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Iron carbide (Fe1−xCx) thin films were successfully grown by plasma-enhanced atomic layer deposition (PEALD) using bis(N,N′-di-tert-butylacetamidinato)iron(II) as a precursor and H2 plasma as a reactant. Smooth and pure Fe1−xCx thin films were obtained by the PEALD process in a layer-by-layer film growth fashion, and the x in the nominal formula of Fe1−xCx is approximately 0.26. For the wide PEALD temperature window from 80 to 210 °C, a saturated film growth rate of 0.04 nm/cycle was achieved. X-ray diffraction and transition electron microscope measurements show that the films grown at deposition temperature 80–170 °C are amorphous; however, at 210 °C, the crystal structure of Fe7C3 is formed. The conformality and resistivity of the deposited films have also been studied. At last, the PEALD Fe1−xCx on carbon cloth shows excellent electrocatalytic performance for hydrogen evolution.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Malnutrition and acute kidney injury (AKI) are common complications in hospitalized patients, and both increase mortality; however, the relationship between them is unknown. This is a retrospective propensity score matching study enrolling 46,549 inpatients, aimed to investigate the association between Nutritional Risk Screening 2002 (NRS-2002) and AKI, and to assess the ability of NRS-2002 and AKI in predicting prognosis. In total, 37,190 (80%) and 9,359 (20%) patients had NRS-2002 scores < 3 and ≥ 3, respectively. Patients with NRS-2002 scores ≥ 3 had longer lengths of stay (12.6±7.8 days vs. 10.4±6.2 days, P < 0.05), higher mortality rates (9.6% vs. 2.5%, P<0.05), and higher incidence of AKI (28% vs. 16%, P < 0.05) than normal nutritional patients. The NRS-2002 showed a strong association with AKI, that is, the risk of AKI changed in parallel with the score of the NRS-2002. In short- and long-term survival, patients with a lower NRS-2002 score or who did not have AKI achieved a significantly lower risk of mortality than those with a high NRS-2002 score or AKI. Univariate Cox regression analyses indicated that both the NRS-2002 and AKI were strongly related to long-term survival (area under the curve (AUC) 0.79 and 0.71) and that the combination of the two showed better accuracy (AUC 0.80) than the individual variables. In conclusion, malnutrition can increase the risk of AKI, and both AKI and malnutrition can worsen the prognosis, that the undernourished patients who develop AKI yield far worse prognosis than normal nutritional patients.
The pathophysiology of obsessive-compulsive disorder (OCD) remains unclear despite extensive neuroimaging work on the disorder. Exposure to medication and comorbid mental disorders can confound the results of OCD studies. The goal of this study was to explore differences in brain functional connectivity (FC) within the cortico-striato-thalamo-cortical (CSTC) loop of drug-naïve and drug-free OCD patients and healthy controls (HCs).
A total of 29 drug-naïve OCD patients, 22 drug-free OCD patients, and 25 HCs matched on age, gender and education level underwent functional magnetic resonance imaging scanning at resting state. Seed-based connectivity analyses were conducted among the three groups. The Yale Brown Obsessive Compulsive Scale and clinical inventories were used to assess the clinical symptoms.
Compared with HCs, the drug-naïve OCD patients had reduced FC within the limbic CSTC loop. In the drug-naïve OCD participants, we also found hyperconnectivity between the supplementary motor area and ventral and dorsal putamen (p < 0.05, corrected for multiple comparisons).
Exposure to antidepressants such as selective serotonin reuptake inhibitors may affect the function of some brain regions. Future longitudinal studies could help to reveal the pharmacotherapeutic mechanisms in these loops.
We investigated the microscopic mineral characteristics of modern eolian dust particulates and the trace-element compositions of the siliciclastic fractions of these samples, collected from the Philippine Sea in 2014 and 2015, and conducted an air mass backwards trajectory analysis of dust particulates in the spring and winter of 2015, to better constrain the provenances and transport dynamics of dust delivered to this region. The microscopic minerals show obvious signatures of dust deposition and physical abrasion, indicating long-distance wind transport from the Asian deserts. The trace-element compositions (Zr–Th–Sc) display a binary mixture of eolian materials derived from the eastern Asian deserts and the central Asian deserts, which is similar to the result of the Sr–Nd isotopic compositions of modern sediment trap sediments collected on the Benham Rise in 2015. We demonstrate that modern dust sediments in the Philippine Sea primarily originate from the Ordos Desert (generally > 80%), while the contributions of the Taklimakan Desert and the Badain Jaran Desert are small. Eolian dust particulates raised from source regions are predominantly transported to the Philippine Sea by the East Asian winter monsoon, but not by the westerlies. In addition, our results indicate that increased precipitation in the source regions can result in relatively low dust fluxes in the Philippine Sea, and there is a period of 6–7 days for eolian dust originating from source areas to be delivered to the Philippine Sea.
Few of the previous studies of clinical high risk of psychosis (CHR) have explored whether outcomes other than conversion, such as poor functioning or treatment responses, are better predicted when using risk calculators. To answer this question, we compared the predictive accuracy between the outcome of conversion and poor functioning by using the NAPLS-2 risk calculator.
Three hundred CHR individuals were identified using the Chinese version of the Structured Interview for Prodromal Symptoms. Of these, 228 (76.0%) completed neurocognitive assessments at baseline and 199 (66.3%) had at least a 1-year follow-up assessment. The latter group was used in the NAPLS-2 risk calculator.
We divided the sample into two broad categories based on different outcome definitions, conversion (n = 46) v. non-conversion (n = 153) or recovery (n = 138) v. poor functioning (n = 61). Interestingly, the NAPLS-2 risk calculator showed moderate discrimination of subsequent conversion to psychosis in this sample with an area under the receiver operating characteristic curve (AUC) of 0.631 (p = 0.007). However, for discriminating poor functioning, the AUC of the model increased to 0.754 (p < 0.001).
Our results suggest that the current risk calculator was a better fit for predicting a poor functional outcome and treatment response than it was in the prediction of conversion to psychosis.
The Upper Ordovician Sandbian to Katian strata from the East Qilianshan (northeastern Tibet Plateau) bear a graptolite fauna of moderately high diversity. Graptolites from the Amplexograptus maxwelli beds to the Appendispinograptus longispinus Biozone (Sa2–Ka4 intervals) proposed herein include 27 species of 13 genera. This important graptolite fauna is first described herein although it was initially reported in 1963. Most of them occur in the A. longispinus Biozone corresponding to the Dicellograptus complexus to Paraorthograptus pacificus biozones of the Wufeng Formation in the Yangtze region. Alulagraptus new genus is established based on the materials from the East Qiqiaogou section. The endemic species, e.g., Alulagraptus ensiformis (Mu and Zhang in Mu et al., 1963), Dicellograptus sinicus Mu and Zhang in Mu et al., 1963, and Climacograptus? papilio Mu and Zhang in Mu et al., 1963, could indicate that East Qilianshan block was separated from South China.
Pumped by rectangular-shaped dissipative soliton resonance (DSR) pulses at 1030 nm, selective excitations of Raman Stokes lines of up to third order with extinction ratios of 8 dB and fifth order with extinction ratios of 4 dB are demonstrated experimentally. The rectangular DSR pulses are generated from a dual-amplifier ytterbium-doped figure-of-eight mode-locked laser constructed using all
-core-diameter large-mode-area fibers. By varying the two pump powers, the peak power of the output DSR pulses can be continuously tuned from 10 W to 100 W and from 30 W to 200 W, respectively, for two different lengths of the nonlinear amplifying loop mirror inside the cavity. High-frequency components are found to correspond to parts of the pulse in the trailing edge when two bandpass filters are used to separate the propagated pulse. Consequently, it provides an all-fiber technique to achieve selective excitation of the Raman shift by adjusting the peak power of the DSR pulse.
Higher fibre intake reduced all-cause and cardiovascular mortality among healthy population, but such data in dialysis patients are limited. We aimed to examine these associations in patients on peritoneal dialysis (PD). This single-centre prospective cohort study enrolled 881 incident PD patients between October 2002 and August 2014. All patients were followed until death, transfer to haemodialysis, renal transplantation or until being censored in June 2018. Demographic data were collected at baseline. Biochemical, dietary and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study. The outcomes were defined as all-cause and cardiovascular death. Cox proportional regression models were applied to explore the relationship between fibre intake and outcomes. Participants with higher fibre intake were more likely to be younger, male and have better residual renal function and serum lipids at baseline. They were prone to maintain better nutrient status, higher blood pressure and lower inflammatory status at baseline and afterwards. Neither baseline nor time-averaged fibre intake did show protective effects on all-cause mortality after multivariate adjustment in the whole cohort. Among non-diabetic PD patients, an independent association between fibre intake and all-cause mortality was found, in which each 1 g/d increase in time-averaged fibre intake correlated to 13 % of reduction in all-cause mortality. We did not observe any benefits of fibre intake in the CVD mortality for both whole cohort and subgroups. The present study revealed that higher dietary fibre intake appeared to have a protective effect on all-cause mortality in non-diabetic PD patients, which suggest that PD patients should be encouraged to eat a diet rich in fibres.
In recent years, soft robotics is widely considered as the most promising field for both research and application. First of all, the actuator is fundamental for designing, modeling, and controlling of soft robots. This paper presents a new type of pneumatic trunk-like soft actuator, which contains a chamber for stiffness adjustment in addition to three chambers for driving. Thus, the salient feature of the proposed actuator is the ability of stiffness self-regulation. The structure of the proposed actuator is described in detail. Then the theoretical models for elongation and bending motion of the actuator are established. The elongation as well as single-chamber and multi-chamber driving bending of the actuator were tested to verify the mathematical models. Finally, a dual-segment soft robot based on the proposed trunk-like soft actuator was developed and tested by experiments, which implies its potential application in practice.
The secondary instabilities of stationary cross-flow vortices in a Mach 6 swept wing flow are studied using Floquet theory. High-frequency secondary instability modes of ‘y’ mode on top of stationary cross-flow vortices, and ‘z’ mode concentrating on the shoulder of the stationary cross-flow vortex are found. The most unstable secondary instability mode is always the ‘z’ mode as in incompressible swept wing flows. A new secondary instability mode concentrating on the trough of the stationary cross-flow vortex is found. The balance analysis of disturbance kinetic energy shows that the new mode belongs to the class of ‘y’ mode. The growth rate of the new ‘y’ mode located on the trough of the stationary cross-flow vortex is significantly larger than that of the ‘y’ mode on top of the stationary cross-flow vortex, and is comparable with the growth rate of the ‘z’ mode. It is also found that the new ‘y’ mode with higher frequency can evolve into the ‘z’ mode further downstream. The role of the pressure fluctuation term, including the pressure diffusion and pressure dilatation, in the energy production of secondary instability modes, is also investigated. It is shown that the pressure diffusion will only enhance the growth rate of the ‘z’ mode with higher frequency, but has little influence on other types of secondary instability mode. However, the pressure dilatation term arising from non-vanishing velocity divergence will reduce the growth rates of all secondary instability modes.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
The third generation of the BeiDou navigation satellite system (BDS-3) is a global navigation system, and is expected to be in full operation by 2020. High-precision orbits are a precondition for BDS-3 to provide a highly accurate service, which needs a global tracking and monitoring capability for the operational satellites. However, it is difficult for BDS to construct global ground monitoring stations. Fortunately, Ka-band Inter-Satellite Link (ISL) antennae fitted to the BDS-3 satellites can be used to extend the visible arc of the Medium Earth Orbit (MEO) satellites and to enhance the ground stations for orbit determination. This paper analyses the ISL-enhanced orbit determination for eight BDS-3 satellites, using the data from ten Chinese domestic stations and 13 international Global Navigation Satellite System (GNSS) Monitoring and Assessment System (iGMAS) overseas stations. The results show that the Three-Dimensional (3D) position Root Mean Square (RMS) error of the Overlapping Orbit Differences (OODs) is approximately 1 m when only ten regional stations are used. When the ISL measurements are added, the 3D position RMS error is decreased to 0·5 m, and the accuracy of the 24-hour orbit prediction can also be improved from 2 m to 0·7 m, which is even better than that of the orbits determined using globally distributed stations. It can be expected that with the subsequent launch of BDS-3 satellites and the increasing number of ISLs, the advantage of the ISL enhanced orbit determination will become more significant.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
There is little evidence in China regarding the cost-effectiveness of non-invasive prenatal testing (NIPT) for Down syndrome (DS). This study aims to evaluate the cost-effectiveness of NIPT and provide evidence to inform decision-making.
To determine the cost-effectiveness of NIPT for DS, a decision-analytic model was developed using the TreeAge Pro software from a societal perspective in a simulated cohort of 10 000 pregnant women. Main indicators were based on field surveys from sampled hospitals in four locations in China and a literature review.
The conventional maternal serum screening (CMSS) strategy, contingent screening strategy (NIPT delivered to high risk pregnant women after CMSS), and universal screening strategy could prevent 3.02, 7.53, and 9.97 DS births, respectively. NIPT would decrease unnecessary invasive procedures, resulting in fewer procedure-related miscarriages. The cost-effectiveness ratio of the contingent screening strategy was the lowest. When compared with the CMSS strategy, the incremental cost per DS birth averted by the contingent screening strategy and universal screening strategy were USD 20,160 and 352,388, respectively. One-way sensitivity analysis showed that, if the cost of NIPT could be decreased to USD 76.92, the cost-effectiveness ratio of the universal screening strategy would be lower than the CMSS strategy.
Although NIPT has the merits of greater effectiveness and safety, CMSS is unlikely to be replaced by NIPT at this time because of NIPT's higher cost. Contingent screening may be an appropriate strategy to balance the effectiveness and cost factors of the new genetic testing technology.
Ceramics are strong but brittle. According to the classical theories, ceramics are brittle mainly because dislocations are suppressed by cracks. Here, the authors report the combined elastic and plastic deformation measurements of nanoceramics, in which dislocation-mediated stiff and ductile behaviors were detected at room temperature. In the synchrotron-based deformation experiments, a marked slope change is observed in the stress–strain relationship of MgAl2O4 nanoceramics at high pressures, indicating that a deformation mechanism shift occurs in the compression and that the nanoceramics sample is elastically stiffer than its bulk counterpart. The bulk-sized MgAl2O4 shows no texturing at pressures up to 37 GPa, which is compatible with the brittle behaviors of ceramics. Surprisingly, substantial texturing is seen in nanoceramic MgAl2O4 at pressures above 4 GPa. The observed stiffening and texturing indicate that dislocation-mediated mechanisms, usually suppressed in bulk-sized ceramics at low temperature, become operative in nanoceramics. This makes nanoceramics stiff and ductile.
Sn–Sb alloy is an ideal candidate for lead-free solder; however, its performance has been inferior to that of Sn–Pb alloy. Here, the authors used ab initio molecular dynamics simulation to investigate the interatomic interaction in Sn–Sb-based lead-free solders. By calculating the electron density distribution, bond population, and partial density of states, the authors found that the Sn–Sb bonds are a mixture of nonlocalized metal and localized covalent bonds. The covalent bond between Sn and Sb is easy to break at higher temperatures, so Sn–Sb (6.4 wt%) had better fluidity than other studied Sn–Sb alloys. Furthermore, adding Cu or Ag into Sn–Sb alloys can decrease the strength of covalent bonds and stabilize the metal bonds, which improves the metallicity and wettability of the Sn–Sb–Cu and Sn–Sb–Cu–Ag systems when the temperature increases. These results are all in good agreement with experimental findings and have significant value for the development of new solder alloys.
Recently, we introduced an epoxy group to mebendazole by a reaction with epichlorohydrin and obtained two isoforms, mebendazole C1 (M-C1) and mebendazole C2 (M-C2). The in vitro effects of mebendazole derivatives at different concentrations on Echinococcus multilocularis protoscoleces and metacestodes as well as cytotoxicity in rat hepatoma (RH) cells were examined. The results demonstrated that the solubility of the two derivatives was greatly improved compared to mebendazole. The mortality of protoscoleces in vitro reached to 70–80% after 7 days of exposure to mebendazole or M-C2, and M-C2 showed higher parasiticidal effects than mebendazole (P > 0.05). The parasiticidal effect of M-C1 was low, even at a concentration of 30 µm. The percentage of damaged metacestodes that were treated with mebendazole and M-C2 in vitro at different concentrations were similar, and M-C1 exhibited insignificant effects on metacestodes. Significant morphological changes on protoscoleces and metacestodes were observed after treatment with mebendazole and M-C2. In addition, the introduction of an epoxy group to mebendazole also reduced its cytotoxicity in RH cells. Our results demonstrate that the introduction of an epoxy group not only improved the solubility of mebendazole, but also increased its parasiticidal effects on E. multilocularis and reduced its cytotoxicity in RH cells.