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Artificial sweeteners are generally used and recommended to alternate added sugar for health promotion. However, the health effects of artificial sweeteners remain unclear. In this study, we included 6371 participants from the National Health and Nutrition Examination Survey with artificial sweetener intake records. Logistic regression and Cox regression were applied to explore the associations between artificial sweeteners and risks of cardiometabolic disorders and mortality. Mendelian randomisation was performed to verify the causal associations. We observed that participants with higher consumption of artificial sweeteners were more likely to be female and older and have above medium socio-economic status. After multivariable adjustment, frequent consumers presented the OR (95 % CI) for hypertension (1·52 (1·29, 1·80)), hypercholesterolaemia (1·28 (1·10, 1·50)), diabetes (3·74 (3·06, 4·57)), obesity (1·52 (1·29, 1·80)), congestive heart failure (1·89 (1·35, 2·62)) and heart attack (1·51 (1·10, 2·04)). Mendelian randomisation confirmed the increased risks of hypertension and type 2 diabetes. Moreover, an increased risk of diabetic mortality was identified in participants who had artificial sweeteners ≥ 1 daily (HR = 2·62 (1·46, 4·69), P = 0·001). Higher consumption of artificial sweeteners is associated with increased risks of cardiometabolic disorders and diabetic mortality. These results suggest that using artificial sweeteners as sugar substitutes may not be beneficial.
Chinese nurses working with immense stress may have issues with burnout during COVID-19 regular prevention and control. There were a few studies investigating status of burnout and associated factors among Chinese nurses. However, the relationships remained unclear.
Objectives
To investigate status and associated factors of nurses’ burnout during COVID-19 regular prevention and control.
Methods
784 nurses completed questionnaires including demographics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, Impact of Event Scale-revised, Perceived Social Support Scale, Connor–Davidson Resilience Scale, General Self-efficacy Scale and Maslach Burnout Inventory.
Results
310 (39.5%), 393 (50.1%) and 576 (73.5%) of respondents were at high risk of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). The risk of EE, DP and reduced PA were moderate, high and high. Nurses with intermediate and senior professional rank and title and worked >40 h every week had lower scores in EE. Those worked in low-risk department reported lower scores in PA. Anxiety, post-traumatic stress disorder (PTSD), self-efficacy and social support were influencing factors of EE and DP, while social support and resilience were associated factors of PA.
Conclusion
Chinese nurses’ burnout during COVID-19 regular prevention and control was serious. Professional rank and title, working unit, weekly working hours, anxiety, PTSD, self-efficacy, social support and resilience were associated factors of burnout.
Evidence of the relationship between fecal short-chain fatty acids (SCFA) levels, dietary quality and type 2 diabetes mellitus (T2DM) in rural populations is limited. Here, we aimed to investigate the association between fecal SCFA levels and T2DM and the combined effects of dietar quality on T2DM in rural China. In total, 100 adults were included in the case–control study. Dietary quality was assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), and SCFA levels were analysed using the GC-MS system. Generalised linear regression was conducted to calculate the OR and 95 % CI to evaluate the effect of SCFA level and dietary quality on the risk of T2DM. Finally, an interaction was used to study the combined effect of SCFA levels and AHEI-2010 scores on T2DM. T2DM participants had lower levels of acetic and butyric acid. Generalised linear regression analysis revealed that the OR (95 % CI) of the highest acetic and butyric acid levels were 0·099 (0·022, 0·441) and 0·210 (0·057, 0·774), respectively, compared with the subjects with the lowest tertile of level. We also observed a significantly lower risk of T2DM with acetic acid levels > 1330·106 μg/g or butyric acid levels > 585·031 μg/g. Moreover, the risks of higher acetic and butyric acid levels of T2DM were 0·007 (95 % CI: 0·001, 0·148), 0·005 (95 % CI: 0·001, 0·120) compared with participants with lower AHEI-2010 scores (all P < 0·05). Acetate and butyrate levels may be important modifiable beneficial factors affecting T2DM in rural China. Improving dietary quality for body metabolism balance should be encouraged to promote good health.
Tuberculosis (TB) infection prevention and control (IPC) in healthcare facilities is key to reducing transmission risk. A framework for systematically improving TB IPC through training and mentorship was implemented in 9 healthcare facilities in China from 2017 to 2019.
Methods:
Facilities conducted standardized TB IPC assessments at baseline and quarterly thereafter for 18 months. Facility-based performance was assessed using quantifiable indicators for IPC core components and administrative, environmental, and respiratory protection controls, and as a composite of all control types We calculated the percentage changes in scores over time and differences by IPC control type and facility characteristics.
Results:
Scores for IPC core components increased by 72% during follow-up when averaged across facilities. The percentage changes for administrative, environmental, and respiratory protection controls were 39%, 46%, and 30%, respectively. Composite scores were 45% higher after the intervention. Overall, scores increased most during the first 6 months. There was no association between IPC implementation and provincial economic development or volume of TB services.
Conclusions:
TB IPC policies and practices showed most improvement early during implementation and did not differ consistently by facility characteristics. The training component of the project helped increase the capacity of healthcare professionals to manage TB transmission risks. Lessons learned here will inform national TB IPC guidance.
Environment-induced epigenetics are involved in diapause regulation, but the molecular mechanism that epigenetically couples nutrient metabolism to diapause regulation remains unclear. In this study, we paid special attention to the significant differences in the level of N6-adenosine methylation (m6A) of dihydroxyacetone phosphate acyltransferase (DHAPAT) and phosphatidate phosphatase (PAP) genes in the lipid metabolism pathway of the bivoltine silkworm (Bombyx mori) strain Qiufeng developed from eggs incubated at a normal temperature (QFHT, diapause egg producer) compared to those from eggs incubated at a low temperature (QFLT, non-diapause egg producer). We knocked down DHAPAT in the pupal stage of the QFLT group, resulting in the non-diapause destined eggs becoming diapausing eggs. In the PAP knockdown group, the colour of the non-diapause destined eggs changed from light yellow to pink 3 days after oviposition, but they hatched as normal. Moreover, we validated that YTHDF3 binds to m6A-modified DHAPAT and PAP mRNAs to promote their stability and translation. These results suggest that RNA m6A methylation participates in the diapause regulation of silkworm by changing the expression levels of DHAPAT and PAP and reveal that m6A epigenetic modification can be combined with a lipid metabolism signal pathway to participate in the regulation of insect diapause traits, which provides a clearer image for exploring the physiological basis of insect diapause.
High-power femtosecond mid-infrared (MIR) lasers are of vast importance to both fundamental research and applications. We report a high-power femtosecond master oscillator power amplifier laser system consisting of a single-mode Er:ZBLAN fiber mode-locked oscillator and pre-amplifier followed by a large-mode-area Er:ZBLAN fiber main amplifier. The main amplifier is actively cooled and bidirectionally pumped at 976 nm, generating a slope efficiency of 26.9%. Pulses of 8.12 W, 148 fs at 2.8 μm with a repetition rate of 69.65 MHz are achieved. To the best of our knowledge, this is the highest average power ever achieved from a femtosecond MIR laser source. Such a compact ultrafast laser system is promising for a wide range of applications, such as medical surgery and material processing.
Schizophrenia is a complex mental disorder with a chronic course. The atypical antipsychotics represented by lurasidone are commonly used in chronic schizophrenia, and its mechanism of action determines the superiority of efficacy and safety. However so far, there are still some adverse reactions, of which the more significant are lethargy, nausea, and sedentary inability. In view of these situations, we will combine nutrition intervention with the use of lurasidone to eliminate adverse reactions and provide help for the formulation of treatment plans.
Subjects and Methods
The study will be based on whether to add nutrition intervention as a difference set up control experiment, the experimental group using lurasidone combined nutrition intervention, the control group using lurasidone single factor intervention. The patients who received treatment in the psychiatric department of our hospital from March 2021 to March 2022 were selected as the research objects, and the efficacy and adverse reactions of the patients were monitored during the treatment. The efficacy will be judged by the medical scale of symptom severity of patients with schizophrenia (Positive and Negative Syndrome Scale, PANSS) and the monitoring data will be statistically analyzed by SPSS.
Results
With the treatment, the results of the Experimental group and the control group are shown in Table 1. The PANSS scores of the two groups finally reached a range of 30-40, with a difference of 4. The incidence of nausea, lethargy and sedentary disorder in adverse symptoms was higher in the control group, and the difference was statistically significant (P < 0.05). It shows that nutritional intervention cannot affect the efficacy of psychosis itself, yet can alleviate the adverse symptoms after medication.Table 1.
Efficacy and adverse reactions of the two groups
Group
PANSS
Nausea
Somnolence
Sedentary disorder
Experimental group (n=46)
32.3±4.1
3(6.5%)
4(8.7%)
2(4.3%)
Control group (n=41)
36.3±5.2
8(19.5%)
6(14.6%)
5(12.2%)
P
>0.05
<0.05
<0.05
<0.05
Conclusions
The group of schizophrenics is not limited to a certain age. Therefore, adverse symptoms caused by psychotropic drugs need to be considered in the practice. Symptoms in the course of the patient’s disease can be used as a treatment optimization path. Although the nutrition intervention strategy has no direct impact on the indicators of mental illness, the prevention of adverse symptoms during treatment can improve the actual experience of patients. In the future, the nutrition strategy will be adaptively optimized to improve the rehabilitation effect of chronic schizophrenia.
Acknowledgements
The research is supported by: Key Discipline of Nutrition and Food Hygiene of Changsha Medical university Quality Engineering Construction Project+2016; Study on Intervention Effect of Mindfulness Acceptance Stress Project on Nurses Aid to COVID-19+Outstanding Youth Project of Scientific Research of Hunan Education Department +2020(264)20B070.
Meristems in land plants share conserved functions but develop highly variable structures. Meristems in seed-free plants, including ferns, usually contain one or a few pyramid-/wedge-shaped apical cells (ACs) as initials, which are lacking in seed plants. It remained unclear how ACs promote cell proliferation in fern gametophytes and whether any persistent AC exists to sustain fern gametophyte development continuously. Here, we uncovered previously undefined ACs maintained even at late developmental stages in fern gametophytes. Through quantitative live-imaging, we determined division patterns and growth dynamics that maintain the persistent AC in Sphenomeris chinensis, a representative fern. The AC and its immediate progenies form a conserved cell packet, driving cell proliferation and prothallus expansion. At the apical centre of gametophytes, the AC and its adjacent progenies display small dimensions resulting from active cell division instead of reduced cell expansion. These findings provide insight into diversified meristem development in land plants.
It has been suggested that added sugar intake is associated with non-alcoholic fatty liver disease (NAFLD). However, previous studies only focused on sugar-sweetened beverages; the evidence for associations with total added sugars and their sources is scarce. This study aimed to examine the associations of total added sugars, their physical forms (liquid v. solid) and food sources with risk of NAFLD among adults in Tianjin, China. We used data from 15 538 participants, free of NAFLD, other liver diseases, CVD, cancer or diabetes at baseline (2013–2018 years). Added sugar intake was estimated from a validated 100-item FFQ. NAFLD was diagnosed by ultrasonography after exclusion of other causes of liver diseases. Multivariable Cox proportional hazards models were fitted to calculate hazard ratios (HR) and corresponding 95 % CI for NAFLD risk with added sugar intake. During a median follow-up of 4·2 years, 3476 incident NAFLD cases were documented. After adjusting for age, sex, BMI and its change from baseline to follow-up, lifestyle factors, personal and family medical history and overall diet quality, the multivariable HR of NAFLD risk were 1·18 (95 % CI 1·06, 1·32) for total added sugars, 1·20 (95 % CI 1·08, 1·33) for liquid added sugars and 0·96 (95 % CI 0·86, 1·07) for solid added sugars when comparing the highest quartiles of intake with the lowest quartiles of intake. In this prospective cohort of Chinese adults, higher intakes of total added sugars and liquid added sugars, but not solid added sugars, were associated with a higher risk of NAFLD.
Our research question was to evaluate the chromosome concordance of trophectoderm (TE) biopsy with noninvasive chromosome screening (NICS) using embryo culture medium renewed twice on Day 3 (D3) and Day 4 (D4). In this study, we evaluated 64 cycles with 223 biopsied blastocysts. These were categorized into two groups based on replacing embryo culture medium on D3 (control group) or on D3 and D4 (experimental group). The fundamental characteristics and main outcomes were compared. The concordance rates of NICS results with TE biopsy were determined according to next generation sequencing results. In total, 103 experimental and 120 control embryo cultures were collected, and the euploid status was analyzed using NICS technology. The overall concordance rates with TE biopsy of the experimental and control groups were 0.86 and 0.75, respectively. Statistically significant difference was found between the two groups. An additional medium renewal of the D4 embryo culture can improve the concordance of NICS with TE biopsy.
Family functioning is associated with anxiety and depression. Perinatal depression and anxiety are common and influence the well-being of women, partners and their offspring. However, little is known about differences in associations between family functioning and mood symptoms in women and their partners in early pregnancy.
Aims
Investigating differences in associations between family functioning and anxious and depressive symptoms in women and their partners in early pregnancy.
Method
In total, 171 woman–partner pairs were enrolled. The Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item scale (GAD-7) and Family Assessment Device (FAD) were performed. Correlation analysis and multiple linear regression analysis were applied to investigate the associations.
Results
In pregnant women, all the subscale scores on the FAD were correlated with total scores on the EPDS and GAD-7 (all P < 0.05), whereas only the Roles subscale showed a predicting effect in regression models (P < 0.01). In partners, all the subscale scores on the FAD were related to total scores on the PHQ-9 (all P < 0.05), whereas only the Problem Solving subscale showed a predicting effect (P = 0.029).
Conclusions
Our findings indicate that family functioning in the domain of roles is associated with anxious and depressive symptoms in pregnant women and functioning in the domain of problem solving is associated with depressive symptoms in partners. Clinicians should pay special attention to roles and problem solving when assessing mood symptoms in pregnant women and their partners. This study also provides a basis for family health education in early pregnancy.
Late Palaeozoic igneous rock associations in response to subduction, accretion, and final closure of the eastern Palaeo-Asian Ocean play a significant role in understanding the geodynamic evolution of the southeastern Central Asian Orogenic Belt. Previous studies have identified a Permian arc magmatic belt associated with the southward-dipping subduction of the eastern Palaeo-Asian Ocean along the Solonker–Changchun suture zone. The genetic mechanism and associated geodynamic settings are of great importance in deciphering the evolution of the eastern Palaeo-Asian Ocean. This paper presents zircon U–Pb–Hf isotope and whole-rock geochemical analyses for a suite of magmatic rocks including the early Permian diorite porphyrites (ca. 281.0 Ma), andesites (ca. 276 Ma) and rhyolites (ca. 275 Ma) in the Kulun region. The diorite porphyrites and andesites have high SiO2 and total alkali contents, and low MgO contents and Mg no. values, with enrichments in large ion lithophile elements and depletions in high-field-strength elements. These geochemical characteristics, together with low-Sr and high-Yb contents, a weak concave-upward shape of middle rare earth elements and negative Eu anomalies, suggest that these intermediate igneous rocks were generated by partial melting of amphibolitic lower crust at a crustal depth of 30–40 km. The rhyolites have heterogeneous isotopic compositions, with ϵHf(t) values and TDM2 ages of –20.8 to +0.5 and 3578∼1494 Ma, implying that they were likely derived from partial melting of a mixed source dominated by recycled ancient crust with minor juvenile crustal materials. The rhyolites show potassic affinity with relatively high K2O and very low Na2O, which was attributed to liquid immiscibility of felsic magma and subsequent limited fractional crystallization of plagioclase. The regional igneous associations, metamorphic events, and coeval sedimentary rocks along the Solonker–Changchun suture zone indicate that the early Permian igneous rocks were formed in an active continental arc environment in response to southward subduction of the eastern Palaeo-Asian Ocean.
Sporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.
Routine coronavirus disease 2019 (COVID-19) screening found 1 asymptomatic COVID-19 patient. An emergency sampling team was organized consisting of 1200 health-care workers, and a total of 3.2228 million COVID-19 samples had been collected and detected. This study summarizes the on-site management experience in large-scale COVID-19 nucleic acid testing from various aspects: staff preparation, materials preparation, site layout, logistics support, and information system support. Suggestions are put forward for the deficiencies and parts needing improvement. Such deficiencies included some sampling sites were not properly chosen, different areas were unclearly marked off from each other, and some site moving lines were confounding; how to communicate with the street service workers who had little professional knowledge on the epidemic spread or the working principles of the workflow and site layout; and the way to resolve conflicts on site.
We aimed to investigate the associations of Dietary Approaches to Stop Hypertension (DASH)-style diet and Mediterranean-style diet with blood pressure (BP) in less-developed ethnic minority regions (LEMR).
Design:
Cross-sectional study.
Setting:
Dietary intakes were assessed by a validated FFQ. Dietary quality was assessed by the DASH-style diet score and the alternative Mediterranean-style diet (aMED) score. The association between dietary quality and BP was evaluated using multivariate linear regression model. We further examined those associations in subgroups of BP level.
Participants:
A total of 81 433 adults from the China Multi-Ethnic Cohort (CMEC) study were included in this study.
Results:
In the overall population, compared with the lowest quintile, the highest quintile of DASH-style diet score was negatively associated with systolic BP (SBP) (coefficient –2·78, 95 % CI –3·15, –2·41; Pfor trend < 0·001), while the highest quintile of aMED score had a weaker negative association with SBP (coefficient –1·43, 95 % CI –1·81, –1·05; Pfor trend < 0·001). Both dietary indices also showed a weaker effect on diastolic BP (coefficient for DASH-style diet –1·06, 95 % CI –1·30, –0·82; coefficient for aMED –0·43, 95 % CI –0·68, –0·19). In the subgroup analysis, both dietary indices showed a stronger beneficial effect on SBP in the hypertension group than in either of the other subgroups.
Conclusion:
Our results indicated that the healthy diet originating from Western developed countries can also have beneficial effects on BP in LEMR. DASH-style diet may be a more appropriate recommendation than aMED as part of a dietary strategy to control BP, especially in hypertensive patients.
The Dayao Paleolithic site, located in Inner Mongolia on the eastern margin of China's vast northwestern drylands, was a lithic quarry-workshop utilized by Pleistocene human migrants through the region. Determining the age of this activity has previously yielded controversial results. Our magnetostratigraphic and OSL dating results suggest the two artifact-bearing paleosols are correlated with MIS 5 and 7, respectively. Correlating paleoclimatic data with marine δ18O records leads us to conclude that two sandy gravel layers containing many artifacts in the lower part of the Dayao sequence were formed during MIS 9 and 11, if not earlier. Our results reveal that the earliest human occupation at the Dayao site occurred before ca. 400 ka during a relatively warm and moist interglacial period, similar to several subsequent occupations, documenting the earliest and northernmost archaeological assemblage yet reported in China's arid northwest. We conclude that the northward and southward displacements of the East Asian summer monsoon rain belt during past interglacial-glacial cycles were responsible for the discontinuous human occupation detected at the Dayao site. The penetration of this precipitation regime into dryland ecologies via the Huanghe (Yellow River) Valley effectively created a corridor for hominin migration into China's arid northwest.
We aimed to investigate whether dietary patterns were associated with the risk of type 2 diabetes mellitus (T2DM) or pre-diabetes in adults of rural area in Henan.
Design:
Cross-sectional study. Principal component analysis was used to identify dietary patterns, while multivariate logistic regression analysis and restricted cubic spline regression models were used to analyse the association between dietary patterns and both pre-diabetes and T2DM.
Setting:
Rural area of Henan province, China.
Participants:
A total of 38 779 adults aged 18–79 years were recruited from the Henan rural cohort study as the subjects.
Results:
The prevalence of pre-diabetes and T2DM in rural Henan was 6·8 % and 9·4 %, respectively. A total of three dietary patterns were assessed in the present study. Dietary pattern I with a high intake of red meat and white meat; dietary pattern II with a high intake of grains, nuts, milk and eggs and dietary pattern III with a high intake of vegetables, staple food and fruits. The highest quintile (Q5) of pattern III could reduce 32·7 % risk of pre-diabetes. The Q5 of pattern II showed a 15·5 % decreased risk of T2DM, in a U-shaped dose–response manner; meanwhile, the Q5 of pattern III was significantly associated with reduced risks of T2DM (OR: 0·582, 95 % CI (0·497, 0·682)).
Conclusions:
Pattern III is beneficial for reducing risk of pre-diabetes or T2DM. Though a higher consumption of ‘grains-nuts-egg’ may associate with a reduced risk of T2DM, excessive intakes should be avoided. This study may provide a reference for the prevention of diabetes on dietary precautions.
The dynamical stability of the cable-driven lower-limb rehabilitation training robot (CLLRTR) is a crucial question. Based on the established dynamics model of CLLRTR, the solution to the wrench closure of the under-constrained system is presented. Secondly, the stability index of CLLRTR is proposed by the Krasovski method. Finally, in order to analyze the stability distribution of CLLRTR in the workspace, the stability evaluation index in the workspace is calculated using the eigenvalue decomposition method. The stability distribution laws of CLLRTR are further verified by the experimental study. The results provide references for studying trajectory planning and anti-pendulum control of CLLRTR.
In recent years, men who have sex with men (MSM) constitute a major group of HIV transmission in China. High primary drug-resistance (PDR) rate in MSM also represents a serious challenge for the Chinese antiretroviral therapy (ART) program. To assess the efficiency of ART in controlling HIV/AIDS infection among MSM, we developed a compartmental model for the annually reported HIV/AIDS MSM from 2007 to 2019 in the Zhejiang Province of China. R0 was 2.3946 (95% CI (2.2961–2.4881)). We predict that 90% of diagnosed HIV/AIDS individuals will have received treatment till 2020, while the proportion of the diagnosed remains as low as 40%. Even when the proportion of the diagnosed reaches 90%, R0 is still larger than the level of AIDS epidemic elimination. ART can effectively control the spread of HIV, even in the presence of drug resistance. The 90-90-90 strategy alone may not eliminate the HIV epidemic in Chinese MSM. Behavioural and biologic interventions are the most effective interventions to control the HIV/AIDS epidemic among MSM.