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This paper exploited an alternative approach to prepare high-quality speckle patterns by uniformly dispersing nano-silica particles onto sample surfaces, helping digital image correlation (DIC) acquire the maximum spatial resolution of local strain up to 92 nm. A case study was carried out by combining this speckle pattern fabrication method with SEM-DIC and electron backscattering diffraction (EBSD). Thus, in situ mapping of local strain with ultra-high spatial resolution and microstructure in commercially pure titanium during plastic deformation could be achieved, which favored revealing the effect of slip transfer on shear strain near grain boundaries. Moreover, the slip systems could be easily identified via the combination of the SEM-DIC and EBSD techniques even though no obvious deformation trace was captured in secondary electron images. Additionally, the complex geometric compatibility factor $( {m}^{\prime}_c)$ relating to geometric compatibility factors (mʹ) and Schmid factors was proposed to predict the shear strain (εxy) at grain boundaries.
Water scarcity is increasingly perceived as a risk in semi-arid and arid regions and it will be more critical in the future. Inter-basin water transfer (IBT) is widely considered as a climate adaptation strategy to minimize water scarcity in water-receiving areas. The South-to-North Water Diversion (SNWD) project is the world’s largest IBT project to alleviate severe water shortages in the Huang–Huai–Hai (HHH) region in China. This chapter takes the SNWD project as an example to quantitatively investigate the impact of the large scale IBT on water scarcity in the HHH region within the context of climate change. The results show that during the twenty-first century, the water supply risk in the region is projected to increase as a result of climatic and societal change. The SNWD project can greatly alleviate water scarcity but might be insufficient in some cases. Besides, to keep pace with escalating demands and completely alleviate water supply problems, demand-oriented management schemes, such as improvement in irrigation water use efficiency, must be undertaken.
Evidence of couples’ BMI and its influence on birth weight is limited and contradictory. Therefore, this study aims to assess the association between couple’s preconception BMI and the risk of small for gestational age (SGA)/large for gestational age (LGA) infant, among over 4·7 million couples in a retrospective cohort study based on the National Free Pre-pregnancy Checkups Project (NFPCP) between December 1, 2013 and November 30, 2016 in China. Among the live births, 256,718 (5·44%) SGA events and 506,495 (10·73%) LGA events were documented, respectively. After adjusting for confounders, underweight men had significantly higher risk [OR 1·17 95%CI (1·15-1·19)] of SGA infants compared with men with normal BMI, while a significant and increased risk of LGA infants was obtained for overweight and obese men [OR 1·08 (95% CI: 1·06-1·09); OR 1·19 (95%CI 1·17-1·20)] respectively. The restricted cubic spline (RCS) result revealed a non-linearly decreasing dose-response relationship of paternal BMI (less than 22·64) with SGA. Meanwhile, a non-linearly increasing dose-response relationship of paternal BMI (more than 22·92) with LGA infants was observed. Moreover, similar results about the association between maternal preconception BMI and SGA/LGA infants were obtained. Abnormal preconception BMIs in either women or men were associated with increased risk of SGA/LGA infants, respectively. Overall, couple’s abnormal weight before pregnancy may be an important preventable risk factor for SGA/LGA infants.
Pancreatic cancer is one of the most malignant tumours with a poor prognosis. In recent years, the incidence of pancreatic cancer is on the rise. Traditional chemotherapy and radiotherapy for pancreatic cancer have been improved, first-line and second-line palliative treatments have been developed, and adjuvant treatments have also been used in clinical. However, the 5-year survival rate is still less than 10% and new treatment methods such as targeted therapy and immunotherapy need to be investigated. In the past decades, many clinical trials of targeted therapies and immunotherapies for pancreatic cancer were launched and some of them showed an ideal prospect in a subgroup of pancreatic cancer patients. The experience of both success and failure of these clinical trials will be helpful to improve these therapies in the future. Therefore, the current research progress and challenges of selected targeted therapies and immunotherapies for pancreatic cancer are reviewed.
Long non-coding RNAs (lncRNAs) exert vital functions in the occurrence and development of various tumours. The aim of this study was to examine the regulatory effect and underlying molecular mechanism of lncRNA small nucleolar RNA host gene 14 (SNHG14) on the proliferation, invasion and migration of thyroid tumour cells. The expression of SNHG14 in thyroid tumour cell lines was determined using qRT-PCR. CCK-8 and western blot were used to detect the effects of SNHG14 on proliferation and apoptosis of thyroid tumour cells. The effect of SNHG14 on the migration and invasion of thyroid tumour cells was analyzed using immunofluorescence, wound-healing and transwell assays. A targeting relationship between SNHG14 and miR-93-5p was determined using bioinformatics software and luciferase reporter assays. In addition, CCK-8, immunofluorescence, wound-healing and transwell assays were applied to demonstrate that SNHG14 promoted the proliferation, migration and invasion of thyroid tumour cells by targeting miR-93-5p. The biological function of SNHG14 in vivo was explored through a xenograft model and immunohistochemistry. SNHG14 was upregulated in thyroid tumour cells compared with normal cells. Downregulation of SNHG14 effectively reduced the proliferation, migration and invasion of TPC-1 cells, and induced cell apoptosis. Moreover, SNHG14 directly targeted miR-93-5p and there was a negative correlation between them. Further functional experiments illustrated that miR-93-5p overexpression dramatically reversed the promoting role of SNHG14 in proliferation, migration and invasion of TPC-1 cells. Our results demonstrated that SNHG14 promotes the proliferation, invasion and migration of thyroid tumour cells by downregulating miR-93-5p.
To examine the association between sleep duration in different stages of life and amnestic mild cognitive impairment (aMCI).
Design, setting, and participants:
A total of 2472 healthy elderly and 505 patients with aMCI in China were included in this study. The study analyzed the association between aMCI and sleep duration in different stages of life.
Measurements:
We compared sleep duration in different stages of life and analyzed the association between Montreal Cognitive Assessment scores and sleep duration by curve estimation. Logistic regression was used to evaluate the association between aMCI and sleep duration.
Results:
In the analysis, there were no results proving that sleep duration in youth (P = 0.719, sleep duration < 10 hours; P = 0.999, sleep duration ≥ 10 hours) or midlife (P = 0.898, sleep duration < 9 hours; P = 0.504, sleep duration ≥ 9 hours) had a significant association with aMCI. In the group sleeping less than 7 hours in late life, each hour more of sleep duration was associated with approximately 0.80 of the original risk of aMCI (P = 0.011, odds ratio = 0.80, 95% confidence interval = 0.68–0.95).
Conclusions:
Among the elderly sleeping less than 7 hours, there is a decreased risk of aMCI for every additional hour of sleep.
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.
Early identification of patients with novel corona virus disease 2019 (COVID-19) who may be at high mortality risk is of great importance.
Methods:
In this retrospective study, we included all patients with COVID-19 at Huanggang Central Hospital from January 23 to March 5, 2020. Data on clinical characteristics and outcomes were compared between survivors and nonsurvivors. Univariable and multivariable logistic regression were used to explore risk factors associated with in-hospital death. A nomogram was established based on the risk factors selected by multivariable analysis.
Results:
A total of 150 patients were enrolled, including 31 nonsurvivors and 119 survivors. The multivariable logistic analysis indicated that increasing the odds of in-hospital death associated with higher Sequential Organ Failure Assessment score (odds ratio [OR], 3.077; 95% confidence interval [CI]: 1.848-5.122; P < 0.001), diabetes (OR, 10.474; 95% CI: 1.554-70.617; P = 0.016), and lactate dehydrogenase greater than 245 U/L (OR, 13.169; 95% CI: 2.934-59.105; P = 0.001) on admission. A nomogram was established based on the results of the multivariable analysis. The AUC of the nomogram was 0.970 (95% CI: 0.947-0.992), showing good accuracy in predicting the risk of in-hospital death.
Conclusions:
This finding would facilitate the early identification of patients with COVID-19 who have a high-risk for fatal outcome.
It is essential to investigate the experiences behind why adolescents start and continue to self-harm in order to develop targeted treatment and prevent future self-harming behaviours.
Aims
The aims of this study are to understand the motivations for initiating and repeating nonfatal self-harm, the different methods used between first-time and repeated self-harm and the reasons that adolescents do not seek help from health services.
Methods
Adolescents with repeated nonfatal self-harm experiences were recruited to participate in individual, semi-structured qualitative interviews. The interviews were analysed with interpretative phenomenological analysis.
Results
We found that nonfatal self-harm among adolescents occurred comparatively early and was often triggered by specific reasons. However, the subsequent nonfatal self-harm could be causeless, with repeated self-harm becoming a maladaptive coping strategy to handle daily pressure and negative emotions. The choice of tools used was related to the ease of accessibility, the life-threatening risk and the size of the scars. Adolescents often concealed their scars on purpose, which made early identification insufficient. Peer influence, such as online chat groups encouraging self-harm by discussing and sharing self-harm pictures, could also lead to increased self-harm. The results also included participants’ opinions on how to stop nonfatal self-harm and their dissatisfaction with the current healthcare services.
Conclusions
The current study provides important implications both for early identification and interventions for adolescents who engage in repeated nonfatal self-harm, and for individualising treatment planning that benefits them. It is also worthwhile to further investigate how peer influence and social media may affect self-harm in adolescents.
We aimed to examine whether baseline neutrophil counts affected the risk of new-onset proteinuria in hypertensive patients, and, if so, whether folic acid treatment is particularly effective in proteinuria prevention in such a setting. A total of 8208 eligible participants without proteinuria at baseline were analysed from the renal substudy of the China Stroke Primary Prevention Trial. Participants were randomised to receive a double-blind daily treatment of 10 mg of enalapril and 0·8 mg of folic acid (n 4101) or 10 mg of enalapril only (n 4107). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The mean age of the participants was 59·5 (sd, 7·4) years, 3088 (37·6 %) of the participants were male. The median treatment duration was 4·4 years. In the enalapril-only group, a significantly higher risk of new-onset proteinuria was found among participants with higher neutrophil counts (quintile 5; ≥4·8 × 109/l, OR 1·44; 95 % CI 1·00, 2·06), compared with those in quintiles 1–4. For those with enalapril and folic acid treatment, compared with the enalapril-only group, the new-onset proteinuria risk was reduced from 5·2 to 2·8 % (OR 0·49; 95 % CI 0·29, 0·82) among participants with higher neutrophil counts (≥4·8 × 109/l), whereas there was no significant effect among those with neutrophil counts <4·8 × 109/l. In summary, among hypertensive patients, those with higher neutrophil counts had increased risk of new-onset proteinuria, and this risk was reduced by 51 % with folic acid treatment.
The positioning technique employing the ubiquitous signals of opportunity of non-cooperative satellites does not send special navigation signals, instead it passively receives satellite signals as noise, presenting advantages of concealment and difficulty for potential attackers. Thus, this study investigates the ranging principle and model using non-cooperative communication satellites and a time difference estimation algorithm. The technology of time difference measurement under non-cooperative observation mode was determined and simulated. A test platform for time difference measurement was built to receive the signal from an unknown geostationary Earth orbit communication satellite and verify the ranging feasibility and performance. The ranging accuracy was found to be smaller than 6 m, as demonstrated by experimental data, which shows the viability of the proposed positioning technique for ranging technology.
The Duobagou Permian–Triassic granites of the Dunhuang orogenic belt are of great importance in understanding the tectonic evolution of the southernmost Central Asian Orogenic Belt. LA-ICP-MS U–Pb zircon ages indicate that Permian–Triassic granitic intrusions from the Duobagou area formed at 276–274 Ma and 246 ± 1 Ma. These granites have high SiO2, Na2O and K2O, but low Al2O3, CaO and MgO contents and belong mainly to the high-K calc-alkaline I-type granite series. Based on whole-rock geochemistry and Sr–Nd and zircon Hf isotopes, the Duobagou Permian–Triassic granites were dominantly derived from the partial melting of lower continental crust formed during late Palaeoproterozoic to Mesoproterozoic times in a post-collisional extensional setting. Permian granites with zircon ϵHf(t) values of −5.4 to +3.1 and Hf model ages of TDM2 = 1.14–1.70 Ga indicate the involvement of a mantle component in their petrogenesis. Triassic granites with higher zircon ϵHf(t) values (+0.5 to +3.8) and TDM2 = 1.08–1.31 Ga suggest more juvenile sources caused by a greater contribution of mantle-derived melts, indicating a significant crustal growth. Regional extension from lithospheric delamination and heating from asthenospheric upwelling were proposed to have triggered the partial melting of lower crust, resulting in the generation of the Permian–Triassic magmatism. This may have been the mechanism for the significant crustal growth during Permian and Triassic times in the southernmost Central Asian Orogenic Belt.
The present study investigated the effect of Bacillus subtilis DSM 29784 (Ba) and enzymes (xylanase and β-glucanases; Enz), alone or in combination (BE) as antibiotic replacements, on the growth performance, digestive enzyme activity, immune response and the intestinal barrier of broiler chickens. In total, 1200 1-d-old broilers were randomly assigned to five dietary treatments, each with six replicate pens of forty birds for 63 d as follows: (a) basal diet (control), supplemented with (b) 1 × 109 colony-forming units (cfu)/kg Ba, (c) 300 mg/kg Enz, (d) 1 × 109 cfu/kg Ba and 300 mg/kg Enz and (e) 250 mg/kg enramycin (ER). Ba, Enz and BE, similar to ER, decreased the feed conversion rate, maintained intestinal integrity with a higher villus height:crypt depth ratio and increased the numbers of goblet cells. The BE group exhibited higher expression of claudin-1 and mucin 2 than the other four groups. BE supplementation significantly increased the α-diversity and β-diversity of the intestinal microbiota and markedly enhanced lipase activity in the duodenal mucosa. Serum endotoxin was significantly decreased in the BE group. Compared with those in the control group, increased superoxide dismutase and glutathione peroxidase activities were observed in the jejunal mucosa of the Ba and BE groups, respectively. In conclusion, the results suggested that dietary treatment with Ba, Enz or BE has beneficial effects on growth performance and anti-oxidative capacity, and BE had better effects than Ba or Enz alone on digestive enzyme activity and the intestinal microbiota. Ba or Enz could be used as an alternative to antibiotics for broiler chickens.
Aberration in leptin expression is one of the most frequent features in the onset and progression of obesity, but the underlying mechanisms are still unclear and need to be clarified. This study investigated the effects of the absence of gut microbiota on body weight and the expression and promoter methylation of the leptin. Male C57 BL/6 J germ-free (GF) and conventional (CV) mice (aged 4–5 weeks) were fed either a normal-fat diet (NFD) or a high-fat diet (HFD) for 16 weeks. Six to eight mice from each group, at 15 weeks, were administered exogenous leptin for 7 d. Leptin expression and body weight gain in GF mice were increased by NFD with more CpG sites hypermethylated at the leptin promoter, whereas there was no change with HFD, compared with CV mice. Adipose or hepatic expression of genes associated with fat synthesis (Acc1, Fas and Srebp-1c), hydrolysis and oxidation (Atgl, Cpt1a, Cpt1c, Ppar-α and Pgc-1α) was lower, and hypothalamus expression of Pomc and Socs3 was higher in GF mice than levels in CV mice, particularly with NFD feeding. Exogenous leptin reduced body weight in both types of mice, with a greater effect on CV mice with NFD. Adipose Lep-R expression was up-regulated, and hepatic Fas and hypothalamic Socs3 were down-regulated in both types of mice. Expression of fat hydrolysis and oxidative genes (Atgl, Hsl, Cpt1a, Cpt1c, Ppar-α and Pgc-1α) was up-regulated in CV mice. Therefore, the effects of gut microbiota on the leptin expression and body weight were affected by dietary fat intake.
We aimed to evaluate the relationship of plasma Mg with the risk of new-onset hyperuricaemia and examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric acid (UA) Sub-study of the China Stroke Primary Prevention Trial (CSPPT). A total of 1685 participants were included in the present study. The main outcome was new-onset hyperuricaemia defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women. The secondary outcome was a change in UA concentration defined as UA at the exit visit minus that at baseline. During a median follow-up duration of 4·3 years, new-onset hyperuricaemia occurred in 290 (17·2 %) participants. There was a significantly inverse relation of plasma Mg with the risk of new-onset hyperuricaemia (per sd increment; OR 0·85; 95 % CI 0·74, 0·99) and change in UA levels (per sd increment; β −3·96 μmol/l; 95 % CI −7·14, −0·79). Consistently, when plasma Mg was analysed as tertiles, a significantly lower risk of new-onset hyperuricaemia (OR 0·67; 95 % CI 0·48, 0·95) and less increase in UA levels (β −8·35 μmol/l; 95 % CI −16·12, −0·58) were found among participants in tertile 3 (≥885·5 μmol/l) compared with those in tertile 1 (<818·9 μmol/l). Similar trends were found in males and females. Higher plasma Mg levels were associated with a decreased risk of new-onset hyperuricaemia in hypertensive adults.
This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment.
Methods
This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization.
Results
A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects.
Conclusions
After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.
Compared to their heterosexual peers, youth who identify as lesbian, gay or bisexual (LGB) tend to suffer higher rates of peer victimisation from bullying. However, studies of LGB adolescents' participation as bullies are scarce. We aimed to examine the possible association of sexual minority identity and the heightened risk of not only being bullied but bullying others as well. We also explored the effect of one's sexual identity on their involvement in bullying through the mediation of coping strategies and mood states.
Methods
A total of 12 218 students were recruited from 18 secondary schools in China. The demographic information, positive and negative coping strategies, mood state (anxiety, depression and hypomania) and information related to bullying and being bullied were collected. Multinomial regression was used to assess the heightened risk of sexual minority groups in comparison to their heterosexual adolescents' counterparts. A structural equation model (SEM) was used to test the mediating role of coping strategy and mood state between one's sex, sexual identity and bullying experience.
Results
Two trends could be observed: (1) LGB groups reported heightened risks of being bullied and bullying others at school than heterosexual peers. However, being a sexual-undeveloped girl seemed to have a protective effect on bullying-related problems. (2) Birth-assigned males were more likely to be bullied as well as bullying others at school when compared to birth-assigned females. SEM analysis revealed that being a sexual minority was directly associated with a higher frequency of being bullied (B = 0.16, 95% CI [0.10, 0.22], p < 0.001) but not bullying others (B = 0.02, 95% CI [−0.02, 0.06], p = 0.398) when compared to the heterosexual group. Negative coping, hypomania, anxiety and depression were associated with a higher frequency of being bullied, while positive coping was associated with a lower frequency of being bullied. Moreover, negative coping, hypomania and depression were associated with a higher frequency of bullying others, while positive coping was associated with a reduced likelihood of bullying others. In addition, being bullied and bullying others were significantly correlated in the SEM model.
Conclusions
This novel research investigated the dynamic nature of the interaction between victim and bullying of LGB school adolescents in China, with a specific exploration of the psychological mechanism behind the pattern of being bullied and bullying others. School-level interventions aimed at teaching positive coping strategies to lower psychological distress are recommended to support sexual minority students.