A proton-cyclotron wave storm generated by unstable proton distribution functions in the solar wind

We use audification of 0.092 s cadence magnetometer data from the Wind spacecraft to identify waves with amplitudes >0.1 nT near the ion gyrofrequency (~0.1 Hz) with duration longer than 1 hr during 2008. We present one of the most common types of event for a case study and find it to be a proton-cyclotron wave storm, coinciding with highly radial magnetic field and a suprathermal proton beam close in density to the core distribution itself. Using linear Vlasov analysis, we conclude that the long-duration, large-amplitude waves are generated by the instability of the proton distribution function. The origin of the beam is unknown, but the radial field period is found in the trailing edge of a fast solar wind stream and resembles other events thought to be caused by magnetic field footpoint motion or interchange reconnection between coronal holes and closed field lines in the corona

Electron cotunneling through doubly occupied quantum dots: effect of spin configuration

A microscopic theory is presented for electron cotunneling through doubly occupied quantum dots in the Coulomb blockade regime. Beyond the semiclassic framework of phenomenological models, a fully quantum mechanical solution for cotunneling of electrons through a one-dimensional quantum dot is obtained using a quantum transmitting boundary method without any fitting parameters. It is revealed that the cotunneling conductance exhibits strong dependence on the spin configuration of the electrons confined inside the dot. Especially for the triplet configuration, the conductance shows an obvious deviation from the well-known quadratic dependence on the applied bias voltage. Furthermore, it is found that the cotunneling conductance reveals more sensitive dependence on the barrier width than the height

Magnetosheath jet occurrence rate in relation to CMEs and SIRs

Magnetosheath jets constitute a significant coupling effect between the solar wind (SW) and the magnetosphere of the Earth. In order to investigate the effects and forecasting of these jets, we present the first-ever statistical study of the jet production during large-scale SW structures like coronal mass ejections (CMEs), stream interaction regions (SIRs) and high speed streams (HSSs). Magnetosheath data from Time History of Events and Macroscale Interactions during Substorms (THEMIS) spacecraft between January 2008 and December 2020 serve as measurement source for jet detection. Two different jet definitions were used to rule out statistical biases induced by our jet detection method. For the CME and SIR + HSS lists, we used lists provided by literature and expanded on incomplete lists using OMNI data to cover the time range of May 1996 to December 2020. We find that the number and total time of observed jets decrease when CME-sheaths hit the Earth. The number of jets is lower throughout the passing of the CME-magnetic ejecta (ME) and recovers quickly afterward. On the other hand, the number of jets increases during SIR and HSS phases. We discuss a few possibilities to explain these statistical results

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups

<p>Abstract</p> <p>Background</p> <p>The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context.</p> <p>Methods</p> <p>Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals.</p> <p>Results</p> <p>Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals.</p> <p>Conclusion</p> <p>It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to improve the reliability of clinical information and the risk-adjustment ability of Case-Mix.</p

The unusual widespread solar energetic particle event on 2013 August 19 Solar origin and particle longitudinal distribution

Context: Late on 2013 August 19, STEREO-A, STEREO-B, MESSENGER, Mars Odyssey, and the L1 spacecraft, spanning a longitudinal range of 222 degrees in the ecliptic plane, observed an energetic particle flux increase. The widespread solar energetic particle (SEP) event was associated with a coronal mass ejection (CME) that came from a region located near the far-side central meridian from Earth's perspective. The CME erupted in two stages, and was accompanied by a late M-class flare observed as a post-eruptive arcade, persisting low-frequency (interplanetary) type II and groups of shock-accelerated type III radio bursts, all of them making this SEP event unusual.Aims: There are two main objectives of this study, disentangling the reasons for the different intensity-time profiles observed by the spacecraft, especially at MESSENGER and STEREO-A locations, longitudinally separated by only 15 degrees, and unravelling the single solar source related with the widespread SEP event.Methods: The analysis of in situ data, such as particle fluxes, anisotropies and timing, and plasma and magnetic field data, is compared with the remote-sensing observations. A spheroid model is applied for the CME-driven shock reconstruction and the ENLIL model is used to characterize the heliospheric conditions, including the evolution of the magnetic connectivity to the shock.Results: The solar source associated with the widespread SEP event is the shock driven by the CME, as the flare observed as a post-eruptive arcade is too late to explain the estimated particle onset. The different intensity-time profiles observed by STEREO-A, located at 0.97 au, and MESSENGER, at 0.33 au, can be interpreted as enhanced particle scattering beyond Mercury's orbit. The longitudinal extent of the shock does not explain by itself the wide spread of particles in the heliosphere. The particle increase observed at L1 may be attributed to cross-field diffusion transport, and this is also the case for STEREO-B, at least until the spacecraft is eventually magnetically connected to the shock when it reaches similar to 0.6 au.</p

Use of hospitalisation history (lookback) to determine prevalence of chronic diseases: impact on modelling of risk factors for haemorrhage in pregnancy

<p>Abstract</p> <p>Background</p> <p>Concern about the completeness of comorbidity information in hospital records has been raised as a limitation of using hospital discharge data for research. The aim of this study is to assess the impact of additional comorbidity information from prior hospital admissions on estimation of prevalence and modelling of risk factors for obstetric haemorrhage.</p> <p>Methods</p> <p>A range of chronic disease prevalence for 53,438 women who had their first birth in New South Wales (NSW), Australia, 2005-2006, were ascertained for up to five years prior to the birth admission (for pregnancy, 2-, 3-, 4- and 5-year periods) and obstetric haemorrhage was identified from maternal hospital records for 2005 and 2006.</p> <p>Results</p> <p>The ascertainment of chronic disease prevalence increased with increasing length of lookback. However, the rate of the increase was slower after 2 to 3 years than for the more recent periods. The effect size of chronic diseases on obstetric haemorrhage risk decreased with the increased case ascertainment associated with longer lookback. Furthermore, longer lookback did not improve the predictive capacity (C-statistic: 0.624) of a model that was based only on the birth admission records.</p> <p>Conclusions</p> <p>Longer ascertainment periods resulted in improved identification of chronic disease history among pregnant women, but the additional information from prior admissions did little to improve the modelling of risk factors for obstetric haemorrhage.</p

FoxQ1 Overexpression Influences Poor Prognosis in Non-Small Cell Lung Cancer, Associates with the Phenomenon of EMT

BACKGROUND: We determined the expression of forkhead box Q1 (FoxQ1), E-cadherin (E-cad), Mucin 1 (MUC1), vimentin (VIM) and S100 calcium binding protein A4 (S100A4), all epithelial-mesenchymal transition (EMT) indicator proteins in non-small cell lung cancer (NSCLC) tissue samples. We also investigated the relationship between these five proteins expression and other clinicopathologic factors in NSCLC. Finally, we assessed the potential value of these markers as prognostic indicators of survival in NSCLC's patients. METHODS: Quantitative real-time PCR and immunohistochemistry were used to characterize the expression of the FoxQ1 mRNA and protein in NSCLC. Expression of transcripts and translated products for the other four EMT indicator proteins was assessed by immunohistochemistry in the same clinical NSCLC samples. RESULTS: FoxQ1 mRNA and protein were up-regulated in NSCLC compared with normal tissues (P = 0.015 and P<0.001, respectively). Expression of FoxQ1 in adenocarcinoma was higher than in squamous cell carcinoma (P = 0.005), and high expression of FoxQ1 correlated with loss of E-cad expression (P = 0.012), and anomalous positivity of VIM (P = 0.024) and S100A4 (P = 0.004). Additional survival analysis showed that high expression of FoxQ1 (P = 0.047) and E-cad (P = 0.021) were independent prognostic factors. CONCLUSION: FoxQ1 maybe plays a specific role in the EMT of NSCLC, and could be used as a prognostic factor for NSCLC

Bar-Coded Pyrosequencing Reveals the Responses of PBDE-Degrading Microbial Communities to Electron Donor Amendments

Polybrominated diphenyl ethers (PBDEs) can be reductively degraded by microorganisms under anaerobic conditions. However, little is known about the effect of electron donors on microbial communities involved in PBDEs degradation. Here we employed 454 Titanium pyrosequencing to examine the phylogenetic diversity, composition, structure and dynamics of microbial communities from microcosms under the conditions of different electron donor amendments. The community structures in each of the five alternate electron donor enrichments were significantly shifted in comparison with those of the control microcosm. Commonly existing OTUs between the treatment and control consortia increased from 5 to 17 and more than 50% of OTUs increased around 13.7 to 186 times at least in one of the microcosms after 90-days enrichment. Although the microbial communities at different taxonomic levels were significantly changed by different environmental variable groups in redundancy analysis, significant correlations were observed between the microbial communities and PBDE congener profiles. The lesser-brominated PBDE congeners, tri-BDE congener (BDE-32) and hexa-BDE, were identified as the key factors shaping the microbial community structures at OTU level. Some rare populations, including the known dechlorinating bacterium, Dehalobacter, showed significant positive-correlation with the amounts of PBDE congeners in the consortia. The same results were also observed on some unclassified bacteria. These results suggest that PBDEs-degrading microbial communities can be successfully enriched, and their structures and compositions can be manipulated through adjusting the environmental parameters

Valvular regurgitation and surgery associated with fenfluramine use: an analysis of 5743 individuals

<p>Abstract</p> <p>Background</p> <p>Use of fenfluramines for weight loss has been associated with the development of characteristic plaques on cardiac valves causing regurgitation. However, previously published studies of exposure to fenfluramines have been limited by relatively small sample size, short duration of follow-up, and the lack of any estimate of the frequency of subsequent valvular surgery. We performed an observational study of 5743 users of fenfluramines examined by echocardiography between July 1997 and February 2004 in a single large cardiology clinic.</p> <p>Results</p> <p>The prevalence of at least mild aortic regurgitation (AR) or moderate mitral regurgitation (MR) was 19.6% in women and 11.8% in men (<it>p </it>< 0.0001 for gender difference). Duration of use was strongly predictive of mild or greater AR (<it>p </it>< 0.0001 for trend), MR (<it>p </it>= 0.002), and tricuspid regurgitation (TR) (<it>p </it>< 0.0001), as was earlier scan date (<it>p </it>< 0.0001 for those scanned prior to 1 January 2000 versus later). Increasing age was also independently associated with increased risk of AR and MR (both <it>p </it>< 0.0001). With mean follow-up of 30.3 months, AR worsened in 15.2%, remained the same in 63.1%, and improved in 21.7%. Corresponding values for MR were 24.8%, 47.4% and 27.9%. Pulmonary hypertension was strongly associated with MR but not AR. Valve surgery was performed on 38 patients (0.66% of 5743), 25 (0.44%) with clear evidence of fenfluramine-related etiology.</p> <p>Conclusion</p> <p>Regurgitant valvulopathy was common in individuals exposed to fenfluramines, more frequent in females, and associated with duration of use in all valves assessed. Valve surgery was performed as frequently for aortic as mitral valves and some tricuspid valve surgeries were also performed. The incidence of surgery appeared to be substantially increased compared with limited general population data.</p