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Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.
This study aimed to introduce a pilot program for hospital-based health technology assessment (HB-HTA) in China and present the participants’ experiences based on seven case studies from seven tertiary hospitals.
Methods
One-year pilot projects were initiated at the beginning of 2018. Seven pilot hospitals were closely followed from the beginning until the completion of their pilot HTA project. Regular interviews were conducted with the hospital managers leading the HB-HTA projects and key members of the special HTA teams. Observations were made based on field trips and written HTA reports.
Results
Three pilot projects evaluated the use of medical consumables, three evaluated the use of surgical or medical interventions, and one evaluated an innovative management model for ventilators. Real-world data were collected from all the pilot projects to assist with the assessments. Most HB-HTA pilot projects achieved remarkable results such as improvements in economic efficiency; however, there were also obvious deficiencies such as the lack of a necessary cost-effectiveness analysis.
Conclusions
The results varied among the seven HB-HTA pilot projects. The HB-HTA pilot program was implemented to promote the use of HB-HTA in hospital decision making in China. At the same time, HB-HTA in China faces challenges. We have made some policy recommendations based on the findings of the pilot projects.
Xiaonanshan is an archaeological site dated to 16.5–13.5 cal kyr BP, situated beside the Ussuri River in China. The lithic assemblages feature microblade debitage, bifacial points and stone adzes, which provide important new materials for this project to explore Neolithisation in the Amur River basin of northeast Asia.
No relevant studies have yet been conducted to explore which measurement can best predict the survival time of patients with cancer cachexia. This study aimed to identify an anthropometric measurement that could predict the 1-year survival of patients with cancer cachexia. We conducted a nested case–control study using data from a multicentre clinical investigation of cancer from 2013 to 2020. Cachexia was defined using the Fearon criteria. A total of 262 patients who survived less than 1 year and 262 patients who survived more than 1 year were included in this study. Six candidate variables were selected based on clinical experience and previous studies. Five variables, BMI, mid-arm circumference, mid-arm muscle circumference, calf circumference and triceps skin fold (TSF), were selected for inclusion in the multivariable model. In the conditional logistic regression analysis, TSF (P = 0·014) was identified as a significant independent protective factor. A similar result was observed in all patients with cancer cachexia (n 3084). In addition, a significantly stronger positive association between TSF and the 1-year survival of patients with cancer cachexia was observed in participants aged > 65 years (OR: 0·94; 95 % CI 0·89, 0·99) than in those aged ≤ 65 years (OR: 0·96; 95 % CI 0·93, 0·99; Pinteraction = 0·013) and in participants with no chronic disease (OR: 0·92; 95 % CI 0·87, 0·97) than in those with chronic disease (OR: 0·97; 95 % CI 0·94, 1·00; Pinteraction = 0·049). According to this study, TSF might be a good anthropometric measurement for predicting 1-year survival in patients with cancer cachexia.
Patients with schizophrenia and individuals with schizotypy, a subclinical group at risk for schizophrenia, have been found to have impairments in cognitive control. The Dual Mechanisms of Cognitive Control (DMC) framework hypothesises that cognitive control can be divided into proactive and reactive control. However, it is unclear whether individuals with schizotypy have differential behavioural impairments and neural correlates underlying these two types of cognitive control.
Method:
Twenty-five individuals with schizotypy and 26 matched healthy controls (HCs) completed both reactive and proactive control tasks with electroencephalographic data recorded. The proportion of congruent and incongruent trials was manipulated in a classic colour-word Stroop task to induce proactive or reactive control. Proactive control was induced in a context with mostly incongruent (MI) trials and reactive control in a context with mostly congruent (MC) trials. Two event-related potential (ERP) components, medial frontal negativity (MFN, associated with conflict detection) and conflict sustained potential (conflict SP, associated with conflict resolution) were examined.
Results:
There was no significant difference between the two groups in terms of behavioural results. In terms of ERP results, in the MC context, HC exhibited significantly larger MFN (360–530 ms) and conflict SP (600–1000 ms) amplitudes than individuals with schizotypy. The two groups did not show any significant difference in MFN or conflict SP in the MI context.
Conclusions:
The present findings provide initial evidence for dissociation of neural activation between proactive and reactive cognitive control in individuals with schizotypy. These findings help us understand cognitive control deficits in the schizophrenia spectrum.
This study aimed at comparing the factors associated with the natural progression between typical progressors (TPs) and rapid progressors (RPs) in HIV-infected individuals. A retrospective study was conducted on 2095 eligible HIV-infected individuals from 1995 to 2016 in a high-risk area of Henan Province, China. Propensity score matching was used to balance covariates, and the conditional logistic regression analyses were performed to explore the factors of natural disease progression among HIV infectors. A total of 379 pairs of RPs and TPs were matched. The standardised difference values of all covariates were less than 10%. HIV-infected individuals transmitted through sexual transmission (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.36–0.85) were more likely to progress to AIDS compared with those infected through contaminated blood. Older age at diagnosis of HIV-infected individuals (OR 0.72, 95% CI 0.58–0.89) exhibited a faster progression to AIDS. HIV-infected individuals identified through a unique survey (OR 7.01, 95% CI 2.99–16.44) were less likely to progress to AIDS compared with those identified through medical institutions. HIV-infected individuals who had higher baseline CD4+T cell counts (OR 3.37, 95% CI 2.59–4.38) had a slower progression to AIDS. These findings provide evidence for natural disease progression from HIV to AIDS between TPs and RPs.
North-east China occupies an important geographic position for understanding the process of Neolithisation in East Asia. Although archaeologists have long debated the trajectory of change in this region, a lack of intensive survey and excavation has precluded convincing interpretations. This article presents research on the newly excavated sites of Huayang and Taoshan in the southern Lesser Khingan Mountains, with a particular focus on the lithic assemblages. Comparative and environmental analyses demonstrate the largely uniform trajectory of lithic technologies across north-east China and close correspondence with Late Glacial palaeoclimatic and palaeoenvironmental changes.
The lichen family Ophioparmaceae contains three genera: Boreoplaca, Hypocenomyce and Ophioparma. The genus Hypocenomyce is reported here for the first time for China, being represented by the species Hypocenomyce scalaris which is distributed in south-western China. For the genus Ophioparma, one new species is described in this paper, namely Ophioparma pruinosa Li S. Wang & Y. Y. Zhang sp. nov., which is characterized by a pruinose thallus and the presence of usnic acid. Ophioparma araucariae is also reported as new for the Chinese lichen biota. Previous reports of O. lapponica in China are recognized as misidentifications of O. ventosa. Descriptions, keys and phylograms are provided for these species.
Previous studies have demonstrated adverse mental health effects of Pb exposure. The purpose of this study is to investigate the relationship between consumption of preserved egg (PE), a high-Pb-containing food and depressive symptoms among adults in China. A sample of 25 213 adults (mean age 41·4 (sd 11·8) years; males, 53·9 %) in Tianjin, China, was studied in a cross-sectional analysis. Dietary intake including PE was assessed using a valid self-administered FFQ. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). The association was estimated by OR using logistic regression models adjusted for multiple confounders. The prevalence of elevated depressive symptoms was 6·6 % (SDS≥50). Compared with the least frequent PE consumption (<once/week), multivariable adjusted OR for elevated depressive symptoms were 1·52 (95 % CI 1·28, 1·81), 2·24 (95 % CI 1·76, 2·81) and 3·31 (95 % CI 2·52, 4·30) for consumption of once, 2–3 times and ≥4 times/week, respectively (Pfor trend<0·0001), indicating a clear dose–response relationship. The results suggested that higher consumption of PE was strongly associated with depressive symptoms among adults in China. These findings underscore the need to consider dietary Pb exposure as a risk factor for psychological distress.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
Methods:
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
Results:
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
Conclusion:
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
Previous studies have supported the theory that there is a positive association between ferritin and carotid atherosclerosis in Western people. Diet plays an important role in determining serum ferritin concentration. Asian dietary patterns are different from Western dietary patterns, implying that there may be a difference in the association of ferritin with carotid atherosclerosis between Asian and Western people. However, few studies focus on the association between ferritin and carotid atherosclerosis among Asians. The aim of this study was to investigate how serum ferritin levels are associated with carotid atherosclerosis in an Asian adult population. A cross-sectional assessment was performed in 8302 adults in Tianjin, China. Carotid intima-media thickness (IMT) and plaques were assessed using ultrasonography, and serum ferritin was measured using the protein chip-chemiluminescence method. Multiple logistic regression analysis was used to examine the association between quartiles of serum ferritin concentration and carotid atherosclerosis. In the present study, the overall prevalence of IMT and carotid plaques in participants is 29·2 and 22·7 %, respectively. In women, after adjustments for potentially confounding factors, the OR of IMT and carotid plaques by increasing serum ferritin quartiles were 1·00, 1·39 (95 % CI 0·98–1·99), 1·39 (95 % CI 0·99–1·97), 1·81 (95 % CI 1·30–2·55) (Pfor trend<0·001) and 1·00, 1·24 (95 % CI 0·89–1·73), 1·18 (95 % CI 0·85–1·65), 1·59 (95 % CI 1·15–2·20) (Pfor trend<0·01), respectively. However, no association was found between serum ferritin and carotid atherosclerosis in men. The study demonstrated that increased serum ferritin levels are independently associated with IMT and carotid plaques in Asian women but not in Asian men.
A “RE-free” and I-phase-containing Mg–8Sn-based alloy system was developed and successfully fabricated through the equal channel angular pressing (ECAP) process. The influence of the Zn/Al mass ratio on the microstructures and mechanical properties of the as-ECAPed Mg–8Sn–(5,6,7)Zn–2(wt%)Al alloys was investigated using an optical microscope, an X-ray diffractometer, a scanning electron microscope, a transmission electron microscope, and a universal testing machine. Grain size, dynamic recrystallization behavior, and texture were found to be greatly affected by the Zn/Al mass ratio. Furthermore, the ultimate tensile strength (250 MPa) and elongation (14.5%) of the alloy with a Zn/Al mass ratio of 3 were considerably increased compared to those of the as-ECAPed alloys with Zn/Al ratios of 2.5 and 3.5 (ultimate tensile strength and elongation of 215 MPa and 13% and 184 MPa and 10%, respectively). This significant enhancement was attributed to extensive grain boundary strengthening, precipitation strengthening, and higher work hardening capacity as well as texture randomization. The strength and ductility of the as-ECAPed alloys are also discussed in terms of the I-phase and Mg2Sn formation.
The morphology, chemistry and phylogenetic relationships of Chinese populations
of Bulbothrix are described. Nine species, including two new
species B. mammillaria Y. Y. Zhang & Li S. Wang sp.
nov. and B. lacinia Y. Y. Zhang & Li S. Wang sp.
nov., and two newly recorded for the flora, B. scortella and
B. meizospora, are reported. Bulbothrix
mammillaria can be recognized by the sparse cilia that are reduced to a
bulbate structure and the broad lobes (3–11 mm). Bulbothrix
lacinia differs from other species of the genus by dark brown,
spherical to short-cylindrical isidia and common lacinulae on the upper surface.
Phylogenetic relationships of currently known ITS sequences from
Bulbothrix were inferred to assess the affinities of the
new species. A key to all known species from China is presented.
Using the incompressible isotropic turbulent fields obtained from direct numerical simulation and large-eddy simulation, we studied the statistics of oscillation structures based on local zero-crossings and their relation with inertial-range intermittency for transverse velocity and passive scalar. Our results show that for both the velocity and passive scalar, the local oscillation structures are statistically scale-invariant at high Reynolds number, and the inertial-range intermittency of the overall flow region is determined by the most intermittent structures characterized by one local zero-crossing. Local flow patterns conditioned on the oscillation structures are characterized by the joint probability density function of the invariants of the filtered velocity gradient tensor at inertial range. We demonstrate that the most intermittent regions for longitudinal velocity tend to lay at the saddle area, while those for the transverse velocity tend to locate at the vortex-dominated area. The connection between the ramp-cliff structures in passive scalar field and the corresponding saddle regions in the velocity field is also verified by the approach of oscillation structure classification.
In the traditional hybrid RANS/LES approaches for the simulation of wall-bounded fluid turbulence, such as detached-eddy simulation (DES), the whole flow domain is divided into an inner layer and an outer layer. Typically the Reynolds-averaged Navier–Stokes (RANS) equations are used for the inner layer, while large-eddy simulation (LES) is used for the outer layer. The transition from the inner-layer solution to the outer-layer solution is often problematic due to the lack of small-scale dynamics in the RANS region. In this paper, we propose to simulate the whole flow domain by large-eddy simulation while enforcing a Reynolds-stress constraint on the subgrid-scale (SGS) stress model in the inner layer. Both the algebraic eddy-viscosity model and the one-equation Spalart–Allmaras (SA) model have been used to constrain the Reynolds stress in the inner layer. In this way, we improve the LES methodology by allowing the mean flow of the inner layer to satisfy the RANS solution while small-scale dynamics is included. We validate the Reynolds-stress-constrained large-eddy simulation (RSC-LES) model by simulating three-dimensional turbulent channel flow and flow past a circular cylinder. Our model is able to predict mean velocity, turbulent stress and skin-friction coefficients more accurately in turbulent channel flow and to estimate the pressure coefficient after separation more precisely in flow past a circular cylinder compared with the pure dynamic Smagorinsky model (DSM) and DES using the same grid resolution. Furthermore, the computational cost of the RSC-LES is almost the same as that of DES.
In Western countries, a history of major depression (MD) is associated with reports of received parenting that is low in warmth and caring and high in control and authoritarianism. Does a similar pattern exist in women in China?
Method
Received parenting was assessed by a shortened version of the Parental Bonding Instrument (PBI) in two groups of Han Chinese women: 1970 clinically ascertained cases with recurrent MD and 2597 matched controls. MD was assessed at personal interview.
Results
Factor analysis of the PBI revealed three factors for both mothers and fathers: warmth, protectiveness, and authoritarianism. Lower warmth and protectiveness and higher authoritarianism from both mother and father were significantly associated with risk for recurrent MD. Parental warmth was positively correlated with parental protectiveness and negatively correlated with parental authoritarianism. When examined together, paternal warmth was more strongly associated with lowered risk for MD than maternal warmth. Furthermore, paternal protectiveness was negatively and maternal protectiveness positively associated with risk for MD.
Conclusions
Although the structure of received parenting is very similar in China and Western countries, the association with MD is not. High parental protectiveness is generally pathogenic in Western countries but protective in China, especially when received from the father. Our results suggest that cultural factors impact on patterns of parenting and their association with MD.
The distribution of genetic diversity between Oryza sativa L. ssp. indica and O. sativa L. ssp. japonica covering different ecological zones in Yunnan was studied, and specific markers of indica/japonica subspecies, paddy/upland rice and different ecological zones were screened, using 36 microsatellite primers and 113 accessions in the Yunnan landrace rice core collection. The genetic diversity of japonica was higher than that of indica, and the ecological zone with the highest and smallest genetic diversity lay in south-east and north-east Yunnan, respectively. This distribution was consistent at morphological and isozyme levels with studies on the entire Yunnan rice resources and core collection. In addition, the results showed that, among 416 markers, there were six indica/japonica-specific markers, 15 specific markers for paddy/upland rice and three specific markers in different ecological zones. The main conclusions are that the landrace rice core collection in Yunnan genetically represents the entire landrace rice resources in Yunnan, the centre of genetic diversity at DNA level lies in south-east Yunnan, and the DNA differentiation between indica and japonica is small. Furthermore, microsatellite markers were useful for studying the genetic diversity, classification and ecotype of germplasm resources and their core collection.
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