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Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
ITGB1 (Integrin β1, CD29) is a member of the integrin family and has a role as a major adhesion receptor. Gastric cancer (GC) is an important cause of mortality worldwide, especially in China. As a potential cancer enhancer, the role ITGB1 plays in GC progression remains unclear. In the current study, our assay on the databases of tumoassociated gene expression and interaction found that the high expression of ITGB1 was closely correlated with the poor prognosis of GC patients. To explore the roles, ITGB1 plays in GC progression, and an ITGB1-deleted cell line (ITGB1−/−SGC7901) was generated using the CRISPR/Cas9 method. The tumor malignancy-associated cell behaviors and microstructures were detected, imaged, and analyzed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT), wound healing, transwell, scanning electron microscopy, laser scanning confocal microscopy, and others. The results indicated that ITGB1 deletion decreased the GC cell proliferation and motility, and inhibited motility-relevant microstructures, such as pseudopodia and filopodia, markedly in ITGB1-deleted SGC7901 cells. The analysis of STRING database and western blots indicated that ITGB1 contributes to the malignancy of GC mediated by Src-mediated FAK/PI3K/Akt signaling pathways. Taken together, the results showed that ITGB1 may be a potential targeting marker for GC diagnosis and therapy in the future.
The scientific application of clinical evidence-based guidelines can reduce the variability of clinical practice, and standardize clinical diagnosis and treatment pathways. At present, many evidence-based guidelines on Chronic Obstructive Pulmonary Disease (COPD) prevention have been issued in countries around the world, but the procedures and evaluation strategies developed by different guidelines are not the same. This study aimed to evaluate the quality of published clinical practice guidelines (CPGs) relating to COPD using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
Databases were systematically searched PubMed, EMBASE, Wan Fang, and CNKI as well as guidelines websites on COPD prevention and treatment. The search period was from inception of the database up to May 2019. The inclusion criteria for this study are as follows: (i) published and in accordance with the definition of the practice guidelines; (ii)the main target population is COPD patients with the diagnostic criteria of the 2019 edition of the global initiative for COPD (GOLD), and the content of the guideline is related to the prevention and treatment practice of COPD; (ii) the same guide is included in the latest updated version; (iv) the published language is English or Chinese. Guidelines that met these inclusion criteria were evaluated for the quality of the AGREE II guidelines. Then, a descriptive analysis was made of the consensus that exists in the guidelines.
A total of fifteen guidelines/Consensuses Statements were included in the study. Two guidelines were assessed as recommended, eleven guidelines were assessed as recommended with modifications and two guidelines were not recommended. The mean scores of the included guidelines in the six domains (scope and purpose, personnel involved in guideline development, rigor of development, clarity, applicability, independence) were 90 percent, 72 percent, 49 percent, 96 percent, 60 percent, 69 percent, respectively. Thus, the study identified a consensus that disease risk factors and recommended interventions were mentioned in the guidelines, and that they comprehensively evaluated the quality of guideline reporting to provide reference for standardizing the development of practice guidelines for COPD in China.
The overall methodological quality of COPD CPGs should be improved. The key recommended areas for improvement include standardization of guideline report writing and synthesis of the latest and best evidence, to develop CPGs for COPD to improve the quality of clinical diagnosis and treatment for COPD.
The disease burden of infectious diarrhea cannot be underestimated. Its seasonal patterns indicate that weather patterns may play an important role and have an important effect on it. The objective of this study was to clarify the relationship between temperature and infectious diarrhea, and diarrhea-like illness.
Distributed lag non-linear model, which was based on the definition of a cross-basis, was used to examine the effect.
Viral diarrhea usually had high incidence in autumn-winter and spring with a peak at -6°C; Norovirus circulated throughout the year with an insignificant peak at 8°C, while related bacteria usually tested positive in summer and peaked at 22°C. The lag-response curve of the proportion of diarrhea-like cases in outpatient and emergency cases revealed that at -6°C, with the lag days increasing, the proportion increased. Similar phenomena were observed at the beginning of the curves of virus and bacterial positive rate, showing that the risk increased as the lag days increased, peaking on days 16 and 9, respectively. The shape of lag-response curve of norovirus positive rate was different from others, presenting m-type, with 2 peaks on day 3 and day 18.
Weather patterns should be taken into account when developing surveillance programs and formulating relevant public health intervention strategies.
A suite of Jurassic–Cretaceous migmatites was newly identified in the Liaodong Peninsula of the eastern North China Craton (NCC). Anatexis is commonly associated with crustal thickening. However, the newly identified migmatites were formed during strong lithospheric thinning accompanied by voluminous magmatism and intense deformation. Field investigations show that the migmatites are spatially associated with low-angle detachment faults. Numerous leucosomes occur either as isolated lenses or thin layers (dykes), parallel to or cross-cutting the foliation. Peritectic minerals such as titanite and sillimanite are distributed mainly along the boundaries of reactant minerals or are accumulated along the foliation. Most zircons show distinct core–rim structures, and the rims have low Th/U ratios (0.01–0.24). Zircon U–Pb dating results indicate that the protoliths of the migmatites were either the Late Triassic (224–221 Ma) diorites or metasedimentary rocks deposited sometime after c. 1857 Ma. The zircon overgrowth rims record crystallization ages of 173–161 Ma and 125 Ma, which represent the formation time of leucosomes. These ages are consistent with those reported magmatic events in the Liaodong Peninsula and surrounding areas. The leucosomes indicate a strong anatectic event during the Jurassic–Cretaceous period. Partial melting occurred through the breakdown of muscovite and biotite with the presence of water-rich fluid under a thermal anomaly regime. The possible mechanism that caused the 173–161 Ma and 125 Ma anatectic events was intimately related to the regional crustal extension during the lithospheric thinning of the NCC. Meanwhile, the newly generated melts further weakened the rigidity of the crust and enhanced the extension.
We document a substantial customer complaint gap between stock and mutual financial firms. To assess whether this 21% per year complaint gap stems from complaint-prone customers in stock insurers, we examine state-adjudicated complaint success. To further delineate between customer selection or treatment explanations, we exploit within insurer complaints around random claims (natural disasters) and attention shocks (media scrutiny). Further tests reveal the complaint gap widens with greater competition, near insolvency thresholds, and with more price regulation. Overall, the results are inconsistent with the hypothesis that mutual financial firms exhibit low customer satisfaction, suggesting customers find this a beneficial organizational structure.
Annexin A2 (ANXA2) is reported to be associated with cancer development. To investigate the roles ANXA2 plays during the development of cancer, the RNAi method was used to inhibit the ANXA2 expression in caco2 (human colorectal cancer cell line) and SMMC7721 (human hepatocarcinoma cell line) cells. The results showed that when the expression of ANXA2 was efficiently inhibited, the growth and motility of both cell lines were significantly decreased, and the development of the motility relevant microstructures, such as pseudopodia, filopodia, and the polymerization of microfilaments and microtubules were obviously inhibited. The cancer cell apoptosis was enhanced without obvious significance. The possible regulating pathway in the process was also predicted and discussed. Our results suggested that ANXA2 plays important roles in maintaining the malignancy of colorectal and hepatic cancer by enhancing the cell proliferation, motility, and development of the motility associated microstructures of cancer cells based on a possible complicated signal pathway.
Direct numerical simulation is conducted to uncover the response of a supersonic turbulent boundary layer to streamwise concave curvature and the related physical mechanisms at a Mach number of 2.95. Streamwise variations of mean flow properties, turbulence statistics and turbulent structures are analysed. A method to define the boundary layer thickness based on the principal strain rate is proposed, which is applicable for boundary layers subjected to wall-normal pressure and velocity gradients. While the wall friction grows with the wall turning, the friction velocity decreases. A logarithmic region with constant slope exists in the concave boundary layer. However, with smaller slope, it is located lower than that of the flat boundary layer. Streamwise varying trends of the velocity and the principal strain rate within different wall-normal regions are different. The turbulence level is promoted by the concave curvature. Due to the increased turbulence generation in the outer layer, secondary bumps are noted in the profiles of streamwise and spanwise turbulence intensity. Peak positions in profiles of wall-normal turbulence intensity and Reynolds shear stress are pushed outward because of the same reason. Attributed to the Görtler instability, the streamwise extended vortices within the hairpin packets are intensified and more vortices are generated. Through accumulations of these vortices with a similar sense of rotation, large-scale streamwise roll cells are formed. Originated from the very large-scale motions and by promoting the ejection, sweep and spanwise events, the formation of large-scale streamwise roll cells is the physical cause of the alterations of the mean properties and turbulence statistics. The roll cells further give rise to the vortex generation. The large number of hairpin vortices formed in the near-wall region lead to the improved wall-normal correlation of turbulence in the concave boundary layer.
TiO2 nanomaterials with platelet or nanosheet morphologies can offer improved properties for photocatalytic applications, but established methods to produce them typically require structure-directing agents since anatase-phase TiO2 does not have a layered structure. In the present work, the preparation of TiO2 nanosheets by the chemical oxidation of TiS2 nanosheets is demonstrated. Electrochemical exfoliation of bulk TiS2 into TiS2 nanosheets, followed by the hydrothermal treatment at 180 °C for 14 h is performed. The results show that polycrystalline TiO2 nanosheets with the anatase structure are formed, and that the nanosheet morphology can still be maintained after the hydrothermal treatment. The TiO2 nanosheets show good photocatalytic activity for the degradation of methylene blue, but the performance is negatively affected by the residual carbon black that was needed in the TiS2 electrode to enable electrochemical exfoliation. These results show that conversion of TiS2 nanosheets to TiO2 nanosheets is a promising synthetic strategy but highlights how the interfacial properties of the obtained materials could be affected by ancillary components in the preparation method.
A novel scheme for power-combined frequency tripler adopting 2N diodes is proposed in this work. Even mode coupled suspended substrate stripline is used to divide and recombine the input and output power. The circuits of the tripler are printed on both sides of the substrate, with N diodes on the front side and the other N diodes on the back side. The front diodes and back diodes are in anti-parallel connection, and DC biased separately to increase the bandwidth and power capacity. Three Q-band prototypes with two, four, and six diodes are fabricated and tested. The output compression powers at output frequency of 43.5 GHz for two/four/six-diode tripler are 9.2, 11, and 12 dBm, respectively. Power capacity is improved with the proposed tripler. Optimum DC bias is also discussed in this work, and it is found that it first increases with drive power, and then drops when large drive power applied because of the increased series resistance of the diode due to high junction temperature.
Objectives: Mental arithmetic is essential to daily life. Researchers have explored the mechanisms that underlie mental arithmetic. Whether mental arithmetic fact retrieval is dependent on surface modality or knowledge format is still highly debated. Chinese individuals typically use a procedure strategy for addition; and they typically use a rote verbal strategy for multiplication. This provides a way to examine the effect of surface modality on different arithmetic operations. Methods: We used a series of neuropsychological tests (i.e., general cognitive, language processing, numerical processing, addition, and multiplication in visual and auditory conditions) for a patient who had experienced a left frontotemporal stroke. Results: The patient had language production impairment; but preserved verbal processing concerning basic numerical abilities. Moreover, the patient had preserved multiplication in the auditory presentation rather than in the visual presentation. The patient suffered from impairments in an addition task, regardless of visual or auditory presentation. Conclusions: The findings suggest that mental multiplication could be characterized as a form of modality-dependent processing, which was accessed through auditory input. The learning strategy of multiplication table recitation could shape the verbal memory of multiplication leading to persistence of the auditory module. (JINS, 2017, 23, 692–699)
More and more rare genetic variants are being detected in the human genome, and it is believed that besides common variants, some rare variants also explain part of the phenotypic variance for human diseases. Due to the importance of rare variants, many statistical methods have been proposed to test for associations between rare variants and human traits. However, in existing studies, most methods only test for associations between multiple loci and one trait; therefore, the joint information of multiple traits has not been considered simultaneously and sufficiently. In this article, we present a study of testing for associations between rare variants and multiple traits, where trait value can be binary, ordinal, quantitative and/or any mixture of them. Based on the method of generalized Kendall's τ, a nonparametric method called NM-RV is proposed. A new kernel function for U-statistic, which could incorporate the information of each rare variant itself, is also presented and is expected to enhance the power of rare variant analysis. We further consider the asymptotic distribution of the proposed association test statistic. Our simulation work suggests that the proposed method is more powerful and robust than existing methods in testing for associations between rare variants and multiple traits, especially for multivariate ordinal traits.
Dilatometric studies of C–Mn hypoeutectoid steel with an as-cast structure were carried out to study the effects of the heating or cooling rate, heating and cooling process on phase transformation, and the thermal expansion coefficient. As the heating or cooling rate (Vc) increased, the characteristic temperatures of Ac1, Acp, and Ac3 also rose, while Ar3, Ar1, and Arp fell. In addition, the phase transformation temperature range (Ac3–Ac1) rose, while (Ar3–Arp) fell as the heating or cooling rate increased. At the same time, the maximum thermal expansion coefficients│αT│ between the heating and cooling processes during phase transformation showed significant differences, and the difference (│ΔαT│) in the maximum │αT│ between these processes increased along with the heating or cooling rate, and this is because of the different phase transformation rates, with regard to the change from austenite to ferrite on cooling and ferrite to austenite on heating. During the heating process, the phase transformation rate of ferrite to austenite first decreases and then increases as the temperature rises, and the phase transformation rate of austenite to ferrite first increases and then decreases during the cooling process. The evolution of carbon and substitutional alloying elements (Si and Mn) in austenite during heating and cooling is also analyzed in this work.
Phyto-oestrogens are a family of plant-derived xeno-oestrogens that appear to have beneficial effects on human health. To date, no data are available about phyto-oestrogen consumption affecting liver health in a population. The present study aimed to explore the relationship of urinary phyto-oestrogen metabolites with serum liver enzymes in US adults. A nationally representative sample of US adults in the National Health and Nutrition Examination Survey (NHANES) 2003–10 was analysed. The cross-sectional study sample consisted of 6438 adults with data on urinary phyto-oestrogen levels, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transaminase (GGT) concentrations and data on other potential confounders. Multivariate logistic regression and linear regression were applied to assess associations between urinary phyto-oestrogen levels and ALT, AST, ALP and GGT concentrations. We found a remarkable association between urinary enterolactone and GGT in both adult males (OR 0·37, 95 % CI 0·22, 0·61; P= 0·003) and females (OR 0·37, 95 % CI 0·26, 0·54; P= 0·009). Moreover, elevated enterolactone levels were inversely associated with ALT and AST levels in adult males. However, no association was present between levels of urinary daidzein, O-desmethylangolensin, equol, enterodiol or genistein with liver enzyme levels in this population. The present study results provide epidemiological evidence that urinary enterolactone levels are associated with liver GGT levels in humans. This suggests a potential protective effect of enterolactone on human liver function. However, the underlying mechanisms still need further investigation.
Phyto-oestrogens are a family of plant-derived xeno-oestrogens that have been shown to prevent cancer in some studies. Whether phyto-oestrogen intake affects obesity status in a population is still unclear. In the present cross-sectional study, we examined the association of urinary phyto-oestrogen metabolites with obesity and metabolic parameters in children and adults. Data from 1294 children (age 6–19 years) and from 3661 adults (age ≥ 20 years) who participated in the US National Health and Nutrition Examination Survey 2001–10 were analysed. Multivariate logistic regression was applied to investigate the associations of BMI, waist circumference, serum metabolites (total cholesterol, HDL-cholesterol, LDL-cholesterol, TAG, fasting glucose and fasting insulin) and the metabolic syndrome with urinary phyto-oestrogen levels. When stratified by age and sex, we found a stronger association (OR 0·30, 95 % CI 0·17, 0·54; P< 0·001) between urinary enterolactone levels and obesity in adult males (age 20–60 years) than in children (age 12–19 years) or the elderly (age >60 years) in the same survey. However, no associations with urinary daidzein, O-desmethylangolensin, equol, enterodiol or genistein were found in the overall population. We also found that the elevation of enterolactone levels was inversely associated with TAG levels, fasting glucose levels, fasting insulin levels and the metabolic syndrome in males aged 20–60 years, but positively associated with HDL-cholesterol levels. The present results provide epidemiological evidence that urinary enterolactone is inversely associated with obesity in adult males.
As the demands of scientific research and application for specimens increase rapidly, biobanks in China have been springing up over the recent years. This paper summarizes Chinese biobanks through investigation and survey on operative, managerial, ethical conditions and challenges of biobanks. At present, hospitals and research institutes in China set up and operate most of the biobanks, collecting human specimens to support clinical and scientific research. With the development of bio-industry and arrival of the big data era, biobanks need not only collect and store human and non-human specimens but also to manage the big data associated with these specimens.
The influence of TiO2 addition to LF refining slag on Ti-stabilized stainless
steel was evaluated using a vacuum induction furnace at 1873 K. The effect of
CaO-SiO2-MgO-Al2O3 basic slags with different TiO2 contents on the titanium loss,
aluminum loss and total oxygen content in the steel was studied. It was observed that the
oxidation rate of Ti first decreases and then increases with the increase in the content
of TiO2 in slag and
reaches the minimum when 8%TiO2 is added to the slag. However, the change in the
oxidation rate of Al shows the opposite tendency. The total oxygen in the molten steel
remains unchanged with time when 8%TiO2 is added to the slag, and the total oxygen of the
others increases monotonically with time. The activities of TiO2 and Al2O3 from the calculation of the ion
and molecule coexistence theory (IMCT) in the initial slag present the same change
tendency, and both first increase and then decrease with the gradual increase in
TiO2 in the slag
and reach the maximum when 8%TiO2 is added to the slag. The results of a kinetic analysis
showed that the rate-determining step of the oxidation of Ti in the steel is the mass
transfer on the slag side, and the rate-determining step of the oxidation of Al in the
steel is the mass transfer on the metal side.
The physics process in a new kind of plasma magnetic field compression generator (MFCG) without the preliminary magnetic field is studied with a zero-dimensional theoretical model. It is found that the plasma liner is accelerated in the conduction stage and is decelerated in the compression stage. The geometry parameters of MFCG effect the load current amplification significantly. The geometry parameters need to be chosen carefully to make the acceleration space and the deceleration space being suitable for the generator circuit and the injected plasma liner to obtain the optimal amplification factor. For the given driven circuit, the typical amplification factor of load current is greater than 2.
High speed framing camera (HSFC) could be used to capture the image of the electron beams generated by the intense electron-beam accelerator (IEBA), and it is useful to visualize the evolution of discharging and plasma generation phenomenon. So an overview of the application of HSFC on the IEBA is presented. First, we introduce the synchronization problem of HSFC and IEBA, and a synchronization trigger system which could provide a trigger signal with rise time of 17 ns and amplitude of about 5 V is presented. Second, an imaging system based on IEBA, HSFC, and the synchronization trigger system is developed, and it can be used to image the developmental process of plasma in the output vacuum chamber of IEBA and to measure the electrical parameter of IEBA and electrical trigger signal in real time. Furthermore, the imaging system is used to investigate the developmental process of the electron beam of the A-K gap in vacuum under 180 nanosecond quasi-square pulses. It is obtained that the short A-K gap is closed prematurely under long pulse operation with plasma expansion velocity of about 6.25 cm/µs and the light emission in the A-K gap region has the characteristics of “re-ignition” with light duration time about 3800 ns. At last, the discharging process of surface flashover channel of poly-methyl methacrylate (PMMA) insulator with gap spacing of 170 mm in vacuum under nanosecond quasi-square pulses is studied by the imaging system, and the change of luminosity is analyzed during the surface flashover process.
As the development of the pulsed power technology, high voltage pulse transformer (HVPT) is usually used instead of Marx generator as a charging device for the pulse forming line (PFL) of intense electron-beam accelerator (IEBA), and which make the IEBA compact. However, during the operation of the IEBA, the HVPT may be destroyed for the failure of electrical insulation and the over-voltage. So in this paper, the output voltage characteristics of IEBA, characteristics of the voltage at the output terminal of HVPT at four kinds of load conditions are analyzed, including load matching, load short, load open, and surface flashover in the vacuum chamber. It is found that load short, load open, and surface flashover in vacuum chamber will affect the voltage at the output terminal of HVPT, and an oscillation wave could be formed, which affect the electrical insulation of HVPT and decrease the lifetime of HVPT. Meanwhile, the waveform of the load voltage is also modified, especially at the conditions of load open and surface flashover in vacuum chamber. When the load is open, the amplitude of the output main pulse of IEBA is twice the charging voltage of BPFL. However, the amplitude of the output pulse of IEBA is modified by the voltage at the output terminal of HVPT, and the resistance of main switch channel has a great effect on the amplitude of the load voltage. When surface flashover occurs in the vacuum chamber, the pulse duration of the output voltage will be decreased. So, during the operation of IEBA, load short, load open and surface flashover in vacuum chamber should be avoided.