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Preterm birth is the leading cause of perinatal mortality and morbidity. Some prospective cohort studies suggested that fish and shellfish consumption may affect the incidence of preterm birth. However, conflicting evidence exists on the relationship between fish and shellfish consumption and preterm birth. This retrospective study was conducted in Lanzhou, China, between 2010 and 2012. A total of 10,179 women were interviewed after delivery to collect information on their past intake of fish and shellfish using food frequency questionnaire. Clinical data including birth outcomes and maternal complications were extracted from medical records of the participants. Logistic regression models were used to estimate odds ratios and 95% confidence intervals to examine the association between fish and shellfish consumption and preterm birth and its clinical subtypes. Fish and shellfish consumption was associated with reduced risk of preterm birth (OR=0.65, 95%CI:0.56-0.77). Increasing frequency of fish and shellfish consumption, compared with no fish and shellfish consumption, were associated with decreasing odds of preterm birth: for ≤ 1 time/ week, OR = 0.74 (95% CI: 0.63-0.89); for ≥2 times a week, OR = 0.57 (95% CI:0.48-0.68). The P for trend was 0.023. Besides, increasing weekly total amount of fish and shellfish consumption, compared with no fish and shellfish consumption, were also associated with decreasing odds of preterm birth: for <350 g/week, OR = 0.67 (95% CI: 0.57-0.78); for ≥350 g/week, OR = 0.57 (95% CI:0.43-0.74). The P for trend was 0.011. Significant trend effect was also seen between fish and shellfish consumption and very preterm birth (P for trend =0.001) and spontaneous preterm birth (P for trend =0.003). Interaction was observed between total fish and shellfish consumption with maternal age (P for interaction=0.041) and pre-pregnancy BMI underweight (P for interaction=0.012). Maternal fish and shellfish consumption was associated with lower incidence of preterm birth. The findings support for the protective role of fish and shellfish consumption in preventing preterm birth and recommend for the national guideline of ≥350 g/week of fish and shellfish consumption among pregnant women.
High dietary fiber intake has been associated with a lower risk of diabetes, but the association of dietary fiber with prediabetes is only speculative, especially in China, where the supportive data from prospective studies is lacking. This study aimed to examine the association between dietary fiber intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18,085 participants of the TCLSIH cohort study who were free of diabetes, prediabetes, cancer, and cardiovascular disease at baseline. Dietary data were collected using a validated 100-item food frequency questionnaire. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 63,175 person-years of follow-up, 4,139 cases of incident prediabetes occurred. The multivariable HRs (95% CIs) of prediabetes for the highest versus lowest quartiles were 0.85 (0.75, 0.98) (P for trend =0.02) for total dietary fiber, 0.84 (0.74, 0.95) (P for trend <0.01) for soluble fiber, and 1.05 (0.93, 1.19) (P for trend =0.38) for insoluble fiber. Fiber from fruits, but not from cereals, beans, and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fiber, soluble fiber, and fiber derived from fruit sources were associated with a lower risk of prediabetes.
The aim of the present study was to compare the rate of preterm birth (PTB) and growth from birth to 18 years between twins conceived by in vitro fertilization (IVF) and twins conceived by spontaneous conception (SC) in mainland China. The retrospective cohort study included 1164 twins resulting from IVF and 25,654 twins conceived spontaneously, of which 494 from IVF and 6338 from SC were opposite-sex twins. PTB and low birth weight (LBW), and growth, including length/height and weight, were compared between the two groups at five stages: infancy (0 year), toddler period (1–2 years), preschool (3–5 years), primary or elementary school (6–11 years), and adolescence (10–18 years). Few statistically significant differences were found for LBW and growth between the two groups after adjusting for PTB and other confounders. Twins born by IVF faced an increased risk of PTB compared with those born by SC (adjusted odds ratio [aOR] 8.21, 95% confidence interval [CI] [3.19, 21.13], p < .001 in all twins and aOR 10.12, 95% CI [2.32, 44.04], p = .002 in opposite-sex twins). Twins born by IVF experienced a similar growth at five stages (0–18 years old) when compared with those born by SC. PTB risk, however, is significantly higher for twins conceived by IVF than those conceived by SC.
Across Eurasia, horse transport transformed ancient societies. Although evidence for chariotry is well dated, the origins of horse riding are less clear. Techniques to distinguish chariotry from riding in archaeological samples rely on elements not typically recovered from many steppe contexts. Here, the authors examine horse remains of Mongolia's Deer Stone-Khirigsuur (DSK) Complex, comparing them with ancient and modern East Asian horses used for both types of transport. DSK horses demonstrate unique dentition damage that could result from steppe chariotry, but may also indicate riding with a shallow rein angle at a fast gait. A key role for chariots in Late Bronze Age Mongolia helps explain the trajectory of horse use in early East Asia.
Chronic inflammation exerts pleiotropic effects in the etiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40–69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HRs) as well as 95% confidence intervals (95% CIs) for the risk of incident COPD. During a median follow-up of 8.96 years (interquartile range 8.29 to 9.53 years), 9016 new-onset events of COPD were documented. We found that regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0.80 (95% CI, 0.75 to 0.85; P<0.001). When subgroup analyses were performed by smoking status, the adjusted HRs for the association of regular glucosamine use with incident COPD were 0.84 (0.73 to 0.96), 0.84 (0.77 to 0.92), and 0.71 (0.62 to 0.80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (P for interaction=0.078). Incident COPD could be reduced by 14% to 84% through a combination of regular glucosamine use and smoking cessation
A new enantiornithine bird is described on the basis of a well preserved partial skeleton from the Upper Cretaceous Qiupa Formation of Henan Province (central China). It provides new evidence about the osteology of Late Cretaceous enantiornithines, which are mainly known from isolated bones; in contrast, Early Cretaceous forms are often represented by complete skeletons. While the postcranial skeleton shows the usual distinctive characters of enantiornithines, the skull displays several features, including confluence of the antorbital fenestra and the orbit and loss of the postorbital, evolved convergently with modern birds. Although some enantiornithines retained primitive cranial morphologies into the latest Cretaceous Period, at least one lineage evolved cranial modifications that parallel those in modern birds.
The present study aimed to explore the association between dietary patterns in abdominal obesity obtained by reduced-rank regression (RRR) with visceral fat index (VFI) as a dependent variable and dyslipidemia in rural adults in Henan, China. A total of 29538 people aged 18-79 were selected from the Henan Rural Cohort Study. RRR analysis was used to identify dietary patterns; logistic regression analysis and restricted cubic spline regression models were applied to analyze the association between dietary patterns in abdominal obesity and dyslipidemia. VFI was used as a mediator to estimate the mediation effect. The crude prevalence of dyslipidemia in rural Henan was 34.2%. The dietary pattern in abdominal obesity was characterized by high carbohydrate and red meat intake and low consumption of fresh fruits, vegetables, milk, and dairy products. After full adjustment, the highest quartile of dietary pattern scores was significantly associated with an increased risk of dyslipidemia (OR: 1.33, 95% CI: 1.23-1.44, P-trend<0.001), there was a non-linear dose-response relationship between them (Poverall-association<0.001, Pnon-lin-association=0.022). The result was similar in dose-response between the dietary pattern scores and VFI. The indirect effect partially mediated by VFI was significant (OR: 1.07, 95% CI: 1.06-1.08). VIF explained approximately 53.3% of the odds of dyslipidemia related to the dietary pattern. Abdominal obesity dietary pattern scores positively affected VFI and dyslipidemia; there was a dose-response in both relationships. Dyslipidemia progression increased with higher abdominal obesity dietary pattern scores. In addition, VFI played a partial mediating role in relationship between abdominal obesity dietary pattern and dyslipidemia.
The sudden outbreak of COVID-19 pandemic has caused tremendous challenges to the medical system. The government and hospitals have taken robust measures to curb the spread of the deadly virus. Its impact on routine medical services is gradually being taken seriously.
To identify the impact of the novel coronavirus pandemic on emergency department (ED) patient flow and the performance of the routine ED service.
This retrospective cohort study was undertaken in a tertiary public teaching hospital ED in Chengdu, China. ED data of patients were routinely collected to compare demographic, clinical characteristics, and outcomes during an 8-week period from January 1st to February 25th in 2019 and 2020. Data were analyzed with the Chi-square statistical test.
Over the study periods, there were 31,855 and 25,244 patients presented to the ED in 2019 and 2020 respectively. During the pandemic period in 2020, the daily number of average ED visits was lower than that in 2019 (430±134.9v.s. 572±38.6, p=0.00), with fewer triage 1&2 cases (145±33.3 v.s.178±15.0, p=0.00). Nevertheless, the mortality increased remarkably during the pandemic period in 2020 (0.2% vs. 0.1%, p=0.009), with higher APACHE II scores (28 vs.19, p= 0.022) and shorter ED elapsed time (0.2 vs. 1.4 days, p=0.016) among these death cases.
The COVID-19 pandemic had an evident impact on the patient’s behavioral patterns and routine emergency services, which caused higher ED mortality.
Although hypnosis has played a part in psychotherapy for a long time, it is not yet seen as an evidence-based therapy and is absent from many practice guidelines when it comes to the treatment of psychiatric disorders. At present, the applications and methods of hypnotherapy are poorly understood and other methods of psychotherapy tend to be favoured. This review article aims to introduce the role of hypnotherapy and its application for certain common psychiatric presentations, as well as examine its efficacy by summarising recent evidence from high-quality outcome studies and meta-analyses.
To explore the characteristics of the mitochondrial genome (mitogenome) of the squeaking silkmoths Rhodinia, a genus of wild silkmoths in the family Saturniidae of Lepidoptera, and reveal phylogenetic relationships, the mitogenome of Rhodinia fugax Butler was determined. This wild silkmoth spins a green cocoon that has potential significance in sericulture, and exhibits a unique feature that its larvae can squeak loudly when touched. The mitogenome of R. fugax is a circular molecule of 15,334 bp long and comprises 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes, and an A + T-rich region, consistent with previous observations of Saturniidae species. The 370-bp A + T-rich region of R. fugax contains no tandem repeat elements and harbors several features common to the Bombycidea insects, but microsatellite AT repeat sequence preceded by the ATTTA motif is not present. Mitogenome-based phylogenetic analysis shows that R. fugax belongs to Attacini, instead of Saturniini. This study presents the first mitogenome for Rhodinia genus.
Deficits in event-related potential (ERP) including duration mismatch negativity (MMN) and P3a have been demonstrated widely in chronic schizophrenia (SZ) but inconsistent findings were reported in first-episode patients. Psychotropic medications and diagnosis might contribute to different findings on MMN/P3a ERP in first-episode patients. The present study examined MMN and P3a in first episode drug naïve SZ and bipolar disorder (BPD) patients and explored the relationships among ERPs, neurocognition and global functioning.
Twenty SZ, 24 BPD and 49 age and sex-matched healthy controls were enrolled in this study. Data of clinical symptoms [Positive and Negative Symptoms Scale (PANSS), Young Manic Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD)], neurocognition [Wechsler Adult Intelligence Scale (WAIS), Cattell's Culture Fair Intelligence Test (CCFT), Delay Matching to Sample (DMS), Rapid Visual Information Processing (RVP)], and functioning [Functioning Assessment Short Test (FAST)] were collected. P3a and MMN were elicited using a passive auditory oddball paradigm.
Significant MMN and P3a deficits and impaired neurocognition were found in both SZ and BPD patients. In SZ, MMN was significantly correlated with FAST (r = 0.48) and CCFT (r = −0.31). In BPD, MMN was significantly correlated with DMS (r = −0.54). For P3a, RVP and FAST scores were significant predictors in SZ, whereas RVP, WAIS and FAST were significant predictors in BPD.
The present study found deficits in MMN, P3a, neurocognition in drug naïve SZ and BPD patients. These deficits appeared to link with levels of higher-order cognition and functioning.
Accurate assessments of potassium intake in children are important for the early prevention of cardiovascular disease. Currently, there is no simple approach for accurate estimation of potassium intake in children. We aim to evaluate the accuracy of 24-hour urinary potassium excretion (24UKV) estimation in children using three common equations: the Kawasaki, Tanaka, and Mage formulas, in a hospital-based setting. A total of 151 participants aged 5˜18 years were initially enrolled, and spot urine samples were collected in the whole 24-hour duration to measure the concentrations of potassium and creatinine. We calculated the mean difference, absolute and relative difference, and misclassification rate between measured 24UKV and the predicted ones using Kawasaki, Tanaka, and Mage formulas in 129 participants. The mean measured 24UKV was 1193.3 mg/d in our study. Mean differences between estimated and measured 24UKV were 1215.6, −14.9, and 230.3 mg/d by the Kawasaki, Tanaka, and Mage formulas, respectively. All estimated 24UKV were significantly different from the measured values in all the timepoint (all P<0.05), except for the predicted values from Tanaka formula using morning, afternoon, and evening spot urine. The proportions with relative differences over 40% were 87.2%, 32.5%, and 47.3% for Kawasaki, Tanaka, and Mage formulas, respectively. Misclassification rates were 91.5% for Kawasaki, 44.4% for Tanaka, and 58.9% for Mage formula at the individual level.
Our findings showed that misclassification could occur on the individual level when using Kawasaki, Tanaka, and Mage formulas to estimate 24UKV from spot urine in the child population.
Little is known about the impact of modifiable risk factors on blood pressure (BP) trajectories and their associations with hypertension (HTN). We aimed to identify BP trajectories in normotensive Chinese adults and explore their influencing factors and associations with HTN. We used data from 3,436 adults with at least four BP measurements between 1989 and 2018 in the China Health and Nutrition Survey, an ongoing cohort study. We measured BP using mercury sphygmomanometers with appropriate cuff sizes in all surveys. We used group-based trajectory modeling to identify BP trajectories between 1989 and 2009 and multiple logistic and Cox regression models to analyze their influencing factors and associations with HTN in 2011-2018. We identified five systolic blood pressure (SBP) trajectories, ‘Low-increasing(LI)’, ‘Low–stable(LS)’, ‘Moderate-increasing(MI)’, ‘High-stable(HS)’, and ‘Moderate-decreasing(MD)’; and four diastolic blood pressure (DBP) trajectories classified as ‘Low-increasing(LI)’, ‘Moderate–stable(MS)’, ‘Low-stable(LS)’ and ‘High-increasing(HI)’. People with higher physical activity (PA) levels and lower waist circumferences (WCs) were less likely to be in the SBP LI, MI, HS, and MD groups (P < 0.05). People with higher fruit and vegetable intakes, lower WCs and salt intakes, and higher PA levels were less likely to be in the DBP LI, MS, and HI groups (P < 0.05). Participants in the SBP HS group (hazard ratio [HR] 2.01) or the DBP LI, MS, and HI groups (HRs 1.38, 1.40, 1.71, respectively) had higher risks of HTN (P < 0.05). This study suggests that BP monitoring is necessary to prevent HTN in the Chinese population.
Electron microscopy has enabled atomic resolution imaging of matter. However, unlike optical spectroscopic imaging, traditional electron microscopes provide limited spectroscopic information in terms of their energy resolution. Only recently, owing to advances in monochromated STEM-EELS, have transmission electron microscopes (TEMs) been able to attain a high energy resolution. We recently proposed combining spectrally selective photoexcitation with HRTEM to achieve sub-nanometer scale optical imaging, a technique we called photoabsorption microscopy using electron analysis (PAMELA). To realize PAMELA-TEM experimentally, we constructed a TEM holder with an optical feedthrough, capable of photoexciting materials with different wavelengths. In this article, we describe our process for designing and fabricating an optical TEM specimen holder, highlighting important aspects of the design.
Pneumatic launch systems for Unmanned Aerial Vehicles (UAVs), including mechanical and pneumatic systems, are complex and non-linear. They are subjected to system parameters during launch, which leads to difficulty in engineering research analysis. For example, the mismatch between the UAV parameters and the parameter design indices of the launch system as well as the unclear design indices of the launching speed and overload of UAVs have a great impact on launch safety. Considering this situation, some studies are presented in this paper. Taking the pneumatic launch system as a research object, a pneumatic launcher dynamic simulation model is built based on co-simulation considering the coupling characteristics of the mechanical structure and transmission system. Its accuracy was verified by laboratory test results. Based on this model, the paper shows the effects of the key parameters, including the mass of the UAV, cylinder volume, pressure and moment of inertia of the pulley block, on the performance of the dynamic characteristics of the launch process. Then, a method for matching the parameter characteristics between the UAV and launch system based on batch simulation is proposed. The set of matching parameter values of the UAV and launch system that satisfy the launch take-off safety criteria are calculated. Finally, the influence of the system parameters of the launch process on the launch performance was analysed in detail, and the design optimised. Meaningful conclusions were obtained. The analysis method and its results can provide a reference for engineering and theoretical research and development of pneumatic launch systems.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.
Acceptance and willingness to pay for the COVID-19 vaccine are unknown.
We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it.
Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale.
Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls.
To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.