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The prediction of prognosis is an important part of management in hepatitis B virus (HBV)-related decompensated cirrhosis patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in HBV-related decompensated cirrhosis patients. We performed a single-centre, observational, retrospective study of 405 HBV-related decompensated cirrhosis patients. Individuals were evaluated within 24 h after admission and the primary outcome was evaluated at 6-months. Multivariable analyses were used to determine whether lactate was independently associated with the prognosis of HBV-related decompensated cirrhosis patients. The area under the ROC (AUROC) was calculated to assess the predictive accuracy compared with existing scores. Serum lactate level was significantly higher in non-surviving patients than in surviving patients. Multivariable analyses demonstrated that lactate was an independent risk factor of 6-months mortality (odds ratio: 2.076, P < 0.001). Receiver operating characteristic (ROC) curves were drawn to evaluate the discriminative ability of lactate for 6-months mortality (AUROC: 0.716, P < 0.001). Based on our patient cohort, the new scores (Model For End-Stage Liver Disease (MELD) + lactate score, Child–Pugh + lactate score) had good accuracy for predicting 6-months mortality (AUROC = 0.769, P < 0.001; AUROC = 0.766, P < 0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001). Serum lactate at admission may be useful for predicting 6-months mortality in HBV-related decompensated cirrhosis patients, and the predictive value of the MELD score and Child–Pugh score was improved by adjusting lactate. Serum lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.
We aimed to describe the clinical features in coronavirus disease 2019 (COVID-19) cases. We studied 134 critically ill COVID-19 cases from 30 December 2019 to 20 February 2020 in an intensive care unit (ICU) at Wuhan Jinyintan Hospital. Demographics, underlying diseases, therapy strategies and test results were collected and analysed from patients on admission, admission to the ICU and 48 h before death. The non-survivors were older (65.46 (s.d. 9.74) vs. 46.45 (s.d. 11.09)) and were more likely to have underlying diseases. The blood group distribution of the COVID-19 cases differed from that of the Han population in Wuhan, with type A being 43.85%; type B, 26.92%; type AB, 10% and type O, 19.23%. Non-survivors tend to develop more severe lymphopaenia, with higher C-reactive protein, interleukin-6, procalcitonin, D-dimer levels and gradually increased with time. The clinical manifestations were non-specific. Compared with survivors, non-survivors more likely to have organ function injury, and to receive mechanical ventilation, either invasively or noninvasively. Multiple organ failure and secondary bacterial infection in the later period is worthy of attention.
The lane-level map, which contains the lane-level information severely lacking in widely used commercial navigation maps, has become an essential data source for autonomous driving systems. The linking relations between lane-level map and commercial navigation map can facilitate an autonomous driving system mapping information between different applications using different maps. In this paper, an approach is proposed to build the linking relations automatically. The different topology networks are first reconstructed into similar structures. Then, to build the linking relations automatically, the adaptive multi-filter algorithm and forward path exploring algorithm are proposed to detect corresponding junctions and paths, respectively. The approach is validated by two real data sets of more than 150 km of roads, mainly highway. The linking relations for nearly 94% of the total road length have been built successfully.
Previous studies have shown conflicting findings regarding the relationship between maternal vitamin D deficiency (VDD) and fetal growth restriction (FGR). We hypothesised that parathyroid hormone (PTH) may be an underlying factor relevant to this potential association. In a prospective birth cohort study, descriptive statistics were evaluated for the demographic characteristics of 3407 pregnancies in the second trimester from three antenatal clinics in Hefei, China. The association of the combined status of vitamin D and PTH with birth weight and the risk of small for gestational age (SGA) was assessed by a multivariate linear and binary logistic regression. We found that declined status of 25-hydroxyvitamin D is associated with lower birth weight (for moderate VDD: adjusted β = −49·4 g, 95 % CI −91·1, −7·8, P < 0·05; for severe VDD: adjusted β = −79·8 g, 95 % CI −127·2, −32·5, P < 0·01), as well as ascended levels of PTH (for elevated PTH: adjusted β = −44·5 g, 95 % CI −82·6, −6·4, P < 0·05). Compared with the non-VDD group with non-elevated PTH, pregnancies with severe VDD and elevated PTH had the lowest neonatal birth weight (adjusted β = −124·7 g, 95 % CI −194·6, −54·8, P < 0·001) and the highest risk of SGA (adjusted risk ratio (RR) = 3·36, 95 % CI 1·41, 8·03, P < 0·01). Notably, the highest risk of less Ca supplementation was founded in severe VDD group with elevated PTH (adjusted RR = 4·67, 95 % CI 2·78, 7·85, P < 0·001). In conclusion, elevated PTH induced by less Ca supplementation would further aggravate the risk of FGR in pregnancies with severe VDD through impaired maternal Ca metabolism homoeostasis.
A series of double-perovskite LaAMnNiO6 (A = La, Pr, Sm) catalysts with mesoporous morphology was prepared by a sol–gel method and further applied into photothermal synergistic degradation of gaseous toluene. Transmission electron microscopy and Brunauer–Emmett–Teller characterizations confirmed that double-perovskite LaAMnNiO6 (A = La, Pr, Sm) had obvious mesoporous structure, which can provide a larger specific surface area and further enhancing the reactivity of catalyst. UV-vis and X-ray photoelectron spectroscopy characterization illustrated that LaSmMnNiO6 possessed higher adsorption oxygen content and light absorption capacity, which contribute to the occurrence of catalytic oxidation in the Mars–van Krevelen redox cycle mechanism. A group of active tests showed that the double-perovskite LaSmMnNiO6 catalyst had a lower reaction initiation temperature (starting reaction at 75 °C) and a lower activity temperature of optimal reaction (more than 90% at 255 °C). Moreover, the research on reaction kinetics of the catalyst demonstrated that LaAMnNiO6 (A = La, Pr, Sm) had lower activation energy and thus exhibited better catalytic activity. The results of the study indicate that the double-perovskite LaAMnNiO6 (A = La, Pr, Sm) has broad application prospects in the field of volatile organic pollutant degradation.
Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates.
Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model.
Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1–31.9%; I2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3–3.7%; I2 = 95.6%), 2.7% (95% CI 2.1–3.4%; I2 = 78.5%) and 45.9% (95% CI 42.1–49.9%; I2 = 0), respectively. Earlier age of onset (Q = 4.38, p = 0.04), high-income countries (Q = 53.29, p < 0.001), North America and Europe and Central Asia (Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts.
Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.
Underground Nuclear Astrophysics in China (JUNA) will take the advantage of the ultra-low background in Jinping underground lab. High current accelerator with an ECR source and detectors were commissioned. JUNA plans to study directly a number of nuclear reactions important to hydrostatic stellar evolution at their relevant stellar energies. At the first period, JUNA aims at the direct measurements of 25Mg(p,γ)26 Al, 19F(p,α) 16 O, 13C(α, n) 16O and 12C(α,γ) 16O near the Gamow window. The current progress of JUNA will be given.
In this study, a thermal–elastic–plastic finite element model is proposed to investigate the effect of volume energy density on the temperature field, molten pool size, and residual stress distribution in the selective laser melting (SLM) process of Inconel 718 alloy. A temperature-dependent thermal–mechanical property of materials is considered, as well as the properties conversion between powder layer and solidified alloy. Within the scope of the study parameters, the simulated molten pool size increases with increasing volume energy density and exhibits linear growth relationship, which are validated by the experimental results and show a good agreement. In addition, five scanning strategies are adopted to study the effect of these scanning strategies on the residual stress distribution in this research. The results show that the residual stress distribution of SLM Inconel 718 specimen largely depends on the scanning strategy. Finally, to reveal the mechanism of residual stress formation, the restraint bar model is used to further analyze the formation mechanism of residual stress during the SLM process.
For a multiplier Hopf algebra pairing 〈A,B〉, we construct a class of group-cograded multiplier Hopf algebras D(A,B), generalizing the classical construction of finite dimensional Hopf algebras introduced by Panaite and Staic Mihai [Isr. J. Math. 158 (2007), 349–365]. Furthermore, if the multiplier Hopf algebra pairing admits a canonical multiplier in M(B⊗A) we show the existence of quasitriangular structure on D(A,B). As an application, some special cases and examples are provided.
To assess the effect of famine exposure during early life on dietary patterns, chronic diseases, and the interaction effect between famine exposure and dietary patterns on chronic diseases in adulthood.
Cross-sectional study. Dietary patterns were derived by factor analysis. Multivariate quantile regression and log-binomial regression were used to evaluate the impact of famine exposure on dietary patterns, chronic diseases and the interaction effect between famine exposure and dietary patterns on chronic diseases, respectively.
Adults aged 45–60 years (n 939).
‘Healthy’, ‘high-fat and high-salt’, ‘Western’ and ‘traditional Chinese’ dietary patterns were identified. Early-childhood and mid-childhood famine exposure were remarkably correlated with high intake of the traditional Chinese dietary pattern. Compared with the non-exposed group (prevalence ratio (PR); 95 % CI), early-childhood (3·13; 1·43, 6·84) and mid-childhood (2·37; 1·05, 5·36) exposed groups showed an increased PR for diabetes, and the early-childhood (2·07; 1·01, 4·25) exposed group showed an increased PR for hypercholesterolaemia. Additionally, relative to the combination of non-exposed group and low-dichotomous high-fat and high-salt dietary pattern, the combination of famine exposure in early life and high-dichotomous high-fat and high-salt dietary pattern in adulthood had higher PR for diabetes (4·95; 1·66, 9·05) and hypercholesterolaemia (3·71; 1·73, 7·60), and significant additive interactions were observed.
Having suffered the Chinese famine in childhood might affect an individual’s dietary habits and health status, and the joint effect between famine and harmful dietary pattern could have serious consequences on later-life health outcomes.
This study was designed to explore the association between undernutrition in the growth period and cardiovascular risk factors in a middle-aged Chinese population. A total of 1756 subjects, aged 45–60 years, were invited to participate in the Hefei Nutrition and Health Study and divided into three groups according to their self-reported animal food intake in the growth period. Group 1, Group 2 and Group 3 were defined as undernutrition, nutritional improvement and the good nutrition group, respectively. In the three groups, the subjects in Groups 1 and 2 had more oil and salt intake (P<0.001), and less eggs and milk intake (P<0.001), when compared with the subjects in Group 3. After adjusting for age, education, smoking status and other confounding factors, it was found that male participants who experienced nutritional improvement before age 18 had higher risk of hypertension [odds ratio (OR)=1.68; 95% confidence intervals (CI): 1.05, 2.69] than those with good nutrition, and female participants with undernutrition (OR=1.52; 95% CI: 1.01, 2.29) and nutritional improvement (OR=1.68; 95% CI: 1.04, 2.69) before age 18 had a higher risk of hypertension than those with good nutrition. For diabetes, obesity, hypercholesterolemia and hypertriglyceridemia, our results did not found difference among the three groups both in male and female. Our findings indicated that nutritional deficiency in childhood was associated with bad dietary behaviors and a significantly increased risk of hypertension in middle age. Therefore, early adequate nutrition is very important for the prevention of non-communicable diseases later.