To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians.
We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation.
A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%.
With appropriate training, maternity hospital’s paediatricians can detect major CHD with high detection rates with an acceptable false positive rate.
To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.
A cross-sectional validation study.
Huashan Hospital, Shanghai, China.
A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.
Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.
Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.
Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.
We previously reported four heterozygous missense mutations of MYH7, KCNQ1, MYLK2, and TMEM70 in a single three-generation Chinese family with dual Long QT and hypertrophic cardiomyopathy phenotypes for the first time. However, the clinical course among the family members was various, and the potential myocardial dysfunction has not been investigated.
The objective of this study was to investigate the echocardiographic and electrocardiographic characteristics in a genetic positive Chinese family with hypertrophic cardiomyopathy and further to explore the association between myocardial dysfunction and electric activity, and the identified mutations.
A comprehensive echocardiogram – standard two-dimensional Doppler echocardiography and three-dimensional speckle tracking echocardiography – and electrocardiogram were obtained for members in this family.
As previously reported, four missense mutations – MYH7-H1717Q, KCNQ1-R190W, MYLK2-K324E, and TMEM70-I147T – were identified in this family. The MYH7-H1717Q mutation carriers had significantly increased left ventricular mass indices, elevated E/e’ ratio, deteriorated global longitudinal stain, but enhanced global circumferential and radial strain compared with those in non-mutation patients (all p<0.05). The KCNQ1-R190W carriers showed significantly prolonged QTc intervals, and the MYLK2-K324E mutation carriers showed inverted T-waves (both p<0.05). However, the TMEM70-I147T mutation carriers had similar echocardiography and electrocardiographic data as non-mutation patients.
Three of the identified four mutations had potential pathogenic effects in this family: MYH7-H1717Q was associated with increased left ventricular thickness, elevated left ventricular filling pressure, and altered myocardial deformation; KCNQ1-R190W and MYLK2-K324E mutations were correlated with electrocardiographic abnormalities reflected in long QT phenotype and inverted T-waves, respectively.
The construction chronology of three of the earliest Dunhuang Mogao Grottoes (Caves 268, 272, and 275) has been the subject of ongoing debate for over half a century. This chronology is a crucial topic in terms of further understanding of the establishment of the Dunhuang Mogao Grottoes, early Buddhism in the Gansu corridor, and its relationship with Buddhism developed in the Central Plains. Building upon archaeological, art historical and radiocarbon (14C) dating studies, we integrate new 14C data with these previously published findings utilizing Bayesian statistical modeling to improve the chronological resolution of this issue. Thus, we determine that all three of these caves were constructed around AD 410–440, suggesting coeval rather than sequential construction.
MicroRNA (miR)-29b plays a crucial role during somatic cell reprogramming. The aim of the current study was to explore the effects of miR-29b on the developmental competence of bovine somatic cell nuclear transfer (SCNT) embryos, as well as the underlying mechanisms of action. The expression level of miR-29b was lower in bovine SCNT embryos at the pronuclear, 8-cell, and blastocyst stages compared with in vitro fertilized embryos. In addition, miR-29b regulates the expression of DNA methyltransferases (Dnmt3a/3b and Dnmt1) in bovine SCNT embryos. We further investigated SCNT embryo developmental competence and found that miR-29b overexpression during bovine SCNT embryonic development does not improve developmental potency and downregulation inhibits developmental potency. Nevertheless, the quality of bovine SCNT embryos at the blastocyst stage improved significantly. The expression of pluripotency factors and cellular proliferation were significantly higher in blastocysts from the miR-29b overexpression group than the control and downregulation groups. In addition, outgrowth potential in blastocysts after miR-29b overexpression was also significantly greater in the miR-29b overexpression group than in the control and downregulation groups. Taken together, these results demonstrated that miR-29b plays an important role in bovine SCNT embryo development.
OBJECTIVES/SPECIFIC AIMS: To investigate whether medical complexity (indicated by multiple providers or healthcare visits) is associated with lower levels of confidence in medication use and lower medication adherence METHODS/STUDY POPULATION: Data on socio-demographics, health encounters, health status, and health attitudes and behaviors from a nationally representative sample of 1575 older Singaporean adults were utilized. The association of medical complexity factors with self-reported medication confidence and adherence was analyzed using logistic regression analysis controlling for age, gender, ethnicity, education, and number of health conditions. RESULTS/ANTICIPATED RESULTS: The survey had a 60% response rate. The mean age of respondents was 72, and 42% were male. We found no significant association between number of visits and either confidence about usage (OR=1.07, 95% CI 0.95–1.20) or medication adherence (OR=1.01, 95% CI 0.90–1.13). We similarly found no significant association between number of providers and either confidence about usage (OR=1.03, 95% CI 0.90–1.18) or medication adherence (OR=1.05, 95% CI 0.93–1.20). Lower confidence about medication use was less likely among males (OR=0.60, 95% CI 0.44–0.80), those with more education (OR=0.29, 95% CI 0.20–0.42) or more comorbidities (OR=0.89, 95% CI 0.82–0.96) and more likely with increasing age (OR=1.06, 95% CI 1.04–1.08). Nonadherence was more likely among Indians (OR=1.62, 95% CI 1.06–2.48) and those with more comorbidities (OR=1.10, 95% CI 1.02–1.18). DISCUSSION/SIGNIFICANCE OF IMPACT: Having more healthcare visits or providers were not independent correlates of lower medication confidence or adherence. Seniors with less education may benefit from interventions to improve confidence about medication use. Participants with more comorbidities expressed greater confidence but admitted to lower adherence. The role of other potential contributors to nonadherence in complex patients (eg, cost and access, patient preference, competing demands) should be evaluated next.
We examined the in vitro developmental competence of parthenogenetic activation (PA) oocytes activated by an electric pulse (EP) and treated with various concentrations of AZD5438 for 4 h. Treatment with 10 µM AZD5438 for 4 h significantly improved the blastocyst formation rate of PA oocytes in comparison with 0, 20, or 50 µM AZD5438 treatment (46.4% vs. 34.5%, 32.3%, and 24.0%, respectively; P < 0.05). The blastocyst formation rate was higher in the group treated with AZD5438 for 4 h than in the groups treated with AZD5438 for 2 or 6 h (42.8% vs. 38.6% and 37.2%, respectively; P > 0.05). Furthermore, 66.67% of blastocysts derived from these AZD5438-treated PA oocytes had a diploid karyotype. The blastocyst formation rate of PA and somatic cell nuclear transfer (SCNT) embryos was similar between oocytes activated by an EP and treated with 2 mM 6-dimethylaminopurine for 4 h and those activated by an EP and treated with 10 µM AZD5438 for 4 h (11.11% vs. 13.40%, P > 0.05). In addition, the level of maturation-promoting factor (MPF) was significantly decreased in oocytes activated by an EP and treated with 10 µM AZD5438 for 4 h. Finally, the mRNA expression levels of apoptosis-related genes (Bax and Bcl-2) and pluripotency-related genes (Oct4, Nanog, and Sox2) were checked by RT-PCR; however, there were no differences between the AZD5438-treated and non-treated control groups. Our results demonstrate that porcine oocyte activation via an EP in combination with AZD5438 treatment can lead to a high blastocyst formation rate in PA and SCNT experiments.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
Change mode and effects analysis (CMEA) is a powerful technique for measuring product flexibility toward future changes and diminishing the cost of redesign as well as shortening time to market. As a systematic methodology, it provides an in-depth view for the investigation of potential changes, causes, and effects in designs, products, and processes. Traditional CMEA determines the risk priorities of change modes by using change potential number, which requires the risk factors of design flexibility, occurrence, and readiness to be precisely evaluated. However, this is not always possible in real applications due to the uncertainty and subjectivity involved in the early design stages. It has been criticized much for its deficiencies in criteria weighting of the risk factors, change potential number calculation, and risk priorities determination of the change modes. This paper presents a systematic evaluation approach for determining a more rational rank of change modes by combining with the entropy weight method, rough number, and grey relational analysis. In this study, the entropy weight method is adopted to calculate the relative importance of risk factors. Rough number is presented to aggregate individual weights and preferences, and to manipulate the vagueness in the evaluation process. Then a rough number enhanced grey relational analysis is proposed to evaluate the risk ranking of change modes. Finally, a practical example is put forward to validate the performance of the proposed method. The result shows that the proposed change mode evaluation method can effectively overcome the shortcomings of traditional CMEA and strengthen the objectivity of product flexibility measurement.
Although many studies worldwide have focused on the relationship between vitamin D and insulin resistance, results remain controversial. Furthermore, concentrations of serum 25-hydroxyvitamin D (25(OH)D) in the Chinese population are unclear. We aimed to investigate vitamin D status and its correlation with insulin resistance among a Chinese adult population.
Serum 25(OH)D, fasting blood glucose, fasting insulin, glycated Hb (HbA1c) and other metabolic parameters were assessed. Neck circumference, waist circumference, hip circumference, weight and height were also measured. Lifestyle factors including smoking and drinking status were obtained. Diabetes mellitus was diagnosed by HbA1c according to the 2010 American Diabetes Association criteria.
Of 7200 residents included, 6597 individuals were ultimately analysed.
We enrolled 2813 males (mean age 52·7 (sd 13·5) years) and 3784 females (52·3 (sd 13·5) years); mean serum 25(OH)D concentration was 43·1 (sd 11·6) and 39·6 (sd 9·8) nmol/l, respectively. Additionally, 83·3 % of participants were 25(OH)D deficient. A significant difference in 25(OH)D was observed between males and females in winter and spring (P<0·001). Furthermore, 25(OH)D concentrations were inversely associated with the homeostasis model assessment of insulin resistance (HOMA-IR) in the overweight and pre-diabetic populations. After adjusting for several variables, 25(OH)D was significantly associated with HOMA-IR in winter. When 25(OH)D values were categorized into quartiles, HOMA-IR was significantly associated with decreasing 25(OH)D.
The majority of the Chinese population was vitamin D deficient and this deficiency was negatively associated with insulin resistance, particularly in the overweight and pre-diabetic populations. Moreover, these associations might be more evident in the winter.
Silicone Rubber (SR) filled with graphene nanoplatelets (GNPs) and carbon black (CB) is prepared for high performance flexible pressure sensor. Due to the synergetic effect of mixed GNPs and CB, the percolation threshold of GNPs/CB/SR is lower than that of CB/SR, which indicates the addition of GNPs is contributed to enhance the electrical conductivity of GNPs/CB/SR. Moreover, the GNPs/CB/SR has a higher electrical stability and weaker resistance creep than that of GNPs/SR. That is to say, the addition of CB can promote the electrical and mechanical performance of GNPs/CB/SR, simultaneously. The pressure sensor array based on GNPs/CB/SR with weight on different sensing element is tested, and the results show that the size of applied loading on the pressure-sensitivity array can be recognized accurately.
As a recently proposed concept, multiple-input multiple-output (MIMO) radars exhibit much higher spatial resolution than traditional transmitter based radars because of the synthesized virtual array. In this paper, the problem of minimum redundancy (MR)-MIMO array synthesis is addressed, which seeks to maximize the virtual array aperture of MIMO radars for a given number of transmitting and receiving elements. A hybrid method combining autocorrelation property of cyclic difference sets (CDSs) and global search characteristics of ant colony optimization (ACO) is proposed for a rapid and numerically-effective exploration of MR-MIMO array configurations. Numerical experiments validate the proposed method, showing improvements in convergence rate and computational cost with respect to bare ACO-based search as well as improvements in the generality and configuration variety with respect to the CDS-based method.
We investigated the effect of human induced pluripotent stem cell (hiPS) medium on porcine somatic cell nuclear transfer and bovine in vitro fertilized early blastocysts, in comparison with North Carolina State University (NCSU)-37 medium and in vitro culture (IVC)-II medium. After 2 days of culture, the diameter of the portion of the blastocyst that was extruded from the zona pellucid dramatically differed between porcine blastocysts cultured in hiPS medium and those cultured in NCSU-37 medium (221.47 ± 38.94 μm versus 481.87 ± 40.61 μm, P < 0.01). Moreover, the diameter of the portion of the blastocyst significantly differed between bovine blastocysts cultured in hiPS medium and those cultured in IVC-II medium (150.30 ± 29.49 μm versus 195.58 ± 41.59 μm, P < 0.01). Furthermore, the total number of cells per porcine and bovine blastocyst was more than two-fold higher in blastocysts cultured in hiPS medium than in those cultured in NCSU-37 medium (44.33 ± 5.28 and 143.33 ± 16.05, P < 0.01) or IVC-II medium (172.12 ± 45.08 and 604.83 ± 242.64, P < 0.01), respectively. These results indicate that hiPS medium markedly improves the quality of porcine and bovine blastocysts.
A two-dimensional particle-in-cell (PIC) simulation is carried out to study the wakefield and stopping power for a hydrogen ion beam pulse with low drift velocity propagation in hydrogen plasmas. The plasma is assumed to be collisionless, uniform, non-magnetized, and in a steady state. Both the pulse ions and plasma particles are treated by the PIC method. The effects of the beam density on the wakefield and stopping power are then obtained and discussed. It is found that as the beam densities increase, the oscillation wakefield induced by the beam become stronger. Besides, the first oscillation wakefield behind the bunch is particularly stronger than others. Moreover, it is found that the stationary stopping power increases linearly with the increase of the beam density in the linear/semilinear region.
Thermal stress can induce birefringence in a laser medium, which can cause depolarization of the laser. The depolarization effect will be very severe in a high-average-power laser. Because the depolarization will make the frequency doubling efficiency decline, it should be compensated. In this paper, the thermal characteristics of two kinds of materials are analyzed in respect of temperature, thermal deformation and thermal stress. The depolarization result from thermal stress was simulated. Depolarization on non-uniform pumping was also simulated, and the compensation method is discussed.
To examine the vitamin D status, SNP of the vitamin D receptor gene (VDR) and the effects of vitamin D supplementation on parathyroid hormone and insulin secretion in adult males with obesity or normal weight in a subtropical Chinese city.
An intervention trial.
Shenzhen City, Guangdong Province, China.
From a cross-sectional survey conducted from June to July, eighty-two normal-weight and ninety-nine obese males (18–69 years) were screened to analyse their vitamin D status and for five SNP of VDR. From these individuals, in the same season of a different year, obese and normal-weight male volunteers (twenty-one per group) were included for an intervention trial with oral vitamin D supplementation at 1250 µg/week for 8 weeks.
For the survey, there was no significant difference (P>0·05) in baseline circulating 25-hydroxyvitamin D concentrations or in the percentages of participants in different categories of vitamin D status between the two groups. The VDR SNP, rs3782905, was significantly associated with obesity (P=0·043), but none of the examined SNP were correlated with serum 25-hydroxyvitamin D when adjusted for age, BMI and study group. After vitamin D supplementation, serum 25-hydroxyvitamin D concentration, hypersecretions of parathyroid hormone and insulin, and insulin resistance in the obese were changed beneficially (P<0·05); however, the increase in serum 25-hydroxyvitamin D was less than that of the normal-weight men.
For obese and normal-weight men of subtropical China, the summer baseline vitamin D status was similar. However, oral vitamin D supplementation revealed a decreased bioavailability of vitamin D in obese men and ameliorated their hypersecretion of parathyroid hormone and insulin resistance.
The aluminothermic reduction and nitridation method using microsized Al powder and nanosized alumina powder was employed to fabricate AlON powder under N2 atmosphere. Single-phase aluminum oxynitride (AlON) can be prepared at a relatively low temperature (1700 °C) with a holding time of 3 h. The powder is ball milled, doped with different amounts of Y2O3 (0.1–0.9 wt%) as a sintering additive, and then shaped into pellets. The pellet sintering is carried out at two relatively low temperatures (1860 and 1880 °C) for 10 h. The transmittance and hardness of the obtained samples varies as the amount of Y2O3 varies. The sample sintered under optimal conditions can reach an ultimate transmittance of 65% with 2 mm thickness. The Vickers hardness of highly transparent AlON ceramic is about 15.95 ± 0.17 GPa, indicating that our method has a promising future in transparent AlON ceramic production. The sintering promoting mechanisms of Y2O3 are also discussed in detail.
The high repetition rate 10 J/10 ns Yb:YAG laser system and its key techniques are reported. The amplifiers in this system have a multi-pass V-shape structure and the heat in the amplifiers is removed by means of laminar water flow. In the main amplifier, the laser is four-pass, and an approximately 8.5 J/1 Hz/10 ns output is achieved in the primary test. The far-field of the output beam is approximately 10 times the diffraction limit. Because of the higher levels of amplified spontaneous emission (ASE) in the main amplifier, the output energy is lower than expected. At the end we discuss some measures that can improve the properties of the laser system.
An experiment was conducted to study the seasonal changes in the fatty acid profile of milk from yaks (Bos grunniens) when kept at altitudes of 3000 m above sea level (a.s.l.) and higher. Data and samples were collected in summer (July), autumn (September), winter (November) and spring (March) from ten lactating yaks (four in spring). The yaks grazed pastures adjacent to the farm building throughout the year. In spring only they received 0·6 kg crop by-products per day (dry matter basis). Fresh alpine grasses, available in summer and autumn, showed high concentrations of α-linolenic acid (46–51 g/100 g lipids) compared with the dry, yellow vegetation of winter and spring (16 g/100 g lipids). In autumn and summer, the milk fat had higher concentrations of polyunsaturated fatty acids than in winter. These polyunsaturated fatty acids were comprised of vaccenic acid, rumenic acid and α-linolenic acid, which are all considered beneficial to human health. The rare fatty acid, γ-linolenic acid, was also detected in yak milk, especially in the milk obtained in spring. The results suggest that yak milk, which is the most important basic food of the Tibetan herders, has the most favourable fatty acid profile when yaks grazed green pasture, which also corresponds to the period of highest milk production.