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Nucleos(t)ide analogues (NAs) are widely used for antiviral therapy in patients with chronic hepatitis B (CHB), but real-world data on treatment patterns and long-term clinical outcomes are not always available. Using data from electronic medical records between January 2011 and December 2016 in Shanghai, China, we evaluated patient characteristics, treatment patterns and clinical outcomes in patients with CHB. There were 6688 patients in the study cohort. The incidences of cirrhosis and hepatocellular carcinoma (HCC) were 41.0‰ and 6.8‰ person-years, respectively. There were more cirrhosis and HCC cases among patients who had shorter NA treatment duration (<365 days), or who were less compliant (<80%). In addition, increased risk of cirrhosis and HCC was observed in patients who did not achieve hepatitis B surface antigen (HBsAg) loss/seroconversion. Moreover, patients with cirrhosis developed after antiviral treatments had a higher incidence of HCC (adjusted hazard ratio 15.86, 95% confidence interval 7.35–34.24). Good compliance with treatment and longer treatment duration significantly decreased the risk of developing cirrhosis and HCC. HBsAg loss seemed to be a protective factor for cirrhosis/HCC in NAs-treated patients with CHB, and cirrhosis was a confirmed risk factor for HCC development as expected.
Recent advances in techniques to generate static ultra-high pressure (>100 GPa) in the diamond anvil cell have significantly enhanced our understanding of the properties of solids under these extreme conditions. In order to characterize the structure of solids at these pressures, X-ray diffraction using synchrotron radiation has become an invaluable tool. Since the highest pressures are attained at the expense of sample volume (~ 100 μm3) , it is best to use the intense radiation available from a synchrotron to study the very small samples used in ultra-high pressure studies. Even with the intense x-ray beams currently available, it is still often desirable to focus the x-ray beam to increase the available flux. We have developed a focusing system which uses multilayer coated spherical mirrors. With this system, intense x-ray beams with sizes smaller than 10 μm by 10 μm can be achieved at a synchrotron radiation beamline. Previously, we used the focusing system for x-ray microprobe experiments.
Diet, obesity and adipokines play important roles in diabetes and CVD; yet, limited studies have assessed the relationship between diet and multiple adipokines. This cross-sectional study assessed associations between diet, adiposity and adipokines in Mexican Americans. The cohort included 1128 participants (age 34·7±8·2 years, BMI 29·5±5·9 kg/m2, 73·2 % female). Dietary intake was assessed by 12-month food frequency questionnaire. Adiposity was measured by BMI, total percentage body fat and percentage trunk fat using dual-energy X-ray absorptiometry. Adiponectin, apelin, C-reactive protein (CRP), dipeptidyl peptidase-4 (DPP-IV), IL-1β, IL-1ra, IL-6, IL-18, leptin, lipocalin, monocyte chemo-attractant protein-1 (MCP-1), resistin, secreted frizzled protein 4 (SFRP-4), SFRP-5, TNF-α and visfatin were assayed with multiplex kits or ELISA. Joint multivariate associations between diet, adiposity and adipokines were analysed using canonical correlations adjusted for age, sex, energy intake and kinship. The median (interquartile range) energy intake was 9514 (7314, 11912) kJ/d. Overall, 55 % of total intake was accounted for by carbohydrates (24 % from sugar). A total of 66 % of the shared variation between diet and adiposity, and 34 % of diet and adipokines were explained by the top canonical correlation. The diet component was most represented by sugar-sweetened beverages (SSB), fruit and vegetables. Participants consuming a diet high in SSB and low in fruits and vegetables had higher adiposity, CRP, leptin, and MCP-1, but lower SFRP-5 than participants with high fruit and vegetable and low SSB intake. In Mexican Americans, diets high in SSB but low in fruits and vegetables contribute to adiposity and a pro-inflammatory adipokine profile.
The present study aim to explore temporal–spatial patterns of water use (WU) efficiency and its influencing factors of maize production in China during 1998–2010. WU and productivity (WP) were quantified by taking irrigation loss into account and the links between WP and nine selected indicators were revealed by the partial least squares regression (PLSR) model. Results showed that national WU and WP in maize production were 138.56 cubic gigametres (Gm3; 0.755 green and 0.245 blue) and 1.079 kg/m3, respectively. WP was enhanced in the present study due to an increase in irrigated crop yield. Provinces located in the middle–lower part of the Yellow River had high proportions of green water and WP, while high proportions of irrigation water and low WP were found in Northwest China. The dosage of pesticides per unit area, relative humidity, average temperature and precipitation were the dominant factors that affected WP. However, the relationships between WP and solar radiation, fertilizer, agricultural machinery power, irrigation proportion and irrigated efficiency were not significant. Findings of the present research may also provide a reference for regional agricultural water management.
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.
Iron-deficiency anemia is a public health concern that frequently occurs in pregnant mammals and neonatal offspring. Ferrous N-carbamylglycinate chelate (Fe-CGly) is a newly designed iron fortifier with proven effects in iron-deficient rats and weanling piglets. However, the effects of this new compound on pregnant mammals are unknown. Therefore, this experiment was conducted to evaluate the effects of Fe-CGly on sow reproductive performance and iron status of both sows and neonatal piglets. A total of 40 large-white sows after second parity were randomly assigned to two groups (n=20). They were receiving a diet including 80 mg Fe/kg as FeSO4 or Fe-CGly, respectively, from day 85 of gestation to parturition. The serum (day 110 of pregnancy) and placentas of sows were sampled. Litter size, mean weight of live born piglets, birth (live) litter weight, number of live born piglets, and the number of still-born piglets, mummies, and weak-born piglets were recorded. Once delivered, eight litters were randomly selected from the 20 litters per treatment, and one new-born male piglet (1.503±0.142 kg) from each selected litter was slaughtered within 3 h after birth from the selected litters, without colostrum ingestion. The serum, longissimus muscle, liver and kidneys of the piglets were collected. The iron status of the serum samples and the messenger RNA level of iron-related genes in the placenta, liver and kidney were analyzed. The results showed that litter weight of live born piglets was higher (P=0.030) in the Fe-CGly group (19.86 kg) than in the FeSO4 group (17.34 kg). Fe-CGly significantly increased placental iron concentration (P<0.05) of sows. It also significantly increased iron saturation and reduced the total iron-binding capacity of piglets (P<0.05) at birth. However, the results revealed that supplementation of Fe-CGly in sows reduced liver and kidney iron concentration of neonatal piglets (P<0.05), indicating decreased iron storage. In addition, the concentration of iron in the colostrum was not significantly changed. Therefore, the present results suggested that replacement of maternal FeSO4 supplement with Fe-CGly in the late-gestating period for sows could improve litter birth weight, probably via enhanced iron transportation in the placenta.
Retreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into ‘success’ and ‘failure’ groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (<18·5), long duration of previous treatment (>6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.
The luminosity of a spiral arm is believed to originate primarily in the very young, newly forming stars; and the spiral arm itself to be a spiral wave which is capable of triggering the formation of the young stars selectively along the wave crest. A semi-empirical study of the density wave patterns predicted in the density wave models of twenty-five external galaxies has been made and one result of this study is presented here. It is found that those galaxies of the sample whose models predict the possibility of strong shock waves are also the galaxies which exhibit long, well-developed spiral arms; and those galaxies whose models predict weak shock waves are also the galaxies which exhibit less-developed spiral structure. This trend is seen through a correlation between w⊥0, the velocity component of basic rotation normal to a spiral arm, which is an important parameter in determining the shock strength on the one hand, and luminosity class, which is a measure of the degree of development of spiral structure on the other.
Annual bluegrass is a weed species in turfgrass environments known for exhibiting resistance to multiple herbicide modes of action, including photosystem II (PSII) inhibitors. To evaluate populations of annual bluegrass for susceptibility to PSII inhibitors of varied chemistries, populations were treated with herbicides from triazolinone, triazine, and substituted urea families: amicarbazone, atrazine, and diuron, respectively. Sequencing of the psbA gene confirmed the presence of a Ser264 to Gly amino acid substitution within populations that exhibited resistance to both atrazine and amicarbazone. A single biotype, DR3, which lacked any previously reported psbA gene point mutation, exhibited resistance to diuron, atrazine, and amicarbazone. DR3 had a significantly lower rate of absorption and translocation of atrazine and had enhanced atrazine metabolism when compared with both the Ser264 to Gly resistant mutant and susceptible biotypes. We thus report possible nontarget mechanisms of resistance to PSII-inhibiting herbicides in annual bluegrass.
We investigate some basic properties of Damped Lyman alpha systems based on the Semi-Analytical model of disk galaxy formation theory. We derive the DLA metallicity, column density, number density, gas content and cosmic star formation rate by assuming that disks form at the center of dark halos, and the modelled DLAs are selected by Monte Carlo simulation according to the distributions of halo properties. We find that DLA hosts are dominated by small galaxies and biased to extended galaxies. In terms of model results, DLAs could naturally arise in a ACDM universe from radiatively cooled gas in dark matter halos. However, model predicts a reverse correlation between metallicity and the column density when compared with observations, regardless of the proposed observational bias. We argue that this could be resulted from the model limitations, or the inadequacy of Schmidt-type star formation mode at high redshift, or/and the diversities of DLA populations.
During the period, work on the problem of the Earth’s rotation has continued to expand and increase its scope. The total number of institutions engaged in the determination of the Earth’s rotation parameters (ERP) by different techniques has been increased significantly. The rotation of the Earth is currently measured by classical astrometry, Doppler and laser satellite tracking, laser ranging of the Moon, and radio interferometry. Several long time series of the ERP are available from most of these techniques, in particular, those made during the Main Campaign of the MERIT project. The various series have been intercompared and their stability, in the time frame of years to days, has been estimated for the purposes of establishing a new conventional terrestrial reference system (COTES). On the other hand, the difficulties of maintaining a regular operation for laser ranging to the Moon (LLR) have been recognized. It resulted in the proposal to organize an one-month campaign of observations in 1985 in order to complement the COTES collocation program and to allow additional intercomparisons with other techniques.
To assess correlations between cruciferous vegetable intake and urinary isothiocyanate (ITC) level, in addition to glutathione S-transferase (GST) genotypes and other individual factors.
The study included cohort participants whose urinary ITC levels had been previously ascertained. Urinary ITC was assessed using HPLC. Usual dietary intake of cruciferous vegetables was assessed using a validated FFQ and total dietary ITC intake was calculated. Recent cruciferous vegetable intake was determined. GST genotypes were assessed using duplex real-time quantitative PCR assays. Spearman correlations were calculated between the covariates and urinary ITC levels and linear regression analyses were used to calculate the mean urinary ITC excretion according to GST genotype.
Urban city in China.
The study included 3589 women and 1015 men from the Shanghai Women’s and Men’s Health Studies.
Median urinary ITC level was 1·61 nmol/mg creatinine. Self-reported usual cruciferous vegetable intake was weakly correlated with urinary ITC level (rs=0·1149; P<0·0001), while self-reported recent intake was more strongly correlated with urinary ITC (rs=0·2591; P<0·0001). Overall, the GST genotypes were not associated with urinary ITC level, but significant differences according to genotype were observed among current smokers and participants who provided an afternoon urine sample. Other factors, including previous gastrectomy or gastritis, were also related to urinary ITC level.
The study suggests that urinary secretion of ITC may provide additional information on cruciferous vegetable intake and that GST genotypes are related to urinary ITC level only in some subgroups.
Reproductive interference is one of the major factors mediating species exclusion among insects. The cryptic species Middle East-Asia Minor 1 (MEAM1) and Mediterranean (MED) of the whitefly Bemisia tabaci complex have invaded many parts of the world and often exhibit niche overlap and reproductive interference. However, contrasting patterns of competitive displacement between the two invaders have been observed between regions such as those in USA and China. Understanding the roles of reproductive interference in competitive interactions between populations of the two species in different regions will help unravel other factors related to their invasion. We integrated laboratory population experiments, behavioural observations and simulation modelling to investigate the role of reproductive interference on species exclusion between MEAM1 and MED in China. In mixed cohorts of the two species MEAM1 always excluded MED in a few generations when the initial proportion of MEAM1 was ⩾0.25. Even when the initial proportion of MEAM1 was only 0.10, however, MEAM1 still had a higher probability of excluding MED than that for MED to exclude MEAM1. Importantly, we show that as MEAM1 increased in relative abundance, MED populations became increasingly male-biased. Detailed behavioural observations confirmed that MEAM1 showed a stronger reproductive interference than MED, leading to reduced frequency of copulation and female progeny production in MED. Using simulation modelling, we linked our behavioural observations with exclusion experiments to show that interspecific asymmetric reproductive interference predicts the rate of species exclusion of MED by MEAM1. These findings not only reveal the importance of reproductive interference in the competitive interactions between the two invasive whiteflies as well as the detailed behavioural mechanisms, but also provide a valuable framework against which the effects of other factors mediating species exclusion can be explored.
An enduring question with regard to the voluntary sector is how it can nurture civic engagement and provide public goods. A World Heritage listing for Penang highlights this question by revealing a vibrant civil society network that has made heritage conservation an issue for public discourse and policy agenda. This paper discusses how the marginalized trajectory of Penang is related to the development of its civic realm, social cohesion and local identity, which are sources of Penang's voluntarism. It then examines the engagement pattern of the Penang Heritage Trust, a leading association, which has mounted resistance against the state's failure in heritage provision. This bottom-up approach has preserved Penang's cultural heritage and associated identity, and reveals the distinct nature and capacity of Penang's voluntary sector that goes against the general pattern in Malaysia.
The use of plasma immersion ion implantation (PIII) as a novel method for the treatment of polymer surfaces is investigated. The effect of PIII treatment on the coefficient of friction, contact angle modification, and surface energy of silicone and EPDM (ethylene-propylene-diene monomer) rubber are investigated as a function of pulse voltage, treatment time, and gas species. Low energy (0 - 8 keV) and high dose (∼1017 - 1018 ions/cm2) implantation of N2, Ar, and CF4 is performed using an inductively coupled plasma source (ICP) at low pressure (0.2 mTorr). PIII treatment reduces the coefficient of friction (μ) of silicone rubber from μ = 0.464 to the range μ = 0.176 – 0.274, and μ of EPDM rubber decreases from 0.9 to the range μ = 0.27 – 0.416 depending on processing conditions. The contact angle of water and diiodomethylene decreases after implantation and increases at higher doses for both silicone and EPDM rubber.
PH3 SDS (safe delivery system) gas was used for the first time in P11 doping experiments to fabricate n+p junctions and NMOS devices. Two gas recipes (PH3 diluted in H2 and He) were investigated. Under lower pressure, a minimum etching effect was observed. A 4x1015/cm2 phosphorus dose and a 22 Ω/□ sheet resistance were achieved in 4 seconds. Very low contamination level was involved. An anomalous tail of P profile in Si substrate was observed using SIMS measurements.
Development of ion doping and hydrogenation equipment using plasma ion implantation (PII) is being studied. It is shown that low energy, high throughput operation could eliminate problems associated with etching, charging, cooling, and contamination. The applications of a new plasma source and neural network implementation optimization are also reported.