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With the increasing demand for innovative electronic products, LED transparent screens are gradually entering the public eye. Polyimide (PI) materials combine high temperature resistance and high transparency, which can be used to prepare flexible copper-clad laminate substrates. The physical and chemical properties of PI materials differ from copper, such as their thermal expansion coefficients (CTEs), surface energy, etc. These differences affect the formation and stability of the interface between copper and PI films, resulting in a short life for LED transparent screens. To enhance PI-copper interfacial adhesion, aminopropyl-terminated polydimethylsiloxane (PDMS) can be used to increase the adhesive ability. Two diamine monomers with a trifluoromethyl structure and a sulfone group structure were selected in this research. Bisphenol type A diether dianhydride is a dianhydride monomer. All three of the above monomers have non-coplanar structures and flexible structural units. The adhesion and optical properties can be improved between the interface of the synthesized PI films and copper foil. PI films containing PDMS 0, 1, 3, and 5 wt% were analyzed using UV spectroscopy. The transmittance of the PI-1/3%, PI-1/5%, PI-2/3%, and PI-2/5% films were all more than 80% at 450 nm. Meanwhile, the T d 5% and T d 10% heat loss and Tg temperatures decreased gradually with the increase in PDMS. The peel adhesion of PI-copper foil was measured using a 180° peel assay. The effect of PDMS addition on peel adhesion was analyzed. PIs-3% films had the greatest peeling intensities of 0.98 N/mm and 0.85 N/mm.

The objective of this study was to investigate the prevalence of vitamin D deficiency or insufficiency and its association with inflammatory markers and type 2 diabetes. We conducted our research at Qingdao Endocrine and Diabetes Hospital, where serum 25-hydroxyvitamin D3 levels were determined for 2,806 individuals with type 2 diabetes aged 30 and older between January 2018 and December 2019. Medical records were analyzed, and data on health, blood lipids, HbA1c, and inflammation were collected. Our results revealed a high prevalence of vitamin D deficiency in the population. Among male and female patients, median serum 25(OH)D3 levels were 22.46 and 19.00 ng/mL, respectively. More than 60% of female patients had vitamin D deficiency, with over 80% having levels below 30 ng/mL. We observed a favorable connection between high-density lipoprotein cholesterol and 25(OH)D3, while triglycerides and HbA1c showed negative correlations. As 25(OH)D3 levels increased, inflammatory markers such as hypersensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), white blood cell count, neutrophil count, and monocyte count decreased (trend test, p < 0.05), although peripheral blood lymphocytes initially increased and then decreased. After controlling for age and gender, multiple linear regression analysis indicated negative correlations between ESR, hsCRP, and white blood cell count with 25(OH)D3 ( p < 0.05). In conclusion, our study demonstrates that individuals with type 2 diabetes often exhibit vitamin D deficiency or insufficiency, which is associated with elevated levels of inflammatory markers in the blood., Competing Interests: Conflict of interest: Authors state no conflict of interest., (© 2024 the author(s), published by De Gruyter.)

Polymer materials with a low dielectric constant and low dielectric loss have the potential to be applied to high-frequency signal transmissions, such as mobile phone antennas and millimeter wave radars. Two types of diamines, 4,4'-diamino-p-tetraphenyl (DPT) and crown ether diamine (CED), were prepared for ternary copolymerization with BPDA in this study. Cross-links with molecular chains were formed, increasing molecular chain distance by utilizing rings of CED. The MPI films exhibit a good thermal performance with the increase in CED addition, with Tg > 380 °C and CTE from -4 × 10 -6 K -1 to 5 × 10 -6 K -1 . The Young's modulus can reach 8.6 GPa, and the tensile strength is above 200 MPa when 5% and 7% CED are introduced. These MPI films exhibit good mechanical performances. The dielectric constant of PI-10% film can go as low as 3.17. Meanwhile, the relationship between dielectric properties and molecular structure has been demonstrated by Molecular Simulation (MS). PI molecules are separated by low dielectric groups, resulting in a decrease in the dielectric constant.

2,4-Dichlorophenol (2,4-DCP) is difficult to degrade rapidly in the environment due to its stable chemical properties, so it was easy to lead to serious chlorophenol pollution in soil. Consequently, a remediation method which is efficient, safe, and economical is required. In this study, electrokinetic (EK) remediation was used to transfer sodium persulfate (Na 2 S 2 O 8 ) into soil to degrade 2,4-DCP, and the effect of several factors (including the addition location of Na 2 S 2 O 8 , applied voltage, and running time) on the remediation efficiency was explored. The concentration of Na 2 S 2 O 8 , residual efficiency of 2,4-DCP and distribution characteristics of pH, and electrical conductivity were analyzed. The results showed that the cathode was the optimal position to add Na 2 S 2 O 8 . Under this condition, Na 2 S 2 O 8 was uniformly distributed in the whole soil column through electromigration. The optimal removal efficiency of 2,4-DCP in soil by adding Na 2 S 2 O 8 was approximately 26% when the voltage gradient was 1.0 V/cm and the operating time was 9 days, which was mainly due to the degradation of S 2 O 8 2- ., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background/objectives: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine., Subjects/methods: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates., Results: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively ( P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively., Conclusions: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life., Trial Registration: ClinicalTrials.gov Identifier: NCT01053195., Competing Interests: Conflict of Interest: The authors declare no potential conflicts of interests., (©2023 The Korean Nutrition Society and the Korean Society of Community Nutrition.)

Large training datasets are important for deep learning-based methods. For medical image segmentation, it could be however difficult to obtain large number of labeled training images solely from one center. Distributed learning, such as swarm learning, has the potential to use multi-center data without breaching data privacy. However, data distributions across centers can vary a lot due to the diverse imaging protocols and vendors (known as feature skew). Also, the regions of interest to be segmented could be different, leading to inhomogeneous label distributions (referred to as label skew). With such non-independently and identically distributed (Non-IID) data, the distributed learning could result in degraded models. In this work, we propose a novel swarm learning approach, which assembles local knowledge from each center while at the same time overcomes forgetting of global knowledge during local training. Specifically, the approach first leverages a label skew-awared loss to preserve the global label knowledge, and then aligns local feature distributions to consolidate global knowledge against local feature skew. We validated our method in three Non-IID scenarios using four public datasets, including the Multi-Centre, Multi-Vendor and Multi-Disease Cardiac Segmentation (M&Ms) dataset, the Federated Tumor Segmentation (FeTS) dataset, the Multi-Modality Whole Heart Segmentation (MMWHS) dataset and the Multi-Site Prostate T2-weighted MRI segmentation (MSProsMRI) dataset. Results show that our method could achieve superior performance over existing methods. Code will be released via https://zmiclab.github.io/projects.html once the paper gets accepted.

Aims: To demonstrate the noninferiority of alogliptin to acarbose, in terms of antidiabetic efficacy, in Chinese people with uncontrolled type 2 diabetes (T2D) and high cardiovascular risk., Materials and Methods: ACADEMIC (NCT03794336) was a randomized, open-label, phase IV study conducted at 46 sites in China. Antidiabetic treatment-naive or metformin-treated adults with uncontrolled T2D (glycated haemoglobin [HbA1c] 58.0-97.0 mmol/mol) were randomized 2:1 to alogliptin 25 mg once daily or acarbose 100 mg three times daily for 16 weeks. All participants had a documented history of coronary heart disease or high cardiovascular risk at screening and received aspirin (acetylsalicylic acid) 100 mg daily throughout the trial. The primary endpoints were change in HbA1c versus baseline, and the incidence of gastrointestinal adverse events (AEs). Safety and tolerability were also assessed., Results: A total of 1088 participants were randomized. Alogliptin was noninferior to acarbose for the change in Week-16 HbA1c (least-squares mean change [standard error] -11.9 [0.4] vs. -11.4 [0.5] mmol/mol, respectively; difference between arms -0.5 [0.7] mmol/mol; 95% confidence interval -1.9 to 0.8 mmol/mol), and was associated with a lower incidence of gastrointestinal AEs (8.9% vs. 33.6%, respectively; P < 0.0001). More alogliptin than acarbose recipients achieved HbA1c <53.0 mmol/mol without gastrointestinal AEs (48.0% vs. 32.7%; P < 0.0001). Discontinuations due to treatment-related AEs were less frequent with alogliptin than acarbose (0.3% vs. 2.5%)., Conclusions: Glycaemic control was comparable between alogliptin and acarbose, but the gastrointestinal tolerability of alogliptin was better. More patients achieved target HbA1c without gastrointestinal AEs with alogliptin, suggesting that this agent may be preferred in clinical practice., (© 2022 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

By applying the locally optimal rotation method to deal with the lowest eigenvalue of a Hessian matrix, we have efficiently incorporated the hyperdynamics method into the ab initio scheme. In the present method, we only need to calculate the first derivative of the potential and several more force calls in each molecular dynamics (MD) step, which makes hyperdynamics simulation applicable in ab initio MD simulations. With this implementation, we are able to simulate defect diffusion in silicon with boost factors up to 10 5 . We utilized both direct MD and the hyperdynamics method to investigate diffusion of lithium atoms and silicon vacancies in silicon. We identified the complex diffusion process. The obtained diffusion coefficients of Li atoms and Si vacancies are in good agreement with the direct MD results.

Introduction: We explored the impact of a temporary tobacco-free public policy for the 2008 Summer Olympics on the smoking prevalence and secondhand smoke exposure among the population of a co-hosting city, Qingdao, China., Methods: The Qingdao Diabetes Survey was analyzed for 2006 (n = 4599) and 2009 (n = 4680), which are survey years before and after the tobacco-free Olympics public policy period (July 2007 to January 2009). We analyzed the differences in self-reported smoking prevalence and exposure to secondhand smoke at home and/or workplace, and compared odds of smoking by survey year and of exposure to secondhand smoke among nonsmokers., Results: From 2006 to 2009, the male smoking prevalence declined from 51.4% (95% confidence interval [CI] = 49.0% to 53.9%) to 42.6% (95% CI = 40.2% to 45.1%), and the proportion of lighter smokers decreased more. Among nonsmokers, the secondhand smoke exposure rate declined from 62.2% (95% CI = 60.5% to 63.9%) to 56.8% (95% CI = 55.1% to 58.6%). Regression analyses show 34% lower odds of men smoking after Olympics (OR = 0.66, 95% CI = 0.57% to 0.77%). Rural residents and individuals who are not retired were more likely to smoke. Female nonsmokers report 17% less exposure to secondhand smoke after Olympics (OR = 0.83, 95% CI = 0.70% to 0.98%). Urban nonsmokers were more likely to be exposed than their rural counterparts., Conclusions: Smoking prevalence among men and secondhand smoke exposure among women significantly decreased in Qingdao, China, after the tobacco-free Olympics public policy period. As only the proportion of lighter smokers decreased, this may help explain why urban nonsmokers reported increased exposure. Unintended increased secondhand smoke exposure and cessation support need to be addressed in large-scale policy campaigns., Implications: Hosting the Olympic Games can help to initiate large-scale tobacco-free public policies for hosting cities. Although previous studies have demonstrated reduction in nonsmoker exposure to secondhand smoke, the impact on the hosting city's smoking prevalence or exposure rates is unclear. After the Olympic Games in Qingdao, China, smoking prevalence among men significantly decreased, mostly due to light smokers. Secondhand smoke exposure at home and/or workplace significantly decreased among female nonsmokers. Urban nonsmokers had an unintended consequence of increased secondhand smoke exposure after the tobacco-free Olympic policy period. Concurrent promotion of cessation support for heavier smokers may be needed., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

A high catalytic system using Cu layered double hydrotalcite (Cu(II)-Mg(II)-Fe(III)LDHs) and hydrogen peroxide (H 2 O 2 ) was developed for the degradation of ethylbenzene. It was identified that the degradation efficiency of ethylbenzene (0.08 mmol L -1 ) and TOC removal were 96.1% and 39.7% respectively in the presence of 0.1 g L -1 Cu(II)-Mg(II)-Fe(III)LDHs with (Cu 2+  + Mg 2+ )/Fe 3+ molar ratio of 5.0 and 0.16 mmol L -1 H 2 O 2 in 6.0 h. Based on ESR and XPS data, hydroxyl radicals (•OH) were the predominant free radical specials generated from the catalytic decomposition of H 2 O 2 for the degradation of ethylbenzene. The redox of Cu(II)/Cu(III) on the layered Cu(II)-Mg(II)-Fe(III)LDHs surface active sites accounted for the formation of •OH radicals and the cycle of Cu(II) in the Cu(II)-Mg(II)-Fe(III)LDHs/H 2 O 2 system were proposed., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: Comparisons between brand and biosimilar basal insulin in hospitalized patients are lacking. We aimed to compare the efficacy and safety of brand insulin glargine vs. biosimilar insulin glargine in non-critical hospitalized patients with type 2 diabetes mellitus (T2DM)., Methods: This retrospective study was conducted using the electronic medical records of 194,006 patients at the Qingdao Endocrine and Diabetes Hospital between January 2006 and December 2017. A total of 476 patients diagnosed with T2DM, hospitalized, and treated with subcutaneous insulin glargine were included. After propensity score matching (1:3), patients who received biosimilar insulin glargine (Basalin) (n = 34) were compared to a matched group of patients who received brand insulin glargine (Lantus) (n = 101). Outcome measures were changes in fasting blood glucose (FBG), the incidence of hypoglycemia, and insulin dose., Results: Compared to patients who received Basalin, patients who received Lantus achieved more reduction in FBG during insulin treatment (- 1.24 mmol/L vs. - 2.20 mmol/L; p = 0.04) and had a lower mean FBG at the end of treatment (8.20 mmol/L vs. 7.26 mmol/L; p = 0.12). Patients in Basalin and Lantus groups had a comparable mean daily dose of basal insulin at initiation (0.19 vs. 0.18 IU/kg; p = 0.30) and end of treatment (0.21 vs. 0.21 IU/kg; p = 0.99), and a similar duration of basal insulin treatment (16.4 vs. 15.3 days; p = 0.74). Hypoglycemia was infrequent in both Basalin and Lantus treatment (one vs. four patients, respectively; p = 1.00) and no severe hypoglycemic events were reported., Conclusion: In a non-critical hospital setting, subcutaneous treatment with Lantus brought significant FBG improvement without increased hypoglycemic risk.

Textual information embedded in the medical image contains rich structured information about the medical condition of a patient. This paper aims at extracting structured textual information from semi-structured medical images. Given the recognized text spans of an image preprocessed by optical character recognition (OCR), due to the spatial discontinuity of texts spans as well as potential errors brought by OCR, the structured information extraction becomes more challenging. In this paper, we propose a domain-specific language, called ODL, which allows users to describe the value and layout of text data contained in the images. Based on the value and spatial constraints described in ODL, the ODL parser associates values found in the image with the data structure in the ODL description, while conforming to the aforementioned constraints. We conduct experiments on a dataset consisting of real medical images, our ODL parser consistently outperforms existing approaches in terms of extraction accuracy, which shows the better tolerance of incorrectly recognized texts, and positional variances between images. This accuracy can be further improved by learning from a few manual corrections., (Copyright © 2019. Published by Elsevier Ltd.)

Background: This study investigated the effectiveness and safety of switching from Basalin® to Lantus® in Chinese patients with diabetes mellitus (DM). Methods:  A retrospective chart review conducted using the electronic medical records of patients hospitalized at the Qingdao Endocrine and Diabetes Hospital from 2005 to 2016. All patients were diagnosed with DM and underwent switching of insulin from Basalin to Lantus during hospitalization. Data collected included fasting (FBG), pre- and post-prandial whole blood glucose, insulin dose, reasons for insulin switching and hypoglycemia. Four study time points were defined as: hospital admission, Basalin initiation, insulin switching (date of final dose of Basalin), and hospital discharge. Blood glucose measurements were imputed as the values recorded closest to the dates of these four time points for each patient. Results: Data from 73 patients (70 patients with type 2 diabetes, 2 with type 1, and 1 undisclosed) were analyzed. At admission, mean glycated hemoglobin (HbA1c) and FBG were 8.9% (SD=1.75) and 9.98 (3.22) mmol/L, respectively. Between Basalin initiation and insulin switch, mean FBG decreased from 9.68 mmol/L to 8.03 mmol/L (p<0.0001), over a mean 10.8 (SD=6.85) days of Basalin treatment, and reduced further to 7.30 mmol/L at discharge (p=0.0116) following a mean 6.6 (7.36) days of Lantus. The final doses of Basalin and Lantus were similar (0.23 vs. 0.24 IU/kg/day; p=0.2409). Furthermore, reductions in pre- and post-prandial blood glucose were also observed between Basalin initiation, insulin switch and hospital discharge. The incidence of confirmed hypoglycemia was low during Basalin (2 [2.4%]) and Lantus (1 [1.2%]) treatment, with no cases of severe hypoglycemia. Conclusion: In this study population, switching from Basalin to Lantus was associated with further reductions in blood glucose, although the dose of insulin glargine did not increase. Further studies are required to verify these findings and determine the reason for this phenomenon., Competing Interests: No competing interests were disclosed.

Aims: To estimate the long-term cost-effectiveness of exenatide twice daily vs insulin glargine once daily as add-on therapy to oral antidiabetic agents (OADs) for Chinese patients with type 2 diabetes (T2DM)., Methods: The Cardiff Diabetes Model was used to simulate disease progression and estimate the long-term effects of exenatide twice daily vs insulin glargine once daily. Patient profiles and treatment effects required for the model were obtained from literature reviews (English and Chinese databases) and from a meta-analysis of 8 randomized controlled trials comparing exenatide twice daily with insulin glargine once daily add-on to OADs for T2DM in China. Medical expenditure data were collected from 639 patients with T2DM (aged ≥18 years) with and without complications incurred between January 1, 2014 and December 31, 2015 from claims databases in Shandong, China. Costs (2014 Chinese Yuan [¥]) and benefits were estimated, from the payers' perspective, over 40 years at a discount rate of 3%. A series of sensitivity analyses were performed., Results: Patients on exenatide twice daily + OAD had a lower predicted incidence of most cardiovascular and hypoglycaemic events and lower total costs compared with those on insulin glargine once daily + OAD. A greater number of quality-adjusted life years (QALYs; 1.94) at a cost saving of ¥117 706 gained was associated with exenatide twice daily vs insulin glargine once daily. (i.e. cost saving of ¥60 764/QALY) per patient., Conclusions: In Chinese patients with T2DM inadequately controlled by OADs, exenatide twice daily is a cost-effective add-on therapy alternative to insulin glargine once daily, and may address the problem of an excess of medical needs resulting from weight gain and hypoglycaemia in T2DM treatment., (© 2017 John Wiley & Sons Ltd.)

Urinary tract infections (UTIs) are common nosocomial infections. This study evaluated the prevalence, pathogens, antibiotic resistances, clinical outcomes, and hospitalization costs associated with complicated UTIs in southern China, and risk factors delaying patient discharge. We retrospectively reviewed electronic medical records of 4,284 (61.4% women) complicated UTI-related hospitalizations from 2008 to 2013. Average patient age was 61.1 years and median hospital stay was 11 days. Pathogens were isolated from 1,071 urine and 148 blood specimens. Gram-negative bacteria were the most frequent and included Escherichia coli (48.2%), Klebsiella pneumoniae (9.5%), Pseudomonas aeruginosa (4.9%), and Proteus mirabilis (4.6%), while Enterococcus spp. (14.4%) was the most common Gram-positive bacteria causing UTIs. Both E. coli and K. pneumoniae showed high resistance rates (>45%) to wide-spectrum penicillins, cephalosporins, aztreonam, and ciprofloxacin. Resistances to beta-lactamase inhibitor/beta-lactam antibiotic combination were relatively lower. Imipenem, meropenem, and amikacin had the greatest activity against E.coli and K. pneumoniae . Recurrent infection was a risk factor for mortality. Age, sex, previous surgery, diabetes, and renal insufficiency were significant risk factors for delayed discharge ( P <0.01). Response to initial treatment was associated with a lower cost. Initial empiric use of antibiotics least associated with resistance may reduce costs and medical resource usage., Competing Interests: Disclosure JW, YC, WG, ZS, and HY are employees of AstraZeneca. ZW and XL received institutional/research grant funding from AstraZeneca for the conduct of the study. The authors report no other conflicts of interest in this work.

Background: Data describing epidemiology, clinical outcomes and treatment patterns, of hospitalised patients with pneumonia in China are limited. We aimed to describe such information among adult pneumonia patients in southern and northern China., Methods: We retrospectively reviewed electronic medical records of pneumonia patients aged ≥18 years, hospitalized between 2008 and 2013 at Guangdong Provincial Hospital of Chinese Medicine (n=3,636), southern China, and between 2010 and 2014 at Peking University People's Hospital, Beijing (n=1,689), northern China, in order to collect data on patient demographics, microbiology, clinical outcomes and treatment and resistance patterns., Results: The mean (SD) age of patients was 60.0 (21.4) and 64.4 (18.4) years in Guangdong and Beijing, respectively. Mean length of hospital stay was 12.1 and 20.8 days, and overall mortality was 2.9% and 8.0%, respectively. Gram-negative bacilli were most frequently isolated, predominantly Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa . Infection with these bacteria was associated with unfavourable clinical outcomes, and the antibiotic resistance among these bacteria increased between 2008-2010 and 2011-2013 in both regions of China. The treatment and choice of antibiotics slightly varied between the two regions based on the susceptible pathogens identified among their populations., Conclusions: Of the pathogens identified, Staphylococcus aureus infection (particularly the methicillin-resistant S. aureus ) was associated with poor clinical outcomes; however antibiotic resistance among S. aureus generally decreased during the study data collection periods. Also, disease severity was greater in Beijing as compared with Guangdong, and this may be associated with higher microbiological diagnosis rate and higher frequency of initial antibiotic modification among Beijing populations., Competing Interests: Conflicts of Interest: Jesus Gonzalez and Judith Hackett were employees of AstraZeneca at the time of the study. The remaining authors declare that they have no conflicts of interest.

CuMgFe layered double hydroxide (CuMgFe-LDH) was successfully synthesized and characterized as an efficient catalyst of persulfate (PS) for the degradation of ethylbenzene. Under the conditions of 0.2gL -1 CuMgFe-LDH and 4.0mmolL -1 persulfate at pH 7.6, the degradation efficiency of 0.08mmolL -1 ethylbenzene was 93.7% with TOC removal efficiency of 65.2% in 24h, and the concentration of Cu leached into the solution was as low as 0.095mgL -1 after the reaction. The reuse of CuMgFe-LDH showed that the catalyst was highly stable after 5 recycles. Electron Spin Resonance (ESR) test and free radical quenching experiment indicated that SO 4 - and OH radicals were the dominant species accounted for the degradation of ethylbenzene in the CuMgFe-LDH/persulfate system. Catalytic mechanism of the formation of a complex of Cu(II)O 3 SOOSO 3 2- and the subsequent redox cycle of Cu(II)/Cu(III) accounted for the generation of radicals was proposed., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background and Objectives: Fruit, vegetable, seafood, and dairy intake may reduce the risk of type 2 diabetes, but this relationship is unclear. We aimed to examine the associations between fruit, vegetable, seafood, and dairy intake and type 2 diabetes prevalence in a Chinese population., Methods and Study Design: A total of 4,343 individuals aged 35-74 years participated in a population-based cross-sectional study in Qingdao, China. The frequency and quantity of fruit, vegetable, seafood, and dairy intake were determined using a standard food frequency questionnaire. Diabetes was classified according to the WHO/IDF 2006 criteria. Logistic regression analysis was employed to estimate odds ratio (OR) for type 2 diabetes in relation to fruit, vegetable, seafood, and dairy intake in a multivariable model., Results: The multivariate-adjusted ORs (95% confidence interval) for the presence of type 2 diabetes were 0.68 (0.46-0.98), 0.50 (0.37-0.68), and 0.91 (0.66-1.25), respectively, for the highest versus the lowest groups regarding total fruit and vegetable, fruit or vegetable intake in women. The ORs for type 2 diabetes prevalence regarding the quantity of fruit and vegetable, fruit, and yogurt intake were 0.88 (0.78-0.99), 0.71 (0.61-0.82), and 0.56 (0.32-0.98) in women, but not in men. Seafood consumption was inversely associated with diabetes risk in men, but not in women; the corresponding figures were 0.58 (0.35-0.96) and 0.92 (0.63-1.36), respectively., Conclusions: Fruit, vegetable, and yogurt intake in women and seafood intake in men were inversely associated with type 2 diabetes prevalence in this Chinese population. These findings require confirmation in a prospective study.

Composite of nanoscale Zero Valent Iron (nZVI) loaded on Biochar (BC) was prepared and characterized as hydrogen peroxide (H 2 O 2 ) activator for the degradation of trichloroethylene (TCE). nZVI is homogeneously loaded on lamellarly structured BC surfaces to form nZVI/BC with specific surface area (S BET ) of 184.91 m 2 g -1 , which can efficiently activate H 2 O 2 to achieve TCE degradation efficiency of 98.9% with TOC removal of 78.2% within 30 min under the conditions of 0.10 mmol L -1 TCE, 1.13 g L -1 nZVI/BC and 1.50 mmol L -1 H 2 O 2 . Test results from the Electron Spin Resonance (ESR) measurement and coumarin based fluorescent probe technology indicated that ∙OH radicals were the dominant species responsible for the degradation of TCE within the nZVI/BC-H 2 O 2 system. Activation mechanism of the redox action of Fe 2+ /Fe 3+ generated under both aerobic and anaerobic conditions from nZVI and single electron transfer process from BC surface bound C-OH to H 2 O 2 promoted decomposition of H 2 O 2 into ∙OH radicals was proposed.

Objective: To study the clinical characteristics related to metabolic disorders and complications in type 2 diabetes mellitus patients hospitalized in the Qingdao Endocrine and Diabetes Hospital from 2006 to 2012 in Qingdao, China., Patient Population and Methods: Data from 14,289 (51% males) type 2 diabetes mellitus patients hospitalized between 2006 and 2012 were collected and analysed. Information on patients' demographic, anthropometric, laboratory and disease histories were extracted from electronic medical records., Results: The mean age of the patients was 60.5 years, with median diabetes duration of 9.0 years. Mean haemoglobin A1c was 8.4%, where <30.0% of patients had haemoglobin A1c <7.0%. In all, 34.5% of patients had low-density lipoprotein cholesterol lower than 2.6 mmol/L and 31.9% had hypertriglyceridaemia. Retinopathy was diagnosed in 51.1% of patients, nephropathy in 21.6%, neuropathy in 50.4%, hypertension in 77.4%, coronary heart disease in 27.6% and peripheral vascular disease in 58.6%. Once hospitalized, 71.1% of patients underwent insulin injection treatments, either mono-therapy or combined with other anti-diabetic drugs. Metformin was prescribed to 36.9% of patients, followed by acarbose 29.9%, thiazolidinediones 18.1%, meglitinides 14.8% and sulfonylureas 10.7%., Conclusion: Inadequate control of hyperglycaemia, poor metabolic profiles and diabetic complications were common challenges for long-term diabetes management in Chinese patients with type 2 diabetes mellitus., (© The Author(s) 2016.)

The rotational accuracy of a machine tool spindle has critical influence upon the geometric shape and surface roughness of finished workpiece. The rotational performance of the rolling element bearings is a main factor which affects the spindle accuracy, especially in the ultra-precision machining. In this paper, a new method is developed to measure the rotational accuracy of rolling element bearings of machine tool spindles. Variable and measurable axial preload is applied to seat the rolling elements in the bearing races, which is used to simulate the operating conditions. A high-precision (radial error is less than 300 nm) and high-stiffness (radial stiffness is 600 N/μm) hydrostatic reference spindle is adopted to rotate the inner race of the test bearing. To prevent the outer race from rotating, a 2-degrees of freedom flexure hinge mechanism (2-DOF FHM) is designed. Correction factors by using stiffness analysis are adopted to eliminate the influences of 2-DOF FHM in the radial direction. Two capacitive displacement sensors with nano-resolution (the highest resolution is 9 nm) are used to measure the radial error motion of the rolling element bearing, without separating the profile error as the traditional rotational accuracy metrology of the spindle. Finally, experimental measurements are performed at different spindle speeds (100-4000 rpm) and axial preloads (75-780 N). Synchronous and asynchronous error motion values are evaluated to demonstrate the feasibility and repeatability of the developed method and instrument.

The incidence of all cancers in China is generally higher in urban areas; however, the mortality risk for affected patients is considerably higher in rural areas. We present a subanalysis investigating the differences in patient and disease characteristics, treatment patterns, and outcomes between rural and urban patients who were diagnosed with breast cancer at West China Hospital between 2005-2009. Baseline patient and disease characteristics were recorded, and patients were followed up for a minimum of 3 years, or until death. For this subanalysis, patients were stratified by their residential status (rural or urban). Of the 2252 patients in the cohort, 76.3% were from urban areas and 22.1% were from rural areas. Significant differences were observed in the prevalence of luminal A and human epidermal growth factor receptor 2-positive breast cancers among rural and urban patients. Estrogen receptor (ER)-positive patients were less likely to receive anti-ER therapy if they were from rural areas compared with urban areas; the use of aromatase inhibitors was also significantly lower for rural patients than urban patients. Univariate, multivariate, and Kaplan-Meier analyses all demonstrated that overall survival and progression-free survival were significantly lower for rural patients than urban patients.

Breast cancer is a significant health issue both globally and within China. Here, we present epidemiological data for female patients diagnosed with breast cancer and treated at West China Hospital, Sichuan University, between 2005 and 2009. Patients who were diagnosed with breast cancer between 2005 and 2009 were enrolled. Data cut-off in this analysis was October 2013, allowing a minimum of 3 years' follow-up, or follow-up until death. Data were collected and subject to statistical analyses to assess relationships between patient and cancer characteristics, treatment patterns and long-term outcomes. A total of 2252 women with breast cancer were included in the analyses. Luminal B was the most common subtype of breast cancer and human epidermal growth factor 2 (HER2)-positive (nonluminal) was the least common. Most patients had early-stage disease (stage ≤IIIa) at diagnosis. Patients with luminal A appeared to have the best overall survival (OS), compared with other subtypes. Hormone-receptor positivity was associated with improved prognosis, compared with negativity (OS hazard ratio [HR] 0.5). Late-stage compared with early-stage disease at diagnosis was associated with much poorer OS across all patients and tumor subtypes. Clear differences were apparent between breast cancer subtypes and the response to treatment. The interaction of breast cancer subtypes, treatments and disease stage is complex. One of the most important factors for improved prognosis is diagnosis and treatment at an early-stage of disease. With breast cancer becoming an increasingly important health concern, this highlights the importance of establishing systems and protocols to identify and treat patients with breast cancer as early as possible., Competing Interests: JW, XL, YC, and WG are employees of AstraZeneca. The other authors declare no relevant conflicts of interest.

Biochar colloids' association with heavy metal needs be studied to precisely evaluate the effectiveness of biochar as sorbents. The structure of biochar colloids and their roles in heavy metal removal were investigated by Fourier-Transform Infrared Spectroscopy, X-ray Diffraction and batch adsorption experiments, respectively. Due to the numerous oxygen function groups and mineral matters contained in biochar colloids, the removal capacity of chromium (Cr) and cadmium (Cd) to biochar colloids was much greater than that of biochar residues. The highest adsorption capacities of Cr(III) and Cd(II) under initial pH 3.5 were obtained by RS400, which were mainly attributed to the presence of oxygen function groups and mineral matters simultaneously. The highest removal capacity of Cr(VI) was observed by RS300 due to the additional reduction by phenolic functional groups of RS300C. Therefore, the functions of biochar colloids for heavy metal removal should be considered., (Copyright © 2016. Published by Elsevier Ltd.)

Complicated intra-abdominal infection (cIAIs) are a common and important cause of morbidity worldwide. In this study, the clinical features, microbiological profiles, antimicrobial patterns and treatments of 3233 cIAI patients (mean age, 47.6 years; 54.7% male) with 3531 hospitalisations from 2008-2013 were retrospectively investigated. The most commonly isolated bacteria were Escherichia coli (47.6%), Klebsiella pneumoniae (16.9%), Enterococcus faecalis (10.4%) and Pseudomonas aeruginosa (8.8%). Ciprofloxacin, aminoglycoside (gentamicin), piperacillin/tazobactam and carbapenems exhibited activity against 53%, 76%, 88% and 100% of extended-spectrum β-lactamase (ESBL)-positive Enterobacteriaceae isolates, respectively. Pseudomonas aeruginosa isolates exhibited 100%, 95%, 88%, 71% and 76% susceptibility to aminoglycoside (gentamicin), ciprofloxacin, meropenem, imipenem and ceftazidime, respectively, and Enterococcus remained 100% susceptible to vancomycin and linezolid. β-Lactam antibacterials other than penicillin (specifically third-generation cephalosporins) and imidazole derivatives (ornidazole and metronidazole) were the most common first-line treatments. Patients subjected to regimen change after initial antibiotic treatment had predisposing conditions (e.g. older age, more severe co-morbidities) and a higher incidence of P. aeruginosa infection; in addition, these patients encountered a higher average cost of care and worse clinical outcomes compared with those without medication modification. Taken together, these findings indicate the importance of appropriate initial empirical therapy and suggest the use of combination therapy comprising cephalosporins and metronidazole., (Copyright © 2016 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.)

Complicated skin and soft tissue infections (cSSTI) are some of the most commonly treated infections in hospitals, and place heavy economic burdens on patients and society. Here we report the findings from an analysis of cSSTI based on a retrospective study which was conducted within the Chinese inpatient population. We focused our research on the analysis of the patient population, antibiotic treatment, clinical outcome and economic burden. The study population comprised 527 selected patients hospitalized between 2008 and 2013. Among the hospitalizations with microbiological diagnoses, 61.41% (n = 113) were diagnosed as infected with Gram-positive bacteria, while 46.20% (n = 85) were infected with Gram-negative bacteria. The most commonly found Gram-positive bacteria was Staphylococcus aureus (40.76%, n = 75), and the most common Gram-negative bacteria was Escherichia coli (14.13%, n = 26). About 20% of the Staphylococcus aureus were methicillin-resistant. The resistance rate of isolated Staphylococcus aureus or Escherichia coli to penicillin was around 90%; in contrast, the resistance rate to vancomycin, linezolid or imipenem was low (<20%). A large percentage of patients were treated with cephalosporins and fluoroquinolones, while vancomycin and imipenem were also included to treat drug-resistant pathogens. Over half of the hospitalizations (58.43%, n = 336) experienced treatment modifications. The cost to patients with antibiotic modifications was relatively higher than to those without. In conclusion, our study offers an analysis of the disease characteristics, microbiological diagnoses, treatment patterns and clinical outcomes of cSSTI in four hospitals in Guangdong Province, and sheds lights on the current clinical management of cSSTI in China.

Objective: This study aims to propose a data-driven framework that takes unstructured free text narratives in Chinese Electronic Medical Records (EMRs) as input and converts them into structured time-event-description triples, where the description is either an elaboration or an outcome of the medical event., Materials and Methods: Our framework uses a hybrid approach. It consists of constructing cross-domain core medical lexica, an unsupervised, iterative algorithm to accrue more accurate terms into the lexica, rules to address Chinese writing conventions and temporal descriptors, and a Support Vector Machine (SVM) algorithm that innovatively utilizes Normalized Google Distance (NGD) to estimate the correlation between medical events and their descriptions., Results: The effectiveness of the framework was demonstrated with a dataset of 24,817 de-identified Chinese EMRs. The cross-domain medical lexica were capable of recognizing terms with an F1-score of 0.896. 98.5% of recorded medical events were linked to temporal descriptors. The NGD SVM description-event matching achieved an F1-score of 0.874. The end-to-end time-event-description extraction of our framework achieved an F1-score of 0.846., Discussion: In terms of named entity recognition, the proposed framework outperforms state-of-the-art supervised learning algorithms (F1-score: 0.896 vs. 0.886). In event-description association, the NGD SVM is superior to SVM using only local context and semantic features (F1-score: 0.874 vs. 0.838)., Conclusions: The framework is data-driven, weakly supervised, and robust against the variations and noises that tend to occur in a large corpus. It addresses Chinese medical writing conventions and variations in writing styles through patterns used for discovering new terms and rules for updating the lexica.

The combination of surfactant enhanced soil washing and degradation of nitrobenzene (NB) in effluent with persulfate was investigated to remediate NB contaminated soil. Aqueous solution of sodium dodecylbenzenesulfonate (SDBS, 24.0 mmol L-1) was used at a given mass ratio of solution to soil (20:1) to extract NB contaminated soil (47.3 mg kg-1), resulting in NB desorption removal efficient of 76.8%. The washing effluent was treated in Fe2+/persulfate and Fe2+/H2O2 systems successively. The degradation removal of NB was 97.9%, being much higher than that of SDBS (51.6%) with addition of 40.0 mmol L-1 Fe2+ and 40.0 mmol L-1 persulfate after 15 min reaction. The preferential degradation was related to the lone pair electron of generated SO4•-, which preferably removes electrons from aromatic parts of NB over long alkyl chains of SDBS through hydrogen abstraction reactions. No preferential degradation was observed in •OH based oxidation because of its hydrogen abstraction or addition mechanism. The sustained SDBS could be reused for washing the contaminated soil. The combination of the effective surfactant-enhanced washing and the preferential degradation of NB with Fe2+/persulfate provide a useful option to remediate NB contaminated soil.

Biochar (BC) supported nanoscale zerovalent iron (nZVI) composite was synthesized and used as an activator for persulfate to enhance the trichloroethylene (TCE) removal in aqueous solutions. The degradation efficiency of TCE (0.15mmolL(-1)) was 99.4% in the presence of nZVI/BC (4.5mmolL(-1), nZVI to BC mass ratio was 1:5) and persulfate (4.5mmolL(-1)) within 5min, which was significantly higher than that (56.6%) in nZVI-persulfate system under the same conditions. Owing to large specific surface area and oxygen-containing functional groups of BC, nZVI/BC enhanced the SO4(-) generation and accelerated TCE degradation. On the basis of the characterization and analysis data, possible activation mechanisms of the Fe(2+)/Fe(3+) (Fe(II)/Fe(III)) redox action and the electron-transfer mediator of the BC oxygen functional groups promoting the generation of SO4(-) in nZVI/BC-persulfate system were clarified., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Aims: To examine and compare health-related quality of life (HRQoL) in people with previously known diabetes, new screen-detected asymptomatic diabetes and people without diabetes., Methods: HRQoL of 4,613 individuals who participated in a population-based cross-sectional diabetes survey in Qingdao, China, in 2009, was assessed using the 15D instrument. A Tobit regression model to estimate the effects of diabetes on HRQoL separate from effects of other health determinants was constructed., Results: Among the surveyed population, 220 (4.8%) individuals had previously known diabetes and 531 (11.5%) individuals had new screen-detected diabetes, defined by fasting plasma glucose ≥7.0 mmol/l and/or 2-h plasma glucose ≥11.1 mmol/l. The age-, gender-, and BMI-adjusted mean 15D score of people without diabetes, with new screen-detected diabetes, and previously known diabetes was 0.975, 0.975, and 0.964, respectively, for urban and 0.971, 0.972, and 0.960, respectively, for rural participants. HRQoL overall and on all the dimensions (p < 0.05) except for hearing, eating, and speech was worse in the people with previously known diabetes compared to those with new screen-detected diabetes and those without diabetes. Compared to people without diabetes, people with new screen-detected diabetes were worse off on the dimension of usual activities (p < 0.05). After adjusting for comorbid diseases and other confounders, the impact of diabetes on reduced HRQoL was diminished., Conclusion: Health-related quality of life was impaired in people with previously known diabetes who had co-morbid conditions, but was largely unaltered in people with newly detected asymptomatic diabetes as compared to people without diabetes.

Objective: Since the incidence rates and risk factor for type 2 diabetes in Chinese populations had not been well known, the aim of this study was to evaluate the impact of weight change and other risk factors on incident type 2 diabetes in Qingdao, China., Methods: A prospective population-based cohort study was carried out, based on subjects aged 35-74 years who participated in the 'Qingdao Diabetes Survey' in 2006. Subjects were free of diabetes at baseline. A total of 1 294 subjects attended the follow up survey between 2009 and 2011. The diagnostic criteria for Diabetes was classified according to both the World Health Organization and the International Diabetes Federation 2006. A logistic regression was built using the backward stepwise selection to assess the effects of risk factors on the incident type 2 diabetes., Results: During a 4-year follow up period, 120 cases with incident type 2 diabetes were identified, with cumulative incidence of diabetes as 11.8% . Participants who developed type 2 diabetes were significantly older, having significantly higher age-adjusted BMI/waist circumference/systolic blood pressure and total cholesterol, than those subjects who remained non-diabetic both in urban and rural areas. Among individuals with no diabetes at the baseline, factors as age, living in the rural areas, baseline BMI and weight change had all independently contributed to the development of diabetes. The multivariate adjusted relative risks (95%CIs) related to the incidence of diabetes were 1.45 (1.13-1.87), 1.93 (1.12-3.34), 1.46 (1.05-2.03) and 1.49 (1.18-1.88), respectively, for a one standard deviation increase in continuous variables. Compared with the reference group of non-obese and with stable weight, factor as weight loss >5% and BMI <28 kg/m² were independently associated with a 67% (RR = 0.33, 95% CI: 0.11-0.97)reduction in the risk of type 2 diabetes, while BMI >28 kg/m² could increase the risk across the levels of weight change. Similar trends were observed in higher waist and weight gain at baseline., Conclusion: This study confirmed the critical importance of obesity in the development of type 2 diabetes. Baseline BMI and weight gain appeared independent predictors on type 2 diabetes.

Aims: To evaluate the performance and cost-effectiveness of two screening methods to identify undiagnosed diabetes at primary care settings among a Chinese population., Methods: Two screening methods using a fasting capillary glucose (FCG) test or a Chinese diabetes risk score (DRS) at primary care settings followed by diagnostic tests were compared. The performance of FCG and DRS was evaluated by using receiver operating characteristic (ROC) curve analysis. The main economic outcome measures were the total cost of screening per 1000 persons, proportion of undiagnosed diabetes detected, and cost per undiagnosed diabetes identified from the societal perspective., Results: Among all participants, 14.6% (1349/9232) had undiagnosed diabetes defined by fasting plasma glucose ≥ 7.0mmol/l and/or 2h plasma glucose ≥ 11.1mmol/l and/or hemoglobin A1c ≥ 6.5%. At the optimal cutoff point of 6.1mmol/l for FCG and 14 for DRS, the sensitivity was 65.1% and 65.8%, and specificity was 72.4% and 55.2%, respectively. The area under the ROC curve was 75.3% for FCG and 63.7% for DRS (P<0.001). Based on the input costs, the total cost of screening 1000 persons was ¥64,000 ($9143) for FCG and ¥81,000 ($11,571) for DRS. The average cost per case identified was ¥674 ($96) for FCG at cutoff point of 6.1mmol/l and ¥844 ($121) for DRS at score of 14. The incremental cost per case identified was ¥17,000 ($2429) for DRS compared to FCG. The dominance relations between strategies remained with the changed in sensitivity analysis., Conclusions: As a first-line screening tool for undiagnosed diabetes, the FCG test performed better than the DRS in primary care settings in China. The non-invasive and layperson-oriented DRS was feasible and detected more cases but more expensive. No strategy has strong dominance that was both more effective and less costly. The favorable strategy will depend on if the purpose of the screening program is to identify more cases or to have lower cost per case., (Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Objective: To develop a New Chinese Diabetes Risk Score for screening undiagnosed type 2 diabetes in China., Research Design and Methods: Data from the China National Diabetes and Metabolic Disorders Study conducted from June 2007 to May 2008 comprising 16,525 men and 25,284 women aged 20-74 years were analyzed. Undiagnosed type 2 diabetes was detected based on fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L in people without a prior history of diabetes. β-Coefficients derived from a multiple logistic regression model predicting the presence of undiagnosed type 2 diabetes were used to calculate the New Chinese Diabetes Risk Score. The performance of the New Chinese Diabetes Risk Score was externally validated in two studies in Qingdao: one is prospective with follow-up from 2006 to 2009 (validation 1) and another cross-sectional conducted in 2009 (validation 2)., Results: The New Chinese Diabetes Risk Score includes age, sex, waist circumference, BMI, systolic blood pressure, and family history of diabetes. The score ranges from 0 to 51. The area under the receiver operating curve of the score for undiagnosed type 2 diabetes was 0.748 (0.739-0.756) in the exploratory population, 0.725 (0.683-0.767) in validation 1, and 0.702 (0.680-0.724) in validation 2. At the optimal cutoff value of 25, the sensitivity and specificity of the score for predicting undiagnosed type 2 diabetes were 92.3 and 35.5%, respectively, in validation 1 and 86.8 and 38.8% in validation 2., Conclusions: The New Chinese Diabetes Risk Score based on nonlaboratory data appears to be a reliable screening tool to detect undiagnosed type 2 diabetes in Chinese population.

Objective: To study joint effect of family history of diabetes (FHD) with obesity on prevalence of type 2 diabetes mellitus in the Chinese and in the Finns., Methods: A total of 1091 Chinese men and 1706 women, 1472 Finnish men and 1694 women, 45-74 years of age were studied. The probability and odds ratio (OR) of having diabetes were estimated using logistic regression analysis. The synergy index (SI) and relative excess risk due to interaction (RERI) of FHD with body mass index (BMI) or waist circumference (WC) was calculated., Results: Age-standardized prevalence of diabetes was higher in individuals with FHD than in those without in both the Chinese and Finns. Compared with individuals without FHD and with BMI <30 kg/m(2), ORs (95% confidence intervals [CI]) for diabetes were 2.7 (1.8, 4.0), 2.8 (1.9, 4.0), 9.1 (5.9, 13.9), respectively, in Finnish men with BMI ≥30 kg/m(2) alone, with FHD alone and with both (SI [95% CI] = 2.4 [1.4, 3.9], RERI = 4.6 [1.3, 8.0]); the corresponding figures were 1.7 (1.0, 2.9), 2.7 (1.8, 4.2) and 4.4 (1.9, 10.4) in Chinese men (SI = 1.4 [0.4, 4.9] RERI = 1.0 [-2.9, 5.0]). They were 3.5 (2.1, 5.8), 2.1 (1.3, 3.4) and 6.8 (4.1, 11.2) in Finnish women (SI = 1.6 [0.9, 2.8], RERI = 2.2 [-0.4, 4.9]), and 1.6 (1.1, 2.2), 2.1 (1.5, 3.0), 3.5 (1.9, 6.4) in Chinese women (SI = 1.5 [0.6, 3.8], RERI = 0.8 [-1.4, 3.0]). The pattern of synergistic effect of FHD with WC on diabetes was similar to that seen with BMI in the Finns but no effect was seen in the Chinese., Conclusions: Both obesity and FHD are independent risk factors for diabetes, but their joint effect is significant only in Finnish men., (Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Transition states are fundamental to understanding the reaction dynamics qualitatively in chemical physics. To date various methods of first principle location of the transition states have been developed. In the absence of the knowledge of the final structure, the softest-mode following method climbs up to a transition state without calculating the Hessian matrix. One weakness of this kind of approaches is that the number of rotations to determine the softest mode is usually unpredictable. In this paper, we propose a locally optimal search direction finding algorithm, namely LOR, which is an extension of the traditional conjugate gradient method without additional calculations of the forces. We also show that the translation of forces improves the numerical stability. Experiments for the Baker test system show that the proposed algorithm is much faster than the original dimer conjugate gradient method.

Background: A simplified model not requiring a clinic visit is important for cardiovascular prevention. We compared such a model, with one requiring clinical measurements for prediction of ischemic stroke., Methods: Five population-based Finnish cohorts comprising 14 296 men and 16 065 women aged 25-64 years were randomly recruited from 1982, and followed up using the national registers until the end of the 2007. The final Cox model included age, prior history of diabetes and hypertension, happy marriage, capability to walk 500 m (self-estimate), regular exercise, vegetable/fruit intake, smoking, body mass index, and systolic blood pressure; the layperson-oriented model was developed by taking blood pressure away from the final model., Results: Four hundred sixty-nine men and 371 women developed ischemic stroke events. The area under the receiver operating characteristic curve (95% confidence interval) for 10 years incidence of ischemic stroke was 0·817 (0·791-0·843) and 0·813 (0·787-0·839) for the model with and without systolic blood pressure in men and 0·815 (0·782-0·848) and 0·812 (0·779-0·844), respectively, in women (P > 0·10). The predicted 10-year events rate matched well with the observed one across deciles of the predicted risk in men (χ(2)  = 11·57, 9df, P = 0·239) and in women (χ(2)  = 11·18, P = 0·263). The overall net reclassification improvement after adding blood pressure was 8·8% (P = 0·016) in men and 3·2% (P = 0·234) in women. The predicted 10-year risk of the ischemic stroke based on global vascular event models that includes coronary heart diseases did not match well with the observed stroke risk., Conclusions: The layperson model performed as well as the clinical-based one., (© 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.)

Objective: To explore the synergistic effect between diabetes family history and abnormal waist-to-hip ratio (WHR) on the incidence of type 2 diabetes., Methods: Population-based case-control study was conducted. The interaction between diabetes family history and abnormal WHR was analysed by an additive model., Results: After adjusting confounding factors by multiple logistic regression analysis, the synergy index was 5.63, the attributable risk was 1.49, and the attributable interaction percent was 52.9%., Conclusion: There was a synergistic effect between diabetes family history and abnormal WHR on the incidence of type 2 diabetes.

Objective: To investigate the association of fresh vegetable consumption with the risk of diabetes in a Chinese population., Methods: Data from 2386 individuals aged 35-74 years who participated in a population-based cross sectional diabetes survey in Qingdao, China were analyzed. Frequency of vegetable intake was obtained using a food frequency questionnaire. Diabetes was defined as self-reported diabetes or undiagnosed diabetes determined by 2-h 75 g oral glucose tolerance test or fasting capillary blood glucose test. Multivariate-adjusted odds ratio (OR) for the presence (vs. the absence) of diabetes in association with the frequency of fresh vegetable intake was estimated using logistic regression analysis., Results: The OR for the presence of diabetes was 1.17 (95% CI 0.66, 2.05) in men and 0.50 (95% CI 0.33, 0.77) in women who ate fresh vegetables more than 14 times/week as compared with those who ate fresh vegetables less than 7 times/week after adjustment for age, family history of diabetes, BMI, systolic blood pressure, 24-h energy intake, physical activity and smoking and drinking., Conclusions: Consumption of fresh vegetables was associated with a low risk of having diabetes in women but not in men in this Chinese population., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

One laboratory-based and two non-laboratory-based models with and without blood pressure measures are developed based on data of 14815 men and 16617 women aged 25-64 years. During the followup 1134 men and 566 women developed coronary heart disease (CHD). The area under the receiver operating characteristic curve (95% CI) for prediction of CHD incidence was 0.823 (0.807-0.839) for the laboratory-based model, 0.808 (0.791-0.824) and 0.803 (0.787-0.820) for the non-laboratory-based models with and without systolic blood pressure in men (P < 0.01 for overall comparison), and 0.878 (0.856-0.901), 0.871 (0.848-0.894), and 0.864 (0.840-0.887), respectively, in women (P < 0.01). The predicted rates matched well with the observed ones (P > 0.10). Compared with the model without blood pressure, the non-laboratory-based model with blood pressure tended to reclassify individuals into the higher risk categories for both event and nonevent groups in both genders. The study concludes the predictive property of the non-laboratory-based models are good.

Due to its high overpotential and low efficiency, the conversion of water to O(2) using solar energy remains a bottleneck for photocatalytic water splitting. Here the microscopic mechanisms of the oxygen evolution reaction (OER) on differently structured anatase surfaces in aqueous surroundings, namely, (101), (001), and (102), are determined and compared systematically by combining first-principles density functional theory calculations and a parallel periodic continuum solvation model. We show that OER involves the sequential removal of protons from surface oxidative species, forming surface peroxo and superoxo intermediates. The initiating step, the first proton removal, dictates the high overpotential. Only at an overpotential of 0.7 V (1.93 V vs SHE) does this rate-controlling step become surmountable at room temperature: the free energy change of the step is 0.69, 0.63, and 0.61 eV for (101), (102), and (001) surfaces, respectively. We therefore conclude that (i) OER is not sensitive to the local surface structure of anatase and (ii) visible light (<∼590 nm) is, in principle, capable of driving the photocatatlytic OER on anatase kinetically. By co-doping high-valent elements into the anatase subsurface, we demonstrate that the high overpotential of the OER can be significantly reduced, with extra occupied levels above the valence band.

Aims: Qingdao Diabetes Prevention Program aims to translate the trial experience to real-life settings with goals to: (1) raise the public awareness of diabetes and diabetes risk factors, and promote healthy diet and physical activity; (2) reduce the number of high-risk people developing diabetes through lifestyle counselling; (3) early diagnosis of diabetes; (4) evaluate the effectiveness, cost-effectiveness, feasibility, acceptability and sustainability of the programs., Program Design: The project's first phase (2006-2009) was focused on health promotion targeting at the entire population of 1.94 million, and training of professionals; and the second phase (2009-2012) on lifestyle counselling targeting at individuals with a diabetes risk score of >or=14. The effectiveness of the intervention and the cost-effectiveness of the program between the intervention arm (n=8000) and the control arm (n=4000) who are randomly selected from the project targeting and not-targeting areas will be evaluated with the diabetes incidence as the primary outcome. Milestone achieved from 2006 to 2009: 3993 health professionals finished training courses; 724,130 educational booklets were distributed to families and 318,284 high-risk individuals recorded and 130,164 underwent at least one follow-up counselling session.

OBJECTIVE The study's goal was to evaluate the performance of A1C and fasting capillary blood glucose (FCG) tests as mass screening tools for diabetes and pre-diabetes, as determined by the standard oral glucose tolerance test (OGTT). RESEARCH DESIGN AND METHODS Data from 2,332 individuals aged 35-74 years who participated in a population-based cross-sectional diabetes survey in Qingdao, China, were analyzed. A 2-h 75-g OGTT was used to diagnose diabetes. The performance of A1C and FCG was evaluated against the results of the OGTTs by using receiver operating characteristic curve (ROC) analysis. RESULTS The prevalence of newly diagnosed diabetes and pre-diabetes (impaired fasting glucose and/or impaired glucose tolerance) was 11.9 and 29.5%, respectively. For subjects with newly diagnosed diabetes, the area under the ROC curve was 0.67 for A1C and 0.77 for FCG (P < 0.01) in men and 0.67 and 0.75 (P < 0.01) in women, whereas for pre-diabetes, these values were 0.47 and 0.64 (P < 0.001) in men and 0.51 and 0.65 (P < 0.001) in women. At the optimal A1C cutoff point of > or =5.6% for newly diagnosed diabetes, sensitivities (specificities) were 64.4% (61.6%) for men and 62.3% (63.3%) for women. CONCLUSIONS As a screening tool for newly diagnosed diabetes and pre-diabetes, the FCG measurement performed better than A1C in this general Chinese population.

Objective: To assess the association of serum uric acid (UA) with components of metabolic syndrome (MetS) in different ethnic groups., Methods: Nondiabetic men (3285) and nondiabetic women (4078) aged 25 to 74 years without a history of cardiovascular disease and gout from Mauritius and Qingdao China, comprising Mauritian Indians, Mauritian Creoles, and an urban Chinese population, were studied. The top quintile of waist circumference, body mass index (BMI), blood pressure, serum total cholesterol and triglycerides, plasma glucose levels, and the bottom quintile of HDL cholesterol was defined as the metabolic disorder. Hyperuricemia was defined if UA values were in the top quintile., Results: In a multivariate model (adjusted for age, cohort, smoking, and alcohol consumption), waist circumference, BMI, and serum triglycerides appeared to be independently associated with hyperuricemia in both sexes and in all ethnic groups except in Chinese women. Multivariate adjusted odds ratios (95% confidence intervals [CIs]) for having three or more metabolic disorders vs fewer than three, corresponding to a one SD increase in serum UA concentration, were 1.75 (1.51 to 2.02), 2.19 (1.71 to 2.82) and 2.30 (1.68 to 3.16) in Indian, Creole, and Chinese men, respectively, and 1.74 (1.52 to 2.00), 1.75 (1.40 to 2.19) and 1.72 (1.37 to 2.16) in Indian, Creole, and Chinese women, respectively., Conclusions: In nondiabetics of Asian and African ancestry, elevated serum UA was closely associated with components of MetS, but whether UA provides additional information to the definition of the MetS in predicting future cardiovascular disease and diabetes needs to be studied.

The current study aimed to evaluate whether individuals with fasting plasma glucose (FPG) of 5.6-6.0 mmol/l has a similar risk profiles for diabetes or impaired glucose tolerance (IGT) to those with FPG of 6.1-6.9 mmol/l. A community-based cross-sectional survey in Chinese adults (20-74 years) was conducted during April-July in 2002. Participants without a prior history of diabetes underwent a standardized 2-h 75 g oral glucose tolerance test. Positive likelihood ratios were calculated to estimate the odds of having diabetes or IGT for subjects with different FPG levels. Among 1856 participants, prevalence of IFG increased from 12.4 to 28.2% with the cut-off value of FPG lowered from 6.1 to 5.6 mmol/l. Individuals with FPG of 6.1-6.9 mmol/l were more obese and insulin resistant than those with FPG of 5.6-6.0 mmol/l. The positive likelihood ratio for diabetes and IGT were 1.83 (1.28-2.61) and 2.60 (1.96-3.44) in subjects with FPG of 6.1-6.9 mmol/l, and 0.54 (0.30-0.95) and 1.47 (1.11-1.95) for those with FPG of 5.6-6.0 mmol/l, respectively. In conclusion, the likelihood of diabetes and IGT was lower in subjects with FPG of 5.6-6.0 mmol/l than in those with FPG of 6.1-6.9 mmol/l. The clinical and social implication of labelling more individuals with impaired fasting glucose needs to be further studied.

The clustering of metabolic and pathophysiological cardiovascular risk factors has long been recognized but it was Reaven who popularized the syndrome in the Banting lecture of 1988. Since 1999, several major international or national organizations proposed their own definitions for the syndrome, named the metabolic syndrome. The prevalence of the metabolic syndrome varies according to definition, ethnicity and gender. The prevalence is under 20% among Chinese and Korean people but over 50% among Maori and Pacific Islanders in New Zealand. People with the metabolic syndrome have 50-60% higher cardiovascular risk than those without. The absolute cardiovascular risk of the metabolic syndrome, however, is not necessarily higher than those of its individual components. The pathogenesis underlying the clustering of cardiovascular risk factors remains unclear. Factors including genetic disposition, obesity, insulin resistance and inflammation have been suggested as being involved. Since the metabolic syndrome is multifactorial in origin, strategies for reducing cardiovascular risk in individuals with the metabolic syndrome involve the management of multiple risks. Lifestyle changes are an effective first-line management; pharmacological interventions for hypertension, diabetes and dyslipidaemia are in accordance with established guidelines. Pharmacological and surgical therapies for obesity are effective in selected patients. In this article we discuss the definitions, prevalence, pathogenesis and management of the metabolic syndrome in relation to cardiovascular risk.

Objective: Serum uric acid (UA) is reported as an important marker of hypertension, coronary heart disease, and diabetes; diabetic subjects have low UA levels. The relationship between UA and fasting plasma glucose (FPG) and 2-h plasma glucose concentrations in non-diabetic subjects as well as in diabetic subjects in general population is not well known. This was investigated in a general Chinese population., Methods: A stratified, random cluster sampling method was performed to select a representative sample of general population aged 20-74 years in Qingdao in 2002. A total of 1288 men and 2344 women participated in the survey. The mean UA concentration was calculated for small glucose intervals and the trend was tested using general linear model., Results: The mean concentrations of UA were 381, 393, 371, and 345 micromol/l in men with FPG of <6.1, 6.1-6.9, > or =7.0 mmol/l (newly diagnosed diabetes), and in those with prior history of diabetes. They were 308, 322, 301, and 293 micromol/l, respectively, in women. The UA levels declined with increasing FPG levels in individuals with newly diagnosed diabetes, with standardized coefficient of -0.26 in men and -0.20 in women, after multivariate adjustment for age, body mass index, triglycerides, and cardiovascular disease history. The relationship between 2-h glucose and UA was not as clear as that for FPG., Conclusion: Serum UA levels tended to increase with increasing FPG levels in non-diabetic individuals, but decrease in diabetic individuals.

Objective: Hyperuricemia and gout have shown an increase worldwide. Data are lacking for the prevalence of hyperuricemia and gout and their correlates in China. We studied the occurrence of these conditions in Chinese adults in the city of Qingdao., Methods: A population-based cross-sectional survey for hyperuricemia and gout was performed among 2438 adults (1535 women, 903 men; aged 20-74 yrs) in 2002. Fasting serum uric acid (UA) and lipid profiles were determined, as well as height, weight, and blood pressure. Hyperuricemia was defined as serum UA levels >or= 420 micromol/l in men and >or= 360 micromol/l in women. Diagnosis of gout was self-reported. Complete biochemical and questionnaire data were available for analysis from 1303 women and 720 men., Results: The age-standardized prevalence was 25.3% for hyperuricemia and 0.36% for gout in adults aged 20 to 74 years. Hyperuricemia was more prevalent in men than in women (32.1% vs 21.8%; p < 0.001). Age-adjusted mean serum UA level was 389.3 micromol/l in men and 315.7 micromol/l in women. Serum UA increased with age in women only (p for trend < 0.001). Body mass index and serum triglycerides had the strongest associations with serum UA in both genders, followed by alcohol drinking and diastolic blood pressure in men, and systolic blood pressure and total cholesterol in women., Conclusion: The prevalence of hyperuricemia in the urban adult population in Qingdao city is high, while the frequency of gout is lower. Obesity, hypertension, and dyslipidemia are the major factors associated with hyperuricemia in this study.

Objective: To assess the potential value of lowering the impaired fasting glucose (IFG) cut point from 110 mg/dL to 100 mg/dL., Methods: Data from pertinent published studies are analyzed in an effort to identify the risk of diabetes, cardiovascular disease, and mortality under various glycemic conditions., Results: The risk of developing diabetes increases with advancing age. The relationship is strongest when the 2-hour plasma glucose level is analyzed, whereas the fasting plasma glucose level is generally stable and changes little with aging. The 2-hour plasma glucose level has a linear relationship with cardiovascular disease and mortality. Most patients with acute myocardial infarction have high 2-hour plasma glucose levels but normal fasting plasma glucose values. Increased mortality risk based on the fasting plasma glucose level does not appear until values of approximately 7 mmol/L (126 mg/dL) and remains relatively flat at lower levels., Conclusion: Lowering the cut point for IFG from 6.1 mmol/L to 5.6 mmol/L (110 mg/dL to 100 mg/dL) increases the prevalence of IFG but does not predict mortality below 7 mmol/L (126 mg/dL).

Evidence accumulated from several large-scale epidemiological and intervention studies strongly indicates that hyperglycaemia and specifically post-challenge hyperglycaemia is an independent factor related to the increased risks of cardiovascular disease. The DECODE (Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe) study has de-emphasized the importance of fasting glucose, in contrast to post-challenge hyperglycaemia, as the principal measurable determinant of glycaemic exposure contributing to the risk of cardiovascular disease in Type 2 diabetes and even in non-diabetic subjects. The study, based on five Finnish DECODE study cohorts, demonstrated that in subjects without previous myocardial infarction, 2-h post-challenge glucose after an oral glucose tolerance test was a stronger predictor of the risk of serious coronary heart disease events than fasting glucose. Post-challenge hyperglycaemia was identified as an independent risk factor for cardiovascular disease also in Cardiovascular Health Study and the Framingham Offspring Study. It seems fair to conclude that post-challenge glucose is likely to be an independent cardiovascular risk factor. The mechanism for the increased risk in the incidence and mortality related to post-challenge hyperglycaemia has been speculated. To recognize that post-challenge hyperglycaemia is an important risk factor for cardiovascular disease may be of a significant preventive importance.