Antibiotic use among future health professionals: A multicentre cross sectional study of Chinese medical student

Background: Antibiotic use leads to antibiotic resistance and antibiotic misuse is high in China and other developing countries. This may arise from beliefs and behaviours of doctors and the pressure they receive from patients. This study aims to understand antibiotic use behaviour for self-limited illness among medical students - the future healthcare professionals. Methods: This is part of a large cross-sectional study of Chinese university students of science, social science and humanities, and medicine. An electronic survey health belief model (HBM) questionnaire was distributed at six universities in China from September to November 2015. The score assessment was based on the constructs of HBM theory. Chi-squared and multivariable logistic regression and adjusted odd ratios (aOR) were used to assess the relationship between demographic characteristics, antibiotic use knowledge and behaviour. Results: In total, 11455 students were asked to participate and 11192 (97.5%) completed the questionnaires. 1819 medical students completed the survey. In the past month 529 (29%) medical students reported at least one self-limited illness. Of those, 285 (54%) self-medicated and 77 (27%) of them used antibiotics. 111 (21%) saw a doctor among whom 64 (58%) received antibiotics. 133 (25%) did nothing. In the past year, 279 (15%) of students used antibiotics for prophylaxis, 273 (15%) ever demanded an antibiotic from a doctor, 1166 (64%) kept a personal stock of antibiotics, 1034 (57%) bought antibiotics at a pharmacy, 97% of these without a prescription. Students with high HBM scores about antibiotics were significantly less likely to self-medicate with antibiotics (aOR 0.37, 95% CI 0.15-0.91, p=0.031), to use antibiotics for prophylaxis (aOR 0.35, 95% CI 0.21-0.60, p<0.0001) or demand an antibiotic (aOR 0.46, 95% CI 0.26-0.81, p=0.007). Students whose father has a higher education level, whose mother is a doctor or who are from urban areas were more likely to stock antibiotics and self-medicate. Conclusion: High rates of antibiotic self-medication (54%) and stocking (64%) were found among medical students. Along with the high rates of unnecessarily prescribed antibiotics by doctors (58%), there is clearly a need for effective antibiotic stewardship and training programs in Chinese healthcare institutions and medical schools.published_or_final_versio

Spatial and temporal variations of aerosols around Beijing in summer 2006: Model evaluation and source apportionment

Regional aerosol model calculations were made using the Weather Research and Forecasting (WRF)-Community Multiscale Air Quality (CMAQ) and WRF-chem models to study spatial and temporal variations of aerosols around Beijing, China, in the summer of 2006, when the Campaigns of Air Quality Research in Beijing and Surrounding Region 2006 (CAREBeijing) intensive campaign was conducted. Model calculations captured temporal variations of primary (such as elemental carbon. (EC)) and secondary (such as sulfate) aerosols observed in and around Beijing. The spatial distributions of aerosol optical depth observed by the MODTS satellite sensors were also reproduced over northeast China. Model calculations showed distinct differences in spatial distributions between primary and secondary aerosols in association with synoptic-scale meteorology. Secondary aerosols increased in air around Beijing on a scale of about 1000 × 1000 km2 under an anticyclonic pressure system. This air mass was transported northward from the high anthropogenic emission area extending south of Beijing with continuous photochemical production. Subsequent cold front passage brought clean air from the north, and polluted air around Beijing was swept to the south of Beijing. This cycle was repeated about once a week and was found to be responsible for observed enhancements/reductions of aerosols at the intensive measurement sites. In contrast to secondary aerosols, the spatial distributions of primary aerosols (EC) reflected those of emissions, resulting in only slight variability despite the changes in synopticscale meteorology. In accordance with these results, source apportionment simulations revealed that primary aerosols around Beijing were controlled by emissions within 100 km around Beijing within the preceding 24 h, while emissions as far as 500 km and within the preceding 3 days were found to affect secondary aerosols. Copyright 2009 by the American Geophysical Union

Z-transform-based FDTD analysis of perfectly conducting cylinder covered with unmagnetized plasma

In this paper, a novel and normalized Z-transform-based finite-difference time-domain (ZTFDTD) method is presented for simulating the interaction of the electromagnetic (EM) wave with unmagnetized plasma. The 2-D ZTFDTD formulations for unmagnetized plasma are derived. Using a simplified 2-D model for a perfectly conducting cylinder covered with unmagnetized plasma, the stealth effect of unmagnetized plasma is studied in different thicknesses of plasma, electron densities of plasma, EM wave frequencies, and plasma collision frequencies. Numerical results indicate that plasma stealth is effective in theory and reasonable selection for the plasma parameters can greatly enhance its effectiveness. © 2007 IEEE

Observational constraints on Cosmic Reionization

Recent observations have set the first constraints on the epoch of reionization (EoR), corresponding to the formation epoch of the first luminous objects. Studies of Gunn-Peterson (GP) absorption, and related phenomena, suggest a qualitative change in the state of the intergalactic medium (IGM) at $z \sim 6$, indicating a rapid increase in the neutral fraction of the IGM, from $x_{HI} 10^{-3}$, perhaps up to 0.1, at $z \ge 6$. Conversely, transmission spikes in the GP trough, and the evolution of the \lya galaxy luminosity function indicate $x_{HI} < 0.5$ at $z\sim 6.5$, while the large scale polarization of the cosmic microwave background (CMB) implies a significant ionization fraction extending to higher redshifts, $z \sim 11 \pm 3$. The results suggest that reionization is less an event than a process, with the process beginning as early as $z \sim 14$, and with the 'percolation', or 'overlap' phase ending at $z \sim 6$. The data are consistent with low luminosity star forming galaxies as being the dominant sources of reionizing photons. Low frequency radio telescopes currently under construction should be able to make the first direct measurements of HI 21cm emission from the neutral IGM during the EoR, and upcoming measurements of secondary CMB temperature anisotropy will provide fine details of the dynamics of the reionized IGM.Comment: to appear in ARAA 2006, vol 44, page 415-462; latex. 84 pages. 15 fi

How do enamelysin and kallikrein 4 process the 32-kDa enamelin?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74876/1/j.1600-0722.2006.00281.x.pd

Detection of Lyman-alpha Emitting Galaxies at Redshift z=4.55

Studies of the formation and early history of galaxies have been hampered by the difficulties inherent in detecting faint galaxy populations at high redshift. As a consequence, observations at the highest redshifts (3.5 < z < 5) have been restricted to objects that are intrinsically bright. These include quasars, radio galaxies, and some Ly alpha-emitting objects that are very close to (within ~10 kpc) -- and appear to be physically associated with -- quasars. But the extremely energetic processes which make these objects easy to detect also make them unrepresentative of normal (field) galaxies. Here we report the discovery using Keck spectroscopic observations of two Ly alpha-emitting galaxies at redshift z = 4.55, which are sufficiently far from the nearest quasar (~700 kpc) that radiation from the quasar is unlikely to provide the excitation source of the Ly alpha emission. Instead, these galaxies appear to be undergoing their first burst of star formation, at a time when the Universe was less than one billion years old.Comment: 8 pages, 1 landscape table, and 3 PostScript figures. Uses aaspp4.sty, flushrt.sty, aj_pt4.sty, overcite.sty (style macros available from xxx.lanl.gov) Figure 1 is bitmapped to 100 dpi. The original PostScript version of Fig. 1 is available via anonymous ftp to ftp://hubble.ifa.hawaii.edu/pub/preprints To appear in Natur

On the implications of aerosol liquid water and phase separation for modeled organic aerosol mass

Water is an important component of PM2.5 Many traditional SOA species are highly soluble and thus can be considered extractable Water can influence the partitioning of compounds traditionally considered insoluble in models Organic aerosol takes up water according to RH Organic aerosol interacts with inorganic water Deviations in ideality (solubility) must be considered

Imaging Circuit Activity in the Rat Brain with Fast Neural EIT and Depth Arrays

Few techniques are specialized for neuroscience at the 'mesoscopic' level of neural circuits. Fast neural electrical impedance tomography (fnEIT) is a novel imaging technique that offers affordability, portability, and high spatial (∼100 μm) and temporal (1 ms) resolution. fnEIT with depth arrays offers the opportunity to study the dynamics of circuits in the brains of animal models. However, current depth array geometries are not optimized for this imaging modality. They feature small, closely packed electrodes with high impedance that do not provide sufficient SNR for high resolution EIT image reconstruction. They also have a highly limited range. It is necessary to develop depth arrays suitable for fnEIT and evaluate their performance in a representative setting for circuit neuroscience. In this study, we optimized the geometry of depth arrays for fnEIT, and then investigated the prospects of imaging thalamocortical circuit activity in the rat brain. Optimization was consistent with the hypothesis that small, closely spaced electrodes were not suitable for fnEIT. In vivo experiments with the optimized geometry then showed that fnEIT can image thalamocortical circuit activity at a high enough resolution to see the activity propagating from specific thalamic nuclei to specific regions of the somatosensory cortex. This bodes well for fnEIT's potential as a technique for circuit neuroscience

Hydrodynamics of a 5D Einstein-dilaton black hole solution and the corresponding BPS state

We apply the potential reconstruction approach to generate a series of asymptotically AdS (aAdS) black hole solutions, with a self-interacting bulk scalar field. Based on the method, we reproduce the pure AdS solution as a consistency check and we also generate a simple analytic 5D black hole solution. We then study various aspects of this solution, such as temperature, entropy density and conserved charges. Furthermore, we study the hydrodynamics of this black hole solution in the framework of fluid/gravity duality, e.g. the ratio of the shear viscosity to the entropy density. In a degenerate case of the 5D black hole solution, we find that the c function decreases monotonically from UV to IR as expected. Finally, we investigate the stability of the degenerate solution by studying the bosonic functional energy of the gravity and the Witten-Nester energy $E_{WN}$. We confirm that the degenerate solution is a BPS domain wall solution. The corresponding superpotential and the solution of the killing spinor equation are found explicitly.Comment: V2: 23 pages, no figure, minor changes, typos corrected, new references and comments added, version accepted by JHE

Observational study of the association of first insulin type in uncontrolled type 2 diabetes with macrovascular and microvascular disease

&lt;p&gt;Aims: To compare the risk of vascular disease, HbA1c and weight change, between first prescribed insulins in people with type 2 diabetes.&lt;/p&gt; &lt;p&gt;Methods: People included in THIN United Kingdom primary care record database who began insulin (2000–2007) after poor control on oral glucose-lowering agents (OGLD) were grouped by the number of OGLDs in their treatment regimen immediately before starting insulin (n = 3,485). Within OGLD group, Cox regression compared macrovascular (all-cause mortality, myocardial infarction, acute coronary syndrome and stroke) and microvascular disease (peripheral neuropathy, nephropathy, and retinopathy) between insulin type (basal, pre-mix or Neutral Protamine Hagedorn, NPH) while ANCOVAs compared haemoglobin A1c (HbA1c) and weight change.&lt;/p&gt; &lt;p&gt;Results: Mean follow-up was 3.6 years. Rates of incident macrovascular events were similar when basal insulin was compared to pre-mix or NPH, adjusted hazard ratio versus basal: pre-mix 1.08 (95% CI 0.73, 1.59); NPH 1.00 (0.63, 1.58) after two OGLDs, and pre-mix 0.97 (0.46, 2.02); NPH 0.77 (0.32, 1.86) after three OGLDs. An increased risk of microvascular disease in NPH versus basal after 3 OGLDs, adjusted hazard ratio1.87 (1.04, 3.36), was not seen after two agents or in comparisons of basal and pre-mix. At one year, after two OGLDs, weight increase was less with basal compared with pre-mix. After three OGLDs, mean HbA1c had reduced less in basal versus pre-mix or NPH at 6–8 and at 9–11 months, and versus pre-mix at 12–14 months.&lt;/p&gt; &lt;p&gt;Conclusion: We found no difference in the risk of macrovascular events between first insulins in the medium term when started during poor glycaemia control. The increased risk of microvascular events with NPH warrants further study. In certain groups, first use of basal insulin was associated with less gain in weight and decrease in HbA1c compared to other insulins.&lt;/p&gt