Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18.5 kg/m(2) [underweight], 18.5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia; for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.
Efficient visible-to-UV photon upconversion via triplet triplet annihilation (TTA) is accomplished in polyurethane (PU) films by developing new, powerful photo sensitizers fully functional in the solid-state matrix. These rationally designed triplet sensitizers feature a bichromophoric scaffold comprising a tris-cyclometalated indium(111) complex covalently tethered to a suitable organic small molecule. The very rapid intramolecular triplet energy transfer from the former to the latter is pivotal for achieving the potent sensitizing ability, because this process out-competes the radiative and nonradiative decays inherent to the metal complex and produces long-lived triplet excitons localized with the acceptor moiety readily available for intermolecular transfer and TTA. Nonetheless, compared to the solution state, the molecular diffusion is greatly limited in solid matrices, which even creates difficulty for the Dexter-type intramolecular energy transfer. This is proven by the experimental results showing that the sensitizing performance of the bichromophoric molecules strongly depends on the spatial distance separating the donor (D) and acceptor (A) units and that incorporating a longer linker between the D and A evidently curbs the TTA upconversion efficiency in PU films. Using a rationally optimized sensitizer structure in combination-with 2,7-di-teit-butylpyrene as the annihilator/emitter, the doped poly-urethane (PU) films demonstrate effective visible-to-UV upconverted.emission signal under noncoherentlight irradiation, attaining an upconversion quantum yield of 2.6%. Such quantum efficiency is the highest value so far reported for the visible-to-UV TTA systems in solid matrices.
Penta-graphene has recently been proposed as a new allotrope of carbon composed of pure pentagons, and displays many novel properties going beyond graphene [Zhang et al., Proc. Natl. Acad. Sci. U. S. A., 2015, 112, 2372]. To further explore the property modulations, we have carried out a theoretical investigation of the hydrogenated and fluorinated penta-graphene sheets. Our first-principles calculations reveal that hydrogenation and fluorination can effectively tune the electronic and mechanical properties of penta-graphene: turning the sheet from semiconducting to insulating; changing the Poisson's ratio from negative to positive, and reducing the Young's modulus. Moreover, the band gaps of the hydrogenated and fluorinated penta-graphene sheets are larger than those of fully hydrogenated and fluorinated graphene by 0.37 and 0.04 eV, respectively. The phonon dispersions and ab initio molecular dynamics simulations confirm that the surface modified penta-graphene sheets are dynamically and thermally stable, and show that the hydrogenated penta-graphene has more Raman-active modes with higher frequencies as compared to the fluorinated penta-graphene.
We generate a large number of monodisperse disk packings in two dimensions via geometric-based packing algorithms including the relaxation algorithm and the Torquato–Jiao algorithm. Using the geometric-structure approach, a clear boundary of the geometrical feasible region in the order map is found which quite differs from that of the jammed region. For a certain packing density higher than 0.83, the crystalline degree varies in different packing samples. We find that the local hexatic order may increase in two fairly different ways as the system densifies. Therefore, two typical non-equilibrium jammed patterns, termed polycrystal and distorted crystal, are defined at high packing densities. Furthermore, their responses to isotropic compression are investigated using a compression–relaxation molecular dynamic protocol. The distorted crystal pattern is more stable than the polycrystal one with smaller displacements despite its low occurrence frequency. The results are helpful in understanding the structure and phase transition of disk packings.
Background Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM. Design and Settings A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing. Methods 412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed. Results Patients with type D personality were significantly more likely to have poor medication adherence (p$<$0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable. Conclusion Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.
An ultra-small and broadband polarization splitter is numerically and experimentally demonstrated based on the double-slit interference in a polymer-film-coated double-slit structure. The hybrid slab waveguide(air-polymer-Au) supports both the transverse-magnetic and transverse-electric modes. The incident beam from the back side can excite these two guided modes of orthogonally polarized states in the hybrid structure. By exploiting the difference slit widths and the large mode birefringence, these two guided modes propagate to the opposite directions along the front metal surface. Moreover, the short interference length broadens the operation bandwidth. Experimentally, a polarization splitter with a lateral dimension of only about 1.6 μm and an operation bandwidth of 50 nm is realized. By designing the double-slit structure in a hybrid strip waveguide, the device dimension can be significant downscaled to about 0.3 × 1.3 μm2. Such an ultra-small and broadband polarization splitter may find important applications in the integrated photonic circuits.
Rapid urbanization and population growth have resulted in worldwide serious water shortage and environmental deterioration. It is then essential for efficient and feasible allocation of scarce water and environment resources to the competing users. Due to inherent uncertainties, decision making for resources allocation is vulnerable to failure. The scheme feasibility can be evaluated by reliability, representing the failure probability. A progressive reliability oriented multi-objective (PROMO) optimal decision-making procedure is proposed in this study to deal with problems with numerous reliability objectives. Dimensionality of the objectives is reduced by a top-down hierarchical reliability analysis (HRA) process combining optimization with evaluation. Pareto solutions of the reformulated model, representing alternative schemes non-dominated with each other, are generated by a metalmodel-based optimization algorithm. Evaluation and identification of Pareto solutions are conducted by multi-criteria decision analysis (MCDA). The PROMO procedure is demonstrated for a case study on industrial structure transformation under strict constraints of water resources and total environmental emissions amounts in Guangzhou City, South China. The Pareto front reveals tradeoffs between economic returns of the industries and system reliability. For different reliability preference scenarios, the Pareto solutions are ranked and the top-rated one was recommended for implementation. The model results indicate that the PROMO procedure is effective for model solving and scheme selection of uncertainty-based multi-objective decision making.
Rapid urbanization and population growth have resulted in worldwide serious water shortage and environmental deterioration. It is then essential for efficient and feasible allocation of scarce water and environment resources to the competing users. Due to inherent uncertainties, decision making for resources allocation is vulnerable to failure. The scheme feasibility can be evaluated by reliability, representing the failure probability. A progressive reliability-oriented multi-objective (PROMO) optimal decision-making procedure is proposed in this study to deal with problems with numerous reliability objectives. Dimensionality of the objectives is reduced by a top-down hierarchical reliability analysis (HRA) process combining optimization with evaluation. Pareto solutions of the reformulated model, representing alternative schemes non-dominated with each other, are generated by a metalmodel-based optimization algorithm. Evaluation and identification of Pareto solutions are conducted by multi-criteria decision analysis (MCDA). The PROMO procedure is demonstrated for a case study on industrial structure transformation under strict constraints of water resources and total environmental emissions amounts in Guangzhou City, South China. The Pareto front reveals tradeoffs between economic returns of the industries and system reliability. For different reliability preference scenarios, the Pareto solutions are ranked and the top-rated one was recommended for implementation. The model results indicate that the PROMO procedure is effective for model solving and scheme selection of uncertainty-based multi-objective decision making.
As a traditional application on various supercomputers, atmospheric modeling has long been suffering from the low performance efficiency. In this paper, we pick the 3D Euler equation solver (the most essential dynamic component for a non-hydrostatic atmospheric model) as the target application, and explore the maximum performance efficiency that can be achieved on CPU-GPU hybrid architectures. Besides presenting the suitable hybrid domain decomposition methodology and taking proper usage of tuning techniques for both the CPU and GPU parts, we further propose a novel GPU tuning technique, namely the customizable data caching mechanism with thread warp rescheduling scheme, which is specifically designed for the Euler solver. Combining all the optimizing approaches together, remarkable performance boost has been achieved on mainstream GPU architectures including Tesla Fermi C2050, K20×, K40 and K80. Especially, on the latest Tesla K80, we demonstrate a 31.64× speedup over the performance of 12-core E5-2697 CPU. In addition, based on a hybrid CPU-GPU node with two 12-core E5-2697 CPUs and two Tesla K80 GPUs, a sustained double-precision performance of 1.04 Tflops (16% of the peak) is achieved, which is remarkably higher than the efficiency of similar optimizing tasks based on heterogeneous platforms (strictly less than 10%, as demonstrated in the related work). In addition, a nearly linear weak scaling efficiency is achieved which demonstrate the effectiveness of our domain decomposition method.
