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This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system.
Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system.
The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control.
There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05).
Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.
We assessed inheritance of resistance to sugarcane brown rust (Puccinia melanocephala) in selfing F1 populations of wild sugarcane germplasm Erianthus rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’. We tested parent and selfing F1 individuals for the brown rust resistance gene, Bru1, that has been shown to confer resistance to brown rust in sugarcane. The Bru1 gene was not detected in E. rockii ‘Yundian 95-19’, E. rockii ‘Yundian 95-20’ or their selfing F1 individuals, and we found there was segregation of resistance in the two selfing F1 populations (segregation ratio: 3:1). The results confirmed resistance in E. rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’ to sugarcane brown rust is controlled by a novel, single dominant gene.
Vehicle license platerecognition in natural scene is an important research topic in computer vision. The license plate recognition approach in the specific scene has become a relatively mature technology. However, license plate recognition in the natural scene is still a challenge since the image parameters are highly affected by the complicated environment. For the purpose of improving the performance of license plate recognition in natural scene, we proposed a solution to recognize real-world Chinese license plate photographs using the DCNN-RNN model. With the implementation of DCNN, the license plate is located and the features of the license plate are extracted after the correction process. Finally, an RNN model is performed to decode the deep features to characters without character segmentation. Our state-of-the-art system results in the accuracy and recall of 92.32 and 91.89% on the car accident scene dataset collected in the natural scene, and 92.88 and 92.09% on Caltech Cars 1999 dataset.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Annexin A2 (ANXA2) is reported to be associated with cancer development. To investigate the roles ANXA2 plays during the development of cancer, the RNAi method was used to inhibit the ANXA2 expression in caco2 (human colorectal cancer cell line) and SMMC7721 (human hepatocarcinoma cell line) cells. The results showed that when the expression of ANXA2 was efficiently inhibited, the growth and motility of both cell lines were significantly decreased, and the development of the motility relevant microstructures, such as pseudopodia, filopodia, and the polymerization of microfilaments and microtubules were obviously inhibited. The cancer cell apoptosis was enhanced without obvious significance. The possible regulating pathway in the process was also predicted and discussed. Our results suggested that ANXA2 plays important roles in maintaining the malignancy of colorectal and hepatic cancer by enhancing the cell proliferation, motility, and development of the motility associated microstructures of cancer cells based on a possible complicated signal pathway.
Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates.
Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model.
Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1–31.9%; I2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3–3.7%; I2 = 95.6%), 2.7% (95% CI 2.1–3.4%; I2 = 78.5%) and 45.9% (95% CI 42.1–49.9%; I2 = 0), respectively. Earlier age of onset (Q = 4.38, p = 0.04), high-income countries (Q = 53.29, p < 0.001), North America and Europe and Central Asia (Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts.
Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.
Concerns over food safety in China not only direct public attention to negative
incidents, but also trigger the government's scrutiny of implicated
firms, particularly MNCs. The question of how to repair legitimacy after media
coverage of negative incidents has become a critical issue for MNCs. Although
the factors for MNCs’ public crises have been identified, how local
contexts and mechanisms shape repair approaches remain unclear. To address this
research gap, we conducted a study of Walmart China's approaches
associated with two negative incidents across two regions. We found that the
negative incidents can be framed differently depending on the local
environment's unfavorability for MNCs. Specifically, the negative
framing gave rise to varying degrees of legitimacy loss and offered different
leeway for MNCs to repair their legitimacy. We also identified the varied
outcomes of different repair approaches. By revealing the linkages among local
context, framing, legitimacy repair, and its outcomes, our study contributes to
research on MNCs’ legitimacy management under institutional
complexity and underscores the China context for legitimacy maintenance. We also
offer insights that advance the institutional approach to legitimacy repair in
this context. Last, we reflect on the techniques for conducting qualitative
research in China.
Residual strain often occurs in metal when it was subjected to the tension load, random vibration, or high impact. The mild steel was selected as the research object, and the feasibility of using nonlinear ultrasonic technique to characterize the residual strain was investigated in this paper. First, the mild steel specimens were stretched to several different kinds of stress, then the nonlinear effect as well as the microstrain of each sample was measured. The results indicate that the microstrain increases with increasing applied stress and reaches a maximum value of about 0.036% as the tensile stress increases to the elastic limit. Compared with the original specimen, the nonlinear parameter of tensile specimen gradually increased within the elastic limit. This result reveals that the variation of nonlinear parameter was related to microstrain in mild steel, because the microstructure observation demonstrated that the dislocation structure was basically unchanged within the elastic limit. This research indicates that the nonlinear ultrasonic method has the promising potential to characterize the microstrain in metals.
Novel NiMoO4-integrated electrode materials were successfully prepared by solvothermal method using Na2MoO4·2H2O and NiSO4·6H2O as main raw materials, water, and ethanol as solvents. The morphology, phase, and structure of the as-prepared materials were characterized by SEM, XRD, Raman, and FT-IR. The electrochemical properties of the materials in supercapacitors were investigated by cyclic voltammetry, constant current charge–discharge, and electrochemical impedance spectroscopy techniques. The effects of volume ratio of water to ethanol (W/E) in solvent on the properties of the product were studied. The results show that the pure phase monoclinic crystal NiMoO4 product can be obtained when the W/E is 2:1. The diameter and length are 0.1–0.3 µm and approximately 3 µm, respectively. As an active material for supercapacitor, the NiMoO4 nanorods material delivered a discharge specific capacitance of 672, 498, and 396 F/g at a current density of 4, 7, and 10 A/g, respectively. The discharge specific capacitance slightly decreased from 815 to 588 F/g with a retention of 72% after 1000 cycles at a current density of 1 A/g. With these superior capacitance properties, the novel NiMoO4 integrated electrode materials could be considered as promising material for supercapacitors.
Maternal one-carbon metabolism during pregnancy is crucial for fetal development and programming by DNA methylation. However, evidence on one-carbon biomarkers other than folate is lacking. We, therefore, investigated whether maternal plasma methyl donors, that is, choline, betaine and methionine, are associated with birth outcomes. Blood samples were obtained from 115 women during gestation (median 26·3 weeks, 90 % range 22·7–33·0 weeks). Plasma choline, betaine, methionine and dimethylglycine were measured using HPLC-tandem MS. Multivariate linear and logistic regression models were used to estimate the association between plasma biomarkers and birth weight, birth length, the risk of small-for-gestational-age and large-for-gestational-age (LGA). Higher level of maternal betaine was associated with lower birth weight (–130·3 (95 % CI –244·8, –15·9) per 1 sd increment for log-transformed betaine). Higher maternal methionine was associated with lower risk of LGA, and adjusted OR, with 95 % CI for 1 sd increase in methionine concentration was 0·44 (95 % CI 0·21, 0·89). Stratified analyses according to infant sex or maternal plasma homocysteine status showed that reduction in birth weight in relation to maternal betaine was only limited to male infants or to who had higher maternal homocysteine status (≥5·1 µmol/l). Higher maternal betaine status was associated with reduced birth weight. Maternal methionine was inversely associated with LGA risk. These findings are needed to be replicated in future larger studies.
The output performances of a bidirectional ring amplifier with twin pulses are demonstrated. Compared to the extraction efficiency of 32% for single-pulse injection, the extraction efficiency of stored energy for twin-pulse injection with bidirectional propagation is increased to 60%. The maximum output energies of the twin pulses are 347 mJ and 351 mJ, and the output energy of a single pulse is only 373 mJ under the same amplifier operating conditions. The experimental results show that the bidirectional ring amplifier with twin pulses can achieve a higher extraction efficiency of stored energy at a lower operating fluence, and has potential applications in high-power and high-energy laser facilities.
Magnetic iron oxide nanoparticles (MIONPs) are particularly attractive in biosensor, antibacterial activity, targeted drug delivery, cell separation, magnetic resonance imaging tumor magnetic hyperthermia, and so on because of their particular properties including superparamagnetic behavior, low toxicity, biocompatibility, etc. Although many methods had been developed to produce MIONPs, some challenges such as severe agglomeration, serious oxidation, and irregular size are still faced in the synthesis of MIONPs. Thus, various strategies had been developed for the surface modification of MIONPs to improve the characteristics of them and obtain multifunctional MIONPs, which will widen the applicational scopes of them. Therefore, the processes, mechanisms, advances, advantages, and disadvantages of six main approaches for the synthesis of MIONPs; surface modification of MIONPs with inorganic materials, organic molecules, and polymer molecules; applications of MIONPs or modified MIONPs; the technical challenges of synthesizing MIONPs; and their limitations in biomedical applications were described in this review to provide the theoretical and technological guidance for their future applications.
A band-stop angular filter (BSF) based on hump volume Bragg gratings (HVBGs) is proposed. Band-stop filtering in a two-stage amplifier laser system is discussed and simulated. Simulation results show that small-scale self-focusing effects in the laser system can be effectively suppressed with the BSF due to the control of fast nonlinear growth in a specific range of spatial frequencies in the laser beam. Near-field modulation of the output beam from the laser system was decreased from 2.69 to 1.37 by controlling the fast nonlinear growth of spatial frequencies ranging from
with the BSF. In addition, the BSF can be used in a plug-and-play scheme and has potential applications in high-power laser systems.
Reynolds-averaged Navier–Stokes (RANS) simulations with turbulence closure models continue to play important roles in industrial flow simulations. However, the commonly used linear eddy-viscosity models are intrinsically unable to handle flows with non-equilibrium turbulence (e.g. flows with massive separation). Reynolds stress models, on the other hand, are plagued by their lack of robustness. Recent studies in plane channel flows found that even substituting Reynolds stresses with errors below 0.5 % from direct numerical simulation databases into RANS equations leads to velocities with large errors (up to 35 %). While such an observation may have only marginal relevance to traditional Reynolds stress models, it is disturbing for the recently emerging data-driven models that treat the Reynolds stress as an explicit source term in the RANS equations, as it suggests that the RANS equations with such models can be ill-conditioned. So far, a rigorous analysis of the condition of such models is still lacking. As such, in this work we propose a metric based on local condition number function for a priori evaluation of the conditioning of the RANS equations. We further show that the ill-conditioning cannot be explained by the global matrix condition number of the discretized RANS equations. Comprehensive numerical tests are performed on turbulent channel flows at various Reynolds numbers and additionally on two complex flows, i.e. flow over periodic hills, and flow in a square duct. Results suggest that the proposed metric can adequately explain observations in previous studies, i.e. deteriorated model conditioning with increasing Reynolds number and better conditioning of the implicit treatment of the Reynolds stress compared to the explicit treatment. This metric can play critical roles in the future development of data-driven turbulence models by enforcing the conditioning as a requirement on these models.
Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.
Refinement and homogenization of primary Si particles in hypereutectic Al–Si alloys is an effective route to enhance the tensile strength and wear resistance and satisfy the industrial requirements for a wide range of applications. Herein, two kinds of semisolid hypereutectic Al–Si alloys are synthesized by using a rotating-rod-induced nucleation technology. The influence of different cooling conditions and shear rates on the apparent viscosity of molten melt of slurry are examined by self-made high-precision and high-temperature apparent viscosity test equipment. The correlation between the shear rate and the uniformity of hard phases has been investigated from the obtained results, fitting curves, and optical microscope. With the increase in the shear rate, the particles tend to become rounder and the apparent viscosity becomes lower. The enhanced shape factor resulted in more rounded grains, which further reduced the apparent viscosity. During the same cooling time, the higher cooling rate resulted in higher solid fraction, generating higher apparent viscosity. The present study provides unique insight into the filling behavior of semisolid hypereutectic Al–Si alloys and serves as a baseline for future work.
Whether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency.
To detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder.
Web-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P < 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed.
Patients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder.
Our results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum.
In this work, carbon nanotubes (CNTs)-templated binuclear metallophthalocyanines (MTAPcCF3)2C (M = Mn, Fe, Co, Ni, Cu, Zn) assemblies (MTAPcCF3)2C–COOH–CNTs are designed and obtained. Whereafter, the structure and morphology of target products are analyzed by many means such as infrared, X-ray diffraction, X-ray photoelectron spectroscopy, and scanning electron microscopy. The electrocatalytic performances of lithium-thionyl chloride battery catalyzed by (MTAPcCF3)2C–COOH–CNTs were carried out. The result shows that all catalysts can improve the battery performance including the discharge time and the initial voltage. The catalytic performance of (MTAPcCF3)2C–COOH–CNTs is ordered following the central metal: Mn > Fe > Ni > Co > Cu > Zn. The cell capacity catalyzed by optimal catalyst (MnTAPcCF3)2C–COOH–CNTs can expand to 28.08 mAˑh, with increase by 142.07%, and the (MnTAPcCF3)2C–COOH–CNTs can extend the discharge time to 551.6 s. Besides, the reaction mechanism is presented on the basis of cyclic voltammetry measurements.
This paper introduces recent activities on Marx-based compact repetitive pulsed power generators at the Institute of Applied Electronics (IAE), China Academy of Engineering Physics (CAEP), over the period 2010–2018. A characteristic feature of the generators described is the use of a simplified bipolar charged Marx circuit, in which the normal isolation resistors or inductors to ground are removed to make the circuit simpler. Several pulse-forming modules developed to generate a 100 ns square wave output are introduced, including thin-film dielectric lines of different structures, a pulse-forming line based on a Printed Circuit Board, and non-uniform pulse-forming networks. A compact repetitive three-electrode spark gap switch with low-jitter, high-voltage, and high-current was developed and is used in the generators. A positive and negative series resonant constant current power supply with high precision and high power is introduced. As an important part of the repetitive pulse power generator, a lower jitter pulse trigger source is introduced. Several typical high-power repetitive pulsed power generators developed at IAE are introduced including a 30 GW low-impedance Marx generator, a compact square-wave pulse generator based on Kapton-film dielectric Blumlein line, a 20 GW high pulse-energy repetitive PFN-Marx generator, and a coaxial Marx generator based on ceramic capacitors. The research of key technologies and their development status are discussed, which can provide a reference for the future development and application of miniaturization of compact and repetitive Marx generators.