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Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China.
Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers.
Based on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life.
Our results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.
The outbreaks of varicella occurring in kindergartens and schools are increasingly notified in Shanghai despite the implementation of one-dose varicella vaccination. We analyzed surveillance data on the notified outbreaks of varicella in Minhang District of Shanghai during 2008–2014. A total of 13 511 varicella cases and 154 outbreaks involving 1558 (11·5%) cases were reported. Annual attack rates of outbreak-associated varicella in outbreak classes were 5·5%–12%. The mean age of the outbreak-associated cases was 8·6 ± 3·1 years. Among 1558 outbreak cases, 660 (42·4%) received one-dose varicella vaccine previously. The proportions of breakthrough varicella infection during outbreaks ranged from 21·5% in 2008 to 86·1% in 2014. Annual breakthrough infection rates in outbreak classes ranged from 5·4% to 7·4%. Breakthrough cases as index cases results in 9·7% of outbreaks, and the average duration of outbreaks was significantly longer in vaccinated cases as index cases than in unvaccinated cases as index cases (11·3 ± 5·8 days vs. 8·6 ± 6·1 days, P < 0·05). The mean time of breakthrough infection since vaccination was 6·2 ± 2·3 years (range 0·6–13·4 years). One-dose varicella vaccination cannot prevent the varicella outbreaks in kindergartens and schools. A second dose of varicella vaccine should be recommended for children.
Pheromone-binding proteins (PBPs) are believed to be involved in the recognition of semiochemicals. In the present study, western blot analysis, fluorescence-binding characteristics and immunolocalization of CmedPBP4 from the rice leaffolder, Cnaphalocrocis medinalis, were investigated. Western blot analysis revealed that CmedPBP4 showed obvious antenna-specific expression patterns in female and male antenna, and made a clearly different sex-biased expression. Immunocytochemical labeling revealed that CmedPBP4 showed specific expression in the trichoid sensilla. Competitive fluorescence binding assays indicated that CmedPBP4 could selectively recognize three sex pheromone components (Z13-18:Ac, Z11-16:Al and Z13-18:OH) and eleven rice plant volatiles, including cyclohexanol, nerolidol, cedrol, dodecanal, ionone, (−)-α-cedrene, (Z)-farnesene, β-myrcene, R-(+)-limonene, (−)-limonene, and (+)-3-carene. Meanwhile the CmedPBP4 detection of sex pheromones and host odorants was pH-dependent. Our results, for the first time, provide further evidence that trichoid sensilla might be play an important role in detecting sex pheromones and host plant volatiles in the C. medinalis moth. Our systematic studies provided further detailed evidence for the function of trichoid sensilla in insect semiochemical perception.
The B-biotype of Bemisia tabaci (Homoptera: Aleyrodidae) has become extremely resistant to commonly used insecticides in China. To further explore the mechanisms of resistance to diafenthiuron, the diafenthiuron induction profiles of carboxylesterase (COE1), glutathione S-transferase (GST) and seven cytochrome P450 genes in both resistant (R-DfWf) and susceptible (S-Lab) strains were characterized. The detoxification genes GST, CYP6CX4, CYP6DW3, CYP6DZ6 and CYP9F, which are known to be constitutively over-expressed in the R-DfWf strain, were significantly upregulated in R-DfWf and S-Lab strains exposed to diafenthiuron at LC50 compared with their levels in strains treated with distilled water (controls); however, CYP6CX1, another detoxification gene, was not upregulated. The upregulation was more pronounced in the R-DfWf strain than in the S-Lab strain exposed to different concentrations of diafenthiuron (LC10 or LC50). Interestingly, COE1, CYP6CM1 and CYP6A, which are not constitutively over-expressed in the R-DfWf strain, were all significantly upregulated after exposure to diafenthiuron. Similarly, significant differences in the expression of these detoxification genes, with the exception of CYP6CM1 in the S-Lab strain, were also observed after exposure to diafenthiuron. However, the induction of CYP6A and COE1 was more pronounced in the S-Lab strain than in the R-DfWf strain after treatment with diafenthiuron at both concentrations, indicating that diafenthiuron induction of CYP6CM1 is specific to the R-DfWf strain, while diafenthiuron induction of the other genes is common to both the R-DfWf and S-Lab strains. These results demonstrate that multiple detoxification genes are co-upregulated in the R-DfWf strain through both constitutive over-expression and induction mechanisms. This knowledge will be useful for rational selection of insecticides for use in resistance management and control of this species.
In the near future, the inactivated enterovirus 71 (EV71) vaccine is expected to become available on the market in China. Since EV71 is a major cause of hand, foot and mouth disease (HFMD), the vaccine is expected to significantly reduce the number of cases, as well as the detrimental economic effect of the disease. However, for a national vaccination strategy to be developed, policy-makers need more information on the socioeconomic burden of EV71 HFMD infection. Based on the 2011 population data, we estimated the clinical and economic effect of EV71 HFMD infection in children aged 0–9 years in Shanghai, China. The annual cost related to HFMD is >US$7.66 million for a population of 1·42 million children aged 0–9 years with an average cost of US$208.2/case. The extrapolated cost for EV71 HFMD infection was US$3.53 million, comprising 46·1% of the overall cost associated with HFMD. Around 97% of all of the HFMD-related expenses were paid for by the families creating a considerable economic burden. Our findings could provide the necessary recommendations on the most effective national EV71 vaccine implementation, as well as a baseline data for assessing the cost-effectiveness of the vaccine in China.
Insect artificial diets are the foundation for mass production of insect predators. Whether there is an influence of long-term rearing with artificial diet on the control ability of predators should be considered. Here, we focused on the effect of nutritional history on the functional response of Geocoris pallidipennis to Myzus persicae. The influence of nutritional history (artificial diet versus natural prey, M. persicae) on the functional response of third to fifth instar nymphs and female G. pallidipennis was examined in the laboratory. The results showed that the functional response curve of both the nymphs and the adult female of G. pallidipennis to M. persicae reflected similar trends on both nutritional histories and confirmed the type II response. Adult female G. pallidipennis reared on either M. persicae or artificial diet produced a significantly better performance than the juvenile stages tested. We estimated that adult female G. pallidipennis can consume 141.6 (artificial diet) or 131.6 (M. persicae) aphids per day, respectively. This indicated that G. pallidipennis reared on both artificial diet and M. persicae displayed high rates of predation.
This paper presents a 3-DOF (degree of freedom) translational parallel manipulator named the Tri-pyramid Robot. Compared to the developed 3-DOF translational parallel manipulators, the Tri-pyramid Robot is designed based on conical displacement subset to exhibit better kinematic characteristic. The inverse position solution is obtained through closed-loop constraint analysis and used to formulate the overall Jacobian matrix of constraints and actuations based on the theory of reciprocal screws. Furthermore, by considering the stiffness of all links, joints, actuators, fixed, and moving platforms, the output stiffness matrix of the Tri-pyramid Robot is derived by the transformations of loads and deformations in the closed-loop form. The relations between the virtual input-output displacements are analyzed by the overall Jacobian matrix and used to build the manipulator's stiffness model. Stiffness performance is evaluated by the extreme eigenvalues of the output stiffness matrix in the reachable workspace. By considering the variations of the structural parameters and the distribution of the output stiffness, the maximal stiffness workspace is obtained through numerical optimization, providing, thereby, basic constraints for the parametric design of the Tri-pyramid Robot.
This study aimed to investigate the validity and feasibility of cervical oesophagostomy as a treatment for patients with severe dysphagia after radiotherapy for nasopharyngeal carcinoma.
The study retrospectively analysed the clinical data, symptoms, physical signs, treatment and outcomes of 12 patients treated with cervical oesophagostomy for severe dysphagia after radiotherapy for nasopharyngeal carcinoma, from 2006 to 2010.
In all 12 cases, the oesophageal stoma remained stable, without any complications such as pharyngeal fistula or inflammation. No oesophageal stricture or granuloma growth was observed. All patients reported significant improvement in their nutritional status and quality of life after the oesophagostomy surgery.
Cervical oesophagostomy is a valid and feasible method of treating severe dysphagia following radiotherapy for nasopharyngeal carcinoma. Oesophagostomy shows specific advantages over nasogastric tubing, gastrostomy and jejunostomy. Patients' nutrition and quality of life can be improved significantly if cervical oesophagostomy is executed in a timely fashion, especially in cases with severe trismus and multiple radiation-induced cranial nerve palsies unresponsive to rehabilitation.
A cluster dynamics model based on rate theory has been developed to describe the accumulation and diffusion processes of helium in tungsten under helium implantation alone or synergistic irradiation with neutron, by involving different types of objects, adopting up-to-date parameters and complex reaction processes as well as considering the diffusion process along with depth. The calculated results under different conditions are in good agreement with experiments much well. The model describes the behavior of helium in tungsten within 2D space of defect type/size and depth on different ions incident conditions (energies and fluences) and material conditions (system temperature and existent sinks), by including the synergistic effect of helium-neutron irradiations and the influence of inherent sinks (dislocation lines and grain boundaries). The model, coded as IRadMat, would be universally applicable to the evolution of defects for ions/neutron irradiated on plasma-facing materials.
The experiment was conducted to evaluate the effects of dietary threonine (Thr) supplement on reproductive performance and immune function of the male mice challenged with pseudorabies virus (PRV). Kun-Ming male mice were assigned randomly to four groups with different Thr levels (0.70%, 0.88%, 1.10% and 1.30%). Half of the mice in each group were injected with PRV or phosphate-buffered saline (PBS) after 5 weeks’ adaptation to diets. The second experiment examined the effects of dietary Thr level on copulation rate, pregnancy rate and average number per litter of PRV- or PBS-challenged male mice that copulated with adult female mice on the 9th day post PRV challenge. Sperm quality and testosterone of mice were decreased after PRV infection, but this effect was attenuated by increasing Thr levels. Copulation and conception rates were increased with increasing Thr levels (P = 0.14), but litter size was not affected (P > 0.05). In the PBS and PRV groups, mice fed higher levels of Thr had increased immunoglobulin (Ig)G, IgA and IgM concentrations. The PRV-specific antibody level, interleukin (IL)-1β and tumor necrosis factor (TNF)-α concentration in PRV groups enhanced with increasing Thr levels; however, there was no difference in PBS groups. Furthermore, higher toll-like receptor (TLR)2 and TLR9 expressions in testis were observed by PRV challenge compared with PBS groups, and higher Thr supplement attenuated PRV-challenged induced the upregulation effect of TLR2 and TLR9 mRNA expression in testis (P < 0.05). These data suggest that higher Thr consumption was recommended in order to counteract the deleterious effects of virus invasion, possibly through the downregulated expression of TLRs, and thus to improve immunity and reproduction performance of male mice challenged with PRV.
Five tropical multi-purpose tree species (MPTS), Enterolobium cyclocarpum, Moringa oleifera, Millettia griffoniana, Pterocarpus santalinoides and Treculia Africana, and one exotic species (Leucaena leucocephala), which acted as the control, planted in a randomized complete block design, were selected to evaluate the potentials as feed supplements for herds in dry seasons of south-western Nigeria. Samples of the MPTS leaves were collected in 2005, 2006, 2007 and 2008, weighed, dried and milled for estimation of biomass production, chemical analysis and measurement of in vitro gas production. Results showed significant differences (P < 0·001) in the biomass production of the MPTS. E. cyclocarpum consistently recorded the highest biomass production, height and collar diameter throughout the experimental period. There were also differences (P ⩽ 0·001) in dry matter (DM), crude protein (CP), ether extract (EE) and ash contents of the MPTS across species and years after planting. M. oleifera recorded the highest CP content of 240 g/kg DM. Interactions were observed between species and year for neutral detergent fibre (NDFom), acid detergent fibre (ADFom) and lignin contents of the MPTS. M. griffoniana and M. oleifera had lower tannin contents, whereas E. cyclocarpum, P. santalinoides, T. africana and L. leucocephala had higher tannin contents. The values reported for mineral contents showed that their levels in the MPTS were adequate for ruminants and there were no differences in the contents of most minerals. In vitro gas production results showed that the potential gas production ‘b’ was highest in M. griffoniana and lowest in P. santalinoides and there were species and year interactions (P ⩽ 0·001) for volatile fatty acid profiles of the supernatant after 96 h incubation. The estimated organic matter digestibility (OMD) and metabolizable energy (ME) of the MPTS were generally high. The high biomass production, CP and low fibre contents, as well as in vitro fermentation characteristics found for the MPTS evaluated in the current study suggest that these are better alternatives in comparison with L. leucocephala. It can be concluded that the MPTS evaluated have potential as sources of feed supplements for ruminants in dry seasons, especially in south western Nigeria.
The pathogenesis of angiostrongyliasis, resulting from Angiostrongylus cantonensis invasion of the human central nervous system, remains elusive. Anthelmintics are usually used to kill worms, although dead worms in the brain may cause severe inflammation which will lead to central nervous system damage. Therefore, combination therapy with anthelmintics and anti-inflammatory drugs in the treatment of human angiostrongyliasis needs further study. To evaluate the efficacy of albendazole combined with a marine fungal extract (m2-9) in A. cantonensis infection, BALB/c mice infected by the third-stage larvae of A. cantonensis were divided into three groups: mice treated with albendazole or m2-9 alone or in combination from day 5 post-inoculation (PI). Several efficacy parameters were recorded, including weight change, worm recovery, neurological function, behavioural analysis, eosinophil and leucocyte counts. The results showed that combination therapy increased body weight, reduced worm burden, improved learning ability, memory and action, decreased neurological dysfunction and leucocyte response in these mice. The combination of albendazole and m2-9 treatment significantly decreased leucocyte response and increased the frequency of rearing, compared to infected mice treated with either drug alone. Therefore, m2-9 is a natural product with potentially significant therapeutic value for angiostrongyliasis and is worthy of further study.
A year-long intervention trial was conducted to characterise the responses of multiple biomarkers of Se status in healthy American adults to supplemental selenomethionine (SeMet) and to identify factors affecting those responses. A total of 261 men and women were randomised to four doses of Se (0, 50, 100 or 200 μg/d as l-SeMet) for 12 months. Responses of several biomarkers of Se status (plasma Se, serum selenoprotein P (SEPP1), plasma glutathione peroxidase activity (GPX3), buccal cell Se, urinary Se) were determined relative to genotype of four selenoproteins (GPX1, GPX3, SEPP1, selenoprotein 15), dietary Se intake and parameters of single-carbon metabolism. Results showed that supplemental SeMet did not affect GPX3 activity or SEPP1 concentration, but produced significant, dose-dependent increases in the Se contents of plasma, urine and buccal cells, each of which plateaued by 9–12 months and was linearly related to effective Se dose (μg/d per kg0·75). The increase in urinary Se excretion was greater for women than men, and for individuals of the GPX1 679 T/T genotype than for those of the GPX1 679 C/C genotype. It is concluded that the most responsive Se-biomarkers in this non-deficient cohort were those related to body Se pools: plasma, buccal cell and urinary Se concentrations. Changes in plasma Se resulted from increases in its non-specific component and were affected by both sex and GPX1 genotype. In a cohort of relatively high Se status, the Se intake (as SeMet) required to support plasma Se concentration at a target level (Sepl-target) is: .
We retrospectively analysed the epidemiological data of all hand, foot, and mouth disease (HFMD) cases from the largest paediatric infectious diseases centre in Shanghai between 2007 and 2010. A total of 28 058 outpatients were diagnosed with HFMD, of which 3948 (14·07%) were hospitalized, 730 (2·60%) had complications with neurological disorders and pulmonary oedema/haemorrhage, and 11 (0·04%) died. The peak season was the summer months. Boys were more affected than girls. Since 2008, the major population group affected has shifted from native Shanghainese children attending preschool to migrant children and younger children cared for at home. Children aged 1–4 years constituted 82·27% of cases. EV-A71 was tested in clinical samples taken from severe cases in 2009 and 2010, and from most inpatients in 2010. EV-A71 was positive in 99·17% and 86·31% of severe cases, respectively in 2009 and 2010. All 12 cases with pulmonary oedema or haemorrhage were infected with EV-A71. Ten (90·90%) of 11 fatal cases were attributable to EV-A71 infection. In 2010, EV-A71-positive cases accounted for 54·12% of inpatients. The dominant circulation of EV-A71 led to the outbreak of HFMD and occurrence of severe and fatal cases.
Sequence variability in three mitochondrial DNA (mtDNA) regions, namely cytochrome c oxidase subunit 3 (cox3), NADH dehydrogenase subunits 1 and 4 (nad1 and nad4) in Spirometra erinaceieuropaei spargana from different geographical regions in China was examined. A portion of each of the cox3 (pcox3), nad1 (pnad1) and nad4 genes (pnad4) were amplified separately from individual S. erinaceieuropaei spargana by polymerase chain reaction (PCR). Representative amplicons were subjected to sequencing in order to estimate sequence variability. The sequences of pcox3, pnad1 and pnad4 were 541, 607 and 847 bp in length, respectively. The A+T contents of the sequences were 68.39–68.76% (pcox3), 63.76–64.91% (pnad1) and 67.18–67.77% (pnad4), respectively, while the intra-specific sequence variations within each of the S. erinaceieuropaei spargana were 0–1.5% for pcox3, 0–2.8% for pnad1 and 0–2.7% for pnad4. Phylogenetic analysis using neighbour joining (NJ), maximum likelihood (ML) and maximum parsimony (MP) methods, indicated that all the spargana isolates in Hunan Province represented S. erinaceieuropaei. These findings demonstrated clearly the usefulness of the three mtDNA sequences for population genetics studies of S. erinaceieuropaei spargana of human and animal health significance.
Laser structures with InGaAsP quantum well were grown on GaAs substrates in a solid source MBE system. Threshold current density Jth as low as 290A/cm2 and slope efficiency as high as 0.68W/A per facet were obtained for uncoated laser chips at 25°C. After 857 hours burn-in at 47A (corresponding to around 47W) at room temperature, power degradation rate was measured to be less than 3×10−6/h.