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The disease burden of infectious diarrhea cannot be underestimated. Its seasonal patterns indicate that weather patterns may play an important role and have an important effect on it. The objective of this study was to clarify the relationship between temperature and infectious diarrhea, and diarrhea-like illness.
Distributed lag non-linear model, which was based on the definition of a cross-basis, was used to examine the effect.
Viral diarrhea usually had high incidence in autumn-winter and spring with a peak at -6°C; Norovirus circulated throughout the year with an insignificant peak at 8°C, while related bacteria usually tested positive in summer and peaked at 22°C. The lag-response curve of the proportion of diarrhea-like cases in outpatient and emergency cases revealed that at -6°C, with the lag days increasing, the proportion increased. Similar phenomena were observed at the beginning of the curves of virus and bacterial positive rate, showing that the risk increased as the lag days increased, peaking on days 16 and 9, respectively. The shape of lag-response curve of norovirus positive rate was different from others, presenting m-type, with 2 peaks on day 3 and day 18.
Weather patterns should be taken into account when developing surveillance programs and formulating relevant public health intervention strategies.
Mach reflection subjected to the influence of an upstream shock wave from the same side is studied here. This situation occurs when two incident shock waves induced by a double wedge reflect at the same point of the reflecting surface and when the downstream incident shock wave is stronger than the upstream one. A shock polar analysis is used to show that this configuration produces an inverted Mach stem and a type IV shock interference between the Mach stem and the upstream shock wave. This shock interference produces a jet that divides the flow stream downstream of the Mach stem into two ducts with different sonic throats, thus complicating the mechanism by which the Mach stem size is determined. A transition analysis shows that the Mach reflection of the downstream shock wave is promoted by the upstream one. Computational fluid dynamics is used to assess the flow pattern anticipated by shock polar analysis and demonstrates how the heights of Mach stem and jet depend on the inflow Mach number and wedge turning angle.
Bituminous limestone of the Ediacaran Shibantan Member of the Dengying Formation (551–539 Ma) in the Yangtze Gorges area contains a rare carbonate-hosted Ediacara-type macrofossil assemblage. This assemblage is dominated by the tubular fossil Wutubus Chen et al., 2014 and discoidal fossils, e.g., Hiemalora Fedonkin, 1982 and Aspidella Billings, 1872, but frondose organisms such as Charnia Ford, 1958, Rangea Gürich, 1929, and Arborea Glaessner and Wade, 1966 are also present. Herein, we report four species of Arborea from the Shibantan assemblage, including the type species Arborea arborea (Glaessner in Glaessner and Daily, 1959) Glaessner and Wade, 1966, Arborea denticulata new species, and two unnamed species, Arborea sp. A and Arborea sp. B. Arborea arborea is the most abundant frond in the Shibantan assemblage. Arborea denticulata n. sp. resembles Arborea arborea in general morphology but differs in its fewer primary branches and lower length/width ratio of primary branches. Arborea sp. A and Arborea sp. B are fronds with a Hiemalora-type basal attachment. Sealing by microbial mats and authigenic cementation may have played an important role in the preservation of Arborea in the Shibantan assemblage. The Shibantan material of Arborea extends the stratigraphic, ecological, and taphonomic ranges of this genus.
A one-dimensional steady-state model for stimulated Raman backscatter (SRS) and stimulated Brillouin backscatter (SBS) processes in laser-irradiated plasmas is presented. Based on a novel “predictor-corrector” method, the model is capable to deal with broadband scattered light and inhomogeneous plasmas, exhibiting robustness and high efficiency. Influences of the electron density and temperature on the linear gains of both SRS and SBS are investigated, which indicates that the SRS gain is more sensitive to the electron density and temperature than that of the SBS. For the low-density case, the SBS dominates the scattering process, while the SRS exhibits much higher reflectivity in the high-density case. The nonlinear saturation mechanisms and competition between SRS and SBS are included in our model by a phenomenological method. The typical anti-correlation between SRS and SBS versus electron density is reproduced in the model. Calculations of the reflectivities are qualitatively in agreement with the typical results of experiments and simulations.
Mach reflection in steady supersonic flow with two incident shock waves that reflect at the same point on the reflecting surface has been studied recently. Under some conditions we have pre-Mach reflection, where the first incident shock wave produces Mach reflection, the reflected shock wave of which intersects the second incident shock wave, leading to a type I shock interference structure. In this study, we find that a critical condition exists to have a double solution of this shock interference, i.e. we may either have type I interference or type II interference. However, numerical simulation shows that, for inverted Mach reflection, the double solution domain is below the theoretical one and for usual Mach reflection, the double solution domain is above the theoretical one. This discrepancy is found to be due to secondary Mach waves on the initial segment of the slipline of the Mach reflection, thus demonstrating for the first time a case where the transition criterion is modified by secondary Mach waves developed over the primary flow structure.
This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment.
This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization.
A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects.
After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.
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 this paper, a novel multilayer substrate integrated dual-mode dielectric resonator (DR) filter is proposed. The square dual-mode DR is made of the high permittivity substrate by removing the undesired portions and the surface coppers so that the relatively high unloaded quality factor of the dominate TM11 pair can be obtained which compared to these fully dielectric-filled substrate integrated waveguides. Meanwhile, it can be easily integrated in an equivalent cavity implemented by multilayer printed circuit boards for filter design, showcasing low in-band loss, light weight, and compact size. For demonstration, a multilayer substrate integrated DR bandpass filter centered at X-band is designed and measured. Good agreement between the simulated and measured results can be observed, and the measured insertion loss at the passband center frequency (8.38 GHz) is 1.1 dB.
Maternal one-carbon metabolism during pregnancy is crucial for fetal development and programming by DNA methylation. However, evidence on one-carbon biomarkers other than folate is lacking. We, therefore, investigated whether maternal plasma methyl donors, that is, choline, betaine and methionine, are associated with birth outcomes. Blood samples were obtained from 115 women during gestation (median 26·3 weeks, 90 % range 22·7–33·0 weeks). Plasma choline, betaine, methionine and dimethylglycine were measured using HPLC-tandem MS. Multivariate linear and logistic regression models were used to estimate the association between plasma biomarkers and birth weight, birth length, the risk of small-for-gestational-age and large-for-gestational-age (LGA). Higher level of maternal betaine was associated with lower birth weight (–130·3 (95 % CI –244·8, –15·9) per 1 sd increment for log-transformed betaine). Higher maternal methionine was associated with lower risk of LGA, and adjusted OR, with 95 % CI for 1 sd increase in methionine concentration was 0·44 (95 % CI 0·21, 0·89). Stratified analyses according to infant sex or maternal plasma homocysteine status showed that reduction in birth weight in relation to maternal betaine was only limited to male infants or to who had higher maternal homocysteine status (≥5·1 µmol/l). Higher maternal betaine status was associated with reduced birth weight. Maternal methionine was inversely associated with LGA risk. These findings are needed to be replicated in future larger studies.
The aim of this study was to investigate the in vivo degradation mechanism and the mechanical properties of poly(lactide-co-glycolide)/beta-tricalcium phosphate (PLGA/β-TCP) composite anchors. Anchors composed of PLGA and β-TCP were implanted in the dorsal subcutaneous tissue of beagle dogs for 6, 12, 16, and 26 weeks. The degradation of the materials was evaluated by measuring the changes in thermal behavior, crystallinity, and mechanical properties. Scanning electron microscope (SEM) was used to observe the surface and longitudinal section of the material. The evaluation of mechanical strength retention and degradation properties suggest that the addition of β-TCP particles efficiently enhances their mechanical properties and thermal characteristics and delays their degradation rate. By analyzing the results of SEM, X-ray diffraction, and differential scanning calorimetry, we can infer that after 12 weeks, the connection between β-TCP and PLGA becomes less compact, which accelerates the decline of mechanical strength.
Mach reflection in steady supersonic flow with two incident shock waves is studied. The second incident shock wave is produced by an additional deflection of the wedge lower surface, at some point ensuring that the two incident shock waves would intersect at the reflecting surface in case of normal reflection. Both theory and computational fluid dynamics (CFD) are used to study the flow structure and the influence of the second incident shock wave. The overall flow configuration, in case of Mach reflection, is shown to be composed of a triple shock structure, a shock/shock interaction structure and a shock/slipline reflection structure. Similar phenomenon, triggered by a high downstream pressure, has been observed before numerically, but not studied theoretically. The second incident shock wave reflects over the slipline to deflect the slipline more towards the reflecting surface, increasing thus the Mach stem height, advancing the transition of regular reflection to Mach reflection of the first incident shock wave, and causing an inverted Mach reflection below the usual von Neumann condition. A Mach stem height model built for a weak second incident shock wave is used to study the influence of the second incident shock wave on the Mach stem height. Both theory and CFD predict a maximum of the Mach stem height at some additional wedge deflection angle.
Dietary energy density (ED) might have influences on body composition. We therefore examined whether ED is associated with body composition among Chinese adults.
We collected dietary data through validated two-day 24 h recalls. ED, defined as the amount of energy per unit weight of food consumed, was calculated based on five methods. Multiple linear regression analyses were performed to explore the associations between ED and body composition parameters, including BMI, fat mass index (FMI), fat-free mass index (FFMI), percentage body fat (%BF) and waist circumference (WC).
Chinese adults (n 1933) in 2013.
After adjusting the covariates, all ED definitions were positively associated with BMI, FMI, FFMI, %BF and WC among women (P<0·01). In men, however, ED with foods only was positively associated with BMI, FMI, FFMI and %BF (P<0·05), but not with WC (P=0·07); we also found null associations between ED with foods and all beverages and body composition among men. Additionally, ED contributed to higher increases of body composition in women than in men (P<0·01).
The present study supports the positive association between ED and body composition among adults in Southwest China, in which beverages may play an important role.
Gamma-ray observations for Supernova remnant (SNR)-molecular cloud (MC) association systems play an important role in the research on the acceleration and propagation of cosmic-ray protons. Through the analysis of 5.6 years of Fermi-Large Area Telescope observation data, here we report on the detection of a gamma-ray emission source near the SNR Kesteven 41 with a significance of 24σ in 0.2–300 GeV. The best-fit location of the gamma-ray source is consistent with the MC with which the SNR interacts. Several hypotheses including both leptonic and hadronic scenarios are considered to investigate the origin of these gamma-rays. The gamma-ray emission can be naturally explained by the decay of neutral pions produced via the collision between high energy protons accelerated by the shock of Kesteven 41 and the adjacent MC. The electron energy budget would be too high for the SNR if the gamma-rays were produced via inverse Compton (IC) scattering off the Cosmic Microwave Background (CMB) photons.
The strain hardening effect and dynamic recovery behavior of a Ni-based superalloy are studied by isothermal compressive tests. A new unified dislocation-density based constitutive model is developed to characterize the strain hardening effect and dynamic recovery behavior of the studied superalloy. In the developed constitutive model, some material parameters (yield stress, strain hardening coefficient, and dynamic recovery coefficient) are assumed as functions of initial grain size, deformation temperature, and strain rate. An iterative algorithm is designed to predict the high-temperature deformation behaviors under time-variant hot working conditions. The hot deformation parameters and material parameters can be updated in each strain increment. Comparisons between the experimental and calculated flow stresses indicate that the developed constitutive model can accurately describe the high-temperature deformation behavior of the studied superalloy. Furthermore, the developed constitutive model is also successfully used for analyzing time-variant hot working processes.
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.
Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24–27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0·79, 95 % CI 0·64, 0·97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1·23, 95 % CI 1·02, 1·49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction = 0·022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.
The present study was conducted to evaluate the anti-parasitic activity of a pure compound from Streptomyces sp. HL-2-14 against fish parasite Ichthyophthirius multifiliis, and elucidate its chemical structure. By electron ionization mass spectrometry (ESI-MS) and nuclear magnetic resonance spectrum (1H NMR and 13C NMR), the compound was identified as amphotericin B (AmB). The in vitro trials revealed that AmB can effectively kill the theronts and tomonts of I. multifiliis with the median lethal concentration (LC50) of 0·8 mg L−1 at 30 min for the theronts and 4·3 mg L−1 at 2 h for the tomonts, respectively. AmB at 5 mg L−1 significantly reduced I. multifiliis infectivity prevalence and intensity on grass carp (Ctenopharyngodon idella), and consequently decreased fish mortality, from 100% in control group to 30% in treated group. The 72 h acute toxicity (LC50) of AmB on grass carp was 20·6 mg L−1, but fish mortality was occurred when exposure to 13·0 mg L−1. These results indicated that AmB was effective in the therapy of I. multifiliis infection, but the safety concentration margin is relatively narrow. Further efforts aiming to decrease the toxicity and improve the therapeutic profile remain to be needed.
The present study aimed to compare the effects of a general dietary intervention and an intervention with low glycaemic load (GL) on glycaemic control, blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus.
Participants were randomly assigned to two groups, receiving either an individualized general dietary intervention (Control group) or an intensive low-GL intervention (Low-GL group) every two weeks, from 24–26 weeks of gestation to delivery.
The Center of Maternal Primary Care in Guangdong General Hospital, China.
Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009.
After the intervention, both groups significantly decreased their dietary intakes of energy, fat and carbohydrate. The Low-GL group had significantly lower values for GL (122 v. 136) and glycaemic index (50 v. 54) but greater dietary fibre intake (33 v. 29 g/d) than did the Control group (all P<0·01). Significantly greater decreases in fasting plasma glucose (−0·33 v. −0·02 mmol/l, P<0·01) and 2 h postprandial glucose (−2·98 v. −2·51 mmol/l, P<0·01), significantly lower increases in total cholesterol (0·12 v. 0·23 mmol/l) and TAG (0·41 v. 0·56 mmol/l) and a significantly lower decrease in HDL cholesterol (−0·01 v. −0·11 mmol/l) were also observed in the Low-GL group compared with the Control group (all P<0·05). There were no significant differences in body weight gain, birth weight or other maternal–fetal perinatal outcomes between the two groups.
The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus.