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We aimed to evaluate the association of coffee consumption with different additives, including milk and/or sweetener (sugar and/or artificial sweetener), and different coffee types, with new-onset acute kidney injury (AKI), and examine the modifying effects of genetic variation in caffeine metabolism. 194 324 participants without AKI at baseline in the UK Biobank were included. The study outcome was new-onset AKI. During a median follow-up of 11·6 years, 5864 participants developed new-onset AKI. Compared with coffee non-consumers, a significantly lower risk of new-onset AKI was found in coffee consumers adding neither milk nor sugar to coffee (hazard ratio (HR), 0·86; 95 % CI, 0·78, 0·94) and adding only milk to coffee (HR,0·83; 95 % CI, 0·78, 0·89), but not in coffee consumers adding only sweetener (HR,1·14; 95 % CI, 0·99, 1·31) and both milk and sweetener to coffee (HR,0·96; 95 % CI, 0·89, 1·03). Moreover, there was a U-shaped association of coffee consumption with new-onset AKI, with the lowest risk at 2–3 drinks/d, in unsweetened coffee (no additives or milk only to coffee), but no association was found in sweetened coffee (sweetener only or both milk and sweetener to coffee). Genetic variation in caffeine metabolism did not significantly modify the association. A similar U-shaped association was found for instant, ground and decaffeinated coffee consumption in unsweetened coffee consumers, but not in sweetened coffee consumers. In conclusion, moderate consumption (2–3 drinks/d) of unsweetened coffee with or without milk was associated with a lower risk of new-onset AKI, irrespective of coffee type and genetic variation in caffeine metabolism.
Depression is a significant mental health concern affecting the overall well-being of adolescents and young adults. Recently, the prevalence of depression has increased among young people. Nonetheless, there is little research delving into the longitudinal epidemiology of adolescent depression over time.
Aims
To investigate the longitudinal epidemiology of depression among adolescents and young adults aged 10–24 years.
Method
Our research focused on young people (aged 10–24 years) with depression, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We explored the age-standardised prevalence, incidence and disability-adjusted life-years (DALYs) of depression in different groups, including various regions, ages, genders and sociodemographic indices, from 1990 to 2019.
Results
The prevalence, incidence and DALYs of depression in young people increased globally between 1990 and 2019. Regionally, higher-income regions like High-Income North America and Australasia recorded rising age-standardised prevalence and incidence rates, whereas low- or middle-income regions mostly saw reductions. Nationally, countries such as Greenland, the USA and Palestine reported the highest age-standardised prevalence and incidence rates in 2019, whereas Qatar witnessed the largest growth over time. The burden disproportionately affected females across age groups and world regions. The most prominent age effect on incidence and prevalence rates was in those aged 20–24 years. The depression burden showed an unfavourable trend in younger cohorts born after 1980, with females reporting a higher cohort risk than males.
Conclusions
Between 1990 and 2019, the general pattern of depression among adolescents varied according to age, gender, time period and generational cohort, across regions and nations.
In this paper, we analyse Turing instability and bifurcations in a host–parasitoid model with nonlocal effect. For a ordinary differential equation model, we provide some preliminary analysis on Hopf bifurcation. For a reaction–diffusion model with local intraspecific prey competition, we first explore the Turing instability of spatially homogeneous steady states. Next, we show that the model can undergo Hopf bifurcation and Turing–Hopf bifurcation, and find that a pair of spatially nonhomogeneous periodic solutions is stable for a (8,0)-mode Turing–Hopf bifurcation and unstable for a (3,0)-mode Turing–Hopf bifurcation. For a reaction–diffusion model with nonlocal intraspecific prey competition, we study the existence of the Hopf bifurcation, double-Hopf bifurcation, Turing bifurcation, and Turing–Hopf bifurcation successively, and find that a spatially nonhomogeneous quasi-periodic solution is unstable for a (0,1)-mode double-Hopf bifurcation. Our results indicate that the model exhibits complex pattern formations, including transient states, monostability, bistability, and tristability. Finally, numerical simulations are provided to illustrate complex dynamics and verify our theoretical results.
The latest international guideline recommended the add-on therapy of ezetimibe and PCSK9 inhibitors in selected people for the secondary prevention of cardiovascular diseases (CVDs). However, it remains unclear whether these regimens fit the Chinese healthcare system economically.
Methods
Based on the Chinese context, this simulation study evaluated four therapeutic strategies including the high-dose statin-only group, ezetimibe plus statin group, PCSK9 inhibitors plus statin group, and PCSK9 inhibitors plus ezetimibe plus statin group. The team developed a Markov model to estimate the incremental cost-effectiveness ratio (ICER). With each 1-yr cycle, the simulation subjects could have nonfatal cardiovascular events (stroke and/or myocardial infarction) or death (vascular or nonvascular death event) with a follow-up duration of 20 yr. Cardiovascular risk reduction was gathered from a network meta-analysis, and cost and utility data were gathered from hospital databases and published research.
Results
For Chinese adults receiving high-dose statins for secondary prevention of CVDs, the ICER was US$68,910 per quality-adjusted life year (QALY) for adding PCSK9 inhibitors, US$20,242 per QALY for adding ezetimibe, US$51,552 per QALY for adding both drugs. Given a threshold of US$37,655 (three times of Chinese GDP), the probability of cost-effectiveness is 2.9 percent for adding PCSK9 inhibitors, 53.1 percent for adding ezetimibe, and 16.8 percent for adding both drugs. To meet the cost-effectiveness, an acquisition price reduction of PCSK9 inhibitors of 33.6 percent is necessary.
Conclusion
In Chinese adults receiving high-dose statins for the secondary prevention of CVDs, adding ezetimibe is cost-effective compared to adding PCSK9 inhibitors and adding both drugs.
The purpose of this study was to analyse the clinical characteristics of patients with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) PCR re-positivity after recovering from coronavirus disease 2019 (COVID-19). Patients (n = 1391) from Guangzhou, China, who had recovered from COVID-19 were recruited between 7 September 2021 and 11 March 2022. Data on epidemiology, symptoms, laboratory test results and treatment were analysed. In this study, 42.7% of recovered patients had re-positive result. Most re-positive patients were asymptomatic, did not have severe comorbidities, and were not contagious. The re-positivity rate was 39%, 46%, 11% and 25% in patients who had received inactivated, mRNA, adenovirus vector and recombinant subunit vaccines, respectively. Seven independent risk factors for testing re-positive were identified, and a predictive model was constructed using these variables. The predictors of re-positivity were COVID-19 vaccination status, previous SARs-CoV-12 infection prior to the most recent episode, renal function, SARS-CoV-2 IgG and IgM antibody levels and white blood cell count. The predictive model could benefit the control of the spread of COVID-19.
Instrument delivery is critical part in vascular intervention surgery. Due to the soft-body structure of instruments, the relationship between manipulation commands and instrument motion is non-linear, making instrument delivery challenging and time-consuming. Reinforcement learning has the potential to learn manipulation skills and automate instrument delivery with enhanced success rates and reduced workload of physicians. However, due to the sample inefficiency when using high-dimensional images, existing reinforcement learning algorithms are limited on realistic vascular robotic systems. To alleviate this problem, this paper proposes discrete soft actor-critic with auto-encoder (DSAC-AE) that augments SAC-discrete with an auxiliary reconstruction task. The algorithm is applied with distributed sample collection and parameter update in a robot-assisted preclinical environment. Experimental results indicate that guidewire delivery can be automatically implemented after 50k sampling steps in less than 15 h, demonstrating the proposed algorithm has the great potential to learn manipulation skill for vascular robotic systems.
This study aimed to evaluate to what extent the different interval times between trophectoderm (TE) biopsy and vitrification influence the clinical outcomes in preimplantation genetic testing (PGT) cycles. Patients who underwent frozen embryo transfer (FET) after PGT between 2015 and 2019 were recruited. In total, 297 cycles with single day 5 euploid blastocyst transfer were included. These cycles were divided into three groups according to the interval times: <1 h group, 1–2 h group, and ≥2 h group. Blastocyst survival, clinical pregnancy, miscarriage, and ongoing pregnancy rates were compared. The results showed that, in PGT-SR cycles, survival rate in the ≥2 h group (96.72%) was significantly lower than in the <1 h group (100%, P = 0.047). The clinical pregnancy rate in the ≥2 h group was 55.93%, significantly lower than in the <1 h group (74.26%, P = 0.017). The ongoing pregnancy rates in the 1–2 h group and the ≥2 h group were 48.28% and 47.46%, respectively, significantly lower than that in the <1 h group (67.33%, P < 0.05). The miscarriage rate in the 1–2 h group was 18.42%, significantly higher than that in the <1 h group (5.33%, P = 0.027). In PGT-A cycles, the clinical pregnancy and ongoing pregnancy rates in the <1 h group were 67.44% and 53.49%, respectively, higher than that in the 1–2 h group (52.94%, 47.06%, P > 0.05) and the ≥2 h group (52.63%, 36.84%, P > 0.05). In conclusion, vitrification of blastocysts beyond 1 h after biopsy significantly influences embryo survival and clinical outcomes and is therefore not recommended.
The dependence of fishbone cycle on energetic particle intensity has been investigated in EAST low-magnetic-shear plasmas. It is observed that the fishbone mode growth rate, saturation amplitude as well as fishbone cycle frequency clearly increase with increasing neutral beam injection (NBI) power. Moreover, enhanced electron density and temperature perturbations as well as energetic particle loss were observed with greater injected NBI power. Simulation results using M3D-K code show that as the NBI power increases, the resonant frequency and the energy of the resonant particles become higher, and the saturation amplitude of the mode also changes, due to the non-perturbative energetic particle contribution. The relationship between the calculated energetic particle pressure ratio and fishbone cycle frequency is obtained as ${f_{\textrm{FC}}} = 2.2{(1000{\beta _{\textrm{ep,calc}}} - 0.1)^{5.9 \pm 0.5}}$. Results consistent with the experimental observations have been achieved based on a predator–prey model.
The flow structures and the acoustic feedback loops of underexpanded round jets are investigated by numerical simulations. The jets have a Mach number of 1 at the nozzle exit and a diameter-based Reynolds number of $2.5 \times {10^3}$. Three nozzle pressure ratios (NPRs) of 2.2, 2.4 and 2.6 are considered. The wavelengths of the screech tones are in good agreement with the experimental measurements on high-Reynolds-number jets in the literature. The screech tones are respectively at the A1 and B modes for the jets at NPRs of 2.2 and 2.6. Two screech tones at the A2 and B modes are identified in the jet at the NPR of 2.4 and the wavelet analyses conducted on the pressure fluctuations confirm that these two modes are contemporaneous. The amplitude and phase fields of fluctuating pressure at the screech frequencies are presented in the nozzle exit plane and azimuthal planes. The effective source locations of the screech tones are determined based on the distributions of the phase. The number of periods contained in the screech feedback loop is equal to the number of cells in the standing wave between the nozzle exit and the effective source. The screech frequencies estimated by the classical feedback model agree well with the numerical results at different modes. A modified model, in which the classical feedback model and the upstream-propagating acoustic wave mode of the jet are combined, shows that the screech feedback loops at the A1 and A2 modes are associated with the same acoustic wave mode. The modified model fails to estimate the screech frequencies at the B mode. Different feedback mechanisms lead to the coexistence of the A2 and B modes. The coherent structures corresponding to different screech modes are extracted by dynamic mode decomposition.
LAMOST has obtained a large number of spectra for K-giant stars whose metallicities are well measured and released in DR5. Combining with the distances, radial velocities and proper motions provided by Gaia DR2, the full position and velocity information has been obtained. Using the Bayesian method we have constrained the rotational velocity of the halo and thick disk components in the local volume within 4 kpc from the Sun. The values of the rotational velocity are and for the halo and disk respectively, with the velocity of LSR assumed to be 232 km s−1. The dispersions of the rotational velocity are and for the two components. What’s more, another hot retrogradely rotating component is discovered.
Harnessing the nonvolatility of magnetism and the power of electric control, magnetoelectric devices that control magnetism electrically promise to deliver next-generation electronics systems that can store and compute large amounts of information with minimal power consumption and ultrafast processing speed. We highlight progress in magnetoelectric memory and logic prototypes using the voltage-controlled magnetic anisotropy (VCMA) effect. First, important performance metrics of VCMA-based magnetoelectric random access memory (MeRAM) are benchmarked against embedded complementary metal oxide semiconductor and other emerging embedded nonvolatile memories. We then discuss scaling of MeRAM from the physics and materials perspectives of the VCMA effect, as well as the use of magnetoelectric logic devices and circuits to realize new computing paradigms with VCMA. Finally, challenges to realize the full potential of VCMA-based memory and logic are presented: VCMA coefficient of 1000 fJ/V-m for energy-efficient write with low errors and tunneling magnetoresistance of 1000% for high density and low noise margin readout. New approaches for deterministic switching based on VCMA are needed. We share perspectives to address these challenges using new materials and device operation schemes.
Given the global water challenges, solar-driven steam generation has become a renewed topic recently as an energy-efficient way for clean water production. Here, a hybrid plasmonic structure consisting of a top layer of TiN nanoparticles (NPs) and a bottom layer of mesoporous anodized alumina membrane (AAM) was rationally designed and fabricated. The top TiN NPs with broadband light absorption acted as a plasmonic heating layer, which converted the absorbed light to heat efficiently for interfacial water heating. The AAM acted as the mechanical support layer, guaranteeing the heat isolation and continuous water replenishment. With optimized thickness of the TiN top layer, a solar steam generation efficiency of 87.7% was achieved in this study. This efficiency is comparable or even higher than prior studies. The current work proves the capability of the TiN NPs as an alternative photothermal material.
SCN5A encodes sodium-channel α-subunit Nav1.5. The mutations of SCN5A can lead to hereditary cardiac arrhythmias such as the long-QT syndrome type 3 and Brugada syndrome. Here we sought to identify novel mutations in a family with arrhythmia.
Methods
Genomic DNA was isolated from blood of the proband, who was diagnosed with atrial flutter. Illumina Hiseq 2000 whole-exome sequencing was performed and an arrhythmia-related gene-filtering strategy was used to analyse the pathogenic genes. Sanger sequencing was applied to verify the mutation co-segregated in the family.
Results and conclusions
A novel missense mutation in SCN5A (C335R) was identified, and this mutation co-segregated within the affected family members. This missense mutation was predicted to result in amplitude reduction in peak Na+ current, further leading to channel protein dysfunction. Our study expands the spectrum of SCN5A mutations and contributes to genetic counselling of families with arrhythmia.
The genus Sphenothallus was erected by Hall (1847, p. 261), who originally considered it a land plant. Sphenothallus was later classified as a marine invertebrate. Moore and Harrington (1956, p. F65) regarded Sphenothallus as a hydrozoan or scyphozoan. Van Iten et al. (1992, p. 139) supported Moore and Harrington's idea, and argued that it displays a close relationship to conularids (also see Li, 2000, p. 91). However, Mason and Yochelson (1985, p. 93–94) suggested that Sphenothallus is an annelid or “worm” (also see Fauchald et al., 1986, p. 64; Feldmann et al., 1986, p. 344–345; Choi, 1990, p. 403; Bartels et al., 1998, p. 114–117). The exact phylogenetic affinity of Sphenothallus is still debated.
We previously reported that medium-chain TAG (MCT) could alleviate hepatic oxidative damage in weanling piglets with intra-uterine growth retardation (IUGR). There is a relationship between oxidative status and energy metabolism, a process involved in substrate availability and glucose flux. Therefore, the aim of this study was to investigate the effects of IUGR and MCT on hepatic energy metabolism and mitochondrial function in weanling piglets. Twenty-four IUGR piglets and twenty-four normal-birth-weight (NBW) piglets were fed a diet of either soyabean oil (SO) or MCT from 21 d of postnatal age to 49 d of postnatal age. Then, the piglets’ biochemical parameters and gene expressions related to energy metabolism and mitochondrial function were determined (n 4). Compared with NBW, IUGR decreased the ATP contents and succinate oxidation rates in the liver of piglets, and reduced hepatic mitochondrial citrate synthase (CS) activity (P<0·05). IUGR piglets exhibited reductions in hepatic mitochondrial DNA (mtDNA) contents and gene expressions related to mitochondrial biogenesis compared with NBW piglets (P<0·05). The MCT diet increased plasma ghrelin concentration and hepatic CS and succinate dehydrogenase activities, but decreased hepatic pyruvate kinase activity compared with the SO diet (P<0·05). The MCT-fed piglets showed improved mtDNA contents and PPARγ coactivator-1α expression in the liver (P<0·05). The MCT diet alleviated decreased mRNA abundance of the hepatic PPARα induced by IUGR (P<0·05). It can therefore be postulated that MCT may have beneficial effects in improving energy metabolism and mitochondrial function in weanling piglets.
In this paper, a three-dimensional (3D) model as a new module of LAP3D code is presented to study the crossed-beam energy transfer (CBET) process. This model is not limited by the paraxial approximation and can be used to deal with a large crossing angle case. Besides, this model is also appropriate for the multi-ion species conditions and even multi-beams problems, which will be very helpful in relevant experiment analysis and the target design. In our 3D simulations, we take the overlapped beams with a 60° crossing angle as an example, and observe obvious energy transfer process, which indicates CBET process might occur between the incident laser beams with a large crossing angle when the matching condition is satisfied. This large crossing angle CBET process also can change the spatial shape of the beam spot, and may have some potential important influence on other laser–plasma interaction instabilities and the energy symmetry in hohlraum.
Poly(lactic acid) (PLA)/graphene oxide (GO) nanocomposites were prepared by solution mixing. Differential scanning calorimetry results indicated that GO was an effective nucleating agent. The size of spherulites decreased, the density of spherulites increased with increasing GO and the crystallinity of PLA increased from 4.34 to 49.01%. For isothermal crystallization, the crystallization rates of PLA/GO nanocomposites were significantly higher than that of neat PLA, in which t0.5 reduced from 9.0 to 2.8. Spindle-like nanopores (about 100–200 nm) that arranged like spherulites were prepared by low temperature foaming. It was found that the crystallization rate increase and spherulite morphology change were insignificant when the content of GO exceeded 0.5 wt%, because the excessive GO increased the number of nucleation sites while restricting the PLA crystal growth. Thus, the arrangement of nanopores did not mimick the spherulites because of imperfect crystal morphology.
The work was intended to explore the effect of the widely available cationic polymer polyethylenimine (PEI) on small diameter poly(ɛ-caprolactone) (PCL) blood vessel grafts. PEI was blended with PCL and electrospun into nanofibrous vascular scaffolds. The morphologies, wettabilities, mechanical properties, and biological activities of the PCL/PEI electrospun nanofibers were investigated. It was found that by increasing the content of PEI to 5% within the scaffolds, the fiber diameters decreased from 469.7 ± 212.1 to 282.5 ± 107.1 nm, the water contact angle was reduced from 126.6 ± 1.1° to 27.6 ± 3.9°, while the Young's modulus increased from 2.0 ± 0.2 to 4.1 ± 0.1 MPa, the suture retention strength increased from 4.2 ± 0.4 to 6.1 ± 0.7 N, and the burst pressure increased from 801.2 ± 14.1 to 926.2 ± 22.8 mmHg. The in vitro evaluations demonstrated that the nanofibers containing 2% PEI promoted the attachment and proliferation of human umbilical vein endothelial cells (HUVECs).
Microcellular injection molding, a process capable of mass-producing complex plastic parts, and particle leaching methods were combined to fabricate porous thermoplastic polyurethane tissue engineering scaffolds. Water soluble polyvinyl alcohol (PVOH) and sodium chloride (NaCl) were used as porogens to improve the porosity and interconnectivity as well as the hydrophilicity of the scaffolds. It was found in the study that the microcellular injection molding process was effective at producing high pore density and porosity. The addition of PVOH decreased the pore diameter and increased the pore density. Furthermore, scaffolds with NaCl and PVOH porogens showed more interconnected pores. The 3T3 fibroblast cell culture was used to confirm the biocompatibility of the scaffolds. Residual PVOH content after leaching increased the hydrophilicity of the scaffolds and further improved cell adhesion and proliferation. The resulting scaffolds offer an alternative scalable tissue scaffold fabrication method for soft tissue scaffold production.
Porous thermoplastic polyurethane (TPU) membranes were produced by the electrospinning process. Two different TPUs and their blends were used to investigate the effects of material composition, solution concentration, and rheological properties on the microstructure, fiber diameter, and fiber diameter distribution of the electrospun membranes. The ratios of hard and soft segments in the solutions were adjusted by varying the blend ratios of TPUs dissolved in N, N-dimethylformamide. The solutions with higher TPU concentrations and more hard segments exhibited a higher viscosity, larger storage and loss moduli, and greater electrospun jet stability. Solutions with concentrations around the critical chain entanglement concentration (Ce) produced bead or beaded fiber structures, while bead-free fibers of a uniform diameter were obtained when the concentration increased to about two times that of Ce. Relationships between the electrospun fiber diameter, the Berry number, and the normalized concentration of the solutions were studied as well.