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 email@example.com
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.
Disabilities in physical activity and functional independence affect the early rehabilitation of stroke survivors. Moreover, a good instrument for assessing activity disability allows accurate assessment of physical disability and assists in prognosis determination.
To compare three assessment tools for physical activity in acute-phase stroke survivors.
We conducted this prospective observational study at an affiliated hospital of a Medical University in Shanghai, China, from June 2018 to November 2019. We administered three instruments to all patients during post-stroke days 5–7, including the Modified Barthel Index (MBI), Instrumental Activities of Daily Living (IADL), and modified Rankin scale (mRs). We analyzed correlations among the aforementioned scales and the National Institutes of Health Stroke Scale (NIHSS) using Spearman’s rank-order correlations test. Univariate analyses were performed using the Mann–Whitney U test. We used a binary logistic regression model to assess the association between the NIHSS (30 days) and patient-related variables. Finally, we used receiver operating characteristic (ROC) curves to assess the predictive value of the multivariate regression models.
There was a high correlation among the three instruments; furthermore, the MBI had a higher correlation with the NIHSS (days 5–7). The NIHSS (day 30) was correlated with thrombolysis. ROC analysis revealed that the mRs-measured disability level had the highest predictive value of short-term stroke severity (30 days).
The MBI was the best scale for measuring disability in physical activity, whereas the mRs showed better accuracy in short-term prediction of stroke severity.
The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan–Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO2/FiO2 value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.
Here, we present an overview of how a tertiary hospital responded to maintain necessary activities and protect patients and staff from the coronavirus disease (COVID-19) outbreak.
Gil Medical Center, a tertiary hospital in Incheon, has operated a special response team since January 21, 2020. All visitors were assessed for body temperature and respiratory symptoms, and screened for recent overseas travel. Suspected COVID-19 patients were taken to a screening clinic. All febrile patients with or without respiratory symptoms were taken to a respiratory safety clinic. An isolation ward, which consisted of 10 negative-pressure rooms, was used to treat confirmed cases. More than 120 beds were prepared for the outbreak, and patients with pneumonia were preemptively isolated.
By May 5, 480 960 visitors were assessed at the control station, 3350 patients visited the triage center, and 1794 were treated in the respiratory safety clinic. Seventeen confirmed cases were admitted to the negative isolation ward, and 350 patients with pneumonia were preemptively isolated. A total of 2977 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction tests were performed.
While tertiary hospitals play an important role in treating both COVID-19 patients and non-COVID-19 patients, hospital staff have to protect themselves from unexpected in-hospital transmission. A multifaceted response must be undertaken to protect tertiary hospitals and their staff during the COVID-19 epidemic.
As city residents eat out more frequently, it is unknown that if iodised salt is still required in home cooking. We analysed the relationship of household salt and eating out on urinary iodine concentration (UIC) in pregnant women. A household condiment weighing method was implemented to collect salt data for a week. A household salt sample was collected. A urine sample was taken at the end of the week. Totally, 4640 participants were investigated. The median UIC was 139·1 μg/l in pregnant women and 148·7, 140·0 and 122·9 μg/l in the first, second and third trimesters. Median UIC in the third trimester was lower than in the other trimesters (P < 0·001). The usage rates of iodised (an iodine content ≥ 5·0 mg/kg) and qualified-iodised (an iodine content ≥ 21·0 mg/kg) salt were 73·9 and 59·3 %. The median UIC in the qualified-iodised salt group was higher than in the non-iodised group (P = 0·037). The median UIC in the non-iodised group who did not eat out was lower than in qualified-salt groups who both did and did not eat out (P = 0·007, <0·001). The proportion of qualified-iodised salt used in home cooking is low, but foods eaten out have universal salt iodisation according to the national compulsory policy. Household iodised salt did not play a decisive role in the iodine status of pregnant women. Pregnant women in their third trimester who are not eating out and using non-iodised salt at home require extra iodine.
Dolostones are widely developed in the middle Permian rocks of East Yunnan, China, mainly in the shoal-facies Maokou Formation. The previously reported dolostone formation mechanisms cannot explain the distribution and geochemical characteristics of these dolostones, in particular their strontium, magnesium and oxygen isotope signatures. To help predict the distribution of dolostone reservoirs and reduce the exploration risk and cost, this study proposes a new model of dolomitization: open thermal convection dolomitization. In this new dolomitization model, Mg2+ in dolomitizing fluids originates mostly from seawater, with a minor component coming from deep hydrothermal fluids. Elevated heat flux (in this case due to the nearby Emei mantle plume) causes spatial temperature variations in the fluid along the circulation flow pathways, resulting in fast and pervasive dolomitization of limestone. The proposed model not only explains the characteristics and distribution of dolostones in the study area but also serves as a reference for predicting the distribution of dolostones in other areas subjected to thermal convection.
The present study evaluated the effects of dietary Zn level on growth performance, serum and hepatopancreas metabolites, expression of genes involved in lipid and energy metabolism, and the signalling pathway of dietary Zn-induced lipolysis. Five isonitrogenous and isolipidic diets were formulated to contain different Zn levels: 46·4 (basal diet), 77·2, 87·0, 117·1 and 136·8 mg/kg, respectively. The results indicated that shrimp fed the diet containing Zn at 117·1 mg/kg had higher weight gain and specific growth rate, and the lowest feed intake and feed conversion rate, than shrimp fed the other diets. The deposition rate of Zn in whole body significantly decreased with increasing dietary Zn level. Dietary Zn prevented the accumulation of free radicals and improved antioxidant activities by increasing Cu/Zn superoxide dismutase and reducing malondialdehyde in hepatopancreas. Dietary Zn supplementation enhanced lipase activity and adiponectin, which could promote TAG breakdown and fatty acid oxidation and lead to reduced lipid in hepatopancreas. The mRNA expressions of ob-rb, adipor, camkkβ, ampk, cd36, mcd and cpt1 involved in Zn-induced lipid catabolism were up-regulated, and the expressions of srebp, acc, fas and scd1 were down-regulated. The mRNA levels of SLC39 family genes (zip3, zip9, zip11 and zip14) in hepatopancreas were up-regulated with increasing dietary Zn level. The results demonstrated that dietary Zn level could significantly affect growth performance, tissue deposition of Zn, lipid metabolites and expression of genes involved in lipogenesis and lipolysis in Litopenaeus vannamei.
Situated between the North China Craton to the east and the Tarim Craton to the west, the northern Alxa area in westernmost Inner Mongolia in China occupies a key location for interpreting the late-stage tectonic evolution of the southern Central Asian Orogenic Belt. New LA-ICP-MS zircon U–Pb dating results reveal 282.2 ± 3.9 Ma gabbros and 216.3 ± 3.2 Ma granites from the Yagan metamorphic core complex in northern Alxa, NW China. The gabbros are characterized by low contents of Si, Na, K, Ti and P and high contents of Mg, Ca, Al and Fe. These gabbros have arc geochemical signatures with relative enrichments in large ion lithophile elements and depletions in high field strength elements, as well as negative εNd(t) (−0.91 to −0.54) and positive εHf(t) (2.59 to 6.37) values. These features indicate that a depleted mantle magma source metasomatized by subduction fluids/melts and contaminated by crustal materials was involved in the processes of magma migration and emplacement. The granites show high-K calc-alkaline and metaluminous to weakly peraluminous affinities, similar to A-type granites. They have positive εNd(t) (1.55 to 1.99) and εHf(t) (5.03 to 7.64) values. These features suggest that the granites were derived from the mixing of mantle and crustal sources and formed in a postcollisional tectonic setting. Considering previous studies, we infer that the final closure of the Palaeo-Asian Ocean in the central part of the southern Central Asian Orogenic Belt occurred in late Permian to Early–Middle Triassic times.
The association between milk consumption and the metabolic syndrome remains inconclusive, and data from Chinese populations are scarce. We conducted a cross-sectional study to investigate the association between milk consumption and the metabolic syndrome and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 5149 participants were included in the final analysis. A logistic regression model was applied to estimate the OR and 95 % CI for the prevalence of the metabolic syndrome and its components according to milk consumption. In addition, the results of our study were further meta-analysed with other published observational studies to quantify the association between the highest v. lowest categories of milk consumption and the metabolic syndrome and its components. There was no significant difference in the odds of having the metabolic syndrome between milk consumers and non-milk consumers (OR 0·86, 95 % CI 0·73, 1·01). However, milk consumers had lower odds of having elevated waist circumference (OR 0·78, 95 % CI 0·67, 0·92), elevated TAG (OR 0·83, 95 % CI 0·70, 0·99) and elevated blood pressure (OR 0·85, 95 % CI 0·73, 0·99). When the results were pooled together with other published studies, higher milk consumption was inversely associated with the risk of the metabolic syndrome (relative risk 0·80, 95 % CI 0·72, 0·88) and its components (except elevated fasting blood glucose); however, these results should be treated with caution as high heterogeneity was observed. In summary, the currently available evidence from observational studies suggests that higher milk consumption may be inversely associated with the metabolic syndrome.
A multilevel nonvolatile memory based on an amorphous indium–gallium–zinc oxide thin-film transistor is successfully demonstrated by using an atomic layer–deposited ZnO film as a charge trapping layer. The memory device shows a much higher erasing efficiency at a negative bias, i.e., after erasing at −13 V for 1 μs, the threshold voltage shift is as large as −7.4 V. In the case of 13 V/1 μs programming (P) and −12 V/1 μs erasing (E), the device demonstrates an ON/OFF readout drain current (IDS) ratio of ∼103 after 105 s, and a large and stable ON/OFF IDS ratio of ∼106 till 104 of P/E cycles. Furthermore, multilevel memory characteristics are also demonstrated on the device, showing an IDS ratio of >102 for 4 different states. Additionally, the device also successfully demonstrates typical synaptic behaviors, such as excitatory and inhibitory postsynaptic current with different memory times at different memory states.
Cinnamomum chago is a woody species of the family Lauraceae endemic to Yunnan province, China, previously known from only one location, and categorized as a Plant Species with Extremely Small Population. We surveyed to determine the distribution and population size of C. chago, characterize its habitat, identify any threats, assess its conservation status, and provide guidelines for its management and conservation. During 2014–2017 we found only 64 mature C. chago, in five locations. These small, fragmented populations occur along Lancang River in Dali Prefecture at altitudes of 2,200–2,400 m. The species' extent of occurrence is c. 923 km2, with an area of occupancy of c. 60 km2. The habitat of the species has been degraded by expansion of pastoral activities and deforestation. We recommend categorization of C. chago as Endangered on the IUCN Red List, prevention of the collection of seeds and wood of the species, protection and monitoring, and ex situ propagation for future reintroductions.
The dipeptide dl-methionyl-dl-methionine (Met-Met) has extremely low water solubility and better absorption than other methionine sources (such as dl-methionine and l-methionine) available in the market. Therefore, six diets (D1, D2, D3, D4, D5 and D6) containing 0, 0·07, 0·15, 0·21, 0·28 and 0·38 % Met-Met were formulated to investigate the effects of Met-Met in juvenile Nile tilapia, Oreochromis niloticus (17 g initial body weight). The results indicated that percentage weight gain and specific growth rate of fish fed with D2 and D3 diets were higher than those fed with D1, D4–D6 diets. The levels of total essential amino acid in whole body of fish fed with D3 and D4 diets were significantly higher than those fed the D1 diet. Superoxide dismutase activity and malondialdehyde content have no significant difference in fish fed the diet with or without Met-Met supplementation. Majority of reads derived from the fish intestine belonged to members of Fusobacteria, followed by Bacteroidetes and Proteobacteria. Diversity of intestinal microbiota and total antioxidant capacity in fish fed with D3 diet was significantly higher than that of other groups. Based on the growth results, the authors conclude that the optimal level of Met is 0·61 % Met with the addition of 0·15 % Met-Met for grower-phase O. niloticus.
Immunomodulation by molecules from Trichinella spiralis (T. spiralis) has been widely reported. Glutathione-S-transferase (GST) is a major immune-modulator of the family of detoxification enzymes. Dendritic cells (DCs) are an important target for the regulation of the immune response by T. spiralis. In this study, the recombinant GST of T. spiralis (rTs-GST) was expressed and purified. rTs-GST induced low CD40 expression and moderate CD80, CD86 and MHC-II expressions and inhibited the increase of CD40, CD80 and CD86 on DCs induced by LPS. We showed that rTs-GST decreased the LPS-induced elevated level of pro-inflammatory cytokines of DCs and enhanced the level of regulatory cytokines IL-10 and TGF-β. Furthermore, co-culture of DCs and CD4+ T cells demonstrated that rTs-GST-treated DCs suppressed the proliferation of OVA-specific CD4+ T cells and increased the population of regulatory T cells (Tregs). rTs-GST-treated DCs induced a higher level of IL-4, IL-10 and TGF-β, but inhibited the level of IFN-γ. This indicates that rTs-GST-pulsed DCs induce both Th2-type responses and Tregs. These findings contribute to the current understanding of the immunomodulation of Ts-GST on cellular response and immunomodulation of T. spiralis.
The influence of the nozzle aspect ratio (
, 2 and 4), stroke length (
, 3.7 and 5.55) and Reynolds number (
, 158, 316 and 632) on the behaviour of elliptic synthetic jets is studied experimentally. Laser-induced fluorescence and two-dimensional and stereoscopic particle image velocimetry are used to analyse the vortex dynamics and evolution mechanism. It is found that the fluid elements around the major axis of an elliptic vortex ring move downstream faster and tend to approach the centreline, while the fluid elements around the minor axis move downstream at a slower speed and away from the centreline, thereby resulting in the occurrence of the well-known axis-switching phenomenon for elliptic synthetic jets. During this process, a pair of arc-like vortices forms ahead of the primary vortex ring, and they are constituted by streamwise vortices in the leg part and spanwise vortices in the head part; two pairs of streamwise vortices form from the inside of the primary vortex ring and develop in the tails. The streamwise vortices are pushed away progressively from the centreline by the synthetic jet vortex rings that are formed during the subsequent periods. These additional vortical structures for non-circular synthetic jets show regular and periodic characteristics, which are quite different from the previous findings for non-circular jets. Their mutual interaction with the vortex ring causes significant changes in the topology of elliptic synthetic jets, which further results in the variation of the statistical characteristics. Increasing the aspect ratio, stroke length and Reynolds number will make the evolution of the synthetic jet become more unstable and complex. In addition, the entrainment rate of an elliptical synthetic jet is larger than that of a circular synthetic jet and it increases with the nozzle aspect ratio (
) and Reynolds number. It is indicated that the formation of streamwise vortices could enhance the entrainment rate. This finding provides substantial evidence for the potential application of elliptic synthetic jets for effective flow control.
Studies show that the gain from China's remarkable growth of the past 35 years has not been evenly shared, especially through the intergenerational transmission of income. To address this concern, we use data from China Health and Nutrition Survey and find the intergenerational income elasticity to be 0.466 in 2011, which suggests that sons’ incomes are affected by their fathers’ economic statuses to a large extent. A cross-country comparison indicates that the degree of generational income mobility in China is lower than that in many developed nations. Meanwhile, by investigating possible transmission channels, we find that the fathers’ investments in the sons’ education and occupation play substantial roles in intergenerational transmission of income. The results not only demonstrate the trends in intergenerational income mobility in China, but also identify the most likely transmission channels, which is of great importance to improving social equality.
Subcutaneous immunotherapy is an effective and safe treatment for allergic rhinitis and allergic asthma. Different symptom scores are used to evaluate the efficacy of subcutaneous immunotherapy in clinical trials.
A total of 58 allergic rhinitis patients sensitised to house dust mites, with or without mild asthma, were included. Symptom score, medication score, visual analogue scale score and quality of life were assessed before and after 6, 12 and 24 months of subcutaneous immunotherapy.
After two years of subcutaneous immunotherapy, asthma symptom scores nearly reached zero, whereas the scores remained higher for nasal symptoms. The changes in asthma symptom scores were markedly different (p < 0.05) and occurred faster than the changes in nasal symptom scores when compared between monosensitised and polysensitised groups. Significant reductions in visual analogue scale score and medication score were demonstrated after subcutaneous immunotherapy.
Two-year subcutaneous immunotherapy with house dust mite vaccine is an effective treatment for both monosensitised and polysensitised allergic patients. The changes in asthma symptom scores were markedly different and occurred quicker than the changes in nasal symptom scores in Chinese house dust mite allergic patients.
To investigate the protein-sparing effect of α-lipoic acid (LA), experimental fish (initial body weight: 18·99 (sd 1·82) g) were fed on a 0, 600 or 1200 mg/kg α-LA diet for 56 d, and hepatocytes were treated with 20 μm compound C, the inhibitor of AMP kinase α (AMPKα), treated for 30 min before α-LA treatment for 24 h. LA significantly decreased lipid content of the whole body and other tissues (P<0·05), and it also promoted protein deposition in vivo (P<0·05). Further, dietary LA significantly decreased the TAG content of serum and increased the NEFA content of serum (P<0·05); however, there were no significant differences among all groups in the hepatopancreas and muscle (P>0·05). Consistent with results from the experiment in vitro, LA activated phosphorylation of AMPKα and notably increased the protein content of adipose TAG lipase in intraperitoneal fat, hepatopancreas and muscle in vivo (P<0·05). Meanwhile, LA significantly up-regulated the mRNA expression of genes involved in fatty acid β-oxidation in the same three areas, and LA also obviously down-regulated the mRNA expression of genes involved in amino acid catabolism in muscle (P<0·05). Besides, it was observed that LA significantly activated the mammalian target of rapamycin (mTOR) pathway in muscle of experimental fish (P<0·05). LA could promote lipolysis and fatty acid β-oxidation via increasing energy supply from lipid catabolism, and then, it could economise on the protein from energy production to increase protein deposition in grass carp. Besides, LA might directly promote protein synthesis through activating the mTOR pathway.
In this paper, zircon U–Pb geochronology, major and trace elements, and Sr–Nd isotope geochemistry of the Baiyanghe dolerites in northern West Junggar of NW China are presented. The U–Pb dating of zircons from the dolerites yielded ages of 272.2±4 Ma and 276.7±6.2 Ma, which indicate the emplacement times. The dolerites are characterized by minor variations in SiO2 (46.89 to 49.07 wt%), high contents of Al2O3 (13.60 to 13.92 wt%) and total Fe2O3 (11.14 to 11.70 wt%), and low contents of MgO (2.67 to 3.64 wt%) and total alkalis (Na2O+K2O, 5.1 to 5.97 wt%, K2O/Na2O = 0.37–0.94), which indicate affinities to metaluminous tholeiite basalt. The REE pattern ((La/Sm)N = 2.25–2.34, (La/Yb)N = 7.42–8.36), V–Ti/1000 and 50*Zr–Ti/50–Sm discrimination diagrams show that these rocks are OIB-type. The high contents of Zr and Ti indicate a within-plate tectonic setting, and samples plot in the ‘plume source’ field shown on the Dy/Yb(N) versus Ce/Yb(N) diagram. The positive εNd(t) values (+7.09 to +7.48), high initial 87Sr/86Sr ratios (0.70442 to 0.70682) and depletions of Nb and Ta elements in the samples can be explained by the involvement of subducted sediments. In summary, it is possible that the Baiyanghe dolerites were derived from an OIB-like mantle source and associated with a mantle plume tectonic setting. Therefore, our samples provide the youngest evidence for the existence of a mantle plume, which may provide new insights into the Late Palaeozoic tectonic setting of West Junggar.
To investigate lung function in Chinese patients suffering from chronic rhinosinusitis with nasal polyps and examine its association with histopathological features.
The lung function of 99 patients with nasal polyps was measured. Haematoxylin and eosin and immunohistochemistry staining were performed to evaluate any inflammatory cells and epithelial tissue remodelling.
Predicted maximal expiratory flow rate at 25 per cent vital capacity was reduced (p < 0.05) in epithelial hyperplasia, and predicted maximal expiratory flow rate at 50 per cent vital capacity was reduced (p < 0.05) in goblet cell hyperplasia. Both peripheral blood eosinophilia and tissue eosinophilia nasal polyps manifested significantly reduced: forced expiratory volume in 1 second/forced vital capacity ratio, predicted maximal expiratory flow rate at 25, 50 and 75 per cent of vital capacity, and predicted maximal mid-expiratory flow. Peripheral blood eosinophils were negatively correlated with predicted maximal expiratory flow rate at 25 and 50 per cent of vital capacity, and predicted maximal mid-expiratory flow. Eosinophils in tissue were negatively correlated with all lung function parameters investigated except predicted forced vital capacity.
Clinicians should be aware of lung function decline in nasal polyps patients, especially in those with tissue eosinophilia.
Accurate prediction of the flow around multi-element airfoil is a prerequisite for improving aerodynamic performance, but its complex flow features impose high demands on turbulence modeling. In this work, delayed detached-eddy-simulation (DDES) and zonal detached-eddy-simulation (ZDES) was applied to simulate the flow past a three-element airfoil. To investigate the effects of numerical dissipation of spatial schemes, the third-order MUSCL and the fifth-order interpolation based on modified Roe scheme were implemented. From the comparisons between the calculations and the available experimental result, third-order MUSCL-Roe can provide satisfactory mean velocity profiles, but the excessive dissipation suppresses the velocity fluctuations level and eliminates the small-scale structures; DDES cannot reproduce the separation near the trailing edge of the flap which lead to the discrepancy in mean pressure coefficients, while ZDES result has better tally with the experiment.
Melt-SHS (self-propagating high-temperature synthesis), based on the SHS process and oxide reaction method, was used for preparation of TiB2/Al composites. The mass ratio of two reactants, Ti powder/TiO2, in initial powder mixture was varied from 0:1 to 1:0. The results showed that the 5 wt% TiB2/Al composites could be successfully produced by a reaction of aluminum powder, TiO2, and B2O3 in Al melt at 950 °C, while the reaction rate was slow. The addition of titanium powder helps to reduce the content of Al2O3 and destroy the coating structure of Al2O3 covered TiB2 particles, which leads to the acceleration of reaction process and improvement of particle concentration. A significant improvement was that TiB2 particles were dispersively distributed when the mass ratio of Ti powder/TiO2 was 2:3. As a result, the 5 wt% TiB2/Al composites fabricated by melt-SHS process with modified reactants ratio showed excellent tensile properties with the ultimate tensile strength as high as 114.24 MPa. Besides, the composite also showed superior ductility.