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There seems to be geographical differences in decisions about breast conserving surgery (BCS) in breast cancer patients. This study was to evaluate patients’ attitude to BCS and to assess the factors affecting cancer practice in West China.
A structured questionnaire was distributed to 184 patients, eliciting information about the patients’ characteristics, occupation, education, family life, recognition of illness, knowledge about BCS, the main means of gaining surgery information, selecting surgery approaches, preferences to breast reservation.
In all, 163 patients completed the questionnaire. The results indicated that only 7.4% of patients received BCS and 23% of the remaining patients desired to have BCS and the affecting factors were significantly associated with their family life, recognition of illness and the main means of gaining surgery information (P < 0.05). No associations were between BCS selecting and the other variables studied. The most frequent reasons for selecting BCS were keeping the female shape and improving quality of life (71%), the second most were postoperative recovery, minimal influence of physical function (47%) and patients’ knowledge about BCS (42%). The most frequent reasons for not selecting BCS were uncertainty about BCS results and worry about recurrence (81%), the second most was the elderly age unnecessary for BCS (40%).
The findings indicate that breast cancer patients in West China do not take BCS as the first choice as the best treatment method. It is warranted that further study of more patients, attitude of patients’ partners and physicians to BCS.
To explore the factors associated with occurrence of suicidal risk after treatment of Selective Serotonin Reuptake Inhibitor (SSRI) in bipolar disorder with their first depressive episode.
One hundred and seventy seven bipolar patients were enrolled in this retrospective study. Demographic and clinic features between non-occurrence of suicidal risk group and occurrence of suicidal risk group were compared. Stepwise Logistic regression model was used to identify the associated factors. Concordance statistics (i.e. the area under the ROC curve) was used to compute the discrimination of the associated factors, and Hosmer-Lemeshow goodness-of-fit statistic was used to measure the goodness-of-fit.
One hundred and fifty four patients were included in non-occurrence of suicidal risk group, while twenty three were included in occurrence of suicidal risk group. Clinical features associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder were as follows: symptom of irritability (OR=4.04, 95 CI:1.40-11.67) and psychotic symptom (OR=6.23, 95 CI:1.40-27.56).
This study demonstrated indicated that psychotic symptom and symptom of irritability were associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder, and it suggested that these two symptoms might be potential to be the predictors of occurrence of suicidal risk after treatment of SSRI in bipolar disorder.
Patients with severe mental disorders in low-resource settings have limited access to services, resulting in overwhelming caregiving burden for families. In extreme cases, this has led to the long-term restraining of patients in their homes. China underwent a nationwide initiative to unlock patients and provide continued treatment. This study aims to quantify household economic burden in families after unlocking and treatment, and to identify factors associated with increased burden due to schizophrenia.
A total of 264 subjects were enrolled from three geographically diverse provinces in 2012. Subjects were patients with schizophrenia who were previously put under restraints and had participated in the ‘unlocking and treatment’ intervention. The primary outcome was the current household economic burden, obtained from past year financial information collected through on-site interview. Patient disease characteristics, treatment, outcomes and family caregiving burden were collected as well. Univariate and multivariate linear regression were used to construct risk factor models for indirect economic burden.
After participating in the intervention, 85% of patients continued to receive mental health services, 70% used medication as prescribed and 80% were never relocked. Family members reported significantly decreased caregiving burden after receiving the intervention. Mean direct and indirect household economic burdens were CNY963 (US$31.7) and CNY11 724 (US$1670) per year, respectively, while family total income was on average CNY12 108 (US$1913) per year. Greater disease severity and poorer patient psychosocial function at time of study were found to be independent factors related to increased indirect burden.
The ‘unlocking and treatment’ intervention has improved the lives of patients and families. Indirect burden due to disease is still a major economic issue that needs to be addressed, potentially through improving treatment and patient functioning. Our findings contribute to the unravelling and eventual elimination of chronic restraining of mentally ill patients in low-resource settings.
This paper presents a numerical approach to predict the thermal residual stresses in polymer nanocomposites reinforced with a periodic array of wavy carbon nanotubes. A three dimensional unit cell model is established to accurately account for the waviness of the nanotube. Periodic boundary conditions are determined for the unit cell with a pair of curved surfaces. Appropriate methods to evaluate the macroscopic stresses and strains are also determined for the unit cell model in which the interior pores of the nanotubes are explicitly included. It is demonstrated that the macroscopic behavior of the nanocomposites is orthotropic due to the symmetries manifested. By employing material properties of the two constituents, the thermal residual stresses and strains induced by high temperature curing and cooling-down are predicted for an epoxy/wavy-nanotube composite. It is also demonstrated that the curing process tends to increase the waviness of the nanotube and the waviness has a significant influence on the distribution of the microscopic residual stresses.
A greater understanding of the rumen microbiota and its function may help find new strategies to improve feed efficiency in cattle. This study aimed to investigate whether the cattle breed affects specific ruminal taxonomic microbial groups and functions associated with feed conversion ratio (FCR), using two genetically related Angus breeds as a model. Total RNA was extracted from 24 rumen content samples collected from purebred Black and Red Angus bulls fed the same forage diet and then subjected to metatranscriptomic analysis. Multivariate discriminant analysis (sparse partial least square discriminant analysis (sPLS-DA)) and analysis of composition of microbiomes were conducted to identify microbial signatures characterizing Black and Red Angus cattle. Our analyses revealed relationships among bacterial signatures, host breeds and FCR. Although Black and Red Angus are genetically similar, sPLS-DA detected 25 bacterial species and 10 functions that differentiated the rumen microbial signatures between those two breeds. In Black Angus, we identified bacterial taxa Chitinophaga pinensis, Clostridium stercorarium and microbial functions with large and small subunits ribosomal proteins L16 and S7 exhibiting a higher abundance in the rumen microbiome. In Red Angus, nonetheless, we identified the poorly characterized bacterial taxon Oscillibacter valericigenes with a higher abundance and pathways related to carbohydrate metabolism. Analysis of composition of microbiomes revealed that C. pinensis and C. stercorarium exhibited a higher abundance in Black Angus compared to Red Angus associated with FCR, suggesting that these bacterial species may play a key role in the feed conversion efficiency of forage-fed bulls. This study highlights how the discovery of signatures of bacterial taxa and their functions can be used to harness the full potential of the rumen microbiome in Angus cattle.
Characterizing ruminal parameters in the context of sampling routine and feed efficiency is fundamental to understand the efficiency of feed utilization in the bovine. Therefore, we evaluated microbial and volatile fatty acid (VFA) profiles, rumen papillae epithelial and stratum corneum thickness and rumen pH (RpH) and temperature (RT) in feedlot cattle. In all, 48 cattle (32 steers plus 16 bulls), fed a high moisture corn and haylage-based ration, underwent a productive performance test to determine residual feed intake (RFI) using feed intake, growth, BW and composition traits. Rumen fluid was collected, then RpH and RT logger were inserted 5.5±1 days before slaughter. At slaughter, the logger was recovered and rumen fluid and rumen tissue were sampled. The relative daily time spent in specific RpH and RT ranges were determined. Polynomial regression analysis was used to characterize RpH and RT circadian patterns. Animals were divided into efficient and inefficient groups based on RFI to compare productive performance and ruminal parameters. Efficient animals consumed 1.8 kg/day less dry matter than inefficient cattle (P⩽0.05) while achieving the same productive performance (P⩾0.10). Ruminal bacteria population was higher (P⩽0.05) (7.6×1011v. 4.3×1011 copy number of 16S rRNA gene/ml rumen fluid) and methanogen population was lower (P⩽0.05) (2.3×109v. 4.9×109 copy number of 16S rRNA gene/ml rumen fluid) in efficient compared with inefficient cattle at slaughter with no differences (P⩾0.10) between samples collected on-farm. No differences (P⩾0.10) in rumen fluid VFA were also observed between feed efficiency groups either on-farm or at slaughter. However, increased (P⩽0.05) acetate, and decreased (P⩽0.05) propionate, butyrate, valerate and caproate concentrations were observed at slaughter compared with on-farm. Efficient had increased (P⩽0.05) rumen epithelium thickness (136 v. 126 µm) compared with inefficient cattle. Efficient animals also spent 318% and 93.2% more time (P⩽0.05) in acidotic (4.14% v. 1.30%) (pH⩽5.6) and optimal (5.6<pH<6.0) (8.53% v. 4.42%) RpH range compared with inefficient cattle. The circadian patterns revealed lower (P⩽0.05) RpH and no differences (P⩾0.10) in RT pre-, during, and post-prandial periods in efficient compared with inefficient cattle. In essence, superior feed efficiency in cattle seems linked to rumen features consistent with improved efficiency of feed utilization. Microbial abundance, rumen epithelial histomorphology, and RpH, may serve as indicators for feed efficiency in cattle. The divergences of assessments made on-farm and at slaughter should be considered in the development of proxies for feed efficiency.
The present work focuses on the deformation and recovery mechanisms of aged monoclinic U–Nb alloy under tension and load–unload cycle testing using in situ X-ray diffraction (XRD). The U–6.2wt% Nb (U–6.2Nb) alloy was prepared and aged at 200 °C, and then underwent tensile testing followed by the in situ XRD. The experimental results indicate that the change of diffraction peaks can serve to accurately characterize the macroscopic deformation and recovery. Compared with the as-quenched alloy, the aged U–6.2Nb alloy displays different behavior during deformation and subsequent recovery. Phase transformation competes with twin rearrangement to dominate the deformation and recovery between elastic stage and slip stage of the alloy. The lattice plane relationship between α″ and γ° during phase transformation has also been given.
Fracture analysis is performed on a cylindrical composite consisting of an outer elastic layer, an inner rigid cylinder and an intermediate sliding interface. Interaction between the sliding interface and a parallel crack under in-plane shear is explored. An interesting phenomenon of oscillatory normal stress occurs on the local interfacial region near to the crack. It leads to local sliding-prevention and promotion effects, which constitute the mechanisms for the variations of stress intensity factors versus interfacial parameters. In addition, another interesting conclusion is that a crack near and parallel to a sliding interface never has the conventional anti-symmetry, even under pure in-plane shear loading.
The study of the evolution of organic matter subjected to space conditions, and more specifically to Solar photons in the vacuum ultraviolet range (120–200 nm) has been undertaken in low-Earth orbit since the 1990s, and implemented on various space platforms. This paper describes a photochemistry experiment called AMINO, conducted during 22 months between 2009 and 2011 on the EXPOSE-R ESA facility, outside the International Space Station. Samples with relevance to astrobiology (connected to comets, carbonaceous meteorites and micrometeorites, the atmosphere of Titan and RNA world hypothesis) have been selected and exposed to space environment. They have been analysed after return to the Earth. This paper is not discussing the results of the experiment, but rather gives a general overview of the project, the details of the hardware used, its configuration and recent developments to enable long-duration exposure of gaseous samples in tight closed cells enabling for the first time to derive quantitative results from gaseous phase samples exposed in space.
We investigated and quantified the factors which may affect the prevalence of cystic echinococcosis caused by Echinococcus granulosus in Rangtang County using a multidisciplinary approach. From a previously performed field survey, epidemiological data were linked with environmental data. Altitude and land surface temperature were extracted from remote-sensing images. Cumulative logistic regression models were used to identify and quantify the potential risk factors. The multiple regression models confirmed that yaks (χ2 = 4·0447, P = 0·0443), dogs (χ2 = 8·3455, P = 0·0039) and altitude (χ2 = 7·6223, P = 0·0058) were positively correlated with the prevalence of cystic echinococcosis, while land surface temperature may have a negative association. The findings showed that dogs and yaks play the most important role in the transmission of cystic echinococcosis, while altitude and land surface temperature may also be involved in the transmission.
The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.
We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.
Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9–6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.
This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
As the product of the wear process, the wear particles record the rich
information to reflect the state of the equipment's inner abrasion. Analysis
of the wear particles in lubricating or hydraulic oils becomes one important
branch of diagnosing the wear states of machine parts. Extracting
characteristic parameter is an indispensable means to analyse wear
particles. In this paper, a method to extract the characteristic parameters
of the wear particle boundary based on chaos theory has been discussed. The
concept of boundary wave has been firstly conducted, and then based on the
Shannon entropy and the theory of phase reconstruction, the concept and the
arithmetic of the singular entropy have been conducted. It has been shown
that the boundary wave of the wear particles is characterised as chaos, so
the singular entropy can be used to describe the complexity of the boundary
of the wear particles. Therefore the singular entropy can be considered as
one of the characteristic parameters of the wear particles.
Actinide isotopes are present in environmental samples at ultra-trace levels (236U concentration is quoted to be on the order of pg/kg or fg/kg). Their detection requires the resolution of mass spectrometry (MS) techniques, but only accelerator mass spectrometry (AMS) has the sensitivity required. In order to perform the isotopic ratio measurements of actinides, such as 236U/238U, an upgrade of the Center for Isotopic Research on Cultural and Environmental Heritage accelerator (CIRCE) in Caserta, Italy, has been performed. The system was originally equipped for radiocarbon AMS measurements. The main difficulty of AMS measurement of 236U is the intense neighboring beam of 238U. Although most of the 238U ions are suppressed by means of magnetic and electrostatic elements, a small fraction of this intense beam can interfere with the rare isotopes. This paper reports the preliminary results of the 236U/238U isotopic ratio measurement limit (<5.6 x 10–11), aimed also to better understand the origin of background ions. For this purpose, a large 16-strip silicon detector providing spatial resolution has been used. In addition, calculations to assess the performance of the system obtained by adding a high-resolution time of flight-energy (TOF-E) detector are discussed.
This paper presents the application of manganese dioxide to
electromagnetic wave absorber. The effective permittivity was calculated by
modified Rayleigh mixing formula, and the electromagnetic wave absorbing
properties of composites with different volume fractions of manganese
dioxide were investigated by the comparison of calculated and experimental
values in 2–12 GHz frequencies. It is found that the pure manganese
dioxide holds a high dielectric constant, which is a function of frequency.
The manganese dioxide composites show high absorbing performance in low
frequencies, and the calculated electromagnetic properties fit the
experimental values for large volume fractions used in this study.
High throughput, thin film synthesis methods have been used to make libraries of diverse metallic and metal-chalcogenide compositions. These libraries have been subject to a variety of screening protocols, including X-ray diffraction (XRD) after repeated annealing steps, and the measurement of temperature dependent electrical properties. The application of these methods for the development of materials for non-magnetic storage media is presented.
High throughput, thin film synthesis and screening methods have been developed to investigate potential bulk metallic glass (BMG) compositions. Physical vapor deposition (PVD) was used for sample synthesis. A novel screening tool was developed to measure changes in resistance vs. temperature of these thin film samples. Example data for 34 compositions in the Mg-rich region of the Mg-Cu-Y ternary system are presented.
In this paper it is shown that the initial stages in the laser-induced roughening in silicon is independent of the atmosphere used, whether it is Ar, vacuum, or SF6. It is also shown that the morphology that results after a few hundred laser pulses strongly depends on the crystallographic orientation of the surface. The morphological features that appear in this first stage have been related to the nature of the solidification process that follows laser melting. A second stage in the roughening process with a dramatic change in morphology takes place when a surface with deep depressions and hills is further irradiated in SF6. Very deep etching occurs in the depressions promoting the formation of microholes that with further irradiation lead to cone formation. It is further shown that the distance between microholes is equal to the distance between the depressions that formed as the initial perturbations developed. Then the wavelength of the initial perturbation and by extension the distance between microholes has been estimated.