Comparative epidemiology of bacteraemia in two ageing populations: Singapore and Denmark.

Burden of bacteraemia is rising due to increased average life expectancy in developed countries. This study aimed to compare the epidemiology and outcomes of bacteraemia in two similarly ageing populations with different ethnicities in Singapore and Denmark. Historical cohorts from the second largest acute-care hospital in Singapore and in the hospitals of two Danish regions included patients aged 15 and above who were admitted from 1 January 2006 to 31 December 2016 with at least 1 day of hospital stay and a pathogenic organism identified. Among 13 144 and 39 073 bacteraemia patients from Singapore and Denmark, similar 30-day mortality rates (16.5%; 20.3%), length of hospital stay (median 14 (IQR: 9-28) days; 11 (6-21)), and admission rate to ICU (15.5%; 15.6%) were observed, respectively. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus ranked among the top four in both countries. However, Singaporeans had a higher proportion of patients with diabetes (46.8%) and renal disease (29.5%) than the Danes (28.0% and 13.7%, respectively), whilst the Danes had a higher proportion of patients with chronic pulmonary disease (18.0%) and malignancy (35.3%) than Singaporeans (9.7% and 16.2%, respectively). Our study showed that top four causative organisms and clinical outcomes were similar between the two cohorts despite pre-existing comorbidities differed.

Realization of Large Low-Stress Elastocaloric Effect in TiZrNbAl Alloy.

Seeking novel high-performance elastocaloric materials with low critical stress plays a crucial role in advancing the development of elastocaloric refrigeration technology. Here, as a first attempt, the elastocaloric effect of TiZrNbAl shape memory alloy at both room temperature and finite temperatures ranging from 245 K to 405 K, is studied systematically. Composition optimization shows that Ti-19Zr-14Nb-1Al (at.%), possessing excellent room-temperature superelasticity with a critical stress of around 100 MPa and a small stress hysteresis of around 70 MPa and outstanding fracture resistance with a compressive strain of 20% and stress of 1.7 GPa, demonstrates a substantial advantage as an elastocaloric refrigerant. At room temperature, a large adiabatic temperature change (ΔTad) of -6.7 K is detected, which is comparable to the highest value reported in the Ti-based alloys. A high elastocaloric cyclic stability, with almost no degradation of ΔTad after 4000 cycles, is observed. Furthermore, the sizeable elastocaloric effect can be steadily expanded from 255 K to 395 K with a temperature window of as large as 140 K. A maximum ΔTad of -7.9 K appears at 355 K. The present work demonstrates a promising potential of TiZrNbAl as a low critical stress and low hysteresis elastocaloric refrigerant.

Frameworks for measuring population health: A scoping review.

INTRODUCTION: Many regions in the world are using the population health approach and require a means to measure the health of their population of interest. Population health frameworks provide a theoretical grounding for conceptualization of population health and therefore a logical basis for selection of indicators. The aim of this scoping review was to provide an overview and summary of the characteristics of existing population health frameworks that have been used to conceptualize the measurement of population health. METHODS: We used the Population, Concept and Context (PCC) framework to define eligibility criteria of frameworks. We were interested in frameworks applicable for general populations, that contained components of measurement of health with or without its antecedents and applied at the population level or used a population health approach. Eligible reports of eligible frameworks should include at least domains and subdomains, purpose, or indicators. We searched 5 databases (Pubmed, EMBASE, Web of Science, NYAM Grey Literature Report, and OpenGrey), governmental and organizational sites on Google and websites of selected organizations using keywords from the PCC framework. Characteristics of the frameworks were summarized descriptively and narratively. RESULTS: Fifty-seven frameworks were included. The majority originated from the US (46%), Europe (23%) and Canada (19%). Apart from 1 framework developed for rural populations and 2 for indigenous populations, the rest were for general urban populations. The numbers of domains, subdomains and indicators were highly variable. Health status and social determinants of health were the most common domains across all frameworks. Different frameworks had different priorities and therefore focus on different domains. CONCLUSION: Key domains common across frameworks other than health status were social determinants of health, health behaviours and healthcare system performance. The results in this review serve as a useful resource for governments and healthcare organizations for informing their population health measurement efforts.

Flatband λ-Ti3O5 towards extraordinary solar steam generation.

Solar steam interfacial evaporation represents a promising strategy for seawater desalination and wastewater purification owing to its environmentally friendly character1-3. To improve the solar-to-steam generation, most previous efforts have focused on effectively harvesting solar energy over the full solar spectrum4-7. However, the importance of tuning joint densities of states in enhancing solar absorption of photothermal materials is less emphasized. Here we propose a route to greatly elevate joint densities of states by introducing a flat-band electronic structure. Our study reveals that metallic λ-Ti3O5 powders show a high solar absorptivity of 96.4% due to Ti-Ti dimer-induced flat bands around the Fermi level. By incorporating them into three-dimensional porous hydrogel-based evaporators with a conical cavity, an unprecedentedly high evaporation rate of roughly 6.09 kilograms per square metre per hour is achieved for 3.5 weight percent saline water under 1 sun of irradiation without salt precipitation. Fundamentally, the Ti-Ti dimers and U-shaped groove structure exposed on the λ-Ti3O5 surface facilitate the dissociation of adsorbed water molecules and benefit the interfacial water evaporation in the form of small clusters. The present work highlights the crucial roles of Ti-Ti dimer-induced flat bands in enchaining solar absorption and peculiar U-shaped grooves in promoting water dissociation, offering insights into access to cost-effective solar-to-steam generation.

Influence of the Sputtering Temperature on Reflectivity and Electrical Properties of ITO/AgIn/ITO Composite Films for High-Reflectivity Anodes.

In this paper, indium tin oxide/silver indium/indium tin oxide (ITO/AgIn/ITO) composite films were deposited on glass substrates by magnetron sputtering. The effects of the sputtering temperature on the optical and electrical properties of the composite films were systematically investigated. The ITO/AgIn/ITO composite films deposited at sputtering temperatures of 25 °C and 100 °C demonstrated a high reflectivity of 95.3% at 550 nm and a resistivity of about 6.8-7.3 µΩ·cm. As the sputtering temperature increased, the reflectivity decreased and the resistivity increased slightly. The close connection between microstructure and surface morphology and the optical and electrical properties of the composite films was further illustrated by scanning electron microscopy imaging and atomic force microscopy imaging. It is shown that the ITO/AgIn/ITO thin films have a promising application for high-reflectivity anodes.

Large Cryogenic Magnetostriction Induced by Hydrostatic Pressure in MnCo0.92Ni0.08Si Alloy.

Giant magnetostriction could be achieved in MnCoSi-based alloys due to the magneto-elastic coupling accompanied by the meta-magnetic transition. In the present work, the effects of hydrostatic pressure on magnetostrictive behavior in MnCo0.92Ni0.08Si alloy have been investigated. The saturation magnetostriction (at 30,000 Oe) could be enhanced from 577 ppm to 5034 ppm by the hydrostatic pressure of 3.2 kbar at 100 K. Moreover, under a magnetic field of 20,000 Oe, the reversible magnetostriction was improved from 20 ppm to 2112 ppm when a hydrostatic pressure of 6.4 kbar was applied at 70 K. In all, it has been found that the magnetostrictive effect of the MnCo0.92Ni0.08Si compound is strongly sensitive to external hydrostatic pressure. This work proves that the MnCoSi-based alloys as a potential cryogenic magnetostrictive material can be modified through applied hydrostatic pressure.

Fabricating Ultra-Narrow Precision Slit Structures with Periodically Reducing Current Over-Growth Electroforming.

An ultra-narrow precision slit with a width of less than ten micrometers is the key structure of some optical components, but the fabrication of these structures is still very difficult to accomplish. To fabricate these slits, this paper proposed a periodically reducing current over-growth electroforming process. In the periodically reducing current over-growth electroforming, the electric current applied to the electrodeposition process is periodically stepped down rather than being constant. Simulations and experimentation studies were carried out to verify the feasibility of the proposed process, and further optimization of process parameters was implemented experimentally to achieve the desired ultra-narrow precision slits. The current values were: I1=Iinitial, I2=0.75Iinitial at Qc=0.5Qt, I3=0.5Iinitial at Qc=0.75Qt,respectively. It was shown that, compared with conventional constant current over-growth electroforming, the proposed process can significantly improve the surface quality and geometrical accuracy of the fabricated slits and can markedly enhance the achievement of the formed ultra-narrow slits. With the proposed process, slits with a width of down to 5 ± 0.1 µm and a surface roughness of less than 62.8 nm can be easily achieved. This can improve the determination sensitivity and linear range of the calibration curves of spectral imagers and food and chemical analysis instruments. Periodically reducing current over-growth electroforming is effective and advantageous in fabricating ultra-narrow precision slits.

Effect of High-Current Pulsed Electron Beam on Properties of Graphene-Modified Aluminum Titanium Carbide Composites.

High-current pulse electron beam (HCPEB) is an advanced surface modification technology developed in recent decades. This paper focuses on the effect of 0.3 wt.% graphene on the electrical conductivity and microhardness of HCPEB-treated Al-20TiC composites. The SEM results show that the titanium carbide was uniformly distributed in the aluminum matrix of the initial sample. Conversely, the graphene showed a small aggregation, and there were holes and cracks on the top surface of the sample. After HCPEB modification, the agglomeration of graphene gradually improved, and the number of surface pores reduced. The X-ray diffraction results show that after HCPEB treatment, the aluminum diffraction peak widened and shifted to a higher angle and the grain was significantly refined. Compared with the initial Al-20TiC composite samples, the conductivity of graphene-modified HCPEB-treated sample increased by 94.3%. The microhardness test results show that the microhardness of the graphene-modified HCPEB-treated sample increased by 18.4%, compared with the initial Al-20TiC composite samples. This enhancement of microhardness is attributed to the joint effects of fine grain strengthening, dispersion strengthening of the second phase, solution strengthening and dislocation strengthening. In brief, HCPEB has good application prospects for powder metallurgy in future.

A Study on the Effect of Graphene in Enhancing the Electrochemical Properties of SnO2-Fe2O3 Anode Materials.

To enhance the conductivity and volume expansion during the charging and discharging of transition metal oxide anode materials, rGO-SnO2-Fe2O3 composite materials with different contents of rGO were prepared by the in situ hydrothermal synthesis method. The SEM morphology revealed a sphere-like fluffy structure, particles of the 0.4%rGO-10%SnO2-Fe2O3 composite were smaller and more compact with a specific surface area of 223.19 m2/g, the first discharge capacity of 1423.75 mAh/g, and the specific capacity could be maintained at 687.60 mAh/g even after 100 cycles. It exhibited a good ratio performance and electrochemical reversibility, smaller charge transfer resistance, and contact resistance, which aided in lithium-ion transport. Its superior electrochemical performance was due to the addition of graphene, which made the spherical particle size distribution more uniform, effectively lowering the volume expansion during the process of charging and discharging and improving the electrochemical cycle stability of the anode materials.

Prediction of Magnetocaloric Effect Induced by Continuous Modulation of Exchange Interaction: A Monte Carlo Study.

A magnetic-to-thermal energy conversion, derived from the continuous modulation of intrinsic exchange energy, is conceived and studied by performing Monte Carlo simulations. On the basis of thermodynamics and Weiss's molecular field theories, we modified the Maxwell formula, where the magnetic entropy change (∆SM) is calculated by integrating the temperature derivative of magnetization under a continuously increasing exchange interaction, rather than an external magnetic field, from zero to a given value. For the conventional ∆SM induced through increasing magnetic field, the ∆SM maximum value is enhanced with increasing magnetic field, while the ∆SM peak temperature is weakly influenced by the magnetic field. On the contrary, the ∆SM induced by changing the exchange interaction is proportional to the exchange interaction while suppressed by a magnetic field. Another feature is that the relative cooling power calculated from the ∆SM induced by changing the exchange interaction is fully independent of the magnetic field perspective for obtaining the magnetically stabilized self-converted refrigerants. The controlled variation of exchange interaction could be realized by partial substitution or the application of hydrostatic pressure to lower the cost of magnetic energy at no expense of magnetocaloric response, which opens an avenue to develop the practical and energy-saving devices of conversion from magnetic energy to thermal energy, highly extending the material species of the magnetocaloric effect.

Crystallography and Microstructure of 7M Martensite in Ni-Mn-Ga Thin Films Epitaxially Grown on (1 1 2¯ 0)-Oriented Al2O3 Substrate.

Epitaxial Ni-Mn-Ga thin films have been extensively investigated, due to their potential applications in magnetic micro-electro-mechanical systems. It has been proposed that the martensitic phase in the <1 1 0>A-oriented film is much more stable than that in the <1 0 0>A-oriented film. Nevertheless, the magnetic properties, microstructural features, and crystal structures of martensite in such films have not been fully revealed. In this work, the <1 1 0>A-oriented Ni51.0Mn27.5Ga21.5 films with different thicknesses were prepared by epitaxially growing on Al2O3(1 1 2¯ 0) substrate by magnetron sputtering. The characterization by X-ray diffraction technique and transmission electron microscopy revealed that all the Ni51.0Mn27.5Ga21.5 films are of 7M martensite at the ambient temperature, with their Type-I and Type-II twinning interfaces nearly parallel to the substrate surface.

Enhanced Magnetostrain in a <0 0 1>A-Textured Ni44.5Co4.9Mn37.5In13.1 Alloy through Superelastic Training

Large magnetostrain can be demonstrated in Ni-Mn-X (X = In, Sn, Sb) meta-magnetic shape memory alloys by resuming the predeformed martensite through magnetic-field-induced reverse martensitic transformation. However, owing to the constraint from the self-accommodated microstructure and randomly distributed crystallographic orientation, spontaneous magnetostrain without predeformation in polycrystalline alloys remains low. Here, by combining microstructure texturing and superelastic training, enhanced spontaneous magnetostrain was achieved in a directionally solidified Ni44.5Co4.9Mn37.5In13.1 alloy with strong <0 0 1>A preferred orientation. After superelastic training through cyclic compressive loading/unloading on the directionally solidified alloy, a large spontaneous magnetostrain of ~0.65% was obtained by applying a magnetic field of 5 T, showing great improvement when compared to that of the untrained situation, i.e., ~0.45%. Such enhanced magnetoresponse is attributed to the internal stress generated through superelastic training, which affects the variant distribution and the resultant output strain in association with the martensitic transformation.

Mitochondrial DNA Variation Correlated With the High Altitude Intolerance in Chinese Young Han Males.

Objective: Acute exposure to hypobaric hypoxia can trigger acute mountain sickness (AMS), while the exact mechanism has not been fully revealed. The role of genetic factors in the susceptibility of various high-altitude diseases has also gained much interest. Previous studies have provided evidence for the link between AMS and certain nuclear genes or mitochondrial haplogroup. The correlation between point mutations of mitochondrial DNA (mtDNA) and AMS was further explored in the present study. Methods: A total of 84 young Han males residing at low altitude were taken to an elevation of 4,000 m within 40 h. We collected data of their heart rate, blood pressure, peripheral oxygen saturation (SaO2), and obtained blood samples, at sea level and at high altitude. AMS was diagnosed using the revised version of the Lake Louise Questionnaire Score. Sequencing was utilized to identify the association between mtDNA alleles and the occurrence of AMS. We also assessed the association between the presence of AMS and physiological variables, and provided a preliminary discussion of the association between genotypic and phenotypic variation. Results: The percentage of neutrophils [Odds ratio (OR): 1.06, 95% confidence interval (CI): 1.01-1.12, P = 0.034) and SaO2 level (OR: 0.87, 95% CI: 0.79-0.95, P = 0.004) were independently associated with the development of AMS. A4576G was a risk factor for AMS (OR: 6.27, 95% CI: 1.2-32.7). T11613C (OR: 0.10, 95% CI: 0.01-0.83), A8923G (OR: 0.15, 95% CI: 0.03-0.76), and T5543C (OR: 0.19, 95% CI: 0.04-0.95) were protective factors for AMS. The level of SaO2 was significantly lower in the individual with A4576G mutation as compared with the individual without A4576G mutation (68.1 ± 7.9 vs. 75.8 ± 6.1, P = 0.001). The level of serum sodium was significantly higher in the individual with A8923G mutation as compared to the individual without A8923G mutation (144.6 ± 1.9 vs. 143.2 ± 1.9, P = 0.027). Conclusions: The increase in neutrophils and the disability to preserve oxygen saturation may be associated with the high altitude intolerance in young Chinese Han males. A4576G is the risk factor for AMS. T11613C, A8923G, and T5543C are protective factors for AMS. The role of A8923G mutation may correlate with the sodium and water balance and the role of the A4576G mutation may be related to the disability to maintain blood oxygen level after quickly entering the plateau.

Giant Elastocaloric Effect in Ni-Mn-Ga-Based Alloys Boosted by a Large Lattice Volume Change upon the Martensitic Transformation.

High-performance elastocaloric materials are highly sought in developing energy-efficient and environmentally friendly solid-state elastocaloric refrigeration. Here, we present an effective strategy to achieve a giant elastocaloric response by enlarging the lattice volume change ΔV/V0 upon the martensitic transformation. Using the Ni50Mn50 binary alloy as the prototype, a large transformation entropy change ΔStr can be tailored in the vicinity of room temperature by simultaneously doping Cu and Ga. Especially, the |ΔStr| values in the ⟨001⟩A-textured Ni30Cu20Mn39.5Ga10.5 and Ni30Cu20Mn39Ga11 alloys prepared by directional solidification can be as large as 47.5 and 46.7 Jkg-1 K-1, respectively, due to the significant ΔV/V0 values, i.e., 1.81 and 1.82%, respectively. Such enhanced ΔStr values thus yield giant ΔTad values of up to -23.5 and -19.3 K on removing the compressive stress in these two alloys, being much higher than those in Heusler-type alloys reported previously. Moreover, owing to the relatively low driving stress endowed by the highly textured microstructure, the specific adiabatic temperature change (|ΔTad/Δσmax|) in the present work can be as large as 77.2 K/GPa. This work is expected to provide new routes in designing high-performance elastocaloric materials with the combination of a giant elastocaloric response and low driving stress.

Large Low-Field Reversible Magnetocaloric Effect in Itinerant-Electron Hf1-xTaxFe2 Alloys.

First-order isostructural magnetoelastic transition with large magnetization difference and controllable thermal hysteresis are highly desirable in the development of high-performance magnetocaloric materials used for energy-efficient and environmental-friendly magnetic refrigeration. Here, we demonstrate large magnetocaloric effect covering the temperature range from 325 K to 245 K in Laves phase Hf1-xTaxFe2 (x = 0.13, 0.14, 0.15, 0.16) alloys undergoing the magnetoelastic transition from antiferromagnetic (AFM) state to ferromagnetic (FM) state on decreasing the temperature. It is shown that with the increase of Ta content, the nature of AFM to FM transition is gradually changed from second-order to first-order. Based on the direct measurements, large reversible adiabatic temperature change (ΔTad) values of 2.7 K and 3.4 K have been achieved under a low magnetic field change of 1.5 T in the Hf0.85Ta0.15Fe2 and Hf0.84Ta0.16Fe2 alloys with the first-order magnetoelastic transition, respectively. Such remarkable magnetocaloric response is attributed to the rather low thermal hysteresis upon the transition as these two alloys are close to intermediate composition point of second-order transition converting to first-order transition.

Frequency of Visit-to-Visit Variability of Resting Heart Rate and the Risk of New-Onset Atrial Fibrillation in the General Population.

Resting heart rate (RHR) has been an established predictor for atrial fibrillation (AF). However, the association of visit-to-visit heart rate variability (VVHRV) with new-onset AF risk over long term remains unclear. Our study investigates the relation of VVHRV to new-onset AF in general population in the prospective study of the Kailuan cohort. A total of 46,126 individuals without arrhythmia were included. They underwent 3 health examinations from 2006 to 2010 and performed follow up. VVHRV was measured by coefficient of variation (CV), variability independent of the mean (VIM), and standard deviation (SD). Participants were separately divided into 5 categories by quintiles of visit-to-visit RHR-CV, RHR-VIM and RHR-SD. Multivariate Cox regression and restricted cubic spline models were performed to establish the association between VVHRV and new-onset AF. 241 new-onset AF occurred during a median follow-up of 7.54 years. The incidence of new-onset AF in the group of the lowest (Q1) and highest quintiles (Q5) of RHR-CV were higher than that in other groups. The HRs for the new-onset AF were 2.07 (95% CI, 1.34-3.21, p < 0.01), in the highest quintile group(Q5) compared with group Q2, and 1.89(95% CI, 1.20-2.97, p < 0.01) in the lowest quintile group(Q1) compared with group Q2. The risk for new-onset AF showed a similar trend using RHR-VIM (p < 0.01) and RHR-SD (p < 0.05) parameters. Further sensitivity analyses indicated the consistent results in subjects without prior cardiovascular disease and without taking beta blockers or CCB. To match the covariates, analyses were also performed by propensity score matching, and prominent trends were also found in RHR-SD and RHR-VIM. In conclusion, the study indicated that higher and lower VVHRV were associated with the increasing risk of new-onset AF, which supporting a U-shaped curve existence.

Altitude Cardiomyopathy Is Associated With Impaired Stress Electrocardiogram and Increased Circulating Inflammation Makers.

Many sea-level residents suffer from acute mountain sickness (AMS) when first visiting altitudes above 4,000 m. Exercise tolerance also decreases as altitude increases. We observed exercise capacity at sea level and under a simulated hypobaric hypoxia condition (SHHC) to explore whether the response to exercise intensity represented by physiological variables could predict AMS development in young men. Eighty young men from a military academy underwent a standard treadmill exercise test (TET) and biochemical blood test at sea level, SHHC, and 4,000-m altitude, sequentially, between December 2015 and March 2016. Exercise-related variables and 12-lead electrocardiogram parameters were obtained. Exercise intensity and AMS development were investigated. After exposure to high altitude, the count of white blood cells, alkaline phosphatase and serum albumin were increased (P < 0.05). There were no significant differences in exercise time and metabolic equivalents (METs) between SHHC and high-altitude exposures (7.05 ± 1.02 vs. 7.22 ± 0.96 min, P = 0.235; 9.62 ± 1.11 vs. 9.38 ± 1.12, P = 0.126, respectively). However, these variables were relatively higher at sea level (8.03 ± 0.24 min, P < 0.01; 10.05 ± 0.31, P < 0.01, respectively). Thus, subjects displayed an equivalent exercise tolerance upon acute exposure to high altitude and to SHHC. The trends of cardiovascular hemodynamics during exercise under the three different conditions were similar. However, both systolic blood pressure and the rate-pressure product at every TET stage were higher at high altitude and under the SHHC than at sea level. After acute exposure to high altitude, 19 (23.8%) subjects developed AMS. Multivariate logistic regression analysis showed that METs under the SHHC {odds ratio (OR) 0.355 per unit increment [95% confidence intervals (CI) 0.159-0.793], P = 0.011}, diastolic blood pressure (DBP) at rest under SHHC [OR 0.893 per mmHg (95%CI 0.805-0.991), P = 0.030], and recovery DBP 3 min after exercise at sea level [OR 1.179 per mmHg (95%CI 1.043-1.333), P = 0.008] were independently associated with AMS. The predictive model had an area under the receiver operating characteristic curve of 0.886 (95%CI 0.803-0.969, P < 0.001). Thus, young men have similar exercise tolerance in acute exposure to high altitude and to SHHC. Moreover, AMS can be predicted with superior accuracy using characteristics easily obtainable with TET.

Effectiveness of Containment Measures Against COVID-19 in Singapore: Implications for Other National Containment Efforts.

BACKGROUND: We hypothesize that comprehensive surveillance of COVID-19 in Singapore has facilitated early case detection and prompt contact tracing and, with community-based measures, contained spread. We assessed the effectiveness of containment measures by estimating transmissibility (effective reproduction number, (Equation is included in full-text article.)) over the course of the outbreak. METHODS: We used a Bayesian data augmentation framework to allocate infectors to infectees with no known infectors and determine serial interval distribution parameters via Markov chain Monte Carlo sampling. We fitted a smoothing spline to the number of secondary cases generated by each infector by respective onset dates to estimate (Equation is included in full-text article.)and evaluated increase in mean number of secondary cases per individual for each day's delay in starting isolation or quarantine. RESULTS: As of April 1, 2020, 1000 COVID-19 cases were reported in Singapore. We estimated a mean serial interval of 4.6 days [95% credible interval (CI) = 4.2, 5.1] with a SD of 3.5 days (95% CI = 3.1, 4.0). The posterior mean (Equation is included in full-text article.)was below one for most of the time, peaking at 1.1 (95% CI = 1.0, 1.3) on week 9 of 2020 due to a spreading event in one of the clusters. Eight hundred twenty-seven (82.7%) of cases infected less than one person on average. Over an interval of 7 days, the incremental mean number of cases generated per individual for each day's delay in starting isolation or quarantine was 0.03 cases (95% CI = 0.02, 0.05). CONCLUSIONS: We estimate that robust surveillance, active case detection, prompt contact tracing, and quarantine of close contacts kept (Equation is included in full-text article.)below one.

Compound Danshen Dripping Pill Promotes Adaptation to Acute High-Altitude Exposure.

Li, Zongbin, Jun Guo, Chunwei Liu, Yajun Shi, Yang Li, Jinli Wang, Dandan Li, Jing Wang, and Yundai Chen. Compound Danshen Dripping Pill promotes adaptation to acute high-altitude exposure. High Alt Med Biol. 21:258-264, 2020. Background: In this study, we aimed to investigate whether the traditional Chinese medicine, Compound Danshen Dripping Pill (CDDP), can prevent acute mountain sickness (AMS). We allocated CDDP and matching placebos to 160 volunteers before they ascended to a high altitude. Treadmill exercise tests, echocardiography, blood routine examinations, biochemical analysis, and blood gas analysis were performed upon arrival at high altitude. The primary outcome included incidence of AMS, exercise times, and metabolic equivalents (METs) of treadmill exercise tests. Second endpoints included the heart rates and rate-pressure product (RPP) before and after treadmill exercise tests. Results: After high-altitude exposure, the incidence of AMS in the CDDP group was lower than that in the placebo group (48.6% vs. 67.6%, p = 0.022). The exercise time of the treadmill exercise test was significantly longer (507 ± 77.9 seconds vs. 457 ± 90.8 seconds, p = 0.004), the heart rate was lower (pre-exercise: 91.8 ± 11.7 beats/min vs. 97.2 ± 12.7 beats/min, p = 0.016; postexercise: 114 ± 22.2 beats/min vs. 121 ± 22.6 beats/min, p = 0.019), the pre-exercise and postexercise RPP were lower (pre-exercise: 1.13 × 104 ± 1.68 × 103 mmHg·beats/min vs. 1.23 × 104 ± 1.84 × 103 mmHg·beats/min, p = 0.027; postexercise: 1.19 × 104 ± 1.75 × 103 mmHg·beats/min vs. 1.31 × 104 ± 2.00 × 103 mmHg·beats/min, p = 0.002), and the MET value of the treadmill exercise test was significantly higher (9.93 ± 1.18 METs vs. 9.31 ± 1.52 METs, p = 0.037) in the CDDP group. Discussion: CDDP decreases the incidence of AMS and enhances exercise tolerance greater than placebo after high-altitude exposure. CDDP decreases the heart rate and myocardial oxygen consumption, increases the levels of hemoglobin, hematocrit, and antioxidant factors, and decreases the levels of inflammatory factors, which may explain the roles of CDDP in improving the adaptation to high-altitude exposure.