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We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case–control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2–4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose–response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
Deep learning methods have been applied to randomly generate images, such as in fashion, furniture design. To date, consideration of human aspects which play a vital role in a design process has not been given significant attention in deep learning approaches. In this paper, results are reported from a human- in-the-loop design method where brain EEG signals are used to capture preferable design features. In the framework developed, an encoder extracting EEG features from raw signals recorded from subjects when viewing images from ImageNet are learned. Secondly, a GAN model is trained conditioned on the encoded EEG features to generate design images. Thirdly, the trained model is used to generate design images from a person's EEG measured brain activity in the cognitive process of thinking about a design. To verify the proposed method, a case study is presented following the proposed approach. The results indicate that the method can generate preferred designs styles guided by the preference related brain signals. In addition, this method could also help improve communication between designers and clients where clients might not be able to express design requests clearly.
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.
Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates.
Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model.
Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1–31.9%; I2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3–3.7%; I2 = 95.6%), 2.7% (95% CI 2.1–3.4%; I2 = 78.5%) and 45.9% (95% CI 42.1–49.9%; I2 = 0), respectively. Earlier age of onset (Q = 4.38, p = 0.04), high-income countries (Q = 53.29, p < 0.001), North America and Europe and Central Asia (Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts.
Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.
Magnetic iron oxide nanoparticles (MIONPs) are particularly attractive in biosensor, antibacterial activity, targeted drug delivery, cell separation, magnetic resonance imaging tumor magnetic hyperthermia, and so on because of their particular properties including superparamagnetic behavior, low toxicity, biocompatibility, etc. Although many methods had been developed to produce MIONPs, some challenges such as severe agglomeration, serious oxidation, and irregular size are still faced in the synthesis of MIONPs. Thus, various strategies had been developed for the surface modification of MIONPs to improve the characteristics of them and obtain multifunctional MIONPs, which will widen the applicational scopes of them. Therefore, the processes, mechanisms, advances, advantages, and disadvantages of six main approaches for the synthesis of MIONPs; surface modification of MIONPs with inorganic materials, organic molecules, and polymer molecules; applications of MIONPs or modified MIONPs; the technical challenges of synthesizing MIONPs; and their limitations in biomedical applications were described in this review to provide the theoretical and technological guidance for their future applications.
Among 300 advanced cancer patients with potential urinary tract infection (UTI), 19 had symptomatic UTI. Among remaining patients (n = 281), 21% had asymptomatic bacteriuria or candiduria, and 14% received inappropriate therapy for 279 antimicrobial days. Bacteriuria or candiduria predicted antimicrobial therapy. At 10,000 to <100,000 CFU/mL, the incidence rate ratio [IRR] was 16.9 (95% confidence interval [CI], 6.0–47.2), and at ≥100,000 CFU/mL, the IRR was 27.9 (95% CI, 10.9–71.2).
Staminodes are sterile stamens that produce no pollen, exhibit diverse structures and perform various functions. Flowers of Phanera yunnanensis possess three fertile stamens with large anthers and long filaments, and seven staminodes with tiny anthers and short filaments. To investigate the adaptive significance of staminodes in this species, we studied effects of staminode removal on pollen removal and deposition, flower visitation rate and fruit set in Xishuangbanna, south-western China. Four species of nectar-foraging pollinators visited flowers, mostly Amegilla zonata and Apis cerana (2.80 ± 0.15 and 1.76 ± 0.41 visits h−1 per flower, respectively). Staminode removal did not affect fruit set, but increased visitation by A. cerana by 2.6-fold, reduced visitation by A. zonata by 68% and increased the pollen removal rate for both pollinators (all effects were significant). Staminode removal significantly reduced pollen deposition rate for A. zonata, but not for A. cerana. These results suggest that the staminodes of P. yunnanensis filter which insects act as pollinators and affect pollen removal and deposition rates. By reducing pollen removal rates, staminodes may implement a pollen-dispensing schedule that spreads pollen dispersal from individual flowers over multiple pollinators. By altering pollen deposition rates, staminodes may influence reproductive fitness in other ways.
Malnutrition remains a leading contributor to the morbidity and mortality of children under the age of 5 years and can weaken the immune system and increase the severity of concurrent infections. Livestock milk with the protective properties of human milk is a potential therapeutic to modulate intestinal microbiota and improve outcomes. The aim of this study was to develop an infection model of childhood malnutrition in the pig to investigate the clinical, intestinal and microbiota changes associated with malnutrition and enterotoxigenic Escherichia coli (ETEC) infection and to test the ability of goat milk and milk from genetically engineered goats expressing the antimicrobial human lysozyme (hLZ) milk to mitigate these effects. Pigs were weaned onto a protein–energy-restricted diet and after 3 weeks were supplemented daily with goat, hLZ or no milk for a further 2 weeks and then challenged with ETEC. The restricted diet enriched faecal microbiota in Proteobacteria as seen in stunted children. Before infection, hLZ milk supplementation improved barrier function and villous height to a greater extent than goat milk. Both goat and hLZ milk enriched for taxa (Ruminococcaceae) associated with weight gain. Post-ETEC infection, pigs supplemented with hLZ milk weighed more, had improved Z-scores, longer villi and showed more stable bacterial populations during ETEC challenge than both the goat and no milk groups. This model of childhood disease was developed to test the confounding effects of malnutrition and infection and demonstrated the potential use of hLZ goat milk to mitigate the impacts of malnutrition and infection.
Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain.
To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning.
A prospective survey study.
An academic medical center.
The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison.
According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2).
The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.
The effects of the thermal cyclic aging treatment on the microstructure and mechanical properties of 2060 Al–Li alloy laser beam welded joints were investigated. Aging treatments were conducted at different temperatures and for different cycles. Test results showed that the tensile strength of the weld joints increased and the elongation slightly decreased after the thermal cycling treatment. It was also found that the heat affected zone (HAZ) of the welds exhibited a significant increase in microhardness, whilst the microhardness variation of the nondendrite equiaxed zone (EQZ) can be neglected. The strengthening effect of the thermal cycling became more obvious as the temperature and cycles increased. The highest strength of around 513 MPa (96% of the base metal) was obtained at the temperature of 180 °C. Reprecipitation of strengthening phases such as T1 in the HAZ at 180 °C was observed by TEM, which can be considered as the main reason for the strengthening effect of the aging treatment.
We sought to identify factors associated with long duration and/or non–first-line choice of treatment for pediatric skin and soft-tissue infections (SSTIs).
Retrospective cohort study.
Ambulatory encounter claims of Medicaid-insured children lacking chronic medical conditions treated for SSTI and/or animal bite injury in Ohio in 2014.
For all diagnoses, long treatment duration was defined as treatment >7 days. Non–first-line choice of treatment for SSTI included treatment with 2 antimicrobials dispensed on the same calendar day or any treatment not listed in the Infectious Diseases Society of America guidelines. The adjusted odds of (1) long treatment duration and (2) non–first-line choice of treatment were calculated for patient age, prescriber type, and patient county of residence characteristics (ie, rural vs metropolitan area and poverty rate).
Of 10,310 encounters with complete data available, long treatment duration was prescribed in 7,968 (77.3%). The most common duration of treatment prescribed was 10 days. A non–first-line choice was prescribed in 1,030 encounters (10%). Dispensation of 2 antimicrobials on the same calendar day was the most common reason for the non–first-line choice, and of these, trimethoprim-sulfamethoxazole plus a first-generation cephalosporin was the most common regimen. Compared to pediatricians, the adjusted odds ratio of long treatment duration was significantly lower for all other primary care specialties. Conversely, nonpediatricians were more likely to prescribe a non–first-line treatment choice. Patient residence in a high-poverty county increased the odds of both long duration and non–first-line choice of treatment.
Healthcare claims may be utilized to measure opportunities for first-line choice and/or shorter duration of treatment for SSTI.
Introduction: To investigate the effects of paroxetine (PAR) on motor and cognitive function recovery in patients with non-depressed ischemic stroke (nD-AIS).
Methods: One hundred sixty-seven patients hospitalized for non-depressed acute ischemic stroke were selected and divided into treatment (T) and control (C) groups using a random number table. All patients received conventional secondary ischemic stroke prevention and rehabilitation training; patients in Group T additionally received treatment with PAR (10 mg/day during week 1 and 20 mg/day thereafter) for 3 months. The follow-up observation lasted 6 months. The Fugl–Meyer motor scale (FMMS), Montreal cognitive assessment (MoCA), and Hamilton depression scale (HAMD) were used on D0, D15, D90, and D180 (T0, 1, 2, and 3, respectively; D180 = 90 days after treatment cessation) after study initiation, and scores were compared between the groups.
Results: The FMMS and MoCA scores differed significantly between Groups T and C at T2 and T3 (p < .05); by contrast, these scores did not differ significantly between the groups at T1 (p > .05). Furthermore, the HAMD scores differed significantly between the two groups at T3 (p < .05), but not at T1 and T2 (p > .05).
Conclusions: PAR treatment may improve motor and cognitive function recovery in patients with nD-AIS. Moreover, PAR may reduce the occurrence of depression after stroke.
Conservation plans for waterbirds in periodically flooded wetlands should be based on a deep understanding of the relationship between habitat availability and the hydrological regime. Using waterbird surveys and remotely sensed images, we investigated how habitat availability for wintering waterbirds was regulated by seasonal water level fluctuation at Shengjin Lake in the lower Yangtze River floodplain, which is an important wintering area along the East Asian-Australasian Flyway. We recorded 52 waterbird species during three field surveys, and categorised them into four groups based on their foraging preferences: grassland, mudflats, shallow water, or deep water. Habitat availability for the four groups was significantly influenced by fluctuations in water level. Habitat for deep-water feeders dominated the lake throughout the year, despite contracting during the wintering season. Water recession during winter exposed more diverse riparian habitats that showed high spatial heterogeneity at the landscape level, with the Upper Lake providing the most suitable habitats for the most diverse and abundant waterbirds. It is worth noting that the water level was regulated highly for aquaculture during the early wintering period, impeding access to suitable habitats for the early-arriving waterbirds that foraged in the riparian mudflats and grassland. Furthermore, rapid water recession from the opening of a sluice gate allowed the exposed moist mudflats to dry up quickly, reducing its suitability for shorebirds and cranes. For effective wintering waterbird conservation in the ephemeral lacustrine wetlands in the Yangtze River floodplain, we suggest stepwise water recession plans, together with the recovery of the aquatic vegetation community and reduction in high-density aquaculture, to synchronise the exposure of foraging habitats with the migration phenology of different waterbird species.
Several studies have suggested that higher carotenoid levels may be beneficial for atherosclerosis patients, but few studies have examined this relationship in the Chinese population. This cross-sectional study examined the association between the levels of carotenoids in diet and serum and carotid intima–media thickness (IMT) in Chinese adults aged 50–75 years in Guangzhou, China. Dietary intake was assessed using a FFQ. HPLC was used to assay the serum concentrations of α-carotene, β-carotene, lutein+zeaxanthin, β-cryptoxanthin and lycopene. The IMT at the common carotid artery (CCA) and bifurcation of the carotid artery was measured by B-mode ultrasound. A total of 3707 and 2947 participants were included in the analyses of dietary and serum carotenoids. After adjustment for demographic, socio-economic and lifestyle factors, all the serum carotenoids levels except lycopene were found to be inversely associated with the IMT at the CCA and bifurcation (Ptrend<0·001 to 0·013) in both men and women. The absolute mean differences in the IMT between the subjects in the extreme quartiles of serum carotenoid levels were 0·034 mm (α-carotene), 0·037 mm (β-carotene), 0·032 mm (lutein+zeaxanthin), 0·030 mm (β-cryptoxanthin), 0·015 mm (lycopene) and 0·035 mm (total carotenoids) at the CCA; the corresponding values were 0·025, 0·053 0·043, 0·050, 0·011 and 0·042 mm at the bifurcation. The favourable associations were also observed between dietary carotenoids (except lycopene) and the CCA IMT. In conclusion, elevated carotenoid levels in diet and serum are associated with lower carotid IMT values (particular at the CCA) in Chinese adults.
The Signor-Lipps effect states that even a sudden mass extinction will invariably appear gradual in the fossil record, due to incomplete fossil preservation. Most previous work on the Signor–Lipps effect has focused on testing whether taxa in a mass extinction went extinct simultaneously or gradually. However, many authors have proposed scenarios in which taxa went extinct in distinct pulses. Little methodology has been developed for quantifying characteristics of such pulsed extinction events. Here we introduce a method for estimating the number of pulses in a mass extinction, based on the positions of fossil occurrences in a stratigraphic section. Rather than using a hypothesis test and assuming simultaneous extinction as the default, we reframe the question by asking what number of pulses best explains the observed fossil record.
Using a two-step algorithm, we are able to estimate not just the number of extinction pulses but also a confidence level or posterior probability for each possible number of pulses. In the first step, we find the maximum likelihood estimate for each possible number of pulses. In the second step, we calculate the Akaike information criterion and Bayesian information criterion weights for each possible number of pulses, and then apply a k-nearest neighbor classifier to these weights. This method gives us a vector of confidence levels for the number of extinction pulses—for instance, we might be 80% confident that there was a single extinction pulse, 15% confident that there were two pulses, and 5% confident that there were three pulses. Equivalently, we can state that we are 95% confident that the number of extinction pulses is one or two. Using simulation studies, we show that the method performs well in a variety of situations, although it has difficulty in the case of decreasing fossil recovery potential, and it is most effective for small numbers of pulses unless the sample size is large. We demonstrate the method using a data set of Late Cretaceous ammonites.
We report a novel tip-type field emission (FE) emitter by synthesizing the few-layer graphene (FLG) flakes on tip of nichrome (8020) wire (ϕ≈80 μm) by microwave plasma enhanced chemical vapor deposition(PECVD). These resultant random arrays of free-standing FLG flakes are aligned vertically to the substrate surface in a high-density and stacked to each other to form several larger “flower-like” agglomerates in spherical shapes. The FE performance of the tip-type FLG flakes emitter shows a low threshold field of 0.55 V/μm, a large field enhancement factor of 9455 ± 46, a large field emission current density of 22.18 A/cm2 at 2.70 V/μm, and an excellent field emission stability at high emission current densities (6.93 A/cm2). It can be used in variety of applications that include cathode-ray tube monitors, X-ray sources, electron microscopes, and other vacuum electronic applications.
Radiocarbon (14C) in dissolved inorganic carbon (DIC) was measured for water samples collected from six deep stations in the Kuroshio Extension (KE) region in the northwestern North Pacific in April–May 2015. Vertical profiles of Δ14C-DIC indicate that bomb-produced 14C was present from the surface to ~1500 m water depth. Large variations in Δ14C-DIC values (300‰) were observed at 500 m water depth among the stations and the differences were likely controlled by transport and mixing dynamics of different water masses in the region. The major Pacific western boundary currents, such as Kuroshio and Oyashio and regional mesoscale eddies, could play important roles affecting the observed Δ14C-DIC variability. The depth profiles of both Δ14C-DIC and DIC concentrations can be predicted by the solution mixing model and can be used as conservative tracers of water mass movement and water parcel homogenization in the ocean.
Children’s poor growth and nutrition status has serious consequences and therefore it is important to understand its contributing factors.
A community-based interventional study focusing on child feeding was conducted in a rural community in China. Data from the intervention group at baseline (1–4 months of age) and follow-up visits (12 and 18 months of age) were used in the present study (n 236). A structural equation model was generated to explore the effects of family wealth, household food safety, dietary intake, diseases and other factors on the growth and nutrition of young children.
Mother’s knowledge and behaviours on household food safety had positive effects on children’s weight-for-age Z-score (WAZ; βdirect=0·03 and 0·15, respectively, at 12 months of age; βdirect=0·02 and 0·08, respectively, at 18 months; P<0·05) and weight-for-length Z-score (WLZ; βdirect=0·04 and 0·21, respectively, at 12 months of age; βdirect=0·01 and 0·06, respectively, at 18 months; P<0·05). While mothers’ feeding behaviours and children’s dietary intake at 12 months of age were positively associated with WAZ and/or WLZ at current and later ages, children’s diseases were negatively associated with WAZ and WLZ cross-sectionally.
Caregiver’s knowledge and feeding behaviours, and children’s dietary intake and diseases, are factors influencing the WAZ and WLZ of children. Promoting feeding and health knowledge and behaviours at early stages of childhood can improve children’s physical growth at later ages.