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Thalassemia is a common monogenic disease in southwestern China, especially in Guizhou province. In this study, 18 309 neonates were examined for thalassemia. The thalassemia carrier rate was 12.90%, which is associated with geographical regions, with carrier frequencies significantly differing between regions (p < 0.0001). The carrier rates for α-thalassemia and β-thalassemia were 8.91% and 3.36%, respectively. There are 22 genotypes identified among 1632 α-thalassemia cases, and 18 genotypes detected among 615 β-thalassemia cases. The birthrates of individuals with intermediate thalassemia and β-thalassemia major were 0.153% and 0.055%, respectively. Methodologically, NGS-Gap-PCR is superior to traditional detection methods, with 65 more cases detected by NGS-Gap-PCR. Since thalassemia-rich genotypes were highly prevalent in this region, early detection of thalassemia carriers would be meaningful for genetic counseling and prevention/treatment of thalassemia. NGS-Gap-PCR provides a powerful tool for neonate genetic testing and clinical diagnosis of thalassemia, especially in high-prevalence regions.

Background Improving and sustaining the quality of nursing care is an intractable and persistent challenge. The patient experience of nursing care can give a different perspective on nursing quality and help clinical nursing staff to direct quality improvement. Attempts to identify what is patient experience, the relationship with nursing care, and the application of patient experience in nursing quality improvement practice, in order to provide advices for constructing the quality standards and quality improvement strategies of nursing care. Methods We conducted a literature review of original research publications. The database platforms Pubmed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang were searched from inception until end of August 2015. After screening retrieved articles, 40 sources (articles and organizational websites) were selected for analysis for the connotation, development and application of patient experience in nursing quality researches. Results Our study identified several concepts about patient experience, roughly sorted out the development path of patient experience in worldwide and the application of patient experience in nursing quality improvement. It points out four precautions when applying patient experience in nursing quality improvement, which are differentiating patient satisfaction and patient experience, choosing appropriate data collection method and appropriate feedback time, and the last but the most important, applying theories to actual clinical practice. Conclusions Professional indexes are important to maintain the care quality, but it cannot fully reflect quality of nursing care, which needs patient experience as the supplement. Nursing staffs need to make more efforts to enhance patient's nursing care experience, and apply the research results to clinical practice, and finally make patient-centered care come true. For future study, the evaluation system and management strategies about patient experience need to be developed to guide nursing quality improvement.

A compact, portable, label-free, and ultra-sensitive sensor is proposed to detect cancerous cells based on Multi-Core Fiber (MCF) comprising of seven cores arranged in a hexagonal shape spliced with Single-Mode Fiber (SMF). Here, cytosensing based on fiber optic Localized Surface Plasmon Resonance (LSPR) is used for the efficient detection of different types of cancer cells. The proposed sensor structure is etched in a controlled manner to increase the evanescent wave (EWs) and coupling of modes between the cores of MCF. The etched MCF based LSPR probe has high refractive index sensitivity (RIS). To further increase the sensitivity, the sensor structure is immobilized with different nanomaterials (NMs) such as optimized size of gold nanoparticles (AuNPs), graphene oxide (GO), and copper oxide nanoflowers (CuO-NFs). AuNPs increase the sensitivity using LSPR, whereas, GO and CuO-NFs helps to increase the biocompatibility of sensor. The developed probe is further coated with 2-deoxy-D-glucose (2-DG) over NMs that are specific for the detection of cancer cells. In this work, various cancerous cell lines i.e. HepG2, Hepa 1–6, MCF-7, A549, and normal cell lines i.e. NCF and LO2 are detected using the developed sensing probe. Various analysis of proposed sensor such as selectivity, reusability, anti-interference ability, and involvement of GLUT receptor in detection has also been performed. The proposed etched sensor is ultra-sensitive for detection of HepG2, Hepa1 6, A549, MCF-7, LO2, and NCF cell lines with a limit of detection (LoD) of 3, 2, 2, 2, 4, 10 cells/mL, respectively in the linear range of 1 × 102–1 × 106 cells/mL.

Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a common type of hemophagocytic lymphohistiocytosis (HLH) that exhibits high rates of morbidity and fatalities. Multiorgan failure caused by Epstein-Barr virus (EBV)-induced hypercytokinemia is one of the main reasons for early deaths. Blood purification techniques have been successfully applied in previously treated hypercytokinemia. However, there were insufficient studies to support the combination of plasma exchange (PE) and continuous renal replacement therapy (CRRT) in treating patients with severe EBV-HLH. In this article, we have summarized the effects of early incorporation of PE and CRRT, together with HLH-2004 chemoimmunotherapy, in 8 pediatric patients with severe EBV-HLH. Early use of PE and CRRT appeared to be well tolerated, and no serious side effects and early deaths were observed. After PE and CRRT procedures, cytokine levels were reduced to normal values, except for soluble interleukin 2 receptor, and significant reductions in EBV DNA, serum ferritin, aspartate transaminase, total bilirubin, total bile acid, lactate dehydrogenase, and body temperature values and increases in the neutrophil count in addition to hemoglobin, albumin, and cholinesterase values were observed. Furthermore, through continuous HLH-2004 treatment regimens, lower limits of detection were exhibited for EBV DNA levels, and all other observational indicator levels were restored to normal. Finally, 7 patients achieved and maintained complete remission for 15 to 24 months, culminating in August 2019. Therefore, it is our suggestion that early incorporation of PE and CRRT with chemoimmunotherapy might be a safe and effective treatment for patients with severe EBV-HLH.

College language lab is “the second classroom” of foreign language teaching. It is a place of effectively cultivating students' ability of self-learning and practicing. This paper analyzes the significance and role of the language laboratory for cultivating students' self-learning and innovation ability, designs out the model of function structue for the openning of the language laboratory, proposes the form of database design, and discusses the system architecture.

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a severe and potentially fatal disease associated with abnormal function of the immune system. Epstein-Barr virus (EBV) is one of the most common triggers of HLH, especially in Asian countries. The control of EBV-HLH is still a challenging issue, particularly the early mortality, which was mainly due to the multi-organ failure coursed by hypercytokinemia. Therefore, control the hypercytokinemia induced by EBV are very important in critical ill EBV-HLH patients. Extracorporeal blood purification techniques already have been successfully applied to control hypercytokinemia in sepsis and septic shock patients. But there are few studies by using plasma exchange (PE) and continuous renal replacement therapy (CRRT) to treat critically ill EBV-HLH. This study aimed to evaluate the effect of PE+CRRT in the control of hypercytokinemia in critical ill EBV-HLH patients. Material and methods: The diagnosis a series of critically ill EBV-HLH patients admitted to the pediatric intensive care unit (PICU) were confirmed by comparing to the clinical and laboratory criteria of the HLH-2004 consensus. Real time polymerase chain reaction was used to detect EBV-DNA copies in the patients' serum, all the patients showed a significantly increasing of EBV-DNA copies in the serum (>1×104 Copies/mL). With the approval of the Ethics Committee and informed consents from the guardians of the patients, PE and CRRT combined HLH-2004 chemo-immunotherapy was used to treat these cases at the initial treatment, all the PE and CRRT sessions were finished in 3-7 days according to the condition of the patients. In addition, other supportive treatments were applied accordingly. The levels of cytokines were measured by using the CBA Human Th1/Th2 Cytokine Kit II (BD Biosciences, San Jose, California). Death occurred in 30 days after the initiation of treatment was defined as early death. Results: Clinical symptoms of all patients were remarkably improved after the PE and CRRT sessions. The EBV-DNA copies in the patients' serum was significantly decreased to around the limits of detection. And the abnormal high levels of cytokines were rapidly recovered to normal values. More importantly, no serious side effects were observed during the treatment. In addition, all the patients except one patient who did not continue the therapy achieved complete remission after 4 weeks' treatment, and no early death occurred in 30 days after the initiation of the treatment. Furthermore, the EBV-DNA were undetectable in the serum of these patients after 6 months. The remissions of these patients were maintained for a median time of 17 months (13-22 months). Conclusions: PE+CRRT associated HLH-2004 chemo-immunotherapy is a safe and effective strategy to control hypercytokinemia in critically ill EBV-HLH patients, and may help in the reduction of early death. More data from randomized, large-scale and multicenter studies are needed to make this conclusion more reliable. Disclosures No relevant conflicts of interest to declare.

Chinese Americans underutilize colorectal cancer screening. This study evaluated a physician-based intervention guided by social cognitive theory (SCT) to inform future research involving minority physicians and patients. Twenty-five Chinese-speaking primary care physicians were randomized into intervention or usual care arms. The intervention included two 45-minute in-office training sessions paired with a dual-language communication guide detailing strategies in addressing Chinese patients' screening barriers. Physicians' feedback on the intervention, their performance data during training, and pre-post intervention survey data were collected and analyzed. Most physicians (~85%) liked the intervention materials but ~84% spent less than 20 minutes reading the guide and only 46% found the length of time for in-office training acceptable. Despite this, the intervention increased physicians' perceived communication self-efficacy with patients (p

Requirement analyses based on use case apply to the requirement description of information system. This paper discusses the requirement analysis and modeling of automobile stamping parts management information system based on use case. Starting from analyzing its business flow diagram, the system activity (actor) and its candidate requirements reflecting from its feature checklist are recognized. The system functional requirements and non functional requirements are captured in the form of the use case, then the requirement model of automobile stamping parts management information system is established..

The development of computer technology has provided advanced methods for the analysis of complex mechanics problems. Along with the enhancement of computer speed, the computational time used in a finite element analysis is reduced significantly. The main work in a pre-bucking finite element analysis will concentrate on structuring the analytical model and the software model. A normalized factor of the normalized determinant DET of stiffness matrix is defined in this article.The finite element analysis model used in the pre-bucking analysis of laminated composite plates and shells is presented based on the characteristic of the DET. An algorithm for controlling computational procedure and determining critical load is also presented. Numerical examples are given to validate the proposed method and satisfactory results are obtained.

The operation phase is not only the longest stage of the life cycle of a project, but also the moment when people accumulates most information of the project. Because of the secular and complexity of property management during the operation period, and as there is large amount of information loss during the several periods before operation, it is very difficult to manage equipments all through the way. Based on the BIM technology, authors build a database of the equipment operation parameters to solve this problem. This paper realizes the real-time monitoring of the update of equipment information, equipment maintenance and fault handling during the operation stage. The research puts forward a new way to improve the standards of property management which will lead to a better economic benefits.

The different lifting mechanisms of compressed garbage transport trunks are analyzed and compared, and the impact of characters and parameters on the functions of the machines is also analyzed. Finally, a kind of lifting mechanism on the basis of the principle of double docking bars is put forward. Creating 3D models of lifting mechanism based on the Pro/E, and using ADAMS to simulating analysis about motion process of mechanism, then the dynamic curve about acceleration of waste bin, press of hydraulic cylinder and other parameters can be gotten, which is valided of optimality of the mechanism and provided reference for a more comprehensive analysis and optimization of similar institutions later.

Nonlinear analysis of plate and shell structures can explain the phenomenon which cannot been explained by classical stability theory, and can obtain better validation of experimental results. Stability problems are essentially nonlinear and their nonlinear finite element solutions ultimately result in solving nonlinear algebraic equations and nonlinear eigenvalue problems. The solutions can define the shape of basic path and determine critical load by using the incremental method, The perturbation methods are used near the critical point, and the basic formulas are given for initial post-buckling analysis by FEM.

With the rapid development of turbo-machinery, foil bearings became a very important type of high-tech mechanical components. Mechanical structure is one of the key influence factors on the progress of foil bearings. Different structure design characteristics of the bearings were described and compared by reviewing published results and patents. Future developments of the patents and models on foil journal bearings were presented to improve the current design structures. Finally, we know what will be done.

Objective The purpose of this study was to investigate the association between cultural views, English proficiency, and regular cervical cancer screening among older Chinese women. Methods The study sample consisted of 473 asymptomatic Chinese participants aged 50 and older recruited from community organizations. The study outcome was regular receipt of Pap tests, defined as having a recent test in the past 3 years and another within 3 years before the present test. Eastern cultural views were measured by a 30-item scale that assessed beliefs about illness and cancer. Sociodemographics, cancer worry, physician recommendation, health insurance, and access barriers were included as covariates in multiple logistic regression models. Results A total of 239 (50.5 %) Chinese American women had regular Pap tests. Findings indicate that 1) women who held more traditional Chinese cultural views were less likely to be a regular screener (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99); 2) women with higher English proficiency were 1.39 times more likely to have received regular Pap tests than women with lower proficiency (OR, 1.39; 95% CI, 1.13–1.72). Conclusion Cultural views and English proficiency were significant predictors of older Chinese American women regular receipt of Pap tests. Future research is needed to identify and design culturally and linguistically competent programs to promote cervical cancer screening.

The management of storage facilities (reservoirs, lakes, and ponds) is an important element of the utilization of a surface water resources system. Dynamic programming (DP) techniques have been used extensively in the analysis and resolution of reservoir systems operation. A major drawback of DP for a multireservoir system is the “curse of dimensionality.” To overcome this problem, this study developed a nonlinear programming (NLP) solution scheme which also integrated the objectives of several stakeholders, objectives which were noncommensurate. The NLP model employed a time series model to generate synthetic inflows into the storage facilities in order to simulate future operations of the system. Two sets of simulations were run, and a statistical test was used to terminate them. The expected values of the decision variables were tabulated and plotted, as well as their standard deviations and probability distributions. The model allows decision makers to adjust operation targets for different alternative operation scenarios.

Background Colorectal cancer (CRC) is one of the leading causes of cancer death in Chinese Americans, but their CRC screening rates remain low. Objective We examined subgroups of Chinese American patients nonadherent to CRC screening guidelines to better inform clinical practices to effectively promote screening. Methods Using latent class analysis of data from 327 participants recruited from 18 primary care clinics, we classified nonadherent patients based on sociodemographics, screening barriers, and attitudinal and clinical factors for CRC screening. Results The best-fitting latent class analysis model described 3 distinctive classes: Western healthcare class (36%), Eastern healthcare class (18%), and mixed healthcare class (46%). Western healthcare class patients were highly educated, with average US residency of 20 years, a high level of English proficiency, the least Eastern cultural views of care, and the greatest exposure to physician recommendations, but reported having no time for screenings. Eastern healthcare class patients were highly educated seniors and recent immigrants with the least CRC knowledge and the most Eastern cultural views. Mixed healthcare class patients had low level of education, resided in the United States for 20 years, and half had sought services of their physicians for at least 3 years, but their knowledge and cultural views were similar to those of Eastern healthcare class patients. Conclusions Nonadherent Chinese American patients are heterogeneous. It is essential to have future intervention programs tailored to address specific screening beliefs and barriers for subtypes of nonadherent patients. Implications for practice Training primary care physicians to recognize patients' different demographic characteristics and healthcare beliefs may facilitate physicians' communication with patients to overcome their barriers and improve screening behaviors.

This paper presents a novel template matching method to detect and track pedestrians for people counting in real-time. Firstly, a novel background subtraction method is proposed for extracting all foreground objects from background. Then, a shadow elimination method is used to remove unwanted shadow from the background. In order to identify pedestrians from non-pedestrian objects, this paper proposed a novel grid-based template matching scheme to robustly verify each pedestrian. Usually, a pedestrian will have different appearances at different positions. The grid-based approach can effectively reduce the perspective effects into a minimum since it uses different templates to record the appearance changes at each grid. When more templates are used, the detection process will become more inefficient. To speed up its efficiency, an integral image is used to filter out all impossible candidates in advance. Lastly, a tracking method is applied to tracking the direction of each moving pedestrian so that the real number of passing people per direction can be counted more accurately. Experimental results have proved that the proposed method is robust, accurate, and powerful in people counting.

Background: Colorectal cancer (CRC) is one of the leading causes of cancer death for Chinese Americans, but the CRC screenings rates remain low among them. Chinese Americans are one of the fast growing populations in the U.S. Chinese who migrated to the U.S. have increased risk for developing CRC. Hence, it is important to increase Chinese Americans' awareness of CRC risk and improve their screening behaviors. There is limited knowledge about the homogeneity of Chinese Americans who are non-adherent to recommended CRC screening guidelines. Research indicates that identifying the subtypes of patients is advantageous for healthcare providers to tailor their communication with patients by focusing on their particular needs and barriers and that can consequently promote their health-seeking behaviors. Objective: We examined the homogeneous subgroups of Chinese-American patients who are non-adherent to CRC screening guidelines to better inform clinical practices to effectively promote screening behaviors. Methods: We used baseline data from an ongoing intervention trial that enrolled non-adherent Chinese-American patients to CRC screening guidelines from 18 primary care clinics from the metropolitan Washington DC, New York, and Philadelphia areas. We used latent class analysis (LCA) to classify 349 non-adherent patients based on their sociodemographics, screening barriers, psychosocial and clinical access factors for CRC screening. After classes were identified, multilevel regression analyses were conducted for class comparison. Results: The mean age of the overall sample was 59 years old (SD=7.41). About half of the sample was female and also about half were college graduate. About 42% reported having received doctor recommendation for CRC screening, but only 10% had screened for CRC. The best-fitting LCA model described three distinctive classes: Western Healthcare Class (WHC, 35%), Eastern Healthcare Class (EHC, 18%) and Mixed Healthcare Class (MHC, 46%). WHC patients were highly-educated with average 20 years of U.S. residency, high level of English proficiency, the least Eastern views of healthcare and the greatest exposure to physician recommendations, but many reported having no time for CRC screenings. EHC patients were highly-educated seniors and recent immigrants with the least CRC knowledge and the strongest traditional views. MHC patients had low level of education, resided in the U.S. for 20 years, and had relatively long relationships with physicians, but their knowledge and Eastern views were similar to those of EHC patients. Conclusions: These findings extend previous literature and demonstrate that there are different sociodemographic and psychosocial factors to account for non-adherent screening behaviors of older Chinese immigrants. Training primary care physicians to understand that there are distinctive heterogeneous subgroups among non-adherent patients and recognize patients' different demographic characteristics (i.e. SES status, years in the U.S.) and healthcare beliefs (e.g. cancer screening) during encounters may facilitate physicians' communication with patients to overcome their barriers and consequently promote their screening behaviors. Citation Format: Carol Strong, Cheng Shuang Ji, Wenchi Liang, Grace Ma, Roger Brown, Judy Huei-yu Wang. Heterogeneous demographic and cultural profiles of nonadherent Chinese-American patients to colorectal cancer screening: A latent class analysis. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A82.