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This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.
Prospective cohort studies linking organ meat consumption and nonalcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between organ meat consumption and risk of NAFLD in a general Chinese adult population. This prospective cohort study included a total of 15,568 adults who were free of liver disease, cardiovascular disease, and cancer at baseline. Dietary information was collected at baseline using a validated food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between organ meat consumption and risk of NAFLD. During a median of 4.2 years of follow-up, we identified 3,604 incident NAFLD cases. After adjusting for demographic characteristics, lifestyle factors, vegetable, fruit, soft drink, seafood, and red meat consumption, the multivariable hazard ratios (95% confidence intervals) for incident NAFLD across consumption of organ meat were 1.00 (reference) for almost never, 1.04 (0.94, 1.15) for tertile 1, 1.08 (0.99, 1.19) for tertile 2, and 1.11 (1.01, 1.22) for tertile 3, respectively (P for trend <0.05). Such association did not differ substantially in the sensitivity analysis. Our study indicates that organ meat consumption was related to a modestly higher risk of NAFLD among Chinese adults. Further investigations are needed to confirm this finding.
This article designs a frog-inspired swimming robot based on pneumatic muscles. The musculoskeletal characteristics of the frog are refined and used as the basis for the design of the robot joint structure and movement mode. The posture adjustment module, joint water seal, and power system are designed to meet the robot’s motion requirements, and the structure optimization design of the robot is completed by combining simulation analysis. The body length of the robot is about 710 mm, and the overall mass is 10 kg. Combining the structural characteristics of the robot, the control system is built to realize the frog-like motion. The robot’s propulsion speed is about 0.6 m/s, the propulsion distance reaches 2.4 m, the turning angle is 30°, and the turning radius is 0.6 m. The prototype experiment verifies the rationality of the frog-inspired swimming robot structure design and the reliability of the control system and water seal.
Sarcopenia is a core contributor to several health consequences, including falls, fractures, physical limitations and disability. The pathophysiological processes of sarcopenia may be counteracted with the proper diet, delaying sarcopenia onset. Dietary pattern analysis is a whole diet approach used to investigate the relationship between diet and sarcopenia. Here, we aimed to investigate this relationship in an elderly Chinese population. A cross-sectional study with 2423 participants aged more than 60 years was performed. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia, composed of low muscle mass plus low grip strength and/or low gait speed. Dietary data were collected using a FFQ that included questions on 100 food items along with their specified serving sizes. Three dietary patterns were derived by factor analysis: sweet pattern, vegetable pattern and animal food pattern. The prevalence of sarcopenia was 16·1 %. The higher vegetable pattern score and animal food pattern score were related to lower prevalence of sarcopenia (Ptrend = 0·006 and < 0·001, respectively); the multivariate-adjusted OR of the prevalence of sarcopenia in the highest v. lowest quartiles were 0·54 (95 % CI 0·34, 0·86) and 0·50 (95 % CI 0·33, 0·74), separately. The sweet pattern score was not significantly related to the prevalence of sarcopenia. The present study showed that vegetable pattern and animal food pattern were related to a lower prevalence of sarcopenia in Chinese older adults. Further studies are required to clarify these findings.
High dietary fiber intake has been associated with a lower risk of diabetes, but the association of dietary fiber with prediabetes is only speculative, especially in China, where the supportive data from prospective studies is lacking. This study aimed to examine the association between dietary fiber intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18,085 participants of the TCLSIH cohort study who were free of diabetes, prediabetes, cancer, and cardiovascular disease at baseline. Dietary data were collected using a validated 100-item food frequency questionnaire. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 63,175 person-years of follow-up, 4,139 cases of incident prediabetes occurred. The multivariable HRs (95% CIs) of prediabetes for the highest versus lowest quartiles were 0.85 (0.75, 0.98) (P for trend =0.02) for total dietary fiber, 0.84 (0.74, 0.95) (P for trend <0.01) for soluble fiber, and 1.05 (0.93, 1.19) (P for trend =0.38) for insoluble fiber. Fiber from fruits, but not from cereals, beans, and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fiber, soluble fiber, and fiber derived from fruit sources were associated with a lower risk of prediabetes.
No relevant studies have yet been conducted to explore which measurement can best predict the survival time of patients with cancer cachexia. This study aimed to identify an anthropometric measurement that could predict the 1-year survival of patients with cancer cachexia. We conducted a nested case–control study using data from a multicentre clinical investigation of cancer from 2013 to 2020. Cachexia was defined using the Fearon criteria. A total of 262 patients who survived less than 1 year and 262 patients who survived more than 1 year were included in this study. Six candidate variables were selected based on clinical experience and previous studies. Five variables, BMI, mid-arm circumference, mid-arm muscle circumference, calf circumference and triceps skin fold (TSF), were selected for inclusion in the multivariable model. In the conditional logistic regression analysis, TSF (P = 0·014) was identified as a significant independent protective factor. A similar result was observed in all patients with cancer cachexia (n 3084). In addition, a significantly stronger positive association between TSF and the 1-year survival of patients with cancer cachexia was observed in participants aged > 65 years (OR: 0·94; 95 % CI 0·89, 0·99) than in those aged ≤ 65 years (OR: 0·96; 95 % CI 0·93, 0·99; Pinteraction = 0·013) and in participants with no chronic disease (OR: 0·92; 95 % CI 0·87, 0·97) than in those with chronic disease (OR: 0·97; 95 % CI 0·94, 1·00; Pinteraction = 0·049). According to this study, TSF might be a good anthropometric measurement for predicting 1-year survival in patients with cancer cachexia.
Creativity is crucial in design. In recent years, growing computational methods are applied to improve the creativity of design. This paper aims to explore an approach to generate creative design images with specific feature or design style. A Generative Adversarial Network model is applied in the approach to learn the specific design style. The target products will be projected into the latent space of model to transfer their styles and generate images. The generated images combine the features of the specific design style and the features of the target product. In the experiment, the approach using the generated images to inspire the human designer to generate the creative design in according styles. According to the primary verification by participants, the generated images can bring novelty and surprise to participants, which gain the positive impact on human creativity.
The staining procedure is critical for investigating intra- and extra-cellular ultrastructure of microorganisms by transmission electron microscopy (TEM). Here, we propose a new ultra-low lead staining (ULLS) technique for preparing the ultrathin sections for TEM analysis. Sections of Enterobacter sp. (bacteria), Aspergillus niger (filamentous fungi), Rhodotorula mucilaginosa (fungi), and Chlamydomonas reinhardtii (microalgae) were tested. Compared with the sections prepared by the typical double-staining technique, ULLS-based sections showed evident advantages: (i) the staining process only required the addition of Pb(NO3)2; (ii) the Pb level during incubation was set as low as 1 mg/L, which had negligible toxicity to most microbial cells; (iii) the Pb cations were added during microbial culture, which avoided complicated sample preparation as in typical double staining. Taking C. reinhardtii as an example, the ULLS technique allowed fine investigation of microbial ultrastructure, e.g., starch granule, mitochondrion, Golgi apparatus, vacuole, and vesicle. Meanwhile, the physiological processes of the cells such as cell lysis and exocytosis were successfully captured, with relatively high contrast. This study hence shows a bright future on preparation of the high-quality ultrathin sections of microbial cells by the ULLS technique.
Seasonal climate variability is an important component of Earth's climate system, and has a significant impact on ecosystems and social systems. However, the temporal resolution of most proxy-based paleoclimate records is limiting to fully understand the past seasonal changes. Here, we used high-precision monthly resolution Sr/Ca records of three Tridacna squamosa specimens from the northern South China Sea (SCS) to reconstruct the sea surface temperature (SST) seasonality during three time periods from the middle Holocene. The results suggested that SST seasonality in the northern SCS during the middle Holocene (3.21 ± 0.98°C) was smaller than that for recent decades (AD 1994–2004, 4.32 ± 0.59°C). Analysis of modern instrumental data showed that the SST seasonality in the northern SCS was dominated by the winter SST, which was deeply influenced by the intensity of East Asian winter monsoon (EAWM). A strong EAWM usually resulted in cooler winter SST and a larger SST seasonality in the northern SCS. The reconstructed Holocene EAWM records showed that the EAWM strengthened from the middle to late Holocene, which was seen in our reconstruction of less SST seasonality changes during the middle Holocene in the northern SCS. This study highlighted that the Sr/Ca ratios from Tridacna shells can be used as a potential high-resolution indicator of past seasonal climate changes.
Seaweeds have numerous biologically active ingredients, such as polysaccharides, polyphenols and carotenoids, that are beneficial to human health. Although these benefits might be related to the synthesis, secretion or reabsorption of uric acid, no studies have explored the relationship between seaweeds consumption and hyperuricaemia (HUA) in the general population. The aim of this study was to investigate whether seaweeds consumption is related to HUA in a large-scale adult population. A cross-sectional study was conducted with 32 365 adults (17 328 men and 15 037 women) in Tianjin, People’s Republic of China. Frequency of seaweeds consumption was assessed by a validated self-administered FFQ. HUA was defined as serum uric acid levels >420 μmol/L in men and >350 μmol/L in women. The association between seaweeds consumption and HUA was assessed by multiple logistic regression analysis. Restricted cubic spline functions were used for non-linearity tests. The prevalence of HUA in men and women was 21·17 % and 5·93 %, respectively. After adjustments for potential confounding factors, the OR (95 % CI) for HUA across seaweed consumption (g/1000 kcal per d) were 1·00 (reference) for level 1, 0·91 (95 % CI 0·81, 1·02) for level 2; 0·90 (95 % CI 0·81, 1·01) for level 3; 0·86 (95 % CI 0·78, 0·97) for level 4 in men and 0·90 (95 % CI 0·73, 1·10) for level 2; 0·82 (95 % CI 0·67, 1·00) for level 3; 0·84 (95 % CI 0·68, 1·03) for level 4 in women, respectively. A negative correlation between seaweeds consumption and HUA in males but not in females was observed. Further studies are needed to explore the causal relationship.
The Dayao Paleolithic site, located in Inner Mongolia on the eastern margin of China's vast northwestern drylands, was a lithic quarry-workshop utilized by Pleistocene human migrants through the region. Determining the age of this activity has previously yielded controversial results. Our magnetostratigraphic and OSL dating results suggest the two artifact-bearing paleosols are correlated with MIS 5 and 7, respectively. Correlating paleoclimatic data with marine δ18O records leads us to conclude that two sandy gravel layers containing many artifacts in the lower part of the Dayao sequence were formed during MIS 9 and 11, if not earlier. Our results reveal that the earliest human occupation at the Dayao site occurred before ca. 400 ka during a relatively warm and moist interglacial period, similar to several subsequent occupations, documenting the earliest and northernmost archaeological assemblage yet reported in China's arid northwest. We conclude that the northward and southward displacements of the East Asian summer monsoon rain belt during past interglacial-glacial cycles were responsible for the discontinuous human occupation detected at the Dayao site. The penetration of this precipitation regime into dryland ecologies via the Huanghe (Yellow River) Valley effectively created a corridor for hominin migration into China's arid northwest.
During the Upper Ordovician–Lower Silurian, chert was widely distributed in the Zhongbao Formation in the eastern part of the North Qilian Orogen. The origin and the tectonic setting of these chert were largely unknown. In order to analyse the material provenance, sedimentary environment, their formation and the tectonic setting, we present petrology and geochemical research on chert samples collected from Shihuigou Section. The evidence provided by radiolarite occurrences, Aluminium (Al)–iron (Fe)–manganese diagram and the silicon(Si)/Si + Al + Fe + calcium ratios suggesting a non-hydrothermal input and the biogenic origin chert. The geochemical features and the petrographic signatures have shown that the chert was also influenced by a terrigenous origin. It is considered that the deposition of the Late Ordovician chert is mainly affected by tectonic collision and volcanic ash events. During the Late Ordovician–Early Silurian transition, huge amounts of volcanic ash were released by massive volcanic activity that fell into the ocean, triggering the proliferation of radiolarians. Finally, in the Late Ordovician–Lower Silurian the tectonic setting of the North Qilian Orogen was not a typical deep-water basin, nor a typical continental margin, but a multi-island deep-water basin, which is closed to the mainland.
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.
Lead-free BaTiO3 (BT)-based multilayer ceramic capacitors (MLCCs) with the thickness of dielectric layers ~9 μm were successfully fabricated by tape-casting and screen-printing techniques. A single phase of the pseudo-cubic structure was revealed by X-ray diffraction. Backscattered images and energy-dispersive X-ray elemental mapping indicated the high quality of MLCCs without observation of interaction, wrapping, or delamination. The relaxor state was confirmed by transmission electron microscopy and temperature-dependent permittivity. Impedance spectroscopy at various temperatures revealed the electrical heterogeneous response for MLCCs with high-resistive electrical components. Improved energy storage performance was obtained by multilayering, comparing with the bulk ceramics. Enhanced recoverable energy density ~6.88 J/cm3 with high efficiency ~90% were realized under an electric field of 820 kV/cm, which is mainly attributed to the intrinsic high-resistivity and relaxor behavior. Furthermore, good temperature (20–85 °C) and frequency stabilities (0.5–50 Hz) were observed in the MLCCs, which are attractive for pulsed power applications.
The aim of this study was to investigate risk factors and psychological stress of health-care workers (HCWs) with coronavirus disease 2019 (COVID-19) in a nonfrontline clinical department.
Data of 2 source patients and all HCWs with infection risk were obtained in a department in Wuhan from January to February 2020. A questionnaire was designed to evaluate psychological stress of COVID-19 on HCWs.
The overall infection rate was 4.8% in HCWs. Ten of 25 HCWs who contacted with 2 source patients were diagnosed with confirmed COVID-19 (8/10) and suspected COVID-19 (2/10). Other 2 HCWs were transmitted by other patients or colleagues. Close care behaviors included physical examination (6/12), life nursing (4/12), ward rounds (4/12), endoscopic examination (2/12). Contacts fluctuated from 1 to 24 times and each contact was short (8.1 min ± 5.6 min). HCWs wore surgical masks (11/12), gloves (7/12), and isolation clothing (3/12) when providing medical care. Most HCWs experienced a mild course with 2 asymptomatic infections, taking 9.8 d and 20.9 d to obtain viral shedding and clinical cure, respectively. Psychological stress included worry (58.3%), anxiety (83.3%), depression (58.3%), and insomnia (58.3%).
Close contact with COVID-19 patients and insufficient protection were key risk factors. Precaution measures and psychological support on COVID-19 is urgently required for HCWs.
As strict measures were taken, the coronavirus disease 2019 (COVID-19) epidemic has been gradually brought under control. As a port city, Shanghai’s main problem has shifted from treating local cases to preventing foreign imports. To prevent the re-outbreak of COVID-19 caused by imported cases, the Shanghai government has set up central isolation sites for all people entering the country from abroad to be placed under medical observation. This report describes how to set up central isolation sites and run them effectively. We put isolation sites in transformed hotels, arranged personnel according to a huge data network, and set up specific procedures to manage guests. The epidemic situation in Shanghai has confirmed the feasibility and effectiveness of the methods that other jurisdictions can adapt for their use.
This cross-sectional study aimed to examine the associations between dietary fibre (DF) intake and depressive symptoms in a general adult population in Tianjin, China. A total of 24 306 participants (mean age 41 years; range 18–91 years) were enrolled. DF intake was assessed using a validated self-administered FFQ. Depressive symptoms were assessed using the Self-Rating Depression Scale. Associations between DF intake and depressive symptoms were estimated using logistic regression analysis. Socio-demographic, behavioural, health status and dietary factors were adjusted. In men, compared with participants in the lowest quartiles for total, soluble, vegetable and soya DF, OR for depressive symptoms in the highest were 0·83 (95 % CI 0·69, 0·99), 0·74 (95 % CI 0·63, 0·87), 0·79 (95 % CI 0·65, 0·96) and 0·69 (95 % CI 0·60, 0·81), respectively. In women, compared with participants in the lowest quartiles for vegetable and soya DF, the OR for depressive symptoms in the highest were 0·77 (95 % CI 0·64, 0·93) and 0·82 (95 % CI 0·70, 0·95), respectively. No association was found between total or soluble DF intake and depressive symptoms in women. No association was found between insoluble, cereal, fruit or tuber DF intake and depressive symptoms in men and women. Linear associations between DF intake and depressive symptoms were only detected for soya DF (men, β = –0·148, P < 0·0001; women, β = –0·069, P = 0·04). Results suggest that intake of soluble, vegetable and soya DF was inversely associated with depressive symptoms. These results should be confirmed through prospective and interventional studies.
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.
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Recent evidence has suggested the protective effects of honey consumption against the metabolic syndrome, but the association between honey intake and NAFLD is still unclear. We investigated how the consumption frequency of honey was associated with NAFLD in the general population. This was a cross-sectional study of 21 979 adults aged 20–90 years. NAFLD was diagnosed based on the ultrasound-diagnosed fatty liver without significant alcohol intake and other liver diseases. Diet information, including consumption frequency of honey, was assessed by a validated 100-item FFQ. OR with 95 % CI were calculated by the binary logistic regression model, adjusting for confounding factors identified by the directed acyclic graph. Overall, 6513 adults (29·6 %) had NAFLD. Compared with participants consuming ≤1 time/week of honey, the multivariable OR of NAFLD were 0·86 (95 % CI 0·77, 0·97) for 2–6 times/week and 1·10 (95 % CI 0·95, 1·27) for ≥1 times/d (Pfor trend = 0·90). The results were generally similar in subgroups of BMI at a cut-point of 24·0 kg/m2 (Pfor interaction = 0·10). In this large-scale study, consuming honey 2–6 times/week was inversely associated with NAFLD, whereas consuming honey ≥1 times/d had no association with NAFLD. These results need replication in other large-scale prospective studies.
A flexible surface-enhanced Raman scattering (SERS) substrate was prepared by vacuum evaporation of silver on the surface of woven nylon fabrics. SERS properties of the Ag-coated nylon fabrics varied as the thickness of silver coatings changed, relative to the morphologies and distribution of silver nanoparticles (NPs) on fiber. The SERS enhancement performance of Ag-coated nylon fabrics was evaluated by collecting Raman signals of different concentrations of p-aminothiophenol (PATP). The results suggested that the nylon fabrics coated with 10 nm thickness Ag NPs coatings possessed high SERS activity and its detection concentration for PATP is as low as 10−9 M. Furthermore, sensitive SERS signals with excellent reproducibility (Relative standard deviation = 8.25%) and stability (30 days) have been demonstrated. In addition, the SERS nylon fabrics have been applied to rapidly detect thiram pesticides on cucumber, which indicated a great potential for trace analysis.