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To evaluate the impact of fetal haemodynamics on surgical and neurodevelopmental outcomes in severe Ebstein anomaly and tricuspid valve dysplasia.
Methods:
Thirty-four fetuses with Ebstein anomaly/tricuspid valve dysplasia were referred from 2013 to 2019 for fetal echocardiography and clinical management. Nineteen fetuses with Ebstein anomaly/tricuspid valve dysplasia and 30 controls underwent cardiovascular magnetic resonance to quantify the fetal blood flow and to calculate cerebral oxygen delivery (cDO2) and consumption (cVO2). The 3D steady-state free precession acquisition was used to measure fetal brain volume. Surgical outcome, brain MRI, and neurodevelopmental follow-up were reviewed.
Results:
Twenty-six fetuses were live born (76%) and survival (65%) at a mean follow-up of 4 years. Nine fetuses had a brain MRI before discharge, and all had clinically silent injuries and volume loss. At 18 months, five single-ventricle patients had a neurodevelopmental delay in cognition and language (mean percentile: 11th), with gross-motor skills more affected than fine-motor skills (mean percentiles: 4th and 34th). Fetuses with Ebstein anomaly/tricuspid valve dysplasia had smaller brains, lower combined ventricular output, ascending aorta, superior caval vien and umbilical vein flows, lower oxygen saturation in ascending aorta and superior caval vien, lower cDO2 and cVO2 (p < 0.05). Superior caval vien/combined ventricular output and descending aorta/combined ventricular output ratios were lower in fetuses with circular shunt (p < 0.05). Fetuses requiring the Starnes procedure tended to have smaller brains, lower combined ventricular output, superior caval vien, descending aorta, and umbilical vein flows.
Conclusions:
All patients with Ebstein anomaly/tricuspid valve dysplasia are at high risk of neurodevelopmental delay and warrant follow-up. Fetal cardiovascular magnetic resonance revealed impaired brain growth with diminished cerebral blood flow and cDO2, the extenting dependent on the severity of the haemodynamic compromise.
This paper conducts a novel empirical analysis of the effect of environmental regulation on local pollution emissions by taking 84 cases of local legislation among 31 provinces in China during 1990–2009. We combine the matching methodology and difference-in-difference method to estimate the causal effect of provincial environmental legislation. Our estimation uncovers that there is no significant pollution abatement effect, however, environmental legislation helps to decrease local pollution emission only for those provinces that have stricter enforcement. Such results remain robust while considering the time lag effect, different types of pollutants, choice of different comparison groups and using of synthetic control method. Generally, our study shows the importance of the enforcement for environmental legislation in China.
Animal studies have suggested that mushroom intake can alleviate non-alcoholic fatty liver disease (NAFLD) due to its anti-inflammatory and antioxidant properties. However, the association between mushroom intake and NAFLD is unknown in humans. We aimed to investigate the association of mushroom intake with NAFLD among Chinese adults. This is a cross-sectional study of 24 236 adults (mean (standard deviation) age: 40·7 (sd 11·9) years; 11 394 men (47·0 %)). Mushroom intake was assessed via a validated FFQ. Newly diagnosed NAFLD was identified based on the results of annual health examinations, including ultrasound findings and a self-reported history of the disease. Multiple logistic models were used to examine the association between mushroom intake and NAFLD. The prevalence of newly diagnosed NAFLD was 19·0 %. Compared with those consuming mushrooms less frequently (≤1 time/week), the fully adjusted OR of newly diagnosed NAFLD were 0·95 (95 % CI 0·86, 1·05) for those consuming 2–3 times/week and 0·76 (95 % CI 0·63, 0·92) for those consuming ≥4 times/week (Pfor trend = 0·01). The inverse association was consistent in subgroups defined by age, sex and BMI. In conclusion, higher mushroom intake was significantly associated with lower prevalence of NAFLD among Chinese adults. Future research is required to understand the causal association between mushroom intake and NAFLD.
Severe phase coarsening and separation in Sn–Bi alloys have brought increasing reliability concern in microelectronic packages. In this study, a phase field model is developed to simulate the microstructural evolution and evaluate the change in macroscopic physical properties of the flip chip Cu/Sn58Bi/Cu joint under the conditions of isothermal aging, as well as the coupled loads of elastic stress and electric current stressing. Results show that large-sized Bi-rich phase particles grow up at the expense of small-sized ones. Under the coupled loads, Bi atoms migrate along the electron flow direction, consequently Bi-rich phase segregates to form a Bi-rich phase layer at the anode. The current crowding ratio in the solder decreases rapidly first and then fluctuates slightly with time. Current density and von Mises stress exhibit inhomogeneous distribution, and both of them are higher in the Sn-rich phase than in the Bi-rich phase. Electric current transfers through the Sn-rich phase and detours the Bi-rich phase. As time proceeds, the resistance of the solder joint increases, and the average von Mises stress of the solder joint decreases. The Bi-rich phase coarsens much faster under the coupled loads than under the conditions of isothermal aging.
Since the late 1990s, hand, foot and mouth disease (HFMD) has become a common health problem that mostly affects children and infants in Southeast and East Asia. Global climate change is considered to be one of the major risk factors for HFMD. This study aimed to assess the correlation between meteorological factors and HFMD in the Asia-Pacific region. PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data and Weipu Database were searched to identify relevant articles published before May 2018. Data were collected and analysed using R software. We searched 2397 articles and identified 51 eligible papers in this study. The present study included eight meteorological factors; mean temperature, mean highest temperature, mean lowest temperature, rainfall, relative humidity and hours of sunshine were positively correlated with HFMD, with correlation coefficients (CORs) of 0.52 (95% confidence interval (CI) 0.42–0.60), 0.43 (95% CI 0.23–0.59), 0.43 (95% CI 0.23–0.60), 0.27 (95% CI 0.19–0.35), 0.19 (95% CI 0.02–0.35) and 0.19 (95% CI 0.11–0.27), respectively. There were sufficient data to support a negative correlation between mean pressure and HFMD (COR = −0.51, 95% CI −0.63 to −0.36). There was no notable correlation with wind speed (COR = 0.10, 95% CI −0.03 to 0.23). Our findings suggest that meteorological factors affect the incidence of HFMD to a certain extent.
Leucine plays an important role in promoting muscle protein synthesis and muscle remodelling. However, what percentage of leucine is appropriate in creep feed and what proteome profile alterations are caused by dietary leucine in the skeletal muscle of piglets remain elusive. In this case, we applied isobaric tags for relative and absolute quantitation to analyse the proteome profile of the longissimus dorsi muscles of weanling piglets fed a normal leucine diet (NL; 1·66 % leucine) and a high-leucine diet (HL; 2·1 % leucine). We identified 157 differentially expressed proteins between these two groups. Bioinformatics analysis of these proteins exhibited the suppression of oxidative phosphorylation and fatty acid β-oxidation, as well as the activation of glycolysis, in the HL group. For further confirmation, we identified that SDHB, ATP5F1, ACADM and HADHB were significantly down-regulated (P<0·01, except ATP5F1, P<0·05), whereas the glycolytic enzyme pyruvate kinase was significantly up-regulated (P<0·05) in the HL group. We also show that enhanced muscle protein synthesis and the transition from slow-to-fast fibres are altered by leucine. Together, these results indicate that leucine may alter energy metabolism and promote slow-to-fast transitions in the skeletal muscle of weanling piglets.
In order to obtain the dynamic variation rule of the sulfur content of liquid steel in
the LF refining process, a complete mathematical model including a desulfurization kinetic
model and temperature model in the deep desulfurization process is presented, based on the
practical production and reaction mechanism of ultra-low-sulfur steel in a LF. The results
show that the calculated values of the sulfur content in liquid steel using the model fit
the experimental values well, and the relative error is less than 8%. The effects of
refining slag on the desulfurization process are analyzed in this paper, which shows that
slag basicity is most important at the early and middle stages of the process, while slag
weight is most important at the middle and late stages. The effect of the above factors on
the final sulfur content of liquid steel is further analyzed quantitatively. The simulated
results provide a theoretical basis to segment control the refining process in order to
achieve the maximum effect, improving efficiency, saving energy and reducing
consumption.
In this paper, we demonstrate a thin film Cu–Ni–Nb alloy deposited directly on silicon, without a designated barrier, showing very high thermal stability at a temperature up to 700 °C for 1 h. Thin [Nb–Ni12]Cux films were sputter deposited and annealed, and their material and electrical properties were studied. The results can be explained by the “cluster-plus-glue atom” model for stable solid solutions, where [Nb–Ni12] cuboctahedral clusters are embedded in a Cu matrix. In this model, the clusters are congruent with the Cu minimizing atomic interactions allowing a good stability. The properties of the films were found to be affected by the Ni/Nb ratios. Especially, the (Nb1.2/13.2Ni12/13.2)0.3Cu99.7 film annealed at 500 °C for 1 h had the lowest electrical resistivity of about 2.7 μΩ cm. And even after 40 h annealing at 500 °C, it maintained a low resistivity of about 2.8 μΩ cm, demonstrating extremely high stabilities against silicide formation.
The Archaean Jiaodong Terrane is located in the southern segment of the Palaeoproterozoic Jiao-Liao-Ji Belt, which separates the Eastern Block of the North China Craton into the Longgang and Langrim blocks. Controversy has long surrounded the issue of whether the Jiaodong Terrane is part of the North China Craton or an exotic terrane. This study presents new zircon U–Pb ages for the major lithologies of the Jiaodong Terrane, and the results indicate that the terrane underwent two main magmatic events at ~2.89 Ga and 2.62–2.56 Ga and two metamorphic events at ~2.5 Ga and 1.9–1.8 Ga. These ages are consistent with those of other metamorphic complexes in the Eastern Block, suggesting that the Jiaodong Terrane was part of the Neoarchaean basement of the Eastern Block, which was reworked at 1.9–1.8 Ga in association with the development of the Palaeoproterozoic Jiao-Liao-Ji Belt.
Complex cerebral aneurysms may require indirect treatment with revascularization. This manuscript describes various surgical revascularization techniques together with clinical outcomes.
Methods:
Thirty-two consecutive patients with complex cerebral aneurysm were managed from November 2005 to October 2008. Techniques used for revascularization were high-flow bypass, low-flow bypass, branch artery reimplantion, and primary reanastomosis. Physiologic and anatomic monitoring technologies, including electroencephalography, somatosensory evoked potential monitoring, microvascular doppler ultrasonography, and/or indocyanine green videoangiography were used intraoperatively to assess both brain physiology and vascular anatomy. Patient outcome was determined using the Glasgow Outcome Scale at discharge and at a mean of 12 months post operation (range 6-25 months).
Results:
Two cervical carotid aneurysms (6%) were resected followed by primary reanastomosis, 21 aneurysms (66%) were trapped following saphenous vein high-flow bypasses, five (16%) were clipped after superficial temporal or occipital artery low-flow bypasses, and four (12%) middle cerebral branch arteries were reimplanted. Of the 32 patients at discharge, 29 (91%) had a Glasgow Outcome Scale of four or five, two (6%) had severe disability, and one (3%) died.
Conclusion:
Cerebral revascularization remains an effective and reliable procedure for treatment of complex cerebral aneurysms. Low morbidity and mortality rates reflect the maturity of patient selection and surgical technique in the management of these lesions.
Sui SG, Wu MX, King ME, Zhang Y, Ling L, Xu JM, Weng XC, Duan L, Shan BC, Li LJ. Abnormal grey matter in victims of rape with PTSD in Mainland China: a voxel-based morphometry study.
Objective:
This study examined changes in brain grey matter in victims of rape (VoR) with and without post-traumatic stress disorder (PTSD). Previous research has focused on PTSD caused by various traumatic events, such as war and disaster, among others. Although considerable research has focused on rape-related PTSD, limited studies have been carried out in the context of Mainland China.
Methods:
The study included 11 VoR with PTSD, 8 VoR without PTSD and 12 healthy comparison (HC) subjects. We used voxel-based morphometry to explore changes in brain grey-matter density (GMD) by applying statistical parametric mapping to high-resolution magnetic resonance images.
Results:
Compared with HC, VoR with PTSD showed significant GMD reductions in the bilateral medial frontal cortex, left middle frontal cortex, middle temporal gyrus and fusiform cortex and significant GMD increases in the right posterior cingulate cortex, postcentral cortex, bilateral precentral cortex and inferior parietal lobule. Compared to VoR without PTSD, VoR with PTSD showed significant GMD reductions in the right uncus, left middle temporal gyrus, and the fusiform cortex, and increases in the left precentral cortex, inferior parietal lobule and right post-central cortex.
Conclusion:
The findings of abnormal GMD in VoR with PTSD support the hypothesis that PTSD is associated with widespread anatomical changes in the brain. The medial frontal cortex, precentral cortex, posterior cingulate cortex, post-central cortex and inferior parietal lobule may play important roles in the neuropathology of PTSD.
This study aimed to explore high-throughput cDNA array monitoring technology and to apply it to the gene expression spectrum analysis of salinity-challenged tobacco plants. A Nicotiana tabacum cDNA library was sequenced and found to consist of 5927 high-quality sequences (GenBank accession nos CV015900-CV021826). By analysing the expressed sequence tags (ESTs), the proportion of N. tabacum genes was identified at the EST level. A cDNA array was constructed based on the tentative unique transcripts (TUTs) derived from EST assembling results. A total of 42 differentially expressed genes were identified, including plasma membrane intrinsic protein 2a, ethylene-responsive proteinase and pre-mRNA splicing factor prp31 gene, suggesting that there was a complicated biological response in N. tabacum under saline stress.
Assume that x∈[0,1) admits its continued fraction expansion x=[a1(x),a2(x),…]. The Khintchine exponent γ(x) of x is defined by when the limit exists. The Khintchine spectrum dim Eξ is studied in detail, where Eξ:={x∈[0,1):γ(x)=ξ}(ξ≥0) and dim denotes the Hausdorff dimension. In particular, we prove the remarkable fact that the Khintchine spectrum dim Eξ, as a function of , is neither concave nor convex. This is a new phenomenon from the usual point of view of multifractal analysis. Fast Khintchine exponents defined by are also studied, where φ(n) tends to infinity faster than n does. Under some regular conditions on φ, it is proved that the fast Khintchine spectrum dim ({x∈[0,1]:γφ(x)=ξ}) is a constant function. Our method also works for other spectra such as the Lyapunov spectrum and the fast Lyapunov spectrum.
We study the dynamic behavior and stability of two connected
Rayleigh beams that are subject to, in addition to two sensors and
two actuators applied at the joint point, one of the actuators also
specially distributed along the beams. We show that with the
distributed control employed, there is a set of generalized
eigenfunctions of the closed-loop system, which forms a Riesz basis
with parenthesis for the state space. Then both the
spectrum-determined growth condition and exponential stability are
concluded for the system. Moreover, we show that the exponential
stability is independent of the location of the joint. The range of
the feedback gains that guarantee the system to be exponentially
stable is identified.
In this paper, we consider the boundary stabilization of a
sandwich beam which consists of two outer stiff layers and a
compliant middle layer. Using Riesz basis approach, we show that
there is a sequence of generalized eigenfunctions, which forms a
Riesz basis in the state space. As a consequence, the
spectrum-determined growth condition as well as the exponential
stability of the closed-loop system are concluded. Finally, the
well-posedness and regularity in the sense of Salamon-Weiss class
as well as the exact controllability are also addressed.
With the aid of a six-dimensional special eigenvector q, T.C.T.Ting finds five new invariants of anisotropic elasticity constants. The purpose of this paper is to consider some character of the eigenvector q. It is pointed that the six-dimensional special eigenvector q is unique, if it is independent of the coordinate transformation, and the general form of a three-rank orthogonal matrix is given if it has a three-dimensional special eigenvector like q. In addition, the concept of the special eigenvector q is extended and 20 invariants of anisotropic elasticity constants are obtained under rotation about x3-axis.
After examining ternary Al-based quasi-crystalline phase diagrams, we pointed out that the presence of e/a-constant and e/a-variant lines is a common phenomenon. Ternary quasi-crystal compositions are located at the crossing point of these lines in ternary phase diagrams. Such an empirical rule can be used to predict the ternary quasi-crystal compositions from binary ones. We applied this rule to the Al–Fe–Ni system and clarified the decagonal phase composition zone. There are two decagonal phases, D-Al72.5Fe14.5Ni13 and D′-Al705Fe12Ni17.5, that correspond respectively to Al–Fe-based and Al–Ni-based decagonal phases in the same ternary system.
The structure and magnetic properties of Nd8.4Fe86Mo1.1B4.5 nanostructured magnets prepared by mechanical alloying (MA), compared with those by mechanical milling (MM), were studied. The intrinsic coercivity μ0Hc, the reduced remanence Jr/Js, and the maximum magnetic energy product (BH)max for Nd8.4Fe86Mo1.1B4.5 magnets were prepared by MM were notably higher than the values of the corresponding MA-prepared samples. The average grain sizes of both α–Fe and Nd2Fe14B in the MM-prepared samples were measurably smaller than corresponding values of the MA-prepared samples. A more homogeneous distribution of α–Fe grains in the MM-prepared samples than in the MA-prepared samples was obtained.
Radar, aerial netting and ground sampling were used to study the autumn migration of Nilaparvata lugens (Stål) in Jiangsu Province in east central China. Emigration of macropterous adults increased from late August until late September as the main rice crop matured and was harvested. In early and mid September, the resulting windborne migrations carried the planthoppers mainly towards the west, although the migration directions ranged (within the western sector) from south to north. By late September, however, displacements were predominantly to the south-west on the then prevailing north-east monsoon winds: migration was particularly rapid when the north-easterlies were reinforced by typhoons. Although in late September such movements to more southerly latitudes are essential for the survival of the planthoppers' progeny, we found no definite evidence for preferential emigration on winds blowing towards the south. There were, however, indications that when winds towards the north occurred, the duration of migratory flight was curtailed. Irrespective of any possible preference for migration on northerlies, a large proportion of the N. lugens population would normally be carried in an adaptive southwards direction, because the advent of the north-east monsoon occurs at a time when the number of flight-ready planthoppers approaches its peak.