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To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency.
Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment–Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition.
A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme.
The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82).
The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.
Primary liver cancer is the third leading cause of cancer-related death worldwide. Most patients are diagnosed at late stages with poor prognosis; thus, identification of modifiable risk factors for primary prevention of liver cancer is urgently needed. The well-established risk factors of liver cancer include chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), heavy alcohol consumption, metabolic diseases such as obesity and diabetes, and aflatoxin exposure. However, a large proportion of cancer cases worldwide cannot be explained by current known risk factors. Dietary factors have been suspected as important, but dietary aetiology of liver cancer remains poorly understood. In this review, we summarised and evaluated the observational studies of diet including single nutrients, food and food groups, as well as dietary patterns with the risk of developing liver cancer. Although there are large knowledge gaps between diet and liver cancer risk, current epidemiological evidence supports an important role of diet in liver cancer development. For example, exposure to aflatoxin, heavy alcohol drinking and possibly dairy product (not including yogurt) intake increase, while intake of coffee, fish and tea, light-to-moderate alcohol drinking and several healthy dietary patterns (e.g. Alternative Healthy Eating Index) may decrease liver cancer risk. Future studies with large sample size and accurate diet measurement are warranted and need to consider issues such as the possible aetiological heterogeneity between liver cancer subtypes, the influence of chronic HBV or HCV infection, the high-risk populations (e.g. cirrhosis) and a potential interplay with host gut microbiota or genetic variations.
This study presents monazite and rutile U–Pb and hornblende and biotite 40Ar/39Ar geochronological data for high-grade rocks of the eastern Grenville-aged Rayner orogen at Mount Brown in order to analyse the extent and degree of Pan-African-aged reworking. Monazite from paragneiss yields U–Pb ages of 910 Ma for larger granular grains and 670–630 Ma for smaller globular beads around garnet porphyroblasts or hosted by symplectites. Rutile from leucogneiss yields U–Pb ages of 520–515 Ma. Hornblende and biotite from different rock types yield 40Ar/39Ar plateau ages of 744 and 520–505 Ma, respectively. Combining these results with published zircon U–Pb age data suggests that granulite facies metamorphism occurred at 910 Ma, with a local low-temperature fluid flow event at 670–630 Ma and thermal reworking at 520–505 Ma. The older age of 744 Ma may reflect cooling or partial resetting of the hornblende 40Ar/39Ar system, indicating that Pan-African-aged reworking did not exceed temperatures much higher than the hornblende Ar closure temperature. These data also suggest that the complete isotopic resetting of some minerals may occur without the growth of new mineral phases, providing an example of the style of reworking that is likely to occur in polymetamorphic terranes.
The surface energy budget over the Antarctic sea ice from 8 April 2016 through 26 November 2016 are presented. From April to October, Sensible heat flux (SH) and subsurface conductive heat flux (G) were the heat source of surface while latent heat flux (LE) and net radiation flux (Rn) were the heat sink of surface. Our results showed larger downward SH (due to the warmer air in our site) and upward LE (due to the drier air and higher wind speed in our site) compared with SHEBA data. However, the values of SH in N-ICE2015 campaign, which located at a zone with stronger winds and more advection of heat in the Arctic, were comparable to our results under clear skies. The values of aerodynamic roughness length (z0m) and scalar roughness length for temperature (z0h), being 1.9 × 10−3 m and 3.7 × 10−5 m, were suggested in this study. It is found that snow melting might increase z0m. Our results also indicate that the value of log(z0h/z0m) was related to the stability of stratification. In addition, several representative parameterization schemes for z0h have been tested and a couple of schemes were found to make a better performance.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Pregnant women (n 1910) in 2017.
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
Hypertrophic cardiomyopathy is an autosomal dominant hereditary disease characterised by left ventricular asymmetry hypertrophy. However, our knowledge of the genetic background in hypertrophic cardiomyopathy cases is limited. Here, we aimed to evaluate pathogenic gene mutations in a family with high-risk hypertrophic cardiomyopathy and analyse the genotype/phenotype relationships in this family.
The proband, her parents, and her niece underwent whole-exome sequencing, and the genotypes of family members were identified using Sanger sequencing. mRNA expression was detected using reverse transcription sequencing. Structural impairments were predicted by homologous modelling. A family survey was conducted for patients with positive results to obtain information on general clinical symptoms, electrocardiography, ambulatory electrocardiography, echocardiography, and 3.0T cardiac magnetic resonance findings. Regular follow-up was performed for up to 6 months.
Five family members, including the proband, carried a cleavage site mutation in the MYBPC3 gene (c.2737+1 (IVS26) G>T), causing exon 26 of the MYBPC3 gene transcript to be skipped and leading to truncation of cardiac myosin-binding protein C. Family survey showed that the earliest onset age was 13 years old, and three people had died suddenly at less than 40 years old. Three pathogenic gene carriers were diagnosed with hypertrophic cardiomyopathy, and all showed severe ventricular septal hypertrophy.
The c.2737+1 (IVS26) G>T mutation in the MYBPC3 gene led to exon 26 skipping, thereby affecting the structure and function of cardiac myosin-binding protein C and leading to severe ventricular hypertrophy and sudden death.
Malnutrition and acute kidney injury (AKI) are common complications in hospitalised patients, and both increase mortality; however, the relationship between them is unknown. This is a retrospective propensity score matching study enrolling 46 549 inpatients, aimed to investigate the association between Nutritional Risk Screening 2002 (NRS-2002) and AKI and to assess the ability of NRS-2002 and AKI in predicting prognosis. In total, 37 190 (80 %) and 9359 (20 %) patients had NRS-2002 scores <3 and ≥3, respectively. Patients with NRS-2002 scores ≥3 had longer lengths of stay (12·6 (sd 7·8) v. 10·4 (sd 6·2) d, P < 0·05), higher mortality rates (9·6 v. 2·5 %, P < 0·05) and higher incidence of AKI (28 v. 16 %, P < 0·05) than patients with normal nutritional status. The NRS-2002 showed a strong association with AKI, that is, the risk of AKI changed in parallel with the score of the NRS-2002. In short- and long-term survival, patients with a lower NRS-2002 score or who did not have AKI achieved a significantly lower risk of mortality than those with a high NRS-2002 score or AKI. Univariate Cox regression analyses indicated that both the NRS-2002 and AKI were strongly related to long-term survival (AUC 0·79 and 0·71) and that the combination of the two showed better accuracy (AUC 0·80) than the individual variables. In conclusion, malnutrition can increase the risk of AKI and both AKI and malnutrition can worsen the prognosis that the undernourished patients who develop AKI yield far worse prognosis than patients with normal nutritional status.
Hand, foot and mouth disease (HFMD) has spread widely and leads to high disease burden in many countries. However, relative transmissibility from male to female individuals remains unclear. HFMD surveillance database was built in Shenzhen City from 2013 to 2017. An intersex transmission susceptible–infectious–recovered model was developed to calculate the transmission relative rate among male individuals, among female individuals, from male to female and from female to male. Two indicators, ratio of transmission relative rate (Rβ) and relative transmissibility index (RTI), were developed to assess the relative transmissibility of male vs. female. During the study period, 270 347 HFMD cases were reported in the city, among which 16 were death cases with a fatality of 0.0059%. Reported incidence of total cases, male cases and female cases was 0.0057 (range: 0.0036–0.0058), 0.0052 (range: 0.0032–0.0053) and 0.0044 (range: 0.0026–0.0047), respectively. The difference was statistically significant between male and female (t = 3.046, P = 0.002). Rβ of male vs. female, female vs. female, from female to male vs. female and from male to female vs. female was 7.69, 1.00, 1.74 and 7.13, respectively. RTI of male vs. female, female vs. female, from female to male vs. female and from male to female vs. female was 3.08, 1.00, 1.88 and 1.43, respectively. Transmissibility of HFMD is different between male and female individuals. Male cases seem to be more transmissible than female.
There is growing evidence that suggests the association of vitamin D status with the development and progression of heart failure (HF). The objective of the present study is to assess the impact of concentration of serum 25-hydroxyvitamin D (25(OH)D) on cardiac prognosis in patients with HF. Between 1 January 2015 and 31 December 2016, we consecutively recruited patients with HF. Patients were followed prospectively for a median duration of 1 year. Serum concentration of 25(OH)D was measured with competitive chemiluminescent immunoassay. The endpoints were cardiac events, including CVD death and rehospitalisation for worsening HF. Univariate and multivariable adjustments were performed with Cox proportional-hazard regression analyses. The 25(OH)D concentration was obtained in 343 patients with a median value of 17·4 (interquartile range 12·6–23·4) ng/ml. There were 102 cardiac events, including forty-three deaths and fifty-nine rehospitalisations. Multivariate Cox hazard analysis found that the serum concentration 25(OH)D was independently associated with cardiac events (hazard ratio 0·93, 95 % CI 0·88, 0·97) and CVD mortality (hazard ratio 0·83; 95 % CI 0·77, 0·89) after adjustment for confounding factors. We divided the HF patients into four groups according to the 25(OH)D quartiles. Kaplan–Meier analysis found that the patients with lower serum 25(OH)D concentration had a higher risk of cardiac events or CVD mortality than those with high serum 25(OH)D concentration (log-rank test P < 0·001 and P = 0·032). Decreased serum concentrations of 25(OH)D were associated with cardiac prognosis and CVD mortality in a Chinese population with HF independent of other baseline HF markers.
Oxidative stress is closely related to metabolic disorders, which can lead to various diseases. Nuclear factor E2-related factor 2 (Nrf2) is a central regulator of oxidative stress. Sodium butyrate (NaB) has been shown to alleviate oxidative stress and insulin resistance, yet how Nrf2 is involved in the action of NaB remains unclear. In the present study, rats were rendered obese by feeding a high-fat diet for 9 weeks. NaB (300 mg/kg), which was gavaged every 2 d for 7 weeks, significantly alleviated high-fat diet-induced oxidative stress and insulin resistance. Additionally, the insulin signalling pathway in the liver was activated by NaB, associated with significant activation of Nrf2, superoxide dismutase and glutathione. Furthermore, hepatic up-regulation of Nrf2 in NaB-treated rats was associated with reduced protein content of histone deacetylase 1 and increased histone H3 acetyl K9 (H3K9Ac) modification on the Nrf2 promoter. The actions of NaB were completely abolished when Nrf2 was knocked down in vitro. Taken together, NaB acts as a histone deacetylase inhibitor to up-regulate Nrf2 expression with enhanced H3K9Ac modification on its promoter. NaB-induced Nrf2 activation stimulates transcription of downstream antioxidant enzymes, thus contributing to the amelioration of high-fat diet-induced oxidative stress and insulin resistance.
The performance of immune system is vital for defending the body from pathogens, and it plays a crucial role in health homoeostasis. In a previous study, we have shown that LFP-20, a twenty-amino acid antimicrobial peptide in the N terminus of porcine lactoferrin, modulated inflammatory response in colitis. Here, we further investigated the effects of LFP-20 on immune homoeostasis to elucidate the mechanism of its anti-inflammation action. A lipopolysaccharide (LPS)-triggered systemic inflammatory response mice model was established. On the basis of observed mucosal lesions and apoptosis in small intestine, we found increased macrophage and neutrophil infiltration in ileum after LPS stimulation. Expectedly, LFP-20 pre-treatment attenuated the LPS-mediated immune disorders in ileum. Moreover, the flow cytometry results indicated pre-treatment with LFP-20 sustained the balance of CD3+CD8+ T cells, B cells and natural killer cells in LPS-triggered immune disturbance. Simultaneously, we demonstrated LFP-20 modulated the secretion of both activated Th1-related IL-12p70, interferon-γ, TNF-α and Th2-related IL-4, IL-5 and IL-6. Furthermore, we found LFP-20 facilitated a balanced Th1 and Th2 response, which triggered cellular defence mechanisms and induced B cells to produce opsonising antibodies belonging to certain IgG subclasses to defend against LPS stimulation. Collectively, our study indicated pre-treatment with LFP-20 could defend against LPS-triggered systemic inflammatory response in mice via modulating immune homoeostasis.
As distinctive spontaneous polarization and far-infrared radiation characteristics, the natural mineral tourmaline (TM) has the regulatory effect on crystallization behavior, which possesses potential application in biomimetic mineralization and bone regeneration. In this study, polyurethane (PU) and gelatin (GE) membranes with different adding proportion of TM nanoparticles were prepared via electrospinning. Additionally, the effect of TM nanoparticles on the mineralization process of hydrophobic PU and hydrophilic GE was investigated by immersing the composite TM/PU and TM/GE electrospun membranes in the 10× simulated body fluid (10SBF) at 37 °C for varying periods of time. SEM images confirmed the well-dispersed TM nanoparticles in the PU and GE electrospun fibers. The mineralization deposition was characterized by the SEM, EDS, XRD, and FTIR, and it indicated that two types of calcium phosphate deposits with different Ca/P molar ratios were obtained when TM/PU membranes and TM/GE membranes were incubated in 10SBF. Honeycomb-like hydroxyapatite crystals nucleated and grew faster on TM/PU and TM/GE membranes than the pure PU and GE membranes, respectively. Furthermore, with the increase of the added TM nanoparticles in the composite membranes, more calcium phosphate crystals were precipitated. These results showed that the added TM nanoparticles were able to improve the mineralization of polymer fibrous membranes, which is potential for the composite bone scaffold.
Direct determination of barrier height (ΦBH) value between Ir and single crystal (001) hydrogen-terminated diamond with lightly boron doped has been performed using x-ray photoelectron spectroscopy technique. 70 nm Ir islands were formed on hydrogen-terminated diamond surface using anodic aluminum oxide. The ΦBH value for Ir/hydrogen-terminated diamond was −0.43 ± 0.14 eV, indicating that Ir was a suitable metal for ohmic contact with hydrogen-terminated diamond. The band diagram of Ir/hydrogen-terminated diamond was obtained. The experimental ΦBH was compared with the theoretical ΦBH in this work.
Graphene oxide (GO) is a promising material in improving the corrosion resistance properties of metals. This improvement significantly relies on the microstructure and electrical properties of GO, which nevertheless is rarely studied. Here, multiscale GOs with different flake sizes and oxidation degrees were fabricated and incorporated into waterborne alkyd resin (AR). The physical and chemical structures of GO and AR/GO composites were characterized in detail. Multiscale GOs are successfully prepared, and the corrosion resistance of AR/GO coatings is measured by electrochemical workstation. Electrochemical experiments indicate that GOs with larger flake sizes have excellent barrier properties due to the shielding effect; GOs with appropriate oxidation degrees could effectively improve the dispersion of GO and avoid the conductive path of GO in the matrix, because oxidation degree of GO could influence the dispersion and electrical properties. The corrosion protection efficiency of AR/GO(GO: 120 μm, 1.5 wt%, sp2/sp3 = 2.61) is 98.14%, which is 2.26 times higher than AR. The multiscale effects of GO on the corrosion resistance property of AR coatings are quite general, thus providing guidelines for developing highly efficient corrosion resistant coatings for practical usage.
Two benzodifuran (BDF) polymers, PBDF-C and PBDF-S, with alkyl and alkylthio substituted thiophene side-chains and benzodithiophene-4,8-dione (BDD) as the acceptor were designed and synthesized. Their optical, electrochemical properties and photovoltaic performances were systematically investigated. The polymer solar cells (PSCs) with a device structure of ITO/PEDOT:PSS/polymer:PC71BM/Ca/Al were fabricated. The PBDF-C based device showed a power conversion efficiency (PCE) of 3.01% after adding 1 vol% 1,8-diodooctane (DIO) as the solvent additive, and PBDF-S gave an enhanced PCE of 3.48% without any post-treatments. The enhancements were from the higher open-circuit voltage (Voc) and fill factor (FF). The thermal- and solvent-treatment-free processing is more favourable for the large area roll-to-roll manufacturing or printing technology for PSCs.
In the search for alternative practices to chemical soil fumigation (CSF), anaerobic soil disinfestation (ASD) has proven to be a promising tool for soil-borne pest management and crop production improvement. The ASD treatment with composted poultry litter (CPL) and molasses (M, a labile carbon source) was identified as an effective approach for a biologically based soil disinfestation system in tomato (Solanum lycopersicum L.) production in Florida. However, environmental and food-safety concerns are associated with animal manure-based amendments, which led to the exploration of composted yard waste (CYW) as a potential substitute for CPL in ASD application. In this study, field trials were conducted in Citra and Immokalee, FL to examine the effects of ASD using CYW, CPL and M compared with a commercially available microbial amendment system on root-knot nematodes, weeds, fruit yield and quality of fresh-market tomato. Treatments included (1) ASD with CPL (11 Mg ha−1) and M (6.9 m3 ha−1) (ASD0.5), (2) ASD with CYW (26.9 Mg ha−1) and M (CYW1 + M), (3) ASD with CYW (13.5 Mg ha−1) and M (CYW0.5 + M), (4) Soil Symphony Amendment (SSA), (5) CYW (26.9 Mg ha−1) alone (CYW1) and (6) a combination of CYW1 + SSA, in comparison with (7) untreated control and (8) CSF (Pic-Clor 60 at 224 kg ha−1). Cumulative soil anaerobiosis was greater in ASD0.5 compared with all the other treatments. The root-knot nematode gall index ratings on the tomato crop were significantly lower in CSF, ASD0.5, CYW1 + M and CYW0.5 + M than untreated control in Citra. Although CYW1 and SSA alone had a moderately suppressive effect on weed coverage and root-knot nematodes, their positive impact on crop performance was limited when used alone. ASD0.5, CYW1 + M and CSF had significantly higher marketable and total fruit yields than untreated control in both locations, while all treatments showed promising results in the Immokalee trial in comparison with untreated control. In general, few differences in major fruit quality attributes were found. Although using CYW in ASD was not as effective as CPL in creating soil anaerobic conditions, the enhanced crop performance in CYW1 + M and CYW0.5 + M suggests the potential of using CYW as an alternative source of organic amendment in combination with M to achieve benefits similar to those obtained with CPL-based ASD.
Plasma levels of very-long-chain SFA (VLCSFA) are associated with the metabolic syndrome (MetS). However, the associations may vary by different biological activities of individual VLCSFA or population characteristics. We aimed to examine the associations of VLCSFA and MetS risk in Chinese adults. Totally, 2008 Chinese population aged 35–59 years were recruited and followed up from 2010 to 2012. Baseline MetS status and plasma fatty acids data were available for 1729 individuals without serious diseases. Among 899 initially metabolically healthy individuals, we identified 212 incident MetS during the follow-up. Logistic regression analysis was used to estimate OR and 95 % CI. Cross-sectionally, each VLCSFA was inversely associated with MetS risk; comparing with the lowest quartile, the multivariate-adjusted OR for the highest quartile were 0·18 (95 % CI 0·13, 0·25) for C20 : 0, 0·26 (95 % CI 0·18, 0·35) for C22 : 0, 0·19 (95 % CI 0·13, 0·26) for C24 : 0 and 0·16 (0·11, 0·22) for total VLCSFA (all Pfor trend<0·001). The associations remained significant after further adjusting for C16 : 0, C18 : 0, C18 : 3n-3, C22 : 6n-3, n-6 PUFA and MUFA, respectively. Based on follow-up data, C20 : 0 or C22 : 0 was also inversely associated with incident MetS risk. Among the five individual MetS components, higher levels of VLCSFA were most strongly inversely associated with elevated TAG (≥1·7 mmol/l). Plasma levels of VLCSFA were significantly and inversely associated with MetS risk and individual MetS components, especially TAG. Further studies are warranted to confirm the findings and explore underlying mechanisms.
Kaolinite can be used for many applications, including the underground storage of gases. Density functional theory was employed to investigate the adsorption of hydrogen molecules on the kaolinite (001) surface. The coverage dependence of the adsorption sites and energetics was studied systematically for a wide range of coverage, Θ (from 1/16 to 1 monolayer). The three-fold hollow site is the most stable, followed by the bridge, top-z and top sites. The adsorption energy of H2 decreased with increasing coverage, thus indicating the lower stability of surface adsorption due to the repulsion of neighbouring H2 molecules. The coverage has obvious effects on hydrogen adsorption. Other properties of the H2/kaolinite (001) system, including the lattice relaxation and changes of electronic density of states, were also studied and are discussed in detail.
As an important member of semiconducting transition metal oxides, MoO2 nanomaterials have many advantages in optical and electrical applications. However, MoO2 itself has no significant photocatalytic performance possibly because of its inferior conductivity and strong recombination of photogenerated electron–hole pairs. Here, we propose a facile, one-step pyrolysis method to prepare a novel C fibers@MoO2 nanoparticles core–shell composite, where the oxidative MoO2 nanoparticles in situ grew on the surface of conducting C fibers. Due to the compositing of MoO2 and C fibers, during photocatalysis tests, the recombination of photogenerated electron–hole pairs was effectively inhibited, and the lifetime of the photogenerated carries was efficiently prolonged, finally significantly improving the solar-driven photocatalytic activity on degrading various organic and inorganic pollutants in water, such as methylene blue, rhodamine B, phenol, and potassium dichromate, showing the great potential for environmental remediation by degrading toxic industrial chemicals in waste water under sunlight. Moreover, the composite presented good stability in composition and structure during the repeated use and long-term storage. In addition, this one-step growth method is an easy-to-handle, environmentally friendly, and low-cost synthesis method for large-scale production.