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BACKGROUND: While folic acid (FA) is widely used to treat elevated total homocysteine (tHcy), promoting vascular health by reducing vascular oxidative stress and modulating endothelial nitric oxide synthase, the optimal daily dose and individual variation by MTHFR C677T genotypes have not been well studied. Therefore, this study aimed to explore the efficacy of eight different FA dosages on tHcy lowering in the overall sample and by MTHFR C677T genotypes. METHODS: This multicentered, randomized, double-blind, controlled clinical trial included 2697 eligible hypertensive adults with elevated tHcy (≥ 10 mmol/L) and without history of stroke and cardiovascular disease. Participants were randomized into eight dose groups of FA combined with 10 mg enalapril maleate, taken daily for 8 weeks of treatment. RESULTS: The intent to treat analysis included 2163 participants. In the overall sample, increasing FA dosage led to steady tHcy reduction within the FA dosing range of 0-1.2 mg. However, a plateau in tHcy lowering was observed in FA dose range of 1.2-1.6 mg, indicating a ceiling effect. In contrast, FA doses were positively and linearly associated with serum folate levels without signs of plateau. Among MTHFR genotype subgroups, participants with the TT genotype showed greater efficacy of FA in tHcy lowering. CONCLUSIONS: This randomized trial lent further support to the efficacy of FA in lowering tHcy; more importantly, it provided critically needed evidence to inform optimal FA dosage. We found that the efficacy of FA in lowering tHcy reaches a plateau if the daily dosage exceeds 1.2 mg, and only has a small gain by increasing the dosage from 0.8 to 1.2 mg. GOV IDENTIFIER: NCT03472508 (Registration Date: March 21, 2018).

Abstract The aim of this study was to investigate the association between baseline resting heart rate (RHR) and all‐cause death in the China Stroke Primary Prevention Trial (CSPPT). A post hoc analysis was conducted using data from 20,648 hypertensive adults without cardiovascular disease in the CSPPT and with baseline RHR data available. Over a median follow‐up duration of 4.5 years, the baseline RHR and risk for all‐cause death had a nonlinear relationship. The risk of all‐cause death was higher in participants with an RHR ≥85 bpm (hazard ratio 1.42; 95% confidence interval 1.03–1.96, p = .031) than in those with a baseline RHR of 75–80 bpm. The effect of RHR on all‐cause death during the treatment period was modified by the folate level (p = .020) and systolic blood pressure (SBP) during treatment(p = .056). The effect of RHR on the risk of all‐cause death was stronger when the folate level was low than when it was high; the risk was higher when the RHR was

Background and purpose: Hypertension significantly contributes to stroke. Previous research has indicated a connection between daytime napping and stroke. Research on the connection between daytime napping duration and first stroke in hypertensive individuals is lacking nevertheless. Methods: This research, which ran from 24 August 2013 to 31 December 2022, recruited 11,252 individuals with hypertension and without a history of stroke from the China Stroke Primary Prevention Trial. To determine the relationship between daytime napping duration and stroke onset in hypertensive individuals, we conducted analyses for threshold effects, multivariate‐adjusted Cox proportional hazard regression models, and Kaplan–Meier survival curves. Results: The duration of daytime napping (<75 min) was positively correlated with stroke risk; beyond 75 min, the risk did not increase further. When compared to hypertensive individuals who napped for 1–30 min, daytime napping 31–60 min (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.06–1.53) and >60 min (HR = 1.37, 95% CI = 1.14–1.65) were substantially related with a greater risk of first stroke. Additionally, this correlation was absent in cases of hemorrhagic stroke, but present in cases of ischemic stroke, specifically for hypertensive individuals who napped for 31–60 min or >60 min (p < 0.05). Kaplan–Meier survival curves displayed that hypertensive individuals who extended daytime napping had an elevated incidence of stroke. Conclusions: Hypertensive individuals who take longer daytime naps (>30 min) are at an elevated risk of stroke onset, particularly ischemic stroke, irrespective of other factors. [ABSTRACT FROM AUTHOR]

A certain dumping site is located near a river, and its overall height and step height are relatively high, which makes the influence of rainwater infiltration greater, posing potential hazards under rainfall conditions. Based on the stacking situation of the site and the surrounding environment, the seepage characteristics of the waste dump under rainfall conditions were studied, and the potential hazards of the waste dump slope were analyzed, then the corresponding treatment plans were proposed. The results show that with continuous rainfall, there will be a transient saturation zone on the surface of the waste dump slope and it will continue to expand to the inside of the slope. During the rainfall process, the pore water pressure of the slope increased rapidly to a positive value, then gradually stabilized, and the slope reached a saturated state. Under the influence of rainfall, the relative stability relationship of the dump slope is: slope bottom>slope top>mid-slope, and the potential hazard site is from + 85 m platform to + 170 m platform. By adding a safety platform and reducing the slope angle, the potential hazards can be effectively controlled. [ABSTRACT FROM AUTHOR]

Purpose: The downward open stoping with subsequent backfill mining method, as a new mining technology, is primarily suitable for extracting orebodies with average to extremely poor rock mass quality or in deep high-stress environments. One of the key technologies of this method involves rapidly constructing cutting slots to create free surfaces and compensation spaces for blasting. This study aims to develop a safe and efficient slot construction technology to enhance the mining efficiency of deep, thick, and fractured orebodies. Method: Therefore, this study proposes a construction method of the cutting slots, named "successive well formation + single lateral blasting". To verify the feasibility of this solution, a field test was conducted at the Sanshandao gold mine, combined with numerical simulation and theoretical calculation Result: This study demonstrates that the proposed method can be used to construct cutting slots safely and efficiently when the rock mass in deep mining is unstable and the stope roof is built with cemented backfill. Conclusion: This method not only significantly improves the safety and efficiency of rock blasting but also reduces blasting disturbances, yields good blasting effects, and exhibits strong adaptability, providing an important reference for the construction of the cutting slots in similar mines. [ABSTRACT FROM AUTHOR]

Although the association between persistent hypertension and the compromise of both micro‐ and macro‐circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial‐ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross‐sectional study of treated hypertensive patients with the last follow‐up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith‐Wagener‐Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable‐adjusted restricted cubic spline model to investigate any potential non‐linear dose‐response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03–1.07, p <.001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37–1.89, p <.001). Two‐piece‐wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated. [ABSTRACT FROM AUTHOR]

Cut patio construction was a critical process in the medium-deep hole or deep hole mining methods, which mainly included staged blasting or one-time grooved blasting. Cut patio was essential in the medium-deep hole mining technology. The common method, the conventional raising, cage raising and climber raising method was usually used to construct the cutting patio, which has great safety risks and low excavation efficiency, which seriously affects the mine production. In recent years, Sanshandao Gold Mine has researched downward sublevel filling mining with medium and deep hole blasting. This research was currently facing the problem of cut patio construction under the backfill roof. This study demonstrated a one-time grooved blasting method fitting the backfill roof condition and its application. By comparing the characteristics of the straight-hole cutting method and the blasting crater method, the straight-hole cutting method was selected for the cut patio construction. By calculating blasting parameters, the diameter of the charging hole was Φ65 mm, and the diameter of the compensation hole was Φ110mm. The distance between the charging and empty holes was 0.3m, which could meet the requirements of blasting compensation space and free surface. In consideration of the surrounding rock stability conditions, a nine-hole cutout method was selected, containing 29 holes, where the cutout hole was designed with 1 central charging hole, 12 empty holes as compensation holes, 4 auxiliary holes, and 12 peripheral holes, after determining the blast hole plugging length, explosive selection, charge structure, differential time, detonation sequence and other process parameters, an in-situ industrial test of cut patio construction was carried out. The industrial test showed that the one-time grooved blasting plan for patio construction was feasible. The blasting rock particle size is uniform with no large blocks and excessive powder, the blasting disturbance is minor, and the blasting patio dimensions meet the design requirements. Overall, this test provided experiences and a reference basis for other one-time grooved blasting technical applications with similar conditions. [ABSTRACT FROM AUTHOR]