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Previous research has suggested an association between depression and subsequent acute stroke incidence, but few studies have examined any effect modification by sociodemographic factors. In addition, no studies have investigated this association among primary care recipients with hypertension.
We examined the anonymized records of all public general outpatient visits by patients aged 45+ during January 2007–December 2010 in Hong Kong to extract primary care patients with hypertension for analysis. We took the last consultation date as the baseline and followed them up for 4 years (until 2011–2014) to observe any subsequent acute hospitalization due to stroke. Mixed-effects Cox models (random intercept across 74 included clinics) were implemented to examine the association between depression (ICPC diagnosis or anti-depressant prescription) at baseline and the hazard of acute stroke (ICD-9: 430–437.9). Effect modification by age, sex, and recipient status of social security assistance was examined in extended models with respective interaction terms specified.
In total, 396 858 eligible patients were included, with 9099 (2.3%) having depression, and 10 851 (2.7%) eventually hospitalized for stroke. From the adjusted analysis, baseline depression was associated with a 17% increased hazard of acute stroke hospitalization [95% confidence interval (CI) 1.03–1.32]. This association was suggested to be even stronger among men than among women (hazard ratio = 1.29, 95% CI 1.00–1.67).
Depression is more strongly associated with acute stroke incidence among male than female primary care patients with hypertension. More integrated services are warranted to address their needs.
There is an overabundance of microswimmers in nature, including bacteria, algae, mammalian cells and so on. They use flagellum, cilia or global shape changes (amoeboid motion) to move forward. In the presence of confining channels, these swimmers exhibit often non-trivial behaviours, such as accumulation at the wall, navigation and so on, and their swimming speed may be strongly influenced by the geometric confinement. Several numerical studies have reported that the presence of walls either enhances or reduces the swimming speed depending on the nature of the swimmer, and also on the confinement. The purpose of this paper is to provide an analytical explanation of several previously obtained numerical results. We treat the case of amoeboid swimmers and the case of squirmers having either a tangential (the classical situation) or normal velocity prescribed at the swimmer surface (pumper). For amoeboid motion we consider a quasi-circular swimmer which allows us to tackle the problem analytically and to extract the equations of the motion of the swimmer, with several explicit analytical or semi-analytical solutions. It is found that the deformation of the amoeboid swimmer as well as a high enough order effect due to confinement are necessary in order to account for previous numerical results. The analytical theory accounts for several features obtained numerically also for non-deformable swimmers.
Guangxi, a province in southwestern China, has the second highest reported number of HIV/AIDS cases in China. This study aimed to develop an accurate and effective model to describe the tendency of HIV and to predict its incidence in Guangxi. HIV incidence data of Guangxi from 2005 to 2016 were obtained from the database of the Chinese Center for Disease Control and Prevention. Long short-term memory (LSTM) neural network models, autoregressive integrated moving average (ARIMA) models, generalised regression neural network (GRNN) models and exponential smoothing (ES) were used to fit the incidence data. Data from 2015 and 2016 were used to validate the most suitable models. The model performances were evaluated by evaluating metrics, including mean square error (MSE), root mean square error, mean absolute error and mean absolute percentage error. The LSTM model had the lowest MSE when the N value (time step) was 12. The most appropriate ARIMA models for incidence in 2015 and 2016 were ARIMA (1, 1, 2) (0, 1, 2)12 and ARIMA (2, 1, 0) (1, 1, 2)12, respectively. The accuracy of GRNN and ES models in forecasting HIV incidence in Guangxi was relatively poor. Four performance metrics of the LSTM model were all lower than the ARIMA, GRNN and ES models. The LSTM model was more effective than other time-series models and is important for the monitoring and control of local HIV epidemics.
The phase-sensitive radio-echo sounder (pRES) is a powerful new instrument that can measure the depth of internal layers and the glacier bed to millimetre accuracy. We use a stationary 16-antenna pRES array on Store Glacier in West Greenland to measure the three-dimensional orientation of dipping internal reflectors, extending the capabilities of pRES beyond conventional depth sounding. This novel technique portrays the effectiveness of pRES in deriving the orientation of dipping internal layers that may complement profiles obtained through other geophysical surveying methods. Deriving ice vertical strain rates from changes in layer depth as measured by a sequence of pRES observations assumes that the internal reflections come from vertically beneath the antenna. By revealing the orientation of internal reflectors and the potential deviation from nadir of their associated reflections, the use of an antenna array can correct this assumption. While the array configuration was able to resolve the geometry of englacial layers, the same configuration could not be used to accurately image the glacier bed. Here, we use simulations of the performance of different array geometries to identify configurations that can be tailored to study different types of basal geometry for future deployments.
Diarrhea is a common cause of morbidity and mortality and the incidence of diarrhea in the world has changed little over the past four decades. To assess the prevalence of and healthcare practices for diarrhea, a cross-sectional study was conducted in Pudong, Shanghai, China. In October 2014, a total of 5324 community residents were interviewed. Respondents were asked if they had experienced diarrhea (defined as ⩾3 passages of watery, loose, bloody, or mucoid stools within a 24-h period) in the previous month prior to the interview. The monthly prevalence of diarrhea was 4·1% (95% CI: 3·3–4·8), corresponding to an incidence rate of 0·54 episodes per person-year. The proportion of individuals with diarrhea who sought healthcare was 21·2% (95% CI: 13·4–29·0). Diarrhea continues to impose a considerable burden on the community and healthcare system in Pudong. Young age and travel were identified as predictors of increased diarrhea occurrence.
The musk deer (Moschus berezovskii) is an economically important species from which musk is extracted and used in perfumes and medicines. Cestodes (parasitic flatworms) of the genus Moniezia are important parasites that infect this endangered species and can cause high mortality in young deer. In 1982, Moniezia (S.) sichuanensis sp. nov. was described from a specimen obtained from wild musk deer. The new species was distinct from the other described species of Moniezia by the sawtooth-shaped interproglottidal glands, the thick vagina and the absence of a cirrus spine. In the present study, 12 cestodes collected from musk deer were examined morphologically and confirmed to be M. sichuanensis. Molecular characterization was performed by amplifying and comparing the internal transcribed spacer 1 (ITS1) and 5.8S rRNA gene (ITS1–5.8S) of ribosomal DNA with available sequences from other Moniezia species. The amplified sequences ranged from 761 to 764 bp and similarity ranged from 98.7–100%, compared to 67.8–92.4% with other Moniezia spp. Construction of a phylogenetic tree using the neighbour-joining method indicated that all 12 ITS1–5.8S sequences formed a single clade, confirming M. sichuanensis as a separate species. This study provides novel molecular insight into M. sichuanensis that could prove useful for future diagnosis and control of monieziasis in musk deer.
A compact hybrid rocket motor design that incorporates a dual-vortical-flow (DVF) concept is proposed. The oxidizer (nitrous oxide, N2O) is injected circumferentially into various sections of the rocket motor, which are sectored by several solid fuel “rings” (made of hydroxyl-terminated polybutadiene, HTPB) that are installed along the central axis of the motor. The proposed configuration not only increases the residence time of the oxidizer flow, it also implies an inherent “roll control” capability of the motor. Based on a DVF motor geometry with a designed thrust level of 11.6 kN, the characteristics of the turbulent reacting flow within the motor and its rocket performance were analyzed with a comprehensive numerical model that implements both real-fluid properties and finite-rate chemistry. Data indicate that the vacuum specific impulse (Isp) of the DVF motor could reach 278 s. The result from a preliminary ground test of a lab-scale DVF hybrid rocket motor (with a designed thrust level of 3,000 N) also shows promising performance. The proposed DVF concept is expected to partly resolve the issue of scalability, which remains challenging for hybrid rocket motors development.
Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder, yet the search for definite genetic etiologies remains elusive. Delineating ASD endophenotypes can boost the statistical power to identify the genetic etiologies and pathophysiology of ASD. We aimed to test for endophenotypes of neuroanatomy and associated intrinsic functional connectivity (iFC) via contrasting male youth with ASD, their unaffected brothers and typically developing (TD) males.
The 94 participants (aged 9–19 years) – 20 male youth with ASD, 20 unaffected brothers and 54 TD males – received clinical assessments, and undertook structural and resting-state functional magnetic resonance imaging scans. Voxel-based morphometry was performed to obtain regional gray and white matter volumes. A seed-based approach, with seeds defined by the regions demonstrating atypical neuroanatomy shared by youth with ASD and unaffected brothers, was implemented to derive iFC. General linear models were used to compare brain structures and iFC among the three groups. Assessment of familiality was investigated by permutation tests for variance of the within-family pair difference.
We found that atypical gray matter volume in the mid-cingulate cortex was shared between male youth with ASD and their unaffected brothers as compared with TD males. Moreover, reduced iFC between the mid-cingulate cortex and the right inferior frontal gyrus, and increased iFC between the mid-cingulate cortex and bilateral middle occipital gyrus were the shared features of male ASD youth and unaffected brothers.
Atypical neuroanatomy and iFC surrounding the mid-cingulate cortex may be a potential endophenotypic marker for ASD in males.
With good combustion characteristics, hydrogen has been developing as a clean alternative fuel of engines. This study is to develop a diesel/hydrogen dual fuel engine. The hydrogen was added at inlet port in a 4-cylinder direct injection turbocharged diesel engine with an EGR (Exhaust Gas Recirculation) system to investigate engine performance and exhaust pollutant. The measured items are composed of the gas pressure of cylinder, crank angle, consumption rate of diesel, consumption rate of hydrogen, air flow rate, emissions (HC, CO2, NOX, and Smoke), and so on. The authors analyze how the addition of hydrogen with EGR system influences the engine performance and emissions. The diesel/hydrogen dual fuel turbocharged engine can increase the brake thermal efficiency with a greater decrease in emissions compared with the turbocharged diesel engine. Furthermore, the authors little altered the engine structure to get the positive effect of energy saving and pollutant decreasing.
In long-term care facilities (LTCFs), the elderly are apt to be infected because those with latent tuberculosis infections (LTBIs) are at an increased risk for reactivation and post-primary TB disease. We report an outbreak of TB in staff and residents in a LTCF. An outbreak investigation was conducted after two TB cases were reported from the LTCF. A tuberculin skin test (TST), bacteriological examination and chest radiograph were administered to all facility staff and residents. An outbreak is defined as at least two epidemiologically linked cases that have identical Mycobacterium tuberculosis genotype isolates. This outbreak infected eight residents and one staff member, who were confirmed to have TB in a LTCF between September 2011 and October 2012. Based on the Becker method, the latent and infectious periods were estimated at 223·6 and 55·9 days. Two initial TST-negative resident contacts were diagnosed as TB cases through comprehensive TB screening. Observing elderly people who have a negative TST after TB screening appears to be necessary, given the long latent period for controlling a TB outbreak in a LTCF. It is important to consider providing LTBI treatment for elderly contacts.
A numerical scheme based on the immersed interface method (IIM) is developed to simulate the dynamics of an axisymmetric viscous drop under an electric field. In this work, the IIM is used to solve both the fluid velocity field and the electric potential field. Detailed numerical studies on the numerical scheme show a second-order convergence. Moreover, our numerical scheme is validated by the good agreement with previous analytical models, and numerical results from the boundary integral simulations. Our method can be extended to Navier-Stokes fluid flow with nonlinear inertia effects.
This multicentre surveillance study was conducted to investigate the trends in incidence and aetiology of healthcare-associated bloodstream infections (HCA-BSIs) in Taiwan. From 2000 to 2011 a total of 56 830 HCA-BSIs were recorded at three medical centres, and coagulase-negative staphylococci (CoNS) were the most common pathogens isolated (n = 9465, 16·7%), followed by E. coli (n = 7599, 13·4%). The incidence of all HCA-BSIs in each and all hospitals significantly increased over the study period owing to the increase of aerobic Gram-positive cocci and Enterobacteriaceae by 4·2% and 3·6%, respectively. Non-fermenting Gram-negative bacteria, Bacteroides spp. and Candida spp. also showed an increase but there was a significant decline in the numbers of methicillin-resistant S. aureus. In conclusion, the incidence of HCA-BSIs in Taiwan is significantly increasing, especially for Enterobacteriaceae and aerobic Gram-positive cocci.
For economizing the space of equipment and increasing the throughput of product, a vertical transportation is usually used for manufacturing a large and thin glass substrate. Due to the fragile characteristic of the large and thin glass substrate, investigation of a method for maintaining the glass substrate stably and safely on a supporting frame during manufacturing processes becomes an important subject. This subject belongs to a kind of moving boundary problem and the method of Arbitrary Lagrangian Eulerian (ALE) with a finite element scheme is suitably used to solve it. Also, related methods of the generalized minimal residual method (GMRES) and pressure convection diffusion method are adopted to calculate pneumatic pressures distributed on the glass substrate. The results show that under a low frequency of the vertical transportation the glass substrate stably lies on the supporting frame, oppositely under a high frequency of the vertical transportation the glass substrate has possibility to depart from the supporting frame. The later situation is disadvantageous to the glass substrate and should be avoided as much as possible.
Miscible thermals are formed by instantaneously releasing a finite volume of buoyant fluid into stagnant ambient. Their subsequent motion is then driven by the buoyancy convection. The gross characteristics (e.g. overall size and velocity) of a thermal have been well studied and reported to be self-similar. However, there have been few studies concerning the internal structure. Here, turbulent miscible thermals (with initial density excess of 5 % and Reynolds number around 2100) have been investigated experimentally through a large number of realizations. The vorticity and density fields were quantified separately by particle image velocimetry (PIV) and planar laser-induced fluorescence (PLIF) techniques. Ensemble-averaged data of the transient development of the miscible thermals are presented. Major outcomes include: (i) validating Turner’s assumption of constant circulation within a buoyant vortex ring; (ii) measuring the vorticity and density distributions within the miscible thermal; (iii) quantifying the effect of baroclinicity on the generation and destruction of vorticity within the thermal; and (iv) identifying the significantly slower decay rate of the peak density as compared to the mean.
We undertook a national paediatric seroprevalence survey of measles, mumps and rubella (MMR) in Singapore to assess the impact of the national childhood immunization programme against these three diseases after introduction of the trivalent MMR vaccine in 1990. The survey involved 1200 residual sera of Singapore residents aged 1–17 years collected from two hospitals between 2008 and 2010. The overall prevalence of antibodies against measles, mumps and rubella was 83·1% [95% confidence interval (CI) 80·9–85·1], 71·8% (95% CI 69·1–74·2) and 88·5% (95% CI 86·6–90·2), respectively. For all three diseases, the lowest prevalence was in children aged 1 year (47·8–62·3%). The seroprevalence of the vaccinated children declined over time. The national MMR immunization programme is effective in raising the herd immunity of the childhood population, although certain age groups are more susceptible to infection, in particular, those who are not eligible for vaccination at age <15 months.
An array of closely spaced round buoyant jets interact dynamically due to the pressure field induced by jet entrainment. Mutual jet attraction can result in a significant change in jet trajectories. Jet merging also leads to overlapping of the passive scalar fields associated with the individual jets, resulting in mixing characteristics that are drastically different from those of an independent free jet. A general semi-analytical model for the dynamic interaction of multiple buoyant jets in stagnant ambient conditions is proposed. The external irrotational flow field induced by the buoyant jets is computed by a distribution of point sinks with strength equal to the entrainment per unit length along the unknown jet trajectories and accounting for boundary effects. The buoyant jet trajectories are then determined by an iterative solution of an integral buoyant jet model by tracking the changes in the external entrainment flow and dynamic pressure fields. The velocity and concentration fields of the jet group are obtained by momentum or kinetic energy superposition for merged jets and plumes, respectively. The modelling approach is supported by numerical solution of the Reynolds-averaged Navier–Stokes equations. The model shows that jet merging and mixing can be significantly affected by jet interactions. Model predictions of the multiple jet trajectories, merging height, as well as the centreline velocity and concentration of the buoyant jet group are in good agreement with experimental data for: (i) a clustered momentum jet group; (ii) a turbulent plume pair; and (iii) a rosette buoyant jet group. Dynamic interactions between a jet group are shown to decrease with the addition of an ambient cross-flow.