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To explore the longitudinal associations between a Chinese healthy diet and the progression of cardiometabolic multimorbidity (CMM) development among Chinese adults. A prospective analysis was conducted utilising data from 18 720 participants in the China Health and Nutrition Survey, spanning from 1997 to 2018. Dietary data were collected by three consecutive 24-h dietary recalls combined with the weighing method. A Chinese healthy diet score was developed by assigning scores to various food components. CMM was defined as the coexistence of two or more cardiometabolic diseases (CMD), including myocardial infarction, stroke and type 2 diabetes, diagnosed through blood indicators and clinical diagnosis. We employed a multistate model to examine the associations between the Chinese healthy diet and the longitudinal progression from being free of CMD to first CMD and then to CMM. Quantile G-computation was utilised to evaluate the relative contribution of each food component. Over a median follow-up period of 7·3 years, 2214 (11·8 %) participants developed first CMD, and 156 (0·83 %) progressed to CMM. Comparing participants in the highest quintile of dietary scores with those in the lowest, we observed a 55 % lower risk of transitioning from baseline to CMM (HR = 0·45, 95 % CI: 0·23, 0·87) and a 60 % lower risk of transition from first CMD to CMM (HR = 0·40, 95 % CI: 0·20, 0·81). Fresh fruits contributed to 42·8 and 43·0 % for delaying CMM and transition from first CMD to CMM, respectively. Our study revealed that greater adherence to the Chinese healthy diet is negatively associated with the risk of CMM.
Practical real-world activities consume energy and emit thermal infrared radiation (TIR). Leveraging this physical fact, we develop a direct, real-time measure of firms’ operating activity using satellite data. Tracking 28,236 factories of Chinese listed firms, we find TIR declines significantly following operational shocks and strongly forecasts subsequent sales growth, costs, investment, employment, and profits. TIR also predicts future stock returns, especially among opaque firms and those with limited investor access, yet sophisticated investors largely ignore this information. Our findings highlight TIR as a distinctive, under-exploited indicator of corporate fundamentals.
This study investigated the factors influencing the mental health of rural doctors in Hebei Province, to provide a basis for improving the mental health of rural doctors and enhancing the level of primary health care.
Background:
The aim of this study was to understand the mental health of rural doctors in Hebei Province, identify the factors that influence it, and propose ways to improve their psychological status and the level of medical service of rural doctors.
Methods:
Rural doctors from 11 cities in Hebei Province were randomly selected, and their basic characteristics and mental health status were surveyed via a structured questionnaire and the Symptom Checklist-90 (SCL-90). The differences between the SCL-90 scores of rural doctors in Hebei Province and the Chinese population norm, as well as the proportion of doctors with mental health problems, were compared. Logistic regression was used to analyse the factors that affect the mental health of rural doctors.
Results:
A total of 2593 valid questionnaires were received. The results of the study revealed several findings: the younger the rural doctors, the greater the incidence of mental health problems (OR = 0.792); female rural doctors were more likely to experience mental health issues than their male counterparts (OR = 0.789); rural doctors with disabilities and chronic diseases faced a significantly greater risk of mental health problems compared to healthy rural doctors (OR = 2.268); rural doctors with longer working hours have a greater incidence of mental health problems; and rural doctors with higher education backgrounds have a higher prevalence of somatization (OR = 1.203).
Conclusion:
Rural doctors who are younger, male, have been in medical service longer, have a chronic illness or disability, and have a high degree of education are at greater risk of developing mental health problems. Attention should be given to the mental health of the rural doctor population to improve primary health care services.
After right ventricular outflow tract obstruction reconstruction for CHD, surgical pulmonary valve replacement, or transcatheter pulmonary valve replacement may be performed if complicated by moderately severe or severe right ventricular outflow tract dysfunction. However, for patients whose anatomy is not suitable for transcatheter pulmonary valve replacement, surgical pulmonary valve replacement is the only option, but it has a higher rate of perioperative complications and longer hospitalisation for patients. In two cases of severe transcatheter pulmonary valve replacement in which percutaneous pulmonary valve implantation could not be performed directly due to the presence of a large right ventricle, a significant decrease in right ventricular function, and significant widening of the pulmonary arteries, we used a new hybridisation procedure to partially fold and reduce the diameter of the significantly widened pulmonary artery trunk without cardiopulmonary bypass by surgically opening the thorax in a median way, and then successfully implanted a percutaneous self-expanding pulmonary valve valve, with good immediate results in the postoperative period. The postoperative recovery was rapid and the recent results were excellent.
In the present study, we investigate the modulation effects of particles on compressible turbulent boundary layers at a Mach number of 6, employing high-fidelity direct numerical simulations based on the Eulerian–Lagrangian point-particle approach. Our findings reveal that the mean and fluctuating velocities in particle-laden flows exhibit similarities to incompressible flows under compressibility transformations and semi-local viscous scaling. With increasing particle mass loading, the reduction in Reynolds shear stress and the increase in particle feedback force constitute competing effects, leading to a non-monotonic variation in skin friction, particularly in turbulence over cold walls. Furthermore, dilatational motions near the wall, manifested as travelling-wave structures, persist under the influence of particles. However, these structures are significantly weakened due to the suppression of solenoidal bursting events and the negative work exerted by the particle feedback force. These findings align with the insight of Yu et al. (J. Fluid. Mech., vol. 984, 2024, A44), who demonstrated that dilatational motions are generated by the vortices associated with intense bursting events, rather than acting as evolving perturbations beneath velocity streaks. The attenuation of travelling-wave structures at higher particle mass loadings also contributes to the reduction in the intensities of wall shear stress and heat flux fluctuations, as well as the probability of extreme events. These results highlight the potential of particle-laden flows to mitigate aerodynamic forces and thermal loads in high-speed vehicles.
This study aimed to investigate the relationship between serum folate levels and the risk of psoriasis by integrating observational study with Mendelian Randomisation (MR) analysis. We firstly conducted an observational study using data from the National Health and Nutrition Examination Survey (NHANES). Subsequently, genetic instruments were selected for two-sample MR analyses to investigate the causal relationship between serum folate levels and the risk of psoriasis. The observational study showed no significant association between serum folate levels and psoriasis. In the fully adjusted model, neither serum folate level as a continuous variable (OR = 0·99, 95 % CI: 0·98, 1·00, P = 0·071) nor serum folate quartiles Q4 compared to Q1 (OR = 0·83, 95 % CI: 0·58, 1·19, P = 0·309) showed statistical significance. The MR analysis revealed that higher genetically predicted serum folate levels from Icelandic and Danish populations were significantly associated with a reduced risk of psoriasis (OR = 0·63, 95 % CI: 0·45, 0·88, P = 0·005). Similarly, higher genetically predicted serum folate levels from South Asian populations were significantly associated with a lower risk of psoriasis (OR = 0·84, 95 % CI: 0·72, 0·98, P = 0·025). Integrating observational study with MR analysis suggests that serum folate levels are protective factors against psoriasis, indicating that higher serum folate levels may help prevent the onset of the disease.
Obesity, a global health issue, is associated with numerous diseases and has been shown to affect male reproductive health by inducing endocrine hormonal changes, chronic inflammation, oxidative stress and epigenetic alterations in reproductive cells. This study investigates the impact of obesity on testicular gene expression across mice, monkeys and humans, identifying 730 conserved testis-specific genes. High-fat diet-induced obesity upregulates GNG5, INHA, MSH5, SLC30A8 and SLC7A4 in testes, suggesting their potential as regulatory targets in testicular damage associated with obesity. Single-cell analysis reveals species-conserved expression patterns of SLC7A4 in Sertoli cells and SLC30A8 in SPG cells. It also confirmed that SLC30A8 and SLC7A4 were significantly upregulated in the testes of spontaneously obese mice. The findings highlight the potential of these genes as regulatory targets in obesity-related testicular dysfunction, providing insights into male reproductive health impairments caused by obesity.
The study aimed to determine the patterns of the vestibular and ocular motor findings in cerebellar infarction (CI).
Methods:
We retrospectively analyzed vestibular and ocular motor test results in 23 CI patients and 32 acute unilateral vestibulopathy (AUVP) patients.
Results:
Among CI cases, the posterior inferior cerebellar artery (PICA) was the most commonly affected territory. Vertigo is predominantly observed in patients with infarctions affecting PICA or anterior inferior cerebellar artery (AICA). Lesions involving the superior cerebellar artery (SCA) mainly result in dizziness. Saccadic intrusion and oscillation, abnormal bilateral smooth pursuit (SP) and abnormal saccades were more prevalent in the CI group than in the AUVP group (all p < 0.05). Horizontal saccades were abnormal in 11 patients (47.8%) with CI. All AUVP patients had normal horizontal saccades. Horizontal SP was impaired in 13 patients (56.5%) with CI, with decreased gain toward both sides in 10 and toward 1 side in 3. Impaired horizontal SP was noted in nine patients (28.1%) with AUVP, with decreased gain toward the contralesional side in all cases. A total of 26.3% (5/19) of patients with CI exhibited subjective visual vertical (SVV) deviation toward the affected side and 31.6% (6/19) toward the unaffected side. In patients with AUVP, 70.0% (21/30) showed SVV deviation toward the affected side.
Conclusions:
Vertigo is mainly seen in PICA or AICA infarctions. SCA lesions mostly cause dizziness. Saccadic intrusion and oscillation, abnormal bilateral SP and abnormal saccades contribute to the diagnosis of CI. Moreover, SVV deviation varies depending on the cerebellar structures involved.
Using longitudinal data on teams and quality competition results, this study examines the impact of team and task familiarity on brewing excellence in the Japanese sake industry from 1956 to 2018. Sake production involves teamwork at every stage, but while some teams work together long term, others experience high turnover. The study highlights two factors: team familiarity, the collective experience of working together, and task familiarity, the individual experience of the task. High familiarity can strengthen team bonds and improve teamwork, but it can also limit the inflow of new knowledge and thus hinder innovation. This study uses data from national quality competitions and brewer lists, and considers the Great East Japan Earthquake of 2011 as an external shock to address endogeneity and estimate the causal relationship between familiarity and competition outcomes. The empirical results show that increases in both team and task familiarity are negatively associated with quality superiority.
The school–vacation cycle may have impacts on the psychological states of adolescents. However, little evidence illustrates how transition from school to vacation impacts students’ psychological states (e.g. depression and anxiety).
Aims
To explore the changing patterns of depression and anxiety symptoms among adolescent students within a school–vacation transition and to provide insights for prevention or intervention targets.
Method
Social demographic data and depression and anxiety symptoms were measured from 1380 adolescent students during the school year (age: 13.8 ± 0.88) and 1100 students during the summer vacation (age: 14.2 ± 0.93) in China. Multilevel mixed-effect models were used to examine the changes in depression and anxiety levels and the associated influencing factors. Network analysis was used to explore the symptom network structures of depression and anxiety during school and vacation.
Results
Depression and anxiety symptoms significantly decreased during the vacation compared to the school period. Being female, higher age and with lower mother's educational level were identified as longitudinal risk factors. Interaction effects were found between group (school versus vacation) and the father's educational level as well as grade. Network analyses demonstrated that the anxiety symptoms, including ‘Nervous’, ‘Control worry’ and ‘Relax’ were the most central symptoms at both times. Psychomotor disturbance, including ‘Restless’, ‘Nervous’ and ‘Motor’, bridged depression and anxiety symptoms. The central and bridge symptoms showed variation across the school vacation.
Conclusions
The school–vacation transition had an impact on students’ depression and anxiety symptoms. Prevention and intervention strategies for adolescents’ depression and anxiety during school and vacation periods should be differentially developed.
In behavioral, biomedical, and psychological studies, structural equation models (SEMs) have been widely used for assessing relationships between latent variables. Regression-type structural models based on parametric functions are often used for such purposes. In many applications, however, parametric SEMs are not adequate to capture subtle patterns in the functions over the entire range of the predictor variable. A different but equally important limitation of traditional parametric SEMs is that they are not designed to handle mixed data types—continuous, count, ordered, and unordered categorical. This paper develops a generalized semiparametric SEM that is able to handle mixed data types and to simultaneously model different functional relationships among latent variables. A structural equation of the proposed SEM is formulated using a series of unspecified smooth functions. The Bayesian P-splines approach and Markov chain Monte Carlo methods are developed to estimate the smooth functions and the unknown parameters. Moreover, we examine the relative benefits of semiparametric modeling over parametric modeling using a Bayesian model-comparison statistic, called the complete deviance information criterion (DIC). The performance of the developed methodology is evaluated using a simulation study. To illustrate the method, we used a data set derived from the National Longitudinal Survey of Youth.
An optical spectrometer system based on 60 channels of fibers has been designed and employed to diagnose light emissions from laser–plasma interactions. The 60 fiber collectors cover an integrated solid angle of $\pi$, enabling the measurement of global energy losses in a symmetrical configuration. A detecting spectral range from ultraviolet to near-infrared, with angular distribution, allows for the understanding of the physical mechanisms involving various plasma modes. Experimental measurements of scattered lights from a conical implosion driven by high-energy nanosecond laser beams at the Shenguang-II Upgrade facility have been demonstrated, serving as reliable diagnostics to characterize laser absorption and energy losses from laser–plasma instabilities. This compact diagnostic system can provide comprehensive insights into laser energy coupling in direct-drive inertial confinement fusion research, which are essential for studying the driving asymmetry and improving the implosion efficiencies.
Time-domain characterization of ultrashort pulses is essential for studying interactions between light and matter. Here, we propose and demonstrate an all-optical pulse sampling technique based on reflected four-wave mixing with perturbation on a solid surface. In this method, a weak perturbation pulse perturbs the four-wave mixing signal generated by a strong fundamental pulse. The modulation signal of the four-wave mixing, which is detected in the reflection geometry to ensure a perfect phase-matching condition, directly reflects the temporal profile of the perturbation pulse. We successfully characterized multi-cycle and few-cycle pulses using this method. The reliability of our approach was verified by comparing it to the widely employed frequency-resolved optical gating method. This technique provides a simple and robust method for characterizing ultrashort laser pulses.
This paper studies the heterogeneity of households’ present bias in a heterogeneous-agent model. Our model jointly matches the average marginal propensities to consume and the wealth distribution in the USA, even when all wealth is liquid. A fiscal stimulus targeting households in the bottom half of the wealth distribution improves the consumption response. A financial literacy campaign removing present bias gets naive households out of the debt trap but harms sophisticated households’ wealth accumulation due to a lower equilibrium interest rate. Finally, we show that a borrowing cost penalty and illiquidity both discipline excessive borrowing and are therefore potential remedies for present bias and naivete.
In contemporary neuroimaging studies, it has been observed that patients with major depressive disorder (MDD) exhibit aberrant spontaneous neural activity, commonly quantified through the amplitude of low-frequency fluctuations (ALFF). However, the substantial individual heterogeneity among patients poses a challenge to reaching a unified conclusion.
Methods
To address this variability, our study adopts a novel framework to parse individualized ALFF abnormalities. We hypothesize that individualized ALFF abnormalities can be portrayed as a unique linear combination of shared differential factors. Our study involved two large multi-center datasets, comprising 2424 patients with MDD and 2183 healthy controls. In patients, individualized ALFF abnormalities were derived through normative modeling and further deconstructed into differential factors using non-negative matrix factorization.
Results
Two positive and two negative factors were identified. These factors were closely linked to clinical characteristics and explained group-level ALFF abnormalities in the two datasets. Moreover, these factors exhibited distinct associations with the distribution of neurotransmitter receptors/transporters, transcriptional profiles of inflammation-related genes, and connectome-informed epicenters, underscoring their neurobiological relevance. Additionally, factor compositions facilitated the identification of four distinct depressive subtypes, each characterized by unique abnormal ALFF patterns and clinical features. Importantly, these findings were successfully replicated in another dataset with different acquisition equipment, protocols, preprocessing strategies, and medication statuses, validating their robustness and generalizability.
Conclusions
This research identifies shared differential factors underlying individual spontaneous neural activity abnormalities in MDD and contributes novel insights into the heterogeneity of spontaneous neural activity abnormalities in MDD.
Developing a model to describe the shock-accelerated cylindrical fluid layer with arbitrary Atwood numbers is essential for uncovering the effect of Atwood numbers on the perturbation growth. The recent model (J. Fluid Mech., vol. 969, 2023, p. A6) reveals several contributions to the instability evolution of a shock-accelerated cylindrical fluid layer but its applicability is limited to cases with an absolute value of Atwood numbers close to $1$, due to the employment of the thin-shell correction and interface coupling effect of the fluid layer in vacuum. By employing the linear stability analysis on a cylindrical fluid layer in which two interfaces separate three arbitrary-density fluids, the present work generalizes the thin-shell correction and interface coupling effect, and thus, extends the recent model to cases with arbitrary Atwood numbers. The accuracy of this extended model in describing the instability evolution of the shock-accelerated fluid layer before reshock is confirmed via direct numerical simulations. In the verification simulations, three fluid-layer configurations are considered, where the outer and intermediate fluids remain fixed and the density of the inner fluid is reduced. Moreover, the mechanisms underlying the effect of the Atwood number at the inner interface on the perturbation growth are mainly elucidated by employing the model to analyse each contribution. As the Atwood number decreases, the dominant contribution of the Richtmyer–Meshkov instability is enhanced due to the stronger waves reverberated inside the layer, leading to weakened perturbation growth at initial in-phase interfaces and enhanced perturbation growth at initial anti-phase interfaces.
This study examined the sour grapes/sweet lemons rationalization through 2 conditions: ‘attainable’ (sweet lemons) and ‘unattainable’ (sour grapes), reflecting China’s 2019-nCoV vaccination strategy. The aim was to find ways to change people’s beliefs and preferences regarding vaccines by easing their safety concerns and encouraging more willingness to get vaccinated. An online survey was conducted from January 22 to 27, 2021, with 3,123 residents across 30 provinces and municipalities in the Chinese mainland. The direction of belief and preference changed in line with the sour grapes/sweet lemons rationalization. Using hypothetical and real contrasts, we compared those for whom the vaccine was relatively unattainable (‘sour grapes’ condition) with those who could get the vaccine easily (‘sweet lemons’). Whether the vaccine was attainable was determined in the early stage of the vaccine roll-out by membership in a select group of workers that was supposed to be vaccinated to the greatest extent possible, or, by being in the second stage when the vaccine was available to all. The attainable conditions demonstrated higher evaluation in vaccine safety, higher willingness to be vaccinated, and lower willingness to wait and see. Hence, we propose that the manipulation of vaccine attainability, which formed the basis of the application of sour grapes/sweet lemons rationalization, can be utilized as a means to manipulate the choice architecture to nudge individuals to ease vaccine safety concerns, reducing wait-and-see tendencies, and enhancing vaccination willingness. This approach can expedite universal vaccination and its associated benefits in future scenarios resembling the 2019-nCoV vaccine rollout.
With the over-use of tetracycline (TC) and its ultimate accumulation in aquatic systems, the demand for TC removal from contaminated water is increasing due to its severe threat to public health. Clay minerals have attracted great attention as low-cost adsorbents for controlling water pollution. The objective of the present study was to measure the adsorption behavior and mechanisms of TC on allophane, a nanosized clay mineral with a hollow spherical structure; to highlight the advantage of the allophane nanostructure, a further objective was to compare allophane with halloysite and montmorillonite, which have nanostructures that differ from allophane. Structural features and surface physicochemical properties were characterized by transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), zeta potential, N2-physisorption, and acid–base titration. The adsorption data showed that TC adsorption followed the pseudo-second order and Langmuir models. The adsorption was pH dependent, as all three clay minerals performed better under neutral to weakly alkaline conditions and maintained high adsorption performance in the presence of co-existing Na+/K+/Ca2+/Mg2+ cations. Regeneration of the adsorbent was excellent, with efficiencies exceeding 75% after five recycles. By comparison, allophane always exhibited the greatest adsorption capacity, up to 796 mg g–1 at ~pH 9. The TC adsorption on allophane and halloysite was dominated by inner-sphere complexation, together with a small amount of electrostatic adsorption, while that on montmorillonite involved mainly interlayer cation exchange. The findings provide insights into the effects of nanostructures of clay minerals on their TC adsorption performance and highlight the huge potential of allophane as an efficient and inexpensive adsorbent for TC removal.
To investigate the associations between dietary patterns and biological ageing, identify the most recommended dietary pattern for ageing and explore the potential mediating role of gut microbiota in less-developed ethnic minority regions (LEMRs). This prospective cohort study included 8288 participants aged 30–79 years from the China Multi-Ethnic Cohort study. Anthropometric measurements and clinical biomarkers were utilised to construct biological age based on Klemera and Doubal’s method (KDM-BA) and KDM-BA acceleration (KDM-AA). Dietary information was obtained through the baseline FFQ. Six dietary patterns were constructed: plant-based diet index, healthful plant-based diet index, unhealthful plant-based diet index, healthy diet score, Dietary Approaches to Stop Hypertension (DASH), and alternative Mediterranean diets. Follow-up adjusted for baseline analysis assessed the associations between dietary patterns and KDM-AA. Additionally, quantile G-computation identified significant beneficial and harmful food groups. In the subsample of 764 participants, we used causal mediation model to explore the mediating role of gut microbiota in these associations. The results showed that all dietary patterns were associated with KDM-AA, with DASH exhibiting the strongest negative association (β = −0·91, 95 % CI (–1·19, −0·63)). The component analyses revealed that beneficial food groups primarily included tea and soy products, whereas harmful groups mainly comprised salt and processed vegetables. In mediation analysis, the Synergistetes and Pyramidobacter possibly mediated the negative associations between plant-based diets and KDM-AA (5·61–9·19 %). Overall, healthy dietary patterns, especially DASH, are negatively associated with biological ageing in LEMRs, indicating that Synergistetes and Pyramidobacter may be potential mediators. Developing appropriate strategies may promote healthy ageing in LEMRs.