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Patients with severe mental disorders in low-resource settings have limited access to services, resulting in overwhelming caregiving burden for families. In extreme cases, this has led to the long-term restraining of patients in their homes. China underwent a nationwide initiative to unlock patients and provide continued treatment. This study aims to quantify household economic burden in families after unlocking and treatment, and to identify factors associated with increased burden due to schizophrenia.
A total of 264 subjects were enrolled from three geographically diverse provinces in 2012. Subjects were patients with schizophrenia who were previously put under restraints and had participated in the ‘unlocking and treatment’ intervention. The primary outcome was the current household economic burden, obtained from past year financial information collected through on-site interview. Patient disease characteristics, treatment, outcomes and family caregiving burden were collected as well. Univariate and multivariate linear regression were used to construct risk factor models for indirect economic burden.
After participating in the intervention, 85% of patients continued to receive mental health services, 70% used medication as prescribed and 80% were never relocked. Family members reported significantly decreased caregiving burden after receiving the intervention. Mean direct and indirect household economic burdens were CNY963 (US$31.7) and CNY11 724 (US$1670) per year, respectively, while family total income was on average CNY12 108 (US$1913) per year. Greater disease severity and poorer patient psychosocial function at time of study were found to be independent factors related to increased indirect burden.
The ‘unlocking and treatment’ intervention has improved the lives of patients and families. Indirect burden due to disease is still a major economic issue that needs to be addressed, potentially through improving treatment and patient functioning. Our findings contribute to the unravelling and eventual elimination of chronic restraining of mentally ill patients in low-resource settings.
Consumption of sugar-sweetened beverages (SSB) by infants and young children are less explored in Asian populations. The Growing Up in Singapore Towards healthy Outcomes cohort study examined associations between SSB intake at 18 months and 5 years of age, with adiposity measures at 6 years of age. We studied Singaporean infants/children with SSB intake assessed by FFQ at 18 months of age (n 555) and 5 years of age (n 767). The median for SSB intakes is 28 (interquartile range 5·5–98) ml at 18 months of age and 111 (interquartile range 57–198) ml at 5 years of age. Association between SSB intake (100 ml/d increments and tertile categories) and adiposity measures (BMI standard deviation scores (sd units), sum of skinfolds (SSF)) and overweight/obesity status were examined using multivariable linear and Poisson regression models, respectively. After adjusting for confounders and additionally for energy intake, SSB intake at age 18 months were not significantly associated with later adiposity measures and overweight/obesity outcomes. In contrast, at age 5 years, SSB intake when modelled as 100 ml/d increments were associated with higher BMI by 0·09 (95 % CI 0·02, 0·16) sd units, higher SSF thickness by 0·68 (95 % CI 0·06, 1·44) mm and increased risk of overweight/obesity by 1·2 (95 % CI 1·07, 1·23) times at age 6 years. Trends were consistent with SSB intake modelled as categorical tertiles. In summary, SSB intake in young childhood is associated with higher risks of adiposity and overweight/obesity. Public health policies working to reduce SSB consumption need to focus on prevention programmes targeted at young children.
The co-occurrence of hepatic cystic echinococcosis (CE) and alveolar echinococcosis (AE) is extremely rare. Here, we present the clinical manifestations and treatment outcomes of three cases with co-occurring CE and AE in the liver. Computed tomography (CT), magnetic resonance imaging and 18FFluorodeoxyglucose Positron Emission Tomography-CT were used for preoperative diagnosis. Specimens were taken intraoperatively and sent for pathological studies to confirm the coexistence of CE and AE by laminated membrane, daughter cysts or germinal layer and infiltration structure. Albendazole was prescribed after operation for 12 months. All patients were completely recovered and showed no recurrence at last follow-up. Therefore, surgical intervention and postoperative application of albendazole are recommended for patients with concurrence of hepatic AE and CE.
The crystal plastic theory was used to examine the effect of film-cooling hole arrangements on mechanical properties of cooled turbine blade. The finite element method was used to analyze the maximum von Mises stress and resolved shear stress of an octahedral slip system considering the number of rows, diameter, spacing, and tangential-to-longitudinal hole spacing (h/l) ratio. The different arrangements were found to have a significant influence on the maximum von Mises stress and resolved shear stress. For the triangular arrangement, the von Mises stress and resolved shear stress were highest with double rows, followed by a single row and then triple rows. For the quadrilateral arrangement, the stresses were highest with double rows, followed by triple rows and then a single row. Increasing the spacing or decreasing the diameter reduced the maximum von Mises stress and weakened the multi-hole interference effect. Both the maximum von Mises stress and resolved shear stress decreased with the h/l ratio.
A nonlinear station-keeping control method for a multi-vectored propeller airship under unknown wind field with thrust saturation is developed, which is composed of three modules: nonlinear model predictive controller (NMPC), disturbance observer (DOB) and tracking differentiator (TD). The nonlinear kinematics and dynamics models are introduced, and the wind effect is considered by the wind-induced aerodynamic force. Based on both models, an explicit NMPC is designed. Then a nonlinear DOB is introduced to estimate the wind disturbance. A TD, showing the relationship between the maximum propulsion force and the maximum flight acceleration, is proposed to handle the thrusts’ amplitude saturation. Stability analysis shows that the closed-loop system is globally asymptotically stable. Simulations for a multi-vectored propeller airship are conducted to demonstrate the robustness and effectiveness of the proposed method.
The mechanical properties of thin-walled plate with close-packed film cooling holes are studied based on the equivalent solid material concept. The equivalent principals of the method of equivalent strain energy, homogenization theory and uniform static deformation are considered. A simplification method of square penetration pattern for pitch and diagonal direction loading is presented. The goodness of fit is calculated to determine the optimal method. The tensile deformation, bending deflection, rotation displacement and maximum Mises equivalent stress of simplification plate models are in good agreement with plate models with close-packed film cooling holes. For square penetration pattern for pitch direction loading, the equivalent errors of Mises equivalent stress are all less than 10% when the ligament efficiency is more than 0.6.
Superior and inferior rice grains have different weights and are located on the upper primary branch and lower secondary branches of the panicle, respectively. To study differences in germination vigour of these two types of grain, a number of factors were investigated from 0 to 48 h of germination. The present study demonstrated that in inferior grains the starch granule structure was looser at 0 h, with full water absorption at 48 h, while in superior grains the structure was tight and dense. Relative water content increased, and dry matter decreased, more rapidly in inferior grains than in superior ones. Abscisic acid and gibberellin levels, as well as α-amylase activity, also changed more rapidly in inferior grains, while soluble sugar content and amylase coding gene expression increased more rapidly in inferior than superior grains during early germination. The expression of OsGAMYB was higher in inferior grains at 24 h but higher in superior grains at 48 h. The phenotypic index of seedlings was higher in seedlings from superior grains at the two-leaf stage. However, the thousand-grain weight and yield per plant in superior and inferior plants showed no significant difference at harvest. The present study indicates that inferior grains germinate faster than superior ones in the early germination stage. Although inferior grains produced weaker seedlings, it is worthwhile using them in rice production due to their comparative yield potential over that of superior grains.
Four complete platysiagid fish specimens are described from the Luoping Biota, Anisian (Middle Triassic), Yunnan Province, southwest China. They are small fishes with bones and scales covered with ganoine. All characters observed, such as nasals meeting in the midline, a keystone-like dermosphenotic, absence of post-rostral bone, two infraorbitals between dermosphenotic and jugal, large antorbital, and two postcleithra, suggest that the new materials belong to a single, new Platysiagum species, P. sinensis sp. nov. Three genera are ascribed to Platysiagidae: Platysiagum, Helmolepis and Caelatichthys. However, most specimens of the first two genera are imprints or fragmentary. The new, well-preserved specimens from the Luoping Biota provide more detailed anatomical information than before, and thus help amend the concept of the Platysiagidae. The Family Platysiagidae was previously classed in the Perleidiformes. Phylogenetic analysis indicates that the Platysiagidae is a member of basal Neopterygii, and its origin seems to predate that of Perleidiformes. Moreover, platysiagid fishes are known from the Middle Triassic of the western Tethys region. The newly found specimens of platysiagids from Luoping provide additional evidence that both eastern and western sides of the Tethys Ocean were biogeographically more connected than previously thought.
In this study, the biomass of winter wheat was estimated by using hyperspectral data obtained from a hyperspectral camera on an Unmanned Aerial Vehicle (UAV). Every two bands from the hyperspectral data were selected to calculate two kinds of vegetation indexes: the Normalized Difference Vegetation Index (NDVI) and Ratio Vegetation Index (RVI). Linear models were established between winter wheat biomass and those indexes, and coefficient of determination R2 was used to draw the two-dimensional distribution of R2 values. The comparison between NDVI and RVI for pixel covered by soil and wheat showed that RVI is more efficient to mask the influence from soil than NDVI. For calculating the NDVI, optimal bands are located mainly around 820 nm and 725 nm to 750 nm. For assessing RVI, the wavelength range from 820 to 832 nm, 794 to 808 nm, 770 to 788 nm, 725 nm to 750 nm and 890 nm for RVI are most suitable. Those optimal bands can achieve a coefficient of determination R2 higher than 0.88 by using the linear regression model in the study.
Bacillary dysentery continues to be a major health issue in developing countries and ambient temperature is a possible environmental determinant. However, evidence about the risk of bacillary dysentery attributable to ambient temperature under climate change scenarios is scarce. We examined the attributable fraction (AF) of temperature-related bacillary dysentery in urban and rural Hefei, China during 2006–2012 and projected its shifting pattern under climate change scenarios using a distributed lag non-linear model. The risk of bacillary dysentery increased with the temperature rise above a threshold (18·4 °C), and the temperature effects appeared to be acute. The proportion of bacillary dysentery attributable to hot temperatures was 18·74% (95 empirical confidence interval (eCI): 8·36–27·44%). Apparent difference of AF was observed between urban and rural areas, with AF varying from 26·87% (95% eCI 16·21–36·68%) in urban area to −1·90% (95 eCI −25·03 to 16·05%) in rural area. Under the climate change scenarios alone (1–4 °C rise), the AF from extreme hot temperatures (>31·2 °C) would rise greatly accompanied by the relatively stable AF from moderate hot temperatures (18·4–31·2 °C). If climate change proceeds, urban area may be more likely to suffer from rapidly increasing burden of disease from extreme hot temperatures in the absence of effective mitigation and adaptation strategies.
The purpose of this study is to highlight the effectiveness and necessity of the computational methods applications for architecture conceptual designs and improve the use of advanced simulation tools in urban planning. The results can provide the urban designers, planners and other decision makers with useful design information for assessing human wind comfort of the surrounding open spaces of public buildings in an urban area. Among different kinds of public buildings, museum architecture is of significant social value and importance for the augmentation of urban image. Using the Guggenheim Museum Bilbao for the case study, this investigation performed CFD simulations of the airflow over the museum to characterize the wind environments around the buildings. The predicted wind speed distributions were used to determine the wind comfort level of the featured spots around the museum for evaluating the suitability allowing visitors to sit or stand at the pedestrian plane for extended periods.
In order to avoid excess feed consumption during the force-feeding period in foie gras production, a dose-response experiment with seven feed consumption levels (450, 540, 630, 720, 810, 900, 990 g/day per bird) was conducted to evaluate the effects of feed consumption levels on growth performance and carcass composition of male Mule ducks from 91 to 102 days of age. One-day-old Mule ducklings (sterile and artificial hybrid of male Albatre Muscovy duck and female Pekin duck were fed a two-phase commercial diets for ad libitum intake from hatching to 91 days of age, followed by graded feeding levels of a corn diet by force-feeding from 91 to 102 days of age. Fifty-six 91-day-old male Mule ducks with similar BW were randomly assigned to seven treatments, with eight birds per treatment. Birds were housed in individual pens. At 102 days of age, final BW was measured and BW gain and feed conversion ratio of ducks from each treatment were calculated from day 91 to 102, and then all ducks were slaughtered to evaluate the yields of skin with subcutaneous fat, abdominal fat, breast meat (including pectoralis major and pectoralis minor), leg meat (including thigh and drum stick), and liver. Significant differences in BW gain, total liver weight and liver relative weight were observed among the treatments (P<0.001). According to the broken-line regression analysis, the optimal feed consumption levels of male Mule ducks from 91 to 102 days of age for maximum BW gain, total liver weight and liver relative weight were 217, 227 and 216 g feed/kg BW0.75·per day, respectively.
A stratospheric airship flies at a working altitude of 20km when it takes off from the ground. During ascent and descent, the wind field and thermal environment are highly complex. The thermal environment affects altitude, whereas wind influences the horizontal position of the airship. At a low altitude, this horizontal position cannot be controlled by thrusts given the low thrust-to-weight ratio, especially under a large wind field. However, it may be controlled indirectly by the pitch angle during ascent and descent with a certain vertical velocity. This study therefore proposes ascending and descending schemes for a stratospheric airship based on the thermal model. In this model, altitude is determined by the net lift/weight, whereas the horizontal position is controlled by the thrust and pitch. The pitch angle is determined by ballonets and an elevator. To allocate pitch control between the ballonets and the elevator under different airspeeds, pseudo-inverse dynamics of varied weight are introduced. In horizontal position control, the method of chain allocation is then applied between a pitch angle and vectored thrust to control the position of a stratospheric airship during ascent/descent.
Chitotriosidase, secreted by activated macrophages, is a biomarker of activated macrophages. In this study, we explored whether chitotriosidase could be adopted as a biomarker to evaluate the curative effect on tuberculosis (TB). Five counties were randomly selected out of 122 counties/cities/districts in Hunan Province, China. Our cases were all TB patients who were newly diagnosed or had been receiving treatment at the Centers for Disease Control (CDCs) of these five counties between April and August in 2009. Healthy controls were selected from a community health facility in the Kaifu district of Changsha City after frequency-matching of gender and age with the cases. Chitotriosidase activity was evaluated by a fluorometric assay. Categorical variables were analysed with the χ2 test. Measurement data in multiple groups were tested with analysis of variance and least significant difference (LSD). Correlation between chitotriosidase activity and the degree of radiological extent (DRE) was examined by Spearman's rank correlation test. The average chitotriosidase activity levels of new TB cases, TB cases with different periods of treatment (<3, 3–6, >6 months) and the control group were 54·47, 34·77, 21·54, 12·73 and 10·53 nmol/h.ml, respectively. Chitotriosidase activity in TB patients declined along with the continuity of treatment. The chitotriosidase activity of both smear-positive and the smear-negative pulmonary TB patients decreased after 6 months' treatment to normal levels (P < 0·05). Moreover, chitotriosidase activity was positively correlated with DRE (r = 0·607, P < 0·001). Our results indicate that chitotriosidase might be a marker of TB treatment effects. However, further follow-up study of TB patients is needed in the future.
Co-infections of cystic echinococcosis (CE) and HIV/AIDS is rare. We report four CE cases that were HIV positive. Three out of the four patients underwent a surgical operation to remove the hydatid cysts in their livers. The operation confirmed that in two of the cases their cysts had ruptured. These patients were given 3 months of albendazole after the operation. Follow-up showed they were remarkably improved in term of their health, although they were still HIV antibody positive 6 months after surgical treatment. Interestingly, the treatment remarkably increased their CD4+ cell population. We showed that surgery is suitable for treating hepatic cystic echinococcosis with HIV/AIDS co-infection.
To understand the clinical epidemiology and molecular characteristics of human bocavirus (HBoV) infection in children with diarrhoea in Guangzhou, South China, we collected 1128 faecal specimens from children with diarrhoea from July 2010 to December 2012. HBoV and five other major enteric viruses were examined using real-time polymerase chain reaction. Human rotavirus (HRV) was the most prevalent pathogen, detected in 250 (22·2%) cases, followed by enteric adenovirus (EADV) in 76 (6·7%) cases, human astrovirus (HAstV) in 38 (3·4%) cases, HBoV in 17 (1·5%) cases, sapovirus (SaV) in 14 (1·2%) cases, and norovirus (NoV) in 9 (0·8%) cases. Co-infections were identified in 3·7% of the study population and 23·5% of HBoV-positive specimens. Phylogenetic analysis revealed 14 HBoV strains to be clustered into species HBoV1 with only minor variations among them. Overall, the detection of HBoV appears to partially contribute to the overall detection gap for enteric infections, single HBoV infection rarely results in severe clinical outcomes, and HBoV sequencing data appears to support conserved genomes across strains identified in this study.
Clownfish and their associated sea anemones are icons of tropical and
subtropical coastal ecosystems, but bleaching and collecting for the
aquarium trade has reduced their population densities in several
Indo-Pacific locations. We surveyed four Entacmaea
quadricolor populations and their associated clownfish
Amphiprion clarkii in Hong Kong. These assemblages
represented a combination of exposed and sheltered, flat bottomed and sloped
conditions. Different from tropical areas, where E.
quadricolor is usually found in sheltered shallow waters, the
four populations in Hong Kong were distributed in 4–10 m depths, being
densest on a 40 × 80 m slope of volcanic rocks (34.2–76.6% substrate cover
and 48.7–102.1 ind m−2) at an exposed site. This distribution
pattern could be explained by the high turbidities associated with river
discharge and sedimentation rates in local waters, which discourage the
establishment of E. quadricolor populations in sheltered bays; shallow
habitats might not be suitable for E. quadricolor in Hong
Kong due to strong wave actions generated by typhoons. Amphiprion
clarkii was present at low densities
(0.07–0.26 fish m−2) across the sites. Our data provide a
baseline for monitoring the changes of these conspicuous members of shallow
water communities in Hong Kong.
Based on the results of the study of convex object motion1 (J. Hopcroft and G. Wilfong, “Motion of objects in contact,” Int. J. Robot. Res., 4(4), 32–46 (1986)), this paper addresses the problem of exact collision detection of a pair of scaled convex polyhedra in relative motion, and determines the contact conditions of tangential contact features, arbitrary relative motion involving translation and rotation, and uniform scaling of the objects about a fixed point. We propose a new concept of the decision curve based on analytical contact equations that characterize a continuum of scaling factors (or a single scaling factor), which ensures that a pair of objects undergoing a scaling transformation will maintain the same tangential contact feature pair (or make instantaneous tangential contact feature transitions). We propose a reliable simulation-based approach to construct the decision curve by hybridizing analytical contact equations and conventional collision detection method, called the Fast Collision Detection Method (FCDM). This method can determine whether two scaled objects will make contact at specific tangential contact features (vertices, edges, or faces) under particular uniform scaling factors and after distinctive relative motion with better accuracy and less computational time than the existing collision detection methods. Finally, we demonstrate our approach for solving motion design in simple assembly/disassembly problems.