We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
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 no-reply@cambridge.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.
Background:
Infection prevention and control (IPC) workflows are often retrospective and manual. New tools, however, have entered the field to facilitate rapid prospective monitoring of infections in hospitals. Although artificial intelligence (AI)–enabled platforms facilitate timely, on-demand integration of clinical data feeds with pathogen whole-genome sequencing (WGS), a standardized workflow to fully harness the power of such tools is lacking. We report a novel, evidence-based workflow that promotes quicker infection surveillance via AI-assisted clinical and WGS data analysis. The algorithm suggests clusters based on a combination of similar minimum inhibitory concentration (MIC) data, timing of sample collection, and shared location stays between patients. It helps to proactively guide IPC professionals during investigation of infectious outbreaks and surveillance of multidrug-resistant organisms and healthcare-acquired infections. Methods: Our team established a 1-year workgroup comprised of IPC practitioners, clinical experts, and scientists in the field. We held weekly roundtables to study lessons learned in an ongoing surveillance effort at a tertiary care hospital—utilizing Philips IntelliSpace Epidemiology (ISEpi), an AI-powered system—to understand how such a tool can enhance practice. Based on real-time case discussions and evidence from the literature, a workflow guidance tool and checklist were codified. Results: In our workflow, data-informed clusters posed by ISEpi underwent triage and expert follow-up analysis to assess: (1) likelihood of transmission(s); (2) potential vector(s) identity; (3) need to request WGS; and (4) intervention(s) to be pursued, if warranted. In a representative sample (spanning October 17, 2019, to November 7, 2019) of 67 total isolates suggested for inclusion in 19 unique cluster investigations, we determined that 9 investigations merited follow-up. Collectively, these 9 investigations involved 21 patients and required 115 minutes to review in ISEpi and an additional 70 minutes of review outside of ISEpi. After review, 6 investigations were deemed unlikely to represent a transmission; the other 3 had potential to represent transmission for which interventions would be performed. Conclusions: This study offers an important framework for adaptation of existing infection control workflow strategies to leverage the utility of rapidly integrated clinical and WGS data. This workflow can also facilitate time-sensitive decisions regarding sequencing of specific pathogens given the preponderance of available clinical data supporting investigations. In this regard, our work sets a new standard of practice: precision infection prevention (PIP). Ongoing effort is aimed at development of AI-powered capabilities for enterprise-level quality and safety improvement initiatives.
Funding: Philips Healthcare provided support for this study.
Disclosures: Alan Doty and Juan Jose Carmona report salary from Philips Healthcare.
The structural changes recent-onset posttraumatic stress disorder (PTSD) subjects were rarely investigated. This study was to compare temporal and causal relationships of structural changes in recent-onset PTSD with trauma-exposed control (TEC) subjects and non-TEC subjects.
Methods
T1-weighted magnetic resonance images of 27 PTSD, 33 TEC and 30 age- and sex-matched healthy control (HC) subjects were studied. The causal network of structural covariance was used to evaluate the causal relationships of structural changes in PTSD patients.
Results
Volumes of bilateral hippocampal and left lingual gyrus were significantly smaller in PTSD patients and TEC subjects than HC subjects. As symptom scores increase, reduction in gray matter volume began in the hippocampus and progressed to the frontal lobe, then to the temporal and occipital cortices (p < 0.05, false discovery rate corrected). The hippocampus might be the primary hub of the directional network and demonstrated positive causal effects on the frontal, temporal and occipital regions (p < 0.05, false discovery rate corrected). The frontal regions, which were identified to be transitional points, projected causal effects to the occipital lobe and temporal regions and received causal effects from the hippocampus (p < 0.05, false discovery rate corrected).
Conclusions
The results offer evidence of localized abnormalities in the bilateral hippocampus and remote abnormalities in multiple temporal and frontal regions in typhoon-exposed PTSD patients.
Earlier studies examining structural brain abnormalities associated with cognitively derived subgroups were mainly cross-sectional in design and had mixed findings. Thus, we obtained cross-sectional and longitudinal data to characterize the extent and trajectory of brain structure abnormalities underlying distinct cognitive subtypes (“preserved,” “deteriorated,” and “compromised”) seen in psychotic spectrum disorders.
Methods.
Data from 364 subjects (225 patients with psychotic conditions and 139 healthy controls) were first used to determine the relationship of cognitive subtypes with cross-sectional measures of subcortical volume and cortical thickness. To probe neurodevelopmental abnormalities, brain structure laterality was examined. To examine whether neuroprogressive abnormalities persist, longitudinal brain structural changes over 5 years were examined within a subset of 101 subjects. Subsequent discriminant analysis using the identified brain measures was performed on an independent subject group.
Results.
Cross-sectional comparisons showed that cortical thinning and limbic volume reductions were most widespread in “deteriorated” cognitive subtype. Laterality comparisons showed more rightward amygdala lateralization in “compromised” than “preserved” subtype. Longitudinal comparisons revealed progressive hippocampal shrinkage in “deteriorated” compared with healthy controls and “preserved” subtype, which correlated with worse negative symptoms, cognitive and psychosocial functioning. Post-hoc discrimination analysis on an independent group of 52 subjects using the identified brain structures found an overall accuracy of 71% for classification of cognitive subtypes.
Conclusion.
These findings point toward distinct extent and trajectory of corticolimbic abnormalities associated with cognitive subtypes in psychosis, which can allow further understanding of the biological course of cognitive functioning over illness course and with treatment.
Ketosis is a metabolic disease of dairy cows often characterized by high concentrations of ketone bodies and fatty acids, but low milk protein and milk production. The Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) and the mechanistic target of rapamycin (mTOR) signaling pathways are central for the regulation of milk protein synthesis. The effect of high levels of fatty acids on these pathways and β-casein synthesis are unknown in dairy cows with clinical ketosis. Mammary gland tissue and blood samples were collected from healthy (n = 15) and clinically-ketotic (n = 15) cows. In addition, bovine mammary epithelial cells (BMEC) were treated with fatty acids, methionine (Met) or prolactin (PRL), respectively. In vivo, the serum concentration of fatty acids was greater (P > 0.05) and the percentage of milk protein (P > 0.05) was lower in cows with clinical ketosis. The JAK2-STAT5 and mTOR signaling pathways were inhibited and the abundance of β-casein was lower in mammary tissue of cows with clinical ketosis (P > 0.05). In vitro, high levels of fatty acids inhibited the JAK2-STAT5 and mTOR signaling pathways (P > 0.05) and further decreased the β-casein synthesis (P > 0.05) in BMEC. Methionine or PRL treatment, as positive regulators, activated the JAK2-STAT5 and mTOR signaling pathways to increase the β-casein synthesis. Importantly, the high concentration of fatty acids attenuated the positive effect of Met or PRL on mTOR, JAK2-STAT5 pathways and the abundance of β-casein (P > 0.05). Overall, these data indicate that the high concentrations of fatty acids that reach the mammary cells during clinical ketosis inhibit mTOR and JAK2-STAT5 signaling pathways, and further suppress β-casein synthesis.
This work demonstrates a double-step method, a simple chemical bath deposition and an in situ polymerization process, to synthesize the stable structure of a composite of Polyaniline/BiVO4/cellulose aerogel (PBC) in wastewater treatment. The poor stability of the carrier catalyst was improved significantly by forming a dense film of polyaniline (PANI) through polymerization on BiVO4/cellulose aerogel (BC). The developed three-dimensional porous structure enhanced photocatalytic stability. For instance, photocatalytic degradation of a dye, methylene blue, reached to 91.67% under the eight times successive irradiation of the visible light. The resulted fine performance could be owed to the strong adsorption of cellulose aerogel, uniform spreading of BiVO4, and the speedy electron separation efficiency of PBC. Moreover, the photocatalytic mechanisms including the role of the free radicals (•OH and •O2−) of the developed PBC were also discussed. The novel structure may present a new insight into the development of the carrier catalyst.
Let
$\{M_{n}\}_{n=1}^{\infty }$
be a sequence of expanding matrices with
$M_{n}=\operatorname{diag}(p_{n},q_{n})$
, and let
$\{{\mathcal{D}}_{n}\}_{n=1}^{\infty }$
be a sequence of digit sets with
${\mathcal{D}}_{n}=\{(0,0)^{t},(a_{n},0)^{t},(0,b_{n})^{t},\pm (a_{n},b_{n})^{t}\}$
, where
$p_{n}$
,
$q_{n}$
,
$a_{n}$
and
$b_{n}$
are positive integers for all
$n\geqslant 1$
. If
$\sup _{n\geqslant 1}\{\frac{a_{n}}{p_{n}},\frac{b_{n}}{q_{n}}\}<\infty$
, then the infinite convolution
$\unicode[STIX]{x1D707}_{\{M_{n}\},\{{\mathcal{D}}_{n}\}}=\unicode[STIX]{x1D6FF}_{M_{1}^{-1}{\mathcal{D}}_{1}}\ast \unicode[STIX]{x1D6FF}_{(M_{1}M_{2})^{-1}{\mathcal{D}}_{2}}\ast \cdots \,$
is a Borel probability measure (Cantor–Dust–Moran measure). In this paper, we investigate whenever there exists a discrete set
$\unicode[STIX]{x1D6EC}$
such that
$\{e^{2\unicode[STIX]{x1D70B}i\langle \unicode[STIX]{x1D706},x\rangle }:\unicode[STIX]{x1D706}\in \unicode[STIX]{x1D6EC}\}$
is an orthonormal basis for
$L^{2}(\unicode[STIX]{x1D707}_{\{M_{n}\},\{{\mathcal{D}}_{n}\}})$
.
The aim of the present study was to explore the influence of tea consumption on diabetes mellitus in the Chinese population. This multi-centre, cross-sectional study was conducted in eight sites from south, east, north, west and middle regions in China by enrolling 12 017 subjects aged 20–70 years. Socio-demographic and general information was collected by a standardised questionnaire. A standard procedure was used to measure anthropometric characteristics and to obtain blood samples. The diagnosis of diabetes was determined using a standard 75-g oral glucose tolerance test. In the final analysis, 10 825 participants were included and multiple logistic models and interaction effect analysis were applied for assessing the association between tea drinking with diabetes. Compared with non-tea drinkers, the multivariable-adjusted OR for newly diagnosed diabetes were 0·80 (95 % CI 0·67, 0·97), 0·88 (95 % CI 0·71, 1·09) and 0·86 (95 % CI 0·67, 1·11) for daily tea drinkers, occasional tea drinkers and seldom tea drinkers, respectively. Furthermore, drinking tea daily was related to decreased risk of diabetes in females by 32 %, elderly (>45 years) by 24 % and obese (BMI > 30 kg/m2) by 34 %. Moreover, drinking dark tea was associated with reduced risk of diabetes by 45 % (OR 0·55; 95 % CI 0·42, 0·72; P < 0·01). The results imply that drinking tea daily was negatively related to risk of diabetes in female, elderly and obese people. In addition, drinking dark tea was associated with decreased risk of type 2 diabetes mellitus.
This study examines the masculinity of Chinese male migrants who earn their living as “dance hosts.” Dance hosts partner middle-aged women in dance halls, sell experiences of intimacy and engage in ongoing romantic relationships with their female clients. This article seeks to capture an intimate and “up-close” portrait of (heterosexual) male dance hosting, and then further addresses dance hosts’ masculine subjectivity by examining the coping strategies they use to overcome the stigma attached to their profession and to assert their masculinity. Ultimately, the article argues that the process of masculine subjectivity formation in the case of male dance hosts is structured by dominant norms of Chinese masculinity. Although seemingly highly subversive, the relationship between dance hosts and clients in fact fulfils conventional gender ideals and encourages the perpetuation of traditional gender roles in China's patriarchal society. This work seeks to offer an understanding of traditional gender norms (or ideals) through the lens of normative Chinese masculinity within the context of a stigmatized occupation.
We established a mastitis model using exogenous infection of the mammary gland of Chinese Holstein cows with Staphylococcus aureus and extracted total RNA from S. aureus-infected and healthy mammary quarters. Differential expression of genes due to mastitis was evaluated using Affymetrix technology and results revealed a total of 1230 differentially expressed mRNAs. A subset of affected genes was verified via Q-PCR and pathway analysis. In addition, Solexa high-throughput sequencing technology was used to analyze profiles of miRNA in infected and healthy quarters. These analyses revealed a total of 52 differentially expressed miRNAs. A subset of those results was verified via Q-PCR. Bioinformatics techniques were used to predict and analyze the correlations among differentially expressed miRNA and mRNA. Results revealed a total of 329 pairs of negatively associated miRNA/mRNA, with 31 upregulated pairs of mRNA and 298 downregulated pairs of mRNA. Differential expression of miR-15a and interleukin-1 receptor-associated kinase-like 2 (IRAK2), were evaluated by western blot and luciferase reporter assays. We conclude that miR-15a and miR-15a target genes (IRAK2) constitute potential miRNA–mRNA regulatory pairs for use as biomarkers to predict a mastitis response.
The Pennsylvania Longitudinal Study of Parents and Children Twin Registry was developed to capture a representative sample of multiple births and their parents in the state of Pennsylvania. The registry has two main efforts. The first began in 2012 through recruitment of adolescents in Pennsylvania schools. The second effort began in January 2019 in partnership with the Pennsylvania Department of Health to capture the birth cohort of twins born from 2007 to 2017. Study recruitment, sample demographics, focus and measures are provided, as well as future directions.
To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Methods:
Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
Results:
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).
Conclusions:
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.
The Beijing Twin Study (BeTwiSt), which was established in 2006, is an ongoing study aiming to investigate the genetic and environmental etiology of adolescent psychopathology. Resting-state brain imaging datasets have been examined for same-sex twins, and other psychological traits and emotional and behavioral variables have been examined for all twins. Based on the registry, the main findings regarding the etiological mechanism underlying adolescent development, magnetic resonance imaging results, and genetic and environmental influences on other psychological traits have been published. This article summarizes the key findings in these three areas and discusses future plans for the BeTwiSt.
Hierarchically porous poly(L-lactic acid) (PLLA)/poly(ε-caprolactone) (PCL) monolithic composites were fabricated by nonsolvent-induced phase separation (NIPS) method without any template for the first time. A homogeneous hierarchical porous structure with relatively large specific surface area containing both mesopores and macropores was confirmed by pore size distribution plots and scanning electron microscopy images, respectively. Fourier transform infrared analysis (FTIR) revealed that PLLA and PCL were physically blended. Differential scanning calorimeter (DSC) analysis further showed that the two components were physically blended but had a slight thermal compatibility. Meanwhile, X-ray diffraction (XRD) tests indicated that the addition of PCL hindered the crystallization of PLLA. Herein, the formation of the mesopores and macropores during the phase separation process was explained from the microscopic point of view according to the results of XRD and DSC. The present monolithic composites with hierarchically porous structures had promising prospect for applications of tissue engineering.
In this paper, the hardness and Young’s moduli along the diffusion paths in fcc Ni–X (X = Rh, Ta, W, Re, Os, and Ir) binary diffusion couples were measured by using the nanoindentation technique. Hardness increases gradually from the pure Ni to the fcc Ni–X alloys, except for the Ni–Os system. While the Young’ moduli in fcc Ni–X alloys scatter much larger and do not show noticeable variation with the addition of element X. After that, the CALPHAD models for description of the composition-dependent hardness and Young’s modulus were proposed, and an in-house code was developed. Based on the present experimental data, the CALPHAD-type descriptions for hardness and Young’s modulus in fcc Ni–X (X = Rh, Ta, W, Re, Os, and Ir) systems were obtained. The model-predicted hardness and Young’s moduli of composition dependence agree with the experimental data in general. It is anticipated that the presently obtained CALPHAD-type hardness and Young’s modulus descriptions, together with the previous thermodynamic and atomic mobility databases, can be used for the future alloy design of novel Ni-based superalloys.
Surface molecularly imprinted polymer of solanesol (SA-SMIP) was prepared by reversed phase suspension polymerization using modified titanium dioxide (TiO2) as carrier, and operation conditions were investigated and optimized. Structures of modified TiO2 and SA-SMIP obtained at optimal conditions were characterized by Fourier transform infrared spectrometer adopting original TiO2 and non-surface molecularly imprinted polymer as reference. The SA-SMIP synthesized under optimal conditions displayed an excellent recognition of SA from the mixture of SA and triacontanol. The maximum separation degree of SA was 2.90. Finally, the adsorption kinetics and isotherm were investigated and analyzed. Adsorption kinetics results indicated that the adsorption of SA-SMIP to SA was a pseudo-second order process, and the adsorption of beginning and later stages was controlled by homogeneous particle diffusion and adsorption reaction process, respectively. Adsorption isotherm results documented hereby were two sorts of bonding sites, complete imprinted cavities and defective imprinted cavities. The adsorption for two bonding sites could be well lined up with the Langmuir model.
In this work, flavonoids in Polygonum cuspidatum Sieb. et Zucc. were extracted by ultrasound-assisted methodology and determined by ultraviolet–visible spectrophotometry. After that, extraction conditions were optimized by the single fact investigation, the central composite design, and response surface methodology (RSM) in turn. The results showed the optimal values of ethanol concentration, solid–liquid ratio, extraction temperature, extraction time, ultrasonic power, and number of extraction times were 60%, 1:20 (g/mL), 45 °C, 34 min; 80 W, and 5, respectively. The extraction ratio of flavonoids could be as high as 94.50%. The influence order of each factor was ultrasonic power > extraction time > extraction temperature > ethanol concentration. The results also showed that the experimental value was close to the predicted value (94.49%) of the established model by RSM, which proved that the established model was reasonable. The thermodynamic results showed that the extraction process was endothermic and could proceed spontaneously.
A field study to optimize the nitrogen (N) top-dressing mode of panicle fertilization and improve rice yields was conducted in mid-eastern China. Japonica cultivar Yunongjing-6 was grown and panicle N fertilizer was applied at the beginning of the inverted fourth leaf stage using three different modes: manual broadcast application (BA) on the soil surface as a control treatment, deep application during ditching at a depth of 15 cm (DD) and manual BA on the soil surface during deep ditching (BAD). The activity of soil enzymes, including invertase, urease, phosphatase and catalase, was increased significantly at the jointing, booting and grain-filling stages with the DD and BAD treatments compared with the traditional BA mode. The DD and BAD treatments also increased basal internode and neck-panicle internode bleeding intensity. The DD treatment gave the highest crop yield, increasing the yield by 0.63 and 0.31 t/hm2 in 2011 and 2012, respectively, compared with BA. The results suggest that ditching during panicle N fertilizer application after sun-drying of the fields increases rice yields, most likely by improving the activity of soil enzymes and enhancing the physiological activity of roots and grain weight.
In most of video coding standards such as high efficiency video coding (HEVC), I-frame assignment is periodic even when the content change is minor, which degrades the coding efficiency. This paper proposes an I-frame assignment method based on Nash bargaining solution (NBS) in game theory to solve this problem. The encoded sequence is divided into several subsequences. Each subsequence is regarded as a game. All group of picture (GOP) in a subsequence is further divided into several sets of GOP. Each set of GOP is regarded as a player and compete for the number of I-frames. The optimal I-frame assignment is determined based on the generalized NBS. Experimental results show the proposed method outperforms HEVC by 5.21% bitrate saving.