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Universal admission screening and follow-up symptom-based testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play critical roles in controlling nosocomial transmission. We describe the performance of test strategies for inpatients and their companions during various disease incidences in Taiwan.
Retrospective population-based cohort study.
The study was conducted across 476 hospitals in Taiwan.
The data for both testing strategies by reverse transcription-polymerase chain reaction for SARS-CoV-2 in newly admitted patients and their companions during May 2021—June 2022 were extracted and analyzed.
The positivity rate of universal admission screening was 0.76% (14,640 of 1,928,676) for patients and 0.37% (5,372 of 1,438,944) for companions. The weekly community incidences of period 1 (May 2021–June 2021), period 2 (July 2021–March 2022), and period 3 (April 2022–June 2022) were 6.57, 0.27, and 1,261, respectively, per 100,000 population. The positivity rates of universal admission screening for patients and companions (4.39% and 2.18%) in period 3 were higher than those in periods 1 (0.29% and 0.04%) and 2 (0.03% and 0.003%) (all P < .01). Among the 22,201 confirmed cases, 9.86% were identified by symptom-based testing. The costs and potential savings of universal admission screening for patients and companions achieved a breakeven point when the test strategy was implemented in a period with weekly community incidences of 27 and 358 per 100,000 population, respectively.
Universal admission screening and follow-up symptom-based testing is important for reducing nosocomial transmission. Implementing universal admission screening at an appropriate time would balance the benefits with costs and potential unintended harms.
This paper investigates the acoustic correlates of stress in European Portuguese. Using a nonce word experiment, this study controls the phonological environment of the stimuli so stressed and unstressed vowels with the same quality can be directly compared. Of the five acoustic measures examined, duration is the most robust correlate of stress, but the effect is limited to certain vowels and speakers. Care is taken to separate the effects of independent phonological processes on acoustic properties that are also influenced by stress.
Amnestic mild cognitive impairment (aMCI) is characterized by delayed P300 latency and reduced grey matter (GM) volume, respectively. The relationship between the features in aMCI is unclear. This study was to investigate the relationship between the altered P300 latency and the GM volume in aMCI.
Thirty-four aMCI and 34 well-matched normal controls (NC) were studied using electroencephalogram during a visual oddball task and scanned with MRI. Both tests were finished in the same day.
As compared with the NC group, the aMCI group exhibited delayed P300 latency in parietal cortex and reduced GM volumes in bilateral temporal pole and left hippocampus/parahippocampal gyrus. A remarkable negative correlation was found between delayed P300 latency and reduced left hippocampal volume only in the aMCI group. Interestingly, the mediating analysis found P300 latency significantly mediated the association between right supramarginal gyrus volume and information processing speed indicated by Stroop Color and Word Test A scores.
The association between delayed P300 latency and reduced left hippocampal volume in aMCI subjects suggests that reduced left hippocampal volume may be the potential structural basis of delayed P300 latency.
This study proposed a method to enable a humanoid robot to step up onto a stair by imitating the step-up motion of a human and to accomplish a lift and carry event in HuroCup of Federation of International RoboSports Association. The step-up motion, divided into five states, was captured by a Kinect sensor, and the human joints corresponded to the humanoid robot joints. Selected servomotors and their angle variation were matched with that of human joint numbers by a designed fuzzy inference system on the basis between the human and the humanoid robot joints. Then, the rest of the robot motors were adjusted by the zero moment point obtained from force-sensing registers to maintain stability. Next, two intermediate transition states were added between each state of the humanoid robot step-up to maintain its balance and reduce motor damage. Finally, to be applied in a real lift and carry event, a vision system was integrated to recognize the edge of a color board and determine a suitable site for the step-up. With these functions integrated, the robot under the proposed method was verified to successfully achieve the task of the lift and carry event without losing its balance or falling.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
We have collected 2330 Cepheids to establish an intuitive 3D map of the Milky Way’s disk. As regards the warp amplitude, the Cepheid disk agrees well with the gas disk for radii up to 15 kpc. However, the mean line of nodes (LON) of the Cepheid disk deviates from the Galactic Center–Sun direction by 17.5±1.0°. This is a new and different result compared with previous results. The LON is not stable at any given radius, but it twists. The twisted pattern suggests that the formation of the Milky Way’s warp is dominated by the massive inner disk. The kinematic warp defined by the Cepheids is also in concordance with the spatial warp. In the 2020 era, the anticipated increasing number of new Cepheids will provide a key opportunity to view our Milky Way’s disk as a whole, and we expect that our knowledge of the disk’s main structural features will be much improved.
Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
This paper presents evidence against the existence of sonority-driven stress in Gujarati. Gujarati is one of the clearest and most revealing cases of sonority-driven stress with distinctions among peripheral vowels. A production experiment was performed to determine the accuracy of the claim that [a] attracts stress away from the default position. Of the five types of phonetic evidence examined, only F1 provides clear evidence for stress, revealing stress to be consistently penultimate, and not sonority-driven. As Gujarati is one of the core cases of sonority-driven stress, this finding challenges the claim that it exists. However, this paper does not exclude the possibility that stress may avoid schwa (or central vowels), as reported for several languages. Theoretical and methodological implications are discussed, particularly for theories that have a ‘symmetric effect’ and for descriptions that are impressionistic.
Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.
A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.
Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.
This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.
In this paper we report a large-scale developmental study of early productive vocabulary acquisition by 928 Chinese-speaking children aged between 1;0 and 2;6, using the Early Vocabulary Inventory for Mandarin Chinese (Hao, Shu, Xing & Li, 2008). The results show that: (i) social words, especially words for people, are the predominant type of words in Chinese-speaking children's earliest productive vocabulary; (ii) overall, Chinese-speaking children's vocabulary contains greater proportions of nouns than other word categories, especially at the earliest vocabulary stage; and (iii) verbs tend to appear earlier for Chinese-speaking children as compared with English-speaking children at the same levels of vocabulary development. In addition, our study has identified the underlying variables that influence the age of acquisition of words, specifically, the interplay between the conceptual (imageability) and linguistic properties (word frequency, word length, and grammatical category) that jointly shape the development of Mandarin-speaking children's early vocabulary.
It is well known that extracellular signal-regulated kinase 8 (ERK8) plays pivotal roles in various mitotic events. But its physiological roles in oocyte meiotic maturation remain unclear. In this study, we found that although no specific ERK8 signal was detected in oocyte at the germinal vesicle stage, ERK8 began to migrate to the periphery of chromosomes shortly after germinal vesicle breakdown. At prometaphase I, metaphase I (MI), anaphase I, telophase I, and metaphase II (MII) stages, ERK8 was stably detected at the spindles. By taxol treatment, we clarified that the ERK8 signal was stained on the spindle fibers as well as microtubule asters in MI and MII oocytes. In fertilized eggs, the ERK8 signal was not observed in the two pronuclei stages. At prometaphase, metaphase, and anaphase of the first mitosis, ERK8 was detected on the mitotic spindle. ERK8 knock down by antibody microinjection and specific siRNA caused abnormal spindles, failed chromosome congression, and decreased first polar body extrusion. Taken together, our results suggest that ERK8 plays an important role in spindle organization during mouse oocyte meiotic maturation and early embryo cleavage.
The research reported in this paper investigated the effects of semantic relatedness of words (closely related vs. distantly related) and morpheme type (free morpheme vs. bound morpheme) on young Chinese children's homophone awareness, an aspect of morphological awareness, in two experiments. The first experiment was a cross-sectional study including 39 children in a beginning kindergarten class, 39 children in an intermediate kindergarten class, and 36 children in a senior kindergarten class. The second experiment was a 7-month longitudinal study involving 43 first graders and 50 second graders at the beginning of the study. In both experiments, the children judged whether orally presented words shared the same morpheme or contained homophonous morphemes. The results suggest that homophone awareness emerges in Chinese children in the kindergarten years. Children's morpheme identification is facilitated by the semantic proximity of words that share a morpheme, and awareness of free morphemes is developed before that of bound morphemes. Furthermore, although semantic relatedness is the most prominent factor in kindergarten, its effect varies as a function of morpheme type in the early primary grades. Our research sheds light on the developmental course of morphological awareness and the factors that influence it.
Renal tubular lipid accumulation is associated with renal injury in the metabolic syndrome, but its mechanisms are not fully elucidated. The purpose of the present study was to investigate the exact mechanism of renal tubular lipid accumulation in the diet-induced metabolic syndrome. The in vivo experiments showed that a high-fat diet induced hyperglycaemia, hyperinsulinaemia and hypertriacylglycerolaemia, subsequent increases in sterol regulatory element binding protein-1 (SREBP-1) and transforming growth factor-β1 (TGF-β1), lipid droplet deposit in renal tubular cells and interstitial extracellular matrix accumulation in Wistar rats. A human renal proximal tubular epithelial cell line (HKC) was used to determine the direct role of insulin, and the results revealed that insulin induced SREBP-1, fatty acid synthase (FASN), TGF-β1 expressions, lipid droplet and extracellular matrix deposits. Knockdown of SREBP-1 by RNA interference technology significantly inhibited FASN, TGF-β1 up-regulation, lipid and extracellular matrix accumulation caused by insulin. In addition, we found that insulin and high glucose could synergistically increase SREBP-1, FASN, TGF-β1 and fibronectin expressions in HKC cells. These results indicate that high-fat diet-induced increased serum insulin and glucose synergistically cause renal tubular lipid deposit and extracellular matrix accumulation via the SREBP-1 pathway.
Growing yellow cattle (Bos taurus, n 30, 1·0–3·5 years old and 75–240 kg) from their native altitude (2000–2800 m) were used to evaluate the effects of altitude, ambient temperature (Ta) and solar radiation on the basal energy metabolism in this large mammal. Fasting heat production (FHP) was measured at altitudes of 2260, 3250 and 4270 m on the Tibetan plateau both in the summer and winter respectively, after a 90 d adaptation period at each experimental site. The gas exchanges of the whole animal were determined continuously for 3 (2260 and 3250 m) or 2 (4270 m) d after a 96 (2260 and 3250 m) or 48 (4270 m) h starvation period, using closed-circuit respiratory masks. Increasing altitude from 2260 to 3250 m at similar Ta in the summer significantly elevated FHP for all animals (P<0·01), and from 3250 to 4270 m for young cattle (P<0·05); increasing altitude from 2260 to 3250 m in the winter also significantly elevated FHP (P<0·05), but the increase was mainly due to the decrease of Ta and the increase in wind speed. No results were obtained at 4270 m in the winter, due to the problems of the animals, adaptating to the altitude. The magnitude of FHP elevation caused by increasing altitude was greater with summer sunshine or winter wind than without them. Increase of Ta from 10·0 to 22·0°C, in the presence of solar radiation, slightly (2260 m) or significantly (3250 and 4270 m, P<0·01) elevated FHP, but slightly reduced it in the absence of solar radiation; decrease of Ta from 0·0 to −30·0°C linearly increased FHP. At 3250 and 4270 m, FHP at the same Ta was higher with summer sunshine or winter wind (3250 m) than without them, but this did not occur at 2260 m. In conclusion, high altitude elevates FHP in yellow cattle in the warm season, and the summer solar radiation and winter wind at high altitude significantly increase metabolic rate. It may be also concluded that the effects of solar radiation on metabolic rate depend on the altitude and the environmental temperature.
Thirty growing yaks Bos grunniens or Poephagus grunniens, 1·0–3·5 years and 50–230kg, from their native altitudes (3000–4000m), were used to study the basal metabolism in this species and to evaluate the effects of high altitude and season on the energy metabolism. Fasting heat production (FHP) was measured at altitudes of 2260, 3250 and 4270m on the Tibetan plateau in both the summer and the winter, after a 90d adaptation period at each experimental site. Gas exchanges of the whole animals were determined continuously for 3d (4–5 times per d, 10–12 min each time) after a 96 h starvation period, using closed-circuit respiratory masks. Increasing altitude at similar ambient temperature (Ta) did not affect (P>0·10) FHP in the summer, but decreased (P<0·05) it at different Ta in the winter. However, the decrease of FHP in the winter was mainly due to the decrease of Ta instead of the increase of altitude. In the summer, the respiratory rate, heart rate and body temperature were unaffected by altitude, except for a decrease (P<0·05) in body temperature at 4270m; in the winter, they were decreased (P<0·05) by increasing altitude. In both seasons, the RER was decreased (P<0·05) by increasing altitude. At all altitudes for all groups, the daily FHP was higher (P<0·05) in the summer (Ta 6–24°C) than in the winter (Ta 0 to -30°C), and the Ta-corrected FHP averaged on 920 kJ/kg body weight0·52 at Ta 8–14°C and on 704 kJ/kg body weight0·52 at Ta -15°C respectively. We conclude that in the yak high altitude has no effect on the energy metabolism, whereas the cold ambient temperature has a significant depressing effect. The results confirm that the yak has an excellent adaptation to both high altitude and extremely cold environments.
In this paper, we prove a Gelfand-Mulvey type of duality for a certain class of rings which includes the Gelfand rings. We also show that the Maximal Ideal Theorem (MIT) can be replaced by the Prime Ideal Theorem (PIT) in the original Gelfand-Mulvey duality.
Quantales were first introduced by Mulvey in order to provide a possible setting for constructive foundations for quantum mechanics, as well as a non-commutative analogue of the maximal spectrum of a C*-algebra. Quantales have since been studied by several authors: see [1, 3, 4, 5].