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This study aimed to explore the relationships between situational and psychological factors and Hong Kong citizens’ plastic waste management (PWM) intentions based on an extended theory of planned behaviour model with situational factors. A total of 996 Hong Kong permanent residents were surveyed, and data were analysed using structural equation modelling. The results revealed that situational factors had a direct and positive effect on PWM intention, but also affected PWM intention indirectly through their significant effects on attitude and perceived behavioural control regarding PWM. The implications for environmental education and policy are discussed.
To investigate the safety and feasibility of midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
A retrospective analysis was performed on 55 patients who underwent transcatheter device closure of atrial septal defects from October, 2019 to May, 2020. All patients received intravenous midazolam and local anesthesia with lidocaine to maintain sedation. A group of previous patients with unpublished data who underwent the same procedure with general anesthesia was set as the control group. The relevant clinical parameters, the Ramsay sedation scores, the numerical rating scale, and the post-operative satisfaction questionnaire were recorded and analyzed.
In the midazolam group, the success rate of atrial septal defect closure was 98.2%. Hemodynamic stability was observed during the procedure. None of the patients needed additional endotracheal intubation for general anesthesia. Compared with the control group, the midazolam group had no statistically significant differences in the Ramsay sedation score and numerical rating scale scores. Patients in the midazolam group experienced more post-operative satisfaction than those in the control group.
Conscious sedation using midazolam is a safe and effective anesthetic technique for transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.
The consumer survey reported in this research paper aims to understand how Chinese mothers learn about and confirm the origin of powdered infant formulas (henceforward formulas), their knowledge level and preferences between formulas from different origins. With globalization, dairy companies can source ingredients for domestic production and manufacture finished products across the world. Chinese consumers are now facing a variety of formulas with different brand origin, main ingredient origin (‘nai yuan’), manufacturing origin, and country-of-purchase. Drawing on a large representative sample of Chinese mothers who have purchased formulas, we found that most of them had intensively engaged in learning about and confirming formulas' origin through different strategies. However, they may not interpret related cues correctly: a majority of Chinese mothers incorrectly considered the ‘main ingredient origin’ as the ‘manufacturing place’ and could not necessarily recognize between ‘foreign’ and ‘domestic’ brands. Among formulas from different origins, authentic foreign branded, produced and packaged formulas showed a high popularity in Tier 1 & 2 cities and among more knowledgeable consumers. In low-tier cities, these products were equally popular as domestically branded and produced formulas using imported milk powders and other ingredients. Formulas directly acquired from overseas markets through unofficial channels were least favoured by consumers. The study shows that Chinese consumers' previous one-sided endorsement towards foreign formulas appears to have weakened. Decisions made by formula companies on the origin of the main ingredient and the place of manufacture would influence product attractiveness, and the segments of Chinese consumers to target.
Engineered biomaterials provide unique functions to overcome the bottlenecks seen in biomedicine. Hence, a technique for rapid and routine tests of collagen is required, in which the test items commonly include molecular weight, crosslinking degree, purity, and sterilization induced structural change. Among them, the crosslinking degree mainly influences collagen properties. In this study, second harmonic generation (SHG) and coherent anti-Stokes Raman scattering (CARS) microscopy are used in combination to explore the collagen structure at molecular and macromolecular scales. These measured parameters are applied for the classification and quantification among the different collagen scaffolds, which were verified by other conventional methods. It is demonstrated that the crosslinking status can be analyzed from SHG images and presented as the coherency of collagen organization that is correlated with the mechanical properties. Also, the comparative analyses of SHG signal and relative CARS signal of amide III band at 1,240 cm−1 to δCH2 band at 1,450 cm−1 of these samples provide information regarding the variation of the molecular structure during a crosslinking process, thus serving as nonlinear optical signatures to indicate a successful crosslinking.
Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.
Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.
Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.
Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
Despite increasing economic integrations with China, worries exist in China's neighboring countries about China's implicit political intention. Do people view trading with China differently? In this article, we incorporate the political context of trade agreements by showing that trade with partners who come with political costs is less likely to be supported. Using a nationally representative survey experiment from Taiwan, we find that trading with China garners less support than trading with Japan or Malaysia, and nationalism suppresses self-interest when the proposed trading partner is China. We show that national attachment, which is neither a proxy for political identification nor a proxy for national chauvinism, becomes a stronger predictor of trade preferences toward China. While the political tension between China and Taiwan is unique, many countries see at least one other country posing a negative externality. Our finding suggests strongly identified nationalists would oppose engaging with a hostile outsider regardless of their self-interest.
To evaluate age-related differences in the independent/combined association of added sugar intake from soda and body adiposity with hyperuricaemia in gender-stratified US adults.
Consumption of added sugar from soda was calculated from 24-h dietary interviews and categorised into none, regular and excessive consumption. Hyperuricaemia was defined as serum uric acid levels >417 mmol/l in men and >357 mmol/l in women. Multiple regression models with interaction terms and logistic models adjusted for covariates were conducted under survey-data modules.
National Health and Nutrition Examination Survey during 2007–2016.
15 338 adults without gout, failing kidneys, an estimated glomerular filtration rate < 30 or diabetes were selected.
The age-stratified prevalence rate of hyperuricaemia was 18·8–20·4 % in males and 6·8–17·3 % in females. Hyperuricaemia prevalence of approximately 50 % was observed in young and middle age males who consumed excessive added sugar from soda. Excessive added sugar intake was observed to be associated with 1·5- to 2·0-fold and 2·0- to 2·3-fold increased risk of the probability of hyperuricaemia in young and middle age males and middle age females, respectively. Study participants, regardless of age or gender, who were obese and consumed excessive added sugar from soda had the highest risk of having hyperuricaemia.
Our study revealed that the association between hyperuricaemia and consumption of excessive added sugar from soda may vary by age and gender. Obese adults who consumed excessive added sugar from soda had the highest risk of hyperuricaemia, a finding that was found across all age-specific groups for both genders.
The objective of this study was to analyze differences in birth weight and overweight/obesity in a Shanghai twin cohort. We also wanted to study their association and explore possible risk factors for the discordance of overweight/obesity within twins. This was an internal case–control study designed for twins. The 2012 Shanghai Twin Registration System baseline survey data of a total of 3417 twin pairs were statistically analyzed using SPSS22 software. Results show that the body mass index (BMI) of the Shanghai twin population increased with age. Twins with a high birth weight had a higher BMI and a higher rate of overweight and obesity; 0- to 6-year-old twins, male twins and dizygotic (DZ) twins had higher rates of overweight/obesity than other groups. The greater the discordant birth weight rate of twins, the more obvious the difference in BMI (p < .05). There was a significant difference in overweight/obesity between twins with a relative difference of birth weight ≥15% in DZ twins (p < .05). DZ twins, male twins and 0- to 6-year-old twins were more likely to be discordant in overweight/obese than others. The discordant birth weight within twins was not a risk factor for discordant overweight/obesity. However, attention should be paid to childhood obesity, and appropriate interventions should be made at the appropriate time. Genetics may play an important role in the occurrence and development of overweight/obesity. In conclusion, discordant growth and development in the uterus early in life may not lead to discordant weight development in the future.
We study the axisymmetric evolution of a liquid film on a solid sphere governed by gravity, capillarity and viscous forces. The lubrication equations established in spherical coordinates are numerically solved using finite elements and local similarity solutions are obtained. Results show that the evolution behaves differently at early and late stages. At the early stage, the interface evolves in such a way that the capillary effect can be ignored. At the late stage, there emerge four zones from top to bottom: a thin film, a ridge ring, a dimple ring and a pendant drop. Each zone is governed by the balance of different forces, and hence is characterized by an individual physical mechanism. Consequently, the pendant drop is quasi-static, and the film thicknesses of other regions follow different scaling laws. The position of the dimple remains unchanged at the late stage.
Exposure to adverse childhood experiences (ACEs) is not only associated with one's adverse health outcomes in adulthood but also increases the risk of child developmental problems in offspring. However, the mechanisms involved in the transmission of the effects of maternal ACEs to the offspring largely remain unexplored. This study sought to identify possible psychosocial pathways of intergenerational effects of maternal ACEs on child development at 6 months. Data from a longitudinal study on maternal childhood adversity and maternal psychosocial risk during pregnancy as well as maternal mental health problems and child development at 6 months postnatal were used. Structural equation modeling with bootstrapping was used to estimate the indirect effects of maternal ACEs on child development at 6 months. The model showed that maternal ACEs indirectly influenced offspring's development via maternal stressful events during pregnancy and pre- and postnatal mental health problems. This finding highlights the possible interventions at the prenatal and postnatal periods. Early identification of women who have ACEs or who are at psychosocial risk during pre- and postnatal periods is critical to provide interventions to buffer those negative effects on offspring's development. Future studies are needed to longitudinally assess the effects of maternal ACEs on child development over time.
Schizotypy refers to schizophrenia-like traits below the clinical threshold in the general population. The pathological development of schizophrenia has been postulated to evolve from the initial coexistence of ‘brain disconnection’ and ‘brain connectivity compensation’ to ‘brain connectivity decompensation’.
In this study, we examined the brain connectivity changes associated with schizotypy by combining brain white matter structural connectivity, static and dynamic functional connectivity analysis of diffusion tensor imaging data and resting-state functional magnetic resonance imaging data. A total of 87 participants with a high level of schizotypal traits and 122 control participants completed the experiment. Group differences in whole-brain white matter structural connectivity probability, static mean functional connectivity strength, dynamic functional connectivity variability and stability among 264 brain sub-regions of interests were investigated.
We found that individuals with high schizotypy exhibited increased structural connectivity probability within the task control network and within the default mode network; increased variability and decreased stability of functional connectivity within the default mode network and between the auditory network and the subcortical network; and decreased static mean functional connectivity strength mainly associated with the sensorimotor network, the default mode network and the task control network.
These findings highlight the specific changes in brain connectivity associated with schizotypy and indicate that both decompensatory and compensatory changes in structural connectivity within the default mode network and the task control network in the context of whole-brain functional disconnection may be an important neurobiological correlate in individuals with high schizotypy.
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.
Non-communicable diseases (NCDs) including obesity, diabetes, and allergy are chronic, multi-factorial conditions that are affected by both genetic and environmental factors. Over the last decade, the microbiome has emerged as a possible contributor to the pathogenesis of NCDs. Microbiome profiles were altered in patients with NCDs, and shift in microbial communities was associated with improvement in these health conditions. Since the genetic component of these diseases cannot be altered, the ability to manipulate the microbiome holds great promise for design of novel therapies in the prevention and treatment of NCDs. Together, the Developmental Origins of Health and Disease concept and the microbial hypothesis propose that early life exposure to environmental stimuli will alter the development and composition of the human microbiome, resulting in health consequences. Recent studies indicated that the environment we are exposed to in early life is instrumental in shaping robust immune development, possibly through modulation of the human microbiome (skin, airway, and gut). Despite much research into human microbiome, the origin of their constituent microbiota remains unclear. Dust (also known as particulate matter) is a key determinant of poor air quality in the modern urban environment. It is ubiquitous and serves as a major source and reservoir of microbial communities that modulates the human microbiome, contributing to health and disease. There are evidence that reported significant associations between environmental dust and NCDs. In this review, we will focus on the impact of dust exposure in shaping the human microbiome and its possible contribution to the development of NCDs.
Singapore's first study on Minimum Income Standards (MIS) focusing on older people was completed in 2018. The study took place in the context of rapid demographic ageing and an income security regime built around a defined contribution pension scheme and intergenerational family support. Moreover, social policies in Singapore tend to lack transparent numerical benchmarks and policy making is not systematically informed by clear notions of needs and standards. With some adaptations, the MIS approach developed in the UK was used to generate a definition of a basic standard of living in Singapore and separate budgets for four household types: elderly man living alone (aged 65 and above), elderly woman living alone, elderly couple, and older man or woman living alone (aged 55 to 64). This chapter sets out the background of the study, presents its method and findings, and explains the significance of introducing MIS to a policy setting such as Singapore.
Income security and policy making
Singapore has one of Asia's fastest-ageing populations (UN, 2018). Increasing life expectancy implies more years in retirement and has made old age income security one of the most pressing policy concerns. The worry is also especially acute as co-residence with adult children and their cash contributions have traditionally been the pillar of income security for elderly persons in the absence of comprehensive formal social security (Ng, 2011a). As family sizes shrink, access to income support from children is projected to decline (Ng, 2015). Co-residence rates have also been steadily declining. At the same time, there are still gaps in income security policy. The primary source of public pensions is the Central Provident Fund (CPF), a defined contribution scheme which attracts mandatory monthly contributions from both employer and employee, and pays an annuity from the age of 65 (CPF Board, 2018). The amount of payment depends on how much savings the individual has accumulated and there are no separate non-contributory pensions. A means-tested public assistance scheme covering less than 1 per cent of the elderly population has been the primary recourse for persons with insufficient incomes (MSF, 2018a, 2018b).
In recent years, several new schemes have been introduced to supplement the CPF and public assistance, such as the Goods and Services Tax (GST) Voucher – Cash (MOF, 2018) and Silver Support Scheme (MOM, 2018a).
Primary liver cancer is the third leading cause of cancer-related death worldwide. Most patients are diagnosed at late stages with poor prognosis; thus, identification of modifiable risk factors for primary prevention of liver cancer is urgently needed. The well-established risk factors of liver cancer include chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), heavy alcohol consumption, metabolic diseases such as obesity and diabetes, and aflatoxin exposure. However, a large proportion of cancer cases worldwide cannot be explained by current known risk factors. Dietary factors have been suspected as important, but dietary aetiology of liver cancer remains poorly understood. In this review, we summarised and evaluated the observational studies of diet including single nutrients, food and food groups, as well as dietary patterns with the risk of developing liver cancer. Although there are large knowledge gaps between diet and liver cancer risk, current epidemiological evidence supports an important role of diet in liver cancer development. For example, exposure to aflatoxin, heavy alcohol drinking and possibly dairy product (not including yogurt) intake increase, while intake of coffee, fish and tea, light-to-moderate alcohol drinking and several healthy dietary patterns (e.g. Alternative Healthy Eating Index) may decrease liver cancer risk. Future studies with large sample size and accurate diet measurement are warranted and need to consider issues such as the possible aetiological heterogeneity between liver cancer subtypes, the influence of chronic HBV or HCV infection, the high-risk populations (e.g. cirrhosis) and a potential interplay with host gut microbiota or genetic variations.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers’ self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.
Richtmyer–Meshkov instability of the SF6 gas layer surrounded by air is experimentally investigated. Using the soap film technique, five kinds of gas layer with two sharp interfaces are generated such that the development of each individual interface is highlighted. The flow patterns are determined by the amplitudes and phases of two corrugated interfaces. For a layer with both interfaces planar, the interface velocity shows that the reflected rarefaction waves from the second interface accelerate the first interface motion. For a layer with the second interface corrugated but the first interface planar, the reflected rarefaction waves make the first interface develop with the same phase as the second interface. For a layer with the first interface corrugated but the second interface planar, the rippled shock seeded from the first interface makes the second interface develop with the same phase as the first interface and the layer evolves into an ‘upstream mushroom’ shape. For two interfaces corrugated with opposite (the same) phase but a larger amplitude for the first interface, the layer evolves into ‘sinuous’ shape (‘bow and arrow’ shape, which has never been observed previously). For the interface amplitude growth in the linear stage, the waves’ effects are considered in the model to give a better prediction. In the nonlinear stage, the effect of the rarefaction waves on the first interface evolution is quantitatively evaluated, and the nonlinear growth is well predicted. It is the first time in experiments to quantify the interfacial instability induced by the rarefaction waves inside the heavy gas layer.
Attention-deficit/hyperactivity disorder (ADHD) is associated with a higher risk of burn injury than in the normal population. Nevertheless, the influence of methylphenidate (MPH) on the risk of burn injury remains unclear. This retrospective cohort study analysed the effect of MPH on the risk of burn injury in children with ADHD.
Data were from Taiwan's National Health Insurance Research Database (NHIRD). The sample comprised individuals younger than 18 years with a diagnosis of ADHD (n = 90 634) in Taiwan's NHIRD between January 1996 and December 2013. We examined the cumulative effect of MPH on burn injury risk using Cox proportional hazards models. We conducted a sensitivity analysis for immortal time bias using a time-dependent Cox model and within-patient comparisons using the self-controlled case series model.
Children with ADHD taking MPH had a reduced risk of burn injury, with a cumulative duration of treatment dose-related effect, compared with those not taking MPH. Compared with children with ADHD not taking MPH, the adjusted hazard ratio for burn injury was 0.70 in children taking MPH for <90 days (95% confidence interval (CI) 0.64–0.77) and 0.43 in children taking MPH for ≥90 days (95% CI 0.40–0.47), with a 50.8% preventable fraction. The negative association of MPH was replicated in age-stratified analysis using time-dependent Cox regression and self-controlled case series models.
This study showed that MPH treatment was associated with a lower risk of burn injury in a cumulative duration of treatment dose-related effect manner.
Literature regarding the health effect of coffee consumption was contradicting, whereby it was found to protect against type 2 diabetes while inducing acute glucose intolerance. Previous studies suggested that adding sugar and milk into coffee may alter the effect of its consumption on glucose metabolism, potentially explaining the contradiction, but this is seldom investigated. This study aimed at assessing the effect of adding milk and sugar into coffee on the postprandial glycemic metabolism after a subsequent, high glycemic index (GI) meal. A total of 11 apparently healthy adults were recruited for this randomized, cross-over acute feeding study. In each experimental session, overnight-fasted participants consumed one cup of the following drinks: espresso (35 ml), instant, boiled, and decaffeinated coffee (all 150 ml). Then they consumed a high GI meal and blood samples were collected every 15–30 minutes in the subsequent two hours. Each type of coffee was tested for 3 times, twice with 50 g low-fat milk and 7.5 g white sugar added (i.e. white coffee) and once without (i.e. black coffee). Postprandial levels of glucose, insulin, and active GLP-1, as well as the incremental area-under-curve (iAUC) of the biomarkers, were compared between black and white coffee, with baseline measurements as a covariate. Results showed that the peak glucose level after the meal was lower in white coffee sessions than black coffee sessions, regardless of coffee types. The difference was the greatest between black and white decaffeinated coffee (mean difference from baseline ± SEM, white coffee: 2.5 ± 0.2 mmol/L; black coffee: 3.3 ± 0.3 mmol/L, p = 0.019). The mean glucose iAUC of white coffee sessions was significantly smaller than black coffee sessions for all coffee types except for instant coffee (all p < 0.05). The peak insulin levels between black and white coffees were not significantly different, yet white decaffeinated coffee had a 35% smaller mean insulin iAUC than black decaffeinated coffee (p = 0.025). The active GLP-1 levels were not significantly different between black and white coffee sessions. These results showed that prior ingestion of coffee with milk and sugar added attenuated the glucose response after the subsequent meal, compared with drinking black coffee beforehand. Our results may provide an explanation for the conflicting literature regarding the protective effects of coffee consumption against type 2 diabetes.