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Background Community health services play an effective role in delaying the progression of diabetes and managing diabetes complications. Previous studies have suggested that the subjective experiences of visits to community health centers by patients with diabetes contributes to their improved health outcomes. However, few studies have evaluated the correlation of glycemic control outcomes with specific service processes and objective experiences of programs received by diabetic patients in the community health service centers. Objective To explore the correlation between the community health service experiences and glycemic control outcomes in patients with diabetes mellitus. Methods A cross-sectional survey design and multi-stage, cluster random sampling method was used to select six community health service centers in the central urban area of Guangzhou, with one family doctor team randomly selected from each center. A total of 336 patients with diabetes who visited the corresponding family doctor teams from September to November 2019 were recruited as the study subjects. A questionnaire was conducted to collect baseline information, fasting plasma glucose (FPG) level, and Primary Care Assessment Tool (PCAT) scores. The glycemic control outcomes of patients were assessed based on the FPG level, and their experiences of community health services were assessed based on the PCAT scores. Logistic regression models were used to evaluate the effect of community health service experiences on glycemic control outcomes in diabetic patients. Results The glycemic control rate of the included diabetic patients was 73.2% (246/336). The total PCAT score and the scores for each dimension of PCAT with good glycemic control outcomes were higher than those of patients with poor glycemic control outcomes, and the difference was statistically significant (P

This study examined the associations of long-term exposure to ambient fine particulate matter (PM2.5) compositions/ozone with methylation of peripheral brain-derived neurotrophic factor (BDNF) promoters. A total of 101 participants were recruited from a cohort in Shijiazhuang, Hebei province, China. They underwent baseline and follow-up surveys in 2011 and 2015. DNA methylation levels were detected by bisulfite-PCR amplification and pyrosequencing. Participants' three-year average levels of PM2.5 compositions and ozone were estimated. Bayesian kernel machine regression (BKMR) models were used to examine the joint effects of pollutants on methylation levels. Exposure to PM2.5 compositions and ozone mixtures at the 75th percentile was associated with increased methylation levels at CpG2 of BDNF promoter (203%, 95% CI: 89, 316) than the lowest level of exposure, and sulfate dominated the effect in the BKMR models.Our findings provide clues to the epigenetic mechanisms for the associations of PM2.5 compositions and ozone with BDNF. [ABSTRACT FROM AUTHOR]

Background: In China, Community Health Centers (CHCs) provide primary healthcare (PHC); however, few studies have examined the quality of PHC services experienced by migrant patients. We examined the potential association between the quality of migrant patients' PHC experiences and the achievement of Patient-Centered Medical Home by CHCs in China. Methods: Between August 2019 and September 2021, 482 migrant patients were recruited from ten CHCs in China's Greater Bay Area. We evaluated CHC service quality using the National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH) questionnaire. We additionally assessed the quality of migrant patients' PHC experiences using the Primary Care Assessment Tools (PCAT). General linear models (GLM) were used to examine the association between the quality of migrant patients' PHC experiences and the achievement of PCMH by CHCs, adjusting for covariates. Results: The recruited CHCs performed poorly on PCMH1, Patient-Centered Access (7.2 ± 2.0), and PCMH2, Team-Based Care (7.4 ± 2.5). Similarly, migrant patients assigned low scores to PCAT dimension C—First-contact care—which assesses access (2.98 ± 0.03), and D—Ongoing care (2.89 ± 0.03). On the other hand, higher-quality CHCs were significantly associated with higher total and dimensional PCAT scores, except for dimensions B and J. For example, the total PCAT score increased by 0.11 (95% CI: 0.07–0.16) with each increase of CHC PCMH level. We additionally identified associations between older migrant patients (> 60 years) and total PCAT and dimension scores, except for dimension E. For instance, the average PCAT score for dimension C among older migrant patients increased by 0.42 (95% CI: 0.27–0.57) with each increase of CHC PCMH level. Among younger migrant patients, this dimension only increased by 0.09 (95% CI: 0.03–0.16). Conclusion: Migrant patients treated at higher-quality CHCs reported better PHC experiences. All observed associations were stronger for older migrants. Our results may inform future healthcare quality improvement studies that focus on the PHC service needs of migrant patients. [ABSTRACT FROM AUTHOR]

Background radiation in the LiDAR detection field of view is complex and variable, and the background noise generated can easily cause false alarms in the receiver, which affects the effective detection of the system. Through the analysis of the influence of background radiation noise of LiDAR on the detection performance, an adaptive suppression method of LiDAR background noise is proposed. This method realizes the rapid suppression of background noise in the instantaneous field of view through an adaptive threshold adjustment of current steering architecture with a back-end digital-to-analog converter (DAC) correction based on the principle of constant false alarm rate (CFAR) control. Aiming at the problem of accurate noise detection and quantification in a very short time, a dynamic comparator is used to replace the traditional continuous comparator. While detecting the number of noise pulses, the measurement of the pulse duration of noise is realized, which improves the accuracy of short-time noise detection. In order to verify the actual effect of the adaptive method, experiments were carried out based on the team's self-developed LiDAR. The experimental results show that the measured noise ratio of the adaptive mode by using this method is the lowest. Even at 12 a.m., the noise ratio of the point cloud obtained by the adaptive mode is 0.012%, compared with 0.08% obtained by the traditional mode, which proves that this method has a good ability to suppress background noise. The proportion of noise reduction of the adaptive mode is more than 80% compared with the traditional mode. It achieves noise suppression through hardware at each detection, and each adjustment can be completed within a single period of pulse detection. Therefore, it has great advantages in real-time detection compared with the back-end software noise reduction processing method, and it is suitable for the application of LiDAR in the complex background environment. [ABSTRACT FROM AUTHOR]

Abstract Background Pyrrolizidine alkaloids (PAs) are probably the most common plant constituents that poison livestock, wildlife, and humans worldwide. Riddelliine is isolated from plants grown in the western United States and is a prototype of genotoxic PAs. Riddelliine was used to investigate the genotoxic effects of PAs via analysis of gene expression in the target tissue of rats in this study. Previously we observed that the mutant frequency in the liver of rats gavaged with riddelliine was 3-fold higher than that in the control group. Molecular analysis of the mutants indicated that there was a statistically significant difference between the mutational spectra from riddelliine-treated and control rats. Results Riddelliine-induced gene expression profiles in livers of Big Blue transgenic rats were determined. The female rats were gavaged with riddelliine at a dose of 1 mg/kg body weight 5 days a week for 12 weeks. Rat whole genome microarray was used to perform genome-wide gene expression studies. When a cutoff value of a two-fold change and a P-value less than 0.01 were used as gene selection criteria, 919 genes were identified as differentially expressed in riddelliine-treated rats compared to the control animals. By analysis with the Ingenuity Pathway Analysis Network, we found that these significantly changed genes were mainly involved in cancer, cell death, tissue development, cellular movement, tissue morphology, cell-to-cell signaling and interaction, and cellular growth and proliferation. We further analyzed the genes involved in metabolism, injury of endothelial cells, liver abnormalities, and cancer development in detail. Conclusion The alterations in gene expression were directly related to the pathological outcomes reported previously. These results provided further insight into the mechanisms involved in toxicity and carcinogenesis after exposure to riddelliine, and permitted us to investigate the interaction of gene products inside the signaling networks.

Organic additives can enhance the amplified spontaneous emission (ASE) performance of inorganic cesium lead halide perovskites (CsPbBr3) but volatility, potential hygroscopicity and oxidative degradation of these additives jeopardizes the thermal stability and shelf‐life of blended CsPbBr3 films. To address this problem, we have fabricated perovskite films in a two‐step solution protocol involving as little added polyethylene oxide (PEO) as possible. These films exhibited enhanced crystallization, improved photoluminescence (PL) intensity and prolonged lifetimes. Their hierarchical morphology and surface passivation lowered the ASE threshold from 278 to 176 μЈ/cm2 under one‐photon nanosecond laser excitation. The proportion of added PEO was 0.3 wt% and was subsequently almost fully removed, thereby reducing its adverse influence on the stability of resulting films under continuous pulsed laser excitation. Stable ASE spectra could be stimulated after storage in air for 10 months. [ABSTRACT FROM AUTHOR]

Inorganic cesium lead halide perovskite (CsPbX3, X = Cl, Br, and I) has attracted increasing attention in the field of laser application due to its excellent stability compared to the organic–inorganic hybrid perovskite since affording the radiation of a long pulse pump source requires high thermal stability of the material. However, it is difficult to observe the amplified spontaneous emission (ASE) of CsPbBr3 using a one-step solution method due to the low solubility of CsBr in the organic solvent. Herein, we fabricate a CsPbBr3 film with a two-step solution method and realize the ASE under the long pulse pumping. Meanwhile, a CsBr aqueous solution is used as an effective additive to increase the concentration of Cs+ in the precursor solution and then to improve the optical amplification properties of the CsPbBr3 films. The films exhibit better crystalline and enhanced photoluminescence intensity. Both the ASE threshold and gain have been significantly improved. Furthermore, the optimized film shows a satisfying stability of ASE after being placed in the air for more than two months. [ABSTRACT FROM AUTHOR]

The measures to reduce the impact of evaporation loss in a natural draft counter-flow wet cooling tower (NDWCT) have important implications for water conservation and emissions reduction. A mathematical model of evaporation loss in the NDWCT was established by using a modified Merkel method. The NDWCTs in the 300 MW and 600 MW power plant were taken as the research objects. Comparing experimental values with calculated values, the relative error was less than 3%. Then, the effect of air parameters on evaporation loss of NDWCT was analyzed. The results showed that, with the increase of dry bulb temperature, the evaporation heat dissipation and the evaporation loss decreased, while the rate of evaporation loss caused by unit temperature difference increased. The ambient temperature increased by 1 °C and the evaporation loss was reduced by nearly 26.65 t/h. When the relative air humidity increased, the evaporation heat dissipation and evaporation loss decreased, and the rate of evaporation loss caused by unit temperature difference decreased. When relative air humidity increased by 1%, the outlet water temperature rose by about 0.08 °C, and the evaporation loss decreased by about 5.63 t/h. [ABSTRACT FROM AUTHOR]

This study examined the associations of long-term exposure to ambient fine particulate matter (PM 2.5 ) compositions/ozone with methylation of peripheral brain-derived neurotrophic factor (BDNF) promoters. A total of 101 participants were recruited from a cohort in Shijiazhuang, Hebei province, China. They underwent baseline and follow-up surveys in 2011 and 2015. DNA methylation levels were detected by bisulfite-PCR amplification and pyrosequencing. Participants' three-year average levels of PM 2.5 compositions and ozone were estimated. Bayesian kernel machine regression (BKMR) models were used to examine the joint effects of pollutants on methylation levels. Exposure to PM 2.5 compositions and ozone mixtures at the 75th percentile was associated with increased methylation levels at CpG2 of BDNF promoter (203%, 95% CI: 89, 316) than the lowest level of exposure, and sulfate dominated the effect in the BKMR models.Our findings provide clues to the epigenetic mechanisms for the associations of PM 2.5 compositions and ozone with BDNF.

Objectives: Patients' experiences are important part of health services quality research, but it's still unclear whether patients' experiences are influenced by resident status. This study aimed to evaluate the association between resident status and patients' primary care experiences with the focus on migrants vs local residents., Design: A cross-sectional study using multistage cluster random sampling was conducted from September to November 2019. The data were analysed using general linear models., Setting: Six community health centres in Guangzhou, China., Participants: 1568 patients aged 20 years or older., Main Outcome Measures: Patients' primary care experiences were assessed using the Primary Care Assessment Tool. The 10 domains included in Primary Care Assessment Tool (PCAT) refers to first contact-utilisation, first contact-access, ongoing care, coordination (referral), coordination (information), comprehensiveness (services available), comprehensiveness (services provided), family-centredness, community orientation and cultural competence from patient's perspective., Results: 1568 questionnaires were analysed. After adjusting for age, sex, education, annual family income, self-perceived health status, chronic condition, annual medical expenditure and medical insurance, the PCAT total scores of the migrants were significantly lower than those of local residents (β=-0.128; 95% CI -0.218 to -0.037). Migrants had significantly lower scores than local residents in first contact utilisation (β=-0.245; 95% CI -0.341 to -0.148), ongoing care (β=-0.175; 95% CI -0.292 to -0.059), family-centredness (β=-0.112; 95% CI -0.225 to 0.001), community orientation (β=-0.176; 95% CI -0.286 to -0.066) and cultural competence (β=-0.270; 95% CI -0.383 to -0.156), respectively., Conclusion: Primary care experiences of migrants were significantly worse off than those of local residents, especially in terms of primary care utilisation, continuity and cultural competence. Given the wide disparity in primary care experiences between migrants and local residents, Chinese healthcare system reform should focus on improving quality of primary care services for migrants, overcoming language barriers and creating patient-centred primary care services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Organic additives can enhance the amplified spontaneous emission (ASE) performance of inorganic cesium lead halide perovskites (CsPbBr 3 ) but volatility, potential hygroscopicity and oxidative degradation of these additives jeopardizes the thermal stability and shelf-life of blended CsPbBr 3 films. To address this problem, we have fabricated perovskite films in a two-step solution protocol involving as little added polyethylene oxide (PEO) as possible. These films exhibited enhanced crystallization, improved photoluminescence (PL) intensity and prolonged lifetimes. Their hierarchical morphology and surface passivation lowered the ASE threshold from 278 to 176 μЈ/cm 2 under one-photon nanosecond laser excitation. The proportion of added PEO was 0.3 wt% and was subsequently almost fully removed, thereby reducing its adverse influence on the stability of resulting films under continuous pulsed laser excitation. Stable ASE spectra could be stimulated after storage in air for 10 months., (© 2021 Wiley-VCH GmbH.)

Objectives: To assess the relationship between occupational health and safety (OH&S)-related behaviours of migrating workers in China and their knowledge regarding OH&S laws and regulations (L&Rs)., Materials and Methods: We sampled 1282 migrant workers from 12 labour-intensive manufacturers in Guangdong, China, with a response rate of 98.6%. Self-reported questionnaires were completed by the participants. Logistic regression models were used to examine the association between OH&S-related behaviours and knowledge among migrant workers adjusting for their demographic features and the survey sites., Results: Migrant workers' behaviour of seeking occupational disease (OD) diagnosis and treatment was found to be statistically significantly correlated with their knowledge of all three OH&S L&Rs. A higher score of knowledge regarding these OH&S L&Rs is associated with a better chance to seek OD diagnosis and treatment. The ORs of the high-score group (subjects correctly answered more than one question) versus the low-score group (subjects correctly answered less than or equal to one question) are 2.02 (95% CI: 1.33 to 3.07) for Law of Occupational Disease Prevention and Treatment, 2.89 (95% CI: 1.65 to 5.09) for Regulations on Safe Management of Dangerous Chemicals and Regulations on Labor Protection for Using Toxic Substances in Workplace and 2.25 (95% CI: 1.34 to 3.77) for Work-Related Injury Insurance Regulations. However, knowledge about these L&Rs is not statistically significantly associated with OH&S-related protective behaviours such as wearing a mask or gloves at work., Conclusions: Knowledge of OH&S L&Rs helps migrant workers in China to seek OD diagnosis and treatment., Competing Interests: Competing interests: Author Jingrong Shi was employed by the company Guangzhou Tianpeng Technology Co.,Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Rapid progress achieved on perovskite solar cells raises the expectation for their further development toward practical applications. Moisture sensitivity of perovskite materials is one of the major obstacles which limits the long-term durability of the perovskite solar cells, especially in outdoor operation where rainfall and water accumulation on the solar panels often occur. Micro/nanopinholes within the functional layers of the devices usually lead to water vapor penetration, thus subsequent decomposition of perovskites, and finally poor device performance and shortened operational lifetime. In this work, low-temperature atomic layer deposition (ALD) technique was utilized to incorporate pinhole-free metal oxide layers (TiO 2 and Al 2 O 3 ) into an inverted perovskite solar cell consisting of indium tin oxide/NiO/perovskite/PC 61 BM/TiO 2 /Ag. The interface properties between the inserted TiO 2 layer and the perovskite layer were investigated by X-ray photoelectron spectroscopy. The results showed that TiO 2 ALD fabrication process had made negligible degradation to the perovskite layer. The TiO 2 layer can significantly reduce interfacial charge recombination loss, improve interfacial contact, and enhance water resistance. A maximum power conversion efficiency (PCE) of 18.3% was achieved for devices with TiO 2 interface layers. A stacked Al 2 O 3 encapsulation layer was designed and deposited on top of the devices to further improve device stability under harsh environmental conditions. The encapsulated devices with the best performance retained 97% of the initial PCE after being stored in ambient condition for a thousand hours. They also showed great water resistance, and no significant degradation in terms of PCE and photocurrent of the devices was observed after they were immersed in deionized water for as long as 2 h. Our approach offers a promising way of developing highly efficient and stable perovskite solar cells under real-world operational conditions.

The cystine-glutamate transporter SLC7A11 has been implicated in chemoresistance, by supplying cystine to the cell for glutathione maintenance. In the NCI-60 cell panel, SLC7A11 expression shows negative correlation with growth inhibitory potency of geldanamycin but not with its analog 17-(allylamino)-17-demethoxygeldanamycin (17-AAG), which differs in the C-17 substituent in that the the methoxy moiety of geldanamycin is replaced by an amino group. Structure and potency analysis classified 18 geldanamycin analogs into two subgroups, "17-O/H" (C-17 methoxy or unsubstituted) and "17-N" (C-17 amino), showing distinct SLC7A11 correlation. We used three 17-O/H analogs and four 17-N analogs to test the role of the 17-substituents in susceptibility to SLC7A11-mediated resistance. In A549 cells, which are resistant to geldanamycin and strongly express SLC7A11, inhibition of SLC7A11 by (S)-4-carboxyphenylglycine or small interfering RNA increased sensitivity to 17-O/H, but had no effect on 17-N analogs. Ectopic expression of SLC7A11 in HepG2 cells, which are sensitive to geldanamycin and express low SLC7A11, confers resistance to geldanamycin, but not to 17-AAG. Antioxidant N-acetylcysteine, a precursor for glutathione synthesis, completely suppressed cytotoxic effects of 17-O/H but had no effect on 17-N analogs, whereas the prooxidant ascorbic acid had the opposite effect. Compared with 17-AAG, geldanamycin led to significantly more intracellular reactive oxygen species (ROS) production, which was quenched by addition of N-acetylcysteine. We conclude that SLC7A11 confers resistance selectively to 17-O/H (e.g., geldanamycin) but not to 17-N (e.g., 17-AAG) analogs partly as a result of differential dependence on ROS for cytotoxicity. Distinct mechanisms could significantly affect antitumor response and organ toxicity of these compounds in vivo.

Background: Pyrrolizidine alkaloids (PAs) are probably the most common plant constituents that poison livestock, wildlife, and humans worldwide. Riddelliine is isolated from plants grown in the western United States and is a prototype of genotoxic PAs. Riddelliine was used to investigate the genotoxic effects of PAs via analysis of gene expression in the target tissue of rats in this study. Previously we observed that the mutant frequency in the liver of rats gavaged with riddelliine was 3-fold higher than that in the control group. Molecular analysis of the mutants indicated that there was a statistically significant difference between the mutational spectra from riddelliine-treated and control rats., Results: Riddelliine-induced gene expression profiles in livers of Big Blue transgenic rats were determined. The female rats were gavaged with riddelliine at a dose of 1 mg/kg body weight 5 days a week for 12 weeks. Rat whole genome microarray was used to perform genome-wide gene expression studies. When a cutoff value of a two-fold change and a P-value less than 0.01 were used as gene selection criteria, 919 genes were identified as differentially expressed in riddelliine-treated rats compared to the control animals. By analysis with the Ingenuity Pathway Analysis Network, we found that these significantly changed genes were mainly involved in cancer, cell death, tissue development, cellular movement, tissue morphology, cell-to-cell signaling and interaction, and cellular growth and proliferation. We further analyzed the genes involved in metabolism, injury of endothelial cells, liver abnormalities, and cancer development in detail., Conclusion: The alterations in gene expression were directly related to the pathological outcomes reported previously. These results provided further insight into the mechanisms involved in toxicity and carcinogenesis after exposure to riddelliine, and permitted us to investigate the interaction of gene products inside the signaling networks.