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.
To determine which set of BMI cut-offs is the most appropriate to define child and adolescent obesity in urban China.
A cross-sectional study was carried out between 1 November and 31 December in 2017.
Community Healthcare Center in Minhang District, Shanghai, China.
A total of 12 426 children and adolescents aged 7–17 years were selected by cluster random sampling. Bioelectrical impedance analysis was the gold standard to measure body composition.
Comparisons of three sets of BMI cut-offs by sensitivity and κ value revealed that the Working Group on Obesity in China (WGOC) (sensitivity 39·9–84·0 %; κ 0·51–0·79) and WHO (sensitivity 25·5–74·5 %; κ 0·35–0·78) cut-offs were not superior to the International Obesity Task Force (IOTF) (sensitivity 47·9–92·4 %; κ 0·58–0·85) cut-offs across all subgroups. The WGOC and WHO cut-offs yielded higher misclassification rates, in the worst case, categorising 11·2 % of girls with high adiposity as normal and 44·4 % of them as overweight, while the IOTF cut-offs categorised 2·3 % as normal and 30·7 % as overweight. Individuals who were classified by the IOTF cut-offs as overweight had the lowest ratios of high adiposity (4·2–41·6 %) than by the BMI cut-offs for each subgroup. Among pubertal girls, none of the BMI-based cut-offs indicated excellent agreement with body fat percentage, and κ value of the WHO cut-offs (0·35 (95 % CI 0·29, 0·41)) was lower than the other two sets of BMI cut-offs (all P < 0·001).
The IOTF cut-offs for Asian should be recommended for child obesity screening in urban China. Pubertal individuals need a more accurate indicator of obesity screening.
Since the first report of the 2019 novel coronavirus disease (COVID-19) in December 2019 in Wuhan, China, the outbreak of the disease has been continuously evolving. Until March 17, 2020, 185, 178 cases had been confirmed, including 81,134 cases in China and 104,044 cases outside of China. In this comment, we report the unexpected beneficial effect of a deployable rapid-assembly shelter hospital on the prevention and treatment of COVID-19. We describe the shelter hospital maintenance, treatment mode and primary treatment methods, which will provide a valuable experience in dealing with public health emergencies, such as COVID-19, for other countries and areas.
As an emerging infectious disease, COVID-19 has involved many countries and regions. With the further development of the epidemic, the proportion of clusters has increased.
In our study, we collected information on COVID-19 clusters in Qingdao City. The epidemiological characteristics and clinical manifestations were analyzed.
Eleven clusters of COVID-19 were reported in Qingdao City between January 29, and February 23, 2020, involving 44 confirmed cases, which accounted for 73.33% of all confirmed cases. From January 19 to February 2, 2020, the cases mainly concentrated in the district that had many designated hospitals. Patients aged 20-59 y old accounted for the largest proportion (68.18%) of cases; the male-to-female sex ratio was 0.52:1. Three cases were infected from exposure to confirmed cases. The average incubation period was 6.28 d. The median number of cases per cluster was 4, and the median duration time was 6 d. The median cumulative number of exposed persons was 53.
More attention should be paid to the epidemic of clusters in prevention and control of COVID-19. In addition to isolating patients, it is essential to track, screen, and isolate those who have come in close contact with patients. Self-isolation is the key especially for healthy people in the epidemic area.
This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment.
This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization.
A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects.
After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.
Hepatitis C virus (HCV) infection was frequent in human immunodeficiency virus (HIV) patients in Yunnan province. We studied the epidemic characteristics of HCV in HIV/HCV co-infected patients. Serum from 894 HIV-1 patients was collected, together with basic information and biochemical features. All samples were infected with HIV through injecting drug users (IDUs) and sexual transmission (ST). The NS5B gene was amplified and sequenced to affirm HCV genotype. In total, 202 HIV patients were co-infected with HCV, and most (81.19%) of co-infected patients were IDUs. Genotype 3b was predominant (37.62%) in these samples, and its frequency was similar in patients with IDU and ST. The frequencies of genotypes 1a, 1b, 3a, 6a, 6n, 2a and 6u were 3.96%, 16.34%, 23.76%, 6.93%, 10.40%, 0.50% and 0.50%, respectively. However, genotype 3a showed significantly different frequency in HCV patients with IDU and ST (P = 0.019). When HCV patients were divided into subgroups, the haemoglobin (HGB) level was significantly higher in patients with genotype 3a than in patients with 3b (P = 0.033), 6a (P = 0.006) and 6n (P = 0.007), respectively. Although no difference existed among HCV subgroups, HIV-viral load was identified to be positively correlated with the HGB level and CD4+ cells when dividing HCV/HIV co-infected persons into male and female groups. In conclusion, genotype 3b was the predominant HCV genotype in Yunnan HIV/HCV co-infected persons. The HGB level was higher in patients with genotype 3a than others. HIV-viral load was positively correlated with the HGB level and CD4+ cells in the male or female HCV-infected group.
Phase retrieval is necessary for propagation-based phase-contrast imaging (PB-PCI). Arhatari established a model for predicting the impact of the sample-to-detector distance and the system noise on the phase retrieval performance. We have extended Arhatari's model to account for the parameters of excessive source size, finite detector resolution, and geometrical magnification for more practical cases. However, there exist interaction effects among these parameters resulting in difficulty of predicting the phase retrieval performance. In this study, we found that optimizing the trade-off among these parameters for phase retrieval is consistent with the improvement of edge enhancement to noise ratio (EE/N) in the “forward problem” of the PB-PCI. Hence, we engaged in establishing a relationship between EE/N and phase retrieval performance in terms of the “forward problem” and “inverse problem” of the PB-PCI, respectively. Our results showed that, at fixed detector resolution, phase retrieval from the phase-contrast projections at the same EE/N level resulted in the consistent phase retrieval performance. Therefore, the performance of phase retrieval can be predicted based on the EE/N level and be quantitatively optimized by increasing EE/N.
This study examines the relationship between filial piety (adult children's filial behaviours and attitudes as well as elderly mothers’ overall evaluation of children's filial piety) and elderly mothers’ reports of intergenerational ambivalence (positive feelings, negative feelings and combined ambivalence) in rural China. We analysed the data from a survey in 2016 covering 2,203 adult children and 802 elderly mothers in Sichuan Province using a two-level mixed-effects modelling analysis. The results indicate that most components of filial piety are associated with mothers’ ambivalence, in that less ambivalence was reported by mothers when their adult children provided more emotional support to, had less conflict with and were evaluated as more filial by their mothers. Interestingly, mothers demonstrated greater positive feelings when their children were more filial in behaviour and attitude, but they also reported greater negative feelings and ambivalence when their children were more obedient, implying that absolute obedience to elderly parents might no longer be accepted by people. These findings may provide further understanding about the correlation between the culture of filial piety and intergenerational relationships in rural China.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Prolonged conditions of chronic stress have the potential to cause mental health difficulties and disrupt developmental processes for children and adolescents. Natural disasters disproportionately affect low-resource areas, yet little is known about the interaction between trauma exposure, chronic stressors, and mental health.
To determine the rates of post-traumatic stress disorder (PTSD), depression and anxiety among adolescents affected by earthquakes in China and Nepal, and examine the specific roles of trauma exposure and chronic stressors across the three mental health outcomes.
A school-based, cross-sectional study of 4,215 adolescents (53% female, ages 15-19 years) was conducted in disaster-affected areas of southern China and Nepal. Participants completed a series of translated and culturally adapted standardized assessments. Mixed effects logistic regression analyses were conducted for each mental health outcome.
The overall rate of PTSD was 22.7% and was higher among Nepalese participants (China: 19.4% vs. Nepal: 26.8%, p<0.001), but did not differ between genders (China: p=0.087 and Nepal: p=0.758). In both countries, the level of trauma exposure was a significant risk factor for PTSD, depression, and anxiety (China: OR’s 1.09-1.18 and Nepal: OR’s 1.08-1.13). Chronic stressors significantly improved the model and further contributed to mental health outcomes (China: OR’s 1.23-1.26 and Nepal: OR’s 1.10-1.23). Multilevel risk and protective factors across all mental health outcomes will be presented.
While there are limited opportunities to protect adolescents from disaster exposure, there is significant potential to address the effects of ongoing economic insecurity, domestic violence, and school cessation that are likely to worsen mental health outcomes. Programs that identify chronic stressors for adolescents in disaster-affected settings, and work to address poverty and violence, will have cascading effects for mental health, development, and security.
More than half of the world’s youth live in the Asia Pacific region, yet efforts to reduce disaster risk for adolescents are hindered by an absence of age-specific data on protection, health, and engagement.
China and Nepal have faced a recent escalation in the number of climatic and geological hazards affecting urban and rural communities. We aimed to examine disaster-related threats experienced by adolescents and their caregivers in China and Nepal, determine the scope for adolescent participation, and elicit recommendations for improving disaster risk reduction.
Sixty-nine adolescents (51% female, ages 13-19) and 72 adults (47% female, ages 22-66) participated in key informant interviews and focus group discussions in disaster-affected areas of southern China and Nepal. Using inductive content analysis, several themes were identified as key to adolescents’ needs.
Security and protection emerged as a central issue, interlinked with preparedness, timely and equitable disaster response, psychosocial support, and adolescent participation. The mental health risks emerging from trauma exposure were substantial. Adolescents made extensive contributions to disaster response including involvement in rescue efforts and delivering first aid, rebuilding homes and caring for family members. Participants forwarded a number of recommendations, including investing in psychological support, skills training, and stronger systems of protection for those at risk of family separation, trafficking, or removal from school.
The findings informed a multilevel, interconnected model for disaster risk reduction tailored to adolescents’ needs. Supporting adolescents’ recovery and long-term resilience after humanitarian crises will require coordinated efforts in preparedness, security, and mental health care.
Liquid films can be entrained when the dewetting velocity attains a threshold, and this dynamical wetting transition has been well studied in the situation of plane substrates. We investigate the forced dewetting in a capillary tube using diffuse-interface simulations and lubrication analysis, focusing on the onset of wetting transition and subsequent interface evolution. Results show that the meniscus remains stable when the displacing rate is below a threshold, beyond which film entrainment occurs and eventually leads to the formation of Taylor bubbles separated by liquid slugs, as has also been observed in the recent experiments of Zhao et al. (Phys. Rev. Lett., vol. 120, 2018, 084501). We derive an analytical solution of the critical capillary number, and demonstrate that the wetting transition is accompanied by a vanishing apparent contact angle and an abrupt drop of the contact-line velocity. Both the bubble and slug lengths are found to depend on the capillary number and the wettability of the wall. A theoretical formula for the bubble length is also proposed and compares favourably with numerical and experimental results.
The present study was undertaken to investigate the antiparasitic activity of extracellular products of Streptomyces albus. Bioactivity-guided isolation of chloroform extracts affording a compound showing potent activity. The structure of the compound was elucidated as salinomycin (SAL) by EI-MS, 1H NMR and 13C NMR. In vitro test showed that SAL has potent anti-parasitic efficacy against theronts of Ichthyophthirius multifiliis with 10 min, 1, 2, 3 and 4 h (effective concentration) EC50 (95% confidence intervals) of 2.12 (2.22–2.02), 1.93 (1.98–1.88), 1.42 (1.47–1.37), 1.35 (1.41–1.31) and 1.11 (1.21–1.01) mg L−1. In vitro antiparasitic assays revealed that SAL could be 100% effective against I. multifiliis encysted tomonts at a concentration of 8.0 mg L−1. In vivo test demonstrated that the number of I. multifiliis trophonts on Erythroculter ilishaeformis treated with SAL was markedly lower than that of control group at 10 days after exposed to theronts (P < 0.05). In the control group, 80% mortality was observed owing to heavy I. multifiliis infection at 10 days. On the other hand, only 30.0% mortality was recorded in the group treated with 8.0 mg L−1 SAL. The median lethal dose (LD50) of SAL for E. ilishaeformis was 32.9 mg L−1.
Goaty flavor and poor consistency may impact consumer acceptance of fermented goat milk. The undesirable characteristics can mainly be attributed to the presence of short-medium chain free fatty acid (SM-FFA) especially C6-C10 fatty acids and low αs1-casein content in goat milk. This study aimed to investigate the effects of polymerized whey protein (PWP) on goaty flavor as well as the texture properties of fermented goat milk in comparison with β-cyclodextrin (β-CD). Samples were evaluated on sensory properties, SM-FFA contents, texture, and apparent viscosity. Compared with control, the fatty acids contents (C6, C8, C10) decreased significantly in fermented goat milk with 0·5% β-CD (22, 71, 54%, respectively) and with 0·7% PWP (45, 58, 71%, respectively). There was a synergistic effect of 0·3% β-CD and 0·6% PWP in decreasing the contents of SM-FFA (C6, C8, C10) sharply by 89, 90, 79%. Under the same percentage of addition, yogurts made with β-CD showed a higher (P < 0·05) apparent viscosity than those with PWP. However, the addition of PWP could increase the texture parameters of fermented goat milk (P < 0·05). Combination of PWP and β-CD presented a more desirable texture and consistency in fermented goat milk. Results indicated that polymerized whey protein can be used to reduce the goaty flavor and improve the texture of fermented goat milk.
BaTiO3-based lead-free piezoelectric materials have long been known as “a mediocre class of piezoelectric materials.” However, they have seen significant renewed interest in recent years ever since the discovery of high piezoelectricity in Ba(Zr, Ti)O3-(Ba, Ca)TiO3 as well as the related Ba(Sn, Ti)O3-(Ba, Ca)TiO3 and Ba(Hf, Ti)O3-(Ba, Ca)TiO3 systems. The unexpectedly high piezoelectricity in this class of BaTiO3 (BT)-based materials is still not well understood and has stimulated significant research activity. We present a concise discussion of the notions leading to high piezoelectricity in BaTiO3-based systems. In particular, the possible role of a multiphase-coexisting point is highlighted.
Hexapod robots are well suited for disaster rescuing tasks due to their stability and load capability. However, most current hexapod robots still rely on static gaits that largely limit their locomotion speed. This paper introduces a hierarchical control strategy to realize a dynamic alternating tripod trotting gait for a hexapod robot based on multi-modal impedance control. At the low level, a position-based impedance controller is developed to realize an adjustable compliant behavior for each leg. At the high level, a new gait controller is developed to generate a stable alternating tripod trotting gait, in which a gait state machine, a leg compliance modulation strategy, and a close-looped body attitude stabilizer are imposed. As a result, the alternating tripod trotting of the hexapod robot can be synchronized as the running of a bipedal robot with stable body attitude. Moreover, this control strategy was verified by experiments on a newly designed pony-sized disaster rescuing robot, HexbotIV, which successfully achieved a dynamic trotting gait with ability to resist the disturbances of mildly uneven terrains. Our control strategy as well as the experimental study can be a valuable reference for other hexapod robots and thus paves a way to the practical deployment of disaster rescuing robots.
To investigate the effects of heat stress on broiler metabolism, we assigned 144 broilers to normal control (NC), heat stress (HS) or pair-fed (PF) groups and then monitored the effects using growth performance, carcass characteristics, biochemical assays and GC-MS-based metabolomics. The up-regulation of cloacal temperature confirmed that our experiment was successful in inducing chronic heat stress. The average daily gain and average daily feed intake of the HS group were significantly lower than those of the NC group, by 28·76 and 18·42 %, respectively (P<0·001), whereas the feed:gain ratio was significantly higher, by 14·49 % (P=0·003), and heat stress also increased leg proportion (P=0·027) and intramuscular fat proportion (P<0·001) and decreased breast proportion (P=0·009). When comparing the HS and NC groups and HS and PF groups, our metabolomics approach identified seventy-eight and thirty-four metabolites, respectively, with significantly different levels (variable importance in the projection values >1 and P<0·05). The greater feed:gain ratio of the HS group was significantly positively correlated with the leg, abdominal fat, subcutaneous fat and intramuscular fat proportions and levels of some free amino acids (proline, l-cysteine, methionine and threonine) but was negatively correlated with breast proportion and levels of some NEFA (stearic acid, arachidonic acid, palmitic acid and oleic acid). These findings indicated that the heat-stressed broilers were in negative energy balance and unable to effectively mobilise fat, thereby resulting in protein decomposition, which subsequently affected growth performance and carcass characteristics.
A new minimally invasive surgical (MIS) robot consisting of a spherical remote center motion (RCM) mechanism with modular design is proposed. A multi-objective dimensional synthesis model is presented to obtain the excellent performance indices. There are four objectives: a global kinematic index, a compactness index, a global comprehensive stiffness index, and a global dynamic index. Other indices characterizing the design requirement, such as workspace, mechanical parameter, and mass, are chosen as constraints. A new decoupled mechanism is raised to solve the coupled motion between the linear platform and the four degrees of freedom (DoF) of surgical instrument as a result of post-driving motors. Another new mechanical decoupled method is proposed to eliminate the coupled motion between the wrist and the forceps, enhance the dexterity of surgical instrument, and improve the independence of each motor. Then, a 7-DoF MIS robotic prototype based on optimization results has been built up. Experiment results validate the effectiveness of the two mechanical decoupled methods. The position change of the RCM point, accuracy, and repeatability of the MIS robot meet the requirements of MIS. Successful animal experiments validate the effectiveness of the novel MIS robot.
Uniaxial compression tests at the temperatures of 573–773 K and strain rates of 0.01–10 s−1 were conducted to investigate the hot deformation behavior and microstructural evolution of Al–Cu–Li X2A66 alloy. The results indicate that the main dynamic softening mechanisms of the alloy are dynamic recovery and partial dynamic recrystallization. The flow stress increases obviously with the decrease of temperature or the increase of strain rate. The material constants considering the effect of strain were determined by sixth-order polynomial fitting based on the corrected data. The developed Arrhenius-type constitutive equation coupling temperature, strain rate, and strain was established and could well predict the flow stress in the whole range of temperatures and strain rates except at 1 s−1 and 573 K. Moreover, the values of correlation coefficient and average absolute relative error were calculated, which further proved that the proposed constitutive model has high accuracy and reliability.
This paper proposes an adaptive guidance law for attacking a ground target based on motion camouflage strategy. The coefficients of normal and bi-normal feedback guidance law are given according to the relative motion relationship under Frenet frame. Utilizing the coefficients, the motion camouflage proportional guidance law is derived. In order to improve the initial overload characteristic of the missile, an adaptive feedback coefficient is introduced. Then, the adaptive guidance law is applied to a longitudinal plane interception problem with impact-angle constraint. Finally, the validity of this guidance law for air-to-ground missiles is proved by simulations.
In this paper, an efficient motion planning method is proposed for a six-legged robot walking on irregular terrain. The method provides the robot with fast-generated free-gait motions to traverse the terrain with medium irregularities. We first of all introduce our six-legged robot with legs in parallel mechanism. After that, we decompose the motion planning problem into two main steps: first is the foothold selection based on a local footstep cost map, in which both terrain features and the robot mobility are considered; second is a whole-body configuration planner which casts the problem into a general convex optimization problem. Such decomposition reduces the complexity of the motion planning problem. Along with the two-step planner, discussions are also given in terms of the robot-environmental relationship, convexity of constraints and robot rotation integration. Both simulations and experiments are carried out on typical irregular terrains. The results demonstrate effectiveness of the planning method.