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This paper presents a multi-band rectangular slot antenna, which can be used in Beidou navigation system, 4G, WLAN and 5G system. The proposed antenna adopts a single feeding line, generating circular polarization for satellite navigation, and linear polarization for mobile communication systems. The proposed antenna consists of three c-type resonators and three rectangular loop slots. A c-type resonator and a rectangular loop slot work together to produce a usable frequency band. Multiple frequency bands can be generated by increasing the number of c-type resonator and rectangular loop slots. It is found that the c-type resonator changes the current distribution on the antenna surface, making the axial ratio less than 3 dB in the low frequency bands. Eventually, five operation frequency bands are realized. Experimentally, it is verified that the impedance bandwidths of each frequency band are 11.8% (1.12–1.26 GHz), 15.4% (1.5–1.75 GHz), 11.9% (2.36–2.66 GHz), 19.7% (3.15–3.84 GHz) and 2.6% (4.47–4.59 GHz), respectively. The measured 3 dB axial ratio bandwidths are 20 MHz at 1.2 and 1.56 GHz, fully covering BDS B1 and B2 bands. The measured gains are 3, 3.59, 4.07, 4.2 and 4.35 dBi, respectively.
We reported a case of pheochromocytoma with initial presentation of cardiac arrest. The patient underwent implantable cardioverter defibrillator for primary prevention but subsequently experienced repeated implantable cardioverter defibrillator shocks and syncopal episodes. A mass was found in the adrenal gland by CT, which was confirmed by anatomopathological analysis of the surgical specimen.
Piezoelectric macro-fibre composite (MFC) actuators are employed onto the flexible leeward surface of an airfoil for active control. Time-resolved aerodynamic forces, membrane deformations and flow fields are synchronously measured at low Reynolds number (Re = 6 × 104). Mean aerodynamics show that the actively controlled airfoil can achieve lift-enhancement and drag-reduction simultaneously in the angle of attack range of 10° ≤ α ≤ 14°, where the rigid airfoil encounters stall. The maximum increments of lift and lift-to-drag ratio are 27.1 % and 126 % at the reduced actuation frequency of ${f^ + } = 3.52$. The unsteady coupling features are further analysed at α = 12°, where the maximum lift-enhancement occurs. It is newly discovered that the membrane vibrations and flow fields are locked into half of the actuation frequency when ${f^ + } > 3$. The shift of the dominant vibration mode from bending to inclining is the reason for the novel ‘half-frequency lock-in’ phenomenon. To the fluid–structure interaction, there are three characteristic frequencies for the actively controlled airfoil: $S{t_1} = 0.5{f^ + }$, $S{t_2} = {f^ + }$, and $S{t_3} = 1.5{f^ + }$. Here, St1 and its harmonics (St2, St3) are coupled with the natural frequencies of the leading-edge shear layer, resulting in the generation of multi-scale flow structures and suppression of flow separation. The lift presents comparable dominant frequencies between St1 and St3, which means the instantaneous lift is determined by the flow structures of St1 and St3. The local membrane bulge and dent affect the instantaneous swirl strength of flow structures near the maximum vibration amplitude location, which is the main reason for the variation of instantaneous lift.
During its transition to a market economy, structural inequalities became increasingly apparent across China’s workforce, threatening social harmony. China’s 2008 Employment Contract Law, legislated amid policy debate, was intended to remedy these phenomena. We examine a crucial element of its remit: has its promotion of continuing contracts as against fixed-term employment contracts been effective? This is crucial for improving workers’ rights through secure employment. How have employers responded to this challenge to their prerogatives in terms of hiring and firing? We analysed data from 2007 and 2012 drawn from All-China Federation of Trade Unions surveys, which cover approximately 80,000 individuals. Using institutional theory, we discuss a variety of employer responses. We find that the Employment Contract Law has increased the likelihood of signing continuing contracts among migrant workers, employees in privately owned enterprises, and those with lower professional titles and who are short-term employees – all disadvantaged labour market categories previously. It has also significantly narrowed gaps regarding access to continuing contracts between these categories and matched advantaged ones. There is also evidence that some employers seek to avoid or sidestep compliance through cost-minimising worker engagement strategies.
Let $R$ be a left coherent ring. It is proven that if an $R$-module $M$ has a finite FP-injective dimension, then the Gorenstein projective (resp. Gorenstein flat) dimension and the projective (resp. flat) dimension coincide. Also, we obtain that the pair ($\mathcal {GP},\, \mathcal {GP}^{\perp }$) forms a projective cotorsion pair under some mild conditions.
Patients with cirrhosis experience worse health-related quality of life (HRQoL), and attempts are warranted further exploration of modifiable factors to improve HRQoL. Data on the impact of malnutrition risk on HRQoL among cirrhosis are limited; thus, we aimed to strengthen understanding by clarifying the relationship between nutritional status and low HRQoL in patients with decompensated cirrhosis. Consecutive inpatients with cirrhosis attending our department within a tertiary hospital were studied. Generic health profiles and malnutrition risk were evaluated by the EuroQol-5D (EQ-5D) and Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) score, respectively. Multiple linear regression analysis was used to determine association of malnutrition risk with low HRQoL. In this cohort of 364 patients with median age of 64 years and 49·5 % male, 55·5 % of the study population reported impairment pertinent to HRQoL in at least one dimension in terms of the EQ-5D. Moreover, malnutrition risk (RFH-NPT score: β coefficient = −0·114, P = 0·038) was proved to be independently associated with poor HRQoL in multiple analysis, after adjustment for significant variables like age, BMI and markers of decompensation. Notably, we found that health dimensions representing physical function (i.e. mobility, self-care and usual activities) are substantially affected, while malnourished patients reported less frequencies of complaints in other domain such as anxiety/depression. In conclusion, the risk of malnutrition assessed by the RFH-NPT score is independently associated with low HRQoL. It is operational to improve HRQoL by identifying patients at high malnutrition risk and providing timely nutrition treatment.
Languages employ different means to manifest the unaccusative-unergative distinction. In Mandarin Chinese, unaccusative verbs are allowed in the inversion construction “V-le NP”, while unergative verbs are not. This grammaticality contrast brings a presence/absence contrast between the two verb classes in the inversion construction in the input. Using an eye fixation task, we investigated whether Mandarin-learning 19-month-olds were sensitive to this specific input frequency contrast. We found that infants distinguished the grammatical versus ungrammatical uses of the two verb classes in the inversion construction “V-le NP” (Experiment 1). When the verb classes were in the “NP V-le” order (Experiment 2) (i.e., the same level of grammaticality), infants showed no evidence of a looking difference. These responses indicate toddlers’ sensitivity to the distribution of the two verb classes in the inversion construction. This distributional information is likely to be one of the potential cues that facilitate their acquisition of the unaccusative-unergative distinction.
Many protected areas worldwide have been established to protect the last natural refuges of flagship animal species. However, long-established protected areas do not always match the current distributions of target species under changing environmental conditions. Here we present a case study of the Asian elephant Elephas maximus in Xishuangbanna, south-west China, to evaluate whether the established protected areas match the species’ current distribution and to identify key habitat patches for Asian elephant conservation. Our results show that currently only 24.5% of the predicted Asian elephant distribution in Xishuangbanna is located within Xishuangbanna National Nature Reserve, which was established for elephant conservation. Based on the predicted Asian elephant distribution, we identified the most important habitat patches for elephant conservation in Xishuangbanna. The three most important patches were outside Xishuangbanna National Nature Reserve and together they contained 43.3% of the estimated food resources for Asian elephants in all patches in Xishuangbanna. Thus, we identified a spatial mismatch between immobile protected areas and mobile animals. We recommend the inclusion of the three identified key habitat patches in a new national park currently being planned by the Chinese authorities for the conservation of the Asian elephant.
To characterize factors associated with increased risk of outpatient parenteral antimicrobial therapy (OPAT) complication.
Design:
Retrospective cohort study.
Setting:
Four hospitals within NYU Langone Health (NYULH).
Patients:
All patients aged ≥18 years with OPAT episodes who were admitted to an acute-care facility at NYULH between January 1, 2017, and December 31, 2020, who had an infectious diseases consultation during admission.
Results:
Overall, 8.45% of OPAT patients suffered a vascular complication and 6.04% suffered an antimicrobial complication. Among these patients, 19.95% had a 30-day readmission and 3.35% had OPAT-related readmission. Also, 1.58% of patients developed a catheter-related bloodstream infection (CRBSI). After adjusting for key confounders, we found that patients discharged to a subacute rehabilitation center (SARC) were more likely to develop a CRBSI (odds ratio [OR], 4.75; P = .005) and to be readmitted for OPAT complications (OR, 2.89; P = .002). Loss to follow-up with the infectious diseases service was associated with increased risks of CRBSI (OR, 3.78; P = .007) and 30-day readmission (OR, 2.59; P < .001).
Conclusions:
Discharge to an SARC is strongly associated with increased risks of readmission for OPAT-related complications and CRBSI. Loss to follow-up with the infectious diseases service is strongly associated with increased risk of readmission and CRBSI. CRBSI prevention during SARC admission is a critically needed public health intervention. Further work must be done for patients undergoing OPAT to improve their follow-up retention with the infectious diseases service.
Depressive symptoms, functional impairment, and decreased quality of life (QOL) are three important domains of major depressive disorder (MDD). However, the possible causal relationship between these factors has yet to be elucidated. Moreover, it is not known whether certain symptoms of MDD are more impairing than others. The network approach is a promising solution to these shortfalls.
Methods
The baseline data of a multicenter prospective project conducted in 11 governances of China were analyzed. In total, 1385 patients with MDD were included. Depressive symptoms, functioning disability, and QOL were evaluated by the 17-item Hamilton Depression Rating Scale (HAMD-17), the Sheehan Disability Scale (SDS), and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). The network was estimated through the graphical Least Absolute Shrinkage and Selection Operator (LASSO) technique in combination with the directed acyclic graph.
Results
Three centrality metrics of the graphical LASSO showed that social life dysfunction, QOL, and late insomnia exhibited the highest strength centrality. The network accuracy and stability were estimated to be robust and stable. The Bayesian network indicated that some depressive symptoms were directly associated with QOL, while other depressive symptoms showed an indirect association with QOL mediated by impaired function. Depressed mood was positioned at the highest level in the model and predicted the activation of functional impairment and anxiety.
Conclusions
Functional disability mediated the relationship between depressive symptoms and QOL. Family functionality and suicidal symptoms were directly related to QOL. Depressed mood played the predominant role in activating both anxiety symptom and functional impairment.
We report dispersion management based on a mismatched-grating compressor for a 100 PW level laser, which utilizes optical parametric chirped pulse amplification and also features large chirped pulse duration and an ultra-broadband spectrum. The numerical calculation indicates that amplified pulses with 4 ns chirped pulse duration and 210 nm spectral bandwidth can be directly compressed to sub-13 fs, which is close to the Fourier-transform limit (FTL). More importantly, the tolerances of the mismatched-grating compressor to the misalignment of the stretcher, the error of the desired grating groove density and the variation of material dispersion are comprehensively analyzed, which is crucially important for its practical application. The results demonstrate that good tolerances and near-FTL compressed pulses can be achieved simultaneously, just by keeping a balance between the residual second-, third- and fourth-order dispersions in the laser system. This work can offer a meaningful guideline for the design and construction of 100 PW level lasers.
Although aberrant brain regional responses are reported in social anxiety disorder (SAD), little is known about resting-state functional connectivity at the macroscale network level. This study aims to identify functional network abnormalities using a multivariate data-driven method in a relatively large and homogenous sample of SAD patients, and assess their potential diagnostic value.
Methods
Forty-six SAD patients and 52 demographically-matched healthy controls (HC) were recruited to undergo clinical evaluation and resting-state functional MRI scanning. We used group independent component analysis to characterize the functional architecture of brain resting-state networks (RSNs) and investigate between-group differences in intra-/inter-network functional network connectivity (FNC). Furtherly, we explored the associations of FNC abnormalities with clinical characteristics, and assessed their ability to discriminate SAD from HC using support vector machine analyses.
Results
SAD patients showed widespread intra-network FNC abnormalities in the default mode network, the subcortical network and the perceptual system (i.e. sensorimotor, auditory and visual networks), and large-scale inter-network FNC abnormalities among those high-order and primary RSNs. Some aberrant FNC signatures were correlated to disease severity and duration, suggesting pathophysiological relevance. Furthermore, intrinsic FNC anomalies allowed individual classification of SAD v. HC with significant accuracy, indicating potential diagnostic efficacy.
Conclusions
SAD patients show distinct patterns of functional synchronization abnormalities both within and across large-scale RSNs, reflecting or causing a network imbalance of bottom-up response and top-down regulation in cognitive, emotional and sensory domains. Therefore, this could offer insights into the neurofunctional substrates of SAD.
Inflammation plays a crucial role in the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD). This study aimed to examine whether the dysregulation of complement components contributes to brain structural defects in patients with mood disorders.
Methods
A total of 52 BD patients, 35 MDD patients, and 53 controls were recruited. The human complement immunology assay was used to measure the levels of complement factors. Whole brain-based analysis was performed to investigate differences in gray matter volume (GMV) and cortical thickness (CT) among the BD, MDD, and control groups, and relationships were explored between neuroanatomical differences and levels of complement components.
Results
GMV in the medial orbital frontal cortex (mOFC) and middle cingulum was lower in both patient groups than in controls, while the CT of the left precentral gyrus and left superior frontal gyrus were affected differently in the two disorders. Concentrations of C1q, C4, factor B, factor H, and properdin were higher in both patient groups than in controls, while concentrations of C3, C4 and factor H were significantly higher in BD than in MDD. Concentrations of C1q, factor H, and properdin showed a significant negative correlation with GMV in the mOFC at the voxel-wise level.
Conclusions
BD and MDD are associated with shared and different alterations in levels of complement factors and structural impairment in the brain. Structural defects in mOFC may be associated with elevated levels of certain complement factors, providing insight into the shared neuro-inflammatory pathogenesis of mood disorders.
Whether starchy and nonstarchy vegetables have distinct impacts on health remains unknown. We prospectively investigated the intake of starchy and nonstarchy vegetables in relation to mortality risk in a nationwide cohort. Diet was assessed using 24-h dietary recalls. Deaths were identified via the record linkage to the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression. During a median follow-up of 7.8 years, 4,904 deaths were documented among 40,074 participants aged 18 years or older. Compared to those with no consumption, participants with daily consumption of ≥ 1 serving of nonstarchy vegetables had a lower risk of mortality (HR = 0.76, 95% CI: 0.66-0.88, ptrend = 0.001). Dark-green and deep-yellow vegetables (HR = 0.79, 95% CI: 0.63-0.99, ptrend = 0.023) and other nonstarchy vegetables (HR = 0.80, 95% CI: 0.70-0.92, ptrend = 0.004) showed similar results. Total starchy vegetable intake exhibited a marginally weak inverse association with mortality risk (HR = 0.89, 95% CI: 0.80-1.00, ptrend = 0.048), while potatoes showed a null association (HR = 0.93, 95% CI: 0.82-1.06, ptrend = 0.186). Restricted cubic spline analysis suggested a linear dose‒response relationship between vegetable intake and death risk, with a plateau at over 300 and 200 grams/day for total and nonstarchy vegetables, respectively. Compared to starchy vegetables, nonstarchy vegetables might be more beneficial to health, although both showed a protective association with mortality risk. The risk reduction in mortality plateaued at approximately 200 grams/day for nonstarchy vegetables and 300 grams/day for total vegetables.
Although attentional bias modification training (ABM) and cognitive behavioural therapy (CBT) are two effective methods to decrease the symptoms of generalized anxiety disorders (GAD), to date, no randomized controlled trials have yet evaluated the effectiveness of an intervention combining internet-based cognitive behavioural therapy (ICBT) and ABM for adults with GAD.
Aims:
This study aimed to investigate the effectiveness of an intervention combining ICBT and ABM for adults with GAD.
Method:
Sixty-three participants diagnosed with GAD were randomly assigned to the treatment group (ICBT with ABM; 31 participants) or the control group (ICBT with ABM placebo; 32 participants), and received 8 weeks of treatment and three evaluations. The CBT, ABM and ABM-placebo training were conducted via the internet. The evaluations were conducted at baseline, 8 weeks later, and 1 month later, respectively.
Results:
Both the treatment and control groups reported significantly reduced anxiety symptoms and attentional bias, with no clear superiority of either intervention. However, the treatment group showed a greater reduction in negative automatic thoughts than the control group after treatment and at 1-month follow-up (η2 = 0.123).
Conclusion:
The results suggest that although not differing in therapeutic efficacy, the intervention combining ICBT and ABM is superior to the intervention combining ICBT and ABM-placebo in the reduction of negative automatic thoughts. ABM may be a useful augmentation of ICBT on reducing anxiety symptoms.
Immune cells play a key role in maintaining renal dynamic balance and dealing with renal injury. The physiological and pathological functions of immune cells are intricately connected to their metabolic characteristics. However, immunometabolism in chronic kidney disease (CKD) is not fully understood. Pathophysiologically, disruption of kidney immune cells homeostasis causes inflammation and tissue damage via triggering metabolic reprogramming. The diverse metabolic characteristics of immune cells at different stages of CKD are strongly associated with their different pathological effect. In this work, we reviewed the metabolic characteristics of immune cells (macrophages, natural killer cells, T cells, natural killer T cells and B cells) and several non-immune cells, as well as potential treatments targeting immunometabolism in CKD. We attempt to elaborate on the metabolic signatures of immune cells and their intimate correlation with non-immune cells in CKD.
This study aimed to analyze the clinical effects of microdissection testicular sperm extraction (micro-TESE) surgery combined with an intracytoplasmic sperm injection (ICSI) regimen in the treatment of non-obstructive azoospermia (NOA) patients with different etiologies. In total, 128 NOA patients participated in this study, in which they received infertility treatment by micro-TESE surgery combined with an ICSI regimen, and all patients were divided into three groups [the Klinefelter syndrome (KS), the idiopathic and the secondary NOA groups]. In addition, the sperm retrieval rate (SRR), fertilization rate, embryo development status and clinical treatment effects were analyzed. Among the 128 NOA patients, the SRR of KS NOA patients was 48.65%, those of idiopathic and the secondary patients were 33.82% and 73.91%, respectively. Regardless of etiologies, there was no correlation with age, hormone value or testicular volume. Further analysis showed that the SRR of the KS group was positively related with testosterone (T) values, and the SRR of the secondary group had a positive relationship with follicle-stimulating hormone or luteinizing hormone values. In the subsequent clinical treatment, the retrieved sperm was subjected to ICSI and achieved good treatment effects, especially in the secondary group, and the implantation rate (55.56%) and clinical pregnancy rate (68.42%) were both higher than those of the idiopathic group (28.75% and 40.00%) and KS group (22.05% and 30.77%). Micro-TESE surgery combined with ICSI insemination is the most effective treatment regimen for NOA patients. The SRR of NOA patients with different etiologies are related to certain specific factors, and micro-TESE surgery seems to be the ideal and only way to have biological children.