To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Cinnamomum chago is a woody species of the family Lauraceae endemic to Yunnan province, China, previously known from only one location, and categorized as a Plant Species with Extremely Small Population. We surveyed to determine the distribution and population size of C. chago, characterize its habitat, identify any threats, assess its conservation status, and provide guidelines for its management and conservation. During 2014–2017 we found only 64 mature C. chago, in five locations. These small, fragmented populations occur along Lancang River in Dali Prefecture at altitudes of 2,200–2,400 m. The species' extent of occurrence is c. 923 km2, with an area of occupancy of c. 60 km2. The habitat of the species has been degraded by expansion of pastoral activities and deforestation. We recommend categorization of C. chago as Endangered on the IUCN Red List, prevention of the collection of seeds and wood of the species, protection and monitoring, and ex situ propagation for future reintroductions.
The aim of this network meta-analysis is to compare bone mineral density (BMD) changes among different osteoporosis prevention interventions in postmenopausal women. We searched MEDLINE, Embase and Cochrane Library from inception to 24 February 2019. Included studies were randomised controlled trials (RCT) comparing the effects of different treatments on BMD in postmenopausal women. Studies were independently screened by six authors in three pairs. Data were extracted independently by two authors and synthesised using Bayesian random-effects network meta-analysis. The results were summarised as mean difference in BMD and surface under the cumulative ranking (SUCRA) of different interventions. A total of ninety RCT (10 777 participants) were included. Ca, vitamin D, vitamin K, oestrogen, exercise, Ca + vitamin D, vitamin D + vitamin K and vitamin D + oestrogen were associated with significantly beneficial effects relative to no treatment or placebo for lumbar spine (LS). For femoral neck (FN), Ca, exercise and vitamin D + oestrogen were associated with significantly beneficial intervention effects relative to no treatment. Ranking probabilities indicated that oestrogen + vitamin D is the best strategy in LS, with a SUCRA of 97·29 % (mean difference: +0·072 g/cm2 compared with no treatment, 95 % credible interval (CrI) 0·045, 0·100 g/cm2), and Ca + exercise is the best strategy in FN, with a SUCRA of 79·71 % (mean difference: +0·029 g/cm2 compared with placebo, 95 % CrI –0·00093, 0·060 g/cm2). In conclusion, in postmenopausal women, many interventions are valuable for improving BMD in LS and FN. Different intervention combinations can affect BMD at different sites diversely.
The effect of maternal folate intake on small-for-gestational-age (SGA) births remains inconclusive. The present study aimed to investigate the associations of maternal folate intake from diet and supplements with the risk of SGA births using data from a cross-sectional study in Shaanxi Province of Northwest China. A total of 7307 women who were within 12 months (median 3; 10th–90th percentile 0–7) after delivery were included. Two-level models were adopted to examine the associations of folate (dietary folate, supplemental folic acid and total folate) intake with the risk of SGA births and birth weight Z score, controlling for a minimum set of confounders that were identified in a directed acyclic graph. Results showed that a higher supplemental folic acid intake during the first trimester was negatively associated with the risk of SGA births (≤60 d v. non-use: OR 0·80; 95 % CI 0·66, 0·96; >60 d v. non-use: OR 0·78; 95 % CI 0·65, 0·94; Ptrend = 0·010; per 10-d increase: OR 0·97; 95 % CI 0·95, 0·99). A higher total folate intake during pregnancy was associated with a reduced risk of SGA births (highest tertile v. lowest tertile: OR 0·77; 95 % CI 0·64, 0·94; Ptrend = 0·010; per one-unit increase in the log-transformed value: OR 0·81; 95 % CI 0·69, 0·95). A similar pattern was observed for the birth weight Z score. Our study suggested that folic acid supplementation during the first trimester and a higher total folate intake during pregnancy were associated with a reduced risk of SGA births.
North-east China occupies an important geographic position for understanding the process of Neolithisation in East Asia. Although archaeologists have long debated the trajectory of change in this region, a lack of intensive survey and excavation has precluded convincing interpretations. This article presents research on the newly excavated sites of Huayang and Taoshan in the southern Lesser Khingan Mountains, with a particular focus on the lithic assemblages. Comparative and environmental analyses demonstrate the largely uniform trajectory of lithic technologies across north-east China and close correspondence with Late Glacial palaeoclimatic and palaeoenvironmental changes.
Objective: Deficits in the semantic learning strategy were observed in subjects with amnestic mild cognitive impairment (aMCI) in our previous study. In the present study, we explored the contributions of executive function and brain structure changes to the decline in the semantic learning strategy in aMCI. Methods: A neuropsychological battery was used to test memory and executive function in 96 aMCI subjects and 90 age- and gender-matched healthy controls (HCs). The semantic clustering ratio on the verbal learning test was calculated to evaluate learning strategy. Medial temporal lobe atrophy (MTA) and white matter hyperintensities (WMH) were measured on MRI with the MTA and Fazekas visual rating scales, respectively. Results: Compared to HCs, aMCI subjects had poorer performance in terms of memory, executive function, and the semantic clustering ratio (P < .001). In aMCI subjects, no significant correlation between learning strategy and executive function was observed. aMCI subjects with obvious MTA demonstrated a lower semantic clustering ratio than those without MTA (P < .001). There was no significant difference in the learning strategies between subjects with high-grade WMH and subjects with low-grade WMH. Conclusion: aMCI subjects showed obvious impairment in the semantic learning strategy, which was attributable to MTA but independent of executive dysfunction and subcortical WMH. These findings need to be further validated in large cohorts with biomarkers identified using volumetric brain measurements. (JINS, 2019, 25, 706–717)
Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.
To explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI.
Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China.
Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status.
Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.
Dynamic trajectory prediction is an important topic in the field of navigation and positioning. Due to the drawbacks of a Global Navigation Satellite System (GNSS) receiver, the trajectory of the position always lags behind the dynamic platform's actual position, especially in highly dynamic situations. In order to solve the prediction of a dynamic trajectory, a generalised extension extrapolated model is proposed in this paper. The model utilises the current motion state and a priori position data of the platform, combines the interpolation and fitting method, adds the angle information as a constraint condition and solves the platform position prediction. In this paper, the feasibility of the generalised extended extrapolation algorithm is analysed theoretically and practically. Simulation results show that the prediction error is within 0.2 metres and experimental results show that the algorithm still has high prediction accuracy when a land vehicle platform is turned through a large angle.
Since 2009, China has initiated a national program on free provision of essential public health services. The national program has expanded both in terms of service categories and funding, showing China's great commitment to universal health coverage. However, with slowdown of public input in the health sector, the government decided to prioritize interventions and optimize reimbursement packages. Researchers in the China National Health Development Research Center (CNHDRC)—the Chinese national health technology assessment (HTA) agency were asked to design the tools to facilitate the decision process.
With multi-criteria decision analysis (MCDA) method, the researchers analyzed value dimensions in public health issues, and built an evidence matrix for the priority-setting decisions. Supported by HTA tools, they appraised interventions and services through literature review and field studies, and projected budget impact of potential adjustment decisions based on cost analysis results. A deliberative process of key stakeholder groups was taken, and their views were counted in making the final recommendations.
Based on evidence review and scores of stakeholders’ judgment, two public health service interventions were recommended for removal, and another two for adjustment (one for merger, one for optimizing care pathway). Cost estimation and potential budgetary impact were also analyzed to support financial decisions.
HTA and MCDA are key tools for defining the value criteria, evidence framework, and deliberative process for the essential public health program. However, lack of cost-effectiveness evidence hinders fine-tuned decisions on resource allocation. Continual health economic evaluation needs to be conducted in the near future.
Previous studies have demonstrated that type 1 diabetes mellitus (T1DM) could be triggered by an early childhood infection. Whether maternal infection during pregnancy is associated with T1DM in offspring is unknown. Therefore, we aimed to study the association using a systematic review and meta-analysis. Eighteen studies including 4304 cases and 25 846 participants were enrolled in this meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were synthesised using random-effects models. Subgroup analyses and sensitivity analyses were conducted to assess the robustness of associations. Overall, the pooled analysis yielded a statistically significant association between maternal infection during pregnancy and childhood T1DM (OR 1.31, 95% CI 1.07–1.62). Furthermore, six studies that tested maternal enterovirus infection showed a pooled OR of 1.54 (95% CI 1.05–2.27). Heterogeneity from different studies was evident (I2 = 70.1%, P < 0.001) and was mainly attributable to the different study designs, ascertaining methods and sample size among different studies. This study provides evidence for an association between maternal infection during pregnancy and childhood T1DM.
We construct two families of few-weight codes for the Lee weight over the ring
based on two different defining sets. For the first defining set, taking the Gray map, we obtain an infinite family of binary two-weight codes which are in fact
-fold replicated MacDonald codes. For the second defining set, we obtain two infinite families of few-weight codes. These few-weight codes can be used to implement secret-sharing schemes.
We present a JASMIN-based two-dimensional parallel implementation of an adaptive combined preconditioner for the solution of linear problems arising in the finite volume discretisation of one-group and multi-group radiation diffusion equations. We first propose the attribute of patch-correlation for cells of a two-dimensional monolayer piecewise rectangular structured grid without any suspensions based on the patch hierarchy of JASMIN, classify and reorder these cells via their attributes, and derive the conversion of cell-permutations. Using two cell-permutations, we then construct some parallel incomplete LU factorisation and substitution algorithms, to provide our parallel -GMRES solver with the help of the default BoomerAMG in the HYPRE library. Numerical results demonstrate that our proposed parallel incomplete LU preconditioner (ILU) is of higher efficiency than the counterpart in the Euclid library, and that the proposed parallel -GMRES solver is more robust and more efficient than the default BoomerAMG-GMRES solver.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
The Da Vinci surgical system is classified as a type “A” medical device in China; the procurement plan of which is regulated by the National Health and Family Planning Commission (NHFP). Between 2010 to 2015, there were thirty-four Da Vinci surgical robots purchased, and installed in thirty tertiary public hospitals across the country. In order to generate context-specific evidence and support further capital funding decisions, the NHFP commissioned a Health Technology Assessment (HTA) of Da Vinci surgical robots, with a focus on real use of the technology in those tertiary public hospitals.
Nine hospitals were selected to collect real word data between 2013 to 2015. Using a cross-sectional survey, data of all robotic surgical cases were collected and described. The unit costs of the robotic surgery were estimated from activity based costing. We also collected cases of prostatectomy (427 versus 421) and hysterectomy (247 versus 105) using the robotic system and laparoscope respectively, and then compared hospital fees and effectiveness during hospitalization. Simulation of the budget impact on health insurance in Shanghai City over the next 5 years was also performed.
A full HTA was conducted based on real data from nine public hospitals in the central and eastern region. Based on a systematic review methodology, we appraised evidence on safety, effectiveness and cost-effectiveness of the Da Vinci surgical robot. Data on technology use, clinical management, and pricing and payment were collected through a cross-sectional survey and interviews of hospital managers, surgeons and nurses. We designed a cohort study on cost-effectiveness of Da Vinci-assisted prostatectomy and hysterectomy, comparing Da Vinci-assisted and laparoscopic prostatectomy (427 vs 421) and Da Vinci-assisted and laparoscopic hysterectomy (247 versus 105). Ethics and inequity issues were discussed based on patient interviews. A budget impact analysis was performed based on scenario mapping of promoting Da Vinci-assisted prostatectomy in Shanghai City over a 5-year timeline.
Due to a lack of evidence on long-term clinical effectiveness and high impact on public finances, the Da Vinci robotic robot should not be procured in large numbers in China. For equipment purchasing the government should strengthen regulations and require the public hospitals to collect more evidence.
The long-term outcome of never-treated patients with schizophrenia is
To compare the 14-year outcomes of never-treated and treated patients
with schizophrenia and to establish predictors for never being
All participants with schizophrenia (n = 510) in Xinjin,
Chengdu, China were identified in an epidemiological investigation of 123
572 people and followed up from 1994 to 2008.
The results showed that there were 30.6%, 25.0% and 20.4% of patients who
received no antipsychotic medication in 1994, 2004 and 2008 respectively.
Compared with treated patients, those who were never treated in 2008 were
significantly older, had significantly fewer family members, had higher
rates of homelessness, death from other causes, being unmarried, living
alone, being without a caregiver and poor family attitudes. Partial and
complete remission in treated patients (57.3%) was significantly higher
than that in the never-treated group (29.8%). Predictors of being in the
never-treated group in 2008 encompassed baseline never-treated status,
being without a caregiver and poor mental health status in 1994.
Many patients with schizophrenia still do not receive antipsychotic
medication in rural areas of China. The 14-year follow-up showed that
outcomes for the untreated group were worse. Community-based mental
healthcare, health insurance and family intervention are crucial for
earlier diagnosis, treatment and rehabilitation in the community.
Students in rural China are dropping out of secondary school at troubling rates. While there is considerable quantitative research on this issue, no systematic effort has been made to assess the deeper reasons behind student decision making through a mixed-methods approach. This article seeks to explore the prevalence, correlates and potential reasons for rural dropout throughout the secondary education process. It brings together results from eight large-scale survey studies covering 24,931 rural secondary students across four provinces, as well as analysis of extensive interviews with 52 students from these same study sites. The results show that the cumulative dropout rate across all windows of secondary education may be as high as 63 per cent. Dropping out is significantly correlated with low academic performance, high opportunity cost, low socio-economic status and poor mental health. A model is developed to suggest that rural dropout is primarily driven by two mechanisms: rational cost-benefit analysis or impulsive, stress-induced decision making.
The paper aims to develop an effective preconditioner and conduct the convergence analysis of the corresponding preconditioned GMRES for the solution of discrete problems originating from multi-group radiation diffusion equations. We firstly investigate the performances of the most widely used preconditioners (ILU(k) and AMG) and their combinations (Bco and Bco), and provide drawbacks on their feasibilities. Secondly, we reveal the underlying complementarity of ILU(k) and AMG by analyzing the features suitable for AMG using more detailed measurements on multiscale nature of matrices and the effect of ILU(k) on multiscale nature. Moreover, we present an adaptive combined preconditioner Bcoα involving an improved ILU(0) along with its convergence constraints. Numerical results demonstrate that Bcoα-GMRES holds the best robustness and efficiency. At last, we analyze the convergence of GMRES with combined preconditioning which not only provides a persuasive support for our proposed algorithms, but also updates the existing estimation theory on condition numbers of combined preconditioned systems.
The NASA Kepler satellite has provided unprecedented high duty-cycle, high-precision light curves for a large number of stars by continuously monitoring a field of view in Cygnus-Lyra region, leading to great progress in both discovering exoplanets and characterizing planet-hosting stars by means of asteroseismic methods. The asteroseismic survey allows the investigation of stars covering the whole H-R diagram. However, the low precision of effective temperatures and surface gravities in the KIC catalogue and the lack of information on chemical composition, metallicity and rotation rate prevent asteroseismic modeling, requiring spectroscopic observations for thousands of asteroseismic targets in the Kepler field in a homogeneous way.
Since the electromagnetic energy gained by the laser wave in a free-electron laser (FEL) is transferred from the kinetic energy loss of a relativistic electron beam, the stability of electron motion is one of the key factors that affect FEL performance. In this paper the stability of electron motion is compared for different focusing regimes. It is demonstrated that the natural focusing regime of a three-dimensional wiggler is easily broken by the self-field of the electron beam. The magnetic focusing regime of an axial guide magnetic field is based on the superposition of a strong Larmor rotation on the transverse quiver motion of the electrons, while the electric focusing regime of an ion-channel guiding field generates an electric force to counteract the divergent effect of the beam self-field. In comparison with the magnetic focusing regime of an external magnetic system, the electric focusing regime of an ion-channel guiding field may yield smaller instantaneous Larmor radius and slighter Larmor-centre deviation from the axis and provide better motion stability.
The aim of the present study was to investigate the prevalence of hyperhomocysteinaemia (HHCY; total plasma homocysteine (tHcy) concentration >15 μmol/l) and its major determinants in healthy Chinese northerners. A descriptive and cross-sectional study was conducted in Shaanxi Province, China. The study sample included 2645 participants (1042 men and 1603 women) aged >20 years. Demographic characteristics and lifestyle factors were assessed via questionnaire interviews and physical examination. Plasma levels of homocysteine and folate and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism were determined according to standard methods. The prevalence of HHCY was 67·7 % (81·4 % in men and 58·8 % in women). The geometric mean of tHcy concentration was 19·1 μmol/l. The OR of HHCY were 0·44 (95 % CI 0·34, 0·57) for women v. men; 1·95 (95 % CI 1·41, 2·70), 1·41 (95 % CI 1·05, 1·88) and 0·76 (95 % CI 0·64, 0·89) for participants with smoking and alcohol drinking cessation and improved physical activity levels, respectively; 0·25 (95 % CI 0·17, 0·38), 0·33 (95 % CI 0·22, 0·49) and 0·56 (95 % CI 0·36, 0·88) for participants with an education level of elementary school, secondary school and university v. illiterate, respectively; 1·41 (95 % CI 1·13, 1·75) and 3·05 (95 % CI 2·35, 3·97) for participants with CT and TT v. CC genotype at MTHFR 677C → T polymorphism, respectively. These results demonstrate that the prevalence of HHCY is considerably high in Chinese northerners, especially in TT subjects, suggesting that implementation of tHcy-lowering strategies, such as lifestyle changes, is necessary.
In 2007–08, seismologists began deploying passive seismic stations over much of the Antarctic ice sheet. These stations routinely log their position by navigation-grade global positioning system (GPS) receivers. This location data can be used to track the stations situated on moving ice. For stations along the traverse from Zhongshan station to Dome A in East Antarctica and at the West Antarctic Ice Sheet divide the estimated velocities of the ice surface based on positions recorded by navigation-grade GPS are consistent with those obtained by high-accuracy geodetic GPS. Most of the estimated velocities have an angle difference of <28° with the steepest downhill vector of the ice surface slope at the stations. These results indicate that navigation-grade GPS measurements over several months provide reliable information on ice sheet movement of ≥1 m yr-1. With an uncertainty of ~0.3–1 m yr-1, this method is able to resolve both very slow ice velocities near Dome A and velocities of >100 m yr-1 on Thwaites Glacier. Information on ice velocity at three locations for which no data from satellite-based interferometric synthetic aperture radar are available have also been provided using this method.