Equivalent homogeneous anisotropic solids are used to represent thick laminates con sisting of large numbers of a repeating sublaminate. The typical sublaminate is used for studying its load-deformation behavior from which the effective elastic constants are derived from the constituent lamina properties. Explicit expressions for effective elastic constants for general thick laminates are presented. Reduced expressions are also derived for balanced laminates containing a single composite system. Numerical examples are in cluded.

Objectives: To examine the nutritional and functional status of community older adults in China, to identify the related factors and best predictors of elder nutrition. Design, setting and subjects: A cross-sectional, descriptive correlation design was utilized. A convenience sample of 162 community older adults (aged $65 years) were administered three questionnaires, which were used to obtain demographic characteristics, nutritional status (Mini Nutritional Assessment, MNA) and functional status (Instrumental Activities of Daily Living, IADL). Results: The mean MNA score was 23?8 (SD 3?92), 36?4 % of elders were at risk of malnutrition and 8?0 % were malnourished; 61?7 % were functionally independent. Spearman's correlation analysis indicated that age, marital status, education level, personal income, number of chronic medical conditions suffered and functional status had significant correlations with nutritional status. Stepwise multiple linear regression analysis identified that the best predictors were the number of chronic conditions suffered, age, functional status and marital status. Conclusions: The study has suggested that nutritional health remains a problem among older adults in the Chinese community. A large proportion was on the borderline of malnutrition, and deficiency as well as excesses coexisted. Malnutrition is an increasing hazard especially for those suffering from more diseases, at a highly advanced age, functionally dependent and widowed.

Solid polymer electrolytes show flexible mechanical characters, excellent electrochemical properties, and impressive battery performance over a wide temperature range.

Nurses should not only pay attention to stroke survivors but also to their caregivers. To help them adjust well from the stroke consequences and avoid depression, nurses should implement effective interventions.

Background Malignant struma ovarii (MSO) is a unique type of ovarian malignancy that data on the survival outcome is limited and management strategy remains controversial due to its extreme rarity. Methods To investigate the clinical characteristics and treatment options in patients with MSO confined to the ovary, while also evaluating the recurrent-free survival (RFS) and overall survival (OS) rate in this population, a retrospective study was conducted. One hundred twenty-five cases of MSO confined to the ovary were enrolled and their clinical characteristics, treatment strategies, and results of follow-up were analyzed. OS and RFS were assessed by Kaplan-Meier analyses and Cox regression models. Results The most common pathological subtype in this cohort was papillary carcinoma (44.8%). Other reported subtypes, in order of prevalence, were follicular variant of papillary carcinoma, follicular carcinoma, and mixed follicular-papillary carcinoma. Surgical treatment options varied in this cohort that 8.0% of the patients received ovarian cystectomy, 33.6% underwent unilateral salpingo-oophorectomy (USO), 5.6% received bilateral salpingo-oophorectomy (BSO), 21.6% received total abdominal hysterectomy with BSO (TAH/BSO), and 17.6% were treated with debulking surgery; 20.0% of them received radioiodine therapy (RAI). Twenty-seven patients experienced recurrence with a median RFS of 14.0 years (95% confidence interval [CI], 9.5–18.5). The 5-year and 10-year recurrent rate were 27.1, 35.2%, respectively. Eight patients died during follow-up, with five attributed to MSO; the 5-year, 10-year, and 20-year OS rate was 95.3, 88.7 and 88.7%, respectively. However, the univariate and multivariate Cox regression showed no potential risk factor for RFS and OS. Conclusion Patients with MSO confined to the ovary had an excellent survival outcome, despite varied treatment strategies, and the recurrent rate was relatively high. We recommend USO as the preferred surgical option in this population since more aggressive surgery does not improve outcomes and the benefits of RAI are uncertain.

Although it is well known that miRNAs play crucial roles in multiple biological processes, there is currently no evidence indicating that milRNAs from Fusarium oxysporum f. sp. lycopersici (Fol ) interfere with tomato resistance during infection.Here, using sRNA-seq, we demonstrate that Fol-milR1, a trans-kingdom small RNA, is exported into tomato cells after infection.The knockout strain ΔFol-milR1 displays attenuated pathogenicity to the susceptible tomato cultivar 'Moneymaker'. On the other hand, Fol-milR1 overexpression strains exhibit enhanced virulence against the resistant cultivar 'Motelle'. Several tomato mRNAs are predicted targets of Fol-milR1. Among these genes, Solyc06g007430 (encoding the CBLinteracting protein kinase, SlyFRG4) is regulated at the posttranscriptional level by Fol-milR1. Furthermore, SlyFRG4 loss-of-function alleles created using CRISPR/Cas9 in tomato ('Motelle') exhibit enhanced disease susceptibility to Fol, further supporting the idea that SlyFRG4 is essential for tomato wilt disease resistance. Notably, our results using immunoprecipitation with specific antiserum suggest that Fol-milR1 interferes with the host immunity machinery by binding to tomato ARGONAUTE 4a (SlyAGO4a). Furthermore, virus-induced gene silenced (VIGS) knock-down SlyAGO4a plants exhibit reduced susceptibility to Fol.Together, our findings support a model in which Fol-milR1 is an sRNA fungal effector that suppresses host immunity by silencing a disease resistance gene, thus providing a novel virulence strategy to achieve infection.

Hybrid ionogel electrolytes have high thermal and electrochemical stability, good ionic conductivity, and potential to suppress Li dendrite formation. Solid-state lithium metal batteries with hybrid electrolytes reveal high capacity and remarkable rate performance.

ObjectiveTo evaluate the efficacy of the program Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) in encouraging physical activities for the prevention of heart attack and stroke among hypertensive patients enrolled in the Community-Based Hypertension Control Program (CBHCP).DesignCluster randomized controlled trial with three waves of longitudinal assessments at baseline, 3 and 6 months post intervention.SettingCommunity-based and patient-centered self-care for behavioral intervention in urban settings of China.ParticipantsA total of 450 participants diagnosed with hypertension from 12 community health centers in Wuhan, China were recruited, and were randomly assigned by center to receive either KM2H2 plus standard CBHCP care (6 centers and 232 patients) or the standard care only (6 centers and 218 patients).InterventionKM2H2 is a behavioral intervention guided by the Transtheoretical Model, the Model of Personalized Medicine and Social Capital Theory. It consists of six intervention sessions and two booster sessions engineered in a progressive manner. The purpose is to motivate and maintain physical activities for the prevention of heart attack and stroke.Outcome MeasuresHeart attack and stroke (clinically diagnosed, primary outcome), blood pressure (measured, secondary outcome), and physical activity (self-report, tertiary outcome) were assessed at the individual level during the baseline, 3- and 6-month post-intervention.ResultsRelative to the standard care, receiving KM2H2 was associated with significant reductions in the incidence of heart attack (3.60% vs. 7.03%, p < .05) and stroke (5.11% vs. 9.90%, p<0.05), and moderate reduction in blood pressure (-3.72mmHg in DBP and -2.92 mmHg in DBP) at 6-month post-intervention; and significant increases in physical activity at 3- (d = 0.53, 95% CI: 0.21, 0.85) and 6-month (d = 0.45, 95% CI: 0.04, 0.85) post-intervention, respectively.ConclusionThe program KM2H2 is efficacious to reduce the risk of heart attack and stroke among senior patients who are on anti-hypertensive medication. Findings of this study provide solid data supporting a formal phase-III trial to establish the effectiveness of KM2H2 for use in community settings for prevention.Trial RegistrationISRCTN Register ISRCTN12608966