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Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections. The use of a possible ACMS definition should be considered for retrospective nursing home infection surveillance.
There seems to be geographical differences in decisions about breast conserving surgery (BCS) in breast cancer patients. This study was to evaluate patients’ attitude to BCS and to assess the factors affecting cancer practice in West China.
A structured questionnaire was distributed to 184 patients, eliciting information about the patients’ characteristics, occupation, education, family life, recognition of illness, knowledge about BCS, the main means of gaining surgery information, selecting surgery approaches, preferences to breast reservation.
In all, 163 patients completed the questionnaire. The results indicated that only 7.4% of patients received BCS and 23% of the remaining patients desired to have BCS and the affecting factors were significantly associated with their family life, recognition of illness and the main means of gaining surgery information (P < 0.05). No associations were between BCS selecting and the other variables studied. The most frequent reasons for selecting BCS were keeping the female shape and improving quality of life (71%), the second most were postoperative recovery, minimal influence of physical function (47%) and patients’ knowledge about BCS (42%). The most frequent reasons for not selecting BCS were uncertainty about BCS results and worry about recurrence (81%), the second most was the elderly age unnecessary for BCS (40%).
The findings indicate that breast cancer patients in West China do not take BCS as the first choice as the best treatment method. It is warranted that further study of more patients, attitude of patients’ partners and physicians to BCS.
Previous studies have shown that the polymorphisms in COMT gene and environmental factors affect the risk of drug dependence, but there’s no research shown in relapse of heroin dependence, and the mechanism underlying remains uncertain.
Examine the interaction between allelic variants of the catechol-O- methlytransferase (COMT) gene and environmental factors (encountering drug-related environmental situations, social support) in contribution to relapse in heroin dependence.
Construct the gene-environment interaction model in order to understand the mechanism for relapse in heroin dependence.
The 249 heroin dependent subjects who followed up at one year after abstinent by using the natural history interview (NHI), social support rateing Scale (SSRS), and other questionnaires were genotyped for eight tagging single nucleotide polymorphisms (SNP) on the COMT gene. General Multifactor Dimensionality Reduction (GMDR) was used to construct the gene-environment interaction model which impacting relapse in heroin dependence.
The relapse group had higher frequencies of encountering drug-related environment (EDE) and G allele and GG genotype frequencies on COMT gene rs4680 locus and less Social Support Scale scores than that in the abstinence group. Logistic regression analysis showed that encountering more drug-related environment and GG genotype carriers were the risk factors for relapse in heroin dependence. GMDR analysis showed that the COMT gene was interact with the frequency of EDE and social support level to impact the relapse in heroin dependence.
Gene-environment interaction between COMT gene and the frequency of EDE and social support were related to heroin dependence relapse.
The use of antidepressants (AD) in children and adolescents has become controversial due to a possible increased risk of suicide, revised evidence about effectiveness, and growing usage. Several studies have been conducted through healthcare databases, mainly restricted to hospitalized cases.
To evaluate the rate of self-harm among children (10–14 years) and adolescents (15–19 years) who use AD and to compare rates between classes of AD, using a common data model.
A retrospective cohort study was conducted in children and adolescents, age 10–19, members of the Quebec (QC) public drug plan or residents of British Columbia (BC), and who received a new AD treatment in 1997–2008 (QC) and 1997–2006 (BC). Self-harm (fatal or non-fatal) was the main outcome. Data sources consisted of prescription, medical services, and hospitalization databases. AD were categorized into: fluoxetine (only AD approved for paediatric use for depression in Canada), non-fluoxetine SSRIs, TCAs, and others. Multivariate logistic regression analyses were conducted using high dimensional propensity scores.
Were included 51,868 and 28,200 AD users from BC and QC, respectively: 70% were females, and 60% had received a diagnosis of depression. Risk of hospitalization for self-harm was 38.15 and 19.23/1000 person-years in BC and QC, respectively. Rates were higher among adolescents (BC: 47.52; QC: 21.36) than children (BC: 17.00, QC: 12.99). For both hospitalized and non-hospitalized cases, while there was no statistically significant difference in risk associated with fluoxetine relative to non-fluoxetine SSRIs, TCAs were associated with a lower risk in BC (OR = 0.47; 95% CI: 0.31–0.72) and Quebec (OR = 0.41; 95% CI: 0.30–0.46).
In two independent large cohorts, there was no apparent differences in risk across ADs. Lower risk of TCAs may be due to residual confounding by indication.
To investigate the difference of visual pattern memory among first-episode treatment-naive patients with deficit and nondeficit schizophrenia.
199 first-episode treatment-naive patients with schizophrenia, and 148 controls were recruited. Schedule for the Deficit Syndrome (SDS) was used to categorize the patients into deficit or nondeficit subtype. Pattern Recognition Memory (PRM) was used to test the immediate and delayed mode of visual pattern memory. Positive and Negative Symptom Scale PANSS was used to assess the degree of patients symptoms.
The PRM immediate mode and delayed mode percent correct was significant lower and time latency was significant longer in two subtypes of patients. There were no significant difference in the performance of immediate mode of PRM between deficit and nondeficit patients[(86.49 ± 15.34) vs. (87.28 ± 16.00), P=0.960]. But the impairment was more severe in patients with deficit schizophrenia [percent correct (63.10 ± 19.17) vs. (70.69 ± 15.34), P< 0.001 time latency 5086.80 ± 7528.54 vs. 3527.40 ± 3649.08 P=0.024] in the delayed mode. and PRM has no significant correlation with the negative symptoms of deficit schizophrenia.
There were significant difference in the performance of immediate and delayed mode of PRM between patients and controls. The difference between first-episode treatment-naïve deficit schizophrenia and nondeficit schizophrenia was only in delayed mode of PRM, and has no correlation with the primary negative symptoms. The deficit schizophrenia is a subtype of schizophrenia with unique impairment of cognitive functions.
The implementation of advanced multi-level modulation schemes such as quadrature phase-shift keying (QPSK) in contrast to the conventional on–off keying is crucial to further boost the terahertz (THz) communications speed. Thereby, carrier phase noise reduction in the THz range is one of the key goals that need to be urgently achieved. In this paper, the photonic-based THz sources and the phase noise problem are briefly summarized. Then, a low phase-noise photonic source based on the stimulated Brillouin scattering (SBS) optical fiber cavity is first applied for a 300-GHz-band QPSK wireless communication link. The highest data rate at forward-error-correction limited condition was 15 Gbaud utilizing the SBS-based photonic source with a small transmit power of ~ −36 dBm. Its transmission characteristics are evaluated and compared with the conventional optical frequency comb generator (OFCG)-based source at 5 Gbaud. The proposed SBS-based photonic source has been proven to offer better performances than the OFCG-based source with respect to the phase noise, optical carrier to noise ratio, and bit error rate in communications.
To evaluate the upper airway morphology changes associated with ageing in adult Chinese patients with obstructive sleep apnoea.
A total of 124 male patients diagnosed with obstructive sleep apnoea by overnight polysomnography, who underwent upper airway computed tomography, were enrolled. The linear dimensions, cross-sectional area and volume of the upper airway region and the surrounding bony frame were measured. The association between ageing and upper airway morphology was analysed.
Soft palate length, minimum cross-sectional area of the retroglossal region, lateral dimensions at the minimum cross-sectional area of the retropalatal and retroglossal regions, nasopharyngeal volume, and average cross-sectional area of the nasopharyngeal region were found to significantly increase with ageing in all patients, while the upper airway shape flattened with ageing. The volume of the retropalatal region increased with ageing among the patients with a body mass index of less than 24 kg/m2. The volume of parapharyngeal fat pad increased with ageing among patients with a body mass index greater than 28 kg/m2.
A number of dimensional, cross-sectional and volumetric parameters of the pharynx increased with age, indicating that non-anatomical factors may play a more important role in the pathogenesis of obstructive sleep apnoea in aged patients.
Nutritional therapy is a cornerstone of burns management. The optimal macronutrient intake for wound healing after burn injury has not been identified, although high-energy, high-protein diets are favoured. The present study aimed to identify the optimal macronutrient intake for burn wound healing. The geometric framework (GF) was used to analyse wound healing after a 10 % total body surface area contact burn in mice ad libitum fed one of the eleven high-energy diets, varying in macronutrient composition with protein (P5−60 %), carbohydrate (C20−75 %) and fat (F20−75 %). In the GF study, the optimal ratio for wound healing was identified as a moderate-protein, high-carbohydrate diet with a protein:carbohydrate:fat (P:C:F) ratio of 1:4:2. High carbohydrate intake was associated with lower mortality, improved body weight and a beneficial pattern of body fat reserves. Protein intake was essential to prevent weight loss and mortality, but a protein intake target of about 7 kJ/d (about 15 % of energy intake) was identified, above which no further benefit was gained. High protein intake was associated with delayed wound healing and increased liver and spleen weight. As the GF study demonstrated that an initial very high protein intake prevented mortality, a very high-protein, moderate-carbohydrate diet (P40:C42:F18) was specifically designed. The dynamic diet study was also designed to combine and validate the benefits of an initial very high protein intake for mortality, and subsequent moderate protein, high carbohydrate intake for optimal wound healing. The dynamic feeding experiment showed switching from an initial very high-protein diet to the optimal moderate-protein, high-carbohydrate diet accelerated wound healing whilst preventing mortality and liver enlargement.
The fatty acid composition of chicken’s meat is largely influenced by dietary lipids, which are often used as supplements to increase dietary caloric density. The underlying key metabolites and pathways influenced by dietary oils remain poorly known in chickens. The objective of this study was to explore the underlying metabolic mechanisms of how diets supplemented with mixed or a single oil with distinct fatty acid composition influence the fatty acid profile in breast muscle of Qingyuan chickens. Birds were fed a corn-soybean meal diet supplemented with either soybean oil (control, CON) or equal amounts of mixed edible oils (MEO; soybean oil : lard : fish oil : coconut oil = 1 : 1 : 0.5 : 0.5) from 1 to 120 days of age. Growth performance and fatty acid composition of muscle lipids were analysed. LC-MS was applied to investigate the effects of CON v. MEO diets on lipid-related metabolites in the muscle of chickens at day 120. Compared with the CON diet, chickens fed the MEO diet had a lower feed conversion ratio (P < 0.05), higher proportions of lauric acid (C12:0), myristic acid (C14:0), palmitoleic acid (C16:1n-7), oleic acid (C18:1n-9), EPA (C20:5n-3) and DHA (C22:6n-3), and a lower linoleic acid (C18:2n-6) content in breast muscle (P < 0.05). Muscle metabolome profiling showed that the most differentially abundant metabolites are phospholipids, including phosphatidylcholines (PC) and phosphatidylethanolamines (PE), which enriched the glycerophospholipid metabolism (P < 0.05). These key differentially abundant metabolites – PC (14:0/20:4), PC (18:1/14:1), PC (18:0/14:1), PC (18:0/18:4), PC (20:0/18:4), PE (22:0/P-16:0), PE (24:0/20:5), PE (22:2/P-18:1), PE (24:0/18:4) – were closely associated with the contents of C12:0, C14:0, DHA and C18:2n-6 in muscle lipids (P < 0.05). The content of glutathione metabolite was higher with MEO than CON diet (P < 0.05). Based on these results, it can be concluded that the diet supplemented with MEO reduced the feed conversion ratio, enriched the content of n-3 fatty acids and modified the related metabolites (including PC, PE and glutathione) in breast muscle of chickens.
The small intestine is an important digestive organ and plays a vital role in the life of a pig. We tested the hypothesis that the length of the small intestine is related to growth performance and intestinal functions of piglets. A total of 60 piglets (Duroc × Landrace × Yorkshire), weaned at day 21, were fed an identical diet during a 28-day trial. At the end of the study, all piglets were sacrificed, dissected and grouped according to small intestine lengths (SILs), either short small intestine (SSI), middle small intestine (MSI) or long small intestine (LSI), respectively. Positive relationships between SIL and BW, average daily gain (ADG), average daily feed intake (ADFI) and gain-to-feed ratios (G : F) were observed. Final BW, ADG, ADFI and G : F significantly increased (P < 0.05) in MSI and LSI piglets compared with SSI piglets. Short small intestine and MSI had greater jejunal mucosa sucrase and alkaline phosphatase activities (P < 0.05) than LSI piglets. The mRNA level of solute carrier family 2 member 2 (Slc2a2) in the jejunal mucosa of SSI piglets was the greatest. The MSI piglets had a greater (P < 0.05) ileal villus height than other piglets and greater (P < 0.05) villus height-to-crypt depth ratios than LSI piglets. However, the LSI piglets had a greater (P < 0.05) ileal crypt depth than SSI piglets. No significant differences in duodenal, jejunal, caecal and colonic morphologies were detected among the groups. Moreover, luminal acetate, propionate, butyrate and total short-chain fatty acid contents were greater (P < 0.05) in SSI and MSI piglets than those in LSI piglets. In addition, there was greater serum glucose concentration in MSI piglets than other piglets. Serum albumin concentration in SSI piglets was the lowest. In conclusion, these results indicate that SIL was significantly positively associated with growth performance, and in terms of intestinal morphology and mucosal digestive enzyme activity, the piglets with a medium length of small intestine have better digestion and absorption properties.
Although numerous studies have investigated the individual effects of salinity, irrigation and fertilization on soil microbial communities, relatively less attention has been paid to their combined influences, especially using molecular techniques. Based on the field of orthogonal designed test and deoxyribonucleic acid sequencing technology, the effects of saline water irrigation amount, salinity level of irrigation water and nitrogen (N) fertilizer rate on soil bacterial community structure were investigated. The results showed that the irrigation amount was the most dominant factor in determining the bacterial richness and diversity, followed by the irrigation water salinity and N fertilizer rate. The values of Chao1 estimator, abundance-based coverage estimator and Shannon indices decreased with an increase in irrigation amount while increased and then decreased with an increase in irrigation water salinity and N fertilizer rate. The highest soil bacterial richness and diversity were obtained under the least irrigation amount (25 mm), medium irrigation water salinity (4.75 dS/m) and medium N fertilizer rate (350 kg/ha). However, different bacterial phyla were found to respond distinctively to these three factors: irrigation amount significantly affected the relative abundances of Proteobacteria and Chloroflexi; irrigation water salinity mostly affected the members of Actinobacteria, Gemmatimonadetes and Acidobacteria; and N fertilizer rate mainly influenced the Bacteroidetes' abundance. The results presented here revealed that the assessment of soil microbial processes under combined irrigation and fertilization treatments needed to be more careful as more variable consequences would be established by comparing with the influences based on an individual factor, such as irrigation amount or N fertilizer rate.
In this study, the thermal deformation of a machine tool structure due to the heat generated during operation was analyzed, and embedded cooling channels were applied to exchange the heat generated during the operation to achieve thermal error suppression. Then, the finite volume method was used to simulate the effect of cooling oil temperature on thermal deformation, and the effect of thermal suppression was experimentally studied using a feed system combined with a cooler to improve the positioning accuracy of the machine tool. In this study, the supply oil temperature in the structural cooling channels was found to significantly affect the position accuracy of the moving table and moving carrier. If the supply oil temperature in the cooling channels is consistent with the operational ambient temperature, the position accuracy of the moving table in the Y direction and the moving carrier in the X and Z directions has the best performance under different feed rates. From the thermal suppression experiments of the embedded cooling channels, the positioning accuracy of the feed system can be improved by approximately 25.5 % during the dynamic feeding process. Furthermore, when the hydrostatic guideway is cooled and dynamic feeding is conducted, positioning accuracy can be improved by up to 47.8 %. The machining accuracy can be improved by approximately 60 % on average by using the embedded cooling channels in this study. Therefore, thermal suppression by the cooling channels in this study can not only effectively improve the positioning accuracy but also enhance machining accuracy, proving that the method is effective for enhancing machine tool accuracy.
We report the dielectric properties of ACu3Ti4O12 (A = Eu2/3, Tb2/3, and Na1/2Eu1/2) (ACTO) in the frequency range of 40 Hz–2.5 MHz and in the temperature range of 293–473 K. The experimental results show that substituting for Ca improves the loss tangent of CaCu3Ti4O12 (CCTO). Although the dielectric constants largely decrease, they remain at a high level of 103. To identify the observed dielectric performances of ACTO, scanning electron microscopy and complex impedance measurements were conducted. The conducting mechanism for the grain of ACTO was found to be ion jumping rather than electron hopping (for the grain of CCTO). The results show that the decreased dielectric constant may be related to the decreased grain size, the different carrier in the grain, the different grain boundary properties, or a combination of these factors. All these factors are associated with the deficiency of oxygen vacancies in the samples of ACTO. The decreased loss tangent may be due to the increase in the grain boundary resistance.
Space Infrared Telescope for Cosmology and Astrophysics (SPICA), the cryogenic infrared space telescope recently pre-selected for a ‘Phase A’ concept study as one of the three remaining candidates for European Space Agency (ESA's) fifth medium class (M5) mission, is foreseen to include a far-infrared polarimetric imager [SPICA-POL, now called B-fields with BOlometers and Polarizers (B-BOP)], which would offer a unique opportunity to resolve major issues in our understanding of the nearby, cold magnetised Universe. This paper presents an overview of the main science drivers for B-BOP, including high dynamic range polarimetric imaging of the cold interstellar medium (ISM) in both our Milky Way and nearby galaxies. Thanks to a cooled telescope, B-BOP will deliver wide-field 100–350
m images of linearly polarised dust emission in Stokes Q and U with a resolution, signal-to-noise ratio, and both intensity and spatial dynamic ranges comparable to those achieved by Herschel images of the cold ISM in total intensity (Stokes I). The B-BOP 200
m images will also have a factor
30 higher resolution than Planck polarisation data. This will make B-BOP a unique tool for characterising the statistical properties of the magnetised ISM and probing the role of magnetic fields in the formation and evolution of the interstellar web of dusty molecular filaments giving birth to most stars in our Galaxy. B-BOP will also be a powerful instrument for studying the magnetism of nearby galaxies and testing Galactic dynamo models, constraining the physics of dust grain alignment, informing the problem of the interaction of cosmic rays with molecular clouds, tracing magnetic fields in the inner layers of protoplanetary disks, and monitoring accretion bursts in embedded protostars.
Quantifying reasonable crop yield gaps and determining potential regions for yield improvement can facilitate regional plant structure adjustment and promote crop production. The current study attempted to evaluate the yield gap in a region at multi-scales through model simulation and farmer investigation. Taking the winter wheat yield gap in the Huang-Huai-Hai farming region (HFR) for the case study, 241 farmers’ fields in four typical high-yield demonstration areas were surveyed to determine the yield limitation index and attainable yield. In addition, the theoretical and realizable yield gap of winter wheat in 386 counties of the HFR was assessed. Results showed that the average field yield of the demonstration plots was 8282 kg/ha, accounting for 0.72 of the potential yield, which represented the highest production in the region. The HFR consists of seven sub-regions designated 2.1–2.7: the largest attainable yield gap existed in the 2.6 sub-region, in the southwest of the HFR, while the smallest was in the 2.2 sub-region, in the northwest of the HFR. With a high irrigated area rate, the yield gap in the 2.2 sub-region could hardly be reduced by increasing irrigation, while a lack of irrigation remained an important limiting factor for narrowing the yield gap in 2.3 sub-region, in the middle of the HFR. Therefore, a multi-scale yield gap evaluation framework integrated with typical field survey and crop model analysis could provide valuable information for narrowing the yield gap.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
The search for life in the Universe is a fundamental problem of astrobiology and modern science. The current progress in the detection of terrestrial-type exoplanets has opened a new avenue in the characterization of exoplanetary atmospheres and in the search for biosignatures of life with the upcoming ground-based and space missions. To specify the conditions favourable for the origin, development and sustainment of life as we know it in other worlds, we need to understand the nature of global (astrospheric), and local (atmospheric and surface) environments of exoplanets in the habitable zones (HZs) around G-K-M dwarf stars including our young Sun. Global environment is formed by propagated disturbances from the planet-hosting stars in the form of stellar flares, coronal mass ejections, energetic particles and winds collectively known as astrospheric space weather. Its characterization will help in understanding how an exoplanetary ecosystem interacts with its host star, as well as in the specification of the physical, chemical and biochemical conditions that can create favourable and/or detrimental conditions for planetary climate and habitability along with evolution of planetary internal dynamics over geological timescales. A key linkage of (astro)physical, chemical and geological processes can only be understood in the framework of interdisciplinary studies with the incorporation of progress in heliophysics, astrophysics, planetary and Earth sciences. The assessment of the impacts of host stars on the climate and habitability of terrestrial (exo)planets will significantly expand the current definition of the HZ to the biogenic zone and provide new observational strategies for searching for signatures of life. The major goal of this paper is to describe and discuss the current status and recent progress in this interdisciplinary field in light of presentations and discussions during the NASA Nexus for Exoplanetary System Science funded workshop ‘Exoplanetary Space Weather, Climate and Habitability’ and to provide a new roadmap for the future development of the emerging field of exoplanetary science and astrobiology.
To compare the epidemiologic features (e.g. settings and transmission mode) and patient clinical characteristics associated with outbreaks of different norovirus (Nov) strains, we retrospectively analysed data of Nov outbreaks occurring in Guangzhou, China from 2012 to 2018. The results suggested that outbreaks of Nov GII.2, GII.17 and GII.4 Sydney exhibited different outbreak settings, transmission modes and symptoms. GII.2 outbreaks mainly occurred in kindergartens, elementary and high schools and were transmitted mainly through person-to-person contact. By contrast, GII.4 Sydney outbreaks frequently occurred in colleges and were primarily associated with foodborne transmission. Cases from GII.2 and GII.17 outbreaks reported vomiting more frequently than those from outbreaks associated with GII.4 Sydney.