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The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) to identify malnutrition risk in patients with liver disease. However, little is known about the application of RFH-NPT to screen for the risk of malnutrition in China, where patients primarily suffer from hepatitis virus-related cirrhosis. A total of 155 cirrhosis patients without liver cancer or uncontrolled comorbid illness were enrolled in this prospective study. We administered the Nutritional Risk Screening 2002 (NRS-2002), RFH-NPT, Malnutrition Universal Screening Tool(MUST), and Liver Disease Undernutrition Screening Tool (LDUST) to the patients within 24 h after admission and performed follow-up observations for 1.5 years. The RFH-NPT and NRS-2002 had higher sensitivities (64.8% and 52.4%) and specificities (60% and 70%) than the other tools with regard to screening for the malnutrition risk in cirrhotic patients. The prevalence of nutritional risk was higher under the use of RFH-NPT against the NRS-2002(63% vs. 51%). RFH-NPT tended more easily to detect the malnutrition risk in patients with advanced Child-Pugh classes (B and C) and lower MELD scores (<15) compared with NRS-2002. The RFH-NPT score was an independent predictive factor for mortality. Patients identified as being at high malnutrition risk with the RFH-NPT had a higher mortality rate than those at a low risk; the same result was not obtained with the NRS-2002. Therefore, we suggest that using RFH-NPT improves the ability of clinicians to predict malnutrition risk in patients with cirrhosis primarily caused by hepatitis virus infection at an earlier stage.
Isolated congenital tricuspid regurgitation other than Ebstein’s anomaly was rare especially for children. The objective of this study was to investigate the clinical characteristics and to assess the results of tricuspid valvuloplasty for children with isolated tricuspid regurgitation.
From January 2010 to June 2019, 10 consecutive patients with isolated tricuspid regurgitation who were unresponsive to drug therapy underwent tricuspid valvuloplasty in our hospital. Patients’ clinical data were analysed retrospectively.
Mean age at operation was 48.5 ± 31.0 (range: 9–106) months and mean weight at operation was 16.1 ± 6.9 (range: 8.6–33.0) kg. All patients presented severe isolated tricuspid regurgitation. According to pathological lesions, the main causes accounted for chordae tendinea rupture (3/10), leaflet cleft (2/10), mal-connected chordal tendinea to leaflets (2/10), elongated chordae (1/10) and chordae absent (1/10), and severe anterior leaflet dysplasia (1/10). Individualised tricuspid valvuloplasty was adapted to all of them successfully. Post-operative echocardiography showed no tricuspid regurgitation in two patients and mild regurgitation in eight patients. The cardiothoracic ratios on their chest roentgenograms decreased from 0.59 ± 0.05 to 0.54 ± 0.05. At the latest follow-up (50.4 ± 47.2 months), echocardiography showed that mild to moderate tricuspid regurgitation in seven patients, moderate tricuspid regurgitation in three patients, and no patient with severe tricuspid regurgitation. All patients were in NYHA functional class I.
For patients with isolated tricuspid regurgitation who were not well responsive to drug therapy, individualised tricuspid valve repair can achieve an excellent result.
In this paper, we report a recent theoretical study of the calculation of the binding energy and photoionization cross section of a single dopant in a spherical hollow or core/shell quantum dot taking into account the interaction of the electron with longitudinal optical phonons. Using Frolich approach and Lee-low Pines transformation, we determine the impact of different parameters such as shell thickness and dopant position on the energy and optical response of a bound polaron for two types of ionic II–VI semiconductors CdTe and ZnSe with different phonon coupling constants. Regardless of the material used, the electron–phonon interaction visibly reduces binding energy. For photoionization cross section, a redshift of resonance peaks was found when the effect of phonons is taken into consideration or when the donor is moved away from the shell center. These calculations provide us insights when choosing between materials for optoelectronic applications.
Comprehensive screening of rice (Oryza sativa L. subsp. japonica Kato) germplasm resources with different nitrogen (N) efficiency levels is effective for improving N use efficiency (NUE) while reducing pollution and providing high quality, yield, and efficiency agriculture. We investigated 14 indices of 38 varieties under three N application levels to assess differences among genotypes. Rice varieties were classified for screening and identifying N efficient. Descriptive statistical analysis results indicated significant differences in relative yield, and also in NUE indices (agronomic utilization rate and partial productivity of N fertilizer). The genotype main effects and genotype–environment interaction effects (GGE) biplot analysis was used to evaluate suitable varieties, compare the stable and high yield capabilities of different varieties, find the ideal variety, and describe the correlation, discrimination and representativeness of the indices under different N application levels. Descriptive statistical, discrimitiveness and representativeness and factor analysis were used to select indices, in which the panicle number per plant and soil and plant analyzer development (SPAD) value were the key indices for evaluation and identification. Heatmap and hierarchical cluster analysis based on the average value of evaluation indices, and scatter plot based on the comprehensive value of N efficiency (P) according to formula showed that all varieties could be divided into five types under different N treatments. Our findings work toward developing N efficient rice varieties to improve NUE, reduce N fertilizer application and thus N waste, consequently mitigating the effects of rice production on the environment to ensure food security and sustainable agricultural development.
The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.
From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).
About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.
About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.
Bile acids (BA) have emerged as signalling molecules regulating intestinal physiology. The importance of intestinal microbiota in production of secondary BA, for example, lithocholic acid (LCA) which impairs enterocyte proliferation and permeability, triggered us to determine the effects of oral probiotics on intestinal BA metabolism. Piglets were weaned at 28 d of age and allocated into control (CON, n 14) or probiotic (PRO, n 14) group fed 50 mg of Lactobacillus plantarum daily, and gut microbiota and BA profile were determined. To test the potential interaction of LCA with bacteria endotoxins in inducing damage of enterocytes, IPEC-J2 cells were treated with LCA, lipopolysaccharide (LPS) and LCA + LPS and expressions of genes related to inflammation, antioxidant capacity and nutrient transport were determined. Compared with the CON group, the PRO group showed lower total LCA level in the ileum and higher relative abundance of the Lactobacillus genus in faeces. In contrast, the relative abundances of Bacteroides, Clostridium_sensu_stricto_1, Parabacteroides and Ruminococcus_1, important bacteria genera in BA biotransformation, were all lower in the PRO than in the CON group. Moreover, PRO piglets had lower postprandial glucagon-like peptide-1 level, while higher glucose level than CON piglets. Co-administration of LPS and LCA led to down-regulated expression of glucose and peptide transporter genes in IPEC-J2 cells. Altogether, oral L. plantarum altered BA profile probably by modulating relative abundances of gut microbial genera that play key roles in BA metabolism and might consequently impact glucose homoeostasis. The detrimental effect of LCA on nutrient transport in enterocytes might be aggravated under LPS challenge.
In this work, we propose a broadband, polarization-insensitive and wide incident angle stable metamaterial absorber (MA) based on the resistive film. The absorber consists of a three-layer structure with each layer of dielectric substrate printed with different shapes of resistive film. The multilayer structure not only extends the absorption bandwidth but also maintains high absorption under large wave incident angles. Numerical simulation shows that the absorptivity of a normal incident wave is above 90% in the frequency range 2.34–18.95 GHz, corresponding to a relative absorption bandwidth of 156%. Moreover, the whole MA structure has a total thickness of 11.3 mm, corresponding to 0.09 λ0 at its lowest absorption frequency. Due to the high symmetry of the structure, the absorber has good polarization insensitivity. In addition, for both transverse electric and transverse magnetic incidence, the proposed absorber achieves an absorptivity of more than 80% at incident angles of up to 45° and thus has good stability for wide incident angles. The absorption principle of the absorber is analyzed by the surface current and power loss density distribution. Parameter analysis is also performed for bandwidth optimization. Due to its advantages of wideband absorption with high efficiency, the proposed absorber has the potential to be applied to the energy-harvesting and electromagnetic stealth fields.
Cognitive decline in advanced age is closely related to dementia. The trajectory of cognitive function in older Chinese is yet to be fully investigated. We aimed to investigate the trajectories of cognitive function in a nationally representative sample of older people living in China and to explore the potential determinants of these trajectories.
This study included 2,038 cognitively healthy persons aged 65–104 years at their first observation in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 12 years and to investigate associations between baseline predictors of group membership and these trajectories.
Three trajectories were identified according to the following types of changes in MMSE scores: slow decline (14.0%), rapid decline (4.5%), and stable function (81.5%). Older age, female gender, having no schooling, a low frequency of leisure activity, and a low baseline MMSE score were associated with the slow decline trajectory. Older age, body mass index (BMI) less than 18.5 kg/m2, and having more than one cardiovascular disease (CVD) were associated with the rapid decline trajectory.
Three trajectories of cognitive function were identified in the older Chinese population. The identified determinants of these trajectories could be targeted for developing prevention and intervention strategies for dementia.
The current study compares the effects of two types of pronunciation instruction (segmental- and suprasegmental-based) on the development of second-year Chinese undergraduate students’ English pronunciation as against a group with no specific pronunciation (NSP) instruction. The participants were 90 university-level students in the Chinese mainland, from three intact classes. One class was taught with a segmental focus (N = 30) and the second with a suprasegmental focus (N = 31), while the third received NSP instruction (N = 29). The results showed that after an 18-week period of instruction, both the segmental and suprasegmental groups made statistically significant progress in pronunciation, as measured by comprehensibility on a sentence-reading task; however, only the suprasegmental group made statistically significant progress in comprehensibility at the spontaneous level, and it was also the only group that maintained these spontaneous gains on the delayed posttest. The positive effects of explicit pronunciation instruction in general and of suprasegmental instruction in particular account for the findings.
We genotyped six SNPs in the genes of p450 family among paranoid schizophrenics and normal controls. All subjects are unrelated Han Chinese. Three showed polymorphic, and no significant differences in allele or genotype frequencies were detected between patients and controls. Thus we obtained no evidence for the involvement of the polymorphisms in paranoid schizophrenia in the population investigated.
Dysfunctions of glutamatergic and GABAergic neurotransmission are two important hypotheses for the pathogenesis of schizophrenia. Thus, genes in the pathway are candidates for schizophrenia susceptibility. Phosphate-activated glutaminase (GLS), glutamine synthetase (GLUL), glutamic acid decarboxylase (GAD), GABA transaminase (ABAT) and succinic semialdehyde dehydrogenase (ALDH5A1) are five primary enzymes in glutamate and GABA synthetic and degradative pathway. In order to investigate the possible involvement of these genes in the development of paranoid schizophrenia, we genotyped 80 paranoid schizophrenics from northern China and 108 matched controls by polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP) methods or directly sequencing of PCR product. Seven SNPs were found to be polymorphic in the population investigated. No significant differences in the genotype distributions or allele frequencies between patients and controls were found. Therefore, we conclude the polymorphisms studied in the five genes do not play major roles in pathogenesis of paranoid schizophrenia in the population investigated.
We performed an association study between three SNPs in the genes of 14-3-3 family and paranoid schizophrenia. SNP rs983583 G/A in the YWHAZ gene showed significant association with paranoid schizophrenia. Our study indicated that the YWHAZ gene was a potential susceptibility gene for paranoid schizophrenia in the population studied.
Major depressive disorder (MDD) is associated with abnormal functional connectivity (FC) of amygdala and decreased function of cortico-limibic circuit, which play important roles in the pathogenesis of MDD. However, little is known about the connectivity alterations in late-onset depression (LOD), and whether such disrupted function is correlated with cognitive impairment is unclear.
A total of twenty-three LOD patients and thirty-seven controls underwent neuropsychological tests and resting-state functional magnetic resonance imaging (RS-fMRI). Regional homogeneity (ReHo) and FC of bilateral amygdala seed were used to analyze blood oxygen level-dependent fMRI data between groups.
Compared to controls, LOD groups showed weaker functional activity in bilateral middle frontal gyrus and left medial orbitofrontal gyrus, moreover, the decreased ReHo was positively correlated with Trail making test-B score (TMTB, r= 0.462,P= 0.04). In aspects of FC, left amygdala has reduced FC with right fusiform gyrus, right superior temporal gyrus and right putamen, while right amygdala has reduced FC with left cerebellum. Further correlative analysis found that the decreased FC between amygdala and right putamen was positively correlated with Verbal fluency test-verb score (VFT-verb, r= 0.513,P= 0.021) and the decreased FC between amygdala and superior temporal gyrus was positively correlated with Auditory Verbal Memory Test-delayed recall score (AVLT-delayed recall, r= 0.446,P= 0.049).
Our finding of reduced activation of prefrontal gyrus as well as decreased connection of bilateral amygdala may be key factors of impaired cognitive function in LOD patients and these changes could be early indicator for cognitive deficits.
To study the relationship between insulin-like growth factor 1 receptor (IGF1R)and subsyndromal symptomatic depression (SSD).
In this case-control study, real-time quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) with TaqMan MGB was used to analyzing the differences of IGF1R gene mRNA expression in peripheral leukocytes between subsyndromal symptomatic depression group(n = 47) and healthy controls(n = 52). At the same time Hamilton Depression Rating Scale -17(HAMD17) were assessed.
IGF1R gene mRNA expression was 0.21 ± 0.11 in SSD group, 0.56 ± 0.37 in healthy group, and there was significant difference between both groups on IGF1R expression(z = 39.54, P < 0.001). the expression levels of IGF1R in SSD patients was not correlated with Hamilton score(r = −0.292, p = 0.275).
This study suggested that the decreased expression of IGF1R were related with the pathophysiology of SSD.
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.
The X chromosome is known to play an important role in many sex-specific diseases. However, only a few single-nucleotide polymorphisms on the X chromosome have been found to be associated with diseases. Compared to the autosomes, conducting association tests on the X chromosome is more intractable due to the difference in the number of X chromosomes between females and males. On the other hand, X-chromosome inactivation takes place in female mammals, which is a phenomenon in which the expression of one copy of two X chromosomes in females is silenced in order to achieve the same gene expression level as that in males. In addition, imprinting effects may be related to certain diseases. Currently, there are some existing approaches taking X-chromosome inactivation into account when testing for associations on the X chromosome. However, none of them allows for imprinting effects. Therefore, in this paper, we propose a robust test, ZXCII, which accounts for both X-chromosome inactivation and imprinting effects without requiring specifying the genetic models in advance. Simulation studies are conducted in order to investigate the validity and performance of ZXCII under various scenarios of different parameter values. The simulation results show that ZXCII controls the type I error rate well when there is no association. Furthermore, with regards to power, ZXCII is robust in all of the situations considered and generally outperforms most of the existing methods in the presence of imprinting effects, especially under complete imprinting effects.
The catechol-O-methyltransferase (COMT) gene is related to dopamine degradation and has been suggested to be involved in the pathogenesis of major depressive disorder (MDD). However, how this gene affects brain function properties in MDD is still unclear.
Fifty patients with MDD and 35 cognitively normal participants underwent a resting-state functional magnetic resonance imaging scan. A voxelwise and data-drive global functional connectivity density (gFCD) analysis was used to investigate the main effects and the interactions of disease states and COMT rs4680 gene polymorphism on brain function.
We found significant group differences of the gFCD in bilateral fusiform area (FFA), post-central and pre-central cortex, left superior temporal gyrus (STG), rectal and superior temporal gyrus and right ventrolateral prefrontal cortex (vlPFC); abnormal gFCDs in left STG were positively correlated with severity of depression in MDD group. Significant disease × COMT interaction effects were found in the bilateral calcarine gyrus, right vlPFC, hippocampus and thalamus, and left SFG and FFA. Further post-hoc tests showed a nonlinear modulation effect of COMT on gFCD in the development of MDD. Interestingly, an inverted U-shaped modulation was found in the prefrontal cortex (control system) but U-shaped modulations were found in the hippocampus, thalamus and occipital cortex (processing system).
Our study demonstrated nonlinear modulation of the interaction between COMT and depression on brain function. These findings expand our understanding of the COMT effect underlying the pathophysiology of MDD.
The potential pattern of regional cerebral blood flow (rCBF) in major depressive disorder (MDD) underlies different response to antidepressants medication remain unclear. This study aimed to investigate the differences of rCBF between patients with different treatment response.
Eighty MDD patients [(44 treatment-responsive depression (RD) and 36 non-responding depression (NRD)] and 42 healthy controls (HC) underwent pulsed arterial spin labeling (PASL) scans in magnetic resonance imaging and clinical estimates. The exact rCBF values of each groups were obtained via quantification evaluation.
Compared to NRD, the RD patients showed decreased rCBF values in frontal sensorimotor network (i.e. left paracentral lobule, left medial frontal gyrus, right superior frontal gyrus and right middle frontal gyrus), and further receiver operating curve (ROC) analyses demonstrated that the altered rCBF in these four regions exhibited outstanding performance on distinguishing NRD from RD. The NRD also exhibited reduced rCBF in bilateral cerebellum posterior lobe and right middle occipital gyrus and elevated rCBF in right postcentral gyrus and right middle frontal gyrus as compared to HC.
The decreased rCBF in frontal sensorimotor network appeared to be distinct characteristics for NRD, and might be severed as promising neuroimaging markers to differentiate depressed patients with weak early response to antidepressant medication. These findings expand our understanding of neural substrate underlying the antidepressant efficacy.
Disclosure of interest
The authors have not supplied their declaration of competing interest.