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Triceps skinfold thickness (TSF) is a surrogate marker of subcutaneous fat. Evidence is limited about the association of sex-specific TSF with the risk of all-cause mortality among maintenance hemodialysis (MHD) patients. We aimed to investigate the longitudinal relationship of TSF with all-cause mortality among MHD patients. A multicenter prospective cohort study was performed in 1034 patients undergoing MHD. The primary outcome was all-cause mortality. Multivariable Cox proportional hazards models were used to evaluate the association of TSF with the risk of mortality. The mean (standard deviation) age of the study population was 54.1 (15.1) years. 599 (57.9%) of the participants were male. The median (interquartile range) of TSF was 9.7 (6.3–13.3 mm) in males and 12.7 (10.0–18.0 mm) in females. Over a median follow up of 4.4 years (interquartile range, 2.4-7.9 years), there were 548 (53.0%) deaths. When TSF was assessed as sex-specific quartiles, compared with those in quartile 1, the adjusted HRs (95%CIs) of all-cause mortality in quartile 2, quartile 3 and quartile 4 were 0.93 (0.73, 1.19), 0.75 (0.58, 0.97) and 0.69 (0.52, 0.92), respectively (P for trend =0.005). Moreover, when analyzed by sex, increased TSF (≥9.7 mm for males and ≥18mm for females) was significantly associated with a reduced risk of all-cause mortality (quartile 3-4 vs. quartile 1-2; HR, 0.70; 95%CI: 0.55, 0.90 in males; quartile 4 vs. Quartile 1-3; HR, 0.69; 95%CI: 0.48, 1.00 in females). In conclusion, high TSF was significantly associated with lower risk of all-cause mortality in MHD patients.
Suicidal ideation (SI) is very common in patients with major depressive disorder (MDD). However, its neural mechanisms remain unclear. The anterior cingulate cortex (ACC) region may be associated with SI in MDD patients. This study aimed to elucidate the neural mechanisms of SI in MDD patients by analyzing changes in gray matter volume (GMV) in brain structures in the ACC region, which has not been adequately studied to date.
Methods
According to the REST-meta-MDD project, this study subjects consisted of 235 healthy controls and 246 MDD patients, including 123 MDD patients with and 123 without SI, and their structural magnetic resonance imaging data were analyzed. The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms. Correlation analysis and logistic regression analysis were used to determine whether there was a correlation between GMV of ACC and SI in MDD patients.
Results
MDD patients with SI had higher HAMD scores and greater GMV in bilateral ACC compared to MDD patients without SI (all p < 0.001). GMV of bilateral ACC was positively correlated with SI in MDD patients and entered the regression equation in the subsequent logistic regression analysis.
Conclusions
Our findings suggest that GMV of ACC may be associated with SI in patients with MDD and is a sensitive biomarker of SI.
The emotion regulation network (ERN) in the brain provides a framework for understanding the neuropathology of affective disorders. Although previous neuroimaging studies have investigated the neurobiological correlates of the ERN in major depressive disorder (MDD), whether patients with MDD exhibit abnormal functional connectivity (FC) patterns in the ERN and whether the abnormal FC in the ERN can serve as a therapeutic response signature remain unclear.
Methods
A large functional magnetic resonance imaging dataset comprising 709 patients with MDD and 725 healthy controls (HCs) recruited across five sites was analyzed. Using a seed-based FC approach, we first investigated the group differences in whole-brain resting-state FC of the 14 ERN seeds between participants with and without MDD. Furthermore, an independent sample (45 MDD patients) was used to evaluate the relationship between the aforementioned abnormal FC in the ERN and symptom improvement after 8 weeks of antidepressant monotherapy.
Results
Compared to the HCs, patients with MDD exhibited aberrant FC between 7 ERN seeds and several cortical and subcortical areas, including the bilateral middle temporal gyrus, bilateral occipital gyrus, right thalamus, calcarine cortex, middle frontal gyrus, and the bilateral superior temporal gyrus. In an independent sample, these aberrant FCs in the ERN were negatively correlated with the reduction rate of the HAMD17 score among MDD patients.
Conclusions
These results might extend our understanding of the neurobiological underpinnings underlying unadaptable or inflexible emotional processing in MDD patients and help to elucidate the mechanisms of therapeutic response.
This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of 3 months. The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between 1 January 2020 and 31 December 2023. The primary outcome is the percentage weight loss. Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 (49·56 %)), followed by balanced dietary guidance (139 (41·00 %)) and pharmacotherapy (32 (9·44 %)). The total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4·98 (3·04, 6·29) %, 7·93 (5·42, 7·93) % and 10·71 (7·74, 13·83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3 % and ≥ 5 % at 1 month (OR = 0·461, P < 0·05; OR = 0·349, P < 0·001). The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.
Interface-resolved direct numerical simulations (DNS) of clustered settling suspensions in a periodic domain are performed to study the filtered drag force for clustered particle-laden flows. Our results show that, for the homogeneous system, the filtered drag is independent of the filter size, whereas for the clustered particle-laden flows, the averaged drag becomes smaller than the homogeneous drag at the filter size above 4 particle diameters. The drag reduction saturates at the filter size being comparable to the cluster size in the horizontal direction in our simulations. A new correlation is proposed to account for the mesoscale effect on the filtered drag force by using drift velocity and variance of the solid volume fraction, based on the modification of existing subgrid drag models for the inhomogeneous system. The existing models for the drift velocity and the variance of the solid volume fraction are assessed using our DNS data. A new model for the drift velocity and the variance of the solid volume fraction is proposed, based on the combination and modification of the previous models. All mesoscale models considered can predict well the filtered drag with comparable accuracy, and are superior to the homogeneous drag model for the clustered system. Our models with the same parameter values obtained from the large-scale system can also predict well the filtered drag for smaller computational domain sizes.
We consider continuous-state branching processes (CB processes) which become extinct almost surely. First, we tackle the problem of describing the stationary measures on $(0,+\infty)$ for such CB processes. We give a representation of the stationary measure in terms of scale functions of related Lévy processes. Then we prove that the stationary measure can be obtained from the vague limit of the potential measure, and, in the critical case, can also be obtained from the vague limit of a normalized transition probability. Next, we prove some limit theorems for the CB process conditioned on extinction in a near future and on extinction at a fixed time. We obtain non-degenerate limit distributions which are of the size-biased type of the stationary measure in the critical case and of the Yaglom distribution in the subcritical case. Finally we explore some further properties of the limit distributions.
Infection mechanism plays a significant role in epidemic models. To investigate the influence of saturation effect, a nonlocal (convolution) dispersal susceptible-infected-susceptible epidemic model with saturated incidence is considered. We first study the impact of dispersal rates and total population size on the basic reproduction number. Yang, Li and Ruan (J. Differ. Equ. 267 (2019) 2011–2051) obtained the limit of basic reproduction number as the dispersal rate tends to zero or infinity under the condition that a corresponding weighted eigenvalue problem has a unique positive principal eigenvalue. We remove this additional condition by a different method, which enables us to reduce the problem on the limiting profile of the basic reproduction number into that of the spectral bound of the corresponding operator. Then we establish the existence and uniqueness of endemic steady states by a equivalent equation and finally investigate the asymptotic profiles of the endemic steady states for small and large diffusion rates to provide reference for disease prevention and control, in which the lack of regularity of the endemic steady state and Harnack inequality makes the limit function of the sequence of the endemic steady state hard to get. Finally, we find whether lowing the movements of susceptible individuals can eradicate the disease or not depends on not only the sign of the difference between the transmission rate and the recovery rate but also the total population size, which is different from that of the model with standard or bilinear incidence.
Tuberculosis (TB) infection prevention and control (IPC) in healthcare facilities is key to reducing transmission risk. A framework for systematically improving TB IPC through training and mentorship was implemented in 9 healthcare facilities in China from 2017 to 2019.
Methods:
Facilities conducted standardized TB IPC assessments at baseline and quarterly thereafter for 18 months. Facility-based performance was assessed using quantifiable indicators for IPC core components and administrative, environmental, and respiratory protection controls, and as a composite of all control types We calculated the percentage changes in scores over time and differences by IPC control type and facility characteristics.
Results:
Scores for IPC core components increased by 72% during follow-up when averaged across facilities. The percentage changes for administrative, environmental, and respiratory protection controls were 39%, 46%, and 30%, respectively. Composite scores were 45% higher after the intervention. Overall, scores increased most during the first 6 months. There was no association between IPC implementation and provincial economic development or volume of TB services.
Conclusions:
TB IPC policies and practices showed most improvement early during implementation and did not differ consistently by facility characteristics. The training component of the project helped increase the capacity of healthcare professionals to manage TB transmission risks. Lessons learned here will inform national TB IPC guidance.
Childhood maltreatment is an established risk factor for psychopathology. However, it remains unclear how childhood traumatic events relate to mental health problems and how the brain is involved. This study examined the serial mediation effect of brain morphological alterations and emotion-/reward-related functions on linking the relationship from maltreatment to depression. We recruited 156 healthy adolescents and young adults and an additional sample of 31 adolescents with major depressive disorder for assessment of childhood maltreatment, depressive symptoms, cognitive reappraisal and anticipatory/consummatory pleasure. Structural MRI data were acquired to identify maltreatment-related cortical and subcortical morphological differences. The mediation models suggested that emotional maltreatment of abuse and neglect, was respectively associated with increased gray matter volume in the ventral striatum and greater thickness in the middle cingulate cortex. These structural alterations were further related to reduced anticipatory pleasure and disrupted cognitive reappraisal, which contributed to more severe depressive symptoms among healthy individuals. The above mediating effects were not replicated in our clinical group partly due to the small sample size. Preventative interventions can target emotional and reward systems to foster resilience and reduce the likelihood of future psychiatric disorders among individuals with a history of maltreatment.
This study aimed to compare changes in the level of health technology assessment (HTA) development from 2016 to 2021, and to inform policies and decisions to promote further development of HTA in China.
Methods
We conducted a cross-sectional and anonymous web-based survey to relevant stakeholders in China in 2016 and 2021 respectively. The mapping of the HTA instrument was used to reflect the HTA development from eight domains. To reduce the influence of confounders and to compare the mapping outcomes between 2016 and 2021 groups, we performed 1:1 propensity score matching methodology in this study. Univariate analysis was performed to compare the differences in these two groups. We also compared the overall results with that of a mapping study that included ten countries.
Results
A total of 212 and 255 respondents completed the survey in 2016 and 2021 respectively. After propensity score matching methodology, 183 cases from the 2016 group and 2021 group were matched. Overall, the mean score of 2021 in most of the domains was higher than in 2016 in China (p < 0.05), matching the level of HTA institutionalization and dissemination strategy, except for the assessment domain. Although China scored significantly lower among the three developed countries, the overall HTA development score for China was comparable among the ten countries.
Conclusions
Our study suggested the level of HTA development in China has made great progress from 2016 to 2021. Prior to HTA activities, the researcher or policy makers should first formulate an explicit assessment goal and scope, and during the assessment process, more attention should be paid to the clinical effectiveness and cost-effectiveness indicator to ensure a higher quality of HTA evidence.
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.
We study the weak convergence of the extremes of supercritical branching Lévy processes $\{\mathbb{X}_t, t \ge0\}$ whose spatial motions are Lévy processes with regularly varying tails. The result is drastically different from the case of branching Brownian motions. We prove that, when properly renormalized, $\mathbb{X}_t$ converges weakly. As a consequence, we obtain a limit theorem for the order statistics of $\mathbb{X}_t$.
By combining the technique of energy selective surface and frequency selective rasorber, an energy selective rasorber is proposed, which performs selective energy protection in the low communication frequency band (0.8–2 GHz) and wave-absorbing property in the high-frequency band (6–18 GHz). The design consists of two layers, of which the bottom one contains a lumped diode structure for energy selection function in the transmission band, while together with the top layer, they perform a wideband wave absorbing function. The simulated and measured results agree well with each other, and both show good absorption in 6–18 GHz and energy-selective property around 1.86 GHz. That is, when the incident power changes from −30 to 14 dBm, the reflection coefficient changes from below −22 dB to above −2 dB, while the transmission coefficient changes from above −3 dB to below −17 dB.
Multilayer dielectric gratings (MLDGs) are crucial for pulse compression in picosecond–petawatt laser systems. Bulged nodular defects, embedded in coating stacks during multilayer deposition, influence the lithographic process and performance of the final MLDG products. In this study, the integration of nanosecond laser conditioning (NLC) into different manufacturing stages of MLDGs was proposed for the first time on multilayer dielectric films (MLDFs) and final grating products to improve laser-induced damage performance. The results suggest that the remaining nodular ejection pits introduced by the two protocols exhibit a high nanosecond laser damage resistance, which remains stable when the irradiated laser fluence is more than twice the nanosecond-laser-induced damage threshold (nanosecond-LIDT) of the unconditioned MLDGs. Furthermore, the picosecond-LIDT of the nodular ejection pit conditioned on the MLDFs was approximately 40% higher than that of the nodular defects, and the loss of the grating structure surrounding the nodular defects was avoided. Therefore, NLC is an effective strategy for improving the laser damage resistance of MLDGs.
Before the Omicron variant ran amok inside China in November 2022, the Chinese central government’s dynamic zero-COVID policy effectively contained the spread of the coronavirus and its variants during multiple waves of outbreaks. However, it was not without cost. This study examines the impacts of stringent lockdown interventions on urban residents’ mental health during the initial outbreak of the Omicron variant in the spring of 2022. Using survey data from 522 respondents within the same neighbourhood and a spatial quasi-experimental design, the results show that strict lockdown interventions are significantly related to higher levels of psychological distress after controlling for observed confounders and that lockdown interventions have further spillover effects on mental health for residents in adjacent residential compounds who are otherwise free. Moreover, the results show that the lack of material supplies and medical care plays a more salient role in explaining lockdown effects on psychological distress than residents’ social interaction and trust levels of COVID-19 policy. Policy and intervention implications are also discussed.
The discharged capillary plasma channel has been extensively studied as a high-gradient particle acceleration and transmission medium. A novel measurement method of plasma channel density profiles has been employed, where the role of plasma channels guiding the advantages of lasers has shown strong appeal. Here, we have studied the high-order transverse plasma density profile distribution using a channel-guided laser, and made detailed measurements of its evolution under various parameters. The paraxial wave equation in a plasma channel with high-order density profile components is analyzed, and the approximate propagation process based on the Gaussian profile laser is obtained on this basis, which agrees well with the simulation under phase conditions. In the experiments, by measuring the integrated transverse laser intensities at the outlet of the channels, the radial quartic density profiles of the plasma channels have been obtained. By precisely synchronizing the detection laser pulses and the plasma channels at various moments, the reconstructed density profile shows an evolution from the radial quartic profile to the quasi-parabolic profile, and the high-order component is indicated as an exponential decline tendency over time. Factors affecting the evolution rate were investigated by varying the incentive source and capillary parameters. It can be found that the discharge voltages and currents are positive factors quickening the evolution, while the electron-ion heating, capillary radii and pressures are negative ones. One plausible explanation is that quartic profile contributions may be linked to plasma heating. This work helps one to understand the mechanisms of the formation, the evolutions of the guiding channel electron-density profiles and their dependences on the external controllable parameters. It provides support and reflection for physical research on discharged capillary plasma and optimizing plasma channels in various applications.
Hydrothermal alteration records fluid–rock interactions and can therefore be used to constrain element migrations during mineralization. Although hydrothermal alteration is widely developed in hydrothermal vein-type uranium deposits in South China, consideration of elemental mass changes during alteration has not been examined. The Egongtang uranium deposit in the central Nanling Range is mainly hosted by the Qingzhangshan granite in South China, and was strongly altered by K-feldspar, quartz, chlorite, illite, haematite, pyrite and carbonates. The alteration section can be divided into five horizontal zones: fresh granite (Zone V), a distal alkaline alteration zone (Zone IV), a chlorite-rich zone (Zone III), a close-to-ore sericite/illite alteration zone (Zone II) and a central mineralization zone with strong haematitization (Zone I). Whole-rock geochemistry of the altered samples indicates that from Zone IV to Zone I, the content of SiO2 and U increases significantly. The mass gains of SiO2, MgO and Fe2O3 were proportional to the concentration of U. The content of trace elements (such as Ba, K, La, Ce, Pr, Sr, P, Eu, etc.) gradually decreases from Zone V to Zone I. The rare earth elements manifest a decrease in light rare earth elements and a slight increase in heavy rare earth elements accordingly from Zone V to Zone I. This study shows that the ore materials of the Egongtang deposit were mainly derived from the Qingzhangshan granites. In the early alkali alterations, large amounts of U were partitioned into the fluids. In the ore-forming stage, ores precipitated accompanied by acid metasomatism such as chloritization, haematitization and carbonation.
Correlations for the interfacial terms in the fluid dissipation rate equation and Reynolds stress equations are established for particle-laden flows, based on data from the interfaced-resolved direct numerical simulations of particle sedimentation in a periodic domain at a density ratio ranging from 0.01 to 1000, a particle concentration ranging from 2.3 % to 30.2 % and a particle Reynolds number below 250. The correlations for the mean drag and the pseudo-turbulent kinetic energy are also reported, which are used for the modelling of the interfacial term in the fluid dissipation rate equation. The interfacial term correlations obtained are then incorporated in the Reynolds stress model (RSM) (i.e. second-moment closure) for the simulation of vertical turbulent channel flows laden with the finite-size particles at relatively low particle volume fractions. The results show that the RSM with new interfacial term correlations can quantitatively predict particle-induced turbulence enhancement or suppression in vertical channel flows.