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Purpose To examine a screen model for detecting undergraduates with higher risk for developing psychosis (HRDP). Design and methods A cross-sectional design with convenience sampling was used. The screen model included exploration stage by self-report scales and confirmation stage by face-to-face interviews. Findings A total of 273 students were detected from 4744 surveys during 4 years. Of them, 120 students with HRDP were identified and 7 had been diagnosed as schizophrenia or bipolar disorders at 12-month follow-up. Practice implications This screen model can be used in early detection for undergraduates with HRDP from large general samples.

BackgroundThere have been reports of increasing azole resistance in Candida tropicalis, especially in the Asia-Pacific region. Here we report on the epidemiology and antifungal susceptibility of C. tropicalis causing invasive candidiasis in China, from a 9-year surveillance study.MethodsFrom August 2009 to July 2018, C. tropicalis isolates (n = 3702) were collected from 87 hospitals across China. Species identification was carried out by mass spectrometry or rDNA sequencing. Antifungal susceptibility was determined by Clinical and Laboratory Standards Institute disk diffusion (CHIF-NET10–14, n = 1510) or Sensititre YeastOne (CHIF-NET15–18, n = 2192) methods.ResultsOverall, 22.2% (823/3702) of the isolates were resistant to fluconazole, with 90.4% (744/823) being cross-resistant to voriconazole. In addition, 16.9 (370/2192) and 71.7% (1572/2192) of the isolates were of non-wild-type phenotype to itraconazole and posaconazole, respectively. Over the 9 years of surveillance, the fluconazole resistance rate continued to increase, rising from 5.7 (7/122) to 31.8% (236/741), while that for voriconazole was almost the same, rising from 5.7 (7/122) to 29.1% (216/741), with no significant statistical differences across the geographic regions. However, significant difference in fluconazole resistance rate was noted between isolates cultured from blood (27.2%, 489/1799) and those from non-blood (17.6%, 334/1903) specimens (P-value < 0.05), and amongst isolates collected from medical wards (28.1%, 312/1110) versus intensive care units (19.6%, 214/1092) and surgical wards (17.9%, 194/1086) (Bonferroni adjusted P-value < 0.05). Although echinocandin resistance remained low (0.8%, 18/2192) during the surveillance period, it was observed in most administrative regions, and one-third (6/18) of these isolates were simultaneously resistant to fluconazole.ConclusionThe continual decrease in the rate of azole susceptibility among C. tropicalis strains has become a nationwide challenge in China, and the emergence of multi-drug resistance could pose further threats. These phenomena call for effective efforts in future interventions.

Background: Recently, diabetic nephropathy (DN) becomes a common health problem in China as one of the major microvascular complications of diabetes mellitus. Therefore, the incipient diagnosis and noninvasive detections in clinic by the association of urinary biomarkers are important for preventing the progress of DN. However, the clinical significance of urinary biomarkers is controversial nowadays. This study thereby aimed to further evaluate the clinical significance of the association of urinary biomarkers in noninvasively predicting the renal damaged extent of the early type 2 DN patients with kidney qi deficiency syndrome in an integrated traditional and western medical center, and preliminarily confirm the correlation between urinary tubular biomarkers and the biological bases of DN patients.Methods: Ninety-two patients in an integrated traditional and western medical center of China were categorized into 3 groups, 20 patients with normo-albuminuria, 50 patients with micro-albuminuria, and 22 patients with macro-albuminuria. In addition to urinary albumin (UAlb) and urinary albumin-to-creatinine ratio (UACR), serum creatinine, estimated glomerular filtration rate and various urinary tubular biomarkers were tested respectively. Besides, clinical characteristics and kidney asthenia syndrome distribution in all patients were observed. Results: In these 3 groups, 24-h UAlb and UACR showed stepwise and significant increases. Urinary cystatin C (UCysC), urinary N-acety1-β-D-glucosaminidase (UNAG) and urinary retinal binding protein (URBP) synchronously showed gradual increases consistent with albuminuria degree in 3 groups. Moreover, 24-h UAlb and UACR were positively correlated with UCysC, UNAG and URBP. In the 72 DN patients with albuminuria, there was a positive correlation between UNAG and URBP, and UCysC was also positively correlated with UNAG and URBP. Additionally, TCM syndrome distributional characteristics in all patients were consistent with the clinical manifestations of kidney qi deficiency syndrome. Conclusion: In this investigation, we ulteriorly demonstrated that the association within UCysC, UNAG, URBP and UAlb may be used as practical targets in noninvasively forecasting the extent of renal injury in the early type 2 DN patients with kidney qi deficiency syndrome. More importantly, we found that urinary tubular biomarkers may be one of the biological bases of DN patients with the specific traditional Chinese medicine syndrome.

2D PbS nanoplatelets (NPLs) form an emerging class of photoactive materials and have been proposed as robust materials for high-performance optoelectronic devices. However, the main drawback of PbS NPLs is the large lateral size, which inhibits their further investigations and practical applications. In this work, ultra-small 2D PbS NPLs with uniform lateral size (11.2 ± 1.7 nm) and thickness (3.7 ± 0.9 nm, ≈6 layers) have been successfully fabricated by a facile liquid-phase exfoliation approach. Their transient optical response and photo-response behavior are evaluated by femtosecond-resolved transient absorption and photo-electrochemical (PEC) measurements. It is shown that the NPLs-based photodetectors (PDs) exhibit excellent photo-response performance from UV to the visible range, showing extremely high photo-responsivity (27.81 mA W-1 ) and remarkable detectivity (3.96 × 1010 Jones), which are figures of merit outperforming currently reported PEC-type PDs. The outstanding properties are further analyzed based on the results of first-principle calculations, including electronic band structure and free energies for the oxygen evolution reaction process. This work highlights promising applications of ultra-small 2D PbS NPLs with the potential for breakthrough developments also in other fields of optoelectronic devices.

Multi-glycoside of Tripterygium wilfordii Hook. f. (GTW) has been proven to be clinically effective in relieving microinflammation in patients with early diabetic nephropathy (DN). However, the therapeutic mechanisms involved in vivo remain unclear. In the process of early DN, microinflammation and activation of p38 mitogen‑activated protein kinase (MAPK) and canonical nuclear factor (NF)-κB signaling pathways are the important mechanisms by which hyperglycemia contributes to glomerulosclerosis (GS). Therefore, this study aimed to examine the ameliorative effects of GTW on GS, and then to clarify its anti‑microinflammatory mechanisms by inhibiting p38 MAPK and NF-κB signaling activities in the kidney. All rats were divided into 4 groups: the sham group, the sham + GTW group, the vehicle group and the GTW group. The suitable dose of GTW and vehicle were daily administered for 8 weeks after the induction of DN by unilateral nephrectomy combined with intraperitoneal injections of streptozotocin (STZ). The general status of the rats, biochemical parameters, renal histological changes and macrophages in glomeruli, as well as expression of the key proteins in the p38 MAPK and canonical NF-κB signaling pathways and inflammatory cytokines including tumor necrosis factor (TNF)-α, interleukin (IL)-1β and transforming growth factor (TGF)-β1 in the kidney were examined, respectively. The results revealed that, GTW improved the general cond-ition and biochemical parameters of the rats, but did not lower blood glucose; GTW attenuated GS and suppressed glomerular microinflammation including the infiltration of ED1+ cells in glomeruli and the protein overexpression of TNF-α, IL-1β and TGF-β1 in the kidney; GTW inhibited the protein overexpression of key signaling molecules of p38 MAPK and canonical NF-κB pathways in the kidney including phosphorylated p38 MAPK, phosphorylated inhibitor protein IκB and NF-κB (p65). On the whole, we expounded that GTW, as a natural regulator in vivo, alleviates GS without affecting hyperglycemia, by exerting anti-microinflammatory effects, including reducing macrophage infiltration in glomeruli, suppressing TNF-α, IL-1β and TGF-β1 overexpression in the kidney and inhibiting p38 MAPK and NF-κB signaling activities.

Spatial cluster detection is widely used for disease surveillance, prevention and containment. However, the commonly used clustering methods cannot resolve the conflicts between the accuracy and efficiency of the detection. This paper proposes an improved method for flexiblyshaped spatial scanning, which can identify irregular spatial clusters more accurately and efficiently. By using a genetic algorithm, we also accelerate the detection process. We convert geographic information to a network structure, in which nodes represent the regions and edges represent the adjacency relationship between regions. According to Kulldorff’s spatial scan statistics, we set the objective function. A constraint condition based on the spectral graph theory is employed to avoid disconnectedness or excessive irregularity of clusters. The algorithm is tested by analysing the simulation data of H1N1 influenza in Beijing. The results show that compared with the previous spatial scan statistic algorithms, our algorithm performs better with shorter time and higher accuracy.

Freezing of gait (FOG) is a common and debilitating symptom in Parkinson’s disease (PD). The current study investigated alterations of resting-state spontaneous brain activity in PD patients with FOG. A total of 29 patients with FOG, 28 patients without FOG and 31 controls were included. All subjects underwent resting-state functional MRI, and the amplitude of low-frequency fluctuation (ALFF) was calculated to measure the spontaneous brain activity. Between-group differences and correlations with FOG severity (both subjective and objective measures) were analyzed. Compared to those without FOG, patients with FOG showed increased ALFF in right anterior cingulate cortex (ACC) and left inferior parietal lobule (IPL), as well as decreased ALFF in right superior frontal gyrus (SFG), bilateral cerebellum and left thalamus. Correlation analyses demonstrated that ALFF within the right SFG, right ACC and bilateral pallidum were positively correlated with FOG; while ALFF within the thalamus, putamen, cerebellum and sensorimotor regions were negatively correlated. Our results indicate that FOG is associated with dysfunction within frontal-parietal regions, along with increased inhibitory outputs from basal ganglia. Additionally, altered activity of cerebellum implicates its role in the pathophysiology of FOG. These findings provide further insight into the underlying neural mechanisms of FOG in PD patients.

Cu-doped quantum dots( QDs) were used as color converting materials for preparing efficient white light-emitting diodes( LEDs). The Cu-doped QDs synthesized by chemical method showed composition-tunable emission from green to deep red and large Stokes shifts. By using the combination of green light-emitting Zn In S∶ Cu QDs and red emitting Zn Cd S∶ Cu QDs with blue Ga N chips,a high color rendering white LED was fabricated. The resulting three-band RGB QD-white LED exhibits high performance with luminous efficacy of 71 lm / W,color rendering index up to 94,CIE-coordinates of( 0. 352 4,0. 365 1),and color temperature of 4 788 K. Based on the changes in the photoluminescence lifetimes of Cu-doped QDs,it is found that the energy transfer process from green Zn In S∶ Cu QDs to red Zn Cd S∶ Cu QDs can be negligible,because the red QDs had no absorption at green band. These results suggest that Cu-doped QDs are promising for solid state lighting.

Internet addiction disorder is a relatively new condition, and the criteria for its diagnosis have been developed only over the last several years. The criteria for Internet addiction remain controversial. We strive to further elucidate the clinical validity of the diagnostic criteria for Internet addiction. To test items of the diagnostic criteria for Internet addiction among adolescents, we conducted a clinical interview study of college students based on longitudinal data on their risky use of the Internet. Forty-one high-risk cases were selected from a 3-year 5-time point longitudinal survey of 716 college freshmen. We examined disputes relevant to symptoms and impairment in the DC-IA-A (Diagnostic Criteria for Internet Addiction among Taiwanese Adolescents). Of the 41 cases, 21 were diagnosed with Internet addiction via a psychiatric interview. In the Internet addiction disorder group, 23.8% of cases had a diagnosis of depression, whereas only 15.0% of the cases in the non-Internet addiction group had a diagnosis of depression. Two major criteria (A8 and A3) had low incidences in these high-risk college students and thus did not help provide a differential diagnosis between the groups. We suggest that A8, ‘excessive effort spent on activities necessary to obtain access to the Internet', should be omitted, and that A3, ‘tolerance: a marked increase in the duration of Internet use needed to achieve satisfaction', should be modified. A1 and A9 should be discussed regarding their role in the diagnosis of Internet addiction disorder. Additional well-designed studies examining the diagnostic criteria and the relationship between factors are needed.

Aiming at the de-noising of GPR echo signal, a de-noising method based on EEMD and wavelet is presented. First the echo signal data is processed with EEMD and yields IMF components. Then the IMF components which indicate noise are subtracted. Next, the high frequency IMF components of the remaining are subjected to wavelet threshold. Finally, the signal is reconstructed using the de-noising IMF and low frequency IMF to realize signal de-noising. Compared with other commonly used methods, EEMD-wavelet method has improvement on SNR. The experiment results show its effectiveness and feasibility in GPR de-noising.

This paper has designed a new diamond computer evaluation method by the use of the diamond evaluation model, and the combination of VC programming technology, and the method has been introduced into the evaluation of regional tourism comprehensive competitiveness. In order to achieve the comprehensive evaluation function of new diamond model, we have designed new diamond comprehensive fuzzy evaluation model by using fuzzy evaluation function to, and have the developed computer evaluation system of regional tourism competitiveness by combining VC programming technology. The system uses the market, enterprises and infrastructure the three aspects of evaluation factors to score the tourism competitiveness, which has realized the evaluation of computer automation function. Competitiveness of regional tourism industry in Shandong, Yunnan and Gansu and other areas is respectively scored through the function, and the results indicate that the comprehensive evaluation score of Yunnan is the highest, and that of Gansu is the lowest.

Spatial cluster detection of infected areas is widely used for disease surveillance, prevention and containment. However, the commonly used cluster methods cannot resolve the conflicts between the accuracy and efficiency of detection. We present an improved method for flexibly shaped spatial scanning, which can identify Irregular spatial clusters much more accurately and efficiently. First, we convert geographic information to a graph structure. Next, we approximately locate the disease regions. And then, based on the approximately located regions, we detect arbitrarily shaped and connected clusters in the graph based on likelihood ratio. Finally, we check the significance of the identified regions by Monte Carlo method. The algorithm is tested by an agent based simulation of H1N1 influenza data in Beijing. The results show that compared with the previous spatial scan statistic algorithms, our algorithm performs better in terms of shorter time and higher accuracy.

Purpose – The purpose of this paper is to investigate the principles on how to reuse the reclaimed wastewater in urban areas and furthermore, to determine appropriate reuse targets and optimize the selection of reuse targets on wastewater. Design/methodology/approach – Use Analytic Hierarchy Process (AHP) to suggest the assessment criteria and subject weights of wastewater reuse. Candidate reclaimed wastewater reuse targets in this study includes “agriculture irrigation,” “industrial use,” “environmental use,” “urban use,” “groundwater recharge,” “life-use water,” and “infusion reservoir.” Findings – The analysis results of the pairwise comparison of the water targets under different assessment criteria level show that in all water targets, agriculture irrigation is more important than industrial use under the “public acceptance” at first. Then, the order results were used to suggest the future wastewater reuse targets under different assessment criteria levels and conducted an acceptance survey on the people of the urban areas. Originality/value – The results of this study can be a useful information for the system analysis of wastewater reclamation and reuse.

By analysis the causal relationship of the public health emergency actions and effects, then establish a generalized model for the prevention and control of public health emergencies by Timed Influence Net (TIN), and on this basis of probability reasoning, inference result can assist analysis the pros and cons the emergency scenario. Method was applied to the example of SARS outbreak in Beijing in 2003 to show the rationality and validity of proposed method. According to the results have a study on the optimization of emergency scenario, optimized conditions comparative and analysis with the actual program. The results show that the proposed method can better support emergency scenario evaluation and optimization.

Existing studies on the propagation of infectious diseases have not sufficiently considered the uncertainties that are related to individual behavior and its influence on individual decision making to prevent infections, even though it is well known that changes in behavior can lead to variations in the macrodynamics of the spread of infectious diseases. These influencing factors can be categorized into emotion-related and cognition-related components. We present a fuzzy cognitive map (FCM) denotative model to describe how the factors of individual emotions and cognition influence each other. We adjust the weight matrix of causal relationships between these factors by using a so-called nonlinear Hebbian learning method. Based on this FCM model, we can implement individual decision rules against possible infections for disease propagation studies. We take the simulation of influenza A [H1N1] spreading on a campus as an example. We find that individual decision making against infections (frequent washing, respirator usage, and crowd contact avoidance) can significantly decrease the at-peak number of infected patients, even when common policies, such as isolation and vaccination, are not deployed.

This study uses an integrated model utilizing a small-world network and choice-based conjoint adoption model to examine the dynamics of consumer choice and diffusion in the hybrid electric vehicles market. It specifically compares the effectiveness of hybrid diffusion through the traditional word of mouth and via social media. The results show that without the advantage of increased gasoline prices, the growth of the hybrid vehicles market is insignificant, and that the Internet has a significant influence on the word of mouth effect in the purchasing process. Hybrid electric vehicles market shares decrease dramatically as a result of negative word of mouth communication via social media. The use of a higher fuel taxes is more effective than providing a subsidy for disposing of old vehicles and purchasing a hybrid.

Podocyte injury is closely related to proteinuria in the progress of diabetic nephropathy(DN). The pathological characters of podocyte injury mainly refer to the change of podocyte form and function, including foot process effacement, reduction of podocyte number and density, podocyte apoptosis, podocyte epithelial-mesenchymal transdifferentiation(EMT)and podocyte hypertrophy. These pathological damages are controlled by multiple signaling pathways in the kidney, such as mammalian target of rapamycin(mTOR)/autophagy pathway, transforming growth factor(TGF)-β1 pathway and Notch pathway. For podocyte injuries induced by high glucose or in murine models of DN, some Chinese herbal medicine(CHM)extracts, such as multiglycoside of Tripterygium wilfordii(GTW), triptolide(TP), astragaloside IV(AS-IV), astragalus polysaccharide(APS)and Panax notoginseng saponins(PNS), have the protective effects in vivo or in vitro. The preliminary studies in China showed that GTW improves podocyte injury in the DN model rats probably through regulating the activity of mTORC1 signaling pathway in the kidney. Therefore, it is the developmental direction for the further study to clarify the interventional effects of CHM based on podocyte injury-related signaling pathway in DN.

The renoprotective effect of inhibitors of renin-angiotensin system (RAS) has been identified through placebo-controlled trials. However, the effect of calcium-channel blockers (CCBs) on renal system is still controversial. Our current meta-analysis includes available evidences to compare the effect of dihydropyridine CCBs and ACEIs or ARBs on renal outcomes and mortality. We also further investigate whether CCBs can be used in combination with inhibitors of RAS to improve the prognosis of patients with chronic kidney disease (CKD).Electronic databases were searched up to July 2012, for clinical randomized controlled trials, assessing the effect of dihydropyridine CCBs on the incidence of end-stage renal disease (ESRD) and all-cause mortality in contrast to ACEIs or ARBs. Eight clinical trials were included containing 25,647 participants. ESRD showed significantly higher frequency with CCBs therapy compared with ACEIs or ARBs therapy, though blood pressure was decreased similarly in both groups in every trial (OR, 1.25; 95% CI, 1.05-1.48; p = 0.01). In contrast, there was no significant difference in the incidence of all-cause mortality between these two groups, though ACEIs or ARBs exhibited better renoprotective effect compared to CCBs (OR, 0.96; 95% CI, 0.89-1.03; p = 0.24).CCBs did not increase all-cause mortality incidence in patients with CKD though they displayed weaker renoprotective, compared to ACEIs or ARBs therapy. Our results suggest the combination of a CCB and an ACEI or ARB should be a preferable antihypertensive therapy in patients with CKD, considering their higher effect in decreasing blood pressure and fewer adverse metabolic problems caused.

Astilbin, a major bioactive compound extracted from Rhizoma smilacis glabrae (RSG), has been reported to possess immunosuppressive properties. Our study first evaluated the effect of astilbin on experimental autoimmune myasthenia gravis (EAMG) in Lewis rats. The results showed that astilbin could attenuate the severity of EAMG by decreasing antigen-specific autoantibodies with up-regulation of regulatory T cells and down-regulation of Th17 cells. In addition to, astilbin also reduced the efficiency of the antigen presenting cells on which the expression of MHC class II decreased. These results suggest that astilbin might be a candidate drug for immunoregulation of EAMG, and provide us new treatment ideas for human myasthenia gravis (MG).

In this paper, we have developed and revealed the wafer-level LED system-in-packaging (WL-LED-SiP) design and process platform. This platform provided an LED system solution with high packaging density, high performance, high reliability and cost effectiveness. Camera phone flash module was adopted as a test vehicle for demonstrating LED-SiP platform technologies, including wafer-level (WL) process integration with micro electromechanical system (MEMS) reflector, cavity-based lithography and through silicon via (TSV) filling. Meanwhile, LED flash module performance, including correlated color temperature (CCT), color rendering index (CRI), light energy and distribution, was characterized. The delivered LED-SiP flash module showed wide-view angle design of 80° × 50° and light energy of 5.7 lx s @ 1/30 s. The volume of the module is 8 × 11 × 4 mm3.

In this paper, a new control scheme of a variable speed grid connected wind energy generation system was presented. The scheme used a squirrel-cage induction generator (SCIG) as generator and it connected to the grid through a back-to-back double PWM converter. According to the characteristics of induction motor, the generator side adopted rotor flux linkage oriented slip frequency vector control technology, and the grid side used the network voltage oriented control and voltage and current dual close-loop control strategy. The simulation results show that the system can work in the state of variable speed constant frequency (VSCF)power generation and the active and reactive power can be controlled with no mutual interference and with good static-dynamic performance.

The mathematical model of the grid-side converter is analyzed. A control system of the grid-side converter used in 7.5kW doubly-fed wind power generation simulation test platform is designed. The TI TMS320F28335 DSP is choosing to be the main controller. The decoupled control and the double closed loops control are adapted in the system. The control strategies of stabilizing DC-link voltage and unity power factor control operating at sub-synchronous and super-synchronous state are realized. The experimental results show that the mathematical model and control strategies are correct and effective.

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A full-duplex radio-over-fiber system with sextuple optical millimeter-wave generation transmit OFDM signal utilizing two parallel phase modulators is proposed.2.5 Gbit/s OFDM signal is modulated on the optical millimeter wave with 60 GHz frequency and transmitted to the base station over standard single-mode fiber(SMF).The generation principle and the transmission performance over fiber of optical millimeter wave generation are analyzed by theory and simulation,respectively.The results show that OFDM have more advantage than NRZ in ROF system.

Ethnopharmacological relevance In traditional Chinese medicine (TCM), Abelmoschus manihot (L.) medic (AM) is a natural medicinal plant used for the treatment of inflammatory diseases. Recently, Huangkui capsule (HKC), a Chinese patent medicine extracted from AM, has been widely applied to the clinical therapy of renal fibrosis in patients with early diabetic nephropathy (DN). However, the therapeutic mechanisms involved in vivo remain ambiguous. The goal of this study is to expound the mechanism in vivo of HKC in order to deepen the understanding of its clinical effects, by using the approaches of contrasting the dose-effects of HKC on oxidative stress (OS) in the kidney compared to α-lipoic acid (LA), and then demonstrating whether and how anti-oxidative properties of HKC or LA might be beneficial for the treatment of renal fibrosis in vivo. Materials and methods Thirty-three rats were divided into 5 groups, a Sham group, a Vehicle group, a L-HKC group, a H-HKC group and a LA group. The different doses of HKC, LA and distilled water were daily administrated for 8 weeks after the induction of DN by the unilateral nephrectomy combined with streptozotocin (STZ) intraperitoneal injections. Rat's general status, biochemical parameters, renal histological changes and OS indicators, as well as the key protein expressions in p38 mitogen-activated protein kinase (p38MAPK)/serine-threonine kinase (Akt) signaling pathways and downstream cytokines including transforming growth factor (TGF)-β1 and tumor necrosis factor (TNF)-α were examined, respectively. Results HKC and LA ameliorated body weight, kidney weight, urinary albumin and renal function including blood urea nitrogen and serum uric acid, attenuated renal fibrosis including the cell numbers and extracellular matrix rate in glomerulus, and controlled OS indicators including malondialdehyde, total superoxide dismutase, 8-hydroxy-2′-deoxyguanosine and nicotinamide adenine dinucleotide phosphate oxidase 4, but did not lower blood glucose in DN model rats. Among them, the anti-renal fibrosis effect of H-HKC was better than that of LA. In addition, HKC simultaneously down-regulated the protein expressions of phosphorylated p38MAPK, phosphorylated Akt (p-Akt), TGF-β1 and TNF-α in the kidney of DN model rats, unlike HKC, LA only down-regulated p-Akt and TNF-α protein expressions. Conclusion We have demonstrated that HKC, similar to LA, is renoprotective via attenuating OS and renal fibrosis in the DN rat model. The potential mechanisms by which HKC and LA exert their therapeutic effects in vivo are respectively through down-regulating the activation of p38MAPK and/or Akt pathways as well as the expressions of TGF-β1 and/or TNF-α in the kidney. Our findings thus provide the useful information about a clinical combination of HKC and LA in early DN patients.

Graphical abstractComplexity and complex systems are all around us: from molecular and cellular systems in biology up to economics and human societies. There is an urgent need for methods that can capture the multi-scale spatio-temporal characteristics of complex systems. Recent emphasis has centered on two methods in particular, those being complex networks and agent-based models. In this paper we look at the combination of these two methods and identify "Complex Agent Networks", as a new emerging computational paradigm for complex system modeling. We argue that complex agent networks are able to capture both individual-level dynamics as well as global-level properties of a complex system, and as such may help to obtain a better understanding of the fundamentals of such systems.We formally describe a form of modeling (which we term complex agent networks) that unifies agent-based modeling and complex networks with respect to the individual agent node model and the networks of agent interactions. Apart from the intrinsic complexity of an agent itself, the interactions among agents can be depicted with spatial models such as grid, map and networks (Fig. 1) and we can map the interactions among agents eventually to networks (Fig. 2).Then we apply CANs to modeling infectious diseases as shown in Fig. 3. Persons are described as agents with heterogeneous disease progression, while the dynamic interactions among agents, that can cause infections, are described by networks.Then we apply CANs to modeling infectious diseases as shown in Fig. 3. Persons are described as agents with heterogeneous disease progression, while the dynamic interactions among agents, that can cause infections, are described by networks.Finally we conclude with a summary of significant research issues related to CANs. Display Omitted HighlightsFormally describes a form of modeling that unifies agent-based modeling and complex networks.Captures both individual-level and global-level dynamics of a system.Describes a system's interaction patterns in networks and its agency in ABM.Reviews existing work from epidemiology, ecology and economics.Presents a detailed example that uses CANs to study infectious disease spreading. Complexity and complex systems are all around us: from molecular and cellular systems in biology up to economics and human societies. There is an urgent need for methods that can capture the multi-scale spatio-temporal characteristics of complex systems. Recent emphasis has centered on two methods in particular, those being complex networks and agent-based models. In this paper we look at the combination of these two methods and identify "Complex Agent Networks", as a new emerging computational paradigm for complex system modeling. We argue that complex agent networks are able to capture both individual-level dynamics as well as global-level properties of a complex system, and as such may help to obtain a better understanding of the fundamentals of such systems.

Objective The purpose of this study was to evaluate the prevalence of depressive symptoms in peri- and post-menopausal Taiwanese women, and to investigate the relation between depressive symptoms and demographic variables, chronic disease status, health habits, stress management, menopausal symptoms, and attitudes toward menopause and aging. Study design Cross-sectional study, using a purposive sample of 566 women between 45 and 60 years of age from a medical center and residential community in Southern Taiwan. Main outcome measures Demographic and health habits questionnaire, Women's Health Initiative Symptom Scale, Attitudes Toward Menopause and Aging Scale, and Center for Epidemiological Studies-Depression Scale (CES-D). Results The prevalence of depressive symptoms (CES-D score ≧ 16) was 38.7% in peri- and post-menopausal Taiwanese women. Bivariate correlations and analyses of variance indicated that higher CES-D scores were related to lower family income, younger age, smoking for a greater number of years, consuming more alcohol, having multiple chronic diseases, not exercising regularly, consulting with a specialist for stress management, having more severe menopausal symptoms, and more negative attitudes toward menopause and aging. A stepwise multiple regression analysis indicated that the key predictors, accounting for 33.7% of the variance, were menopausal symptoms, attitudes toward menopause and aging, family income, and chronic disease status. Conclusions Results highlight the importance of considering psychosocial factors, life style, and chronic disease management in providing health guidance for peri- and post-menopausal women to enhance their quality of life and reduce the risk of depressive symptoms.

OBJECTIVE: Acute lung injury (ALI), is a major cause of morbidity and mortality, which is routinely treated with the administration of systemic glucocorticoids. The current study investigated the distribution and therapeutic effect of a dexamethasone(DXM)-loaded immunoliposome (NLP) functionalized with pulmonary surfactant protein A (SP-A) antibody (SPA-DXM-NLP) in an animal model. METHODS: DXM-NLP was prepared using film dispersion combined with extrusion techniques. SP-A antibody was used as the lung targeting agent. Tissue distribution of SPA-DXM-NLP was investigated in liver, spleen, kidney and lung tissue. The efficacy of SPA-DXM-NLP against lung injury was assessed in a rat model of bleomycin-induced acute lung injury. RESULTS: The SPA-DXM-NLP complex was successfully synthesized and the particles were stable at 4°C. Pulmonary dexamethasone levels were 40 times higher with SPA-DXM-NLP than conventional dexamethasone injection. Administration of SPA-DXM-NLP significantly attenuated lung injury and inflammation, decreased incidence of infection, and increased survival in animal models. CONCLUSIONS: The administration of SPA-DXM-NLP to animal models resulted in increased levels of DXM in the lungs, indicating active targeting. The efficacy against ALI of the immunoliposomes was shown to be superior to conventional dexamethasone administration. These results demonstrate the potential of actively targeted glucocorticoid therapy in the treatment of lung disease in clinical practice.

BACKGROUND: Genetic variations in vitamin D receptor (VDR) may contribute to tuberculosis (TB) risk. Many studies have investigated the association between VDR BsmI gene polymorphism and TB risk, but yielded inconclusive results. METHODOLOGY/PRINCIPAL FINDINGS: We performed a comprehensive meta-analysis of 15 publications with a total of 2309 cases and 3568 controls. We assessed the strength of the association between VDR BsmI gene polymorphism and TB risk and performed sub-group analyses by ethnicity, sample size and Hardy-Weinberg equilibrium (HWE). We found a statistically significant correlation between VDR BsmI gene polymorphism and decreased TB risk in four comparison models: allele model (b vs. B: OR = 0.78, 95% CI = 0.67, 0.89; Pheterogeneity = 0.004), homozygote model (bb vs. BB: OR = 0.61, 95% CI = 0.43, 0.87; Pheterogeneity = 0.001), recessive model (bb vs. Bb+BB: OR = 0.70, 95% CI = 0.56, 0.88; Pheterogeneity = 0.005) and dominant model (bb+Bb vs. BB: OR = 0.77, 95% CI = 0.61, 0.97; Pheterogeneity = 0.010), especially in studies based on Asian population. Sub-group analyses also revealed that there was a statistically decreased TB risk in "small" studies (0.5. Meta-regression and stratification analysis both showed that the ethnicity and sample size contributed to heterogeneity. CONCLUSIONS: This meta-analysis suggests that VDR BsmI gene polymorphism is associated with a significant decreased TB risk, especially in Asian population.

Background The transmission through contacts among MSM (men who have sex with men) is one of the dominating contributors to HIV prevalence in industrialized countries. In Amsterdam, the capital of the Netherlands, the MSM risk group has been traced for decades. This has motivated studies which provide detailed information about MSM's risk behavior statistically, psychologically and sociologically. Despite the era of potent antiretroviral therapy, the incidence of HIV among MSM increases. In the long term the contradictory effects of risk behavior and effective therapy are still poorly understood. Methods Using a previously presented Complex Agent Network model, we describe steady and casual partnerships to predict the HIV spreading among MSM. Behavior-related parameters and values, inferred from studies on Amsterdam MSM, are fed into the model; we validate the model using historical yearly incidence data. Subsequently, we study scenarios to assess the contradictory effects of risk behavior and effective therapy, by varying corresponding values of parameters. Finally, we conduct quantitative analysis based on the resulting incidence data. Results The simulated incidence reproduces the ACS historical incidence well and helps to predict the HIV epidemic among MSM in Amsterdam. Our results show that in the long run the positive influence of effective therapy can be outweighed by an increase in risk behavior of at least 30% for MSM. Conclusion We recommend, based on the model predictions, that lowering risk behavior is the prominent control mechanism of HIV incidence even in the presence of effective therapy.

While generating audible sound with high directivity utilizing the nonlinear propagation effects of ultrasonic in the air, a solution based on DSP (Digital Signal Processor) is presented to solve the problem of distortion in audio beam loudspeaker, and the hardware system for signal processing is designed. Compared with the idealized output simulated from MATLAB, the real output of the hardware system is satisfactory. Moreover, the cost of the design is much lower than that of the past solution using pure circuit or FPGA, and the modifiable performance of DSP program makes the early research work of audio beam loudspeaker more convenient. The design is expected to accelerate the commercialization of the audio beam loudspeaker.

We propose a theoretical design for a compact photonic crystal (PC) polarization beam splitter (PBS) based on the multimode interference (MMI) effect. The size of a conventional MMI device designed by the self-imaging principle is not compact enough; therefore, we design a compact PC PBS based on the difference of the interference effect between TE and TM modes. Within the MMI coupler, the dependence of interference of modes on propagation distance is weak for a TE wave and strong for a TM wave; as a result, the length of the MMI section can be only seven lattice constants. Simulation results show that the insertion losses are 0.32 and 0.89 dB, and the extinction ratios are 14.4 and 17.5 dB for Port 1 (TE mode) and Port 2 (TM mode), respectively.

With the exponential growth in the world population and the constant increase in human mobility, the possible impact of outbreaks of epidemics on cities is increasing, especially in high-density urban areas such as public transportation and transfer points. The volume and proximity of people in these areas can lead to an observed dramatic increase in the transmission of airborne viruses and related pathogens. Due to the critical role these areas play in transmission, it is vital that we have a comprehensive understanding of the ‘transmission highways’ in these areas to predict or prevent the spreading of infectious diseases in general. The principled approach of this paper is to combine and utilize as much information as possible from relevant sources and to integrate these data in a simulated environment that allows for scenario testing and decision support. In this paper, we describe a novel approach to study the spread of airborne diseases in cities by combining traffic information with geo-spatial data, infection dynamics and spreading characteristics. The system is currently being used in an attempt to understand the outbreak of influenza in densely populated cities in China.

Background/Purpose Internet addiction is the coming problem around the world. The diagnostic criteria for Internet addiction among adolescents (DC-IA-A) has become a widely used measure for assessing the presence of Internet addiction in Taiwan. This study examined the diagnosis criteria for Internet addiction in adolescents by expert evaluation. Methods Twenty psychiatrists rated the adequacy of each criterion in DC-IA-A. The content validity and homogeneity reliability proposed by Aiken were calculated. Results The coefficients content validity and homogeneity reliability showed twenty psychiatrists agreed on each of DC-IA-A as relevant to the diagnosis of Internet addiction, though several criteria need improvements. Two criteria “excessive time spent on Internet activities and leaving the Internet” and “excessive effort spent on activities necessary to obtain access to the Internet” should be omitted, and the criteria of “tolerance” should be modified. Conclusion The diagnostic criteria for Internet addiction among adolescents should be revised to meet the real condition of this population.