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One of Tom Dishion's most significant contributions to prevention science was the development of affordable, ecologically valid interventions, such as the Family Check-Up, that screen for child and family risk factors broadly, but concentrate family-specific interventions on those with greatest potential for population impact. In the spirit of this approach, investigators examined effects of a brief, universal postnatal home visiting program on child emergency medical care and billing costs from birth to age 24 months. Family Connects is a community-wide public health intervention that combines identification and alignment of community services and resources with brief, postpartum nurse home visits designed to assess risk, provide supportive guidance, and connect families with identified risk to community resources. Over 18 months, families of all 4,777 resident Durham County, North Carolina, births were randomly assigned based on even or odd birth date to receive a postnatal nurse home visiting intervention or services as usual (control). Independently, 549 of these families were randomly selected and participated in an impact evaluation study. Families, blind to study goals, provided written consent to access hospital administrative records. Results indicate that children randomly assigned to Family Connects had significantly less total emergency medical care (by 37%) through age 24 months, with results observed across almost all subgroups. Examination of billing records indicate a $3.17 decrease in total billing costs for each $1 in program costs. Overall, results suggest that community-wide postpartum support program can significantly reduce population rates of child emergency medical care through age 24 months while being cost-beneficial to communities.
Major depressive disorder (MDD) is highly heterogeneous and can be classified as treatment-resistant depression (TRD) or antidepressant-responsive depression (non-TRD) based on patients' responses to antidepressant treatment. Methods for distinguishing between TRD and non-TRD are critical clinical concerns. Deficits of cortical inhibition (CI) have been reported to play an influential role in the pathophysiology of MDD. Whether TRD patients' CI is more impaired than that of non-TRD patients remains unclear.
Paired-pulse transcranial magnetic stimulation (ppTMS) was used to measure cortical inhibitory function including GABAA- and GABAB-receptor-related CI and cortical excitatory function including glutamate-receptor-related intracortical facilitation (ICF). We recruited 36 healthy controls (HC) and 36 patients with MDD (non-TRD, n = 16; TRD, n = 20). All participants received evaluations for depression severity and ppTMS examinations. Non-TRD patients received an additional ppTMS examination after 3 months of treatment with the SSRI escitalopram.
Patients with TRD exhibited reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI), as shown by abnormally higher estimates, than those with non-TRD or HC (F = 11.030, p < 0.001; F = 10.309, p < 0.001, respectively). After an adequate trial of escitalopram treatment, the LICI of non-TRD reduced significantly (t = − 3.628, p < 0.001), whereas the ICF remained lower than that of HC and showed no difference from pretreatment non-TRD.
TRD was characterized by relatively reduced CI, including both GABAA- and GABAB-receptor-mediated neurons while non-TRD preserved partial CI. In non-TRD, SSRIs may mainly modulate GABAB-receptor-related LICI. Our findings revealed distinguishable features of CI in antidepressant-resistant and responsive major depression.
Minimally invasive surgery is a developing direction of modern medicine. With the successful development of controllable capsule endoscopies, capsule robots are very popular in the field of gastrointestinal medicine. At present, the study of intestinal robots is aimed at the pipeline environment of a single-phase liquid flow. But there exist food residues (i.e. solid particles) or liquid foods in the actual intestine, so intestinal fluid should be liquid–solid or liquid–liquid two-phase mixed fluid. For inner spiral capsule robots with different internal diameters and outer spiral capsule robots, using computational fluid dynamics (CFD) method, the operational performance indicators (i.e. axial thrust force, circumferential resisting moment and maximum pressure to pipeline wall) of spiral capsule robots are numerically calculated in the liquid–solid or liquid–liquid two-phase mixed fluid. By the orthogonal experimental optimization method, the optimum design of spiral capsule robots is obtained in the liquid–solid mixed fluid. The experimental verification has been also carried out. The results show that in the liquid–solid two-phase fluid, the axial thrust force and circumferential resisting moment of the spiral capsule robots decrease with the increase of the size or concentration of solid particles. In the same liquid–solid or liquid–liquid mixed fluid, the operational performance indicators of outer spiral robots are much higher than those of inner spiral robots, and the operational performance indicators of inner spiral robots with bigger internal diameters are higher than those with smaller internal diameters. Adding solid particles of high concentration in the pipeline containing liquid will reduce the drive performance of spiral capsule robots, but adding another liquid of high viscosity will improve the drive performance of spiral capsule robots.
Rats with a normal birth weight (NBW) or intra-uterine growth retardation (IUGR) were fed basic diets (NBW and IUGR groups) or basic diets supplemented with curcumin (NC and IC groups) from 6 to 12 weeks. The body weight of IUGR rats was lower (P<0·05) than that of the controls. Rats with IUGR showed higher (P<0·05) concentrations of TNF-α, IL-1β and IL-6; higher (P<0·05) activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in their serum; and increased (P<0·05) concentrations of malondialdehyde (MDA), protein carbonyl (PC) and 8-hydroxy-2'-deoxyguanosine (8-OHDG) in the liver compared with the NBW rats. The livers of IUGR rats exhibited a lower (P<0·05) superoxide dismutase activity and decreased (P<0·05) metabolic efficiency of the hepatic glutathione redox cycle compared with those of the NBW rats. In response to dietary curcumin supplementation, concentrations of inflammatory cytokines and activities of AST and ALT in the serum and MDA, PC and 8-OHDG in the liver were lower (P<0·05), and the hepatic glutathione redox cycle in the liver was improved (P<0·05) in the IC group than in the IUGR group. These results were associated with lower (P<0·05) phosphorylated levels of the NF-κB pathway and Janus kinase 2 (JAK2) and higher (P<0·05) mRNA expression of genes involved in the nuclear factor, erythroid 2-like 2 (Nfe2l2)/antioxidant response element (ARE) pathway in the liver of the IC rats than that of the IUGR rats. Maternal undernutrition decreased birth weight and led to inflammation, oxidative damage and injury in rats. Curcumin appeared to be beneficial in preventing IUGR-induced inflammation, oxidative damage and injury by activating the expression of the NF-κB, JAK/STAT and Nfe2l2/ARE pathways in the liver.
Somatic cell nuclear transfer (SCNT) is an important technique for life science research. However, most SCNT embryos fail to develop to term due to undefined reprogramming defects. Here, we show that abnormal Xi occurs in somatic cell NT blastocysts, whereas in female blastocysts derived from cumulus cell nuclear transfer, both X chromosomes were inactive. H3K27me3 removal by Kdm6a mRNA overexpression could significantly improve preimplantation development of NT embryos, and even reached a 70.2% blastocyst rate of cleaved embryos compared with the 38.5% rate of the control. H3K27me3 levels were significantly reduced in blastomeres from cloned blastocysts after overexpression of Kdm6a. qPCR indicated that rDNA transcription increased in both NT embryos and 293T cells after overexpression of Kdm6a. Our findings demonstrate that overexpression of Kdm6a improved the development of cloned mouse embryos by reducing H3K27me3 and increasing rDNA transcription.
A new simple mathematical method has been proposed to predict rock stress around a noncircular tunnel and the method is calibrated and validated with a numerical model. It can be found that the tunnel shapes and polar angles affect the applicable zone of the theoretical model significantly and the applicable zone of a rectangular tunnel was obtained using this method. The method can be used to predict the values of the concentrated stress, and to analyze the change rate of rock stress and back to calculate the mechanical boundary condition in the applicable zone. The results of the stress change rate indicate that the horizontal stress is negatively related to the vertical boundary load and positively related to the horizontal boundary load. The vertical stress is negatively related to the horizontal boundary load and positively related to the vertical boundary load. These findings can be used to explain the evolution of the vertical increment in stress obtained with field-based borehole stress monitoring.
Hydrogen embrittlement behaviors of a 22Mn–0.6C (mass%) twinning induced plasticity (TWIP) steel with the grain sizes of 21 μm (coarse grain) and 0.58 μm (ultrafine grain) were investigated by means of hydrogen precharging and subsequent slow strain rate tensile tests. The total elongation and fracture stress for both of the coarse-grained and ultrafine-grained specimens decreased by hydrogen charging. The area fraction of the brittle fracture surfaces in the ultrafine-grained specimen was much smaller than that in the coarse-grained specimen. Three-point bending test also showed that the reduction of the fracture toughness by the introduction of hydrogen was much smaller in the ultrafine-grained specimen than that in the coarse-grained specimen. It was concluded that the suppressed hydrogen embrittlement by grain refinement in the 22Mn–0.6C TWIP steel was probably due to the smaller hydrogen contents per unit grain boundary area in the finer grain-sized material.
In this work, the reduction mechanism of potassium chromate (K2CrO4) was investigated via in situ high-temperature X-ray diffraction coupled with Fourier transform infrared spectroscopy. During the hydrogen reduction of K2CrO4, the formation of K3CrO4, KCrO2, and KxCrO2 were detected for the first time. The study discovered that K2CrO4 was firstly reduced to K3CrO4 and an amorphous Cr(III) intermediate product at low temperature (400–500 °C). Moreover, the K3CrO4 was the only crystalline material at this stage. As the temperature increased, a stabilized amorphous CrOOH was formed. At a high temperature (550–700 °C), KCrO2 was generated. Interestingly, a portion of KCrO2 was spontaneously decomposed during the hydrogen reduction, accompanying by the formation of K0.7CrO2. Finally, the results clearly illustrated the reduction mechanism of K2CrO4: K2CrO4 → K3CrO4 → amorphous intermediate → KCrO2.
This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
Promoting life satisfaction in later life has long been both a policy and practice challenge. This study examined the association between older adults' self-image and life satisfaction, and that between their intergenerational relationships and life satisfaction. Given that sources of wellbeing for older men and women may vary due to socially constructed realities in early life, gender differences were also investigated in the correlates of life satisfaction. A face-to-face questionnaire survey was conducted in 2014 with a sample of 1,099 older adults aged 60 years and over from four cities in China. Findings of this study showed that older adults’ self-image and intergenerational relationships were significantly associated with their life satisfaction after controlling for certain socio-demographic characteristics, and health and self-care ability. The correlates of life satisfaction were shown to differ between older men and women. Programmes and Services should be developed for older adults to explore and identify positive aspects of themselves, to improve their relationships with their adult children, and to foster a more positive image of ageing in wider society. In addition, service providers should take gender differences in correlates of life satisfaction into account in service and intervention programme development.
The composite Li-ion battery anode material of Fe2SiO4, Fe3O4, Fe3C (Fe-Si-O) and carbon nanotubes was prepared by a simple one-step reaction between ferrocene and tetraethyl orthosilicate. When cycled at 100 mA g-1, this material exhibited ever-increasing capacities and reached 588 mAh g-1 at the 280th cycle. At 500 mA g-1, a reversible capacity of 350 mAh g-1 was retained for 600 cycles. Compared with Fe3O4 materials, the Fe-Si-O/CNT exhibited superior long-term high-rate performance, which could mainly result from its enhanced stability and conductivities by introducing silicates and CNTs during the one-step synthesis.
In recent years, with the increasingly frequent variety of large-scale disasters that have happened in China, the Chinese People’s Armed Police Forces (PAP) has undertaken increasingly frequent and diversified tasks, which has led to greater requirements for the construction of emergency medical rescue equipment. Therefore, as determined by the characteristics of the PAP’s tasks and based on the construction of special boxes and frame tent equipment, a new PAP mobile rescue hospital system was successfully developed, and all PAP provincial-level medical rescue teams have been equipped with this system. In the present article, we describe this mobile rescue hospital system, which is mainly composed of professional emergency vehicles, frame-type tents, and advanced medical equipment. The system has the following characteristics: significant integration, a fast response, flexibility, and practicability. The mobile rescue system is generally used as the army’s own health service support system and to provide certain emergency medical rescue services to disaster-stricken people. The successful construction and further application of this system have significance in terms of accelerating the response of rescue teams and the emergency treatment ability of the PAP’s provincial-level emergency medical rescue teams. (Disaster Med Public Health Preparedness. 2018;12:455–459)
The present study investigated alteration of brain resting-state activity induced by antidepressant treatment and attempted to investigate whether treatment efficacy can be predicted at an early stage of pharmacological treatment.
Forty-eight first-episode medication-free patients diagnosed with major depression received treatment with escitalopram. Resting-state functional magnetic resonance imaging was administered prior to treatment, 5 h after the first dose, during the course of pharmacological treatment (week 4) and at endpoint (week 8). Resting-state activity was evaluated in the course of the 8-week treatment and in relation to clinical improvement.
Escitalopram dynamically modified resting-state activity in depression during the treatment. After 5 h the antidepressant induced a significant decrease in the signal in the occipital cortex and an increase in the dorsolateral and dorsomedial prefrontal cortices and middle cingulate cortex. Furthermore, while remitters demonstrated more obvious changes following treatment, these were more modest in non-responders suggesting possible tonic and dynamic differences in the serotonergic system. Changes after 5 h in the caudate, occipital and temporal cortices were the best predictor of clinical remission at endpoint.
This study revealed the possibility of using the measurement of resting-state neural changes a few hours after acute administration of antidepressant to identify individuals likely to remit after a few weeks of treatment.
This work aims to provide a systematic experimental study of the wake behind two staggered square cylinders at a Reynolds number
. Four distinct flow regimes, i.e. two single-street modes S-I and S-II and two double-street modes T-I and T-II, are identified based on extensive data, including Strouhal numbers
, flow structures and their downstream evolution. S-I, S-II and T-II are each further subdivided into two types. The flow characteristics in each regime are presented in terms of shear layer reattachment and impingement, vortex impingement, gap flow behaviour, interaction between cylinders and downstream evolution of the wake. A detailed discussion is made regarding how the physical aspects of the flow are connected to the initial conditions and the
To fully understand the sugar-sweetened beverage (SSB) consumption status among Chinese young children and to explore its association with weight gain.
In this cross-sectional study, data on sociodemographic characteristics, SSB intake and weight/height were collected by means of face-to-face interviews. The intake of SSB among young Chinese children in relation to their age, different characteristics and types of SSB consumed is described, and the association between SSB intake and BMI-for-age Z-score and overweight is explored.
Seven large cities and two villages in China.
Nine hundred and forty-six healthy children, aged 3–7 years.
The proportion of SSB intake among Chinese young children was 80·5 %; 3·4 % were daily consumers, 34·0 % (31·4 %) consumed at least once per week (month). The per capita and per consumer SSB intake was 63·1 9 (sd 100·8) and 78·4 (sd 106·9) ml/d. Children from rural areas consumed twice, or even triple, the amount of SSB as those from urban areas (P<0·001) and great disparities existed between the types of SSB consumed by urban and rural children. An association was found between increased SSB intake and higher BMI-for-age Z-score (P<0·05) after adjusting for potential confounders; there was also an association between SSB intake and increased risk of being overweight or obese.
The consumption status of SSB in Chinese young children is of concern. There was a positive association between SSB intake and weight gain. Measures should be taken to improve the present situation of SSB consumption among Chinese young children.
The present study investigated the effects of different levels of urea nitrogen (N) fertilizer on nutrient accumulation, in vitro rumen gas production and fermentation characteristics of forage oat straw (FOS) from oats (Avena sativa L. ‘Qinghai 444’) grown in the Tibet region of China. Fertilizer, applied at seeding (day 1), stem elongation (days 52–54) and heading (days 63–67), increased plant height and prolonged the maturity stage of the plant by 4–11 days compared with the non-fertilized control. Oat plants were harvested at maturity at the node 3–4 cm above ground, and then separated into grains and FOS. Both FOS and grain yields increased quadratically with increasing N fertilization, and their theoretical maximums occurred at the N fertilizing rates of 439 and 385 kg/ha, respectively. Increases in N fertilization did not affect the hemicellulose content of FOS, but substantially promoted the accumulation of crude protein, cellulose and lignin, resulting in a decrease in the energy content available for metabolism. A 72-h incubation of FOS with rumen fluids from lactating cows showed that increasing N resulted in FOS that showed a slower fermentation rate, decreased in vitro dry matter disappearance and lower cumulative gas production, but unchanged fermentation gas composition. Nitrogen fertilization increased the final pH in culture fluids and decreased the microbial volatile fatty acid (VFA) production. The molar proportions of acetate and propionate were not affected, but molar propionate proportion decreased linearly with increasing urea fertilization, and consequently, the ratio of lipogenic (e.g., acetate and butyrate)-to-glucogenic acids (propionate) tended to increase. In brief, increasing urea N fertilization promoted the growth of forage oats and increased the biomass yield as well as the crude protein and cellulose content of FOS. Considering the negative effect of increased lignin content on nutrient digestibility and total VFA production, the suggested range of urea N fertilization is 156–363 kg N/ha for forage oats planted in Tibet to retain the nutritive value of FOS in the rumen.
A completely randomized experiment for planting highland barley in 36 field plots of the Lhasa Agricultural Experiment Station was applied to investigate the effect of urea nitrogen (N) fertilization levels of 0 (control), 156, 258, 363, 465 and 570 kg/ha on nutrient accumulation, in vitro rumen gas production and fermentation characteristics of highland barley straw (HBS). Each urea application was divided into three portions of 0.4, 0.3 and 0.3 and sequentially fertilized at seeding (growth stage (GS) 0), stem elongation (GS 32) and heading (GS 49), respectively. The maturity stage lasted 5–13 days longer in response to the urea N fertilization compared with the control. After removing grains, HBS biomass was harvested at maturity. The biomass yields of leaf, stem, straw and grain were increased quadratically with increasing urea N fertilization, and HBS and grain yields peaked at the estimated urea N fertilization levels of 385 and 428 kg/ha, respectively. The increase of urea N fertilization increased the accumulation of crude protein, cellulose and lignin, and decreased the content of ash and hemicellulose in HBS, resulting in a decrease of the energy content available to be metabolized. After incubating HBS for 72 h with rumen fluids from lactating cows, the urea N fertilization decreased in vitro dry matter disappearance and cumulative gas production, and slightly altered fermentation end-gas composition. Urea N fertilization decreased microbial volatile fatty acid production, but did not alter the ratio of lipogenic acetate and butyrate to glucogenic propionate. In a brief, the current urea N fertilization strategy promoted the growth of the highland barley and increased biomass yield, protein and cellulose accumulation of HBS. A urea N fertilization level ⩽385 kg/ha could be sufficient for growth of highland barley in Tibet without a consequent nutritive reduction in ruminal digestion.