Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We...Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.展开更多
Objective The present study aimed to investigate the association of red meat usual intake with metabolic syndrome(Met S),and explore the contribution of red meat usual intake to serum ferritin.Methods Based on the dat...Objective The present study aimed to investigate the association of red meat usual intake with metabolic syndrome(Met S),and explore the contribution of red meat usual intake to serum ferritin.Methods Based on the data from the longitudinal China Health and Nutrition Survey(CHNS),2,797 healthy adults aged 18–75 years without hypertension,diabetes,and Met S were selected in 2009 as subjects and follow-up studies were carried out till 2015.We used the National Cancer Institute(NCI)method to estimate the usual intake of foods.Multivariable logistic regressions were performed to evaluate the association between red meat usual intake and the risk of Met S.Quantile regression analysis was used to study the relationship between red meat consumption and serum ferritin levels.Results After adjusting for potential confounders,red meat,and fresh red meat were positively associated with the risk of Met S(RR=1.41,95%CI:1.05–1.90 and RR=1.37,95%CI:1.02–1.85,respectively).These relationships showed increasing trend(P<0.05).The level of serum ferritin increased significantly with the number of Met S components(P<0.05).The quantile regression analysis showed that red meat and fresh red meat usual intake had a significant positive association with serum ferritin levels across the entire conditional serum ferritin distribution(P<0.05).Processed red meat did not exhibit a similar association.Conclusion Higher red meat usual intake was associated with an increased risk of Met S and elevated serum ferritin levels.展开更多
It is shown that evolution characteristics of black hole(BH)parameters in the pure disk-accretion are determined uniquely by BH spin parameter aa_(*).Some unusual evolution characteristics of the parameters of BH accr...It is shown that evolution characteristics of black hole(BH)parameters in the pure disk-accretion are determined uniquely by BH spin parameter aa_(*).Some unusual evolution characteristics of the parameters of BH accretion disks,such as angular velocity,temperature and event horizon radius,are investigated in both thin and thick disk-accretion.And the corresponding turning points,a_(*)^(c),are derived.In addition,two characteristic functions describing the evolution of BH parameters are derived for thin and thick disks,respectively.展开更多
We study the superfluid behavior of a population imbalanced ultracold atomic Fermi gases with a short range attractive interaction in a one-dimensional(1D)optical lattice,using a pairing fluctuation theory.We show tha...We study the superfluid behavior of a population imbalanced ultracold atomic Fermi gases with a short range attractive interaction in a one-dimensional(1D)optical lattice,using a pairing fluctuation theory.We show that,besides widespread pseudogap phenomena and intermediate temperature superfluidity,the superfluid phase is readily destroyed except in a limited region of the parameter space.We find a new mechanism for pair hopping,assisted by the excessive majority fermions,in the presence of continuum-lattice mixing,which leads to an unusual constant Bose-Einstein condensate(BEC)asymptote for Tc that is independent of pairing strength.In result,on the BEC side of unitarity,superfluidity,when it exists,may be strongly enhanced by population imbalance.展开更多
The usual fermion realizations of quantum algebra S1_(q)(2) defining higher-dimensional representations are built in this letter.Using them,we construct a usual fermion system with quantum group symmetry of S1_(q)(2) ...The usual fermion realizations of quantum algebra S1_(q)(2) defining higher-dimensional representations are built in this letter.Using them,we construct a usual fermion system with quantum group symmetry of S1_(q)(2) as a q-deformation of the pairing correlation model in many-body problems.Its energy spectra are exactly solved out from the representation theory of S1_(q)(2).展开更多
An ultra-thin Co2MnSi(0.5 nm)/Mn Ga(1.5 nm) bilayer capped with Pt(5 nm) has been successfully grown by molecular-beam epitaxy.It is a potential candidate of synthetic antiferromagnets due to antiferromagnetic couplin...An ultra-thin Co2MnSi(0.5 nm)/Mn Ga(1.5 nm) bilayer capped with Pt(5 nm) has been successfully grown by molecular-beam epitaxy.It is a potential candidate of synthetic antiferromagnets due to antiferromagnetic coupling between Co2MnSi and MnGa,which is a promising skyrmion-racetrack-memory medium without skyrmion Hall effect after capping with a Pt layer.Unusual humps in transverse Hall resistance loops are clearly observed in the temperature range from 260 to 400 K.This anomaly is generally attributed to topological Hall effect,but other than that,we prove that non-uniform rotation of magnetic moments in the bilayer with magnetic field sweeping is also a possible mechanism contributed to the unusual hump.展开更多
Business as Usual （BaU） scenario in developing countries has been a debated issue in climate change negotiations. This paper analyzes different definitions of BaU and points out that the major difference among these...Business as Usual （BaU） scenario in developing countries has been a debated issue in climate change negotiations. This paper analyzes different definitions of BaU and points out that the major difference among these definitions is how to set the starting point of BaU projections, that is the so called base year. Some international institutions use current policy scenarios to project a BaU trajectory of developing countries. Such definition will lead to an underestimation of BaU emissions of developing countries and thus an underestimation of mitigation efforts. This paper concludes with a suggestion to use a without policy scenario with a clear base year as definition of BaU. Such a definition will set an objective benchmark to assess mitigation efforts of develonin countries.展开更多
When assessing food intake patterns in groups of individuals, a major problem is finding usual intake distribution. This study aimed at searching for a probability distribution to estimate the usual intake of nutrient...When assessing food intake patterns in groups of individuals, a major problem is finding usual intake distribution. This study aimed at searching for a probability distribution to estimate the usual intake of nutrients using data from a cross-sectional investigation on nutrition students from a public university in Sao Paulo state, Brazil. Data on 119 women aged 19 to 30 years old were used. All women answered a questionnaire about their lifestyle, diet and demographics. Food intake was evaluated from a non-consecutive three-day 24-hour food record. Different probability distributions were tested for vitamins C and E, panthotenic acid, folate, zinc, copper and calcium where data normalization was not possible. Empirical comparisons were performed, and inadequacy prevalence was calculated by comparing with the NRC method. It was concluded that if a more realistic distribution for usual intake is found, results can be more accurate as compared to those achieved by other methods.展开更多
Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart revi...Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart review study. Setting： A large, academically-affiliated Veteran Affairs Healthcare System providing primary and tertiary care. Patients： 580 patients were identified as having an active prescription for amiodarone for at least 60 days from January l, 2009 to August 31, 2013 and receiving primary care at the VAAHS （Veterans Affairs Ann Arbor Healthcare System）. Results： Nearly all patients had TSH and LFTs at baseline regardless of study group. Significant associations between baseline rates for CXR, ECG, PFT, and opbthalmologic exams were found, with higher rates in the clinic and template arms compared to usual care. Similar patterns for all monitoring outcome rates were also found for both the 6- and 12-month measures. Conclusions： Patients on amiodarone who are followed by a pharmacist-managed clinic or where a restricted ordering template was used had increased compliance with amiodarone monitoring guidelines compared to usual care. Use of a restricted template may be a reasonable option in place of a pharmacist-managed service.展开更多
Background:The prognosis of acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is very poor with a high mortality.The aim of this study was to describe the clinical features and survival of patients with AE-IP...Background:The prognosis of acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is very poor with a high mortality.The aim of this study was to describe the clinical features and survival of patients with AE-IPF with usual pulmonary fibrosis(UIP)and possible UIP(P-UIP)pattern on chest high resolution computed tomography(HRCT).Methods:This retrospective study included 107 patients with AE-IPF admitted to Nanjing Drum Tower Hospital from January 2010 to December 2016.The subjects were divided into UIP(n=86)and P-UIP group(n=21)based on chest HRCT.Continuous variables were analyzed using Student's t test or Mann-Whimey U test.Categorical variables were analyzed using x2 test.Log-rank test was used for the survival analysis.Cox proportional models evaluated the risk factors for AE occurrence and survival.Results:The male,older patients,previous N-acetylcysteine use,elevated white blood cell(WBC)counts,and microbiology infection were more common in the UIP group than the P-UIP group(X2=13.567,P<0.001;z=-2.936,P=0.003;X2=5.901,P=0.015;t=2.048,P=0.043;x2=10.297,P=0.036,respectively).The percentage of AE with UIP pattern in idiopathic interstitial pneumonia(ⅡP)was significantly higher than P-UIP pattern(X2=40.011,P<0.001).Smoking was the risk factor for AE within 6 months after IPF diagnosis in the UIP group.The cumulative proportion survival of 30-days was significantly higher in the UIP group compared with the P-UIP group(x2=5.489,P=0.019)despite of the similar overall survival in the two groups.Multivariate Cox regression analysis indicated WBC count,partial pressure of oxygen in artery(PaO2)/ffactional concentration of inspired oxygen(FiOz),and computed tomography(CT)score were the independent predictors for survival in the UIP group(hazard ratio[HR]:1.070,95%confidential interval[CI]:1.027-1.114,P=0.001;HR:0.992,95%CI:0.986-0.997,P=0.002;and HR:1.649,95%CI:1.253-2.171,P<0.001,respectively).Conclusions:AE occurrence of UIP patients in IIP was significantly more than P-UIP cases.The short-term survival was better in the UIP group despite of the similar overall survival in the two groups.WBC count,PaO2/FiO2,and CT score were the independent predictors for survival in UIP subjects.展开更多
The delusional United States Congress has just approved sanctions legislation which destabilizes the internationalsystem and the U.S. constitutional order. Will it lead to war？
HU Meijuan, 49, is a high-ranking engineer in charge of computer operations at the Qinshan Nuclear Power Station, the first nuclear power station built by China. Among more than 600 technicians, there are many women, ...HU Meijuan, 49, is a high-ranking engineer in charge of computer operations at the Qinshan Nuclear Power Station, the first nuclear power station built by China. Among more than 600 technicians, there are many women, but Hu is considered the most understanding of them. In 1987 the Qinshan Nuclear Power Station started operations in scenic Hangzhouwan. A large group of qualified personnel展开更多
文摘Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.
基金funded by the Ministry of Finance of the People’s Republic of China[No.13103110700015005]Carolina Population Center[No.P2CHD050924,T32 HD007168]+1 种基金the University of North Carolina at Chapel Hill,the NIH[No.R01-HD30880,DK056350,R24 HD050924,and R01-HD38700]the NIH Fogarty International Center[No.D43TW009077,D43 TW007709].
文摘Objective The present study aimed to investigate the association of red meat usual intake with metabolic syndrome(Met S),and explore the contribution of red meat usual intake to serum ferritin.Methods Based on the data from the longitudinal China Health and Nutrition Survey(CHNS),2,797 healthy adults aged 18–75 years without hypertension,diabetes,and Met S were selected in 2009 as subjects and follow-up studies were carried out till 2015.We used the National Cancer Institute(NCI)method to estimate the usual intake of foods.Multivariable logistic regressions were performed to evaluate the association between red meat usual intake and the risk of Met S.Quantile regression analysis was used to study the relationship between red meat consumption and serum ferritin levels.Results After adjusting for potential confounders,red meat,and fresh red meat were positively associated with the risk of Met S(RR=1.41,95%CI:1.05–1.90 and RR=1.37,95%CI:1.02–1.85,respectively).These relationships showed increasing trend(P<0.05).The level of serum ferritin increased significantly with the number of Met S components(P<0.05).The quantile regression analysis showed that red meat and fresh red meat usual intake had a significant positive association with serum ferritin levels across the entire conditional serum ferritin distribution(P<0.05).Processed red meat did not exhibit a similar association.Conclusion Higher red meat usual intake was associated with an increased risk of Met S and elevated serum ferritin levels.
基金Supported by the National Natural Science Foundation of China under Grant No.19773005.
文摘It is shown that evolution characteristics of black hole(BH)parameters in the pure disk-accretion are determined uniquely by BH spin parameter aa_(*).Some unusual evolution characteristics of the parameters of BH accretion disks,such as angular velocity,temperature and event horizon radius,are investigated in both thin and thick disk-accretion.And the corresponding turning points,a_(*)^(c),are derived.In addition,two characteristic functions describing the evolution of BH parameters are derived for thin and thick disks,respectively.
基金National Natural Science Foundation of China(Grant Nos.11774309 and 11674283)Natural Science Foundation of Zhejiang Province of China(Grant No.LZ13A040001)。
文摘We study the superfluid behavior of a population imbalanced ultracold atomic Fermi gases with a short range attractive interaction in a one-dimensional(1D)optical lattice,using a pairing fluctuation theory.We show that,besides widespread pseudogap phenomena and intermediate temperature superfluidity,the superfluid phase is readily destroyed except in a limited region of the parameter space.We find a new mechanism for pair hopping,assisted by the excessive majority fermions,in the presence of continuum-lattice mixing,which leads to an unusual constant Bose-Einstein condensate(BEC)asymptote for Tc that is independent of pairing strength.In result,on the BEC side of unitarity,superfluidity,when it exists,may be strongly enhanced by population imbalance.
基金Supported by the National Natural Science Foundation of China.
文摘The usual fermion realizations of quantum algebra S1_(q)(2) defining higher-dimensional representations are built in this letter.Using them,we construct a usual fermion system with quantum group symmetry of S1_(q)(2) as a q-deformation of the pairing correlation model in many-body problems.Its energy spectra are exactly solved out from the representation theory of S1_(q)(2).
基金Supported by the National Program on Key Basic Research Project under Grant No.2018YFB0407601the Strategic Priority Research Program of the Chinese Academy of Sciences under Grant Nos.XDB44000000 and QYZDY-SSW-JSC015the National Natural Science Foundation of China under Grant Nos.11874349 and 11774339。
文摘An ultra-thin Co2MnSi(0.5 nm)/Mn Ga(1.5 nm) bilayer capped with Pt(5 nm) has been successfully grown by molecular-beam epitaxy.It is a potential candidate of synthetic antiferromagnets due to antiferromagnetic coupling between Co2MnSi and MnGa,which is a promising skyrmion-racetrack-memory medium without skyrmion Hall effect after capping with a Pt layer.Unusual humps in transverse Hall resistance loops are clearly observed in the temperature range from 260 to 400 K.This anomaly is generally attributed to topological Hall effect,but other than that,we prove that non-uniform rotation of magnetic moments in the bilayer with magnetic field sweeping is also a possible mechanism contributed to the unusual hump.
基金supported by Natural Science Foundation(No.71173131)National Program on Key BasicResearch Projects(No.2010CB95500)of China
文摘Business as Usual （BaU） scenario in developing countries has been a debated issue in climate change negotiations. This paper analyzes different definitions of BaU and points out that the major difference among these definitions is how to set the starting point of BaU projections, that is the so called base year. Some international institutions use current policy scenarios to project a BaU trajectory of developing countries. Such definition will lead to an underestimation of BaU emissions of developing countries and thus an underestimation of mitigation efforts. This paper concludes with a suggestion to use a without policy scenario with a clear base year as definition of BaU. Such a definition will set an objective benchmark to assess mitigation efforts of develonin countries.
文摘When assessing food intake patterns in groups of individuals, a major problem is finding usual intake distribution. This study aimed at searching for a probability distribution to estimate the usual intake of nutrients using data from a cross-sectional investigation on nutrition students from a public university in Sao Paulo state, Brazil. Data on 119 women aged 19 to 30 years old were used. All women answered a questionnaire about their lifestyle, diet and demographics. Food intake was evaluated from a non-consecutive three-day 24-hour food record. Different probability distributions were tested for vitamins C and E, panthotenic acid, folate, zinc, copper and calcium where data normalization was not possible. Empirical comparisons were performed, and inadequacy prevalence was calculated by comparing with the NRC method. It was concluded that if a more realistic distribution for usual intake is found, results can be more accurate as compared to those achieved by other methods.
文摘Objective： To assess whether adherence to amiodarone monitoring differed pre- and post-amiodarone restriction template and implementation of the pharmacist-managed clinic. Design： This was a retrospective chart review study. Setting： A large, academically-affiliated Veteran Affairs Healthcare System providing primary and tertiary care. Patients： 580 patients were identified as having an active prescription for amiodarone for at least 60 days from January l, 2009 to August 31, 2013 and receiving primary care at the VAAHS （Veterans Affairs Ann Arbor Healthcare System）. Results： Nearly all patients had TSH and LFTs at baseline regardless of study group. Significant associations between baseline rates for CXR, ECG, PFT, and opbthalmologic exams were found, with higher rates in the clinic and template arms compared to usual care. Similar patterns for all monitoring outcome rates were also found for both the 6- and 12-month measures. Conclusions： Patients on amiodarone who are followed by a pharmacist-managed clinic or where a restricted ordering template was used had increased compliance with amiodarone monitoring guidelines compared to usual care. Use of a restricted template may be a reasonable option in place of a pharmacist-managed service.
基金partially supported by the grants from the National Natural Science Foundation of China(No.81200049 and No.81670059)the Nanjing Medical Science and Technique Development Foundation(No.ORX17005).
文摘Background:The prognosis of acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is very poor with a high mortality.The aim of this study was to describe the clinical features and survival of patients with AE-IPF with usual pulmonary fibrosis(UIP)and possible UIP(P-UIP)pattern on chest high resolution computed tomography(HRCT).Methods:This retrospective study included 107 patients with AE-IPF admitted to Nanjing Drum Tower Hospital from January 2010 to December 2016.The subjects were divided into UIP(n=86)and P-UIP group(n=21)based on chest HRCT.Continuous variables were analyzed using Student's t test or Mann-Whimey U test.Categorical variables were analyzed using x2 test.Log-rank test was used for the survival analysis.Cox proportional models evaluated the risk factors for AE occurrence and survival.Results:The male,older patients,previous N-acetylcysteine use,elevated white blood cell(WBC)counts,and microbiology infection were more common in the UIP group than the P-UIP group(X2=13.567,P<0.001;z=-2.936,P=0.003;X2=5.901,P=0.015;t=2.048,P=0.043;x2=10.297,P=0.036,respectively).The percentage of AE with UIP pattern in idiopathic interstitial pneumonia(ⅡP)was significantly higher than P-UIP pattern(X2=40.011,P<0.001).Smoking was the risk factor for AE within 6 months after IPF diagnosis in the UIP group.The cumulative proportion survival of 30-days was significantly higher in the UIP group compared with the P-UIP group(x2=5.489,P=0.019)despite of the similar overall survival in the two groups.Multivariate Cox regression analysis indicated WBC count,partial pressure of oxygen in artery(PaO2)/ffactional concentration of inspired oxygen(FiOz),and computed tomography(CT)score were the independent predictors for survival in the UIP group(hazard ratio[HR]:1.070,95%confidential interval[CI]:1.027-1.114,P=0.001;HR:0.992,95%CI:0.986-0.997,P=0.002;and HR:1.649,95%CI:1.253-2.171,P<0.001,respectively).Conclusions:AE occurrence of UIP patients in IIP was significantly more than P-UIP cases.The short-term survival was better in the UIP group despite of the similar overall survival in the two groups.WBC count,PaO2/FiO2,and CT score were the independent predictors for survival in UIP subjects.
文摘The delusional United States Congress has just approved sanctions legislation which destabilizes the internationalsystem and the U.S. constitutional order. Will it lead to war？
文摘HU Meijuan, 49, is a high-ranking engineer in charge of computer operations at the Qinshan Nuclear Power Station, the first nuclear power station built by China. Among more than 600 technicians, there are many women, but Hu is considered the most understanding of them. In 1987 the Qinshan Nuclear Power Station started operations in scenic Hangzhouwan. A large group of qualified personnel
