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Depression is highly prevalent in haemodialysis patients, and diet might play an important role. Therefore, we conducted this cross-sectional study to determine the association between dietary fatty acids (FA) consumption and the prevalence of depression in maintenance haemodialysis (MHD) patients. Dietary intake was assessed using a validated FFQ between December 2021 and January 2022. The daily intake of dietary FA was categorised into three groups, and the lowest tertile was used as the reference category. Depression was assessed using the Patient Health Questionnaire-9. Logistic regression and restricted cubic spline (RCS) models were applied to assess the relationship between dietary FA intake and the prevalence of depression. As a result, after adjustment for potential confounders, a higher intake of total FA [odds ratio (OR)T3 vs. T1 = 1·59, 95 % confidence interval (CI) = 1·04, 2·46] and saturated fatty acids (SFA) (ORT3 vs. T1 = 1·83, 95 % CI = 1·19, 2·84) was associated with a higher prevalence of depressive symptoms. Significant positive linear trends were also observed (P < 0·05) except for SFA intake. Similarly, the prevalence of depression in MHD patients increased by 20% (OR = 1.20, 95% CI = 1.01–1.43) for each standard deviation increment in SFA intake. RCS analysis indicated an inverse U-shaped correlation between SFA and depression (Pnonlinear > 0·05). Additionally, the sensitivity analysis produced similar results. Furthermore, no statistically significant association was observed in the subgroup analysis with significant interaction. In conclusion, higher total dietary FA and SFA were positively associated with depressive symptoms among MHD patients. These findings inform future research exploring potential mechanism underlying the association between dietary FA and depressive symptoms in MHD patients.
We present a systematic study on the effects of small aspect ratios $\varGamma$ on heat transport in liquid metal convection with a Prandtl number of $Pr=0.029$. The study covers $1/20\le \varGamma \le 1$ experimentally and $1/50\le \varGamma \le 1$ numerically, and a Rayleigh number $Ra$ range of $4\times 10^3 \le Ra \le 7\times 10^{9}$. It is found experimentally that the local effective heat transport scaling exponent $\gamma$ changes with both $Ra$ and $\varGamma$, attaining a $\varGamma$-dependent maximum value before transition-to-turbulence and approaches $\gamma =0.25$ in the turbulence state as $Ra$ increases. Just above the onset of convection, Shishkina (Phys. Rev. Fluids, vol 6, 2021, 090502) derived a length scale $\ell =H/(1+1.49\varGamma ^{-2})^{1/3}$. Our numerical study shows $Ra_{\ell }$, i.e. $Ra$ based on $\ell$, serves as a proper control parameter for heat transport above the onset with $Nu-1=0.018(1+0.34/\varGamma ^2)(Ra/Ra_{c,\varGamma }-1)$. Here $Ra_{c,\varGamma }$ represents the $\varGamma$-dependent critical $Ra$ for the onset of convection and $Nu$ is the Nusselt number. In the turbulent state, for a general scaling law of $Nu-1\sim Ra^\alpha$, we propose a length scale $\ell = H/(1+1.49\varGamma ^{-2})^{1/[3(1-\alpha )]}$. In the case of turbulent liquid metal convection with $\alpha =1/4$, our measurement shows that the heat transport will become weakly dependent on $\varGamma$ with $Ra_{\ell }\equiv Ra/(1+1.49\varGamma ^{-2})^{4/3} \ge 7\times 10^5$. Finally, once the flow becomes time-dependent, the growth rate of $Nu$ with $Ra$ declines compared with the linear growth rate in the convection state. A hysteresis is observed in a $\varGamma =1/3$ cell when the flow becomes time-dependent. Measurements of the large-scale circulation suggest the hysteresis is caused by the system switching from a single-roll-mode to a double-roll-mode in an oscillation state.
This experiment aimed to investigate the impacts of tributyrin (TB) dietary supplementation on serum biochemical indices and meat quality characteristics of longissimus thoracis et lumborum (LTL) muscle of lambs after weaning. Thirty healthy Small-Tailed Han female lambs (27.5 ± 4.1 kg; mean ± standard deviation) were randomly assigned to five treatments: basal diet (1) without TB, (2) with 0.5 g/kg TB, (3) with 1.0 g/kg TB, (4) with 2.0 g/kg TB or (5) with 4.0 g/kg TB. Each treatment consisted of six lambs, and the lambs were weaned on d 90 and were raised until d 165. Results showed that supplementing TB significantly promoted serum immunoglobulin concentrations of lambs such as immunoglobulins G, A and M. Besides, TB significantly increased muscle ether extract content, intermuscular fat length, pH value and redness but decreased lightness, drip loss and shear force. In addition, TB significantly elevated inosine-5ʹ-phosphate content and upregulated the relative expressions of genes related to lipid metabolism such as SREBP-1C, SCD, PPARγ, FAS and LPL. The mostly important, TB significantly enhanced essential amino acids (EAAs) and conjugated linoleic acids contents of the LTL muscle, despite it decreased total unsaturated fatty acids level. In conclusion, supplementing TB not only could promote the healthy status of weaned lambs via promoting serum immunity but also may improve nutritional quality of LTL muscle by improving EAA and conjugated linoleic acid contents.
The epidemiological and burden characteristics of nutritional deficiencies (ND) have been evolving, and it is crucial to identify geographical disparities and emerging trends. This study aimed to analyse the global, regional and national trends in the burden of ND over the past 30 years. Data were obtained from the Global Burden of Disease (GBD) 2019 database for the period 1990–2019. The study examined the incidence rates and disability-adjusted life years (DALY) of ND at various levels. Globally, the incidence rate of ND decreased from 2226·2 per 100 000 in 2019 to 2096·3 per 100 000 in the same year, indicating a decline of 5·8 %. The average annual percentage change (AAPC) was −0·21 (–0·31, −0·11). Similarly, DALY, prevalence and mortality rates of ND exhibited significant declines (AAPC = −3·21 (–3·45, −2·96), AAPC = −0·53 (–0·55, −0·51) and AAPC = −4·97 (–5·75, −4·19), respectively). The incidence rate of ND varied based on age group, sex, cause and geographical area. Moreover, a negative association was observed between incidence and the sociodemographic index. At the regional level, the South Asia and sub-Saharan Africa regions had the highest incidence rates of ND. In conclusion, the global incidence rate of ND showed a mixed pattern, while the DALY rate consistently declined. Additionally, prevalence and mortality rates of ND decreased between 1990 and 2019.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
Using thermal convection in liquid metal, we show that strong spatial confinement not only delays the onset Rayleigh number $Ra_c$ of Rayleigh–Bénard instability but also postpones the various flow-state transitions. The $Ra_c$ and the transition to fully developed turbulence Rayleigh number $Ra_f$ depend on the aspect ratio $\varGamma$ with $Ra_c\sim \varGamma ^{-4.05}$ and $Ra_f\sim \varGamma ^{-3.01}$, implying that the stabilization effects caused by the strong spatial confinement are weaker on the transition to fully developed turbulence when compared with that on the onset. When the flow state is characterized by the supercritical Rayleigh number $Ra/Ra_{c}$ ($Ra$ is the Rayleigh number), our study shows that the transition to fully developed turbulence in strongly confined geometries is advanced. For example, while the flow becomes fully developed turbulence at $Ra\approx 200Ra_c$ in a $\varGamma =1$ cell, the same transition in a $\varGamma =1/20$ cell only requires $Ra\approx 3Ra_c$. Direct numerical simulation and linear stability analysis show that in the strongly confined regime, multiple vertically stacked roll structures appear just above the onset of convection. With an increase of the driving strength, the flow switches between different-roll states stochastically, resulting in no well-defined large-scale coherent flow. Owing to this new mechanism that only exists in systems with $\varGamma <1$, the flow becomes turbulent in a much earlier stage. These findings shed new light on how turbulence is generated in strongly confined geometries.
We present an experimental study of Rayleigh–Bénard convection using liquid metal alloy gallium-indium-tin as the working fluid with a Prandtl number of $Pr=0.029$. The flow state and the heat transport were measured in a Rayleigh number range of $1.2\times 10^{4} \le Ra \le 1.3\times 10^{7}$. The temperature fluctuation at the cell centre is used as a proxy for the flow state. It is found that, as $Ra$ increases from the lower end of the parameter range, the flow evolves from a convection state to an oscillation state, a chaotic state and finally a turbulent state for $Ra>10^5$. The study suggests that the large-scale circulation in the turbulent state is a residual of the cell structure near the onset of convection, which is in contrast with the case of $Pr\sim 1$, where the cell structure is transiently replaced by high order flow modes before the emergence of the large-scale circulation in the turbulent state. The evolution of the flow state is also reflected by the heat transport characterised by the Nusselt number $Nu$ and the probability density function (p.d.f.) of the temperature fluctuation at the cell centre. It is found that the effective local heat transport scaling exponent $\gamma$, i.e. $Nu\sim Ra^{\gamma }$, changes continuously from $\gamma =0.49$ at $Ra\sim 10^4$ to $\gamma =0.25$ for $Ra>10^6$. Meanwhile, the p.d.f. at the cell centre gradually evolves from a Gaussian-like shape before the transition to turbulence to an exponential-like shape in the turbulent state. For $Ra>10^6$, the flow shows self-similar behaviour, which is revealed by the universal shape of the p.d.f. of the temperature fluctuation at the cell centre and a $Nu=0.19Ra^{0.25}$ scaling for the heat transport.
In this paper, a broadband, low insertion loss, and compact folded substrate integrated waveguide (FSIW) phase shifter is proposed for the first time. By loading the complementary split-ring resonators (CSRRs) on the middle metal layer of the FSIW, a closed-type slow-wave transmission line (TL) is obtained, which can provide a wideband phase shift (39%) compared with the equal-length fast-wave one. The enclosed structure of the CSRR-loaded FSIW prevents the CSRRs from radiation as suffered in the previous reported CSRR-loaded TLs, resulting in a low insertion loss. This feature greatly reduces the amplitude imbalance between the main line and the reference line of the phase shifter. In addition, no transition structure is required between the FSIWs with and without CSRRs for broadband impedance matching, which makes the phase shifter more compact and easier to integrate with other FSIW devices. To validate the performance of the proposed phase shifter and to illustrate its ease integration, a novel FSIW 180° directional coupler that consists of an FSIW 90° coupler and an FSIW 90° phase shifter is designed, fabricated, and measured. The measured results agree well with the simulated data.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
Aims
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Method
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Results
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
Conclusions
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
The objective of this study was to analyze differences in birth weight and overweight/obesity in a Shanghai twin cohort. We also wanted to study their association and explore possible risk factors for the discordance of overweight/obesity within twins. This was an internal case–control study designed for twins. The 2012 Shanghai Twin Registration System baseline survey data of a total of 3417 twin pairs were statistically analyzed using SPSS22 software. Results show that the body mass index (BMI) of the Shanghai twin population increased with age. Twins with a high birth weight had a higher BMI and a higher rate of overweight and obesity; 0- to 6-year-old twins, male twins and dizygotic (DZ) twins had higher rates of overweight/obesity than other groups. The greater the discordant birth weight rate of twins, the more obvious the difference in BMI (p < .05). There was a significant difference in overweight/obesity between twins with a relative difference of birth weight ≥15% in DZ twins (p < .05). DZ twins, male twins and 0- to 6-year-old twins were more likely to be discordant in overweight/obese than others. The discordant birth weight within twins was not a risk factor for discordant overweight/obesity. However, attention should be paid to childhood obesity, and appropriate interventions should be made at the appropriate time. Genetics may play an important role in the occurrence and development of overweight/obesity. In conclusion, discordant growth and development in the uterus early in life may not lead to discordant weight development in the future.
A non-local, ordinary state-based, peridynamic elastoplastic model is formulated to numerically simulate the fracture of reinforced concrete materials. Several basic definitions are first discussed to avoid confusion; and then, a detailed derivation of the force vector state is presented, leading to a unified expression of force state for one-, two- and three-dimensional elasticity problems. Furthermore, an ordinary state-based peridynamic (OSB PD) elastoplastic analysis approach is developed for both plastic compressible and incompressible materials, including the constitutive relationship, the yield function, the consistency condition and the plasticity flow rule. The peridynamic predictions of a quasi-static deformation of the steel rods are in good agreement with the analytical solution. Moreover, the OSB PD plasticity is verified by analyzing a square plate with or without a central hole suffering different loading-unloading paths. Finally, a two dimensional reinforced concrete clamped beam subjected to impact loading is simulated with the proposed OSB PD elastoplasticity, demonstrating its capability in capturing the damage characteristics and structural failure behavior. Simulation results show good accuracy of the peridynamics in simulating elastoplastic problems.
Dietary salt intake may vary depending on different lifestyles. We aimed to estimate the different salt intakes and evaluate the knowledge and self-awareness about salt among people speaking the Teochew, Teochew–Hakka and Hakka dialects in the Chaoshan region of southern China.
Design:
The study followed a cluster sampling of residents in Chaoshan region. General characteristics, lifestyles, health status as well as knowledge and self-awareness related to salt intake were investigated using a questionnaire. Anthropometric variables as well as Na and K excretion in a 24-h urine collection were measured.
Setting:
Chaoshan region of China.
Participants:
Four hundred fifteen adults who spoke only one of these three dialects.
Results:
The salt intake of adults who spoke the Teochew, Teochew–Hakka and Hakka dialects was 7·19 (interquartile range (IQR) 5·29–10·17), 9·03 (IQR 6·62–11·54) and 10·12 (IQR 7·61–12·82) g/d, respectively, with significant differences between Teochew and Teochew–Hakka speakers and between Teochew and Hakka speakers (both P < 0·05). The Na:K ratio for adults who spoke the three dialects was 3·00 (IQR 2·00–4·11), 3·50 (IQR 2·64–4·82) and 4·52 (IQR 3·35–5·97), respectively, and differed significantly among the groups (all P < 0·05). Multiple linear regression analysis showed increased Na:K ratio associated with hypertension (β = 0·71, P = 0·043) in Hakka speakers. Knowledge and self-awareness about salt intake were poor in this population.
Conclusions:
Salt intake was closely related to lifestyles and was higher than the upper limit (5 g/d) recommended by the WHO in adults of Chaoshan, especially those speaking the Hakka dialect.
The aim of the present study was to explore the influence of tea consumption on diabetes mellitus in the Chinese population. This multi-centre, cross-sectional study was conducted in eight sites from south, east, north, west and middle regions in China by enrolling 12 017 subjects aged 20–70 years. Socio-demographic and general information was collected by a standardised questionnaire. A standard procedure was used to measure anthropometric characteristics and to obtain blood samples. The diagnosis of diabetes was determined using a standard 75-g oral glucose tolerance test. In the final analysis, 10 825 participants were included and multiple logistic models and interaction effect analysis were applied for assessing the association between tea drinking with diabetes. Compared with non-tea drinkers, the multivariable-adjusted OR for newly diagnosed diabetes were 0·80 (95 % CI 0·67, 0·97), 0·88 (95 % CI 0·71, 1·09) and 0·86 (95 % CI 0·67, 1·11) for daily tea drinkers, occasional tea drinkers and seldom tea drinkers, respectively. Furthermore, drinking tea daily was related to decreased risk of diabetes in females by 32 %, elderly (>45 years) by 24 % and obese (BMI > 30 kg/m2) by 34 %. Moreover, drinking dark tea was associated with reduced risk of diabetes by 45 % (OR 0·55; 95 % CI 0·42, 0·72; P < 0·01). The results imply that drinking tea daily was negatively related to risk of diabetes in female, elderly and obese people. In addition, drinking dark tea was associated with decreased risk of type 2 diabetes mellitus.
We present an experimental study of the reversal of the large-scale circulation (LSC) in quasi-two-dimensional turbulent Rayleigh–Bénard convection. It is found that there exists a transition in the Rayleigh number ($Ra$) dependence of the reversal rate $f$ with two distinct scalings: for $Ra$ less than a transitional value $Ra_{t}$, the non-dimensionalized reversal rate $ft_{E}\sim Ra^{-1.09}$; however, for higher $Ra$ the scaling changes to $ft_{E}\sim Ra^{-3.06}$, where $t_{E}$ is the turnover time of the LSC. Flow visualization shows that this regime transition originates from a change in flow topology from a single-roll state to a new, less stable, abnormal single-roll state with substructures inside the single roll. The emergence of the substructures inside the LSC lowers the energy barrier for the flow reversals to occur and leads to a slower decay of $f$ with $Ra$. Detailed analysis reveals that, although it is the corner rolls that trigger the reversal event, the probability for the occurrence of reversals mainly depends on the stability of the LSC. This is supported by a model we proposed to predict the critical condition for the transition, which agrees well with the experimental results.
This paper presents a novel balanced-to-balanced power divider (PD) based on a simple and compact three-line coupled structure for the first time. By bisecting the proposed symmetrical structure, the differential mode (DM) and the common mode (CM) equivalent circuits can be obtained for analysis. The DM equivalent circuit exhibits a three-line in-phase power dividing response, and then a resistor is added between the two outputs for achieving good isolation. Meanwhile, the CM equivalent circuit shows a three-line all-stop response so that the CM suppression in this design does not need to be considered. Accordingly, the detailed design procedure of the DM PD is given. For demonstration, a prototype centered at 1.95 GHz is designed, fabricated, and measured. The simulated and measured results with good agreement are presented, showing low DM loss and wideband CM suppression.
Previous neuroimaging studies demonstrated that retinal detachment (RD) subjects were associated with abnormal spontaneous brain activities; however, whether the altered interhemispheric functional connectivity (FC) occurred in RD patients remains unknown. The current study tried to explore the alternations of interhemispheric FC of the whole brain in unilateral RD patients using the voxel-mirrored homotopic connectivity (VMHC) method and their connections to clinical features. Methods: We recruited 30 patients with RD (16 males and 14 females) and 30 healthy controls (HCs) (16 males and 14 females) whose age and sex were closely matched. All subjects underwent the rs-fMRI scans. The VMHC method was applied to directly assess the hemispheres’ functional interaction. The VMHC in these brain areas, which could be used as biomarkers to differentiate RD from HC, was identified by the receiver operating characteristic (ROC) curve analyses. The relations between these patients’ clinical features and their mean VMHC signal values in multiple brain regions were calculated by Pearson correlation analysis. Results: RD patients had significantly lower VMHC values than HCs in the bilateral occipital lobe (Brodmann areas, BA 18), bilateral superior temporal gyrus (BA 39), and bilateral cuneus (BA 19). Moreover, the mean VMHC signal values of the bilateral cuneus were in positive correlation with the duration of the RD (r = 0.446, P = 0.013). Conclusion: Our results provided an evidence of disturbed interhemispheric FC in the visual area occurred in RD patients, which might provide some useful information to understand the neural mechanism of RD patients with acute vision loss. Furthermore, the VMHC values might indicate the progress of the RD.
Calcification in cardiovascular aortic atherosclerotic plaque contains Ca-phosphate minerals. However, most research on cardiovascular calcification has focused on its physiological properties rather than its mineralogical features. In this present study, cardiovascular calcification was characterized by collecting samples from patients’ tissues and applying mineralogical techniques. Synchrotron radiation-based micro-X-ray diffraction showed the calcification had a similar structure to hydroxylapatite (HAp). Transmission electron microscopy showed some structurally HAp-like spherical particles with a diameter of ∼200 nm and acicular crystals ∼100 nm × ∼20 nm in size. Selected-area electron diffraction indicated that these mineral particles belonged to the hexagonal crystal system. Fourier-transform infrared (FTIR) spectroscopy showed three typical peaks at 1469 cm−1, 1455 cm−1 and 1413 cm−1, indicating that the carbonate group in the calcification plaque substituted for a hydroxyl group to form B-type CHAp (Ca10(PO4,CO3)x(OH)y). The FTIR mapping results illustrated the intergrowth of calcification and organic tissues and the inhomogeneous substitution of phosphate by carbonate in the calcification area. X-ray absorption near-edge structure analysis affirmed that the chemical environments of Ca in the calcification were close to those in HAp. Based on these mineralogical characteristics, the calcification in plaque is identified as a mixture phase of HAp and B-type carbonate HAp, which is similar to the composition of bones.
The purpose of this study was to investigate the joint associations of dietary pattern and television viewing with risk factors of CVD among urban adults in China. A community-based cross-sectional study was conducted among urban adults in Nanjing, China. Five dietary patterns were identified based on a FFQ. Television time was obtained from a standard questionnaire and further classified into two categories (≤7, >7 h/week). Multiple logistic regression was used to calculate the OR and 95 % CI for the separate and joint associations of dietary patterns and television viewing with CVD risk factors. Compared with other dietary patterns, participants who followed the healthy traditional pattern had a lower likelihood of abdominal obesity (AO) (OR 0·52; 95 % CI 0·41, 0·67). Participants watching television no more than 7 h/week presented a 19 and 21 % lower likelihood for hypertension (HT) and elevated total cholesterol (ETC) than those with television time >7 h/week. Individuals who had less television time and a healthy dietary pattern had a lower OR for the presence of AO (OR 0·48; 95 % CI 0·36, 0·65), HT (OR 0·71; 95 % CI 0·66, 0·77), ETC (OR 0·72; 95 % CI 0·57, 0·91) and elevated TAG (OR 0·76; 95 % CI 0·61, 0·95), compared with those who followed other dietary patterns and television time >7 h/week. In conclusion, both healthy traditional pattern and less television time are jointly associated with reduced levels of CVD risk factors. It has important public health implications regarding the precision prevention of CVD at population level.