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Predictors of compliance with aspirin in children following cardiac catheterisation have not been identified. The aim of this study is to identify the caregivers’ knowledge, compliance with aspirin medication, and predictors of compliance with aspirin in children with Congenital Heart Disease (CHD) post-percutaneous transcatheter occlusion.
A cross-sectional explorative design was adopted using a self-administered questionnaire and conducted between May 2017 and May 2018. Recruited were 220 caregivers of children with CHD post-percutaneous transcatheter occlusion. Questionnaires included child and caregivers’ characteristics, a self-designed and tested knowledge about aspirin scale (scoring scale 0–2), and the 8-item Morisky Medication Adherence Scale (scoring scale 0–8). Data were analysed using multivariate binary logistic regression analysis to identify predictors of compliance with aspirin.
Of the 220 eligible children and caregivers, 210 (95.5%) responded and 209 surveys were included in the analysis. The mean score of knowledge was 7.25 (standard deviation 2.27). The mean score of compliance was 5.65 (standard deviation 1.36). Child’s age, length of aspirin use, health insurance policies, relationship to child, monthly income, and knowledge about aspirin of caregivers were independent predictors of compliance with aspirin (p < 0.05).
Caregivers of children with CHD had an adequate level of knowledge about aspirin. Compliance to aspirin medication reported by caregivers was low. Predictors of medium to high compliance with aspirin were related to the child’s age and socio-economic reasons. Further studies are needed to identify effective strategies to improve knowledge, compliance with medication, and long-term outcomes of children with CHD.
Previous studies have shown conflicting findings regarding the relationship between maternal vitamin D deficiency (VDD) and fetal growth restriction (FGR). We hypothesised that parathyroid hormone (PTH) may be an underlying factor relevant to this potential association. In a prospective birth cohort study, descriptive statistics were evaluated for the demographic characteristics of 3407 pregnancies in the second trimester from three antenatal clinics in Hefei, China. The association of the combined status of vitamin D and PTH with birth weight and the risk of small for gestational age (SGA) was assessed by a multivariate linear and binary logistic regression. We found that declined status of 25-hydroxyvitamin D is associated with lower birth weight (for moderate VDD: adjusted β = −49·4 g, 95 % CI −91·1, −7·8, P < 0·05; for severe VDD: adjusted β = −79·8 g, 95 % CI −127·2, −32·5, P < 0·01), as well as ascended levels of PTH (for elevated PTH: adjusted β = −44·5 g, 95 % CI −82·6, −6·4, P < 0·05). Compared with the non-VDD group with non-elevated PTH, pregnancies with severe VDD and elevated PTH had the lowest neonatal birth weight (adjusted β = −124·7 g, 95 % CI −194·6, −54·8, P < 0·001) and the highest risk of SGA (adjusted risk ratio (RR) = 3·36, 95 % CI 1·41, 8·03, P < 0·01). Notably, the highest risk of less Ca supplementation was founded in severe VDD group with elevated PTH (adjusted RR = 4·67, 95 % CI 2·78, 7·85, P < 0·001). In conclusion, elevated PTH induced by less Ca supplementation would further aggravate the risk of FGR in pregnancies with severe VDD through impaired maternal Ca metabolism homoeostasis.
Financial institutions typically avoid projects that will have a significant adverse effect on cultural heritage because it creates unwelcome risk and can affect their reputation. For bank clients, adverse project effects on cultural heritage can result in reputation risk, impede access to finance and insurance, increase operational costs, and jeopardize on-time and on-budget delivery of projects. To address this risk, financial institutions implement environmental and social policy frameworks that include specific requirements for the consideration of cultural heritage. This article examines the place of cultural heritage in the lending practices of 25 of the world's largest private-sector banks and its relevance for heritage practitioners who may be retained to provide advice, review or undertake fieldwork, and prepare studies in keeping with the private-sector bank policies and external standards described. The article concludes with a recommended best practice for private-sector financial institutions, a call to action for heritage practitioners to advocate for robust safeguards, and a call for support of the UN's Sustainable Development Goals by both heritage practitioners and private-sector financial institutions.
A scalable battery recycling strategy to recover and regenerate solid electrolytes and cathode materials in spent all solid-state batteries, reducing energy consumption and greenhouse gases.
With the rapidly increasing ubiquity of lithium-ion batteries (LIBs), sustainable battery recycling is a matter of growing urgency. The major challenge faced in LIB sustainability lies with the fact that the current LIBs are not designed for recycling, making it difficult to engineer recycling approaches that avoid breaking batteries down into their raw materials. Thus, it is prudent to explore new approaches to both fabricate and recycle next-generation batteries before they enter the market. Here, we developed a sustainable design and scalable recycling strategy for next-generation all solid-state batteries (ASSBs). We use the EverBatt model to analyze the relative energy consumption and environmental impact compared to conventional recycling methods. We demonstrate efficient separation and recovery of spent solid electrolytes and electrodes from a lithium metal ASSB and directly regenerate them into usable formats without damaging their core chemical structure. The recycled materials are then reconstituted to fabricate new batteries, achieving similar performance as pristine ASSBs, completing the cycle. This work demonstrates the first fully recycled ASSB and provides critical design consideration for future sustainable batteries.
In the field of modernised Global Navigation Satellite System (GNSS) signal design, several Dual-frequency Constant Envelope Multiplexing (DCEM) methods have been recently proposed. However, the existing DCEM methods, such as Alternative Binary Offset Carrier (AltBOC), generalised AltBOC and Asymmetric Constant Envelope Binary Offset Carrier (ACE-BOC), are only applied in some special cases. In this paper, we present a unified DCEM design framework for GNSS signals. The existing DCEM methods can be unified in this framework. First, the signal components at two carrier frequencies are combined into two single-frequency constant envelope signals. Then, the linear sum of dual-frequency signals with non-constant envelopes is obtained. Finally, the linear sum is converted into the corresponding DCEM signal by solving an optimisation problem. The proposed design framework has no strict constraints on the number, power ratio and phase relationship of the signal components. Moreover, some special design cases under this framework are also analysed in detail. The analytical results show that the proposed design method can reach higher multiplexing efficiency compared with the existing methods. Based on the proposed method, we suggest a scheme to multiplex the BeiDou regional signals and global signals at the B2 frequency. The simulation results of correlation functions and Power Spectrum Density (PSD) verify the correctness and effectiveness of the proposed design method.
OBJECTIVES/SPECIFIC AIMS: The food reward circuitry regulates hedonic eating especially in relation to palatable hypercaloric foods, which can lead to chronic overeating and consequent overweight and obesity. Evidence supports that there is considerable overlap within the brain reward circuitry between palatable hypercaloric food intake and substance addiction. The goal of this study was to identify associations between addiction-related genes and body mass index. We hypothesized that addiction-related genes potentially participate in the food reward circuitry if they are associated with obesity traits. METHODS/STUDY POPULATION: A secondary analysis was conducted with 1093 African American adolescents and young adults from the New Mother’s Study. Anthropometric, genetic, demographic and lifestyle measurements were available at the 18-year follow-up assessments. A total of 1350 single nucleotide polymorphisms mapped to 127 addiction-related genes were assessed. A total of 186 ancestry informative markers were used to adjust for population stratification. Generalized estimating equation models were used to identify genetic associations, including additive, dominant, and recessive models, and control for correlations within families. RESULTS/ANTICIPATED RESULTS: The participants ranged from 15 to 23 years of age. Of them, 42.7% were overweight or obese. Significant associations with body mass index were identified for 13 single nucleotide polymorphisms mapped to 11 addiction-related genes, including LEP (p 0.027–<0.001). Most of these genes are involved in dopaminergic, opioidergic, serotonergic pathways, and stress. DISCUSSION/SIGNIFICANCE OF IMPACT: Our results support the role of dopaminergic and opioidergic pathways in the food reward circuitry, and suggest a potential involvement of serotonergic pathways and genes related to stress in the food reward circuitry. Further investigation of the identified genes will facilitate delineation and understanding of the brain food reward system and its relationship with obesity.
Task-specific dystonia is characterized by abnormal repetitive movements or postures in a specific body part that is triggered and ends with a task, such as writing. Failing medications, surgery, specifically disruption of key nuclei in the thalamus, can provide excellent symptomatic relief. Transcranial magnetic resonance (MR)-guided focused ultrasound is an emerging incision-less thermoablation technique. We describe MR-guided focused ultrasound tandem ablation of the ventral intermediate and ventralis oralis posterior nuclei in a 60-year-old patient with writer’s cramp. The clinical improvement was immediate with incremental benefit from the latter lesion, which was sustained at 6 months follow-up.
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.
In this paper, we present an efficient rescaling scheme for computing the long-time dynamics of expanding interfaces. The idea is to design an adaptive time-space mapping such that in the new time scale, the interfaces evolves logarithmically fast at early growth stage and exponentially fast at later times. The new spatial scale guarantees the conservation of the area/volume enclosed by the interface. Compared with the original rescaling method in [J. Comput. Phys. 225(1) (2007) 554–567], this adaptive scheme dramatically improves the slow evolution at early times when the size of the interface is small. Our results show that the original three-week computation in [J. Comput. Phys. 225(1) (2007) 554–567] can be reproduced in about one day using the adaptive scheme. We then present the largest and most complicated Hele-Shaw simulation up to date.
Se and green tea have been shown in epidemiological, observational and preclinical studies to be inversely related to the risk of developing colorectal cancer (CRC). However, there are limited studies to evaluate their regulatory effects on genes/proteins that relate to CRC oncogenesis in human subjects, such as selenoproteins, WNT signalling pathway, inflammation and methylation. This study examined the effects of supplementation of Se using Brazil nuts and green tea extract (GTE) capsules, alone and in combination, on targeted biomarkers. In total, thirty-two volunteers (>50 years of age) with plasma Se≤1·36 µmol/l were randomised to one of three treatment groups: nine to Se (approximately 48 µg/d) as six Brazil nuts, eleven to four GTE capsules (800 mg (-)-epigallocatechin-3-gallate) and twelve to a combination of Brazil nuts and GTE. Blood and rectal biopsies were obtained before and after each intervention. Plasma Se levels, rectal selenoprotein P (SePP) and β-catenin mRNA increased significantly in subjects consuming Brazil nuts alone or in combination, whereas rectal DNA methyltransferase (DNMT1) and NF-κB mRNA were reduced significantly in subjects consuming GTE alone or in combination. None of the interventions significantly affected rectal acetylated histone H3 or Ki-67 expression at the protein level or plasma C-reactive protein. Effects of the combination of Brazil nuts and GTE did not differ from what would be expected from either agent alone. In conclusion, supplementation of Brazil nuts and/or GTE regulates targeted biomarkers related to CRC oncogenesis, specifically genes associated with selenoproteins (SePP), WNT signalling (β-catenin), inflammation (NF-κB) and methylation (DNMT1). Their combination does not appear to provide additional effects compared with either agent alone.
Although there has been considerable computer-aided conceptual design research, most of the proposed approaches are domain specific and can merely achieve conceptual design of energy flows-processing systems. Therefore, this research is devoted to the development of a general (i.e., domain-independent) and knowledge-based methodology that can search in a wide multidisciplinary solution space for suitable solution principles for desired material-flow processing functions without designers' biases toward familiar solution principles. It first proposes an ontology-based approach for representing desired material-flow processing functions in a formal and unambiguous manner. Then a rule-based approach is proposed to represent the functional knowledge of a known solution principle in a general and flexible manner. Thereafter, a simulation-based retrieval approach is developed, which can search for suitable solution principles for desired material-flow processing functions. The proposed approaches have been implemented as a computer-aided conceptual design system for test. The conceptual design of a coin-sorting device demonstrates that our functional representation methodology can make the proposed computer-aided conceptual design system to effectively and precisely retrieve suitable solution principles for a desired material-flow processing function.
Graphite flakes (Gf)/Si/Al composites have been fabricated with different volume fraction of graphite by vacuum gas pressure infiltration. In the composites, the addition of Si played a role of spacing apart graphite layers, which can produce voids between layers for the infiltration of molten aluminum. Microstructural characterization indicated that the reinforcements were fairly distributed in the Al and a clean interface lacking of Al3C4 phase was formed between Al and Gf. With the increase of Gf from 39 to 81 vol%, the longitudinal thermal conductivity (TC) of composites increased from 294 to 390 W/m K, but the open porosity increased from 1.85 to 6.03%. Besides, a joint M1–M2 prediction model was established, which considered that the microstructure of composites lies in between two models: (M1) a layered structure in binary metal-particle composites and (M2) ternary composites that oriented flakes randomly distributed in metal-particle confirmed a better theoretical prediction of TC.
Recent studies have suggested an association between vitamin D and non-alcoholic fatty liver disease (NAFLD); however, some results are subject to debate. This study was carried out to evaluate the correlation between NAFLD and vitamin D in men and women in East China. The data were obtained from a cross-sectional study that focused on the health and metabolic status of adults in sixteen areas of East China. According to ultrasonic assessments, the patients were divided into normal and NAFLD groups. Demographic characteristics and biochemical measurements were obtained. Binary logistic regression analysis was used to explore the association. In total, 5066 subjects were enrolled, and 2193 (43·3 %) were diagnosed with NAFLD; 84·56 % of the subjects showed vitamin D deficiency. Subjects with high vitamin D levels had a lower prevalence of NAFLD, particularly male subjects. Within the highest quartile of vitamin D levels, the prevalence of NAFLD was 40·8 %, whereas the lowest quartile of vitamin D levels showed a prevalence of 62·2 %, which was unchanged in women across the vitamin D levels. Binary logistic analysis showed that decreased vitamin D levels were associated with an increased risk of NAFLD (OR 1·54; 95 % CI 1·26, 1·88). This study suggests that vitamin D levels are significantly associated with NAFLD and that vitamin D acts as an independent factor for NAFLD prevalence, particularly in males in East China. Vitamin D interventional treatment might be a new target for controlling NAFLD; elucidating the mechanism requires further research.
In situ transmission electron microscopy (TEM) has become an
increasingly important tool for materials characterization. It provides key
information on the structural dynamics of a material during transformations and
the ability to correlate a material’s structure and properties. With
the recent advances in instrumentation, including aberration-corrected optics,
sample environment control, the sample stage, and fast and sensitive data
acquisition, in situ TEM characterization has become more
powerful. In this article, a brief review of the current status and future
opportunities of in situ TEM is provided. The article also
introduces the six articles in this issue of MRS Bulletin
exploring the frontiers of in situ electron microscopy,
including liquid and gas environmental TEM, dynamic four-dimensional TEM,
studies on nanomechanics and ferroelectric domain switching, and
state-of-the-art atomic imaging of light elements (i.e., carbon atoms) and
The studies of differences in life history and suitability of both water temperatures and trophic levels among rotifer sibling species improve our understanding of speciation, sibling species coexistence and possible niche differentiation over space and time, and consequences for the functioning of ecosystems induced by climate change and eutrophication. We collected Brachionus calyciflorus from Lake Baixiang and Lake Kongque, two tropical shallow lakes, in Xishuangbanna city, Yunnan, China, clonally cultured them in laboratory, and found that the B. calyciflorus complex contains two sibling species named sibling species BNA13 and BNB3 by phylogenetic analysis, and investigated the life-table parameters of the two sibling species BNA13 and BNB3 at four temperatures (16, 20, 24 and 28°C) and four algal densities (0.5, 1.0, 2.0 and 4.0×106 cells.mL−1). The results showed that the responses to increasing temperature and algal density for each of the life-table parameters differed with rotifer sibling species. Sibling species, temperature, algal density and their interactions almost all significantly affected the durations of juvenile period, embryonic development, reproductive period, post-reproductive period, mean lifespan, net reproductive rate, generation time and intrinsic rate of population growth. Sibling species significantly affected the age-specific survivorship. Temperature, algal density and their interaction and the interaction of sibling species and temperature significantly affected the age-specific fecundity. Regardless of the effects of temperature and algal density, the durations of juvenile period, embryonic development, reproductive period, post-reproductive period and mean lifespan, age-specific survivorship, net reproductive rate and generation time of the B. calyciflorus sibling species BNA13 were greater than those of BNB3, but the intrinsic rate of population growth of BNA13 was lower than those of BNB3. This suggests that the two B. calyciflorus sibling species adopted variable life history strategies, low population growth and high survivorship for sibling species BNA13, and high population growth and low survivorship for sibling species BNB3. Both the intrinsic rates of population growth of BNA13 and BNB3 were the highest at 28°C and 4.0×106 cells.mL−1 algal density, indicating that some adaptations of the B. calyciflorus sibling species BNA13 and BNB3 in tropical shallow lakes to water temperatures and trophic levels were similar, and they have the potential for coexistence in single waterbody of higher temperature and higher trophic level.