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Benzodiazepine receptor agonists (BZRAs) are commonly used clinically and data on their hazardous use from large populations of psychiatric patients is limited.
To assess the current status of hazardous BZRA use and related factors in Chinese out-patient psychiatric settings.
The study included out-patients with at least one BZRA prescription from five psychiatric settings in east, central and west China in 2018. Demographic and prescription information were extracted from the electronic prescription database. We defined the co-occurrence of overdose and long-term use as hazardous use, and patients whose recorded diagnoses did not meet any indications approved by the Chinese Food and Drug Administration as over-indication users. Additionally, 200 hazardous users were randomly selected for follow-up interview to confirm the actual situation.
Among 720 054 out-patients, 164 450 (22.8%) had at least one BZRA prescription; 55.9% of patients were prescribed over-indication and 3% were defined as hazardous users. Multilevel multivariate regression analysis with hospital as a random effect showed that factors associated with hazardous use were older age (18–64 years: β = 0.018; 95% CI 0.013–0.023; >65 years: β = 0.015; 95% CI 0.010–0.021), male (β = 0.005, 95% CI 0.003–0.007), over-indication (β = 0.013, 95% CI 0.012–0.015), more out-patient visits (β = 0.006, 95% CI 0.006–0.006) and more visits to different doctors (β = 0.007, 95% CI 0.007–0.008); 98.5% of hazardous users (197/200) could not be contacted.
BZRAs are commonly used and there is a relatively large proportion of over-indication users among Chinese psychiatric out-patients. However, only a small proportion of hazardous users were detected. The study highlights how to use prescription data to support improvements in clinical practice.
During the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were opened in Wuhan, China, to isolate and care for patients with mild or moderate symptoms. The patients and staff in the hospitals faced mental health challenges. This paper reports the experiences and mental health needs from them.
Following the qualitative design, semi-structured interviews were conducted in the EastWest Lake Fangcang Shelter Hospital, Wuhan on March 2020. Data collection and analysis was based on grounded theory. Open coding was adapted and a structured codebook was developed through coding seminars. The themes and subthemes were then confirmed through thematic analysis. The findings were further explained and integrated in a theoretical framework.
A total of 10 COVID-19 patients and 13 staff, including doctors, nurses, psychiatrists, and policemen participated in the interviews. They have common needs, as well as their own needs. The perspectives from the staff also did complement for needs of the patients. The mental health needs were generalized into four themes, that is, basic needs, information and communication, emotional needs, and social support, each with several subthemes. In addition, there were some external factors that regulated the internal needs, which were summarized in a theoretical framework.
The study indicates the directions on hospital management, mental health services, policy making, and social work to meet the mental health needs of the inpatients and staff from temporary shelter hospitals like Fangcang in Wuhan during the COVID-19 pandemic.
Bainite transformation in steels is influenced by various factors. In the present work, bainite transformation in medium carbon high alloyed steel was investigated focusing on the influence of preexisting VC carbides on the morphology and transformation kinetics of the subsequently formed bainite. Hot-work die steels were held at 950 °C for various times to precipitate VC carbides, then rapidly cooled from 950 to 350 °C and held at this temperature for the bainite transformation. It is found that the bainite transformation was obviously accelerated by the preexisting VC carbides precipitated at the austenite region. The precipitation of carbides leads to a decrease in carbon concentration in the matrix, which decreases the effective activation energy and increases the highest temperature for the nucleation of bainite. Besides, bainite was observed to grow beside the VC carbides. It suggests that the VC carbides in the matrix act as nucleation sites for the bainite transformation. In the specimens, the bainite transformation is accelerated, and a higher fraction of bainite is formed when there are carbides in the matrix.
Porous carbon nanomaterials with significant capacitive performance were successfully prepared through a simple two-step process of thermal-polymerization and carbonization without an additional template. As a result, the as-prepared porous carbon nanomaterials of sample-A and sample-B exhibited an amorphous phase with low graphitization. And sample-A showed a moderate specific surface area of 476.39 m2/g, larger than that of sample-B (280.94 m2/g). The relatively high mass specific capacitance of 205.1 F/g at a scan rate of 5 mV/s and 211 F/g at a current density of 4 A/g was obtained by sample-A, which are higher than those of sample-B (82.6 F/g at 5 mV/s and 78.6 F/g at 4 A/g). Sample-A also showed excellent conductivity and superior cyclic stability with 94.19% capacitance retention after 5000 cycles, which are also higher than those of sample-B. This work proposed a cost-effective, green, and promising strategy for the large-scale preparation of porous carbon nanomaterial electrodes.
We address the competitive precipitation and coprecipitation of three types of secondary phases, i.e., Cu-rich precipitates (CRPs), reverted austenite (RA), and alloyed carbide, in a high-strength low-alloy steel with austenite reversion treatment at 675 °C by using electron back-scatter diffraction, transmission electron microscopy, and atom probe tomography. There is a strong competitive diffusion of Ni and Cu participating in austenite reversion and Cu precipitation with the fact that no CRPs are detected in and around the RA. Meanwhile, there is also a strong competitive diffusion of austenite stabilizing element Ni and carbide-forming elements Cr and Mo into the pre-existing C-rich zone, leading to the formation of nonequilibrium alloyed carbide deviating from the stoichiometric composition. On the other hand, the alloyed carbide and CRPs provide constituent elements for each other and make the coprecipitation thermodynamically favorable. The knowledge on the interactive formation of these three features provides versatile access to tailor the distributional morphology of CRPs, RA, and alloyed carbide via a multistage heat treatment and thus realize their beneficial effect on strength and toughness.
Atomic layer deposition (ALD) ZnO film as seed layer for growing aligned ZnO nanorods arrays is demonstrated. The effects of the deposition temperature and film thickness to the morphology of the ZnO nanorods are studied. The ALD is found to have its advantage over the conventional dip-coating method when being applied to three-dimensional (3D) substrates, as exemplified by the macroporous Si adn CNT arrays. As one example, the CNT-ZnO 3D hybrid nanostructures are obtained which might be useful for energy-related applications.
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