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Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.
Fatigue performance of metallic nanolayered composites (NLCs) has been gaining more and more attention due to the rapid development in the field of both micro-electro-mechanical systems and high-performance engineering structure materials and the increasing demand for long-term fatigue reliability. Metallic NLCs have exhibited different damage behaviors due to the effect of high-density heterogeneous interface compared with bulk materials and thin metal films. In this review paper, the cyclic deformation damage behavior, fatigue cracking feature, and fatigue properties of some metallic NLCs are reviewed. Effects of length scales, including layer thickness and grain size, on fatigue damage behaviors of the NLCs are revealed, and the transition of the fatigue cracking behavior and the corresponding damage mechanism are discussed. Then, the fatigue properties of some typical metallic NLCs are presented and compared with that of bulk materials and metal thin films. The effect of interface type and grain boundary alignment is also discussed to correlate with fatigue cracking resistance of the NLCs. Finally, some prospective research topics on fatigue performance of metallic NLCs are addressed.
Maternal dietary patterns and macronutrients intake have been shown to affect the development of gestational diabetes mellitus (GDM), but the findings are inconsistent. We aimed to identify maternal dietary patterns and examine their associations with GDM risk, and to evaluate the contributions of macronutrients intake to these associations. We included 2755 Chinese pregnant women from the Tongji Maternal and Child Health Cohort. Dietary intakes were assessed using a validated semi-quantitative FFQ 2 weeks before the diagnosis of GDM. GDM (n 248) was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24–28 weeks gestation. We derived five different dietary patterns from a principal component analysis. The results showed that high fish–meat–eggs scores, which were positively related to protein intake and inversely related to carbohydrate intake, were associated with a higher risk of GDM (adjusted OR for quartile 4 v. quartile 1: 1·83; 95 % CI 1·21, 2·79; Ptrend=0·007) and higher plasma glucose levels. In contrast, high rice–wheat–fruits scores, which were positively related to carbohydrate intake and inversely related to protein intake, were associated with lower risk of GDM (adjusted OR for quartile 3 v. quartile 1: 0·54; 95 % CI 0·36, 0·83; Ptrend=0·010) and lower plasma glucose levels. In addition, dietary protein and carbohydrate intake significantly contributed to the associations between dietary patterns and GDM risk or glucose levels. These findings suggest that a dietary pattern characterised by high protein and low carbohydrate intake in pregnancy was associated with a higher risk of GDM, which may provide important clues for dietary guidance during pregnancy to prevent GDM.
Introduction: To investigate the effects of paroxetine (PAR) on motor and cognitive function recovery in patients with non-depressed ischemic stroke (nD-AIS).
Methods: One hundred sixty-seven patients hospitalized for non-depressed acute ischemic stroke were selected and divided into treatment (T) and control (C) groups using a random number table. All patients received conventional secondary ischemic stroke prevention and rehabilitation training; patients in Group T additionally received treatment with PAR (10 mg/day during week 1 and 20 mg/day thereafter) for 3 months. The follow-up observation lasted 6 months. The Fugl–Meyer motor scale (FMMS), Montreal cognitive assessment (MoCA), and Hamilton depression scale (HAMD) were used on D0, D15, D90, and D180 (T0, 1, 2, and 3, respectively; D180 = 90 days after treatment cessation) after study initiation, and scores were compared between the groups.
Results: The FMMS and MoCA scores differed significantly between Groups T and C at T2 and T3 (p < .05); by contrast, these scores did not differ significantly between the groups at T1 (p > .05). Furthermore, the HAMD scores differed significantly between the two groups at T3 (p < .05), but not at T1 and T2 (p > .05).
Conclusions: PAR treatment may improve motor and cognitive function recovery in patients with nD-AIS. Moreover, PAR may reduce the occurrence of depression after stroke.
Dietary energy density (ED) might have influences on body composition. We therefore examined whether ED is associated with body composition among Chinese adults.
We collected dietary data through validated two-day 24 h recalls. ED, defined as the amount of energy per unit weight of food consumed, was calculated based on five methods. Multiple linear regression analyses were performed to explore the associations between ED and body composition parameters, including BMI, fat mass index (FMI), fat-free mass index (FFMI), percentage body fat (%BF) and waist circumference (WC).
Chinese adults (n 1933) in 2013.
After adjusting the covariates, all ED definitions were positively associated with BMI, FMI, FFMI, %BF and WC among women (P<0·01). In men, however, ED with foods only was positively associated with BMI, FMI, FFMI and %BF (P<0·05), but not with WC (P=0·07); we also found null associations between ED with foods and all beverages and body composition among men. Additionally, ED contributed to higher increases of body composition in women than in men (P<0·01).
The present study supports the positive association between ED and body composition among adults in Southwest China, in which beverages may play an important role.
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.
The novel visible-light-responsive direct solid-state Z-scheme g-C3N4/BiOI heterojunction has been synthesized successfully by means of a solid phase calcination method and used for the degradation of microcystin-LR (MC-LR). The layered g-C3N4 disperses on the surface of BiOI microspheres. The samples are characterized by FESEM, HRTEM, XRD, FT-IR, UV-vis spectroscopy, XPS, BET, PL, and Mott–Sckottky. The photocatalytic activity and photodegradation mechanism of the as-prepared g-C3N4/BiOI microsphere photocatalysts are conducted under visible light irradiation using MC-LR as the target pollutant. The g-C3N4/BiOI material exhibits superior photocatalytic performance when compared with pure BiOI, the possible reason is the efficient separation of photogenerated carriers at the interface between g-C3N4 and BiOI. The heterostructure is responsible for the improved separation efficiency of photogenerated electron–hole pairs and thus the higher photocatalytic activity. The possible photocatalytic mechanism is proposed based on relative band positions of these two semiconductors.
A comprehensive geochronological and geochemical study was carried out on the gneissic monzogranites, porphyritic granodiorites and charnockites in the Gaozhou complex of the Yunkai massif in the southern part of the South China block to better understand the Early Palaeozoic tectonic regime of the South China block. Laser ablation – inductively coupled plasma – mass spectrometry (LA-ICP-MS) U–Pb dating of zircons indicates an age of 453.2 ± 5.1 Ma to the formation of the gneissic monzogranites, whereas the porphyritic granodiorites and charnockites were generated at 437.0 ± 1.5 Ma and 435.2 ± 2.2 Ma, respectively. The gneissic monzogranites show geochemical features consistent with the high-K, calc-alkaline rock series and are strongly peraluminous. They have SiO2 contents ranging from 67.75 to 69.65 wt. % and relatively low CaO contents (1.66–1.94 wt. %). Their REE patterns are fractionated with enriched LREEs and negative Eu anomalies. The samples also show enrichment in LILEs (e.g. Rb and K) and Pb, and depletion in Sr, Ba and HFSEs (e.g. Nb, Ta, Ti and P). They have εNd(t) values of −8.2 to −7.7. Conversely, the porphyritic granodiorites and charnockites are characterized as medium-K, calc-alkaline rock series and weakly to strongly peraluminous. They exhibit pronounced depletions in HFSEs and positive Pb anomalies. Compared to the earlier gneissic monzogranites, these rocks have relatively lower SiO2 (65.50–69.36 wt. %), but higher CaO contents (3.34–4.05 wt. %), and have slightly lower εNd(t) values (−9.1 to −8.4). Petrography and geochemical compositions of the gneissic monzogranites indicate that they are S-type granite and likely formed by partial melting of Neoproterozoic to Early Palaeozoic immature metagreywackes; whereas The porphyritic granodiorites and charnockites are A-type granite and likely derived from low degrees of partial melting of the dry, granulitic residue depleted by prior extraction of granitic melt. The new data for the Caledonian granitoids in the Yunkai massif suggest that they were formed in a post-collisional tectonic setting. They represent the earliest post-collisional alkaline magmatism reported so far in the Yunkai massif, and thus indicate a tectonic regime switch, from compression to extension, as early as the Late Ordovician to Early Silurian (~450–435 Ma).
We examined the in vitro developmental competence of parthenogenetic activation (PA) oocytes activated by an electric pulse (EP) and treated with various concentrations of AZD5438 for 4 h. Treatment with 10 µM AZD5438 for 4 h significantly improved the blastocyst formation rate of PA oocytes in comparison with 0, 20, or 50 µM AZD5438 treatment (46.4% vs. 34.5%, 32.3%, and 24.0%, respectively; P < 0.05). The blastocyst formation rate was higher in the group treated with AZD5438 for 4 h than in the groups treated with AZD5438 for 2 or 6 h (42.8% vs. 38.6% and 37.2%, respectively; P > 0.05). Furthermore, 66.67% of blastocysts derived from these AZD5438-treated PA oocytes had a diploid karyotype. The blastocyst formation rate of PA and somatic cell nuclear transfer (SCNT) embryos was similar between oocytes activated by an EP and treated with 2 mM 6-dimethylaminopurine for 4 h and those activated by an EP and treated with 10 µM AZD5438 for 4 h (11.11% vs. 13.40%, P > 0.05). In addition, the level of maturation-promoting factor (MPF) was significantly decreased in oocytes activated by an EP and treated with 10 µM AZD5438 for 4 h. Finally, the mRNA expression levels of apoptosis-related genes (Bax and Bcl-2) and pluripotency-related genes (Oct4, Nanog, and Sox2) were checked by RT-PCR; however, there were no differences between the AZD5438-treated and non-treated control groups. Our results demonstrate that porcine oocyte activation via an EP in combination with AZD5438 treatment can lead to a high blastocyst formation rate in PA and SCNT experiments.
This paper presents a reliable in-motion alignment algorithm for a low cost Strapdown Inertial Navigation System/Global Positioning System (SINS/GPS) combination under random misalignment angles, which transforms attitude alignment into an attitude estimation problem. Based on Rodrigues parameters, an alignment model with a linear state-space equation and a second order nonlinear measurement equation is established. Furthermore, by employing a Taylor expansion on the nonlinear measurement equation, we implement a second order Extended Kalman Filter (EKF2). The proposed method uses a single filter that can not only determine the initial attitude, but also estimate the sensor errors. In addition, a scheme is given for avoiding singularity, which makes the algorithm more widely suitable for random misalignment angles. Experimental ground tests are performed with a low-cost Micro-Electromechanical System (MEMS) SINS, which validates the efficacy of the proposed method. The performance compared to the traditional alignment algorithm is also given.
Some risk factors of stroke may play a role in white matter hyperintensity (WMH). Metabolic syndrome (MetS) is a recognised risk factor of stroke, but it is controversial whether MetS is also associated with WMH. We examined the association of MetS with the prevalence of WMH in acute stroke patients. We conducted a cross-sectional study in 246 acute ischemia stroke patients. The patients with acute stroke were clinically evaluated, including waistline circumference, blood pressure, glycaemia, serum triglyceride and high density lipoprotein cholesterol level. The degree of WMH was assessed by Fluid-attenuated inversion recovery (FLAIR) sequence of magnetic resonance imaging (MRI) scans. MetS was diagnosed using the criteria by the National Cholesterol Education Adult Treatment Panel III. MetS was the independent variable evaluated in Binary regression analyses. It is found that old age (>60 years old), MetS and smoking were significantly associated with WMH in univariate analysis (p < .05). Spearman rank correlation showed that old age and MetS are related to WMH (r = 0.18, p = .005 and r = 0.18, p = .004, respectively). Hypertension is weakly but not significantly associated with WMH in correlation analysis (r = 0.11, p = .08). In multiple regression analysis, age and MetS remained independently associated with WMH (OR = 7.6, 95% CI 0.2–0.7 and OR = 11.7, 95% CI 0.1–0.5). Hypertension and hyperglycaemia tend to be associated but not significantly with WMH (p = .07, p = .08). Other MetS components such as large waist circumference and dyslipidaemia showed no association with WMH. After adjustment for age, WMH is significantly associated with MetS in stroke patients. Hypertension and hyperglycaemia tend to associated but not significantly with WMH in stroke patients.
Palaeoproterozic metasedimentary rocks, also referred to as khondalites, characterized by Al-rich minerals, are extensively exposed in the nucleus of the Yangtze craton, South China block. Samples of garnet–sillimanite gneiss in the khondalite suite were collected from the Kongling complex for Nd isotopic and elemental geochemical study. These rocks are characterized by variable SiO2 contents ranging from 35.71 to 58.07 wt%, and have low CaO (0.45–0.84 wt%) but high Al2O3 (18.56–29.04 wt%), Cr (174–334 ppm) and Ni (42.5–153 ppm) contents. They have high CIW (Chemical Index of Weathering) values (90.4–94.7), indicating intense chemical weathering of the source material. The samples display light rare earth elements (LREE) enrichment with negative Eu anomalies (Eu/Eu*=0.40–0.68), and have flat heavy rare earth elements (HREE) patterns. The high contents of transition elements (e.g. Cr, Ni, Sc, V) and moderately radiogenic Nd isotopic compositions suggest that the paragneisses might be those of first-cycle erosion products of predominantly mafic rocks mixing with small amounts of felsic moderately evolved Archaean crustal source. Geochemical and Nd isotopic compositions reveal that at least some of the protoliths of Kongling khondalite were sourced from local pre-existing mafic igneous rocks in a continental arc tectonic setting. Combined with documented zircon U–Pb geochronological data, we propose that the Palaeoproterozoic high-pressure granulite-facies metamorphism, rapid weathering, erosion and deposition of the khondalites in the interior of the Yangtze craton might be related to a Palaeoproterozoic collisional orogenic event during 2.1–1.9 Ga, consistent with the worldwide contemporary orogeny, implying that the Yangtze craton may have been an important component of the Palaeoprotorozoic Columbia supercontinent.
In this work, fluorescent Bacillus subtilis (B. subtilis) cells were developed as probes for imaging applications and to explore behaviorial interaction between B. subtilis and Staphylococcus aureus (S. aureus). A novel biological strategy of coupling intracellular biochemical reactions for controllable biosynthesis of CdSe quantum dots by living B. subtilis cells was demonstrated, through which highly luminant and photostable fluorescent B. subtilis cells were achieved with good uniformity. With the help of the obtained fluorescent B. subtilis cells probes, S. aureus cells responded to co-cultured B. subtilis and to aggregate. The degree of aggregation was calculated and nonlinearly fitted to a polynomial model. Systematic investigations of their interactions implied that B. subtilis cells inhibit the growth of neighboring S. aureus cells, and this inhibition was affected by both the growth stage and the amount of surrounding B. subtilis cells. Compared to traditional methods of studying bacterial interaction between two species, such as solid culture medium colony observation and imaging mass spectrometry detection, the procedures were more simple, vivid, and photostable due to the efficient fluorescence intralabeling with less influence on the cells’ surface, which might provide a new paradigm for future visualization of microbial behavior.
Crack propagation behaviors in a precracked single crystal Ag under mode I loading at different temperatures are studied by molecular dynamics simulation. The simulation results show that the crack propagation behaviors are sensitive to external temperature. At 0 K, the crack propagates in a brittle manner. Crack tip blunting and void generation are first observed followed by void growth and linkage with the main crack, which lead to the propagation of the main crack and brittle failure immediately without any microstructure evolution. As the temperature gets higher, more void nucleations and dislocation emissions occur in the crack propagation process. The deformation of the single crystal Ag can be considered as plastic deformation due to dislocation emissions. The crack propagation dynamics characterizing the microstructure evolution of atoms around the crack tip is also shown. Finally, it is shown that the stress of the single crystal Ag changes with the crack length synchronously.
X-ray powder diffraction data, unit-cell parameters, and space group for letrozole, C17H11N5, are reported [a = 7.034(0) Å, b = 16.177(5) Å, c = 13.411(3) Å, α = γ = 90°, β = 105.71(9)°, unit-cell volume V = 1469.0(3) Å3, Z = 4, and space-group P21/c]. All measured lines were indexed and are consistent with the P21/c space group. No detectable impurity was observed.
Numerical investigations of body-wake interactions were carried out by simulating the flow over a rod–airfoil configuration using high-order implicit large eddy simulation (HILES) for the incoming velocity
and a Reynolds number based on the airfoil chord
. The flow over five different rod–airfoil configurations with different distances of
, 4, 6, 8 and 10, respectively, were calculated for the analysis of body-wake interaction phenomena. Various fundamental mechanisms dictating the intricate flow phenomena including force varying regulation, flow structures and flow patterns in the interaction region, turbulent fluctuations and their suppression, noise radiation and fluid resonant oscillation, have been studied systematically. Due to the airfoil downstream, a relatively higher base pressure is exerted on the surface of the cylinder upstream, and the pressure fluctuation on the surface of the rod–airfoil configuration with
is significantly suppressed, resulting in a reduction of the fluctuating lift. Following the distance between the cylinder and airfoil strongly decreases, Kármán-street shedding is suppressed due to the blocking effect. The flow in this interaction region has two opposite tendencies: the influence of the airfoil on the steady flow is to accelerate it and the counter-rotating vortices connecting with the leading edge of the airfoil tend to slow the flow down. There may be two flow patterns associated with the interference region, i.e. the Kármán-street suppressing mode and the Kármán-street shedding mode. The primary vortex shedding behind the cylinder upstream, and the shedding wake impingement onto the airfoil downstream, play a dominant role in the production of turbulent fluctuations. When primary vortex shedding is suppressed, the intensity of impingement is weakened, resulting in a significant suppression of the turbulent fluctuations. Due to these factors, a special broadband noise without a manifestly distinguishable peak is radiated by the rod–airfoil configuration with
. The fluid resonant oscillation within the flow interaction between the turbulent wake and the bodies was further investigated by adopting a feedback model, which confirmed that the effect of fluid resonant oscillation becomes stronger when
and 10. The results obtained in this study provide physical insight into the understanding of the mechanisms relevant to the body-wake interaction.
Post-flare loops (PFLs) usually appear in the late phase of eruptive flares as an arcade-like loop system. The Atmospheric Imaging Assembly (AIA) on-board the Solar Dynamics Observatory (SDO) delivers continuously high temporal and spatial resolution extreme ultraviolet (EUV) observations, providing a unique chance to study the PFLs. In this work, we use SDO/AIA high-quality EUV images to study the dark loop-like features in post-flare loops (DPFLs) of an X5.4 flare. Our analysis shows that: 1) the DPFLs are darker than their surrounding and the bright loops, but are brighter than the EUV background; 2) the DPFLs appear in multiple EUV channels, which indicates that they are absorption features; 3) the DPFLs are associated with downflows that are caused by the thermal instability in the cooling process of the flare.
To examine the vitamin D status, SNP of the vitamin D receptor gene (VDR) and the effects of vitamin D supplementation on parathyroid hormone and insulin secretion in adult males with obesity or normal weight in a subtropical Chinese city.
An intervention trial.
Shenzhen City, Guangdong Province, China.
From a cross-sectional survey conducted from June to July, eighty-two normal-weight and ninety-nine obese males (18–69 years) were screened to analyse their vitamin D status and for five SNP of VDR. From these individuals, in the same season of a different year, obese and normal-weight male volunteers (twenty-one per group) were included for an intervention trial with oral vitamin D supplementation at 1250 µg/week for 8 weeks.
For the survey, there was no significant difference (P>0·05) in baseline circulating 25-hydroxyvitamin D concentrations or in the percentages of participants in different categories of vitamin D status between the two groups. The VDR SNP, rs3782905, was significantly associated with obesity (P=0·043), but none of the examined SNP were correlated with serum 25-hydroxyvitamin D when adjusted for age, BMI and study group. After vitamin D supplementation, serum 25-hydroxyvitamin D concentration, hypersecretions of parathyroid hormone and insulin, and insulin resistance in the obese were changed beneficially (P<0·05); however, the increase in serum 25-hydroxyvitamin D was less than that of the normal-weight men.
For obese and normal-weight men of subtropical China, the summer baseline vitamin D status was similar. However, oral vitamin D supplementation revealed a decreased bioavailability of vitamin D in obese men and ameliorated their hypersecretion of parathyroid hormone and insulin resistance.
A continuous nonflux inclusion-removal method, rotating gas bubble stirring, is used to purify Mg–10Gd–3Y–0.5Zr melt. The effects of rotating gas bubble stirring process parameters (Ar flow rate, time, and rotating speed) on purifying effectiveness, mechanical properties, and fracture behavior of sand-cast Mg–10Gd–3Y–0.5Zr alloy are studied. The results show that too high or too low Ar flow rate is unfavorable for inclusion-removal. The results also indicate that the high rotary speed of spraying gas is helpful to improve the inclusion-removal and mechanical properties. But when the melt is subjected to overtime gas bubbling treatment, the mechanical properties became poor again. Nonflux purification does not change the microstructure of Mg–10Gd–3Y–0.5Zr alloy. However, rotating gas bubble stirring has a certain effect on the fracture pattern of the alloy. In addition, the melt purifying mechanism of the gas bubble stirring treatment for the sand-cast alloy was discussed systematically.