We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
To explore the associations between nutrition literacy (NL) and possible sarcopenia in older Chinese adults. A cross-sectional study was conducted. NL was assessed using a twelve-item short-form NL scale. Possible sarcopenia was identified using SARC-CALF. Logistic regression was used to calculate OR and 95 % CI for NL and the incidence of possible sarcopenia. A total of 1338 older individuals, aged 71·41 (sd 6·84) years, were enrolled in this study. After confounders were adjusted for, older adults in the upper quartile of NL were found to be 52 % less likely to have possible sarcopenia than those in the lower quartile of NL (OR = 0·48, 95 % CI: 0·29, 0·77). The associations between NL and possible sarcopenia were present only in those who lived in rural areas (OR: 0·38, 95 % CI: 0·19, 0·77), had a primary school education or less (OR: 0·21, 95 % CI: 0·09, 0·48), had a monthly income < 3000 RMB (OR: 0·39, 95 % CI: 0·22, 0·70) and had chronic diseases (OR: 0·37, 95 % CI: 0·22, 0·63). Moreover, an interaction effect was observed between having a chronic disease and junior high school education and being in the upper quartile of NL. The prevalence of possible sarcopenia in older Chinese adults is substantial, with prevalence decreasing with increasing NL. Moreover, the association between NL and possible sarcopenia varies by residence type, education level, monthly income and chronic disease experience. Targeted NL interventions are required to prevent and manage sarcopenia in older adults, particularly those with low socio-economic status and chronic diseases.
Gentiana straminea Maxim. (Gentianaceae) is an important traditional Tibetan herb that is mainly distributed on the Qinghai-Tibetan Plateau. Despite its agricultural and pharmacological importance, there remains a paucity of microsatellite markers, particularly expressed sequence tag-simple sequence repeat (EST-SSR) markers, available for this local endemic species. In this study, based on previous Illumina transcriptome data of G. straminea, a total of 96 EST-SSR markers were initially designed and tested. Thirty-two of 96 loci (33.33%) were successfully amplified and verified for validation. Among them, 10 were polymorphic and had clear bands. The polymorphism information content values were 0.09–0.799, the number of alleles per locus ranged from 3 to 14, and the levels of observed and expected heterozygosity were 0.078–0.722 and 0.238–0.884, respectively, which suggested a high level of information. Moreover, cross-amplification was successful for 10 loci in two other related species, Gentiana macrophylla Pallas and Gentiana dahurica Fischer. These EST-SSR markers provide a valuable tool for investigating the genetic diversity related to quantitative traits and population genetic studies on G. straminea and related species in sect. Cruciata Gaudin.
This paper investigates women's learning experiences in the Confucian tradition and the social dismay and stigma associated with them. Despite being considered a meta-virtue in the Confucian tradition, learning becomes rather complex when women are the learners. It is viewed by learned women as a curse rather than a blessing in pre-modern China; it is associated with the stigma of “leftover women” and “the third sex” in contemporary China. Based on an examination of works written by women thinkers, I argue that the asymmetry in social recognition for men's and women's learning is rooted in the social and family structure of nei (in) and wai (out), which does not assign sufficient cultural and moral significance to learning achieved in the nei domain nor permit its continuous and accumulative existence. I propose two preliminary steps to rectify the issue of the lack of social and moral recognition of women's learning: first, a reforming of the nei and wai structure to allow assigning more moral, cultural, and normative significance to affairs in the nei domain. Second, re-examine and utilize classical Confucian texts such as the Mencius and later works by women writers to support and guide such reformations.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
This chapter advocates for a naturalistic ethical framework that bases normative components in basic human functions, such as emotions, as an effective approach to address intergenerational ethics questions. Using Mencius’s ethical framework as an example, which establishes emotional pivot points to incorporate others’ concerns and worries into moral deliberation, the chapter argues that this approach provides significant theoretical advantages over frameworks that rely on a familial-role-based relational understanding of Confucian ethics and moral cultivation through rituals. The chapter also highlights the flexibility and adaptability of Mencian ethics, which was redeveloped over a thousand years later during the Neo-Confucian flowering and serves as evidence of its philosophical framework’s ability to connect people emotionally and ethically across time.
Klebsiella pneumoniae are common pathogens causing bloodstream infection (BSI) that increasingly express carbapenem resistance worldwide. To date, no study has precisely investigated the impact of carbapenem resistance in K. pneumoniae (CRKP) BSI on mortality.
Methods:
This retrospective study included 87 patients with CRKP BSI and 321 patients with carbapenem-susceptible K. pneumoniae (CSKP) BSI from 2015 to 2020. Propensity score analyses with stabilized inverse probability of treatment weighting (IPTW-S) was applied to balance covariates. The hazard ratio for 30-day mortality associated with carbapenem resistance was estimated using Cox regression and Kaplan-Meier curves.
Results:
The 30-day crude mortality rates were 43.7% in patients with CRKP BSI and 17.8% in patients with CSKP BSI (P < .001). Age ≥55 years, underlying hematological malignancies and hemodialysis were independently associated with mortality in CRKP BSI. A skin or soft-tissue infection source, urinary catheter, and underlying chronic obstructive pulmonary disease were predictors of mortality in CSKP BSI. The group characteristics were well balanced after IPTW-S. The adjusted hazard ratio for 30-day mortality for CRKP BSI was 1.607 (interquartile range, 0.814–3.171).
Conclusions:
Carbapenem resistance was not associated with a significant increase in 30-day mortality in KP BSI; patient and disease factors were primary determinants of outcomes.
Multi-criteria decision analysis (MCDA) is a useful tool in complex decision-making situations and has been used in medical fields to evaluate treatment options and drug selection. We aimed to provide valuable insights on the use of MCDA in health care through examining the research focus of existing studies, major fields, major applications, most productive authors and countries, and most common journals in the domain using a scientometric and bibliometric analysis.
Methods
Publications related to MCDA in health care were identified by searching the Web of Science Core Collection on 14 July 2021. Three bibliometric software programs (VOSviewer, Bibliometrix, and CiteSpace) were used to conduct the analysis.
Results
A total of 410 publications were identified from 196 academic journals (average yearly growth rate of 32% from 1999 to 2021), with 23,637 co-cited references by 871 institutions from 70 countries or regions. The USA was the most productive country (n=80), while the Universiti Pendidikan Sultan Idris (n=16), Université de Montréal (n= 13), and Syreon Research Institute (n=12) were the most productive institutions. The biggest nodes in every cluster of author networks were Aos Alaa Zaidan, Mireille Goetghebeur, and Zoltan Kalo. The top journals in terms of number of articles (n=17) and citations (n=1,673) were Value in Health and the Journal of Medical Systems, respectively. The research hotspots mainly included the analytic hierarchy process (AHP), decision-making, health technology assessment, and healthcare waste management. In the recent literature there was more emphasis on coronavirus disease 2019 (COVID-19) and fuzzy Technique for Order Preference by Similarities to Ideal Solution (TOPSIS). Big data, telemedicine, TOPSIS, and the fuzzy AHP, which are well-developed and important themes, may be the trends in future research.
Conclusions
This study provides a holistic picture of the MCDA-related literature published in health care. MCDA has a broad application in different topic areas and would be helpful for practitioners, researchers, and decision makers working in health care when faced with complex decisions. It can be argued that the door is still open for improving the role of MCDA in health care, both in its technologies and its application.
Aiming at the problem of low accuracy of robot joint fault diagnosis, a fault diagnosis method of robot joint based on BP neural network is designed. In this paper, the UR10 robot is taken as the research object, and the end pose data of the robot are collected in real time. By injecting different joint errors and changing the sampling frequency, the joint fault database is collected and established, and the BP neural network is used for training to obtain the robot neural network fault diagnosis model. The fault diagnosis model can output the joint fault of the input end pose data. And we analyzed the influence of different joint angle errors and different training sets on the accuracy of joint fault diagnosis of the robot. The results show that when the sampling frequency is 250 Hz, the simulation result of joint fault diagnosis accuracy with the fault degree of 0.5° is 99.17%, and the experimental result is 97.87%. Compared with traditional data-driven methods, it has higher accuracy and diagnostic efficiency, and compared with existing machine learning methods, it also achieves a high accuracy while reducing the network complexity. The effectiveness of the BP neural network robot joint fault diagnosis method is verified by experiments.
Accumulating evidence suggests that supplementation of n-3 PUFA was associated with reduction in risk of major cardiovascular events. This meta-analysis was to systematically evaluate whether daily supplementation and accumulated intake of n-3 PUFA are associated with improved left ventricular (LV) remodelling in patients with chronic heart failure (CHF). Articles were obtained from Pubmed, Clinical key and Web of Science from inception to January 1 in 2021, and a total of twelve trials involving 2162 participants were eligible for inclusion. The sources of study heterogeneity were explained by I2 statistic and subgroup analysis. Compared with placebo groups, n-3 PUFA supplementation improved LV ejection fraction (LVEF) (eleven trials, 2112 participants, weighted mean difference (WMD) = 2·52, 95 % CI 1·25, 3·80, I2 = 87·8 %) and decreased LV end systolic volume (five studies, 905 participants, WMD = –3·22, 95 % CI 3·67, −2·77, I2 = 0·0 %) using the continuous variables analysis. Notably, the high accumulated n-3 PUFA dosage groups (≥ 600 g) presented a prominent improvement in LVEF, while the low and middle accumulated dosage (≤ 300 and 300–600 g) showed no effects on LVEF. In addition, n-3 PUFA supplementation decreased the levels of pro-inflammatory mediators including TNF-α, IL-6 (IL-6) and hypersensitive c-reactive protein. Therefore, the present meta-analysis demonstrated that n-3 PUFA consumption was associated with a substantial improvement of LV function and remodelling in patients subjected to CHF. The accumulated dosage of n-3 PUFA intake is vital for its cardiac protective role.
As an important index to quantitatively measure the motion performance of a manipulator, motion reliability is affected by many factors, such as joint clearance. The present research utilized a UR10 manipulator as the research object. A factor mapping model for influencing the motion reliability was established. The link flexibility factor, joint flexibility factor, joint clearance factor, and Denavit–Hartenberg (DH) parameters were comprehensively considered in this model. The coupling relationship among the various factors was concisely expressed. Subsequently, the nonlinear response surface method was used to calculate the reliability and sensitivity of the manipulator, which provided an applicable reference for its trajectory planning and motion control. In addition, a data-driven fault diagnosis method based on the kernel principal component analysis (KPCA) was used to verify the motion accuracy and sensitivity of the manipulator, and joint rotation failure was considered as an example to verify the accuracy of the KPCA method. This study on the motion reliability of the manipulator is of great significance for the current motion performance, adjusting the control strategy and optimizing the completion effect of the motion task of a manipulator.
Schistosomiasis has been subjected to extensive control efforts in the People's Republic of China (China) which aims to eliminate the disease by 2030. We describe baseline results of a longitudinal cohort study undertaken in the Dongting and Poyang lakes areas of central China designed to determine the prevalence of Schistosoma japonicum in humans, animals (goats and bovines) and Oncomelania snails utilizing molecular diagnostics procedures. Data from the Chinese National Schistosomiasis Control Programme (CNSCP) were compared with the molecular results obtained.
Sixteen villages from Hunan and Jiangxi provinces were surveyed; animals were only found in Hunan. The prevalence of schistosomiasis in humans was 1.8% in Jiangxi and 8.0% in Hunan determined by real-time polymerase chain reaction (PCR), while 18.3% of animals were positive by digital droplet PCR. The CNSCP data indicated that all villages harboured S. japonicum-infected individuals, detected serologically by indirect haemagglutination assay (IHA), but very few, if any, of these were subsequently positive by Kato-Katz (KK).
Based on the outcome of the IHA and KK results, the CNSCP incorporates targeted human praziquantel chemotherapy but this approach can miss some infections as evidenced by the results reported here. Sensitive molecular diagnostics can play a key role in the elimination of schistosomiasis in China and inform control measures allowing for a more systematic approach to treatment.
Early life exposure to famine was associated with adulthood metabolic syndrome and nonalcoholic fatty liver disease (NAFLD), and NAFLD was also affected by cardiometabolic traits. However, the role of cardiometabolic traits in the associations from famine exposure to NAFLD was largely unknown. This study aimed to investigate whether the relationship between early life famine exposure and adulthood NAFLD risk was mediated by cardiometabolic traits. Overall, 7578 subjects aged 56·0 (sd 3·7) years in the Dongfeng–Tongji cohort were included and classified into late-exposed (1952–1954), middle-exposed (1954–1956), early-childhood-exposed (1956–1958), fetal-exposed (1959–1961) and non-exposed (1962–1966, reference) group according to the birth year. NAFLD was diagnosed by experienced physicians via abdominal B-type ultrasound inspection. Mediation analysis was used to evaluate the mediating effects of cardiometabolic traits. Compared with those non-exposed, after multivariable adjustment, participants in fetal-exposed group (OR: 1·37; 95 % CI 1·08, 1·73) had 37 % higher risk to develop NAFLD, and the overall childhood-exposed group had marginally significant association with NAFLD (OR: 1·39; 95 % CI 0·99, 1·94). Stratification analysis found the famine–NAFLD associations more evident in women and those born in areas severely affected by famine. Mediation analysis showed that cardiometabolic traits such as total cholesterol, TAG glucose index, γ-glutamyl transpeptidase, alkaline phosphatase and alanine aminotransferase mediated 6·7–22·2 % of the relation from famine exposure to higher NAFLD risk. Early life exposure to famine was related to increased adulthood NAFLD risk, and this relationship was partly mediated by cardiometabolic traits.
Shame is frequently viewed as a destructive emotion; but it can also be understood in terms of change and growth. This essay highlights the problematic values that cause pervasive and frequent shame and the importance of resisting and changing these values. Using Confucian insights, I situate shame in an interactive process between the individual's values and that of their society, thus, being vulnerable to shame represents both one's connection to a community and an openness to others’ negative feedback. This process provides an important arena where personal values interact with communal ones. The Confucian tradition, I argue, affords individuals a degree of autonomy in internalization through urging them to cultivate and maintain a keen sense of shame. My discussion also offers resources for understanding the various aspects of this interactive process—how individuals with similar experiences of shame may, through channeling their experiences, influence social values and propel moral progress.
A 1178 J near diffraction limited 527 nm laser is realized in a complete closed-loop adaptive optics (AO) controlled off-axis multi-pass amplification laser system. Generated from a fiber laser and amplified by the pre-amplifier and the main amplifier, a 1053 nm laser beam with the energy of 1900 J is obtained and converted into a 527 nm laser beam by a KDP crystal with 62% conversion efficiency, 1178 J and beam quality of 7.93 times the diffraction limit (DL). By using a complete closed-loop AO configuration, the static and dynamic wavefront distortions of the laser system are measured and compensated. After correction, the diameter of the circle enclosing 80% energy is improved remarkably from 7.93DL to 1.29DL. The focal spot is highly concentrated and the 1178 J, 527 nm near diffraction limited laser is achieved.
A few former studies suggested that there are partial overlaps in abnormal brain structure and cognitive function between hypochondriasis (HS) and schizophrenia (SZ). But their differences in brain activity and cognitive function were unclear.
Methods:
Twenty-one HS patients, 23 SZ patients, and 24 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI) with the regional homogeneity analysis (ReHo), subsequently exploring the relationship between ReHo value and cognitive functions. The support vector machines (SVM) were used on effectiveness evaluation of ReHo for differentiating HS from SZ.
Results:
Compared with HC, HS showed significantly increased ReHo values in right middle temporal gyrus (MTG), left inferior parietal lobe (IPL), and right fusiform gyrus (FG), while SZ showed increased ReHo in left insula, decreased ReHo values in right paracentral lobule. Additionally, HS showed significantly higher ReHo values in FG, MTG, and left paracentral lobule, but lower in insula than SZ. The higher ReHo values in insula were associated with worse performance in MATRICS consensus cognitive battery (MCCB) in HS group. SVM analysis showed a combination of the ReHo values in insula and FG was able to satisfactorily distinguish the HS and SZ patients.
Conclusion:
Our results suggested that the altered default mode network (DMN), of which abnormal spontaneous neural activity occurs in multiple brain regions, might play a key role in the pathogenesis of HS, and the resting-state alterations of insula are closely related to cognitive dysfunction in HS. Furthermore, the combination of the ReHo in FG and insula was a relatively ideal indicator to distinguish HS from SZ.
A multicenter study of sharps injuries (SIs) and other blood or body fluid (OBBF) exposures was conducted among 33,156 healthcare workers (HCWs) from 175 hospitals in Anhui, China. In total, 12,178 HCWs (36.7%) had experienced at least 1 SI in the previous 12 months and 8,116 HCWs (24.5%) had experienced at least 1 OBBF exposure during the previous 12 months.
While birth cohorts are shaped by underpinning life course frameworks, few if any report how they select them. This review aimed to (1) summarise publicly available frameworks relevant to planning and communicating large new early-life cohorts and (2) help select frameworks to guide and communicate Generation Victoria (GenV), a whole-of-state birth and parent cohort in planning in the state of Victoria, Australia. We identified potential frameworks from prior knowledge, networks and a pragmatic literature search in 2019. We considered for inclusion only frameworks with an existing visual graphic. We summarised each framework’s concept, then judged it on a seven-item matrix (Scope, Dimensions, Outcomes, Life course, Mechanisms, Multi-age, and Visual Clarity) to be of high, intermediate or low relevance to GenV. We presented and evaluated 14 life course frameworks across research and policy. Two, nine and three frameworks, respectively, were ranked as high, intermediate and low relevance to GenV, although none totally communicated its scope and intent. Shonkoff’s biodevelopmental framework was selected as GenV’s primary framework, adapted to include ongoing feedback loops through the life course and influence of an individual’s outcomes on the next generation. Because conceptual simplicity precluded the primary framework from capturing the wide range of relevant exposures, we selected the Australian Institute of Health and Welfare’s person-centred model as a secondary framework. This summary of existing life course frameworks may prove helpful to other cohorts in planning. Our transparent process and focus on visual communication are already assisting in explaining and selecting measures for GenV. The feasibility, comprehension and validity of these frameworks could be further tested at implementation.
The present study was conducted to test the hypothesis that dietary supplementation with a nano chitosan–zinc complex (CP–Zn, 100 mg/kg Zn) could alleviate weaning stress in piglets challenged with enterotoxigenic Escherichia coli K88 by improving growth performance and intestinal antioxidant capacity. The in vivo effects of CP–Zn on growth performance variables (including gastrointestinal digestion and absorption functions and the levels of key proteins related to muscle growth) and the antioxidant capacity of the small intestine (SI) were evaluated in seventy-two weaned piglets. The porcine jejunal epithelial cell line IPEC-J2 was used to further investigate the antioxidant mechanism of CP–Zn in vitro. The results showed that CP–Zn supplementation increased the jejunal villus height and decreased the diarrhoea rate in weaned piglets. CP–Zn supplementation also improved growth performance (average daily gain and average daily feed intake), increased the activity of carbohydrate digestion-related enzymes (amylase, maltase, sucrase and lactase) and the mRNA expression levels of nutrient transporters (Na+-dependent glucose transporter 1, glucose transporter type 2, peptide transporter 1 and excitatory amino acid carrier 1) in the jejunum and up-regulated the expression levels of mammalian target of rapamycin (mTOR) pathway-related proteins (insulin receptor substrate 1, phospho-mTOR and phospho-p70S6K) in muscle. In addition, CP–Zn supplementation increased glutathione content, enhanced total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-px) activity, and reduced malondialdehyde (MDA) content in the jejunum. Furthermore, CP–Zn decreased the content of MDA and reactive oxygen species, enhanced the activity of T-SOD and GSH-px and up-regulated the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins (Nrf2, NAD(P)H:quinone oxidoreductase 1 and haeme oxygenase 1) in lipopolysaccharide-stimulated IPEC-J2 cells. Collectively, these findings indicate that CP–Zn supplementation can improve growth performance and the antioxidant capacity of the SI in piglets, thus alleviating weaning stress.
Global warming will directly influence agricultural production and present new challenges for food security in semiarid regions of China. A warming experiment was conducted in Guyuan, China using infrared ray radiators to study the impact of warming on crop growth, yield and quality of a potato–broad bean–winter wheat crop rotation system. Warming significantly affected the crop photosynthesis rates of the potato–broad bean–winter wheat rotation system. In the podding stage of broad bean and the heading, blooming and booting stages of winter wheat, the photosynthesis rate was significantly decreased when the temperature increased by 0.5–2.0°C. The growing period of the potato–broad bean–winter wheat rotation system was shortened by 20–40 days per 3-year-period, and the fallow period was prolonged by 4–13 days per 3-year-period. The water use efficiency of the potato–broad bean–winter wheat rotation decreased by 8.6% when the temperature increased by 1.02.0°C. The yield of the potato–broad bean–winter wheat rotation increased by 6.1–7.7% when the temperature increased by 0.5–1.0°C. However, yield decreased 12.9–13.4% when temperature increased by 1.0–2.0°C. Potato protein significantly decreased by 9.3–17.6% and the winter wheat fat significantly decreased by 6.7% when the temperature increased by 0.5–2.0°C. The results indicate that global warming could seriously affect the crop growth, yield and water use of the potato–broad bean–winter wheat rotation in semiarid regions of China.