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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 COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.
From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).
About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.
About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.
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.
As an emerging infectious disease, COVID-19 has involved many countries and regions. With the further development of the epidemic, the proportion of clusters has increased.
In our study, we collected information on COVID-19 clusters in Qingdao City. The epidemiological characteristics and clinical manifestations were analyzed.
Eleven clusters of COVID-19 were reported in Qingdao City between January 29, and February 23, 2020, involving 44 confirmed cases, which accounted for 73.33% of all confirmed cases. From January 19 to February 2, 2020, the cases mainly concentrated in the district that had many designated hospitals. Patients aged 20-59 y old accounted for the largest proportion (68.18%) of cases; the male-to-female sex ratio was 0.52:1. Three cases were infected from exposure to confirmed cases. The average incubation period was 6.28 d. The median number of cases per cluster was 4, and the median duration time was 6 d. The median cumulative number of exposed persons was 53.
More attention should be paid to the epidemic of clusters in prevention and control of COVID-19. In addition to isolating patients, it is essential to track, screen, and isolate those who have come in close contact with patients. Self-isolation is the key especially for healthy people in the epidemic area.
In recent years, there have been a significant influenza activity and emerging influenza strains in China, resulting in an increasing number of influenza virus infections and leading to public health concerns. The aims of this study were to identify the epidemiological and aetiological characteristics of influenza and establish seasonal autoregressive integrated moving average (SARIMA) models for forecasting the percentage of visits for influenza-like illness (ILI%) in urban and rural areas of Shenyang. Influenza surveillance data were obtained for ILI cases and influenza virus positivity from 18 sentinel hospitals. The SARIMA models were constructed to predict ILI% for January–December 2019. During 2010–2018, the influenza activity was higher in urban than in rural areas. The age distribution of ILI cases showed the highest rate in young children aged 0–4 years. Seasonal A/H3N2, influenza B virus and pandemic A/H1N1 continuously co-circulated in winter and spring seasons. In addition, the SARIMA (0, 1, 0) (0, 1, 2)12 model for the urban area and the SARIMA (1, 1, 1) (1, 1, 0)12 model for the rural area were appropriate for predicting influenza incidence. Our findings suggested that there were regional and seasonal distinctions of ILI activity in Shenyang. A co-epidemic pattern of influenza strains was evident in terms of seasonal influenza activity. Young children were more susceptible to influenza virus infection than adults. These results provide a reference for future influenza prevention and control strategies in the study area.
Trypophloeus klimeschi Eggers (Coleoptera: Curculionidae: Scolytinae) was first discovered in China in 2003, and it exhibits strong species specificity to Populus alba var. pyramidalis Bunge (Salicaceae). To screen plant volatile compounds for monitoring and trapping T. klimeschi, the electroantennogram responses of adult T. klimeschi to eight plant volatiles, including nonanal, 2-methylbutanal, decanal, 2-hydroxybenzaldehyde, (Z)-3-hexen-1-ol benzoate, methyl benzoate, methyl salicylate, and geraniol were tested at various concentrations. Behavioural responses of female and male adults to various concentrations of these eight plant volatiles were also determined using a Y-tube olfactometer. We then tested the effectiveness of these compounds as lures for trapping T. klimeschi in the field. Electroantennogram tests showed that T. klimeschi possesses olfactory sensitivity for eight compounds. Additionally, walking T. klimeschi exhibited attraction to low concentrations (≤ 1 μg/μL) of all eight compounds in Y-tube olfactometer. Field experiment results indicated that baits composed of each volatile compound alone were more attractive to greater numbers of T. klimeschi than the control. The methyl benzoate bait was better attracted by T. klimeschi than other tested volatiles. These results suggest that these compounds could be used in attraction of this stem-boring pest. This study could have important implications for the development of an effective semiochemical-based management tool for T. klimeschi in the field.
Aiming at three-dimensional (3D) terminal guidance problem, a novel guidance model is established in this paper, in which line-of-sight (LOS) range is treated as an independent variable, describing the relative motion between the vehicle and the target. The guidance model includes two differential equations that describe LOS’s pitch and yaw motions in which the pitch motion is separately decoupled. This model avoids the inaccuracy of simplified two-dimensional (2D) guidance model and the complexity of 3D coupled guidance model, which not only maintains the accuracy but also simplifies the guidance law design. The application of this guidance model is studied for optimal re-entry guidance law with impact angle constraint, which is presented in the form of normal overload. Compared with optimal guidance laws based on traditional guidance model, the proposed one based on novel guidance model is implemented with the LOS range instead of time-to-go, which avoids the problem of the time-to-go estimation of traditional optimal guidance laws. Finally, the correctness and validity of the guidance model and guidance law are verified by numerical simulation. The guidance model and guidance law proposed in this paper provide a new way for the design of terminal guidance.
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.
BaTiO3-based lead-free piezoelectric materials have long been known as “a mediocre class of piezoelectric materials.” However, they have seen significant renewed interest in recent years ever since the discovery of high piezoelectricity in Ba(Zr, Ti)O3-(Ba, Ca)TiO3 as well as the related Ba(Sn, Ti)O3-(Ba, Ca)TiO3 and Ba(Hf, Ti)O3-(Ba, Ca)TiO3 systems. The unexpectedly high piezoelectricity in this class of BaTiO3 (BT)-based materials is still not well understood and has stimulated significant research activity. We present a concise discussion of the notions leading to high piezoelectricity in BaTiO3-based systems. In particular, the possible role of a multiphase-coexisting point is highlighted.
The phase transitions involving calcite (CaCO3-I), CaCO3-II, CaCO3-III and CaCO3-IIIb were investigated using a diamond anvil cell and micro-Raman spectroscopy. Based on the results obtained from in situ observations and Raman measurements made with six natural calcite crystals, the phase transition from calcite to CaCO3-II took place between 1.56 and 1.67 GPa under ambient temperature. Under a precise pressure of 1.97 ± 0.03 GPa, three CaCO3 samples were observed to transform from CaCO3-II directly to CaCO3-III, while in the other three samples both CaCO3-III and CaCO3-IIIb crystal structures were detected. Transformation from CaCO3-IIIb to CaCO3-III was completed in a short period in one sample, whereas in the other two samples coexistence of CaCO3-III and CaCO3-IIIb was observed over a wide pressure range from 1.97 to 3.38 GPa, with sluggish transformation from CaCO3-IIIb to CaCO3-III being observed after the samples were preserved under 3.38 GPa for 72 h. Hence, it can be concluded that CaCO3-IIIb is a metastable intermediate phase occurring during the reconstructive transformation from CaCO3-II to CaCO3-III. Splitting of the C–O in-plane bending (ν4) and symmetric stretching (ν1) vibrations and appearance of new lattice vibrations in the Raman spectra of CaCO3-III and CaCO3-IIIb suggest a lowering in crystal symmetry during the transformation from CaCO3-II through CaCO3-IIIb to CaCO3-III, which is in good agreement with the observed sequence of phase symmetries.
Macroscopic assembling of responsive hydrogels has been used to construct soft actuators that transform their shape upon external stimuli. It remains a challenge to establish a robust assembling interface between gels. Here, we demonstrate a fabrication of bilayered hydrogel actuators assembled by host-guest recognition at the interface. The supramolecular recognition enabled efficient, rapid, and robust macroscopic assembling of hydrogels, which was utilized to create gel bilayers that were actuated upon unbalanced swelling/deswelling.
This paper proposes an adaptive guidance law for attacking a ground target based on motion camouflage strategy. The coefficients of normal and bi-normal feedback guidance law are given according to the relative motion relationship under Frenet frame. Utilizing the coefficients, the motion camouflage proportional guidance law is derived. In order to improve the initial overload characteristic of the missile, an adaptive feedback coefficient is introduced. Then, the adaptive guidance law is applied to a longitudinal plane interception problem with impact-angle constraint. Finally, the validity of this guidance law for air-to-ground missiles is proved by simulations.
Kawasaki disease, which is characterised by systemic vasculitides accompanied by acute fever, is regularly treated by intravenous immunoglobulin to avoid lesion formation in the coronary artery; however, the mechanism of intravenous immunoglobulin therapy is unclear. Hence, we aimed to analyse the global expression profile of serum exosomal proteins before and after administering intravenous immunoglobulin.
Two-dimensional electrophoresis coupled with mass spectrometry analysis was used to identify the differentially expressed proteome of serum exosomes in patients with Kawasaki disease before and after intravenous immunoglobulin therapy.
Our analysis revealed 69 differential protein spots in the Kawasaki disease group with changes larger than 1.5-fold and 59 differential ones in patients after intravenous immunoglobulin therapy compared with the control group. Gene ontology analysis revealed that the acute-phase response disappeared, the functions of the complement system and innate immune response were enhanced, and the antibacterial humoral response pathway of corticosteroids and cardioprotection emerged after administration of intravenous immunoglobulin. Further, we showed that complement C3 and apolipoprotein A-IV levels increased before and decreased after intravenous immunoglobulin therapy and that the insulin-like growth factor-binding protein complex acid labile subunit displayed reverse alteration before and after intravenous immunoglobulin therapy. These observations might be potential indicators of intravenous immunoglobulin function.
Our results show the differential proteomic profile of serum exosomes of patients with Kawasaki disease before and after intravenous immunoglobulin therapy, such as complement C3, apolipoprotein A-IV, and insulin-like growth factor-binding protein complex acid labile subunit. These results may be useful in the identification of markers for monitoring intravenous immunoglobulin therapy in patients with Kawasaki disease.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
A strapdown inertial navigation system and celestial navigation system integrated autonomous navigation scheme is proposed in this paper, using the navigation information obtained from Earth sensors and star sensors. To eliminate the adverse effect caused by the asymmetry of Earth infrared radiance, the relationship between Earth infrared radiance brightness and effective horizon height is found. According to the relationship as well as the measuring principle of the Earth sensor, this paper derives a function to correct the measurement of the Earth sensor. Then, the angle-distance of stars can be calculated, and using this information, we can estimate the navigation information of a ballistic missile by least square estimation. The simulation results show that the error of Earth infrared radiance has a great effect on the navigation precision, and by using the correction scheme, this adverse effect can be greatly mitigated. This correction scheme is available and effective.
To investigate the potential influence of dietary Se intake on mortality among Chinese populations.
We prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women’s Health Study (SWHS) and the Shanghai Men’s Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI.
Urban city in China.
Chinese adults (n 133 957).
During an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; Ptrend<0·0001) and 0·80 (95 % CI 0·66, 0·98; Ptrend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; Ptrend=0·0001) and 0·66 (95 % CI 0·54, 0·82; Ptrend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses.
Dietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.
The objective of this study was to build a database to collect infectious disease information at the scene of a disaster through the use of 128 epidemiological questionnaires and 47 types of options, with rapid acquisition of information regarding infectious disease and rapid questionnaire customization at the scene of disaster relief by use of a personal digital assistant (PDA).
SQL Server 2005 (Microsoft Corp, Redmond, WA) was used to create the option database for the infectious disease investigation, to develop a client application for the PDA, and to deploy the application on the server side. The users accessed the server for data collection and questionnaire customization with the PDA.
A database with a set of comprehensive options was created and an application system was developed for the Android operating system (Google Inc, Mountain View, CA). On this basis, an infectious disease information collection system was built for use at the scene of disaster relief. The creation of an infectious disease information collection system and rapid questionnaire customization through the use of a PDA was achieved.
This system integrated computer technology and mobile communication technology to develop an infectious disease information collection system and to allow for rapid questionnaire customization at the scene of disaster relief. (Disaster Med Public Health Preparedness. 2017;11:668–673)
In this paper, a new technical scheme of high-voltage, long-pulse generator, mostly based on solid-state power devices, including magnetic pulse compressor, Blumlein-type rolled strip pulse-forming line (RSPFL) and inductive voltage adder (IVA), is proposed and investigated numerically and experimentally. The generator has potential advantages of high average power level, high repetitive rate capability, long lifetime, and long pulse achievability, which meet the requirements of military and industrial application of the pulsed power technology. Specifically, a two-stage magnetic pulse compressor was set up with iron-based amorphous cores. Total compression ratio of the device is approximately 12 and the achieved voltage efficiency is up to 92%. Low impedance, long-duration Blumlein-type RSPFL was established with characteristic impendence and electrical length of 3 Ω and 100 ns, respectively. Mylar film was selected as the solid-state dielectric. Increased by a four-stage IVA, typical quasi-square pulse was obtained with peak current of 2.3 kA and duration over 200 ns. As the resistance of the dummy load was measured to be 60 Ω, the peak voltage was approximately 138 kV. Experiments show reasonable agreement with numerical analysis.