To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
HfO2–Sm3TaO7 ceramics are prepared through a solid-state reaction method. The X-ray diffraction and structural refinement show that the phase structures of HfO2–Sm3TaO7 ceramics are an ordered orthorhombic phase and the space groups are belonging to Ccmm. The degree of the structural disorder increases with increasing HfO2 content. The solid solution mechanism reveals that Hf4+ exists in the form of interstitial ions that cause crystal expansion when the doping content is less than 4 mol%. When the doping concentration of HfO2 ≥ 4 mol%, the Hf4+ ions can substitute an equal number of Sm3+ and Ta5+ ions. The phase transition of Sm3TaO7 ceramics is removed with increasing HfO2 content, and the 8 mol% HfO2–Sm3TaO7 ceramics have a high thermal expansion coefficient of 10.2 × 10−6 K−1 at 1200 °C. The 2 mol% HfO2–Sm3TaO7 ceramics have the lowest thermal conductivity (1.03 W/m K at 900 °C), which is lower than previous research of the 7–8 YSZ. The outstanding thermophysical properties of HfO2–Sm3TaO7 ceramics indicate that they are potential thermal-barrier coating materials.
To investigate homocysteine (Hcy) and folate levels, prevalence of hyperhomocysteinaemia (HHcy) and folate deficiency, which are affected by lifestyles in urban, agricultural and stock-raising populations.
This is a cross-sectional study.
Urban, agricultural and stock-raising regions in Emin, China.
Totally 1926 subjects – 885 (45·9 %) from urban, 861 (44·7 %) from agricultural and 180 (9·4 %) from stock-raising regions – were obtained using multistage stratified random sampling. Inclusion criteria encompassed inhabitants aged ≥15 years who resided at the current address for ≥6 months and agreed to participate in the study. Surveys on health behaviour questionnaires and physical examinations were conducted and blood samples collected.
The folate level of subjects from the stock-raising region was the lowest, followed by those from the agricultural region, and the highest in those from the urban region (3·48 v. 6·50 v. 7·12 ng/ml, P < 0·001), whereas mean Hcy showed no significant difference across regions. The OR for HHcy in stock-raising regions was 1·90 (95 % CI 1·11, 3·27) compared with the urban region after adjusting for all possible covariates. The OR for folate deficiency in stock-raising and agriculture regions was 11·51 (95 % CI 7·09, 18·67) and 1·91 (95 % CI 1·30, 2·82), respectively, compared with the urban region after adjusting for all possible covariates.
HHcy and folate deficiency are highly prevalent in stock-raisers, which is of important reference for HHcy control in Xinjiang, with a possibility of extension to others with approximate lifestyles.
This study aimed to gain insight into how adipose tissue of Tibetan sheep regulates energy homoeostasis to cope with low energy intake under the harsh environment of the Qinghai-Tibetan Plateau (QTP). We compared Tibetan and Small-tailed Han sheep (n 24 of each breed), all wethers and 1·5 years of age, which were each divided randomly into four groups and offered diets of different digestible energy (DE) densities: 8·21, 9·33, 10·45 and 11·57 MJ DE/kg DM. When the sheep lost body mass and were assumed to be in negative energy balance: (1) adipocyte diameter in subcutaneous adipose tissue was smaller and decreased to a greater extent in Tibetan than in Small-tailed Han sheep, but the opposite occurred in the visceral adipose tissue; (2) Tibetan sheep showed higher insulin receptor mRNA expression and lower concentrations of catabolic hormones than Small-tailed Han sheep and (3) Tibetan sheep had lower capacity for glucose and fatty acid uptake than Small-tailed Han sheep. Moreover, Tibetan sheep had lower AMPKα mRNA expression but higher mammalian target of rapamycin mRNA expression in the adipocytes than Small-tailed Han sheep. We concluded that Tibetan sheep had lower catabolism but higher anabolism in adipose tissue and reduced the capacity for glucose and fatty acid uptake to a greater extent than Small-tailed Han sheep to maintain energy homoeostasis when in negative energy balance. These responses provide Tibetan sheep with a high ability to cope with low energy intake and with the harsh environment of the QTP.
Transmission of varicella occurs frequently in schools and households. We investigated the characteristics of varicella cases derived from within-household transmission and the modes of varicella transmission between school and household settings in Shanghai, China, from 2009 to 2018. Within-household transmission occurred in 278 households, of which 134 transmission events were between children. Sixty-one household varicella transmission events may be attributed to isolation procedures for infected students during school outbreaks, and 7.6% of school outbreaks were caused by schoolchildren cases derived from within-household transmission. The frequency of ‘school-household-school’ transmission adds an additional layer of complexity to the control of school varicella outbreaks. Administration of varicella vaccine as post-exposure prophylaxis after exposure is considered to be an effective measure to control varicella spread within households and schools.
Wireless power transfer (WPT) has attracted attention from academia and industry in recent years. WPT has natural electrical isolation between primary and secondary side, which ensures safe charging in an underwater environment. This breakthrough technology greatly facilitates the deep-sea power transmission. However, at the current stage the transferred power and energy efficiency level are not up to that of the WPT system in the air. The major concerns include the attenuation is seawater, extreme temperature and pressure conditions, disturbance of ocean currents, and bio-security. Three questions are answered in this paper: first, the expressions of eddy current loss and attenuation of electromagnetic wave in seawater are unified, and the influence of seawater as transmission medium on the WPT system is discussed. Second, the evolution of electromagnetic coupling structure suitable for underwater applications is studied. Third, the loss and heating effects of an underwater WPT system and the corresponding bio-fouling phenomenon are investigated. The questions above were addressed through analysis of electrical properties, coupler structures, and bio-fouling effects of the underwater WPT system. This paper will facilitate the study and research on underwater WPT applications.
SmTaO4 ceramics have excellent high-temperature phase stabilities and mechanical properties and show great potential for use as next-generation thermal barrier coating (TBC) materials. CeO2–SmTaO4 ceramics are prepared via high-temperature solid–state reaction. It retains a single monoclinic phase structure. Ce4+ was reduced to Ce3+ by high-temperature deoxidation, and the Ce3+ ions substitute for an equal number of Sm3+ ions. The CeO2–SmTaO4 ceramics had lower thermal conductivities [1.09–2.75 W/(m K)] than yttria-stabilized zirconia (YSZ) [2.1–2.7 W/(m K)] at 100–800 °C, which decreased dramatically with increasing temperature. SmTaO4 doped with 2% CeO2 had lower thermal conductivity [1.09 W/(m K), 800 °C] than SmTaO4 [1.42 W/(m K), 800 °C] and 2% ZrO2-doped SmTaO4 ceramics [1.22 W/(m K), 800 °C]. The low thermal conductivity is attributed to Ce3+ substitution for an equal number of Sm3+ ions, and because Ce3+ ions are the strongest phonon scattering centers, they can decrease the phonon mean free path effectively. The thermal expansion coefficient of 8% CeO2–SmTaO4 ceramics is approximately 10.3 × 10−6 K−1 at 1200 °C, which is slightly higher than that of both YSZ (10.0 × 10−6 K−1) and SmTaO4 (9.58 × 10−6 K−1). The outstanding thermophysical properties indicate that CeO2–SmTaO4 ceramics are potential TBC materials.
Autonomous ships are gaining in importance and are expected to shape the future of the global shipping industry. This evolutionary shift raises serious issues about compliance with the International Regulations for Preventing Collisions at Sea 1972 (COLREGs). This paper reviews the literature on autonomous ships from the perspective of the obligations of good seamanship imposed by COLREGs. The authors conclude that to facilitate the introduction of autonomous ships, the application barriers presented by COLREGs need to be analysed. With this goal, this paper presents a perspective from navigational practice. Four nautical scientists and two deck officers were invited to give their opinions. The analysis indicates that COLREGs require further elaboration and amendments to eliminate uncertainty of interpretation. In particular, the paper highlights the need to amend the ‘look-out’ rule (COLREGs Rule 5) to permit look-out by ‘computer vision’ alone while, at the same time, preserving the distinction between vessels navigating in restricted visibility and in sight of one another.
This study seeks to identify healthcare utilization patterns following symptomatic respiratory tract infections (RTIs) and the variables that may influence these patterns.
RTIs are responsible for the bulk of the primary healthcare burden worldwide. Yet, the use of health services for RTIs displays great discrepancies between populations. This research examines the influence of social demographics, economic factors, and accessibility on healthcare utilization following RTIs.
Structured interviews were administered by trained physicians at the households of informants selected by cluster randomization. Descriptive and multivariate binary logistic regression analysis was performed to assess healthcare utilization and associated independent variables.
A total of 60 678 informants completed the interviews. Of the 2.9% informants exhibiting upper RTIs, 69.5–73.9% sought clinical care. Healthcare utilization rates for common cold, influenza, nine acute upper RTIs, and overall RTIs demonstrate statistically significant associations with the variables of age, type of residence, employment, medical insurance, annual food expenditure, distance to medical facilities, and others. The odds ratios for healthcare utilization rates varied substantially, ranging from 0.026 to 9.364. More than 69% of informants with RTIs sought clinical interventions. These findings signify a marked issue with the large amount of healthcare for self-limited RTIs.
The nutritional intake of Tibetan sheep on the harsh Qinghai–Tibetan Plateau is often under maintenance requirements, especially during the long, cold winter. However, they have adapted well and even thrive under these conditions. The aim of the present study was to gain insight into how the rumen epithelium of Tibetan sheep has adapted to the consumption of low-energy-level diets. For this purpose, we compared Tibetan and small-tailed Han sheep (n 24 of each breed, all wethers and 1·5 years of age), which were divided randomly into one of four groups and offered ad libitum diets of different digestible energy (DE) densities: 8·21, 9·33, 10·45 and 11·57 MJ DE/kg DM. The Tibetan sheep had higher rumen concentrations of total SCFA, acetate, butyrate and iso-acids but lower concentrations of propionate than small-tailed Han sheep. The Tibetan sheep had higher absorption capability of SCFA due to the greater absorption surface area and higher mRNA expression of the SCFA absorption relative genes than small-tailed Han sheep. For the metabolism of SCFA in the rumen epithelium, the small-tailed Han sheep showed higher utilisation of the ketogenesis pathway than Tibetan sheep; however, Tibetan sheep had greater regulation capacity in SCFA metabolism pathways. These differences between breeds allowed the Tibetan sheep to have greater capability of absorbing SCFA and better capacity to regulate the metabolism of SCFA, which would allow them to cope with low energy intake better than small-tailed Han sheep.
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.
Shifts in ceramic technology are often assumed to reflect wider social changes. Closer attention, however, needs to be directed to the fundamental issue of production. Shifts in the ceramic record of the Tao River Valley in north-western China (c. 2100 BC) are no exception and the relationships between ceramic form, clay recipes and communities of practice have not been previously investigated for this region. Here, petrographic analysis demonstrates that, despite major shifts in ceramic form and surface treatment, production techniques, raw materials and exchange relationships show surprising continuity through time.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
A novel and highly efficient Ag3VO4/C3N4/reduced TiO2 microsphere composite was obtained through a hydrothermal and depositional process. The microstructure, individual components with different proportions, and optical properties of the ternary nanocomposites were intensively studied. The prepared ternary composites exhibited superior photocatalytic performance of degradation of methylene blue compared with single component and S1 (C3N4/reduced TiO2) binary composites, demonstrating that the introduction of Ag3VO4 into g-C3N4/r-TiO2 can effectively improve the photocatalytic activity. Recycling experiments confirmed that the nanocomposites exhibited superior cycle performance. The enhanced capability could be attributed to a synergetic effect including the formation of heterojunction, large surface area, improved light absorption, matched energy band structure, and the improved separation efficiency of photogenerated charges coming from dual Z-scheme structure. Particularly, the introduction of Ag3VO4 makes the dual Z-scheme charge transfer pathway completed with improved separation efficiency and stronger redox ability of photogenerated electrons and holes. The work provides a promising method to develop a new dual Z-scheme photocatalytic system to remove environmental pollutant.
The Katian (Upper Ordovician) Shiyanhe Formation at the Sigang section, Neixiang area, Henan Province, central China, has been investigated for carbon isotope (δ13Ccarb) chemostratigraphy. The carbon isotopic data document signal between the two major Ordovician positive shifts in δ13C, the early Katian Guttenberg and the Hirnantian excursions. The Kope (Ka1/2), Fairview (Ka2/3), Waynesville (Ka3/4), Whitewater (Ka4) excursions and a doubtful Elkhorn (Ka4) excursion are identified herein. The continuous and well-defined conodont zonal succession of the Sigang section provides a secure biostratigraphic framework for the mid-late Katian carbon isotope chemostratigraphy in China. Correlation between carbon-isotope data curve and the relative sea-level changes shows no clear correspondence, and hence the sea-level change is probably not the main driver of δ13C excursions during the Katian. Intercontinentally, the mid–late Katian carbon isotope excursions, identified mainly in the North American and Baltoscandian successions, are useful for improving long-distance stratigraphic correlations. This further suggests that these excursions represent global perturbations in the carbon cycle.
Distinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.
Participants were family members bereaved by US military service death (N = 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.
All four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86–96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47–82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly ‘very good’ (κ = 0.86–0.96).
The four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.
The aim of this meta-analysis was to provide a comprehensive overview of human immunodeficiency virus (HIV)-1 subtypes and to investigate temporal and geographical trends of the HIV-1 epidemic among men who have sex with men (MSM) in China. Chinese and English articles published between January 2007 and December 2017 were systematically searched. Pooled HIV-1 prevalence was calculated, and its stability was analysed using sensitivity analysis. Subgroups were based on study time period, sampling area and prevalence. Publication bias was measured using Funnel plot and Egger's test. A total of 68 independent studies that included HIV-1 molecular investigations were eligible for meta-analysis. Circulating recombinant form (CRF) 01_AE (57.36%, 95% confidence interval (CI) 53.76–60.92) was confirmed as the most prevalent HIV-1 subtype among MSM in China. Subgroup analysis for time period found that CRF01_AE steadily increased prior to 2012 but decreased during 2012–2016. Further whereas CRF07_BC increased over time, B/B′ decreased over time. CRF55_01B has increased in recent years, with higher pooled estimated rate in Guangdong (12.22%, 95% CI 10.34–13.17) and Fujian (8.65%, 95% CI 4.98–13.17) provinces. The distribution of HIV-1 subtypes among MSM in China has changed across different regions and periods. HIV-1 strains in MSM are becoming more complex. Long-term molecular monitoring in this population remains necessary for HIV-1 epidemic control and prevention.
The associations between growth during early life and subsequent cognitive development and physical outcomes are not widely known in low-resource settings. We examined postnatal weight and height gain through early life and related these measurements to the nutritional status and intellectual development of the same children when they were between 7 and 9 years old. Mothers had enrolled in an randomised controlled trial to evaluate the effect of prenatal micronutrient supplementation on birth weight. Their children were born in 2004, their height and weight were measured at 6, 12, 18 and 24 months of age and were followed up between October 2012 and September 2013 (at ages 7–9 years, n 650). Height-for-age, weight-for-age and BMI-for-age were used to describe the nutritional status, and the Wechsler Intelligence Scale for Children fourth edition was used to measure the intellectual function. Multilevel linear and logistic modelling was used to estimate the association between early growth and subsequent growth and intellectual function. After adjustment, weight gain from 6 to 12 months of age was associated with Full-scale Intelligence Quotient, Verbal Comprehension Index, Working Memory Index and Perceptual Reasoning Index. Weight gain during early life was associated with subsequent nutritional status. For every 1 kg increase in weight during the 0- to 6-month period, the OR for underweight, thinness and stunting at 7–9 years of age were 0·19 (95 % CI 0·09, 0·37), 0·34 (95 % CI 0·19, 0·59) and 0·40 (95 % CI 0·19, 0·83), respectively. Weight gain during the periods of 6–12 months of age and 18–24 months of age was also associated with a lower risk of being underweight. Weight gain during early life was associated with better growth outcomes and improved intellectual development in young school-aged children.