We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Online ordering will be unavailable from 17:00 GMT on Friday, April 25 until 17:00 GMT on Sunday, April 27 due to maintenance. We apologise for the inconvenience.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The English spoken in China is categorised within the Expanding Circle in the World Englishes paradigm. Of late, the diversity of Chinese dialects has drawn scholarly attention to China English accents. This study contributes to the existing literature on China English by focusing on the Sichuan province in southwestern China. It involves participants from the largest Han ethnic group and the Yi minority. English monophthongs produced by 40 Sichuan Han and Yi speakers were elicited, and their distribution and contrasts were examined and compared to provide insights into the production of their English vowels. Findings from the instrumental analysis indicate a lack of vowel-quality contrasts in specific vowel pairs produced by both Han and Yi speakers, resulting in a simplified vowel system. There are notable differences between Han and Yi speakers in the production of English vowels, possibly influenced by their different first languages. In addition, specific gender-based inconsistencies were also found, suggesting gender as an influencing factor in the production of English monophthong vowels. Overall, this study identifies Sichuan English as an emerging sub-variety of China English and supports the perspective that China English is an evolving and distinct variety rather than an interlanguage.
The femtosecond laser filament-induced air laser plays a significant role for the remote sensing of air pollutants. The spatial distributions of air laser intensity were investigated experimentally in previous studies. However, the mechanism of the air laser propagation properties inside the filament plasma has not been quite clear yet. Moreover, few studies have been dedicated to the reproduction of the air laser profile from nitrogen molecules propagating in the filament plasma based on the numerical simulation method. In this study, the lasing action of the air laser from the transition of the first negative (0,0) band of nitrogen ions at 391 nm was simulated during the femtosecond laser filamentation. The beam profile of the air laser changes from a Gaussian or super-Gaussian shape to an outer ring structure by increasing the filament length or nitrogen ion density, which is in accord with the previous experimental result. A multiple-diffraction effect has been proposed to clarify the mechanism of the outer rings beam pattern formation, which is induced by the dynamical interaction between the lasing effect and diffraction effect of the air laser propagating inside the filament plasma. In addition, the amplified air laser power as a function of both the filament length and nitrogen ion density was investigated. Our study would pave the way to improve the energy conversion efficiency and directivity of remote air lasers, which would be significant for remote sensing applications.
Design is a highly nonlinear chaotic dynamic process with many possible solutions, which requires enormous knowledge for designers. This paper investigates how environment-based design (EBD) methodology can help designers use only necessary knowledge for their creativity based on three methods: information search, knowledge acquisition and knowledge application. The methods are applied in an aircraft pylon design, which is evaluated by two aerospace design specialists. The paper discussed the different roles of EBD for novice and expert designers in regard to overcoming emotion and knowledge barriers to achieving designer creativity.
Breast cancer is a high-risk disease with a high mortality rate among women. Chemotherapy plays an important role in the treatment of breast cancer. However, chemotherapy eventually results in tumours that are resistant to drugs. In recent years, many studies have revealed that the activation of Wnt/β-catenin signalling is crucial for the emergence and growth of breast tumours as well as the development of drug resistance. Additionally, drugs that target this pathway can reverse drug resistance in breast cancer therapy. Traditional Chinese medicine has the properties of multi-target and tenderness. Therefore, integrating traditional Chinese medicine and modern medicine into chemotherapy provides a new strategy for reversing the drug resistance of breast tumours. This paper mainly reviews the possible mechanism of Wnt/β-catenin in promoting the process of breast tumour drug resistance, and the progress of alkaloids extracted from traditional Chinese medicine in the targeting of this pathway in order to reverse the drug resistance of breast cancer.
The relationship of a diet low in fibre with mortality has not been evaluated. This study aims to assess the burden of non-communicable chronic diseases (NCD) attributable to a diet low in fibre globally from 1990 to 2019.
Design:
All data were from the Global Burden of Disease (GBD) Study 2019, in which the mortality, disability-adjusted life-years (DALY) and years lived with disability (YLD) were estimated with Bayesian geospatial regression using data at global, regional and country level acquired from an extensively systematic review.
Setting:
All data sourced from the GBD Study 2019.
Participants:
All age groups for both sexes.
Results:
The age-standardised mortality rates (ASMR) declined in most GBD regions; however, in Southern sub-Saharan Africa, the ASMR increased from 4·07 (95 % uncertainty interval (UI) (2·08, 6·34)) to 4·60 (95 % UI (2·59, 6·90)), and in Central sub-Saharan Africa, the ASMR increased from 7·46 (95 % UI (3·64, 11·90)) to 9·34 (95 % UI (4·69, 15·25)). Uptrends were observed in the age-standardised YLD rates attributable to a diet low in fibre in a number of GBD regions. The burden caused by diabetes mellitus increased in Central Asia, Southern sub-Saharan Africa and Eastern Europe.
Conclusions:
The burdens of disease attributable to a diet low in fibre in Southern sub-Saharan Africa and Central sub-Saharan Africa and the age-standardised YLD rates in a number of GBD regions increased from 1990 to 2019. Therefore, greater efforts are needed to reduce the disease burden caused by a diet low in fibre.
Different from developed countries, there is a paucity of research examining how the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets relate to lipids in less-developed ethnic minority regions (LEMR). A total of 83 081 participants from seven ethnic groups were retrieved from the baseline data of the China Multi-Ethnic Cohort study, which was conducted in less-developed Southwest China between May 2018 and September 2019. Multivariable linear regression models were then used to examine the associations of the DASH and alternative Mediterranean diet (AMED) scores, assessed by modified DASH score and AMED, as well as their components with total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, TAG and TC/HDL-cholesterol. The DASH scores were negatively associated with TC, HDL-cholesterol and TAG. Comparing the highest quintiles with the lowest DASH scores, TC decreased 0·0708 (95 % CI −0·0923, −0·0493) mmol/l, HDL-cholesterol decreased 0·0380 (95 % CI −0·0462, −0·0299) mmol/l and TAG decreased 0·0668 (95 % CI −0·0994, −0·0341) mmol/l. The AMED scores were negatively associated with TC, LDL-cholesterol and HDL-cholesterol. Comparing the highest quintiles with the lowest AMED scores, TC decreased 0·0816 (95 % CI −0·1035, −0·0597) mmol/l, LDL-cholesterol decreased 0·0297 (95 % CI −0·0477, −0·0118) mmol/l and HDL-cholesterol decreased 0·0275 (95 % CI −0·0358, −0·0192) mmol/l. Although both the DASH diet and the Mediterranean diet were negatively associated with blood lipids, those associations showed different patterns in LEMR, particularly for TAG and HDL-cholesterol.
To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines.
Design:
Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group.
Setting:
From nine cities in mainland China.
Participants:
A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014.
Results:
The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8–17·1), 14·2 (12·1–16·4) and 12·6 (10·4–14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes.
Conclusions:
Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.
Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, accounting for the time course of illness using generalised multivariate logistic regression. Significant symptoms included abdominal pain, cough, diarrhoea, fever, headache, muscle ache, runny nose, sore throat, temperature between 37.5 and 37.9 °C and temperature above 38 °C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity at 0.67. To further evaluate accuracy of model predictions, leave-one-out cross-validation confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity decreased to 0.56. External validation datasets reported similar result. Our study provides a tool to discern COVID-19 patients from controls using symptoms and day from illness onset with good predictive performance. It could be considered as a framework to complement laboratory testing in order to differentiate COVID-19 from other patients presenting with acute symptoms in outpatient care.
Tuberculosis (TB) remains a global public health threat. Misdiagnosis and delayed therapy of sputum smear-negative TB can affect the treatment outcomes and promote pathogen transmission. The application of Xpert MTB/RIF assay in bronchoalveolar lavage fluid (BALF) has been recommended but needs clinical evidence. We carried out a prospective study in the Nanjing Public Health Medical Center from September 2018 to August 2019. Pulmonary tuberculosis (PTB) patients were enrolled in the study if they had negative results of sputum smear. We compared the performance of Xpert MTB/RIF assay in sputum and BALF using sputum culture as the reference. In addition to this, we applied parallel tests using sputum culture, sputum-based Xpert MTB/RIF assay and BALF-based Xpert MTB/RIF assay to jointly detect smear-negative PTB using clinical diagnosis as the reference. With mycobacterial culture as the reference standard, Xpert MTB/RIF of BALF showed a higher sensitivity (14/16, 87.5%), but a relatively lower specificity (57/92, 62.0%). Xpert MTB/RIF of sputum showed relatively lower sensitivity (6/10, 60.0%) and higher specificity (63/88, 71.6%). Compared with sputum culture, Xpert MTB /RIF assay reduced the median detection time of MTB from 30 to 0 days, which significantly shortened the diagnosis time of the smear-negative TB patients. Among the combined detections, the positive detection proportion was improved with significant differences comparing with sputum culture only, from 11.1% (10/90) to 46.7% (42/90) (P < 0.05). Our study showed Xpert MTB/RIF in BALF had a better performance in detecting MTB of smear-negative patients.
Acute haemorrhagic conjunctivitis is a highly contagious eye disease, the prediction of acute haemorrhagic conjunctivitis is very important to prevent and grasp its development trend. We use the exponential smoothing model and the seasonal autoregressive integrated moving average (SARIMA) model to analyse and predict. The monthly incidence data from 2004 to 2017 were used to fit two models, the actual incidence of acute haemorrhagic conjunctivitis in 2018 was used to validate the model. Finally, the prediction effect of exponential smoothing is best, the mean square error and the mean absolute percentage error were 0.0152 and 0.1871, respectively. In addition, the incidence of acute haemorrhagic conjunctivitis in Chongqing had a seasonal trend characteristic, with the peak period from June to September each year.
Many clinical trials showed favorable effects of high-doses supplemental n-3 polyunsaturated fatty acids (PUFA) on cardio-metabolic risk factors. However, limited studies examined the prospective associations of circulating n-3 PUFA with body fat and its distribution, metabolic syndrome (MS), carotid atherosclerosis, and nonalcoholic fatty liver disease (NAFLD) in subjects with habitual diets containing low levels of n-3 PUFA.
Materials and Methods
This community-based prospective study enrolled 4048 participants (40–75 years) at baseline (2008–2010, 2013) from Guangzhou, China. They were followed-up approximately once every 3 years. Fatty acids in erythrocyte membranes were measured at baseline. We determined metabolic syndrome factors, body fat by DXA scanning, carotid intima-media thickness (IMT) and NAFLD by ultrasound at the visits. General information, anthropometric indices, habitual dietary intake and other covariates were assessed at each visit.
Results
Among the total 4048 subjects, 3075 and 2671 subjects had erythrocyte n-3 PUFA data and completed the first and second follow-ups. Generally, erythrocyte n-3 PUFA were favorably associated with body fat (particularly at abdomen) and its changes, and with the presence and incidence of MS, type 2 diabetes, carotid IMT thickening. The participants with the highest (vs lowest) quartile of n-3 PUFA were associated with -5.81% fat mass (p < 0.001) and -2.11% of fat mass change at the abdomen (Android) area. The adjusted hazards ratios (95% CI) for the highest (vs. lowest) group were 0.74 (0.61, 0.89) (total n-3 PUFA), 0.71 (0.59, 0.86) (docosahexaenoic acid, DHA), 0.78 (0.65, 0.95) (docosapentaenoic acid, DPA), 1.96 (1.60, 2.40) (gamma-linolenic acid, GLA) for MS; 0.70(0.55, 0.90) (total n-3 PUFA), 0.67(0.52,0.87) (DHA) and 0.73(0.57,0.93) (DPA) for bifurcation IMT thickening, 0.57(0.38, 0.86) (eicosapentaenoic acid, EPA) and 0.63 (0.41, 0.95) (DPA) for type 2 diabetes, and 1.18 (1.09, 1.33) (DHA) for alleviated NAFLD. Both higher levels of total and individual marine n-3 PUFAs (DHA, EPA and DPA) were associated with lower blood pressure at baseline and lower changes in diastolic and systolic blood pressure over the follow-up period. Plant n-3 PUFA (α-linolenic acid, ALA) largely had less significant association with the above-mentioned indices as compared with marine n-3 PUFAs.
Discussion
Higher proportions of erythrocyte n-3 PUFA (particularly marine sources) was associated with lower body fat, blood pressure and their changes, and lower risks of MS, type 2 diabetes and bifurcation IMT thickening, but higher chance of alleviated NAFLD in middle-aged and older adults.
Cognitive decline in advanced age is closely related to dementia. The trajectory of cognitive function in older Chinese is yet to be fully investigated. We aimed to investigate the trajectories of cognitive function in a nationally representative sample of older people living in China and to explore the potential determinants of these trajectories.
Methods:
This study included 2,038 cognitively healthy persons aged 65–104 years at their first observation in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 12 years and to investigate associations between baseline predictors of group membership and these trajectories.
Results:
Three trajectories were identified according to the following types of changes in MMSE scores: slow decline (14.0%), rapid decline (4.5%), and stable function (81.5%). Older age, female gender, having no schooling, a low frequency of leisure activity, and a low baseline MMSE score were associated with the slow decline trajectory. Older age, body mass index (BMI) less than 18.5 kg/m2, and having more than one cardiovascular disease (CVD) were associated with the rapid decline trajectory.
Conclusion:
Three trajectories of cognitive function were identified in the older Chinese population. The identified determinants of these trajectories could be targeted for developing prevention and intervention strategies for dementia.
During the last glacial termination, a warming trend was generally interrupted by rapid millennium-scale cold reversals, such as the Greenland (Isotope) Stadial 1 (GS-1) and GS-2a events. To understand how glaciers on the Tibetan Plateau (TP) responded to these rapid climate events, this study constrained the timing and extent of three glacial events during the late-glacial period. Specifically, using a cosmogenic 10Be exposure dating method, we dated three prominent glacial moraines (PM1, PM2, PM3) back to 15,850 ± 980, 14,140 ± 880, and 12,430 ± 790 yr in the Pagele valley, southern TP, corresponding to GS-2a, Greenland Interstadial 1 (GI-1), and GS-1, respectively. By simulating glacial extents forced by different climate scenarios, the study constrained the temperature decreases relative to present to be 2.6°C–2.9°C, ~1.6°C, and 1.4°C–1.5°C during the GS-2a, GI-1, and GS-1 periods in the region, with precipitation values of 60%–80%, ~100%, and 80%–90% of present value, respectively. Considering information from oceanic and atmospheric circulation, the study suggested that on the TP, the glacial events during the last glacial termination were well connected with the millennium-scale climate events in the North Atlantic region through the westerlies, while the Indian summer monsoon played a positive role in sustaining the glaciers under the warming climate trend.
A tunable ultrafast intensity-rotating optical field is generated by overlapping a pair of 20 Hz, 800 nm chirped pulses with a Michelson interferometer (MI). Its rotating rate can be up to 10 trillion radians per second ($\text{Trad}/\text{s}$), which can be flexibly tuned with a mirror in the MI. Besides, its fold rotational symmetry structure is also changeable by controlling the difference from the topological charges of the pulse pair. Experimentally, we have successfully developed a two-petal lattice with a tunable rotating speed from $3.9~\text{Trad}/\text{s}$ up to $11.9~\text{Trad}/\text{s}$, which is confirmed by our single-shot ultrafast frame imager based on noncollinear optical-parametric amplification with its highest frame rate of 15 trillion frames per second (Tfps). This work is carried out at a low repetition rate. Therefore, it can be applied at relativistic, even ultrarelativistic, intensities, which usually operate in low repetition rate ultrashort and ultraintense laser systems. We believe that it may have application in laser-plasma-based accelerators, strong terahertz radiations and celestial phenomena.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
Design:
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Setting:
Southwest China.
Participants:
Pregnant women (n 1910) in 2017.
Results:
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Conclusions:
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
Cryptorchidism, characterized by the presence of one (unilateral) or both (bilateral) undescended testes, is a common male urogenital defect. Cryptorchidism can lead to male infertility, testicular cancer being the most extreme clinical symptom, as well as psychological issues of the inflicted individual. Despite this, both knowledge about the aetiology of cryptorchidism and the mechanism for cryptorchidism-induced male infertility remain limited. In this present study, by using an artificial cryptorchid mouse model, we investigated the effects of surgery-induced cryptorchidism on spermatogenic cells and seminiferous epithelial cycles. We found that surgery-induced cryptorchidism led to a reduced testicular weight, aberrant seminiferous epithelial cycles and impaired spermatogenesis characterized by degenerating spermatogenic cells. We also observed multinucleated giant cells after surgery-induced cryptorchidism. Transmission electron microscopy, terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) and western blot assays demonstrated cryptorchidism-induced apoptosis of spermatogenic cells. Moreover, we identified the occurrence of autophagy in germ cells after surgery-induced cryptorchidism. Interestingly, apoptosis and autophagy were synchronous, suggestive of their synergetic roles in promoting germ cell death. Our results provide novel insights into the cryptorchidism-induced male infertility, thereby contributing to the development of male contraceptive strategies as well as treatment options for male infertility caused by cryptorchidism.
This paper presents a complete two-step phase-shifting (TSPS) spectral phase interferometry for direct electric-field reconstruction (SPIDER) to improve the reconstruction of ultrafast optical fields. Here, complete TSPS acts as a balanced detection that can not only remove the effect of the dc term of the interferogram, but also reduce measurement noises, and thereby improve the capability of SPIDER to measure the pulses with narrow spectra or complex spectral structures. Some prisms are chosen to replace some environment-sensitive optical components, especially reflective optics to improve operating stability and improve signal-to-noise ratio further. Our experiments show that the available shear can be decreased to 1.5% of the spectral width, which is only about $1/3$ compared with traditional SPIDER.
The present study deals with a theoretical investigation of a close-contact melting (CCM) process involving a vertical cylinder on a horizontal isothermal surface, where the liquid phase is a non-Newtonian viscoplastic fluid that behaves according to the Bingham model. Accordingly, a new approach is formulated based on the thin layer approximation and different quasi-steady process assumptions. By analytical derivation, an algebraic equation that relates the molten layer thickness and the solid bulk height is developed. The problem is then solved numerically, coupled with another equation for the melting rate. The new model shows that as the yield stress increases the melting rate decreases and the molten layer thickness increases. It is found that under certain conditions, the model can be reduced to a form that allows an analytical solution. The approximate model predicts an exponential dependence of both the melt fraction and the molten layer thickness. Comparison between the numerical and analytical solutions shows that the analytical approximation provides an excellent estimation for sufficiently large values of the yield stress. Dimensional analysis, which is supported by the analytical model results, reveals the dimensionless groups that govern the problem. For the general case, the melt fraction is a function of two dimensionless groups. For the analytical approximation, it is shown that the melt fraction is governed by a single dimensionless group and that the molten layer thickness is governed by two dimensionless groups.
This paper investigates a wideband and low axial ratio circularly polarized (CP) antenna, which is composed of a monopole on a novel polarization rotating reflective surface (PRRS) based on a corner-truncated artificial magnetic conductor (AMC) structure. By adjusting the dimensions of truncated corner properly, the PRRS has two polarization rotation (PR) frequency points. Then, a large PR band of 18% (5.55–6.65 GHz) can be achieved with two adjacent PR frequency points coming together. The profile of the newly PRRS is only0.04λ0. With corner-truncated AMC-based PRRS loading, a measured impedance bandwidth of 1.8 GHz (5.4–7.2 GHz) and the 3 dB axial ratio bandwidth of 1 GHz (5.55–6.65 GHz) could be obtained by the monopole antenna and validated by measurements. The values of AR were well below 1 dB at most of the CP region, which show a perfect CP performance. Moreover, the proposed antenna has exhibited a large axial ratio beamwidth in both the xoz- and yoz-planes and a peak gain of 6.1 dBic within the operational bandwidth.