Background & Aims Mother-to-infant transmission is the major cause of hepatitis B virus (HBV) infection among immunized children. There has been much debate about screening pregnant women and ...administering hepatitis B immunoglobulin (HBIG) to newborns. We analyzed the rate of HBV infection among children born to hepatitis B surface antigen (HBsAg)-positive mothers and whether HBIG administration reduces transmission. Methods We analyzed data from 2356 children born to HBsAg-positive mothers, identified through prenatal maternal screens. In addition to HBV vaccines, HBIG was given to all 583 children with hepatitis B e antigen (HBeAg)-positive mothers and to 723 of 1773 children with HBeAg-negative mothers. Serology tests for HBV were performed from 2007 to 2009, when children were 0.5–10 years old. Results A significantly greater percentage of children with HBeAg-positive mothers tested positive for antibodies against the hepatitis B core protein (16.76%) and HBsAg (9.26%) than children with HBeAg-negative mothers (1.58% and 0.29%, respectively; P < .0001 and <.001). Among the HBV-infected children, the rate of chronicity also was higher among children with HBeAg-positive mothers than children with HBeAg-negative mothers (54% vs 17%; P = .002). Similar rates of antibodies against the hepatitis B core protein (0.99% and 1.88%; P = .19) and HBsAg (0.14% and 0.29%; P = .65) were noted in children born to HBeAg-negative mothers who were or were not given HBIG. Infantile fulminant hepatitis developed in 1 of 1050 children who did not receive HBIG (.095%). Conclusions Children born to HBeAg-positive mothers are at greatest risk for chronic HBV infection (9.26%), despite immunization. Administration of HBIG to infants born to HBeAg-negative mothers did not appear to reduce the rate of chronic HBV infection, but might prevent infantile fulminant hepatitis. Screening pregnant women for HBsAg and HBeAg might control mother-to-infant transmission of HBV.
Abstract
Background
The incidence of breast cancer among younger East Asian women has been increasing rapidly over recent decades. This international collaborative study systemically compared the ...differences in age-specific incidences and pathological characteristics of breast cancer in East Asian women and women of predominantly European ancestry.
Methods
We excerpted analytic data from six national cancer registries (979 675 cases) and eight hospitals (18 008 cases) in East Asian countries and/or regions and, for comparisons, from the US Surveillance, Epidemiology, and End Results program database. Linear regression analyses of age-specific incidences of female breast cancer and logistic regression analyses of age-specific pathological characteristics of breast cancer were performed. All statistical tests were two-sided.
Results
Unlike female colorectal cancer, the age-specific incidences of breast cancer among East Asian women aged 59 years and younger increased disproportionally over recent decades relative to rates in US contemporaries. For years 2010–2014, the estimated age-specific probability of estrogen receptor positivity increased with age in American patients, whereas that of triple-negative breast cancer (TNBC) declined with age. No similar trends were evident in East Asian patients; their probability of estrogen receptor positivity at age 40–49 years was statistically significantly higher (odd ratio OR = 1.50, 95% confidence interval CI = 1.36 to 1.67, P < .001) and of TNBC was statistically significantly lower (OR = 0.79, 95% CI = 0.71 to 0.88, P < .001), whereas the probability of ER positivity at age 50–59 years was statistically significantly lower (OR = 0.88, 95% CI = 0.828 to 0.95, P < .001). Subgroup analyses of US Surveillance, Epidemiology, and End Results data showed similarly distinct patterns between East Asian American and white American patients.
Conclusions
Contrasting age-specific incidences and pathological characteristics of breast cancer between East Asian and American women, as well as between East Asian Americans and white Americans, suggests racial differences in the biology.
For the requirements of efficient integration and simple fabrication, a new codesign approach for a microstrip filter with an antenna array with reduced sidelobe level is introduced in this ...communication. The microstrip patch antennas and the stub-loaded resonators are used to illustrate the synthesis of a bandpass filtering antenna array. By controlling the coupling strength between the resonators, a uniform or nonuniform power divider network can be obtained. A nonuniform power division is used to reduce the sidelobe level. The equivalent lumped circuit model is developed and analyzed in detail. Two types of eight-element filtering antenna array with uniform and tapered power-distribution among the elements have been designed. Simulated and measured results provide a good verification for the theoretical concepts.
A differential third-order Chebyshev filtering microstrip antenna array with high common-mode (CM) rejection is presented. The feeding structure consisting of one line resonator and one H-shaped ...resonator as well as the microstrip antenna elements together provide the three stages in the bandpass filter design. Under differential-mode excitation, the H-shaped resonator can be effectively coupled with the line resonator, and thus differential signals can be radiated. However, under CM excitation, the H-shaped resonator cannot be excited so that the CM suppression can be achieved. A prototype antenna array with center frequency at 3.5 GHz has been designed and fabricated to experimentally validate the principle and design approach. Experimental results exhibit that the proposed differential filtering antenna array features high CM rejection, low cross-polarization level, and good filtering response.
In this communication, a new design for the microstrip-fed slot antenna with a directive radiation pattern for WLAN/WiMAX application is presented. By utilizing a two-element array topology, a ...unidirectional radiation pattern is obtained. Without any directors and reflectors, the proposed slot antenna shows advantages in terms of compact size and high front-to-back gain ratio in the azimuthal plane. Four directional slot antennas are then placed in a square loop array to obtain nearly orthogonal patterns. Thus, a compact multiple input multiple output array with high isolation among those four elements is achieved. Simulated and measured results are presented to validate the practicality of the proposed antenna structures.
Milk products are good sources of calcium that may reduce bone resorption and help prevent bone loss as well as promote bone remodeling and increase bone formation. Kefir is a product made by kefir ...grains that degrade milk proteins into various peptides with health-promoting effects, including antithrombotic, antimicrobial and calcium-absorption enhancing bioactivities. In a controlled, parallel, double-blind intervention study over 6 months, we investigated the effects of kefir-fermented milk (1,600 mg) supplemented with calcium bicarbonate (CaCO3, 1,500 mg) and bone metabolism in 40 osteoporosis patients, and compared them with CaCO3 alone without kefir supplements. Bone turnover markers were measured in fasting blood samples collected before therapy and at 1, 3, and 6 months. Bone mineral density (BMD) values at the spine, total hip, and hip femoral neck were assessed by dual-energy x-ray absorptiometry (DXA) at baseline and at 6 months. Among patients treated with kefir-fermented milk, the relationships between baseline turnover and 6 months changes in DXA-determined BMD were significantly improved. The serum β C-terminal telopeptide of type I collagen (β-CTX) in those with T-scores > -1 patients significantly decreased after three months treatment. The formation marker serum osteocalcin (OC) turned from negative to positive after 6 months, representing the effect of kefir treatment. Serum parathyroid hormone (PTH) increased significantly after treatment with kefir, but decreased significantly in the control group. PTH may promote bone remodeling after treatment with kefir for 6 months. In this pilot study, we concluded that kefir-fermented milk therapy was associated with short-term changes in turnover and greater 6-month increases in hip BMD among osteoporotic patients.
ClinicalTrials.gov NCT02361372.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Even though the increasing clinical recognition of primary aldosteronism (PA) as a public health issue, its heightened risk profiles and the availability of targeted surgical/medical treatment being ...more understood, consensus in its diagnosis and management based on medical evidence, while recognizing the constraints of our real-world clinical practice in Taiwan, has not been reached.
The Taiwan Society of Aldosteronism (TSA) Task Force acknowledges the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics into the management of PA.
When there is suspicion of PA, a plasma aldosterone to renin ratio (ARR) should be obtained initially. Patients with abnormal ARR will undergo confirmatory laboratory and image tests. Subtype classification with adrenal venous sampling (AVS) or NP-59 nuclear imaging, if AVS not available, to lateralize PA is recommended when patients are considered for adrenalectomy. The strengths and weaknesses of the currently available identification methods are discussed, focusing especially on result interpretation.
With this consensus we hope to raise more awareness of PA among medical professionals and hypertensive patients in Taiwan, and to facilitate reconciliation of better detection, identification and treatment of patients with PA.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This communication presents a wide stopband filtering antenna element and its application in multi-input multi-output (MIMO) system. Microstrip terminated coupled lines and a rectangle patch are ...utilized to generate the filtering function. By varying the length of the parallel coupled lines and open-circuited stubs, multiple transmission zeros can be introduced in the spurious band. Appropriate positioning the location of these transmission zeros enables a wide harmonic suppression. To demonstrate the proposed method, a wide stopband filtering antenna is designed and further applied in a four-element MIMO array. The measured and simulated results agree well. The proposed MIMO antenna obtains an attenuation of 12.6 dB up to <inline-formula> <tex-math notation="LaTeX">6.6\times </tex-math></inline-formula> the center frequency.
•Nonlinear in-plane equilibrium of arch-beam structures was derived firstly.•Nonlinear buckling behaviors are thoroughly different with single arch structures.•Stationary point of inflexion of ...nonlinear equilibrium path is different with single arch structures.•Stable bifurcation phenomenon was observed firstly in nonlinear buckling of arch structures.•Symmetric and asymmetric buckling requirement are independent with each other.
This paper investigates analytical predictions for non-linear behavior and buckling of pin-ended arch-beam structures. The nonlinear in-plane equilibrium is derived based on the principle of virtual work and the force balance condition of the ends of arch-beam structures. A new calculation method of the stationary point of inflexion is proposed and used to develop the symmetric buckling requirement for arch-beam structures. The asymmetric buckling requirement as well as all the possible nonlinear buckling behaviors and corresponding buckling requirements for arch-beam structures are also investigated analytically. The accuracy of proposed analytical solutions is validated through the comparisons against finite element analysis results. The major findings of this theoretical investigation are: (1) the analytical solution of the symmetric buckling requirement for arch-beam structures is thoroughly different from that for the single arch structures; (2) a stable bifurcation phenomenon can be observed in the nonlinear asymmetric buckling of arch-beam structures, in which buckling load increases as the asymmetric buckling occurs; (3) the symmetric buckling requirement and the asymmetric buckling requirement of arch-beam structures are independent of each other and the asymmetric buckling can occur before the stationary point of inflexion; and (4) the nonlinear buckling behavior of arch-beam structures is more complicated than the behavior of single arch structures, and six different buckling phenomena can be observed by changing the parameters of compression stiffness ratio between the beam and the arch, modified slenderness and rise-to-span ratio.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
