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To measure the associations of sociodemographic and behavioural factors with fruit and vegetable consumption among adults in China.
A cross-sectional study.
A 2015 wave of the China Health and Nutrition Survey.
Totally, 11 910 adults aged 18 to 64 years.
Adjusted log binomial regression analyses showed that adults with higher income levels had higher fruit intake than those with low income levels (medium income group, risk ratio (RR): 1·28; 95 % CI: 1·16, 1·41; high income group, RR: 1·58; 95 % CI: 1·43, 1·74). Current smokers had lower fruit intake than non-smokers (RR: 0·86; 95 % CI: 0·77, 0·96). Adults living in southern China had higher vegetable intake (RR: 1·88; 95 % CI: 1·76, 2·01) but lower fruit intake (RR: 0·85; 95 % CI: 0·79, 0·91) than adults in northern China. With increasing age, adults had higher fruit intake (50–64 years, RR: 1·20; 95 % CI: 1·09, 1·33; reference category 18–34 years) and higher vegetable intake (35–49 years, RR: 1·13; 95 % CI: 1·05, 1·22; 50–64 years, RR: 1·22; 95 % CI: 1·13, 1·31).
Our findings identify a range of sociodemographic and behavioural factors associated with fruit and vegetable consumption among Chinese adults. They also point to the need for public health nutrition interventions for socially disadvantaged populations in China.
Studies have suggested an association between metabolic and cerebrocardiovascular diseases and major depressive disorder (MDD). However, the risk of metabolic and cerebrocardiovascular diseases in the unaffected siblings of patients with MDD remains uncertain. Using the Taiwan National Health Insurance Research Database, 22,438 unaffected siblings of patients with MDD and 89,752 age-/sex-matched controls were selected and followed up from 1996 to the end of 2011. Individuals who developed metabolic and cerebrocardiovascular diseases during the follow-up period were identified. Compared with the controls, the unaffected siblings of patients with MDD had a higher prevalence of metabolic diseases, such as hypertension (5.0% vs. 4.5%, p = 0.007), dyslipidemia (5.6% vs. 4.8%, p < 0.001), and obesity (1.7% vs. 1.5%, p = 0.028), and cerebrocardiovascular diseases, such as ischemic stroke (0.6% vs. 0.4%, p < 0.005) and ischemic heart disease (2.1% vs. 1.7%, p < 0.001). Logistic regression analyses revealed that the unaffected siblings of patients with MDD were more likely to develop hypertension, dyslipidemia, ischemic stroke, and ischemic heart diseases during the follow-up period than the controls. Our study revealed a familial coaggregation between MDD and metabolic and cerebrocardiovascular diseases. Additional studies are required to investigate the shared pathophysiology of MDD and metabolic and cerebrocardiovascular diseases.
Shifts in the maternal gut microbiota have been implicated in the development of gestational diabetes mellitus (GDM). Understanding the interaction between gut microbiota and host glucose metabolism will provide a new target of prediction and treatment. In this nested case-control study, we aimed to investigate the causal effects of gut microbiota from GDM patients on the glucose metabolism of germ-free (GF) mice. Stool and peripheral blood samples, as well as clinical information, were collected from 45 GDM patients and 45 healthy controls (matched by age and prepregnancy body mass index (BMI)) in the first and second trimester. Gut microbiota profiles were explored by next-generation sequencing of the 16S rRNA gene, and inflammatory factors in peripheral blood were analyzed by enzyme-linked immunosorbent assay. Fecal samples from GDM and non-GDM donors were transferred to GF mice. The gut microbiota of women with GDM showed reduced richness, specifically decreased Bacteroides and Akkermansia, as well as increased Faecalibacterium. The relative abundance of Akkermansia was negatively associated with blood glucose levels, and the relative abundance of Faecalibacterium was positively related to inflammatory factor concentrations. The transfer of fecal microbiota from GDM and non-GDM donors to GF mice resulted in different gut microbiota colonization patterns, and hyperglycemia was induced in mice that received GDM donor microbiota. These results suggested that the shifting pattern of gut microbiota in GDM patients contributed to disease pathogenesis.
Family coaggregation of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia have been presented in previous studies. The shared genetic and environmental factors among psychiatric disorders remain elusive.
This nationwide population-based study examined familial coaggregation of major psychiatric disorders in first-degree relatives (FDRs) of individuals with ASD. Taiwan's National Health Insurance Research Database was used to identify 26 667 individuals with ASD and 67 998 FDRs of individuals with ASD. The cohort was matched in 1:4 ratio to 271 992 controls. The relative risks (RRs) and 95% confidence intervals (CI) of ADHD, ASD, BD, MDD and schizophrenia were assessed among FDRs of individuals with ASD and ASD with intellectual disability (ASD-ID).
FDRs of individuals with ASD have higher RRs of major psychiatric disorders compared with controls: ASD 17.46 (CI 15.50–19.67), ADHD 3.94 (CI 3.72–4.17), schizophrenia 3.05 (CI 2.74–3.40), BD 2.22 (CI 1.98–2.48) and MDD 1.88 (CI 1.76–2.00). Higher RRs of schizophrenia (4.47, CI 3.95–5.06) and ASD (18.54, CI 16.18–21.23) were observed in FDRs of individuals with both ASD-ID, compared with ASD only.
The risk for major psychiatric disorders was consistently elevated across all types of FDRs of individuals with ASD. FDRs of individuals with ASD-ID are at further higher risk for ASD and schizophrenia. Our results provide leads for future investigation of shared etiologic pathways of ASD, ID and major psychiatric disorders and highlight the importance of mental health care delivered to at-risk families for early diagnoses and interventions.
The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern. The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. A total of 131 patients diagnosed with COVID-19 from 13 February 2020 to 14 March 2020 in a hospital in Wuhan designated for treating COVID-19 were enrolled in the current study. These 131 patients had a median age of 64 years old (interquartile range: 56–71 years old). Furthermore, among these patients, 111 (91.8%) patients were discharged and 12 (9.2%) patients died in the hospital. The pooled analysis revealed that the NLR at admission was significantly elevated for non-survivors, when compared to survivors (P < 0.001). The NLR of 3.338 was associated with all-cause mortality, with a sensitivity of 100.0% and a specificity of 84.0% (area under the curve (AUC): 0.963, 95% confidence interval (CI) 0.911–1.000; P < 0.001). In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). The NLR was significantly associated with the development of death in patients with COVID-19. Hence, NLR is a useful biomarker to predict the all-cause mortality of COVID-19.
In this article, we investigate the problem of parameter identification of spatial–temporal varying processes described by a general nonlinear partial differential equation and validate the feasibility and robustness of the proposed algorithm using a group of coordinated mobile robots equipped with sensors in a realistic diffusion field. Based on the online parameter identification method developed in our previous work using multiple mobile robots, in this article, we first develop a parameterized model that represents the nonlinear spatially distributed field, then develop a parameter identification scheme consisting of a cooperative Kalman filter and recursive least square method. In the experiments, we focus on the diffusion field and consider the realistic scenarios that the diffusion field contains obstacles and hazard zones that the robots should avoid. The identified parameters together with the located source could potentially assist in the reconstruction and monitoring of the field. To validate the proposed methods, we generate a controllable carbon dioxide (CO2) field in our laboratory and build a static CO2 sensor network to measure and calibrate the field. With the reconstructed realistic diffusion field measured by the sensor network, a multi-robot system is developed to perform the parameter identification in the field. The results of simulations and experiments show satisfactory performance and robustness of the proposed algorithms.
Based on an accurate numerical solution of the kinetic equation using well-resolved spatial and velocity grids, the separation of rarefied gas flow in a microchannel with double rectangular bends is investigated over a wide range of Knudsen and Reynolds numbers. Rarefaction effects are found to play different roles in flow separation (vortex formation) at the concave and convex corners. Flow separations near the concave and convex corners are only observed for a Knudsen number up to
, respectively. With further increase of the Knudsen number, flow separation disappears. Due to the velocity slip at the solid walls, the concave (convex) vortex is suppressed (enhanced), which leads to the late (early) onset of separation of rarefied gas flows with respect to the Reynolds number. The critical Reynolds numbers for the emergence of concave and convex vortices are found to be as low as
, respectively. The slip velocity near the concave (convex) corner is found to increase (decrease) when the Knudsen number increases. An adverse pressure gradient appears near the concave corner for all the examined Knudsen numbers, while for the convex corner it only occurs when the Knudsen number is less than
. Due to the secondary flow and adverse pressure gradient near the rectangular bends, the mass flow rate ratio between the bent and straight channels of the same length is a non-monotonic function of the Knudsen number. Our results clarify the diversified and often contradictory observations reported in the literature about flow rate enhancement and vortex formation in bent microchannels.
This paper describes the study protocol, which aims to evaluate the effectiveness of a multifaceted intervention package called ‘Enhanced Primary Healthcare’ (EnPHC) on the process of care and intermediate clinical outcomes among patients with Type 2 diabetes mellitus (T2DM) and hypertension. Other outcome measures include patients’ experience and healthcare providers’ job satisfaction.
In 2014, almost two-thirds of Malaysia’s adult population aged 18 years or older had T2DM, hypertension or hypercholesterolaemia. An analysis of health system performance from 2016 to 2018 revealed that the control and management of diabetes and hypertension in Malaysia was suboptimal with almost half of the patients not diagnosed and just one-quarter of patients with diabetes appropriately treated. EnPHC framework aims to improve diagnosis and effective management of T2DM, hypertension or hypercholesterolaemia and their risk factors by increasing prevention, optimising management and improving surveillance of diagnosed patients.
This is a quasi-experimental controlled study which involves 20 intervention and 20 control clinics in two different states in Malaysia, namely Johor and Selangor. The clinics in the two states were matched and randomly allocated to ‘intervention’ and ‘control’ arms. The EnPHC framework targets different levels from community to primary healthcare clinics and integrated referral networks.
Data are collected via a retrospective chart review (RCR), patient exit survey, healthcare provider survey and an intervention checklist. The data collected are entered into tablet computers which have installed in them an offline survey application. Interrupted time series and difference-in-differences (DiD) analyses will be conducted to report outcomes.
The 7 degrees of freedom (DOF) redundant manipulator greatly improves obstacle/singularity avoidance capability and operational flexibility. However, the inverse kinematics problem of this manipulator is very difficult to solve because it has an infinite number of solutions. This paper uses a new numerical sequence processing method with a closed-loop framework to solve the inverse kinematics of the 7-DOF redundant manipulator. Simulation and experiment show that this method has high commonality. No special structure of the robot is required, and this method has improved computational efficiency and reliability.
TiAl alloys are potential structural high-temperature structural materials at a service temperature of ~900 °C, while poor ductility at room temperature and high creep rate at the elevated temperature limits the applications. To improve the room-temperature and high-temperature mechanical properties of Ti–44Al–5Nb–3Cr–1.5Zr, Mo and B were introduced into this system and Ti–44Al–5Nb–3Cr–1.5Zr–xMo–yB alloys were proposed. And then, we, respectively, studied the microstructures and mechanical properties of Ti–44Al–5Nb–3Cr–1.5Zr–xMo–0B and Ti–44Al–5Nb–3Cr–1.5Zr–1Mo–yB to elucidate the role for the addition of Mo and B. It is found that Mo can increase the fraction of B2 phase in the alloys and the microstructures of the alloys are greatly refined by the addition of B. The compression test results indicate that Mo has a positive influence on the high-temperature compressive properties of TiAl-based alloys, whereas B addition can improve their room-temperature compressive properties of Ti–44Al–5Nb–3Cr–1.5Zr–1Mo–yB alloys; the morphology of borides in each sample should be the structural origin for these phenomena.
Studies have suggested the detrimental effects of obesity and systemic inflammation on the cognitive function of patients with bipolar or major depressive disorder. However, the complex associations between affective disorder, obesity, systemic inflammation, and cognitive dysfunction remain unclear.
Overall, 110 patients with affective disorder (59 with bipolar I disorder and 51 with major depressive disorder) who scored ≥61 on the Global Assessment of Functioning and 51 age- and sex-matched controls were enrolled. Body mass index ≥25 kg/m2 was defined as obesity or overweight. Levels of proinflammatory cytokines—including interleukin-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP)—were measured, and cognitive function was assessed using various methods, including the Wisconsin Card Sorting Test (WCST) and go/no-go task.
Patients with bipolar I disorder or major depressive disorder were more likely to be obese or overweight, had higher CRP and TNF-α levels, and had greater executive dysfunction in the WCST than the controls. TNF-α level (P < .05) but not affective disorder diagnosis or obesity/overweight was significantly associated with cognitive function deficits, although obesity/overweight and diagnosis were significantly associated with increased TNF-α level.
Our findings may indicate that proinflammatory cytokines, but not obesity or overweight, have crucial effects on cognitive function in patients with bipolar I disorder or major depressive disorder, although proinflammatory cytokines and obesity or overweight were found to be strongly associated. The complex relationships between affective disorder diagnosis, proinflammatory cytokine levels, obesity or overweight, and cognitive function require further investigation.
The bacterial foraging optimisation (BFO) algorithm is a commonly adopted bio-inspired optimisation algorithm. However, BFO is not a proper choice in coping with continuous global path planning in the context of unmanned surface vehicles (USVs). In this paper, a grid partition-based BFO algorithm, named AS-BFO, is proposed to address this issue in which the enhancement is contributed by the involvement of the A* algorithm. The chemotaxis operation is redesigned in AS-BFO. Through repeated simulations, the relative optimal parameter combination of the proposed algorithm is obtained and the most influential parameters are identified by sensitivity analysis. The performance of AS-BFO is evaluated via five size grid maps and the results show that AS-BFO has advantages in USV global path planning.
The antidepressant effect of low-dose ketamine infusion on Taiwanese patients with anxious vs nonanxious treatment-resistant depression (ANX-TRD vs NANX-TRD) has remained unknown.
In total, 71 patients with TRD were randomized to three groups. Each group had participants who received saline infusions mixed with 0 (a normal saline infusion), 0.2, and 0.5 mg/kg of ketamine. Participants were followed up for 2 weeks. Anxious depression was defined as major depressive disorder with a total score of 7 or more on the 17-item Hamilton Depression Rating Scale Anxiety-Somatization factor. Generalized estimating equation models were used to investigate the effects of treatment (ketamine vs placebo) and depression type (ANX-TRD vs NANX-TRD) in the reduction of depressive symptoms during the follow-up period.
Patients with ANX-TRD were less likely to respond to a single low-dose ketamine infusion than those with NANX-TRD. Among patients with NANX-TRD, low-dose ketamine infusion was significantly superior to placebo for reducing depressive symptoms. However, among patients with ANX-TRD, ketamine was not superior to placebo; nonetheless, approximately 30% of the patients responded to ketamine infusion compared to 13% who responded to the placebo.
Low-dose ketamine infusion was effective for Taiwanese patients with NANX-TRD but not so effective for those with ANX-TRD. A higher level of anxiety severity accompanying depression was related to greater depression severity. This may confound and reduce the antidepressant effect of ketamine infusion.
The storage root of alligatorweed [Alternanthera philoxeroides (Mart.) Griseb.] growing in terrestrial habitats is an important metamorphic organ for its propagation, overwintering, and spread. However, the regulatory mechanism adventitious root expansion to form storage roots is still unclear. To reveal the changes accompanying the root-swelling process, we quantified sugar, soluble protein, and phytohormone content in adventitious and storage roots. Results demonstrated that sucrose, fructose, and soluble protein increased in storage roots, whereas abscisic acid (ABA), indoleacetic acid (IAA), brassinosteroid (BR), gibberellin, jasmonic acid, and cytokinin (trans-zeatin [tZ] and isopentenyladenine [iP] and the corresponding ribosides tZR and iPR). tZ-type (tZR and tZ) content decreased, suggesting the involvement of sugars and hormones in the formation of storage roots. To further reveal the molecular basis of A. philoxeroides’s ability to form storage roots and provide candidate genes for molecular function analyses, we assembled a de novo transcriptome of A. philoxeroides based on four sets of RNA-sequencing data. According to functional annotation and expression profiling, 42 unigenes involved in sucrose synthesis and hydrolysis were identified, in addition to 70, 58, and 78 unigenes in ABA, BR, and IAA signal transduction, respectively. The quantitative reverse transcriptase polymerase chain reaction analysis revealed 21 unigenes involved in sugar metabolism and hormone signal transduction were differentially expressed during the formation of storage roots. These results revealed metabolic changes during the formation of storage roots and provide candidate genes involved in sugar and phytohormone metabolism in A. philoxeroides.
To compare therapeutic efficacy, social function, discontinue rate, relapse and recurrence rate of the depression outpatients with first episode between Venlafaxine extended release and Fluoxertine hydrochloride treatment. Methods In this 48 week natural parallel follow-up study, total 188 patients who meet ICD-10 criteria for a major depressive episode were admitted and assigned to receive either Venlafaxine Extended Release (Venlafaxine XR group) (n=89) or Fluoxertine hydrochloride(Fluoxertine group) (n=99).At baseline,week2,8,12,16,24,32,48,Hamilton Rating Scale for Depression (HAMD)-17 item was used to value disease severity, and Social Disability Screening Schedule(SDSS)for social disability, and the discontinue, relapse and recurrence rates were compared. Results (1) At week 24 Venlafaxine XR group had much lower HAMD17 total score than Fluoxertine group (P<0.05). (2)The remission rate and response rate between two groups had no statistical difference (P>0.05). (3) At week 12, Venlafaxine XR group had a higher SDSS score than Fluoxertine group (P<0.05).(4)At week 12, 16, 24, 32,48,Venlafaxine XR group displayed lower discontinue rates (P<0.05). Venlafaxine XR group had a longer treatment course than Fluoxertine did [(30.99±15.98) weeks vs. [(22.57±15.26) weeks] (P<0.01). (5) The relapse and recurrence rates of two groups had no statistical difference (P>0.05). Conclusions In the acute phase, Venlafaxine XR has a better effect for social function and treatment adherence than Fluoxertine hydrochloride. In the continued phase and sustained phase, Venlafaxine XR performs better for symptoms relief and treatment adherence.Venlafaxine XR has parallel performance with Fluoxertine hydrochloride by the terms of therapeutic efficacy, social function restore, relapse and recurrence rate.
Studies revealed that prenatal stress (PS) may increase the vulnerability to depression in their offspring, and ERK-CREB signal system might play a role in its mechanism.
Objectives and aims
The present study investigated the effect of MK-801 on depressive-like behavior and its impacts on ERK2, CREB, Bcl-2 mRNA expression in PS female rat offspring.
The pregnant rats were randomly divided into three groups, the control group (Con) was left undisturbed, the PS-saline group (PS-saline) and the PS-MK-801 group (PS-MK-801) were subjected to restraint stress on days 14–20 of pregnancy three times daily for 45 min, and received an i.p. administration of saline or MK-801(sigma, 0.2 mg/kg) 30 min before the first stress respectively. Forced swimming test was undertaken to assess depressive-like behavior in one month female offspring. ERK2, CREB, Bcl-2 mRNA in the hippocampus, frontal cortex, and striatum were detected by RT-PCR.
PS-saline spent significantly more immobile time compared to Con and PS-MK-801 (P < 0.05). ERK2 and CREB mRNA expression in hippocampus and frontal cortex was significantly decreased in PS-saline compared to Con and PS-MK-801 (P < 0.05), while in striatum CREB mRNA expression in PS-saline was lower than Con (P < 0.05). Bcl-2 mRNA expression in hippocampus and striatum was significantly decreased in PS-saline (P < 0.05), and in frontal cortex, its expression was significantly lower in PS-saline and PS-MK-801 (P < 0.05).
PS may suppress ERK-CREB signal pathway in female offspring rats, which could be partly prevented by MK- 801. (Supported by National Natural Science Foundation of China, No: 30970952).
The debates about depressive disorder and cognition impairment are supported by controversial data.
We launched the study to investigate cognitive change in first onset depressive patients over a 6 year period.
A prospective cohort was performed. Participants included 206 cases of first onset depressive Chinese outpatient aged from 17 to 60 year old and followed from Apr. 2003-Feb. 2004 to Apr. 2009-Feb. 2010 in Shanghai. During the first 48 weeks, case management service was delivered. Participants were assessed by 17-HAMD and HAMA scale at baseline, week 12, week 32, week 48, and year 6. Cognitive changes were assessed using the WMS-RC, WAIS-RC, and WCST at baseline (n = 116), week 12 (n = 80) and year 6 (n = 24), 41 normal participants as control.
(1) During the first depressive onset, cognitive performance deteriorated comparing with those of control group (P < 0.01).
(2) At week 12,effective medication could relieve symptom and improve cognition function (P < 0.05), cognitive performance compared between patient and control with no obvious difference (P > 0.05). While patient group had a significantly larger proportion (whose Memory Quotient below 85) than control group did (χ2 = 5.66, P < 0.05).
(3) Using a general linear mixed model to estimate cognitive change,patients with more severe depressive retardation and lower education had a worse short-term memory over 6 years (estimate = -1.65, SE = 0.80, P < 0.05;estimate=1.63, SE = 0.30, P < 0.01), adjusting for demographics and medical status.
The first onset depressive patient has cognitive defects. Memory does not full recovery after symptom relief. Short-term memory impairment persists over 6 years with relative factors.
The rhoptry kinase 18 of Toxoplasma gondii (TgROP18) has been identified as a key virulence factor that allows the parasite to escape from host immune defences and promotes its proliferation in host cells. Although much research is focused on the interaction between host cells and TgROP18, the development of monoclonal antibodies (mAbs) against TgROP18 has not been reported till date. To produce mAbs targeting TgROP18, two hybridomas secreting mAbs against TgROP18, designated as A1 and T2, were generated using cell fusion technology. The subtypes of the A1 and T2 mAbs were identified as IgG3 λ and IgM κ, and peptide scanning revealed that the core sequences of the antigenic epitopes were 180LRAQRRRSELVFE192 and 351NYFLLMMRAEADM363, respectively. The T2 mAb specifically reacted with both T. gondii type I and Chinese I, but not with T. gondii type II, Plasmodium falciparum or Schistosoma japonicum. Finally, the sequences of heavy chain and light chain complementarity-determining regions of T2 were amplified, cloned and characterized, making the modification of the mAb feasible in the future. The development of mAbs against TgROP18 would aid the investigation of the molecular mechanisms underlying the modulation of host cellular functions by TgROP18, and in the development of strategies to diagnose and treat Toxoplasmosis.