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Considering the influence of body’s growth and development on thyroid volume (TVOL), whether five existed corrected methods could be applied to correct TVOL remains unclear, in terms of Chinese children’s increased growth and development trends. This study aimed to compare the applicability of five correction methods: Body Surface Area corrected Volume (BSAV), Body Mass Indicator corrected Volume (BMIV), Weight and Height corrected Volume Indicator (WHVI), Height corrected Volume Indicator 1 (HVI1) and Height corrected Volume Indicator 2 (HVI2) and to establish the reference values for correction methods. The data of Iodine Nutrition and Thyroid Function Survey were used to analyse the differences in TVOL between normal and abnormal thyroid function children. Data of National Iodine Deficiency Disorders Survey were used to compare five correction methods and to establish their reference values. The median urinary iodine concentrations of children surveyed were 256·1 μg/l in 2009 and 192·6 μg/l in 2019. No significant difference was found in TVOL and thyroid goitre rate between children with normal and abnormal thyroid function. In the determination of goitre, HVI1, HVI2, BSAV and BMIV all showed high agreement with TVOL, while the area under the receiver operating characteristic curve (AUC) of WHVI was relatively low for children aged 8 (AUC = 0·8993) and 9 (AUC = 0·8866) years. Most differences of TVOL between light and heavy weight, short and tall height children can be eliminated by BSAV. BSAV was the best corrected method in this research. Reference values were established for corrected TVOL in Chinese children aged 8–10 years by sex.
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.
Accumulating evidence suggests that supplementation of omega-3 polyunsaturated fatty acids (ω−3 PUFAs) was associated with reduction in risk of major cardiovascular events. This meta-analysis was to systematically evaluate whether daily supplementation and accumulated intake of ω−3 PUFAs is associated with improved left ventricular (LV) remodeling 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 12 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, ω−3 PUFAs supplementation improved LV ejection fraction (LVEF) (11 trials, 2112 participants, WMD=2.52, 95%CI 1.25 to 3.80, I2=87.8%) and decreased LV end-systolic volume (LVESV) (5 studies, 905 participants, WMD=−3.22, 95%CI −3.67 to −2.77, I2=0.0%) by using the continuous variables analysis. Notably, the high accumulated ω−3 PUFAs dosage groups (≥600g) presented a prominent improvement in LVEF, while the low and middle accumulated dosage (≤300g and 300-600g) showed no effects on LVEF. In addition, ω−3 PUFAs supplementation decreased the levels of pro-inflammatory mediators including tumor necrosis factor−α (TNF-α), interleukin-6 (IL-6) and hypersensitive-c-reactive protein (Hs-CRP). Therefore, the present meta-analysis demonstrated that ω−3 PUFAs consumption was associated with a substantial improvement of LV function and remodeling in patients subjected to CHF. The accumulated dosage of ω-3 PUFAs intake is vital for its cardiac protective role.
Prospective cohort studies linking organ meat consumption and nonalcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between organ meat consumption and risk of NAFLD in a general Chinese adult population. This prospective cohort study included a total of 15,568 adults who were free of liver disease, cardiovascular disease, and cancer at baseline. Dietary information was collected at baseline using a validated food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between organ meat consumption and risk of NAFLD. During a median of 4.2 years of follow-up, we identified 3,604 incident NAFLD cases. After adjusting for demographic characteristics, lifestyle factors, vegetable, fruit, soft drink, seafood, and red meat consumption, the multivariable hazard ratios (95% confidence intervals) for incident NAFLD across consumption of organ meat were 1.00 (reference) for almost never, 1.04 (0.94, 1.15) for tertile 1, 1.08 (0.99, 1.19) for tertile 2, and 1.11 (1.01, 1.22) for tertile 3, respectively (P for trend <0.05). Such association did not differ substantially in the sensitivity analysis. Our study indicates that organ meat consumption was related to a modestly higher risk of NAFLD among Chinese adults. Further investigations are needed to confirm this finding.
In order to improve the removal efficiency of clays in oil refining, to explore the related factors and to clarify the removal mechanism of alkaline nitride, a series of modified clays was prepared to test removal of alkaline nitride from lubricating oil. After the addition of 1 wt.% FeCl3, the removal rate of alkaline nitride increased from 33.6% to 43.3%. Furthermore, the acidity and chlorine content did not exceed acceptable levels. The testing methods of N2 adsorption–desorption, particle-size distribution, Fourier-transform infrared spectroscopy and X-ray diffraction were conducted to verify the removal mechanism. The removal rate of alkaline nitride is mainly related to the density of Lewis acid sites. The Fourier-transform infrared spectra confirmed the existence of the complexation reaction. The basic nitrides were removed by chemical adsorption via Fe3+-complexation.
In training deep learning networks, the optimizer and related learning rate are often used without much thought or with minimal tuning, even though it is crucial in ensuring a fast convergence to a good quality minimum of the loss function that can also generalize well on the test dataset. Drawing inspiration from the successful application of cyclical learning rate policy to computer vision tasks, we explore how cyclical learning rate can be applied to train transformer-based neural networks for neural machine translation. From our carefully designed experiments, we show that the choice of optimizers and the associated cyclical learning rate policy can have a significant impact on the performance. In addition, we establish guidelines when applying cyclical learning rates to neural machine translation tasks.
Reconstructing the history of elite communication in ancient China benefits from additional archaeological evidence. We combine textual analysis with new human stable carbon and nitrogen isotope data from two Chu burials in the Jingzhou area to reveal significant dietary differences among Chu nobles of the middle Warring States period (c. 350 BC). This research provides important new information on the close interaction between the aristocratic families of the Qin and Chu.
Excessive iodine can lead to goiters. However, the relationship between the water iodine concentration (WIC) and goiter rate (GR) is unclear. This study aims to explore the factors that influence children’s GR in areas with high WIC and analyse the threshold value of the GR increase associated with the WIC. According to the monitoring of the areas with high WIC in China in 2018–2020, a total of 54 050 children in eight high water iodine provinces were chosen. Drinking water, urine and edible salt samples of children were collected. The thyroid volume (Tvol) was measured. A generalised additive model (GAM) was used to analyse the relationship between the WIC and GR in children. Among the 54 050 children in areas with high WIC, the overall GR was 3·34 %, the median of water iodine concentration was 127·0 µg/l, the median of urinary iodine concentration was 318 µg/l and the non-iodised salt coverage rate (NISCR) was 63·51 %. According to the GAM analysis results, water iodine and urinary iodine are factors that influence the Tvol and GR, while the NISCR affects only the GR. When the WIC was more than 420 µg/l or the urinary iodine concentration was more than 800 µg/l, the GR increased rapidly. When the NISCR reached more than 85 %, the GR was the lowest. Thus, in areas with high WIC, WIC more than 420 µg/l may increase the risk of goiter, and the NISCR should be increased to over 85 % to avoid goiters in children.
The article aims to estimate and forecast the transmissibility of shigellosis and explore the association of meteorological factors with shigellosis. The mathematical model named Susceptible–Exposed–Symptomatic/Asymptomatic–Recovered–Water/Food (SEIARW) was used to explore the feature of shigellosis transmission based on the data of Wuhan City, China, from 2005 to 2017. The study applied effective reproduction number (Reff) to estimate the transmissibility. Daily meteorological data from 2008 to 2017 were used to determine Spearman's correlation with reported new cases and Reff. The SEIARW model fit the data well (χ2 = 0.00046, p > 0.999). The simulation results showed that the reservoir-to-person transmission of the shigellosis route has been interrupted. The Reff would be reduced to a transmission threshold of 1.00 (95% confidence interval (CI) 0.82–1.19) in 2035. Reducing the infectious period to 11.25 days would also decrease the value of Reff to 0.99. There was a significant correlation between new cases of shigellosis and atmospheric pressure, temperature, wind speed and sun hours per day. The correlation coefficients, although statistically significant, were very low (<0.3). In Wuhan, China, the main transmission pattern of shigellosis is person-to-person. Meteorological factors, especially daily atmospheric pressure and temperature, may influence the epidemic of shigellosis.
The incidence of gout has increased rapidly in recent years, and the suspected lack of awareness of gout among general practitioners may lead to misdiagnosis and inappropriate treatment.
Aim:
To assess general practitioners’ management of gout at community health service clinics in the Tongzhou district of Beijing, as well as the factors that contributed to optimal decision making.
Methods:
A survey based on current guidelines for assessment and management of gout was sent to 245 general practitioners at community health service clinics in the Tongzhou district of Beijing. The questionnaire included personal information of general practitioners and ten items that addressed knowledge of gout. Our questionnaire was self-administered and distributed electronically via WeChat, and data were collected on a platform called ‘Wenjuanwang’. Statistical analysis was performed using SPSS version 19.0 software.
Results:
Totally, 216 general practitioners responded to the survey. About three-quarters (71.8%) reported having received Continuing Medical Education (CME) about gout. More than half (54.6%) reported an awareness of treat to target (T2T) for gout. However, the overall rate of good understanding of gout was only 6.5%, a basic knowledge of gout was 55.6%, and understanding about gout diagnosis and treatment was only 11.1%. The general practitioners’ understanding of basic concepts related to gout indicated that CME could improve their understanding (P < 0.05). An analysis of the general practitioners’ rate of comprehension of gout diagnosis and treatment showed that education level, CME, and familiarity with T2T could improve understandings of gout diagnosis and treatment (P < 0.05).
Conclusion:
There are serious deficits in understandings about gout among general practitioners in the Tongzhou district of Beijing. Quality CME is needed to improve Chinese general practitioners’ management of gout.
The Brain Health Test-7 (BHT-7) is a revised tool from the original BHT, containing more tests about frontal lobe function. It was developed with theaim of identifying patients with mild cognitive impairment (MCI) and early dementia.
Research objective
Here we report the validity of the BHT-7 versus the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in differentpsychiatry or neurology clinics.
Methods
Patients with memory complaints were recruited in this study from the outpatient clinic of psychiatry or neurology in 3 different kinds of hospitals. Allpatients underwent the evaluation of the BHT-7, MMSE, MoCA, and clinical dementia rating (CDR). The clinical diagnosis (normal, MCI, dementia) was made by consensus meeting, taking into account all available data.
Demographic data and the scores of the MMSE, MoCA, and BHT-7 between groups were compared. Logistic regression was adopted for analysis of optimal cutoff values, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve,and the area under the ROC curve (AUC).
Results
We enrolled a total of 1090 subjects (normal 402, MCI 317, dementia 371); of them, 705 (64.7%) were female. There was a statistically significant differencein age, years of education, and 3 cognitive test scores among the 3 groups.
Compared with the MMSE and MoCA, the BHT-7 performed slightly betterthan MMSE and MoCA in differentiating MCI or dementia from the normalcontrols (Table 1). For BHT- 7, the cutoff point was 17 between normal andMCI, and 14 between normal and dementia. These cutoff points for BHT-7were consistent through 3 different clinical settings, but inconsistent for MMSE and MoCA. The testing time for the BHT-7 was about 5-7 minutes, shorter than that of the MMSE and MoCA.
Conclusion
Compared with MMSE and MoCA, the BHT-7 showed slightly better performance in differentiating normal from MCI or dementia subjects. The testing time for the BHT-7 was shorter, and its cutoff points were consistent through different outpatient clinic settings. The results support that BHT-7 is auseful cognitive screening tool for MCI or early dementia in various hospital settings.
Table 1
Comparisons of the performance of BHT-7, MMSE, MoCA
High dietary fiber intake has been associated with a lower risk of diabetes, but the association of dietary fiber with prediabetes is only speculative, especially in China, where the supportive data from prospective studies is lacking. This study aimed to examine the association between dietary fiber intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18,085 participants of the TCLSIH cohort study who were free of diabetes, prediabetes, cancer, and cardiovascular disease at baseline. Dietary data were collected using a validated 100-item food frequency questionnaire. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 63,175 person-years of follow-up, 4,139 cases of incident prediabetes occurred. The multivariable HRs (95% CIs) of prediabetes for the highest versus lowest quartiles were 0.85 (0.75, 0.98) (P for trend =0.02) for total dietary fiber, 0.84 (0.74, 0.95) (P for trend <0.01) for soluble fiber, and 1.05 (0.93, 1.19) (P for trend =0.38) for insoluble fiber. Fiber from fruits, but not from cereals, beans, and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fiber, soluble fiber, and fiber derived from fruit sources were associated with a lower risk of prediabetes.
Chronic inflammation exerts pleiotropic effects in the aetiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40–69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HR) as well as 95 % CI for the risk of incident COPD. During a median follow-up of 8·96 years (interquartile range 8·29–9·53 years), 9016 new-onset events of COPD were documented. We found that the regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0·80 (95 % CI, 0·75, 0·85; P < 0·001). When subgroup analyses were performed by smoking status, the adjusted HR for the association of regular glucosamine use with incident COPD were 0·84 (0·73, 0·96), 0·84 (0·77, 0·92) and 0·71 (0·62, 0·80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (Pfor interaction = 0·078). Incident COPD could be reduced by 14 % to 84 % through a combination of regular glucosamine use and smoking cessation.
EPA and DHA are essential for maternal and fetal health, but epidemiological data are sparse in China. We examined the trends of EPA alone and a combination of EPA plus DHA in pregnant and lactating women in three distinct geographic regions in China and explored their potential influencing factors. A total of 1015 healthy women during mid-pregnancy, late pregnancy or lactation were recruited from Weihai (coastland), Yueyang (lakeland) and Baotou (inland) cities of China between May and July of 2014. Maternal EPA and DHA concentrations (percentage of total fatty acids) in plasma and erythrocytes were measured by capillary GC. Adjusted EPA plus DHA concentrations in both plasma and erythrocytes significantly declined from mid-pregnancy (2·92 %, 6·95 %) to late pregnancy (2·20 %, 6·42 %) and lactation (2·40 %, 6·29 %) (Ptrend < 0·001); and both concentrations were highest in coastland, followed by lakeland, and lowest in inland (P < 0·001). Regarding EPA alone, the concentrations were higher in women during lactation or late pregnancy and in women in coastland and inland areas. Moreover, concentrations of EPA or EPA plus DHA were higher in women with older age, higher education, higher annual family income per capita and higher dietary intake of marine aquatic product and mutton. In lactating women, erythrocyte EPA concentration was higher in those having breast-feeding partially v. exclusively. In conclusion, maternal plasma and erythrocyte concentrations of EPA plus DHA or EPA alone differed with geographic regions, physiological periods and maternal characteristics, indicating a need of population-specific health strategies to improve fatty acids status in pregnant and lactating women.
Hispanic adults in the USA tend to have a disproportionate prevalence of metabolic syndrome (MetS) as compared to other races.
Design:
We examined whether the association between acculturation and MetS and its components are mediated by the intake of fruit in Hispanics.
Setting:
Data from the National Health and Nutrition Examination Surveys 2009–2016 were used in this study.
Participants:
A total of 2078 Hispanics aged ≥ 20 years were included in this analysis.
Results:
The mediating role of total fruit intake was assessed using multivariable-adjusted logistic structural equation models with the bootstrapping method by estimating indirect (IE) and direct (DE) effects from acculturation to MetS. High acculturation was associated with increased odds of MetS (adjusted OR = 1·20, 95 % CI 1·04, 1·39), central obesity (OR = 1·24, 95 % CI 1·07, 1·44) and high blood pressure (OR = 1·16, 95 % CI 1·02, 1·32) among Hispanic adults. Total fruits intake partially mediated the associations of acculturation with MetS (ORIE = 1·02, 95 % CI 1·00, 1·03) and central obesity (ORIE = 1·02, 95 % CI 1·00, 1·03), whereas fully mediated the association between acculturation and high blood pressure (ORIE = 1·03, 95 % CI 1·01, 1·06). Moreover, intake of total fruits fully mediated the acculturation–MetS association among Mexican Americans (ORIE = 1·02, 95 % CI 1·00, 1·05).
Conclusions:
Our findings suggested that increasing fruit consumption may reduce the impact of high acculturation on MetS development in Hispanic adults. Further studies are needed to confirm these findings.
The coffee white stem borer, Xylotrechus quadripes Chevrolat (Coleoptera: Cerambycidae), is a major destructive pest of Coffea arabica L. (Gentianales: Rubiaceae), widely planted in many Asian countries, including China. Quantitative real-time polymerase chain reaction (qRT-PCR) is a common method for quantitative analysis of gene transcription levels. To obtain accurate and reliable qRT-PCR results, it is necessary to select suitable reference genes to different experimental conditions for normalizing the target gene expression. However, the stability of the expression of reference genes in X. quadripes has rarely been studied. In this study, the expression stability of nine candidate reference genes were investigated under biotic and abiotic conditions for use in qRT-PCR's normalization. By integrating the results of four algorithms of NormFinder, BestKeeper, geNorm, and RefFinder, the optimal reference gene combinations in different experimental conditions were performed as follows: RPL10a and EIF3D were the optimal reference genes for developmental stage samples, EIF4E, RPL10a, and RPS27a for tissue samples, V-ATP and EF1α for the sex samples, EIF3D and V-ATP for temperature treatment, RPS27a and RPL10a for insecticide stress, and RPL10a, RPS27a, and EF1α for all the samples. This study will help to obtain the stable internal reference genes under biotic and abiotic conditions and lay the foundation for in-depth functional research of target genes or genomics on olfactory molecular mechanisms, temperature adaptability, and insecticide resistance in X. quadripes.
The policy of Universal Salt Iodisation (USI) could reduce population’s thyroid volume (TVOL) in iodine deficiency areas. Conversely, the improved growth and developmental status of children might increase the TVOL accordingly. Whether the decreased TVOL by USI conceals the increase effect of height and weight on TVOL is unclear. The aim of this study was to analyse the association between height, weight, iodine supplementation and TVOL. Five national Iodine Deficiency Disorder surveys were matched into four pairs according to the purpose of analysis. County-level data of both detected by paired surveys were incorporated; 1:1 random pairing method was used to match counties or individuals. The difference of TVOL between different height, weight, different iodine supplementation measures groups and the association between TVOL and them were studied. The mean height and weight of children aged 8–10 years increased from 129·9 cm and 26·9 kg in 2002 to 136·2 cm and 32·1 kg in 2019, while the median TVOL decreased from 3·10 ml to 2·61 ml. Iodine supplementation measures can affect TVOL; after excluding iodine effects, the median TVOL was increased with the height and weight. On the other side, after excluding the influence of height and weight, the median TVOL remained decreased. Only age, weight and salt iodine were significantly associated with TVOL in multiple linear models. Development of height and weight in children is the evidence of improved nutrition. The decreased TVOL caused by iodised salt measures conceals the increase effect of height and weight on TVOL. Age, weight and salt iodine affect TVOL significantly.
Seaweeds have numerous biologically active ingredients, such as polysaccharides, polyphenols and carotenoids, that are beneficial to human health. Although these benefits might be related to the synthesis, secretion or reabsorption of uric acid, no studies have explored the relationship between seaweeds consumption and hyperuricaemia (HUA) in the general population. The aim of this study was to investigate whether seaweeds consumption is related to HUA in a large-scale adult population. A cross-sectional study was conducted with 32 365 adults (17 328 men and 15 037 women) in Tianjin, People’s Republic of China. Frequency of seaweeds consumption was assessed by a validated self-administered FFQ. HUA was defined as serum uric acid levels >420 μmol/L in men and >350 μmol/L in women. The association between seaweeds consumption and HUA was assessed by multiple logistic regression analysis. Restricted cubic spline functions were used for non-linearity tests. The prevalence of HUA in men and women was 21·17 % and 5·93 %, respectively. After adjustments for potential confounding factors, the OR (95 % CI) for HUA across seaweed consumption (g/1000 kcal per d) were 1·00 (reference) for level 1, 0·91 (95 % CI 0·81, 1·02) for level 2; 0·90 (95 % CI 0·81, 1·01) for level 3; 0·86 (95 % CI 0·78, 0·97) for level 4 in men and 0·90 (95 % CI 0·73, 1·10) for level 2; 0·82 (95 % CI 0·67, 1·00) for level 3; 0·84 (95 % CI 0·68, 1·03) for level 4 in women, respectively. A negative correlation between seaweeds consumption and HUA in males but not in females was observed. Further studies are needed to explore the causal relationship.
Calcification within breast cancer is a diagnostically significant radiological feature that generally consists of hydroxylapatite. Samples from 30 cases of breast carcinoma with calcification were investigated using optical microscopy, energy-dispersive X-ray analysis, transmission-electron microscopy, Fourier-transform infrared spectroscopy, Raman spectroscopy, synchrotron radiation X-ray diffraction and X-ray fluorescence. Under optical microscopy, the calcifications were found to consist of either irregular aggregates with widths > 200 μm or spherical aggregates similar to psammoma bodies with an average diameter of 30 μm. Transmission-electron microscopy showed that short columnar or dumbbell-shaped crystals with widths of 10–15 nm and lengths of 20–50 nm were the most common morphology; spherical aggregates (~1 μm in diameter) with amorphous coatings of fibrous nanocrystals were also observed. Results indicated that hydroxylapatite was the dominant mineral phase in the calcifications, and both CO32– and cation substitutions (Na, Mg, Zn, Fe, Sr, Cu and Mn) were present in the hydroxylapatite structure. Fourier-transform infrared spectra show peaks at 872 and 880 cm–1 indicating that CO32– substituted both the OH– (A type) and PO43– (B type) sites of hydroxylapatite, making it an A and B mixed type. The ratio of B- to A-type substitution was estimated in the range of 1.1–18.7 from the ratio of peak intensities (I872/I880), accompanied with CO32– contents from 1.1% to 14.5%. Trace arsenic, detected in situ by synchrotron radiation X-ray fluorescence was found to be distributed uniformly in the calcifications in the form of AsO43– substituting for PO43–. It is therefore proposed that identifying these trace elements in breast cancer calcifications may be promising for future clinical diagnostics.
Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China.
Methods
Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions.
Results
The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty.
Conclusions
This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.