Search

Abstract Background This study was aimed to examine the effectiveness of App-assisted self-care in a Beijing community based on intelligent family physician-optimised collaborative model (IFOCM) program. Methods We conducted a survey of 12,050 hypertensive patients between Jan 2014 and Dec 2021. Generalized linear model was used to analyze the covariates that associated with blood pressure (BP) control. Decision tree and random forest algorithm was used to extract the important factors of BP outcome. Results The study included 5937 patients, mean age 66.2 ± 10.8, with hypertension in the baseline; 3108(52.4) were female. The community management resulted in mean systolic BP and diastolic BP reductions of 4.6 mmHg and 3.8 mmHg at follow-up. There were 3661 (61.6%) hypertension patients with BP control, increasing from 55.0% in 2014 to 75.0% in 2021. After adjusted for covariates, antihypertensive medication adherence, diabetes, and APP-assisted self-care were common predictors associated with BP control in GLM model and machine learning algorithm. Conclusion Community management based on IFOCM program significantly improved BP control in hypertensive patients. APP-assisted self-care would be beneficial for the management of chronic disease.

The feasibility of PVA fiber rubber concrete modified by modifier in the structure was investigated using the portal frame as the research object. The basic mechanical properties of modified PVA rubber concrete materials were tested mechanically first, and then ABAQUS was used to establish the ordinary concrete portal frame model, and after confirming the model’s rationality, the rubber concrete, PVA rubber concrete, and modified PVA rubber concrete models were established on this basis, and the displacement and strain comparison analysis with ordinary concrete was carried out. The simulation results show that using PVA rubber concrete material in the concrete frame structure can improve the large deformation of rubber concrete, and using PVA rubber concrete treated with a modifier can improve structural strength and deformation even more.

Sleep-wake rhythm disturbances, which are characterized by abnormal sleep timing or duration, are associated with cognitive dysfunction. Photoacoustic treatments including light and sound stimulation have been found to be effective in modulating sleep patterns and improving cognitive behavior in abnormal sleep-wake pattern experiments. In this study, we examined whether light and sound interventions could reduce sleep-wake pattern disturbances and memory deficits in a sleep rhythm disturbance model. We established a model of sleep rhythm disturbance in C57BL/6J mice via a sleep deprivation method involving manual cage tapping, cage jostling, and nest disturbance. We used a Mini Mitter radio transmitter device to monitor motor activity in the mice and fear conditioning tests to assess cognitive function. Our results indicated that an intervention in which the mice were exposed to blue light (40-Hz flickering frequency) for 1 hour during their subjective daytime significantly improved the 24-hour-acrophase shift and reduced the degree of memory deficit induced by sleep deprivation. However, interventions in which the mice were exposed to a 40-Hz blue light at offset time or subjective night time points, as well as 2 Hz-blue light at 3 intervention time points (subjective day time, subjective night time, and offset time points), had no positive effects on circadian rhythm shift or memory deficits. Additionally, a 2000-Hz sound intervention during subjective day time attenuated the 24-hour-acrophase shift and memory decline, while 440-Hz and 4000-Hz sounds had no effect on circadian rhythms. Overall, these results demonstrate that photoacoustic treatment effectively corrected abnormal sleep-wake patterns and cognitive dysfunction associated with sleep-deprivation-induced disturbances in sleep-wake rhythm. All animal experiments were approved by the Experimental Animal Ethics Committee of Drum Tower Hospital Affiliated to the Medical College of Nanjing University, China (approval No. 20171102) on November 20, 2017.

Isoflurane and sevoflurane are both inhalation anesthetics, but in clinical application, sevoflurane has been considered to be less suitable for long-term anesthesia because of its catabolic compounds and potential nephrotoxicity. Nevertheless, recent studies have shown that these two inhalation anesthetics are similar in hepatorenal toxicity, cost, and long-term anesthetic effect. Moreover, sevoflurane possibly has less cognitive impact on young mice. In this study, C57BL/6 mice aged 8–10 weeks were exposed to 1.2% isoflurane or 2.4% sevoflurane for 6 hours. Cognitive function and memory were examined in young mice using the novel object recognition, contextual fear conditioning, and cued-fear extinction tests. Western blot assay was performed to detect expression levels of D1 dopamine receptor, catechol-O-methyltransferase, phospho-glycogen synthase kinase-3β, and total glycogen synthase kinase-3β in the hippocampus. Our results show that impaired performance was not detected in mice exposed to sevoflurane during the novel object recognition test. Contextual memory impairment in the fear conditioning test was shorter in the sevoflurane group than the isoflurane group. Long-term sevoflurane exposure did not affect memory consolidation, while isoflurane led to memory consolidation and reduced retention. Downregulation of hippocampal D1 dopamine receptors and phosphorylated glycogen synthase kinase-3β/total glycogen synthase kinase-3β and upregulation of catechol-O-methyltransferase may be associated with differing memory performance after exposure to isoflurane or sevoflurane. These results confirm that sevoflurane has less effect on cognitive impairment than isoflurane, which may be related to expression of D1 dopamine receptors and catechol-O-methyltransferase and phosphorylation of glycogen synthase kinase-3β in the hippocampus. This study was approved by the Institutional Animal Care and Use Committee, Nanjing University, China on November 20, 2017 (approval No. 20171102).

The thermal conductivity of waste heat removal system of CPR1000 unit is analyzed, and the rate margin of primary circuit is studied. In this study, the design parameters of a domestic CPR1000 residual heat removal system are used to study the primary loop temperature margin according to the different core states, and the primary loop temperature margin according to the different valve openings of the residual heat removal system (RRA) . The results show that the CPR1000 unit has a large margin in cooling down, but there is no room for improvement in the process of heating up. Therefore, it is necessary for CPR1000 unit to enhance the effect of primary loop heating and cooling rate on primary loop thermal stress, material and control operation of system equipment.

A quench boiler is the key equipment in ethylene production for the rapid cooling of high-temperature cracking gas. In the boiler, heat transfer is occurs between the hot cracking gas passing through the inner heat exchange tubes with an average temperature of 385 °C and cold water (or boiler water) passing through the inner heat exchange tubes with an average temperature of 350 °C. Required for double-pipe heat transfer, special tubesheets formed by welding flat-round tubes side by side are difficult to design, as no suitable design code is available. The thermal expansion difference between the inner heat exchange tubes and the jacketed tubes could lead to high thermal stress on the tubesheet. In this study, we investigated the effects of pretension or prestretching of the heat exchange tubes on stress distribution and strength assessment of the flat-round tubesheet in a quench boiler under two dangerous load conditions. Results show that without prestretching the heat exchange tubes, the flat-round tubesheet cannot pass the strength assessment. Prestretching the heat exchange tubes is necessary, and a pretension of 9 mm is most suitable. The magnitude of the pretension of the heat exchange tubes should be determined based on the thermal expansion difference between the inner heat exchange tubes and the jacketed tubes, with consideration of the strength improvement of the flat-round tubesheet.

BackgroundThe highly charged nitrogen ions (Nq+, q=3, 5, 6) are one of the main charged ions in the solar wind. Study of K-shell X-ray emissions in collisions of Nq+ (q=3, 5, 6) ions with a Cu surface is of great significance for understanding the de-excitation process of "hollow atoms" and the generation mechanism of comet X-rays.PurposeThis study aims to investigate characteristics of K-shell X-ray emission in impacts of Nq+ (q=3, 5, 6) ions with a Cu surface.MethodsThe Nq+ (q=3, 5, 6) ion beam was generated by the electron cyclotron resonance ion source (ECRIS) in Institute of Modern Physics, Chinese Academy of Sciences. The K-shell X-ray spectra resulted from collisions of the Nq+ ions with the Cu surface were acquired by a silicon drift detector (SDD). Based on the X-ray spectra, K-shell X-ray yields and ionization cross sections were calculated.ResultsThe results show that, for the Nq+ (q=3, 5) ion incidence, K-shell X-ray emissions are attributed to close collisions of the ions with Cu atoms on the subsurface of the target, and that the K-shell X-ray yields and ionization cross sections increase monotonically with the increase of kinetic energy of the incident ions. For the N6+ ion incidence, the K-shell X-ray yields have no obvious dependence on kinetic energy of the incident ions. The K-shell X-rays are primarily emitted from the above-surface of Cu target through the de-exciting of the formed "hollow N atoms", and they account for about 97% of the total X-rays. In addition, the X-ray yield of the N5+ ion incidence is higher than that of N3+ ions.ConclusionsThis study provides basic data for the understanding the de-excitation process of "hollow atoms" and the generation mechanism of comet X-rays.

This paper explored the value of learner’s stories for ESL (English as a Second Language) teachers’ teaching and research through a narrative inquiry of the lived English learning experience of a first generation Canadian immigrant. It first reviewed the concept of narrative and the significance of launching narrative inquiry. Then, it presented an interview conducted with the Canadian immigrant as a model of narrative inquiry. Themes of the narrative interview were found to resonate with theoretical issues of SLE (Second Language Education), ESL and SLA (Second Language Acquisition). Considering the themes and the entire interviewing process, this paper closed with a discussion of the benefits of narrative inquiry for ESL teachers’ teaching and research.

The regulatory mechanism of mammary gland development and lactation is important, as lactation not only provides healthy milk for infants, but also provides health benefits to mothers. Circular RNAs (circRNAs) have recently received much attention, but only a few have been functionally characterized. In the present study, the structure and expression profile of a rat Tc2n-derived circular RNA (cTc2n) was investigated by several protocols. The cTc2n comprised exons10 and 11 of the Tc2ngeneandhad no poly(A)structure. The expression of cTc2n was significantly higher in the mammary gland of rat than in other tissues, including the heart, liver, spleen, lung, kidney, uterus and ovary. The abundance of cTc2n was the highest on day 1, and significantly declined on day 7, slightly increasing on day 21 postpartum. This finding indicates that cTc2n might play an important role in lactation.

Confined deformation, e.g. mechanical twinning, shear banding, and Lüders banding, etc. was extensively observed in metals and alloys with low stacking-fault energies, especially under complex loadings, governing the mechanical properties. It is often accompanied with gradient microstructures to accommodate the stress concentrations. Understanding the micromechanical behaviors of structural materials having confined deformation is important for evaluating the structural stabilities of engineering components. Synchrotron-based techniques provide powerful tools for multiscale microstructural characterization owing to their good resolution in real/reciprocal space, fast data collection/processing and flexible application scenarios. In this paper, the synchrotron-based high-energy X-ray diffraction (HE-XRD) and microdiffraction (μXRD) techniques in combination with traditional characterization methods are used to reveal the deformational gradient structures/stresses under different loading modes in multiscale. The structure/stress gradients induced by laser shot peening treatment and the deformation twins generated during uniaxial tensile loading in pure titanium were systematically studied by HE-XRD and μXRD, in order to elucidate the accommodating role of the deformational structures subjected to various confined scenarios. The new finding regarding the micromechanical behaviors related to confined deformation contributes to the in-depth understanding of related complex deformation behaviors.

Background/Aims: Ambulatory blood pressure monitoring (ABPM) in chronic kidney disease (CKD) patients has been extensively studied, but few investigations have attempted to relate ABPM with CKD stages. The objectives of this article were to compare ABPM parameters for the diagnosis and treatment determination of CKD with daytime clinic blood pressure (BP) measurements. We also investigated BP and renal injury in combined hypertension and CKD. We supposed ABPM was important in combined hypertension and CKD. Methods: We compared ABPM in hypertension patients, including 152 patients with combined hypertension and CKD. Patients with combined hypertension and CKD were grouped according to severity into stages 1 through 3 (Stage 1-3) and stages 4 and 5 (Stage 4-5). Results: In the Stage 4-5 group, systolic BP (SBP) (daytime, nighttime and 24 h mean), diastolic BP (DBP), pulse pressure and SBP standard deviations (SD) (daytime and 24 h) were higher. SBP and DBP loads were significantly higher in the Stage 4-5 group. The nighttime load was higher than the daytime load. Mean arterial pressure (MAP) was higher and heart rates (HR) were faster in the Stage 4-5 group. Conclusions: BP load should be a component employed in ABPM to determine cardiovascular risk stratification. MAP and HR might be associated with risk to develop end-stage renal disease.

The global use of English in diverse cultural contexts calls into question the dominant representations of Anglo-American culture in English language textbooks. To contribute to the discussion of this issue, this study aimed to investigate the attitudes of Chinese College English teachers towards a more balanced treatment of culture in English language teaching when they need to follow a required textbook. It examined the results of a focus group interview, in which a total of six female Chinese English teachers were invited to share their opinions and practices of teaching English culture in China's college classrooms. It was noted that cultures other than Anglo-American culture received inadequate attention and focus in the teachers' teaching process because they lacked both control over syllabus design and sufficient awareness of the relationship between global cultures and English today. Without gaining solid institutional support, altering perception of the English language and adjusting professional identity, it seemed difficult for the teachers to exert greater autonomy in the classroom to enhance their students' communicative competence and teach English truly as an international language.

The objective of this study was to investigate the flow dynamics and temperature characteristics under different reservoir operation scenarios and weather conditions in the river-reservoir system, which can be used to set scientific guidelines for river management and conservation planning strategies. The calibrated three-dimensional model provided simulated unsteady water surface elevation, temperature, velocity and discharge at different layers (depths) in different locations. A series of operation scenarios were modeled to understand and quantify formation, propagation, and disappearance of density currents that are resulted from combinations of daily repeated large release (DRLR) of different durations and solar heating. DRLRs (140 m3/s) with longer durations pushed the bottom cold water further downstream and maintained the bottom water temperature cooler. Variations of weather conditions (e.g., drops of air temperature and solar radiation) directly controled variations of bottom-layer water temperature. The daily drop rate of bottom temperature was related to the rate and duration of air temperature drop. Under the practice for the water turbines running at downstream, it clearly showed the shocking withdrawal and stopping effect from the downstream operation. The velocity for the whole cross-section were almost increased with same magnitude of about 0.1 m/s at GOUS and JML.