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Hurricane Harvey left a path of destruction in its wake, resulting in over 100 deaths and damaging critical infrastructure. During a disaster, public health surveillance is necessary to track emerging illnesses and injuries, identify at-risk populations, and assess the effectiveness of response efforts. The Centers for Disease Control and Prevention (CDC) and American Red Cross collaborate on shelter surveillance to monitor the health of the sheltered population and help guide response efforts.
We analyzed data collected from 24 Red Cross shelters between August 25, 2017, and September 14, 2017. We described the aggregate morbidity data collected during Harvey compared with previous hurricanes (Gustav, Ike, and Sandy).
Over one-third (38%) of reasons for visit were for health care maintenance; 33% for acute illnesses, which includes respiratory conditions, gastrointestinal symptoms, and pain; 19% for exacerbation of chronic disease; 7% for mental health; and 4% for injury. The Red Cross treated 41% of clients within the shelters; however, reporting of disposition was often missed. These results are comparable to previous hurricanes.
The capacity of Red Cross shelter staff to address the acute health needs of shelter residents is a critical resource for local public health agencies overwhelmed by the disaster. However, there remains room for improvement because reporting remained inconsistent.
Malnutrition remains a leading contributor to the morbidity and mortality of children under the age of 5 years and can weaken the immune system and increase the severity of concurrent infections. Livestock milk with the protective properties of human milk is a potential therapeutic to modulate intestinal microbiota and improve outcomes. The aim of this study was to develop an infection model of childhood malnutrition in the pig to investigate the clinical, intestinal and microbiota changes associated with malnutrition and enterotoxigenic Escherichia coli (ETEC) infection and to test the ability of goat milk and milk from genetically engineered goats expressing the antimicrobial human lysozyme (hLZ) milk to mitigate these effects. Pigs were weaned onto a protein–energy-restricted diet and after 3 weeks were supplemented daily with goat, hLZ or no milk for a further 2 weeks and then challenged with ETEC. The restricted diet enriched faecal microbiota in Proteobacteria as seen in stunted children. Before infection, hLZ milk supplementation improved barrier function and villous height to a greater extent than goat milk. Both goat and hLZ milk enriched for taxa (Ruminococcaceae) associated with weight gain. Post-ETEC infection, pigs supplemented with hLZ milk weighed more, had improved Z-scores, longer villi and showed more stable bacterial populations during ETEC challenge than both the goat and no milk groups. This model of childhood disease was developed to test the confounding effects of malnutrition and infection and demonstrated the potential use of hLZ goat milk to mitigate the impacts of malnutrition and infection.
Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.
Conservation of resources theory is employed to examine the effect of workplace support on thriving at work and the mediation of thriving at work on the workplace support and life satisfaction relationship using data on white-collar workers in China. We find that workplace support is positively related to thriving at work and thriving at work is positively related to life satisfaction. We also find that thriving at work fully mediates the relationship between life satisfaction and supervisor support, while the relationship between life satisfaction and coworker support is partially mediated by thriving at work. Consistent with the COR caravan and spillover hypothesis, we conclude that thriving at work is a mechanism that transmits the positive effects of workplace support on life satisfaction. The research findings suggest that an increase in workplace support can benefit both individuals and organizations by improving individuals’ thriving at work and life satisfaction.
We derive mass changes of the Greenland ice sheet (GIS) for 2003–07 from ICESat laser altimetry and compare them with results for 1992–2002 from ERS radar and airborne laser altimetry. The GIS continued to grow inland and thin at the margins during 2003–07, but surface melting and accelerated flow significantly increased the marginal thinning compared with the 1990s. The net balance changed from a small loss of 7 ± 3 Gt a−1 in the 1990s to 171 ± 4 Gt a−1 for 2003–07, contributing 0.5 mm a−1 to recent global sea-level rise. We divide the derived mass changes into two components: (1) from changes in melting and ice dynamics and (2) from changes in precipitation and accumulation rate. We use our firn compaction model to calculate the elevation changes driven by changes in both temperature and accumulation rate and to calculate the appropriate density to convert the accumulation-driven changes to mass changes. Increased losses from melting and ice dynamics (17–206 Gt a−1) are over seven times larger than increased gains from precipitation (10–35 Gt a−1) during a warming period of ∼2 K (10 a)−1 over the GIS. Above 2000 m elevation, the rate of gain decreased from 44 to 28 Gt a−1, while below 2000 m the rate of loss increased from 51 to 198 Gt a−1. Enhanced thinning below the equilibrium line on outlet glaciers indicates that increased melting has a significant impact on outlet glaciers, as well as accelerating ice flow. Increased thinning at higher elevations appears to be induced by dynamic coupling to thinning at the margins on decadal timescales.
Ten ice-sheet models are used to study sensitivity of the Greenland and Antarctic ice sheets to prescribed changes of surface mass balance, sub-ice-shelf melting and basal sliding. Results exhibit a large range in projected contributions to sea-level change. In most cases, the ice volume above flotation lost is linearly dependent on the strength of the forcing. Combinations of forcings can be closely approximated by linearly summing the contributions from single forcing experiments, suggesting that nonlinear feedbacks are modest. Our models indicate that Greenland is more sensitive than Antarctica to likely atmospheric changes in temperature and precipitation, while Antarctica is more sensitive to increased ice-shelf basal melting. An experiment approximating the Intergovernmental Panel on Climate Change’s RCP8.5 scenario produces additional first-century contributions to sea level of 22.3 and 8.1 cm from Greenland and Antarctica, respectively, with a range among models of 62 and 14 cm, respectively. By 200 years, projections increase to 53.2 and 26.7 cm, respectively, with ranges of 79 and 43 cm. Linear interpolation of the sensitivity results closely approximates these projections, revealing the relative contributions of the individual forcings on the combined volume change and suggesting that total ice-sheet response to complicated forcings over 200 years can be linearized.
The rock art and the associated natural scenery at 38 sites located in the Zuojiang River valley, in the southwest of Guangxi Zhuang Autonomous Region, southern China, were inscribed recently on UNESCO’s World Heritage List. The painted panel at the site of Mt. Huashan is probably the largest known rock art panel in the world, consisting of approximately 1900 identifiable figures and occupying an area of approximately 8000 m2. To determine a precise age on the rock art at Mt. Huashan, 56 secondary carbonate layers above and below the paintings were studied for their mineralogy, oxygen, and carbon isotopic compositions and dated by the 230Th/U method. The 230Th/U dating results demonstrate that ages of the rock paintings can be bracketed between 1856±16 and 1728±41yr BP corresponding to the middle to the end of the Eastern Han dynasty (AD 25 to 220). The results imply that the rock painting practices at Mt. Huashan probably lasted more than a century, and the Zuojiang rock art is younger than that at Baiyunwan and Cangyuan in Yunnan Province by 1 to 10 centuries.
Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT).
To test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive–behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years.
Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years.
In total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P = 0.90) and worse social function with CBT-HA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT-HA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT-HA except for non-significant greater differences in those with moderate or severe personality disorder.
The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.
The Chinese giant salamander Andrias davidianus is endemic to China and is Critically Endangered, largely because of overexploitation for food. This species is an expensive delicacy in China, and a rapidly growing industry to farm the species has developed throughout much of the country, centred on the Qinling Mountain region of Shaanxi Province. During a 2010 workshop on Chinese giant salamander conservation, which involved a range of stakeholders from across China, it became clear that the conservation community knew little about the salamander farming industry and whether it posed actual or potential threats or opportunities for conservation of the Chinese giant salamander. We therefore conducted a series of investigations to understand the industry better. Our results indicate that although farming of Chinese giant salamanders has the potential to be a positive development for conservation by supplying market demand with farmed animals, it is currently more likely to threaten than support conservation of the species, with continued overexploitation and the potential added impacts of infectious disease and genetic pollution arising from farming practices such as movement of animals across the country and the release of untreated farm wastewater and farmed salamanders to the wild.
This paper is a preliminary attempt at a history of the western world's interest in Chinese currency and numismatics. It focuses on Western language publications of the eighteenth and nineteenth centuries, and pays particular attention to the backgrounds of the authors of those publications on the grounds that they were the first people to shape the field in Europe and the USA.
This work deals with the influence of sodium on the properties of CZTSSe material and solar cells. For that purpose, two types of substrates are compared, one with low sodium content (borosilicate glass), the other one with higher sodium content (soda-lime glass). In each case the Na-content in the CZTSSe passing from the substrate through the Mo back contact is quantified by secondary ion mass spectroscopy analysis. Photoluminescence spectroscopy indicates that better quality material is achievable when increasing the Na-content in the CZTSSe. The material characterization results are compared to the photovoltaic properties. Index Terms — Cu2ZnSn(S1-xSex)4, CZTSSe, CZTS, CZTSe, Sodium, Kesterite, thin film, solar cell.
The kingdom of Khotan lay 2,628 kilometres to the north-west of the Tang capital at Chang'an. Strategically located in the south-west of the Taklamakan Desert, Khotan was a meeting point of different ethnic groups, languages, cultures and traditions, and was renowned as a centre of Buddhism. With its unique combination of influences, Khotanese society was quite different from that of Turfan to the north of the Taklamakan. In addition to the indigenous practices and traditions that developed in Khotan, this kingdom was always under the influence of major external political powers: Khotan was a vassal kingdom of the Hephtalites or Turkic peoples during the sixth century, came under increasing Chinese influence in the seventh and eighth centuries, was under Tibetan occupation from the 790s to 840s, and thereafter under the Chinese again. The secular documentary evidence from Khotan, written in Khotanese and Chinese, from the seventh and eighth centuries reflects everyday life there, and reveals the impact of Chinese administrative changes on traditional practices.
When the Tang dynasty took power in 618, it inherited the multicurrency system of earlier dynasties. The zuyongdiao tax system, in effect from the start of the dynasty, required each taxpayer to submit taxes in grain, labour and cloth. At the same time, the government also minted coins, which constituted some 10 per cent of the total money supply. A persistent shortage of copper limited the number of minted coins the government could issue. Accordingly, officials tried to ensure that sufficient coins and textiles circulated so that both forms of money remained in use. They displayed no consistent preference for one form of money over the other but devised policies to encourage the use of whichever form was then in short supply.
Most economists and historians today conceive of money in narrow terms – probably because they have grown up in the modern world and are used to our system of coins, paper notes, cheques and credit cards. Although economic historians are generally aware that some earlier societies (in Africa, Scandinavia and elsewhere) used other items as money, they do not usually pay much attention to these examples. Few realise that the government of China, governing an empire of some 60 million people during the Tang dynasty (618–907), implemented a complex financial system that recognised grain, coins and textiles as money. The government received taxes in coin and in kind, produced to specific standards (specific widths and lengths of textiles) that would then be redistributed, being used for official salaries and military expenses among other expenditures. Although some of the surviving evidence comes from the Silk Road sites of Turfan, Dunhuang and Khotan in northwest China (where the dry climate has preserved many documents and some actual examples of tax textiles), this multicurrency system was in use throughout the entire empire during the seventh to tenth centuries. At the time, Tang China was possibly the largest economy in the world, rivalled only by the Abbasid Empire (751–1258).
The idea for this project was Helen Wang's. At the International Symposium of Ancient Coins and the Culture of the Silk Road, organised by the Shanghai Museum, in December 2006, she asked Rong Xinjiang and Valerie Hansen if they would be interested in working together on the theme of textiles as money on the Silk Road. Too often, money is assumed to mean metal coins, and the abstract concept of the Silk Road is used to evoke a somewhat ethereal east-meets-west context. While the idea of silk as money is not new to those who know Chinese history, it seemed that few people had really explored the mechanics of how textiles were used in this way.