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The relationship of a diet low in fiber with mortality has not been evaluated. This study aims to assess the burden of non-communicable chronic diseases (NCDs) attributable to a diet low in fiber globally from 1990 to 2019.
All data were from the Global Burden of Disease (GBD) Study 2019, in which the mortality, disability-adjusted life-years (DALYs), and years lived with disability (YLDs) were estimated with Bayesian geospatial regression using data at global, regional, and country level acquired from an extensively systematic review.
All data sourced from the GBD Study 2019.
All age groups for both sexes.
The age-standardized mortality rates (ASMRs) declined in most GBD regions; however, in Southern Sub-Saharan Africa, the ASMR increased from 4.07 (95% uncertainty interval (UI): [2.08, 6.34]) to 4.60 (95% UI: [2.59, 6.90]), and in Central Sub-Saharan Africa, the ASMR increased from 7.46 (95% UI: [3.64, 11.90]) to 9.34 (95% UI: [4.69, 15.25]). Uptrends were observed in the age-standardized YLDs rates attributable to a diet low in fiber in a number of GBD regions. The burden caused by diabetes mellitus increase in Central Asia, Southern Sub-Saharan Africa and Eastern Europe.
The burdens of disease attributable to a diet low in fiber in Southern Sub-Saharan Africa and Central Sub-Saharan Africa and the age-standardized YLDs rates in a number of GBD regions increased from 1990 to 2019. Therefore, greater efforts are needed to reduce the disease burden caused by a diet low in fiber.
The bacterial community is important for shaping the fermentation characteristics of silage. This study aimed to investigate the fermentation characteristics, bacterial community and predicted functional characteristics of red clover (Trifolium pratense L.) silage. First-cutting red clover was collected at the early bloom stage, wilted for 5 h and then ensiled in 10 litre-capacity silos. Triplicate silos were sampled after 1, 3, 7, 15, 30 and 60 days of ensiling, respectively. The bacterial communities on days 3 and 60 were assessed through high-throughput sequencing technology, and 16S rRNA-gene predicted functional characteristics were analysed based on the KEGG using Tax4Fun. After 60 days of ensiling, red clover silage was fermented well, as indicated by high lactic acid (~77.3 g/kg DM), and low concentrations of butyric acid (~3.73 g/kg DM) and ammonia nitrogen (~55.0 g/kg TN). During the initial stage of ensiling, fructose and glucose were more preferred than sucrose for microbes. The predominant genus Lactococcus (0.542) on day 3 was replaced by Lactobacillus (0.553) on day 60. The metabolism of amino acids, energy, cofactors and vitamins was inhibited, while the metabolism of nucleotides and carbohydrates was enhanced after ensiling. High-throughput sequencing technology combined with 16S rRNA gene-predicted functional analyses revealed the differences during the early and late stages of red clover silage not only for distinct bacterial compositions but also for specific functional traits. Our results could provide a comprehensive insight into bacterial community and their functional profiles to further improve the silage quality.
Lithospheric thinning occurred in the North China Craton (NCC) that resulted in extensive Mesozoic magmatism, which has provided the opportunity to explore the mechanism of the destruction of the NCC. In this study, new zircon U–Pb ages, geochemical and Lu–Hf isotopic data are presented for Early Cretaceous adakitic rocks in the Liaodong Peninsula, with the aim of establishing their origin as well as the thinning mechanism of the NCC. The zircon U–Pb data show that crystallization occurred during 127–120 Ma (i.e. Early Cretaceous). These rocks are characterized by high Sr (294–711 ppm) content and Sr/Y ratio (38.5–108), low Yb (0.54–1.24 ppm) and Y (4.9–16.4 ppm) contents, and with no obvious Eu anomalies, implying that they are adakitic rocks. They are enriched in large-ion lithophile elements (e.g. Ba, K, Pb and Sr) and depleted in high-field-strength elements (e.g. Nb, Ta, P and Ti). These adakitic rocks have negative zircon ϵHf(t) contents (−28.9 to −15.0) with two-stage Hf model ages (TDM2) of 3004–2131 Ma. Based on the geochemical features, such as low TiO2 and MgO contents, and high La/Yb and K2O/Na2O ratios, these adakites originated from the partial melting of thickened eclogitic lower crust. They were in an extensional setting associated with the slab rollback of the Palaeo-Pacific Ocean. In combination with previous studies, as a result of the rapid retracting of the Palaeo-Pacific Ocean during 130–120 Ma, the asthenosphere upwelled and modified the thickened lithospheric mantle, which lost its stability, resulting in the lithospheric delamination and thinning of the NCC.
This study investigated whether subjective unrest-related distress was associated with probable depression during and after the 2019 anti-ELAB movement in Hong Kong.
Population-representative data were collected from 7157 Hong Kong Chinese in four cross-sectional surveys (July 2019–July 2020). Logistic regression examined the association between subjective unrest-related distress and probable depression (PHQ-9 ⩾ 10), stratified by the number of conflicts/protests across the four timepoints.
Unrest-related distress was positively associated with probable depression across different numbers of conflicts/protests.
Unrest-related distress is a core indicator of probable depression. Public health interventions should target at resolving the distress during seemingly peaceful period after unrest.
To address the shortcomings of existing methods for rotorcraft searching, positioning, tracking and landing on a ship at sea, a dual-channel LIDAR searching, positioning, tracking and landing system (DCLSPTLS) is proposed in this paper, which utilises the multi-pulse laser echoes accumulation method and the physical phenomenon that the laser reflectivity of the ship deck in the near-infrared band is four orders of magnitude higher than that of the sea surface. The DCLSPTLS searching and positioning model, tracking model and landing model are established, respectively. The searching and positioning model can provide estimates of the azimuth angle, the distance of the ship relative to the rotorcraft and the ship's course. With the above parameters as inputs, the total tracking time and the direction of the rotorcraft tracking speed can be obtained by using the tracking model. The landing model can calculate the pitch and the roll angles of the ship's deck relative to the rotorcraft by using the least squares method and the laser irradiation coordinates. The simulation shows that the DCLSPTLS can realise the functions of rotorcraft searching, positioning, tracking and landing by using the above parameters. To verify the effectiveness of the DCLSPTLS, a functional test is performed using a rotorcraft and a model ship on a lake. The test results are consistent with the results of the simulation.
This experiment was conducted to evaluate the impact of substituting rice straw with citrus pulp (CRP), sweet potato peels (SPP) and vines (SPV) on fermentation quality and in vitro digestibility when ensiled with or without wet brewers' grains (WBG). Seven treatments were set as follows: (i) rice straw only (control); (ii) 800 g rice straw/kg + 200 g CRP/kg (RC); (iii) 720 g rice straw/kg + 180 g CRP/kg + 100 g WBG/kg (RC+); (iv) 800 g rice straw/kg + 200 g SPP/kg (RP); (v) 720 g rice straw + 180 g SPP/kg + 100 g WBG/kg (RP+); (vi) 800 g rice straw/kg + 200 g SPV/kg (RV); (vii) 720 g rice straw/kg + 180 g SPV/kg + 100 g WBG/kg (RV+). After ensiling for 3, 7, 14, 30 and 60 days, silos were opened for fermentation profile, aerobic stability and in vitro parameter analyses. All substitution types improved fermentation quality, characterized by significantly lower pH and NH3-N content, higher lactic acid content and V-scores. WBG application promoted hetero-fermentation and significantly increased DM losses, acetic acid and ethanol contents. After 60 days of ensiling, the NDF, ADF and cellulose contents in mixed silages significantly decreased compared to control. During aerobic exposure, WBG application significantly prolonged aerobic stability. SPV substitution significantly improved in vitro digestibility of dry matter, NDF and ADF. In conclusion, the SPP substitution combined with WBG application was recommended as a result of the optimal balance of fermentation quality, aerobic stability and in vitro digestibility.
The mumps resurgence has frequently been reported around the world in recent years, especially in many counties mumps vaccines have been widely used. This study aimed to describe the spatial epidemiological characteristics of mumps in Jiangsu, and provide a scientific basis for the implementation and adjustment of strategies to prevent and control mumps. The epidemiological characteristics were described with ratio or proportion. Spatial autocorrelation, Tango's flexible spatial scan statistics, and Kulldorff's elliptic spatiotemporal scan statistics were applied to identify the spatial autocorrelation, detect hot and cold spots of mumps incidence, and aggregation areas. A total of 172 775 cases were reported from 2004 to 2020 in Jiangsu. The general trend of mumps incidence is declining with a bimodal seasonal distribution identified mainly in summer and winter, respectively. Children aged 5–10 years old are the main risk group. A migration trend of hot spots from southeast to northwest over time was found. Similar high-risk aggregations were detected in the northwestern parts through spatial-temporal analysis with the most likely cluster time frame around 2019. Local medical and health administrations should formulate and implement targeted health care policies and allocate health resources more appropriately corresponding to the epidemiological characteristics of mumps.
Grey matter (GM) reduction is a consistent observation in established late stages of schizophrenia, but patients in the untreated early stages of illness display an increase as well as a decrease in GM distribution relative to healthy controls (HC). The relative excess of GM may indicate putative compensatory responses, though to date its relevance is unclear.
343 first-episode treatment-naïve patients with schizophrenia (FES) and 342 HC were recruited. Multivariate source-based morphometry was performed to identify covarying ‘networks' of grey matter concentration (GMC). Neurocognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and symptom burden using the Positive and Negative Symptoms Scale (PANSS) were obtained. Bivariate linear relationships between GMC and cognition/symptoms were studied.
Compared to healthy subjects, FES had prominently lower GMC in two components; the first consists of the anterior insula, inferior frontal gyrus, anterior cingulate and the second component with the superior temporal gyrus, precuneus, inferior/superior parietal lobule, cuneus, and lingual gyrus. Higher GMC was seen in adjacent areas of the middle and superior temporal gyrus, middle frontal gyrus, inferior parietal cortex and putamen. Greater GMC of this component was associated with lower duration of untreated psychosis, less severe positive symptoms and better performance on cognitive tests.
In untreated stages of schizophrenia, both a distributed lower and higher GMC is observable. While the higher GMC is relatively modest, it occurs across frontoparietal, temporal and subcortical regions in association with reduced illness burden suggesting a compensatory role for higher GMC in the early stages of schizophrenia.
Contrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention.
360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years.
Compared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year.
Specialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study.
Previously reported wearable systems for people with Parkinson’s disease (PD) have been focused on the detection of abnormal gait. They suffered from limited accuracy, large latency, poor durability, comfort, and convenience for daily use. Herewith we report an intelligent wearable system (IWS) that can accurately detect abnormal gait in real-time and provide timely cueing for PD patients. The system features novel sensitive, comfortable and durable plantar pressure sensing insoles with a highly compressed data set, an accurate and fast gait algorithm, and wirelessly controlled timely sensory cueing devices. A total of 29 PD patients participated in the first phase without cueing for developing processes of the algorithm, which achieved an accuracy of over 97% for off-line detection of freezing of gait (FoG). In the second phase with cueing, the evaluation of the whole system was conducted with 16 PD subjects via trial and a questionnaire survey. This system demonstrated an accuracy of 94% for real-time detection of FoG and a mean latency of 0.37 s between the onset of FoG and cueing activation. In questionnaire survey, 88% of the PD participants confirmed that this wearable system could effectively enhance walking, 81% thought that the system was comfortable and convenient, and 70% overcame the FoG. Therefore, the IWS makes it an effective, powerful, and convenient tool for enhancing the mobility of people with PD.
High-Mg andesites (HMAs) are crucial for the reconstruction of plate tectonics, continental margin formation and lithospheric evolution. In this study, we present new fossil age, whole-rock geochemical and Sr–Nd isotope data on the newly discovered Dundunshan Group HMAs in the Dundunshan area of the Beishan orogen (central-southern Central Asian Orogenic Belt). The Dundunshan HMA samples are characterized by high MgO (6.47–7.02 wt%) contents and high Mg# values (67.27–68.77), with SiO2 (58.57–62.13 wt%), Al2O3 (14.49–16.07 wt%) and CaO (5.05–6.24 wt%) resembling typical HMAs. The Dundunshan HMA samples are calc-alkaline and strongly enriched in light rare earth elements (LREEs) and large-ion lithophile elements (LILEs), with slightly negative Eu anomaly and high-field-strength element (HFSE) depletions. Their (87Sr/86Sr)i ratios (0.7041–0.7057) and ϵNd(t) (3.73–5.59) indicate that the Dundunshan HMAs were mainly formed by the interactions between subducted oceanic sediment-derived melts and mantle peridotites. Fossil evidence and published radiometric age data constrain the formation of the Dundunshan HMAs to early Late Devonian time. Sedimentological features of the Middle Devonian Sangejing Formation and regional tectonic correlation suggest that the Hongliuhe–Niujuanzi–Xichangjing Ocean in the Dundunshan area was likely closed during late Middle Devonian time, and that the Dundunshan HMAs were formed in a post-collision extensional setting.
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.
Deficits in event-related potential (ERP) including duration mismatch negativity (MMN) and P3a have been demonstrated widely in chronic schizophrenia (SZ) but inconsistent findings were reported in first-episode patients. Psychotropic medications and diagnosis might contribute to different findings on MMN/P3a ERP in first-episode patients. The present study examined MMN and P3a in first episode drug naïve SZ and bipolar disorder (BPD) patients and explored the relationships among ERPs, neurocognition and global functioning.
Twenty SZ, 24 BPD and 49 age and sex-matched healthy controls were enrolled in this study. Data of clinical symptoms [Positive and Negative Symptoms Scale (PANSS), Young Manic Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD)], neurocognition [Wechsler Adult Intelligence Scale (WAIS), Cattell's Culture Fair Intelligence Test (CCFT), Delay Matching to Sample (DMS), Rapid Visual Information Processing (RVP)], and functioning [Functioning Assessment Short Test (FAST)] were collected. P3a and MMN were elicited using a passive auditory oddball paradigm.
Significant MMN and P3a deficits and impaired neurocognition were found in both SZ and BPD patients. In SZ, MMN was significantly correlated with FAST (r = 0.48) and CCFT (r = −0.31). In BPD, MMN was significantly correlated with DMS (r = −0.54). For P3a, RVP and FAST scores were significant predictors in SZ, whereas RVP, WAIS and FAST were significant predictors in BPD.
The present study found deficits in MMN, P3a, neurocognition in drug naïve SZ and BPD patients. These deficits appeared to link with levels of higher-order cognition and functioning.
Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI).
This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period.
A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients.
These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.
Aortic valve repair in children is still a challenge. The aim of this study was to analyse the surgical results of children with aortic regurgitation who underwent single leaflet reconstruction using the Ozaki procedure in our medical centre.
A retrospective study was conducted of nine children with aortic regurgitation who received single leaflet reconstruction from May 2017 to September 2019. Paired t-tests and Wilcoxon signed rank tests were used to compare the data at different time points.
The median surgical age was 4.7 (3.5, 6.4) years. Eight patients were pre-operatively diagnosed with severe aortic regurgitation, while one had moderate regurgitation. The left ventricles were significantly enlarged, with an average z-score of 3.8. Single leaflet reconstruction was carried out using glutaraldehyde-treated autologous pericardium under the standard Ozaki procedure. The median follow-up was 22 (14, 33) months. There was no post-operative death or re-intervention. One patient had moderate or more aortic regurgitation during the follow-up. The average degree of aortic regurgitation was mild, and the average z-score of the left ventricle decreased to −0.2 in the last follow-up.
Single leaflet reconstruction using the Ozaki procedure was an effective surgical method for treating children with aortic regurgitation in our centre with satisfactory short-term results.
The aim of the present study was to compare the rate of preterm birth (PTB) and growth from birth to 18 years between twins conceived by in vitro fertilization (IVF) and twins conceived by spontaneous conception (SC) in mainland China. The retrospective cohort study included 1164 twins resulting from IVF and 25,654 twins conceived spontaneously, of which 494 from IVF and 6338 from SC were opposite-sex twins. PTB and low birth weight (LBW), and growth, including length/height and weight, were compared between the two groups at five stages: infancy (0 year), toddler period (1–2 years), preschool (3–5 years), primary or elementary school (6–11 years), and adolescence (10–18 years). Few statistically significant differences were found for LBW and growth between the two groups after adjusting for PTB and other confounders. Twins born by IVF faced an increased risk of PTB compared with those born by SC (adjusted odds ratio [aOR] 8.21, 95% confidence interval [CI] [3.19, 21.13], p < .001 in all twins and aOR 10.12, 95% CI [2.32, 44.04], p = .002 in opposite-sex twins). Twins born by IVF experienced a similar growth at five stages (0–18 years old) when compared with those born by SC. PTB risk, however, is significantly higher for twins conceived by IVF than those conceived by SC.
Environmental hypoxia exposure causes fertility problems in human and animals. Compelling evidence suggests that chronic hypoxia impairs spermatogenesis and reduces sperm motility. However, it is unclear whether paternal hypoxic exposure affects fertilization and early embryo development. In the present study, we exposed male mice to high altitude (3200 m above sea level) for 7 or 60 days to evaluate the effects of hypoxia on sperm quality, zygotic DNA methylation and blastocyst formation. Compared with age-matched controls, hypoxia-treated males exhibited reduced fertility after mating with normoxic females as a result of defects in sperm motility and function. Results of in vitro fertilization (IVF) experiments revealed that 60 days’ exposure significantly reduced cleavage and blastocyst rates by 30% and 70%, respectively. Immunohistochemical staining of pronuclear formation indicated that the pronuclear formation process was disturbed and expression of imprinted genes was reduced in early embryos after paternal hypoxia. Overall, the findings of this study suggested that exposing male mice to hypoxia impaired sperm function and affected key events during early embryo development in mammals.