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A 71-year-old man was admitted for gradually difficult walking for 3 years along with memory impairment and urinary incontinence for 1 year. At first, this patient just complained of weakness while walking and dizziness. He was treated for arterial hypertension; however, no relief was obtained. He experienced more difficulties in walking and initiating steps. Besides these symptoms, his memory and thinking ability declined. His wife found that he responded slowly with personality change from a talkative and considerative gentleman to a silent man with apathy. The patient often felt urinary urgency, sometimes with incontinence. It was considered as symptoms of prostate hypertrophy. He was referred to a neurologist and MRI reported some lacunar infarctions and brain atrophy (retrospectively, lateral ventricles enlargement already existed). His Mini-Mental State Examination (MMSE) score was 18 points. Lumbar puncture (LP) was performed and cerebrospinal fluid (CSF) results were normal. The patient was diagnosed as having vascular dementia, hypertension and treated with neuroprotective agents and antihypertensives. After hospitalization, his symptoms were temporarily and partially relieved. His MMSE score was improved to 24 points when he was discharged.
A high-carbohydrate diet could achieve a protein-sparing effect, but it may cause negative impacts on the growth condition of fish due to their poor utilisation ability of carbohydrate. How to reduce the adverse effects caused by a high-carbohydrate diet is important for the development of aquaculture. In the present study, we aimed to identify whether inulin could attenuate the metabolic syndrome caused by a high-carbohydrate diet in fish. Nile tilapia (Oreochromis niloticus) (1·19 (sd 0·01) g) were supplied with 35 % carbohydrate (CON), 45 % carbohydrate (HC) and 45 % carbohydrate + 5 g/kg inulin (HCI) diets for 10 weeks. The results showed that addition of inulin improved the survival rate when fish were challenged with Aeromonas hydrophila, indicating that inulin had an immunostimulatory effect. Compared with the HC group, the HCI group had lower lipid accumulation in liver and the gene expression analyses indicated that addition of inulin down-regulated genes related to lipogenesis and up-regulated genes relevant to β-oxidation significantly (P < 0·05). Higher liver glycogen and glucose tolerance were found in the HCI group compared with the HC group (P < 0·05). These results indicated that inulin could alleviate the metabolic syndrome induced by a high-carbohydrate diet. Furthermore, addition of inulin to a high-carbohydrate diet changed the intestinal bacterial composition and significantly increased the concentration of acetic acid and propionic acid in fish gut which have the potential to increase pathogen resistance and regulate metabolic characteristics in fish. Collectively, our results demonstrated a possible causal role for the gut microbiome in metabolic improvements induced by inulin in fish.
Eurasian steppes experienced frequent cultural transfers, human migration, and diffusion of techniques during the Bronze Age. The Hami Oasis is one of the most dynamic areas and has attracted multiple cultural flows. It is an important area that connects various routes of the Tianshan Corridor with the Hexi Corridor in western China. The Tianshanbeilu cemetery is the largest Bronze Age cemetery in Hami. Thirty-seven new radiocarbon dates allowed us to establish a new and more accurate chronology for Tianshanbeilu. Our results showed that the Tianshanbeilu cemetery was used from approximately 2022–1802 cal BC and remained in use from 1093–707 cal BC. This indicates that Tianshanbeilu is the earliest and longest-used known cemetery in eastern Xinjiang. By incorporating the typology of artifacts and stratigraphic relationships, the development of the Tianshanbeilu cemetery was divided into four phases. The first phase was from 2011–1672 cal BC, the second phase was from 1660–1408 cal BC, the third phase was from 1385–1256 cal BC, and the fourth phase was from 1214–1029 cal BC.
Hypertrophic cardiomyopathy is an autosomal dominant hereditary disease characterised by left ventricular asymmetry hypertrophy. However, our knowledge of the genetic background in hypertrophic cardiomyopathy cases is limited. Here, we aimed to evaluate pathogenic gene mutations in a family with high-risk hypertrophic cardiomyopathy and analyse the genotype/phenotype relationships in this family.
The proband, her parents, and her niece underwent whole-exome sequencing, and the genotypes of family members were identified using Sanger sequencing. mRNA expression was detected using reverse transcription sequencing. Structural impairments were predicted by homologous modelling. A family survey was conducted for patients with positive results to obtain information on general clinical symptoms, electrocardiography, ambulatory electrocardiography, echocardiography, and 3.0T cardiac magnetic resonance findings. Regular follow-up was performed for up to 6 months.
Five family members, including the proband, carried a cleavage site mutation in the MYBPC3 gene (c.2737+1 (IVS26) G>T), causing exon 26 of the MYBPC3 gene transcript to be skipped and leading to truncation of cardiac myosin-binding protein C. Family survey showed that the earliest onset age was 13 years old, and three people had died suddenly at less than 40 years old. Three pathogenic gene carriers were diagnosed with hypertrophic cardiomyopathy, and all showed severe ventricular septal hypertrophy.
The c.2737+1 (IVS26) G>T mutation in the MYBPC3 gene led to exon 26 skipping, thereby affecting the structure and function of cardiac myosin-binding protein C and leading to severe ventricular hypertrophy and sudden death.
Cellulitis is a common infection of the skin and soft tissue. Susceptibility to cellulitis is related to microorganism virulence, the host immunity status and environmental factors. This retrospective study from 2001 to 2013 investigated relationships between the monthly incidence rate of cellulitis and meteorological factors using data from the Taiwanese Health Insurance Dataset and the Taiwanese Central Weather Bureau. Meteorological data included temperature, hours of sunshine, relative humidity, total rainfall and total number of rainy days. In otal, 195 841 patients were diagnosed with cellulitis and the incidence rate was strongly correlated with temperature (γS = 0.84, P < 0.001), total sunshine hours (γS = 0.65, P < 0.001) and total rainfall (γS = 0.53, P < 0.001). The incidence rate of cellulitis increased by 3.47/100 000 cases for every 1° elevation in environmental temperature. Our results may assist clinicians in educating the public of the increased risk of cellulitis during warm seasons and possible predisposing environmental factors for infection.
We investigate the defect structures around a spherical colloidal particle in a cholesteric liquid crystal using spectral method, which is specially devised to cope with the inhomogeneity of the cholesteric at infinity. We pay particular attention to the cholesteric counterparts of nematic metastable configurations. When the spherical colloidal particle imposes strong homeotropic anchoring on its surface, besides the well-known twisted Saturn ring, we find another metastable defect configuration, which corresponds to the dipole in a nematic, without outside confinement. This configuration is energetically preferable to the twisted Saturn ring when the particle size is large compared to the nematic coherence length and small compared to the cholesteric pitch. When the colloidal particle imposes strong planar anchoring, we find the cholesteric twist can result in a split of the defect core on the particle surface similar to that found in a nematic liquid crystal by lowering temperature or increasing particle size.
A series of oxidation experiments were carried out on these novel γ/γ′-strengthened cobalt-based alloys of the systems Co–9Al–10W and Co–9Al–10W–0.02X (X = La, Ce, Dy, Y) at 900 °C. The appropriate amounts’ addition of rare earth elements leads to improved oxidation properties at 900 °C, especially La elements show the best oxidation resistance (129.008 mg/cm2). However, the base Co–9Al–10W alloy shows the worst oxidation performance (151.544 mg/cm2). Multilayer oxide layers formed during the oxidation process, the outer were mainly CoO and Co3O4 oxides, and the middle layer contained complex oxides (containing Co, Al, and W). The inner layer consists of little discontinuous oxides, included few Al2O3 oxides. There existed a different crack width and the base alloy had the widest crack. Moreover, there exists a phase transformation (γ/γ′ to γ/Co3W) at the interface between oxide film and substrate.
This rapid review aimed to determine the effectiveness of Sustained Low Efficiency Dialysis (SLED) when compared to Continuous Renal Replacement Therapy (CRRT) and Continuous Veno-Venous Hemofiltration (CVVH) in the treatment of acute renal failure (ARF) with a view to implementing SLED in a tertiary hospital in 2014.
A rapid review was performed on the effect of SLED for patients with ARF compared with CRRT or CVVH. The outcomes of interest were mortality, hemodynamic stability, reduced utilization of intensive care unit (ICU) and cost-effectiveness. The search terms ("sustained low-efficiency dialysis[MESH]”) were used to search PubMed, the Cochrane Library, UK NHS Centre for Reviews and Dissemination databases and the US National Guidelines Clearinghouse for relevant articles until 2014.
Four observational and two randomized controlled trial (RCT) studies were found. The results showed that 90-day mortality, was similar between groups (SLED: 49.6 percent versus CVVH: 55.6 percent, p = .43). Hemodynamic stability did not differ between SLED and CVVH and between SLED and CRRT. Patients in the SLED group had significantly fewer days of mechanical ventilation (17.7 ± 19.4 versus 20.9 ± 19.8, p = .047) and fewer days in the ICU (19.6 ± 20.1 versus 23.7 ± 21.9, p = .04). Patients treated with SLED needed fewer blood transfusions (1,375 ± 2,573 ml versus 1,976 ± 3,316 ml, p = .02) and had a substantial reduction in nursing time (p < .001). The hospital weekly costs were CAD1,431 for SLED, CAD2,607 for CRRT with heparin, and CAD 3,089 for CRRT with citrate. Dialysis using SLED was associated with higher first post-dialysis mean arterial pressure (p = .003) than those treated with CVVH, which led to lower mortality.
The evidence suggests that SLED can be used as an alternative to CRRT, as the outcomes were similar. SLED provides solute removal equivalent to CRRT at significantly lower cost.
The isothermal oxidation experiments were carried out on several new γ/γ′-strengthened cobalt-base alloys Co–Al–W–4Cr–0.02X (X = La, Ce, Dy, Y) at 900 and 800 °C. Due to an appropriate content of additional elements, the change in the morphology occurred and it significantly improved the oxidation resistance compared with those without Cr, among which the one with La elements shows the best oxidation resistance. Multiple oxide layers are also formed during the oxidation process, with CoWO4 and CoAl2O4 phases in the outer layer, and Cr, Al, W, and Co (e.g., Cr2O3) in the middle layer. The inner layer consists of some Al2O3 oxides, while more protective Al2O3 oxide was formed, esp. at the temperature of 800 °C. Both Cr2O3 and Al2O3 oxides were effectively protective oxides, which can prevent the intrusion of oxygen into the alloy substrate. Moreover, a phase transformation (γ/γ′ to γ/Co3W) was observed at the interface between oxide layer and substrate.
Declines in populations of the Critically Endangered Spoon-billed Sandpiper Calidris pygmaeus have been rapid, with the breeding population now perhaps numbering fewer than 120 pairs. The reasons for this decline remain unresolved. Whilst there is evidence that hunting in wintering areas is an important factor, loss of suitable habitat on passage and wintering areas is also of concern. While some key sites for the species are already documented, many of their wintering locations are described here for the first time. Their wintering range primarily stretches from Bangladesh to China. Comprehensive surveys of potential Spoon-billed Sandpiper wintering sites from 2005 to 2013 showed a wide distribution with three key concentrations in Myanmar and Bangladesh, but also regular sites in China, Vietnam and Thailand. The identification of all important non-breeding sites remains of high priority for the conservation of the species. Here, we present the results of field surveys of wintering Spoon-billed Sandpipers that took place in six countries between 2005 and 2013 and present species distribution models which map the potential wintering areas. These include known and currently unrecognised wintering locations. Our maximum entropy model did not identify any new extensive candidate areas within the winter distribution, suggesting that most key sites are already known, but it did identify small sites on the coast of eastern Bangladesh, western Myanmar, and the Guangxi and Guangdong regions of China that may merit further investigation. As no extensive areas of new potential habitat were identified, we suggest that the priorities for the conservation of this species are habitat protection in important wintering and passage areas and reducing hunting pressure on birds at these sites.
In this paper, the recent studies of laboratory astrophysics with strong magnetic fields in China have been reviewed. On the Shenguang-II laser facility of the National Laboratory on High-Power Lasers and Physics, a laser-driven strong magnetic field up to 200 T has been achieved. The experiment was performed to model the interaction of solar wind with dayside magnetosphere. Also the low beta plasma magnetic reconnection (MR) has been studied. Theoretically, the model has been developed to deal with the atomic structures and processes in strong magnetic field. Also the study of shock wave generation in the magnetized counter-streaming plasmas is introduced.
With the development of ultraintense terawatt (TW) and petawatt (PW) laser systems, powerful terahertz (THz) radiation from laser–plasma interactions has been reported. Plasma-based THz systems, which are usually operated at extremely low repetition rates, call for single-shot diagnostics. In this paper, various state-of-the-art single-shot detection methods are introduced or designed for measurements and applications involved in high-power plasma-based THz sciences.
Ross River virus (RRV) is the most common vector-borne disease in Australia. It is vitally important to make appropriate projections on the future spread of RRV under various climate change scenarios because such information is essential for policy-makers to identify vulnerable communities and to better manage RRV epidemics. However, there are many methodological challenges in projecting the impact of climate change on the transmission of RRV disease. This study critically examined the methodological issues and proposed possible solutions. A literature search was conducted between January and October 2012, using the electronic databases Medline, Web of Science and PubMed. Nineteen relevant papers were identified. These studies demonstrate that key challenges for projecting future climate change on RRV disease include: (1) a complex ecology (e.g. many mosquito vectors, immunity, heterogeneous in both time and space); (2) unclear interactions between social and environmental factors; and (3) uncertainty in climate change modelling and socioeconomic development scenarios. Future risk assessments of climate change will ultimately need to better understand the ecology of RRV disease and to integrate climate change scenarios with local socioeconomic and environmental factors, in order to develop effective adaptation strategies to prevent or reduce RRV transmission.
For over three decades, bone conduction hearing aids have been changing the lives of patients with impaired hearing. The size, appearance and fitting discomfort of early generations of bone conduction hearing aids made them unpopular. The advent of bone-anchored hearing aids in the 1970s offered patients improved sound quality and fitting comfort, due to the application of osseointegration. However, the issue of post-operative peri-abutment pin tract wound infection persisted. The Bonebridge system incorporates the first active bone conduction device, and aims to resolve peri-abutment issues. Implantation of this system in an Asian patient is presented.
It is found that there is an upper-limit critical power for self-guided propagation of intense lasers in plasma in addition to the well-known lower-limit critical power set by the relativistic effect. Above this upper-limit critical power, the laser pulse experiences defocusing due to expulsion of local plasma electrons by the transverse ponderomotive force. Associated with the upper-limit power, a lower-limit critical plasma density is also found for a given laser spot size, below which self-focusing does not occur for any laser power. Both the upper-limit power and the lower-limit density are derived theoretically and verified by two-dimensional particle-in-cell simulations. The present study provides new guidance for experimental designs, where self-guided propagation of lasers is essential.
Adsorption of Escherichia coli (E. coli) cells on red mud (RM) is important in the interactions between RM and bacteria. The objective of this work is to study adsorption of E. coli onto RM and to determine its influence in relation to the surface properties of RM. The effects of different calcination temperatures on the surface properties of red mud were investigated by thermogravimetric analysis, x-ray diffraction, scanning electron microscopy, Brunauer, Emmett, Teller (surface measurement)/N2 adsorption method, and zeta potential analysis. A higher adsorption capacity was observed from RM calcinated at 700 °C (RM700) due to larger pores formed on the surface of RM. The correlation between the adsorption efficacy and surface properties of RM is discussed and the extended Derjaguin-Landau-Verwey-Overbeek theory suggests that when the adsorption reaches equilibrium, the increased adsorption of E. coli onto RM is due to the smaller energy barrier between E. coli and RM700 as compared with that between E. coli and raw RM (RM0).
Uniform ytterbium ion and erbium ion codoped gadolinium oxyfluoride (GdOF: Yb3+, Er3+) hollow nanospheres of 100-nm diameter were synthesized via the nanoscale Kirkendall approach, using colloidal nanospheres of ytterbium ion and erbium ion codoped gadolinium hydroxide [Gd(OH)3: Yb3+, Er3+] as sacrificial templates and titanium tetrafluoride as fluorine source under hydrothermal condition. The shell thickness of the as-synthesized GdOF: Yb3+, Er3+ hollow nanospheres can be facilely tuned from 31 to 13 nm by controlling reaction temperature and reaction time. The upconversion emission color could be adjusted from red to yellow to green when the host lattices variedfrom gadolinium (III) oxide to gadolinium oxyfluoride to gadolinium fluoride. Furthermore, the formation mechanism of the hollow GdOF: Yb3+, Er3+ nanospheres was found to depend on the fluorine source.
The use of the stapes coupling technique, employed in the Vibrant Soundbridge system, is technically less demanding than the vibroplasty technique, and is more likely to generate a positive outcome without significantly changing residual hearing or resulting in medical or surgical complication.
We report a patient with repeated left ossiculoplasty failure, who was successfully implanted with a Vibrant Soundbridge.
We believe that the stapes coupling technique can provide natural stimulation to the inner ear, resulting in a better perceived sound quality.