探讨英文学术期刊审稿专家资源管理与维护,提高学术期刊同行评议的效能,加强期刊学术质量把控。文章基于在国际英文学术期刊Global Health Research and Policy的工作实践,根据期刊不同发展阶段的侧重点差异,辅以期刊动态指标数据分析,...探讨英文学术期刊审稿专家资源管理与维护,提高学术期刊同行评议的效能,加强期刊学术质量把控。文章基于在国际英文学术期刊Global Health Research and Policy的工作实践,根据期刊不同发展阶段的侧重点差异,辅以期刊动态指标数据分析,梳理并总结若干条顺应期刊发展规律的审稿专家资源拓展策略,旨在为我国英文学术期刊编辑与审稿专家建立稳定有效的合作互动提供参考。展开更多
本文以Global Health Research and Policy英文期刊近年来国际化建设为例,梳理并总结了中国英文学术期刊在迈向国际化探索和实践中的有效策略。主要包括“借船出海”与国际接轨;整合内部优势资源,对外拓展期刊国际影响力;引进国际人才,...本文以Global Health Research and Policy英文期刊近年来国际化建设为例,梳理并总结了中国英文学术期刊在迈向国际化探索和实践中的有效策略。主要包括“借船出海”与国际接轨;整合内部优势资源,对外拓展期刊国际影响力;引进国际人才,构建学术共同体,加强国际出版传播力;组织特色专题,向世界讲好“中国故事”,创新APC定价规则等。中国英文学术期刊的国际化发展应努力践行中国特色的国际化,建构具有中国特色的出版学科体系和国际学术话语体系。展开更多
Introduction Task-shifting and task-sharing strategies show promise for managing chronic diseases especially in low-income and middle-income countries(LMICs),though their effectiveness in multimorbidity management rem...Introduction Task-shifting and task-sharing strategies show promise for managing chronic diseases especially in low-income and middle-income countries(LMICs),though their effectiveness in multimorbidity management remains unclear.This study synthesised evidence on task-shifting and task-sharing strategies globally and assessed the impact on core health outcomes in multimorbidity management.Methods We conducted a systematic review and meta-analysis of global studies evaluating task-shifting and sharing interventions for individuals with multimorbidity.Six databases,including PubMed,Embase,Web of Science,Ovid(Medline),CINAHL and Cochrane Library,were searched for studies reporting the core outcomes of multimorbidity management in quality of life,mortality,hospitalisation,emergency department visits and symptoms of depression and anxiety.Random-effects models were used to calculate pooled effect sizes with heterogeneity assessed through subgroup and meta-regression analyses.Results From 8471 records,36 studies from 14 countries were included,with only 5 conducted in LMICs.Twenty-one studies,encompassing 20989 participants,were eligible for meta-analysis.More than half of the studies involved nurses as delegates,with some sharing the tasks with health professionals and about 10%of studies involved non-health professionals,including community healthcare workers as delegates to share the responsibility in caring for individuals with multimorbidity.Most studies were multicomponent,with 16.7%addressing all guideline-recommended aspects of multimorbidity management.By pooling the findings,task-shifting and task-sharing interventions were associated with a 27%reduction in mortality(OR:0.73,95%CI:0.55 to 0.97,I2=0%),a modest improvement in quality of life(standardised mean difference(SMD):0.1,95%CI:0.03 to 0.17,I2=47%)and reduced symptoms of depression(SMD:0.27,95%CI:−0.52 to–0.02,I2=90%),but showed no significant effect on hospitalisation,emergency visits or anxiety-related symptoms.展开更多
A significant number and range of challenges besetting sustainability can be traced to the actions and inter actions of multiple autonomous agents(people mostly)and the entities they create(e.g.,institutions,policies,...A significant number and range of challenges besetting sustainability can be traced to the actions and inter actions of multiple autonomous agents(people mostly)and the entities they create(e.g.,institutions,policies,social network)in the corresponding social-environmental systems(SES).To address these challenges,we need to understand decisions made and actions taken by agents,the outcomes of their actions,including the feedbacks on the corresponding agents and environment.The science of complex adaptive systems-complex adaptive sys tems(CAS)science-has a significant potential to handle such challenges.We address the advantages of CAS science for sustainability by identifying the key elements and challenges in sustainability science,the generic features of CAS,and the key advances and challenges in modeling CAS.Artificial intelligence and data science combined with agent-based modeling promise to improve understanding of agents’behaviors,detect SES struc tures,and formulate SES mechanisms.展开更多
Central poststroke pain(CPSP)is a medical complication that arises poststroke and significantly impacts the quality of life and social functioning of affected individuals.Despite ongoing research,the exact pathomechan...Central poststroke pain(CPSP)is a medical complication that arises poststroke and significantly impacts the quality of life and social functioning of affected individuals.Despite ongoing research,the exact pathomechanisms of CPSP remain unclear,and practical treatments are still unavailable.Our review aims to systematically analyse current clinical and preclinical studies on CPSP,which is critical for identifying gaps in knowledge and guiding the development of effective therapies.The review will clarify the clinical characteristics,evaluation scales and contemporary therapeutic approaches for CPSP based on clinical investigations.It will particularly emphasise the CPSP model initiated by stroke,shedding light on its underlying mechanisms and evaluating treatments validated in preclinical studies.Furthermore,the review will not only highlight methodological limitations in animal trials but also offer specific recommendations to researchers to improve the quality of future investigations and guide the development of effective therapies.This review is expected to provide valuable insights into the current knowledge regarding CPSP and can serve as a guide for future research and clinical practice.The review will contribute to the scientific understanding of CPSP and help develop effective clinical interventions.展开更多
背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存...背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。展开更多
A wide variety of studies have estimated the magnitude of global terrestrial net primary production （NPP）, but its variations, both spatially and temporally, still remain uncertain. By using an improved process-base...A wide variety of studies have estimated the magnitude of global terrestrial net primary production （NPP）, but its variations, both spatially and temporally, still remain uncertain. By using an improved process-based terrestrial ecosystem model （DLEM, Dynamic Land Ecosystem Model）, we provide an estimate of global terrestrial NPP induced by multiple environmental factors and examine the response of terrestrial NPP to climate variability at biome and global levels and along latitudes throughout the first decade of the 21st century. The model simulation estimates an average global terrestrial NPP of 54.6 Pg C yr-1 during 2000-2009, varying from 52.8 Pg C yr-1 in the dry year of 2002 to 56.4 Pg C yr-1 in the wet year of 2008. In wet years, a large increase in terrestrial NPP compared to the decadal mean was prevalent in Amazonia, Africa and Australia. In dry years, however, we found a 3.2% reduction in global terrestrial NPP compared to the decadal mean, primarily due to limited moisture supply in tropical regions. At a global level, precipitation explained approximately 63% of the variation in terrestrial NPP, while the rest was attributed to changes in temperature and other environmental factors. Precipitation was the major factor determining inter-annual variation in terrestrial NPP in low-latitude regions. However, in midand high-latitude regions, temperature variability largely controlled the magnitude of terrestrial NPP. Our results imply that pro- jected climate warming and increasing climate extreme events would alter the magnitude and spatiotemporal patterns of global terrestrial NPP.展开更多
The hydrologic changes and the impact of these changes constitute a fundamental global-warmingrelated concern. Faced with threats to human life and natural ecosystems, such as droughts, floods, and soil erosion, water...The hydrologic changes and the impact of these changes constitute a fundamental global-warmingrelated concern. Faced with threats to human life and natural ecosystems, such as droughts, floods, and soil erosion, water resource planners must increasingly make future risk assessments. Though hydrological predictions associated with the global climate change are already being performed, mainly through the use of GCMs, coarse spatial resolutions and uncertain physical processes limit the representation of terrestrial water/energy interactions and the variability in such systems as the Asian monsoon. Despite numerous studies, the regional responses of hydrologic changes resulting from climate change remains inconclusive. In this paper, an attempt at dynamical downsealing of future hydrologic projection under global climate change in Asia is addressed. The authors conducted present and future Asian regional climate simulations which were nested in the results of Atmospheric General Circulation Model （AGCM） experiments. The regional climate model could capture the general simulated features of the AGCM. Also, some regional phenomena such as orographic precipitation, which did not appear in the outcome of the AGCM simulation, were successfully produced. Under global warming, the increase of water vapor associated with the warmed air temperature was projected. It was projected to bring more abundant water vapor to the southern portions of India and the Bay of Bengal, and to enhance precipitation especially over the mountainous regions, the western part of India and the southern edge of the Tibetan Plateau. As a result of the changes in the synoptic flow patterns and precipitation under global warming, the increases of annual mean precipitation and surface runoff were projected in many regions of Asia. However, both the positive and negative changes of seasonal surface runoff were projected in some regions which will increase the flood risk and cause a mismatch between water demand and water availability in the agricultural season.展开更多
With the ERA40 reanalysis daily data for 1958-2001, the global atmospheric seasonal-mean diabatic heating and transient heating are computed by using the residual diagnosis of the thermodynamic equation. The three-dim...With the ERA40 reanalysis daily data for 1958-2001, the global atmospheric seasonal-mean diabatic heating and transient heating are computed by using the residual diagnosis of the thermodynamic equation. The three-dimensional structures for the two types of heating are described and compared. It is demonstrated that the diabatic heating is basically characterized by strong and deep convective heating in the tropics, shallow heating in the midlatitudes and deep cooling in the subtropics and high-latitudes. The tropical diabatic heating always shifts towards the summer hemisphere, but the midlatitude heating and high-latitude cooling tend to be strong in the winter hemisphere. On the other hand, the transient heating due to transient eddy transfer is characterized by a meridional dipole pattern with cooling in the subtropics and heating in the mid- and high-latitudes, as well as by a vertical dipole pattern in the midlatitudes with cooling at lower levels and heating in the mid- and higher-levels, which gives rise to a sloped structure in the transient heating oriented from the lower levels in the high latitudes and higher levels in the midlatitudes. The transient heating is closely related to a storm track along which the transient eddy activity is much stronger in the winter hemisphere than in the summer hemisphere. In Northern Hemisphere, the transient heating locates in the western oceanic basin, while it is zonally-oriented in Southern Hemisphere, for which the transient heating and cooling are far separated over South Pacific during the cold season. The transient heating tends to cancel the diabatic heating over most of the globe. However, it dominates the mid-tropospheric heating in the midlatitudes. Therefore, the atmospheric transient processes act to help the atmosphere gain more heat in the high-latitudes and in the mid-troposphere of midlatitudes, reallocating the atmospheric heat obtained from the diabatic heating.展开更多
Soil organic carbon(SOC)in croplands is a key property of soil quality for ensuring food security and agricultural sustainability,and also plays a central role in the global carbon(C)budget.When managed sustainably,so...Soil organic carbon(SOC)in croplands is a key property of soil quality for ensuring food security and agricultural sustainability,and also plays a central role in the global carbon(C)budget.When managed sustainably,soils may play a critical role in mitigating climate change by sequestering C and decreasing greenhouse gas emissions into the atmosphere.However,the magnitude and spatio-temporal patterns of global cropland SOC are far from well constrained due to high land surface heterogeneity,complicated mechanisms,and multiple influencing factors.Here,we use a process-based agroecosystem model(DLEM-Ag)in combination with diverse spatially-explicit gridded environmental data to quantify the long-term trend of SOC storage in global cropland area during 1901-2010 and identify the relative impacts of climate change,elevated CO2,nitrogen deposition,land cover change,and land management practices such as nitrogen fertilizer use and irrigation.Model results show that the total SOC and SOC density in the 2000s increased by 125%and 48.8%,respectively,compared to the early 20th century.This SOC increase was primarily attributed to cropland expansion and nitrogen fertilizer use.Factorial analysis suggests that climate change reduced approximately 3.2%(or 2,166 Tg C)of the total SOC over the past 110 years.Our results indicate that croplands have a large potential to sequester C through implementing better land use management practices,which may partially offset SOC loss caused by climate change.展开更多
Using the CAM3.0 model, we investigated the respective effects of aerosol concentration increasing and decadal variation of global sea surface temperature(SST) around year 1976/77 on the East Asian precipitation in bo...Using the CAM3.0 model, we investigated the respective effects of aerosol concentration increasing and decadal variation of global sea surface temperature(SST) around year 1976/77 on the East Asian precipitation in boreal summer. By doubling the concentration of the sulfate aerosol and black carbon aerosol separately and synchronously in East Asia(100-150 °E, 20-50 °N), the climate effects of these aerosols are specifically investigated. The results show that both the decadal SST changing and aerosol concentration increasing could lead to rainfall decreasing in the center of East Asia, but increasing in the regions along southeast coast areas of China. However, the different patterns of rainfall over ocean and lower wind field over Asian continent between aerosol experiments and SST experiments in CAM3.0 indicate the presence of different mechanisms. In the increased aerosol concentration experiments, scattering effect is the main climate effect for both sulfate and black carbon aerosols in the Eastern Asian summer. Especially in the increased sulfate aerosol concentration experiment, the climate scattering effect of aerosol leads to the most significant temperature decreasing, sinking convection anomalies and decreased rainfall in the troposphere over the central part of East Asia. However, in an increased black carbon aerosol concentration experiment, weakened sinking convection anomalies exist at the southerly position. This weakened sinking and its compensating rising convection anomalies in the south lead to the heavy rainfall over southeast coast areas of China. When concentrations of both sulfate and black carbon aerosols increase synchronously, the anomalous rainfall distribution is somewhat like that in the increased black carbon concentration aerosol experiment but with less intensity.展开更多
The purpose of this study is to analyze economic impacts of reducing greenhouse gases emissions significantly. A large amount of emissions reductions are required throughout this century to avoid dangerous climate cha...The purpose of this study is to analyze economic impacts of reducing greenhouse gases emissions significantly. A large amount of emissions reductions are required throughout this century to avoid dangerous climate change, and understanding the economic consequences under such situations is important and meaningful. The AIM/CGE [Global] model, a recursive dynamic computable general equilibrium model on a global scale, is applied to analyze carbon prices and changes in GDP when implementing five policy scenarios represented by emissions pathways, respectively. As a result of the analysis, higher carbon prices and larger decreases in GDP compared to the baseline emissions scenario are observed when emissions are reduced more deeply. However, such GDP losses are rather small and insignificant compared to the GDP growth observed throughout the century. These results suggest that although it is challenging to reduce emissions until the level to avoid dangerous climate change, there is a sufficient possibility to achieve it from economic perspectives.展开更多
In this paper, we mainly summarize and review the progresses in recent climatological studies(by CMSR,IAP/CAS and some associated domestic and international institutions) on the interannual and interdecadal variabilit...In this paper, we mainly summarize and review the progresses in recent climatological studies(by CMSR,IAP/CAS and some associated domestic and international institutions) on the interannual and interdecadal variabilities of monsoon troughs and their impacts on tropical cyclones and typhoons(TCs) geneses over the western North Pacific Ocean. The climatological characteristics of monsoon troughs and four types of circulation patterns favorable to TCs genesis over the western North Pacific Ocean in summer and autumn are given in this paper. It is also shown in this paper that the monsoon trough over the western North Pacific Ocean has obvious interannual and interdecadal variabilities. Especially, it is revealed in this paper that the interannual and interdecadal variabilities of the monsoon trough over the western North Pacific Ocean influence the TCs genesis not only through the impact on distributions of the vorticity in the lower troposphere and the divergence in the upper troposphere, the water vapor in the mid-and lower troposphere and the vertical shear of wind fields between the upper and lower troposphere over the western North Pacific Ocean, but also through the dynamical effects of the transition between convectively coupled tropical waves and providing disturbance energy. Besides, some climatological problems associated with TCs activity over the western North Pacific Ocean that need to be studied further are also pointed out in this paper.展开更多
Pharmaceutical technology is an indispensable and important link in drug research and development,which plays a key role in drug research and development quality.In the background of science and technology development...Pharmaceutical technology is an indispensable and important link in drug research and development,which plays a key role in drug research and development quality.In the background of science and technology development,pharmaceutical technology has been greatly developed,but also to promote the quality of drug research and development,to provide more guarantee for people’s health.In the new era,how to achieve pharmaceutical technology innovation,so as to further improve the quality of drug research and development,is an important research topic in the current related industries.This paper mainly revolves around quality of pharmaceutical technology development of a series of exploration,in the traditional drug development based on a better control of drug quality,the future of smart pharmaceutical green pharmaceutical development direction,aims to further enhance the pharmaceutical technology,promote the quality of research and development to promote the comprehensive,promote the steady development of the pharmaceutical industry as a whole.展开更多
文摘探讨英文学术期刊审稿专家资源管理与维护,提高学术期刊同行评议的效能,加强期刊学术质量把控。文章基于在国际英文学术期刊Global Health Research and Policy的工作实践,根据期刊不同发展阶段的侧重点差异,辅以期刊动态指标数据分析,梳理并总结若干条顺应期刊发展规律的审稿专家资源拓展策略,旨在为我国英文学术期刊编辑与审稿专家建立稳定有效的合作互动提供参考。
文摘本文以Global Health Research and Policy英文期刊近年来国际化建设为例,梳理并总结了中国英文学术期刊在迈向国际化探索和实践中的有效策略。主要包括“借船出海”与国际接轨;整合内部优势资源,对外拓展期刊国际影响力;引进国际人才,构建学术共同体,加强国际出版传播力;组织特色专题,向世界讲好“中国故事”,创新APC定价规则等。中国英文学术期刊的国际化发展应努力践行中国特色的国际化,建构具有中国特色的出版学科体系和国际学术话语体系。
基金supported by the National Key R&D programprogramme of China(Grant No.2023 YFC 3605002)Noncommunicable Chronic Disease National Science and Technology Major Project(Grant No.2023ZD0506001)+1 种基金the CAMS Innovation Fund for Medical Sciences(ClFMS)(Grant No.2025-I2M-KJ-029)the non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(Grant No.2022-ZHCH330-01).
文摘Introduction Task-shifting and task-sharing strategies show promise for managing chronic diseases especially in low-income and middle-income countries(LMICs),though their effectiveness in multimorbidity management remains unclear.This study synthesised evidence on task-shifting and task-sharing strategies globally and assessed the impact on core health outcomes in multimorbidity management.Methods We conducted a systematic review and meta-analysis of global studies evaluating task-shifting and sharing interventions for individuals with multimorbidity.Six databases,including PubMed,Embase,Web of Science,Ovid(Medline),CINAHL and Cochrane Library,were searched for studies reporting the core outcomes of multimorbidity management in quality of life,mortality,hospitalisation,emergency department visits and symptoms of depression and anxiety.Random-effects models were used to calculate pooled effect sizes with heterogeneity assessed through subgroup and meta-regression analyses.Results From 8471 records,36 studies from 14 countries were included,with only 5 conducted in LMICs.Twenty-one studies,encompassing 20989 participants,were eligible for meta-analysis.More than half of the studies involved nurses as delegates,with some sharing the tasks with health professionals and about 10%of studies involved non-health professionals,including community healthcare workers as delegates to share the responsibility in caring for individuals with multimorbidity.Most studies were multicomponent,with 16.7%addressing all guideline-recommended aspects of multimorbidity management.By pooling the findings,task-shifting and task-sharing interventions were associated with a 27%reduction in mortality(OR:0.73,95%CI:0.55 to 0.97,I2=0%),a modest improvement in quality of life(standardised mean difference(SMD):0.1,95%CI:0.03 to 0.17,I2=47%)and reduced symptoms of depression(SMD:0.27,95%CI:−0.52 to–0.02,I2=90%),but showed no significant effect on hospitalisation,emergency visits or anxiety-related symptoms.
基金The National Science Foundation funded this research under the Dy-namics of Coupled Natural and Human Systems program(Grants No.DEB-1212183 and BCS-1826839)support from San Diego State University and Auburn University.
文摘A significant number and range of challenges besetting sustainability can be traced to the actions and inter actions of multiple autonomous agents(people mostly)and the entities they create(e.g.,institutions,policies,social network)in the corresponding social-environmental systems(SES).To address these challenges,we need to understand decisions made and actions taken by agents,the outcomes of their actions,including the feedbacks on the corresponding agents and environment.The science of complex adaptive systems-complex adaptive sys tems(CAS)science-has a significant potential to handle such challenges.We address the advantages of CAS science for sustainability by identifying the key elements and challenges in sustainability science,the generic features of CAS,and the key advances and challenges in modeling CAS.Artificial intelligence and data science combined with agent-based modeling promise to improve understanding of agents’behaviors,detect SES struc tures,and formulate SES mechanisms.
基金supported by the National Natural Science Foundation of China(82371339 and U1704166)the Key Scientific Research Projects of Higher Education Institutions in Henan Province(24A320029).
文摘Central poststroke pain(CPSP)is a medical complication that arises poststroke and significantly impacts the quality of life and social functioning of affected individuals.Despite ongoing research,the exact pathomechanisms of CPSP remain unclear,and practical treatments are still unavailable.Our review aims to systematically analyse current clinical and preclinical studies on CPSP,which is critical for identifying gaps in knowledge and guiding the development of effective therapies.The review will clarify the clinical characteristics,evaluation scales and contemporary therapeutic approaches for CPSP based on clinical investigations.It will particularly emphasise the CPSP model initiated by stroke,shedding light on its underlying mechanisms and evaluating treatments validated in preclinical studies.Furthermore,the review will not only highlight methodological limitations in animal trials but also offer specific recommendations to researchers to improve the quality of future investigations and guide the development of effective therapies.This review is expected to provide valuable insights into the current knowledge regarding CPSP and can serve as a guide for future research and clinical practice.The review will contribute to the scientific understanding of CPSP and help develop effective clinical interventions.
文摘背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。
基金NSF Decadal and Regional Climate Prediction using Earth System Models,No.AGS-1243220NSF Dynamics of Coupled Natural and Human Systems,No.1210360+2 种基金NSF Computer and Network Systems,No.CNS-1059376NASA Land Cover/Land Use Change Program,No.NNX08AL73G S01NASA Interdisciplinary Science Program,No.NNX10AU06G,No.NNX11AD47G
文摘A wide variety of studies have estimated the magnitude of global terrestrial net primary production （NPP）, but its variations, both spatially and temporally, still remain uncertain. By using an improved process-based terrestrial ecosystem model （DLEM, Dynamic Land Ecosystem Model）, we provide an estimate of global terrestrial NPP induced by multiple environmental factors and examine the response of terrestrial NPP to climate variability at biome and global levels and along latitudes throughout the first decade of the 21st century. The model simulation estimates an average global terrestrial NPP of 54.6 Pg C yr-1 during 2000-2009, varying from 52.8 Pg C yr-1 in the dry year of 2002 to 56.4 Pg C yr-1 in the wet year of 2008. In wet years, a large increase in terrestrial NPP compared to the decadal mean was prevalent in Amazonia, Africa and Australia. In dry years, however, we found a 3.2% reduction in global terrestrial NPP compared to the decadal mean, primarily due to limited moisture supply in tropical regions. At a global level, precipitation explained approximately 63% of the variation in terrestrial NPP, while the rest was attributed to changes in temperature and other environmental factors. Precipitation was the major factor determining inter-annual variation in terrestrial NPP in low-latitude regions. However, in midand high-latitude regions, temperature variability largely controlled the magnitude of terrestrial NPP. Our results imply that pro- jected climate warming and increasing climate extreme events would alter the magnitude and spatiotemporal patterns of global terrestrial NPP.
基金the Global Environment Research Fund of Japan's Ministry of the En- vironment (S-5-3)The data used in this study were acquired as part of the Tropical Rainfall Measuring Mission (TRMM)+1 种基金The algorithms were developed by the TRMM Science TeamThe data were processed by the TRMM Science Data and Information System (TSDIS) and the TRMM Offce.
文摘The hydrologic changes and the impact of these changes constitute a fundamental global-warmingrelated concern. Faced with threats to human life and natural ecosystems, such as droughts, floods, and soil erosion, water resource planners must increasingly make future risk assessments. Though hydrological predictions associated with the global climate change are already being performed, mainly through the use of GCMs, coarse spatial resolutions and uncertain physical processes limit the representation of terrestrial water/energy interactions and the variability in such systems as the Asian monsoon. Despite numerous studies, the regional responses of hydrologic changes resulting from climate change remains inconclusive. In this paper, an attempt at dynamical downsealing of future hydrologic projection under global climate change in Asia is addressed. The authors conducted present and future Asian regional climate simulations which were nested in the results of Atmospheric General Circulation Model （AGCM） experiments. The regional climate model could capture the general simulated features of the AGCM. Also, some regional phenomena such as orographic precipitation, which did not appear in the outcome of the AGCM simulation, were successfully produced. Under global warming, the increase of water vapor associated with the warmed air temperature was projected. It was projected to bring more abundant water vapor to the southern portions of India and the Bay of Bengal, and to enhance precipitation especially over the mountainous regions, the western part of India and the southern edge of the Tibetan Plateau. As a result of the changes in the synoptic flow patterns and precipitation under global warming, the increases of annual mean precipitation and surface runoff were projected in many regions of Asia. However, both the positive and negative changes of seasonal surface runoff were projected in some regions which will increase the flood risk and cause a mismatch between water demand and water availability in the agricultural season.
基金973 program (2010CB428504)National Natural Science Foundation of China (40730953+3 种基金40805025)National Public Benefit Research Foundation of China (GYHY200806004GYHY200706005)Jiangsu Natural Science Foundation (BK2008027)
文摘With the ERA40 reanalysis daily data for 1958-2001, the global atmospheric seasonal-mean diabatic heating and transient heating are computed by using the residual diagnosis of the thermodynamic equation. The three-dimensional structures for the two types of heating are described and compared. It is demonstrated that the diabatic heating is basically characterized by strong and deep convective heating in the tropics, shallow heating in the midlatitudes and deep cooling in the subtropics and high-latitudes. The tropical diabatic heating always shifts towards the summer hemisphere, but the midlatitude heating and high-latitude cooling tend to be strong in the winter hemisphere. On the other hand, the transient heating due to transient eddy transfer is characterized by a meridional dipole pattern with cooling in the subtropics and heating in the mid- and high-latitudes, as well as by a vertical dipole pattern in the midlatitudes with cooling at lower levels and heating in the mid- and higher-levels, which gives rise to a sloped structure in the transient heating oriented from the lower levels in the high latitudes and higher levels in the midlatitudes. The transient heating is closely related to a storm track along which the transient eddy activity is much stronger in the winter hemisphere than in the summer hemisphere. In Northern Hemisphere, the transient heating locates in the western oceanic basin, while it is zonally-oriented in Southern Hemisphere, for which the transient heating and cooling are far separated over South Pacific during the cold season. The transient heating tends to cancel the diabatic heating over most of the globe. However, it dominates the mid-tropospheric heating in the midlatitudes. Therefore, the atmospheric transient processes act to help the atmosphere gain more heat in the high-latitudes and in the mid-troposphere of midlatitudes, reallocating the atmospheric heat obtained from the diabatic heating.
基金supported by NASA Kentucky NNX15AR69H,NSF grant nos.1940696,1903722,and 1243232Andrew Carnegie Fellowship Award no.G-F-19-56910.
文摘Soil organic carbon(SOC)in croplands is a key property of soil quality for ensuring food security and agricultural sustainability,and also plays a central role in the global carbon(C)budget.When managed sustainably,soils may play a critical role in mitigating climate change by sequestering C and decreasing greenhouse gas emissions into the atmosphere.However,the magnitude and spatio-temporal patterns of global cropland SOC are far from well constrained due to high land surface heterogeneity,complicated mechanisms,and multiple influencing factors.Here,we use a process-based agroecosystem model(DLEM-Ag)in combination with diverse spatially-explicit gridded environmental data to quantify the long-term trend of SOC storage in global cropland area during 1901-2010 and identify the relative impacts of climate change,elevated CO2,nitrogen deposition,land cover change,and land management practices such as nitrogen fertilizer use and irrigation.Model results show that the total SOC and SOC density in the 2000s increased by 125%and 48.8%,respectively,compared to the early 20th century.This SOC increase was primarily attributed to cropland expansion and nitrogen fertilizer use.Factorial analysis suggests that climate change reduced approximately 3.2%(or 2,166 Tg C)of the total SOC over the past 110 years.Our results indicate that croplands have a large potential to sequester C through implementing better land use management practices,which may partially offset SOC loss caused by climate change.
基金National Key Program for Developing Basic Science(2016YFA0600303)National Natural Science Foundation of China(41675064,41621005,41330420,41275068)+2 种基金Jiangsu Province Science Foundation(SBK2015020577)Key Laboratory Project Foundation(KLME1501)Jiangsu Collaborative Innovation Center for Climate Change
文摘Using the CAM3.0 model, we investigated the respective effects of aerosol concentration increasing and decadal variation of global sea surface temperature(SST) around year 1976/77 on the East Asian precipitation in boreal summer. By doubling the concentration of the sulfate aerosol and black carbon aerosol separately and synchronously in East Asia(100-150 °E, 20-50 °N), the climate effects of these aerosols are specifically investigated. The results show that both the decadal SST changing and aerosol concentration increasing could lead to rainfall decreasing in the center of East Asia, but increasing in the regions along southeast coast areas of China. However, the different patterns of rainfall over ocean and lower wind field over Asian continent between aerosol experiments and SST experiments in CAM3.0 indicate the presence of different mechanisms. In the increased aerosol concentration experiments, scattering effect is the main climate effect for both sulfate and black carbon aerosols in the Eastern Asian summer. Especially in the increased sulfate aerosol concentration experiment, the climate scattering effect of aerosol leads to the most significant temperature decreasing, sinking convection anomalies and decreased rainfall in the troposphere over the central part of East Asia. However, in an increased black carbon aerosol concentration experiment, weakened sinking convection anomalies exist at the southerly position. This weakened sinking and its compensating rising convection anomalies in the south lead to the heavy rainfall over southeast coast areas of China. When concentrations of both sulfate and black carbon aerosols increase synchronously, the anomalous rainfall distribution is somewhat like that in the increased black carbon concentration aerosol experiment but with less intensity.
文摘The purpose of this study is to analyze economic impacts of reducing greenhouse gases emissions significantly. A large amount of emissions reductions are required throughout this century to avoid dangerous climate change, and understanding the economic consequences under such situations is important and meaningful. The AIM/CGE [Global] model, a recursive dynamic computable general equilibrium model on a global scale, is applied to analyze carbon prices and changes in GDP when implementing five policy scenarios represented by emissions pathways, respectively. As a result of the analysis, higher carbon prices and larger decreases in GDP compared to the baseline emissions scenario are observed when emissions are reduced more deeply. However, such GDP losses are rather small and insignificant compared to the GDP growth observed throughout the century. These results suggest that although it is challenging to reduce emissions until the level to avoid dangerous climate change, there is a sufficient possibility to achieve it from economic perspectives.
基金National Natural Science Foundation of China(41375065)National Natural Science Foundation of China(41461164005,41230527)National Key Research and Development Program of China(2016YFA0600603)
文摘In this paper, we mainly summarize and review the progresses in recent climatological studies(by CMSR,IAP/CAS and some associated domestic and international institutions) on the interannual and interdecadal variabilities of monsoon troughs and their impacts on tropical cyclones and typhoons(TCs) geneses over the western North Pacific Ocean. The climatological characteristics of monsoon troughs and four types of circulation patterns favorable to TCs genesis over the western North Pacific Ocean in summer and autumn are given in this paper. It is also shown in this paper that the monsoon trough over the western North Pacific Ocean has obvious interannual and interdecadal variabilities. Especially, it is revealed in this paper that the interannual and interdecadal variabilities of the monsoon trough over the western North Pacific Ocean influence the TCs genesis not only through the impact on distributions of the vorticity in the lower troposphere and the divergence in the upper troposphere, the water vapor in the mid-and lower troposphere and the vertical shear of wind fields between the upper and lower troposphere over the western North Pacific Ocean, but also through the dynamical effects of the transition between convectively coupled tropical waves and providing disturbance energy. Besides, some climatological problems associated with TCs activity over the western North Pacific Ocean that need to be studied further are also pointed out in this paper.
文摘Pharmaceutical technology is an indispensable and important link in drug research and development,which plays a key role in drug research and development quality.In the background of science and technology development,pharmaceutical technology has been greatly developed,but also to promote the quality of drug research and development,to provide more guarantee for people’s health.In the new era,how to achieve pharmaceutical technology innovation,so as to further improve the quality of drug research and development,is an important research topic in the current related industries.This paper mainly revolves around quality of pharmaceutical technology development of a series of exploration,in the traditional drug development based on a better control of drug quality,the future of smart pharmaceutical green pharmaceutical development direction,aims to further enhance the pharmaceutical technology,promote the quality of research and development to promote the comprehensive,promote the steady development of the pharmaceutical industry as a whole.
