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To assess helical tomotherapy (TOMO) current clinical application and practice in mainland China.
Materials and methods:
Data were collected for all TOMO units clinically operational in mainland China by 30 April 2016, including (a) the distribution of installation and staffing levels; (b) types of cancers treated; (c) utilisation efficiency; (d) quality assurance; (e) maintenance; (f) optional features; and (g) satisfaction levels. The data were collected as a census and analysed qualitatively and quantitatively.
As of 30 April 2016, 23 TOMO units were used clinically by 22 hospitals in mainland China. In the same period, 22,558 cancer patients were treated. For TOMO units with more than a year of clinical utilisation, a median of 378 cases were treated annually per machine. The median daily operation was 10·5 hours, and treatment headcount was 38·3 patients. The median service outage rate was 2·6%, and the most common cause was malfunction of the multi-leaf collimator. In terms of overall satisfaction levels, 3 hospitals were very satisfied, 16 were satisfied and 3 considered their satisfaction level as average.
The overall operation of TOMO is good, but there are some problems due to running at full capacity, lack of clinical efficacy research and insufficient quality assurance regulations.
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.
The addition of vegetable to carbohydrate-based meals was shown to contribute to glycaemic management. The aim of this study was to investigate the impact of homogenisation on vegetables added to rice meals in terms of acute glycaemic responses (GR). In a randomised crossover trial, sixteen healthy volunteers completed thirteen test sessions, which included two sessions for glucose control, two for rice and nine for different vegetable-rice mixed meals: cooked pak choi and cooked rice (CP+R); cooked cauliflower and cooked rice (CC+R); cooked eggplant and cooked rice (CE+R); and their homogenised counterparts, both raw or cooked. Postprandial GR tests, in vitro carbohydrate digestion and chemical analyses were carried out for each test meal. Compared with pure rice, CE+R, CP+R and CC+R meals achieved significantly lower glycaemic indexes (GI) of 67, 71 and 73, whereas their homogenised counterparts failed to show significant difference with rice. The hydrolysis indexes (HI) of CE+R, CP+R and CC+R were 69·6, 83·8 and 80·6 % of the HI of the rice control. CE had the greatest effect on lowering the GI, the incremental area under the blood glucose curve from 0 to 120 min, the peak glucose value, the maximum amplitude of glucose excursion in 0–120 min (MAGE0–120), the HI and rapid available starch. Both in vitro and in vivo tests demonstrated that incorporating non-homogenised cooked vegetables into a rice meal could slow the carbohydrate digestion and improve postprandial GR. Texture properties of vegetable may play an important role in underlying glycaemic control mechanisms.
Over the past three decades, China has shown tremendous interest in the “Singapore model” through its sending of tens of thousands of cadres to Singapore for executive training and graduate education. Although this phenomenon has been studied, no attention has been drawn to the perspectives of those mid-level cadres who took part in the training and what those perspectives might imply. Utilizing a unique dataset of over 1,350 mid-level cadres graduating from the “Mayors’ Class” in Singapore from 1995 to 2016 and follow-up surveys and interviews, this article intends to fill this gap. We found that the most appealing characteristics of the “Singapore model” for these mid-level officials lay in practical governance lessons and their potential transferability rather than in ideologies. This finding challenges conventional wisdom that the most plausible rationale of China's learning from Singapore is political. We also examine Xi Jinping's view of Singapore and its relevance to China's latest national agendas in building a “learning nation” and strengthening the CCP's resilience through anti-corruption and intra-party regeneration. The conclusion places the China–Singapore case within the context of the changing trend of transnational knowledge transfer in the non-Western world.
A novel synthetic air data estimation method without using air data sensors is presented, and the method only relies on the information from the Navigation System (NS) and Flight Control System (FCS). The aircraft's aerodynamic model is also required to make a connection between the FCS control parameters and the NS measurements. The airspeed, angle of attack and sideslip, angular velocity and wind speed are defined as state vectors, and state equations are established through the aircraft's aerodynamic model and dynamics. Linear velocity and angular velocity provided by the navigation system are considered as the measurement vector. To deal with variable wind fields, a novel Initialised Three-step Extended Kalman Filter (ITEKF), which considers the wind speed as an unknown input, is developed to track the variation of wind speed. Simulation results based on a Generic Hypersonic Vehicle (GHV) model are presented and compared with an existing method. Factors affecting the method's accuracy include the navigation system accuracy and the aerodynamic model error, are also discussed.
Dementia screening is a public health priority in Taiwan, where the prevalence of dementia is increasing because of an aging population. However, the reasons affect community-dwelling people to accept a referral to memory specialist clinic after dementia screening was still unclear. To investigate the feasibility, acceptability, sensitivity, and specificity of the ascertain dementia 8-item informant questionnaire (AD8) to screen for patients with cognitive impairments in Taiwan's primary healthcare system.
Researchers invited community-dwelling people whose age was above 50-year-old to attend the Memory Screening Project. AD8 was used to perform the informant interview with adult patients who were attending the Memory Screening Project in Taiwan. Individuals who scored ≥2 on the AD8 was suggested to accept referral for further cognitive performance evaluation tests, which included three validated dementia tests, i.e. the Mini-Mental Screening Examination (MMSE), the Cognitive Abilities Screening Instrument (CASI), and the Clinical Dementia Rating (CDR).
Of the 102 participants who scored ≥2 on the AD8, only 25.5% attended the referral appointment. In participants who had achieved six or more years of education, AD8 scores were not significantly different between groups and could not differentiate between the non-dementia and patients with dementia in the receiver-operator characteristics curve analysis. In contrast, in those participants who had received less than six years of education, the AD8 scores significantly differentiated between non-dementia and patients with dementia (p = 0.03).
There was a low rate of attendance at a specialist memory clinic following referral after the AD8 interview. Higher levels of education facilitated individuals to make a decision to accept the recommended referral appointment, while the AD8 showed a higher rate of differentiation between individuals who had received an education of less than six years.
Apathy is a condition characterized by a lack of motivation that manifests in emotional, behavioral, and cognitive domains. Although previous studies have indicated that apathy is associated with frontal lesions, few studies have focused on the different subdomains of apathy, and no in vivo human biochemical data have been obtained to examine the neurochemical changes related to apathy in patients with Alzheimer's disease (AD). Thus, we investigated the frontal neurochemical alterations related to apathy among patients with AD using proton magnetic resonance spectroscopy (1H MRS).
Apathy was assessed through the Apathy Evaluation Scale (AES). 1H MRS was performed to measure neurochemical metabolite levels in the anterior cingulate region and right orbitofrontal region. Associations between neurochemical metabolites and the total score and subscores of each domain of the AES were analyzed.
Altogether, 36 patients completed the study. Patients with lower N-acetylaspartate/creatine ratios (NAA/Cr) in the anterior cingulate region demonstrated higher total apathy scores (β = −0.56, p = 0.003) with adjustments for age, gender, educational level, dementia severity, and depression severity. In a further analysis, a lower NAA/Cr in the anterior cingulate region was associated with all subdomains of apathy, including cognition (β = −0.43, p = 0.028), behavior (β = −0.55, p = 0.002), and emotion (β = −0.50, p = 0.005). No statistically significant associations were discovered in the right orbitofrontal region.
Our results suggest that apathy, in each of its cognitive, behavioral, or emotional subdomains is associated with brain neurochemical alterations in the anterior cingulate region. Abnormal neuronal integrity over the anterior cingulate cortex may exhibit a central role in causing all aspects of apathy in patients with AD.
Nutritional status of 380 hospitalised children aged from 1 month to 5 years with liver disease was evaluated in a single paediatric centre. The total prevalence of stunting (height-for-age Z (HAZ) < −2), underweight (weight-for-age Z (WAZ) < −2) and wasting (weight-for-height Z < −2) was 9·8, 9·0 and 7·9 %, respectively. The overall nutritional risk (−2 ≤ Z < −1) of stunting, underweight and wasting was 11·8, 12·9 and 12·6 %. The prevalence of undernutrition was significantly higher in children with cholestasis than children without cholestasis (stunting, 17·5 %/4·4 %, P < 0·001, and underweight, 14·9 %/4·9 %, P < 0·001). HAZ and WAZ scores were significantly higher in children without cholestasis than children with cholestasis (0·58 (sd 1·59)/−0·68 (sd 1·99), P < 0·001, and 0·37 (sd 1·35)/−0·47 (sd 1·75), P < 0·001). Further multivariate logistic regression analysis strengthened the evidence that cholestasis was significantly associated with undernutrition of stunting (OR = 4·18, P = 0·002) and underweight (OR = 3·26, P = 0·008), and suggested that the prevalence of stunting caused by infection was lower than other aetiologies in hospitalised children with liver disease (OR = 0·10, P = 0·002). We concluded that a high prevalence of malnutrition and risk of undernutrition presents in hospitalised young children with liver disease, especially in children with cholestasis. Nutrition assessment is recommended for hospitalised children with liver disease.
Neural Network-based approaches have recently produced good performances in Natural language tasks, such as Supertagging. In the supertagging task, a Supertag (Lexical category) is assigned to each word in an input sequence. Combinatory Categorial Grammar Supertagging is a more challenging problem than various sequence-tagging problems, such as part-of-speech (POS) tagging and named entity recognition due to the large number of the lexical categories. Specifically, simple Recurrent Neural Network (RNN) has shown to significantly outperform the previous state-of-the-art feed-forward neural networks. On the other hand, it is well known that Recurrent Networks fail to learn long dependencies. In this paper, we introduce a new neural network architecture based on backward and Bidirectional Long Short-Term Memory (BLSTM) Networks that has the ability to memorize information for long dependencies and benefit from both past and future information. State-of-the-art methods focus on previous information, whereas BLSTM has access to information in both previous and future directions. Our main findings are that bidirectional networks outperform unidirectional ones, and Long Short-Term Memory (LSTM) networks are more precise and successful than both unidirectional and bidirectional standard RNNs. Experiment results reveal the effectiveness of our proposed method on both in-domain and out-of-domain datasets. Experiments show improvements about (1.2 per cent) over standard RNN.
Crystallized FeB and Fe2B powders were synthesized by a molten salt method with elemental Fe and B powders as starting materials. The results indicated that the presence of molten NaCl/KCl salts and the excess of Fe or B powders were essential to obtain pure FeB or Fe2B powders. The formation mechanism of iron borides was investigated by examining the phase compositions of the obtained products with different molar ratio of Fe/B. It was found that Fe powders firstly reacted with B powders to form Fe2B phase, and FeB phase formed from the reaction between Fe2B and excessive B. The as-synthesized FeB and Fe2B powders had a uniform short-rod and plate like morphology, respectively. Both FeB and Fe2B exhibited typical soft magnetic behavior. The saturation magnetization and the coercivity were 36.4 emu/g and 15.5 kA/m for FeB, 126.9 emu/g and 6.1 kA/m for Fe2B, respectively. The electrochemical performances of the as-synthesized FeB powders were evaluated by cyclic voltammetry, galvanostatic charge–discharge and electrochemical impedance test.
The Lorentz factor (Γ) is an important parameter related to the relativistic jet physics. We study the evolution patterns of Γ within gamma-ray burst (GRB) and active galactic nuclear jets for individual GRB 090168, GRB 140508A, and 3C 454.3. By estimating the Γ values for well-separated pulses in GRBs 090618 and 140508A with an empirical relation derived from typical GRBs, we find that the Γ evolution pattern in the two GRBs are different. The increasing-to-coasting evolution pattern of Γ in GRB 090618 likely indicates that the GRB fireball is still being accelerated in the prompt phase. The clear decrease evolution pattern of Γ in GRB 140508A suggests the deceleration of the fireball components. By deriving the Γ value through fitting their spectral energy distribution in different flares of 3C 454.3, a pattern of Γ-tracking-γ-ray flux is clearly found, likely indicating that the observed gamma-ray flares are being due to the Doppler boosting effect to the jet emission.
The paleoclimate application of speleothem δ13C is influenced by site-specific processes. Here we present four stalagmite δ13C records from two caves in southern China, covering early and late Marine Isotope Stage (MIS) 3 and the Holocene, to investigate the spatio-temporal pattern of calcite δ13C changes and the relationship with Asian monsoon (AM) variability. In each growth period, precessional- to millennial-scale changes are clear in the δ18O record. In contrast, millennial variability is absent in the δ13C record, which characterizes persistent centennial oscillations. However, centennial-scale δ18O variations agree well with those of δ13C, with a larger amplitude in δ13C changes (about twice that of δ18O). This suggests that soil humidity balance associated with regional hydrological circulations is important for these centennial δ13C changes, although evaporation-related kinetic fractionation can induce concurrent enrichments in δ18O and δ13C. In frequency, the detrended δ18O and δ13C records are coupled at a periodicity of about 300 yr during the last glacial period and 150 yr during the Holocene. Those centennial-scale δ13C variations are generally consistent with Greenland temperature variability, indicating a climate response over broad regions. Thus, strong co-variation of δ18O and δ13C records should have a climatic origin, even if it is amplified by kinetic effects.
In this note we give a simple proof of the endpoint regularity for the uncentred Hardy–Littlewood maximal function on
. Our proof is based on identities for the local maximum points of the corresponding maximal functions, which are of interest in their own right.
Single-walled carbon nanotube (SWNT) and conductive polymer composite were studied as a potential electrode candidate for plastic electronic devices such as organic light-emitting diodes (OLEDs) and solar cells. A novel conductive polymer, poly(2,7–9,9(di(oxy-2,5,8-trioxadecane))fluorene) (PFO), was synthesized and characterized as a surfactant to disperse SWNTs in solutions. The ethylene oxide (EO) side chain of rigid PFO backbone acts as a template to wrap around SWNTs in solution. Up to 0.02% (by weight) of SWNTs are stabilized and well separated in the solution phase. The carbon nanotube can be dispersed in solutions for over 4 mo. Transmission electron microscopy (TEM) images of solvent cast film suggest highly uniformed SWNT distribution incorporated in the conductive polymer matrix. Transmittance characterization shows the film is as transparent as indium tin oxide conducting glass. Conductivity measurement shows SWNTs can effectively inject charges into the PFO polymer matrix at low voltage. The current versus voltage profile of the SWNT/PFO composite film (2% SWNT in PFO by weight) shows that the majority current conducting is carried by SWNTs.
Many studies have suggested that folate-related one-carbon metabolism-related nutrients may play a role in certain cancer risks, but few studies have assessed their associations with the risk for nasopharyngeal carcinoma (NPC). In this study, we investigated the association between four folate-related one-carbon metabolism-related nutrients (folate, vitamin B6, vitamin B12 and methionine) and NPC risk in Chinese adults. A total of 600 patients newly diagnosed (within 3 months) with NPC were individually matched with 600 hospital-based controls by age, sex and household type (urban v. rural). Folate, vitamin B6, vitamin B12 and methionine intakes were measured using a validated seventy-eight-item FFQ. A higher dietary folate or vitamin B6 intake was associated with a lower NPC risk after adjusting for potential confounders. The adjusted OR of NPC for quartiles 2–4 (v. 1) were 0·66 (95 % CI 0·48, 0·91), 0·52 (95 % CI 0·37, 0·74) and 0·34 (95 % CI 0·23, 0·50) (Ptrend<0·001) for folate and 0·72 (95 % CI 0·52, 1·00), 0·55 (95 % CI 0·39, 0·78) and 0·44 (95 % CI 0·30, 0·63) (Ptrend<0·001) for vitamin B6. No significant association with NPC risk was observed for dietary vitamin B12 or methionine intake. The risk for NPC with dietary folate intake was more evident in the participants who were not exposed to toxic substances than in those who were exposed (Pinteraction=0·014). This study suggests that dietary folate and vitamin B6 may be protective for NPC in a high-risk population.