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Risk factors and prevalence of pulmonary nontuberculous mycobacterial (NTM) diseases were retrospectively evaluated in 1208 suspected pulmonary TB patients seeking care at the Affiliated Hospital of Hangzhou Normal University between July 2018 and December 2018. Further analysis of 390 culture-positive cases demonstrated that 358 (358/390, 91.8%) were infected with Mycobacterium tuberculosis (MTB), 24 (24/390, 6.2%) with NTM and eight (8/390, 2.0%) with both MTB and NTM. M. intracellulare was the most prevalent NTM isolated (16/24, 66.7%), followed by M. abscessus (3/24), M. kansasii (2/24), M. avium (1/24), M. szulgai (1/24) and M. fortuitum (1/24). The difference between NTM and TB case rates for the ⩾65-year-old age group significantly exceeded the difference for the reference group (patients aged 25–44 years) (OR (95% CI): 4.63 (1.03–20.90)). Pulmonary NTM diseases incidence positively correlated with prior TB history (OR (95% CI): 12.92 (3.24–31.82)). Moreover, pulmonary NTM patients were significantly more likely to exhibit underlying bronchiectasis than pulmonary TB patients (OR (95% CI): 18.89 (7.54–47.88)). In conclusion, approximately one-tenth of culture-positive suspected pulmonary TB patients are infected with NTM (most frequently M. intracellulare) in Zhejiang Province, China. The elderly and those with bronchiectasis or a history of TB are at the greatest risk of contracting pulmonary NTM disease.
Facilitated by the establishment of terrestrial networks and satellite constellations of Automatic Identification System (AIS) receivers, large quantities of spatial and temporal information that trace ships' paths have been collected. The exponential increase in the amount of AIS data has caused expensive and time-consuming transmission, calculation and storage problems. Using appropriate trajectory simplification methods in a timely manner to compress redundant information while minimising the loss of importation information is important. To minimise the simplification error, this paper proposes an online multi-dimensional simplification algorithm for AIS trajectory streaming data. The simplification algorithm takes into account position, direction and speed preservation. Finally, a comparison experiment with other algorithms is made to examine the effectiveness of this algorithm. The results indicate that the proposed online multi-dimensional simplification algorithm can effectively preserve a ship's motion state, including its position, speed and course.
To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.
Genome-wide association studies (GWAS) have consistently revealed that a variant of microRNA 137 (MIR137) shows a quite significant association with schizophrenia. Identifying the network of genes regulated by MIR137 could provide insights into the biological processes underlying schizophrenia. In addition, DLPFC functional connectivity, a robust correlate of MIR137, may provide plausible endophenotypes. However, the regulatory role of the MIR137 gene network in the disrupted functional connectivity remains unclear. Here, we tested the effects of the MIR137 regulated genes on the risk for schizophrenia and DLPFC functional connectivity.
To evaluate the additive effects of the MIR137 regulated genes (N = 1274), we calculated a MIR137 polygenic risk score (PRS) for schizophrenia and tested its association with the risk for schizophrenia in the genomic data of a Han Chinese population that included schizophrenia patients (N = 589) and normal controls (N = 575). We then investigated the association between MIR137 PRS and DLPFC functional connectivity in two independent young healthy cohorts (N = 356 and N = 314).
We found that the MIR137 PRS successfully captured the differences in genetic structure between the patients and controls, but the single gene MIR137 did not. We then consistently found that a higher MIR137 PRS was correlated with lower functional connectivities between the DLPFC and both the superior parietal cortex and the inferior temporal cortex in two independent cohorts.
The findings suggested that these two functional connectivities of the DLPFC could be important endophenotypes linking the MIR137-regulated genetic structure to schizophrenia.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
Choices between options represented in a multidimensional space, in which each dimension signifies a distinct attribute describing the objects, are presumably guided by the principle of value maximization. However, the current study assumes that in a real-world setting, those who are able to imagine things that do not actually exist could modify the multidimensional space by self-generating an unoffered but fictional dimension. We define the utility (Uv) assigned by the decision makers to the options on the offered/given dimension as value (v[x]) and the utility (Uw) on the self-generated/fictional dimension as worth (w[xc]). Our series of experiments demonstrated that an option with a greater value established strictly on that given set of dimensions might not necessarily be chosen (which contradicted the principle of value maximization). Choosing an option with less value (i.e. giving away the bigger pear) behavior can be described and explained by the “worth-based choice” approach, as people behave to select the option with the highest worth rather than that with the highest value. We are optimistic that the resulting findings will facilitate our understanding of the beauty of such a “one step further” choice and assist us in understanding the following: the ability to further generate a fictional dimension and to assign a delayed utility (worth) to the options on the fictional dimension, and to make a worth-based choice, which could eventually be taken as the operational definition to measure the degree of “fiction-generating ability”, as proposed by Harari (2014).
This article contributes to the discussion about proper product safety in the wake of disruptive digital technologies. By picking the example of 3D printing we analyse why incumbent product liability law does not incentivise optimal deterrence of harmful 3D printed products. We identify the new business models associated with 3D printing as the main trigger for the non-applicability of incumbent liability law. The new business models are characterised by making no strong reference to economies of scale. As a result, the informational content of specific producers and their products is scarce and the identification of tortfeasors becomes a challenge for the legal system. While there is yet no easy solution to the problem, we provide at the end of the article an inventory of institutions that may take the lead in finding new proper liability rules and safety regulations.
Healthcare-associated infections (HAIs) are a major worldwide public-health problem, but less data are available on the long-term trends of HAIs and antimicrobial use in Eastern China. This study describes the prevalence and long-term trends of HAIs and antimicrobial use in a tertiary care teaching hospital in Hefei, Anhui, China from 2010 to 2017 based on annual point-prevalence surveys. A total of 12 505 inpatients were included; 600 HAIs were recorded in 533 patients, with an overall prevalence of 4.26% and a frequency of 4.80%. No evidence was found for an increasing or decreasing trend in prevalence of HAI over 8 years (trend χ2 = 2.15, P = 0.143). However, significant differences in prevalence of HAI were evident between the surveys (χ2 = 21.14, P < 0.001). The intensive care unit had the highest frequency of HAIs (24.36%) and respiratory tract infections accounted for 62.50% of all cases; Escherichia coli was the most common pathogen (16.67%). A 44.13% prevalence of antimicrobial use with a gradually decreasing trend over time was recorded. More attention should be paid to potential high-risk clinical departments and HAI types with further enhancement of rational antimicrobial use.
In this work, corrosion-resistant fluoridated Ca–Mg–P composite coatings were prepared on magnesium alloys via a hydrothermal assisted sol–gel process. All these coatings derived from Coating Sols with different F− concentrations are composed of fluoridated hydroxyapatite, magnesium hydroxide, and dittmarite. When F− concentration of Coating Sol is 0.03 M, the coating exhibited uniform and dense surface, and its thickness reached 32 μm, thus possessing a high charge transfer resistance of 312 ± 12.69 kΩ cm2 in simulated body fluid (SBF). Immersion test in SBF showed that this coating could quickly induce the formation of the mineralized layer, implying relatively high bioactivity. After 49 days of immersion, the original composite coating and newly formed mineralized layer reached 60 μm in thickness, providing effective long-term protection for magnesium alloys. These attractive results indicate that this fluoridated Ca–Mg–P composite coating is a promising protective coating on biodegradable magnesium and magnesium alloy implants for orthopaedic applications.
In risky decision making, whether decision makers follow an expectation rule as hypothesised by mainstream theories is a compelling question. To tackle this question and enrich our knowledge of the underlying mechanism of risky decision making, we developed a series of new experimental paradigms that directly examined the computation processes to systematically investigate the process of risky decision making and explore the boundary condition of expectation rule over the course of a decade. In this article, we introduce these methods and review behavioural, eye-tracking, event-related potential, and functional magnetic resonance imaging studies that employed these methods. Results of these studies consistently showed that decision makers in the single-application condition did not perform the weighting and summing process assumed by the expectation rule. Moreover, decision makers were inclined to adopt a non-compensatory strategy, such as a heuristic one, in risky decision making. Furthermore, results indicated that the expectation rule was only applicable for conditions that involved decisions applied to numerous events (multiple applications) or to people (everyone). The findings indicated that using an index based on expected value to prescribe human risk preferences appears to be an artificial or false index of risk preference, and emphasised a new methodological direction for risky decision-making research.
This paper presents a novel asymmetric coplanar waveguide-fed quad-band hybrid antenna for wireless applications. The proposed hybrid antenna combines a conventional monopole antenna and a zeroth-order resonator antenna to perform a dual-mode operation. The first mode is generated by a slotted monopole antenna, supporting the two higher resonances at about 3.5 and 5.8 GHz. The second mode is supported by loading a composite right-/left-handed transmission line unit cell near the slotted monopole, contributing to the two lower resonances at about 1.6 and 2.5 GHz. It is printed on an FR4 substrate with the overall dimensions of 40 mm × 24 mm × 1.6 mm. Experimental results demonstrate that it can cover the global positioning system (1.57–1.59 GHz), wireless local area network (2.4–2.485, 5.15–5.35, and 5.725–5.825 GHz), and worldwide interoperability for microwave access (2.5–2.69, 3.3–3.7, and 5.25–5.85 GHz) applications with monopole-like radiation patterns and acceptable gains.
Iron-deficiency anemia is a public health concern that frequently occurs in pregnant mammals and neonatal offspring. Ferrous N-carbamylglycinate chelate (Fe-CGly) is a newly designed iron fortifier with proven effects in iron-deficient rats and weanling piglets. However, the effects of this new compound on pregnant mammals are unknown. Therefore, this experiment was conducted to evaluate the effects of Fe-CGly on sow reproductive performance and iron status of both sows and neonatal piglets. A total of 40 large-white sows after second parity were randomly assigned to two groups (n=20). They were receiving a diet including 80 mg Fe/kg as FeSO4 or Fe-CGly, respectively, from day 85 of gestation to parturition. The serum (day 110 of pregnancy) and placentas of sows were sampled. Litter size, mean weight of live born piglets, birth (live) litter weight, number of live born piglets, and the number of still-born piglets, mummies, and weak-born piglets were recorded. Once delivered, eight litters were randomly selected from the 20 litters per treatment, and one new-born male piglet (1.503±0.142 kg) from each selected litter was slaughtered within 3 h after birth from the selected litters, without colostrum ingestion. The serum, longissimus muscle, liver and kidneys of the piglets were collected. The iron status of the serum samples and the messenger RNA level of iron-related genes in the placenta, liver and kidney were analyzed. The results showed that litter weight of live born piglets was higher (P=0.030) in the Fe-CGly group (19.86 kg) than in the FeSO4 group (17.34 kg). Fe-CGly significantly increased placental iron concentration (P<0.05) of sows. It also significantly increased iron saturation and reduced the total iron-binding capacity of piglets (P<0.05) at birth. However, the results revealed that supplementation of Fe-CGly in sows reduced liver and kidney iron concentration of neonatal piglets (P<0.05), indicating decreased iron storage. In addition, the concentration of iron in the colostrum was not significantly changed. Therefore, the present results suggested that replacement of maternal FeSO4 supplement with Fe-CGly in the late-gestating period for sows could improve litter birth weight, probably via enhanced iron transportation in the placenta.
The Chinese Loess Plateau (CLP) in North China is an important terrestrial archive that witnessed the environmental changes and mammal and early human evolution in Asia over the past 2.6 Ma. Establishing precise ages for the Pleistocene faunas on the CLP is critical for better understanding of these environmental, biological, and archaeological issues. Here we report a new magnetostratigraphic record that places age constraints on the Linyi Fauna on the southeastern CLP. Our investigated 170-m-thick Linyi section mainly consists of two portions: (1) an overlying eolian Quaternary loess-paleosol sequence and (2) underlying fluvial-lacustrine sand and silty clay. Paleomagnetic results suggest that the composite section records the Brunhes chron, Jaramillo and Olduvai subchrons, and successive reverse polarity portions of the intervening Matuyama chron. The Linyi Fauna is located between Jaramillo and Olduvai subchrons in the fluvial-lacustrine interval, with an estimated age of ~1.5–1.6 Ma. Combining previously dated faunas, we establish a Pleistocene magnetochronology spanning from 2.54 to 0.65 Ma for the faunas on the CLP.
Four isonitrogenous and isoenergetic purified diets containing free arachidonic acid (ARA) or EPA (control group), 0·30 % ARA, 0·30 % EPA and 0·30 % ARA+EPA (equivalent) were designed to feed juvenile grass carp (10·21 (sd 0·10) g) for 10 weeks. Only the EPA group presented better growth performance compared with the control group (P<0·05). Dietary ARA and EPA were incorporated into polar lipids more than non-polar lipids in hepatopancreas but not intraperitoneal fat (IPF) tissue. Fish fed ARA and EPA showed an increase of serum superoxide dismutase and catalase activities, and decrease of glutathione peroxidase activity and malondialdehyde contents (P<0·05). The hepatopancreatic TAG levels decreased both in ARA and EPA groups (P<0·05), accompanied by the decrease of lipoprotein lipase (LPL) activity in the ARA group (P<0·05). Fatty acid synthase (FAS), diacylglycerol O-acyltransferase and apoE gene expression in the hepatopancreas decreased in fish fed ARA and EPA, but only the ARA group exhibited increased mRNA level of adipose TAG lipase (ATGL) (P<0·05). Decreased IPF index and adipocyte sizes were found in the ARA group (P<0·05). Meanwhile, the ARA group showed decreased expression levels of adipogenic genes CCAAT enhancer-binding protein α, LPL and FAS, and increased levels of the lipid catabolic genes PPARα, ATGL, hormone-sensitive lipase and carnitine palmitoyltransferase 1 (CPT-1) in IPF, whereas the EPA group only increased PPARα and CPT-1 mRNA expression and showed less levels than the ARA group. Overall, dietary EPA is beneficial to the growth performance, whereas ARA is more potent in inducing lipolysis and inhibiting adipogenesis, especially in IPF. Meanwhile, dietary ARA and EPA showed the similar preference in esterification and the improvement in antioxidant response.
Freedom from fear and freedom from want are two of the fundamental freedoms and likely related to changes in the environment. It has usually been assumed that our subjective feelings should change accordingly with changes in the objective environment. However, two counterintuitive effects reviewed in this article imply a rather complex psychological mechanism behind how people respond to environmental changes and strive for the freedom from fear and want. The first is the ‘psychological typhoon eye’ effect, in which the closer people are to hazards, the calmer they feel. Several possible explanations have been proposed, but the mechanism behind this effect remains unclear. The findings are important for future post-disaster interventions and helpful for policy makers in risk management and researchers in risk studies. The second effect is the ‘town dislocation’ effect, wherein although inhabitants’ objective quality of life is improved during the urbanisation process, the projected endorsement and rated social ambience of town residents is lower than that of residents in the country and in the city; this effect is mediated by social support. The findings have implications for how to better assess the urbanisation process and how to improve people's affective appraisals of their living environment.
In Taiwan the discussion of civil society emerged in the 1980s and peaked in the early 1990s, when the society underwent political democratization. Civil society was considered a public sphere, enjoying relatively autonomy from the control of the state or the market. The birth of civil society in Taiwan came about by the proliferation of non-profit organizations, community organizations, and professional and voluntary groups through continuous social mobilization. Lawmaking was indispensable for the consolidation of civil society. New ordinances, ranging from human rights, environmental regulation to cultural preservation, were brought to the agenda. The emergence of civil society allowed people to leverage themselves from the control of the state and the market. In addition to this, the new Taiwanese identity that took shape in the 1990s reinforced the civil society that was in the making. However, across the turn of the millennium, as the state– society relationship reconfigured, civil society also differentiated. Both the market and the state tried to entrench civil society, which more often than not led to many different voices within civil society. Conflicts among various social groups have become a noticeable feature in the debates and decision-making processes of public affairs.
Against this backdrop we would like to trace the early history of the development of the idea of heritage preservation in Taiwan. The emergence of the heritage preservation movement and related policies is closely intertwined with the changing cultural politics that reflect the contested meanings of national and local identities in Taiwan. Before the lifting of martial law in 1987, civil society had played a significant role in heritagemaking. Since 1987, civil society has further pushed the state to change the laws and policies governing heritage preservation.
The first piece of legislation in this area, the Cultural Heritage Preservation Act, was promulgated in Taiwan in 1982, while the country was still under authoritarian rule. The implementation of the Heritage Act and associated cultural policies inevitably reflected the Chinese nationalist historical narrative; however, at the same time, it created negotiable spaces for diverse narratives through the imported notion of “cultural heritage”, which could be seen as an indirect challenge to the dominant narrative.
The in situ synthesis of nickel-based composite coating reinforced with WC particle on mild steel has been investigated. Results show a planar crystal at the interface and some relatively coarse columnar dendrites on the side of the coating near the substrate. The synthesized WC particles homogenously distribute in the coating without cracks and pores. The maximum size, mean size, and volume fraction of the WC particle is 270 µm, 35 µm, and 71%, respectively. The microhardness value of the prepared coating can be up to a maximum of 755 HV2. The synthesized WC particles generally show a unique triangular prism shape, whose evolution rule and growth mechanism are investigated by Bravais–Friedel–Donnay–Harker theory. It is deduced that crystal structure and interface energy play important role in determining the shape of WC, which evolves from sphere to hexagonal prism and finally to triangular prism.