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We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case–control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2–4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose–response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
Employing atomic-scale simulations, the response of a high-angle grain boundary (GB), the soft/hard GB, against external loading was systematically investigated. Under tensile loading close to the hard orientation, strain-induced dynamic recrystallization was observed to initiate through direct soft-to-hard grain reorientation, which was triggered by stress mismatch, inhibited by surface tension from the soft-hard GB, and proceeded by interface ledges. Such grain reorientation corresponds with expansion and contraction of the hard grain along and perpendicular to the loading direction, respectively, accompanied by local atomic shuffling, providing relatively large normal strain of 8.3% with activation energy of 0.04 eV per atom. Tensile strain and residual dislocations on the hard/soft GB facilitate the initiation of dynamic recrystallization by lowering the energy barrier and the critical stress for grain reorientation, respectively.
As rarely large flake graphite (9 mesh) was recently exploited in China, it was innovatively developed as the raw material to prepare a novel wound dressing based on large expanded graphite (EG) in this work. The EG worms were prepared in an easy oxidative intercalation and thermal expansion method. Afterward, chitosan was grafted onto the surface of EG by chemical modification, forming CS-EG worms. CS-EG sponge dressings were then obtained by pressing a number of CS-EG worms together by external force. Due to the porous structure and large specific surface area, the produced CS-EG sponges exhibited outstanding adsorption capacity for wound exudate. They could also promote blood coagulation by adsorbing the blood cells and proteins quickly and effectively, showing excellent hemostatic performance. The eminent performances and the simple preparation process ensure the great application potential of CS-EG as a dressing material. This is also the first time to report the application of the traditional carbon material, EG, to act as a dressing material after chemical modification.
Equity is the core of primary care. The issue of equity in health has become urgent and China has attached increasing attention to it. With rapid economic development and great change of the policy on medical insurance, the pattern of equity in health has changed a lot. Reform of healthcare in Zhejiang province is at the forefront of China; studies on Zhejiang are of great significance to the whole country. This paper aims to measure the equity in health from the perspectives of health needs and health seeking behavior, and provides suggestions for decision making.
A household survey was conducted in August 2016. A sample of 1000 households, 2807 individuals in Zhejiang was obtained with the multi-stage stratified cluster sampling method. Descriptive analysis and Chi-square test were adopted in the analysis. The value of concentration index was used to measure the equity.
This study finds that the poor have more urgent health needs and poorer health situation compared with the rich. The utilization of outpatient services was almost equal, whilst the utilization of hospitalization was pro-rich (the rich use more).Individuals with employer-based medical insurance use more outpatient services than those with rural and urban medical insurance. Compared to the rich, there were more people in the poorer income groups who didn't use inpatient services due to financial difficulties.
The issue of equity in health has attracted broad attention in the world, and China is no exception. We measured and analyzed the equity of health needs and absent rate of health services. We find that the poor have more urgent health needs and high absent rate of inpatient services compared with the rich. Income level and medical insurance may well explain the equity of outpatient and inequity of hospitalization. In view of the pro-rich inequity of hospitalization, more financial protection should be provided for the poor.
To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.
A cross-sectional validation study.
Huashan Hospital, Shanghai, China.
A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.
Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.
Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.
Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.
The immobilization of cytochrome c (cyt c) on tea polyphenol functionalized and reduced graphene oxide (TPG) was carried out by a simple adsorption process. Intriguingly, TPG with large surface area exhibited excellent adsorption behaviors and good biocompatibility. The adsorbed materials were characterized by various methods including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). And the effects of adsorption behavior of cyt c were discussed in detail. The results showed the adsorption behavior was dependent on the pH value and showed a high adsorption capacity as high as 1.414 × 104 mg/g and was friendly to normal cells (mouse fibroblast cell line, L929). In conclusion, we proposed the introduction of TPG as novel material and used the adsorption method to immobilize cyt c, which would provide a novel material and simple method for the enrichment of protein.
Dilated Cardiomyopathy is a serious heart disorder that may induce sudden cardiac death and heart failure. Significant progress has been made in understanding the molecular basis of dilated cardiomyopathy. In previous studies, mutations in more than fifty genes have been identified in dilated cardiomyopathy patients. The purpose of this study was to detect the genetic lesion in a family from the central south of China affected by severe dilated cardiomyopathy.
Whole-exome sequencing combined with cardiomyopathy-related genes list were used to analyse the mutations of the proband. Co-segregation analysis was performed by Sanger sequencing.
Results and conclusions
Two novel heterozygous mutations – Myosin Binding Protein C: p.L1014RfsX6 and Titin: p.R9793X – were identified in the proband. The deletion mutation c.3041delT/p.L1014RfsX6 caused a premature stop codon at position 1020 in exon 28 of the Myosin Binding Protein C. The nonsense mutation, c.29377 C>T/ p. R9793X, of Titin was located in the highly evolutionarily conserved domain, resulting in truncation of the Titin protein as well. Co-segregation analysis further revealed that the Myosin Binding Protein C mutation came from his mother and the Titin mutation came from his father. Both mutations are reported in dilated cardiomyopathy patients for the first time. Our study not only provides a unique example of the genes and molecular mechanisms involved in dilated cardiomyopathy but also expands the spectrum of Myosin Binding Protein C and Titin mutations and contributes to the genetic diagnosis and counselling of dilated cardiomyopathy patients.
Environmental characteristics (for example, temperature, photoperiod) as seasonal cues can affect the offspring sex ratio and reproductive tactics of many hymenopteran insects. Leptocybe invasa Fisher & La Salle is the most critical invasive insect pest of Eucalyptus spp. in the world and displays thelytokous reproduction. In the current study, we studied the effects of temperature and photoperiod on offspring sex ratio and reproductive tactics in L. invasa. Results show that sex ratio (female: male) of L. invasa was under 15, 25 and 35 °C with both L 12: D 12 and L 16: D 8, and cold and thermal acclimation were 74.5:1, 71.0:1, 59.0:0, 17.3:1, 53.0:0, 64.0:0, 47.0:1 and 56.0:0, respectively, which was highly significantly female biased and with no significant difference due to temperature or photoperiod. Offspring virgin females oviposited and induced the bump-shaped galls on plants under the same conditions as described above. Constant temperature, photoperiod and their interaction, and cold and thermal acclimation had no significant effect on the infestation rates of Eucalyptus branches induced by offspring virgin females. Thus, temperature, photoperiod and cold and thermal acclimation did not influence female-biased sex ratio and tactics with thelytokous reproduction of offspring females in L. invasa.
Propofol is a intravenous anaesthetic most commonly used in ultrasound oocyte retrieval. We studied if the use of propofol had an effect on mouse oocyte maturation, pregnancy, childbirth and progeny and investigated the correlation between propofol side effects and reproductive performance in mice. There was no statistical difference in mating, pregnancy, childbirth, litter size, the number of stillbirths and survival between each group (P>0.05). Propofol also had no effect on polar body extrusion in oocyte maturation as well as on pronucleus formation and, subsequently, early embryo development (P>0.05). An increased concentration of propofol had no effect on this result, although propofol at more than 0.01 mg/ml reduced polar body extrusion. Different concentrations of propofol had no effect on oocyte culture in vitro, pronucleus formation and early embryo development.
To investigate the impact of viral and bacterial co-infection in hospitalised children with Mycoplasma pneumoniae pneumonia (RMPP). Retrospective analysis of 396 children with RMPP in our hospital admitted between 1 January 2011 and 31 December 2016 was performed. Nasal aspirate samples were collected for pathogen detection and clinical data were collected. We analysed clinical characteristics, lung imaging characteristics and pathogenic species among these children. Of the 396 RMPP cases, 107 (27.02%) had co-infection with other pathogen, with Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus being the most common bacteria of infection and human bocavirus (HBoV), human rhinovirus, respiratory syncytial virus being the most common viruses of infection. Children with co-infection were younger than that with single infection (P = 0.010). Children with both virus and bacteria co-infection had been the youngest (P = 0.040). Children with co-infection had a longer fever process, higher leukocyte count, higher C-reactive protein compared with single infection (P < 0.05). Children with co-infection had a higher percentage of pnemothorax and diffuse large area of inflammation in chest X-ray manifestation compared with children with single infection (P < 0.05). S. pneumonia and HBoV was the leading cause of co-infection in RMPP. Co-infections led to more disease severity in children with RMPP compared with single infections.
Although the importance of public satisfaction is well documented, few studies have been conducted on the diversity of citizens’ evaluations of the various levels of government. This study explored hierarchical government satisfaction among the public in two culturally Chinese societies, namely China and Taiwan. Basing the analysis on the perspective of responsibility attribution, this paper proposes that the two publics’ distinctive perceptions, which are shaped by different information flows, lead hierarchical government satisfaction in the two societies in separate directions. This argument is supported by the empirical findings from the sixth wave of the World Values Survey. The findings confirm that personal evaluations, including household economic satisfaction, democratic evaluation, and public service confidence, exert more influence over local government satisfaction in China, but conversely have a greater impact on central government satisfaction in Taiwan. Moreover, these evaluations are shown to affect hierarchical government satisfaction differently in the two societies. The evidence reveals that the two publics attribute blame for problems to different administrative objects: Chinese citizens tend to blame local governments, whereas Taiwanese citizens are inclined to criticize the central government.
Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.
A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.
Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.
This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.
SCN5A encodes sodium-channel α-subunit Nav1.5. The mutations of SCN5A can lead to hereditary cardiac arrhythmias such as the long-QT syndrome type 3 and Brugada syndrome. Here we sought to identify novel mutations in a family with arrhythmia.
Genomic DNA was isolated from blood of the proband, who was diagnosed with atrial flutter. Illumina Hiseq 2000 whole-exome sequencing was performed and an arrhythmia-related gene-filtering strategy was used to analyse the pathogenic genes. Sanger sequencing was applied to verify the mutation co-segregated in the family.
Results and conclusions
A novel missense mutation in SCN5A (C335R) was identified, and this mutation co-segregated within the affected family members. This missense mutation was predicted to result in amplitude reduction in peak Na+ current, further leading to channel protein dysfunction. Our study expands the spectrum of SCN5A mutations and contributes to genetic counselling of families with arrhythmia.
Drawing from self-concept and implicit leadership theories, we propose a multilevel model to examine whether, why, and when self-sacrificial leadership motivates followers’ affiliative and challenging citizenship behaviors in China. Data from 329 full-time employees in 83 work groups provide support for the hypothesized model. Specifically, we demonstrated that self-sacrificial leadership was positively related to followers’ relational self-concept constructs of leader identification and leader-based self-esteem, which had differential, downstream implications for followers’ two types of citizenship behavior. Whereas leader identification was found to mediate the positive relationship between self-sacrificial leadership and affiliative citizenship behavior only, leader-based self-esteem mediated the positive relationships of self-sacrificial leadership with both affiliative and challenging citizenship behaviors. We further demonstrated individual power distance orientation as a significant cultural contingency in the above mediation relationships, which were found to exist among followers with low rather than high power distance orientations. We conclude by discussing the theoretical and practical implications of these findings.
Sexual offenses cause harm to the victims’ physical and psychological functions. This study was conducted to evaluate the risk of incident psychiatric disorders in sexual assault victims. Taiwan’s National Health Insurance Research Database was used to conduct a nationwide population-based cohort study to assess the risk of incident psychiatric disorders in sexual assault victims and to further evaluate the respective risk estimates on the basis of diagnostic patterns. A total of 81 sexual assault victims and 324 controls matched by sex, age and residential area were included. The mean age of the sexual assault victims was 18.39 (sd 10.23) years, and 93.83% (76/81) of the sample were females. Sexual assault victims had a higher incidence density of psychiatric disorders than did the control group (9.2% per year, 95% confidence interval [CI] 1.1–33.2% per year v. 1.1% per year, 95% CI .4–15.7% per year; p=.037). Sexual assault was an independent risk factor for incident psychiatric disorders, with an incidence rate ratio of 3.40 (95% CI 1.04–26.41) after adjustment for potential confounding factors. Assessment of psychiatric disorders should be implemented in the integrative care of sexual assault victims. Physicians providing clinical care to the sexual assault victims should receive more all-round training to understand and manage this type of violence.
A series of self-assembled WO3–BiVO4 nanostructured thin films with 17, 25, 50, 67, and 100 mol% WO3 were grown on the (001) yttria-stabilized zirconia (YSZ) substrate by pulsed laser deposition method. The microstructures including crystalline phases, epitaxial relationship, interface structures, and chemical composition distributions were investigated by a combination of various electron microscopy techniques including scanning electron microscopy, transmission electron microscopy, and X-ray energy dispersive spectroscopy. The monoclinic BiVO4 formed the matrix, in which WO3 nanopillars were embedded with specific epitaxial relationships. In BiVO4-rich sample, orthorhombic Bi2WO6 was formed. However, metastable hexagonal WO3 phase and orthorhombic WO3 phase coexisted in other composite samples. The thin amorphous layer at the film/substrate interface indicated that the mismatch strain between films and substrate is released. The hydrostatic tensile strain due to thermal expansion mismatch between BiVO4 and WO3 as well as the diffusion of Bi into the WO3 stabilized the metastable h-WO3. A WO3–BiVO4 pseudobinary phase diagram was proposed based on the magnitude of the thermal expansion mismatch and the distance of Bi diffusion, which can be applied to design the microstructures of WO3–BiVO4 heterojunctions and optimize their photoelectrochemical properties.
New samples of fusulinids collected in the Tengchong Block, western Yunnan, China, are systematically studied and presented here. The fusulinid fauna from the Xishancun section in the Shanmutang area is dominated by Chusenella and Nankinella, whereas that from the Shuangheyan area is composed mainly of Chusenella and Schwagerina. Both faunas are dated as Roadian–Capitanian (middle Permian). These new findings are integrated with fusulinid taxa reported earlier from the block to demonstrate the taxonomic features and paleogeographic significance of Permian fusulinids. The low generic diversity through early and middle Permian and the paucity of middle Permian neoschwagerinids and verbeekinids in the block confirm its Gondwana-affinity attributes. Moreover, the Permian fusulinids of the Tengchong Block are depauperate; i.e., consisting of a limited number of species with abundant individuals. This particular feature commonly suggests an inhospitable environment, and carbonates of varied facies containing these faunas in the Tengchong Block suggest a facies-independent factor as the reason, most likely the relatively low temperature of seawater.
In the foreland area of western Taiwan, some of the pre-orogenic basement-involved normal faults were reactivated during the subsequent compressional tectonics. The main purpose of this paper is to investigate the role played by the pre-existing normal faults in the recent tectonics of western Taiwan. In NW Taiwan, reactivated normal faults with a strike-slip component have developed by linkage of reactivated single pre-existing normal faults in the foreland basin and acted as transverse structures for low-angle thrusts in the outer fold-and-thrust belt. In the later stage of their development, the transverse structures were thrusted and appear underneath the low-angle thrusts or became tear faults in the inner fold-and-thrust belt. In SW Taiwan, where the foreland basin is lacking normal fault reactivation, the pre-existing normal faults passively acted as ramp for the low-angle thrusts in the inner fold-and-thrust belt. Some of the active faults in western Taiwan may also be related to reactivated normal faults with right-lateral slip component. Some main earthquake shocks related to either strike-slip or thrust fault plane solution occurred on reactivated normal faults, implying a relationship between the pre-existing normal fault and the triggering of the recent major earthquakes. Along-strike contrast in structural style of normal fault reactivation gives rise to different characteristics of the deformation front for different parts of the foreland area in western Taiwan. Variations in the degree of normal fault reactivation also provide some insights into the way the crust embedding the pre-existing normal faults deformed in response to orogenic contraction.
The concept of reference system, reference frame, coordinate system and celestial sphere in a relativistic framework are given. The problems on the choice of celestial coordinate systems and the definition of the light deflection are discussed. Our suggestions are listed in Sec. 5.