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To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.
We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents’ functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents’ cognitive status independently.
The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.
A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.
This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system.
Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system.
The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control.
There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05).
Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.
In this contribution, we devoted ourselves to fabricating aggregation-induced emission (AIE) activity copolymers via one-pot combination of RAFT polymerization and Biginelli reaction for the first time. When the feeding ratio of TPB was 33.5%, the molar fraction of TPB was, respectively, about 14.2 and 22.5% in PEG-PTE1 copolymers by two-step strategy and PEG-PTE2 copolymers by one-pot strategy with the similar structure. The Mn of PEG-PTE1 increased to 59,300 from 52,800 of PEG-AE presoma with narrow PDI, which was more than Mn of PEG-PTE2 with 52,300. As compared with PEG-PTE2, when the feeding ratio of TPB was 48.6%, the molar fraction of TPB increased to 32.6% in PEG-PTE3. In aqueous solution, the as-obtained PEG-PTE2 copolymers can self-assemble into fluorescent organic nanoparticles (FONs) with 100–180 nm spherical morphology, the maximal emission peak of which presented at 460 nm with the obvious AIE phenomenon. Moreover, due to the low toxicity and excellent cell dyeing behavior, the as-prepared PEG-PTE2 copolymers displayed great potential for biomedical applications.
In this paper, a novel decoupling technique for closely spaced E-plane patch antennas using defect ground structure (DGS) is proposed. The electric field coupling between the antennas is suppressed by etching DGS which consists of a pair of rectangular slots and four stubs on the ground plane. Moreover, unlike the other methods, the DGS is not etched in the middle of the antennas but loaded along the outer edge of the radiated patch. Thus, through the adopted technology the distance between the antenna elements is reduced and the isolation is increased. To validate the improvements by adopting the proposed technology, the array with DGS loading has been fabricated and then measured. The measurement results show that designed antennas have 95 MHz 10-dB impedance bandwidth, which is 25 MHz higher than that of the antenna without DGS. More importantly, isolation improvements have been increased from 8.5 to 31.3 dB by using the decoupling technique when the antennas are placed with a 0.032 λ0 edge-to-edge distance, where λ0 is the free-space wavelength. Therefore, this technique can be widely applied to improve isolation in a compact and low profile antenna system.
The three-dimensional flow characteristics of the compressible vortex ring generated by under-expanded circular jets with two typical pressure ratios, i.e.
(moderate) and 4.0 (high), are investigated numerically with the use of large-eddy simulations. Our results illustrate that these two pressure ratios correspond to different shock structures (shock cell and Mach disc, respectively) within the jet. These two typical types of flow structures and characteristics are discussed and validated with experiments, and the different generation mechanisms of the secondary vortex rings are compared. Moreover, detailed information about the evolution of the secondary vortex ring, primary vortex ring and turbulence transition features, including the radial and azimuthal modes, is investigated. The geometric features and mixing effects of the jets are also explored.
Compared with traditional START Triage Method, the Sacco Triage Method is a new way to access death risk in disaster scenes. However, due to the difficulties in disaster medical research, there is still no evidence to prove which one is more effective.
To assess and compare the value of START Triage Method and Sacco Triage Method in the death risk assessment of transport and the one-month death risk assessment of the earthquake mass trauma patients.
A retrospective analysis was conducted on 1,612 patients who were transferred to the West China Hospital by assigning to different triage levels by Sacco Triage Method and START Triage Method respectively. Both of the triage methods were evaluated based on death cases on either during transport or in the emergency department, using the area under the receiver-operator curve.
For death during the transport and in the emergency department, the receiver-operator curve of two groups reflected as 0.721 and 0.649. For death in a consequence, the receiver-operator curve of the two groups was revealed as 0.667 and 0.519.
As an accurate triage method, the Sacco Triage Method may be used in a mass casualty incident. It is a more effective way than the START Triage Method for the evaluation of death risk assessment of the mass trauma patients.
Hollow mesoporous polydopamine (HMPDA) microcapsules were prepared by a template method using silica nanoparticles as the templates. The template method was also used for the formation of mesoporous polydopamine (PDA), which is driven by π–π interactions of trimethylbenzene and PDA, in which the PDA wall with mesoporous structure can be obtained after template removal by extraction. Because of its surface mesoporous structure and large central cavity structure, HMPDA microcapsules have unique adsorption properties. Compared with other porous materials, PDA has better biosafety because dopamine itself is a bionic material. The above properties are of great significance for the application of HMPDA microcapsules in the field of biologic medicine, especially in drug carriers.
We demonstrate an all-fiber high-power linearly polarized supercontinuum source with polarization-maintaining photonic crystal fibers (PM-PCFs) as the nonlinear medium. The source exhibits an average output power of 3.8 W with a flat spectrum from 480 nm to 2100 nm at the
10 dB level, except for the residual pump peak. The polarization extinction ratio (PER) is measured to be greater than 20 dB at selected sample wavelength points (532 nm, 1064 nm and 1550 nm) at the highest pump power level and greater than 20 dB at all wavelengths from 800 nm to 1500 nm at the low pump power level. We also experimentally study the spectral properties when the pump light propagates along different axes of the PM-PCF. The results show that propagating parallel to the slow axis enables a broader spectrum in the PM-PCF in this case, probably due to matching of the dispersion properties with the pump light, which is qualitatively in accordance with the numerical simulation. To our best knowledge, this is the first demonstration of a watt-level linearly polarized supercontinuum source generated from PM-PCFs in an all-fiber structure.
Text readability assessment is a challenging interdisciplinary endeavor with rich practical implications. It has long drawn the attention of researchers internationally, and the readability models since developed have been widely applied to various fields. Previous readability models have only made use of linguistic features employed for general text analysis and have not been sufficiently accurate when used to gauge domain-specific texts. In view of this, this study proposes a latent-semantic-analysis (LSA)-constructed hierarchical conceptual space that can be used to train a readability model to accurately assess domain-specific texts. Compared with a baseline reference using a traditional model, the new model improves by 13.88% to achieve 68.98% of accuracy when leveling social science texts, and by 24.61% to achieve 73.96% of accuracy when assessing natural science texts. We then combine the readability features developed for the current study with general linguistic features, and the accuracy of leveling social science texts improves by an even higher degree of 31.58% to achieve 86.68%, and that of natural science texts by 26.56% to achieve 75.91%. These results indicate that the readability features developed in this study can be used both to train a readability model for leveling domain-specific texts and also in combination with the more common linguistic features to enhance the efficacy of the model. Future research can expand the generalizability of the model by assessing texts from different fields and grade levels using the proposed method, thus enhancing the practical applications of this new method.
Toxigenic Clostridium difficile (C. difficile) carriers represent an important source in the transmission of C. difficile infection (CDI) during hospitalisation, but its prevalence and mode in patients with hepatic cirrhosis are not well established. We investigated longitudinal changes in carriage rates and strain types of toxigenic C. difficile from admission to discharge among hepatic cirrhosis patients. Toxigenic C. difficile was detected in 104 (19.8%) of 526 hepatic cirrhosis patients on admission, and the carriage status changed in a portion of patients during hospitalisation. Approximately 56% (58/104) of patients lost the colonisation during their hospital stay. Among the remaining 48 patients who remained positive for toxigenic C. difficile, the numbers of patients who were positive at one, two, three and four isolations were 10 (55.6%), three (16.7%), two (11.1%) and three (16.7%), respectively. Twenty-eight patients retained a particular monophyletic strain at multiple isolations. The genotype most frequently identified was the same as that frequently identified in symptomatic CDI patients. A total of 25% (26/104) of patients were diagnosed with CDI during their hospital stay. Conclusions: Colonisation with toxigenic C. difficile strains occurs frequently in cirrhosis patients and is a risk factor for CDI.
The Steptoean Positive Carbon Isotope Excursion (SPICE) is globally distributed in late Cambrian sedimentary records but controversially heterogeneous in its magnitudes. Here we use multiple geochemical proxies to investigate the late Cambrian carbonates from the Tangwangzhai section in North China, which were deposited in a shallow coastal environment with three depositional sequences (S1–S3). Each sequence comprises a transgressive systems tract (TST) and a highstand systems tract (HST). The REE + Y and trace element records are consistent with the depositional condition and indicate that terrigenous influence was more significant in the TST than HST. δ13Ccarb and δ34SCAS are low in the TST relative to HST, consistent with the scenario that terrigenous inputs were profoundly aggressive to seawater by introducing 13C-depleted and 34S-depleted materials. Within the TST of S2, the SPICE excursion shows a scaled-down δ13Ccarb positive shift (∼1.7 ‰) relative to its general records (∼4–6 ‰); the corresponding δ34SCAS show no positive excursion. This ‘atypical’ SPICE record is attributed to enhanced 13C-depleted and 34S-depleted terrigenous influence during the TST, which would reduce the amplitude of δ13Ccarb excursion, and even obscure δ34SCAS excursion. Meanwhile the subaerial unconformity at the base of TST would also cause a partially missing and a ‘snapshot’ preservation. Our study confirms significant local influence to the SPICE records, and further supports the heterogeneity and low sulphate concentrations of the late Cambrian seawater, because of which the SPICE records may be vulnerable to specific depositional conditions (e.g. sea-level, terrigenous input).
The associations between growth during early life and subsequent cognitive development and physical outcomes are not widely known in low-resource settings. We examined postnatal weight and height gain through early life and related these measurements to the nutritional status and intellectual development of the same children when they were between 7 and 9 years old. Mothers had enrolled in an randomised controlled trial to evaluate the effect of prenatal micronutrient supplementation on birth weight. Their children were born in 2004, their height and weight were measured at 6, 12, 18 and 24 months of age and were followed up between October 2012 and September 2013 (at ages 7–9 years, n 650). Height-for-age, weight-for-age and BMI-for-age were used to describe the nutritional status, and the Wechsler Intelligence Scale for Children fourth edition was used to measure the intellectual function. Multilevel linear and logistic modelling was used to estimate the association between early growth and subsequent growth and intellectual function. After adjustment, weight gain from 6 to 12 months of age was associated with Full-scale Intelligence Quotient, Verbal Comprehension Index, Working Memory Index and Perceptual Reasoning Index. Weight gain during early life was associated with subsequent nutritional status. For every 1 kg increase in weight during the 0- to 6-month period, the OR for underweight, thinness and stunting at 7–9 years of age were 0·19 (95 % CI 0·09, 0·37), 0·34 (95 % CI 0·19, 0·59) and 0·40 (95 % CI 0·19, 0·83), respectively. Weight gain during the periods of 6–12 months of age and 18–24 months of age was also associated with a lower risk of being underweight. Weight gain during early life was associated with better growth outcomes and improved intellectual development in young school-aged children.
We conducted a 9-d seismic experiment in October 2015 at Laohugou Glacier No. 12. We identified microseismic signals using the short-term/long-term average trigger algorithm at four stations and classified them as long and short-duration events based on waveform, frequency, duration and magnitude characteristics. Both categories show systematical diurnal trends. The long-duration events are low-frequency tremor-like events that mainly occurred during the daytime with only several events per day. These events lasted tens of seconds to tens of minutes and are likely related to resonance of daytime meltwater. The dominant short-duration events mostly occurred during the night time with a peak occurrence frequency of ~360 h−1. Their short-duration (<0.2 s), high frequency (20–100 Hz) and dominance of Rayleigh waves are typical of events for near-surface crack opening. A strong negative correlation between the hourly event number and temperature change rate suggests that the occurrence of night-time events is controlled by the rate of night-time cooling. We estimated the near-surface tensile stress due to thermal contraction at night to be tens of kilopascals, which is enough to induce opening of surface cracks with pre-existing local stress concentrations, although we cannot exclude the effect of refreezing of meltwater produced during the day.
There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.
To examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences.
A school-based health survey was conducted in three provinces in China between 2013–2014. A total of 14 820 students aged 10–20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt.
Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85–2.67) for girls and 1.81 (95% CI 1.53–2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5–6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P < 0.05).
ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.
The impact of an ageing workforce on the workplace is a concern internationally. Governments are increasingly encouraging the continued labour market participation of older workers, seeking to remove previous barriers to the extension of working lives and give more choice to workers. Despite these legislative drivers, research has consistently found a lack of systematic approaches by employers to prepare and benefit from these demographic and labour market changes. In this paper, qualitative research is drawn upon to examine how managers and older workers think about age and ageing in the workplace; the support put in place for older workers, as well as future priorities; and the lived experiences of the older workers. It is highlighted that employees’ age and fitness for work is treated on an individual basis, rather than having formal plans to manage the workplace for older workers. This thus indicates a hands-off approach from management.
Globally, the prevalence of childhood obesity has substantially increased at an alarming rate. This study investigated associations between dietary patterns and overweight/obesity in 3- to 6-year-old children. Recruited children were from four prefecture-level cities in Eastern China. Childhood overweight and obesity were defined according to WHO Child Growth Standards. Individual dietary patterns were assessed by a comprehensive self-administered FFQ using thirty-five food items. Using factor analysis two dietary patterns were derived: the traditional Chinese pattern was characterised by high consumption of cereals, vegetables and fresh juices while the modern pattern was characterised by high consumption of Western fast food, Chinese fast food, sweets/sugary foods and carbonated beverages. The associations of dietary patterns with overweight/obesity were evaluated by logistic regression models. Data of 8900 preschool children from thirty-five kindergartens recruited from March to June 2015 were used in the final analysis. Adherence to the modern dietary pattern was positively associated with children's age while adherence to the traditional dietary pattern was positively associated with maternal education; these associations were statistically significant. After adjustment, we found that being in the highest tertile of any identified dietary patterns was not significantly associated with overweight and obesity. Dietary patterns are not associated with overweight/obesity in Chinese preschool children. Prospective studies are needed to establish a causal link between dietary patterns and childhood obesity.
In this work, differential scanning calorimetry (DSC) was used to characterize and analyze the precipitation/dissolution kinetics of second phase particles during the cooling/reheating process in a vanadium microalloyed steel. The results indicated that three obvious exothermic peaks were detected on the cooling DSC curve. Furthermore, three corresponding endothermic peaks were also detected on the heating DSC curve. Combined with thermodynamic calculation and transmission electron microscopy analysis, these three exothermic peaks along cooling DSC curve were defined as the precipitation reaction of V(CN), the reaction of austenite transformation into ferrite and the precipitation reaction of VC, respectively. Meanwhile, three corresponding reverse reactions for cooling were also defined along the reheating DSC curve. The linear regression result revealed that the precipitation activation energies for V(CN) and VC were identified as 311.2 kJ/mol and 167.6 kJ/mol, respectively. The dissolution activation energies for VC and V(CN) were identified as 255.4 kJ/mol and 592.6 kJ/mol, respectively.
The solute equilibrium partition coefficients (ki) of C, Si, Mn, P, and S in high sulfur steel during the solidification process were investigated by the thermodynamic calculation. The effect of MnS precipitation on ki was explored. The results showed that the precipitation of MnS inclusion would influence the concentrations of solutes Mn and S, leading to the changing of ki. Due to the precipitation of MnS, the kC and kS decreased first and then increased with temperature decreasing, while kSi, kMn, and kP changed monotonously. The impacts of solidification temperature on kSi and kMn were greater than that on kC, kS, and kP. With the increase of S content, kC, kSi, and kP increased while kMn and kS decreased. Whereas, an opposite effect was found with the increase of Mn content. The order of influence extent by S and Mn contents was kSi > kS > kMn > kC > kP.