To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Not all plant-based and animal foods exert the same health effects due to their various nutrient compositions. We aimed to assess the quality of plant-based vs. animal foods in relation to mortality in a prospective cohort study. Using data collected from a nationally representative sample of 36,825 adults in the National Health and Nutrition Examination Survey 1999-2014, we developed a de novo Comprehensive Diet Quality Index (cDQI) that assesses the quality of 17 foods based on the healthfulness, and separately scored the quality of 11 plant-based foods in a plant-based Diet Quality Index (pDQI) and 6 animal foods in an animal-based Diet Quality index (aDQI). Mortality from all causes, heart disease, and cancer were obtained from linkage to the National Death Index through December 31, 2015. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. During a median follow-up of 8.3 years, 4,669 all-cause deaths occurred, including 798 deaths due to heart disease and 1,021 due to cancer. Compared to individuals in the lowest quartile, those in the highest quartile of cDQI had a lower risk of all-cause mortality (HR=0.75, 95% CI: 0.65, 0.86; P-trend<0.001), which largely reflected the inverse relationship between quality of plant-based foods (pDQI) and all-cause mortality (HR=0.66; 95% CI: 0.58, 0.74, P-trend<0.001). No independent association was found for the quality of animal-foods (aDQI) and mortality. Our results suggest that consuming healthy plant-based foods is associated with lower all-cause mortality among US adults.
There is growing interest globally in using real-world data (RWD) and real-world evidence (RWE) for health technology assessment (HTA). Optimal collection, analysis, and use of RWD/RWE to inform HTA requires a conceptual framework to standardize processes and ensure consistency. However, such framework is currently lacking in Asia, a region that is likely to benefit from RWD/RWE for at least two reasons. First, there is often limited Asian representation in clinical trials unless specifically conducted in Asian populations, and RWD may help to fill the evidence gap. Second, in a few Asian health systems, reimbursement decisions are not made at market entry; thus, allowing RWD/RWE to be collected to give more certainty about the effectiveness of technologies in the local setting and inform their appropriate use. Furthermore, an alignment of RWD/RWE policies across Asia would equip decision makers with context-relevant evidence, and improve timely patient access to new technologies. Using data collected from eleven health systems in Asia, this paper provides a review of the current landscape of RWD/RWE in Asia to inform HTA and explores a way forward to align policies within the region. This paper concludes with a proposal to establish an international collaboration among academics and HTA agencies in the region: the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) working group, which seeks to develop a non-binding guidance document on the use of RWD/RWE to inform HTA for decision making in Asia.
A control volume based analytical method for calculating the efficiency
of flapping foil power generators was developed for single and tandem foil configurations. Ignoring unsteady effects and non-uniform pressures resulted in theoretical limits identical to the Betz (
for a single turbine) and Newman (
for tandem turbines) limits. Inclusion of unsteady flow and non-uniform pressure distributions produced theoretical efficiency maxima in excess of these limits. Simulation of single and tandem foil cases to determine the magnitude of these effects showed that the Betz limit would not be exceeded by a single foil system in practice, but that it is conceivable that a tandem foil system could exceed the Newman limit due to the strong unsteady vortex wake of the upstream turbine entraining additional energy into the path of the downstream turbine and maintaining pressures in the wake below ambient.
A novel ionic liquid/α-ZrP (C16MIM/α-ZrP) lamellar nanocomposite was fabricated via the electrostatic self-assembly deposition technique by using exfoliated α-ZrP nanosheets and guest molecules (1-hexadecyl-3-methylimidazolium bromide) as building blocks under mild conditions. C16MIM/α-ZrP nanocomposite was characterized by various analytical techniques such as X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscope (SEM), Fourier transform infrared spectroscopy, and synchronous thermal analyzer. The net interlayer spacing of α-ZrP determined by XRD confirmed that the C16MIM cations formed a monolayer arrangement between the α-ZrP nanosheets. The morphology and microstructure of C16MIM/α-ZrP composite were observed using SEM and TEM. The C16MIM/α-ZrP modified glass carbon electrode exhibited excellent electrocatalytic activity toward the oxidation of nitrite in weak base media. The results obtained with differential pulse voltammetry demonstrated that the C16MIM/α-ZrP hybrid detected nitrite linearly in the concentration range from 7.3 μM to 1.25 mM with the detection limit of 1.26 μM (S/N = 3). Additionally, the prepared sensor showed outstanding reproducibility, high stability, and anti-interference capability.
In the current research, a 60-day experiment was conducted with the purpose of exploring the impacts of methionine on growth performance, muscle nutritive deposition, muscle fibre growth and type I collagen synthesis as well as related signaling pathway. Six diets (iso-nitrogenous) differing in methionine concentrations (2.54, 4.85, 7.43, 10.12, 12.40 and 15.11 g kg-1 diets) were fed to 540 grass carp (178.47 ± 0.36 g). Results showed (P < 0.05) that, compared with methionine deficiency, optimal level of dietary methionine (1) increased feed intake (FI), feed efficiency (FE), specific growth rate (SGR) and percentage weight gain (PWG); (2) increased fish muscle protein, lipid and free amino acid contents, and improved fish muscle fatty acid profile as well as increased protein content in part associated with TORC1/S6K1 signaling pathway; (3) increased the frequency distribution of muscle fibre with >50 µm of diameter; (4) increased type I collagen synthesis partly related to TGF-β1/Smads and CK2/TORC1 signaling pathways. In conclusion, dietary methionine improved muscle growth, which might be due to the regulation of muscle nutritive deposition, and muscle fibre growth and type I collagen synthesis related signal molecules. Finally, according to PWG and muscle collagen content, the methionine requirements for on-growing grass carp (178-626 g) were estimated to be 9.56 g kg-1 diet (33.26 g kg-1 protein of diet) and 9.28 g kg-1 diet (32.29 g kg-1 of dietary protein), respectively.
The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.
From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).
About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.
About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.
Ketosis is a metabolic disease of dairy cows often characterized by high concentrations of ketone bodies and fatty acids, but low milk protein and milk production. The Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) and the mechanistic target of rapamycin (mTOR) signaling pathways are central for the regulation of milk protein synthesis. The effect of high levels of fatty acids on these pathways and β-casein synthesis are unknown in dairy cows with clinical ketosis. Mammary gland tissue and blood samples were collected from healthy (n = 15) and clinically-ketotic (n = 15) cows. In addition, bovine mammary epithelial cells (BMEC) were treated with fatty acids, methionine (Met) or prolactin (PRL), respectively. In vivo, the serum concentration of fatty acids was greater (P > 0.05) and the percentage of milk protein (P > 0.05) was lower in cows with clinical ketosis. The JAK2-STAT5 and mTOR signaling pathways were inhibited and the abundance of β-casein was lower in mammary tissue of cows with clinical ketosis (P > 0.05). In vitro, high levels of fatty acids inhibited the JAK2-STAT5 and mTOR signaling pathways (P > 0.05) and further decreased the β-casein synthesis (P > 0.05) in BMEC. Methionine or PRL treatment, as positive regulators, activated the JAK2-STAT5 and mTOR signaling pathways to increase the β-casein synthesis. Importantly, the high concentration of fatty acids attenuated the positive effect of Met or PRL on mTOR, JAK2-STAT5 pathways and the abundance of β-casein (P > 0.05). Overall, these data indicate that the high concentrations of fatty acids that reach the mammary cells during clinical ketosis inhibit mTOR and JAK2-STAT5 signaling pathways, and further suppress β-casein synthesis.
To investigate the executive function and learning ability of the patients with first-episode schizophrenia, and its relationship with the patients’ clinical symptoms.
50 schizophrenia patients and 50 healthy controls were tested by the Tower of London (TOL). All the subjects received two phases of the test of TOL continuously, with a break of 1 minute. And Positive and Negative Symptom Scale (PANSS) was used to assess the clinical symptoms of the patients.
Compared with the control group, the number of reply during the 1st phase (x1) and the 2nd phase (x2)of the patients group, was lower (P<0.01); the reaction time during the 1st phase (t1) and the 2nd phase (t2) was longer (P<0.01); while the rate of correct answer during the 1st phase (p1) and the 2nd phase (p2) do not differ. For the control group, x2 was higher than x1 (P<0.01), and t2 was shorter than t1 (P<0.01). However, for the schizophrenia group, there were no difference between x1 and x2, t1 and t2. The value of x1, p1, x2 of the patients were correlated negatively with the PANSS negative subscale score (P< 0.05), and t1 and t2 were correlated positively with the the negative subscale score (P< 0.01). The performance of the TOL did not correlated with the PANSS positive subscale score and general psychopathology subscale score.
The executive function and learning ability of the schizophrenics are impaired and the impairment of the cognitive function is significantly correlated with the negative symptoms of schizophrenia patients.
Cognitive dysfunction was thought to be one of the core features of schizophrenia. And the executive function of the patients was paid more attention by more and more researchers and clinicians.
To investigate the executive function and the learning ability of the patients with first-episode schizophrenia, and their relationships with psychiatric symptoms.
Fifty cases of first-episode schizophrenia patients and fifty age- and gender-matched healthy controls were tested by a computerized version of Tower of London (TOL) test. The scores of the Positive and Negative Syndrome Scale(PANSS) in the group of schizophrenia patients were over 60.
The numbers of the correct answer [x1 :(14.62 ± 4.12), x2: (14.80 ± 4.70)] during the first session and the second session of the TOL test of the patients group were significantly lower than that of the control group [x1: (17.48 ± 3.79), x2:(18.68 ± 3.19)], and the reaction times [t1: (9.27 ± 4.37) seconds, t2: (9.51 ± 5.58) seconds] of the two sessions of TOL were longer than the control group [t1: (7.28 ± 2.04) seconds, t2: (6.67 ± 1.51) seconds], P < 0.01. For the control group, x2 was significantly greater than x1, and t2 shorter than t1 (P < 0.01), while for the patients group, there was no difference between the performances of the first session and the second session. The scores of TOL in the schizophrenia patients were correlated with the negative symptom score of PANSS (P < 0.05) and were not correlated with the scores of other subscales of PANSS (P > 0.05).
The executive function and the learning ability of schizophrenia are impaired and the cognitive dysfunction is correlated with negative symptoms.
Multiple neurotrophic factors, including vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF)-2, nerve growth factor (NGF) and insulin-like growth factor(IGF)-1, have been shown to play important roles in the pathophysiology of mood disorders. However, insufficient clinical data supporting the importance of these neurotrophic factors in mood disorders, especially manic episode, have made inconclusive to make a connection between these factors and the disorder.
This study intended to investigate possible peripheral biomarkers in serum of manic episode of bipolar disorder.
We aimed to investigate whether or not serum levels of VEGF, FGF-2, NGF and IGF-1 varied in manic state.
Serum levels of VEGF, FGF-2, NGF and IGF-1 were examined in 70 drug-naïve patients with manic episode of bipolar disorder (BM) as well as 50 healthy controls, using an ELISA method.
The mean serum levels of VEGF, FGF-2, NGF and IGF-1 were 168.13±225.61pg/ml, 279.09±378.62pg/ml, 61.38±171.67pg/ml and 162.01±72.00ng/ml in BM patients, and 140.80±143.71pg/ml, 275.46±235.29pg/ml, 36.34±15.14pg/ml and 138.90±80.11ng/ml in healthy controls, respectively. Serum levels of FGF-2, NGF and IGF-1 in patients were significantly higher than those in healthy controls (Z=−2.896, P=0.004; Z=− 2.050, P=0.040; Z=−2.188, P=0.029; respectively), although there was no statistical difference in the serum levels of VEGF between two groups (Z=-0.468, P=0.639). Moreover, serum levels of NGF in patients correlated with the duration of disorder (rs=−0.241, P=0.044).
The increase in serum levels of FGF-2, NGF and IGF-1 in manic state may reflect a neuroprotective role for these factors, and these factors may be considered biological markers for manic episode.
Antipsychotic drugs (APDs) are the first-line pharmacological treatments for schizophrenia. Recent human studies have found that myelin integrity could be improved by APD treatment in schizophrenia patients. Previous studies indicated that regulation of oligodendrocyte development and function may be a novel target for APDs.
The aim of this current study was to examine the possible effects of the antipsychotic drugs (APDs) haloperidol (HAL), olanzapine (OLA), and quetiapine (QUE) on the development of oligodendroglial lineage cells.
CG4 cells, an oligodendrocyte progenitor cell line, were treated with various concentrations of HAL, OLA, or QUE for specific periods. The proliferation and differentiation of the CG4 cells were measured. The regulation of CG4 cell differentiation by oligodendrocyte lineage transcription factors 1 and 2 (Olig1 and Olig2) was examined.
The APDs used in this study had no effect on the proliferation of CG4 cells. The APDs elevated the expression of 2’,3’-cyclic nucleotide 3’-phosphodiesterase (CNP), a specific marker of oligodendrocytes, and promoted the CG4 cells to differentiate into CNP positive oligodendrocytes. QUE and OLA increased the expression of Olig1 and Olig2 whereas HAL only increased the expression of Olig2.
Our findings suggest that oligodendrocyte development is a target of HAL, OLA, and QUE and provide further evidence of the important role of oligodendrocytes in the pathophysiology and treatment of schizophrenia. They also indicate that the expression level of oligodendrocyte/myelinrelated genes could be profoundly affected by APDs.
Recently, a triple-network model suggested the abnormal interactions between the executive-control network (ECN), default-mode network (DMN) and salience network (SN) are important characteristics of addiction, in which the SN plays a critical role in allocating attentional resources toward the ECN and DMN. Although increasing studies have reported dysfunctions in these brain networks in Internet gaming disorder (IGD), interactions between these networks, particularly in the context of the triple-network model, have not been investigated in IGD. Thus, we aimed to assess alterations in the inter-network interactions of these large-scale networks in IGD, and to associate the alterations with IGD-related behaviors.
DMN, ECN and SN were identified using group-level independent component analysis (gICA) in 39 individuals with IGD and 34 age and gender matched healthy controls (HCs). Then alterations in the SN-ECN and SN-DMN connectivity, as well as in the modulation of ECN versus DMN by SN, using a resource allocation index (RAI) developed and validated previously in nicotine addiction, were assessed. Further, associations between these altered network coupling and clinical assessments were also examined.
Compared with HCs, IGD had significantly increased SN-DMN connectivity and decreased RAI in right hemisphere (rRAI), and the rRAI in IGD was negatively associated with their scores of craving.
These findings suggest that the deficient modulation of ECN versus DMN by SN might provide a mechanistic framework to better understand the neural basis of IGD and might provide novel evidence for the triple-network model in IGD.
Tempering cooling rate plays a significant role in the impact toughness of 2CrMoV weld metal. Three different tempering cooling rate experiments were carried out; it is found that the impact toughness of weld metal improved from 44.61 to 117.49 J as the cooling rate increased from 5 to 40 °C/h. Microstructure characterization revealed that the large blocky M–A constituents and cluster precipitation were considered to act as stress concentration sources and cleavage fracture initiators at a cooling rate of 5 °C/h. Under the cooling rate of 20 °C/h, the decrease of blocky M–A constituents as well as homogeneous distribution of precipitation induced the transition from cleavage to interfacial decohesion. The chance of crack propagation in intragranular ferrite matrix was increased, which needed to absorb more energy and improve impact toughness. When the tempering cooling rate reached at 40 °C/h, the cracks mainly propagated in the ferrite matrix; meanwhile, fine and homogeneous distribution of precipitation greatly inhibited crack propagation and led to higher impact toughness.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
Transmission of varicella occurs frequently in schools and households. We investigated the characteristics of varicella cases derived from within-household transmission and the modes of varicella transmission between school and household settings in Shanghai, China, from 2009 to 2018. Within-household transmission occurred in 278 households, of which 134 transmission events were between children. Sixty-one household varicella transmission events may be attributed to isolation procedures for infected students during school outbreaks, and 7.6% of school outbreaks were caused by schoolchildren cases derived from within-household transmission. The frequency of ‘school-household-school’ transmission adds an additional layer of complexity to the control of school varicella outbreaks. Administration of varicella vaccine as post-exposure prophylaxis after exposure is considered to be an effective measure to control varicella spread within households and schools.
The safe and efficient capture of radioactive iodine is highly necessary, but still remains an ongoing challenge. Herein, because of its special layer structure, CuBi–CO3-layered double hydroxides (CuBi–CO3-LDHs) are used to serve as a generic platform, and 3D hierarchical flowerlike ZIF-67/CuBi–CO3-LDH composites are synthesized by a simple coprecipitation method. After immobilization, the flowerlike morphology of CuBi–CO3-LDHs can be completely preserved and proved by scanning electron microscope. Various affecting factors on adsorption performance are investigated, including adsorbent dose, initial concentration of iodine, and temperature. The experimental and modeling results manifest that iodine adsorption is accurately elucidated by pseudo-second-order model, and the equilibrium isotherm is accordant with the Freundlich model. Moreover, the regeneration experiment indicates that ZIF-67/CuBi–CO3-LDH composites possess good stability and reusability for the removal of iodine. The possible adsorption mechanisms of iodine on ZIF-67/CuBi–CO3-LDHs involve particular layer structure and the strong interaction between nitrogen of imidazole ring and iodine, which were investigated by X-ray diffraction, energy-dispersive X-ray, and X-ray photoelectron spectroscopy spectra. The good performance for the iodine adsorption indicates that ZIF-67/CuBi–CO3-LDHs may be identified as a promising adsorbent in the field of iodine capture.