To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.
Diet has direct and indirect effects on health through inflammation and the gut microbiome. We investigated total dietary inflammatory potential via the literature-derived index (Dietary Inflammatory Index (DII®)) with gut microbiota diversity, composition and function. In cancer-free patient volunteers initially approached at colonoscopy and healthy volunteers recruited from the medical centre community, we assessed 16S ribosomal DNA in all subjects who provided dietary assessments and stool samples (n 101) and the gut metagenome in a subset of patients with residual fasting blood samples (n 34). Associations of energy-adjusted DII scores with microbial diversity and composition were examined using linear regression, permutational multivariate ANOVA and linear discriminant analysis. Spearman correlation was used to evaluate associations of species and pathways with DII and circulating inflammatory markers. Across DII levels, α- and β-diversity did not significantly differ; however, Ruminococcus torques, Eubacterium nodatum, Acidaminococcus intestini and Clostridium leptum were more abundant in the most pro-inflammatory diet group, while Akkermansia muciniphila was enriched in the most anti-inflammatory diet group. With adjustment for age and BMI, R. torques, E. nodatum and A. intestini remained significantly associated with a more pro-inflammatory diet. In the metagenomic and fasting blood subset, A. intestini was correlated with circulating plasminogen activator inhibitor-1, a pro-inflammatory marker (rho = 0·40), but no associations remained significant upon correction for multiple testing. An index reflecting overall inflammatory potential of the diet was associated with specific microbes, but not overall diversity of the gut microbiome in our study. Findings from this preliminary study warrant further research in larger samples and prospective cohorts.
Introduction: Several recent observational studies have presented concerning data regarding the safety of cardioversion (CV) for acute atrial fibrillation and flutter (AAFF). We conducted this systematic review to determine whether it is safe to cardiovert AAFF patients without prescribing oral anticoagulation (OAC) post-CV for those who are CHADS-65 negative. Methods: We conducted a librarian assisted search of MEDLINE, Embase, and Cochrane from inception through November 23, 2019. We included observational studies and randomized trials reporting thromboembolic (TE) events (i.e. stroke, transient ischemic attack, or systemic thromboembolism) within 30 days following CV in patients with AAFF, where onset of symptoms was <48 hours. Two reviewers independently screened studies and extracted data. The main outcome was risk of TE events within 30 days post-CV, stratified by OAC use. Risk of bias was assessed with the Quality in Prognostic Studies (QUIPS) tool. The primary analysis was based on prospective studies and the secondary analysis was based on retrospective studies. We performed meta-analyses for TE events where 2 or more studies were available, by applying the DerSimonian-Laird random-effects model. We implemented analyses stratified by study design using Open MetaAnalyst and generated the forest plots. Results: Our search yielded 969 titles; 74 were selected for full-text review and 20 studies were included in the review. The primary meta-analysis of 6 prospective studies, including two randomized trials, found a TE event rate of 0.15% (2 TE events/1,314 CVs). Within this prospective group, lack of OAC use was associated with a decreased risk of TE events (RR = 2.15 where RR >1 indicates increased risk of TE events with OAC compared to no OAC; 95% CI 0.50 to 9.31; I2 = 0%). Five of the 6 prospective studies had a low or moderate risk of bias in all QUIPS domains. Secondary meta-analysis of 6 retrospective studies revealed a TE event rate of 0.53% (56 TE events/10,521 CVs). This subgroup showed a trend favouring OAC use with decreased risk of TE events (RR = 0.34 where RR <1 suggests decreased risk of TE events with OAC; 95% CI 0.17 to 0.72; I2 = 0%). Conclusion: In the primary analysis of prospective studies, we found a low TE event rate following CV of AAFF, irrespective of OAC use. This contradicts previous analyses of retrospective studies. Our study supports the longstanding practice of not necessarily prescribing OAC post-CV in the ED for AAFF patients who are CHADS-65 negative.
Opiate drug psychological dependence is acknowledged as a difficult problem in the world. Several studies have shown the short-term efficacy of deep brain stimulation (DBS) in reducing opiate addiction. In this case report, we report on long-term results up to five years in an opiate addiction patient.
A 24-year-old man with three-year history of opiate addiction presented with several withdraw syndromes and more than three-time failures in detoxification.
The patient was treated with bilateral DBS of the nucleus accumbens (NAc) for opiate psychological dependence. No relapse was found during the follow-up periods.
This study suggests that DBS of the NAC could be an effective treatment of patients in reducing psychological dependence with a good recovery in psychological dysfunction.
Lurasidone has demonstrated low propensity for metabolic disturbance in adult patients with schizophrenia in short-term studies.
To evaluate metabolic syndrome occurrence during long-term lurasidone treatment in patients with schizophrenia.
To compare metabolic syndrome rates with lurasidone versus other antipsychotic agents.
Metabolic syndrome rates (as defined by the US National Cholesterol Education Program-Adult Treatment Panel III) were evaluated in adult patients with schizophrenia treated with lurasidone in 2 long-term, active-controlled studies (quetiapine XR or risperidone). In the quetiapine XR-controlled study, patients completing a 6-week, double-blind, placebo-controlled, fixed-dose trial of lurasidone (74 mg/d or 148 mg/d) or quetiapine XR (600 mg/d) continued on double-blind, flexibly dosed lurasidone (37–148 mg/d) or quetiapine XR (200–800 mg/d) for up to 12 months. In the risperidone-controlled study, patients received double-blind, flexibly dosed lurasidone (37–111 mg/d) or risperidone (2–6 mg/d) for up to 12 months.
Among patients without metabolic syndrome at baseline in the quetiapine XR-controlled study, 2.4% (2/84) of lurasidone-treated patients and 7.4% (2/27) of quetiapine XR-treated patients developed metabolic syndrome at month 12 (P = NS). Of patients without metabolic syndrome at baseline in the risperidone-controlled study, 10.3% (12/117) and 23.2% (16/69) of lurasidone- and risperidone-treated patients, respectively, developed metabolic syndrome at month 12 (P = 0.02).
Long-term treatment with lurasidone was associated with lower rates of metabolic syndrome in patients with schizophrenia compared to treatment with quetiapine XR or risperidone.
Sunovion Pharmaceuticals Inc.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Diet modifies the risk of colorectal cancer (CRC), and inconclusive evidence suggests that yogurt may protect against CRC. We analysed the data collected from two separate colonoscopy-based case–control studies. The Tennessee Colorectal Polyp Study (TCPS) and Johns Hopkins Biofilm Study included 5446 and 1061 participants, respectively, diagnosed with hyperplastic polyp (HP), sessile serrated polyp, adenomatous polyp (AP) or without any polyps. Multinomial logistic regression models were used to derive OR and 95 % CI to evaluate comparisons between cases and polyp-free controls and case–case comparisons between different polyp types. We evaluated the association between frequency of yogurt intake and probiotic use with the diagnosis of colorectal polyps. In the TCPS, daily yogurt intake v. no/rare intake was associated with decreased odds of HP (OR 0·54; 95 % CI 0·31, 0·95) and weekly yogurt intake was associated with decreased odds of AP among women (OR 0·73; 95 % CI 0·55, 0·98). In the Biofilm Study, both weekly yogurt intake and probiotic use were associated with a non-significant reduction in odds of overall AP (OR 0·75; 95 % CI 0·54, 1·04) and (OR 0·72; 95 % CI 0·49, 1·06) in comparison with no use, respectively. In summary, yogurt intake may be associated with decreased odds of HP and AP and probiotic use may be associated with decreased odds of AP. Further prospective studies are needed to verify these associations.
We have detected 27 new supernova remnants (SNRs) using a new data release of the GLEAM survey from the Murchison Widefield Array telescope, including the lowest surface brightness SNR ever detected, G 0.1 – 9.7. Our method uses spectral fitting to the radio continuum to derive spectral indices for 26/27 candidates, and our low-frequency observations probe a steeper spectrum population than previously discovered. None of the candidates have coincident WISE mid-IR emission, further showing that the emission is non-thermal. Using pulsar associations we derive physical properties for six candidate SNRs, finding G 0.1 – 9.7 may be younger than 10 kyr. Sixty per cent of the candidates subtend areas larger than 0.2 deg2 on the sky, compared to < 25% of previously detected SNRs. We also make the first detection of two SNRs in the Galactic longitude range 220°–240°.
This work makes available a further
of the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey, covering half of the accessible galactic plane, across 20 frequency bands sampling 72–231 MHz, with resolution
. Unlike previous GLEAM data releases, we used multi-scale CLEAN to better deconvolve large-scale galactic structure. For the galactic longitude ranges
$345^\circ < l < 67^\circ$
$180^\circ < l < 240^\circ$
, we provide a compact source catalogue of 22 037 components selected from a 60-MHz bandwidth image centred at 200 MHz, with RMS noise
and position accuracy better than 2 arcsec. The catalogue has a completeness of 50% at
, and a reliability of 99.86%. It covers galactic latitudes
towards the galactic centre and
for other regions, and is available from Vizier; images covering
for all longitudes are made available on the GLEAM Virtual Observatory (VO).server and SkyView.
We examined the latest data release from the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey covering 345° < l < 60° and 180° < l < 240°, using these data and that of the Widefield Infrared Survey Explorer to follow up proposed candidate Supernova Remnant (SNR) from other sources. Of the 101 candidates proposed in the region, we are able to definitively confirm ten as SNRs, tentatively confirm two as SNRs, and reclassify five as H ii regions. A further two are detectable in our images but difficult to classify; the remaining 82 are undetectable in these data. We also investigated the 18 unclassified Multi-Array Galactic Plane Imaging Survey (MAGPIS) candidate SNRs, newly confirming three as SNRs, reclassifying two as H ii regions, and exploring the unusual spectra and morphology of two others.
The work described in this research communication aimed to investigate whether rumen-protected methionine (Met) supplementation during the periparturient period would affect the expression of galectins in blood-derived neutrophils, and secretion of galectins, IL (interleukin)-1β, IL-6, myeloperoxidase (MPO), and glucose in plasma. Because supplementation of rumen-protected Met would alleviate inflammation and oxidative stress during the peripartal period, we hypothesized that enhancing Met supply would benefit the innate immune response at least in part by altering the expression of galectin genes associated with neutrophil activity and inflammation. Galectins (Gal) have an immuno-modulating effect acting like cell-surface receptors whose activation often results in signaling cascades stimulating cells such as neutrophils. This study revealed an association between Met supplementation and galectin expression and secretion. This implies that galectin expression and secretion can be modulated by Met supplementation. Further studies are needed to evaluate the regulation of galectin gene expression for therapeutic and dietary intervention in the peripartal cow.
Many institutions evaluate applications for local seed funding by recruiting peer reviewers from their own institutional community. Smaller institutions, however, often face difficulty locating qualified local reviewers who are not in conflict with the proposal. As a larger pool of reviewers may be accessed through a cross-institutional collaborative process, nine Clinical and Translational Science Award (CTSA) hubs formed a consortium in 2016 to facilitate reviewer exchanges. Data were collected to evaluate the feasibility and preliminary efficacy of the consortium.
The CTSA External Reviewer Exchange Consortium (CEREC) has been supported by a custom-built web-based application that facilitates the process and tracks the efficiency and productivity of the exchange.
All nine of the original CEREC members remain actively engaged in the exchange. Between January 2017 and May 2019, CEREC supported the review process for 23 individual calls for proposals. Out of the 412 reviews requested, 368 were received, for a fulfillment ratio of 89.3%. The yield on reviewer invitations has remained consistently high, with approximately one-third of invitations being accepted, and of the reviewers who agreed to provide a review, 88.3% submitted a complete review. Surveys of reviewers and pilot program administrators indicate high satisfaction with the process.
These data indicate that a reviewer exchange consortium is feasible, adds value to participating partners, and is sustainable over time.
In evaluating the quality of table eggs and the developmental stages of embryonic eggs, spectroscopic techniques provide greater efficiency than traditional, time-consuming and laborious approaches. This review summarises recent developments in the spectroscopic analysis of table eggs, including the determination of the chemical composition (ratios of performance to standard deviation of 4.38, 2.25, 2.28, 2.31, and 3.03 for fat, moisture, and protein in egg yolk and moisture and protein in egg albumen, respectively, have been reported). A Haugh unit detection accuracy RMSEP (root mean square error of prediction) for quality of 6.29 was obtained by hyperspectral imaging) for table eggs and fertility detection (for white-shell eggs, fertility detection has been realised at a promising rate of 93.5%) and gender determination in hatching eggs. In conclusion, hyperspectral imaging generally outperforms visible or near-infrared reflectance spectroscopy when evaluating both consumption eggs and hatching eggs, and near-infrared reflectance Raman and fluorescence spectroscopy exhibit a strong potential for gender determination prior to hatching. Scientists have attained a correct sexing rate above 90% at 3.5 d of egg incubation without removing the inner shell membrane. In the detection of blood-spot eggs or fertile eggs, eggshell colour proved to be a negative factor.
We apply two methods to estimate the 21-cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly spaced triangles of antenna tiles, as well as an estimate based on data gridded to the uv-plane. The direct and gridded bispectrum estimators are applied to 21 h of high-band (167–197 MHz; z = 6.2–7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point-source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 h, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21-cm bispectrum may be accessible in less time than the 21-cm power spectrum for some wave modes, with detections in hundreds of hours.
While assessing the environmental impact of nuclear power plants, researchers have focused their attention on radiocarbon (14C) owing to its high mobility in the environment and important radiological impact on human beings. The 10 MW high-temperature gas-cooled reactor (HTR-10) is the first pebble-bed gas-cooled test reactor in China that adopted helium as primary coolant and graphite spheres containing tristructural-isotropic (TRISO) coated particles as fuel elements. A series of experiments on the 14C source terms in HTR-10 was conducted: (1) measurement of the specific activity and distribution of typical nuclides in the irradiated graphite spheres from the core, (2) measurement of the activity concentration of 14C in the primary coolant, and (3) measurement of the amount of 14C discharged in the effluent from the stack. All experimental data on 14C available for HTR-10 were summarized and analyzed using theoretical calculations. A sensitivity study on the total porosity, open porosity, and percentage of closed pores that became open after irradiating the matrix graphite was performed to illustrate their effects on the activity concentration of 14C in the primary coolant and activity amount of 14C in various deduction routes.
Two-dimensional particle-in-cell (PIC) simulations have been used to investigate the interaction between a laser pulse and a foil exposed to an external strong longitudinal magnetic field. Compared with that in the absence of the external magnetic field, the divergence of proton with the magnetic field in radiation pressure acceleration (RPA) regimes has improved remarkably due to the restriction of the electron transverse expansion. During the RPA process, the foil develops into a typical bubble-like shape resulting from the combined action of transversal ponderomotive force and instabilities. However, the foil prefers to be in a cone-like shape by using the magnetic field. The dependence of proton divergence on the strength of magnetic field has been studied, and an optimal magnetic field of nearly 60 kT is achieved in these simulations.
The Chinese white pine beetle Dendroctonus armandi (Coleoptera: Scolytinae) typically displays bivoltinism at altitudes below 1700 m in the Qinling Mountains, China. The periods of host colonization and larval overwintering are two important phases in the life cycle of bark beetles, as it is during these periods that they have to contend with host plant defences and periods of intense cold, respectively. Although during different seasons, the females and males of Chinese white pine beetles show varying tolerances to host plant terpenoids, the sex ratio and survival physiology condition of the two beetle generations are unknown. We investigated the sex ratio of individuals, and also examined the body mass, energy stores, and detoxication enzymes of males and females in each of the two generations in order to determine the overall population stability of each generation. We identified a female-biased sex ratio among adults in both generations. Furthermore, patterns of body mass, energy stores, and detoxication enzymes were found to differ between the two sexes and two seasons. Compared with the males, the females have a larger body mass and higher amounts of stored lipids, which are assumed to be adaptations designed to overcome host resistance and facilitate subsequent oviposition.
Streamwise velocity and wall-shear stress are acquired simultaneously with a hot-wire and an array of azimuthal/spanwise-spaced skin friction sensors in large-scale pipe and boundary layer flow facilities at high Reynolds numbers. These allow for a correlation analysis on a per-scale basis between the velocity and reference skin friction signals to reveal which velocity-based turbulent motions are stochastically coherent with turbulent skin friction. In the logarithmic region, the wall-attached structures in both the pipe and boundary layers show evidence of self-similarity, and the range of scales over which the self-similarity is observed decreases with an increasing azimuthal/spanwise offset between the velocity and the reference skin friction signals. The present empirical observations support the existence of a self-similar range of wall-attached turbulence, which in turn are used to extend the model of Baars et al. (J. Fluid Mech., vol. 823, p. R2) to include the azimuthal/spanwise trends. Furthermore, the region where the self-similarity is observed correspond with the wall height where the mean momentum equation formally admits a self-similar invariant form, and simultaneously where the mean and variance profiles of the streamwise velocity exhibit logarithmic dependence. The experimental observations suggest that the self-similar wall-attached structures follow an aspect ratio of
in the streamwise, spanwise and wall-normal directions, respectively.
This study presents findings from a first-of-its-kind measurement campaign that includes simultaneous measurements of the full velocity and vorticity vectors in both pipe and boundary layer flows under matched spatial resolution and Reynolds number conditions. Comparison of canonical turbulent flows offers insight into the role(s) played by features that are unique to one or the other. Pipe and zero pressure gradient boundary layer flows are often compared with the goal of elucidating the roles of geometry and a free boundary condition on turbulent wall flows. Prior experimental efforts towards this end have focused primarily on the streamwise component of velocity, while direct numerical simulations are at relatively low Reynolds numbers. In contrast, this study presents experimental measurements of all three components of both velocity and vorticity for friction Reynolds numbers
ranging from 5000 to 10 000. Differences in the two transverse Reynolds normal stresses are shown to exist throughout the log layer and wake layer at Reynolds numbers that exceed those of existing numerical data sets. The turbulence enstrophy profiles are also shown to exhibit differences spanning from the outer edge of the log layer to the outer flow boundary. Skewness and kurtosis profiles of the velocity and vorticity components imply the existence of a ‘quiescent core’ in pipe flow, as described by Kwon et al. (J. Fluid Mech., vol. 751, 2014, pp. 228–254) for channel flow at lower
, and characterize the extent of its influence in the pipe. Observed differences between statistical profiles of velocity and vorticity are then discussed in the context of a structural difference between free-stream intermittency in the boundary layer and ‘quiescent core’ intermittency in the pipe that is detectable to wall distances as small as 5 % of the layer thickness.
Starch digestion in the small intestines of the dairy cow is low, to a large extent, due to a shortage of syntheses of α-amylase. One strategy to improve the situation is to enhance the synthesis of α-amylase. The mammalian target of rapamycin (mTOR) signalling pathway, which acts as a central regulator of protein synthesis, can be activated by leucine. Our objectives were to investigate the effects of leucine on the mTOR signalling pathway and to define the associations between these signalling activities and the synthesis of pancreatic enzymes using an in vitro model of cultured Holstein dairy calf pancreatic tissue. The pancreatic tissue was incubated in culture medium containing l-leucine for 3 h, and samples were collected hourly, with the control being included but not containing l-leucine. The leucine supplementation increased α-amylase and trypsin activities and the messenger RNA expression of their coding genes (P <0.05), and it enhanced the mTOR synthesis and the phosphorylation of mTOR, ribosomal protein S6 kinase 1 and eukaryotic initiation factor 4E-binding protein 1 (P <0.05). In addition, rapamycin inhibited the mTOR signal pathway factors during leucine treatment. In sum, the leucine regulates α-amylase and trypsin synthesis in dairy calves through the regulation of the mTOR signal pathways.