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The relationship between serum Mg and blood cell counts in Chinese adult diabetes or central obesity was assessed by investigating 8163 subjects with China Health and Nutrition Survey (mean age 59⋅6 years, 54⋅9 % men). Participants were classified according to blood Mg (below 0⋅65 mmol/l, or 0⋅66–0⋅94 mmol/l or above 0⋅95 mmol/l), type 2 diabetes (yes/no) and central obesity (yes/no). Leucocytes, erythrocytes, platelets (PLT), Hb and glycated Hb (HbA1c) were determined using standardised methods and conditions. HbAc1, leucocytes and PLT were significantly higher among subjects with central obesity than without central obesity (P < 0⋅05). A significant increase for Hb, erythrocytes, PLT, but not leucocytes, across progressive Mg groups was observed in subjects without diabetes (P < 0⋅05). Hb, erythrocytes and HbAc1 were significantly higher among subjects with higher Mg than in subjects with lower Mg with diabetes (P < 0⋅05). Central obesity disturbed the positive association between PLT count and serum Mg. Type 2 diabetes caused metabolism disorder in serum Mg, blood sugar and blood cell count. Hb, erythrocytes and PLT, but not leucocytes, are positively correlated with serum Mg, but this association is somehow disturbed by type 2 diabetes or central obesity.
This study investigated the effects of glutamine (GLN) pretreatment on CD4+ T cell polarization and remote kidney injury in mice with gut-derived polymicrobial sepsis. Mice were randomly assigned to 3 groups: normal control fed with AIN-93G diet, and 2 sepsis groups provided with either AIN-93G-based diet or identical components except part of casein was replaced by GLN. Mice were given their respective diets for 2 weeks. Then, mice in the sepsis groups were performed with cecal ligation and puncture and were sacrificed at 72 h after the surgery. Blood, spleens and kidneys were collected for further examination. The results showed that sepsis resulted in decreased circulating and splenic total T lymphocyte and CD4+ T cell percentages, whereas interleukin (IL)-4-, and Foxp3-expressing CD4+ T cells percentages were upregulated. Compared to the sepsis control group, pretreatment with GLN maintained blood T and CD4+ T cells, reduced percentages of IL-4- and Foxp3-expressing CD4+ T cells. Also, a more pronounced activation and increased anti-apoptotic Bcl-2 gene expression of splenic CD4+ T cells were observed. Concomitant with the decreased plasma IL-6, keratinocyte-derived chemokine (KC) levels, the gene expression of KC, macrophage inflammatory protein-2 and renal injury biomarker Kim-1 were down-regulated when GLN was administered. These findings suggest that antecedent of GLN administration elicit a more-balanced blood T helper cell polarization, sustained T cell populations, prevented splenic CD4+ T cell apoptosis and attenuated kidney injury at late phase of polymicrobial sepsis. GLN may have benefits in subjects in risk of abdominal infection.
This study proposes two multimodal frameworks to classify pathological voice samples by combining acoustic signals and medical records. In the first framework, acoustic signals are transformed into static supervectors via Gaussian mixture models; then, a deep neural network (DNN) combines the supervectors with the medical record and classifies the voice signals. In the second framework, both acoustic features and medical data are processed through first-stage DNNs individually; then, a second-stage DNN combines the outputs of the first-stage DNNs and performs classification. Voice samples were recorded in a specific voice clinic of a tertiary teaching hospital, including three common categories of vocal diseases, i.e. glottic neoplasm, phonotraumatic lesions, and vocal paralysis. Experimental results demonstrated that the proposed framework yields significant accuracy and unweighted average recall (UAR) improvements of 2.02–10.32% and 2.48–17.31%, respectively, compared with systems that use only acoustic signals or medical records. The proposed algorithm also provides higher accuracy and UAR than traditional feature-based and model-based combination methods.
Shareholder activism has changed corporate governance around the world in the past decade. Conventional wisdom holds that shareholder activism is only effective in firms with dispersed ownership; there has been much less discussion on whether and how activism would work in firms with controlling shareholders. This article fills this gap by investigating whether and how legal mechanisms influence strategy planning and activism outcomes based on hand-collected data regarding activists’ initiatives against firms with concentrated ownership in Hong Kong from 2003 to 2017. This article finds that cases using formal legal mechanisms appear to have had a higher success rate. Among the legal tools available, minority veto rights are the most popular mechanism used by activists in Hong Kong, and are quite effective in leveraging their position in controlled firms. Furthermore, the availability of legal remedies and the ownership level of controlling shareholders are factors that influence activists’ strategies. Most activist initiatives against controlled firms involve corporate governance disputes where activists can rely on legal protection to enhance their bargaining position. On the other hand, activists tend not to make their demands public, and they also avoid exercising legal rights when controlling shareholders control the majority of the shares.
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.
Much effort has been devoted to improving the efficiency of animal cloning. The aim of this study was to investigate the effect of BRG1 contained in Xenopus egg extracts on the development of cloned mouse embryos. The results showed that mouse NIH/3T3 cells were able to express pluripotent genes after treatment with egg extracts, indicating that the egg extracts contained reprogramming factors. After co-injection of Xenopus egg extracts and single mouse cumulus cells into enucleated mouse oocytes, statistically higher pronucleus formation and development rates were observed in the egg Extract− co-injected group compared with those in the no egg extract-injected (NT) group (38–66% vs 18–34%, P<0.001). Removal of BRG1 protein from Xenopus egg extracts was conducted, and the BRG1-depleted extracts were co-injected with single donor cells into recipient oocytes. The results showed that the percentages of pronucleus formation were significantly higher in both BRG1-depleted and BRG1-intact groups than that in the nuclear transfer (NT) group (94, 64% vs 50%, P<0.05). Furthermore, percentages in the BRG1-depleted group were even higher than in the BRG1-intact group (94% vs 64%). More confined expression of Oct4 in the inner cell mass (ICM) was observed in the blastocyst derived from the egg extract-injected groups. However, Nanog expression was more contracted in the ICM of cloned blastocysts in the BRG1-depleted group than in the BGR1-intact group. Based on the present study, BRG1 might not play an essential role in reprogramming, but the factors enhancing pronucleus formation and development of cloned mouse embryos are contained in Xenopus egg extracts.
The effective charge of an element is a parameter characterizing the electromigration effect, which can determine the reliability of interconnection in electronic technologies. In this work, machine learning approaches were employed to model the effective charge (z*) as a linear function of physically meaningful elemental properties. Average fivefold (leave-out-alloy-group) cross-validation yielded root-mean-square-error divided by whole data set standard deviation (RMSE/σ) values of 0.37 ± 0.01 (0.22 ± 0.18), respectively, and R2 values of 0.86. Extrapolation to z* of totally new alloys showed limited but potentially useful predictive ability. The model was used in predicting z* for technologically relevant host–impurity pairs.
The modification of halloysite nanotubes (HNTs) as fillers is very effective at improving the performance of polymers. A novel modification of HNTs through grafting dodecylamine onto their surfaces was conducted here. Owing to the improvement in dispersibility of HNTs in polytetrafluoroethylene (PTFE), the mechanical properties and wear resistance (in particular) of the dodecylamine-modified HNT-filled PTFE composite were enhanced significantly.
This article mainly focuses on stabilization treatments that influence stress corrosion resistance of an AA5383-H15 alloy after undergoing sensitization treatment at 100 °C/168 h. The results show that without stabilization of the sensitized AA5383-H15 alloy, the β precipitates are distributed continuously like a mesh at grain boundary, and this is the main cause of intergranular corrosion failure. However, applying 3 different stabilization treatments (220 °C/3 h, 250 °C/3 h, and 280 °C/3 h) to the AA5383-H15 alloy shows a dramatic decrease in the β phase precipitation routes along the grain boundaries after the sensitization treatment, and thus an effective improvement in the corrosion resistance performance of AA5383-H15 alloys. Of all the stabilization treatments, the application of 250 °C/3 h stabilization treatment is found to be most effective. Applying 250 °C/3 h stabilization treatment facilitated partial recrystallization of the matrix, leading to suppress the continuous precipitation of the β phase along the grain boundaries during sensitization but instead precipitate in discontinuous mesh-like distribution, which can decrease its sensitivity to stress corrosion.
“Tailor-made” training programs have been started in two theme parks in North and East Taiwan after the dust explosion of Ba-xien theme park in 2015. The training programs emphasized several areas. They work to strengthen the incident command system (ICS) and the skills of first responders, especially evacuation, placement, triage, and first aid, as well as to assist the park’s cooperation with local disaster response units, such as the fire department and Health Bureau.
The first step was to find out the practical problems of the two theme parks, and then make a one-year, tailor-made training program according to the needs of parks and different levels of staff: senior supervisors, middle-level district supervisors, and frontline colleagues. After the phased training, the training results are inspected in the non-scripted exercise mode.
It was found that the staff are relatively familiar with the evacuation process and placement of tourists. The initial emergency responses such as triage, first aid skills, and patient transport gradually improve after several drills. The ICS operation and communication also became more effective and efficient. The regional emergency response units could understand these theme parks capability and how to cooperate with them.
The experience of emergency response training and exercise in these two theme parks has shown that such a model is feasible and should be valued.
On February 6, 2018, a 6.0 magnitude earthquake struck Hualien, a county of East Taiwan. Hualien Tzu Chi Hospital, the only tertiary hospital in East Taiwan, activated the mass casualty incident (MCI) call and received 144 patients that night. Our operation did not perform satisfactorily despite regular MCI drills. Thus, a new strategy to cope with the increasing frequency of disaster-related MCIs was developed.
To facilitate the management of disaster-related MCIs, we developed a novel Disaster Response System which includes a triage system combining Simple Triage and Rapid Treatment (START) and Five-Level Taiwan Triage and Acuity Scale (TTAS), a novel registration system for MCIs, and anonymous patient identification and reporting system.
We begin the triage with the START method and then shift to the TTAS. The new registration system only needs the patient’s gender, age, and triage category. Patients are then assigned to different treatment areas accordingly. Further dispositions are applied after initial stabilization management. To identify the anonymous disaster victims, we take photographs of victims after clean-up and display them on an electronic bulletin with the patient list to the families in our emergency department. Real-time casualty statistics are collected automatically and synchronized to the governmental administrative system.
This novel Disaster Response System reduces the time from patient arrival to definite treatment and disposition in a simulated mass casualty incident exercise. The victim identification bulletin provides clear information to those who are seeking their family, and thus, avoids the chaos of the scene.
From the experience of the earthquake-related MCI, we found that inadequate training causes time mis-triage and treatment delays. Our Disaster Response System facilitates the workflow with an easily practiced algorithm, reveals on-time and easily accessible information to the public, and altogether improves our MCI management.
Wearable electrochromic devices are considered as the essential components for the development of smart clothing with the intelligent sensing, actuating, and displaying functions. In this study, the electrochromic composite flexible membranes of polyaniline (PANI) and reduced graphene oxide (RGO) were fabricated by in situ polymerization of aniline monomer in the presence of RGO dispersion. The effects of RGO concentration on the morphology, chemical structure, crystallinity, and electrochromic behavior of the composite membranes were studied. Our experimental results show that the conductivity of PANI/RGO composite membrane increases with the increasing of RGO concentration from 0.1 to 0.25 wt%, and the highest conductivity is 3.57 S/cm. An improved electrochemical performance with good electrochromic cycle characteristic of the PANI/RGO composite can be obtained, which shows a wide color range from green to black compared with the PANI membrane that ranging from green to dark blue. This research provides a systematical investigation of flexible PANI-based electrochromic membrane, which has the potential application in the field of wearable electrochromic devices in the future.