Abstract
Background
Although effective results of many studies support the use of spinal cord stimulation in chronic pain patients, no randomized controlled trial has been undertaken in China to ...date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.
Method
Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average visual analog scale (VAS) score ≥ 5 will undergo a spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-month follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre- and post-randomization), and 6 months. The primary outcome is the difference of maximal VAS score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1-, 3-, and 6-month follow-ups; responder rate (VAS score improving by 50%); achievement rate of a desirable pain state (VAS score ≤ 4); awake times during sleep; Beck Depression Inventory for depression evaluation; short-form 36 for quality of life evaluation; drug usage; and satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle.
Discussion
The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.
Trial registration
ClinicalTrials.gov
NCT03858790
. Registered on March 1, 2019, retrospectively registered
Reducing agricultural carbon emissions is important to enable carbon emission peaking by 2030 in China. However, China's transformation towards large-scale farming brings uncertainties to carbon ...emission reduction. This study quantifies the carbon emissions from cropping based on life cycle assessment and estimates the effects of farm size on carbon emissions using a fixed effects model. Furthermore, the variations of the carbon emissions from cropping driven by the changes in farm size in future years are projected through scenario analysis. Results demonstrate an inverted U-shaped change in total carbon emission from cropping as farm size increases, which is dominated by the changes in the carbon emission from fertilizer. Projections illustrate that large-scale farming transformation will postpone the peak year of total carbon emission from cropping until 2048 if the change in farm size follows a historical trend, although it is conducive to reducing total carbon emission in the long run. The findings indicate that environmental regulations to reduce fertilizer usages should be strengthened for carbon emission abatement in the early stage of large-scale farming transformation, which are also informative to other developing countries with small farm size.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors such as exposure to vapors, gases, ...dust and fumes (VGDF) for accelerate disease progression has important significance.
We conducted COPD surveillance in six cities of southern China between 2014 and 2019. We recorded the diagnosis of chronic bronchitis, respiratory symptoms, occupational exposure to VGDF and other covariates by using a structured questionnaire. Logistic regression and multivariate linear regression model were adopted for analysis. We performed sensitivity analyses based on two methods of propensity score (PS) methods to evaluate the robustness of our results.
A total of 7,418 participants were included. Cough odds ratios (ORs): 1.60, 95% confidence interval (CI): 1.22 to 2.08 and phlegm (OR: 1.49, 95% CI: 1.19 to 1.85) correlated significantly with exposure to dust. There was an increased risk of cough (OR: 1.53, 95% CI: 1.11 to 2.07) for occupational exposure to gas/vapor/fume. Dual exposure to dust and gas/vapor/fume was associated with a significantly increased risk of chronic bronchitis (OR: 1.74, 95% CI: 1.20 to 2.52), cough (OR: 1.43, 95% CI: 1.15 to 1.79) and phlegm (OR: 1.49, 95% CI: 1.24 to 1.79). In 5,249 participants with complete data of spirometry, gas/vapor/fume was associated with a decreased ratio of forced expiratory volume in one second and forced vital capacity (FEV
/FVC) (β: -1.05, 95% CI: -1.85 to -0.26) and maximal mid-expiratory flow (MMEF) (β: -0.15, 95% CI: -0.23 to -0.07). Dual exposure to dust and gas/vapor/fume was significantly associated with decreased FEV
/FVC (β: -0.74, 95% CI: -1.28 to -0.20) and MMEF (β: -0.06, 95% CI: -0.12 to -0.01). Results of sensitivity analysis were not materially changed.
VGDF exposure is associated with chronic bronchitis, respiratory symptoms and decreased lung function, suggesting that VGDF contributes to the pathogenesis and progression of COPD.
Mode overlapping promotes the capability in manipulating optical absorption. Based on such a mechanism, an all-dielectric metasurface has the capability of perfectly absorbing incident optical energy ...without the assistance of a mirror. Here, an array of thin germanium waveguide-like units is designed as a special absorber possessing some advantages by overlapping two localized resonant modes. Such a thin absorber can realize strong absorption even though the germanium material is of low loss at the O band. It is found that the absorption capability is about three times stronger than that of an unpatterned germanium film with the same thickness, and wideband strong absorption is obtained at the same time. The structure is continuous so that it can conduct carriers in photodetection. The suggested method would be heuristic in the photodetection area.
Absorbers such as photonic crystals, metasurfaces, and nanowires have been demonstrated to have important applications in solar cells, detectors, etc. The application of thin-layer-based absorbers to ...photodetectors is beneficial to simultaneously improve responsivity and 3 dB bandwidth. In this work, we propose a high-contrast-gratings-like absorber to achieve ultra-high absorption based on a thin Germanium layer. High absorption approximately 95% at wavelength 1310 nm is reached for TE-polarized incidence due to the interference of two guided modes, which is 4 times compared to the planar film with the same thickness. The high absorption of the absorber is also experimentally demonstrated. This work shows a new method for enhanced absorption with thin Germanium layer, indicating a promising prospect for high-efficiency photodetection.
The paper serves as an introduction to this special issue reporting research findings previously published in China's leading tourism journal, Tourism Tribune. It describes the origins of the initial ...decision to undertake the project, the difficulties experienced, but more importantly comments on the papers. Such comments draw attention to the different traditions of tourism between the West and China, to the role of the Chinese government in the development of tourism, to the role of tourism itself in Chinese policy and the implicit challenges tourism presents as people increasingly see the taking of holidays as part of the ‘new normal’ of Chinese life under Xi's ‘Chinese Dream’.
•Introduces and comments on themes in Chinese tourism research.•Notes the issues arising from the comparative newness of social science research in China.•Attributes concerns over classifications to a Maoist-Marxist scientific tradition.•Identifies tensions over the need of the State to retain control over people's movements and the move to consumerism.
•Excessive apoptosis of male germ cell occurs after Roundup® exposure.•Over-expression of XAF1 triggers germ cell apoptosis following Roundup® exposure.•Roundup® exposure has potential toxicity on ...male reproductive health in mammals.
Roundup® is extensively used for weed control worldwide. Residues of this compound may lead to side effects of the male reproductive system. However, the toxic effects and mechanisms of Roundup® of male germ cells remain unclear. We aimed to investigate the apoptosis-inducing effects of Roundup® on mouse male germ cells and explore the role of a novel tumor suppressor XAF1 (X-linked inhibitor of apoptosis-associated factor 1) involved in this process. We demonstrated that Roundup® can impair spermatogenesis, decrease sperm motility and concentration, and increase the sperm deformity rate in mice. In addition, excessive apoptosis of germ cells accompanied by the overexpression of XAF1 occurred after Roundup® exposure both in vitro and in vivo. Furthermore, the low expression of XIAP (X-linked inhibitor of apoptosis) induced by Roundup® was inversely correlated with XAF1. Moreover, the knockdown of XAF1 attenuated germ cell apoptosis, improved XIAP expression and inhibited the activation of its downstream target proteins, caspase-3 and PARP, after Roundup® exposure. Taken together, our data indicated that XAF1 plays an important role in Roundup®-induced male germ cell apoptosis. The present study suggested that Roundup® exposure has potential negative implications on male reproductive health in mammals.
Histamine (HA) is an essential test item for fishery samples. However, the fast and effective determination of HA is difficult due to its simple structure and small molecular size. In this study, a ...sensitive and specific monoclonal antibody against
p
-nitrobenzoylated histamine (NPHA), which can be easily obtained from the reaction of HA and
p
-nitrobenzoic acid
N
-hydroxysuccinimide ester (PNBA-OSu) under mild conditions, was generated for the first time. Based on this mAb, an immunochromato-graphic assay strip (ICA strip) using a colloidal gold nano particles-antibody (GNPs) probe for rapid detection of HA in saury samples was established. After screening the coating antigens and optimization of analytical parameters, a heterologous coating based ICA strip exhibited the most excellent detection ability with a visual detection limit (VDL) of 6.0 mg kg
−1
in qualitative experiments and a detection limit (by a strip reader) of 1.0 mg kg
−1
in semi-quantitative experiments for saury samples, with no cross-reactivity with HA analogs. Good correlation between the ICA strip with liquid chromatography-tandem mass spectrometry was achieved for spiked and naturally contaminated saury samples. Overall, this method is suitable for screening of HA residue for large scale fish samples in a quick, simple and low-cost manner.
We define and study a
-adic analogue of the incomplete gamma function related to Morita’s
-adic gamma function. We also discuss a combinatorial identity related to the Artin-Hasse series, which is a ...special case of the exponential principle in combinatorics. From this we deduce a curious
-adic property of
for a topologically finitely generated group
, using a characterization of
-adic continuity for certain functions
due to O’Desky-Richman. In the end, we give an exposition of some standard properties of the Artin-Hasse series.
Background
Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical ...expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends.
Methods
From 2012 to 2014, a hospital‐based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan (CNY; 1 CNY = 0.155 USD) based on the 2011 value and inflated using the year‐specific health care consumer price index for China.
Results
A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002 (25,111 CNY) to 2011 (46,124 CNY). The average expenditures were 34,460 CNY for stage I, 39,302 CNY for stage II, 40,353 CNY for stage III, and 37,432 CNY for stage IV diseases (P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy (P < 0.05). Drugs contributed to 45.02% of the overall expenditure.
Conclusions
These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early‐stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.
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