Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified...Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.A...BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.AIM To evaluate the incidence and prognostic significance of post-PCI psychological disorders in elderly patients with heart failure,and to examine their association with medication adherence and major adverse cardiovascular events(MACE).METHODS This retrospective cohort study included 330 consecutive patients aged≥60 years with heart failure who underwent PCI between 2018 and 2021 at a single center,excluding those with prior psychiatric diagnoses.Psychological status within six months post-discharge was assessed using validated Chinese versions of the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale,and medication adherence was measured by the 8-item Morisky Medication Adherence Scale(MMAS-8)scale.A subset of 145 patients with≥24 months of follow-up were analyzed for MACEs.Multivariate logistic regression and Kaplan-Meier survival analyses were performed.RESULTS Post-PCI psychological disorders were identified in 40%of patients,with anxiety(36%),depression(32%),and comorbid symptoms(22%)being most prevalent.Affected patients had lower MMAS-8 scores[median 5(IQR 4-6)vs 6(IQR 5-7),P=0.002]and a higher rate of low adherence(51.5%vs 30.3%,P<0.001).Among the 145 patients followed longitudinally,MACEs occurred in 17.9%,with 65.4%of events in those with psychological disorders.Psychological disorders(OR=2.66,95% CI:1.11-6.41,P=0.028)and low adherence(OR=2.77,95% CI:1.17-6.56,P=0.021)were independently associated with increased MACE risk.Kaplan-Meier analysis showed reduced MACE-free survival in patients with psychological disorders(HR=2.68,95%CI:1.25-5.73;log-rank P=0.008).CONCLUSION Post-PCI psychological disorders are common in elderly patients with heart failure and independently predict poorer adherence and worse cardiovascular outcomes.Routine psychological assessment and adherence interventions may improve prognosis in this vulnerable population.展开更多
BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often ci...BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often cited as a concern when initiating treatment.Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored.AIM To evaluate factors associated with adherence to hepatitis B oral antiviral treatment.METHODS A global online survey was administered anonymously to adults(aged 18 years or older)living with chronic hepatitis B.A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis.Indices for treatment affordability,healthcare service acceptability,and individual physical,psychological,and emotional functioning were constructed(Cronbach’s alpha=0.71-0.83).Data analysis was conducted using Stata/BE 17.0.RESULTS Overall,81%of respondents reported high adherence to hepatitis B treatment.Lower adherence was observed among individuals who identified as African or African American(P=0.008).Among participants with low adherence,60%cited affordability as a challenge(P=0.068),53%identified healthcare service acceptability as a challenge(P=0.04),79%described physical functioning as a challenge(P=0.002),and 40.5%reported difficulties with psychological functioning(P=0.55).CONCLUSION Findings demonstrate high treatment adherence,although access to and acceptability of healthcare services,as well as an individual’s physical functioning challenges,appear to be related to low adherence.展开更多
BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encoura...BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.展开更多
Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, H...Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.展开更多
Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.T...Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.展开更多
Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 wer...Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.展开更多
Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is infl...Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.展开更多
This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relations...This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.展开更多
Investigations into the long-term creep behavior of Beishan granite in uniaxial compression were conducted.Four levels of axial stress(60,70,87,and 95 MPa)were applied to rock specimens.Contrasting with earlier resear...Investigations into the long-term creep behavior of Beishan granite in uniaxial compression were conducted.Four levels of axial stress(60,70,87,and 95 MPa)were applied to rock specimens.Contrasting with earlier research,the long-term creep data in this work present a substantial advancement in the time dimension.Except for the sample subjected to 60 MPa axial loading,which did not fail after a loading duration of 1650 d,the specimens under the other three stresses all failed after sustained constant loading durations of 1204,1023,and 839 d,respectively.A lower envelope of driving stress-ratio for crystalline rocks was obtained,tending towards approximately 0.45 over an infinite time scale.According to the experimental results,as axial stress increases,both the axial strain accumulated in the transient creep process and the strain rate associated with steady-state creep deformation increase exponentially;however,the share of steady-state creep strain remains nearly constant at about82.53%.A novel damage-based creep model was put forward.It provides an enhanced depiction of the comprehensive creep process in rocks,notably improving the accuracy in forecasting the accelerated creep phase,which significantly impacts the long-term stability of engineering structures.展开更多
While oceanic and coastal acidification has gained increased attention,long-term pH trends and their drivers in large freshwater systems remain poorly understood.The Laurentian Great Lakes are the world’s largest fre...While oceanic and coastal acidification has gained increased attention,long-term pH trends and their drivers in large freshwater systems remain poorly understood.The Laurentian Great Lakes are the world’s largest freshwater system,and in many ways resemble marine ecosystems.However,unlike the open ocean and coastal waters where pH has declined due to rising atmospheric CO_(2),no significant pH trends have been observed in the Laurentian Great Lakes,despite significant ecosystem changes driven partly by the invasion of dreissenid mussels.This study examined 41 years of field observations from Lake Michigan to investigate the long-term carbonate chemistry dynamics.Observational results revealed substantial declines in both total alkalinity(TA)and dissolved inorganic carbon(DIC)over the four decades.Mussel shell calcification emerged as the primary mechanism behind these declines,accounting for 97%and 47%of the observed changes in TA and DIC,respectively,lowering water column pH by 0.24 units.Elevated carbon accumulation in soft mussel tissues,coupled with long-term changes in the air-water pCO_(2)gradient during summer,significantly contributed to long-term DIC variations,explaining 18%and 28%of the lake-wide DIC loss.These two mechanisms also resulted in an overall pH increase of 0.09 and 0.12 units,largely offsetting the calcification-driven pH decrease.These findings bridge a gap in acidification research for large freshwater systems and provide valuable insights for comprehensive lake-wide management strategies.展开更多
Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a referen...Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.展开更多
AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longit...AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.展开更多
Taking the rural low-income population of Zhejiang Province as its subject, this paper examines how to build a sustainable income-growth mechanism and identify feasible implementation paths within the context of the c...Taking the rural low-income population of Zhejiang Province as its subject, this paper examines how to build a sustainable income-growth mechanism and identify feasible implementation paths within the context of the common prosperity strategy. The research identifies key obstacles to income expansion, including an undiversified industrial structure, insufficient human capital, and a lack of robust social protection. These call for systemic solutions featuring institutional innovation, resource consolidation, and capability enhancement. Building on Zhejiang's experience as a common prosperity demonstration zone, the article constructs an integrated framework centered on four pillars: industrial empowerment, education upgrading, social security reinforcement, and digital coordination. It further offers concrete policy proposals involving the cultivation of localized industries, vocational skill training, enhanced safety nets, and the adoption of digital tools. The study thus offers both theoretical insights and practical paradigms for tackling the challenge of raising incomes in low-income rural areas.展开更多
Long-term manure application has the potential to alleviate soil acidification, and increase carbon sequestration and nutrient availability, thus improving cropland fertility. However, the mechanisms behind greenhouse...Long-term manure application has the potential to alleviate soil acidification, and increase carbon sequestration and nutrient availability, thus improving cropland fertility. However, the mechanisms behind greenhouse gas N_(2)O emissions from acidic soil mediated by long-term manure application remain poorly understood. Herein, we investigated N_(2)O emission and its linkage with gross N mineralization and nitrification rates, as well as nitrifying and denitrifying microbes in an acidic upland soil subjected to 36-year fertilization treatments, including an unfertilized control(CK), inorganic fertilizer(F), 2× rate of inorganic fertilizer(2F), manure(M), and the combination of inorganic fertilizer and manure(FM) treatments. Compared to the CK treatment(1.34 μg N kg^(-1) d^(-1)), fertilization strongly increased N_(2)O emissions by 34-fold on average, with more pronounced increases in the manure-amendment(10.6-169 μg N kg^(-1) d^(-1)) than those in the inorganic fertilizer treatments(3.26-5.51 μg N kg^(-1) d^(-1)). The manure amendment-stimulated N_(2)O emissions were highly associated with increased soil pH, mean weight diameter of soil aggregates, substrate availability(e.g., particulate organic carbon, NO_(3)^(-)and available phosphorus), gross N mineralization rates, denitrifier abundances and the(nirK+nirS)/nosZ ratio. These findings suggest that the increased N_(2)O emissions primarily resulted from alleviated acidification, increased substrate availability and improved soil structure, thus enhancing microbial N mineralization and favoring N_(2)O^(-)producing denitrifiers over N_(2)O consumers. Moreover, ammonia-oxidizing bacteria(AOB) rather than ammonia-oxidizing archaea(AOA) positively correlated with soil NO_(3)^(-)concentration and N_(2)O emissions, indicating that nitrification indirectly contributed to N_(2)O production by supplying NO_(3)^(-)for denitrification. Collectively, manure amendment potentially stimulates N_(2)O emissions, primarily resulting from alleviated soil acidification and increased substrate availability, thus enhancing N mineralization and denitrifier-mediated N_(2)O production. Our findings suggest that consideration should be given to the greenhouse gas budgets of agricultural ecosystems when applying manure for managing the pH and fertility of acidic soils.展开更多
Waterborne acrylic coatings are widely utilized due to their cost-effectiveness,high transparency,strong resistance to weather and chemicals,impressive mechanical properties,and excellent adhesion to various substrate...Waterborne acrylic coatings are widely utilized due to their cost-effectiveness,high transparency,strong resistance to weather and chemicals,impressive mechanical properties,and excellent adhesion to various substrates.In these coatings,a reactive emulsifier containing phosphate groups can be integrated into the molecular chain during polymerization,which enhances the coating's compactness and corrosion resistance.This work focuses on the synthesis of styrene-butyl acrylate(St-BA)latex and methyl methacrylate-butyl acrylate(MMA-BA)latex using the reactive phosphate emulsifier ANPEO_(10)-P_(1) through seed emulsion polymerization,achieving a conversion rate of approximately 99%and a solid content close to 50%.The resulting coatings from St-BA and MMA-BA latexes demonstrated long-term corrosion protection for carbon steel and aluminum alloy due to in-situ phosphatization,effectively preventing flash rust.Notably,the MMA-BA coating exhibited remarkable durability,enduring immersion for up to 1224 h(51 d)on Q 235 carbon steel before reaching the failure threshold(|Z|0.01 Hz£106Ω·cm^(2))on Q 235 carbon steel.On 5052 aluminum alloy,the St-BA coating maintained|Z|0.01 Hz>10^(8)Ω·cm^(2) for 480 h(20 d).Furthermore,the corrosion resistance of St-BA and MMA BA coatings on Q 235 steel sheet and 5052 aluminum alloy surpassed that of commercially available MMA-BA and St BA coatings after immersion in a 3.5 wt%NaCl aqueous solution.This work also delves into the anticorrosion mechanism of MMA-BA and St-BA coatings.展开更多
Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors ...Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.展开更多
AIM:To assess adherence rates to nucleos(t)ide analogues(NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence.METHODS:The questionnaire study was conducted...AIM:To assess adherence rates to nucleos(t)ide analogues(NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence.METHODS:The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital.All patients who were currently taking one or more NUCs were asked to complete a structured,selfadministered 32-item questionnaire.Adherence was measured using visual analogue scales.The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire.RESULTS:A total of 80 patients completed the questionnaire.Sixty six percent of the patients(n = 49) reported optimal adherence whilst 25(33.8%) graded their adherence to NUCs as suboptimal.Thirty four(43%) patients reported to have omitted taking their NUCs sometime in the past.Recent non-adherence was uncommon.Amongst the patients who reported skipping medications,the most common reason cited was 'forgetfulness'(n = 27,56.25%).Other common reasons included:ran out of medications(n = 5,10.42%),being too busy(n = 4,8.33%) and due to a change in daily routine(n = 5,10.42%).Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs(P = 0.04).Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs(P = 0.04).CONCLUSION:Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome.Communication and education appear central and strategies need to be implemented to improve ongoing adherence.展开更多
基金supported by the National R&D Program for Cancer Control through the National Cancer Center funded by the Ministry of Health & Welfare, Republic of Korea (No. HA21C0225)。
文摘Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.AIM To evaluate the incidence and prognostic significance of post-PCI psychological disorders in elderly patients with heart failure,and to examine their association with medication adherence and major adverse cardiovascular events(MACE).METHODS This retrospective cohort study included 330 consecutive patients aged≥60 years with heart failure who underwent PCI between 2018 and 2021 at a single center,excluding those with prior psychiatric diagnoses.Psychological status within six months post-discharge was assessed using validated Chinese versions of the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale,and medication adherence was measured by the 8-item Morisky Medication Adherence Scale(MMAS-8)scale.A subset of 145 patients with≥24 months of follow-up were analyzed for MACEs.Multivariate logistic regression and Kaplan-Meier survival analyses were performed.RESULTS Post-PCI psychological disorders were identified in 40%of patients,with anxiety(36%),depression(32%),and comorbid symptoms(22%)being most prevalent.Affected patients had lower MMAS-8 scores[median 5(IQR 4-6)vs 6(IQR 5-7),P=0.002]and a higher rate of low adherence(51.5%vs 30.3%,P<0.001).Among the 145 patients followed longitudinally,MACEs occurred in 17.9%,with 65.4%of events in those with psychological disorders.Psychological disorders(OR=2.66,95% CI:1.11-6.41,P=0.028)and low adherence(OR=2.77,95% CI:1.17-6.56,P=0.021)were independently associated with increased MACE risk.Kaplan-Meier analysis showed reduced MACE-free survival in patients with psychological disorders(HR=2.68,95%CI:1.25-5.73;log-rank P=0.008).CONCLUSION Post-PCI psychological disorders are common in elderly patients with heart failure and independently predict poorer adherence and worse cardiovascular outcomes.Routine psychological assessment and adherence interventions may improve prognosis in this vulnerable population.
文摘BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often cited as a concern when initiating treatment.Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored.AIM To evaluate factors associated with adherence to hepatitis B oral antiviral treatment.METHODS A global online survey was administered anonymously to adults(aged 18 years or older)living with chronic hepatitis B.A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis.Indices for treatment affordability,healthcare service acceptability,and individual physical,psychological,and emotional functioning were constructed(Cronbach’s alpha=0.71-0.83).Data analysis was conducted using Stata/BE 17.0.RESULTS Overall,81%of respondents reported high adherence to hepatitis B treatment.Lower adherence was observed among individuals who identified as African or African American(P=0.008).Among participants with low adherence,60%cited affordability as a challenge(P=0.068),53%identified healthcare service acceptability as a challenge(P=0.04),79%described physical functioning as a challenge(P=0.002),and 40.5%reported difficulties with psychological functioning(P=0.55).CONCLUSION Findings demonstrate high treatment adherence,although access to and acceptability of healthcare services,as well as an individual’s physical functioning challenges,appear to be related to low adherence.
文摘BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.
文摘Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.
文摘Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.
文摘Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.
文摘Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.
文摘This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.
基金financially supported by the China Atomic Energy Authority(CAEA)through the Geological Disposal Programthe National Natural Science Foundation of China(No.42307258)the China National Nuclear Corporation Fundamental Research Project(No.CNNC-JCYJ-202307)。
文摘Investigations into the long-term creep behavior of Beishan granite in uniaxial compression were conducted.Four levels of axial stress(60,70,87,and 95 MPa)were applied to rock specimens.Contrasting with earlier research,the long-term creep data in this work present a substantial advancement in the time dimension.Except for the sample subjected to 60 MPa axial loading,which did not fail after a loading duration of 1650 d,the specimens under the other three stresses all failed after sustained constant loading durations of 1204,1023,and 839 d,respectively.A lower envelope of driving stress-ratio for crystalline rocks was obtained,tending towards approximately 0.45 over an infinite time scale.According to the experimental results,as axial stress increases,both the axial strain accumulated in the transient creep process and the strain rate associated with steady-state creep deformation increase exponentially;however,the share of steady-state creep strain remains nearly constant at about82.53%.A novel damage-based creep model was put forward.It provides an enhanced depiction of the comprehensive creep process in rocks,notably improving the accuracy in forecasting the accelerated creep phase,which significantly impacts the long-term stability of engineering structures.
基金Supported by the National Natural Science Foundation of China(No.43277051)the Key Laboratory of Integrated Regulation and Resources Development of Shallow Lakes of Ministry of Education(No.B230203006).
文摘While oceanic and coastal acidification has gained increased attention,long-term pH trends and their drivers in large freshwater systems remain poorly understood.The Laurentian Great Lakes are the world’s largest freshwater system,and in many ways resemble marine ecosystems.However,unlike the open ocean and coastal waters where pH has declined due to rising atmospheric CO_(2),no significant pH trends have been observed in the Laurentian Great Lakes,despite significant ecosystem changes driven partly by the invasion of dreissenid mussels.This study examined 41 years of field observations from Lake Michigan to investigate the long-term carbonate chemistry dynamics.Observational results revealed substantial declines in both total alkalinity(TA)and dissolved inorganic carbon(DIC)over the four decades.Mussel shell calcification emerged as the primary mechanism behind these declines,accounting for 97%and 47%of the observed changes in TA and DIC,respectively,lowering water column pH by 0.24 units.Elevated carbon accumulation in soft mussel tissues,coupled with long-term changes in the air-water pCO_(2)gradient during summer,significantly contributed to long-term DIC variations,explaining 18%and 28%of the lake-wide DIC loss.These two mechanisms also resulted in an overall pH increase of 0.09 and 0.12 units,largely offsetting the calcification-driven pH decrease.These findings bridge a gap in acidification research for large freshwater systems and provide valuable insights for comprehensive lake-wide management strategies.
文摘Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.
文摘AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.
文摘Taking the rural low-income population of Zhejiang Province as its subject, this paper examines how to build a sustainable income-growth mechanism and identify feasible implementation paths within the context of the common prosperity strategy. The research identifies key obstacles to income expansion, including an undiversified industrial structure, insufficient human capital, and a lack of robust social protection. These call for systemic solutions featuring institutional innovation, resource consolidation, and capability enhancement. Building on Zhejiang's experience as a common prosperity demonstration zone, the article constructs an integrated framework centered on four pillars: industrial empowerment, education upgrading, social security reinforcement, and digital coordination. It further offers concrete policy proposals involving the cultivation of localized industries, vocational skill training, enhanced safety nets, and the adoption of digital tools. The study thus offers both theoretical insights and practical paradigms for tackling the challenge of raising incomes in low-income rural areas.
基金financially supported by the National Science & Technology Fundamental Resources Investigation Project of China (2021FY100501)the Youth Innovation of Chinese Academy of Agricultural Sciences (Y2023QC16)。
文摘Long-term manure application has the potential to alleviate soil acidification, and increase carbon sequestration and nutrient availability, thus improving cropland fertility. However, the mechanisms behind greenhouse gas N_(2)O emissions from acidic soil mediated by long-term manure application remain poorly understood. Herein, we investigated N_(2)O emission and its linkage with gross N mineralization and nitrification rates, as well as nitrifying and denitrifying microbes in an acidic upland soil subjected to 36-year fertilization treatments, including an unfertilized control(CK), inorganic fertilizer(F), 2× rate of inorganic fertilizer(2F), manure(M), and the combination of inorganic fertilizer and manure(FM) treatments. Compared to the CK treatment(1.34 μg N kg^(-1) d^(-1)), fertilization strongly increased N_(2)O emissions by 34-fold on average, with more pronounced increases in the manure-amendment(10.6-169 μg N kg^(-1) d^(-1)) than those in the inorganic fertilizer treatments(3.26-5.51 μg N kg^(-1) d^(-1)). The manure amendment-stimulated N_(2)O emissions were highly associated with increased soil pH, mean weight diameter of soil aggregates, substrate availability(e.g., particulate organic carbon, NO_(3)^(-)and available phosphorus), gross N mineralization rates, denitrifier abundances and the(nirK+nirS)/nosZ ratio. These findings suggest that the increased N_(2)O emissions primarily resulted from alleviated acidification, increased substrate availability and improved soil structure, thus enhancing microbial N mineralization and favoring N_(2)O^(-)producing denitrifiers over N_(2)O consumers. Moreover, ammonia-oxidizing bacteria(AOB) rather than ammonia-oxidizing archaea(AOA) positively correlated with soil NO_(3)^(-)concentration and N_(2)O emissions, indicating that nitrification indirectly contributed to N_(2)O production by supplying NO_(3)^(-)for denitrification. Collectively, manure amendment potentially stimulates N_(2)O emissions, primarily resulting from alleviated soil acidification and increased substrate availability, thus enhancing N mineralization and denitrifier-mediated N_(2)O production. Our findings suggest that consideration should be given to the greenhouse gas budgets of agricultural ecosystems when applying manure for managing the pH and fertility of acidic soils.
基金Project(52373065)supported by the National Natural Science Foundation of ChinaProject(2220004002898)supported by the Zhuhai Industry University Research Cooperation and Basic and Applied Research Projects,China。
文摘Waterborne acrylic coatings are widely utilized due to their cost-effectiveness,high transparency,strong resistance to weather and chemicals,impressive mechanical properties,and excellent adhesion to various substrates.In these coatings,a reactive emulsifier containing phosphate groups can be integrated into the molecular chain during polymerization,which enhances the coating's compactness and corrosion resistance.This work focuses on the synthesis of styrene-butyl acrylate(St-BA)latex and methyl methacrylate-butyl acrylate(MMA-BA)latex using the reactive phosphate emulsifier ANPEO_(10)-P_(1) through seed emulsion polymerization,achieving a conversion rate of approximately 99%and a solid content close to 50%.The resulting coatings from St-BA and MMA-BA latexes demonstrated long-term corrosion protection for carbon steel and aluminum alloy due to in-situ phosphatization,effectively preventing flash rust.Notably,the MMA-BA coating exhibited remarkable durability,enduring immersion for up to 1224 h(51 d)on Q 235 carbon steel before reaching the failure threshold(|Z|0.01 Hz£106Ω·cm^(2))on Q 235 carbon steel.On 5052 aluminum alloy,the St-BA coating maintained|Z|0.01 Hz>10^(8)Ω·cm^(2) for 480 h(20 d).Furthermore,the corrosion resistance of St-BA and MMA BA coatings on Q 235 steel sheet and 5052 aluminum alloy surpassed that of commercially available MMA-BA and St BA coatings after immersion in a 3.5 wt%NaCl aqueous solution.This work also delves into the anticorrosion mechanism of MMA-BA and St-BA coatings.
基金supported by the National Key R&D Program of China(2018YFC2000600)
文摘Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.
文摘AIM:To assess adherence rates to nucleos(t)ide analogues(NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence.METHODS:The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital.All patients who were currently taking one or more NUCs were asked to complete a structured,selfadministered 32-item questionnaire.Adherence was measured using visual analogue scales.The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire.RESULTS:A total of 80 patients completed the questionnaire.Sixty six percent of the patients(n = 49) reported optimal adherence whilst 25(33.8%) graded their adherence to NUCs as suboptimal.Thirty four(43%) patients reported to have omitted taking their NUCs sometime in the past.Recent non-adherence was uncommon.Amongst the patients who reported skipping medications,the most common reason cited was 'forgetfulness'(n = 27,56.25%).Other common reasons included:ran out of medications(n = 5,10.42%),being too busy(n = 4,8.33%) and due to a change in daily routine(n = 5,10.42%).Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs(P = 0.04).Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs(P = 0.04).CONCLUSION:Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome.Communication and education appear central and strategies need to be implemented to improve ongoing adherence.
