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Taking graphene nanoribbons (GNRs) and gamma-graphyne nanoribbons (GYNRs) as examples, we demonstrate that the twisted deformation is an efficient method to modulate the thermal transport properties of materials. The nonequilibrium Green's function results show that the thermal conductance of this two carbon nanoribbons can be modulated controllably and reversibly over a wide range (more than 55% at room temperature) by controlling the twisted angle, while the tuning range of the twisted angle depends on the width and length of the system. The further analysis reveals that the reduction of thermal conductance mainly originates from the phonon scattering due to the inhomogeneous force constant in the twisted nanoribbons. These interesting findings indicate that twisted GNRs and GYNRs can be utilized as thermal conductance modulators and provide useful guidance for designing materials with desired thermal conductance. [ABSTRACT FROM AUTHOR]

Background: Monitoring and evaluating changes of quality of primary care for older adult hypertensive patients is part of effective delivery of primary care. This study aimed to investigate changes of older adult hypertensive patients' perceived quality of primary care over time in Shanghai. Methods: Two rounds of cross-sectional questionnaire surveys were conducted in Shanghai in November 2011 and June 2013. A total of 437 patients participated in the first Round survey and 443 in the second. Primary care attributes were collected from Community Health Center users through on-site face-to-face interview surveys using the validated Primary Care Assessment Tool. Multiple linear regressions were used to determine whether there was any difference in primary quality of care scores between 2011 and 2013 surveys. Results: Compared with those in the first Round, participants in the second Round reported higher scores in total primary care quality (28.73 vs. 27.75, P <0.001), as well as primary care attributes including first-contact utilization (2.81 vs. 2.60, P <0.001) and accessibility (2.48 vs. 2.44, P <0.05), continuity of care (3.38 vs. 3.27, P <0.001), coordination of information (3.82 vs. 3.67, P <0.001), comprehensiveness of service availability (3.51 vs. 3.39, P <0.001) and provision (2.69 vs. 2.43, P <0.001), and cultural competence (2.67 vs. 2.49, P <0.05), but a lower score in coordination of services (2.45 vs. 2.55, P < 0.05). Conclusion: Older adult hypertensive patients perceived better primary care quality from 2011 to 2013 in Shanghai. This may be associated with the general practitioner team service in Shanghai where hypertensive patients were targeted. [ABSTRACT FROM AUTHOR]

Besides waste gas and liquid, high-temperature particles are important media of waste heat and their temperature exceeds 1000°C on many occasions. The cross-flow heat transfer is important in this waste heat recovering process, but there are few references reported about the theoretical modeling. Therefore, a theoretical model was developed for the cooling process in a horizontal moving bed of high-temperature particles. The purpose of the study is to estimate the influence of temperature field and flow field on heat transfer and bed resistance in the cross-flow cooling process. Three modes such as conduction, convection and radiation are considered in the model. This model was used to analyze heat transfer in a horizontal moving bed of cement clinker and was verified by comparing some simulative results with the tested and collected data from an actual cement clinker plant in China. The simulative temperature of cement clinker was 200°C as same as that collected in the actual cement clinker plant. In the moving bed, the highest pressure drop occurs at the front top and the strongest heat transfer occurs at the front bottom. In the considered conditions with even distribution of cooling air, the highest pressure drop is 3205.9 Pa/m, the biggest specific heat transfer rate of 1683.1 kW/m³. Thermal radiation plays a minor role in this cooling process with the biggest radiation proportion is only 0.149 at the front top. This mode plays a minor role in this cooling process of the cement clinker, comparing with the thermal convection. With constant flow rate of cooling air, the distribution can regulate the local cooling rate rather than the final temperature of the cement clinker. [ABSTRACT FROM AUTHOR]

Objective To assess changes in the quality of primary care in two megacities following the introduction of health system reforms in China. Methods We conducted multistage stratified random face-to-face surveys of patients visiting community health centres in Shanghai in 2011 and 2013, and Shenzhen in 2012 and 2013. Quality of primary care was measured using an assessment tool. Difference-in-difference analyses based on multiple linear regressions were used to compare the changes over time, after controlling for potential confounders. Findings Most (2721) of the 3214 participants used a community health centre as their regular source of care and were included in our analyses.The mean total scores for quality of primary care were similar for Shanghai and Shenzhen at baseline. In Shenzhen, the mean total scores for all participants and those on low incomes had worsened by 0.922 (95% CI: 0.629 to 1.215) and 1.203 (95% CI: 0.397 to 2.009), respectively. In Shanghai, however, there were improvements in the mean total scores which included increases in the scores for first-contact utilization, continuity, coordination of information and comprehensiveness. ConclusionThe quality of primary care improved in Shanghai butnotinShenzhen.Thismay be because, in Shanghai, beneficial long-term relationships between patients and general practitioners were supported by capitation payments and the provision of services tailored to the local health priorities. [ABSTRACT FROM AUTHOR]

We investigate the size and edge roughness dependence on thermal conductivity of monolayer MoS2 (MLMoS2) by phonon Boltzmann transport equation combined with relaxation time approximation. The relative contribution of spectral phonons to thermal conductivity is explored, and we compared the characteristics of phonon transport with those in single layer graphene (SLG), which is a representative two-dimensional material. Quite different from SLG, because of the ultra-short intrinsic phonon mean free path, the thermal conductivity of MLMoS2 ribbons is size and roughness insensitive. The LA phonons have the major contribution to thermal conductivity of MLMoS2, and the ZA phonons in MLMoS2 have high relative contribution to thermal con-ductivity. The relative contribution to thermal conductivity from both high frequency and low frequency phonons in MLMoS2 is lower than that in SLG. The underlying mechanism of these dis-tinct characteristics results from the different phonon dispersions and anharmonic characteristic between MLMoS2 and SLG. [ABSTRACT FROM AUTHOR]

Introduction This study analyzed inequalities in health status among different socioeconomic and demographic rural residents covered by the New Rural Cooperative Medical System in China. Methods A cross-sectional study was conducted in Lian Yungang City, China. A total of 337 respondents, who were selected by using a multistage stratified systematic random sampling method, completed the surveys. A questionnaire consisting of EQ-5D and demographic and socioeconomic information was adopted for data collection, and was administered by face-to-face interviews. Multiple regression models were employed to examine the differences in the Visual Analogue Scale (VAS) score and the EQ-5D dimensions. Results Compared with those with lower education attainment, the respondents with higher education levels tended to report a higher VAS score (β = 2.666, 95% CI: 0.978 to 6.310), and were less likely to suffer from pain/discomfort (OR = 3.968; 95% CI: 1.447 to 10.880). The singles were more likely than the married to report moderate or extreme problems in usual activities (OR = 4.583; 95% CI: 1.188 to 17.676) and mobility (OR = 10.666; 95% CI: 2.464 to 6.171). However, no statistically significant differences were identified between the respondents with different income levels in the VAS score and EQ-5D dimensions. Conclusions This study suggests that the singles and the people with lower education levels are high-risk groups for poorer health status in the Chinese rural population. The findings from this study warrant further investigation. [ABSTRACT FROM AUTHOR]

Background This paper reports findings from the prevalence survey conducted in Shandong China in 2010, a province with a population of 94 million. This study aimed to estimate TB prevalence of the province in 2010 in comparison with the 2000 survey; and to compare yields of TB cases from different case finding approaches. Methods A population based, cross-sectional survey was conducted using multi-stage random cluster sampling. 54,279 adults participated in the survey with a response rate of 96%. Doctors interviewed and classified participants as suspected TB cases if they presented with persistent cough, abnormal chest X-ray (CXRAY), or both. Three sputum specimens of all suspected cases were collected and sent for smear microscopy and culture. Results Adjusted prevalence rate of bacteriologically confirmed cases was 34 per 100,000 for adults in Shandong in 2010. Compared to the 2000 survey, TB prevalence has declined by 80%. 53% of bacteriologically confirmed cases did not present persistent cough. The yield of bacteriologically confirmed cases was 47% by symptom screening and 95% by CXRAY. Over 50% of TB cases were among over 65's. Conclusions The prevalence rate of bacteriologically confirmed cases was significantly reduced compared with 2000. The survey raised challenges to identify TB cases without clear symptoms. [ABSTRACT FROM AUTHOR]

Background: This paper reports findings from the prevalence survey conducted in Shandong China in 2010, a province with a population of 94 million. This study aimed to estimate TB prevalence of the province in 2010 in comparison with the 2000 survey; and to compare yields of TB cases from different case finding approaches. Methods: A population based, cross-sectional survey was conducted using multi-stage random cluster sampling. 54,279 adults participated in the survey with a response rate of 96%. Doctors interviewed and classified participants as suspected TB cases if they presented with persistent cough, abnormal chest X-ray (CXRAY), or both. Three sputum specimens of all suspected cases were collected and sent for smear microscopy and culture. Results: Adjusted prevalence rate of bacteriologically confirmed cases was 34 per 100,000 for adults in Shandong in 2010. Compared to the 2000 survey, TB prevalence has declined by 80%. 53% of bacteriologically confirmed cases did not present persistent cough. The yield of bacteriologically confirmed cases was 47% by symptom screening and 95% by CXRAY. Over 50% of TB cases were among over 65's. Conclusions: The prevalence rate of bacteriologically confirmed cases was significantly reduced compared with 2000. The survey raised challenges to identify TB cases without clear symptoms. [ABSTRACT FROM AUTHOR]

Background Cardiovascular disease (CVD) is a major cause of death in China. Despite government efforts, the majority of hypertensive and diabetic patients in China do not receive proper treatment. Reducing CVD events requires long-term care that is proactive, patient-centred, community-based, and sustainable. We have designed a package of interventions for patients at high risk of CVD to be implemented by family doctors based in township hospitals (providers of primary care) in rural Zhejiang, China. This trial aims to determine whether the systematic CVD risk reduction package results in reduced CVD events among patients at risk of CVD compared with usual care, and whether the package is cost-effective and suitable for routine implementation and scale-up. Methods/Design This is a prospective, open-label, cluster randomized controlled trial (RCT) with blinded data analysis. The trial will randomize 67 township hospitals with 31,708 participants in three counties in Zhejiang Province. Participants will be identified from existing health records and will comprise adults aged 50 to 74 years, with a calculated 10-year CVD risk of 20% or higher, or diabetes. In the intervention arm, participants will receive a package of interventions including: 1) healthy lifestyle counseling (smoking cessation, and salt, oil, and alcohol reduction); 2) prescription of a combination of drugs (antihypertensives, aspirin, and statin); and 3) adherence support for drug compliance and healthy lifestyle change. In the control arm, participants will receive usual care for hypertension and diabetes management at individual clinicians' discretion. The primary outcome is the incidence of severe CVD events over 24 months of follow-up. All CVD events will be defined according to the World Health Organization (WHO) monitoring of trends and determinants in cardiovascular disease (MONICA) definitions, diagnosed at the county hospital or higher level, and reported by the Zhejiang surveillance system. Secondary outcomes include: mean systolic and diastolic blood pressure, blood glucose, serum total cholesterol (TC), and adherence to appointments, and drugs and lifestyle changes. Discussion This trial focuses on risk reduction of CVD rather than specific diseases. It is not designed to compare therapeutic and healthy lifestyle interventions, but rather their combined effects in primary care settings. Through the trial, we intend to understand the effectiveness of the comprehensive CVD reduction package in routine practice. We also intend to understand the barriers and facilitators to implementing the package, and thus to advise on policy and practice change. Trial registration Current Controlled Trials: ISRCTN58988083 [ABSTRACT FROM AUTHOR]

Background: Public hospitals in China play an important role in tuberculosis (TB) control. Three models of hospital and TB control exist in China. The dispensary model is the most common one in which a TB dispensary provides both clinical and public health care. The specialist model is similar to the former except that a specialist TB hospital is located in the same area. The specialist hospital should treat only complicated TB cases but it also treats simple cases in practice. The integrated model is a new development to integrate TB service in public hospitals. Patients were diagnosed, treated and followed up in this public hospital in this model while the TB dispensary provides public health service as case reporting and mass education. This study aims to compare patient care seeking pathways under the three models, and to provide policy recommendation for the TB control system reform in China. Methods: Six sites, two in each model, were selected across four provinces, with 293 newly treated uncomplicated TB patients being randomly selected. Results: The majority (68%) of TB patients were diagnosed in hospitals. Patients in the integrated model presented the simplest care seeking pathways, with the least number of providers visited (2.2), shortest treatment delays (2 days) and the least medical expenditure (2729RMB/401USD). On the contrary, patients in the specialist model had the highest number of provider visits (4), longest treatment delays (23 days) and the highest medical expenditure (11626RMB/1710USD). Logistic regression suggested that patients who were hospitalised tended to have longer treatment delays and higher medical expenditure. Conclusion: Specialist hospital treating uncomplicated cases not using the standard regimens posed a threat to TB control. The integrated model has shortened patient treatment pathways, and reduced patient costs; therefore, it could be considered as the direction for future reform of China's TB control system. [ABSTRACT FROM AUTHOR]

Background and Aims: Current cardiovascular disease (CVD) prevention is based on diagnosis and treatment of specific disease. Little is known for high risk people with CVD at the community level. In rural China, health records of all residents were established after the recent health reforms. This study aims to describe the characters of the rural population with high CVD risk regarding their clinical indicators, disease patterns, drug treatment and adherence. Methods and Results: 17042 (87%) of all the 19500 rural residents in the two townships had valid health records in 2009. We employed a validated tool, the Asian Equation, to screen 8182 (48%) resident health records of those aged between 40-75 years in 2010. Those who were identified with a CVD risk of 20% or higher were selected for a face-to-face questionnaire survey regarding their diagnosed disease and drug treatment. 453 individuals were identified as high risk of CVD, with an average age of 53 years, 62% males, 50% smoking rate and average systolic blood pressure of 161 mmHg. 386 (85%) participated in the survey, while 294 (76%) were diagnosed with and 88 (23%) were suspects of CVD, hypertension, diabetes or hyperlipidaemia. 75 (19%) took drug regularly and 125 (32%) either stopped treatment or missed drugs. The most often used drugs were calcium channel blockers (20%). Only 2% used aspirins and 0.8% used statins. The median costs of drugs were 17 RMB (USD2.66) per month. Conclusion: The majority of the high risk population in our setting of rural China had already been diagnosed with a CVD related disease, but very few took any drugs, and less still took highly effective drugs to prevent CVD. A holistic strategy focused on population with high risk CVD and based on the current China public health reform is suggested in the context of primary care. [ABSTRACT FROM AUTHOR]

Background: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study. [ABSTRACT FROM AUTHOR]

Background: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study. [ABSTRACT FROM AUTHOR]

Objective To understand barriers to tuberculosis (TB) care among migrant TB patients in Shanghai after the introduction of the TB-free treatment policy which has applied to migrants since 2003, and to provide policy recommendations to improve TB control in migrant populations in big cities. Methods In-depth interviews were conducted with 34 migrant patients who registered on the Shanghai TB programme as new bacteria positive pulmonary TB cases. Patients were purposively selected across six districts of Shanghai to give a balance of gender and TB treatment phase. Results Financial constraints were reported as the biggest barriers to TB service among migrant patients. Many migrant patients experienced high medical costs both before and after their TB diagnosis. The government free treatment policy only covered a small fraction of patients’ total costs. However, respondents tended to stay in Shanghai for treatment because their families were in Shanghai, they were more confident with the quality of medical care there or they felt they could not earn cash at home. Migrant patients had a limited knowledge of TB and the free TB treatment policy, and reported being laid off from work or avoided after having TB. Conclusions Health system problems caused the biggest barrier to migrant patients’ access to TB care. The free treatment policy alone has little, if any, effect in reducing migrant patients’ financial stress: it is also essential to provide social welfare, including living subsidies, for poor migrant TB patients. [ABSTRACT FROM AUTHOR]

A direct grafting method has been demonstrated to successfully incorporate the π-acceptor, 2,4,5,7-tetranitro-9-fluorenylideneaminooxy propionic acid (TAPA), onto silica. Adsorption isotherms were measured for complexation of 4,6-dimethyldibenzothiophene (4,6-DMDBT) from n-heptane onto the TAPA-functionalized silica adsorbent. At 25 °C, maximum adsorption capacity was measured to be 58.6 mg/g for binding 4,6-DMDBT, which is 4-fold higher than that of the nonfunctionalized, bare silica sample with a surface area of 480 m 2/g. The results from batch studies suggest that adsorption occurs via a 1:1 complexation between 4,6-DMDBT and TAPA. Adsorption isotherm data were collected at 0, 25, and 40 °C; these data were used to develop a relationship between the Henry’s constant for adsorption and temperature. The molar enthalpy of adsorption was calculated to be Δ Hads= −12.1 kJ/mol; this value is evidence for formation of π-electron acceptor−donor complexes. [ABSTRACT FROM AUTHOR]

Background: The TB operational guideline (the deskguide) is a detailed action guide for county TB doctors aiming to improve the quality of DOTS, while the China national TB policy guide is a guide to TB control that is comprehensive but lacks operational usability for frontline TB doctors. This study reports the process of deskguide adaptation, its scale-up and lessons learnt for policy implications. Methods: The deskguide was translated, reviewed, and revised in a working group process. Details of the eight adaptation steps are reported here. An operational study was embedded in the adaptation process. Two comparable prefectures were chosen as pilot and control sites in each of two participating provinces. In the pilot sites, the deskguide was used with the national policy guide in routine in-service training and supervisory trips; while in the control sites, only the national policy guide was used. In-depth interviews and focus groups were conducted with 16 county TB doctors, 16 township doctors, 17 village doctors, 63 TB patients and 57 patient family members. Following piloting, the deskguide was incorporated into the national TB guidelines for county TB dispensary use. Results: Qualitative research identified that the deskguide was useful in the daily practice of county TB doctors. Patients in the pilot sites had a better knowledge of TB and better treatment support compared with those in the control sites. Conclusion: The adaptation process highlighted a number of general strategies to adapt generic guidelines into country specific ones: 1) local policy-makers and practitioners should have a leading role; 2) a systematic working process should be employed with capable focal persons; and 3) the guideline should be embedded within the current programmes so it is sustainable and replicable for further scale-up. [ABSTRACT FROM AUTHOR]

Imprinted polymers were grafted successfully from silica gel via atom-transfer radical polymerization. Measured binding kinetics for protected amino acid templates onto the molecularly imprinted polymers on silica gel (MIP-SG) and MIPs prepared by conventional solution-phase synthesis demonstrated that the MIP-SG had improved mass-transfer properties and also had higher binding capacity per unit mass of polymer. In addition, a high-performance liquid chromatography column packed with MIP-SG showed higher column efficiency and better resolution for the enantiomers, Boc-l-tryptophan and Boc-d-tryptophan, relative to a column packed with the conventionally prepared MIP. When Boc-l-Trp was used as the template molecule during MIP-SG synthesis, the column packed with the resulting polymer retained the Boc-l-Trp to longer elution time than the Boc-d-Trp. This order of elution was switched when Boc-d-Trp was used as template. [ABSTRACT FROM AUTHOR]

This paper proposes a new method of pulverized coal gasification using high-temperature tertiary air in a cement precalciner, in which an external hanging gasifier is added nearby. A full-scale model is established and simulated for the entrained flow gasifier. During the gasification process, the global reaction mechanism is used to model the release and reactions of volatiles from pulverized coal, and a particle surface reaction model is employed to calculate the fixed carbon content. The mechanism by which reducing gas reacts with NO is also considered. The results of the velocity, temperature, gas composition, NO x emissions, calorific value, volatile conversion ratio and char burnout ratio, are achieved in the simulation. The results show that the volatile conversion ratios were close to 100%, and the carbon conversion ratios ranged from 27.97% to 62.76% among all the tested conditions. The concentrations of NO at the outlet of the gasifier were 109, 98, 75, 91, 87, 76, and 90 mg/m3 separately in 7 conditions. These values are significantly lower than those of complete combustion. However, the addition of raw meal had the best temperature control effect, leading to a significant decrease in thermal NO x production and no side effects on the stability of the production line. • Pulverized coal gasification using high-temperature tertiary air in a gasifier was simulated. The results were compared with the experimental data. The feasibility of the model and the reliability of the algorithm were verified. • The change in the excess air coefficient, the addition of steam, and the addition of raw meal can all be used to control the temperature and protect the materials of the gasifier. • The concentrations of NO at the outlet of the gasifier were 109, 98, 75, 91, 87, 76, and 90 mg/m3 separately in 7 conditions. These values are significantly lower than those of complete combustion (mostly around 800–900 mg/m3). [ABSTRACT FROM AUTHOR]

Although graphene holds great promise in thermal applications owing to its superior thermal conductivity, an intriguing question remains as to which polarizations and frequencies are dominant in its heat conduction. In this work, by incorporating the direction-dependent phonon-boundary scattering and the special selection rule for three-phonon scattering into the linearized phonon Boltzmann transport equation, we systematically investigate the relative contributions from longitudinal-acoustic, transverse-acoustic, and out-of-plane acoustic (ZA) branches to the thermal conductivity of graphene ribbons, focusing on the effects of their size and temperature. We find that the relative contribution from ZA branch to heat conduction increases with decreasing the size, specularity parameter, and temperature of graphene ribbons. Our analysis reveals that this change arises from the huge difference in the phonon dispersion and in the phonon mean free path of Umklapp process between in-plane and out-of-plane branches. [ABSTRACT FROM AUTHOR]

• Through theoretical analysis of the influence of the internal temperature rise and external magnetic field on the dynamics of MRD, the results show that the temperature rise effect reduces the yield stress and viscosity of MRF, and resulting in a reduction of the output damping force. • Finite element software COMSOL was used to simulate the temperature field and magnetic field inside MRD. The results of the temperature field show that the temperature rise is related to the heating of the coil, and the greater the coil input current, the greater the temperature rise. The magnetic field simulation results show that there is magnetic leakage in the magnetic field of MRD, and it indicates that the external magnetic field will inevitably affect the magnetic field of MRD through the damping gap. • The experimental results show that the dynamic characteristics of MRD are greatly affected by the temperature rise effect and the external magnetic field, and the experimental results are consistent with the theoretical analysis. The magnetorheological damper (MRD) is a kind of energy dissipation device, which converts vibration mechanical energy into self-heat energy during operation. The dynamic performance of MRD is affected by uncertain factors such as temperature and external magnetic field. In this paper, basing on the temperature rise theory and external magnetic field interference theory of MRD, it analyses the influence of temperature effect and external magnetic field on the dynamic performance of MRD. Under sinusoidal excitation, the internal temperature field and magnetic field distribution of MRD are simulated by COMSOL, and it calculates the changes of temperature and magnetic field in MRD by the conditions of input current of 0.4A, 0.8A and 1.2A. The temperature rise and external magnetic field test are carried out. Under the same input current, the temperature rise of the outer wall of the cylinder is measured. The results show that the input current increases, the temperature rise of MRD increases, and the temperature of MRD increases, the output damping force decreases obviously. When the input current is 0.4A, the temperature of MRD rises to 40℃, the maximum output damping force decreases by 11.2%, and the current is 1.2A, the maximum output damping force decreases by 18.6%. When external magnetic field is applied, the output damping force of MRD increases. The magnetic induction intensity of the external magnetic field increases from 10mT to 30mT, when the incoming current is 0.4A, the maximum output damping force increases by 5.9%, and the current is 1.2A, the maximum output damping force increases by 5.1%. Therefore, applying external magnetic field to compensate the decreasing value of output damping force caused by temperature rise effect has a certain effect. The results show that the variation trend of theoretical analysis, simulation calculation and experimental verification is consistent. [ABSTRACT FROM AUTHOR]

Innate lymphoid cells (ILCs) function in producing effector cytokines in response to pathogenic infections. However, the roles and related mechanisms of the ILC subpopulations, ILC1 and ILC2, which mirror Th1 and Th2 in adaptive immunity, remain unclear. In this study, we found the markedly elevated levels of the ILC1 transcription factor T-bet, the effector cytokine IFN-γ and the IL/receptor signaling molecules IL-12/IL-12R, which are indispensable for ILC1 differentiation, in the helper ILCs of chronic hepatitis B (CHB) patients. The elevated level of the ILC1 population was significantly associated with hepatic damage in CHB patients, and was not related to telbivudine treatment. In contrast, although we also observed elevated levels of ILC2-related factors, including IL-33, ST2, GATA3 and IL-13 in helper ILCs, the extent of elevation shown by each was lower than that shown by the ILC1-related factors. Furthermore, the activity of the ILC2s did not correlate with either HBV copies or liver damage. The findings of this study suggest potential pro-inflammatory roles for ILC1s in CHB pathogenesis, potentiating these cells and their related molecules as targets of diagnostic, prognostic and/or therapeutic strategies for hepatitis B. [ABSTRACT FROM AUTHOR]

We reformulate the linearized phonon Boltzmann transport equation by incorporating the direction-dependent phonon-boundary scattering, and based on this equation, we study the thermal conductivity of Si1-xGex nanowires and derive their phonon mean free path spectrum. Due to the severe suppression of high-frequency phonons by alloy scattering, the low frequency phonons in Si1-xGex nanowires have a much higher contribution to the thermal conductivity than pure silicon nanowires. We also find that Si1-xGex nanowires possess a stronger length-dependent, weaker diameter-dependent, and weaker surface roughness-dependent thermal conductivity than silicon nanowires. These findings are potentially useful for engineering Si1-xGex nanowires for thermoelectric applications. [ABSTRACT FROM AUTHOR]

We theoretically investigate the phonon scattering by vacancies, including the impacts of missing mass and linkages (τv-1) and the variation of the force constant of bonds associated with vacancies (τA-1) by the bond-order-length-strength correlation mechanism. We find that in bulk crystals, the phonon scattering rate due to change of force constant τA-1 is about three orders of magnitude lower than that due to missing mass and linkages τv-1 . In contrast to the negligible τA-1 in bulk materials, τA-1 in two-dimensional materials can be 3-10 folds larger than τv-1. Incorporating this phonon scattering mechanism to the Boltzmann transport equation derives that the thermal conductivity of vacancy defective graphene is severely reduced even for very low vacancy density. High-frequency phonon contribution to thermal conductivity reduces substantially. Our findings are helpful not only to understand the severe suppression of thermal conductivity by vacancies, but also to manipulate thermal conductivity in two-dimensional materials by phononic engineering. [ABSTRACT FROM AUTHOR]

Background Providing good quality primary health care to all inhabitants is one of the Chinese Government's health care objectives. However, information is scarce regarding the difference in quality of primary health care delivered to migrants and local residents respectively. This study aimed to compare patients' perceptions of quality of primary health care between migrants and local patients, and their willingness to use and recommend primary health care to others. Methods A cross-sectional survey was conducted. 787 patients in total were chosen from four randomly drawn Community Health Centers (CHCs) for interviews. Results Local residents scored higher than migrants in terms of their satisfaction with types of drugs available (3.62 vs. 3.45, p = 0.035), attitude of health workers (4.41 vs. 4.14, p = 0.042) and waiting time (4.30 vs. 3.86, p < 0.001). Even though there was no significant difference in overall satisfaction between local residents and migrants (4.16 vs. 3.91, p = 0.159), migrants were more likely to utilize primary health care as the first choice for their usual health problems (94.1% vs. 87.1%, p = 0.032), while local residents were more inclined to recommend Traditional Chinese Medicine to others (65.6% vs. 56.6%, p = 0.026). Conclusions Quality of primary health care given to migrants is less satisfactory than to local residents in terms of attitude of health workers and waiting time. Our study suggests quality of care could be improved through extending opening hours of CHCs and strengthening professional ethics education. Considering CHCs as the first choice by migrants might be due to their health insurance scheme, while locals' recommendations for traditional Chinese medicine were possibly because of cultural differences. [ABSTRACT FROM AUTHOR]

Background Strengthening primary care is key to Hong Kong's ongoing health system reform. Primary care remains unregulated, private sector dominated and financed mainly out-of-pocket. This study sought to examine the association between patients' socioeconomic status (SES), source of health payments and the quality of primary care they accessed to inform policy discussions. Methods Data was collected from 1,994 respondents in a stratified random telephone survey with a 68% response rate, using the validated primary care assessment tool (PCAT). Education, household-income and type of housing were selected as indicators of SES. Multivariable ordinal logistic regression models were created to examine associations between indicators of SES and scores of quality. Results Higher household-income was most significantly associated with better experiences of quality. Respondents with HK$ 15000-39999 (USD1934-5158) and HK$40000(USD5159) and above were 47% (OR 1.47, 95% CI 1.10-1.96) and 2 times (OR 2.07, 95% CI 1.38-3.09) more likely to experience better quality than the lowest-income group respectively. Income group HK$ 40000 (USD5159) and above was 84% more likely to have better utilization (OR 1.84, 95% CI (1.21-2.78), and 2 times more likely to receive better comprehensiveness (OR 1.90, 95% CI 1.26-2.87). Patients who used only private insurance were 80% (OR 1.80, 95% CI 1.20-2.68) more likely to experience better quality than those who paid out-of-pocket. Conclusions Our results show that the quality of primary care experienced in HK tended to be higher for those who had higher income and private insurance, and were able to pay out-of-pocket for the care. This indicated that the inequality in primary care is likely to be related with the private dominated primary care system in Hong Kong. More public responsibility on primary health care should be sought for in HK and similar contexts to reduce the inequality in primary care. [ABSTRACT FROM AUTHOR]

Based on van der Waals density functional calculations, we have studied few-quintuple-layer (QL) films of Bi2Se3 and Bi2Te3. The separation between the QLs near the surface is found to have a large increase after relaxation, whereas, the separation between the inner QLs is smaller and approaches the bulk value as the thickness grows, showing a two-dimensional to three-dimensional structural crossover. Accordingly, the surface Dirac cone of the Bi2Se3 film is evidently gapped for small thicknesses (two to four QLs), and the gap is reduced and, finally, is closed with the increasing thickness, agreeing well with the experiments. We further studied the substrate effect by investigating the Bi2Se3/graphene system. It is found that the underlying graphene induces a giant thickness-dependent Rashba splitting and Dirac point shift. Because Bi2Te3 films have smaller relative inter-QL expansion and stronger spin-orbit coupling, the topological features start to appear in the film as thin as two QLs in good accord with the experiments. [ABSTRACT FROM AUTHOR]

Based on first-principles calculations within density functional theory, we find that Pb adlayers can induce a giant Rashba spin splitting in the quantum well states of an underlying Bi2Se3 film. As the thickness of the Pb adlayers varies, the distance between the Pb adlayer and the Bi2Se3 film, the charge density at the interface, and the binding between the Pb adlayers exhibit an oscillatory behavior due to the quantum size effects, which in turn modulates the magnitude of the Rashba spin splitting of the quantum well states in the Bi2Se3 film. [ABSTRACT FROM AUTHOR]

Purpose: To solve complex health issues, an innovative and multidisciplinary framework is necessary. The Clinical Public Health (CPH) Division was established at the University of Toronto (UofT), Canada to foster inte-gration of primary care, preventive medicine and public health in education, practice and research. To better understand how the construct of CPH might be applied, we surveyed clinicians, researchers and public health professionals affiliated with the CPH Division to assess their understanding of the CPH concept and its utility in fostering broad collaboration.Methods: A two-wave anonymous survey of the active faculty of the CPH Division, UofT was conducted across Canada. Wave 1 participants (n = 187; 2016) were asked to define CPH, while Wave 2 participants (n = 192; 2017) were provided a synthesis of Wave 1 results and asked to rank each definition. Both waves were asked about the need for a common definition, and to comment on CPH.Results: Response rates for the first and second waves were 25% and 22%, respectively. Of the six definitions of CPH from Wave 1, "the intersection of clinical practice and public health," was most highly ranked by Wave 2 participants. Positive perceptions of CPH included multidisciplinary collaboration, new fields and insights, forward thinking and innovation. Negative perceptions included CPH being a confusing term, too narrow in scope or too clinical.Conclusion: The concept of Clinical Public Health can foster multidisciplinary collaboration to address com-plex health issues because it provides a useful framework for bringing together key disciplines and diverse professional specialties. [ABSTRACT FROM AUTHOR]

The article discusses the medical foreign aid and policy of China. It discusses the importance of medical aid in the country's foreign aid policy, the expansion of China's medical aid in Africa, the commitment to expanding public health initiatives demonstrated by the 2013 Beijing Declaration, and China's focus on providing sustainable development assistance in health.

Background: Tuberculosis (TB) is an infectious disease of major public health concern. The disease has demonstrated large space-time variations. This study aims to explore the space-time dynamics of TB cases in an economically and geographically dynamic province in China with specific references of TB control for policy makers. Methods: Data on all reported TB cases from 2009 to 2012 were collected from the TB program at the Zhejiang Provincial Center for Disease Control and Prevention. We employed time series and exploratory spatial data analyses, including Moran's I, Local Getis's Gi*, and Kulldorff's space-time scan statistics, to identify the temporal trends and spatial patterns of TB at a county level. Results: A total of 147,941 TB cases were reported during 2009-2012 in Zhejiang. A higher proportion of TB cases were younger, male, and registered permanent residents among all TB cases notified in the province. TB cases were reported most frequently in April with small peaks in June, July, and October. This disease was spatially clustering with Moran's I values ranged from 0.29 to 0.32 (p < 0.001). A most likely cluster and ten secondary clusters were identified, mainly concentrated in the southeast and west counties of the province. Conclusions: This study identified seasonal patterns and significant space-time clusters of TB cases in Zhejiang, China. Poverty, migration, and seasonal effects may play important roles in potential clusters. [ABSTRACT FROM AUTHOR]

Background: There are three major models of primary care providers (Community Health Centers, CHCs) in China, i.e., government managed, hospital managed and privately owned CHCs. We performed a systematic review of structures and health care delivery patterns of the three models of CHCs.Methods: Studies from relevant English and Chinese databases for the period of 1997-2011 were searched. Two independent researchers extracted data from the eligible studies using a standardized abstraction form. Methodological quality of included articles was assessed with the Mixed Methods Appraisal Tool (MMAT).Results: A total of 13 studies was included in the final analysis. Compared with the other two models, private CHCs had a smaller health workforce and lower share of government funding in their total revenues. Private CHCs also had fewer training opportunities, were less recognized by health insurance schemes and tended to provide primary care services of poor quality. Hospital managed CHCs attracted patients through their higher quality of clinical care, while private CHCs attracted users through convenience and medical equipment.Conclusions: Our study suggested that government and hospital managed CHCs were more competent and provided better primary care than privately owned CHCs. Further studies are warranted to comprehensively compare performances among different models of CHCs. [ABSTRACT FROM AUTHOR]

The article presents a study on the operational and financial differences of hospitals in China based on geography and levels of government ownership. It mentions the challenges faced by the public hospital systems as the country transitions from a socialist ideology to a market economy, a study finding showing the significant impact of geographic location on financial performance and another suggesting the significant impact of hospital level on both operational and financial performance.

In China's healthcare reform, community health centers (CHCs) are designed to take a pivotal role in providing primary care. Whilst about 20% of all outpatient care in China is delivered by the traditional Chinese medicine (TCM) sector, hospitals, instead of CHCs, are major providers. Using current patterns of patient utilization this study aims to inform CHCs on how they may strengthen access to TCM services. Three thousand three hundred and sixty CHC patients from six cities within the urban Pearl Delta Region were enumerated using multistage cluster sampling. Fifty-two percent had visited herbalists within three months with a mean visit frequency of 1.50 times. Herbal treatments, which are cheaper than western medicines, were more popular amongst those who needed to pay out of pocket including the uninsured. Herbal medicines appeared to be an alternative for those who are underinsured. Acupuncturists and massage therapists were visited by smaller proportions, 6.58% and 5.98%, respectively, with a mean three-month visit of 0.27 and 0.26 times. Access was restricted by lack of social insurance coverage. Whilst increasing provision of TCM in CHCs might respond to patient demand, increasing insurance coverage for TCM needs to be evaluated using current evidence on safety and effectiveness. [ABSTRACT FROM AUTHOR]

The authors reflect on the management of non-communicable diseases in low and middle income countries. The suggest that the global political commitment necessary to tackle the burden of non-communicable diseases has increased. They argue that ongoing research and behavioral change among health care providers may help in the prevention and management of non-communicable diseases in low and middle income countries.

Background: The healthcare system of mainland China is undergoing drastic reform and the optimal models for healthcare financing for provision of primary care will need to be identified. This study compared the performance indicators of the community health centres (CHCs) under different healthcare financing systems in the six cities of the Pearl River Delta region. Methods: Approximately 300 hypertensive patients were randomly recruited from the computerized chronic disease management records provided by one CHC in each of the six cities in 2011 using a multi-stage cluster random sampling method. The major outcome measures included the treatment rate of hypertension, defined as prescription of ≥ one antihypertensive agent; and the control rate of hypertension, defined as systolic blood pressure levels <140 mmHg and diastolic blood pressure levels <90 mmHg in patients without diabetes mellitus, or <130/80 mmHg among patients with concomitant diabetes. Binary logistic regression analyses were conducted with these two measures as outcome variables, respectively, controlling for patients' socio-demographic variables. The financing system (Hospital- vs. Government- vs. private-funded) was the independent variable tested for association with the outcomes. Results: From 1,830 patients with an average age of 65.9 years (SD 12.8), the overall treatment and control rates were 75.4% and 20.2%, respectively. When compared with hospital-funded CHCs, patients seen in the Government-funded (adjusted odds ratio [AOR] 0.462, 95% C.I. 0.325-0.656) and private-funded CHCs (AOR 0.031, 95% C.I. 0.019-0.052) were significantly less likely to be prescribed antihypertensive medication. However, the Government-funded CHC was more likely to have optimal BP control (AOR 1.628, 95% C.I. 1.157-2.291) whilst the privately-funded CHC was less likely to achieve BP control (AOR 0.146, 95% C.I. 0.069-0.310), irrespective of whether antihypertensive drugs were prescribed. Conclusions: Privately-funded CHCs had the lowest rates of BP treatment and control due to a variety of potential factors as discussed. [ABSTRACT FROM AUTHOR]

Graphyne, a new allotrope of carbon, is a current topic of focus in the nanomaterial research community. We investigate the thermal transport property of graphyne nanoribbons (GYNRs) by using the nonequilibrium Green's-function method. The thermal conductance of GYNRs is only approximately 40% that of graphene nanoribbons. A distinct width dependence of the thermal property is observed in GYNRs as well. The conductance of armchair-edged GYNRs (A-GYNRs) shows a linear width dependence, while a steplike width dependence is displayed in the conductance of zigzag-edged GYNRs (Z-GYNRs). Moreover, the conductance of an A-GYNR is larger than that of a Z-GYNR of the same width, indicating obvious anisotropic transport in graphyne (twice that in graphene). In addition, the thermal transport in graphyne family nanoribbons is also explored. The results show that the conductance of graphyne family nanoribbons is insensitive to the acetylenic linkages, but depends on the number of benzene rings. These findings could offer useful guidelines for the design and performance improvement of the graphyne-based nanodevices. [ABSTRACT FROM AUTHOR]

Abstract: Fully glazed facade that has been increasingly used in Singapore causes higher energy consumption and thermal discomfort due to higher solar gain. The use of double glazed facade system with ventilation system is one way to solve these problems. The objective of this paper is to investigate the effects of double glazed facade with ventilation system on the energy consumption, thermal comfort and condensation and compare to single glazed facade system. TAS and CFD software were utilized to calculate energy consumption, thermal comfort and condensation for single glazed facade building as well as double glazed facade building. The simulation results showed double glazed facade with natural ventilation were able to minimize energy consumption as well as to enhance the thermal comfort. Turning the mechanical fans on could also solve the condensation problem due to high humidity. [Copyright &y& Elsevier]

Inflammatory myofibroblastic tumors (IMTs) are uncommon, mesenchymal lesions, and malignant transformation is extremely rare. The current study presents the case of a 56-year-old female with a rapidly growing mass in the right breast, which was diagnosed as IMT. Immunohistochemically, the mass was positive for smooth muscle actin (SMA) and Ki-67 (positive staining in 30% of the cells), and negative for S-100, cluster of differentiation (CD)34, p63 and cytokeratin. Malignant transformation to metaplastic carcinoma of the spindle-cell type was observed following surgical resection. This metaplastic carcinoma demonstrated positive immunoreactivity for cytokeratin, vimentin, CD34, p63 and Ki-67 (>30%), and was negative for cytokeratin 7, SMA, desmin and S-100. The patient underwent total mastectomy of the right breast, followed by palliative chemotherapy with capecitabine; however, the patient succumbed to the disease after 12 weeks. The unusual case presented in the current study emphasizes the importance of pre-operative examinations to determine the benign or malignant nature of IMTs, which aids in the choice of appropriate surgical procedures. [ABSTRACT FROM AUTHOR]

A vertical heterostructure is an effective method for regulating the properties of 2D materials that are superior to their individual components due to the interfacial interaction. Here, 2D ZnSe/BiOX (X  =  Cl, Br, I) vertical heterostructures as potential photocatalysts for water splitting are systematically investigated using first-principles calculations. The results indicate that the binding strength of the heterostructure is larger than  −17.6 meV Å−2, favoring its experimental realization. Furthermore, the phonon dispersion and ab initio molecular dynamics (AIMD) analysis also indicate its good dynamical and thermodynamic stability. Remarkably, the ZnSe/BiOX heterostructures form a type-II band alignment with a direct band gap ranging from 1.78 eV to 2.06 eV, which enables the separation of electrons and holes in two different layers upon visible-light irradiation. The ZnSe/BiOX heterostructures also show high electron mobility, leading to fast migration of photogenerated electrons and extension of their lifetimes. The projected band structure, partial density of states, and partial charge densities show that the electrons of the valence band maximum (VBM) and conduction band minimum (CBM) are located at different sides of the ZnSe/BiOX heterostructures. According to the Bader charge analysis and charge density difference, an internal electric field exists across the interface which will effectively promote the separation of the photoinduced electron–hole pairs. The band-edge positions of the ZnSe/BiOX heterostructures have demonstrated that the band levels of the VBM and CBM stride the oxidation and reduction potential for water splitting. In addition, the band gaps and band-edge positions of the ZnSe/BiOX heterostructures can be tuned by the in-layer biaxial strain. Therefore, our results suggest that ZnSe/BiOX heterostructures are a promising potential application for water splitting under visible light as a novel photocatalyst. [ABSTRACT FROM AUTHOR]

The structural, electronic, and optical properties of a 2D out-of-plane heterostructure of MoO2/WO2 are investigated with first-principle calculations. The most favorable stacking configuration was a direct band gap semiconductor of ~1.71 eV, which is in the range of visible light. Interestingly, we found that the lowest conduction band and the uppermost valance band were dominated by the d electron from the MoO2 and WO2 layer respectively, based on the decomposed charge density analysis. It implies that the photoexcited electron and hole can be well separated in the MoO2/WO2 heterostructure in photocatalysis. The calculated optical absorption spectra of a MoO2/WO2 heterostructure have remarkable responses in the visible light area. Our results suggest that a MoO2/WO2 heterostructure has potential applications in photocatalysis. [ABSTRACT FROM AUTHOR]

The article presents the author's views on the difficulty of translating health service research results into practice. The author also suggests some solutions for the problem. According to the author, under the current model of health service research, researchers find solution to the problems and then try to convince decision makers and practitioners to implement them.

Based on first-principles calculations in the framework of van der Waals density functional theory, we investigate the structural, electronic properties and band-gap tuning of the h-BN/MoS2/h-BN sandwich heterostructure under an external electric field. We find that, different from the suspended monolayer MoS2 with a direct band-gap, h-BN/MoS2/h-BN has an indirect band-gap. Particular attention has been focused on the engineering of the band-gap of the h-BN/MoS2/h-BN heterostructure via application of an external electric field. With the increase of electric field, the band-gap of the h-BN/MoS2/h-BN heterostructure undergoes an indirect-to-direct band-gap transition. Once the electric field intensity is larger than 0.1 V Å−1, the gap value of direct band-gap shrinks almost linearly with the field-strength, which indicates that the h-BN/MoS2/h-BN heterostructure is a viable candidate for optoelectronic applications. [ABSTRACT FROM AUTHOR]