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Hyperhomocysteinaemia (HHcy) is associated with all-cause mortality in some disease states. However, the correlation between HHcy and the risk of mortality in the general population has rarely been researched. We aimed to evaluate the association between HHcy and all-cause and cause-specific mortality among adults in the USA. This study analysed data from the National Health and Nutrition Examination Survey database (1999–2002 survey cycle). A multivariable Cox regression model was built to evaluate the correlation between HHcy and all-cause and cause-specific mortality. Smooth curve fitting was used to analyse their dose-dependent relationship. A total of 8442 adults aged 18–70 years were included in this study. After a median follow-up period of 14·7 years, 1007 (11·9 %) deaths occurred including 197 CVD-related deaths, 255 cancer-related deaths and fifty-eight respiratory disease deaths. The participants with HHcy had a 93 % increased risk of all-cause mortality (hazard ratio (HR) 1·93; 95 % CI (1·48, 2·51)), 160 % increased risk of CVD mortality (HR 2·60; 95 % CI (1·52, 4·45)) and 82 % increased risk of cancer mortality (HR 1·82; 95 % CI (1·03, 3·21)) compared with those without HHcy. For unmeasured confounding, E-value analysis proved to be robust. In conclusion, HHcy was associated with high risk of all-cause and cause-specific (CVD, cancer) mortality among adults aged below 70 years.
A drag correlation is established for laminar particle-laden flows, based on data from the interfaced-resolved direct numerical simulations (IR-DNS) of particle sedimentation in a periodic domain at density ratio ranging from 2 to 1000, particle concentration ranging from 0.59 % to 14.16 %, and particle Reynolds number below 132. Our drag decreases slightly with increasing density ratio when the other parameters are fixed. The drag correlation is then corrected to account for the turbulence effect by introducing the relative turbulent kinetic energy, from the IR-DNS data of the upward turbulent channel flows laden with the particles larger than the Kolmogorov length scale at relatively low particle volume fractions. A drift velocity model is developed to obtain the effective slip velocity from the interphase mean velocity difference for the vertical turbulent channel flow by considering the effects of particle inertia, particle concentration distribution and large-scale streamwise vortices.
Severe fever with thrombocytopenia syndrome (SFTS) virus has caused a large number of human infections since discovered in 2009. This study elucidated epidemiological features and fatal risk factors of SFTS cases accumulated up to ten years in Taizhou, a coastal prefecture of Zhejiang Province in Eastern China. A total of 188 hospitalised SFTS cases (including 40 deaths) reported to Taizhou Center for Disease Control and Prevention (CDC) during 2011–2020 were enrolled in the study. In the past decade, the annual incidence of SFTS increased over the years (P < 0.001) along with an expanding epidemic area, and the case fatality of hospitalised cases has remained high (21.3%). Although most cases occurred in hilly areas, a coastal island had the highest incidence and case fatality. The majority of cases were over the age of 60 years (72.3%), and both incidence and case fatality of SFTS increased with age. Multivariate logistic regression analysis showed that age (OR 7.47, 95% CI 1.32–42.33; P = 0.023), and haemorrhagic manifestations including petechiae (OR 7.76, 95% CI 1.17–51.50; P = 0.034), gingival haemorrhage (OR 5.38, 95% CI 1.25–23.15; P = 0.024) and melena (OR 5.75, 95% CI 1.18–28.07; P = 0.031) were significantly associated with the death of SFTS cases. Five family clusters identified were farmers, among four of which the index patients were female with a history of hypertension. Based on the study, age is a critical risk factor for incidence and case fatality of SFTS. With an increased annual incidence over the last ten years, SFTS remains a public health threat that should not be ignored. Further study is needed to look at the natural foci in the coastal islands.
Low molecular weight glutenin subunits (LWM-GSs) play a crucial role in determining wheat flour processing quality. In this work, 35 novel LMW-GS genes (32 active and three pseudogenes) from three Aegilops umbellulata (2n = 2x = 14, UU) accessions were amplified by allelic-specific PCR. We found that all LMW-GS genes had the same primary structure shared by other known LMW-GSs. Thirty-two active genes encode 31 typical LMW-m-type subunits. The MZ424050 possessed nine cysteine residues with an extra cysteine residue located in the last amino acid residue of the conserved C-terminal III, which could benefit the formation of larger glutenin polymers, and therefore may have positive effects on dough properties. We have found extensive variations which were mainly resulted from single-nucleotide polymorphisms (SNPs) and insertions and deletions (InDels) among the LMW-GS genes in Ae. umbellulata. Our results demonstrated that Ae. umbellulata is an important source of LMW-GS variants and the potential value of the novel LMW-GS alleles for wheat quality improvement.
Lower-crust-derived adakitic rocks in the Gangdese belt provide important constraints on the timing of Tibetan crustal thickening and on the relative contributions of magmatic and tectonic processes. Here we present geochronological and geochemical data for the Wangdui porphyritic monzogranites in the western Gangdese belt. Zircon U–Pb dating yields emplacement ages of 46–44 Ma. All samples have high Sr (321–599 ppm), low Yb (0.76–1.33 ppm) and Y (10.6–18.3 ppm) contents, with high La/Yb (51.1–72.3) and Sr/Y (21.0–51.4) ratios, indicating adakitic affinities. The low MgO (0.97–1.76 wt %), Cr (7.49–53.6 ppm) and Ni (4.75–29.1 ppm) contents, as well as high 87Sr/86Sr(i) (0.7143–0.7145), low ϵNd(t) (−10.4 to −9.8) and zircon ϵHf(t) (−17.7 to 0.4) values, suggest that the Wangdui pluton most likely originated from partial melting of the thickened ancient lower crust. In combination with previously published data, despite the east–west-trending heterogeneity of crustal composition in the Gangdese belt, the La/Yb ratios of magmatic rocks reveal that both western and eastern segments experienced remarkable crustal thickening in the Eocene. However, in contrast to the thickened juvenile lower crust in the eastern segment formed by the underplating of mantle-derived magmas, tectonic shortening plays a more crucial role in thickening of the ancient basement in western Gangdese. In fact, such Eocene-thickened ancient lower-crust-derived adakitic rocks are widely distributed in the central Himalayan–Tibetan orogen. This, together with the extensive development of fold–thrust belts, suggests that tectonic shortening might be the main mechanism accounting for the crustal thickening associated with the India–Asia collision.
Sporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.
Consumption of sugar-sweetened beverages (SSB) is associated with overweight and obesity in children and adolescents. Although existing research confirms the significance of economic and social factors as determinants of SSB intake, comparative studies on political factors and cross-national analyses are lacking. Research indicates that including women in the process of political decision-making promotes healthcare and child protection. This study examined how women’s parliamentary representation influences children’s and adolescents’ SSB intake compared with adults.
The study used cross-national food and beverage intake data from the Global Dietary Database. The outcome measurement was SSB consumption (g/day) for different population groups. We modelled SSB intake as a function of age groups, women’s parliamentary representation at the national level (the independent variable), regime types (the contextual factor) and import tariffs on SSB (the mediator) using country and time-fixed effects regression models.
One-hundred eighty-five countries across three waves from 2005 to 2015.
Different population groups.
The impact of female representation on reducing SSB consumption is more prevalent in children and adolescents than in adults. Furthermore, the effect of women’s parliamentary representation on SSB consumption among children and adolescents is conditional on a country’s democratic status. Finally, the marginal effect decreases when import tariffs on SSB are considered a link in a causal chain. No changes in adult SSB intake are statistically significant.
The findings suggest that the presence of women in the legislature can have a substantial impact on child and adolescent health.
To explore motivations, self-regulation barriers and strategies in a multi-ethnic Southeast Asian population with overweight and obesity.
Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data were analysed using thematic framework analysis and constant comparison method.
Specialist weight management clinic.
Twenty-two participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants were 37·5 (interquartile range (IQR) = 13·3) and 39·2 kg/m2 (IQR = 6·1), respectively. And 31·8 % were men, majority had a high intention to adopt healthy eating behaviours (median = 6·5; IQR = 4·8–6·3) and 59 % of the participants had a medium level of self-regulation.
Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by the sense of responsibility as the family’s pillar of support and to feel ‘normal’ again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes: habitual overconsumption – mindful self-discipline; proximity and convenience of food available – mental tenacity; momentary lack of motivation and sense of control – motivational boosters; and overeating triggers – removing triggers. We highlighted six unique overeating triggers namely: trigger activities (e.g. using social media); eating with family, friends and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day.
Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters and self-regulation skills to cope with momentary overeating triggers.
Listeriosis is a rare but serious foodborne disease caused by Listeria monocytogenes. This matched case–control study (1:1 ratio) aimed to identify the risk factors associated with food consumption and food-handling habits for the occurrence of sporadic listeriosis in Beijing, China. Cases were defined as patients from whom Listeria was isolated, in addition to the presence of symptoms, including fever, bacteraemia, sepsis and other clinical manifestations corresponding to listeriosis, which were reported via the Beijing Foodborne Disease Surveillance System. Basic patient information and possible risk factors associated with food consumption and food-handling habits were collected through face-to-face interviews. One hundred and six cases were enrolled from 1 January 2018 to 31 December 2020, including 52 perinatal cases and 54 non-perinatal cases. In the non-perinatal group, the consumption of Chinese cold dishes increased the risk of infection by 3.43-fold (95% confidence interval 1.27–9.25, χ2 = 5.92, P = 0.02). In the perinatal group, the risk of infection reduced by 95.2% when raw and cooked foods were well-separated (χ2 = 5.11, P = 0.02). These findings provide important scientific evidence for preventing infection by L. monocytogenes and improving the dissemination of advice regarding food safety for vulnerable populations.
Prolonged parturition duration has been widely demonstrated to be a risk factor for incidence of stillbirth. This study evaluated the supply of dietary fibre on the parturition duration, gut microbiota and metabolome using sows as a model. A total of 40 Yorkshire sows were randomly given diet containing normal level of dietary fibre (NDF, 17·5 % dietary fibre) or high level of dietary fibre (HDF, 33·5 % dietary fibre). Faecal microbiota profiled with 16S rRNA amplicon sequencing, SCFA and metabolome in the faeces and plasma around parturition were compared between the dietary groups. Correlation analysis was conducted to further explore the potential associations between specific bacterial taxa and metabolites. Results showed that HDF diet significantly improved the parturition process as presented by the shorter parturition duration. HDF diet increased the abundance of the phyla Bacteroidetes and Synergistetes and multiple genera. Except for butyrate, SCFA levels in the faeces and plasma of sows at parturition were elevated in HDF group. The abundances of fifteen and twelve metabolites in the faeces and plasma, respectively, markedly differ between HDF and NDF sows. These metabolites are involved in energy metabolism and bacterial metabolism. Correlation analysis also showed associations between specific bacteria taxa and metabolites. Collectively, our study indicates that the improvement of parturition duration by high fibre intake in late gestation is associated with gut microbiota, production of SCFA and other metabolites, potentially serving for energy metabolism.
Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia.
To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers.
We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites.
We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19–85.74%; sensitivity, 75.31–89.29% and area under the receiver operating characteristic curve, 0.797–0.909.
These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
This paper investigates the relationship between fingers and time representations in naturalistic Chinese Sign Language (CSL). Based on a CSL Corpus (Shanghai Variant, 2016–), we offer a thorough description of finger configurations for time expressions from 63 deaf signers, including three main types: digital, numeral incorporation, and points-to-fingers. The former two were further divided into vertical and horizontal fingers according to the orientation of fingertips. The results showed that there were interconnections between finger representations, numbers, ordering, and time in CSL. Vertical fingers were mainly used to quantify time units, whereas horizontal fingers were mostly used for sequencing or ordering events, and their forms could be influenced by Chinese number characters and the vertical writing direction. Furthermore, the use of points-to-fingers (e.g., pointing to the thumb, index, or little finger) formed temporal connectives in CSL and could be patterned to put a conversation in order. Additionally, CSL adopted similar linguistic forms in sequential time and adverbs of reason (e.g., cause and effect: events that happened earlier and events that happen later). Such a cause-and-effect relationship was a special type of temporal sequence. In conclusion, fingers are essential for time representation in CSL and their forms are biologically and culturally shaped.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.
The provenance and tectonic setting of the Lower–Middle Triassic clastic sediments from the Napo basin, South China, have been examined here using detrital modes, whole-rock geochemistry and detrital zircon U–Pb ages. Field investigations indicate that these sediments consist of fan delta, slope and turbidity fan facies with dominantly southward palaeocurrent directions. Detrital modes and geochemical characteristics of the clastic rocks indicate that they were derived from mixed magmatic arc and Palaeozoic successions in a continental island arc setting, with no significant sediment recycling. The U–Pb age spectra of sandstone detrital zircons from different stratigraphic positions are similar, with one major group (300–230 Ma), two subordinate groups (400–320 Ma and 480–420 Ma, respectively) and two scattered groups (1200–800 Ma and 2000–1700 Ma, respectively). Thus, we consider that the north late Permian – Middle Triassic volcanic rocks and the uplifted Palaeozoic sedimentary/volcanic sequences constituted the predominant sources. The detritus derived from the late Permian Emeishan mafic rocks is subordinate and limited. The pre-Devonian zircons are likely sedimentary-recycled or magmatic-captured instead of directly derived from the early Palaeozoic orogen (e.g. Yunkai massif) and Neoproterozoic Jiangnan orogen because of the topographic barrier of a magmatic arc and carbonate platform. Considering the spatial and temporal distribution characteristics of the volcanic arc and ophiolite, we suggest that the Triassic Napo basin was a fore-arc basin within a continental island arc setting, which developed in response to the northward subduction of the Babu–Cao Bang branch ocean beneath the South China Block.
This study aimed to investigate the characteristics of uncertainty in illness and the coping styles of patients with severe coronavirus 2019 (COVID-19) and to explore their relationship to provide effective guidance for clinical nursing. A cross-sectional survey was used to investigate 56 severe patients with COVID-19 in a designated hospital in Wuhan. A general information questionnaire, the Mishel Uncertainty in Illness Scale for Adults (MUIS-A) and the Medical Coping Modes Questionnaire (MCMQ) were used to collect the data. A statistical analysis was performed. The total score of the MUIS-A was a 66.29 ± 17.25 which was at a low level, while the total score of the MCMQ was 54.16 ± 6.39. The scores of facing and avoiding were significantly higher than those in the norm. The difference in the yielding dimension of patients with different family economic situations was statistically significant. The total score of MUIS-A correlated negatively with the coping style of facing and avoiding and positively correlated with the coping style of yielding. The coping style of patients was one of the factors influencing uncertainty in illness. Nursing staff need to pay close attention to the psychological state of their patients, understand their coping styles and actively correct negative coping styles to reduce the uncertainty in illness and promote physical as well as mental recovery.
Abrupt depth transitions (ADTs) have recently been identified as potential causes of ‘rogue’ ocean waves. When stationary and (close-to-) normally distributed waves travel into shallower water over an ADT, distinct spatially localized peaks in the probability of extreme waves occur. These peaks have been predicted numerically, observed experimentally, but not explained theoretically. Providing this theoretical explanation using a leading-order-physics-based statistical model, we show, by comparing to new experiments and numerical simulations, that the peaks arise from the interaction between linear free and second-order bound waves, also present in the absence of the ADT, and new second-order free waves generated due to the ADT.
In order to improve the working performance of the lower limb rehabilitation robot and the safety of the trained object, the mechanical characteristics of a cable-driven lower limb rehabilitation robot (CDLR) are studied. The dynamic model of the designed CDLR was established. Four kinds of cable tension optimization algorithms were proposed to obtain a good rehabilitation training effect, and the quality of the feasible workspace of the CDLR was analyzed. Finally, a real-time evaluation index of the cable tension optimization algorithms was given to measure the calculation speed of the optimization algorithms. The numerical research results were provided to confirm the characteristics of the four kinds of the optimization algorithms. The research results provide a basis for the follow-up research on the safety and compliance control strategy of the CDLR system.
People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia).
PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex.
Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3–406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5–417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4–1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60–2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7–50.4)].
The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.