程使用广谱抗菌药物是引发XDR-GNB感染最重要的危险因素。根据现有的临床研究和实验室数据,共识提供治疗各种XDRGNB感染的联合用药推荐方案,其中常用的抗菌药物有替加环素、多黏菌素、碳青霉烯类、氨基糖苷类和磷霉素等。同时建议实行严格的感染控制措施,包括手卫生、接触隔离、主动筛查、环境消毒、去定植和抗菌药物应用管理等遏制XDRGNB感染的传播。

钢铁供应链金融动态货值融资模式探究——以A企业为例

近年来,随着钢铁行业形势不断下滑和互联网迅猛发展,钢铁行业逐渐采取互联网手段来改善传统的供应链金融模式以促进钢贸行业的发展.基于电商平台和物流服务基地相互联合作用,分析A企业“平台＋基地”的钢铁供应链动态货值融资模式现状,提出钢铁供应链动态融资风险控制的具体措施,从而推动钢铁行业的稳定发展.

Methods for a blind analysis of isobar data collected by the STAR collaboration

In 2018,the STAR collaboration collected data from^(96)_(44)Ru+^(96)_(44)Ru and^(96)_(40)Zr+^(96)_(40)Zr at√^(S)NN=200 Ge V to search for the presence of the chiral magnetic effect in collisions of nuclei.The isobar collision species alternated frequently between 9644 Ru+^(96)_(44)Ru and^(96)_(40)Zr+^(96)_(40)Zr.In order to conduct blind analyses of studies related to the chiral magnetic effect in these isobar data,STAR developed a three-step blind analysis procedure.Analysts are initially provided a"reference sample"of data,comprised of a mix of events from the two species,the order of which respects time-dependent changes in run conditions.After tuning analysis codes and performing time-dependent quality assurance on the reference sample,analysts are provided a species-blind sample suitable for calculating efficiencies and corrections for individual≈30-min data-taking runs.For this sample,species-specific information is disguised,but individual output files contain data from a single isobar species.Only run-by-run corrections and code alteration subsequent to these corrections are allowed at this stage.Following these modifications,the"frozen"code is passed over the fully un-blind data,completing the blind analysis.As a check of the feasibility of the blind analysis procedure,analysts completed a"mock data challenge,"analyzing data from Au+Au collisions at√^(S)NN=27 Ge V,collected in 2018.The Au+Au data were prepared in the same manner intended for the isobar blind data.The details of the blind analysis procedure and results from the mock data challenge are presented.

Detection of diabetic retinopathy in its early stages using textural features of optical coherence tomography angiography

The aim of this study is to detect whether the quantitative textural features of optical coherencetomography angiography (OCTA) images can be used to detect the eyes in the early stage ofdiabetic retinopathy (DR) from eyes with diabetes and no DR (NDR). Textural features includingfractal dimension, contrast, correlation, entropy, energy, and homogeneity were calculatedfrom the OCTA images. The Student's t-test was performed to identify the textural featuresthat can be able to detect DR in the early stage. The area under the receiver operating characteristic(AUROC) curves, sensitivity, and specicity were calculated between the study groups.Our results indicated that the fractal dimension in ICP and SVP and the correlation in SVCshowed the statistical signicance between mild NPDR patients and NDR patients. The ROCanalysis results showed that the AUROC of the fractal dimension in ICP was 0.736 with 0.773sensitivity and 0.700 specicity. The cuto® point in ICP was 2.616. The OCTA-based fractaldimension was able to discriminate diabetic eyes with early retinopathy from healthy and NDRwith higher sensitivity and specicity. The OCTA-based correlation showed the power to differentiatethe mild NPDR eyes from the normal healthy and diabetic eyes. These results suggestthat texture-based features of OCTA have the potential to assist in the assessment of therapeuticinterventions to prevent early DR in diabetic subjects.

Mechanisms behind the environmental sensitivity of carbon fiber reinforced polytetrafluoroethylene(PTFE)

Carbon fiber reinforced polytetrafluoroethylene (CF/PTFE) composites are known for their exceptional tribological performance when sliding against steel or cast iron in inert gas environments. Compared to experiments in humid air, about an order of magnitude lower wear rate and several times lower coefficient of friction have been reported for tests conducted in dry nitrogen and hydrogen. Moreover, trace moisture has been shown to affect the friction and wear significantly of this tribosystem, although a possible effect of oxygen cannot be ruled out due to uncertainties regarding the oxygen concentrations. While several studies have pointed out the environmental sensitivity of CF/PTFE, the understanding of the underlying mechanisms are very limited. The objective of this research is to investigate the individual and combined effect of oxygen and moisture on the tribological behavior of CF/PTFE sliding against steel. Additionally, this study aims to elucidate the underlying mechanisms that govern the environmental sensitivity of the system. Climate-controlled three-pin-on-disc experiments were conducted in nitrogen atmospheres at various concentrations of oxygen and moisture. The tribological results clearly demonstrate that both moisture and oxygen contribute to increased friction and wear. However, the adverse effect was much more pronounced for oxygen than moisture. A qualitative method was developed to estimate the tribofilm coverage on the CF/PTFE surface. Results showed strong correlation between high coverage of strongly adhered tribofilm and low wear rate. Moreover, a loosely adhered tribofilm was observed on top of the CF/PTFE surface in presence of moisture. FTIR analysis indicated that the loosely adhered tribofilm found in the moisture-enriched environment contained a significant amount of adsorbed water, which may explain the lower coefficient of friction in presence of moisture compared to oxygen. The adsorbed water in the loosely adhered tribofilm could be an indication of moisture-driven lubrication by the non-graphitic carbon in the tribofilm.

A detailed comparison of the composition of(RE)-Ba-Cu-O-Ag bulk superconductors

The homogeneity of the microstructure and composition are critical in determining the properties of rare earthbarium‐cuprate,single grain bulk superconductors[(RE)BCO].The magnitude of the trapped magnetic field achieveable in these technologically important materials,in particular,is influenced heavily by the size and distribution of(RE)_(2)BaCuO_(x)(RE‐211)flux pinning inclusions in the bulk microstructure,whereas the size and distribution of silver agglomerates present within the bulk superconducting matrix correlate directly with improved mechanical properties.With careful engineering,these materials have significant potential for application in range of devices related to energy storage,medicine,electro‐magnetic machinery and microelectronic technology.Fabrication of(RE)BCO bulk superconductors typically involves heating a powder compact above its peritectic decomposition temperature followed by slow cooling to facilitate the growth of a single grain.Each(RE)BCO composition has a different peritectic temperature and growth rate,which,therefore,necessitates different requirements in the heating profile.The fabrication temperature and growth rate,for example,may have an effect on the RE‐211 and silver distribution,which may,in turn,affect the superconducting properties of the resulting single grain.In this work we compare the distributions of silver and RE‐211 in the single grain microstructures of YBCOAg,GdBCO‐Ag,EuBCO‐Ag and SmBCO‐Ag bulk superconductors using optical microscopy,scanning electron microscopy and energy dispersive X‐ray spectroscopy.We observe that the distributions are very similar along both the a/b‐axis and c‐axis of these materials.This suggests that factors other than the maximum temperature used to achieve peritectic decomposition and the rate of single grain growth are particularly influential in determining the properties of the as‐processed samples in the top seeded melt growth process.This observation demonstrates there is freedom to use(RE)materials interchangeably between different applications as required,for example,for functional or economic reasons.

Ion motion effects on the generation of short-cycle relativistic laser pulses during radiation pressure acceleration

The effects of ion motion on the generation of short-cycle relativistic laser pulses during radiation pressure acceleration are investigated by analytical modeling and particle-in-cell simulations. Studies show that the rear part of the transmitted pulse modulated by ion motion is sharper compared with the case of the electron shutter only. In this study, the ions further modulate the short-cycle pulses transmitted. A 3.9 fs laser pulse with an intensity of 1.33×1021W cm-2is generated by properly controlling the motions of the electron and ion in the simulations. The short-cycle laser pulse source proposed can be applied in the generation of single attosecond pulses and electron acceleration in a small bubble regime.

China’s participation in the international RRT for I_(c) measurement of superconducting cables organized by IEC/TC90

Currently,IEC/TC90 is working on standardizing the method for measuring critical current(Ic)in superconducting cables.At the end of 2020,an international round robin test(RRT)was organized,in which five Chinese institutions participated,and four accomplished the test.The electric-field versus current(E-I)curves obtained by each institution are highly repeatable.Those obtained by different institutions are nearly identical after appropriate curve averaging,indicating high reproducibility,except the last participant's inner core curves.The discrepancy was later determined to be the result of sample cable damage.After excluding highly deviated data,it is determined that the maximum relative standard uncertainty in I_(c) is 0.7%,and the maximum relative standard uncertainty in n-value is 12.8%.The I_(c)values are comparable to Japan's domestic RRT results,but the n-values are significantly different.The test results support the DC four-terminal method as a recommended test method,with a target relative uncertainty of less than 2%for the Ic value.