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Craft story recall test in the National Alzheimer’s Coordinating Center Uniformed Data Set 3 (NACC UDS3) neuropsychological battery has been employed to assess verbal memory and assist clinical diagnosis of mild cognitive impairment (MCI) and dementia. While a Chinese version of the test was adapted, no existing literature has examined the diagnostic validity of the test in Chinese Americans. This study aimed to evaluate the predictive validity of both immediate and delayed recall.
Participants and Methods:
The Chinese version of Craft Story was administered in to 78 Chinese participants per their language preference of Mandarin or Cantonese. Outcome measures were verbatim and paraphrase recall of the story immediately and after a 20-minute delay. A multiple linear regression was performed to investigate the association of each outcome measure with age, education, gender, age when moved to the U.S., years in the U.S., and testing language. To assess its diagnostic value, cutoff standard deviation scores of -1.5 and -2.0 from the mean of the clinically cognitive normal participants were generated for MCI and dementia diagnoses, respectively. Due to the small sample size, a normative group fitting the mean age (73 years), years of education (12 years), and the majority gender (female) of the current sample were used to identify standard cut points. A receiver-operating characteristic analysis was used to compare predicted diagnosis with actual clinical diagnosis obtained through patients’ overall performance and a consensus meeting by licensed clinicians.
Results:
Younger age (p < 0.05) and being tested in Mandarin (p < .01) were positively associated with immediate and delayed recall. Strong positive correlations between each measure were observed (all p < .001), indicating a significant relationship between information encoded and retained. Among all the participants, 15 (19.2%) were diagnosed with MCI and 22 (28.2%) with dementia. For MCI diagnosis, the standard cutoff scores demonstrated adequate sensitivity (verbatim=82%, paraphrase=91%) but low specificity (verbatim=44%, paraphrase=67%) in all outcome measures. For dementia diagnosis, delayed recall showed strong sensitivity (100%) and adequate specificity (75%) in both verbatim and paraphrasing scores. Immediate recall paraphrase (sensitivity = 95%, specificity = 50%) showed a better sensitivity but lower specificity than verbatim scoring (sensitivity = 86%, specificity = 58%). The accuracy was higher in delayed recall for both MCI and dementia diagnosis. A preliminary analysis on the optimal cut points indicated higher cutoff scores to distinguish MCI and dementia from clinically cognitive normal population, and from each other (e.g., the optimal cut point for delayed verbatim in distinguishing MCI from normal is 8.0 (sensitivity=89%, specificity=73%, AUC=84.3%)).
Conclusions:
Consistent with previous literature, Craft Story delayed recall served as a more accurate diagnostic tool for both MCI and dementia compared to immediate recall in older Chinese Americans. However, poor specificity might increase the chance of following false positive subjects in clinical trials. In addition, testing language appeared to impact performance on verbal memory recall of constructed information. Thus, future studies should focus on developing normative scores that address both the overall cultural differences of Chinese Americans and the heterogeneity within this population.
Suppose you need to complete a task of 5 steps, each of which has equal difficulty and pass rate. You somehow have a privilege that can ensure you pass one of the steps, but you need to decide which step to be privileged before you start the task. Which step do you want to privilege? Mathematically speaking, the effect of each step on the final outcome is identical, and so there seems to be no prima facie reason for a preference. Five studies were conducted to explore this issue. In Study 1, participants could place the privilege on any of steps 1–5. Participants were most inclined to privilege step 5. In Study 2, participants needed to pay some money to purchase the privilege for steps 1–5, respectively. Participants would pay most money for step 5. Study 3 directly reminded participants that the probability of success of the whole task is mathematically the same, no matter on which step the privilege is placed, but most of the participants still prefer to privilege the final step. Study 4 supposed that the outcomes of all steps were not announced until all steps were finished, and asked how painful participants would feel if they passed all steps but one. People thought they would feel most painful when they failed at the final step. In Study 5, an implicit association test showed that people associated the first step with easy and the final step with hard. These results demonstrated the phenomenon of the final step effect and suggested that both anticipated painfulness and stereotype may play a role in this phenomenon.
This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.
Using a sample of 21,628 firm-year observations from the Chinese stock market during the period of 2008–2017, this study finds that the divorce–marriage ratio, the proxy for marital demography, is significantly positively associated with corporate greenwashing. This finding suggests that higher divorce–marriage ratio is associated with stronger individualistic social atmosphere, lower conformity to social norms, and more unfavorable attitude towards environmental conservation, abets firms to talk the talk rather than walk the walk, and foments corporate greenwashing. Moreover, China's Environmental Protection Law attenuates above positive relation. Lastly, our conclusions are robust to sensitivity tests using the divorce rate, alternative proxies for greenwashing, and individual-level divorce data, and further our findings are also valid after addressing the endogeneity issue.
It is essential to investigate the experiences behind why adolescents start and continue to self-harm in order to develop targeted treatment and prevent future self-harming behaviours.
Aims
The aims of this study are to understand the motivations for initiating and repeating nonfatal self-harm, the different methods used between first-time and repeated self-harm and the reasons that adolescents do not seek help from health services.
Methods
Adolescents with repeated nonfatal self-harm experiences were recruited to participate in individual, semi-structured qualitative interviews. The interviews were analysed with interpretative phenomenological analysis.
Results
We found that nonfatal self-harm among adolescents occurred comparatively early and was often triggered by specific reasons. However, the subsequent nonfatal self-harm could be causeless, with repeated self-harm becoming a maladaptive coping strategy to handle daily pressure and negative emotions. The choice of tools used was related to the ease of accessibility, the life-threatening risk and the size of the scars. Adolescents often concealed their scars on purpose, which made early identification insufficient. Peer influence, such as online chat groups encouraging self-harm by discussing and sharing self-harm pictures, could also lead to increased self-harm. The results also included participants’ opinions on how to stop nonfatal self-harm and their dissatisfaction with the current healthcare services.
Conclusions
The current study provides important implications both for early identification and interventions for adolescents who engage in repeated nonfatal self-harm, and for individualising treatment planning that benefits them. It is also worthwhile to further investigate how peer influence and social media may affect self-harm in adolescents.
The spring-tine harrow is gaining popularity for mechanical weeding. However, its weeding performance and mechanism have not been well understood. A spring-tine harrow was first tested in a controlled indoor soil bin at four different travel speeds (4, 6, 8, and 10 km h−1) with three different spring-loading settings (low, medium, and high). Then the harrow was tested in a wheat (Triticum aestivum L.) field at the same spring-loading settings at three different weeding timings (early, middle, and late) in 2019 and 2020. Soil cutting forces (draft and vertical), soil displacements (forward and lateral), soil working depth, weed control efficacy, weed density, and crop damage were measured. The results showed that the spring-loading setting had a more dominant effect on working depth and soil cutting forces than the speed. The soil displacements were more dependent on the speed compared with the spring-loading setting. Treatment effects on weeding performance indicators in the field were similar across years. Adjusting the spring-loading setting from low to high improved the weeding efficacy from 44.9% to 73.9% in 2019 and from 51.6% to 78.1% in 2020. Consequently, the final weed density was minimized at the high loading setting, with the reduction in 2020 being significant. The middle weeding timing caused the least crop damage, while reducing the final weed density by approximately one-third compared with the control (without mechanical weeding), which was the most desired outcome among the three timings tested.
The outbreak of COVID-19 generated severe emotional reactions, and restricted mobility was a crucial measure to reduce the spread of the virus. This study describes the changes in public emotional reactions and mobility patterns in the Chinese population during the COVID-19 outbreak.
Methods
We collected data on public emotional reactions in response to the outbreak through Weibo, the Chinese Twitter, between 1st January and 31st March 2020. Using anonymized location-tracking information, we analyzed the daily mobility patterns of approximately 90% of Sichuan residents.
Results
There were three distinct phases of the emotional and behavioral reactions to the COVID-19 outbreak. The alarm phase (19th–26th January) was a restriction-free period, characterized by few new daily cases, but a large amount public negative emotions [the number of negative comments per Weibo post increased by 246.9 per day, 95% confidence interval (CI) 122.5–371.3], and a substantial increase in self-limiting mobility (from 45.6% to 54.5%, changing by 1.5% per day, 95% CI 0.7%–2.3%). The epidemic phase (27th January–15th February) exhibited rapidly increasing numbers of new daily cases, decreasing expression of negative emotions (a decrease of 27.3 negative comments per post per day, 95% CI −40.4 to −14.2), and a stabilized level of self-limiting mobility. The relief phase (16th February–31st March) had a steady decline in new daily cases and decreasing levels of negative emotion and self-limiting mobility.
Conclusions
During the COVID-19 outbreak in China, the public's emotional reaction was strongest before the actual peak of the outbreak and declined thereafter. The change in human mobility patterns occurred before the implementation of restriction orders, suggesting a possible link between emotion and behavior.
This paper presents a complete two-step phase-shifting (TSPS) spectral phase interferometry for direct electric-field reconstruction (SPIDER) to improve the reconstruction of ultrafast optical fields. Here, complete TSPS acts as a balanced detection that can not only remove the effect of the dc term of the interferogram, but also reduce measurement noises, and thereby improve the capability of SPIDER to measure the pulses with narrow spectra or complex spectral structures. Some prisms are chosen to replace some environment-sensitive optical components, especially reflective optics to improve operating stability and improve signal-to-noise ratio further. Our experiments show that the available shear can be decreased to 1.5% of the spectral width, which is only about $1/3$ compared with traditional SPIDER.
Patient’s needs and rights are the key to delivering state-of-the-art modern nursing care. It is especially challenging to provide proper nursing care for patients who are reaching the end of life (EOL). In Chinese culture nursing practice, the perception and expectations of these EOL patients are not well known. This article explores the feelings and wishes of 16 terminally ill Chinese cancer patients who are going through the dying process. An open-ended questionnaire with eight items was used to interview 16 terminally ill Chinese cancer patients, and was then analyzed by a combined approach employing grounded theory and interpretive phenomenological analysis. Four dimensions were explored: first, patient’s attitudes towards death, such as accepting the fact calmly, striving to survive, and the desire for control; second, the care desired during the dying process, including avoiding excessive treatment and dying with dignity; third, the degree of the patient’s acceptance of death; and fourth, the consequences of death. This cognitive study offers a fundamental understanding of perceptions of death of terminally ill cancer patients from the Chinese culture. Their attitude toward death was complex. They did not prefer aggressive treatment and most of them had given a great deal of thought to their death.
The structural integrity of nuclear fission and fusion power plant components is the focus of this research. The state of the art is using micro scale specimens milled with a focussed ion beam (FIB). Because of their very low volume such specimens can be lab tested, even when irradiated to low or medium level of activity. This offers a possibility of testing multiple specimens to investigate stochastic effects, e.g. effects of irradiation on the shift of the ductile to brittle transition. However, FIB milled specimens suffer from Ga contamination, to the degree that the validity of fracture data obtained on such specimens is questionable. We propose to use nano-additive manufacturing as an alternative to FIB for making micro scale fracture specimens. A combination of two-photon polymerization and electrodeposition and sputtering was used to manufacture micro-scale Brazilian disk fracture specimens (CBD), which are free from Ga and thus better suited for the study of irradiation effects on structural integrity. In this study Ni CBD specimens were made with 30 µm diameter and up to 13 µm thickness. The slot width varied between 1 µm to 2.9 µm width the corresponding slot length of between 7.5 µm and 8 µm. Consecutive FIB characterization shows that the specimens have polycrystalline microstructure with sub-µm grains. The work is ongoing making W CBD specimens and on reducing the slot width and using chemical vapor deposition fabrication.
This research was designed for the first time to investigate the photocatalytic activities of MoO3/g-C3N4 composite in converting CO2 to fuels under simulated sunlight irradiation. The composite was synthesized using a simple impregnation-heating method and MoO3 nanoparticles was in situ decorated on the g-C3N4 sheet. Characterization results indicated that the introduction of MoO3 nanoparticles into g-C3N4 fabricated a direct Z-scheme heterojunction structure. The effective interfacial charge-transfer across the heterojunction significantly promoted the separation efficiency of charge carriers. The optimal CO2 conversion rate of the composite reached 25.6 μmol/(h gcat), which was 2.7 times higher than that of g-C3N4. Additionally, the synthesized MoO3/g-C3N4 also presented excellent photoactivity in RhB degradation under visible-light irradiation.
Objective: To study the relationship of Nε-(carboxymethyl)-lysine level (CML)
with microstructure changes of white matter (WM), and cognitive impairment
in patients with type 2 diabetes mellitus (T2DM) and to discuss the
potential mechanism underlying T2DM-associated cognitive impairment. Methods: The study was performed in T2DM patients (n=22) with disease course
≥5 years and age ranging from 65 to 75 years old. A control group consisted
of 25 sex- and age-matched healthy volunteers. Fractional anisotropy (FA) of
several WM regions was analyzed by diffusion tensor imaging scan. Plasma CML
levels were measured by enzyme-linked immunosorbent assay, and cognitive
function was assessed by Mini-Mental State Examination and Montreal
cognitive assessment (MoCA). Results: The total Mini-Mental State Examination score in the patient group
(25.72±3.13) was significantly lower than the control group (28.16±2.45)
(p<0.05). In addition, the total MoCA score in the patient group
(22.15±3.56) was significantly lower than the control group 25.63±4.12)
(p<0.01). In the patient group, FA values were significantly decreased in
the corpus callosum, cingulate fasciculus, inferior fronto-occipital
fasciculus, parietal WM, hippocampus, and temporal lobes relative to
corresponding regions of healthy controls (p<0.05). Plasma CML level was
negatively correlated with average FA values in the global brain (r=−0.58,
p<0.01) and MoCA scores (r=−0.47, p<0.05). Conclusions: In T2DM, WM microstructure changes occur in older patients, and
elevations in CML may play a role in the development of cognitive
impairment.
Many studies have suggested that folate-related one-carbon metabolism-related nutrients may play a role in certain cancer risks, but few studies have assessed their associations with the risk for nasopharyngeal carcinoma (NPC). In this study, we investigated the association between four folate-related one-carbon metabolism-related nutrients (folate, vitamin B6, vitamin B12 and methionine) and NPC risk in Chinese adults. A total of 600 patients newly diagnosed (within 3 months) with NPC were individually matched with 600 hospital-based controls by age, sex and household type (urban v. rural). Folate, vitamin B6, vitamin B12 and methionine intakes were measured using a validated seventy-eight-item FFQ. A higher dietary folate or vitamin B6 intake was associated with a lower NPC risk after adjusting for potential confounders. The adjusted OR of NPC for quartiles 2–4 (v. 1) were 0·66 (95 % CI 0·48, 0·91), 0·52 (95 % CI 0·37, 0·74) and 0·34 (95 % CI 0·23, 0·50) (Ptrend<0·001) for folate and 0·72 (95 % CI 0·52, 1·00), 0·55 (95 % CI 0·39, 0·78) and 0·44 (95 % CI 0·30, 0·63) (Ptrend<0·001) for vitamin B6. No significant association with NPC risk was observed for dietary vitamin B12 or methionine intake. The risk for NPC with dietary folate intake was more evident in the participants who were not exposed to toxic substances than in those who were exposed (Pinteraction=0·014). This study suggests that dietary folate and vitamin B6 may be protective for NPC in a high-risk population.
Novel hybrid diblock copolymers consisting of bidentate ligand-functionalized chains have been synthesized via click reaction and RAFT radical polymerization. The chemical structure and molecular weight of the synthesized poly(methacrylate-POSS)-block-poly(4-vinylbenzyl-2-pyridine-1H-1,2,3-triazole) (PMAPOSS-b-PVBPT) were characterized by NMR and GPC. The copolymers had been utilized to construct metal-containing polymer micelle by the metal–ligand coordination and electrostatic interaction in this study. The self-assembly behaviors of PMAPOSS-b-PVBPT in chloroform, a common solvent, under the effect of Zn(OTf)2 and HAuCl4 were investigated by TEM, DLS, and variable temperature NMR. Besides, micellization of this diblock copolymer was achieved in ethylene glycol, a selective solvent for PMAPOSS-b-PVBPT. The experimental results revealed that the incorporation of heterocyclic rings bearing nitrogen atoms in polymer side chains played an important role in the construction of metal-containing copolymer micelles. The prepared metal-containing PMAPOSS-b-PVBPT micelles had good dynamic and thermal stability due to the strong metal–ligand coordination interaction and electrostatic interaction.
The microstructures of the cast Mg–3Al–1Zn–xCe (x = 0, 0.2, 0.4, 0.8, and 1.2 wt%) alloys produced by twin-roll casting were observed to reveal the effect of cerium (Ce) on the Mg–3Al–1Zn (AZ31) alloy. Transmission electron microscopy (TEM) image of Al4Ce particles at the centers of grains was observed, and the crystallographic calculations between Al4Ce and α-Mg were examined on the basis of the edge-to-edge matching model. The results indicated that the addition of Ce effectively reduces the grain size of the cast AZ31 alloy produced by twin-roll casting. The finest grains with an average grain size of 55 μm are achieved at 0.4 wt% addition of Ce. TEM observation and good crystallographic matching between Al4Ce and α-Mg suggest that promotion of heterogeneous nucleation of α-Mg on Al4Ce particles formed in the melt is responsible for the grain refinement when adding Ce to the cast AZ31 alloy.
Accumulated evidence suggests that social support is influenced by genetic and environmental factors. However, there are little data that examine this issue from Asian samples. We reported results from a preliminary study that examined familial effects on social support in a Chinese adult twin sample. We administered a 10-item social support instrument that measures three dimensions of social support (i.e., objective support, subjective support, and utilization of support) developed for the Chinese population. Two hundred forty-two same-sex twin pairs, where both members of the pair completed the personal interview, were included in the final analysis. Structural equation modeling was used to estimate additive genetic (A), shared environmental (C), and nonshared environmental (E) effects on each dimension of social support. Familial factors (A+C) explained 56.63% [95% CI = 45.48–65.72%] and 42.42% [95% CI = 29.93–53.25%] of the total phenotypic variances of subjective support and utilization of support, respectively. For the objective support, genetic effects did not exist, but common environmental effect explained 37.56% [95% CI = 26.17–48.28%] of the total phenotypic variances. Neither gender nor age effects were seen on any dimension of social support. Except for objective support, genetic factors probably influence variation in subjective support and utilization of support. Shared environmental factors may influence all dimensions of social support.
A joule level of XeF(C-A) laser optically pumped by a sectioned
surface discharge was developed. The irradiative intensity of pumping
source was diagnosed by calculating XeF2 photo-dissociation
wave evolvement which was photographed by a framing camera. The photon
flux in the wavelength region of 140 to 170nm is about 5 ×
1023 photon s−1cm−2, that
corresponds to the irradiative brightness temperature of more than 25000
K. The laser experiments were carried out in different conditions. The
maximum laser output energy of 2.5 J was obtained with the total
conversion efficiency of 0.1%.
Prostaglandin E2 (PGE2) is shown to be essential for female reproduction. Cyclooxygenase (COX) is a rate-limiting enzyme in prostaglandin synthesis from arachidonic acid and exists in two isoforms: COX-1 and COX-2. Prostaglandin E synthase (PGES) is a terminal prostanoid synthase and can catalyse the isomerization of the COX product PGH2 to PGE2, including microsomal PGES-1 (mPGES-1), cytosolic PGES (cPGES) and mPGES-2. This study examined the protein expression of COX-1, COX-2, mPGES-1, cPGES and mPGES-2 in preimplantation mouse embryos by immunohistochemistry. Embryos at different stages collected from oviducts or uteri were transferred into a flushed oviduct of non-pregnant mice. The oviducts containing embryos were paraffin-embedded and processed for immunostaining. COX-1 immunostaining was at a basal level in zygotes and a low level at the 2-cell stage, reaching a high level from the 4-cell to blastocyst stage. COX-2 immunostaining was at a low level at the zygote stage and was maintained at a high level from the 2-cell to blastocyst stages. A low level of mPGES-1 immunostaining was observed from the zygote to 8-cell stages. The signal for mPGES-1 immunostaining became stronger at the morula stage and was strongly seen at the blastocyst stage. cPGES immunostaining was strongly observed in zygotes, 2-cell and 8-cell embryos. There was a slight decrease in cPGES immunostaining at the 4-cell, morula and blastocyst stages. mPGES-2 immunostaining was at a low level from the zygote to morula stages and at a high level at the blastocyst stage. We found that the COX-1, COX-2, mPGES-1, cPGES and mPGES-2 protein signals were all at a high level at the blastocyst stage. PGE2 produced during the preimplantation development may play roles during embryo transport and implantation.