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Sporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.
This study topologically describes near-wall flows around a surface-mounted cylinder at a high Reynolds number ($Re$) of $5\times 10^4$ and in a very thick boundary layer, which were partially measured or technically approximated from the literature. For complete and rational flow construction, we use high-resolution simulations and critical-point theory. The large-scale near-wake vortex is composed of two connected segments rolled up from the sides of the cylinder and from the free end. Another large-scale side vortex clearly roots on two notable foci on the lower side wall. In the junction region, the side vortex moves upwards with a curved trajectory, which induces the formation of nodes on the ground surface. In the free-end region, the side vortex is compressed, which results in a smaller trailing-edge vortex and its downstream movement. Only tip vortices are observed in the far wake. The origin of the tip vortices and their distinction from the near-wake vortex are discussed. Further analyses suggest that $Re$ independence should be treated with high caution when $Re$ increases from 500 to ${O}(10^4)$. The occurrence of upwash flow behind the cylinder strongly depends on the increase in $Re$, the mechanism of which is also provided. The separation–reattachment process in the junction region and the trailing-edge vortices are discovered only at a high $Re$. The former should significantly affect the strength of the side vortex in the junction region and the latter should cause a sharp drop in pressure near the trailing edge.
South-east Asia's diverse coastal wetlands, which span natural mudflats and mangroves to man-made salt pans, offer critical habitat for many migratory waterbird species in the East Asian–Australasian Flyway. Species dependent on these wetlands include nearly the entire population of the Critically Endangered spoon-billed sandpiper Calidris pygmaea and the Endangered spotted greenshank Tringa guttifer, and significant populations of several other globally threatened and declining species. Presently, more than 50 coastal Important Bird and Biodiversity Areas (IBAs) in the region (7.4% of all South-east Asian IBAs) support at least one threatened migratory species. However, recent studies continue to reveal major knowledge gaps on the distribution of migratory waterbirds and important wetland sites along South-east Asia's vast coastline, including undiscovered and potential IBAs. Alongside this, there are critical gaps in the representation of coastal wetlands across the protected area networks of many countries in this region (e.g. Viet Nam, Indonesia, Malaysia), hindering effective conservation. Although a better understanding of the value of coastal wetlands to people and their importance to migratory species is necessary, governments and other stakeholders need to do more to strengthen the conservation of these ecosystems by improving protected area coverage, habitat restoration, and coastal governance and management. This must be underpinned by the judicious use of evidence-based approaches, including satellite-tracking of migratory birds, ecological research and ground surveys.
We study the asymptotic behaviour of convective heat transfer for turbulent flows in high-porosity fluid-saturated media by two-dimensional high-resolution numerical simulation. The generalized Navier–Stokes equations for incompressible fluid flow and the heat transport equation in porous media at the representative element volume scale are solved by the lattice Boltzmann method, wherein the non-Darcian effects are taken into consideration. The asymptotic behaviour of the Nusselt number $N$ has been revealed for Rayleigh numbers $10^4\leq R\leq 10^{11}$ and Darcy numbers $10^{-6}\leq \xi \leq 10^6$: all the data for various Darcy numbers gradually collapse onto a unique line with increasing Rayleigh number. The asymptote can be well represented by $N=0.146\times R^{0.286}$ for $R>2\times 10^7$, which approaches the relationship for the Rayleigh–Bénard turbulent convection of free fluid flows. The transition can be characterized by a scaling analysis with $R^{}\xi ^{3/2}\sim 1$, below which, however, the data collapse onto the Darcy limit for porous media. The Reynolds number and the Nusselt number both increase with Darcy number above the onset of convection, whereas a premature saturation of the Nusselt number is observed in comparison with that of the Reynolds number. The counter-gradient heat transport by the large-scale flows is quantified, which compensates for the increase of the gradient heat transport with Darcy number. The heat transfer in high-porosity fluid-saturated media with a very small Darcy number $\xi \geq 10^{-6}$ can be comparable to that of free fluid flows for a sufficiently high Rayleigh number $R\geq 10^{11}$.
To investigate the effects of dietary fibre on follicular atresia in pigs fed a high-fat diet, we fed thirty-two prepubescent gilts a basal diet (CON) or a CON diet supplemented with 300 g/d dietary fibre (fibre), 240 g/d soya oil (SO) or both (fibre + SO). At the 19th day of the 4th oestrus cycle, gilts fed the SO diet showed 112 % more atretic follicles and greater expression of the apoptotic markers, Bax and caspase-3, and these effects were reversed by the fibre diet. The abundance of SCFA-producing microbes was decreased by the SO diet, but this effect was reversed by fibre treatment. Concentrations of serotonin and melatonin in the serum and follicular fluid were increased by the fibre diet. Overall, dietary fibre protected against high fat feeding-induced follicular atresia at least partly via gut microbiota-related serotonin–melatonin synthesis. These results provide insight into preventing negative effects on fertility in humans consuming a high-energy diet.
We aimed to evaluate the relationship of plasma Mg with the risk of new-onset hyperuricaemia and examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric acid (UA) Sub-study of the China Stroke Primary Prevention Trial (CSPPT). A total of 1685 participants were included in the present study. The main outcome was new-onset hyperuricaemia defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women. The secondary outcome was a change in UA concentration defined as UA at the exit visit minus that at baseline. During a median follow-up duration of 4·3 years, new-onset hyperuricaemia occurred in 290 (17·2 %) participants. There was a significantly inverse relation of plasma Mg with the risk of new-onset hyperuricaemia (per sd increment; OR 0·85; 95 % CI 0·74, 0·99) and change in UA levels (per sd increment; β −3·96 μmol/l; 95 % CI −7·14, −0·79). Consistently, when plasma Mg was analysed as tertiles, a significantly lower risk of new-onset hyperuricaemia (OR 0·67; 95 % CI 0·48, 0·95) and less increase in UA levels (β −8·35 μmol/l; 95 % CI −16·12, −0·58) were found among participants in tertile 3 (≥885·5 μmol/l) compared with those in tertile 1 (<818·9 μmol/l). Similar trends were found in males and females. Higher plasma Mg levels were associated with a decreased risk of new-onset hyperuricaemia in hypertensive adults.
Geochronological, major and trace element, and Sr–Nd–Hf isotopic data are reported for the monzonitic rocks of the Fushan pluton in the Taihang Mountains, central North China Craton, in order to investigate their sources, petrogenesis and tectonic implications. Zircon U–Pb dating results reveal that the Fushan pluton was emplaced during the Early Cretaceous (∼126–124 Ma). The monzonites and quartz monzonites are mainly characterized by calc-alkaline and magnesian features and display light rare earth element (LREE) enrichment and flat heavy REE (HREE) patterns with slightly positive Eu anomalies. They have similar whole-rock initial 87Sr/86Sr ratios (0.70653–0.70819), εNd(t) values (−13.6 to −18.6) and zircon εHf(t) values (−21.8 to −17.3). The primary magma of the Fushan pluton was derived from the partial melting of a spinel-facies amphibole-bearing ancient enriched lithospheric mantle. The monzonitic rocks also have high Ba–Sr and low Y and Yb contents, with high Sr/Y and La/Yb ratios. These geochemical features of monzonitic rocks are not only inherited from the magma source but also significantly enhanced by crystal fractionation during magmatic evolution; e.g. hornblende fractionation increased the Ba–Sr concentrations and Sr/Y ratios. During the Early Cretaceous, the slab sinking and roll-back of the Palaeo-Pacific Plate could have created an ancient big mantle wedge beneath East Asia and induced a lithospheric extensional process in the central North China Craton within an intracontinental setting.
The present study was undertaken to investigate the antiparasitic activity of extracellular products of Streptomyces albus. Bioactivity-guided isolation of chloroform extracts affording a compound showing potent activity. The structure of the compound was elucidated as salinomycin (SAL) by EI-MS, 1H NMR and 13C NMR. In vitro test showed that SAL has potent anti-parasitic efficacy against theronts of Ichthyophthirius multifiliis with 10 min, 1, 2, 3 and 4 h (effective concentration) EC50 (95% confidence intervals) of 2.12 (2.22–2.02), 1.93 (1.98–1.88), 1.42 (1.47–1.37), 1.35 (1.41–1.31) and 1.11 (1.21–1.01) mg L−1. In vitro antiparasitic assays revealed that SAL could be 100% effective against I. multifiliis encysted tomonts at a concentration of 8.0 mg L−1. In vivo test demonstrated that the number of I. multifiliis trophonts on Erythroculter ilishaeformis treated with SAL was markedly lower than that of control group at 10 days after exposed to theronts (P < 0.05). In the control group, 80% mortality was observed owing to heavy I. multifiliis infection at 10 days. On the other hand, only 30.0% mortality was recorded in the group treated with 8.0 mg L−1 SAL. The median lethal dose (LD50) of SAL for E. ilishaeformis was 32.9 mg L−1.
The findings of previous studies remain controversial on the optimal management required for effective seizure control after surgical excision of arteriovenous malformations (AVMs). We evaluated the efficacy of additional bipolar electrocoagulation on the electrically positive cortex guided by intraoperative electrocorticography (ECoG) for controlling cerebral AVMs-related epilepsy.
Clinical Material and Methods:
Sixty consecutive patients with seizure due to cerebral AVMs, who underwent surgical excision of cerebral AVMs and intraoperative ECoG, were assessed. The AVMs and surrounding hemosiderin stained tissue were completely removed, and bipolar electrocoagulation was applied on the surrounding cerebral cortex where epileptic discharges were monitored via intraoperative ECoG. Patients were followed up at three to six months after the surgery and then annually. We evaluated seizure outcome by using Engel's classification and postoperative complications.
Results:
Forty-nine patients (81.6%) were detected of epileptic discharges before and after AVMs excision. These patients underwent the removal of AVMs plus bipolar electrocoagulation on spike-positive site cortex. After electrocoagulation, 45 patients' epileptic discharges disappeared, while four obviously diminished. Fifty-five of 60 patients (91.7%) had follow-up lasting at least 22 months (mean 51.1 months; range 22-93 months). Determined by the Engel Seizure Outcome Scale, 39 patients (70.9%) were Class I, seven (12.7%) Class II, five (9.0%) Class III, and four (7.2%) Class IV.
Conclusions:
Even alter the complete removal of AVM and sunwinding gliolic and hemosiderin stained tissue, a high-frequency residual spike remained on the surrounding cerebral cortex. Effective surgical seizure control can be achieved by carrying on I additional bipolar electrocoagulation on the cortex guided by the intraoperative ECoG.
The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.
Methods and results
In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.
Conclusions
A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.
The aim of this study is to develop predictive models to predict organ at risk (OAR) complication level, classification of OAR dose-volume and combination of this function with our in-house developed treatment decision support system.
Materials and methods
We analysed the support vector machine and decision tree algorithm for predicting OAR complication level and toxicity in order to integrate this function into our in-house radiation treatment planning decision support system. A total of 12 TomoTherapyTM treatment plans for prostate cancer were established, and a hundred modelled plans were generated to analyse the toxicity prediction for bladder and rectum.
Results
The toxicity prediction algorithm analysis showed 91·0% accuracy in the training process. A scatter plot for bladder and rectum was obtained by 100 modelled plans and classification result derived. OAR complication level was analysed and risk factor for 25% bladder and 50% rectum was detected by decision tree. Therefore, it was shown that complication prediction of patients using big data-based clinical information is possible.
Conclusion
We verified the accuracy of the tested algorithm using prostate cancer cases. Side effects can be minimised by applying this predictive modelling algorithm with the planning decision support system for patient-specific radiotherapy planning.
Exchange rates influence a country's trading capability, foreign reserves and competitiveness. Recently, the exchange rate between the Chinese RMB and the U.S. dollar has been a contentious issue in both the United States and China. In this paper, we conduct a historical review of how the United States deployed negotiation strategies with China on the exchange rate issue and consider the degree to which it follows theoretical expectations. We then analyze the changing nature of the factors which shape exchange rate negotiations between the two nations in projecting alternative scenarios for the future of conflict resolution between the U.S. and China on this issue. We predict that the U.S. is likely to continue alternating between competition and collaboration, a negotiation cycle influenced by U.S. domestic politics, and China is less likely to continue with accommodation and compromise. The sequencing and timing of each nation's negotiation strategy will lead to widely divergent consequences for the management of exchange rates and the world economy.
The purpose of the present study was to examine the influence of maternal pre-pregnancy BMI and gestational weight gain (GWG) on initiation and duration of infant breast-feeding in a prospective birth cohort study.
Design
Breast-feeding information was collected at 1, 3, 6 and 12 months postpartum. The association of pre-pregnancy BMI and GWG with delayed lactogenesis II and termination of exclusive breast-feeding was assessed with logistic regression analysis. The risk of early termination of any breast-feeding during the first year postpartum was assessed with Cox proportional hazards models.
Setting
Urban city in China.
Subjects
Women with infants from the Ma’anshan Birth Cohort Study (n 3196).
Results
The median duration of any breast-feeding in this cohort was 7·0 months. Pre-pregnancy obese women had higher risks of delayed lactogenesis II (risk ratio=1·89; 95 % CI 1·04, 3·43) and early termination of any breast-feeding (hazard ratio=1·38; 95 % CI 1·09, 1·75) adjusted for potential maternal and infant confounders, when compared with normal-weight women. No differences in breast-feeding initiation or duration of exclusive breast-feeding according to pre-pregnancy BMI were found. Moreover, GWG was not associated with any poor breast-feeding outcomes.
Conclusions
The present study indicated that pre-pregnancy obesity increases the risks of delayed lactogenesis II and early termination of any breast-feeding in Chinese women.
For the first time, we estimated the population sizes of two swan species and four goose species from observations during the non-breeding period in East Asia. Based on combined counts from South Korea, Japan and China, we estimated the total abundance of these species as follows: 42,000–47,000 Whooper Swans Cygnus cygnus; 99,000–141,000 Tundra Swans C. columbianus bewickii; 56,000–98,000 Swan Geese Anser cygnoides; 157,000–194,000 Bean Geese A. fabalis; 231,000–283,000 Greater White-fronted Geese A. albifrons; and 14,000–19,000 Lesser White-fronted Geese A. erythropus. While the count data from Korea and Japan provide a good reflection of numbers present, there remain gaps in the coverage in China, which particularly affect the precision of the estimates for Bean, Greater and Lesser White-fronted Geese as well as Tundra Swans. Lack of subspecies distinction of Bean Geese in China until recently also limits our ability to determine the true status of A. f. middendorffii there, but all indications suggest this population numbers around 18,000 individuals and is in need of urgent attention. The small, highly concentrated and declining numbers of Lesser White-fronted Geese give concern for this species, as do the major declines in Greater White-fronted Geese in China (in contrast to numbers in Japan and Korea, considered to be a separate flyway). In the absence of any demographic data, it is impossible to interpret the causes of these changes in abundance. Improved monitoring, including demographic and tracking studies are required to provide the necessary information to retain populations in favourable conservation status.
Environmental filtering and competitive interactions are important ecological processes in community assembly. The contribution of the two processes to community assembly can be evaluated by shifts in functional diversity patterns. We examined the correlations between functional diversity of six traits (leaf chlorophyll concentration, dry matter content, size, specific leaf area, thickness and wood density) and environmental gradients (topography and soil) for 92 species in the 20-ha Dinghushan forest plot in China. A partial Mantel test showed that most of the community-weighted mean trait values changed with terrain convexity and soil fertility, which implied that environmental filtering was occurring. Functional diversity of many traits significantly increased with increasing terrain convexity and soil fertility, which was associated with increased light and below-ground resources respectively. These results suggest that co-occurring species are functionally convergent in regions of strong abiotic stress under the environmental filtering, but functionally divergent in more benign environments due to resource partitioning and competitive interactions. Single-trait diversity and multivariate functional diversity had different relationships with environmental factors, indicating that traits were related to different niche axes, and associated with different ecological processes, which demonstrated the importance of focusing niche axes in traits selection. Between 9% and 41% of variation in functional diversity of different traits was explained by environmental factors in stepwise multiple regression models. Terrain convexity and soil fertility were the best predictors of functional diversity, which contributed 30.5% and 29.0% of total R2 to the model. These provided essential evidence that different environmental factors had distinguishing impacts on regulating diversity of traits.
The analytical capacity models of an airport with two runways system are developed in this paper and the theoretical capacity curves yielded by this model are analysed. The statistic airport capacity estimation methodology based on historical data is introduced as well. Both analytical models and statistic strategy are applied to estimate the capacity of the two runways system of a typical airport. Two sets of airport capacity curves obtained in different ways are compared and analysed. The result of the analysis indicates that the mathematical model works effectively in a fairly accurate way in the estimation of airport capacity.
Early identification of patients with bipolar disorder during their first depressive episode is beneficial to the outcome of the disorder and treatment, but traditionally this has been a great challenge to clinicians. Recently, brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the pathophysiology of bipolar disorder and major depressive disorder (MDD), but it is not clear whether BDNF levels can be used to predict bipolar disorder among patients in their first major depressive episode.
Aims
To explore whether BDNF levels can differentiate between MDD and bipolar disorder in the first depressive episode.
Method
A total of 203 patients with a first major depressive episode as well as 167 healthy controls were recruited. After 3 years of bi-annual follow-up, 164 patients with a major depressive episode completed the study, and of these, 21 were identified as having bipolar disorder and 143 patients were diagnosed as having MDD. BDNF gene expression and plasma levels at baseline were compared among the bipolar disorder, MDD and healthy control groups. Logistic regression and decision tree methods were applied to determine the best model for predicting bipolar disorder at the first depressive episode.
Results
At baseline, patients in the bipolar disorder and MDD groups showed lower BDNF mRNA levels (P<0.001 and P = 0.02 respectively) and plasma levels (P = 0.002 and P = 0.01 respectively) compared with healthy controls. Similarly, BDNF levels in the bipolar disorder group were lower than those in the MDD group. These results showed that the best model for predicting bipolar disorder during a first depressive episode was a combination of BDNF mRNA levels with plasma BDNF levels (receiver operating characteristics (ROC) = 0.80, logistic regression; ROC = 0.84, decision tree).
Conclusions
Our findings suggest that BDNF levels may serve as a potential differential diagnostic biomarker for bipolar disorder in a patient's first depressive episode.
The mesoporous and nanorods SnO2 are synthesized by controlling the state of SnCl2·2H2O precursor with SBA-15 as hard template, and the possible formation mechanisms at different assembling modes inside the ordered mesoporous silica templates are proposed. In addition, SnO2 nanoparticles are synthesized by hydrolysis depositing method. The electrochemical tests of as-prepared samples indicate that the reticular stacking structure of the nanorods would limit the Li+ ions to intercalate, but the effect of volume expansion in this case upon cycling is insignificant. The mesostructure SnO2 tends to be stable after partial structural collapse at first few cycles. And the Li+ ions can readily intercalate and de-intercalate into/from its ordered channels structure, which provides a high capacity and an improved cycle property. Although SnO2 nanoparticles deliver high capacity at an early stage, the agglomeration may induce the capacity to drop rapidly after a certain number of cycles.