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Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
Mutation in CFAP43 leads to severe asthenozoospermia and multiple morphological abnormalities of the sperm flagellum (MMAF) in both human and mouse. Previous studies have shown that disruption of intra-manchette transport (IMT) caused failure of flagellum assembly and sperm head shaping. In a previous study, therefore, we postulated that disruption of IMT may contribute to the failure of sperm flagellum formation and result in MMAF, however the mechanisms underlying these defects are still poorly understood. Cfap43-deficient mice were studied here to reveal the cellular mechanisms of abnormal sperm head morphology and MMAF. Depletion of Cfap43 led to abnormal spermiogenesis and caused MMAF, sperm head abnormality and oligozoospermia. Furthermore, both abnormal manchette and disorganized ectoplasmic specialization (ES) could be observed at the elongated spermatids in Cfap43-deficient mice. Therefore, our findings demonstrated that, in mice, CFAP43-mediated IMT is essential for sperm head shaping and sperm flagellum formation.
Potassium and cerium co-doped Bi4Ti2.86W0.14O12 ceramics with a formula of (K0.5Ce0.5)xBi4−xTi2.86W0.14O12 (abbreviated as KC100x-BITW, x = 0, 0.02, 0.04, 0.06, 0.08, 0.1) were prepared by a conventional solid-state reaction method. The effect of (K0.5Ce0.5) complex doping amount on the structure, dielectric, and piezoelectric properties of the KC100x-BITW ceramics was investigated. X-ray diffraction results indicated that the KC100x-BITW ceramics are Aurivillius-type phase with the bismuth layer structure. (K0.5Ce0.5) complex addition first increases and then decreases the grain size which can be observed by scanning electron microscopy. With the increase of (K0.5Ce0.5) complex doping amount, the Curie temperature (TC) was slightly decreased from 632 to 608 oC. The dielectric and piezoelectric properties were optimized in KC100x-BITW ceramics with x = 0.08 as follows: d33 = 24 pC/N, kp = 8.2%, Qm = 6766, εr = 135 (@100 kHz), tanδ = 0.28% (@100 kHz), Tc = 611 oC, and resistivity ρ = 2.9 × 106 Ω cm at 500 oC, indicating that the KC100x-BITW ceramics are suitable for high-temperature piezoelectric sensing applications.
A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.
To reveal the thermal shock resistance of double-layer thermal barrier coatings (TBCs), two types of TBCs were prepared via atmospheric plasma spraying, i.e., Gd2Zr2O7/yttria-stabilized zirconia (GZ/YSZ) TBCs and La2Zr2O7 (LZ)/YSZ TBCs, respectively. Subsequently, thermal cycling tests of the two TBCs were conducted at 1100 °C and their thermal shock resistance and failure mechanism were comparatively investigated through experiments and the finite element method. The results showed that the thermal shock failure of the two TBCs occurred inside the top ceramic coating. However, the GZ/YSZ TBCs had longer thermal cycling life. It was the mechanical properties of the top ceramic coating, and the thermal stresses arising from the thermal mismatch between the top ceramic coating and the substrate that determined the thermal cycling life of the two TBCs together. Compared with the LZ layer in the LZ/YSZ TBCs, the GZ layer in the GZ/YSZ TBCs had smaller elastic modulus, larger fracture toughness, and smaller thermal stresses, which led to the higher crack propagation resistance and less spallation tendency of the GZ/YSZ TBCs. Therefore, the GZ/YSZ TBCs exhibited superior thermal shock resistance to the LZ/YSZ TBCs.
The mortality of coronavirus disease 2019 (COVID-19) differs between countries and regions. This study aimed to clarify the clinical characteristics of imported and second-generation cases in Shaanxi. This study included 134 COVID-19 cases in Shaanxi outside Wuhan. Clinical data were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. In total, 34.3% of the 134 patients were severe cases, 11.2% had complications. As of 7 March 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, direct bilirubin, lactate dehydrogenase and hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P < 0.05). Baseline lymphocyte count was higher in survived patients than in non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 (IL-6) level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest computed tomography images in 51.5% of the pneumonia cases. Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.
In this paper, dual-band and tri-band bandpass filters (BPFs) with fully independent and controllable passbands based on multipath-embedded resonators are presented. The dual-band BPF consists of two double open-ended stub-loaded terminal-shorted resonators (DOESL-TSRs) with a common via-hole connected along the symmetric plane of the filter. Based on DOESL-TSRs, a triple open-ended stub-loaded terminal-shorted resonator (TOESL-TSR) is proposed in the design of tri-band BPFs. The resonant characteristics of DOESL-TSR/TOESL-TSR are analyzed by the numerical calculation method. The measured results of the dual-band BPF show that the center frequencies (CFs) are located at 2.595 and 5.75 GHz, respectively, with 3 dB fraction bandwidth (FBWs) of 15 and 12.8%. The measured CFs of the tri-band BPF are located at 2.545, 3.775, and 5.95 GHz, respectively, with 3 dB FBWs of 9.8, 9.3, and 5.5%. Both of the filters exhibit the merits of fully independent and controllable passbands, high selectivity, and compact size.
Wedge-induced oblique detonation waves (ODWs) have been studied widely, but their interactions with complicated geometries have not been fully addressed. In this study, we investigate ODW interaction with a deflected upper corner due to confinement change upstream of the ODW. Numerical simulations are conducted using the reactive Euler equations with a two-step induction–reaction kinetic model. Two ODWs without the upper wall deflection are first simulated to resolve the basic structures with inflow Mach numbers
$M_0 = 6$
and 7. Thereafter, we introduce a deflected upper confinement, resulting in a new wave configuration. This wave is characterized by a post-turning, triangular recirculation zone coupled with a gaseous wedge connecting the deflection point and ODW surface. A parametric study is performed to analyse the effects of the deflection location, deflection angle and activation energy of the heat release reaction. The results reveal that the wave configuration is due to the evolution of ODW decoupling in an expanded supersonic flow. We further study the surface stability and structural unsteadiness arising for
$M_0 = 6$
. Upstream-travelling transverse waves are observed for the first time, and effects of different parameters on the surface instability are analysed via fast Fourier transforms. Two destabilizing mechanisms of ODW structures are proposed, one from the post-surface thermal choking and the other from the enhanced surface instability.
To improve the endurance performance of long-endurance Unmanned Aerial Vehicles (UAVs), a smart morphing method to adjust the UAV and flight mode continuously during flight is proposed. Using this method as a starting point, a smart morphing long-endurance UAV design is conducted and the resulting improvement in the endurance performance studied. Firstly, the initial overall design of the smart morphing long-endurance UAV is carried out, then the morphing form is designed and various control parameters are selected. Secondly, based on multi-agent theory, an architecture for the smart morphing control system is built and the workflow of the smart morphing control system is planned. The morphing decision method is designed in detail based on the particle swarm optimisation algorithm. Finally, a simulation of the smart morphing approach in the climb and cruise stages is carried out to quantitatively verify the improvement in the endurance performance. The simulation results show that the smart morphing method can improve the cruise time by 4.1% with the same fuel consumption.
We explored the genetic architecture of metabolic risk factors of cardiovascular diseases (CVDs) and their clustering in Chinese boys and girls. Seven metabolic traits (body mass index [BMI], waist circumference [WC], systolic blood pressure [SBP], diastolic blood pressure [DBP], total cholesterol [TC], triglyceride [TG], and uric acid [UA]) were measured in a sample of 1016 twins between 8 and 17 years of age, recruited from the Qingdao Twin Registry. Cholesky, independent pathway, and common pathway models were used to identify the latent genetic structure behind the clustering of these metabolic traits. Genetic architecture of these metabolic traits was largely similar in boys and girls. The highest heritability was found for BMI (a2 = 0.63) in boys and TC (a2 = .69) in girls. Three heritable factors, adiposity (BMI and WC), blood pressure (SBP and DBP), and metabolite factors (TC, TG, and UA), which formed one higher-order latent phenotype, were identified. Latent genetic, common environmental, and unique environmental factors indirectly impacted the three factors through one single latent factor. Our results suggest that there is one latent factor influencing several metabolic traits, which are known risk factors of CVDs in young Chinese twins. Latent genetic, common environmental, and unique environmental factors indirectly imposed on them. These results inform strategies for gene pleiotropic discovery and intervening of CVD risk factors during childhood and adolescence.
This cross-sectional study aimed to examine the associations between dietary fibre (DF) intake and depressive symptoms in a general adult population in Tianjin, China. A total of 24 306 participants (mean age 41 years; range 18–91 years) were enrolled. DF intake was assessed using a validated self-administered FFQ. Depressive symptoms were assessed using the Self-Rating Depression Scale. Associations between DF intake and depressive symptoms were estimated using logistic regression analysis. Socio-demographic, behavioural, health status and dietary factors were adjusted. In men, compared with participants in the lowest quartiles for total, soluble, vegetable and soya DF, OR for depressive symptoms in the highest were 0·83 (95 % CI 0·69, 0·99), 0·74 (95 % CI 0·63, 0·87), 0·79 (95 % CI 0·65, 0·96) and 0·69 (95 % CI 0·60, 0·81), respectively. In women, compared with participants in the lowest quartiles for vegetable and soya DF, the OR for depressive symptoms in the highest were 0·77 (95 % CI 0·64, 0·93) and 0·82 (95 % CI 0·70, 0·95), respectively. No association was found between total or soluble DF intake and depressive symptoms in women. No association was found between insoluble, cereal, fruit or tuber DF intake and depressive symptoms in men and women. Linear associations between DF intake and depressive symptoms were only detected for soya DF (men, β = –0·148, P < 0·0001; women, β = –0·069, P = 0·04). Results suggest that intake of soluble, vegetable and soya DF was inversely associated with depressive symptoms. These results should be confirmed through prospective and interventional studies.
Shifts in the maternal gut microbiota have been implicated in the development of gestational diabetes mellitus (GDM). Understanding the interaction between gut microbiota and host glucose metabolism will provide a new target of prediction and treatment. In this nested case-control study, we aimed to investigate the causal effects of gut microbiota from GDM patients on the glucose metabolism of germ-free (GF) mice. Stool and peripheral blood samples, as well as clinical information, were collected from 45 GDM patients and 45 healthy controls (matched by age and prepregnancy body mass index (BMI)) in the first and second trimester. Gut microbiota profiles were explored by next-generation sequencing of the 16S rRNA gene, and inflammatory factors in peripheral blood were analyzed by enzyme-linked immunosorbent assay. Fecal samples from GDM and non-GDM donors were transferred to GF mice. The gut microbiota of women with GDM showed reduced richness, specifically decreased Bacteroides and Akkermansia, as well as increased Faecalibacterium. The relative abundance of Akkermansia was negatively associated with blood glucose levels, and the relative abundance of Faecalibacterium was positively related to inflammatory factor concentrations. The transfer of fecal microbiota from GDM and non-GDM donors to GF mice resulted in different gut microbiota colonization patterns, and hyperglycemia was induced in mice that received GDM donor microbiota. These results suggested that the shifting pattern of gut microbiota in GDM patients contributed to disease pathogenesis.
Fullerene dimers have attracted extensive attention due to their unique structures and fascinating properties. Here, fullerene dimer derivatives with four to six carbon atoms in the esters are designed and synthesized. The property differences that caused by the carbon number in the esters of the fullerene dimers are investigated by performing their electrochemical, optical, and photoelectric measurements. As the carbon atom numbers in the esters increase from four to five and six, the absorption intensities increase to 1.6- and 4.4-folds. The intensities of the fluorescence spectra increase to 1.8- and 5.2-folds. Their photocurrent increases to 2- and 7-folds under the irradiation of a 405-nm laser. The LUMO energy levels move downward slightly from −3.89 to −3.90 and −3.92 eV, respectively. Our results indicate that as the carbon number increases, the carbon chain lengths in the ester structures increase, very slight effects produced on the energy levels of the fullerene dimers, but strongly contribute to their chemical activities and thus the photoelectronic efficiencies.
Fat-soluble vitamins during pregnancy are of vital importance for fetal growth and development. The present study aimed at exploring the association between vitamin A, E and D status during pregnancy and birth weight. A total of 19,640 women with singleton deliveries from a retrospective study were included. Data were collected by the hospital electronic information system. Maternal serum vitamin A, E and D concentrations were measured during pregnancy. Logistic regression was performed to estimate the association between the vitamins status and low birth weight (LBW) or macrosomia. Women with excessive vitamin E were more likely to have macrosomia (OR: 1.30, 95% CI: 1.07-1.59) compared with adequate concentration. When focusing on Z scores, there was a positive association between vitamin E and macrosomia in the 1st (OR: 1.07, 95% CI: 1.00-1.14), 2nd (OR: 1.27, 95% CI: 1.11-1.46) and 3rd (OR: 1.28, 95% CI: 1.06-1.54) trimesters; vitamin A was positively associated with LBW in the 1st (OR: 1.14, 95% CI: 1.01-1.29), 2nd (OR: 1.31, 95% CI: 1.05-1.63) and 3rd (OR: 2.00, 95% CI: 1.45-2.74) trimesters, and negatively associated with macrosomia in the 2nd (OR: 0.79, 95% CI: 0.70-0.89) and 3rd (OR: 0.77, 95% CI: 0.62-0.95) trimesters. The study identified that high concentrations of vitamin E are associated with macrosomia. Maintaining a moderate concentration of vitamin A during pregnancy might be beneficial to achieve optimal birth weight. Further studies to explore the mechanism of associations above are warranted.
The development of thermoelectric measurement technology at nanoscale is a challenging task. Here, a novel MEMS-based dual temperature control (DTC) measurement method for thermoelectric properties of individual nanowires was proposed. Different from conventional thermal bridge testing devices, this DTC thermoelectric testing device can obtain the thermoelectric properties by independently control ambient temperature and temperature difference between two ends of the nanowires through two separate resistance thermometers without auxiliary heating devices. The reliability of the model and the testing accuracy were verified by accurately measuring the thermal conductivity, electrical conductivity, and the absolute value of the Seebeck coefficient of VO2 nanowires.
The variability of the East Asian monsoon (EAM) during the Holocene exhibits significant regional response, and its evolution needs further discussion. A well-dated, high-resolution sea-surface temperature record based on long-chain unsaturated alkenones, grain-size data, and clay mineral assemblages from the South Yellow Sea sediment is presented to investigate the sedimentary provenance and reconstruct the EAM over the past 9.5 ka. The results show that the sediments are most likely supplied by the Huanghe. The evolution of the East Asian summer monsoon (EASM) can be divided into three periods: strong and relatively stable conditions during 9.5–7.0 ka, weakened conditions during 7.0–1.5 ka, and strengthened conditions during 1.5–0 ka. The East Asian winter monsoon (EAWM) has experienced five periods: weakened conditions during 9.5–6.7 ka, weak and relatively stable conditions during 6.7–5.6 ka, strong and relatively stable conditions during 5.6–2.6 ka, strengthened conditions during 2.6–1.5 ka, and weak and stable conditions during 1.5–0 ka. Moreover, in-phase correlation was found between the EAWM and EASM at the orbital time scale in response to orbital-driven solar insolation, but out-of-phase correlation at a centennial time scale is predominantly associated with solar activity.
Hot-water ice-coring drills are often used to recover ice core samples from desirable depths in conjunction with full-scale hot-water drilling systems. However, the recovered cores exhibit varying qualities. The coring performance of a hot-water ice-coring drill depends significantly on the structure of the coring drill head (nozzle angle, diameter and number). To discover the most significant factor affecting ice-coring performance, nine types of drill heads were designed and tested in this study according to the orthogonal test design. Results indicated that the nozzle angle is the most significant factor that affects the coring quality and the optimal angle is ~15°. The number of nozzles is the second most important factor; a large number assists in obtaining ice cores of high quality. The optimal nozzle configuration to recover good quality cores are the following: the nozzle diameter, number of nozzles and nozzle angle are 1 mm, 60 nozzles and 15°, respectively, with the maximum diameter and 2 mm, 60 nozzles and 15°, respectively, with the maximum length.
No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment.
This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance.
Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6).
Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.
Renal fibrosis is common especially in the elderly population. Recently, we found that vitamin D deficiency caused prostatic hyperplasia. This study aimed to investigate whether vitamin D deficiency promotes renal fibrosis and functional impairment. All mice except controls were fed with vitamin D-deficient (VDD) diets, beginning from their early life. The absolute and relative kidney weights on postnatal week 20 were decreased in VDD diet-fed male pups but not in female pups. A mild pathological damage was observed in VDD diet-fed male pups but not in females. Further analysis showed that VDD-induced pathological damage was aggravated, accompanied by renal dysfunction in 40-week-old male pups. An obvious collagen deposition was observed in VDD diet-fed 40-week-old male pups. Moreover, renal α-smooth muscle actin (α-SMA), a marker of epithelial–mesenchymal transition (EMT), and Tgf-β mRNA were up-regulated. The in vitro experiment showed that 1,25-dihydroxyvitamin D3 alleviated transforming growth factor-β1 (TGF-β1)-mediated down-regulation of E-cadherin and inhibited TGF-β1-evoked up-regulation of N-cadherin, vimentin and α-SMA in renal epithelial HK-2 cells. Moreover, 1,25-dihydroxyvitamin D3 suppressed TGF-β1-evoked Smad2/3 phosphorylation in HK-2 cells. These results provide experimental evidence that long-term vitamin D deficiency promotes renal fibrosis and functional impairment, at least partially, through aggravating TGF-β/Smad2/3-mediated EMT in middle-aged male mice.