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To investigate the effect of maternal hepatitis B surface antigen (HBsAg) carrier status during pregnancy on pregnancy outcomes in a population of patients in Hangzhou, China. A retrospective cohort study was conducted to analyse data from 20 753 pregnant women who delivered at Hangzhou Women's Hospital between January 2015 and March 2020. Of these, 18 693 were normal pregnant women (the non-exposed group) and 735 were HBsAg carriers (the exposed group). We then analysed by binary multivariate logistic regression to determine the association between maternal HBsAg-positive and adverse pregnancy outcomes. The prevalence of HBsAg carriers was 3.78% and the odds ratio (OR) for maternal age in the exposed group was 1.081. Pregnant women who are HBsAg-positive in Hangzhou, China, are at higher risk of a range of adverse pregnancy outcomes, including intrahepatic cholestasis of pregnancy (ICP) (adjusted OR (aOR) 3.169), low birth weight (aOR 2.337), thrombocytopenia (aOR 2.226), fallopian cysts (aOR 1.610), caesarean scar pregnancy (aOR 1.283), foetal distress (aOR 1.414). Therefore, the obstetricians should pay particular attention to ICP, low birth weight, thrombocytopenia, fallopian cysts, caesarean scar, foetal distress in HBsAg-positive pregnant women.
Increasing evidence supports sarcopenia as an important parameter for predicting cardiometabolic risks. The objective of this study was to investigate the relationship between muscle mass, muscle strength, and physical performance, and cardiovascular risk among older community-dwelling adults.
The associations between dynapenia, sarcopenia, and Framingham risk score (FRS) were estimated by multivariate regression models.
Muscle mass is estimated by skeletal muscle mass index using a bioelectrical impedance analysis. Muscle strength is measured by handgrip strength using an analogue isometric dynamometer. Physical performance is measured by gait speed using a 6-m walking distance. Dynapenia was defined as low muscle strength and/or slow gait speed presents with normal muscle mass. The diagnosis of presarcopenia and sarcopenia was based on criteria proposed by the Asian Working Group for Sarcopenia in 2014. The FRS was used for evaluating 10-year coronary heart disease (CHD) risk.
Adults aged 65 years and older who attended health examinations from 2015 to 2017 were recruited.
There were totally 709 subjects enrolled in this study. Dynapenic men (n 47) had 17·70 ± 5·08 % FRS and sarcopenic women (n 74) had 7·74 ± 6·06 % FRS. Participants with presarcopenia had the lowest FRS (men: 15·41 ± 5·35 %; women: 5·25 ± 3·70 %). Men with dynapenia had higher FRS than the presarcopenia group with odds ratio (OR) of 2·52 (95 % confidence interval (CI): 1·03, 6·14). Women with sarcopenia had significantly higher FRS than the presarcopenia group with OR of 2·81 (95 % CI: 1·09, 7·27).
Older dynapenic men and older sarcopenic women had higher risks of 10-year CHD. Presarcopenic older adults had the lowest CHD risk in both genders.
Contrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention.
360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years.
Compared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year.
Specialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study.
There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America.
Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors.
A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v. 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively.
The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.
Laser–plasma accelerators (LPAs) have great potential to realize a compact X-ray free-electron laser (FEL), which is limited by the beam properties currently. Two-color high-intensity X-ray FEL provides a powerful tool for probing ultrafast dynamic systems. In this paper, we present a simple and feasible method to generate a two-color X-ray FEL pulse based on an LPA beam. In this scheme, time-dependent mismatch along the bunch is generated and manipulated by the designed lattice system, enabling FEL lasing at different wavelength within two undulator sections. The time separation between the two pulses can be precisely adjusted by varying the time-delay chicane. Numerical simulations show that two-color soft X-ray FELs with gigawatt-level peak power and femtosecond duration can be generated, which confirm the validity and feasibility of the scheme.
Schistosomiasis has been subjected to extensive control efforts in the People's Republic of China (China) which aims to eliminate the disease by 2030. We describe baseline results of a longitudinal cohort study undertaken in the Dongting and Poyang lakes areas of central China designed to determine the prevalence of Schistosoma japonicum in humans, animals (goats and bovines) and Oncomelania snails utilizing molecular diagnostics procedures. Data from the Chinese National Schistosomiasis Control Programme (CNSCP) were compared with the molecular results obtained.
Sixteen villages from Hunan and Jiangxi provinces were surveyed; animals were only found in Hunan. The prevalence of schistosomiasis in humans was 1.8% in Jiangxi and 8.0% in Hunan determined by real-time polymerase chain reaction (PCR), while 18.3% of animals were positive by digital droplet PCR. The CNSCP data indicated that all villages harboured S. japonicum-infected individuals, detected serologically by indirect haemagglutination assay (IHA), but very few, if any, of these were subsequently positive by Kato-Katz (KK).
Based on the outcome of the IHA and KK results, the CNSCP incorporates targeted human praziquantel chemotherapy but this approach can miss some infections as evidenced by the results reported here. Sensitive molecular diagnostics can play a key role in the elimination of schistosomiasis in China and inform control measures allowing for a more systematic approach to treatment.
This paper is part of a program to understand the parameter spaces of dynamical systems generated by meromorphic functions with finitely many singular values. We give a full description of the parameter space for a specific family based on the exponential function that has precisely two finite asymptotic values and one attracting fixed point. It represents a step beyond the previous work by Goldberg and Keen [The mapping class group of a generic quadratic rational map and automorphisms of the 2-shift. Invent. Math.101(2) (1990), 335–372] on degree two rational functions with analogous constraints: two critical values and an attracting fixed point. What is interesting and promising for pushing the general program even further is that, despite the presence of the essential singularity, our new functions exhibit a dynamic structure as similar as one could hope to the rational case, and that the philosophy of the techniques used in the rational case could be adapted.
General nonlinear equations describing reversed shear Alfvén eigenmode (RSAE) self-modulation via zero-frequency zonal structure (ZFZS) generation are derived using nonlinear gyrokinetic theory, which are then applied to study the spontaneous ZFZS excitation as well as RSAE nonlinear saturation. It is found that both electrostatic zonal flow and electromagnetic zonal current can be preferentially excited by finite-amplitude RSAE, depending on specific plasma parameters. The modification to local shear Alfvén wave continuum is evaluated using the derived saturation level of zonal current, which is shown to play a comparable role in saturating RSAE with the ZFZS scattering.
The Jueluotage area, which is located in the southern branch of the Eastern Tianshan and northeast of the Tarim Basin, represents a vital locality for investigating intracontinental reactivation induced by the tectonic events at the Eurasian plate margin. This study applies zircon and apatite (U–Th)/He and apatite fission-track thermochronology to the Jueluotage area in the Eastern Tianshan. Our data and thermal history modelling show that the Jueluotage area experienced Triassic–Early Jurassic (˜240–180 Ma) cooling, reflecting the closure of the North Tianshan Ocean and subsequent far-field effects of collision/accretion of the Qiangtang Block and Kunlun terrane. Following this period of fast cooling, a differential exhumation process occurred between the various tectonic belts in the Jueluotage area. The Aqishan–Yamansu belt was exposed at the surface during the Triassic–Early Jurassic cooling phase and experienced subsequent burial, which continued until Early Cretaceous time when a pulse of exhumation occurred. However, the major fault zones (Kanggurtag ductile shear zone and Aqikkuduk Fault) and Central Tianshan arc have remained tectonically stable since Early Jurassic time. No Cenozoic rapid cooling was recorded by the low-temperature thermochronology results in this study, indicating that much of the Jueluotage area was exhumed to the upper crust in the late Mesozoic period.
This study was designed to investigate the effects of dietary starch structure on muscle protein synthesis and gastrointestinal amino acid (AA) transport and metabolism of goats. Twenty-seven Xiangdong black female goats (average body weight = 9·00 ± 1·12 kg) were randomly assigned to three treatments, i.e., fed a T1 (normal maize 100 %, high amylose maize 0 %), T2 (normal maize 50 %, high amylose maize 50 %) and T3 (normal maize 0 %, high amylose maize 100 %) diet for 35 d. All AA in the ileal mucosa were decreased linearly as amylose:amylopectin increased in diets (P < 0·05). The plasma valine (linear, P = 0·03), leucine (linear, P = 0·04) and total AA content (linear, P = 0·03) increased linearly with the increase in the ratio of amylose in the diet. The relative mRNA levels of solute carrier family 38 member 1 (linear, P = 0·01), solute carrier family 3 member 2 (linear, P = 0·02) and solute carrier family 38 member 9 (linear, P = 0·02) in the ileum increased linearly with the increase in the ratio of amylose in the diet. With the increase in the ratio of amylose:amylopectin in the diet, the mRNA levels of acetyl-CoA dehydrogenase B (linear, P = 0·04), branched-chain amino acid transferase 1 (linear, P = 0·02) and branched-chain α-keto acid dehydrogenase complex B (linear, P = 0·01) in the ileum decreased linearly. Our results revealed that the protein abundances of phosphorylated mammalian target of rapamycin (p-mTOR) (P < 0·001), phosphorylated 4E-binding protein 1 (P < 0·001) and phosphorylated ribosomal protein S6 kinases 1 (P < 0·001) of T2 and T3 were significantly higher than that of T1. In general, a diet with a high amylose ratio could reduce the consumption of AA in the intestine, allowing more AA to enter the blood to maintain higher muscle protein synthesis through the mTOR pathway.
In nature, competing species often achieve coexistence through niche differentiation. We examined this phenomenon for Pachycrepoideus vindemmiae and Spalangia endius (Hymenoptera: Pteromalidae), two species of pupal parasitoids that are considered biological control agents of house fly, Musca domestica (Diptera: Muscidae). We examined the ability of each species, alone and in combination, to locate host pupae buried at different depths (0, 1, 2, 4, and 6 cm) in three types of substrate (sand, dry wheat bran, and spent fly diet). We then evaluated the competitiveness of each species by allowing first one species, then the other species, to parasitise host individuals within time periods ranging from less than 2 hours to 96 hours of each other. Spalangia endius exhibited greater ability than did P. vindemmiae to locate host pupae buried at depths below one centimetre. Conversely, P. vindemmiae exhibited a greater competitive ability, being more likely to emerge from pupae co-parasitised by S. endius, regardless of oviposition interval or sequence. Our findings suggest that these two parasitoid species coexist through niche differentiation. Our findings also indicate that to increase the effectiveness of biological control, the environmental conditions and risk of interspecific competition should be considered when selecting parasitoid species for release.
The development of high-yielding, short-duration super-rice hybrids is important for ensuring food security in China where multiple cropping is widely practiced and large-scale farming has gradually emerged. In this study, field experiments were conducted over 3 years to identify the yield formation characteristics in the shorter-duration (∼120 days) super-rice hybrid ‘Guiliangyou 2’ (G2) by comparing it with the longer-duration (∼130 days) super-rice hybrid ‘Y-liangyou 1’ (Y1). The results showed that G2 had a shorter pre-heading growth duration and consequently a shorter total growth duration compared to Y1. Compared to Y1, G2 had lower total biomass production that resulted from lower daily solar radiation, apparent radiation use efficiency (RUE), crop growth rate (CGR), and biomass production during the pre-heading period, but the grain yield was not significantly lower than that of Y1 because it was compensated for by the higher harvest index that resulted from slower leaf senescence (i.e., slower decline in leaf area index during the post-heading period) and higher RUE, CGR, and biomass production during the post-heading period. Our findings suggest that it is feasible to reduce the dependence of yield formation on growth duration to a certain extent in rice by increasing the use efficiency of solar radiation through crop improvement and also highlight the need for a greater fundamental understanding of the physiological processes involved in the higher use efficiency of solar radiation in super-rice hybrids.
X-ray powder diffraction data, unit-cell parameters, and space group for N,N-dimethyl-1H-benzo[d]imidazol-2-amine, C9H11N3, are reported [a = 11.379(3) Å, b = 10.227(5) Å, c = 7.151(1) Å, α = 90°, β = 90°, γ = 90°, unit-cell volume V = 832.318 Å3, Z = 4, ρcal = 1.286 g cm−3, and space group P21212]. All measured lines were indexed and were consistent with the P21212 space group. No detectable impurities were observed.
The most important issue for the clinical application of sarcopenic obesity (SO) is the lack of a consensus definition. The aim of the present study was to determine the best measurement for SO by estimating the association between various definitions and the risk of falls and metabolic syndrome (MS). We studied a community of 765 adults aged 65 years and older in 2015–2017. Sarcopenia obesity was measured by sarcopenia (defined by low muscle mass with either low handgrip strength or low gait speed or both) plus obesity (defined by waist circumference, body fat percentage and BMI). The MS was defined according to the National Cholesterol Education Program ATP III. Logistic regression models were constructed to examine the relationships between sarcopenia obesity and risk of fall and MS. In the analysis of the fall risk with SO defined by waist circumference, the participants with non-sarcopenia/non-obesity were treated as the reference group. The OR to fall in participants with SO was 10·16 (95 % CI 2·71, 38·13) after adjusting for confounding covariates. In the analysis of the risk of the MS between participants with individual components of sarcopenia coupled with obesity defined by waist circumference, the risk was statistically significant for low gait speed (OR: 7·19; 95 % CI 3·61, 14·30) and low grip strength (OR: 9·19; 95 % CI 5·00, 16·91). A combination of low grip strength and abdominal obesity for identifying SO may be a more precise and practical method for predicting target populations with unfavourable health risks, such as falls risk and MS.
Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, accounting for the time course of illness using generalised multivariate logistic regression. Significant symptoms included abdominal pain, cough, diarrhoea, fever, headache, muscle ache, runny nose, sore throat, temperature between 37.5 and 37.9 °C and temperature above 38 °C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity at 0.67. To further evaluate accuracy of model predictions, leave-one-out cross-validation confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity decreased to 0.56. External validation datasets reported similar result. Our study provides a tool to discern COVID-19 patients from controls using symptoms and day from illness onset with good predictive performance. It could be considered as a framework to complement laboratory testing in order to differentiate COVID-19 from other patients presenting with acute symptoms in outpatient care.
Inflammation might play a role in bipolar disorder (BD), but it remains unclear the relationship between inflammation and brain structural and functional abnormalities in patients with BD. In this study, we focused on the alterations of functional connectivity (FC), peripheral pro-inflammatory cytokines and their correlations to investigate the role of inflammation in FC in BD depression.
In this study, 42 unmedicated patients with BD II depression and 62 healthy controls (HCs) were enrolled. Resting-state-functional magnetic resonance imaging was performed in all participants and independent component analysis was used. Serum levels of Interleukin-6 (IL-6) and Interleukin-8 (IL-8) were measured in all participants. Correlation between FC values and IL-6 and IL-8 levels in BD was calculated.
Compared with the HCs, BD II patients showed decreased FC in the left orbitofrontal cortex (OFC) implicating the limbic network and the right precentral gyrus implicating the somatomotor network. BD II showed increased IL-6 (p = 0.039), IL-8 (p = 0.002) levels. Moreover, abnormal FC in the right precentral gyrus were inversely correlated with the IL-8 (r = −0.458, p = 0.004) levels in BD II. No significant correlation was found between FC in the left OFC and cytokines levels.
Our findings that serum IL-8 levels are associated with impaired FC in the right precentral gyrus in BD II patients suggest that inflammation might play a crucial role in brain functional abnormalities in BD.