We investigated whether self‐blood pressure monitoring (SBPM) can improve the control rate of blood pressure (BP), adherence of antihypertensive medications, and the awareness of the importance of BP ...control in hypertensive patients. A total of 7751 patients who visited the outpatient clinics of private and university hospitals in Korea were given automatic electronic BP monitors and were recommended to measure their BP daily at home for 3 months. Changes in office BP, attainment of target BP, adherence to taking antihypertensive drugs, and awareness of BP were compared before and after SBPM. Patients and physicians were surveyed on their perception of BP and SBPM. Mean BP significantly decreased from 142/88 to 129/80 mm Hg (P < .001), and attainment of the target BP increased from 32% to 59% (P < .001) after SBPM. Drug non‐adherence, which was defined as patient's not taking medication days per week, decreased significantly from 0.86 days to 0.53 days (P < .001). The rate of awareness of the BP goal increased from 57% to 81% (P < .001). Patients estimated that their mean BP was 125/81 mm Hg, but their actual mean BP was 142/88 mm Hg. Awareness about the importance of SBPM increased from 90% to 98%. The rate of SBPM ≥ once per week further increased, from 34% to 96%. In conclusion, SBPM is associated with reduced BP, better BP control rate, greater drug adherence, and improved perception of BP by the patients.
The environment is a major issue for both society and industry. Stakeholder demands, environmental ethics and environmental awareness may all have a substantial impact on a company's environmental ...performance. In this research, we investigate the impact of stakeholders' pressures, environmental ethics, and environmental awareness on environmental performance, which is mediated through the concept of green innovation. A survey questionnaire is used in the study to gather information from 410 managers working in different Chinese manufacturing firms. Structural equation modeling (SEM) is used to assess the data and test the assumptions that have been put forward. According to the study's results, stakeholders' pressures in terms of regulatory pressures, customer pressures, and competitor pressures; environmental ethics, and environmental awareness all had a positive effect on both green product innovation and green process innovation, which in turn had a favorable impact on environmental performance. Moreover, both green product and process innovation partially mediated the link between stakeholders' pressures, environmental ethics, and environmental performance except in the case of environmental awareness. These findings provide light on the significance of stakeholder demands, environmental ethics, and environmental awareness in encouraging green innovation and increasing environmental performance.
•We studied stakeholders' impact on environmental performance.•Variables studied include pressures, ethics and awareness via green innovation.•The questionnaire survey involved 410 Chinese managers in manufacturing firms.•Structural equation modeling (SEM) was deployed to assess and validate assumptions.•These variables positively impact green innovation for environmental performance.
Seismic soil pressures are critical analysis components to understand and design for soil-structure interaction of sub-surface structures. A large scale experimental research program conducted at ...E-Defense's Shake table in Miki, Japan, included unprecedented seismic soil pressure measurements on a vertical, flexible, hollow shaft with model scale dimensions of 0.8 m square and 7.0 m in height. The densely instrumented vertical shaft was part of a larger system of underground structures, placed in an 8.0 m diameter laminar soil box. The two-layer soil stratigraphy consisted of an upper layer of medium dense sand and a lower layer of simulated bedrock. The hollow vertical shaft was constructed of aluminum and scaled to 1/20th of its prototype dimension. Two-directional, scaled ground motions of the 1995 Kobe earthquake were applied via shake table loading and seismic pressures were recorded using contact pressure sensors. Experimental results, including a dynamic system characterization, site response analyses, pressure time histories, and seismic pressure distribution profiles provide a critical benchmark for imminent numerical studies and the advancement of seismic soil pressure models for flexible structures. Following a thorough review of soil pressure analysis methodologies in literature, a detailed description of the large scale test and experimental results is presented. A comparison with limit state and elastic-based analytical approaches for retaining walls found in literature showed that, despite the unique shaft geometry, analytical methods accounting for the structural flexibility were able to closely predict the experimental soil pressures, while methodologies derived for rigid subsurface elements can only serve as rough preliminary estimate and should not be employed in performance based geotechnical analyses.
•Large scale shake table experiments of underground structures were conducted.•Seismic soil pressures were recorded on flexible underground structures.•A unique data set is presented and analyzed, pressure distribution profiles derived.•Soil pressures are compared with current analysis methods in literature.
The prognostic importance of derived central/aortic blood pressures (BPs) in relation to brachial office and ambulatory BPs has never been investigated in patients with resistant hypertension (RHT) ...or type 2 diabetes (T2D). We aimed to evaluate it in two cohorts with 532 individuals with RHT and 467 with T2D (median follow-ups 4.4 and 7.3 years, respectively).
Central/aortic pressure waveforms were estimated by radial tonometry by a type 1 device (SphygmoCor device/software), and other parameters of central hemodynamics (augmentation index and Buckberg indices) were calculated. Multivariate Cox regressions examined the associations between central and peripheral BPs with cardiovascular events incidence and mortality, and C -statistics and the integrated discrimination improvement index evaluated the improvement in risk discrimination.
During follow-up, there were 52 cardiovascular events and 51 all-cause deaths in the RHT and 104 and 137 in the T2D cohort. No aortic BP was better than its brachial counterpart in predicting risk or improving discrimination for any outcome in either cohort. In the RHT cohort, ambulatory BPs were superior to central and office-brachial BPs. Otherwise, the augmentation index in RHT (hazard ratios: 1.5, for 1-SD increment) and the Buckberg index in T2D (hazard ratios: 0.7-0.8) were independent predictors of cardiovascular/mortality outcomes, and improved risk discrimination (integrated discrimination improvement up to 25% in RHT and 15% in T2D).
Derived aortic BPs by a type 1 device did not improve cardiovascular/mortality risk prediction over brachial BPs in our cohorts of patients with RHT and T2D, but additional parameters of central hemodynamics may be useful.
Though with abundant water resources in China, unevenly geographical and temporal distribution of water resources have constantly resulted in many severe water issues in various cities, such as ...inundation, drought, urban flooding, water shortage, water pollution, and inaccessibility of safe drinking water, in addition to the negative impacts of climate change. Intensive industrialization, fast urbanization, and prompt modernization have aggravated the water conflicts between different stakeholders. Furthermore, nearly 60% of Chinese population is agglomerated in urban area to exacerbate the water stress in cities, especially in megacities. In order to evaluate the performance of the integrated water resources management (IWRM) in major cities in China, and to reveal the key obstacles and challenges to the IWRM in these cities for future improvement, the modified City Blueprint® Approach, in combining with the hierarchical cluster analysis (HCA), were applied to examine the efficiency, effectiveness, and capability of the IWRM in 32 selected major cities in China, including 4 municipalities directly under the Central Government, 27 provincial capitals, and Shenzhen (a fast-emerging city located on the Pearl River Delta). The City Blueprint® Approach, consisting of three complementary frameworks, is a systematic analytic and diagnostic tool to assess the major challenges to cities (Trends and Pressures Framework, TPF), to appraise the management of urban water cycle (City Blueprint Framework, CBF), and to identify the paths of water governance improvement (Governance Capacity Framework, GCF). Significant differences have been observed between various districts and different cities. For TPF, in general, environmental pressures increase as the city scale expands, where river peak discharges and urban drainage flood are two common environmental challenges encountered by all cities. Social pressures decline and the financial pressures slightly decrease as city scale enlarged, where economic pressure and education rate are dominant indicators within each city category, respectively. For CBF, all cities have realized a great achievement in providing good basic water services, in addition to excellent performance of five indicators, drinking water quality, access to drinking water, access to sanitation, wastewater treatment, and management and action plans. In contrast, nutrient and energy recovery, public participation, and solid waste recycling, are the most critical issues to be resolved by all cities. For GCF, higher score in Enabling symbolizes the good performance of governance capacity to result in well management and action plans. Unfortunately, low score in Knowing, especially in the condition of useful knowledge, has caused the poor performance of public participation. Through HCA, the similarities and disparities between cities within diverse city categories were also revealed. In order to enhance the IWRM in major cities in China, various recommendations for future improvement were then provided, accordingly.
•River peak discharges & urban drainage flood are two key environmental challenges.•Good basic water services have been realized in all major China’s cities.•Waste resources recycling & energy recovery are critical issues to be resolved.•Excellent governance capacity leads to well management and action plans.•Poor performance of public participation is caused by deficient useful knowledge.
The squeeze film effect was discussed in several fields, but mostly under the same pressure boundary conditions. However, pressures at the inlet and outlet are different for aerostatic bearings. In ...this paper, the dynamic Reynolds equation group, with the stiffness and damping pressure written separately, is deducted and numerically solved with a high-pressure boundary for a parallel flat and circular thin film. The circular thin film considers the two results of the supply pressure boundary inside and outside. All dynamic pressure distribution and stiffness curves are given in a dimensionless form, and a comparative analysis of squeeze film characteristics with and without external pressure is conducted. From the calculation results, it can be concluded that the squeeze effect shows damping for zero-frequency and stiffness for infinite-frequency for compressible lubricants. The dynamic pressure in the static high pressure region is also high at high frequencies affected by gas compressibility. Based on these analytical results, the transfer functions of the thin film are given to further analyze the dynamic performance of aerostatic bearings, and the shape of the response curve approximates an exponential decay form, even when the amplitude increases to 10% of the gas film thickness.
Summary
Fine‐grained marine sediments containing large undissolved gas bubbles are widely distributed around the world. Presence of the bubbles could degrade the undrained shear strength (su) of the ...soil, when the gas pressure ug is relatively high as compared with the effective stress in the saturated soil matrix. Meanwhile, the addition of bubbles may also increase su when the difference between ug and pore water pressure uw becomes smaller than the water entry value, causing partial water drainage from the saturated matrix into the bubbles (bubble flooding) during globally undrained shearing. A new constitutive model for describing the two competing effects on the stress‐strain relationship of fine‐grained gassy soil is proposed within the framework of critical state soil mechanics. The gassy soil is considered as a three‐phase composite material with compressible cavities, which allows water entry from the saturated matrix. Bubble flooding is modelled by introducing an additional positive volumetric strain increment of the saturated clay matrix, which is dependent on the difference between pore gas and pore water pressure based on experimental observations. A modified hardening law based on that of the modified Cam clay model is employed, which in conjunction with the expression for bubble flooding, can describe both the detrimental and beneficial effects of gas bubbles on soil strength and plastic hardening in shear. Only two extra parameters in addition to those in the modified Cam clay model are used. It is shown that the key features of the stress‐strain relationship of three fine‐grained gassy soils can be reproduced satisfactorily.
The current research focuses on the analysis of different dynamic effects of an air pocket located at mid-pipe length on transient pressures based on experimental data. Different flow rates and air ...pocket volumes are analysed. Several features are identified in the pressure-head signal associated with the air pocket: initial pressure drop, higher maximum overpressure peaks, increased pressure wave damping and delay. These features result from the superposition of pressure waves associated with the entrapped air contraction and expansion. Smaller air pockets generate minor reflections, whereas larger air-pockets tend to disperse and artificially attenuate maximum pressures. Video recording images of the air pocket during the transient event allow observation of two types of behaviour: one associated with lower transients, characterized by an air pocket volume variation with a clear air-water interface; and another one associated with more severe transients in which air mixes with water. Finally, there is a critical air pocket volume, independent of the initial flow rate, that leads to the highest overpressures.
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