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Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a severe and life-threatening complication, characterised by multi-organ failure and high short-term mortality. However, there is limited information on the impact of various comorbidities on HBV-ACLF in a large population. This study aimed to investigate the relationship between comorbidities, complications and mortality. In this retrospective observational study, we identified 2166 cases of HBV-ACLF hospitalised from January 2010 to March 2018. Demographic data from the patients, medical history, treatment, laboratory indices, comorbidities and complications were collected. The mortality rate in our study group was 47.37%. Type 2 diabetes mellitus was the most common comorbidity, followed by alcoholic liver disease. Spontaneous bacterial peritonitis, pneumonia and hepatic encephalopathy (HE) were common in these patients. Diabetes mellitus and hyperthyroidism are risk factors for death within 90 days, together with gastrointestinal bleeding and HE at admission, HE and hepatorenal syndrome during hospitalisation. Knowledge of risk factors can help identify HBV-ACLF patients with a poor prognosis for HBV-ACLF with comorbidities and complications.
This study aimed to investigate the organization, workload, and psychological impact of COVID-19 on healthcare workers from the domestic Medical Aid Teams (MATs) sent to Wuhan in China.
Leaders and members of MATs involved in the care for COVID-19 patients were invited to participate in a study by completing 2 separate self-report questionnaires from April 1 to 24, 2020.
A total of 9 MAT leaders were involved and 464 valid questionnaires were collected from 140 doctors and 324 nurses. Mean age of the doctors and nurses were 39.34 ± 6.70 (26∼58 years old) and 31.88 ± 5.29 (21∼52 years old), with 72 (15.5%) being males. Nurses were identified as an independent risk factor (HR 1.898; P = 0.001) for a day working time in the multivariate analysis. The proportions of psychological consulting received among nurses were higher than those among doctors (49.7 vs 30.0%, P < 0.001). More than 50% of the anesthetists and emergency doctors who have received psychological consulting thought that it was effective according to self-evaluation.
This study focused on healthcare workers’ situation during the early period of the pandemic. Nurses worked longer than doctors. The effectiveness of psychological consulting depends on the physicians’ specialties and the working conditions of the nurses and psychological consulting targeting different specialties need to be improved.
Gut microbiome and dietary patterns have been suggested to be associated with depression/anxiety. However, limited effort has been made to explore the effects of possible interactions between diet and microbiome on the risks of depression and anxiety.
Using the latest genome-wide association studies findings in gut microbiome and dietary habits, polygenic risk scores (PRSs) analysis of gut microbiome and dietary habits was conducted in the UK Biobank cohort. Logistic/linear regression models were applied for evaluating the associations for gut microbiome-PRS, dietary habits-PRS, and their interactions with depression/anxiety status and Patient Health Questionnaire (PHQ-9)/Generalized Anxiety Disorder-7 (GAD-7) score by R software.
We observed 51 common diet–gut microbiome interactions shared by both PHQ score and depression status, such as overall beef intake × genus Sporobacter [hurdle binary (HB)] (PPHQ = 7.88 × 10−4, Pdepression status = 5.86 × 10−4); carbohydrate × genus Lactococcus (HB) (PPHQ = 0.0295, Pdepression status = 0.0150). We detected 41 common diet–gut microbiome interactions shared by GAD score and anxiety status, such as sugar × genus Parasutterella (rank normal transformed) (PGAD = 5.15 × 10−3, Panxiety status = 0.0347); tablespoons of raw vegetables per day × family Coriobacteriaceae (HB) (PGAD = 6.02 × 10−4, Panxiety status = 0.0345). Some common significant interactions shared by depression and anxiety were identified, such as overall beef intake × genus Sporobacter (HB).
Our study results expanded our understanding of how to comprehensively consider the relationships for dietary habits–gut microbiome interactions with depression and anxiety.
Wealth management products have been popular investment vehicles in China, and they are governed by standard form contracts. Existing studies mainly focus on the risk of such products and suggest having special laws to provide more protection for customers. Little is known about the actual contents of wealth management product contracts. Based on 66 hand-collected wealth management product contracts from major Chinese commercial banks, this article tries to explore the contractual relationship between giant banks and individual customers. It also tests the exploitation theory in a Chinese context by analysing whether the wealth management product contracts are more pro-seller or pro-buyer relative to the laws and regulations in China. Our findings reinforce the argument that standard form contracts are designed in favour of the sellers. The wealth management product contracts are tilted toward the commercial banks relative to the default rules. These contracts contain massive clauses that limit banks’ liabilities and restrict customers’ choice of conflict resolution mechanisms. However, a counter-intuitive finding is that national commercial banks provide less pro-seller terms than the local ones. We argue that the explanations for such variation in contract practices among Chinese commercial banks lie in the enforcement of relevant laws and regulations and the unique nature of national commercial banks.
Frozen embryo transfer (FET) has been adopted by growing number of reproductive medicine centers due to the improved outcome compared with fresh embryo transfer. However, few studies have focused on the impact of embryo cryopreservation duration on pregnancy-related complications and neonatal birthweight. Thus, a retrospective cohort study including all FET cycles with livebirth deliveries in a university affiliated hospital from May 2010 to September 2017 was conducted. These deliveries were grouped by the cryopreservation duration of the transferred embryo (≤3 months, 4–6 months, 7–12 months, and >12 months). The associations between embryo cryopreservation duration and pregnancy-related complications were evaluated among the groups using multinomial logistic regression. Neonatal birthweight was compared according to the stratification of singletons and multiples using multinomial and multilevel logistic regression, respectively. Among all 12,158 FET cycles, a total of 3864 livebirth deliveries comprising 2995 singletons and 1739 multiples were included. Compared with those within 3 months, women undergoing FET after a cryopreservation time longer than 3 months did not show any increased risk of gestational diabetes mellitus, gestational hypertension, preeclampsia, meconium staining of the amniotic fluid, or preterm birth. Furthermore, the risk of lower birthweight, macrosomia, small-for-gestational-age, or large-for-gestational-age for either singletons or multiples was not affected by long-term cryopreservation. In summary, embryo cryopreservation duration does not have negative effects on pregnancy-related complications or birthweight after FET.
A few former studies suggested that there are partial overlaps in abnormal brain structure and cognitive function between hypochondriasis (HS) and schizophrenia (SZ). But their differences in brain activity and cognitive function were unclear.
Twenty-one HS patients, 23 SZ patients, and 24 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI) with the regional homogeneity analysis (ReHo), subsequently exploring the relationship between ReHo value and cognitive functions. The support vector machines (SVM) were used on effectiveness evaluation of ReHo for differentiating HS from SZ.
Compared with HC, HS showed significantly increased ReHo values in right middle temporal gyrus (MTG), left inferior parietal lobe (IPL), and right fusiform gyrus (FG), while SZ showed increased ReHo in left insula, decreased ReHo values in right paracentral lobule. Additionally, HS showed significantly higher ReHo values in FG, MTG, and left paracentral lobule, but lower in insula than SZ. The higher ReHo values in insula were associated with worse performance in MATRICS consensus cognitive battery (MCCB) in HS group. SVM analysis showed a combination of the ReHo values in insula and FG was able to satisfactorily distinguish the HS and SZ patients.
Our results suggested that the altered default mode network (DMN), of which abnormal spontaneous neural activity occurs in multiple brain regions, might play a key role in the pathogenesis of HS, and the resting-state alterations of insula are closely related to cognitive dysfunction in HS. Furthermore, the combination of the ReHo in FG and insula was a relatively ideal indicator to distinguish HS from SZ.
A multidisciplinary fieldwork and research project was recently begun at the Yangshang site (220–140 ka), a late Early Paleolithic locale in the western Chinese Loess Plateau. 1696 lithic artifacts and 337 faunal remains were recovered during the excavation. Sedimentological and paleoenvironmental investigations indicate the site preserves a relatively long and minimally disturbed archaeological sequence associated with paleoenvironmental changes during MIS 7–6. A detailed techno-typological analysis of Yangshang's lithic assemblages was undertaken to examine the influence of glacial cycles on late Middle Pleistocene hominin technological strategies in the western Chinese Loess Plateau. The results show that while the Yangshang site is dominated by quartz-based core/flake assemblages typical of most Early Paleolithic sites in North China, the lithic assemblages provide evidence that different provisioning systems existed during the penultimate glaciation. We argue that these shifts reflect changes in land use and mobility that were tied to climate change. Our results suggest that theoretically informed statistical analyses of so-called unchanging and crude lithic technology can yield meaningful evidence for behavioral shifts.
A 1178 J near diffraction limited 527 nm laser is realized in a complete closed-loop adaptive optics (AO) controlled off-axis multi-pass amplification laser system. Generated from a fiber laser and amplified by the pre-amplifier and the main amplifier, a 1053 nm laser beam with the energy of 1900 J is obtained and converted into a 527 nm laser beam by a KDP crystal with 62% conversion efficiency, 1178 J and beam quality of 7.93 times the diffraction limit (DL). By using a complete closed-loop AO configuration, the static and dynamic wavefront distortions of the laser system are measured and compensated. After correction, the diameter of the circle enclosing 80% energy is improved remarkably from 7.93DL to 1.29DL. The focal spot is highly concentrated and the 1178 J, 527 nm near diffraction limited laser is achieved.
We present a theoretical study of mode evolution in high-power distributed side-coupled cladding-pumped (DSCCP) fiber amplifiers. A semi-analytical model taking the side-pumping schemes, transverse mode competition, and stimulated thermal Rayleigh scattering into consideration has been built, which can model the static and dynamic mode evolution in high-power DSCCP fiber amplifiers. The mode evolution behavior has been investigated with variation of the fiber amplifier parameters, such as the pump power distribution, the length of the DSCCP fiber, the averaged coupling coefficient, the number of the pump cores and the arrangement of the pump cores. Interestingly, it revealed that static mode evolution induced by transverse mode competition is different from the dynamic evolution induced by stimulated thermal Rayleigh scattering. This shows that the high-order mode experiences a slightly higher gain in DSCCP fiber amplifiers, but the mode instability thresholds for DSCCP fiber amplifiers are higher than those for their end-coupled counterparts. By increasing the pump core number and reducing the averaged coupling coefficient, the mode instability threshold can be increased, which indicates that DSCCP fibers can provide additional mitigation strategies of dynamic mode instability.
This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.
This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.
There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.
The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
The present study was conducted to test the hypothesis that dietary supplementation with a nano chitosan–zinc complex (CP–Zn, 100 mg/kg Zn) could alleviate weaning stress in piglets challenged with enterotoxigenic Escherichia coli K88 by improving growth performance and intestinal antioxidant capacity. The in vivo effects of CP–Zn on growth performance variables (including gastrointestinal digestion and absorption functions and the levels of key proteins related to muscle growth) and the antioxidant capacity of the small intestine (SI) were evaluated in seventy-two weaned piglets. The porcine jejunal epithelial cell line IPEC-J2 was used to further investigate the antioxidant mechanism of CP–Zn in vitro. The results showed that CP–Zn supplementation increased the jejunal villus height and decreased the diarrhoea rate in weaned piglets. CP–Zn supplementation also improved growth performance (average daily gain and average daily feed intake), increased the activity of carbohydrate digestion-related enzymes (amylase, maltase, sucrase and lactase) and the mRNA expression levels of nutrient transporters (Na+-dependent glucose transporter 1, glucose transporter type 2, peptide transporter 1 and excitatory amino acid carrier 1) in the jejunum and up-regulated the expression levels of mammalian target of rapamycin (mTOR) pathway-related proteins (insulin receptor substrate 1, phospho-mTOR and phospho-p70S6K) in muscle. In addition, CP–Zn supplementation increased glutathione content, enhanced total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-px) activity, and reduced malondialdehyde (MDA) content in the jejunum. Furthermore, CP–Zn decreased the content of MDA and reactive oxygen species, enhanced the activity of T-SOD and GSH-px and up-regulated the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins (Nrf2, NAD(P)H:quinone oxidoreductase 1 and haeme oxygenase 1) in lipopolysaccharide-stimulated IPEC-J2 cells. Collectively, these findings indicate that CP–Zn supplementation can improve growth performance and the antioxidant capacity of the SI in piglets, thus alleviating weaning stress.
Iridium (Ir) has an extremely high melting point (2443 °C), high chemical stability and is one of the most promising high-temperature materials. However, Ir is more difficult to process compared with other face-centered cubic metals, such as Ni and Al, which limits its applications. To solve this problem, we study the effect of 32 alloying elements (X) on stacking fault energy of dilute Ir-based alloys generated by shear deformation using the first-principles calculations. The investigation reveals that there are many alloying elements studied herein decrease the stacking fault energy of face-centered cubic (fcc) Ir, and the most effective element in reducing stacking fault energy of fcc Ir is Zn. The microscopic mechanism is caused by electron redistribution in the local stacking fault area. These results are expected to provide valuable guidance for the further design and application of Ir-based alloys.
Having enterprises engaged in environmentally friendly behavior is an important part of reducing negative environmental impacts. This study makes a quantitative analysis against the backdrop of China's transitional economic system. The results show that politically-connected enterprises significantly reduce environmental expenditure, but this only holds for state-owned enterprises; private enterprises with political connections spend significantly more. Analysis of the efficiency of environmental expenditure indicates that, for private enterprises, environmental spending is used as a way to maintain political connections, with rent-seeking as the likely motivation. Politically-connected private enterprises have not reduced their emissions to the same extent as state-owned enterprises, despite increased expenditure. Given the scale of environmental degradation in China during a period of massive economic and social upheaval, the results of this analysis provide a quantitative case for policy change: governments should shift focus to the results that environmental spending produces.
Birth weight influences not only brain development, but also mental health outcomes, including depression, but the underlying mechanism is unclear.
The phenotypic data of 12,872–91,009 participants (59.18–63.38% women) from UK Biobank were included to test the associations between the birth weight, depression, and brain volumes through the linear and logistic regression models. As birth weight is highly heritable, the polygenic risk scores (PRSs) of birth weight were calculated from the UK Biobank cohort (154,539 participants, 56.90% women) to estimate the effect of birth weight-related genetic variation on the development of depression and brain volumes. Finally, the mediation analyses of step approach and mediation analysis were used to estimate the role of brain volumes in the association between birth weight and depression. All analyses were conducted sex stratified to assess sex-specific role in the associations.
We observed associations between birth weight and depression (odds ratio [OR] = 0.968, 95% confidence interval [CI] = 0.957–0.979, p = 2.29 × 10−6). Positive associations were observed between birth weight and brain volumes, such as gray matter (B = 0.131, p = 3.51 × 10−74) and white matter (B = 0.129, p = 1.67 × 10−74). Depression was also associated with brain volume, such as left thalamus (OR = 0.891, 95% CI = 0.850–0.933, p = 4.46 × 10−5) and right thalamus (OR = 0.884, 95% CI = 0.841–0.928, p = 2.67 × 10−5). Additionally, significant mediation effects of brain volume were found for the associations between birth weight and depression through steps approach and mediation analysis, such as gray matter (B = –0.220, p = 0.020) and right thalamus (B = –0.207, p = 0.014).
Our results showed the associations among birth weight, depression, and brain volumes, and the mediation effect of brain volumes also provide evidence for the sex-specific of associations.
The novel coronavirus disease 2019 (COVID-19) pandemic has spread to over 213 countries and territories. We sought to describe the clinical features of fatalities in patients with severe COVID-19.
We conducted an Internet-based retrospective cohort study through retrieving the clinical information of 100 COVID-19 deaths from nonduplicating incidental reports in Chinese provincial and other governmental websites between January 23 and March 10, 2020.
Approximately 6 of 10 COVID-19 deaths were males (64.0%). The average age was 70.7 ± 13.5 y, and 84% of patients were elderly (over age 60 y). The mean duration from admission to diagnosis was 2.2 ± 3.8 d (median: 1 d). The mean duration from diagnosis to death was 9.9 ± 7.0 d (median: 9 d). Approximately 3 of 4 cases (76.0%) were complicated by 1 or more chronic diseases, including hypertension (41.0%), diabetes (29.0%) and coronary heart disease (27.0%), respiratory disorders (23.0%), and cerebrovascular disease (12.0%). Fever (46.0%), cough (33.0%), and shortness of breath (9.0%) were the most common first symptoms. Multiple organ failure (67.9%), circulatory failure (20.2%), and respiratory failure (11.9%) are the top 3 direct causes of death.
COVID-19 deaths are mainly elderly and patients with chronic diseases especially cardiovascular disorders and diabetes. Multiple organ failure is the most common direct cause of death.
HfO2–Sm3TaO7 ceramics are prepared through a solid-state reaction method. The X-ray diffraction and structural refinement show that the phase structures of HfO2–Sm3TaO7 ceramics are an ordered orthorhombic phase and the space groups are belonging to Ccmm. The degree of the structural disorder increases with increasing HfO2 content. The solid solution mechanism reveals that Hf4+ exists in the form of interstitial ions that cause crystal expansion when the doping content is less than 4 mol%. When the doping concentration of HfO2 ≥ 4 mol%, the Hf4+ ions can substitute an equal number of Sm3+ and Ta5+ ions. The phase transition of Sm3TaO7 ceramics is removed with increasing HfO2 content, and the 8 mol% HfO2–Sm3TaO7 ceramics have a high thermal expansion coefficient of 10.2 × 10−6 K−1 at 1200 °C. The 2 mol% HfO2–Sm3TaO7 ceramics have the lowest thermal conductivity (1.03 W/m K at 900 °C), which is lower than previous research of the 7–8 YSZ. The outstanding thermophysical properties of HfO2–Sm3TaO7 ceramics indicate that they are potential thermal-barrier coating materials.
The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan–Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO2/FiO2 value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.
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.
The nitrogen-decorated CeO2/reduced graphene oxide nanocomposite (CeO2/N-rGO) was one-step synthesized by a facile hydrothermal technique and applied as counter electrode materials for dye-sensitized solar cells (DSSCs). For comparison, CeO2/rGO and rGO were also synthesized by adjusting corresponding reactants. It was found that the as-synthesized CeO2/N-rGO shows better electrocatalytic activity for triiodide/iodide reduction than that of pure rGO and CeO2/rGO, and a synergistic effect of nitrogen and CeO2 on the rGO sheets was observed. The photoelectric conversion efficiency of DSSCs based on CeO2/N-rGO counter electrode was 3.20%, which is higher than that of CeO2/rGO (2.45%) and rGO counter electrode (1.37%). Furthermore, the synergistic effect of nitrogen and CeO2 on the rGO sheets was also discussed in detail with different CeO2 amount levels. It is believed that this one-step synthetic method is a potential way to synthesize low-cost and efficient rGO-based multiple composited counter electrode materials to replace more expensive Pt.
The current study aimed to evaluate the association of major dietary patterns with anxiety in middle-aged adults in eastern China.
Dietary intake was assessed using a semi-quantitative FFQ. Binary logistic regression analysis was used to estimate OR and 95 % CI for anxiety according to quartiles of each dietary pattern score.
Evidence regarding the relationship between dietary patterns and anxiety in the Chinese population is scarce.
The study participants were 1360 Chinese adults aged 45–59 years, who participated in a health survey at the time of periodic check-up in the city of Linyi, Shandong Province, China.
Four major dietary patterns were identified by factor analysis: traditional Chinese, western, grains–vegetables and high-salt diets. After adjusting for potential confounders, participants in the highest quartile of the western pattern had greater odds for anxiety, compared with those in the lowest quartile (OR 1·35, 95 % CI 1·000, 3·086, P < 0·05). In contrast, participants in the highest quartile of the grains–vegetables pattern had lower odds for anxiety than did those in the lowest quartile (OR 0·78, 95 % CI 0·574, 1·000, P < 0·05). Moreover, no significant associations were observed between the traditional Chinese and high-salt patterns and the risk of anxiety.
Our findings indicate that the western pattern is associated with an increased risk, and the grains–vegetables pattern is associated with a decreased risk of anxiety.