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The association of chocolate consumption with risk of gestational diabetes has not been examined. We aimed to investigate the prospective association between chocolate consumption and risk of gestational diabetes in a large birth cohort in Japan. A total of 97,454 pregnant women with a median gestational age of 12 weeks were recruited from January 2011 to March 2014. Data on demographic information, disease history, socioeconomic status, lifestyle, and dietary habits were obtained at the study enrollment. Dietary intakes during the past 12 months before study enrollment were assessed through a semi-quantitative food frequency questionnaire. The logistic regression was used to obtain the odds ratio of gestational diabetes in relation to chocolate consumption. Among 84,948 women eligible for the analysis, 1904 cases of gestational diabetes (2.2%) were identified during the period of pregnancy. After control for potential confounding factors including age, smoking status, drinking status, education level, occupation, pre-pregnant body mass index, depression, previous history of macrosomia babies, parity, physical activity, and dietary factors, women in the highest quartile of chocolate consumption, compared with those in the lowest quartile, had a significantly lower risk of developing gestational diabetes (odds ratio ½ 0.78, 95% confidence interval: 0.67-0.90; P for trend ½ 0.002). Stratified analyses suggested that the association was not significantly modified by pre-pregnancy body mass index, age, parity, smoking status, or drinking status. The present prospective cohort study provided evidence that chocolate consumption was associated with a significant lower risk of gestational diabetes in Japanese women.
Fabrication and characterization of solution-processed, all-inorganic quantum dots (QDs) light-emitting diodes (QLEDs) incorporating colloidal CdSe/ZnS QDs are presented. Using a simple solvothermal process, Cu-doped NiO nanocrystals were fabricated and applied as a hole transport layer in all inorganic QLEDs. Cu-doped NiO nanocrystals are ascribed to bunsenite cubic structure. The transmittance of the film is more than 81%. The hole-only devices of Au/QDs/Cu–NiO/ITO structures showed that 5% mol Cu doped NiO film obtained the largest hole current. The resulting devices show pure QD electroluminescent emissions with a maximum electroluminescence brightness of 2258 cd/m2 after doping 5% mol Cu in NiO, which is almost 4-fold compared with that of intrinsic NiO due to the enhanced carrier concentration and conductivity. The current efficiency and EQE of the assembled all-inorganic QLED exhibited the maximum values of 1.18 cd/A and 1.223%, respectively.
To examine urban–rural disparity in childhood stunting, wasting and malnutrition at national and subnational levels in Chinese primary-school children in 2010 and 2014.
Data were obtained from two nationwide cross-sectional surveys conducted in 2010 and 2014. Malnutrition was classified using the Chinese national ‘Screening Standard for Malnutrition of Children’.
All twenty-seven mainland provinces and four municipalities of mainland China.
Children aged 7–12 years (n 215 214; 107 741 in 2010 and 107 473 in 2014) from thirty-one provinces.
Stunting, wasting and malnutrition prevalence were 1·9, 12·3 and 13·7 % in 2010, but decreased to 1·0, 9·4 and 10·2 % in 2014, respectively. The prevalence of stunting, wasting and malnutrition in both urban and rural children was higher in western provinces, while lower in eastern provinces. Although the prevalence of wasting and malnutrition was higher in rural children than their urban counterparts, the urban–rural disparity in both wasting and malnutrition decreased from 2010 to 2014 (prevalence OR: wasting, 1·35 to 1·16; malnutrition, 1·50 to 1·27). A reversal occurred in 2014 in several eastern provinces where the prevalence of wasting and malnutrition in urban children surpassed their rural peers. The urban–rural disparity was larger in western provinces than eastern provinces.
The shrinking urban–rural disparity and the reversal in wasting and malnutrition suggest that the malnutrition situation has improved during the post-crisis period, especially in the western provinces. Region-specific policies and interventions can be useful to sustainably mitigate malnutrition in Chinese children, especially in rural areas and the western provinces.
Social attention ability is crucial for human adaptive social behaviors and interpersonal communications, and the malfunction of which has been implicated in autism spectrum disorder (ASD), a highly genetic neurodevelopmental disorder marked by striking social deficits.
Using a classical twin design, the current study investigated the genetic contribution to individual variation in social and non-social attention abilities, and further probed their potential genetic linkage. Moreover, individual autistic traits were further measured in an independent group of non-twin participants to examine the hypothetical link between the core social attention ability and ASD.
We found reliable genetic influences on the social attentional effects induced by two distinct cues (eye gaze and walking direction), with 91% of their covariance accounted for by common genetic effects. However, no evidence of heritability or shared genetic effects was observed for the attentional effect directed by a non-social cue (i.e. arrow direction) and its correlation with the social attention ability. Remarkably, one's autistic traits could well predict his/her heritable core social attention ability extracted from the conventional social attentional effect.
These findings together suggest that human social attention ability is supported by unique genetic mechanisms that can be shared across different social, but not non-social, processing. Moreover, they also encourage the identification of ‘social attention genes’ and highlight the critical role of the core human social attention ability in seeking the endophenotypes of social cognitive disorders including ASD.
OBJECTIVES/SPECIFIC AIMS: Missing data is a common problem in research studies that may lead to inconclusive or inaccurate results. It may even lead to harm secondary to wrong research conclusions. The purpose of this ancillary study is to measure the differences in missing data following implementation of a variety of mechanisms to improve data quality and documentation in a global quality improvement study. Many of the sites involved in the study were in low-income or middle-income countries with minimal research infrastructure. Missing data is defined as “values that are not available that would be meaningful for analysis if they were observed” (The prevention and treatment of missing data, New Engl J Med 367; 14, nejm.org, October 4, 2012). METHODS/STUDY POPULATION: All study sites used REDCap software to enter various data points including hospital and ICU admission and discharge dates as well as whether items on a Checklist relevant to processes of care in the ICU were reviewed. After initial general data collection phase, we categorized data as “must have” and “good to have.” “Must have” variables were defined as data variables that were essential for the study outcomes. “Good to have” variables would not affect the main outcomes of the study if missing. We measured completeness of data using the in-built REDCap data quality check feature. We used several strategies to encourage reduction of missing data. We initially did random data checks but noted that the amount of missing data was substantial and could not be adequately addressed this way. Second, we created excel sheets highlighting missing data for each site and notified sites. This proved onerous to create and made it burdensome for sites to identify easily where data was missing. Third, we built a custom report form in REDCap specifically able to identify which “must have” data points were missing. This could be easily accessed by the principal investigator at each site and made completing the data forms more straightforward. We encouraged all sites to complete their data collection by sending weekly data reports to each site highlighting the patients with missing data. An instructional YouTube tutorial was also created and the link was shared with all sites to demonstrate how to use the custom built report form in REDCap and how to appropriately fill in the missing data. Since this was a global study, we communicated with sites using a variety of locally favored mechanisms including Zoom, FaceTime, WeChat, WhatsApp as well as email. By harnessing the buy-in of local champions our approach was successful. RESULTS/ANTICIPATED RESULTS: The total number of patients recruited for the CERTAIN study is 4843. The rate of all missing variables improved with the efforts described above. Hospital admission dates were missing in 8.4% pre efforts and 4.2% post efforts (p<0.01). ICU admission dates were missing in 5.5% pre and 2.0% post (p<0.01). Documentation of completion of processes of care (including central line review, urinary catheter review, consideration for blood transfusion) improved significantly from pre to post (p<0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: Missing data can be a problem in all types of research studies. This study provides some preliminary evidence for effective approaches that can reduce the problem of missing data when conducting a global study at sites with limited research infrastructure in place. By addressing the concern about missing data, we can be more confident that our results can be accurately analyzed and interpreted, improving the quality of the research.
This paper examines the relationships of income with education and health using heterogeneous panel cointegration techniques to account for the potential cross-country heterogeneity in the effects of education and health. Our main results are: (i) education and health are, on average, income-enhancing; (ii) for different schooling levels, although primary education lowers income, both secondary and tertiary education raise income with larger impacts for the former than the latter, on average; (iii) there is considerable heterogeneity in the effects of education and health on income across countries; and (iv) the effect of education (health) on income tends to be greater (smaller) in countries with higher levels of development, greater (less) trade openness, less abundant natural resources, less corruption, higher levels of democracy, and a more homogeneous society.
The objective of this study was to explore the clinical effect of the transcatheter closure of congenital perimembranous ventricular septal defect using the Amplatzer duct occluder 2.
Between February 2012 and December 2016, 51 patients were subjected to Amplatzer duct occluder 2 for transcatheter closure of perimembranous ventricular septal defect. A total of 51 patients with perimembranous ventricular septal defect who underwent transcatheter closure by the conventional membranous ventricular septal occluder comprised the control group. The success rate and complications were compared, and indications of Amplatzer duct occluder 2 for perimembranous ventricular septal defect were explored.
The success rate of the interventional procedure was 98.0% (50/51) in the group of Amplatzer duct occluder 2 versus 100% in the group of conventional membranous ventricular septal occluder. The mean age of the patients of Amplatzer duct occluder group was 5.0±3.7 years (range: 1.5–25.0), and the mean weight was 19.3±8.1 kg (range: 11.0–52.0). The mean outlet diameter of the defects was 2.8±0.6 mm (range: 1.8–5.1) as measured by transthoracic echocardiography. The device was implanted by a retrograde approach in 40 patients and antegrade approach in 10 patients. No statistical significance was observed in the incidence of complication and hospitalisation duration between the two groups; however, the Amplatzer duct occluder 2 group was cost-effective (p<0.05) and required less fluoroscopy time (p<0.05). Neither deaths nor new onset of aortic and tricuspid insufficiency occurred during the median 26.2 months (range: 3–65) of follow-up.
Amplatzer duct occluder 2 has advantages of simple manipulation and less medical costs compared with conventional device in transcatheter closure of small type perimembranous ventricular septal defect.
To examine and quantify the potential dose–response relationship between green tea intake and the risk of gastric cancer.
We searched PubMed, EMBASE, Web of Science, CBM, CNKI and VIP up to December 2015 without language restrictions.
A systematic review and dose–response meta-analysis of observational studies.
Five cohort studies and eight case–control studies.
Compared with the lowest level of green tea intake, the pooled relative risk (95 % CI) of gastric cancer was 1·05 (0·90, 1·21, I2=20·3 %) for the cohort studies and the pooled OR (95 % CI) was 0·84 (0·74, 0·95, I2=48·3 %) for the case–control studies. The pooled relative risk of gastric cancer was 0·79 (0·63, 0·97, I2=63·8 %) for intake of 6 cups green tea/d, 0·59 (0·42, 0·82, I2=1·0 %) for 25 years of green tea intake and 7·60 (1·67, 34·60, I2=86·5 %) for drinking very hot green tea.
Drinking green tea has a certain preventive effect on reducing the risk of gastric cancer, particularly for long-term and high-dose consumption. Drinking too high-temperature green tea may increase the risk of gastric cancer, but it is still unclear whether high-temperature green tea is a risk factor for gastric cancer. Further studies should be performed to obtain more detailed results, including other gastric cancer risk factors such as smoking and alcohol consumption and the dose of the effective components in green tea, to provide more reliable evidence-based medical references for the relationship between green tea and gastric cancer.
Ce3+ ions in ceria nanoparticles (NPs) play a role as reactive sites in the adsorption of silicate anions. However, the limited concentration of Ce3+ ions in ceria NPs remains a major challenge in this regard. Herein, we report a simple strategy to synthesize Ce3+-enriched core–shell ceria NPs for enhanced adsorption of silicate anions. To increase the overall Ce3+ concentration, a shell layer is composed of Ce3+-rich ultrasmall ceria NPs approximately 5 nm in size. The Ce3+ concentration of such core–shell ceria NPs is increased by 12.7–17.1% relative to that of the pristine ceria NPs, resulting in increased adsorption of silicate anions. The Freundlich model fits the observed adsorption isotherm well and the constants of adsorption capacity (KF) and adsorption intensity (1/n) indicate higher adsorption affinity of the core–shell ceria NPs for silicate anions. We attribute these improvements to the increased Ce3+ concentration contributed by the ultrasmall ceria coating. This strategy can be used for enhancing the reactivity of ceria materials.
By reflowing Cu/Sn/Ni ultrafine interconnects under a temperature gradient, a new transient liquid phase (TLP) bonding process was proposed for three-dimensional packaging applications. The evolution of the dominant (Cu,Ni)6Sn5 intermetallic compounds depends strongly on the temperature gradient. The essential cause of such dependence is attributed to the different amounts of Cu and Ni atomic fluxes being introduced into the liquid solder. Under the coupling effect of thermomigration and Cu–Ni cross-interaction, the total atomic flux of Cu and Ni is promoted. As a result, the growth of dense (Cu,Ni)6Sn5 is significantly accelerated and the formation of Cu3Sn is eliminated. The new TLP bonding process consumes only a limited amount of the Ni substrate, but much more from the Cu substrate. The mechanism for the new TLP bonding process is discussed and experimentally verified in this study.
The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude.
Methods and results
In the first part, we prospectively recruited 7088 unselected Tibetan children (4–17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3–3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4–13.7%) had a larger proportion of complex CHD than those above this altitude (2.0–3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.
A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.
Improvements in understanding glacial extents and chronologies for the southeastern slope of the western Nyaiqentanglha Shan on the Tibetan Plateau are required to understand regional climate changes during the Last Glacial cycle. A two-dimensional numerical model of mass balance, based on snow–ice melting factors, and of ice flow for mountain glaciers is used to assess the glacier sensitivity to climatic change in a catchment of the region. The model can reproduce valley glaciers, wide-tongued glaciers and a coalescing glacier within step temperature lowering and precipitation increasing experiments. The model sensitivity experiments also indicate that the dependence of glacier growth on temperature and/or precipitation is nonlinear. The model results suggest that the valley glaciers respond more sensitively to an imposed climate change than wide-tongued and coalescing glaciers. Guided by field geological evidence of former glacier extent and other independent paleoclimate reconstructions, the model is also used to constrain the most realistic multi-year mean temperatures to be 2.9–4.6°C and 1.8–2.5°C lower than present in the glacial stages of the Last Glacial Maximum and middle marine oxygen isotope stage 3, respectively.
In traditional antenna design, metal components are not placed in the central part of the antenna as they change the characteristics of near field radiation. However, we show that placing a metal ring in the centre of the strip lines, which connect the ends of folded high-frequency dipoles, does not damage the performance of the feed. Instead it significantly improves the voltage standing wave ratio of the feed whilst other performance indicators are not compromised. Thus, our findings show an excellent way of improving the wide band feed. Based on this foundation, a new circularly polarised feed for operation between 0.4 to 2 GHz is introduced for the Chinese Spectral Radioheliograph in this paper. The issue of a feed impedance matching network is investigated. By optimising the impedance matching, the performance of the feed is enhanced with respect to the previous realisations of the Eleven feed. The simulation and experimental results show that the gain of the feed is about 10 dBi, and the VSWR is less than 2:1. In addition, the feed has a low axial ratio, fixed phase centre location, and constant beam width in the range of 0.4 to 2 GHz.
We present experimental studies of higher-order modes of the flow in turbulent thermal convection in cells of aspect ratio (
) 1 and 0.5. The working fluid is water with the Prandtl number (
) kept at around 5.0. The Rayleigh number (
) ranges from
. We found that in
cells, the first mode, which corresponds to the large-scale circulation (LSC), dominates the flow. The second mode (quadrupole mode), the third mode (sextupole mode) and the fourth mode (octupole mode) are very weak, on average these higher-order modes each contains less than 4 % of the total flow energy. In
cells, the first mode is still the strongest but less dominant, the second mode becomes stronger which contains 13.7 % of the total flow energy and the third and the fourth modes are also stronger (containing 6.5 % and 1.1 % of the total flow energy respectively). It is found that during a reversal/cessation, the amplitude of the second mode and the remaining modes experiences a rapid increase followed by a decrease, which is opposite to the behaviour of the amplitude of the first mode – it decreases to almost zero then rebounds. In addition, it is found that during the cessation (reversal) of the LSC, the second mode dominates, containing 51.3 % (50.1 %) of the total flow energy, which reveals that the commonly called cessation event is not the cessation of the entire flow but only the cessation of the first mode (LSC). The experiment reveals that the second mode and the remaining higher-order modes play important roles in the dynamical process of the reversal/cessation of the LSC. We also show direct evidence that the first mode is more efficient for heat transfer. Furthermore, our study reveals that, during the cessation/reversal of the LSC,
drops to its local minimum and the minimum of
is ahead of the minimum of the amplitude of the LSC; and reversals can be distinguished from cessations in terms of global heat transport. A direct velocity measurement reveals the flow structure of the first- and higher-order modes.
We aimed to examine the contribution of blood lipids to the association between BMI and blood pressure (BP) in children with overweight and obesity. Data were collected in elementary and high schools of Chaoyang District, Beijing, China in 2012. Participants’ weight, height, BP and fasting plasma lipid profile were measured by standard protocols. Mediation analysis was used to examine the mediation role of blood lipids on the relation between BMI and BP, with age included as a covariate. We found that in boys 8·29 % (mediation effect=0·106, P=0·012) of the association between BMI and systolic BP was mediated through TAG. TAG mediated 12·53 % (mediation effect=0·093, P=0·018) and LDL-cholesterol mediated 7·75 % (mediation effect=0·57, P=0·046) of the association between BMI and diastolic BP was mediated by TAG and LDL-cholesterol, respectively. However, blood lipids did not show the mediation effect in girls. Our findings suggested that there was a sex difference in the contribution of blood lipids to the association between BMI and BP. Controlling TAG or LDL-cholesterol may be beneficial for reducing the risk of the BMI-related high BP in overweight boys; however, this outcome is not the case when controlling TAG or LDL-cholesterol in girls. This study may provide clues to explore the underlying mechanism of the association between obesity and hypertension.
The present study was performed to identify the genotype of a hypertrophic cardiomyopathy family and investigate the clinicopathogenic characteristics and prognostic features of relevant genetic abnormalities. Target sequence capture sequencing was performed to screen for pathogenic alleles in a 32-year-old female patient (proband). Sanger sequencing was carried out to verify the results. Sanger sequencing was also performed on other family members to identify allele carriers. A survival analysis was carried out using published literature and our findings. We found that the proband and her son harboured a Gly716Arg sequence variant of the β-myosin heavy chain. Neither the proband’s father nor the mother were carriers of this sequence variant; thus, the mutation was classified as “de novo”. Further survival analysis revealed that female patients appear to have a longer life expectancy compared with males. Our study may provide an effective approach for the genetic diagnosis of hypertrophic cardiomyopathy.
This study describes findings of the impacts of Hurricane Sandy on environmental factors including power outages, air quality, water quality, and weather factors and how these affected mental health during the hurricane.
An ecological study was conducted at the county level to describe changes in environmental factors—especially power outages—and their relationships to emergency department (ED) visits for mental health problems by use of a Poisson regression model.
We found that many environmental hazards occurred as co-exposures during Hurricane Sandy in addition to flooding. Mental health ED visits corresponded with the peak of maximum daily power blackouts, with a 3-day lag, and were positively associated with power blackouts in Bronx (prevalence ratio [PR]: 8.82, 95% confidence interval [CI]: 1.27–61.42) and Queens (PR: 2.47, 95% CI: 1.05–5.82) counties. A possible dose-response relationship was found between the quantile of maximum blackout percentage and the risk of mental health in the Bronx.
We found that multiple co-environmental hazards occurred during Hurricane Sandy, especially power blackouts that mediated this disaster’s impacts. The effects of power outage on mental health had large geographic variations and were substantial, especially in communities with low sociodemographic status. These findings may provide new insights for future disaster response and preparedness efforts. (Disaster Med Public Health Preparedness. 2016;10:314–319)