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We assessed longitudinal association between calcium intake during adolescence and hypertension in adulthood.
Methods and Results:
Longitudinal study data of 1611 participants from the China Health and Nutrition Survey during 1991-2011 were used. On average they were followed for 11.4 years. Dietary calcium intake during adolescence was assessed based on three 24-hour dietary recalls collected in each visit/survey between 1991 and 2009 (seven waves). The intake was recoded into quartiles. Cumulative mean±SD calcium intake was 199.9±144.8 mg/1000 kcal/day during adolescence. In total 102 participants had hypertension in adulthood (97 men and 5 women). There was a clear U-shaped association between adolescence calcium intake quartiles and adulthood hypertension: across the quartiles, hypertension prevalence was 6.7%, 4.0%, 5.2% and 9.5%, respectively. After adjustment for potential confounders including weight status and dietary pattern, odds ratios (OR, 95%CI) for hypertension were 2.32 (95%CI 1.07-5.00) for lowest quartile, 1.00 (reference), 1.34 (95%CI 0.61-2.97), and 3.10 (95%CI 1.49-6.46) across the quartiles.
Lower or higher calcium intake during adolescence was associated with hypertension in adulthood independent of weight status and dietary pattern.
The late Palaeozoic Yong’an–Meizhou depression belt is an important iron (Fe) and polymetallic metallogenic belt in southern China. It has undergone a transformation from Tethys to the circum-Pacific tectonic domain. The Luoyang deposit is one of the typical Fe skarn deposits in the Yong’an–Meizhou depression belt of eastern China. Garnet is a characteristic mineral in the deposit. Two generations of garnets are detected in the deposit based on their textural characteristics and trace-element contents, and are represented by Fe-enriched andradite. The first generation of garnets (Grt1) have two types of garnets (Grt1-A and Grt1-B). Type A garnets of the first generation (Grt1-A) (Adr80-88) replaced by massive diopside-magnetite assemblage exhibit distinct oscillatory zonings and display patterns of enriched light rare earth elements (LREE) to weak heavy rare earth elements (HREE), with weak negative to positive Eu anomalies, and highest U, ΣREE and Sn contents. Type B garnets of the first generation (Grt1-B) are irregular zones (Adr94-96) coexisting with magnetite, in which Grt1-A is generally dissolved, and have obviously LREE-enriched and HREE-depleted patterns, with weak negative to positive Eu anomalies, and moderate U, ΣREE and Zn contents. Garnets of the second generation (Grt2) (Adr96-99) that replaced massive magnetite together with sphalerite show unzoned patterns, with a flat REE pattern and pronounced negative Eu anomalies as well as contents of lowest U and ΣREE, and highest W. The substitution of REEs in garnets occurs as [X2+]VIII –1[REE3+]VIII +1[Si4+]IV –1[Z3+]IV +1in an Al-enriched environment. Luoyang hydrothermal fluids shifted from reducing conditions with relatively high-U and -ΣREE characteristics to oxidizing conditions with relatively low-U and -ΣREE characteristics. The reduced siderophile elements and increased fO2 in fluid during Grt1-B formation caused magnetite mineralization and reduced Zn contents during Grt2 formation, causing the deposition of sphalerite. All garnets formed from magmatic fluid and were controlled by infiltrative metasomatism in an opened system.
The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (Pinteraction = 0·017 for NASH and Pinteraction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.
Schizophrenia has been primarily conceptualized as a disorder of high-order cognitive functions with deficits in executive brain regions. Yet due to the increasing reports of early sensory processing deficit, recent models focus more on the developmental effects of impaired sensory process on high-order functions. The present study examined whether this pathological interaction relates to an overarching system-level imbalance, specifically a disruption in macroscale hierarchy affecting integration and segregation of unimodal and transmodal networks.
We applied a novel combination of connectome gradient and stepwise connectivity analysis to resting-state fMRI to characterize the sensorimotor-to-transmodal cortical hierarchy organization (96 patients v. 122 controls).
We demonstrated compression of the cortical hierarchy organization in schizophrenia, with a prominent compression from the sensorimotor region and a less prominent compression from the frontal−parietal region, resulting in a diminished separation between sensory and fronto-parietal cognitive systems. Further analyses suggested reduced differentiation related to atypical functional connectome transition from unimodal to transmodal brain areas. Specifically, we found hypo-connectivity within unimodal regions and hyper-connectivity between unimodal regions and fronto-parietal and ventral attention regions along the classical sensation-to-cognition continuum (voxel-level corrected, p < 0.05).
The compression of cortical hierarchy organization represents a novel and integrative system-level substrate underlying the pathological interaction of early sensory and cognitive function in schizophrenia. This abnormal cortical hierarchy organization suggests cascading impairments from the disruption of the somatosensory−motor system and inefficient integration of bottom-up sensory information with attentional demands and executive control processes partially account for high-level cognitive deficits characteristic of schizophrenia.
The association between blood transfusion and ventilator-associated events (VAEs) has not been fully understood. We sought to determine whether blood transfusion increases the risk of a VAE.
Nested case-control study.
This study was based on a registry of healthcare-associated infections in intensive care units at West China Hospital system.
1,657 VAE cases and 3,293 matched controls were identified.
For each case, 2 controls were randomly selected using incidence density sampling. We defined blood transfusion as a time-dependent variable, and we used weighted Cox models to calculate hazard ratios (HRs) for all 3 tiers of VAEs.
Blood transfusion was associated with increased risk of ventilator-associated complication-plus (VAC-plus; HR, 1.47; 95% CI, 1.22–1.77; P <.001), VAC-only (HR, 1.29; 95% CI, 1.01–1.65; P = .038), infection-related VAC-plus (IVAC-plus; HR, 1.78; 95% CI, 1.33–2.39; P < .001), and possible ventilator-associated pneumonia (PVAP; HR, 2.10; 95% CI, 1.10–3.99; P = .024). Red blood cell (RBC) transfusion was also associated with increased risk of VAC-plus (HR, 1.34; 95% CI, 1.08–1.65; P = .007), IVAC-plus (HR, 1.70; 95% CI, 1.22–2.36; P = .002), and PVAP (HR, 2.49; 95% CI, 1.17–5.28; P = .018). Compared to patients without transfusion, the risk of VAE was significantly higher in patients with RBC transfusions of >3 units (HR, 1.73; 95% CI, 1.25–2.40; P = .001) but not in those with RBC transfusions of 0–3 units.
Blood transfusions were associated with increased risk of all tiers of VAE. The risk was significantly higher among patients who were transfused with >3 units of RBCs.
To unveil the adaptation of Litopenaeus vannamei to elevated ambient ammonia-N, crustacean hyperglycaemic hormone (CHH) was knocked down to investigate its function in glucose metabolism pathway under ammonia-N exposure. When CHH was silenced, haemolymph glucose increased significantly during 3–6 h, decreased significantly during 12–48 h and recovered to the control groups’ level at 72 h. After CHH knock-down, dopamine (DA) contents reduced significantly during 3–24 h, which recovered after 48 h. Besides, the expressions of guanylyl cyclase (GC) and DA1R in the hepatopancreas decreased significantly, while DA4R increased significantly. Correspondingly, the contents of cyclic AMP (cAMP), cyclic GMP (cGMP) and diacylglycerol (DAG) and the expressions of protein kinase A (PKA), protein kinase G (PKG), AMP active protein kinase α (AMPKα) and AMPKγ were significantly down-regulated, while the levels of protein kinase C (PKC) and AMPKβ were significantly up-regulated. The expressions of cyclic AMP response element-binding protein (CREB) and GLUT2 decreased significantly, while GLUT1 increased significantly. Moreover, glycogen content, glycogen synthase and glycogen phosphorylase activities in hepatopancreas and muscle were significantly increased. Furthermore, the levels of key enzymes hexokinase, pyruvate kinase and phosphofructokinase in glycolysis (GLY), rate-limiting enzymes citrate synthase in tricarboxylic acid and critical enzymes phosphoenolpyruvate carboxykinase, fructose diphosphate and glucose-6-phosphatase in gluconeogenesis (GNG) were significantly decreased in hepatopancreas. These results suggest that CHH affects DA and then they affect their receptors to transmit glucose metabolism signals into the hepatopancreas of L. vannamei under ammonia-N stress. CHH acts on the cGMP-PKG-AMPKα-CREB pathway through GC, and CHH affects DA to influence cAMP-PKA-AMPKγ-CREB and DAG-PKC-AMPKβ-CREB pathways, thereby regulating GLUT, inhibiting glycogen metabolism and promoting GLY and GNG. This study contributes to further understand glucose metabolism mechanism of crustacean in response to environmental stress.
The North Qilian Orogenic Belt is surrounded by the Tarim Craton to the NW and the North China Craton to the NE. The Precambrian continental crust remnants that are distributed in the North Qilian Orogenic Belt are termed the North Qilian Block (NQB), and their tectonic evolution has profound implications for the evolution of the Columbia Supercontinent. Here we present major- and trace-element and Sr–Nd–Hf isotope data for (meta-) basalts from the Beidahe Group (BDHG) and Zhulongguan Group (ZLGG) in the western North Qilian Orogenic Belt, to investigate the tectonic evolution of the NQB during the Proterozoic Eon. The protoliths of Palaeoproterozoic amphibole gneisses and plagioclase amphibolites from the BDHG are calc-alkaline series basalts. These metabasalts show island-arc-basalt affinities with variable Nd and Hf isotopes (ϵNd(t) = −5.0–0.6 and 2.7–4.3; ϵHf(t) = −14.2–2.0 and 6.9–8.8) and were generated by partial melting of the asthenospheric mantle that was metasomatized by aqueous fluid and sediment melt in a continental-arc setting. The early Mesoproterozoic ZLGG basalts show features of shoshonite-series basalts and are geochemically similar to ocean-island basalts. These basalts show variable (87Sr/86Sr)i, ϵNd(t) and ϵHf(t) values of 0.70464–0.70699, −1–2.6 and −1.5–5.7, and are products of mantle plume magmatism that participated with subducted oceanic crust in an intracontinental rift setting. This study suggests that the NQB underwent tectonic evolution from palaeo-oceanic subduction to intracontinental rifting during the Palaeoproterozoic–Mesoproterozoic eras. Furthermore, the above tectonomagmatic events were in response to convergence–splitting events of the Columbia Supercontinent during the Palaeoproterozoic–Mesoproterozoic eras.
With the characteristics of full autonomy and no accumulated errors, polarisation navigation shows tremendous prospects in underwater scenarios. In this paper, inspired by the polarisation vision of aquatic organisms, a novel point-source polarisation sensor with high spectral adaptability (400 nm–760 nm) is designed for underwater orientation. To enhance the environmental applicability of the underwater polarisation sensor, a novel sensor model based on the underwater light intensity attenuation coefficient and optical coupling coefficient is established. In addition, concerned with the influence of light intensity uncertainty on sensor performance underwater, an antagonistic polarisation algorithm is adopted for the first time, to improve the accuracy of angle of polarisation and degree of polarisation in the low signal-to-noise ratio environment underwater. Finally, indoor and outdoor experiments are carried out to evaluate the performance of the designed polarisation sensor. The results show that the designed point-source polarisation sensor can acquire polarised light and be used for heading determination underwater.
The study aimed to investigate behavioural intentions to receive free and self-paid COVID-19 vaccinations (BICV-F and BICV-SP) among Chinese university students if the vaccine was 80% effective with rare mild side effects, to examine their associations with social media exposures and peer discussions regarding COVID-19 vaccination, and to explore the mediational role of perceived information sufficiency about COVID-19 vaccination. An online anonymous survey (N = 6922) was conducted in November 2020 in five Chinese provinces. Logistic regression and path analysis were adopted. The prevalence of BICV-F and BICV-SP were 78.1% and 57.7%. BICV-F was positively associated with the frequencies of passive social media exposure (adjusted odds ratio (AOR) = 1.32, P < 0.001), active social media interaction (AOR = 1.13, P < 0.001) and peer discussions (AOR = 1.17, P < 0.001). Indirect effects of the three factors on BICV-F via perceived information sufficiency were all significant (P < 0.001). The direct effect of active social media interaction on BICV-F was significantly negative (P < 0.001). Similar associations/mediations were observed for BICV-SP. The COVID-19 vaccination intention of Chinese university students needs improvement. Boosting social media exposures and peer discussions may raise students' perceived information sufficiency and subsequently increase their vaccination intention. Considering the potential negative effect of active social media interaction, caution is needed when using social media to promote COVID-19 vaccination.
To assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and related parameters to the severity of coronavirus disease 2019 (COVID-19) symptoms. Clinical data from 38 COVID-19 patients who were diagnosed, treated and discharged from the Qishan Hospital in Yantai over the period from January to February 2020 were analysed. NLR and procalcitonin (PCT) were determined in the first and fourth weeks after their admission, along with the clinical characteristics and laboratory test results of these patients. Based on results as obtained on the first and fourth weeks after admission, five indices consisting of NLR, white blood cells, neutrophils, lymphocytes (LY) and monocytes (MON) were selected to generate receiver operating characteristic curves, while optimal cutoff values, sensitivities and specificities were obtained according to the Yuden index. Statistically significant differences in neutrophils, LY and the NLR were present in the severe vs. moderate COVID-19 group from the first to the fourth week of their hospitalisation. The cut-off value of NLR for predicting the severity of COVID-19 was 4.425, with a sensitivity of 0.855 and a specificity of 0.979. A statistically significant positive correlation was present between PCT and NLR in the severe group as determined within the first week of admission. NLR can serve as a predictor of COVID-19 disease severity as patients' progress from the first to the fourth week of their hospitalisation. The statistically significant positive correlation between levels of NLR and PCT in severe patients indicated that increases in NLR were accompanied with gradual increases in PCT.
This study compared dementia knowledge between older Chinese adults in Melbourne, Australia, and Beijing, China, and explored factors associated with dementia knowledge between these two groups. Ultimately, this study aimed to inform the development of tailored dementia education programs for older Chinese adults.
A cross-sectional design was employed in this study.
Participants were recruited from 5 Chinese community senior groups in Melbourne and 10 community health centers in Beijing from March to May 2019.
A total of 379 older Chinese adults aged 50 and over completed the questionnaire, including 153 from Melbourne and 226 from Beijing.
Dementia knowledge was assessed using the Alzheimer’s Disease Knowledge Scale (ADKS). Demographic characteristics, dementia-related experience, and the mental health status of participants were collected. Stepwise linear regression was used to analyze the factors associated with dementia knowledge.
In general, older Chinese adults in Melbourne and Beijing reported similar levels of dementia knowledge for both the overall ADKS scale (mean ± SD: 17.2 ± 2.9 in Melbourne vs. 17.5 ± 2.9 in Beijing, p > 0.05) and the seven subdomains. Of the subdomains, the highest correct response rates were observed in the life impact of the dementia subdomain, and the lowest rates were observed in the caregiving subdomain. Stepwise linear regression analysis revealed that younger age and self-reported dementia worry were significantly associated with higher levels of dementia knowledge in the Melbourne group, whereas a positive family history of dementia was significantly associated with higher levels of dementia knowledge in the Beijing group.
Older Chinese adults living in Melbourne and Beijing share similar levels of dementia knowledge, but factors associated with their knowledge are different. These findings will inform the development of culturally and socially appropriate dementia education programs for older Chinese populations in different countries.
The architectural connections between western Central Asia and China are not well understood. Recent investigations at the Haermodun site in central Xinjiang reveals new evidence of the influence of western Central Asia on the construction of fortifications in China during the early first millennium AD.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
The study was conducted using data from 5 adult ICUs of a referral hospital.
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
Based on a cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we aimed to evaluate the relationship between sleep duration and the incidence of cognitive impairment among older Chinese adults.
We conducted a prospective analysis based on 3692 participants from the CLHLS at baseline (in 2011), and as a 3-year follow-up (till 2014), 531 participants (14.4%) had cognitive impairment, which was defined as a Mini-Mental State Examination score <24. Sleep duration was classified into three groups: short (≤5 hours/day), normal (>5 but <10 hours), and long (≥10 hours/day). A logistic regression model was used to examine the association between baseline sleep duration and cognitive impairment after adjusting for sociodemographic data, living habits, and health conditions.
Five hundred sixty-two participants (15.2%) were in the short-duration group, and 608 participants (16.5%) were in the long-duration group. After adjusting for multiple potential confounders, compared with normal sleep duration, long sleep duration was associated with the incidence of cognitive impairment (OR = 1.309, 95% CI: 1.019–1.683), especially among men (OR = 1.527, 95% CI: 1.041–2.240) and those having a primary and above education level (OR = 1.559, 95% CI: 1.029–2.361). No significant association was observed between short sleep duration and cognitive impairment (OR = 0.860, 95% CI: 0.646–1.145).
Excessive sleep may increase the risk of cognitive impairment in older individuals. It may be a suggestive sign of early neurodegeneration and may be a useful clinical tool to identify those at a higher risk of progressing to cognitive impairment.
The TanDEM-X DEM is a valuable data source for estimating glacier mass balance. However, the accuracy of TanDEM-X elevation over glaciers can be affected by microwave penetration and phase decorrelation. To investigate the bias of TanDEM-X DEMs of glaciers on the Tibetan Plateau, these DEMs were subtracted from SPOT-6 DEMs obtained around the same time at two study sites. The average bias over the studied glacier areas in West Kunlun (175.0 km2) was 2.106 ± 0.012 m in April 2014, and it was 1.523 ± 0.011 m in Geladandong (228.8 km2) in October 2013. By combining backscatter coefficients and interferometric coherence maps, we found surface decorrelation and baseline decorrelation can cause obvious bias in addition to microwave penetration. If the optical/laser data and winter TanDEM-X data were used as new and historic elevation sources for mass-balance measurements over an arbitrary observation period of 10 years, the glacier mass loss rates in West Kunlun and Geladandong would be potentially underestimated by 0.218 ± 0.016 and 0.158 ± 0.011 m w.e. a−1, respectively. The impact is therefore significant, and users should carefully treat the bias of TanDEM-X DEMs when retrieving a geodetic glacier mass balance.
Fossil charcoals from archaeological sites provide direct evidence for the relationship between environmental change and ancient peoples’ livelihoods in the past. Our identification of 5811 fossil charcoal fragments from 84 samples suggested temperate deciduous and mixed conifer-broadleaved forests as the dominant vegetation at the Erdaojingzi site in northeastern China ca. 3500 cal yr BP; the major representative taxa were Quercus, Pinus, and Ulmus. Four woody plants probably supplied humans with food resources at the Erdaojingzi site, including Quercus, Ulmus, Amygdalus/Armeniaca, and Ziziphus. The nuts of Quercus were utilized as staple foods because of their rich starch content. The leaves of Ulmus may have been used by humans because of their massive dietary fibre. Amygdalus/Armeniaca and Ziziphus probably provided fruits for humans. Based on the coexistence approach (CA) used on the fossil charcoals, we found that the MAT anomaly was 7.9 ± 5.9°C at ca. 3500 cal yr BP, which is almost the same as the modern one (7.8°C), while the MAP was halved from 772 ± 301 mm at ca. 3500 cal yr BP to 370 mm currently. The wet climate might have facilitated significant development of rain-fed agriculture, promoted the emergence of large settlements, and eventually facilitated the birth of civilization.