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Risk factors and prevalence of pulmonary nontuberculous mycobacterial (NTM) diseases were retrospectively evaluated in 1208 suspected pulmonary TB patients seeking care at the Affiliated Hospital of Hangzhou Normal University between July 2018 and December 2018. Further analysis of 390 culture-positive cases demonstrated that 358 (358/390, 91.8%) were infected with Mycobacterium tuberculosis (MTB), 24 (24/390, 6.2%) with NTM and eight (8/390, 2.0%) with both MTB and NTM. M. intracellulare was the most prevalent NTM isolated (16/24, 66.7%), followed by M. abscessus (3/24), M. kansasii (2/24), M. avium (1/24), M. szulgai (1/24) and M. fortuitum (1/24). The difference between NTM and TB case rates for the ⩾65-year-old age group significantly exceeded the difference for the reference group (patients aged 25–44 years) (OR (95% CI): 4.63 (1.03–20.90)). Pulmonary NTM diseases incidence positively correlated with prior TB history (OR (95% CI): 12.92 (3.24–31.82)). Moreover, pulmonary NTM patients were significantly more likely to exhibit underlying bronchiectasis than pulmonary TB patients (OR (95% CI): 18.89 (7.54–47.88)). In conclusion, approximately one-tenth of culture-positive suspected pulmonary TB patients are infected with NTM (most frequently M. intracellulare) in Zhejiang Province, China. The elderly and those with bronchiectasis or a history of TB are at the greatest risk of contracting pulmonary NTM disease.
Composite materials include various components with different structures, which cooperatively increase their properties and extend their application. In this study, the graphitic carbon nitride (g-C3N4) guest material was assembled into the porous of the SiO2 aerogel, which was prepared during the gel process. By this way, the g-C3N4 could be absolutely encapsulated into the porous of the disordered porous SiO2 aerogel. The prepared g-C3N4/SiO2 composite had a loose porous structure and exhibited the much higher photocatalytic activity to the photodegradation of rhodamine B (RhB) under visible light. The disordered porous structure enhanced photocatalytic activity, and the degradation rate reached to 96.42% in 90 min under the irradiation of visible light, which could be attributed to its high surface area and effective electron–hole separation rate. The catalyst had the much higher stability and could be easily recycled utilization. The prepared composites could be applied to degrade organic pollutants in wastewater.
Choices between options represented in a multidimensional space, in which each dimension signifies a distinct attribute describing the objects, are presumably guided by the principle of value maximization. However, the current study assumes that in a real-world setting, those who are able to imagine things that do not actually exist could modify the multidimensional space by self-generating an unoffered but fictional dimension. We define the utility (Uv) assigned by the decision makers to the options on the offered/given dimension as value (v[x]) and the utility (Uw) on the self-generated/fictional dimension as worth (w[xc]). Our series of experiments demonstrated that an option with a greater value established strictly on that given set of dimensions might not necessarily be chosen (which contradicted the principle of value maximization). Choosing an option with less value (i.e. giving away the bigger pear) behavior can be described and explained by the “worth-based choice” approach, as people behave to select the option with the highest worth rather than that with the highest value. We are optimistic that the resulting findings will facilitate our understanding of the beauty of such a “one step further” choice and assist us in understanding the following: the ability to further generate a fictional dimension and to assign a delayed utility (worth) to the options on the fictional dimension, and to make a worth-based choice, which could eventually be taken as the operational definition to measure the degree of “fiction-generating ability”, as proposed by Harari (2014).
Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.
Heading angle is a vital parameter in maintaining a vessel's track along a planned course and should be guaranteed in a stable and reliable way. An innovative method of heading determination based on a fisheye camera, which is almost totally unaffected by electromagnetism and geomagnetism, is proposed in this paper. In addition, unlike traditional astronomical methods, it also has a certain degree of adaptability to cloudy weather. Utilising the super wide Field Of View (FOV) of the camera, it is able to simultaneously image the Moon and the horizon. The Moon is treated as the observed celestial body and the horizon works as the horizontal datum. Two experiments were conducted at sea, successfully proving the feasibility of this method. The proposed heading determination system has the merits of automation, resistance to interference and could be miniaturised, making application viable.
Since 2010, Jankowski’s Bunting Emberiza jankowskii has been listed as ‘Endangered’ on the IUCN Red List of Threatened Species. However, because no comprehensive surveys had been conducted, it was not known whether undiscovered populations existed elsewhere, so the population status of the species could not be assessed accurately. The aim of this study was to assess the breeding distribution and population size of Jankowski’s Bunting in China. Fifty sites in Inner Mongolia, and Jilin, Heilongjiang, Liaoning and Hebei Provinces were surveyed to locate suitable habitat and breeding populations of Jankowski’s Bunting. The surveyed sites included historical breeding distribution areas, wintering sites, and regions adjacent to historical breeding distribution areas. We confirmed that Jankowski’s Bunting has disappeared from most of its former breeding distributions, with the exceptions of Dagang, Xiergen and Tumiji. Additionally, 13 new breeding sites were discovered in Inner Mongolia. All currently known populations breed in Mongolian steppe-vegetation zones, with shrubs dominated by the natural Siberian apricot Prunus sibirica, indicating that this type of habitat is crucial for the survival of the species. Based on remote sensing, the suitable breeding habitat for Jankowski’s Bunting is estimated to be approximately 280 km2. The population size of Jankowski’s Bunting could range between 9,800 and 12,500 individuals, which is much higher than the numbers estimated in previous reports that were based on partial surveys. The suitable habitat remaining in Inner Mongolia would highly benefit from the implementation of the National Key Public Forest Protection Project. The population size of Jankowski’s Bunting is larger than previously estimated, but it is still threatened by habitat degradation and fragmentation, and our survey results reinforce the need for more research. The status of Jankowski’s Bunting in China still meets the IUCN criteria B2ab for an ‘Endangered’ species.
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.
The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.
Methods and results
In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.
A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.
Worldwide 350 million people suffer from major depression, with the majority of cases occurring in low- and middle-income countries. We examined the patterns, correlates and care-seeking behaviour of adults suffering from major depressive episode (MDE) in China.
A nationwide study recruited 512 891 adults aged 30–79 years from 10 provinces across China during 2004–2008. The 12-month prevalence of MDE was assessed by the Modified Composite International Diagnostic Interview-short form. Logistic regression yielded adjusted odds ratios (ORs) of MDE associated with socio-economic, lifestyle and health-related factors and major stressful life events.
Overall, 0.7% of participants had MDE and a further 2.4% had major depressive symptoms. Stressful life events were strongly associated with MDE [adjusted OR 14.7, 95% confidence interval (CI) 13.7–15.7], with a dose–response relationship with the number of such events experienced. Family conflict had the highest OR for MDE (18.9, 95% CI 16.8–21.2) among the 10 stressful life events. The risk of MDE was also positively associated with rural residency (OR 1.5, 95% CI 1.4–1.7), low income (OR 2.3, 95% CI 2.1–2.4), living alone (OR 2.6, 95% CI 2.3–3.0), smoking (OR 1.4, 95% CI 1.3–1.6) and certain other mental disorders (e.g. anxiety, phobia). Similar, albeit weaker, associations were observed with depressive symptoms. Among those with MDE, about 15% sought medical help or took psychiatric medication, 15% reported having suicidal ideation and 6% reported attempting suicide.
Among Chinese adults, the patterns and correlates of MDE were generally consistent with those observed in the West. The low rates of seeking professional help and treatment highlight the great gap in mental health services in China.
In light of government investment over the past decade, we explored the capacity for disaster response in Heilongjiang Province, identifying the factors that affect response capacity.
We surveyed 1257 medical staff in 65 secondary and tertiary hospitals in Heilongjiang province to explore their perceptions of disaster management capacity using a cross-sectional multistage, stratified cluster sampling method.
All tertiary hospitals (100%) and most secondary hospitals (93%) have documented disaster management plans that are regularly reviewed. In secondary hospitals, drills were less prevalent (76.7%) but the occurrence of simulated training exercises was closer to tertiary hospitals (86.0%). We noted that 95.4% of all hospitals have leadership groups responsible for disaster preparedness capacity building, but only 10.8% have a stockpiled network of reserve supplies.
Although response capacity has improved in Heilongjiang Province, vulnerabilities remain. We recommend that priorities should be targeted at preparedness capacity building, in terms of reliable and relevant operational response plans, the expansion of existing response mechanisms to oversee local education and scenario training, and to ensure there is sufficient access to protective equipment and materials, either held in reserve, or alternatively by activating resilient supply chain mechanisms. (Disaster Med Public Health Preparedness. 2018;12:176–183)
The present study was performed to identify the genotype of a hypertrophic cardiomyopathy family and investigate the clinicopathogenic characteristics and prognostic features of relevant genetic abnormalities. Target sequence capture sequencing was performed to screen for pathogenic alleles in a 32-year-old female patient (proband). Sanger sequencing was carried out to verify the results. Sanger sequencing was also performed on other family members to identify allele carriers. A survival analysis was carried out using published literature and our findings. We found that the proband and her son harboured a Gly716Arg sequence variant of the β-myosin heavy chain. Neither the proband’s father nor the mother were carriers of this sequence variant; thus, the mutation was classified as “de novo”. Further survival analysis revealed that female patients appear to have a longer life expectancy compared with males. Our study may provide an effective approach for the genetic diagnosis of hypertrophic cardiomyopathy.
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 first human infection with avian influenza A(H7N9) virus was reported in Shanghai, China in March 2013. An additional 32 cases of human H7N9 infection were identified in the following months from March to April 2013 in Shanghai. Here we conducted a case-control study of the patients with H7N9 infection (n = 25) using controls matched by age, sex, and residence to determine risk factors for H7N9 infection. Our findings suggest that chronic disease and frequency of visiting a live poultry market (>10 times, or 1–9 times during the 2 weeks before illness onset) were likely to be significantly associated with H7N9 infection, with the odds ratios being 4·07 [95% confidence interval (CI) 1·32–12·56], 10·61 (95% CI 1·85–60·74), and 3·76 (95% CI 1·31–10·79), respectively. Effective strategies for live poultry market control should be reinforced and ongoing education of the public is warranted to promote behavioural changes that can help to eliminate direct or indirect contact with influenza A(H7N9) virus.
A model for predicting the austenite grain growth during a common heating process including continuous and isothermal heating processes in medium carbon alloy steel 42CrMo was developed. The isothermal austenite grain growth kinetics were studied with conditions involving soaking time and soaking temperature. The time exponent n in the model was obtained considering the influence of the initial grain size rather than simply utilizing Beck’s equation. The results showed that the value of the time exponent n is 3.55 ± 0.30 when the temperature is above 1000 °C, while the value is 8.33 when the temperature is below 1000 °C. When the temperature is below 1000 °C, the pinning effect of carbides contributes to the higher value of the time exponent. Based on the isothermal model and the rule of additivity, a model for predicting the grain growth occurring during continuous heating was proposed. A reasonable agreement between the calculations and experimental measurements of grain size was obtained. According to the model, the effect of the initial austenite grain size on the final austenite grain size during induction quenching was analyzed. The initial austenite grain size has a significant effect on the final austenite grain size. In order to obtain a refined quenched microstructure, it is necessary to refine the microstructure at room temperature.
Recently, the detection of non-bulk superconductivity with unexpectedly high onset-Tcs up to 49 K in Pr-doped CaFe2As2 [(Ca,Pr)122] single crystals and the report of a Tc up to 65 K in one-unit-cell (1UC) FeSe epi-films, offer an unusual opportunity to seek an answer to the question posed in the title. Through systematic compositional, structural, resistive, and magnetic investigations on (Ca,Pr)122 single crystals, we have observed a doping-level-independent Tc, the simultaneous appearance of superparamagnetism and superconductivity, large magnetic anisotropy, and the existence of mesoscopic-2D structures in these crystals, thus providing clear evidence consistent with the proposed interface-enhanced Tc in these naturally occurring rareearth-doped Fe-based superconductors, (Ca,R)122. Similar resistive and magnetic measurements were also made on the 3–4UC FeSe ultrathin epi-films. We have detected weak links in the Meissner state below 20 K, weakly coupled small superconducting patches between 20–45 K, and collective excitations of spin and/or superconducting nature between 45–80 K. The unusual frequency dependences of the diamagnetic moment observed in the films in different temperature ranges will be presented and their implications discussed.
The present study aims to evaluate the antiparasitic activity of active components from Costus speciosus against Ichthyophthirius multifiliis. Bioassay-guided fractionation was employed to identify active compounds from C. speciosus yielding 2 bioactive compounds: Gracillin and Zingibernsis newsaponin. In-vitro assays revealed that Gracillin and Zingibernsis newsaponin could be 100% effective against I. multifiliis at concentrations of 0·8 and 4·5 mg L−1, with median effective concentration (EC50) values of 0·53 and 3·2 mg L−1, respectively. All protomonts and encysted tomonts were killed when the concentrations of Gracillin and Zingibernsis newsaponin were 1·0 and 5·0 mg L−1. In-vivo experiments demonstrated that fish treated with Gracillin and Zingibernsis newsaponin at concentrations of 1·0 and 5·0 mg L−1 carried significantly fewer parasites than the control (P<0·05). Mortality of fish did not occur in the treatment group (Zingibernsis newsaponin at 5·0 mg L−1) during the trial, although 100% of untreated fish died. Acute toxicities (LD50) of Gracillin and Zingibernsis newsaponin for grass carp were 1·64 and 20·7 mg L−1, respectively. These results provided evidence that the 2 compounds can be selected as lead compounds for the development of new drugs against I. multifiliis.
To assess correlations between cruciferous vegetable intake and urinary isothiocyanate (ITC) level, in addition to glutathione S-transferase (GST) genotypes and other individual factors.
The study included cohort participants whose urinary ITC levels had been previously ascertained. Urinary ITC was assessed using HPLC. Usual dietary intake of cruciferous vegetables was assessed using a validated FFQ and total dietary ITC intake was calculated. Recent cruciferous vegetable intake was determined. GST genotypes were assessed using duplex real-time quantitative PCR assays. Spearman correlations were calculated between the covariates and urinary ITC levels and linear regression analyses were used to calculate the mean urinary ITC excretion according to GST genotype.
Urban city in China.
The study included 3589 women and 1015 men from the Shanghai Women’s and Men’s Health Studies.
Median urinary ITC level was 1·61 nmol/mg creatinine. Self-reported usual cruciferous vegetable intake was weakly correlated with urinary ITC level (rs=0·1149; P<0·0001), while self-reported recent intake was more strongly correlated with urinary ITC (rs=0·2591; P<0·0001). Overall, the GST genotypes were not associated with urinary ITC level, but significant differences according to genotype were observed among current smokers and participants who provided an afternoon urine sample. Other factors, including previous gastrectomy or gastritis, were also related to urinary ITC level.
The study suggests that urinary secretion of ITC may provide additional information on cruciferous vegetable intake and that GST genotypes are related to urinary ITC level only in some subgroups.