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To examine the association between adherence to plant-based diets and mortality.
Design:
Prospective study. We calculated a plant-based diet index (PDI) by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful PDI (hPDI) and an unhealthful PDI (uPDI) by further separating the healthy plant foods from less-healthy plant foods.
Setting:
The VA Million Veteran Program.
Participants:
315 919 men and women aged 19–104 years who completed a FFQ at the baseline.
Results:
We documented 31 136 deaths during the follow-up. A higher PDI was significantly associated with lower total mortality (hazard ratio (HR) comparing extreme deciles = 0·75, 95 % CI: 0·71, 0·79, Ptrend < 0·001]. We observed an inverse association between hPDI and total mortality (HR comparing extreme deciles = 0·64, 95 % CI: 0·61, 0·68, Ptrend < 0·001), whereas uPDI was positively associated with total mortality (HR comparing extreme deciles = 1·41, 95 % CI: 1·33, 1·49, Ptrend < 0·001). Similar significant associations of PDI, hPDI and uPDI were also observed for CVD and cancer mortality. The associations between the PDI and total mortality were consistent among African and European American participants, and participants free from CVD and cancer and those who were diagnosed with major chronic disease at baseline.
Conclusions:
A greater adherence to a plant-based diet was associated with substantially lower total mortality in this large population of veterans. These findings support recommending plant-rich dietary patterns for the prevention of major chronic diseases.
This study aims to explore clinicians’ practices and attitudes regarding advance care planning (ACP) in mainland China.
Methods
This study was a multicenter cross-sectional survey. Clinicians from tertiary hospitals in Beijing, Guangxi, and Inner Mongolia were invited to participate in the study. A questionnaire was formulated based on related literature to obtain information including demographic characteristics, and practices and attitudes toward ACP.
Results
The total number of participants included 285 clinicians. The data response rate was 84.57%. Most of the clinicians had an inadequate understanding of ACP. Only a few clinicians had experience in participating or witnessing an ACP or related end-of-life discussions. Among 285 clinicians, 69.82% of clinicians were willing to introduce ACP to patients. Two hundred and thirty-eight (83.51%) clinicians wanted more education on ACP. Almost all clinicians believed that patients had the right to know about their diagnosis, prognosis, and available care options. Most clinicians (82.11%) regarded that ACP was partially feasible in mainland China. If clinicians had a serious illness, almost everyone was willing to find out their true health status and decide for themselves, and 81.40% wanted to institute an ACP for themselves. The biggest barriers to the use of ACP in mainland China were cultural factors. Statistical analysis revealed that some or good understanding level (P = 0.0052) and practical experience (P = 0.0127) of ACP were associated with the positive willingness.
Significance of results
ACP is still in its infancy in mainland China. Clinicians had inadequate understanding and minimal exposure to ACP. Most clinicians recognized the value and significance of ACP and had a positive attitude toward ACP. Clinicians need to be provided with education and training to promote their ACP practices. Culturally appropriate ACP processes and documents need to be developed based on Chinese culture and Chinese needs.
The southeastern Central Asian Orogenic Belt (CAOB) records the assembly process between several micro-continental blocks and the North China Craton (NCC), with the consumption of the Paleo-Asian Ocean (PAO), but whether the S-wards subduction of the PAO beneath the northern NCC was ongoing during Carboniferous–Permian time is still being debated. A key issue to resolve this controversy is whether the Carboniferous magmatism in the northern NCC was continental arc magmatism. The Alxa Block is the western segment of the northern NCC and contiguous to the southeastern CAOB, and their Carboniferous–Permian magmatism could have occurred in similar tectonic settings. In this contribution, new zircon U–Pb ages, elemental geochemistry and Sr–Nd isotopic analyses are presented for three early Carboniferous granitic plutons in the southwestern Alxa Block. Two newly identified aluminous A-type granites, an alkali-feldspar granite (331.6 ± 1.6 Ma) and a monzogranite (331.8 ± 1.7 Ma), exhibit juvenile and radiogenic Sr–Nd isotopic features, respectively. Although a granodiorite (326.2 ± 6.6 Ma) is characterized by high Sr/Y ratios (97.4–139.9), which is generally treated as an adikitic feature, this sample has highly radiogenic Sr–Nd isotopes and displays significantly higher K2O/Na2O ratios than typical adakites. These three granites were probably derived from the partial melting of Precambrian continental crustal sources heated by upwelling asthenosphere in lithospheric extensional setting. Regionally, both the Alxa Block and the southeastern CAOB are characterized by the formation of early Carboniferous extension-related magmatic rocks but lack coeval sedimentary deposits, suggesting a uniform lithospheric extensional setting rather than a simple continental arc.
Based on hubs of neural circuits associated with addiction and their degree centrality (DC), this study aimed to construct the addiction-related brain networks for patients diagnosed with heroin dependence undertaking stable methadone maintenance treatment (MMT) and further prospectively identify the ones at high risk for relapse with cluster analysis.
Methods
Sixty-two male MMT patients and 30 matched healthy controls (HC) underwent brain resting-state functional MRI data acquisition. The patients received 26-month follow-up for the monthly illegal-drug-use information. Ten addiction-related hubs were chosen to construct a user-defined network for the patients. Then the networks were discriminated with K-means-clustering-algorithm into different groups and followed by comparative analysis to the groups and HC. Regression analysis was used to investigate the brain regions significantly contributed to relapse.
Results
Sixty MMT patients were classified into two groups according to their brain-network patterns calculated by the best clustering-number-K. The two groups had no difference in the demographic, psychological indicators and clinical information except relapse rate and total heroin consumption. The group with high-relapse had a wider range of DC changes in the cortical−striatal−thalamic circuit relative to HC and a reduced DC in the mesocorticolimbic circuit relative to the low-relapse group. DC activity in NAc, vACC, hippocampus and amygdala were closely related with relapse.
Conclusion
MMT patients can be identified and classified into two subgroups with significantly different relapse rates by defining distinct brain-network patterns even if we are blind to their relapse outcomes in advance. This may provide a new strategy to optimize MMT.
Major depressive disorder (MDD) is a clinically and biologically heterogeneous syndrome. Identifying discrete subtypes of illness with distinguishing neurobiological substrates and clinical features is a promising strategy for guiding personalised therapeutics.
Aims
This study aimed to identify depression subtypes with correlated patterns of functional network connectivity and clinical symptoms by clustering patients according to a weighted linear combination of both features in a relatively large, medication-naïve depression sample.
Method
We recruited 115 medication-naïve adults with MDD and 129 matched healthy controls, and evaluated all participants with magnetic resonance imaging. We used regularised canonical correlation analysis to identify component mapping relationships between functional network connectivity and symptom profiles, and K-means clustering was used to define distinct subtypes of patients.
Results
Two subtypes of MDD were identified: insomnia-dominated subtype 1 and anhedonia-dominated subtype 2. Subtype 1 was characterised by abnormal hyperconnectivity within the ventral attention network and sleep maintenance insomnia. Subtype 2 was characterised by abnormal hypoconnectivity in the subcortical and dorsal attention networks, and prominent anhedonia symptoms.
Conclusions
Our study identified two distinct subtypes of patients with specific neurobiological and clinical symptom profiles. These findings advance understanding of the biological and clinical heterogeneity of MDD, offering a pathway for defining categorical subtypes of illness via consideration of both biological and clinical features.
Anaemia is a global public health problem affecting women worldwide, and reproductive-age women are at increased risk. We conducted a population-based cross-sectional study analysing the prevalence of overall anaemia and anaemia according to severity in Chinese pre-pregnant women to update current knowledge on anaemia epidemiology. Based on the National Free Preconception Check-up Projects supported by the Chinese government, 5 679 782 women participating in this project in 2017 were included in the present study. The cyanmethemoglobin method was applied to assess Hb concentrations. Univariate and multivariate logistic regressions were applied for associated factors. The prevalence of anaemia among Chinese pre-pregnant women was 21·64 % (mild: 14·10 %, moderate: 7·17 % and severe : 0·37 %). The prevalence of overall and severe anaemia was the highest in Tibet and the lowest in Beijing among thirty-one provinces. Women’s age, region, ethnic origin, educational level, occupation and pregnancy history were all correlated with anaemia. Women with B blood type (adjusted OR (aOR) = 0·89), higher BMI (overweight: aOR = 0·84; obesity: aOR = 0·70) and alcohol consumption (aOR = 0·69) were less likely to have anaemia, while those with rhesus negative blood type (aOR = 1·10), history of anaemia (aOR = 2·60), older age at menarche (aOR = 1·19), heavy menstrual blood loss (aOR = 1·39), longer menstrual period (aOR = 1·09) and shorter menstrual cycle (aOR = 1·08) were more likely to suffer from anaemia. Meat or egg eaters were not significantly associated with severe anaemia. Anaemia is of moderate public health significance among Chinese pre-pregnant women. Interventions should be considered to prevent anaemia to the greatest extent possible to avoid potential harm in this population.
To assess the prevalence of metabolic syndrome (MetS) in Chinese adults living in Ningbo and to examine the association between alcohol consumption and MetS and its medical components.
Design:
A representative survey in Ningbo was conducted in 2015 covering socio-demography. A FFQ together with additional questionnaires was used to collect information on alcohol consumption, diet, demography, lifestyle and medical information. Multivariable logistic regression and generalised linear models were used to examine the association between alcohol consumption and both MetS and its medical components, respectively.
Setting:
Ningbo, China.
Participants:
A total of 2853 adults ≥ 20 years (44 % men) in this final analysis.
Results:
The prevalence of frequent alcohol drinkers and MetS was 29·9 % and 28·0 %, respectively. Significantly higher prevalence of MetS and mean values of medical components were found in the group of frequent alcohol drinkers with an exception for HDL-cholesterol, compared with less or non-alcohol drinkers. Frequent alcohol consumption was associated with higher odds of developing MetS and positively associated with medical components excepting waist circumference.
Conclusions:
Frequent alcohol consumption contributed to a higher prevalence of MetS and unfavourable influence on MetS and its medical components among Chinese adults. A public health intervention on alcohol restriction is necessary for the prevention and control of the ongoing epidemic MetS.
Fullerene dimers have attracted extensive attention due to their unique structures and fascinating properties. Here, fullerene dimer derivatives with four to six carbon atoms in the esters are designed and synthesized. The property differences that caused by the carbon number in the esters of the fullerene dimers are investigated by performing their electrochemical, optical, and photoelectric measurements. As the carbon atom numbers in the esters increase from four to five and six, the absorption intensities increase to 1.6- and 4.4-folds. The intensities of the fluorescence spectra increase to 1.8- and 5.2-folds. Their photocurrent increases to 2- and 7-folds under the irradiation of a 405-nm laser. The LUMO energy levels move downward slightly from −3.89 to −3.90 and −3.92 eV, respectively. Our results indicate that as the carbon number increases, the carbon chain lengths in the ester structures increase, very slight effects produced on the energy levels of the fullerene dimers, but strongly contribute to their chemical activities and thus the photoelectronic efficiencies.
Exosomes derived from hepatocellular carcinoma (HCC) cells are nanovesicles and are involved in the occurrence and development of HCC, they also serve as important carriers and drug targets of nanodrug delivery systems. The external shape and internal structure of exosomes are important indexes of identification, and isolated intact morphology is crucial to biological function integrity. However, given their susceptibility to various influencing factors, the external shape and internal structure of exosomes derived from HCC cells remain incompletely studied. In this study, exosomes purified from HCC cells were isolated at different centrifugation speeds and examined via multiple electron microscopy (EM) techniques. The results demonstrate that exosomes possess a nearly spherical shape and bilipid membranous vesicle with a concave cavity structure containing electron-dense and coated vesicles, suggesting the possible existence of subpopulations of exosomes with specific functions. The exosomes isolated at ultracentrifugation (UC) speed (≥110,000×g) presented irregular and diverse external morphologies, indicating the effect on the integrity of the exosomes. Transforming growth factor signaling bioactive substances (TGF-β1, S100A8, and S100A9) can be found in exosomes by performing Western blotting, showing that the internal content is associated with metastasis of HCC. These findings show that EMelectron microscopy and UC speed can affect exosome characteristics, including external shape, internal structure, and content of bioactive substances. The electron-dense and coated vesicles that had been discovered in exosomes might become new additional morphological features, which could help to improve the interpretation of experimental results and widen our understanding of exosome morphology.
Resistant starch (RS) was recently approved to exert a powerful influence on gut health, but the effect of RS on the caecal barrier function in meat ducks has not been well defined. Thus, the effect of raw potato starch (RPS), a widely adopted RS material, on microbial composition and barrier function of caecum for meat ducks was determined. A total of 360 Cherry Valley male ducks of 1-d-old were randomly divided and fed diets with 0 (control), 12, or 24 % RPS for 35 d. Diets supplemented with RPS significantly elevated villus height and villus height:crypt depth ratio in the caecum. The 16S rRNA sequence analysis indicated that the diet with 12 % RPS had a higher relative abundance of Firmicutes and the butyrate-producing bacteria Faecalibacterium, Subdoligranulum, and Erysipelatoclostridium were enriched in all diets. Lactobacillus and Bifidobacterium were significantly increased in the 24 % RPS diet v. the control diet. When compared with the control diet, the diet with 12 % RPS was also found to notably increase acetate, propionate and butyrate contents and up-regulated barrier-related genes including claudin-1, zonula occludens-1, mucin-2 and proglucagon in the caecum. Furthermore, the addition of 12 % RPS significantly reduced plasma TNF-α, IL-1β and endotoxin concentrations. These data revealed that diets supplemented with 12 % RPS partially improved caecal barrier function in meat ducks by enhancing intestinal morphology and barrier markers expression, modulating the microbiota composition and attenuating inflammatory markers.
Pinewood nematode, Bursaphelenchus xylophilus, a pine parasitic nematode, poses a serious threat to its host pine forests globally. When dispersal-stage larvae 4 (dauer, DL4) of B. xylophilus enters the new pine, it moults into propagative adult (dauer recovery) and reproduces quickly to kill the host pine. Here, we found pine chemical volatiles, rather than the common dauer recovery factors of nematodes (e.g. suitable temperatures, nutrient availability or density), promote B. xylophilus dauer recovery. The results showed that volatilization of chemicals in host pines could attract DL4 and promote DL4 recovery. To identify which chemicals promote this process, we determined the stimulated activity of the main volatiles of pines including six monoterpenes and two sesquiterpenes. Results showed that all the six monoterpenes promoted dauer recovery, especially β-pinene and β-myrcene, but the two sesquiterpenes have no effect on the transformation. Furthermore, β-pinene performed gradient effects on dauer recovery. We hypothesized that when DL4 infect pine trees, the pine volatiles released from the feeding wounds are used as chemical signals for DL4 transformation to adult to reproduce and rapidly kill the pines. Our study identified the B. xylophilus dauer recovery chemical signal and may contribute to preventing pine wilt disease.
In 1987, Alavi, Malde, Schwenk and Erdős conjectured that the independence polynomial of any tree is unimodal. Although it attracts many researchers' attention, it is still open. Motivated by this conjecture, in this paper, we prove that rooted products of some graphs preserve real rootedness of independence polynomials. As application, we not only give a unified proof for some known results, but also we can apply them to generate infinite kinds of trees whose independence polynomials have only real zeros. Thus their independence polynomials are unimodal.
Compared with traditional stainless steels, high nitrogen stainless steels (HNSS), have been widely used due to their high strength, toughness along with excellent corrosion resistance and low cost, formed by partial replacement of Ni (austenite-forming element) by N. The evolution of the microstructure of a Cr19Mn19Mo2N0.7 stainless steel is investigated after solution treatment at 1010, 1060, 1200 or 1250°C for 30min. A complex multilayer structure has been found under a negative pressure vacuum. A white ferritic layer at the surface is formed, and a subsurface layer with full austenitic structure and a bulk microstructure comprising of austenite and ferrite are detected. With increasing solution temperature, the surface layer thickness increases. The formation of the multilayer structure is attributed to an outward diffusion, a diffusive retardation and an abnormal accumulation of nitrogen during solution treatment.
The current experiment aimed at assessing the effects of dietary supplementation of guanidino acetic acid (GAA) on growth performance, thigh meat quality and development of small intestine in broilers. A total of 360 1-day-old female broiler chicks were distributed randomly to four groups of 90 birds each, and each group received GAA dosages of 0, 0.4, 0.8 and 1.2 g/kg of feed dry matter. During the whole experiment of 60 days, broilers had ad libitum access to water and feed and the feed intake was recorded daily. All broilers were weighed before and after the experiment, and 30 broilers of each group were selected randomly to slaughter at the end. Increasing dietary supplementation of GAA increased final live weight and daily body weight gain, gain-to-feed ratio, thigh muscle pH value and fibre diameter of broilers, but decreased daily feed intake, drip loss, cooking loss, shear force value, hardness, gumminess and chewiness of thigh meat. In addition, increasing supplementation of GAA quadratically increased duodenal, jejunal and ileal villus height and width and ratio of villus height to crypt depth, but decreased crypt depth. The results indicated that GAA as a feed additive may support better development of small intestine, thereby resulting in improvement of growth performance and meat quality of broilers.
Both genetic selection and increasing nutrient density for improving growth performance had inadvertently increased leg problems of meat ducks, which adversely affects animal welfare. We hypothesised that slowing weight gain with improving tibia quality probably enhanced tibial mechanical properties and alleviated leg deformities. Therefore, the present study aimed to evaluate the effect of graded Ca supplementation in a low-nutrient density (LND) diet on tibia composition and bone turnover in meat ducks. A total of 720 15-d-old male meat ducks were randomly assigned and fed a standard nutrient density positive control (PC) diet containing 0·9 % Ca, and four LND diets with 0·5, 0·7, 0·9 and 1·1 % Ca, respectively. Ducks fed the 0·5 % Ca LND diet and the PC diet had higher incidence of tibial dyschondroplasia (TD). When compared with the 0·5 % Ca LND diet, LND diets with ≥0·7 % Ca significantly improved tibia composition, microarchitecture and mechanical properties, and consequently decreased the incidence of TD. Furthermore, LND diets with ≥0·7 % Ca increased osteocyte-specific gene mRNA expression, blocked the expression of osteoblast differentiation marker genes including osteocalcin, collagenase-1 and alkaline phosphatase (ALP), and also decreased the expression of osteoclast differentiation genes, such as vacuolar-type H+-ATPase, cathepsin K and receptor activator of NF-κB. Meanwhile bone markers such as serum ALP, osteocalcin (both osteoblast markers) and tartrate-resistant acid phosphatase (an osteoclast marker) were significantly decreased in at least 0·7 % Ca treated groups. These findings indicated that LND diets with ≥0·7 % Ca decreased bone turnover, which subsequently increased tibia quality for 35-d-old meat ducks.
This paper investigates the articulation of approximant /ɹ/ in New Zealand English (NZE), and tests whether the patterns documented for rhotic varieties of English hold in a non-rhotic dialect. Midsagittal ultrasound data for 62 speakers producing 13 tokens of /ɹ/ in various phonetic environments were categorized according to the taxonomy by Delattre & Freeman (1968), and semi-automatically traced and quantified using the AAA software (Articulate Instruments Ltd. 2012) and a Modified Curvature Index (MCI; Dawson, Tiede & Whalen 2016). Twenty-five NZE speakers produced tip-down /ɹ/ exclusively, 12 tip-up /ɹ/ exclusively, and 25 produced both, partially depending on context. Those speakers who produced both variants used the most tip-down /ɹ/ in front vowel contexts, the most tip-up /ɹ/ in back vowel contexts, and varying rates in low central vowel contexts. The NZE speakers produced tip-up /ɹ/ most often in word-initial position, followed by intervocalic, then coronal, and least often in velar contexts. The results indicate that the allophonic variation patterns of /ɹ/ in NZE are similar to those of American English (Mielke, Baker & Archangeli 2010, 2016). We show that MCI values can be used to facilitate /ɹ/ gesture classification; linear mixed-effects models fit on the MCI values of manually categorized tongue contours show significant differences between all but two of Delattre & Freeman's (1968) tongue types. Overall, the results support theories of modular speech motor control with articulation strategies evolving from local rather than global optimization processes, and a mechanical model of rhotic variation (see Stavness et al. 2012).
We present a first-principles investigation on the optical absorption of tungsten trioxide, an electrochromic material. Using state-of-the-art techniques, the absorption spectra are calculated for the cubic, monoclinic, and amorphous phases. For both crystalline and disordered structures, doping induces strong absorption in the infrared. Absorption in the visible range increases with the degree of structural distortion; the absorption coefficient in the blue exceeds 103 cm−1 at doping levels above 1020 cm−3 in the monoclinic phase. Increased disorder in disordered structures significantly enhances the visible-range absorption. We identify the microscopic mechanism as optical absorption originating at conduction-band-derived states that are filled by doping.