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It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
Methods
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
Results
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
COVID-19 is erupting globally and Wuhan successfully controlled it within a month. Infections arose from infectious persons outside hospitals. After data revision, data-based and model-based analyses are implemented and the conclusions are as follows. The incubation period of most infected people may be 6-7 days. The number of infectious persons outside hospitals in Wuhan on Jan.20 is about 10000 and reached more than 20000 on the day of Lockdown, it exceeded 72000 on Feb.4. Both data-based and model-based analyses gave out the evolution of the reproduction number, which is over 2.5 in early January, then go down to 1.62 in late January and 1.20 in early February, a sudden drop to less than 0.5 due to the strict Stay-at-home management after Feb.11. Strategies of Stay-at-home, Safe-protective measures and Ark hospitals are the main contributions to control COVID-19 in Wuhan. Two inflection points of COVID-19 in Wuhan exactly correspond to Feb.5 and Feb.15, the two days when Ark hospitals were introduced and the complete implementation of Stay-at-home. Based on the expression of the reproduction number, group immunity also is discussed. It shows that only when the group immunization rate is over 75 percent can COVID-19 be under control, group immunity actually would be full infection and the total deaths will be 220,000 for a city as big as Wuhan. Sensitivity analysis suggests that 30 percent of people staying at home in combination with better behavior changes, such as social-distancing and frequent hand-washing, can effectively contain COVID-19. But only when this proportion is over 60 percent can the control effect and efficiency like Wuhan be obtained.
Due to the lack of research between the inner layers in the structure of colonic mucous and the metabolism of fatty acid in the constipation model, we aim to determine the changes in the mucous phenotype of the colonic glycocalyx and the microbial community structure following treatment with Rhubarb extract in our research. The constipation and treatment models are generated using adult male C57BL/6N mice. We perform light microscopy and transmission electron microscopy (TEM) to detect a Muc2-rich inner mucus layer attached to mice colon under different conditions. In addition, 16S rDNA sequencing is performed to examine the intestinal flora. According to TEM images, we demonstrate that Rhubarb can promote mucin secretion and find direct evidence of dendritic structure-linked mucus structures with its assembly into a lamellar network in a pore size distribution in the isolated colon section. Moreover, the diversity of intestinal flora has noticeable changes in constipated mice. The present study characterizes a dendritic structure and persistent cross-links have significant changes accompanied by the alteration of intestinal flora in feces in models of constipation and pretreatment with Rhubarb extract.
This study evaluated the association between inflammatory diets as measured by the dietary inflammatory index (DII), and inflammation biomarkers, and the development of preeclampsia among the Chinese population. We followed the reporting guidelines of the STROBE statement for observational studies. A total of 466 preeclampsia cases aged over 18 years were recruited between March 2016 and June 2019, and 466 healthy controls were 1:1 ratio matched by age (± 3 years), week of gestation (± 1 week), and gestational diabetes mellitus. The energy-adjusted DII (E-DII) was computed based on dietary intake assessed using a 79-item semiquantitative food frequency questionnaire (FFQ). Inflammatory biomarkers were analyzed by ELISA kits. The mean E-DII scores were -0.65 ± 1.58 for cases and -1.19 ± 1.47 for controls (P value <0.001). E-DII scores positively correlated with IFN-γ (rs = 0.194, P value = 0.001) and IL-4 (rs = 0.135, P value = 0.021). After multivariable adjustment, E-DII scores were positively related to preeclampsia risk (P trend <0.001). The highest tertile of E-DII was 2.18 times the lowest tertiles (95% CI = 1.52, 3.13). The odds of preeclampsia increased by 30% (95% CI= 18%, 43%, P value <0.001) for each E-DII score increase. The preeclampsia risk was positively associated with IL-2 (OR = 1.07, 95% CI = 1.03, 1.11), IL-4 (OR = 1.26, 95% CI = 1.03, 1.54) and TGF-β (OR = 1.17, 95% CI = 1.06, 1.29). Therefore, proinflammatory diets, corresponding to higher IL-2, IL-4 and TGF-β levels, were associated with increased preeclampsia risk.
It is important to know how much of the increased atmospheric CO2 is derived from fossil fuel emissions. Here, we review the progress in atmospheric fossil fuel CO2 (CO2ff) tracing over recent years by measurement of Δ14C in Chinese cities. In this paper we make progress by expanding the analysis from some locations to more regional views, by combining observations with modeling, and by making a preliminary comparison of observation-derived CO2ff with inventory-derived CO2ff. We have obtained a general picture of Chinese urban CO2ff and characteristics of its spatio-temporal variations at different scale, and identified the corresponding influencing factors. Interestingly, we found that the weekend effect of CO2ff was less evident in Chinese cities. In addition, we observed simultaneous variations in CO2ff and PM2.5 in a winter haze event in Beijing and a simultaneous decrease in annual averages of CO2ff and PM2.5 in Xi’an based on multi-year (2011–2016) Δ14CO2 monitoring. We found that local coal combustion was the main source of CO2ff in Xi’an, which is located in the Guanzhong basin, by applying a WRF-Chem model and looking at δ13C signatures. Thus, reduction of coal consumption is a crucial target for carbon emissions reduction in China.
The role of neurological proteins in the development of bipolar disorder (BD) and schizophrenia (SCZ) remains elusive now. The current study aims to explore the potential genetic correlations of plasma neurological proteins with BD and SCZ.
Methods:
By using the latest genome-wide association study (GWAS) summary data of BD and SCZ (including 41,917 BD cases, 11,260 SCZ cases, and 396,091 controls) derived from the Psychiatric GWAS Consortium website (PGC) and a recently released GWAS of neurological proteins (including 750 individuals), we performed a linkage disequilibrium score regression (LDSC) analysis to detect the potential genetic correlations between the two common psychiatric disorders and each of the 92 neurological proteins. Two-sample Mendelian randomisation (MR) analysis was then applied to assess the bidirectional causal relationship between the neurological proteins identified by LDSC, BD and SCZ.
Results:
LDSC analysis identified one neurological protein, NEP, which shows suggestive genetic correlation signals for both BD (coefficient = −0.165, p value = 0.035) and SCZ (coefficient = −0.235, p value = 0.020). However, those association did not remain significant after strict Bonferroni correction. Two sample MR analysis found that there was an association between genetically predicted level of NEP protein, BD (odd ratio [OR] = 0.87, p value = 1.61 × 10−6) and SCZ (OR = 0.90, p value = 4.04 × 10−6). However, in the opposite direction, there is no genetically predicted association between BD, SCZ, and NEP protein level.
Conclusion:
This study provided novel clues for understanding the genetic effects of neurological proteins on BD and SCZ.
For individual cultures, findings on regulating embryo density by changing the microdrop volume are contradictory. The aim of this study was to investigate the relationship between embryo density and the developmental outcome of day 3 embryos after adjusting covariates. In total, 1196 embryos from 206 couples who had undergone in vitro fertilization treatment were analyzed retrospectively. Three embryo densities were used routinely, i.e. one embryo in a drop (30 μl/embryo), two embryos in a drop (15 μl/embryo) and three embryos in a drop (10 μl/embryo). Embryo quality on day 3 was evaluated, both the cell number of day 3 embryos and the proportion of successful implantations served as endpoints. Maternal age, paternal age, antral follicles and level of anti-Müllerian hormone, type of infertility, controlled ovarian stimulation protocol, length of stimulation, number of retrieved oocytes, number of zygotes (two pronuclei) and insemination type were covariates and adjusted. After adjusting fully for all covariates, the cell number of day 3 embryos was significantly increased by 0.40 (95% CI 0.00, 0.79; P = 0.048) and 0.78 (95% CI 0.02, 1.54; P = 0.044) in the 15 μl/embryo and 10 μl/embryo group separately, compared with the 30 μl/embryo group. The proportions of implanted embryos were 42.1%, 48.7% and 0.0% in the 30 μl/embryo, 15 μl/embryo and 10 μl/embryo groups respectively. There was no statistical significance (P = 0.22) between the 30 μl/embryo group and the 15 μl/embryo group. After adjusting for confounders that were significant in univariate analysis, embryo density was still not associated with day 3 embryo implantation potential (P > 0.05). In a 30-μl microdrop, culturing embryos with an embryo density of both 15 and 10 μl/embryo increased the cell number of day 3 embryos, which did not benefit embryo implanting potential, compared with individual culture of 30 μl/embryo.
We perform a theoretical investigation of the instability of a helical vortex filament beneath a free surface in a semi-infinite ideal fluid. The focus is on the leading-order free-surface boundary effect upon the equilibrium form and instability of the vortex. This effect is characterised by the Froude number $F_r = U(gh^*)^{-{1}/{2}}$ where $g$ is gravity, and $U = \varGamma /(2{\rm \pi} b^*)$ with $\varGamma$ being the strength, $2{\rm \pi} b^*$ the pitch and $h^*$ the centre submergence of the helical vortex. In the case of $F_r \rightarrow 0$ corresponding to the presence of a rigid boundary, a new approximate equilibrium form is found if the vortex possesses a non-zero rotational velocity. Compared with the infinite fluid case (Widnall, J. Fluid Mech., vol. 54, no. 4, 1972, pp. 641–663), the vortex is destabilised (or stabilised) to relatively short- (or long-)wavelength sub-harmonic perturbations, but remains stable to super-harmonic perturbations. The wall-boundary effect becomes stronger for smaller helix angle and could dominate over the self-induced flow effect depending on the submergence. In the case of $F_r > 0$, we obtain the surface wave solution induced by the vortex in the context of linearised potential-flow theory. The wave elevation is unbounded when the $m$th wave mode becomes resonant as $F_r$ approaches the critical Froude numbers ${\mathcal {F}} (m) = (C_0^*/U)^{-1} (mh^*/b^*)^{-{1}/{2}}$, $m=1, 2, \ldots,$ where $C_0^*$ is the induced wave speed. We find that the new approximate equilibrium of the vortex exists if and only if $F_r < {\mathcal {F}}(1)$. Compared with the infinite fluid and $F_r \rightarrow 0$ cases, the wave effect causes the vortex to be destabilised to super-harmonic and long-wavelength sub-harmonic perturbations with generally faster growth rate for greater $F_r$ and smaller helix angle.
This study examined the influences of coated folic acid (CFA) and coated riboflavin (CRF) on bull performance, nutrients digestion and ruminal fermentation. Forty-eight Angus bulls based on a randomised block and 2 × 2 factorial design were assigned to four treatments. The CFA of 0 or 6 mg of folic acid/kg DM was supplemented in diets with CRF 0 or 60 mg riboflavin (RF)/kg DM. Supplementation of CRF in diets with CFA had greater increase in daily weight gain and feed efficiency than in diets without CFA. Supplementation with CFA or CRF enhanced digestibility of DM, organic matter, crude protein, neutral-detergent fibre and non-fibre carbohydrate. Ruminal pH and ammonia N content decreased and total volatile fatty acids concentration and acetate to propionate ratio elevated for CFA or CRF addition. Supplement of CFA or CRF increased the activities of fibrolytic enzymes and the numbers of total bacteria, protozoa, fungi, dominant fibrolytic bacteria and Prevotella ruminicola. The activities of α-amylase, protease and pectinase and the numbers of Butyrivibrio fibrisolvens and Ruminobacter amylophilus were increased by CFA but were unaffected by CRF. Blood concentration of folate elevated and homocysteine decreased for CFA addition. The CRF supplementation elevated blood concentrations of folate and RF. These findings suggested that CFA or CRF inclusion had facilitating effects on performance and ruminal fermentation, and combined addition of CFA and CRF had greater increase in performance than CFA or CRF addition alone in bulls.
To compare the prevalence of overweight or obesity (ow/ob) with WHO BMI cut-off points, International Obesity Task Force (IOTF) cut-off points and Chinese BMI criteria and examine its potential factors among preschool children in Hunan Province.
Design:
A cross-sectional survey including anthropometric measurements and questionnaires about children’s information, caregivers’ socio-demographic characteristics and maternal characteristics. χ2 tests and univariate and multivariate binary logistic regression were performed to evaluate the possible factors of ow/ob.
Setting:
Hunan, China, from September to October 2019.
Participants:
In total, 7664 children 2 to 6 years of age.
Results:
According to Chinese BMI criteria, about 1 in 7–8 children aged 2–6 years had ow/ob in Hunan, China. The overall estimated prevalence of ow/ob among 2- to 6-year-old children was significantly higher when based on the Chinese BMI criteria compared with the WHO BMI cut-off points and IOTF cut-off points. According to Chinese BMI criteria, ow/ob was associated with residing in urban areas, older age, male sex, eating snacking food more frequently, macrosomia delivery, caesarean birth, heavier maternal prepregnancy weight and pre-delivery weight.
Conclusion:
The prevalence of ow/ob in preschool children in Hunan Province remains high. More ow/ob children could be screened out according to Chinese BMI cut-offs compared with WHO and IOTF BMI criteria. In the future, targeted intervention studies with matched controls will be needed to assess the long-term effects of intervention measures to provide more information for childhood obesity prevention and treatment.
During the first postnatal week in rodents, cholinergic retinal waves initiate in starburst amacrine cells (SACs), propagating to retinal ganglion cells (RGCs) and visual centers, essential for visual circuit refinement. By modulating exocytosis in SACs, dynamic changes in the protein kinase A (PKA) activity can regulate the spatiotemporal patterns of cholinergic waves. Previously, cysteine string protein-α (CSPα) is found to interact with the core exocytotic machinery by PKA-mediated phosphorylation at serine 10 (S10). However, whether PKA-mediated CSPα phosphorylation may regulate cholinergic waves via SACs remains unknown. Here, we examined how CSPα phosphorylation in SACs regulates cholinergic waves. First, we identified that CSPα1 is the major isoform in developing rat SACs and the inner plexiform layer during the first postnatal week. Using SAC-specific expression, we found that the CSPα1-PKA-phosphodeficient mutant (CSP-S10A) decreased wave frequency, but did not alter the wave spatial correlation compared to control, wild-type CSPα1 (CSP-WT), or two PKA-phosphomimetic mutants (CSP-S10D and CSP-S10E). These suggest that CSPα-S10 phosphodeficiency in SACs dampens the frequency of cholinergic waves. Moreover, the level of phospho-PKA substrates was significantly reduced in SACs overexpressing CSP-S10A compared to control or CSP-WT, suggesting that the dampened wave frequency is correlated with the decreased PKA activity. Further, compared to control or CSP-WT, CSP-S10A in SACs reduced the periodicity of wave-associated postsynaptic currents (PSCs) in neighboring RGCs, suggesting that these RGCs received the weakened synaptic inputs from SACs overexpressing CSP-S10A. Finally, CSP-S10A in SACs decreased the PSC amplitude and the slope to peak PSC compared to control or CSP-WT, suggesting that CSPα-S10 phosphodeficiency may dampen the speed of the SAC-RGC transmission. Thus, via PKA-mediated phosphorylation, CSPα in SACs may facilitate the SAC-RGC transmission, contributing to the robust frequency of cholinergic waves.
The mechanisms of leading-edge vortex (LEV) formation and its stable attachment to revolving wings depend highly on Reynolds number ($\textit {Re}$). In this study, using numerical methods, we examined the $\textit {Re}$ dependence of LEV formation dynamics and stability on revolving wings with $\textit {Re}$ ranging from 10 to 5000. Our results show that the duration of the LEV formation period and its steady-state intensity both reduce significantly as $\textit {Re}$ decreases from 1000 to 10. Moreover, the primary mechanisms contributing to LEV stability can vary at different $\textit {Re}$ levels. At $\textit {Re} <200$, the LEV stability is mainly driven by viscous diffusion. At $200<\textit {Re} <1000$, the LEV is maintained by two distinct vortex-tilting-based mechanisms, i.e. the planetary vorticity tilting and the radial–tangential vorticity balance. At $\textit {Re}>1000$, the radial–tangential vorticity balance becomes the primary contributor to LEV stability, in addition to secondary contributions from tip-ward vorticity convection, vortex compression and planetary vorticity tilting. It is further shown that the regions of tip-ward vorticity convection and tip-ward pressure gradient almost overlap at high $\textit {Re}$. In addition, the contribution of planetary vorticity tilting in LEV stability is $\textit {Re}$-independent. This work provides novel insights into the various mechanisms, in particular those of vortex tilting, in driving the LEV formation and stability on low-$\textit {Re}$ revolving wings.
Early adversity confers risk for depression in part through its association with recent (i.e., proximal) acute stress. However, it remains unresolved whether: a) early adversity predicts increases in recent acute stress over time; b) all – or only certain types – of recent events mediate the relationship between early adversity and depression; and c) early adversity places individuals at greater risk for depression via greater exposure to independent (i.e., fateful) interpersonal events or via greater generation of dependent (i.e., partially self-initiated) interpersonal events (i.e., stress generation) or both. These questions were examined in a 3-wave longitudinal study of early adolescent girls (N = 125; M = 12.35 years [SD = .77]) with no history of diagnosable depression using contextual life stress and diagnostic interviews. Path analyses indicated that increases in past-year acute interpersonal, but not non-interpersonal, stress mediated the link between early adversity and depressive symptoms. The mediating role of interpersonal events was limited to independent ones, suggesting increases in interpersonal event exposure, not interpersonal stress generation, acted as a mediator. Finally, findings support prior evidence that early adversity may not directly predict future depressive symptoms. Implications for understanding the role of recent stress in the association between early adversity and adolescent depression are discussed.
Lacustrine sediments are important archives for paleoclimate research, but there are evident carbon reservoir effects. Radiocarbon (14C) ages of lake sediments must be corrected for these effects before applying them to paleoclimate research. The authors review the lacustrine research from the last 20 years from different climatic regions in China, and systematically investigate the 14C age and correction methods used in the studies of 81 lakes. It is found that the climate-vegetation cover and distribution of carbonate around lakes are dominant factor controlling radiocarbon reservoir effects. In eastern China, the average 14C reservoir age is about 500 14C years and is associated with relatively dense vegetation. However, in northwest China and Qinghai-Tibet Plateau, widespread carbonate bedrock may markedly increase the radiocarbon reservoir age which frequently is about 1500 and 2500 14C years. A piecewise linear regression model provides more reliable 14C reservoir age correction that accounts for sedimentary facies and sedimentation rate changes. It is worth mentioning that when analyzing 14C ages deviated greatly from time sequence, the age anomalies may indicate important effects relevant to the study of climate and environmental changes.
This study aimed to determine the risk factors for chronic diseases and to identify the potential influencing mechanisms from the perspectives of lifestyle and dietary factors. The findings could provide updated and innovative evidence for the prevention and control of chronic diseases.
Design:
A cross-sectional study.
Setting:
Shanghai, China.
Participants:
1005 adults from Yangpu district of Shanghai participated in the study, and responded to questions on dietary habits, lifestyle and health status.
Results:
Residents suffering from chronic diseases accounted for about 34·99 % of the respondents. Logistic regression analysis showed that age, diet quality, amount of exercise and tea drinking were related to chronic diseases. Age > 60 and overeating (Diet Balance Index total score > 0) had negative additive interaction on the occurrence of chronic disease, while overexercise (Physical Activity Index > 17·1) and tea drinking had negative multiplicative interaction and negative additive interaction on the occurrence of chronic disease. Diet quality, physical activity and tea drinking were incomplete mediators of the relationship between types of medical insurance residents participating in and chronic diseases.
Conclusions:
The residents in Yangpu District of Shanghai have a high prevalence of chronic diseases. Strengthening access of residents to health education and interventions to prevent chronic diseases and cultivating healthy eating and exercise habits of residents are crucial. The nutritional environment of the elderly population should be considered, and the reimbursement level of different types of medical insurance should be designed reasonably to improve the accessibility of medical and health services and reduce the risk of chronic diseases.
Cognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β-amyloid (Aβ) deposits in brain regions responsible for global cognition.
Methods
We recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain Aβ pathology and glucose use, respectively, in some patients.
Results
MDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more Aβ deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal Aβ deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected.
Conclusions
Late-life depression, particularly TRD, had increased brain Aβ deposits and showed vulnerability to Aβ deposits. A detrimental role of Aβ deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD.
Bistabilities of two equilibrium states discovered in the coupled side-by-side Kármán wakes are investigated through Floquet analysis and direct numerical simulation (DNS) with different initial conditions over a range of gap-to-diameter ratio ($g^*= 0.2\text {--}3.5$) and Reynolds number ($Re = 47\text {--}100$). Two bistabilities are found in the transitional $g^*-Re$ regions from in-phase (IP) to anti-phase (AP) vortex shedding states. By initialising the flow in DNS with zero initial conditions, the flow in the first bistable region (i.e. bistable IP/FF$_C$ at $g^*= 1.4 \text {--} 2.0$, where FF$_C$ denotes the conditional flip-flop flow) attains flip-flop (FF) flow, it settles into the IP state by initialising the flow with an IP flow. The second bistability is observed between cylinder-scale IP and AP states at large $g^*$ ($=$ 2.0–3.5). The transition from the FF$_C$ to IP is dependent on initial conditions and irreversible over the parameter space, meaning that the flow cannot revert back to the FF$_C$ state once it jumps to the IP state irrespective of the direction of $Re$ variations. Its counterpart for the bistable IP/AP state is reversible. We also found that the FF$_C$ flow in the first bistable region is primarily bifurcated from synchronised AP with cluster-scale features, possibly because the cluster-scale AP flow is inherently unstable to FF flow instabilities. It is demonstrated that the irreversible bistability exists in other interacting wakes around multiple cylinders. A good understanding of flow bistabilities is pivotal to flow control applications and the interpretation of desynchronised flow features observed at high $Re$ values.