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To assess the rate and factors associated with healthcare personnel (HCP) testing positive for SARS-CoV-2 after an occupational exposure
Retrospective cohort study
Academic medical center with sites in Minnesota, Wisconsin, Arizona, and Florida
HCP with a high or medium risk occupational exposure to a patient or other HCP with SARS-CoV-2
We reviewed the records of HCP with significant occupational exposures from March 20th, 2020 through December 31st, 2020. We then performed regression analysis to assess the impact of demographic and occupational variables to assess their impact on the likelihood of testing positive for SARS-CoV-2
A total of 2,253 confirmed occupational exposures occurred during the study period. Employees were the source for 57.1% of exposures. Overall, 101 (4.5%) HCP tested positive in the postexposure period. Of these, 80 had employee sources of exposure and 21 had patient sources of exposure. The post exposure infection rate was 6.2% when employees were the source, compared to 2.2% with patient sources. In a multivariate analysis, occupational exposure from an employee source had a higher risk of testing positive compared to a patient source (OR 3.22 95% CI (1.72-6.04)). Gender, age, high-risk exposure, and HCP role were not associated with increased risk of testing positive.
The risk of acquiring COVID-19 following a significant occupational exposure is relatively low, even in the pre-vaccination era. Exposure to an infectious coworker carries a higher risk than exposure to a patient. Continued vigilance and precautions remain necessary in healthcare settings.
X-ray powder diffraction data, unit-cell parameters, and space group for rivaroxaban, C19H18ClN3O5S, are reported [a = 9.010(3) Å, b = 10.986(6) Å, c = 11.230(1) Å, α = 63.439(5)°, β = 74.355(4)°, γ = 78.133(3)°, unit-cell volume V = 952.87 Å3, Z = 2, ρcal = 1.519 g cm−3, and space group P1]. All measured lines were indexed and are consistent with the P1 space group. No detectable impurities were observed.
The southeastern Central Asian Orogenic Belt (CAOB) records the assembly process between several micro-continental blocks and the North China Craton (NCC), with the consumption of the Paleo-Asian Ocean (PAO), but whether the S-wards subduction of the PAO beneath the northern NCC was ongoing during Carboniferous–Permian time is still being debated. A key issue to resolve this controversy is whether the Carboniferous magmatism in the northern NCC was continental arc magmatism. The Alxa Block is the western segment of the northern NCC and contiguous to the southeastern CAOB, and their Carboniferous–Permian magmatism could have occurred in similar tectonic settings. In this contribution, new zircon U–Pb ages, elemental geochemistry and Sr–Nd isotopic analyses are presented for three early Carboniferous granitic plutons in the southwestern Alxa Block. Two newly identified aluminous A-type granites, an alkali-feldspar granite (331.6 ± 1.6 Ma) and a monzogranite (331.8 ± 1.7 Ma), exhibit juvenile and radiogenic Sr–Nd isotopic features, respectively. Although a granodiorite (326.2 ± 6.6 Ma) is characterized by high Sr/Y ratios (97.4–139.9), which is generally treated as an adikitic feature, this sample has highly radiogenic Sr–Nd isotopes and displays significantly higher K2O/Na2O ratios than typical adakites. These three granites were probably derived from the partial melting of Precambrian continental crustal sources heated by upwelling asthenosphere in lithospheric extensional setting. Regionally, both the Alxa Block and the southeastern CAOB are characterized by the formation of early Carboniferous extension-related magmatic rocks but lack coeval sedimentary deposits, suggesting a uniform lithospheric extensional setting rather than a simple continental arc.
Although many organizations encourage employees to voice, employees may be reluctant to voice directly because they are afraid that their supervisors will perceive it as challenging their face (i.e., the positive image or social value of an individual). Alternatively, employees could deliver improvements or express concerns to their supervisors using indirect and implicit approaches, which we refer to as ‘implicit voice delivery’. Applying face theory, we examine the antecedents and outcomes as well as two boundary conditions of implicit voice delivery in organizations with two studies. In Study 1, we define the construct and develop a measure of implicit voice delivery. In Study 2, we test our proposed model with supervisor-subordinate dyadic data from a time-lagged survey. Results demonstrate that concern for other people's face drives employees to express their voices implicitly and that this relationship is stronger when supervisors’ concern for their own face is high rather than low. In addition, implicit voice delivery is associated with supervisors’ favorable response in terms of voice endorsement. Furthermore, the effect on voice endorsement is stronger when the supervisor is more able to infer meaning from implicit messages. Theoretical contribution and managerial implications are discussed.
The present study aimed to explore the association between dietary patterns in abdominal obesity obtained by reduced-rank regression (RRR) with visceral fat index (VFI) as a dependent variable and dyslipidemia in rural adults in Henan, China. A total of 29538 people aged 18–79 were selected from the Henan Rural Cohort Study. RRR analysis was used to identify dietary patterns; logistic regression analysis and restricted cubic spline regression models were applied to analyze the association between dietary patterns in abdominal obesity and dyslipidemia. VFI was used as a mediator to estimate the mediation effect. The dietary pattern in abdominal obesity was characterized by high carbohydrate and red meat intake and low consumption of fresh fruits, vegetables, milk, etc. After full adjustment, the highest quartile of dietary pattern scores was significantly associated with an increased risk of dyslipidemia (OR: 1·33, 95 % CI 1·23–1·44, Ptrend < 0·001), there was a non-linear dose–response relationship between them (Poverall-association < 0·001, Pnon-lin-association = 0·022). The result was similar in dose-response between the dietary pattern scores and VFI. The indirect effect partially mediated by VFI was significant (OR: 1·07, 95 % CI 1·06–1·08). VIF explained approximately 53·3 % of odds of dyslipidemia related to the dietary pattern. Abdominal obesity dietary pattern scores positively affected VFI and dyslipidemia; there was a dose-response in both relationships. Dyslipidemia progression increased with higher abdominal obesity dietary pattern scores. In addition, VFI played a partial mediating role in relationship between abdominal obesity dietary pattern and dyslipidemia.
Based on the fully compressible Navier–Stokes equations, the linear stability of thermal convection in rapidly rotating spherical shells of various radius ratios $\eta$ is studied for a wide range of Taylor number $Ta$, Prandtl number $Pr$ and the number of density scale height $N_\rho$. Besides the classical inertial mode and columnar mode, which are widely studied by the Boussinesq approximation and anelastic approximation, the quasi-geostrophic compressible mode is also identified in a wide range of $N_\rho$ and $Pr$ for all $\eta$ considered, and this mode mainly occurs in the convection with relatively small $Pr$ and large $N_\rho$. The instability processes are classified into five categories. In general, for the specified wavenumber $m$, the parameter space ($Pr, N_\rho$) of the fifth category, in which the base state loses stability via the quasi-geostrophic compressible mode and remains unstable, shrinks as $\eta$ increases. The asymptotic scaling behaviours of the critical Rayleigh numbers $Ra_c$ and corresponding wavenumbers $m_c$ to $Ta$ are found at different $\eta$ for the same instability mode. As $\eta$ increases, the flow stability is strengthened. Furthermore, the linearized perturbation equations and Reynolds–Orr equation are employed to quantitatively analyse the mechanical mechanisms and flow instability mechanisms of different modes. In the quasi-geostrophic compressible mode, the time-derivative term of disturbance density in the continuity equation and the diffusion term of disturbance temperature in the energy equation are found to be critical, while in the columnar and inertial modes, they can generally be ignored. Because the time-derivative term of the disturbance density in the continuity equation cannot be ignored, the anelastic approximation fails to capture the instability mode in the small-$Pr$ and large-$N_\rho$ system, where convection onset is dominated by the quasi-geostrophic compressible mode. However, all the modes are primarily governed by the balance between the Coriolis force and the pressure gradient, based on the momentum equation. Physically, the most important difference between the quasi-geostrophic compressible mode and the columnar mode is the role played by the disturbance pressure. The disturbance pressure performs negative work for the former mode, which appears to stabilize the flow, while it destabilizes the flow for the latter mode. As $\eta$ increases, in the former mode the relative work performed by the disturbance pressure increases and in the latter mode decreases.
Household entrepreneurship is a basic unit of entrepreneurial activity, and a crucial aspect of connecting personal and social wellbeing. This study examines the relationship between the proportion of elderly family members and household entrepreneurship. This study also assesses the mediating effect of the middle-aged generation's support to their parents and the moderating effect of the parents’ support with respect to the proportion of elderly family members and entrepreneurship. We use data from the China Family Panel Studies. We adopt the instrumental variable method to deal with endogeneity, robustness and credibility of the estimation results. The results show that a higher proportion of elderly family members impedes household entrepreneurship. Moreover, the financial and instrumental support provided by the middle-aged generation to their parents significantly mediates the relationship between the proportion of elderly family members and household entrepreneurship. In turn, parents’ financial support to the middle-aged generation moderates the focal relationship; however, parents’ instrumental support does not moderate the focal relationship. These findings emphasise the need to develop a comprehensive social security network for older adults that will indirectly promote household entrepreneurship, and improve personal and social wellbeing.
Maternal folic acid (FA) plays an important role in the fetus development, but it is unknown the response of hepatic metabolism in the offspring from different litter sizes to maternal FA supplementation. In the present study, this was done by feeding the ewes with 0, 16 and 32 mg/(kg·DM) FA supplemented diet during pregnancy and analysing the hepatic one-carbon metabolism-related indices and gene expression in the neonatal lambs of different litter sizes (twins, TW; triplets, TR). Regardless of litter sizes, the concentrations of folate, methionine, S-adenosylmethionine and DNA methyltransferase increased significantly, but homocysteine and S-adenosylhomocysteine decreased in the liver of newborn lambs from ewes whose diet was supplemented with FA. In TW, maternal FA status has little effect on hepatic genes expression profile of newborn lambs, and no significant enriched pathway was found. However, DEG involved in cell proliferation such as CCNA2, CCNB2, CCNE2, CDK1 and BUB1 were significantly enriched when the ewes were supplemented with FA in TR groups. In addition, nucleotide synthesis-related genes such as POLD1, POLD2, MCM4 and MCM5 were enriched markedly in DNA replication and pyrimidine metabolism pathways in triplets when a higher FA ingestion [32 mg/(kg·DM)] was implemented in ewes. This finding demonstrated that the hepatic methyl metabolism in TW and TR newborn lambs was regulated by maternal FA status. The hepatic cell proliferation and nucleotide metabolism related genes in TR were more susceptible to maternal dietary FA supplementation during pregnancy.
Creativity is crucial in design. In recent years, growing computational methods are applied to improve the creativity of design. This paper aims to explore an approach to generate creative design images with specific feature or design style. A Generative Adversarial Network model is applied in the approach to learn the specific design style. The target products will be projected into the latent space of model to transfer their styles and generate images. The generated images combine the features of the specific design style and the features of the target product. In the experiment, the approach using the generated images to inspire the human designer to generate the creative design in according styles. According to the primary verification by participants, the generated images can bring novelty and surprise to participants, which gain the positive impact on human creativity.
DNA methylation is one of the most important epigenetic modifications in breast cancer (BC) development, and long-term dietary habits can alter DNA methylation. Cadherin-4 (CDH4, a member of the cadherin family) encodes Ca2+-dependent cell–cell adhesion glycoproteins. We conducted a case–control study (380 newly diagnosed BC and 439 cancer-free controls) to explore the relationship of CDH4 methylation in peripheral blood leukocyte DNA (PBL DNA), as well as its combined and interactive effects with dietary factors on BC risk. A case-only study (335 newly diagnosed BC) was conducted to analyse the association between CDH4 methylation in breast tissue DNA and dietary factors. CDH4 methylation was detected using quantitative methylation-specific PCR. Unconditional logistic regressions were used to analyse the association of CDH4 methylation in PBL DNA and BC risk. Cross-over analysis and unconditional logistic regression were used to calculate the combined and interactive effects between CDH4 methylation in PBL DNA and dietary factors in BC. CDH4 hypermethylation was significantly associated with increased BC risk in PBL DNA (ORadjusted (ORadj) = 2·70, (95 % CI 1·90, 3·83), P < 0·001). CDH4 hypermethylation also showed significant combined effects with the consumption of vegetables (ORadj = 4·33, (95 % CI 2·63, 7·10)), allium vegetables (ORadj = 7·00, (95 % CI 4·17, 11·77)), fish (ORadj = 7·92, (95 % CI 3·79, 16·53)), milk (ORadj = 6·30, (95 % CI 3·41, 11·66)), overnight food (ORadj = 4·63, (95 % CI 2·69, 7·99)), pork (ORadj = 5·59, (95 % CI 2·94, 10·62)) and physical activity (ORadj = 4·72, (95 % CI 2·87, 7·76)). Moreover, consuming milk was significantly related with decreased risk of CDH4 methylation (OR = 0·61, (95 % CI 0·38, 0·99)) in breast tissue. Our findings may provide direct guidance on the dietary intake for specific methylated carriers to decrease their risk for developing BC.
The staining procedure is critical for investigating intra- and extra-cellular ultrastructure of microorganisms by transmission electron microscopy (TEM). Here, we propose a new ultra-low lead staining (ULLS) technique for preparing the ultrathin sections for TEM analysis. Sections of Enterobacter sp. (bacteria), Aspergillus niger (filamentous fungi), Rhodotorula mucilaginosa (fungi), and Chlamydomonas reinhardtii (microalgae) were tested. Compared with the sections prepared by the typical double-staining technique, ULLS-based sections showed evident advantages: (i) the staining process only required the addition of Pb(NO3)2; (ii) the Pb level during incubation was set as low as 1 mg/L, which had negligible toxicity to most microbial cells; (iii) the Pb cations were added during microbial culture, which avoided complicated sample preparation as in typical double staining. Taking C. reinhardtii as an example, the ULLS technique allowed fine investigation of microbial ultrastructure, e.g., starch granule, mitochondrion, Golgi apparatus, vacuole, and vesicle. Meanwhile, the physiological processes of the cells such as cell lysis and exocytosis were successfully captured, with relatively high contrast. This study hence shows a bright future on preparation of the high-quality ultrathin sections of microbial cells by the ULLS technique.
The interplay between sustainability and anthropogenic landscape transformation is crucial to understanding the past decline and eradication of wild animals. The Bronze Age site of Zaoshugounao is located in the Guanzhong region of China, an area critical in the formation and development of early Chinese civilisation. Drawing upon zooarchaeological, palaeoenvironmental and textual evidence, analysis of sika deer remains from Zaoshugounao reveals sustainable sika deer-hunting strategies at the site, despite an overall long-term trend in the sika deer population decline and habitat loss. The authors’ results highlight the complexity and diversity of human-sika relations and contribute to ongoing discussions surrounding wild animal eradication and conservation in China.
Poor utilisation efficiency of carbohydrate always leads to metabolic phenotypes in fish. The intestinal microbiota plays an important role in carbohydrate degradation. Whether the intestinal bacteria could alleviate high-carbohydrate diet (HCD)-induced metabolic phenotypes in fish remains unknown. Here, a strain affiliated to Bacillus amyloliquefaciens was isolated from the intestine of Nile tilapia. A basal diet (CON), HCD or HCD supplemented with B. amy SS1 (HCB) was used to feed fish for 10 weeks. The beneficial effects of B. amy SS1 on weight gain and protein accumulation were observed. Fasting glucose and lipid deposition were decreased in the HCB group compared with the HCD group. High-throughput sequencing showed that the abundance of acetate-producing bacteria was increased in the HCB group relative to the HCD group. Gas chromatographic analysis indicated that the concentration of intestinal acetate was increased dramatically in the HCB group compared with that in the HCD group. Glucagon-like peptide-1 was also increased in the intestine and serum of the HCB group. Thus, fish were fed with HCD, HCD supplemented with sodium acetate at 900 mg/kg (HLA), 1800 mg/kg (HMA) or 3600 mg/kg (HHA) diet for 8 weeks, and the HMA and HHA groups mirrored the effects of B. amy SS1. This study revealed that B. amy SS1 could alleviate the metabolic phenotypes caused by HCD by enriching acetate-producing bacteria in fish intestines. Regulating the intestinal microbiota and their metabolites might represent a powerful strategy for fish nutrition modulation and health maintenance in future.
As the remnant of the South Qilian Ocean, the South Qilian suture zone recorded abundant information on the Cambrian–Ordovician subduction history of the southern branch of the Proto-Tethyan Ocean. However, the closure timing of the South Qilian Ocean and subsequent collision are poorly constrained. In this study, we report early Silurian (433–435 Ma) U–Pb ages of felsic subvolcanic rocks from Lianhuashan, Ayishan and Shihuiyao of the Lajishan district within the South Qilian suture zone. They intruded the Late Ordovician – Silurian sedimentary or Late Ordovician volcanic rocks and have high SiO2 (61.43–73.06 wt%), Sr/Y ratios with significant different rare earth elements (REEs) and trace-element spider diagrams, and Sr–Nd isotopic compositions, probably implying that they were formed through distinctly different generation mechanisms. Geochemistry of the Lianhuashan dacites reveals compositions typical of adakitic rocks derived from partial melting of lower crust in a thickened setting. The Ayishan dacites were derived from partial melting of crustal materials with the involvement of minor peridotite mantle, and the Shihuiyao rhyolites were derived from partial melting of felsic crust. The similar geochemical characteristics of coeval post-collisional igneous rocks in the Central Qilian and South Qilian blocks indicates that the lower Silurian subvolcanic rocks were generated in a thickened crust of post-collisional setting. Considering their intrusive contacts with Late Ordovician – Silurian retro-foreland basin and Late Ordovician collisional volcanic rocks, we propose that the South Qilian suture zone was at a transitional stage from collisional to post-collisional during the early Silurian Period.
Invasive species face new selective pressures and low genetic variation caused by genetic bottlenecks and founder effects when they are introduced into novel environments. Epigenetic variation may help them to cope with these problems. Mile-a-minute (Mikania micrantha Kunth) is a highly invasive exotic weed that has seriously damaged biodiversity and agricultural ecosystems. We first adopted methylation-sensitive amplified polymorphism (MSAP) markers to investigate epigenetic variation of 21 M. micrantha populations in southern China, and further explored the effects of environmental factors on population epigenetic differentiation by correlating epigenetic and climate and soil data. Adaptive epiloci positively correlated with climate/soil variables were identified. Minimum temperature of the coldest month and mean temperature of the coldest quarter were considered as decisive factors for its distribution. Climate is presumed to play a relatively more important role than soil in shaping the adaptive epigenetic differentiation in M. micrantha. Under ongoing global warming, populations of M. micrantha are predicted to expand northward. In addition, the weed also presented higher epigenetic variation compared with genetic variation. Leaf shape variation was detected related to methylation-state change at the population level.
During the last few decades, the lake-terminating glaciers in the Himalaya have receded faster than the land-terminating glaciers as proglacial lakes have exacerbated the mass loss of their host glaciers. Monitoring the impacts of glacier recession and dynamics on lake extent and water volume provides an approach to assess the mass interplay between glaciers and proglacial lakes. We describe the recession of Longbasaba Glacier and estimate the mass wastage and its contribution to the water volume of its proglacial lake. The results show that the glacier area has decreased by 3% during 1988–2018, with a more variable recession prior to 2008 than in the last decade. Longbasaba Lake has expanded by 164% in area and 237% in water volume, primarily as a result of meltwater inflow produced from surface lowering of the glacier. Over the periods 1988–2000 and 2000–18, the mass loss contributed by glacier thinning has decreased from 81 to 61% of the total mass loss, accompanied by a nearly doubled contribution from terminus retreat. With the current rate of retreat, Longbasaba glacier is expected to terminate in its proglacial lake for another four decades. The hazard risk of this lake is expected to continue to increase in the near future because of the projected continued glacier mass loss and related lake expansion.
Pyroptosis is a recently identified mechanism of programmed cell death related to Caspase-1 that triggers a series of inflammatory reactions by releasing several proinflammatory factors such as IL-1β and IL-18. The process is characterised by the rupture of cell membranes and the release of cell contents through the mediation of gasdermin (GSDM) proteins. GSDMD is an important member of the GSDM family and plays a critical role in the two pathways of pyroptosis. Diabetic nephropathy (DN) is a microvascular complication of diabetes and a major cause of end-stage renal disease. Recently, it was revealed that GSDMD-mediated pyroptosis plays an important role in the occurrence and development of DN. In this review, we focus on two types of kidney cells, tubular epithelial cells and renal podocytes, to illustrate the mechanism of pyroptosis in DN and provide new ideas for the prevention, early diagnosis and molecular therapy of DN.
The impact of diet on the metabolic syndrome (MetS) and CVD has been investigated widely, but few studies have investigated the association between dietary patterns (DP) and the predicted CVD, derived from reduced rank regression (RRR). The objectives of this study were to derive DP using RRR and principal component analysis (PCA) and investigate their associations with the MetS and estimated 10-year atherosclerotic CVD (ASCVD). We used the baseline dataset from the Xinjiang multi-ethnic cohort study in China, collected from June 2018 to May 2019. A total of 14 982 subjects aged 35–74 years from Urumqi, Huo Cheng and Mo Yu were included in the analysis. The 10-year ASCVD risk was estimated using the Chinese ASCVD risk equations. The associations of DP with the MetS and 10-year ASCVD were determined using multivariable logistic regression models. In Urumqi and Mo Yu, the increased RRR DP score was associated with a higher OR of having the MetS and with a higher OR of elevated 10-year ASCVD risk. However, only the first DP determined by PCA in Urumqi was inversely associated with the MetS and elevated 10-year ASCVD risk. The prevalence of the MetS and elevated ASCVD risk in urban population is higher than that in rural areas. Our results may help nutritionists develop more targeted dietary strategies to prevent the MetS and ASCVD in different regions in China.
Childhood trauma is a vulnerability factor for the development of obsessive–compulsive disorder (OCD). Empirical findings suggest that trauma-related alterations in brain networks, especially in thalamus-related regions, have been observed in OCD patients. However, the relationship between childhood trauma and thalamic connectivity in patients with OCD remains unclear. The present study aimed to examine the impact of childhood trauma on thalamic functional connectivity in OCD patients.
Magnetic resonance imaging resting-state scans were acquired in 79 patients with OCD, including 22 patients with a high level of childhood trauma (OCD_HCT), 57 patients with a low level of childhood trauma (OCD_LCT) and 47 healthy controls. Seven thalamic subdivisions were chosen as regions of interest (ROIs) to examine the group difference in thalamic ROIs and whole-brain resting-state functional connectivity (rsFC).
We found significantly decreased caudate-thalamic rsFC in OCD patients as a whole group and also in OCD_LCT patients, compared with healthy controls. However, OCD_HCT patients exhibited increased thalamic rsFC with the prefrontal cortex when compared with both OCD_LCT patients and healthy controls.
Taken together, OCD patients with high and low levels of childhood trauma exhibit different pathological alterations in thalamic rsFC, suggesting that childhood trauma may be a predisposing factor for some OCD patients.
A high-carbohydrate diet could achieve a protein-sparing effect, but it may cause negative impacts on the growth condition of fish due to their poor utilisation ability of carbohydrate. How to reduce the adverse effects caused by a high-carbohydrate diet is important for the development of aquaculture. In the present study, we aimed to identify whether inulin could attenuate the metabolic syndrome caused by a high-carbohydrate diet in fish. Nile tilapia (Oreochromis niloticus) (1·19 (sd 0·01) g) were supplied with 35 % carbohydrate (CON), 45 % carbohydrate (HC) and 45 % carbohydrate + 5 g/kg inulin (HCI) diets for 10 weeks. The results showed that addition of inulin improved the survival rate when fish were challenged with Aeromonas hydrophila, indicating that inulin had an immunostimulatory effect. Compared with the HC group, the HCI group had lower lipid accumulation in liver and the gene expression analyses indicated that addition of inulin down-regulated genes related to lipogenesis and up-regulated genes relevant to β-oxidation significantly (P < 0·05). Higher liver glycogen and glucose tolerance were found in the HCI group compared with the HC group (P < 0·05). These results indicated that inulin could alleviate the metabolic syndrome induced by a high-carbohydrate diet. Furthermore, addition of inulin to a high-carbohydrate diet changed the intestinal bacterial composition and significantly increased the concentration of acetic acid and propionic acid in fish gut which have the potential to increase pathogen resistance and regulate metabolic characteristics in fish. Collectively, our results demonstrated a possible causal role for the gut microbiome in metabolic improvements induced by inulin in fish.