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We sought to assess the degree to which environmental risk factors affect CHD prevalence using a case–control study.
Methods:
A hospital-based study was conducted by collecting data from outpatients between January 2016 and January 2021, which included 31 CHD cases and 72 controls from eastern China. Risk ratios were estimated using univariate and multivariate logistic regression models and mediating effect analysis.
Results:
Residential characteristics (usage of cement flooring, odds ratio = 17.04[1.954–148.574], P = 0.01; musty smell, odds ratio = 3.105[1.198–8.051], P = 0.02) and indoor total volatile organic compound levels of participants’ room (odds ratio = 31.846[8.187–123.872, P < 0.001), benzene level (odds ratio = 7.370[2.289–23.726], P = 0.001) increased the risk of CHDs in offspring. And folic acid plays a masking effect, which mitigates the affection of the total volatile organic compound (indirect effect = -0.072[−0.138,-0.033]) and formaldehyde (indirect effect = −0.109[-0.381,-0.006]) levels on the incidence of CHDs. While food intake including milk (odds ratio = 0.396[0.16–0.977], P = 0.044), sea fish (odds ratio = 0.273[0.086–0.867], P = 0.028), and wheat (odds ratio = 0.390[0.154–0.990], P = 0.048) were all protective factors for the occurrence of CHDs. Factors including women reproductive history (history of conception control, odds ratio = 2.648[1.062–6.603], P = 0.037; history of threatened abortion, odds ratio = 2.632[1.005–6.894], P = 0.049; history of dysmenorrhoea (odds ratio = 2.720[1.075–6.878], P = 0.035); sleep status (napping habit during daytime, odds ratio = 0.856[0.355–2.063], P = 0.047; poor sleep quality, odds ratio = 3.180[1.037–9.754], P = 0.043); and work status (working time > 40h weekly, odds ratio = 2.882[1.172–7.086], P = 0.021) also influenced the CHDs incidence to differing degrees.
Conclusion:
Diet habits, nutrients intake, psychological status of pregnant women, and residential air quality were associated with fetal CHDs. Indoor total volatile organic compound content was significantly correlated with CHDs risk, and folic acid may serve as a masking factor that reduce the harmful effects of air pollutants.
Poor diet is a major contributing factor to the increasing prevalence of non-communicable diseases. There is a need for effective nutrition care in primary care that manages the bulk of such diseases. This study aimed to describe the self-perceived nutrition competence of primary care physicians (PCPs) in Singapore and to evaluate the associated factors.
Methods:
A cross-sectional study utilizing an anonymous online survey platform was conducted among PCPs from a public primary care institution in Singapore. We collected data on PCPs’ sociodemographic information, previous nutrition education and personal dietary habits, and measured self-perceived nutrition competence using the NUTrition COMPetence (NUTCOMP) questionnaire. Multivariable linear regression was conducted to examine the association between PCPs’ characteristics with their self-perceived nutrition competence.
Results:
Totally, 153 PCPs (45.9%) completed the survey in full. Among the four NUTCOMP constructs, ‘nutrition knowledge’ (2.8 ± 0.6) and ‘nutrition skills’ (2.9 ± 0.6) had the lowest mean scores followed by ‘nutrition communication and counselling’ (3.1 ± 0.6) and ‘attitudes towards providing nutrition care’ (4.3 ± 0.5). PCPs with formal nutrition training had significantly higher NUTCOMP scores compared with those without (β = 10.76, 95%CI:4.57–16.94), and those with 5 to 9 years and more than 10 years of work experience had significantly higher scores than those with less than 5 years (β = 7.62, 95%CI:0.44–14.81, and β = 9.44, 95%CI:2.85–16.04, respectively).
Conclusion:
PCPs had lowest self-perceived confidence in nutrition knowledge and skills. Previous formal nutrition education and a longer primary care work experience were associated with better self-perceived nutrition competence. Future research to better integrate nutrition competencies into formal education programmes may be useful to improve PCPs’ self-perceived nutrition competence.
When a word is being translated, its immediately adjacent lexical items may impact the translation of the target word. However, the impact of adjacent lexical items on the oral translation of a target word situated in central vision remains unexplored. This behavioral study used a bilingual version of the flanker paradigm to examine the impact of within- and cross-language semantic effects on oral word translation. Unbalanced bilinguals were presented with a central target word that was flanked by two flanking words on either side. The target-flanker relations were manipulated as a function of semantic relatedness (identical, related and unrelated) and language congruency (congruent and incongruent). The task was to orally translate the target word from L1 to L2 (forward translation) in one session and from L2 to L1 (backward translation) in the other while ignoring the flanker words. Results showed faster responses for forward compared to backward translation. Moreover, in within-language (congruent) but not in cross-language (incongruent) contexts, semantic priming effects were observed in both directions of translation, with the effects being larger for backward than forward translation. Additionally, substantial cross-language semantic repetition priming effects were obtained. The findings are discussed within the framework of a two-process account for oral word translation.
Although dietary factors have been examined as potential risk factors for liver cancer, the evidence is still inconclusive. Using a diet-wide association analysis, our research evaluated the associations of 126 foods and nutrients on the risk of liver cancer in a Chinese population. We obtained the diet consumption of 72,680 women in the Shanghai Women’s Health Study using baseline dietary questionnaires. The association between each food and nutrient and liver cancer risk was quantified by Cox regression model. A false discovery rate of 0.05 was used to determine the foods and nutrients which need to be verified. Totally 256 incident liver cancer cases were identified in 1,267,391 person-years during the follow-up duration. At the statistical significance level (P ≤ 0.05), higher intakes of cooked wheaten foods, pear, grape and copper were inversely associated with liver cancer risk, while spinach, leafy vegetables, eggplant and carrots showed the positive associations. After considering multiple comparisons, no dietary variable was associated with liver cancer risk. Similar findings were seen in the stratification, secondary and sensitivity analyses. Our findings observed no significant association between dietary factors and liver cancer risk after considering multiple comparisons in Chinese women. More evidence is needed to explore the associations between diet and female liver cancer occurrence.
Emerging evidence has shown a strong correlation between serum triacylglycerol (TAG) levels, the inflammatory response, and Parkinson’s disease (PD) onset. However, the causal relationship between TAG levels and PD has not been well-established. We aimed to investigate the relationship between serum TAG levels and risk of PD and explore the potential mediating role of circulating immune cells and inflammatory proteins. We utilised genotype data from the GeneRISK cohort, and summary data from genome wide association studies investigating PD, circulating immune cells, inflammatory proteins, and plasma lipidomes. Using Mendelian randomization (MR) and multivariate MR (MVMR) analysis, we further adjusted for phosphatidylcholine (17:0_18:1) and triacylglycerol (58:7). Our results suggested a robust causal link between higher serum TAG (51:4) levels and a decreased risk of PD, with one standard deviation genetically instrumented higher serum TAG (51:4) level leading to a 21 percent [95% CI, 0.66 – 0.96] reduction in the risk of PD (p = 0.015). Additionally, the results of the mediation analysis suggested a possible role for mediation through circulating immune cells (including IgD-CD38-B cells and resting CD4 regulatory T cells), but not circulating inflammatory proteins, in the causal relationship between the plasma lipidomes and PD. Our study confirms a causal relationship between higher serum TAG (51:4) levels and a lower risk of PD and clarifies a possible role for mediation through circulating immune cells, but not inflammatory proteins. These findings indicate that serum triacylglycerol (51:4) regulates immunity to effectively lower the risk of PD.
The associations between obesity and liver diseases are complex and diverse. To explore the causal relationships between obesity and liver diseases, we applied two-sample Mendelian randomisation (MR) and multivariable MR analysis. The data of exposures (BMI and WHRadjBMI) and outcomes (liver diseases and liver function biomarker) were obtained from the open genome-wide association study database. A two-sample MR study revealed that the genetically predicted BMI and WHRadjBMI were associated with non-alcoholic fatty liver disease, liver fibrosis and autoimmune hepatitis. Obesity was not associated with primary biliary cholangitis, liver failure, liver cell carcinoma, viral hepatitis and secondary malignant neoplasm of liver. A higher WHRadjBMI was associated with higher levels of biomarkers of lipid accumulation and metabolic disorders. These findings indicated independent causal roles of obesity in non-alcoholic fatty liver disease, liver fibrosis and impaired liver metabolic function rather than in viral or autoimmune liver disease.
The comorbidity between schizophrenia (SCZ) and inflammatory bowel disease (IBD) observed in epidemiological studies is partially attributed to genetic overlap, but the magnitude of shared genetic components and the causality relationship between them remains unclear.
Methods
By leveraging large-scale genome-wide association study (GWAS) summary statistics for SCZ, IBD, ulcerative colitis (UC), and Crohn's disease (CD), we conducted a comprehensive genetic pleiotropic analysis to uncover shared loci, genes, or biological processes between SCZ and each of IBD, UC, and CD, independently. Univariable and multivariable Mendelian randomization (MR) analyses were applied to assess the causality across these two disorders.
Results
SCZ genetically correlated with IBD (rg = 0.14, p = 3.65 × 10−9), UC (rg = 0.15, p = 4.88 × 10−8), and CD (rg = 0.12, p = 2.27 × 10−6), all surpassed the Bonferroni correction. Cross-trait meta-analysis identified 64, 52, and 66 significantly independent loci associated with SCZ and IBD, UC, and CD, respectively. Follow-up gene-based analysis found 11 novel pleiotropic genes (KAT5, RABEP1, ELP5, CSNK1G1, etc) in all joint phenotypes. Co-expression and pathway enrichment analysis illustrated those novel genes were mainly involved in core immune-related signal transduction and cerebral disorder-related pathways. In univariable MR, genetic predisposition to SCZ was associated with an increased risk of IBD (OR 1.11, 95% CI 1.07–1.15, p = 1.85 × 10−6). Multivariable MR indicated a causal effect of genetic liability to SCZ on IBD risk independent of Actinobacteria (OR 1.11, 95% CI 1.06–1.16, p = 1.34 × 10−6) or BMI (OR 1.11, 95% CI 1.04–1.18, p = 1.84 × 10−3).
Conclusions
We confirmed a shared genetic basis, pleiotropic loci/genes, and causal relationship between SCZ and IBD, providing novel insights into the biological mechanism and therapeutic targets underlying these two disorders.
The prevalence of non-suicidal self-injury (NSSI) among adolescents underscores the importance of understanding the complex factors that drive this behaviour. Framed within broader constructs of emotional regulation theories, alexithymia and peer victimisation are thought to interact to influence NSSI behaviours.
Aim
This research addresses whether alexithymia and peer victimisation serve as risk factors for NSSI and, if so, how these factors interact with each other.
Method
This quantitative study analysed data from 605 adolescents, using a range of validated self-report measures including the Toronto Alexithymia Scale. Statistical analyses including one-way analysis of variance, multiple regression and structural equation modelling were employed to scrutinise the relationships among the variables.
Results
Alexithymia and peer victimisation significantly predicted NSSI behaviours. Specifically, the ‘difficulty in identifying feelings’ subscale of alexithymia emerged as a noteworthy predictor of NSSI (P < 0.001). Peer victimisation mediated the relationship between alexithymia and NSSI, explaining approximately 24.50% of alexithymia's total effect on NSSI. In addition, age was a significant predictor of NSSI, but gender and education years were not (P > 0.05). These relationships were found to be invariant across genders.
Conclusions
This study enriches our understanding of the interplay between alexithymia, peer victimisation and NSSI, particularly within the Chinese context. Its findings have significant implications for a rethinking of alexithymia's theoretical construct and interventions targeting emotional literacy and peer dynamics among adolescents. Future research could benefit from a longitudinal design to establish causality.
Few studies have evaluated the joint effect of trace elements on spontaneous preterm birth (SPTB). This study aimed to examine the relationships between the individual or mixed maternal serum concentrations of Fe, Cu, Zn, Se, Sr and Mo during pregnancy, and risk of SPTB. Inductively coupled plasma MS was employed to determine maternal serum concentrations of the six trace elements in 192 cases with SPTB and 282 controls with full-term delivery. Multivariate logistic regression, weighted quantile sum regression (WQSR) and Bayesian kernel machine regression (BKMR) were used to evaluate the individual and joint effects of trace elements on SPTB. The median concentrations of Sr and Mo were significantly higher in controls than in SPTB group (P < 0·05). In multivariate logistic regression analysis, compared with the lowest quartile levels of individual trace elements, the third- and fourth-quartile Sr or Mo concentrations were significantly associated with reduced risk of SPTB with adjusted OR (aOR) of 0·432 (95 CI < 0·05). In multivariate logistic regression analysis, compared with the lowest quartile levels of individual trace elements, the third- and fourth-quartile Sr or Mo concentrations were significantly associated with reduced risk of SPTB with adjusted aOR of 0·432 (95 % CI 0·247, 0·756), 0·386 (95 % CI 0·213, 0·701), 0·512 (95 % CI 0·297, 0·883) and 0·559 (95 % CI 0·321, 0·972), respectively. WQSR revealed the inverse combined effect of the trace elements mixture on SPTB (aOR = 0·368, 95 % CI 0·228, 0·593). BKMR analysis confirmed the overall mixture of the trace elements was inversely associated with the risk of SPTB, and the independent effect of Sr and Mo was significant. Our findings suggest that the risk of SPTB decreased with concentrations of the six trace elements, with Sr and Mo being the major contributors.
All-fiber coherent beam combiners based on the self-imaging effect can achieve a near-perfect single laser beam, which can provide a promising way to overcome the power limitation of a single-fiber laser. One of the key points is combining efficiency, which is determined by various mismatches during fabrication. A theoretical model has been built, and the mismatch error is analyzed numerically for the first time. The mismatch errors have been numerically studied with the beam quality and combining efficiency being chosen as the evaluation criteria. The tolerance of each mismatch error for causing 1% loss is calculated to guide the design of the beam combiners. The simulation results are consistent with the experimental results, which show that the mismatch error of the square-core fiber is the main cause of the efficiency loss. The results can provide useful guidance for the fabrication of all-fiber coherent beam combiners.
Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma.
Methods
An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study.
Results
The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications.
Conclusion
The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.
Objectives: Central-line–associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that a care bundle is effective in reducing CLABSI rates; however, the data on long-term sustainability and cost savings of bundled care are limited. Methods: From January 2011 to December 2020, a prospective surveillance was performed to monitor CLABSI at a university hospital in northern Taiwan. To reduce the CLABSI rate, a hospital-wide bundled care program for CLABSI prevention was implemented in 2013. We evaluated the long-term effect of the care bundle on CLABSI incidence and length of stay in the ICU. Results: During the study period, the overall CLABSI incidence decreased from 8.22 per 1,000 catheter days before the care bundle was implemented to 6.33 per 1,000 catheter days in 2020 (P for trend <.01). The most common pathogens causing CLABSI were gut organisms (1,420 of 2,363, 60.1%), followed by environmental organisms (734 of 2,363, 31.1%) and skin organisms (177 of 2,363, 7.5%). The decreasing trend was statistically significant in the incidence of CLABSI caused by skin organisms (P for trend < .01), but not in the incidence of CLABSI caused by environmental organisms (P for trend = .86) or gut organisms (P for trend = .06). In the multivariable analysis, implementation of this care bundle was independently associated with a decrease in the CLABSI rate (RR, 0.77; 95% CI, 0.66–0.88). Compared with patients without CLABSI, patients with CLABSI had a longer average ICU length of stay (27 vs 17 days). Conclusions: A sustainable reduction in the incidence of CLABSI caused by common commensals could be achieved through a cost-saving bundled care program.
Circulating n-3 PUFA, which integrate endogenous and exogenous n-3 PUFA, can be better used to investigate the relationship between n-3 PUFA and disease. However, studies examining the associations between circulating n-3 PUFA and colorectal cancer (CRC) risk were limited, and the results remained inconclusive. This case–control study aimed to examine the association between serum n-3 PUFA and CRC risk in Chinese population. A total of 680 CRC cases and 680 sex- and age-matched (5-year interval) controls were included. Fatty acids were assayed by GC. OR and 95 % CI were calculated using multivariable logistic regression after adjustment for potential confounders. Higher level of serum α-linolenic acid (ALA), docosapentaenoic acid (DPA), DHA, long-chain n-3 PUFA and total n-3 PUFA were associated with lower odds of CRC. The adjusted OR and 95 % CI were 0·34 (0·24, 0·49, Pfor trend < 0·001) for ALA, 0·57 (0·40, 0·80, Pfor trend < 0·001) for DPA, 0·48 (0·34, 0·68, Pfor trend < 0·001) for DHA, 0·39 (0·27, 0·56, Pfor trend < 0·001) for long-chain n-3 PUFA and 0·31 (0·22, 0·45, Pfor trend < 0·001) for total n-3 PUFA comparing the highest with the lowest quartile. However, there was no statistically significant association between EPA and odds of CRC. Analysis stratified by sex showed that ALA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of CRC in both sexes. This study indicated that serum ALA, DPA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of having CRC in Chinese population.
Path planning is a key research issue in the field of unmanned aerial vehicle (UAV) applications. In practical applications, multi-objective path planning is usually required for multi-UAVs, so this paper proposes the improved balanced artificial bee colony (IB-ABC) algorithm to optimize multi-objective path planning. The algorithm adopts the ABC algorithm that emphasizes the global search capability, which is based on iterative feedback information. It uses single-element points, multi-element points, and iteration constraints to optimize the strategies of employed bees, follower bees, and scout bees, respectively. In terms of time and priority, simulation experiments prove that the IB-ABC algorithm can balance local and global search capabilities, accelerate the speed of convergence, and realize multi-UAV path planning in complex mountain environments.
Excavation at Mogou, a Bronze Age cemetery containing over 1700 burials and 6000 individuals, has revealed a diverse range of multiple burials. Building on this dataset, the Mogou Multidisciplinary Investigation Project aims to explore connections between kinship, burial space and social organisation in Bronze Age north-west China.
With the rapid development of the national economy, the demand for electricity is also growing. Thermal power generation accounts for the highest proportion of power generation, and coal is the most commonly used combustion material. The massive combustion of coal has led to serious environmental pollution. It is significant to improve energy conversion efficiency and reduce pollutant emissions effectively. In this paper, an extreme learning machine model based on improved Kalman particle swarm optimization (ELM-IKPSO) is proposed to establish the boiler combustion model. The proposed modeling method is applied to the combustion modeling process of a 300 MWe pulverized coal boiler. The simulation results show that compared with the same type of modeling method, ELM-IKPSO can better predict the boiler thermal efficiency and NOx emission concentration and also show better generalization performance. Finally, multi-objective optimization is carried out on the established model, and a set of mutually non-dominated boiler combustion solutions is obtained.
Late Palaeozoic igneous rock associations in response to subduction, accretion, and final closure of the eastern Palaeo-Asian Ocean play a significant role in understanding the geodynamic evolution of the southeastern Central Asian Orogenic Belt. Previous studies have identified a Permian arc magmatic belt associated with the southward-dipping subduction of the eastern Palaeo-Asian Ocean along the Solonker–Changchun suture zone. The genetic mechanism and associated geodynamic settings are of great importance in deciphering the evolution of the eastern Palaeo-Asian Ocean. This paper presents zircon U–Pb–Hf isotope and whole-rock geochemical analyses for a suite of magmatic rocks including the early Permian diorite porphyrites (ca. 281.0 Ma), andesites (ca. 276 Ma) and rhyolites (ca. 275 Ma) in the Kulun region. The diorite porphyrites and andesites have high SiO2 and total alkali contents, and low MgO contents and Mg no. values, with enrichments in large ion lithophile elements and depletions in high-field-strength elements. These geochemical characteristics, together with low-Sr and high-Yb contents, a weak concave-upward shape of middle rare earth elements and negative Eu anomalies, suggest that these intermediate igneous rocks were generated by partial melting of amphibolitic lower crust at a crustal depth of 30–40 km. The rhyolites have heterogeneous isotopic compositions, with ϵHf(t) values and TDM2 ages of –20.8 to +0.5 and 3578∼1494 Ma, implying that they were likely derived from partial melting of a mixed source dominated by recycled ancient crust with minor juvenile crustal materials. The rhyolites show potassic affinity with relatively high K2O and very low Na2O, which was attributed to liquid immiscibility of felsic magma and subsequent limited fractional crystallization of plagioclase. The regional igneous associations, metamorphic events, and coeval sedimentary rocks along the Solonker–Changchun suture zone indicate that the early Permian igneous rocks were formed in an active continental arc environment in response to southward subduction of the eastern Palaeo-Asian Ocean.
This study aimed to investigate the organization, workload, and psychological impact of COVID-19 on healthcare workers from the domestic Medical Aid Teams (MATs) sent to Wuhan in China.
Methods:
Leaders and members of MATs involved in the care for COVID-19 patients were invited to participate in a study by completing 2 separate self-report questionnaires from April 1 to 24, 2020.
Results:
A total of 9 MAT leaders were involved and 464 valid questionnaires were collected from 140 doctors and 324 nurses. Mean age of the doctors and nurses were 39.34 ± 6.70 (26∼58 years old) and 31.88 ± 5.29 (21∼52 years old), with 72 (15.5%) being males. Nurses were identified as an independent risk factor (HR 1.898; P = 0.001) for a day working time in the multivariate analysis. The proportions of psychological consulting received among nurses were higher than those among doctors (49.7 vs 30.0%, P < 0.001). More than 50% of the anesthetists and emergency doctors who have received psychological consulting thought that it was effective according to self-evaluation.
Conclusions:
This study focused on healthcare workers’ situation during the early period of the pandemic. Nurses worked longer than doctors. The effectiveness of psychological consulting depends on the physicians’ specialties and the working conditions of the nurses and psychological consulting targeting different specialties need to be improved.
Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD.
Methods
A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT.
Results
ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group.
Conclusions
ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.