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A southern population (S) from Xiushui County (29°1′N, 114°4′E) and a northern population (N) from Shenyang city (41°48′N, 123°23′E) of the cabbage beetle, Colaphellus bowringi vary greatly in their life-history traits, and may serve as an excellent model with which to study the inheritance of life-history traits. In the present study, we performed intraspecific hybridization using the two populations, comparing the key life-history traits (fecundity, development time, body weight, growth rate, and sexual size dimorphism (SDD)) between the two populations (S♀ × S♂ and N♀ × N♂) and their two hybrid populations (S♀ × N♂ and N♀ × S♂ populations) at 19, 22, 25, and 28°C. Our results showed that there were significant differences in life-history traits between the two parental populations, with the S population having a significantly higher fecundity, shorter larval development time, larger body weight, higher growth rate, and greater weight loss during metamorphosis than the N population at almost all temperatures. However, these life-history traits in the two hybrid populations were intermediate between those of their parents. The life-history traits in the S × N and N × S populations more closely resembled those of the maternal S population and N population, respectively, showing maternal effects. Weight loss for both sexes was highest in the S population, followed by the S × N, N × S, and N populations at all temperatures, suggesting that larger pupae lost more weight during metamorphosis. The changes in SSD with temperature were similar between the S and the S × N populations and between the N and the N × S populations, also suggesting a maternal effect. Overall, our results showed no drastic effect of hybridization on C. bowringi, being neither negative (hybrid inferiority) nor positive (heterosis). Rather, the phenotypes of hybrids were intermediate between the phenotypes of their parents.
We report a case of a 25-year-old man diagnosed with an unusual case of cor triatriatum sinister with a mobile left atrial thrombus. He was hospitalised with aggravating dyspnoea. Transthoracic echocardiography revealed a membrane-like structure traversing the left atrial and a small orifice of about 7.1 mm. The mean pressure gradient was 12.94 mmHg across the orifice of the membrane-like structure and there was a mobile mass in the post-erosuperior chamber. The anomaly was rectified by a surgical resection. Timely diagnosis and surgical repair may prevent stroke in patients with unusual cor triatriatum sinister.
To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families.
One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations.
Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20–30-min lecture and 30–40-min interaction).
A total of 153 adolescents aged 10–15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students).
Elementary and junior high school students’ nutrition knowledge scores (range 0–6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (–22·9 %, P = 0·02) and 0·29 serving/d (–18·9 %, P = 0·03), respectively. Junior high school students’ mean snacking frequency and fried food intake dropped to 0·75 d/week (–21·3 %, P = 0·008) and 0·10 serving/d (–28·8 %, P = 0·01), respectively.
Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families.
It can be challenging for a democratic government to effectively make policies that address crucial national problems. While a bulk of literature reports that many democracies have overcome this challenge through centralization of legislative organization, few studies have explained why legislative decentralization that allegedly impairs policymaking performance would take place. Drawing on Taiwan's experience and over 13,000 legislative bills proposed in Taiwan's parliament between 1993 and 2012, this article demonstrates that the legislative decentralization during the onset of Taiwan's democratization slightly revived the policymaking performance of a near-paralysed parliament. Like drinking poison to quench the thirst, myopic politicians may opt for legislative decentralization as an instant remedy to ease severe legislative obstruction, despite the unfavourable consequences that the resulting decentralized legislative organization may eventually bring about. These findings shed new light on the evolution of legislative organization and account for the difficulties in policymaking facing developing democracies.
The variable stiffness actuator (VSA) is helpful to realize the post-collision safety strategies for safe human–robot interaction.1 The stiffness of the robot will be reduced to protect the user from injury when the collision between the robot and human occurs. However, The VSA has a mechanism limit constraint that can cause harm to users even if the stiffness is minimized. Accordingly, in this article, a concept combining danger index and robust fault detection and isolation is presented and applied to active–passive variable stiffness elastic actuator (APVSEA). APVSEA can actively change joint stiffness with the change of danger index. Experimental results show that this concept can effectively confirm the fault mode and provide additional protection measures to ensure the safety of users when the joint stiffness has been adjusted to the minimum.
The aim of this study was to explore the application of the flipped classroom approach in the training of Mass Casualty Triage (MCT) to medical undergraduate students.
In this study, 103 fourth-year medical students were randomly divided into a Flipped Classroom (FC) group (n = 51) and a Traditional Lecture-based Classroom (TLC) group (n = 52). A post-class quiz, simulated field triage (SFT) and feedback questionnaires were performed to assess both groups of students for their learning of the course.
In the post-quiz, the median (IQR) scores achieved by students from the FC and TLC groups were 42(5) and 39(5.5), respectively. Significant differences were found between the two groups. In the SFT, overall triage accuracy was 67.06% for FC, and 64.23% for TLC students. Over-triage and under-triage errors occurred in 18.43% and 14.50% of the FC group, respectively. The TLC group had a similar pattern of 20.77% over-triage and 15.0% under-triage errors. No significant differences were found regarding overall triage accuracy or triage errors between the two groups.
The FC approach could enhance course grades reflected in the post-quiz and improve students’ satisfaction with the class. However, there was no significant difference of competency between the two groups demonstrated in the SFT exercise.
This paper concerns with the existence of multiple solutions for a class of elliptic problems with discontinuous nonlinearity. By using dual variational methods, properties of the Nehari manifolds and Ekeland's variational principle, we show how the ‘shape’ of the graph of the function A affects the number of nontrivial solutions.
We examine how local political corruption affects firm innovation in the United States. We find that firms located in highly corrupt areas are less innovative as measured by their patenting activities. The results are robust to the inclusion of a broad set of regional characteristics, instrumental variable analysis, matching analysis, difference-in-differences test, and alternative proxies for local corruption. Further analysis shows that reduced innovation incentives due to high extortion risk and decreased threat of competition could be the possible economic channels through which corruption affects innovation. Overall, our results indicate that local political corruption impedes corporate innovation in the United States.
Increasing evidence supports that 5HTTLPR polymorphism of the serotonin transporter gene(5HTTLPR) might associate to bipolar disorder and affective temperaments as measured by TEMPS-A. But the results are discrepant, furthermore, there are no data from Chinese population.
The present study was designed to investigate association between 5HTTLPR and bipolar disorder and affective temperaments of patients with bipolar disorder in the specific Chinese population and add new evidence to the field.
There hundred and five patients with bipolar disorder and 272 normal controls were included in the present case-control study⌧Temperament Evaluation of Memphis, Pisa, Paris and San Diego -autoquestionnaire version (TEMPS-A) in Chinese was used to assess affective temperament. Chi-square test, T test, Nonparametric test and ANOVA were employed to explore association between 5HTTLPR polymorphism and bipolar disorder and affective temperament of patients with bipolar disorder.
5-HTTLPR L/S polymorphism was associated with bipolar disorder in female (genotype χ2 = 6.769⌧P = 0.034⌧allele χ2 = 6.028⌧P = 0.014) and the S allele was associated with anxious temperament (t = 8.248⌧P = 0.005) in patients with bipolar disorder. the LA allele of 5-HTTLPR rs25531 A/G polymorphism was associated with hyperthymic temperament in patients with bipolar disorder (Z = −2.205⌧P = 0.027).
5-HTTLPR might have an effect on the prevalence of bipolar disorder in female and regulate affective temperaments of patients with bipolar disorder in some degree in Chinese population.
Bioinformatic investigations indicate that has-mir-206 (microRNA-206, miRNA-206) could regulate BDNF protein synthesis by interfering with BDNF mRNA translation, which is disrupted in bipolar disorder (BPD).
This study is to investigate whether miRNA-206 gene variants were associated with BPD susceptibility in a Han Chinese population.
342 patients who met DSM-IV criteria for bipolar disorder type I (BPD-I) or type II (BPD-II) and 386 matched health controls were enrolled into this study. the miRNA-206 gene and +/-500bp were selected for gene sequencing. for the case-control genetic comparisons, differences in the genotype and allele distributions between patients and controls were examined using Pearson's χ2 test.
Gene sequencing showed that there are two polymorphisms rs16882131(C/T) and rs62408583 (A/C) located at the upstream of miRNA-206 gene, which are complete linkage disequilibrium. the association analysis showed that there was no significant difference for genotype frequencies (χ2 = 2.075, df = 2, P = 0.354) or for allele frequencies (χ2 = 0.041, df = 1, P = 0.839) between BPD patients and controls. Similarly, no significant difference was found between BPD-I patients and controls (genotype χ2 = 1.411, df = 2, P = 0.494; allele χ2 = 0.380, df = 1, P = 0.538). However, there was significant difference between BPD-II patients and controls (genotype χ2 = 7.933, df = 2, P = 0.019; allele χ2 = 5.403, df = 1, P = 0.020).
Our findings do not support that BPD susceptibility was associated with miRNA-206 gene polymorphisms in the studied Han Chinese population. the association between miRNA-206 gene polymorphisms and bipolar disorder type II is needed to be carefully interpreted. Further studies are necessary to elucidate the involvement miRNA-206 in the pathophysiology of BPD.
The cascade of energy in turbulent flows, i.e. the transfer of kinetic energy from large to small flow scales or vice versa (backward cascade), has been the cornerstone of most theories and models of turbulence since the 1940s. Yet, understanding the spatial organisation of kinetic energy transfer remains an outstanding challenge in fluid mechanics. Here, we unveil the three-dimensional structure of the energy cascade across the shear-dominated scales using numerical data of homogeneous shear turbulence. We show that the characteristic flow structure associated with the energy transfer is a vortex shaped as an inverted hairpin followed by an upright hairpin. The asymmetry between the forward and backward cascade arises from the opposite flow circulation within the hairpins, which triggers reversed patterns in the flow.
The aim of this study was to develop and externally validate a simple-to-use nomogram for predicting the survival of hospitalised human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients (hospitalised person living with HIV/AIDS (PLWHAs)). Hospitalised PLWHAs (n = 3724) between January 2012 and December 2014 were enrolled in the training cohort. HIV-infected inpatients (n = 1987) admitted in 2015 were included as the external-validation cohort. The least absolute shrinkage and selection operator method was used to perform data dimension reduction and select the optimal predictors. The nomogram incorporated 11 independent predictors, including occupation, antiretroviral therapy, pneumonia, tuberculosis, Talaromyces marneffei, hypertension, septicemia, anaemia, respiratory failure, hypoproteinemia and electrolyte disturbances. The Likelihood χ2 statistic of the model was 516.30 (P = 0.000). Integrated Brier Score was 0.076 and Brier scores of the nomogram at the 10-day and 20-day time points were 0.046 and 0.071, respectively. The area under the curves for receiver operating characteristic were 0.819 and 0.828, and precision-recall curves were 0.242 and 0.378 at two time points. Calibration plots and decision curve analysis in the two sets showed good performance and a high net benefit of nomogram. In conclusion, the nomogram developed in the current study has relatively high calibration and is clinically useful. It provides a convenient and useful tool for timely clinical decision-making and the risk management of hospitalised PLWHAs.
To improve the prenatal diagnosis for anomalous origin of pulmonary artery branches by comparing and analyzing different types of fetal echocardiography features.
Between June 2012 and December 2018, fetal echocardiographic features were analyzed retrospectively from fetuses with a prenatal diagnosis of anomalous origin of pulmonary artery branch. The main points of identification were summarized.
A total of 12 fetuses were diagnosed, including anomalous origin of a pulmonary artery branch from the innominate artery and six cases with unilateral absence of pulmonary artery. The shared characteristic sonographic finding was the lack of confluence at the bifurcation of the main pulmonary artery. The differences between the two conditions are highlighted by the origin of the anomalous vessel. In fetuses with anomalous origin of one pulmonary artery branch, the affected pulmonary artery arose from the posterior wall of the ascending aorta as noted on three vessels and trachea view as well as the long axis of the left ventricular outflow tract. This is in contrast to fetuses with unilateral absence of pulmonary artery, where the origin of affected pulmonary artery arises from the base of the innominate artery via the ipsilateral patent arterial duct as evident on the three vessels and trachea view and the coronal view of innominate (brachiocephalic) artery.
(1) The main similarity is an absence of a confluence at the bifurcation of the main pulmonary artery. (2) The main distinguishing feature is the origin of the anomalous vessel from either the subclavian or directly from the aorta.
The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in Taiwan
This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.
The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.
The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.
Direct numerical simulation of the Navier–Stokes equations is carried out to investigate the interaction of a conical shock wave with a turbulent boundary layer developing over a flat plate at free-stream Mach number
and Reynolds number
, based on the upstream boundary layer momentum thickness. The shock is generated by a circular cone with half opening angle
. As found in experiments, the wall pressure exhibits a distinctive N-wave signature, with a sharp peak right past the precursor shock generated at the cone apex, followed by an extended zone with favourable pressure gradient, and terminated by the trailing shock associated with recompression in the wake of the cone. The boundary layer behaviour is strongly affected by the imposed pressure gradient. Streaks are suppressed in adverse pressure gradient (APG) zones, but re-form rapidly in downstream favourable pressure gradient (FPG) zones. Three-dimensional mean flow separation is only observed in the first APG region associated with the formation of a horseshoe vortex, whereas the second APG region features an incipient detachment state, with scattered spots of instantaneous reversed flow. As found in canonical geometrically two-dimensional wedge-generated shock–boundary layer interactions, different amplification of the turbulent stress components is observed through the interacting shock system, with approach to an isotropic state in APG regions, and to a two-component anisotropic state in FPG. The general adequacy of the Boussinesq hypothesis is found to predict the spatial organization of the turbulent shear stresses, although different eddy viscosities should be used for each component, as in tensor eddy-viscosity models, or in full Reynolds stress closures.
In this contribution, we devoted ourselves to fabricating aggregation-induced emission (AIE) activity copolymers via one-pot combination of RAFT polymerization and Biginelli reaction for the first time. When the feeding ratio of TPB was 33.5%, the molar fraction of TPB was, respectively, about 14.2 and 22.5% in PEG-PTE1 copolymers by two-step strategy and PEG-PTE2 copolymers by one-pot strategy with the similar structure. The Mn of PEG-PTE1 increased to 59,300 from 52,800 of PEG-AE presoma with narrow PDI, which was more than Mn of PEG-PTE2 with 52,300. As compared with PEG-PTE2, when the feeding ratio of TPB was 48.6%, the molar fraction of TPB increased to 32.6% in PEG-PTE3. In aqueous solution, the as-obtained PEG-PTE2 copolymers can self-assemble into fluorescent organic nanoparticles (FONs) with 100–180 nm spherical morphology, the maximal emission peak of which presented at 460 nm with the obvious AIE phenomenon. Moreover, due to the low toxicity and excellent cell dyeing behavior, the as-prepared PEG-PTE2 copolymers displayed great potential for biomedical applications.
Altered heart rate variability (HRV), an index of autonomic nervous system function, has been reported in generalized anxiety disorder (GAD), but the results have been mixed. Thus, the present study, using a large sample size and better methodology, aims to examine whether GAD is associated with impaired HRV, both at rest and in response to posture challenges.
In total, 1832 participants were recruited in this study, consisting of 682 patients with GAD (including 326 drug- and comorbidity-free GAD patients) and 1150 healthy controls. Short-term HRV was measured during the supine-standing-supine test (5-min per position). Propensity score matching (PSM), a relatively novel method, was used to control for potential confounders.
After PSM algorithm, drug- and comorbidity-free GAD patients had reductions in resting (baseline) high-frequency power (HF), an index for parasympathetic modulation, and increases in the low-frequency/HF ratio (LF/HF), an index for sympathovagal balance as compared to matched controls. Furthermore, the responses of HF and LF/HF to posture changes were all attenuated when compared with matched controls. Effect sizes, given by Cohen's d, for resting HF and HF reactivity were 0.42 and 0.36–0.42, respectively.
GAD is associated with altered sympathovagal balance, characterized by attenuation in both resting vagal modulation and vagal reactivity, with an almost medium effect size (Cohen's d ≈ 0.4), regardless of medication use or comorbidity status.
In order to increase the speed, precision and robustness against the engine failure in solving optimal endo-atmospheric ascent trajectory of a launch vehicle, a rapid multi-layer solving method with improved numerical algorithms was proposed. The proposed method is capable of decomposing a large number of intervals into multiple layers with advantageous convergence property. Firstly, the problem of solving optimal endo-atmospheric ascent trajectory, which was subjected to path constraints and terminal constraints, was transformed into a Hamilton Two Point Boundary Value Problem (TPBVP). Then, through the finite difference method and numerical solving algorithm, the Hamilton TPBVP was iteratively solved with fewer initial discrete intervals. The initial values of higher-layer iterations were obtained by interpolating convergent solutions at sparse nodes into the doubly discrete nodes of high layers. The process was repeatedly performed until the solving precision met the requirements. To decrease the calculation load in solving TPBVPs, two improved solving algorithms without and with fewer Jacobian calculations were studied, respectively the Derivative-free Spectral Algorithm for Nonlinear Equations(DF-SANE) combined with the improved derivative-free nonmonotone line search strategy, and the Modified Newton method with a relaxation factor in combination with the Inverse Broyden Quasi-Newton method, denoted as ‘MN-IBQ’. Simulation verifications showed that the multi-layer method had significantly higher solving speed than the single-layer method. For the improved numerical algorithms, the DF-SANE was trapped in the local convergence problem. While using the proposed MN-IBQ can further increase the solving rate. Typical engine failure simulations showed that the multi-layer method with the MN-IBQ algorithm had not only significantly higher solving speed but also stronger robustness, where the traditional single-layer method could not adapt. In addition, the thrust loss tolerance limits for the multi-layer solving method were given for different engine failure times. The results show promising potential of the proposed approach in trajectory online generation and closed-loop guidance of launch vehicles at the endo-atmospheric ascent stage.
Gallstone disease (GSD) represents a significant health burden and is reported to be strongly related to obesity. This study examined the effect of sex on the association of BMI, waist circumference (WC) and percentage body fat mass (%FM) with GSD. We enrolled 15 671 middle-aged Taiwanese adults undergoing a physical check-up at a health examination centre. Multiple logistic regression analysis was conducted to identify the association of BMI, WC and %FM with the presence of GSD. AUC of the receiver–operating characteristic (ROC) curves were calculated for BMI, WC and %FM to compare their respective ability to correctly classify patients with GSD. From our findings, GSD prevalence was 8·1 % in men and 6·3 % in women. The percentage of markedly increased obesity indicators was significantly higher in patients with GSD than in those without GSD. Multivariate analysis showed that all obesity indicators were significant predictors of the presence of GSD in women after adjustment. In men, only BMI and WC were significantly associated with the presence of GSD. In the ROC curve analysis, BMI and WC were the best predictors of GSD risk in women and men, respectively. The obesity indicators better predicted the presence of GSD in women than in men. In conclusion, the best obesity indicator of GSD risk differed by sex. In addition to body weight, fat mass and central obesity were associated with GSD risk in women. In men, central obesity may play a more important role in predicting GSD risk.
Nutrition therapy is considered an important treatment of burn patients. The aim of the study was to delineate the nutritional support in severe burn patients and to investigate association between nutritional practice and clinical outcomes. Severe burn patients were enrolled (n 100). In 90 % of the cases, the burn injury covered above 70 % of the total body surface area. Mean interval from injury to nutrition start was 2·4 (sd 1·1) d. Sixty-seven patients were initiated with enteral nutrition (EN) with a median time of 1 d from injury to first feed. Twenty-two patients began with parenteral nutrition (PN). During the study, thirty-two patients developed EN intolerance. Patients received an average of about 70 % of prescribed energy and protein. Patients with EN providing <30 % energy had significantly higher 28- d and in-hospital mortality than patients with EN providing more than 30 % of energy. Mortality at 28 d was 11 % and in-hospital mortality was 45 %. Multiple regression analysis demonstrated that EN providing <30 % energy and septic shock were independent risk factors for 28- d prognosis. EN could be initiated early in severe burn patients. Majority patients needed PN supplementation for energy requirement and EN feeding intolerance. Post-pyloric feeding is more efficient than gastric feeding in EN tolerance and energy supplement. It is difficult for severe burn patients to obtain enough feeding, especially in the early stage of the disease. More than 2 weeks of underfeeding is harmful to recovery.