To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Neuroinflammation and brain structural abnormalities are found in bipolar disorder (BD). Elevated levels of cytokines and chemokines have been detected in the serum and cerebrospinal fluid of patients with BD. This study investigated the association between peripheral inflammatory markers and brain subregion volumes in BD patients.
Euthymic patients with bipolar I disorder (BD-I) aged 20–45 years underwent whole-brain magnetic resonance imaging. Plasma levels of monocyte chemoattractant protein-1 (MCP-1), chitinase-3-like protein 1 (also known as YKL-40), fractalkine (FKN), soluble tumour necrosis factor receptor-1 (sTNF-R1), interleukin-1β, and transforming growth factor-β1 were measured on the day of neuroimaging. Clinical data were obtained from medical records and interviewing patients and reliable others.
We recruited 31 patients with a mean age of 29.5 years. In multivariate regression analysis, plasma level YKL-40, a chemokine, was the most common inflammatory marker among these measurements displaying significantly negative association with the volume of various brain subareas across the frontal, temporal, and parietal lobes. Higher YKL-40 and sTNF-R1 levels were both significantly associated with lower volumes of the left anterior cingulum, left frontal lobe, right superior temporal gyrus, and supramarginal gyrus. A greater number of total lifetime mood episodes were also associated with smaller volumes of the right caudate nucleus and bilateral frontal lobes.
The volume of brain regions known to be relevant to BD-I may be diminished in relation to higher plasma level of YKL-40, sTNF-R1, and more lifetime mood episodes. Macrophage and macrophage-like cells may be involved in brain volume reduction among BD-I patients.
The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern. The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. A total of 131 patients diagnosed with COVID-19 from 13 February 2020 to 14 March 2020 in a hospital in Wuhan designated for treating COVID-19 were enrolled in the current study. These 131 patients had a median age of 64 years old (interquartile range: 56–71 years old). Furthermore, among these patients, 111 (91.8%) patients were discharged and 12 (9.2%) patients died in the hospital. The pooled analysis revealed that the NLR at admission was significantly elevated for non-survivors, when compared to survivors (P < 0.001). The NLR of 3.338 was associated with all-cause mortality, with a sensitivity of 100.0% and a specificity of 84.0% (area under the curve (AUC): 0.963, 95% confidence interval (CI) 0.911–1.000; P < 0.001). In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). The NLR was significantly associated with the development of death in patients with COVID-19. Hence, NLR is a useful biomarker to predict the all-cause mortality of COVID-19.
Isolation of multidrug-resistant gram-negative bacteria (MDR-GNB) from patients in the community has been increasingly observed. A prediction model for MDR-GNB colonization and infection risk stratification on hospital admission is needed to improve patient care.
A 2-stage, prospective study was performed with 995 and 998 emergency department patients enrolled, respectively. MDR-GNB colonization was defined as isolates resistant to 3 or more classes of antibiotics, identified in either the surveillance or early (≤48 hours) clinical cultures.
A score-assigned MDR-GNB colonization prediction model was developed and validated using clinical and microbiological data from 995 patients enrolled in the first stage of the study; 122 of these patients (12.3%) were MDR-GNB colonized. We identified 5 independent predictors: age>70 years (odds ratio [OR], 1.84 [95% confidence interval (CI), 1.06–3.17]; 1 point), assigned point value in the model), residence in a long-term-care facility (OR, 3.64 [95% CI, 1.57–8.43); 3 points), history of cerebrovascular accidents (OR, 2.23 [95% CI, 1.24–4.01]; 2 points), hospitalization within 1 month (OR, 2.63 [95% CI, 1.39–4.96]; 2 points), and recent antibiotic exposure (OR, 2.18 [95% CI, 1.16–4.11]; 2 points). The model displayed good discrimination in the derivation and validation sets (area under ROC curve, 0.75 and 0.80, respectively) with the best cutoffs of<4 and ≥4 points for low- and high-risk MDR-GNB colonization, respectively. When applied to 998 patients in the second stage of the study, the model successfully stratified the risk of MDR-GNB infection during hospitalization between low- and high-risk groups (probability, 0.02 vs 0.12, respectively; log-rank test, P<.001).
A model was developed to optimize both the decision to initiate antimicrobial therapy and the infection control interventions to mitigate threats from MDR-GNB.
Gauged river flow records from China generally span only a few decades, which hampers the detection of long-term, decadal- to centennial-scale cycles and trends in streamflow variability. New and updated tree-ring chronologies help reconstructed the water-year (October–September) streamflow for the Aksu River, which is an important river at the edge of the Taklimakan Desert that drains into the Tarim Basin. The reconstruction dates back to 1692 and has an adjusted r2 of 0.61 (1957–2006). Based on frequency, intensity and duration of droughts and pluvial events, the lowest streamflows occurred in the 1920s. Since then streamflow has continuously increased, and was exceptionally rapidly after the 1960s, until today. The start and end of the 20th century to the present were the highest streamflow periods. The mid-20th century was the longest and driest period over the past 300 yr. The reconstructed streamflow series has a strong positive correlation with the North Atlantic Oscillation Index. Changes in mid-latitude circulation patterns influencing precipitation may have indirectly resulted in streamflow variations along the Aksu River over the past 300 yr. The rapid increase and the exceptional streamflows of the 1960s are likely linked with global warming and mid-latitude atmospheric circulation changes.
August–July precipitation has been reconstructed back to AD 1724 for the Mohe region in the northern Greater Higgnan Mountains, China, using Pinus sylvestris var. mongolica tree-ring width. The reconstruction explains 39% of the variance in the precipitation observed from AD 1960–2008. Some droughts noted in historical documents are precisely captured in our reconstruction. Wet periods occurred during the periods of AD 1734–1785, AD 1805–1830, AD 1863–1880, AD 1922–1961, and AD 1983–1998; while the periods of AD 1786–1804, AD 1831–1862, AD 1881–1921, and AD 1962–1982 were relatively dry. Power spectral and wavelet analyses demonstrated the existence of significant 24-yr, 12-yr, and 2-yr cycles of variability. The results of the spatial correlations suggest that our reconstruction contains climatic signals for the southern Stanovoy Range and the northern Greater Higgnan Mountains. The positive correlations between the new reconstructed precipitation series and two precipitation reconstructions indicate that our precipitation reconstruction captures broad-scale regional climatic variations. A comparison between the weakening tendency of summer monsoon and the dry period of our reconstruction reveals that the annual precipitation in the Mohe region is partly influenced by the East Asian Summer Monsoon.
We have developed a low cost and convenient approach to fabricate ITO-comparable transparent electrodes by using solution process of silver nanowires mixed with poly peroxotitanic acid (PPT) gel. The PPT gel is applied to connect the dispersed silver nanowires to preserve its high conductivity while remaining transparency and reducing surface roughness of the transparent electrode. The silver nanowires were synthesized via a modified polyol method, and the PPT gels were prepared by sol-gel method in appropriate concentrations. After applying the PPT gels, the sheet resistance of the transparent electrodes was improved from 192 Ω/□ to 44.7 Ω/□ with a transmittance of 81 %. And the roughness (RMS) was decreased from 106.3 nm to 48.1 nm. The PPT gel also improved the reliability of the proposed electrodes, which the conductivity was remained after general atmospheric storage of 6 months. We also demonstrate an Alq3 based OLED with the proposed transparent electrodes.
Three robust tree-ring density chronologies were developed for the western Tianshan Mountains of northwestern China. The chronologies were significantly correlated and form a regional chronology (GLD). The GLD had significant and positive correlations with temperature of warm seasons. Based on this relationship, the mean minimum temperatures of May to August were reconstructed using the GLD chronology for the period AD 1657 to 2008. The temperature reconstruction exhibited temperature patterns on interannual to centennial timescales, and showed that the end of the 20th century is the warmest period in the past 352 years. The reconstructed temperature variation has a teleconnection with large-scale atmospheric–oceanic variability and captures long- and broad-scale regional climatic variations.
The present study examined the effect of glutamine (Gln)-enriched diets before sepsis or Gln-containing total parenteral nutrition (TPN) after sepsis, or both, on the phagocytic activity and blood lymphocyte subpopulation in rats with gut-derived sepsis. Rats were assigned to a control group or one of four experimental groups. The control group and groups 1 and 2 were fed a semipurified diet; groups 3 and 4 had part of casein replaced by Gln. After feeding the diets for 10d, sepsis was induced by caecal ligation and puncture (CLP); TPN was maintained for 3d after CLP. The control group and groups 1 and 3 were infused with conventional TPN and groups 2 and 4 were supplemented with Gln in the TPN solution. All rats were killed 3d after CLP or sham operation to examine their immune responses. The results showed that compared with the control group, the phagocytic activities of peritoneal macrophages were enhanced in groups 3 and 4, but not in groups 1 and 2. The proportion of CD3+ cells in group 1 was significantly lower (P<0·05) than that of the control group, whereas no differences were observed among the control and Gln-supplemented groups. The CD4+ cell proportion was significantly lower (P<0·05) in group 1 compared with the control group and groups 3 and 4. These findings suggest that Gln-enriched diets before CLP significantly enhanced peritoneal macrophage phagocytic activity, preserved CD4+ cells and maintained blood total T lymphocytes in gut-derived sepsis. However, parenteral Gln administration after caecal ligation and puncture had no favourable effects on modulating immune response in septic rats.
We studied the incidence and clinical significance of early post-traumatic seizures after severe closed head injury.
This prospective study is based on clinical observation of 3340 adult patients with severe closed head injuries, each of them having a Glasgow Coma Scale (GCS) 3 to 8 after trauma. Anticonvulsant agents were not given to these patients unless there was evidence of seizure.
One hundred and twenty-one patients (3.6%) experienced seizures within 1 week after head injury; 42 of these (1.26% of the series) had seizures within 24 hours after trauma. The incidence of intracerebral parenchymal damage was found to be higher among those patients who developed seizures in the first week (66.1%) than in those who did not (62.7%). However this result did not reach statistical significance. The patients with early seizures had a lower mortality rate (p < 0.01). In patients who survived from the initial injury, the occurrence of early post-traumatic seizures did not appear to influence the neurological recovery at 6 months after injury.
Presence of intracerebral parenchymal damage on CT scan after severe closed head injury does not increase the risk of early post-traumatic seizures. With proper treatment, patients presenting with early seizures may have a lower mortality rate. However, the occurrence of early seizures does not influence the neurological recovery in patients who survive the initial severe closed head injury.
Email your librarian or administrator to recommend adding this to your organisation's collection.