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Exoskeleton robot can assist people and reduce energy consumption when they walk with heavy weight, so as to protect their health and travel longer distances. This work analyzes the cross gait during walking and designs a dual-drive four joint time-sharing assistance exoskeleton system, which controls the four joints through two motors to realize the assistance to the wearer’s movement process. The control curve and adaptive control algorithm are designed to help different people with various walking gaits and speeds, the effectiveness of exoskeleton system is proved by testing metabolism. When the exoskeleton wearer carries 25 kg weight (load equal to 36% of body mass) and travels at the average speed of 5 km/h, the metabolic rate of the exoskeleton wearers decreases by an average of 7.79%, the reduction magnitude is comparable to the effect of taking off 7.33 kg during walking.
Aiming at the problem that adaptive Monte Carlo localization (AMCL) algorithm is difficult to localize in large scenes and similar environments. This paper uses a semantic information-assisted approach to improve the AMCL algorithm. This method realizes the robust localization of the robot in the large scenes and similar environments. Firstly, the 2D grid map created by simultaneous localization and mapping using lidar can obtain highly accurate indoor environmental contour information. Secondly, the semantic object capture is achieved by using a depth camera combined with an instance segmentation algorithm. Then, the semantic grid map is created by mapping the semantic point cloud through the back-projection process of the pinhole camera. Finally, semantic grid maps are used as a priori information to assist in localization, which will be used to improve the initial particle swarm distribution in the global localization of the AMCL algorithm and thus will solve the robot localization problem in this environment. The experimental evidence shows that the semantic grid map solves the environmental information degradation problem caused by 2D lidar as well as improves the robot’s perception of the environment. In addition, this paper improves the localization robustness of the AMCL algorithm in large scenes and similar environments, resulting in an average localization success rate of about 90% or even higher, and further reduces the number of iterations. The global localization problem of robots in large scenes and similar environments is effectively solved.
Due to less light scattering and a better signal-to-noise ratio in deep imaging, two-photon fluorescence microscopy (TPFM) has been widely used in biomedical photonics since its advent. However, optical aberrations degrade the performance of TPFM in terms of the signal intensity and the imaging depth and therefore restrict its application. Here, we introduce adaptive optics based on the genetic algorithm to detect the distorted wavefront of the excitation laser beam and then perform aberration correction to optimize the performance of TPFM. By using a spatial light modulator as the wavefront controller, the correction phase is obtained through a signal feedback loop and a process of natural selection. The experimental results show that the signal intensity and imaging depth of TPFM are improved after aberration correction. Finally, the method was applied to two-photon fluorescence lifetime imaging, which helps to improve the signal-to-noise ratio and the accuracy of lifetime analysis. Furthermore, the method can also be implemented in other experiments, such as three-photon microscopy, light-sheet microscopy, and super-resolution microscopy.
Neuroimaging- and machine-learning-based brain-age prediction of schizophrenia is well established. However, the diagnostic significance and the effect of early medication on first-episode schizophrenia remains unclear.
To explore whether predicted brain age can be used as a biomarker for schizophrenia diagnosis, and the relationship between clinical characteristics and brain-predicted age difference (PAD), and the effects of early medication on predicted brain age.
The predicted model was built on 523 diffusion tensor imaging magnetic resonance imaging scans from healthy controls. First, the brain-PAD of 60 patients with first-episode schizophrenia, 60 healthy controls and 21 follow-up patients from the principal data-set and 40 pairs of individuals in the replication data-set were calculated. Next, the brain-PAD between groups were compared and the correlations between brain-PAD and clinical measurements were analysed.
The patients showed a significant increase in brain-PAD compared with healthy controls. After early medication, the brain-PAD of patients decreased significantly compared with baseline (P < 0.001). The fractional anisotropy value of 31/33 white matter tract features, which related to the brain-PAD scores, had significantly statistical differences before and after measurements (P < 0.05, false discovery rate corrected). Correlation analysis showed that the age gap was negatively associated with the positive score on the Positive and Negative Syndrome Scale in the principal data-set (r = −0.326, P = 0.014).
The brain age of patients with first-episode schizophrenia may be older than their chronological age. Early medication holds promise for improving the patient's brain ageing. Neuroimaging-based brain-age prediction can provide novel insights into the understanding of schizophrenia.
As part of a long-term experiment to determine the impacts of composted manure and straw amendments (replacing 50% of chemical fertilizer with composted pig manure, wheat straw return combined with chemical fertilizer, and setting no fertilizer and chemical fertilizer-only as controls) on rice-associated weeds in a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, species richness, abundance, density, and biomass of weeds were assessed during years 8 and 9. Fertilization decreased the species richness and total density of rice-associated weeds but increased their total biomass. The species richness and densities of broadleaf and sedge weeds decreased with fertilization, while species richness of grass weeds increased only with straw return and density was not significantly affected. The shoot biomass per square meter of grass and broadleaf weeds was significantly higher with fertilization treatments than with the no-fertilizer control, while that of sedge weeds declined with fertilizer application. With fertilization, the densities of monarch redstem (Ammannia baccifera L.) and smallflower umbrella sedge (Cyperus difformis L.) decreased, that of Chinese sprangletop [Leptochloa chinensis (L.) Nees] increased, and those of barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.] and monochoria [Monochoria vaginalis (Burm. f.) C. Presl ex Kunth] were not significantly affected. Ammannia baccifera was the most abundant weed species in all treatments. Whereas composted pig manure plus fertilizer resulted in higher density of A. baccifera and lower shoot biomass per plant than chemical fertilizer only, wheat straw return plus chemical fertilizer caused lower density and shoot biomass of A. baccifera. Therefore, it may be possible that fertilization strategies that suppress specific weeds could be used as improved weed management program components in rice production systems.
The southeastern Central Asian Orogenic Belt (CAOB) records the assembly process between several micro-continental blocks and the North China Craton (NCC), with the consumption of the Paleo-Asian Ocean (PAO), but whether the S-wards subduction of the PAO beneath the northern NCC was ongoing during Carboniferous–Permian time is still being debated. A key issue to resolve this controversy is whether the Carboniferous magmatism in the northern NCC was continental arc magmatism. The Alxa Block is the western segment of the northern NCC and contiguous to the southeastern CAOB, and their Carboniferous–Permian magmatism could have occurred in similar tectonic settings. In this contribution, new zircon U–Pb ages, elemental geochemistry and Sr–Nd isotopic analyses are presented for three early Carboniferous granitic plutons in the southwestern Alxa Block. Two newly identified aluminous A-type granites, an alkali-feldspar granite (331.6 ± 1.6 Ma) and a monzogranite (331.8 ± 1.7 Ma), exhibit juvenile and radiogenic Sr–Nd isotopic features, respectively. Although a granodiorite (326.2 ± 6.6 Ma) is characterized by high Sr/Y ratios (97.4–139.9), which is generally treated as an adikitic feature, this sample has highly radiogenic Sr–Nd isotopes and displays significantly higher K2O/Na2O ratios than typical adakites. These three granites were probably derived from the partial melting of Precambrian continental crustal sources heated by upwelling asthenosphere in lithospheric extensional setting. Regionally, both the Alxa Block and the southeastern CAOB are characterized by the formation of early Carboniferous extension-related magmatic rocks but lack coeval sedimentary deposits, suggesting a uniform lithospheric extensional setting rather than a simple continental arc.
Celestial navigation is an important means of maritime navigation; it can automatically achieve inertially referenced positioning and orientation after a long period of development. However, the impact of different accuracy of observations and the influence of nonstationary states, such as ship speed change and steering, are not taken into account in existing algorithms. To solve this problem, this paper proposes an adaptively robust maritime celestial navigation algorithm, in which each observation value is given an equivalent weight according to the robust estimation theory, and the dynamic balance between astronomical observation and prediction values of vessel motion is adjusted by applying the adaptive factor. With this system, compared with the frequently used least square method and extended Kalman filter algorithm, not only are the real-time and high-precision navigation parameters, such as position, course, and speed for the vessel, calculated simultaneously, but also the influence of abnormal observation and vessel motion status change could be well suppressed.
South-east Asia's diverse coastal wetlands, which span natural mudflats and mangroves to man-made salt pans, offer critical habitat for many migratory waterbird species in the East Asian–Australasian Flyway. Species dependent on these wetlands include nearly the entire population of the Critically Endangered spoon-billed sandpiper Calidris pygmaea and the Endangered spotted greenshank Tringa guttifer, and significant populations of several other globally threatened and declining species. Presently, more than 50 coastal Important Bird and Biodiversity Areas (IBAs) in the region (7.4% of all South-east Asian IBAs) support at least one threatened migratory species. However, recent studies continue to reveal major knowledge gaps on the distribution of migratory waterbirds and important wetland sites along South-east Asia's vast coastline, including undiscovered and potential IBAs. Alongside this, there are critical gaps in the representation of coastal wetlands across the protected area networks of many countries in this region (e.g. Viet Nam, Indonesia, Malaysia), hindering effective conservation. Although a better understanding of the value of coastal wetlands to people and their importance to migratory species is necessary, governments and other stakeholders need to do more to strengthen the conservation of these ecosystems by improving protected area coverage, habitat restoration, and coastal governance and management. This must be underpinned by the judicious use of evidence-based approaches, including satellite-tracking of migratory birds, ecological research and ground surveys.
Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.
A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.
A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).
Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.
As a neuroprogressive illness, depression is accompanied by brain structural abnormality that extends to many brain regions. However, the progressive structural alteration pattern remains unknown.
To elaborate the progressive structural alteration of depression according to illness duration, we recruited 195 never-treated first-episode patients with depression and 130 healthy controls (HCs) undergoing T1-weighted MRI scans. Voxel-based morphometry method was adopted to measure gray matter volume (GMV) for each participant. Patients were first divided into three stages according to the length of illness duration, then we explored stage-specific GMV alterations and the causal effect relationship between them using causal structural covariance network (CaSCN) analysis.
Overall, patients with depression presented stage-specific GMV alterations compared with HCs. Regions including the hippocampus, the thalamus and the ventral medial prefrontal cortex (vmPFC) presented GMV alteration at onset of illness. Then as the illness advanced, others regions began to present GMV alterations. These results suggested that GMV alteration originated from the hippocampus, the thalamus and vmPFC then expanded to other brain regions. The results of CaSCN analysis revealed that the hippocampus and the vmPFC corporately exerted causal effect on regions such as nucleus accumbens, the precuneus and the cerebellum. In addition, GMV alteration in the hippocampus was also potentially causally related to that in the dorsolateral frontal gyrus.
Consistent with the neuroprogressive hypothesis, our results reveal progressive morphological alteration originating from the vmPFC and the hippocampus and further elucidate possible details about disease progression of depression.
Singapore is prominent in the global trade of pet birds, primarily parrots. This includes its role as a key international transit hub, and also its growing domestic market, including for threatened species. There is a need to understand the trade beyond volumes and flows, including consumer knowledge, preferences and behaviours, and interactions with vendors, hobbyist groups and supporting industries. We used three methods to examine this: (1) a questionnaire with stakeholders (including parrot owners, hobbyist group members, breeders and supporting industry professionals), about the motivations for parrot ownership and interest in sustainable trade, (2) semi-structured interviews with key informants about trade dynamics, and (3) a review of online hobbyist groups. Based on our findings, we provide an initial mapping of the country's parrot trade ecosystem. Fifty-one per cent of respondents claimed to be a member of a parrot hobbyist group and 64% agreed their participation in such groups had encouraged them to purchase more parrots. The majority (71%) of parrot owners reported a preference for captive-bred rather than wild-caught parrots, and 72% were concerned about the illegal hunting of parrots for commercial trade. Most were willing to pay more (70%) and wait longer (73%) to procure a sustainably sourced parrot. Our approach presents the wildlife trade as a complex social phenomenon, with multiple physical and online channels, regulatory challenges, social networks, and evolving consumer preferences. We also document the pivotal role of hobbyist groups and their untapped potential to leverage these networks to improve sustainable trade.
Acceptance and willingness to pay for the COVID-19 vaccine are unknown.
We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it.
Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale.
Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls.
To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.
Schizophrenia is a severe and complex psychiatric disorder that needs treatment based on extensive experience. Antipsychotic drugs have already become the cornerstone of the treatment for schizophrenia; however, the therapeutic effect is of significant variability among patients, and only around a third of patients with schizophrenia show good efficacy. Meanwhile, drug-induced metabolic syndrome and other side-effects significantly affect treatment adherence and prognosis. Therefore, strategies for drug selection are desperately needed. In this study, we will perform pharmacogenomics research and set up an individualised preferred treatment prediction model.
We aim to create a standard clinical cohort, with multidimensional index assessment of antipsychotic treatment for patients with schizophrenia.
This trial is designed as a randomised clinical trial comparing treatment with different kinds of antipsychotics. A total sample of 2000 patients with schizophrenia will be recruited from in-patient units from five clinical research centres. Using a computer-generated program, the participants will be randomly assigned to four treatment groups: aripiprazole, olanzapine, quetiapine and risperidone. The primary outcomes will be measured as changes in the Positive and Negative Syndrome Scale of schizophrenia, which reflects the efficacy. Secondary outcomes include the measure of side-effects, such as metabolic syndromes. The efficacy evaluation and side-effects assessment will be performed at baseline, 2 weeks, 6 weeks and 3 months.
This trial will assess the efficacy and side effects of antipsychotics and create a standard clinical cohort with a multi-dimensional index assessment of antipsychotic treatment for schizophrenia patients.
This study aims to set up an individualized preferred treatment prediction model through the genetic analysis of patients using different kinds of antipsychotics.
As threats to biodiversity proliferate, establishment and expansion of protected areas have increasingly been advocated in recent decades. In establishing a network of protected areas, recurrent assessments of the biodiversity conservation actually afforded by these areas is required. Gap analysis has been useful to evaluate the sufficiency and performance of protected areas. We surveyed Reeves’s Pheasant Syrmaticus reevesii populations in 2018–2019 across its distribution range in central China to quantify the distribution of habitat suitable for this species. Our goal was to ascertain the current distribution of Reeves’s Pheasant and then identify the gaps in protecting Reeves’s Pheasant of the existing national nature reserve (NNR) network to provide suggestions for improving the conservation of this important species. The existing NNR network encompassed only 17.0% of the habitat suitable for Reeves’s Pheasant. Based on the current distributions of both suitable habitat and NNRs for Reeves’s Pheasant, we suggest most currently unprotected areas comprised moderately suitable habitat for species and should be prioritized in the future. A multiple species approach using Reeves’s Pheasant as a flagship species should be considered to understand the extent of mismatch between the distributions of protected areas and suitable habitat to improve the management effectiveness of NNRs. This case study provides an example of how the development of a conservation reserve network may be based on species distribution and habitat assessments and is useful to conservation efforts in other regions and for other species.
Efficient photosynthesis requires a balance of ATP and NADPH production/consumption in chloroplasts, and the exportation of reducing equivalents from chloroplasts is important for balancing stromal ATP/NADPH ratio. Here, we showed that the overexpression of purple acid phosphatase 2 on the outer membranes of chloroplasts and mitochondria can streamline the production and consumption of reducing equivalents in these two organelles, respectively. A higher capacity of consumption of reducing equivalents in mitochondria can indirectly help chloroplasts to balance the ATP/NADPH ratio in stroma and recycle NADP+, the electron acceptors of the linear electron flow (LEF). A higher rate of ATP and NADPH production from the LEF, a higher capacity of carbon fixation by the Calvin–Benson–Bassham (CBB) cycle and a greater consumption of NADH in mitochondria enhance photosynthesis in the chloroplasts, ATP production in the mitochondria and sucrose synthesis in the cytosol and eventually boost plant growth and seed yields in the overexpression lines.
The purpose of this study was to evaluate the mid-term outcome of aortic valve replacement for bicuspid aortic valve and tricuspid aortic valve and the related risk factors.
From January 2014 to June 2019, 177 tricuspid aortic valve patients and 101 bicuspid aortic valve patients who underwent aortic valve replacement in our hospital were collected. 1:1 propensity score matching analysis was used to control the bias in patient selection. The perioperative and follow-up data between the two groups were compared. Independent risk factors which were associated with the continued dilatation of the ascending aorta were identified by univariate or multivariate logistic regression analysis.
After the matching procedure, 160 patients were included in the analysis (80 in each group). Baseline characteristics, intraoperative, and perioperative outcomes were similar between the two groups (all p > 0.05). Moreover, 67 patients in the tricuspid aortic valve group and 70 in the bicuspid aortic valve group completed the follow-up. The ascending aorta change, annual change rate, and the proportion of continuous dilation of ascending aorta in bicuspid aortic valve group were significantly higher than those in the tricuspid aortic valve group (p < 0.05). Multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.173; 95% CI 1.772, 15.101; p = 0.003), aortic regurgitation (OR 3.673; 95% CI 1.133, 11.908; p = 0.030), and aortic valve stenosis with regurgitation (OR 6.489; 95% CI 1.726, 24.404; p = 0.006) were independent risk factors for the continued dilatation of the ascending aorta in all AV patients. Furthermore, the multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.157; 95% CI 1.053, 25.272; p = 0.043), age ≥ 40 years (OR 6.956; 95% CI 1.228, 39.410; p = 0.028), and aortic regurgitation (OR 4.322; 95% CI 1.174, 15.911; p = 0.028) were independent risk factors for the continued dilatation of the ascending aorta in bicuspid aortic valve patients.
Compared with tricuspid aortic valve patients, the ascending aorta of bicuspid aortic valve patients is more likely to continue to enlarge after aortic valve replacement. Type 1 in bicuspid aortic valve, age ≥ 40 years, and aortic regurgitation were the independent risk factors.
NaY zeolite was synthesized from kaolin/dimethyl sulfoxide (DMSO) intercalation composites using an in situ crystallization technique. The effects of the intercalation ratios and the amounts of the kaolin/DMSO intercalation composite on the synthesis of an NaY zeolite molecular sieve were studied. The samples were characterized by X-ray diffraction, Fourier-transform infrared spectroscopy, differential thermal analysis, N2 adsorption–desorption and scanning electron microscopy. In the in situ synthesis system, when the kaolin/DMSO intercalation composite was added, pure NaY zeolite was formed. By increasing the amount of kaolin/DMSO intercalation composite added, the crystallinity of the samples increased, and after reaching the maximum amount of kaolin/DMSO intercalation composite added, the crystallinity decreased with further increases of the amount of kaolin/DMSO intercalation composite added. To higher intercalation ratio, the crystallinity can be greatly improved at the lower addition content. At an intercalation ratio of 84%, the added amount of kaolin/DMSO intercalation composite was 2.5% and the crystallinity of the NaY zeolite molecular sieve reached a maximum value of 45%. At intercalation ratios of 55% and 22%, the amount of kaolin/DMSO intercalation composite added was 15% and the crystallinities of the NaY zeolite molecular sieves were 44% and 47%, respectively. The NaY zeolite has good thermal stability and a particle diameter of ~0.5 μm. The Brunauer–Emmett–Teller (BET) specific surface area and pore volume of the sample were 519 m2 g–1 and 0.355 cm3 g–1, respectively.
A study was conducted to identify whether composted manure and straw amendments (replacement of a portion of chemical fertilizer [50% of the total nitrogen application] with composted pig manure, and straw return [all straw from the previous rice crop] combined with chemical fertilizer) compared with no fertilization and chemical fertilizer only would change the dominant species of wheat-associated weeds as well as influence their growth and seed yield in a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system. The study was initiated in 2010, and the treatment effects on the species, density, plant height, shoot biomass, seed yield of dominant weeds, and wheat yields were assessed in 2017 and 2018. Fertilization significantly increased the height, density, and yield of wheat, as well as the shoot biomass of wheat-associated weeds, but decreased the weed species number. A total of 17 and 14 weed species were recorded in the experimental wheat fields in 2017 and 2018, respectively. The most dominant weed species were American sloughgrass [Beckmannia syzigachne (Steud.) Fernald] and catchweed bedstraw (Galium aparine L.), which made up more than 64% of the weed community in all treatments. When the chemical fertilizer application was amended with pig manure compost and straw return, the relative abundance of B. syzigachne significantly decreased, while the relative abundance of G. aparine significantly increased. The application of the chemical fertilizer-only treatment resulted in increases in the density, shoot biomass, and seed yield of B. syzigachne, while the composted manure and straw amendments applied together with chemical fertilizer led to significant increases in the density, shoot biomass, and seed yield of G. aparine. Consequently, further research on ways to promote greater cropping system diversity will be needed to prevent the selection of weed species that are adapted to a limited suite of crop management practices.
Hypertension represents one of the most common pre-existing conditions and comorbidities in Coronavirus disease 2019 (COVID-19) patients. To explore whether hypertension serves as a risk factor for disease severity, a multi-centre, retrospective study was conducted in COVID-19 patients. A total of 498 consecutively hospitalised patients with lab-confirmed COVID-19 in China were enrolled in this cohort. Using logistic regression, we assessed the association between hypertension and the likelihood of severe illness with adjustment for confounders. We observed that more than 16% of the enrolled patients exhibited pre-existing hypertension on admission. More severe COVID-19 cases occurred in individuals with hypertension than those without hypertension (21% vs. 10%, P = 0.007). Hypertension associated with the increased risk of severe illness, which was not modified by other demographic factors, such as age, sex, hospital geological location and blood pressure levels on admission. More attention and treatment should be offered to patients with underlying hypertension, who usually are older, have more comorbidities and more susceptible to cardiac complications.
We aimed to examine whether baseline neutrophil counts affected the risk of new-onset proteinuria in hypertensive patients, and, if so, whether folic acid treatment is particularly effective in proteinuria prevention in such a setting. A total of 8208 eligible participants without proteinuria at baseline were analysed from the renal substudy of the China Stroke Primary Prevention Trial. Participants were randomised to receive a double-blind daily treatment of 10 mg of enalapril and 0·8 mg of folic acid (n 4101) or 10 mg of enalapril only (n 4107). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The mean age of the participants was 59·5 (sd, 7·4) years, 3088 (37·6 %) of the participants were male. The median treatment duration was 4·4 years. In the enalapril-only group, a significantly higher risk of new-onset proteinuria was found among participants with higher neutrophil counts (quintile 5; ≥4·8 × 109/l, OR 1·44; 95 % CI 1·00, 2·06), compared with those in quintiles 1–4. For those with enalapril and folic acid treatment, compared with the enalapril-only group, the new-onset proteinuria risk was reduced from 5·2 to 2·8 % (OR 0·49; 95 % CI 0·29, 0·82) among participants with higher neutrophil counts (≥4·8 × 109/l), whereas there was no significant effect among those with neutrophil counts <4·8 × 109/l. In summary, among hypertensive patients, those with higher neutrophil counts had increased risk of new-onset proteinuria, and this risk was reduced by 51 % with folic acid treatment.