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We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case–control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2–4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose–response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
In this study, a data-driven method for the construction of a reduced-order model (ROM) for complex flows is proposed. The method uses the proper orthogonal decomposition (POD) modes as the orthogonal basis and the dynamic mode decomposition method to obtain linear equations for the temporal evolution coefficients of the modes. This method eliminates the need for the governing equations of the flows involved, and therefore saves the effort of deriving the projected equations and proving their consistency, convergence and stability, as required by the conventional Galerkin projection method, which has been successfully applied to incompressible flows but is hard to extend to compressible flows. Using a sparsity-promoting algorithm, the dimensionality of the ROM is further reduced to a minimum. The ROMs of the natural and bypass transitions of supersonic boundary layers at
are constructed by the proposed data-driven method. The temporal evolution of the POD modes shows good agreement with that obtained by direct numerical simulations in both cases.
Image stitching is important for the perception and manipulation of undersea robots. In spite of a well-developed technique, it is still challenging for undersea images because of their inevitable appearance ambiguity caused by the limited light in the undersea environment, and local disturbance caused by moving objects, ocean current, etc. To get a clean and stable background panorama in the undersea environment, this paper proposes an undersea image-stitching method by introducing graph-based registration and blending procedures. Specifically, in the registration procedure, matching the features in each undersea image pair is formulated and solved by graph matching, to incorporate the structural information between features. In the blending procedure, an energy function on the indirect graph Markov random field is proposed, which takes both image consistency and neighboring consistency into consideration. Coincidentally, both graph matching and energy minimization can be mathematically formulated by integer quadratic programming problems with different constraints; the recently proposed graduated nonconvexity and concavity procedure is used to optimize both problems. Experiments on both synthetic images and real-world undersea images witness the effectiveness of the proposed method.
Employing atomic-scale simulations, the response of a high-angle grain boundary (GB), the soft/hard GB, against external loading was systematically investigated. Under tensile loading close to the hard orientation, strain-induced dynamic recrystallization was observed to initiate through direct soft-to-hard grain reorientation, which was triggered by stress mismatch, inhibited by surface tension from the soft-hard GB, and proceeded by interface ledges. Such grain reorientation corresponds with expansion and contraction of the hard grain along and perpendicular to the loading direction, respectively, accompanied by local atomic shuffling, providing relatively large normal strain of 8.3% with activation energy of 0.04 eV per atom. Tensile strain and residual dislocations on the hard/soft GB facilitate the initiation of dynamic recrystallization by lowering the energy barrier and the critical stress for grain reorientation, respectively.
Ceramics are strong but brittle. According to the classical theories, ceramics are brittle mainly because dislocations are suppressed by cracks. Here, the authors report the combined elastic and plastic deformation measurements of nanoceramics, in which dislocation-mediated stiff and ductile behaviors were detected at room temperature. In the synchrotron-based deformation experiments, a marked slope change is observed in the stress–strain relationship of MgAl2O4 nanoceramics at high pressures, indicating that a deformation mechanism shift occurs in the compression and that the nanoceramics sample is elastically stiffer than its bulk counterpart. The bulk-sized MgAl2O4 shows no texturing at pressures up to 37 GPa, which is compatible with the brittle behaviors of ceramics. Surprisingly, substantial texturing is seen in nanoceramic MgAl2O4 at pressures above 4 GPa. The observed stiffening and texturing indicate that dislocation-mediated mechanisms, usually suppressed in bulk-sized ceramics at low temperature, become operative in nanoceramics. This makes nanoceramics stiff and ductile.
Recently, we introduced an epoxy group to mebendazole by a reaction with epichlorohydrin and obtained two isoforms, mebendazole C1 (M-C1) and mebendazole C2 (M-C2). The in vitro effects of mebendazole derivatives at different concentrations on Echinococcus multilocularis protoscoleces and metacestodes as well as cytotoxicity in rat hepatoma (RH) cells were examined. The results demonstrated that the solubility of the two derivatives was greatly improved compared to mebendazole. The mortality of protoscoleces in vitro reached to 70–80% after 7 days of exposure to mebendazole or M-C2, and M-C2 showed higher parasiticidal effects than mebendazole (P > 0.05). The parasiticidal effect of M-C1 was low, even at a concentration of 30 µm. The percentage of damaged metacestodes that were treated with mebendazole and M-C2 in vitro at different concentrations were similar, and M-C1 exhibited insignificant effects on metacestodes. Significant morphological changes on protoscoleces and metacestodes were observed after treatment with mebendazole and M-C2. In addition, the introduction of an epoxy group to mebendazole also reduced its cytotoxicity in RH cells. Our results demonstrate that the introduction of an epoxy group not only improved the solubility of mebendazole, but also increased its parasiticidal effects on E. multilocularis and reduced its cytotoxicity in RH cells.
This paper presents a hybrid strategy-based coordinate controller with a novel nonlinear disturbance observer for autonomous underwater vehicle manipulator systems (UVMSs). This method can reduce the influence from external unknown disturbances, inner coupling effects and model uncertainties by using a modified disturbance observer. Considering the natural redundancy property of the UVMS, the redundancy resolution algorithm is often utilized to give desired trajectories in the vehicle–joint space. However, because of the calibration errors, assembling errors and numerical errors, these desired trajectories may not lead the end-effector to the goal point accurately. To realize accurate motion control even when small errors exist in the planning phase, a hybrid strategy is introduced to transform the controller in the joint–vehicle space to the controller in the task space. Numerical simulations based on a UVMS have been carried out to testify the effectiveness of the proposed coordinate controller and the hybrid strategy. During the simulations, unknown disturbances are exerted upon the system. The trajectory tracking and error fixing performances are discussed in comparative analyses. The controller also maintains robust characteristics in comparison with the passivity-based controller and the proposed controller but without the disturbance observer. Experiments are also carried out to test its performance.
A series of metal oxides (MnFeOx, MnCrOx, MnTiOx, and MnFeTiOx) supported on attapulgite (ATP) were synthesized by coprecipitation for the low-temperature selective catalytic reduction (SCR) of NOx with NH3. Then, they were subjected to appropriate characterizations for their properties (XRD, TEM, BET, XPS, etc.). The catalytic activity of MnFeTiOx/ATP catalyst was over 95% NOx conversion within a wide temperature window between of 175 and 300 °C, and 88% N2 selectivity. Moreover, MnFeTiOx/ATP presented excellent potassium resistance relative to the traditional V–W–Ti catalyst, and its denitration performance was significantly improved. The NOx conversion rate could be restored to nearly 90% at 210 °C after removing potassium via washing of K–MnFeTiOx/ATP. In addition, the MnFeTiOx/ATP showed better SO2 resistance and stability than the traditional V–W–Ti catalyst. Therefore, the MnFeTiOx/ATP catalyst has been proved to have broad prospects in NH3-SCR.
Nutrition therapy is considered an important treatment of burn patients. The aim of the study was to delineate the nutritional support in severe burn patients and to investigate association between nutritional practice and clinical outcomes. Severe burn patients were enrolled (n 100). In 90 % of the cases, the burn injury covered above 70 % of the total body surface area. Mean interval from injury to nutrition start was 2·4 (sd 1·1) d. Sixty-seven patients were initiated with enteral nutrition (EN) with a median time of 1 d from injury to first feed. Twenty-two patients began with parenteral nutrition (PN). During the study, thirty-two patients developed EN intolerance. Patients received an average of about 70 % of prescribed energy and protein. Patients with EN providing <30 % energy had significantly higher 28- d and in-hospital mortality than patients with EN providing more than 30 % of energy. Mortality at 28 d was 11 % and in-hospital mortality was 45 %. Multiple regression analysis demonstrated that EN providing <30 % energy and septic shock were independent risk factors for 28- d prognosis. EN could be initiated early in severe burn patients. Majority patients needed PN supplementation for energy requirement and EN feeding intolerance. Post-pyloric feeding is more efficient than gastric feeding in EN tolerance and energy supplement. It is difficult for severe burn patients to obtain enough feeding, especially in the early stage of the disease. More than 2 weeks of underfeeding is harmful to recovery.
Drag reduction at the external surface of a cylinder in turbulent flows along the axial direction by circumferential wall motion is studied by direct numerical simulations. The circumferential wall oscillation can lead to drag reduction due to the formation of a Stokes layer, but it may also result in centrifugal instability, which can enhance turbulence and increase drag. In the present work, the Reynolds number based on the reference friction velocity and the nominal thickness of the boundary layer is 272. A map describing the relationship between the drag-reduction rate and the control parameters, namely, the angular frequency
and the streamwise wavenumber
, is obtained at the oscillation amplitude of
is the friction velocity of the uncontrolled flow and
is the kinematic viscosity of the fluid. The maximum drag-reduction rate and the maximum drag-increase rate are both approximately 48 %, which are respectively attained at
(0.0126, 0.0148) and (0.0246, 0.0018). The drag-reduction rate can be scaled well with the help of the effective thickness of the Stokes layer. The drag increase is observed in a narrow triangular region in the frequency–wavenumber plane. The vortices induced by the centrifugal instability become the primary coherent structure in the near-wall region, and they are closely correlated with the high skin friction. In these drag-increase cases, the effective control frequency or wavenumber is crucial in scaling the drag-increase rate. As the wall curvature normalised by the boundary layer thickness becomes larger, the drag-increase region in the
plane as well as the maximum drag-increase rate also become larger. Net energy saving with a considerable drag-reduction rate is possible when reducing the oscillation amplitude. At
, a net energy saving of 18 % can be achieved with a drag-reduction rate of 25 % if only the power dissipation due to viscous stress is taken into account in an ideal actuation system.
Health system reform is considered a tough issue worldwide. Great efforts have been made toward health system building and strengthening. However, it is still unclear which health system is appropriate for different countries. This study aimed to systematically compare the characteristics of the establishment periods between eighty-eight counties of National Health Service (NHS) and Social Health Insurance (SHI).
Forty-eight NHS countries and forty SHI countries with data availability were selected. The establishment years of current health systems and other eighteen indicators in economics, society, population and health during establishment periods were collected. Comparison between NHS and SHI was conducted by descriptive analysis of every indicator.
Most NHS countries were established during the cold war, while SHI had been set up since the cold war ended. The median of gross domestic product (GDP) per capita, urbanization rate and aging rate of SHI were USD 1535 in current dollars, 58.2 percent and 9.8 percent, respectively; compared with USD 1387, 41.2 percent and 4.7 percent, respectively of NHS. NHS countries had a smaller total population, lower mortality rate and elderly dependency ratio, while the birth rate and children's dependency ratio were higher. SHI countries showed a higher life expectancy and lower mortality rate in infants and children. NHS countries spent less in total health expenditure and a lower proportion of GDP. The median health expenditure per capita of SHI and NHS were USD 188 and USD 131 in current dollars, respectively. There was little difference among maternal mortality rates, and public and private health expenditure proportions.
NHS and SHI countries had different characteristics during the health system establishment periods. NHS was established earlier than SHI overall, so that SHI revealed higher levels in economic and social development. Health outcomes of NHS countries were slightly lower than SHI ones, while health expenditure was more in SHI countries. Specific social, economic, demographic and health conditions should be considered when countries are building their own health systems.
In this paper, we review the status of the multifunctional experimental platform at the National Laboratory of High Power Laser and Physics (NLHPLP). The platform, including the SG-II laser facility, SG-II 9th beam, SG-II upgrade (SG-II UP) facility, and SG-II 5 PW facility, is operational and available for interested scientists studying inertial confinement fusion (ICF) and a broad range of high-energy-density physics. These facilities can provide important experimental capabilities by combining different pulse widths of nanosecond, picosecond, and femtosecond scales. In addition, the SG-II UP facility, consisting of a single petawatt system and an eight-beam nanosecond system, is introduced including several laser technologies that have been developed to ensure the performance of the facility. Recent developments of the SG-II 5 PW facility are also presented.
We sought to examine the potential modifiers in the association between long-term low-dose folic acid supplementation and the reduction of serum total homocysteine (tHcy) among hypertensive patients, using data from the China Stroke Primary Prevention Trial (CSPPT). This analysis included 16 867 participants who had complete data on tHcy measurements at both the baseline and exit visit. After a median treatment period of 4·5 years, folic acid treatment significantly reduced the tHcy levels by 1·6 μmol/l (95 % CI 1·4, 1·8). More importantly, after adjustment for baseline tHcy and other important covariates, a greater degree of tHcy reduction was observed in certain subgroups: males, the methylenetetrahydrofolate reductase (MTHFR) 677TT genotype, higher baseline tHcy levels (≥12·5 (median) v. <12·5 μmol/l), lower folate levels (<8·0 (median) v. ≥8·0 ng/ml), estimated glomerular filtration rate (eGFR) <60 ml/min per 1·73 m2 (v. 60–<90 and ≥90 ml/min per 1·73 m2), ever smokers and concomitant use of diuretics (P for all interactions <0·05). The degree of tHcy reduction associated with long-term folic acid supplementation can be significantly affected by sex, MTHFR C677T genotypes, baseline folate, tHcy, eGFR levels and smoking status.
In this paper the notion of sub-exponential measure complexity for an invariant Borel probability measure of a topological dynamical system is introduced. Then a minimal distal skew product map on the torus with sub-exponential measure complexity is constructed.
Novel cerium-loaded MnTiOx/attapulgite (Ce/MnTiOx/ATP) and cerium-doped MnTiOx/attapulgite (Ce–MnTiOx/ATP) catalysts for low-temperature selective catalytic reduction of nitrogen oxides (NOx) with ammonia (NH3-SCR) were synthesized by co-precipitation methods. The results of catalytic activity testing for the as-prepared Ce–MnTiOx/ATP and Ce/MnTiOx/ATP indicated that the Ce–MnTiOx/ATP catalyst exhibited better catalytic performance with over 80% NOx conversion within a wide temperature window between 170 and 350°, and the highest NOx conversion attained for the Ce–MnTiOx/ATP catalyst was 97.5%. A series of characterization illustrated that the Ce–MnTiOx/ATP catalyst exhibited a higher specific surface area, oxygen vacancy, redox ability, and acid site as compared to that of the Ce/MnTiOx/ATP catalyst. The performance tests showed that the Ce–MnTiOx/ATP catalyst exhibited not only better SO2 & H2O resistance but also higher N2 selectivity and good stability. Therefore, the Ce–MnTiOx/ATP catalyst was testified to be a promising catalyst for NH3-SCR.
This study examines the transition of stable falling to tumbling flight for freely falling heavy plates in a two-dimensional viscous fluid, solved via direct numerical simulation with the immersed boundary method. The simulations are performed at a range of Reynolds number (
) of up to 500 and a dimensionless moment of inertia (
) up to 10. It is found that a plate may settle to stable falling or develop into tumbling descent depending on the initial angle of release
. The characteristics and performance that distinguish two flight states are investigated. This bistability is analysed with phase portraits and the region mapped across the regime of
at a specific thickness ratio. In determining the flight state, the respective critical
is found to follow a power law through
. It is suggested that the changing slope of the lift curve that the plate undergoes sets the two flight states apart. Flow fields also reveal that the recirculation behind the plate is confined by the vortex structures and provides an additional rotation to the plate. An experiment is performed suggesting that bistability also occurs at Re
. Other shapes are also simulated and the different bistable effects are discussed.
Help-seeking is important to access appropriate care and improve mental health. However, individuals often delay or avoid seeking help for mental health problems. Interventions to improve help-seeking have been developed, but their effectiveness is unclear. A systematic review and meta-analysis were therefore conducted to examine the effectiveness of mental health related help-seeking interventions. Nine databases in English, German and Chinese were searched for randomised and non-randomised controlled trials. Effect sizes were calculated for attitudes, intentions and behaviours to seek formal, informal and self-help. Ninety-eight studies with 69 208 participants were included. Interventions yielded significant short-term benefits in terms of formal help-seeking, self-help, as well as mental health literacy and personal stigma. There were also positive long-term effects on formal help-seeking behaviours. The most common intervention types were strategies to increase mental health literacy, destigmatisation (both had positive short-term effects on formal help-seeking behaviours) as well as motivational enhancement (with positive long-term effects on formal help-seeking behaviours). Interventions improved formal help-seeking behaviours if delivered to people with or at risk of mental health problems, but not among children, adolescents or the general public. There was no evidence that interventions increased the use of informal help. Few studies were conducted in low- and middle-income countries (LMICs). This study provides evidence for the effectiveness of help-seeking interventions in terms of improving attitudes, intentions and behaviours to seek formal help for mental health problems among adults. Future research should develop effective interventions to improve informal help-seeking, for specific target groups and in LMICs settings.