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While birth cohorts are shaped by underpinning life course frameworks, few if any report how they select them. This review aimed to (1) summarise publicly available frameworks relevant to planning and communicating large new early-life cohorts and (2) help select frameworks to guide and communicate Generation Victoria (GenV), a whole-of-state birth and parent cohort in planning in the state of Victoria, Australia. We identified potential frameworks from prior knowledge, networks and a pragmatic literature search in 2019. We considered for inclusion only frameworks with an existing visual graphic. We summarised each framework’s concept, then judged it on a seven-item matrix (Scope, Dimensions, Outcomes, Life course, Mechanisms, Multi-age, and Visual Clarity) to be of high, intermediate or low relevance to GenV. We presented and evaluated 14 life course frameworks across research and policy. Two, nine and three frameworks, respectively, were ranked as high, intermediate and low relevance to GenV, although none totally communicated its scope and intent. Shonkoff’s biodevelopmental framework was selected as GenV’s primary framework, adapted to include ongoing feedback loops through the life course and influence of an individual’s outcomes on the next generation. Because conceptual simplicity precluded the primary framework from capturing the wide range of relevant exposures, we selected the Australian Institute of Health and Welfare’s person-centred model as a secondary framework. This summary of existing life course frameworks may prove helpful to other cohorts in planning. Our transparent process and focus on visual communication are already assisting in explaining and selecting measures for GenV. The feasibility, comprehension and validity of these frameworks could be further tested at implementation.
In December 2019, the first confirmed case of pneumonia caused by a novel coronavirus was reported. Coronavirus disease 2019 (COVID-19) is currently spreading around the world. The relationships among the pandemic and its associated travel restrictions, social distancing measures, contact tracing, mask-wearing habits and medical consultation efficiency have not yet been extensively assessed. Based on the epidemic data reported by the Health Commission of Wenzhou, we analysed the developmental characteristics of the epidemic and modified the Susceptible-Exposed-Infectious-Removed (SEIR) model in three discrete ways. (1) According to the implemented preventive measures, the epidemic was divided into three stages: initial, outbreak and controlled. (2) We added many factors, such as health protections, travel restrictions and social distancing, close-contact tracing and the time from symptom onset to hospitalisation (TSOH), to the model. (3) Exposed and infected people were subdivided into isolated and free-moving populations. For the parameter estimation of the model, the average TSOH and daily cured cases, deaths and imported cases can be obtained through individual data from epidemiological investigations. The changes in daily contacts are simulated using the intracity travel intensity (ICTI) from the Baidu Migration Big Data platform. The optimal values of the remaining parameters are calculated by the grid search method. With this model, we calculated the sensitivity of the control measures with regard to the prevention of the spread of the epidemic by simulating the number of infected people in various hypothetical situations. Simultaneously, through a simulation of a second epidemic, the challenges from the rebound of the epidemic were analysed, and prevention and control recommendations were made. The results show that the modified SEIR model can effectively simulate the spread of COVID-19 in Wenzhou. The policy of the lockdown of Wuhan, the launch of the first-level Public Health Emergency Preparedness measures on 23 January 2020 and the implementation of resident travel control measures on 31 January 2020 were crucial to COVID-19 control.
While application of clustering algorithms to atom probe tomography data have enabled quantification of solute clusters in terms of number density, size, and subcomposition there exist other properties (e.g., volume, surface area, and composition) that are better determined by defining an interface between the cluster and the surrounding matrix. The limitation in composition results from an ion selection step where the expected matrix ion types are omitted from the cluster search algorithm to enhance the contrast between the matrix and cluster and to reduce the complexity of the search. Previously, composition determination within solute clusters has utilized a secondary envelopment and erosion step on top of conventional methods such as maximum separation. In this work, we present a novel stochastic method that combines the particle identification fidelity of a conventional clustering algorithm with the analytical flexibility of mesh-based approaches through the generation of alpha shapes for each identified cluster. The corresponding mesh accounts for concave components of the clusters and determines the volume and surface area of the clusters; additionally, the mesh boundary is utilized to update the total composition according to the internal ions.
Hypertension represents one of the most common pre-existing conditions and comorbidities in Coronavirus disease 2019 (COVID-19) patients. To explore whether hypertension serves as a risk factor for disease severity, a multi-centre, retrospective study was conducted in COVID-19 patients. A total of 498 consecutively hospitalised patients with lab-confirmed COVID-19 in China were enrolled in this cohort. Using logistic regression, we assessed the association between hypertension and the likelihood of severe illness with adjustment for confounders. We observed that more than 16% of the enrolled patients exhibited pre-existing hypertension on admission. More severe COVID-19 cases occurred in individuals with hypertension than those without hypertension (21% vs. 10%, P = 0.007). Hypertension associated with the increased risk of severe illness, which was not modified by other demographic factors, such as age, sex, hospital geological location and blood pressure levels on admission. More attention and treatment should be offered to patients with underlying hypertension, who usually are older, have more comorbidities and more susceptible to cardiac complications.
We aimed to examine whether baseline neutrophil counts affected the risk of new-onset proteinuria in hypertensive patients, and, if so, whether folic acid treatment is particularly effective in proteinuria prevention in such a setting. A total of 8,208 eligible participants without proteinuria at baseline were analyzed from the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT). Participants were randomized to receive a double-blind daily treatment of 10mg enalapril and 0.8mg folic acid (n=4,101) or 10mg enalapril alone (n=4,107). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The mean age of the participants was 59.5 (SD, 7.4) years, 3,088 (37.6%) of the participants were male. The median treatment duration was 4.4 years. In the enalapril-alone group, a significantly higher risk of new-onset proteinuria was found among participants with higher neutrophil counts (quintile 5; ≥4.8×109/L, OR, 1.44; 95%CI: 1.00, 2.06), compared with those in quintile 1-4. For those with enalapril and folic acid treatment, compared with the enalapril-alone, the new-onset proteinuria risk was reduced from 5.2% to 2.8% (OR, 0.49; 95%CI: 0.29, 0.82) among participants with higher neutrophil counts (≥4.8×109/L), whereas there was no significant effect among those with neutrophil counts <4.8×109/L. In summary, among hypertensive patients, those with higher neutrophil counts had increased risk of new-onset proteinuria, and this risk was reduced by 51% with folic acid treatment. If confirmed, neutrophil counts may serve as a biomarker to identify high-risk individuals who could particularly benefit from folic acid treatment.
The association between dietary iron intake and diabetes risk remains inconsistent. We aimed to explore the association of dietary iron intake and type 2 diabetes mellitus (T2DM) risk in middle-aged and older adults in urban China. This study used data from the Guangzhou Nutrition and Health Study (GNHS), an on-going community-based prospective cohort study. Participants were recruited from 2008 to 2013 in Guangzhou community. 2,696 participants aged 40-75 years without T2DM at baseline were included in data analyses, with a median of 5.6 (IQR: 4.1-5.9) years of follow-up. T2DM was identified by self-reported diagnosis, fasting glucose ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%. Cox proportional hazard models were used to estimate HRs and 95%CIs. We ascertained 205 incident T2DM cases during 13,476 person-years. The adjusted HR for T2DM risk in the fourth quartile of heme iron intake was 1.92 (95%CI: 1.07, 3.46; P-trend=0.010), compared with the first quartile intake. These significant associations were found in heme iron intake from total meat (HR:2.74; 95%CI: 1.22, 6.15; P-trend=0.011) and heme iron intake from red meat (HR:1.86; 95%CI: 1.01, 3.44; P-trend=0.034), but not heme iron intake from processed meat, poultry or fish/shellfish. The association between dietary intake of total iron or nonheme iron with T2DM risk had no significance. Our findings suggested that higher dietary intake of heme iron (especially from red meat), but not total iron or nonheme iron, was associated with greater T2DM risk in middle-aged and older adults.
The present study was conducted to test the hypothesis that dietary supplementation with a nano chitosan–zinc complex (CP–Zn, 100 mg/kg Zn) could alleviate weaning stress in piglets challenged with enterotoxigenic Escherichia coli K88 by improving growth performance and intestinal antioxidant capacity. The in vivo effects of CP–Zn on growth performance variables (including gastrointestinal digestion and absorption functions and the levels of key proteins related to muscle growth) and the antioxidant capacity of the small intestine (SI) were evaluated in seventy-two weaned piglets. The porcine jejunal epithelial cell line IPEC-J2 was used to further investigate the antioxidant mechanism of CP–Zn in vitro. The results showed that CP–Zn supplementation increased the jejunal villus height and decreased the diarrhoea rate in weaned piglets. CP–Zn supplementation also improved growth performance (average daily gain and average daily feed intake), increased the activity of carbohydrate digestion-related enzymes (amylase, maltase, sucrase and lactase) and the mRNA expression levels of nutrient transporters (Na+-dependent glucose transporter 1, glucose transporter type 2, peptide transporter 1 and excitatory amino acid carrier 1) in the jejunum and up-regulated the expression levels of mammalian target of rapamycin (mTOR) pathway-related proteins (insulin receptor substrate 1, phospho-mTOR and phospho-p70S6K) in muscle. In addition, CP–Zn supplementation increased glutathione content, enhanced total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-px) activity, and reduced malondialdehyde (MDA) content in the jejunum. Furthermore, CP–Zn decreased the content of MDA and reactive oxygen species, enhanced the activity of T-SOD and GSH-px and up-regulated the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins (Nrf2, NAD(P)H:quinone oxidoreductase 1 and haeme oxygenase 1) in lipopolysaccharide-stimulated IPEC-J2 cells. Collectively, these findings indicate that CP–Zn supplementation can improve growth performance and the antioxidant capacity of the SI in piglets, thus alleviating weaning stress.
In this study, we analysed the prevalence of diabetes in Inner Mongolia and explored the relationship between dietary patterns and diabetes using the Chinese Dietary Balance Index-16 (DBI-16). This study was a surveillance survey of Chronic Disease and Nutrition Monitoring among Chinese Adults in Inner Mongolia in 2015. Dietary data were collected using the 24-h dietary recall and weighing method over 3 consecutive days. Dietary quality was evaluated via the DBI-16. A generalized linear model was used to examine the associations between the DBI-16 and dietary patterns. The relationship between dietary patterns and diabetes was analysed using logistic regression. In Inner Mongolia, the diabetes prevalence was 8.5%, and the estimated standardized prevalence was 6.0%. Four major dietary patterns were identified: ‘meat/dairy products’, ‘traditional northern’, ‘high cereal/tuber’ and ‘high-salt/alcohol’. Generalized linear models showed that the ‘meat/dairy products’ pattern was relatively balanced (βLBS = −1.993, βHBS = −0.206, βDQD = −2.199; all P<0.05) and was associated with a lower diabetes risk (odds ratio [OR]: 0.565; 95% confidence interval [CI]: 0.338–0.945; P<0.05) after adjusting for potential confounders. The other three dietary patterns (i.e., ‘traditional northern’, ‘high cereal/tuber’ and ‘high-salt/alcohol’) exhibited relatively unbalanced dietary quality and were unassociated with diabetes risk. Diabetes prevalence in Inner Mongolia was moderate. The dietary quality of the ‘meat/dairy products’ pattern was relatively balanced and was correlated with a decreased risk of diabetes prevalence, suggesting that dietary quality may help decrease the diabetes prevalence and provide a suggestion for local dietary guidelines.
Global warming will directly influence agricultural production and present new challenges for food security in semiarid regions of China. A warming experiment was conducted in Guyuan, China using infrared ray radiators to study the impact of warming on crop growth, yield and quality of a potato–broad bean–winter wheat crop rotation system. Warming significantly affected the crop photosynthesis rates of the potato–broad bean–winter wheat rotation system. In the podding stage of broad bean and the heading, blooming and booting stages of winter wheat, the photosynthesis rate was significantly decreased when the temperature increased by 0.5–2.0°C. The growing period of the potato–broad bean–winter wheat rotation system was shortened by 20–40 days per 3-year-period, and the fallow period was prolonged by 4–13 days per 3-year-period. The water use efficiency of the potato–broad bean–winter wheat rotation decreased by 8.6% when the temperature increased by 1.02.0°C. The yield of the potato–broad bean–winter wheat rotation increased by 6.1–7.7% when the temperature increased by 0.5–1.0°C. However, yield decreased 12.9–13.4% when temperature increased by 1.0–2.0°C. Potato protein significantly decreased by 9.3–17.6% and the winter wheat fat significantly decreased by 6.7% when the temperature increased by 0.5–2.0°C. The results indicate that global warming could seriously affect the crop growth, yield and water use of the potato–broad bean–winter wheat rotation in semiarid regions of China.
The treatment of relapsed/refractory multiple myeloma (RRMM), a common hematological malignancy, remains a great challenge in China, partially due to the limited accessibility to novel agents and inadequate public health insurance coverage. Ixazomib, a novel oral proteasome inhibitor (PI), was approved by the China Food and Drug Administration (CFDA) for RRMM in 2018. While bortezomib, a traditional PI, is the recommended agent in the clinical guideline for MM. Here, we compared their costs and effectiveness.
RRMM patients who has received an ixazomib-based regimen (at least 2 cycles) were analyzed. Using a propensity score matching method, we generated a control group of RRMM patients who received the bortezomib-based regimen. The criteria included the number of treatment lines, age, and the revised international staging system stage (R-ISS) which representing the disease stage for myeloma, and paired at a ratio of 1:2 (allowing one control to match multiples). The difference in hospitalization stay, grade 3/4 adverse events rates, overall response rate (ORR), mortality during treatment, and treatment costs was then compared.
Nineteen patients received ixazomib and twenty-seven that received bortezomib were included. The ixazomib-group demonstrated a shorter hospital stay (9 days versus 27 days, p < 0.001), lower grade 3–4 adverse events rates (42.1% versus 55.6%, p < 0.001), higher ORR (63.2% versus 48.1%, p = 0.228), and lower mortality rate during treatment (0% versus 7.4%, p = 0.169) than that of bortezomib-group. The ixazomib group had lower total costs (127,620CNY versus 156,424CNY [18,033USD versus 22,103USD], p > 0.05), lower drug costs (98,376CNY versus 103,307CNY [13,901USD versus 14,598USD], p > 0.05), and the lower costs of supportive treatment (5,507CNY versus 14,701 CNY [778USD versus 2,077USD], p < 0.001). Only in terms of self-funded costs, the bortezomib-based regimen was significantly lower (37,127CNY versus 11,521CNY [5,246USD versus 1,628USD], p < 0.001).
Compared with the bortezomib-based regimen, the ixazomib-based regimen has better therapeutic effects on MM patients while saving costs. Hence, it may be preferable for use in the treatment of RRMM in China.
The experimental music of Chinese musicians including Yan Jun, Li Jianhong, Jun-Y Chao, Shen Piji and the Tea Rockers Quintet embodies a particular mode of thinking rooted in Chinese qi-philosophy known as shanshui (山水)-thought, which considers nature and the environment as secret and nurturing. Shanshui-thought cultivates an existential gesture of following rather than obeying or conquering; it requires tacit resonance rather than object knowing. Shanshui-thought enables us to recognise the cosmic, aesthetic and moral values of music qualities of dan (淡) (quiet and bland) and you (幽) (inward expandedness), once described as ‘poverty’ and ‘darkness’ by the composer Christian Wolff of what he calls ascetic minimalism.
The general public is familiar with weather forecasts and their utility, and the field of weather forecasting is well-established. Even the theoretical limit of the weather forecasting – two weeks – is known. In contrast, familiarity with climate prediction is low outside of the research field, the theoretical basis is not fully established, and we do not know the extent to which climate can be predicted. Variations in climate, however, can have large societal and economic consequences, as they can lead to droughts and floods, and spells of extreme hot and cold weather. Thus, improving our capabilities to predict climate is important and urgent, as it can enhance climate services and thereby contribute to the sustainable development of humans in this era of climate change.
This study aimed at estimating the transmissibility of hepatitis C. The data for hepatitis C cases were collected in six districts in Xiamen City, China from 2004 to 2018. A population-mixed susceptible-infectious-chronic-recovered (SICR) model was used to fit the data and the parameters of the model were calculated. The basic reproduction number (R0) and the number of newly transmitted cases by a primary case per month (MNI) were adopted to quantitatively assess the transmissibility of hepatitis C virus (HCV). Eleven curve estimation models were employed to predict the trends of R0 and MNI in the city. The SICR model fits the reported HCV data well (P < 0.01). The median R0 of each district in Xiamen is 0.4059. R0 follows the cubic model curve, the compound curve and the power function curve. The median MNI of each district in Xiamen is 0.0020. MNI follows the cubic model curve, the compound curve and the power function curve. The transmissibility of HCV follows a decreasing trend, which reveals that under the current policy for prevention and control, there would be a high feasibility to eliminate the transmission of HCV in the city.
Few studies have suggested that long-term adherence to low-carbohydrate diets (LCD) may affect maternal glucose metabolism in western countries. We aimed to investigate the association between LCD during pregnancy and glucose metabolism in Chinese population. A total of 1,018 women in mid-pregnancy were recruited in 2017-2018. Participants underwent a 75g oral glucose tolerance test (OGTT). Daily dietary intakes over the past month were accessed using a validated food frequency questionnaire. The overall, animal, and vegetable LCD scores which represent adherence to different low-carbohydrate dietary patterns were calculated. Mixed linear regression and generalized linear mixed regression were conducted to evaluate the associations between LCD scores and maternal glucose metabolism. Of the 1,018 subjects, 194 (19.1%) was diagnosed with gestational diabetes mellitus (GDM). The overall LCD score (β: 0.024, standard error (SE): 0.008, PFDR=0.02) and animal LCD score (β: 0.023, SE: 0.008, PFDR=0.02) was positively associated with OGTT 1-h glucose. No significant associations were found between the three different LCD scores with fasting plasma glucose (FPG), OGTT 2-h glucose, or insulin resistance, respectively. Compared with the lowest quartile, the crude odds ratios of GDM for the highest quartile were 1.84 (95% CI: 1.14, 2.95) for overall LCD score (P for trend = 0.02) and 1.56 (1.00, 2.45) for animal LCD score (P for trend = 0.02). However, these associations became nonsignificant after adjustment for covariates. In conclusion, a low-carbohydrate dietary pattern with high animal protein and fat is associated with higher postprandial 1-h glucose levels in Chinese pregnant women.
This article examines the roles digital technologies have played in propelling the shifts in modes of financial governance which have been led by the Chinese Communist Party and enacted by a wide spectrum of regulative actors. Based on analyses of the laws, policies and regulations surrounding digital financial technologies, or so-called fintechs, as well as in-depth interviews with government officials and fintech business executives, I argue that the proliferation of fintechs challenged the existing regulatory schemes defined by the Central Bank and the State Council. This forced a reconsideration of the Chinese government's hegemonic strategies in governing the rapidly changing financial industries. While digital technologies have been promoted to accomplish the goals set by the Party for financial marketization and modernization, a set of institutions including regulatory, organizational and normative rules have been developed to strengthen the Party's control over the digitization of finance. This contradiction is pivotal to understanding the Party's financial policymaking in the digital age.
Increased intake of vegetables and fruits has been associated with reduced risk of tuberculosis infection. Vegetables and fruits exert immunoregulatory effects; however, it is not clear whether vegetables and fruits have an adjuvant treatment effect on tuberculosis. Between 2009 and 2013, a hospital-based cohort study was conducted in Linyi, Shandong Province, China. Treatment outcome was ascertained by sputum smear and chest computerised tomography, and dietary intake was assessed by a semi-quantitative FFQ. The dietary questionnaire was conducted at the end of month 2 of treatment initiation. Participants recalled their dietary intake of the previous 2 months. A total of 2309 patients were enrolled in this study. After 6 months of treatment, 2099 patients were successfully treated and 210 were uncured. In multivariate models, higher intake of total vegetables and fruits (OR 0·70; 95 % CI 0·49, 0·99), total vegetables (OR 0·68; 95 % CI 0·48, 0·97), dark-coloured vegetables (OR 0·61; 95 % CI 0·43, 0·86) and light-coloured vegetables (OR 0·67; 95 % CI 0·48, 0·95) were associated with reduced failure rate of tuberculosis treatment. No association was found between total fruit intake and reduced failure rate of tuberculosis treatment (OR 0·98; 95 % CI 0·70, 1·37). High intake of total vegetables and fruits, especially vegetables, is associated with lower risk of failure of tuberculosis treatment in pulmonary tuberculosis patients. The results provide important information for dietary guidelines during tuberculosis treatment.