To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Influenza virus infections can lead to a number of secondary complications, including sepsis. We applied linear regression models to mortality and hospital admission data coded for septicaemia from 1998 to 2019 in Hong Kong, and estimated that septicaemia was associated with an annual average excess mortality rate of 0.23 (95% CI 0.04–0.40) per 100 000 persons per year and an excess septicaemia hospitalisation rate of 1.73 (95% CI 0.94–2.50) per 100 000 persons per year. The highest excess morbidity and mortality was found in older adults and young children, and during influenza A(H3N2) epidemics.
Volunteering is a popular activity among middle-aged and older adults as means to contribute to the society and to maintain personal health and wellbeing. While the benefits of volunteering have been well-documented in the current literature, it does not tend to distinguish between various types of volunteering activities. This cross-sectional study aims to compare the effects of instrumental (e.g. food preparation, fundraising) and cognitively demanding volunteering activities (e.g. befriending, mentoring) in a sample of 487 middle-aged and older Hong Kong Chinese adults. Participation in instrumental and cognitively demanding volunteering, life satisfaction, depressive symptoms, cognitive functioning and hand-grip strength were measured. The results of two-way between-subject robust analyses of variance demonstrated significant main effects of volunteering type and their interaction effect with age on life satisfaction and depressive symptoms. Comparisons among four volunteering groups (no volunteering, instrumental volunteering, cognitively demanding volunteering and both types) revealed that individuals engaging in instrumental volunteering exhibited lower life satisfaction and more depressive symptoms compared to those who engaged in cognitively demanding volunteering and those who did not volunteer at all. This detrimental pattern of instrumental volunteering was only seen in middle-aged adults, but not in older adults. Findings of this study revealed distinctive effects of two volunteering types, and provide valuable directions for designing future volunteering programmes.
Educational inequalities in cardiometabolic diseases (CMD) are globally recognised; nonetheless, the evidence on potential explanatory mechanisms and effective strategies for CMD prevention and inequality reduction is relatively scarce in Asia. Therefore, the current study examined the extent and potential mediators of the association of education level with CMD conditions (i.e., hypertension and diabetes) in an advanced economy in Asia.
A cross-sectional study.
This territory-wide cross-sectional Population Health Survey in 2014–2015 was performed in Hong Kong. Demographic, socio-economic and lifestyle factors were collected via questionnaire, while clinical data on blood pressure and glucose levels, lipid profiles and anthropometric measures were obtained during health examination. Hypertension and diabetes statuses were objectively defined by both clinical data and the use of relevant medications.
2297 community-dwelling adults aged between 15–84 years recruited via systematic replicated sampling of living quarters.
Multivariable binary logistic regression analysis showed that lower education level was significantly associated with hypertension among women but not men, whereas similar pattern was also observed for diabetes and other related clinical risk factors. Also, general and abdominal obesity were independently associated with hypertension and diabetes among both women and men, and substantially mediated the observed inequalities across education levels among women. Specifically, abdominal obesity was a particularly strong risk factor and mediator for diabetes.
Educational patterning of CMD was more apparent among women in Hong Kong. Obesity control appears to be important for both overall CMD prevention and reduction of educational inequalities in CMD among women.
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
The nonlinear evolution of electron Weibel instability in a symmetric, counterstream, unmagnetized electron–positron e−/e+ plasmas is studied by a 2D particle-in-cell (PIC) method. The magnetic field is produced and amplified by the Weibel instability, which extracts energy from the plasma anisotropy. A weakly relativistic drift velocity of 0.5c is considered for two counterstreaming e−/e+ plasma flows. Simulations show that in a homogeneous e−/e+ plasma distribution, the magnetic field amplifies exponentially in the linear regime and rapidly decays after saturation. However, in the case of inhomogeneous e−/e+ plasma distribution, the magnetic field re-amplifies at post-saturation. We also find that the amount of magnetic field amplification at post-saturation depends on the strength of the density inhomogeneity of the upstream plasma distribution. The temperature calculation shows that the finite thermal anisotropy exists in the case of an inhomogeneous plasma distribution which leads to the second-stage magnetic field amplification after the first saturation. Such density inhomogeneities are present in a variety of astrophysical sources: for example, in supernova remnants and gamma-ray bursts. Therefore, the present analysis is very useful in understanding these astrophysical sources, where anisotropic density fluctuations are very common in the downstream region of the relativistic shocks and the widely distributed magnetic field.
Previous research has suggested an association between depression and subsequent acute stroke incidence, but few studies have examined any effect modification by sociodemographic factors. In addition, no studies have investigated this association among primary care recipients with hypertension.
We examined the anonymized records of all public general outpatient visits by patients aged 45+ during January 2007–December 2010 in Hong Kong to extract primary care patients with hypertension for analysis. We took the last consultation date as the baseline and followed them up for 4 years (until 2011–2014) to observe any subsequent acute hospitalization due to stroke. Mixed-effects Cox models (random intercept across 74 included clinics) were implemented to examine the association between depression (ICPC diagnosis or anti-depressant prescription) at baseline and the hazard of acute stroke (ICD-9: 430–437.9). Effect modification by age, sex, and recipient status of social security assistance was examined in extended models with respective interaction terms specified.
In total, 396 858 eligible patients were included, with 9099 (2.3%) having depression, and 10 851 (2.7%) eventually hospitalized for stroke. From the adjusted analysis, baseline depression was associated with a 17% increased hazard of acute stroke hospitalization [95% confidence interval (CI) 1.03–1.32]. This association was suggested to be even stronger among men than among women (hazard ratio = 1.29, 95% CI 1.00–1.67).
Depression is more strongly associated with acute stroke incidence among male than female primary care patients with hypertension. More integrated services are warranted to address their needs.
Depression is a common mental disorder that substantially impairs a client's functioning. the aim of this study is to examine the predictive factors of quality of life (QOL) for depression from longitudinal perspectives. 237 outpatients with depression were recruited in the study. They were from a psychiatric outpatient clinic in northern Taiwan. All subjects were tested on the baseline and followed up twice during 3-year period. the average age of subjects was 47.1 years. Most subjects were female, married and lived with their spouses.Seventy subjects participated in both follow ups (T2 and T3). there were no significant differences on the demographic characteristics at T1 between the respondents (N = 70) and non-respondents (N = 167) except for gender. the subjects were tested on the WHOQOL-BREF-Taiwan version, occupational self assessment, mastery, social support and Center of Epidemiology Study-Depression Scale (CESD). the data were analyzed by mixed effect model using SAS computer program.The severity of depression could predict overall QOL, overall health and 13 items of QOL. the type of antidepressants had significant impact on the subjects’ QOL in 10 items. the occupational competence and sense of mastery predicted 13 items (50%) and 14 items (53.8%), respectively.In order to advance the treatment outcomes, the professionals should pay more attention on the enhancement of the sense of competence and mastery. We suggested that treatments should target at improving adaptive skills, lifestyle, and occupational competence.
We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations.
Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression.
We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33–1.62) to 1.05 (95% CI: 1.01–1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05).
Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.
Results of comprehensive particle image velocimetry measurements investigating the dynamics of turbulent jets in a rotating fluid are presented. It is observed that background system rotation induces a time-periodic formation–breakdown cycle of the jets. The flow dynamics associated with this process is studied in detail. It is found that the frequency of the cycle increases linearly with the background rotation rate. The data show that the onset of the breakdown phase and of the reformation phase of the cycle can be characterized in terms of a local Rossby number employing an internal velocity and a length scale of the jet. The critical values for this local Rossby number, for onset of breakdown and reformation, scale linearly with a global Rossby number based on the flow conditions at the source. The analysis of the experimental data suggests centrifugal instability as the potential origin of the formation–breakdown cycle.
The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.
Social centers for older people.
664 Chinese older adults with chronic pain.
Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.
For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.
The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.
Rhizoctonia solani Kühn and Pythium aphanidermatum Edson cause cabbage seedling damping-off, resulting in severe yield losses. The current study demonstrates the production of toxic volatile organic compounds (VOCs) by two strains of Bacillus mycoides and the evaluation of a potential use of B. mycoides as a biocontrol agent to control cabbage damping-off. Two VOCs, dimethyl disulphide and ammonia, were found to reduce radial growth, cause hyphal deformation and result in organelle degeneration in both R. solani and P. aphanidermatum. Pathogen hyphae, after being exposed to VOCs, showed poor rigidity, shrinkage, curling and swelling. The amount of VOCs produced by B. mycoides and the antagonistic activity against plant pathogens varied, depending on the type of medium used to culture bacteria. Application of B. mycoides cell suspensions to cultivation medium promotes growth of five different plant species tested. Experiments conducted in greenhouses revealed that B. mycoides did not reduce damping-off incidence caused by R. solani. However, B. mycoides reduced damping-off incidence induced by P. aphanidermatum by as much as 45% on cabbage seedlings. The results provide valuable information on the feasibility of utilizing B. mycoides as a biocontrol agent in controlling cabbage damping-off.
We investigated the clinical predictors of methicillin-resistance and their impact on mortality in 371 patients with Staphylococcus aureus bacteraemia identified from two prospective multi-centre studies. Methicillin resistant S. aureus (MRSA) accounted for 42.2% of community-onset and 74.5% of hospital-onset cases. No significant clinical difference was found between patients infected with MRSA vs. methicillin-sensitive S. aureus (MSSA), except that the former were more likely to have had hospital-onset bacteraemia and received antibiotics in the preceding 90 days. After stratifying according to the acquisition site, prior antibiotic use was the only independent predictor of having MRSA in both community-onset and hospital-onset cases. The frequency of inappropriate empirical antibiotic therapy was higher in patients with MRSA than in those with MSSA bacteraemia. However, methicillin resistance was not a predictor of mortality in patients and the clinical characteristics and outcomes of both MRSA and MSSA bacteraemia were similar. This study indicates that there are no definitive clinical or epidemiological risk factors which could distinguish MRSA from MSSA cases with the exception of the previous use of antibiotics for having MRSA bacteraemia, which emphasises the prudent use of glycopeptide treatment of patients at risk for invasive MRSA infections.
Holstein-Friesian steer beef production is renowned globally as a secondary product of the milk industry. Grass feeding is a common practice in raising Holstein steers because of its low cost. Furthermore, grass feeding is an alternative way to produce beef with a balanced n-6 to n-3 fatty acids (FAs) ratio. However, the performance and meat quality of Holstein-Friesian cattle is more likely to depend on a high-quality diet. The aim of this study was to observe whether feeding two mixed diets; a corn-based total mixed ration (TMR) with winter ryegrass (Lolium perenne) or flaxseed oil-supplemented pellets with reed canary grass haylage (n-3 mix) provided benefits on carcass weight, meat quality and FA composition compared with cattle fed with reed canary grass (Phalaris arundinacea) haylage alone. In all, 15 21-month-old Holstein-Friesian steers were randomly assigned to three group pens, were allowed free access to water and were fed different experimental diets for 150 days. Blood samples were taken a week before slaughter. Carcass weight and meat quality were evaluated after slaughter. Plasma lipid levels and aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), creatine kinase (CK) and alkaline phosphatase (ALP) activities were determined. Diet did not affect plasma triglyceride levels and GGT activity. Plasma cholesterol levels, including low-density and high-density lipoproteins, were higher in both mixed-diet groups than in the haylae group. The highest activities of plasma AST, CK and ALP were observed in the haylage group, followed by n-3 mix and TMR groups, respectively. Carcass weight was lower in the haylage group than in the other groups and no differences were found between the TMR and n-3 mix groups. Although the n-3 mix-fed and haylage-fed beef provided lower n-6 to n-3 FAs ratio than TMR-fed beef, the roasted beef obtained from the TMR group was more acceptable with better overall meat physicochemical properties and sensory scores. According to daily cost, carcass weight and n-6 to n-3 FAs ratio, the finishing diet containing flaxseed oil-supplemented pellets and reed canary grass haylage at the as-fed ratio of 40 : 60 could be beneficial for the production of n-3-enriched beef.
Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments.
A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis.
A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an ‘a priori’ design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report ‘a priori’ designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09–1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06–1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06–1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81–0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04–1.25), completed by more review authors (AOR 1.12, 95% CI 1.01–1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01–2.59) were associated with better performance in publication bias assessment.
The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.
Extended-spectrum β-lactamase (ESBL) production has been very rare in serotype K1 Klebsiella pneumoniae ST23 strains, which are well-known invasive community strains. Among 92 ESBL-producing strains identified in 218 isolates from nine Asian countries, serotype K1 K. pneumoniae strains were screened. Two ESBL-producing K. pneumoniae isolates from Singapore and Indonesia were determined to be serotype K1 and ST23. Their plasmids, which contain CTX-M-15 genes, are transferable rendering the effective transfer of ESBL resistance plasmids to other organisms.
Live cells can sense the mechanical characteristics of the microenvironment and translate the mechanical cues to intracellular biochemical signals in physiology and disease. To investigate intracellular signaling transduction during mechanosensing, nanotechnologies, and FRET live-cell imaging technologies have been developed to visualize the output signals in real time, such as intracellular molecular activity. Meanwhile, micropatterned technologies have been applied to modulate the physical and mechanical environment surrounding the cell to fine-tune the input signals in cellular mechanosensing. These advanced technologies can join forces and shed new light into the molecular networks that control mechanotransduction in normal conditions and disease.
Additional high-quality evidence for predictors of peritonsillar abscess recurrence could lead to better-informed treatment decisions regarding tonsillectomy.
In this study, 172 patients, who had been diagnosed and treated for peritonsillar abscess, were evaluated at follow up. A retrospective review of medical records and a telephone survey were performed. The clinical characteristics analysed included underlying disease, laboratory findings and computed tomography findings. Cox proportional hazard models were used to identify risk factors for peritonsillar abscess recurrence.
The recurrence rate of peritonsillar abscess was 13.9 per cent. Univariate analysis indicated that extraperitonsillar spread of the abscess (beyond the peritonsillar area) on computed tomography and a history of recurrent tonsillitis were associated with recurrence. Multivariate analysis also indicated that extraperitonsillar spread (p = 0.007; hazard ratio = 3.399) and recurrent tonsillitis history (p < 0.001; hazard ratio = 11.953) were significant risk factors for recurrence.
Our results suggest that tonsillectomy may be indicated as a treatment for peritonsillar abscess in patients with a history of recurrent tonsillitis or extraperitonsillar spread on computed tomography.