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The prediction of prognosis is an important part of management in hepatitis B virus (HBV)-related decompensated cirrhosis patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in HBV-related decompensated cirrhosis patients. We performed a single-centre, observational, retrospective study of 405 HBV-related decompensated cirrhosis patients. Individuals were evaluated within 24 h after admission and the primary outcome was evaluated at 6-months. Multivariable analyses were used to determine whether lactate was independently associated with the prognosis of HBV-related decompensated cirrhosis patients. The area under the ROC (AUROC) was calculated to assess the predictive accuracy compared with existing scores. Serum lactate level was significantly higher in non-surviving patients than in surviving patients. Multivariable analyses demonstrated that lactate was an independent risk factor of 6-months mortality (odds ratio: 2.076, P < 0.001). Receiver operating characteristic (ROC) curves were drawn to evaluate the discriminative ability of lactate for 6-months mortality (AUROC: 0.716, P < 0.001). Based on our patient cohort, the new scores (Model For End-Stage Liver Disease (MELD) + lactate score, Child–Pugh + lactate score) had good accuracy for predicting 6-months mortality (AUROC = 0.769, P < 0.001; AUROC = 0.766, P < 0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001). Serum lactate at admission may be useful for predicting 6-months mortality in HBV-related decompensated cirrhosis patients, and the predictive value of the MELD score and Child–Pugh score was improved by adjusting lactate. Serum lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.
Narrowband microwave generation with tuneable frequency is demonstrated by illuminating a photoconductive semiconductor switch (PCSS) with a burst-mode fibre laser. The whole system is composed of a high-power linearly polarized burst-mode pulsed fibre laser and a linear-state PCSS. To obtain a high-performance microwave signal, a desired envelope of burst is necessary and a pulse pre-compensation technique is adopted to avoid envelope distortion induced by the gain-saturation effect. Resulting from the technique, homogenous peak power distribution in each burst is ensured. The maximum energy of the laser burst pulse reaches 200 μJ with a burst duration of 100 ns at the average power of 10 W, corresponding to a peak power of 4 kW. When the PCSS is illuminated by the burst-mode fibre laser, narrowband microwave generation with tuneable frequency (0.80–1.12 GHz) is obtained with a power up to 300 W. To the best of the authors’ knowledge, it is the first demonstration of frequency-tuneable narrowband microwave generation based on a fibre laser. The high-power burst-mode fibre laser reported here has great potential for generating high-power arbitrary microwave signals for a great deal of applicable demands such as smart adaptive radar and intelligent high-power microwave systems.
Population ageing, together with urbanisation, has become one of the greatest challenges throughout the world in the 21st century. Approximately one million people turn 60 each month worldwide. By 2050, more than 20 per cent of the global population is predicted to be 60 years old or above. Thus, an increasing need is evident for age-friendly communities, services and structures. Numerous studies on age-friendly cities and communities (AFCCs) have been conducted over the past decade. The large volume literature makes it necessary to figure out key areas and the evolution trends of studies on AFCCs. Therefore, this paper aims to provide a comprehensive review of existing literature pertaining to AFCCs. A total of 231 collected publications are analysed and visualised by CiteSpace. According to the keywords and document co-citation networks that are generated, the foundation, hot topics and domains of AFCC research are grouped. Three major themes, namely the characteristics of AFCCs, the application of the World Health Organization's framework in urban and rural areas worldwide, and the measurement of cities’ and communities’ age-friendliness, are identified. In addition, a roadmap of AFCC research is developed. The results of this research will therefore benefit researchers and practitioners.
To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life.
A prospective longitudinal cohort study.
This study was conducted in Shanghai, China.
Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018.
Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor–Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life.
Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = −.051, p = .0006), neurological function (B = −.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = −.100, p =< .0001), depression (B = −.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = −.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = −.014, p = .0273), and time (B = −.031, p < .0001).
Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.
The time to positivity (TTP) of blood cultures has been considered a predictor of clinical outcomes for bacteremia. This retrospective study aimed to determine the clinical value of TTP for the prognostic assessment of patients with Escherichia coli bacteremia. A total of 167 adult patients with E.coli bacteremia identified over a 22-month period in a 3500-bed university teaching hospital in China were studied. The standard cut-off TTP was 11 h in the patient cohort. The septic shock occurred in 27.9% of patients with early TTP (⩽11 h) and in 7.1% of those with a prolonged TTP (>11 h) (P = 0.003). The mortality rate was significantly higher for patients in the early than in the late group (17.7% vs. 4.0%, P < 0.001). Multivariate analysis showed that an early TTP (OR 4.50, 95% CI 1.70–11.93), intensive care unit admission (OR 8.39, 95% CI 2.01–35.14) and neutropenia (OR 4.20, 95% CI 1.55–11.40) were independently associated with septic shock. Likewise, the independent risk factors for mortality of patients were an early TTP (OR 3.80, 95% CI 1.04–12.90), intensive care unit admission (OR 6.45; 95% CI 1.14–36.53), a Pittsburgh bacteremia score ⩾2 (OR 4.34, 95% CI 1.22–15.47) and a Charlson Comorbidity Index ⩾3 (OR 11.29, 95% CI 2.81–45.39). Overall, a TTP for blood cultures within 11 h appears to be associated with worse outcomes for patients with E.coli bacteremia.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
The LiCoO2 films were directly deposited on stainless steel (SS) using medium-frequency magnetron sputtering, and the effects of annealing parameters, such as ambiences, temperatures, holding times, and heating rates, were systematically compared based on surface morphologies, crystal structures, and electrochemical properties. The results demonstrate that an aerobic atmosphere with 3.5 Pa is the most important parameter to maintain the performance of LiCoO2 films. The influence of the annealing temperature (>550 °C) ranks second because the formed (101) or (104) planes of LiCoO2 facilitate Li+ migration. A short holding time of 20 min and a moderate heating rate of 3 °C/min are selected to reduce the oxidation or inter-diffusion between the LiCoO2 films and the SS substrate. Finally, the optimal annealing process is confirmed and corresponds to the initial discharge capacity of 37.56 μA h/(cm2 μm) and the capacity retention of 83.81% at the 50th cycle.
In the present modern age, a robot works like human and is controlled in such a manner that its movements should not create hindrance in human activities. This characteristic involves gesture feat and gesture recognition. This article is aimed to describe the developments in algorithms devised for obstacle avoidance in robot navigation which can open a new horizon for advancement in businesses. For this purpose, our study is focused on gesture recognition to mean socio-technological implication. Literature review on this issue reveals that movement of robots can be made efficient by introducing gesture-based collision avoidance techniques. Experimental results illustrated a high level of robustness and usability of the Gesture recognition (GR) system. The overall error rate is almost 10%. In our subjective judgment, we assume that GR system is very well-suited to instruct a mobile service robot to change its path on the instruction of human.
Compared with traditional stainless steels, high nitrogen stainless steels (HNSS), have been widely used due to their high strength, toughness along with excellent corrosion resistance and low cost, formed by partial replacement of Ni (austenite-forming element) by N. The evolution of the microstructure of a Cr19Mn19Mo2N0.7 stainless steel is investigated after solution treatment at 1010, 1060, 1200 or 1250°C for 30min. A complex multilayer structure has been found under a negative pressure vacuum. A white ferritic layer at the surface is formed, and a subsurface layer with full austenitic structure and a bulk microstructure comprising of austenite and ferrite are detected. With increasing solution temperature, the surface layer thickness increases. The formation of the multilayer structure is attributed to an outward diffusion, a diffusive retardation and an abnormal accumulation of nitrogen during solution treatment.
This study was designed to explore the association between undernutrition in the growth period and cardiovascular risk factors in a middle-aged Chinese population. A total of 1756 subjects, aged 45–60 years, were invited to participate in the Hefei Nutrition and Health Study and divided into three groups according to their self-reported animal food intake in the growth period. Group 1, Group 2 and Group 3 were defined as undernutrition, nutritional improvement and the good nutrition group, respectively. In the three groups, the subjects in Groups 1 and 2 had more oil and salt intake (P<0.001), and less eggs and milk intake (P<0.001), when compared with the subjects in Group 3. After adjusting for age, education, smoking status and other confounding factors, it was found that male participants who experienced nutritional improvement before age 18 had higher risk of hypertension [odds ratio (OR)=1.68; 95% confidence intervals (CI): 1.05, 2.69] than those with good nutrition, and female participants with undernutrition (OR=1.52; 95% CI: 1.01, 2.29) and nutritional improvement (OR=1.68; 95% CI: 1.04, 2.69) before age 18 had a higher risk of hypertension than those with good nutrition. For diabetes, obesity, hypercholesterolemia and hypertriglyceridemia, our results did not found difference among the three groups both in male and female. Our findings indicated that nutritional deficiency in childhood was associated with bad dietary behaviors and a significantly increased risk of hypertension in middle age. Therefore, early adequate nutrition is very important for the prevention of non-communicable diseases later.
CDKN1C and KCNQ1OT1 are imprinted genes that might be potential regulators of placental development. This study investigated placental expressions of CDKN1C and KCNQ1OT1 in monozygotic twins with and without selective intrauterine growth restriction (sIUGR). Seventeen sIUGR and fifteen normal monozygotic(MZ) twin pairs were examined. Placental mRNA expressions of CDKN1C and KCNQ1OT1 were detected by real-time fluorescent quantitative PCR. CDKN1C protein expression was detected by immunohistochemical assay and Western-blotting. In the sIUGR group, smaller fetuses had a smaller share of the placenta, and CDKN1C protein expression was significantly increased while KCNQ1OT1 mRNA expression was significantly decreased. The CDKN1C/KCNQ1OT1 mRNA ratio was lower in the larger fetus than in the smaller fetus (p < .05). In the control group, CDKN1C protein expression showed no difference between larger and smaller fetuses, while KCNQ1OT1 mRNA expression was significantly lower in the larger fetus, and the CDKN1C/KCNQ1OT1 mRNA ratio was higher in the larger fetus than in the smaller fetus (p < .05). Our findings showed that pathogenesis of sIUGR may be related to the co-effect of the up-regulated protein expression of CDKN1C and down-regulated mRNA expression of KCNQ1OT1 in the placenta.
In this paper, Fe–B amorphous submicrometer particles with a size of 180 nm were synthesized by liquid phase reduction method. The as-synthesized Fe–B amorphous submicrometer particles were annealed at 400, 500, and 600 °C, respectively. The effect of annealing temperature on structure, magnetic properties, and microwave absorption properties of Fe–B submicrometer particles was investigated. Results show that the as-synthesized Fe–B amorphous submicrometer particles were crystallized into Fe2B phase when the annealing temperature was 479 °C. The microwave absorption properties of Fe–B submicrometer particles were dependent on annealing temperature, the paraffin composites containing 60 wt% Fe–B submicrometer particles annealed at 500 °C showed a minimal reflection loss (RL) as low as −43.16 dB at 3.12 GHz with a thickness of 5.1 mm, and the effective microwave absorption (RL < −20 dB) was obtained in a wide frequency range of 2.28–10.48 GHz by adjusting the thickness from 1.8 to 6 mm, indicating excellent electromagnetic absorption properties.
We present deep optical spectroscopy of seven planetary nebulae (PNe) in the substructures of M31, three in the Northern Spur and four associated with the Giant Stream. The spectra were obtained with the OSIRIS spectrograph on the 10.4 m GTC. The detection of the [O iii] λ4363 auroral line in all PNe of our sample enables reliable abundance determinations. Our targets have low N/O (<0.5) and He/H ratios, indicating that they are probably Type II PNe. The PNe in our sample have rather homogeneous oxygen abundances, with an average value of 8.56±0.10. Based on the abundances as well as the spatial and kinematical information of our targets, we speculate that the Northern Spur and the Giant Stream might have the same origin. We raise a hypothesis that the dwarf satellite M32 might be responsible for these two substructures. New observations have recently been made to assess this hypothesis.
A comparative study of two classes of third-order implicit time integration schemes is presented for a third-order hierarchical WENO reconstructed discontinuous Galerkin (rDG) method to solve the 3D unsteady compressible Navier-Stokes equations: — 1) the explicit first stage, single diagonally implicit Runge-Kutta (ESDIRK3) scheme, and 2) the Rosenbrock-Wanner (ROW) schemes based on the differential algebraic equations (DAEs) of Index-2. Compared with the ESDIRK3 scheme, a remarkable feature of the ROW schemes is that, they only require one approximate Jacobian matrix calculation every time step, thus considerably reducing the overall computational cost. A variety of test cases, ranging from inviscid flows to DNS of turbulent flows, are presented to assess the performance of these schemes. Numerical experiments demonstrate that the third-order ROW scheme for the DAEs of index-2 can not only achieve the designed formal order of temporal convergence accuracy in a benchmark test, but also require significantly less computing time than its ESDIRK3 counterpart to converge to the same level of discretization errors in all of the flow simulations in this study, indicating that the ROW methods provide an attractive alternative for the higher-order time-accurate integration of the unsteady compressible Navier-Stokes equations.
The tin–bismuth eutectic alloy possesses anomalous physicochemical properties that are dependent on temperature. This paper reports the interfacial reaction and growth behavior of the intermetallic compound (IMC) layer during the dissolution of solid copper in liquid eutectic tin–bismuth at 673–823 K under the influence of the structural transition of liquid eutectic tin–bismuth. The structural transition markedly affected the dissolution rate constant of solid copper and the growth rate of the IMCs. Correspondingly, the application of the liquid structural transition significantly decreased the activation energy of dissolution and increased the apparent activation energy for IMC growth. Moreover, two major roles of elemental Bi on the formation and growth of the IMCs were suggested.
In order to check whether (un)civilised behaviour can be a valid indigenous intergroup comparison dimension for Chinese people, three studies were conducted based on stereotypic explanatory bias (SEB). Study 1 examined the media representation of Chinese and Western (un)civilised behaviours, and the SEB results suggested ingroup derogation of Chinese people regarding civilised behaviour. Study 2 aimed to use a more empirical approach to further analyse Chinese intergroup bias for civilised behaviour at both implicit and explicit levels. Chinese participants’ SEB results indicated ingroup derogation and outgroup favouritism were at the implicit level; however, ingroup favouritism and outgroup derogation were at the explicit level. Study 3 was designed to examine how stereotypes that were verified in Study 2 would be changed by manipulating the presentation of extreme, stereotype-relevant information in the form of an internet blog. These findings suggest that (un)civilised behaviour can be a valid indigenous intergroup comparison dimension for Chinese people who perceive themselves as a disadvantaged group compared to Westerners on this dimension. Finally, theoretical contribution and practical implications for social change are discussed.
The current meta-analysis evaluated the association between vitamin B12 intake and blood vitamin B12 level and colorectal cancer (CRC) risk.
The PubMed and EMBASE databases were searched. A dose–response analysis was performed with generalized least squares regression, with the relative risk (RR) and 95 % CI as effect values.
The meta-analysis included seventeen studies.
A total of 10 601 patients.
The non-linear dose–response relationship between total vitamin B12 intake and CRC risk was insignificant (P=0·690), but the relationship between dietary vitamin B12 intake and CRC risk was significant (P<0·001). Every 4·5 μg/d increment in total and dietary vitamin B12 intake was inversely associated with CRC risk (total intake: RR=0·963; 95 % CI 0·928, 0·999; dietary intake: RR=0·914; 95 % CI 0·856, 0·977). The inverse association between vitamin B12 intake and CRC risk was also significant when vitamin B12 intake was over a dosage threshold, enhancing the non-linear relationship. The non-linear dose–response relationship between blood vitamin B12 level and CRC risk was insignificant (P=0·219). There was an insignificant association between every 150 pmol/l increment in blood vitamin B12 level and CRC risk (RR=1·023; 95 % CI 0·881, 1·187).
Our meta-analysis indicates that evidence supports the use of vitamin B12 for cancer prevention, especially among populations with high-dose vitamin B12 intake, and that the association between CRC risk and total vitamin B12 intake is stronger than between CRC risk and dietary vitamin B12 intake only.
Postnatal rapid growth by excess intake of nutrients has been associated with an increased susceptibility to diseases in neonates with intra-uterine growth restricted (IUGR). The aim of the present study was to determine whether postnatal nutritional restriction could improve intestinal development and immune function of neonates with IUGR using piglets as model. A total of twelve pairs of normal-birth weight (NBW) and IUGR piglets (7 d old) were randomly assigned to receive adequate nutrient intake or restricted nutrient intake (RNI) by artificially liquid feeding for a period of 21 d. Blood samples and intestinal tissues were collected at necropsy and were analysed for morphology, digestive enzyme activities, immune cells and expression of innate immunity-related genes. The results indicated that both IUGR and postnatal nutritional restriction delayed the growth rate during the sucking period. Irrespective of nutrient intake, piglets with IUGR had a significantly lower villous height and crypt depth in the ileum than the NBW piglets. Moreover, IUGR decreased alkaline phosphatase activity while enhanced lactase activity in the jejunum and mRNA expressions of Toll-like receptor 9 (TLR-9) and DNA methyltransferase 1 (DNMT1) in the ileum of piglets. Irrespective of body weight, RNI significantly decreased the number and/or percentage of peripheral leucocytes, lymphocytes and monocytes of piglets, whereas the percentage of neutrophils and the ratio of CD4+ to CD8+ were increased. Furthermore, RNI markedly enhanced the mRNA expression of TLR-9 and DNMT1, but decreased the expression of NOD2 and TRAF-6 in the ileum of piglets. In summary, postnatal nutritional restriction led to abnormal cellular and innate immune response, as well as delayed the growth and intestinal development of IUGR piglets.