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We aimed to investigate the relationship between the neutrophil to lymphocyte ratio (NLR) and nutritional parameters in chronic kidney disease (CKD) patients. In this cross-sectional study, 187 nondialysis CKD patients were enrolled. Daily energy intake (DEI) and daily protein intake (DPI) were assessed by 3-day dietary records. Protein-energy wasting (PEW) was defined as Subjective Global Assessment (SGA) class B and C. Spearman correlation analysis, logistic regression analysis and receiver operating characteristic curve (ROC) analysis were performed. The median NLR was 2.51 (1.83, 3.83). Patients with CKD stage 5 had the highest NLR level. A total of 19.3% (n=36) of patients suffered from PEW. The NLR was positively correlated with SGA and serum phosphorus (P), and the NLR was negatively correlated with body mass index (BMI), waist and hip circumference (WC, HC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), DPI and haemoglobin (Hb). Multivariate logistic regression analysis adjusted for DPI, DEI, serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA) and Hb showed that a high NLR was an independent risk factor for PEW [odds ratio (OR) = 1.393, 95% confidence interval (CI)= 1.078–1.800, P=0.011]. ROC analysis showed that a NLR ≥ 2.62 had the ability to identify PEW among CKD patients, with a sensitivity of 77.8%, a specificity of 62.3%, and an area under the curve (AUC) of 0.71 (95% CI= 0.63–0.81, P<0.001). The NLR was closely associated with nutritional status. NLR may be an indicator of PEW in CKD patients.
The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma (LUAD). The Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 LUAD patients without epidermal growth factor receptor (EGFR) mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing LUAD. According to the PG-SGA, 63 (16·3 %), 174 (44·7 %) and 78 (20·1 %) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36·2 %) patients based on the NRS 2002. The average LOS for tumour patients in Northern China was 12·5 d. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P < 0·001), NRS 2002 (P < 0·001) and latest weight loss (P < 0·001) predicted the longer LOS. LOS was related to nutritional status and hospitalisation expenses (P < 0·001). LUAD patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P < 0·001). In Northern Chinese patients with LUAD, a risk for undernutrition evaluated by the PG-SGA, the NRS 2002 and recent weight loss, but not BMI, could predict a longer LOS.
Almost all hospitals are equipped with air-conditioning systems to provide a comfortable environment for patients and staff. However, the accumulation of dust and moisture within these systems increases the risk of transmission of microbes and have on occasion been associated with outbreaks of infection. Nevertheless, the impact of air-conditioning on the transmission of microorganisms leading to infection remains largely uncertain. We conducted a scoping review to screen systematically the evidence for such an association in the face of the coronavirus disease 2019 epidemic. PubMed, Embase and Web of Science databases were explored for relevant studies addressing microbial contamination of the air, their transmission and association with infectious diseases. The review process yielded 21 publications, 17 of which were cross-sectional studies, three were cohort studies and one case−control study. Our analysis showed that, compared with naturally ventilated areas, microbial loads were significantly lower in air-conditioned areas, but the incidence of infections increased if not properly managed. The use of high-efficiency particulate air (HEPA) filtration not only decreased transmission of airborne bioaerosols and various microorganisms, but also reduced the risk of infections. By contrast, contaminated air-conditioning systems in hospital rooms were associated with a higher risk of patient infection. Cleaning and maintenance of such systems to recommended standards should be performed regularly and where appropriate, the installation of HEPA filters can effectively mitigate microbial contamination in the public areas of hospitals.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
Varicella is a highly infectious contagious disease, and Chongqing is one of the high incidence areas in China. To understand the epidemic regularity and predict the epidemic trend of varicella is of great significance to the risk analysis and health resource allocation in the health sector. First, we used the ‘STL’ function to decompose the incidence of varicella to understand its trend and seasonality. Second, we established SARIMA model for linear fitting, and then took the residual of the SARIMA model as the sample to fit the LS-SVM model, to explain the non-linearity of the residuals. The monthly varicella incidence peaks in April to June and October to December. Mixed model was compared to SARIMA model, the prediction error of the hybrid model was smaller, and the RMSE and MAPE values of the hybrid model were 0.7525 and 0.0647, respectively, the mixed model had a better prediction effect. Based on the study, the incidence of varicella in Chongqing has an obvious seasonal trend, and a hybrid model can also predict the incidence of varicella well. Thus, hybrid model analysis is a feasible and simple method to predict varicella in Chongqing.
Prolonged sitting in a fixed or constrained position exposes aircraft passengers to long-term static loading of their bodies, which has deleterious effects on passengers’ comfort throughout the duration of the flight. The previous studies focused primarily on office and driving sitting postures and few studies, however, focused on the sitting postures of passengers in aircraft. Consequently, the aim of the present study is to detect and recognize the sitting postures of aircraft passengers in relation to sitting discomfort. A total of 24 subjects were recruited for the experiment, which lasted for 2 h. Furthermore, a total of 489 sitting postures were extracted and the pressure data between subjects and seat was collected from the experiment. After the detection of sitting postures, eight types of sitting postures were classified based on key parts (trunk, back, and legs) of the human bodies. Thereafter, the eight types of sitting postures were recognized with the aid of pressure data of seat pan and backrest employing several machine learning methods. The best classification rate of 89.26% was obtained from the support vector machine (SVM) with radial basis function (RBF) kernel. The detection and recognition of the eight types of sitting postures of aircraft passengers in this study provided an insight into aircraft passengers’ discomfort and seat design.
The North Qilian Orogenic Belt is surrounded by the Tarim Craton to the NW and the North China Craton to the NE. The Precambrian continental crust remnants that are distributed in the North Qilian Orogenic Belt are termed the North Qilian Block (NQB), and their tectonic evolution has profound implications for the evolution of the Columbia Supercontinent. Here we present major- and trace-element and Sr–Nd–Hf isotope data for (meta-) basalts from the Beidahe Group (BDHG) and Zhulongguan Group (ZLGG) in the western North Qilian Orogenic Belt, to investigate the tectonic evolution of the NQB during the Proterozoic Eon. The protoliths of Palaeoproterozoic amphibole gneisses and plagioclase amphibolites from the BDHG are calc-alkaline series basalts. These metabasalts show island-arc-basalt affinities with variable Nd and Hf isotopes (ϵNd(t) = −5.0–0.6 and 2.7–4.3; ϵHf(t) = −14.2–2.0 and 6.9–8.8) and were generated by partial melting of the asthenospheric mantle that was metasomatized by aqueous fluid and sediment melt in a continental-arc setting. The early Mesoproterozoic ZLGG basalts show features of shoshonite-series basalts and are geochemically similar to ocean-island basalts. These basalts show variable (87Sr/86Sr)i, ϵNd(t) and ϵHf(t) values of 0.70464–0.70699, −1–2.6 and −1.5–5.7, and are products of mantle plume magmatism that participated with subducted oceanic crust in an intracontinental rift setting. This study suggests that the NQB underwent tectonic evolution from palaeo-oceanic subduction to intracontinental rifting during the Palaeoproterozoic–Mesoproterozoic eras. Furthermore, the above tectonomagmatic events were in response to convergence–splitting events of the Columbia Supercontinent during the Palaeoproterozoic–Mesoproterozoic eras.
People with serious mental illness are at great risk of suicide, but little is known about the suicide rates among this population. We aimed to quantify the suicide rates among people with serious mental illness (bipolar disorder, major depression, or schizophrenia).
PubMed and Web of Science were searched to identify studies published from 1 January 1975 to 10 December 2020. We assessed English-language studies for the suicide rates among people with serious mental illness. Random-effects meta-analysis was used. Changes in follow-up time and the suicide rates were presented by a locally weighted scatter-plot smoothing (LOESS) curve. Suicide rate ratio was estimated for assessments of difference in suicide rate by sex.
Of 5014 identified studies, 41 were included in this analysis. The pooled suicide rate was 312.8 per 100 000 person-years (95% CI 230.3–406.8). Europe was reported to have the highest pooled suicide rate of 335.2 per 100 000 person-years (95% CI 261.5–417.6). Major depression had the highest suicide rate of 534.3 per 100 000 person-years (95% CI 30.4–1448.7). There is a downward trend in suicide rate estimates over follow-up time. Excess risk of suicide in males was found [1.90 (95% CI 1.60–2.25)]. The most common suicide method was poisoning [21.9 per 100 000 person-years (95% CI 3.7–50.4)].
The suicide rates among people with serious mental illness were high, highlighting the requirements for increasing psychological assessment and monitoring. Further study should focus on region and age differences in suicide among this population.
This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect.
A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed.
There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group.
The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.
Poor utilisation efficiency of carbohydrate always leads to metabolic phenotypes in fish. The intestinal microbiota plays an important role in carbohydrate degradation. Whether the intestinal bacteria could alleviate high-carbohydrate diet (HCD)-induced metabolic phenotypes in fish remains unknown. Here, a strain affiliated to Bacillus amyloliquefaciens was isolated from the intestine of Nile tilapia. A basal diet (CON), HCD or HCD supplemented with B. amy SS1 (HCB) was used to feed fish for 10 weeks. The beneficial effects of B. amy SS1 on weight gain and protein accumulation were observed. Fasting glucose and lipid deposition were decreased in the HCB group compared with the HCD group. High-throughput sequencing showed that the abundance of acetate-producing bacteria was increased in the HCB group relative to the HCD group. Gas chromatographic analysis indicated that the concentration of intestinal acetate was increased dramatically in the HCB group compared with that in the HCD group. Glucagon-like peptide-1 was also increased in the intestine and serum of the HCB group. Thus, fish were fed with HCD, HCD supplemented with sodium acetate at 900 mg/kg (HLA), 1800 mg/kg (HMA) or 3600 mg/kg (HHA) diet for 8 weeks, and the HMA and HHA groups mirrored the effects of B. amy SS1. This study revealed that B. amy SS1 could alleviate the metabolic phenotypes caused by HCD by enriching acetate-producing bacteria in fish intestines. Regulating the intestinal microbiota and their metabolites might represent a powerful strategy for fish nutrition modulation and health maintenance in future.
The impact of diet on the metabolic syndrome (MetS) and CVD has been investigated widely, but few studies have investigated the association between dietary patterns (DP) and the predicted CVD, derived from reduced rank regression (RRR). The objectives of this study were to derive DP using RRR and principal component analysis (PCA) and investigate their associations with the MetS and estimated 10-year atherosclerotic CVD (ASCVD). We used the baseline dataset from the Xinjiang multi-ethnic cohort study in China, collected from June 2018 to May 2019. A total of 14 982 subjects aged 35–74 years from Urumqi, Huo Cheng and Mo Yu were included in the analysis. The 10-year ASCVD risk was estimated using the Chinese ASCVD risk equations. The associations of DP with the MetS and 10-year ASCVD were determined using multivariable logistic regression models. In Urumqi and Mo Yu, the increased RRR DP score was associated with a higher OR of having the MetS and with a higher OR of elevated 10-year ASCVD risk. However, only the first DP determined by PCA in Urumqi was inversely associated with the MetS and elevated 10-year ASCVD risk. The prevalence of the MetS and elevated ASCVD risk in urban population is higher than that in rural areas. Our results may help nutritionists develop more targeted dietary strategies to prevent the MetS and ASCVD in different regions in China.
The widespread occurrence of late Mesozoic volcanic rocks in SE China is associated with widespread mineralization. Most geologists have accepted the model of Pacific plate subduction beneath the eastern Asian continent, but there are still controversies, especially the initial timing of the tectonic transition. In order to understand the tectonic evolution of the palaeo-Pacific plate subduction, an integrated study of zircon U–Pb, Lu–Hf isotope compositions and whole-rock geochemistry was carried out for Mesozoic volcanic rocks in eastern Fujian Province. According to the field observations and zircon U–Pb ages, these volcanic rocks can be divided into three phases: an early stage of Late Jurassic volcanic rocks (Phase 1, 159–153 Ma), a late stage of Late Jurassic volcanic rocks (Phase 2, 152–146 Ma) and an early stage of Early Cretaceous volcanic rocks (Phase 3, 143–139 Ma). Overall, these volcanic rocks are composed of intermediate–acid pyroclastic rocks and lava, with high SiO2, Na2O, K2O and Al2O3 contents, belonging to the high-K calc-alkaline and peraluminous series, with enrichment in large ion lithophile and light rare earth elements but depletion in high-field-strength elements and heavy rare earth elements. However, the Phase 1 and 2 volcanic rocks contain different zircon Hf isotopic compositions and whole-rock geochemistry to the Phase 3 volcanic rocks, implying that they have a different petrogenesis. Our study combined with previous research shows that the decreasing zircon ϵHf(t) values of the Middle–Late Jurassic volcanic rocks indicate a decreasing mantle-derived material contribution. On the contrary, the majority of the Early Cretaceous volcanic rocks have variable ϵHf(t) values, requiring varied degrees of involvement of juvenile components in their origin. Thus, we consider that the Late Jurassic volcanic rocks were generated in a compressional tectonic environment during the early stage (> 146 Ma) of palaeo-Pacific subduction. In contrast, the Cretaceous volcanic rocks were formed in an extensional tectonic setting during a later stage (< 143 Ma) of subduction.
Cotton fibre yield and quality are markedly influenced by drought and high-temperature stress. We examined the traits of the leaf stomata in 39 cotton genotypes subjected to exogenous phytohormone abscisic acid (ABA) signalling, electrolyte leakage under 40°C thermal stress, and relative GhHsfA, GhbZIP and GhHSP70 expression levels under two treatments. Stomatal density and area ranged from 66 to 182/mm2 and 663 to 1305 μm2, respectively. Under exogenous ABA signalling, the changes in stomatal aperture (ΔSAp) were in the range of 2.5–31.2%; ΔSAp and relative GhHsfA, GhbZIP and GhHSP70 expression levels were significantly correlated, respectively. Electrolyte leakage increased unequally among cotton genotypes after heat stress. The changes in electrolyte leakage (ΔEL) and relative GhHsfA, GhbZIP and GhHSP70 expression levels were very strongly correlated, respectively. Their relative expression levels could be used as references for the rapid identification of stress-tolerant cotton strains. Cluster analysis of the 39 cotton genotypes indicated that Xinluzao36, Shiyang1, shinong98-7 and Zhongmiansuo293 are heat- and drought-resistant. We integrated both analysis of physiological parameters and molecular methods to identify cotton varieties with the drought and heat tolerance, in order to provide a reference for the selection of materials and methods for the research and production of cotton.
We find and prove a class of congruences modulo 4 for eta-products associated with certain ternary quadratic forms. This study was inspired by similar conjectured congruences modulo 4 for certain mock theta functions.
Predictors of compliance with aspirin in children following cardiac catheterisation have not been identified. The aim of this study is to identify the caregivers’ knowledge, compliance with aspirin medication, and predictors of compliance with aspirin in children with Congenital Heart Disease (CHD) post-percutaneous transcatheter occlusion.
A cross-sectional explorative design was adopted using a self-administered questionnaire and conducted between May 2017 and May 2018. Recruited were 220 caregivers of children with CHD post-percutaneous transcatheter occlusion. Questionnaires included child and caregivers’ characteristics, a self-designed and tested knowledge about aspirin scale (scoring scale 0–2), and the 8-item Morisky Medication Adherence Scale (scoring scale 0–8). Data were analysed using multivariate binary logistic regression analysis to identify predictors of compliance with aspirin.
Of the 220 eligible children and caregivers, 210 (95.5%) responded and 209 surveys were included in the analysis. The mean score of knowledge was 7.25 (standard deviation 2.27). The mean score of compliance was 5.65 (standard deviation 1.36). Child’s age, length of aspirin use, health insurance policies, relationship to child, monthly income, and knowledge about aspirin of caregivers were independent predictors of compliance with aspirin (p < 0.05).
Caregivers of children with CHD had an adequate level of knowledge about aspirin. Compliance to aspirin medication reported by caregivers was low. Predictors of medium to high compliance with aspirin were related to the child’s age and socio-economic reasons. Further studies are needed to identify effective strategies to improve knowledge, compliance with medication, and long-term outcomes of children with CHD.
As a crucial concept for understanding Chinese social behavior, face derives from the complicated structure of Confucianism and has continued to develop as a consequence of modernization. This chapter aims to present a series of culture-inclusive theories from the psychological perspective to illustrate face dynamism in Chinese societies. Specifically, the aims of this chapter are threefold: First, to present culture-inclusive theories of face dynamism in Chinese societies as potential materials for intercultural training related to social interactions with the Chinese. Second, to present a glossary of face-related concepts, each defined and reinterpreted in the context of current culture-inclusive theories, and to illustrate their usage as language games by Chinese people in daily social interactions. Third, the discussion of face extends from the interpersonal level to the international level, in order to highlight its cultural significance in intercultural interactions with the Chinese. We focus on the most significant and unique cultural element during intercultural interactions with the Chinese, namely face, by illustrating various roles it plays in Chinese societies. From traditional to modern usage, from personal to national level, we hope that the discussions will shed light on the why and how of face in Chinese social interactions.
A higher dietary intake or serum concentration of betaine has been associated with greater lean body mass in middle-aged and older adults. However, it remains unknown whether betaine intake is associated with age-related loss of skeletal muscle mass (SMM). We assessed the association between dietary betaine intake and relative changes in SMM after 3 years in middle-aged adults. A total of 1242 participants aged 41–60 years from the Guangzhou Nutrition and Health Study 2011–2013 and 2014–2017 with body composition measurements by dual-energy X-ray absorptiometry were included. A face-to-face questionnaire was used to collect general baseline information. After adjustment for potential confounders, multiple linear regression found that energy-adjusted dietary betaine intake was significantly and positively associated with relative changes (i.e. percentage loss or increase) in SMM of legs, limbs and appendicular skeletal mass index (ASMI) over 3 years of follow-up (β 0·322 (se 0·157), 0·309 (se 0·142) and 0·303 (se 0·145), respectively; P < 0·05). The ANCOVA models revealed that participants in the highest betaine tertile had significantly less loss in SMM of limbs and ASMI and more increase in SMM of legs over 3 years of follow-up, compared with those in the bottom betaine tertile (all Ptrend < 0·05). In conclusion, our findings suggest that elevated higher dietary betaine intake may be associated with less loss of SMM of legs, limbs and ASMI in middle-aged adults.