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To gain more comprehensive understanding of metabolic syndrome (Mets) among in general Chinese population.
Cross-sectional study. Mets was defined by three widely accepted definitions including modified Adults Treatment Panel (ATP) III criteria, International Diabetes Federation (IDF) criteria and harmonized definition. Risk factors were evaluated by using multivariate logistic regression.
Nineteen rural villages in northeast China.
The survey was conducted in September 2017 and May 2018 on 10 926 individuals.
According to modified ATP III criteria, IDF criteria and harmonised definition, the overall prevalence of Mets was 41·3 % (95 % CI 40·3, 42·2), 34·2 % (95 % CI 33·2, 35·1) and 44·1 % (95 % CI 43·1, 45·1), respectively. Females had a higher prevalence, and elevated blood pressure was the most frequent. Age, female sex, non-peasant worker, higher BMI and lower-annual income were independent risk factors of Mets in all three definitions (all ps < 0·05). Based on modified ATP III criteria and harmonised definition, heavy drinking was positively correlated with Mets. In contrast, former drinking was inversely associated with Mets.
Mets is highly prevalent in rural areas of northeast China. Its independent risk factors include higher age, female sex, non-peasantry worker, higher BMI and lower-annual income. Modified ATP III criteria and harmonised definition may be superior definitions of Mets.
In this work, we studied an atomic layer deposition (ALD) process of ZrO2 with the precursors of tetrakis(dimethylamido)zirconium(IV) and water. We investigated the growth characteristics and mechanism of the ALD ZrO2 in the temperature range of 50–275 °C. Furthermore, the evolutions of film thickness and morphology were studied and discussed. It was found that the growth rate of ZrO2 decreased almost linearly with the increasing temperature from ∼1.81 Å/cycle at 50 °C to ∼0.8 Å/cycle at 225 °C. Interestingly, it was revealed that the growth of ZrO2 films ceased after a certain number of ALD cycles at a temperature higher than 250 °C. We also verified that the crystallinity of ZrO2 evolved with deposition temperature from amorphous to crystalline phase. In addition, the wettability of ZrO2 films was studied, showing a hydrophobic nature.
The microbiota–gut–brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients.
We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD.
The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890.
The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.
We argue that economic inequality between ethnic groups increases state repression. We contend that a high level of ethnic inequality fuels distributional conflicts between poor and rich ethnic groups. It also increases the salience of ethnic identity and promotes ethnic mobilization to challenge the status quo. This between-group tension creates collective grievances for ethnic groups, mounts challenges to incumbent governments and increases perceived threats to governments. The greater the perceived threats, the more likely that governments will employ coercive measures. We further argue that the impact of ethnic inequality on state repression is moderated by the level of democracy. Various institutional mechanisms in democracies increase the costs of repression, reducing leaders’ incentives to employ coercive measures, even when facing high levels of ethnic inequality. Evidence from 152 countries between 1992 and 2011 supports our arguments.
To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).
Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.
At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).
Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.
Visual stimuli can be useful in supporting design ideation process. However, researchers still know very little about how stimuli should be delivered to designers during the early design stage. This question is crucial to the effective use of stimuli because previous researches have proved that ill-presented stimuli can have a negative impact on design creativity. Therefore, an empirical study was conducted with the aim of exploring if and how combinational pictorial stimuli can affect designers' creative performance. Results from a total of 36 participants show that the design outcomes presented by the group exposed to combinational pictorial stimuli were more creative than those given by the group exposed to no stimuli or randomly presented pictorial stimuli. These results imply that the form of stimuli delivery can affect creative design outcomes and combinational pictorial stimuli best support design creativity among these three conditions. These findings give us a better understanding of the roles that visual stimuli play in design, which is expected to bring us important implications for both design education and design support tool development
Combinational creativity is a significant element of design in supporting designers to generate creative ideas during the early phases of design. There exists three driven approaches to combinational creativity: problem-, similarity- and inspiration-driven. This study provides further insights into the three combinational creativity driven approaches, exploring which approach could lead to ideas that are more creative in the context of practical product design. The results from a case study reveal that the problem- driven approach could lead to more creative and novel ideas or products compared with the similarity- and inspiration-driven approach. Products originating from the similarity- and inspiration-driven approach are at comparable levels. This study provides better understanding of combinational creativity in practical design. It also delivers benefits to designers in improving creative idea generation, and supports design researchers in exploring future ideation methods and design support tools employing the concept of 'combination'.
This research investigated patients who underwent surgery for a dilated aorta associated with a connective tissue disease or inflammatory vasculitis in children and adolescents.
Materials and Methods:
The medical records of 11 patients who underwent aortic surgery for dilatation resulting from a connective tissue disease or inflammatory vasculitis between 2000 and 2017 were retrospectively reviewed.
The median age and body weight of the patients were 9.6 years (range 5.4 months–15.5 years) and 25.8 kg (range 6.8–81.5), respectively. The associated diseases were Marfan syndrome (n = 3), Loeys-Dietz syndrome (n = 3), Kawasaki disease (n = 1), Takayasu arteritis (n = 1), PHACE syndrome (n = 1), tuberous sclerosis (n = 1), and unknown (n = 1). The most common initially affected area was the ascending aorta. During the 66.4 ± 35.9 months of follow-up, two Marfan syndrome patients died, and four patients (one Marfan syndrome and three Loeys-Dietz syndrome) had repeated aortic operation. Except for one patient, the functional class was well maintained in all patients who were followed up.
Cases of surgical treatment for a dilated aorta associated with a connective tissue disease and inflammatory vasculitis are rare in children and adolescents at our institution. Most of the patients in this study showed a tolerable postoperative course. However, the aorta showed progressive dilation over time even after surgical treatment, especially in patients with Loeys-Dietz syndrome. In these patients, close and more frequent regular follow-up is required.
In a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, a study was conducted to determine the effects of different fertilization regimens (no fertilization, replacement of a portion of chemical fertilizer with composted pig manure, chemical fertilizer only, and straw return combined with chemical fertilizer) on the weed communities and wheat yields after 4 and 5 yr. The impact of the long-term recurrent fertilization regimen initiated in 2010 on the composition and diversity of weed communities and the impact of the components and total amount of fertilizer on wheat yields were assessed in 2014 and 2015. Totals of 19 and 16 weed species were identified in experimental wheat fields in 2014 and 2015, respectively, but the occurrence of weed species varied according to the fertilization regimen. American sloughgrass [Beckmannia syzigachne (Steud.) Fernald], water starwort [Myosoton aquaticum (L.) Moench], and lyrate hemistepta (Hemistepta lyrata Bunge.) were adapted to all fertilization treatments and were the dominant weed species in the experimental wheat fields. The greatest number of weed species were observed under the no-fertilization treatment, in which 40% of the weed community was composed of broadleaf weeds and the lowest wheat yields were obtained. With fertilizer application, the number of weed species was reduced, the height of weeds increased significantly, the density of broadleaf weeds was significantly reduced, the biodiversity indices of weed communities decreased significantly, and higher wheat yields were obtained. Only the chemical fertilizer plus composted pig manure treatment and the chemical fertilizer–only treatment increased the density of grassy weeds and the total weed community density. The treatment with chemical fertilizer only also resulted in the highest density of B. syzigachne. Rice straw return combined with chemical fertilizer yielded the lowest total weed density, which suggests that it inhibited occurrence of weeds. The different fertilizer regimens not only affected the weed species composition, distribution, and diversity, but also the weed density. Our study provides new information from a rice–wheat rotation system on the relationship between soil amendments and agricultural weed infestation.
Population-based colorectal cancer (CRC) screening programs that use a fecal immunochemical test (FIT) are often faced with a noncompliance issue and its subsequent waiting time (WT) for those FIT positives complying with confirmatory diagnosis. We aimed to identify factors associated with both of the correlated problems in the same model.
A total of 294,469 subjects, either with positive FIT test results or having a family history, collected from 2004 to 2013 were enrolled for analysis. We applied a hurdle Poisson regression model to accommodate the hurdle of compliance and also its related WT for undergoing colonoscopy while assessing factors responsible for the mixture of the two outcomes.
The effect on compliance and WT varied with contextual factors, such as geographic areas, type of screening units, and level of urbanization. The hurdle score, representing the risk score in association with noncompliance, and the WT score, reflecting the rate of taking colonoscopy, were used to classify subjects into each of three groups representing the degree of compliance and the level of health awareness.
Our model was not only successfully applied to evaluating factors associated with the compliance and the WT distribution, but also developed into a useful assessment model for stratifying the risk and predicting whether and when screenees comply with the procedure of receiving confirmatory diagnosis given contextual factors and individual characteristics.
This study was conducted to evaluate the cost-effectiveness of sunitinib versus interferon-alfa for the treatment of advanced and/or metastatic renal cell carcinoma (RCC) in Singapore.
A partitioned survival model with three health states (progression-free, progressive disease, and death) was developed from a healthcare payer perspective over a 10-year time horizon. Survival curves from the pivotal trial of sunitinib versus interferon-alfa were extrapolated beyond the trial period to estimate the underlying progression-free survival and overall survival parametric distributions. Health state utilities were derived from the literature and direct costs were sourced from local public healthcare institutions. The sunitinib dose in the model reflected local prescribing practices whereby a combination of 50 mg (28 percent) and 37.5 mg (72 percent) strengths are used.
The base-case analysis comparing sunitinib versus interferon-alfa resulted in an incremental cost effectiveness ratio (ICER) of SGD191,061 (USD139,757) per quality-adjusted life-year gained. Sensitivity analysis demonstrated that the ICER was most sensitive to variations in the utility value assumed for the progression-free health state and the price of sunitinib.
In the absence of any price reduction, sunitinib had an exceedingly high ICER and was not considered a cost-effective use of healthcare resources in Singapore's context for the first-line treatment of advanced RCC. The findings from our evaluation will be useful to inform local healthcare decision making and resource allocations for tyrosine kinase inhibitors when appraised alongside comparative clinical effectiveness data and payer affordability considerations.
Nanocarbon materials, such as carbon nanotubes, graphene, and their derivatives, are regarded as promising reinforcing agents in metal matrix composites (MMCs) because of their excellent intrinsic mechanical properties. Considering the various types of nanocarbons with different defect states and intrinsic properties, there is a potential for tailoring the mechanical behavior of nanocarbon-reinforced MMCs. This article reviews recent developments in both the processing and the structure–property correlations of these composites. Particular emphasis is given to the structure and properties of the nanocarbon–metal interfaces, as the external mechanical load is transferred between the nanocarbon and the metal matrix across their interfaces. Moreover, in addition to the intuitive load-bearing effect of the nanocarbon reinforcements, a copious interplay between nanocarbons and dislocations in the metal matrix has been found, which alters the deformation behavior that leads to additional strengthening. For structural applications, scalable fabrication routes for the nanocarbon-metal composites need to be developed, and studies on the mechanical behavior under real service conditions are needed.
Many studies have addressed the effect of neighborhood density (phonological similarity among words) on word learning in quiet listening conditions. We explored how noise influences the effect of neighborhood density on children's word learning. One-hundred-and-two preschoolers learned nonwords varied in neighborhood density in one of four listening conditions: quiet, +15 dB signal-to-noise ratio (SNR), +6 dB SNR, and 0 dB SNR. Results showed that a high-density advantage for children under quiet listening condition was significantly reduced as noise increased. This finding implies an adverse impact of noise on long-term outcomes of word learning.
A conventional Differential GPS (DGPS) techniques-based velocity and acceleration method (named here as ‘DVA’) may be difficult to implement in the Antarctic as there is a sparse distribution of reference stations over Antarctica. Thus, in order to overcome the baseline limitations and to obtain highly accurate and reliable velocity and acceleration estimates for airborne gravimetry, a network-based velocity and acceleration determination approach (named here as ‘NVA’), which introduces a wide network of stations and is independent of precise clock information, is applied. Here its performance for velocity and acceleration determination is fully exploited by using Global Positioning System (GPS), GLONASS, Galileo and BeiDou observations. Additionally, a standalone receiver-based method named ‘SVA’, which requires precise clock information, is also implemented for comparison. During static tests and a flight experiment over Antarctica, it was found that the NVA method yields more robust results than the SVA and DVA methods when applied to a wide area network. Moreover, the addition of GLONASS, Galileo and BeiDou systems can increase the accuracy of velocity and acceleration estimates by 39% and 43% with NVA compared to a GPS-only solution.
To investigate changes in vegetation and climate with altitude, we established forest plots and recorded climatic data at 100-m intervals between 550–1100 m asl on the western slopes of Mount Batilamu, Mount Koroyanitu range, Viti Levu, Fiji. Trees with a dbh ≥10 cm were identified and measured in 21 10 × 10-m plots, starting at 750 m altitude. Temperature and relative humidity sensors were deployed in two habitats, leaf litter and 50 cm above the ground, and two vegetation types, grasslands and forest, at six altitudes over a 48-h period. Two significantly distinct forest types, lowland and montane, were present. Montane forest was found at higher elevations (>950 m asl) and had significantly higher stem density. Mean temperature decreased significantly with altitude and was strongly moderated by vegetation type (lower average and less variation in forest). While average relative humidity significantly increased with altitude, it was strongly moderated by both habitat and vegetation type (higher average and less variation in leaf litter and forest). The lapse rate varied with time of day (higher during the day) and vegetation type (higher in grasslands). Therefore, vegetation and microhabitats create unique microclimates, and this should be considered when investigating current or future climatic patterns along altitudinal gradients on forested mountains.
Raman scattered O VI features at 6825 Å and 7082 Å found in symbiotic stars are important spectroscopic tools to probe the mass transfer process. Adopting a Monte Carlo approach, we perform a profile analysis of Raman O VI features of the yellow SySt AG Draconis and make a comparison with the spectrum obtained with CFHT. It is assumed that the accretion flow is convergent on the entering side with enhanced O VI emission and the flux ratio F(1032)/F(1038)∼1, whereas on the opposite side the flow is divergent with low O VI emission and F(1032/F(1038)∼2. Our best fit to the spectrum is obtained from our model with a mass-loss rate of the giant ∼4 × 10−7 M⊙ yr−1. A slight red wing excess in the spectrum suggests the presence of bipolar neutral components receding in the directions perpendicular to the binary orbital plane with a speed ∼70km s−1