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In this paper, a broadband, low insertion loss, and compact folded substrate integrated waveguide (FSIW) phase shifter is proposed for the first time. By loading the complementary split-ring resonators (CSRRs) on the middle metal layer of the FSIW, a closed-type slow-wave transmission line (TL) is obtained, which can provide a wideband phase shift (39%) compared with the equal-length fast-wave one. The enclosed structure of the CSRR-loaded FSIW prevents the CSRRs from radiation as suffered in the previous reported CSRR-loaded TLs, resulting in a low insertion loss. This feature greatly reduces the amplitude imbalance between the main line and the reference line of the phase shifter. In addition, no transition structure is required between the FSIWs with and without CSRRs for broadband impedance matching, which makes the phase shifter more compact and easier to integrate with other FSIW devices. To validate the performance of the proposed phase shifter and to illustrate its ease integration, a novel FSIW 180° directional coupler that consists of an FSIW 90° coupler and an FSIW 90° phase shifter is designed, fabricated, and measured. The measured results agree well with the simulated data.
Due to the lack of research between the inner layers in the structure of colonic mucous and the metabolism of fatty acid in the constipation model, we aim to determine the changes in the mucous phenotype of the colonic glycocalyx and the microbial community structure following treatment with Rhubarb extract in our research. The constipation and treatment models are generated using adult male C57BL/6N mice. We perform light microscopy and transmission electron microscopy (TEM) to detect a Muc2-rich inner mucus layer attached to mice colon under different conditions. In addition, 16S rDNA sequencing is performed to examine the intestinal flora. According to TEM images, we demonstrate that Rhubarb can promote mucin secretion and find direct evidence of dendritic structure-linked mucus structures with its assembly into a lamellar network in a pore size distribution in the isolated colon section. Moreover, the diversity of intestinal flora has noticeable changes in constipated mice. The present study characterizes a dendritic structure and persistent cross-links have significant changes accompanied by the alteration of intestinal flora in feces in models of constipation and pretreatment with Rhubarb extract.
Demodex infestation and density changes remain one of the main challenges in some clinical settings. Tumour necrosis factor-α (TNF-α) inhibitors have been recommended as a first-line treatment for ankylosing spondylitis (AS). However, there have been no studies investigating the impact of TNF-α inhibitor adalimumab on changes in the Demodex density in patients with AS. The aim of this study was to investigate Demodex density changes before and after adalimumab treatment and analyse the relationship between the Demodex density and clinical characteristics in AS. It was found that the Demodex density was positively correlated with age and C-reactive protein levels and the number of Demodex mites could increase after adalimumab treatment in AS.
To compare the prevalence of overweight or obesity (ow/ob) with WHO BMI cut-off points, International Obesity Task Force (IOTF) cut-off points and Chinese BMI criteria and examine its potential factors among preschool children in Hunan Province.
Design:
A cross-sectional survey including anthropometric measurements and questionnaires about children’s information, caregivers’ socio-demographic characteristics and maternal characteristics. χ2 tests and univariate and multivariate binary logistic regression were performed to evaluate the possible factors of ow/ob.
Setting:
Hunan, China, from September to October 2019.
Participants:
In total, 7664 children 2 to 6 years of age.
Results:
According to Chinese BMI criteria, about 1 in 7–8 children aged 2–6 years had ow/ob in Hunan, China. The overall estimated prevalence of ow/ob among 2- to 6-year-old children was significantly higher when based on the Chinese BMI criteria compared with the WHO BMI cut-off points and IOTF cut-off points. According to Chinese BMI criteria, ow/ob was associated with residing in urban areas, older age, male sex, eating snacking food more frequently, macrosomia delivery, caesarean birth, heavier maternal prepregnancy weight and pre-delivery weight.
Conclusion:
The prevalence of ow/ob in preschool children in Hunan Province remains high. More ow/ob children could be screened out according to Chinese BMI cut-offs compared with WHO and IOTF BMI criteria. In the future, targeted intervention studies with matched controls will be needed to assess the long-term effects of intervention measures to provide more information for childhood obesity prevention and treatment.
The late Palaeozoic Yong’an–Meizhou depression belt is an important iron (Fe) and polymetallic metallogenic belt in southern China. It has undergone a transformation from Tethys to the circum-Pacific tectonic domain. The Luoyang deposit is one of the typical Fe skarn deposits in the Yong’an–Meizhou depression belt of eastern China. Garnet is a characteristic mineral in the deposit. Two generations of garnets are detected in the deposit based on their textural characteristics and trace-element contents, and are represented by Fe-enriched andradite. The first generation of garnets (Grt1) have two types of garnets (Grt1-A and Grt1-B). Type A garnets of the first generation (Grt1-A) (Adr80-88) replaced by massive diopside-magnetite assemblage exhibit distinct oscillatory zonings and display patterns of enriched light rare earth elements (LREE) to weak heavy rare earth elements (HREE), with weak negative to positive Eu anomalies, and highest U, ΣREE and Sn contents. Type B garnets of the first generation (Grt1-B) are irregular zones (Adr94-96) coexisting with magnetite, in which Grt1-A is generally dissolved, and have obviously LREE-enriched and HREE-depleted patterns, with weak negative to positive Eu anomalies, and moderate U, ΣREE and Zn contents. Garnets of the second generation (Grt2) (Adr96-99) that replaced massive magnetite together with sphalerite show unzoned patterns, with a flat REE pattern and pronounced negative Eu anomalies as well as contents of lowest U and ΣREE, and highest W. The substitution of REEs in garnets occurs as [X2+]VIII –1[REE3+]VIII +1[Si4+]IV –1[Z3+]IV +1in an Al-enriched environment. Luoyang hydrothermal fluids shifted from reducing conditions with relatively high-U and -ΣREE characteristics to oxidizing conditions with relatively low-U and -ΣREE characteristics. The reduced siderophile elements and increased fO2 in fluid during Grt1-B formation caused magnetite mineralization and reduced Zn contents during Grt2 formation, causing the deposition of sphalerite. All garnets formed from magmatic fluid and were controlled by infiltrative metasomatism in an opened system.
The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
This paper considers risk-sensitive average optimization for denumerable continuous-time Markov decision processes (CTMDPs), in which the transition and cost rates are allowed to be unbounded, and the policies can be randomized history dependent. We first derive the multiplicative dynamic programming principle and some new facts for risk-sensitive finite-horizon CTMDPs. Then, we establish the existence and uniqueness of a solution to the risk-sensitive average optimality equation (RS-AOE) through the results for risk-sensitive finite-horizon CTMDPs developed here, and also prove the existence of an optimal stationary policy via the RS-AOE. Furthermore, for the case of finite actions available at each state, we construct a sequence of models of finite-state CTMDPs with optimal stationary policies which can be obtained by a policy iteration algorithm in a finite number of iterations, and prove that an average optimal policy for the case of infinitely countable states can be approximated by those of the finite-state models. Finally, we illustrate the conditions and the iteration algorithm with an example.
We consider a gradual-impulse control problem of continuous-time Markov decision processes, where the system performance is measured by the expectation of the exponential utility of the total cost. We show, under natural conditions on the system primitives, the existence of a deterministic stationary optimal policy out of a more general class of policies that allow multiple simultaneous impulses, randomized selection of impulses with random effects, and accumulation of jumps. After characterizing the value function using the optimality equation, we reduce the gradual-impulse control problem to an equivalent simple discrete-time Markov decision process, whose action space is the union of the sets of gradual and impulsive actions.
With the characteristics of full autonomy and no accumulated errors, polarisation navigation shows tremendous prospects in underwater scenarios. In this paper, inspired by the polarisation vision of aquatic organisms, a novel point-source polarisation sensor with high spectral adaptability (400 nm–760 nm) is designed for underwater orientation. To enhance the environmental applicability of the underwater polarisation sensor, a novel sensor model based on the underwater light intensity attenuation coefficient and optical coupling coefficient is established. In addition, concerned with the influence of light intensity uncertainty on sensor performance underwater, an antagonistic polarisation algorithm is adopted for the first time, to improve the accuracy of angle of polarisation and degree of polarisation in the low signal-to-noise ratio environment underwater. Finally, indoor and outdoor experiments are carried out to evaluate the performance of the designed polarisation sensor. The results show that the designed point-source polarisation sensor can acquire polarised light and be used for heading determination underwater.
The TanDEM-X DEM is a valuable data source for estimating glacier mass balance. However, the accuracy of TanDEM-X elevation over glaciers can be affected by microwave penetration and phase decorrelation. To investigate the bias of TanDEM-X DEMs of glaciers on the Tibetan Plateau, these DEMs were subtracted from SPOT-6 DEMs obtained around the same time at two study sites. The average bias over the studied glacier areas in West Kunlun (175.0 km2) was 2.106 ± 0.012 m in April 2014, and it was 1.523 ± 0.011 m in Geladandong (228.8 km2) in October 2013. By combining backscatter coefficients and interferometric coherence maps, we found surface decorrelation and baseline decorrelation can cause obvious bias in addition to microwave penetration. If the optical/laser data and winter TanDEM-X data were used as new and historic elevation sources for mass-balance measurements over an arbitrary observation period of 10 years, the glacier mass loss rates in West Kunlun and Geladandong would be potentially underestimated by 0.218 ± 0.016 and 0.158 ± 0.011 m w.e. a−1, respectively. The impact is therefore significant, and users should carefully treat the bias of TanDEM-X DEMs when retrieving a geodetic glacier mass balance.
Aiming at 3SPS+1PS parallel hip joint simulator, the maximum stress of branched chains under the suggested trajectory is obtained by elastodynamic analysis. Based on Corten-Dolan fatigue damage theory and Rain-flow counting method, the dynamic stress of each branched chain is statistically analyzed. The fatigue life prediction shows that branched-chain A2P2C2 is the weakest component for the simulator. Finally, the fatigue reliability is analyzed and the fatigue life and reliability under different structural parameters are discussed. The study shows that the fatigue life of each branched chain can be increased or balanced by increasing structural parameters or exchanging initial motion parameters.
This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.
Methods
This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.
Results
There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.
Conclusions
The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development.
Aims
This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China.
Method
Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses.
Results
The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015.
Conclusions
This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.
During recent stratigraphical and micropaleontological investigations of the Gulupu section in Tüna, Yadong, of the Eocene Zhepure Formation, numerous holoplanktonic mollusks (pteropods) were recovered. Four species, assignable to two genera of pteropods (including Limacina yadongensis new species) were systematically described and illustrated, and a gastropod-bivalve biofacies was identified. This is the first report of Eocene (Ypresian) pteropods in southern Tibet; the same stratum also yields many other neritic faunas. The data presented in this study suggest that a semi-closed restricted gulf in the Tüna area existed and the occurrence of pteropods in Tüna may indicate transport from more open, deep water by oceanic currents during early Eocene. Based on the analysis of paleogeographical distribution of pteropods, it indicates that a Tethys seaway existed during the early Eocene (Ypresian).
Dietary habits have been implicated in the development and severity of non-alcoholic fatty liver disease (NAFLD). Several epidemiological studies attempted to assess the relationship between food groups and the likelihood of NAFLD, but these results were conflicting. The present meta-analysis was conducted to assess the association between food groups and the likelihood of NAFLD. Published literature was retrieved and screened from MEDLINE, Embase and Web of Science. Out of 7892 retrieved articles, twenty-four observational studies (fifteen cross-sectional studies and nine case–control studies) met our eligibility criteria and were finally included in this systematic review and meta-analysis. Consumption of both red meat and soft drinks contributed to a positive association with NAFLD. Inversely, nut consumption was negatively associated with NAFLD. There were no significant influences on the likelihood of NAFLD about consuming whole grains, refined grains, fish, fruits, vegetables, eggs, dairy products and legumes. This meta-analysis suggests that individuals who consumed more red meat and soft drinks may have a significantly increased likelihood of NAFLD, whereas higher nut intake may be negatively associated with NAFLD. Further prospective studies are required to assess the association between food patterns and NAFLD.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
Design:
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Setting:
Southwest China.
Participants:
Pregnant women (n 1910) in 2017.
Results:
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Conclusions:
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
Identifying risk factors and mortality of individuals with Alzheimer’s disease (AD) could have important implications for the clinical management of AD.
Objective:
This pilot study aimed to examine the overall mortality of AD patients over a 10-year surveillance period in Shanghai, China. This study is an extension of our previous investigation on mortality of neurodegenerative diseases.
Methods:
One hundred and thirty-two AD patients recruited from the memory clinics of two hospitals in Shanghai in 2007 were followed up until December 31, 2017 or death, representing a follow-up period of up to 10 years. Overall standardized mortality ratios (SMRs) were calculated, and predictors for survival at recruitment were estimated.
Results:
Sixty-seven patients had died by December 31, 2017, and the SMR at 10 years of follow-up was 1.225 (95% confidence interval 0.944–1.563). Employing Cox’s proportional hazard modeling, lower Mini-Mental State Examination score, and comorbid diabetes predicted poor survival in this cohort.
Conclusion:
This pilot study suggests a similar survival trend of patients with AD compared to the general population in Shanghai urban region. Poor cognitive status and comorbid diabetes had a negative impact on the survival of AD patients.
The microbiota–gut–brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients.
Methods
We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD.
Results
The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890.
Conclusions
The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.