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From the size of A4 paper to 5G in the telecommunications sector, standards are ubiquitous. Standard essential patents (SEPs), which protect technology essential to standards, enable their proprietors to gain significant market power. Antitrust authorities therefore scrutinize the exercise of SEPs for breaches of competition law. In this regard, the ability of SEP proprietors to obtain injunctions against implementers as a remedy for infringement of SEPs where licensing negotiations have broken down or are ‘ongoing’ has proven controversial. Some fear that this enables SEP proprietors to threaten injunctions unless implementers agree to unfair, unreasonable, or discriminatory terms. In Huawei Technologies Co Ltd v ZTE Corp [2015] ECLI:EU:C:2015:477, the Court of Justice of the European Union identified circumstances where a SEP proprietor's application for injunctive relief as a remedy for infringement of its SEP constitutes an abuse of a dominant position, with the classification of the SEP proprietor's application as being abusive forming a ‘FRAND Defence’ which implementers may invoke against the grant of the injunction requested. This article analyzes whether this approach can be replicated by the Singapore Courts and whether the Chinese Courts, which have already dealt with SEP licensing disputes, adopt a similar approach.
To examine the associations between factors based on the social cognitive theory (SCT) and behavioral intention among doctors and nurses in China toward free and self-paid (600 RMB or US$91) severe acute respiratory coronavirus virus 2 (SARS-CoV-2) vaccination given 80% effectiveness and rare mild side effects.
Design:
Cross-sectional study.
Setting:
Public hospitals.
Participants:
The study included 362 doctors and 1,702 nurses in major departments of 5 hospitals of 3 Chinese provinces.
Methods:
An anonymous online survey was conducted from October to November 2020, facilitated by hospital administrators through online WeChat/QQ working groups. Data on outcome expectations, self-efficacy, norms, and COVID-19–related work experiences were collected. Multivariate logistic regression models were used for data analyses.
Results:
The logistic regression analysis showed that physical (eg, protective effect of vaccination) and self-evaluative outcome expectations (eg, anticipated regret), self-efficacy, norms (eg, descriptive norm, subjective norm, professional norm, and moral norm), and job satisfaction were significantly and positively associated with the free and self-paid SARS-CoV-2 vaccination intention outcomes among doctors and nurses, adjusted for background variables. Doctors who had engaged in COVID-19–related work reported higher self-paid vaccination intention.
Conclusions:
Health promotion is needed to improve the uptake of SARS-CoV-2 vaccination among healthcare workers. Such interventions may consider modifying the identified factors of vaccination intention, including strengthening perceived efficacy, positive feelings about vaccination, the need to avoid future regret, self-efficacy, and social norms. Future studies should examine the actual behavior patterns of SARS-CoV-2 vaccination, and the efficacy of promotion intervention should be tested in randomized controlled studies.
The study aimed to investigate behavioural intentions to receive free and self-paid COVID-19 vaccinations (BICV-F and BICV-SP) among Chinese university students if the vaccine was 80% effective with rare mild side effects, to examine their associations with social media exposures and peer discussions regarding COVID-19 vaccination, and to explore the mediational role of perceived information sufficiency about COVID-19 vaccination. An online anonymous survey (N = 6922) was conducted in November 2020 in five Chinese provinces. Logistic regression and path analysis were adopted. The prevalence of BICV-F and BICV-SP were 78.1% and 57.7%. BICV-F was positively associated with the frequencies of passive social media exposure (adjusted odds ratio (AOR) = 1.32, P < 0.001), active social media interaction (AOR = 1.13, P < 0.001) and peer discussions (AOR = 1.17, P < 0.001). Indirect effects of the three factors on BICV-F via perceived information sufficiency were all significant (P < 0.001). The direct effect of active social media interaction on BICV-F was significantly negative (P < 0.001). Similar associations/mediations were observed for BICV-SP. The COVID-19 vaccination intention of Chinese university students needs improvement. Boosting social media exposures and peer discussions may raise students' perceived information sufficiency and subsequently increase their vaccination intention. Considering the potential negative effect of active social media interaction, caution is needed when using social media to promote COVID-19 vaccination.
The relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms.
Method
This is a population-based two-phase household survey of Chinese population in Hong Kong aged 16–75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up.
Results
The 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up.
Conclusions
Results highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.
Background. Diffuse low-grade gliomas (LGGs) are infiltrative, slow-growing primary brain tumours that remain relatively asymptomatic for long periods of time before transforming into aggressive high-grade gliomas. Surveillance of tumour stability is performed primarily by serial imaging. Methods. We retrospectively identified LGG patients that were managed by observation with numerous (≥8) serial magnetic resonance imaging (MRI) studies. Tumour volumes were measured by manual segmentation on imaging. Demographic information, tumour histopathological data, and radiological interpretations were collected from electronic medical records. MRI radiology reports of tumour volume stability were classified into "growth" and "no growth" interpretations. Results. Of 74 LGG patients, 10 (13.5%) patients were included in the study. A median of 11 MRIs (range, 8-18) over a median of 79.7 months (range, 39.8-113.8 months) were analyzed per patient. Tumour diameter linearly increased at a median rate of 2.17 mm/year. Cox regression analysis showed that initial tumour volume predicted time to clinical intervention, and Mann-Whitney U test found that tumours of patients diagnosed before age 50 grew more slowly. Radiology interpretations that reported "no growth" (n=66) corresponded to a median measured growth of 3.90 mL and 11.0% compared to the comparison scan. Reports of "growth" (n=36) corresponded to median measured volume increases of 9.36 mL and 20.5%. Conclusion. We retrospectively analyzed the natural history of LGGs in serially-imaged patients at a single institution. Comparisons to the literature suggest that this is a subset of particularly slow-growing and low-risk tumours. We also highlight the clinical value of performing accurate LGG volumetric analyses.
Background: Functional magnetic resonance imaging (fMRI) is being increasingly used for the preoperative evaluation of patients with brain tumours. Methods: The study is a retrospective chart review investigating the use of clinical fMRI from 2002 through 2013 in the preoperative evaluation of brain tumour patients. Baseline demographic and clinical data were collected. The specific fMRI protocols used for each patient were recorded. Results: Sixty patients were identified over the 12-year period. The tumour types most commonly investigated were high-grade glioma (World Health Organization grade III or IV), low-grade glioma (World Health Organization grade II), and meningioma. Most common presenting symptoms were seizures (69.6%), language deficits (23.2%), and headache (19.6%). There was a predominance of left hemispheric lesions investigated with fMRI (76.8% vs 23.2% for right). The most commonly involved lobes were frontal (64.3%), temporal (33.9%), parietal (21.4%), and insular (7.1%). The most common fMRI paradigms were language (83.9%), motor (75.0%), sensory (16.1%), and memory (10.7%). The majority of patients ultimately underwent a craniotomy (75.0%), whereas smaller groups underwent stereotactic biopsy (8.9%) and nonsurgical management (16.1%). Time from request for fMRI to actual fMRI acquisition was 3.1±2.3 weeks. Time from fMRI acquisition to intervention was 4.9±5.5 weeks. Conclusions: We have characterized patient demographics in a retrospective single-surgeon cohort undergoing preoperative clinical fMRI at a Canadian centre. Our experience suggests an acceptable wait time from scan request to scan completion/analysis and from scan to intervention.
Anxiety disorders are prevalent yet under-recognized in late life. We examined the prevalence of anxiety disorders in a representative sample of community dwelling older adults in Hong Kong.
Method:
Data on 1,158 non-demented respondents aged 60–75 years were extracted from the Hong Kong Mental Morbidity survey (HKMMS). Anxiety was assessed with the revised Clinical Interview Schedule (CIS-R).
Result:
One hundred and thirty-seven respondents (11.9%, 95% CI = 10–13.7%) had common mental disorders with a CIS-R score of 12 or above. 8% (95% CI = 6.5–9.6%) had anxiety, 2.2% (95% CI = 1.3–3%) had an anxiety disorder comorbid with depressive disorder, and 1.7% (95% CI = 1–2.5%) had depression. Anxious individuals were more likely to be females (χ2 = 25.3, p < 0.001), had higher chronic physical burden (t = −9.3, p < 0.001), lower SF-12 physical functioning score (t = 9.2, p < 0.001), and poorer delayed recall (t = 2.3, p = 0.022). The risk of anxiety was higher for females (OR 2.8, 95% C.I. 1.7–4.6, p < 0.001) and those with physical illnesses (OR 1.4, 95% C.I. 1.3–1.6, p < 0.001). The risk of anxiety disorders increased in those with disorders of cardiovascular (OR 1.9, 95% C.I. 1.2–2.9, p = 0.003), musculoskeletal (OR 2.0, 95% C.I. 1.5–2.7, p < 0.001), and genitourinary system (OR 2.0, 95% C.I. 1.3–3.2, p = 0.002).
Conclusions:
The prevalence of anxiety disorders in Hong Kong older population was 8%. Female gender and those with poor physical health were at a greater risk of developing anxiety disorders. Our findings also suggested potential risk for early sign of memory impairment in cognitively healthy individuals with anxiety disorders.
Previously, it has been shown that strawberry (SB) or blueberry (BB) supplementations, when fed to rats from 19 to 21 months of age, reverse age-related decrements in motor and cognitive performance. We have postulated that these effects may be the result of a number of positive benefits of the berry polyphenols, including decreased stress signalling, increased neurogenesis, and increased signals involved in learning and memory. Thus, the present study was carried out to examine these mechanisms in aged animals by administering a control, 2 % SB- or 2 % BB-supplemented diet to aged Fischer 344 rats for 8 weeks to ascertain their effectiveness in reversing age-related deficits in behavioural and neuronal function. The results showed that rats consuming the berry diets exhibited enhanced motor performance and improved cognition, specifically working memory. In addition, the rats supplemented with BB and SB diets showed increased hippocampal neurogenesis and expression of insulin-like growth factor 1, although the improvements in working memory performance could not solely be explained by these increases. The diverse polyphenolics in these berry fruits may have additional mechanisms of action that could account for their relative differences in efficacy.
To evaluate high-circulation US and Canadian newspaper coverage of the Institute of Medicine (IOM) report Dietary Reference Intakes for Calcium and Vitamin D and assess pre-report and post-report reporter-specific vitamin D-related coverage.
Design
Two independent reviewers analysed the newspaper articles. The key report findings cited, proportion of sentences describing the IOM report and proportion of sentences describing critical viewpoints on the report were calculated. The content of articles written by reporters with a history of pre-report vitamin D-related articles was compared with that of articles written by reporters without such a history.
Setting
Factiva and LexisNexis searches of the top thirty US and three English-language Canadian print newspapers, by circulation.
Subjects
Articles on the IOM report published from 30 November to 21 December 2010 and previous vitamin D-related articles written by the same reporters.
Results
Only ten articles met inclusion/exclusion criteria. Articles inconsistently cited the key findings in the IOM report. Reporters with a history of pre-report articles highlighting the benefits of vitamin D dedicated a greater proportion of sentences to viewpoints critical of the IOM report (P < 0·01). There was no significant difference between pre-report publication history and proportion of sentences focused on the IOM report. A borderline-significant difference (P = 0·058) was observed between pre-report articles highlighting the benefits of vitamin D and the absence of reference to potential risks of vitamin D overconsumption.
Conclusion
Our findings suggest that newspaper articles did not consistently or comprehensively report the IOM recommendations and that pre-report publication history of reporters was related to post-report article content.
Over the past decade, there has been tremendous progress in our understanding of oligodendrocyte biology. Many of the factors that are important for the specification of oligodendrocytes during development have been identified (Kessaris et al., 2008). In addition, the emergence of genomic technologies has greatly improved our understanding of the factors that affect oligodendrocytes during development and in disease. In this chapter, we highlight some of the significant discoveries that have advanced our understanding of the genetic factors that are important in oligodendrocytes, and we identify some of the contributions that were made to this field using genomic technologies.
OLIGODENDROCYTE SPECIFICATION
A great deal of progress has been made in understanding the earliest events of oligodendrocyte specification. The spinal cord has received the most attention, and soluble signaling molecules such as sonic hedgehog (Shh) (Cai et al., 2005) and bone morphogenic proteins (BMPs) are key early regulators of oligodendrocyte development in this part of the central nervous system (CNS). Shh is secreted from the ventral floor plate and is required for the specification of oligodendrocytes (Orentas et al., 1999). Shh signaling induces the expression of the basic helix-loop-helix (bHLH) transcription factors Olig1 and Olig2 in a region of the ventral spinal cord referred to as the motor neuron progenitor (pMN) domain (Lu et al., 2000; Zhou et al., 2000). Shh and Olig gene expression is required for oligodendrocyte specification in the spinal cord and brain (Zhou and Anderson, 2002).
The present study focused on the hypothesis that dietary supplementation with medium-chain TAG (MCT) will improve cognitive function in aged dogs by providing the brain with energy in the form of ketones. Aged Beagle dogs were subjected to a baseline battery of cognitive tests, which were used to establish cognitively equivalent control or treatment groups. The dogs in the treatment group were maintained on a diet supplemented with 5·5 % MCT. After an initial wash-in period, all the dogs were tested with a battery of cognitive test protocols, which assessed sequentially landmark discrimination learning ability, egocentric visuospatial function and attention. The groups were maintained on the diets for 8 months. The MCT-supplemented group showed significantly better performance in most of the test protocols than the control group. The group differences also varied as a function of task difficulty, with the more difficult task showing greater supplementation effects than the easier tasks. The group given the MCT supplement showed significantly elevated levels of β-hydroxybutyrate, a ketone body. These results indicate, first, that long-term supplementation with MCT can have cognition-improving effects, and second, that MCT supplementation increases circulating levels of ketones. The results support the hypothesis that brain function of aged dogs can be improved by MCT supplementation, which provides the brain with an alternative energy source.
Conventional top-down lithographic processes approach their practical and theoretical limits at dimensional scales less than 100 nm. Alternative bottom-up methods are being investigated to build nanoscale architectures, including the use of biomolecules whose functional groups bind inorganic particles. In this study, the fabrication and alignment of microtubule-based nanowires are investigated. Microtubules (MT) are fibrous proteins found in nearly all eukaryotes. Our work was carried out using polymerized alpha- and beta-tubulins, which were cross-linked with glutaraldehyde to stabilize the protein structure. Ni coated microtubules were fabricated by reducing Ni2+ to Ni0 on Pd activated microtubule surface. Focus Ion Beam was used to write metal contacts on these Ni microtubule nanowires and DC conductivity values were measured. Au deposition on MT was performed by both electroless deposition and electrodeposition, by reducing HAuCl4 onto MT prebound with 2 nm Au colloids. Although most MTs exhibited discontinuous Au binding, a fraction of MTs were covered completely by Au. Preliminary electrical measurements for these materials are reported. Alignment of microtubules was also achieved by injecting MTs into microfluidic devices over amine-coated substrate surfaces. These biotemplating approaches are the first steps towards constructing more complicated 2D and 3D architectures.
This study aims to investigate Severe Acute Respiratory Syndrome (SARS)-related behaviours of travellers returning to Hong Kong by air. A total of 820 travellers returning to Hong Kong by air were interviewed about their SARS-related behaviours in April 2003. Three quarters of the respondents wore a mask most/all of the time on board, 15% did so in public places at the travel destination. Perceived susceptibility to SARS at the destination predicted mask-wearing in public places and avoidance of crowded places, and perceived efficacy was a predictor for mask-wearing during flight. Approximately 16% of the respondents stated that they would delay their medical consultation for flu-like symptoms until returning to Hong Kong. Nearly 18·2% stated that they would not wear a mask in public places at the destination if they had flu-like symptoms. Education programmes, special services and effective thermal screening are required to minimize the chance of the spread of SARS by air travellers.
For each variety of bands [Vscr ], we give a formula for ϕ[Vscr ](m,k), which is the largest integer such that for every band B in [Vscr ] generated by m generators and k relations, there is a subset of the generators of size ϕ[Vscr ](m,k) which generates a (relatively) free sub-band of B as a basis. We also determine the semilattice structure of a finitely presented band.
The use of randomized control trials to assess the usefulness of therapeutic drugs over the last half century has brought significant benefits to patient care. The full potential benefits, however, have been only partially fulfilled because available data are frequently poorly used. Meta-analysis has emerged as an important tool for combining clinical evidence. Several examples are presented that compared the results of cumulative meta-analysis of randomized control trials with clinical expert recommendations. These comparisons demonstrated that clinical expert recommendations are often not synchronized with accumulating evidence, and this lack of recognition often resulted in delays in the acceptance of effective drugs and the slow abandonment of possibly harmful therapeutic practices. The problems of inappropriate therapeutic drug use will only intensify as new drugs are introduced and new uses for established drugs are proposed. The rational use of therapeutic drugs can be achieved only through the routine use of meta-analysis on high-quality clinical data. Some suggestions are made to improve the quality of the original research and the ways of assembling meta-analyses and disseminating their results.
There is limited information relating Ca intake to bone and height acquisition among Oriental children who consume little or even no milk. The present controlled study investigated the acquisition of bone mass and height of Chinese children with an initial Ca intake of approximately 567 mg/d who were supplemented to about 800 mg/d. Eighty-four 7-year-old Hong Kong Chinese children underwent an 18-month randomized, double-blind, controlled Ca-supplementation trial. The children were randomized to receive either 300 mg elemental Ca or a placebo tablet daily. Bone mass of the distal one-third radius was measured by single-photon absorptiometry, lumbar spine and femoral neck were determined using dual-energy X-ray absorptiometry. Measurements were repeated 6-monthly. Baseline serum 25-hydroxycholecalciferol concentration and physical activity were also assessed. Baseline Ca intakes of the study group and controls were respectively 571 (SD 326) and 563 (SD 337) mg/d. There were no significant differences in baseline serum 25-hydroxycholecalciferol concentration (P = 0·71) and physical activity (P = 0·36) between the study and control groups. After 18 months the study group had significantly greater increases in lumbar-spinal bone mineral content (20·9 v. 16. 34%; P = 0·035), lumbar-spinal area (11·16 v. 8·71%; P = 0middot;049), and a moderately greater increment in areal bone mineral density of the radius (7·74 0·600%; P = 0.081) when compared with the controls. The results confirm a positive effect of Ca on bone mass of the spine and radius but no effects on femoral-neck and height increase. A longer trial is warranted to confirm a positive Ca effect during childhood that may modify future peak bone mass.
A double-blind controlled Ca supplementation trial was conducted for 6 months in thirty-four 7-year-old Chinese children from Hongkong and Jiangmen, China. The children were randomly allocated to the study group (n 17) or control group (n 17), and a CaCO3 tablet (300 mg Ca) or a placebo tablet was taken daily. True fractional Ca absorption (TFCA) was evaluated before and after the trial using stable isotopes: 8 mg44Ca mixed in 100 g chocolate milk was given after an intravenous injection of 0·75 mg 42Ca. There was no significant difference in baseline TFCA between the study group (60·6 (SD 11·4)%) and the controls (58·2 (SD 9.0)% P = 0·55). Serum 25-hydroxycholecalciferol levels were comparable between the two groups (P = 0·71). After 6 months, TFCA of the study group (55·6 (SD 12·7)%) was significantly lower than that of the controls (64·3 (SD 10·7)% P = 0·015). By comparing the individual changes in TFCA after the trial between the two groups there was a non-significant reduction in TFCA (5·03 (SD 12·4)% P = 0·11, Wilcoxon signed-rank test) in the study group (60·6–55·6%), whereas a significant increase in TFCA (6·17(SD 7·7)% P = 0·004, Wilcoxon signed-rank test) was observed in the controls (58·2–64·3%). The differential in TFCA between the two groups after 6 months was significantly different (P = 0·001), and remained significant after adjustment for baseline dietary intakes, weight and height by multiple-regression analysis (P = 0·003). If the mechanism of TFCA from chocolate milk in response to the treatment effects is similar to that from the total diet, then our results suggest that children with adequate vitamin D status can adapt to a change in Ca intake by adjusting the efficiency of TFCA. In corollary, children on habitually-low Ca diets have a higher TFCA than the counterparts with higher Ca diets.
True fractional Ca absorption (TFCA) was compared in children with different habitual Ca intakes using a double-label stable-isotope technique. Chinese children aged 7 years from Hongkong (n 22) and Jiangmen (n 12) participated in the study. An oral administration of 8 mg 44Ca in 100 g chocolate milk was given shortly after an intravenous injection of 0·75 mg 42Ca. Ca isotopic ratios were determined in urine samples collected 24 h later using thermal-ionization mass spectrometry. There was no significant difference in TFCA between Jiangmen and Hongkong children (P=0·16). TFCA of a lower-Ca-intake group (Ca > 500 mg/d, n 19) with mean Ca intake 359 mg/d was 63·1 (SD 10·7)%; and that of a higher-Ca-intake group (Ca > 500 mg/d, n 15) with mean Ca intake 862 mg/d was 54·8 (SD 7·3)%; the difference in TFCA was significant (P=0·016). Serum levels of 25-hydroxycholecalciferol of the children were adequate (33·7 (SD 7·7) ng/ml). The present study indicates that growing children accustomed to a low-Ca diet appear to be able to enhance their absorptive capacity. If it is assumed that dietary Ca absorption by Chinese children resembles their TFCA from a single meal of chocolate milk, then the recommended dietary allowance (RDA) for Ca for Chinese children would be lower than the US RDA (800 mg/d), which is based on an estimated 40% Ca absorption as reported for Caucasian children. A comparative absorption study is necessary to determine whether there is any difference in TFCA between Caucasian and Chinese children.
This study evaluated Ca intake in Hong Kong Chinese children and examined the association between long-term Ca intake and bone mineral content (BMC) in children. Longitudinal dietary intake from birth to 5 years was obtained in 128 children (sixty-seven boys, sixty-one girls). Ca intakes were evaluated by dietary history and cross-checked with food frequency and 24 h recall. At age 5 years BMC was determined at the one-third distal radius of the right arm using single-photon absorptiometry. The mean Ca intake of 133 children at 5 years was 546 (SD 325) mg/d. Milk was the chief source of Ca (43·5 %). From birth to 5 years, 90 % of the children had been taking milk regularly. The mean BMC and bone width (BW) of these children were 0·317 (SD 0·042) g/cm and 0·756 (SD 0·074) cm respectively. BMC was not correlated with current intakes of Ca, energy and protein but was positively correlated with weight (r 0·57), height (r 0·47) and BW (r 0·66). However, cumulative Ca intake throughout the past 5 years showed significant correlation with BMC (r 0·235, P = 0·0133). The significant correlation remained even after weight, height, BW, sex. and cumulative intakes of energy and protein were adjusted in multiple regression analysis (r 0·248, P = 0·0107). Moreover, using principal component analysis, Ca intake during the 2nd year of life had the strongest correlation with BMC at 5 years (r 0·240, P = 0·02). Ca intake of Hong Kong Chinese children was higher than the RDA of the Food and Agriculture Organization/World Health Organization (1962) and achieved 66% of the current US recommendation (National Research Council, 1989). The increased regular milk consumption reflects a significant change in dietary habits of the younger generation. Children with a habitually higher Ca intake throughout the past 5 years, particularly in the 2nd year, were found to have higher BMC.
This introduction and the three essays that follow it examine ambulatory cardiac monitoring for specific clinical indications. They also examine the ways in which evidence from the literature may be synthesized through the framework of decision analysis to guide its appropriate use and identify areas in which more research is needed. The essays discuss ambulatory cardiac monitoring for evaluation of syncope in the elderly; detection of silent ischemia after a myocardial infarction; and selection of antiarrhythmic drugs for malignant ventricular arrhythmias.