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We aim to examine the relation of several folate forms (5-methyltetrahydrofolate [5-mTHF], unmetabolized folic acid [UMFA], and MeFox) with kidney function and albuminuria, which remained uncertain. The cross-sectional study was conducted in 18,757 participants from National Health and Nutrition Examination Survey 2011–2018. The kidney outcomes were reduced estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m2), microalbuminuria (albumin-to-creatinine ratio of 30-299 mg/g), and macroalbuminuria (albumin-to-creatinine ratio ≥ 300 mg/g).Overall, there were significant inverse associations between serum 5-mTHF and kidney outcomes with significant lower prevalence of reduced eGFR (OR, 0.71; 95%CI: 0.57-0.87) and macroalbuminuria (OR, 0.65; 95%CI: 0.46-0.91) in participants in quartile 3-4 (vs. quartile 1-2; ≥34.0 vs. <34.0nmol/L; both P for trend across quartiles <0.05). In contrast, there were significant positive relationship between serum UMFA and kidney outcomes with significant higher prevalence of reduced eGFR in participants in quartile 2-4 (vs. quartile 1; ≥0.5 vs. <0.5nmol/L; OR, 2.12; 95%CI: 1.45-3.12; P for trend <0.001) and higher prevalence of macroalbuminuria in participants in quartile 4 (vs. quartile 1-3; ≥ 1.0 vs. <1.0 nmol/L; OR, 1.46; 95%CI: 1.06-2.01; P for trend <0.001). However, there was no significant associations of 5-mTHF and UMFA with microalbuminuria. In addition, there were significant positive relationships of serum MeFox with reduced eGFR, microalbuminuria and macroalbuminuria (all P for trend <0.01). In conclusion, higher 5-mTHF level, along with lower UMFA and MeFox level, were associated with lower prevalence of kidney outcomes, which may help counsel future clinical trials and nutritional guidelines regarding the folate supplement.
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.
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.
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).
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.
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.
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.
This finding would facilitate the early identification of patients with COVID-19 who have a high-risk for fatal outcome.
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 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.
Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs.
To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members.
Cross-sectional survey of 4665 men 18–34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments.
Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour.
Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.
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.
Objective: Deficits in the semantic learning strategy were observed in subjects with amnestic mild cognitive impairment (aMCI) in our previous study. In the present study, we explored the contributions of executive function and brain structure changes to the decline in the semantic learning strategy in aMCI. Methods: A neuropsychological battery was used to test memory and executive function in 96 aMCI subjects and 90 age- and gender-matched healthy controls (HCs). The semantic clustering ratio on the verbal learning test was calculated to evaluate learning strategy. Medial temporal lobe atrophy (MTA) and white matter hyperintensities (WMH) were measured on MRI with the MTA and Fazekas visual rating scales, respectively. Results: Compared to HCs, aMCI subjects had poorer performance in terms of memory, executive function, and the semantic clustering ratio (P < .001). In aMCI subjects, no significant correlation between learning strategy and executive function was observed. aMCI subjects with obvious MTA demonstrated a lower semantic clustering ratio than those without MTA (P < .001). There was no significant difference in the learning strategies between subjects with high-grade WMH and subjects with low-grade WMH. Conclusion: aMCI subjects showed obvious impairment in the semantic learning strategy, which was attributable to MTA but independent of executive dysfunction and subcortical WMH. These findings need to be further validated in large cohorts with biomarkers identified using volumetric brain measurements. (JINS, 2019, 25, 706–717)
China has made great achievements in health insurance coverage and healthcare financing. Nonetheless, the rate of catastrophic health expenditure (CHE) in China was 13 percent in 2008, which is higher than in some other countries. There are differences among the provinces in China in terms of the lifestyles, customs, prevalent medical conditions, and health consciousness of their populations. This study aimed to compare the proportion of households with CHE and the factors influencing this expenditure between the Zhejiang and Qinghai province in China.
Data were derived from household surveys conducted in Zhejiang and Qinghai. Sampling was based on a multi-stage, stratified random cluster method. Households with CHE were defined as those with an out-of-pocket payment for health care that was at least 40 percent of the household income. Univariate and multivariate logistic regression analyses were used to identify the factors associated with CHE.
A total of 1,598 households were included: 995 in Zhejiang and 603 in Qinghai. The average rates of CHE in Zhejiang and Qinghai were 10 percent and 31 percent, respectively. The economic status of a household influenced the likelihood of experiencing CHE; households headed by an employed person were less likely to experience CHE. In contrast, households that included outpatients or individuals with chronic diseases had a higher risk of experiencing CHE across the two provinces. Poorer or uninsured households in Zhejiang were more likely to experience CHE, as were households in Qinghai that included outpatients or were headed by a person from a minority nationality.
This study highlighted the importance of promoting economic development, expanding employment, and adjusting policies to better protect individuals with chronic diseases and outpatients from the risk of CHE. The Chinese government should pay more attention to actual conditions in different provinces to ensure that policy decisions incorporate local knowledge.
Two series of binuclear metal phthalocyanine complexes M2(PcTN)2Nap and M2(PcTA)2Nap (M = Mn2+, Fe2+, Co2+, Cu2+) were designed and synthesized through the liquid solvent method and amination reaction. Elemental analysis, IR, and UV-vis spectroscopy were applied to characterize the compounds. To evaluate their catalytic performance, all the compounds were respectively added into the electrolyte of Li/SOCl2 battery systems as well as three-electrode systems for cyclic voltammetry (CV) measurements. The research studies indicate that the average discharge voltage and discharge time of the battery could be effectively enhanced by 0.2440 V and 810.7 s when compared with the battery in the absence of the compounds. As for capacities of the batteries containing catalysts, they were also found to have an improvement of 51.78–91.62%. Among the effects of diverse metal ions on the catalytic performance of phthalocyanines, the complexes whose center metal ions were Mn2+ or Co2+ exhibited relatively high catalytic performance. Meanwhile, combined with experimental results of CV analyses, the suggested catalytic mechanism of binuclear phthalocyanines for catalyzing Li/SOCl2 batteries had been proposed.
Evidence on the association between maternal Hb concentration and preterm birth (PTB) risk is inconclusive. This paper aimed to explore whether women with anaemia or high Hb level before pregnancy would be at higher risk of PTB. We conducted a population-based cohort study with 2 722 274 women aged 20–49 years, who participated in National Free Pre-Pregnancy Checkups Project between 2013 and 2015 and delivered a singleton before 2016 in rural China. Logistic models were used to estimate OR and 95 % CI after adjusting for confounding variables. Restricted cubic spline models were applied to evaluate the dose–response relationships. A total of 192 819 (7·08 %) women had preterm deliveries. Compared with women with Hb of 110–149 g/l, the multivariable-adjusted OR for PTB was 1·19 (95 % CI 0·98, 1·44) for women with Hb<70 g/l, 1·01 (95 % CI 0·97, 1·03) for 70–99 g/l, 0·96 (95 % CI 0·95, 0·98) for 100–109 g/l, 1·04 (95 % CI 1·01, 1·06) for 150–159 g/l, 1·11 (95 % CI 1·05, 1·17) for 160–169 g/l and 1·19 (95 % CI 1·11, 1·27) for ≥170 g/l, respectively. The multivariable-adjusted OR for very PTB (VPTB) was 1·07 (95 % CI 1·03, 1·12) and 1·06 (95 % CI 1·01, 1·12) for women with Hb <110 and ≥150 g/l, compared with those with Hb of 110–149 g/l, respectively. Our study identified a U-shaped relationship between maternal preconception Hb concentration and PTB risk. Both preconception anaemia and high Hb level can significantly increase VPTB risk. Appropriate intervention for women with abnormal Hb levels before pregnancy is very necessary.
Admissible regions for higher-order finite volume method (FVM) grids are considered. A new Hermite quintic FVM and a new hybrid quintic FVM are constructed to solve elliptic boundary value problems, and the corresponding admissible regions are investigated. A sufficient condition for the uniform local-ellipticity of the new hybrid quintic FVM is obtained when its admissible region is known. In addition, the admissible regions for a large number of higher-order FVMs are provided. For the same class of FVM (Lagrange, Hermite or hybrid), the higher order FVM has a smaller admissible region such that stronger geometric restrictions are required to guarantee its uniform local-ellipticity.
To determine the prevalence of high weight at different characteristics, understand the perceptions and behaviours towards high body weight, and determine potential influencing factors of body weight misperception among high-weight adults in Jilin Province.
A cross-sectional survey with complex sampling design was conducted. We described the prevalence and perception of high body weight.
Northeast China in 2012.
Adults (n 20 552) aged 18–79 years.
Of overweight individuals, 37·4 % considered themselves as ‘normal weight’, 4·8 % reported themselves as being ‘very thin’ and only 53·1 % were aware of their own weight being ‘overweight’. About 1·8 % of both male and female obese individuals perceived themselves as ‘very thin’. Only 29·1 % of obese people thought of themselves as ‘too fat’. Nearly 30·0 % of centrally obese men and women perceived that their waist circumference was about right and they were of ‘normal weight’; 5·7 % of the centrally obese even perceived themselves as being ‘very thin’. Only 51·8 and 12·5 % of centrally obese individuals reported themselves to be ‘overweight’ or ‘too fat’. Body weight misperception was more common in rural residents (OR; 95 % CI: 1·340; 1·191, 1·509). The prevalence of body weight misperception increased with age (middle age: 1·826; 1·605, 2·078; old people: 3·101; 2·648, 3·632) and declined with increased education level (junior middle school: 0·628; 0·545, 0·723; senior middle school: 0·498; 0·426, 0·583; undergraduate and above: 0·395; 0·320, 0·487).
Body weight misperception was common among adults from Jilin Province.
We derive single integral representations for the exact distribution of the sum of independent generalized Pareto random variables. The integrands involve the incomplete and complementary incomplete gamma functions. Applications to insurance and catastrophe bonds are described.
Growth of unexpected phases from a composite target of BiFeO3:BiMnO3 and/or BiFeO3:BiCrO3 has been explored using pulsed laser deposition. The Bi2FeMnO6 tetragonal phase can be grown directly on SrTiO3 (STO) substrate, while two phases (S1 and S2) were found to grow on LaAlO3 (LAO) substrates with narrow growth windows. However, introducing a thin CeO2 buffer layer effectively broadens the growth window for the pure S1 phase, regardless of the substrate. Moreover, we discovered two new phases (X1 and X2) when growing on STO substrates using a BiFeO3:BiCrO3 target. Pure X2 phase can be obtained on CeO2-buffered STO and LAO substrates. This work demonstrates that some unexpected phases can be stabilized in a thin film form by using composite perovskite BiRO3 (R = Cr, Mn, Fe, Co, Ni) targets. Furthermore, it also indicates that CeO2 can serve as a general template for the growth of bismuth compounds with potential room-temperature multiferroicity.
The c-Jun N-terminal kinases (JNK) are members of the mitogen-activated protein kinase family and are activated by environmental stress. Se plays an important role in the biological pathways by forming selenoprotein. Selenoproteins have been shown to exhibit a variety of biological functions including antioxidant functions and maintaining cellular redox balance, and compromise of such important proteins would lead to oxidative stress and apoptosis. We examined the expression levels of JNK in Kashin–Beck disease (KBD) patients, tested the potential protective effects of sodium selenite on tert-butyl hydroperoxide (tBHP)-induced oxidative injury and apoptosis in human chondrocytes as well as its underlying mechanism in this study. We produced an oxidative damage model induced by tBHP in C28/I2 human chondrocytes to test the essential anti-apoptosis effects of Se in vitro. The results indicated that the expression level of phosphorylated JNK was significantly increased in KBD patients. Cell apoptosis was increased and molecule expressions of the JNK signalling pathway were activated in the tBHP-injured chondrocytes. Na2SeO3 protected against tBHP-induced oxidative stress and apoptosis in cells by increasing cell viability, reducing reactive oxygen species generation, increasing Glutathione peroxidase (GPx) activity and down-regulating the JNK pathway. These results demonstrate that apoptosis induced by tBHP in chondrocytes might be mediated via up-regulation of the JNK pathway; Na2SeO3 has an effect of anti-apoptosis by down-regulating the JNK signalling pathway.
Temporal variations in the taxonomic relatedness of periphytic ciliate
microfauna during colonization periods were studied in coastal waters of the
Yellow Sea, northern China, from May to June 2010. Samples were collected at
two depths of 1 and 3 m, using glass slides as artificial substrates. The
colonization dynamics of ciliate microfauna on the slides revealed similar
patterns in species composition at both depths. In the immature communities
(1–7 days), the taxonomic patterns showed high variability compared to those
in the mature ones (10 days and more). However, taxonomic relatedness
parameters at the two depths differed during early stages of colonization
(e.g. 1–3 days). Taxonomic diversity (Δ) was subject to high variability
(coefficients of variation >10%) in both immature and mature communities,
whereas taxonomic distinctness (Δ*), average taxonomic distinctness
(Δ+) and variation in taxonomic distinctness (Λ+)
showed high stability (coefficients of variation <10%) during the
colonization times of 3–21 days. These findings suggest that 3–21-day
exposure times are sufficient to detect the taxonomic distinctness of
periphytic ciliate microfauna at water depths of 1–3 m for the purposes of
ecological research and monitoring of marine ecosystems.
Bladder tissue engineering technology has provided an alternative treatment for patients with congenital bladder conditions (e.g. bladder exstrophy) and conditions such as radiation damage, infection, interstitial cystitis, neuropathic small bladder disease, and bladder cancer. To treat these end-stage bladder diseases, a partial or total cystectomy is often performed, followed by the creation of a neobladder or a continent urinary reservoir using intestinal segments to restore bladder capacity. However, using bowel tissue for this purpose may cause many side effects, although a recent study showed that all children with neurogenic bladder disease are at increased risk of bladder cancer regardless of exposure to intestinal tissue in the urinary tract . Therefore, new clinical and surgical techniques are needed in order to allow these patients to live healthier and more normal lives. The authors of a clinical study recently reported that it is possible to engineer neo-bladder tissue using autologous cells seeded on biodegradable scaffolds  and that this engineered tissue can be used to enlarge the bladder volume and improve function for patients with neuropathic diseases. Additionally, increasing evidence indicates that the use of patients’ own stem cells provides a promising alternative for patients with end-stage bladder diseases in cases in which healthy autologous bladder cells might not be available.