Syndromic Recognition of Influenza A Infection in a Low Prevalence Community Setting

BACKGROUND: With epidemics of influenza A virus infection, people and medical professionals are all concerned about symptoms or syndromes that may indicate the infection with influenza A virus. METHODOLOGY/PRINCIPAL FINDINGS: A prospective study was performed at a community clinic of a metropolitan area. Throat swab was sampled for 3-6 consecutive adult patients with new episode (<3 days) of respiratory tract infection every weekday from Dec. 8, 2005 to Mar. 31, 2006. Demographic data, relevant history, symptoms and signs were recorded. Samples were processed with multiplex real time PCR for 9 common respiratory tract pathogens and by virus culture. Throat swab samples were positive for Influenza A virus with multiplex real time PCR system in 12 of 240 patients. The 12 influenza A positive cases were with more clusters and chills than the other 228. Certain symptoms and syndromes increased the likelihood of influenza A virus infection. The syndrome of high fever plus chills plus cough, better with clustering of cases in household or workplace, is with the highest likelihood (positive likelihood ratio 95; 95% CI 12-750). Absence of both cluster and chills provides moderate evidence against the infection (negative likelihood ratio 0.51; 95% CI 0.29-0.90). CONCLUSIONS/SIGNIFICANCE: Syndromic recognition is not diagnostic but is useful for discriminating between influenza A infection and common cold. In addition to relevant travel history, confirmatory molecular test can be applied to subjects with high likelihood when the disease prevalence is low

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Energy Strategies of the Rising China and Its Impact：A Case Study of Chinese Investment In North & West Africa

摘要 改革開放後的中國政治社群，因為經濟的快速成長而同時面臨能源需求的高速成長。隨著中國逐漸地依賴外來能源作為其能源消費（特別是原油）的主力，「能源不安全」的情況也隨之產生。在本文中，筆者藉由分析中國現行的能源生產及消費狀況，提出前述中國的能源安全的問題包含了：由供需成長差額所引起的「供需與價格困境」，由原油過度依賴中東北非地區所引起的「運輸安全困境」、由國際新興能源需求興起所造成的「國際能源競爭」及源自於中國能源背景及企業競爭能力的「生產效率不足」問題。面對這個嚴峻的情況，中國政府積極建立其能源安全戰略，在國內層面透過強化海軍、增進原油儲備、升級技術、改變能源結構、成立高層級能源委員會對應。而在國外則透過其全球的能源安全戰略，以政府的外交力量和國營能源企業，在非洲及全球展開了競逐能源供給的龐大戰略性工程。 本文利用「中國整體」、「西北非」、「蘇丹及奈及利亞」為基準，建立一個可以相互印證並參照的三層次論述，勾勒出中國能源戰略從上至下的施行面貌以及數據資料分析。文末並透過戰略性貿易理論的應用和前述資料的呈現，歸類出中國在西北非能源投資具有「高度彈性」、「高額投入」、「低透明度」以及「緊扣菁英階層」的特性，並且預測未來在西北非投資，將會擴大並延伸溢出至能源以外的產業，但也可能引發階級與利益團體之間的衝突。而中國能源安全戰略在整體上，則會朝向擴散式、週期性的方式發展，並與中國社會的能源外部利益高度相關。Abstract Due to the Chinese “Reform and Opening up” policy OF 1979 and the following economic growth and industrialization, the energy demand of the Chinese political community has been increasing enormously. The innate insufficiency of Chinese energy resources has forced China to rely on foreign imports, creating a certain degree of “energy insecurity.” This article analyzes the context of this phenomenon; encapsulates the insecurity into the following four parts: demand and price dilemma, transportation security dilemma, the issue of international energy competition, and the issue of insufficient energy production. The article states that, to fairly deal with these issues and dilemmas, the Chinese government is actively building its energy security strategy. At the domestic level, the Chinese government has been strengthening its naval capability, increasing its strategic oil reserve; upgrading energy technology and infrastructure, and formed a high level government committee tasked with the sole duty of handling its energy insecurity. As for the international level, China has been using its diplomatic influence and its national oil companies to build a grand strategy racing for more energy supply in Africa and all over the world. Using the basis of three different levels of discussion, including the perspective of general Chinese energy security as a whole, Chinese energy engagement particularly in West and North Africa, and Chinese energy investment and trade in Sudan and Nigeria, this article seeks to present a corresponding and related three-level analysis, which reflects the culture of Chinese energy security not only from the top to the bottom but also from the strategic thinking to the actual execution. In the end of the paragraph, through the implication of Strategic Trade Theory and data collected throughout the research, this article states that Chinese energy association with West and North Africa can be described by four elements: high elasticity, great amount of capital investment, low transparency, and strong linkage to the elite level. The research also predicts that the Chinese investment in the energy field and basic infrastructure in Africa will overflow to other departments, yet the strong connection between the African elite and Chinese government might bring cross-leveled conflict. This article also predicts that the general development of Chinese energy security strategy will be in a proliferating and cyclical manner, and the cycle will be highly related with the extent of the exterior advantage that energy security could bring.目次 第一章、 緒論 第一節、 研究動機 1 第二節、 研究目的、問題與假設 4 第三節、 研究架構 13 第四節、 研究方法及研究途徑 15 第五節、 文獻探討 17 第六節、 章節安排及研究時程 24 第二章、 中國國家能源安全戰略 第一節、 背景、發展脈絡及現況 27 第二節、 中國的能源安全困境與其對外能源安全戰略 40 第三節、 中國能源安全戰略論析及及其與能源安全困境的關聯 55 第三章、 中國對外能源安全戰略的非洲意涵 第一節、 中國全球能源安全戰略中的非洲意義 75 第二節、 中國非洲能源戰略的主要行為者暨執行模式 86 第三節、 中國對西北非整體能源相關投資及貿易概況 100 第四節、 小結 108 第四章、 中國能源安全戰略與其西北非 能源投資及貿易的個案研究 第一節、 蘇丹的個案研究 109 第二節、 奈及利亞的個案研究 123 第三節、 小結 135 第五章、 中國能源安全戰略在西北非實踐的綜合性分析 第一節、 中國能源安全戰略在西北非實踐的通則與特色 137 第二節、 戰略性貿易理論與中國在非洲能源安全戰略 144 第六章、 結論 15

Microwave-Assisted Solvent Bonding for Polymethyl Methacrylate Microfluidic Device

This paper demonstrated a microwave-assisted solvent bonding method that uses organic solvent to seal the thermoplastic substrates with microwave assistance. This direct bonding is a simple and straightforward process that starts with solvent application followed by microwave irradiation without the need for expensive facilities or complex procedures. The organic solvent applied at the bonding interface is used in dissolving and dielectric heating of the thermoplastic surfaces to seal the thermoplastic substrates under microwave assistance. We evaluated acetone and ethanol to seal the polymethyl methacrylate (PMMA) microfluidic device. The bonding performance, such as bonding coverage, geometry stability, and bonding strength (tensile) were observed and compared with the oven-heating and non-heating control experiments under the same force applications. Results showed that the microwave-assisted solvent bonding method presents a high bonding yield (maximum &gt; 99%) and bonding strength (maximum ~2.77 MPa) without microchannel distortion, which can be used for various microfluidic applications

Performance Enhancement of Pentacene-Based Organic Thin-Film Transistors Using a High-K PVA/Low-K PVP Bilayer as the Gate Insulator

In this study, we proposed using the high-K polyvinyl alcohol (PVA)/low-K poly-4-vinylphenol (PVP) bilayer structure as the gate insulator to improve the performance of a pentacene-based organic thin-film transistor. The dielectric constant of the optimal high-K PVA/low-K PVP bilayer was 5.6, which was higher than that of the single PVP layer. It resulted in an increase in the gate capacitance and an increased drain current. The surface morphology of the bilayer gate dielectric could be suitable for pentacene grain growth because the PVP layer was deposited above the organic PVA surface, thereby replacing the inorganic surface of the ITO gate electrode. The device performances were significantly improved by using the bilayer gate dielectric based upon the high-K characteristics of the PVA layer and the enlargement of the pentacene grain. Notably, the field-effect mobility was increased from 0.16 to 1.12 cm2/(Vs), 7 times higher than that of the control sample

Short-term Outcome of Pulmonary Hemorrhage in Very-Low-Birth-Weight Preterm Infants

Severe pulmonary hemorrhage is a serious complication with a high mortality rate in preterm infants with respiratory distress syndrome (RDS) after surfactant therapy. The aim of this study is to evaluate the efficacy of our current management strategy for neonates with severe pulmonary hemorrhage. Materials and methods: Very-low-birth-weight (VLBW) infants who developed severe pulmonary hemorrhage were studied from January 2006 to August 2011. Treatment for severe pulmonary hemorrhage in our neonatal intensive care unit (NICU) included intratracheal epinephrine spraying/irrigation, blood component therapy, and as necessary, surfactant supplement therapy was administered in cases that secondary RDS was diagnosed. High frequency oscillatory ventilation (HFOV) was utilized when hypoxia or respiratory acidosis persisted under conventional mechanical ventilation (CMV). We then described the clinical courses of severe pulmonary hemorrhage following our management. Results: A total of 18 (3.2%) out of 469 VLBW infants developed severe pulmonary hemorrhage. The mean gestational age was 27 weeks, the mean birth weight was 822 g, and the onset age was 2.5 days after birth. There was no severe pulmonary hemorrhage-associated mortality during this period with the exception of one case, in which an infant died after the parents refused to do further therapy. Sixteen (88.8%) neonates had RDS and 13 received surfactant therapy. Twelve (66.6%) cases developed secondary RDS following the onset of severe pulmonary hemorrhage, and four cases received surfactant supplement therapy. In the surfactant supplement group, alveolar-arterial oxygen difference (AaDO2) and oxygenation index (OI) during the 2–4 hours postpulmonary hemorrhage period showed statistically significant improvement, whereas the other group only showed a tendency toward improvement without reaching statistical significance when compared to the baseline data. Duration of high oxygen requirement [defined as fraction of inspired oxygen (FiO2) > 40%] was also less in the surfactant supplement group. Conclusion: This data suggests that our current strategy is effective for treating severe pulmonary hemorrhage in VLBW infants. Surfactant therapy for severe pulmonary hemorrhage may also be beneficial for improving lung function and may shorten the duration of high oxygen requirement