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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.
We investigate the phased evolution and variation of the South Asian monsoon and resulting weathering intensity and physical erosion in the Himalaya–Karakoram Mountains since late Pliocene time (c. 3.4 Ma) using a comprehensive approach. Neodymium and strontium isotopic compositions and single-grain zircon U–Pb age spectra reveal the sources of the deposits in the east Arabian Sea, and show a combination of sources from the Himalaya and the Karakoram–Kohistan–Ladakh Mountains, with sediments from the Indian Peninsula such as the Deccan Traps or Craton. We interpret shifts in the sediment sources to have been forced by sea-level changes that correlate with South Asian monsoon rainfall variation since late Pliocene time. We collected 908 samples from the International Ocean Discovery Program Hole U1456A, which was drilled in the east Arabian Sea. Time series of hematite content and grain size of the sediments were examined downcore. We found South Asian monsoon precipitation and weathering intensity experienced three phases from late Pliocene time. Lower monsoon precipitation, with a lower variability and strong weathering intensity, occurred during 3.4–2.4 Ma; an increased and more variable South Asian monsoon rainfall, along with strengthened but fluctuating weathering intensity, occurred at 1.8–1.1 Ma; and a reduced rainfall with lower South Asian monsoon precipitation variability and moderate weathering intensity marked the period 1.1–0.1 Ma. Maximum entropy spectral analysis and wavelet transform show that there were orbital-dominated cycles of periods c. 100 and c. 41 ka in these proxy-based time series. We propose that the monsoon, sea level, global temperature and insolation together forced the weathering and erosion in SW Asia.
Stimulated Raman scattering (SRS) in plasma in a non-eigenmode regime is studied theoretically and numerically. Different from normal SRS with the eigen electrostatic mode excited, the non-eigenmode SRS is developed at plasma density
when the laser amplitude is larger than a certain threshold. To satisfy the phase-matching conditions of frequency and wavenumber, the excited electrostatic mode has a constant frequency around half of the incident light frequency
, which is no longer the eigenmode of electron plasma wave
. Both the scattered light and the electrostatic wave are trapped in plasma with their group velocities being zero. Super-hot electrons are produced by the non-eigen electrostatic wave. Our theoretical model is validated by particle-in-cell simulations. The SRS driven in this non-eigenmode regime is an important laser energy loss mechanism in the laser plasma interactions as long as the laser intensity is higher than
This study attempts to figure out the seasonality of the transmissibility of hand, foot and mouth disease (HFMD). A mathematical model was established to calculate the transmissibility based on the reported data for HFMD in Xiamen City, China from 2014 to 2018. The transmissibility was measured by effective reproduction number (Reff) in order to evaluate the seasonal characteristics of HFMD. A total of 43 659 HFMD cases were reported in Xiamen, for the period 2014 to 2018. The median of annual incidence was 221.87 per 100 000 persons (range: 167.98/100,000–283.34/100 000). The reported data had a great fitting effect with the model (R2 = 0.9212, P < 0.0001), it has been shown that there are two epidemic peaks of HFMD in Xiamen every year. Both incidence and effective reproduction number had seasonal characteristics. The peak of incidence, 1–2 months later than the effective reproduction number, occurred in Summer and Autumn, that is, June and October each year. Both the incidence and transmissibility of HFMD have obvious seasonal characteristics, and two annual epidemic peaks as well. The peak of incidence is 1–2 months later than Reff.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
The Neoproterozoic Jiangnan orogenic belt records the accretion and collision between the Yangtze and Cathaysia blocks in South China. The orogen is divisible into three units: a northeastern domain (also referred to as the Huaiyu or Shuangxiwu domain), a central domain (Jiuling domain) and an undifferentiated southwestern domain. Detrital zircons from the oldest sequences (Shuangqiaoshan, Lengjiaxi, Fanjingshan and Sibao groups) in the central and southwest domains yield similar age spectra with major age populations at c. 875–820 Ma, along with minor Palaeo- to Mesoproterozoic and Archaean ages. The dominance of detrital ages close to the deposition ages of the units, along with juvenile zircon Hf isotopic compositions and arc-like whole-rock compositional data, indicate the sedimentary units accumulated adjacent to a convergent plate margin magmatic arc. The presence of Mesoproterozoic and older zircons, both as detritus in the units and as xenocrysts within igneous rocks displaying a subduction-related signature, along with the compositional data, place the magmatic arc along a continental margin. In the northeastern domain, the oldest coeval sequence (Shuangxiwu and Qigong groups) and arc igneous suites are dated at c. 970–850 Ma, and lack older detritus and xenocrysts, indicating they represent an accreted oceanic arc system.
To improve biped locomotion’s robustness to internal and external disturbances, this study proposes a hierarchical structure with three control levels. At the high level, a foothold sequence is generated so that the Center of Mass (CoM) trajectory tracks a planned path. The planning procedure is simplified by selecting the midpoint between two consecutive Center of Pressure (CoP) points as the feature point. At the middle level, a novel robust hybrid controller is devised to drive perturbed system states back to the nominal trajectory within finite cycles without chattering. The novelty lies in that the hybrid controller is not subject to linear CoM dynamic constraints. The hybrid controller consists of two sub-controllers: an oscillation controller and a smoothing controller. For the oscillation controller, the desired CoM height is specified as a sine-shaped function, avoiding a new attractive limit cycle. However, this controller results in the inevitable chattering because of discontinuities. A smoothing controller provides continuous properties and thus can inhibit the chattering problem, but has a smaller region of attraction compared with the oscillation controller. A hybrid controller merges the two controllers for a smooth transition. At the low level, the desired CoM motion is defined as tasks and embedded in a whole body operational space (WBOS) controller to compute the joint torques analytically. The novelty of the low-level controller lies in that within the WBOS framework, CoM motion is not subject to fixed CoM dynamics and thus can be generalized.
Brain structural connectome comprise of a minority of efficiently interconnected rich club nodes that are regarded as ‘high-order regions’. The remission of major depressive disorder (MDD) in response to selective serotonin reuptake inhibitor (SSRI) treatment could be investigated by the hierarchical structural connectomes’ alterations of subnetworks.
Fifty-five MDD patients who achieved remission underwent diffusion tensors imaging (DTI) scanning from 3 cohorts before and after 8-weeks antidepressant treatment. Five hierarchical subnetworks namely, rich, local, feeder, rich-feeder and feeder-local, were constructed according to the different combinations of connections and nodes as defined by rich club architecture. The critical treatment-related subnetwork pattern was explored by multivariate pattern analysis with support vector machine to differ the pre-/post-treatment patients. Then, relationships between graph metrics of discriminative subnetworks/ nodes and clinical variables were further explored.
The feeder-local subnetwork presented the most discriminative power in differing pre-/post- treatment patients, while the rich-feeder subnetwork had the highest discriminative power when comparing pre-treatment patients and controls. Furthermore, based on the feeder connection, which indicates the information transmission between the core and non-core architectures of brain networks, its topological measures were found to be significantly correlated with the reduction rate of 17-item Hamilton Rating Scale for Depression.
Although pathological lesion on MDD relied on abnormal core organization, disease remission was association with the compensation from non-core organization. These results suggested that the dysfunctions arising from hierarchical subnetworks are compensated by increased information interactions between core brain regions and functionally diverse regions.
The fundamental cause for the statically indeterminate problem in the force analysis of overconstrained parallel mechanisms (PMs) is found to be the presence of the linearly dependent overconstrained wrenches. Based on the fundamental cause, a unified expression of the solution for the magnitudes of the constraint wrenches of both the limb stiffness decoupled and limb stiffness coupled overconstrained PMs is derived. When the weight of each link is considered, depending on whether additional component forces are generated along the axes of the overconstrained wrenches, two different situations should be considered. One situation is that no additional component force is generated along the axes of the overconstrained wrenches under the weight of the links in the corresponding limb. In this case, the added constraint wrenches at the limb’s end can be calculated directly, and used as a part of the generalized external wrench. The other situation is that additional component forces are generated. In this case, the elastic deformations in the axes of the overconstrained wrenches generated by those component forces should be considered, and the deformation compatibility equations between the overconstrained wrenches are reformulated.
Graphene (G) has attracted great interest because of its excellent chemical and electrical properties. However, the aggregation of graphene restricts its application. Herein, linoleic acid sodium salt (LASS), a low-cost and environmentally friendly material, was used to improve the dispersion of graphene through covalent interaction. Then, the mixture (G@LASS) was integrated with acrylic resin matrix via hydrogen bond between the carboxyl and ester groups. The excellent interfacial compatibility between G@LASS and acrylic matrix, as well as good dispersibility of G@LASS, was demonstrated by Fourier-transform infrared spectroscopy, X-ray photoelectron spectroscopy, Raman, and scanning electron microscopy tests. Compared with acrylic matrix, the surface hydrophobicity of G@LASS@Acrylic increased considerably because of its compact structure. G@LASS@Acrylic composites meet the requirement of antistatic materials when the content of G was only about 0.5 wt%. The results showed that conductive pathways were established successfully through this method.
Mosses have adapted to the Antarctic environment and are an ideal medium for studying plant resistance to abiotic stress. Chalcone synthase is the first committed enzyme in the flavonoid metabolic pathway, which plays an indispensable role in plant resistance to adversity. In this study, six genes (Pn021, PnCHS088, Pn270, PnCHS444, PnCHS768 and Pn847) were identified in the Antarctic moss Pohlia nutans Lindberg transcriptome by reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE). Sequence alignment and three-dimensional structure analysis revealed the conserved amino acid residues of the enzymes of the chalcone synthase family, including three catalytic residues (Cys164, His303 and Asn336) and two substrate recognition residues (Phe215 and Phe265). Phylogenetic analysis indicated that PnCHS088, PnCHS444 and PnCHS768 might be chalcone synthase but that Pn021 is more like stilbenecarboxylate synthase. These genes were located at the transition between fungi and advanced plants in the phylogenetic tree. In addition, real-time PCR analysis revealed that the expression profiles of the six P. nutans genes were influenced by diverse abiotic stresses as well as by abscisic acid and methyl jasmonate. The results presented here contribute to the study of the CHS gene family in polar mosses and further reveal the mechanisms underlying the adaptation of mosses to extreme environments.
Polydopamine (PDA) is a biopolymer, which can form uniform thin films on almost all solid substrates as well as at the liquid/air interface. Carbonized polydopamine possesses graphite-like structure and exhibits high electrical conductivity, which makes it a potential carbon-based thin film conductor. However, studies on mechanical behavior of PDA and its derived materials are very limited. In this study, PDA samples were synthesized through self-assembly of dopamine in aqueous solution. Elastic modulus of thin films was measured using the nanoindentation technique. It is shown that the Young’s modulus of PDA thin film increased with increasing heat treatment temperature (up to 600°C). Doping with Cu ions also increased the Young’s modulus of PDA. Furthermore, all PDA thin films, with and without Cu, exhibited creep behavior.
Absolute instability modes due to secondary scattering of stimulated Raman scattering (SRS) in a large nonuniform plasma are studied theoretically and numerically. The backscattered light of convective SRS can be considered as a pump light with a finite bandwidth. The different frequency components of the backscattered light can be coupled to develop absolute SRS instability near their quarter-critical densities via rescattering process. The absolute SRS mode develops a Langmuir wave with a high phase velocity of about
the light speed in vacuum. Given that most electrons are at low velocities in the linear stage, the absolute SRS mode grows with very weak Landau damping. When the interaction evolves into the nonlinear regime, the Langmuir wave can heat abundant electrons up to a few hundred keV via the SRS rescattering. Our theoretical model is validated by particle-in-cell simulations. The absolute instabilities may play a considerable role in the experiments of inertial confinement fusion.
Identifying the relative importance of urban and non-urban land-use types for potential denitrification derived N2O at a regional scale is critical for quantifying the impacts of human activities on nitrous oxide (N2O) emission under changing environments. In this study we used a regional dataset from China including 197 soil samples and six land-use types to evaluate the main predictors (land use, heavy metals, soil pH, soil moisture, substrate availability, functional and broad microbial abundances) of potential denitrification using multivariate and pathway analysis. Our results provide empirical evidence that soils on farms have the greatest potential denitrifying ability (PDA) (10.92±6.08ng N2O-N·g–1 dry soil·min–1) followed by urban soil (6.80±5.35ng N2O-N·g–1 dry soil·min–1). Our models indicate that land use (low vs. high human activity), followed by total nitrogen (TN) and heavy metals (Cu, Zn, Pb, Cd) was the most important driver of PDA. In addition, our path analysis suggests that at least part of the impacts of land use on potential denitrification were mediated via microbial abundance, soil pH and substrates including TN, dissolved organic carbon and nitrate. This study identifies the main predictors of denitrification at a regional scale which is needed to quantify the impact of human activities on ecosystem functionality under changing conditions.
Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China.
Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers.
Based on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life.
Our results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.
Turnover intention is a negative outcome for an organization. The purpose of this article is to examine the relationships among work passion, subjective well-being, career adaptability, and turnover intention for Chinese government employees. The article consists of an empirical study with a sample of 472 government employees in Shandong Province, China. Participants completed a series of questionnaires in three waves. The results indicate that harmonious passion is negatively related to turnover intention and that obsessive passion is positively related to turnover intention. Additionally, the relationship between harmonious/obsessive passion and turnover is mediated by subjective well-being, and career adaptability moderates the relationship between harmonious/obsessive passion and subjective well-being. Implications are discussed.