We determined whether a town-level comprehensive intervention program could lower the salt intake of a population. The parallel, cluster randomized controlled trial was carried out between October ...2018 and January 2020 in 48 towns from 12 counties across 6 provinces in China. All participants were asked to complete the 24 h urine collections, anthropometric measurements and questionnaires at the baseline and one-year post-intervention survey. A total of 2693 participants aged 18 to 75 years were recruited at the baseline. A total of 1347 individuals in 24 towns were allocated to the intervention group and the others were allocated to the control group. Valid information from 2335 respondents was collected in the follow-up survey. The 24-h urinary sodium excretion was 189.7 mmol/24 h for the intervention group and 196.1 mmol/24 h for the control group at baseline. At a one-year follow-up, the mean effect of salt intake did not show a significant change (p = 0.31) in the intervention group compared to the control group. However, the mean result of potassium excretion in the intervention group increased by 2.18 mmol/24 h (85.03 mg/24 h) (p = 0.004) and systolic blood pressure decreased by 2.95 mmHg (p < 0.001). The salt-related knowledge and attitude toward salt reduction improved significantly in the intervention group (p < 0.05). A longer period of intervention and follow-up assessment might be needed to evaluate the long-term effectiveness of the program on salt reduction.
Systemic inflammation, reflected by increased plasma concentrations of C-reactive protein (CRP) and fibrinogen, is associated with increased risk of coronary heart disease, but its relevance for ...stroke types remains unclear. Moreover, evidence is limited in non-European populations. We investigated associations of CRP and fibrinogen with risks of incident major coronary events (MCE), ischemic stroke (IS) and intracerebral hemorrhage (ICH) in a cohort of Chinese adults. A nested case-control study within the prospective China Kadoorie Biobank included 1,508 incident MCE cases, 5,418 IS cases, 4,476 ICH cases, and 5,285 common controls, aged 30-79 years. High-sensitivity CRP and low-density lipoprotein cholesterol (LDL-C) were measured in baseline plasma samples from all participants, and fibrinogen in a subset (n = 9,380). Logistic regression yielded adjusted odds ratios (ORs) per SD higher usual levels of log-transformed CRP and fibrinogen. The overall mean (SD) baseline LDL-C was 91.6 mg/dL (24.0) and geometric mean (95% CI) CRP and fibrinogen were 0.90 mg/L (0.87-0.93) and 3.01 g/L (2.98-3.03), respectively. There were approximately log-linear positive associations of CRP with each outcome, which persisted after adjustment for LDL-C and other risk factors, with adjusted ORs (95% CI) per SD higher CRP of 1.67 (1.44-1.94) for MCE and 1.22 (1.10-1.36) for both IS and ICH. No associations of fibrinogen with MCE, IS, or ICH were identified. Adding CRP to prediction models based on established risk factors improved model fit for each of MCE, IS, and ICH, with small improvements in C-statistic and correct reclassification of controls to lower risk groups. Among Chinese adults, who have low mean LDL-C, CRP, but not fibrinogen, was independently associated with increased risks of MCE and stroke.
In order to investigate the effect of cement slurry penetration during cementing in gas hydrate-bearing sediments. In this study, gas hydrate bearing sediments in Shenhu Area of the South China Sea ...is taken as the research object, numerical simulation software TOUGH+HYDRATE is used to realistically reproduce the process of cement slurry exothermic and penetration by “continuous segmental simulation.” The physical properties response of sediments near the well wall during cementing under different cementing process parameters and sediment geological parameters are well studied. Results show that the hydration exothermic rate of cement slurry has significant influence on the decomposition degree of hydrate in the penetration area, when it is higher than 0.21 J·(g·s)
−1
, the hydrate in the penetration range is completely decomposed. The cementing pressure difference affects the cement slurry penetration depth, the extent of sediment pressurization and heat-up, which in turn affects the range of the decomposition zones. In addition, it is helpful to increase pore pressure and hydrate phase equilibrium, but it should be strictly controlled within the window of sediment fracture pressure. Extending the holding time of cementing pressure difference expands the heat-up and decomposition zones, but also delays the onset of hydrate decomposition. Higher saturation prevents the penetration of cement slurry and weakens the diffusion of pore pressure, which causes the shrinkage of the heat-up and decomposition zones, and makes higher pressure in the decomposition zone. The hydrate phase equilibrium environment directly determines the resistance of hydrate sediments to perturbation, with insignificant changes in physical properties in stable sediments. The permeability affects the transport efficiency of pore fluid and expands the heat-up zone and decomposition zone, but also weakens the pore pressure peak of sediment, the increase of permeability from 1 to 100 mD expands the decomposition zone from 1 to 10 cm. The porosity has a less significant effects on the extent of sediment physical properties. This study is a valuable guide and reference for hydrate sediment cementing operations.
ObjectiveThe application of bowel movement frequency (BMF) in primary care is limited by the lack of solid evidence about the associations of BMF with health outcomes apart from Parkinson’s disease ...and colorectal cancer. We examined the prospective associations of BMF with major vascular and non-vascular diseases outside the digestive system.DesignPopulation-based prospective cohort study.SettingThe China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008.Participants487 198 participants aged 30 to 79 years without cancer, heart disease or stroke at baseline were included and followed up for a median of 10 years. The usual BMF was self-reported once at baseline.Primary and secondary outcome measuresIncident events of predefined major vascular and non-vascular diseases.ResultsIn multivariable-adjusted analyses, participants having bowel movements ‘more than once a day’ had higher risks of ischaemic heart disease (IHD), heart failure, chronic obstructive pulmonary disease, type 2 diabetes mellitus and chronic kidney disease (CKD) when compared with the reference group (‘once a day’). The respective HRs (95% CIs) were 1.12 (1.09 to 1.16), 1.33 (1.22 to 1.46), 1.28 (1.22 to 1.36), 1.20 (1.15 to 1.26) and 1.15 (1.07 to 1.24). The lowest BMF (‘less than three times a week’) was also associated with higher risks of IHD, major coronary events, ischaemic stroke and CKD. The respective HRs were 1.07 (1.02 to 1.12), 1.22 (1.10 to 1.36), 1.11 (1.05 to 1.16) and 1.20 (1.07 to 1.35).ConclusionBMF was associated with future risks of multiple vascular and non-vascular diseases. The integration of BMF assessment and health counselling into primary care should be considered.
Absolute risks of stroke are typically estimated using measurements of cardiovascular disease risk factors recorded at a single visit. However, the comparative utility of single versus sequential ...risk factor measurements for stroke prediction is unclear. Risk factors were recorded on three separate visits on 13,753 individuals in the prospective China Kadoorie Biobank. All participants were stroke-free at baseline (2004-2008), first resurvey (2008), and second resurvey (2013-2014), and were followed-up for incident cases of first stroke in the 3 years following the second resurvey. To reflect the models currently used in clinical practice, sex-specific Cox models were developed to estimate 3-year risks of stroke using single measurements recorded at second resurvey and were retrospectively applied to risk factor data from previous visits. Temporal trends in the Cox-generated risk estimates from 2004 to 2014 were analyzed using linear mixed effects models. To assess the value of more flexible machine learning approaches and the incorporation of longitudinal data, we developed gradient boosted tree (GBT) models for 3-year prediction of stroke using both single measurements and sequential measurements of risk factor inputs. Overall, Cox-generated estimates for 3-year stroke risk increased by 0.3% per annum in men and 0.2% per annum in women, but varied substantially between individuals. The risk estimates at second resurvey were highly correlated with the annual increase of risk for each individual (men: r = 0.91, women: r = 0.89), and performance of the longitudinal GBT models was comparable with both Cox and GBT models that considered measurements from only a single visit (AUCs: 0.779-0.811 in men, 0.724-0.756 in women). These results provide support for current clinical guidelines, which recommend using risk factor measurements recorded at a single visit for stroke prediction.
A severely cold climate has a significant impact on cardiovascular health, involving temperature, air environment, exercise and diet. Existing studies have revealed that green space, as an important ...health resource, may play a positive role in promoting cardiovascular health through the air environment and exercise. Studies focusing on the correlation between green space and cardiovascular health are rarely carried out in winter cities. The purpose of this paper is to take a winter city in China as an empirical case to explore the correlation between green space in a neighbourhood and cardiovascular health in a representative sample at the neighbourhood level, combining the results with Urban Residential Area Planning and Design Standards (GB50180-2018) in China and the existing research. The results showed that green space characteristics of a neighbourhood were related to cardiovascular disease and some of its risk factors. In neighbourhoods with a Green Space Ratio lower than 28%, residents had a higher risk of physical inactivity, overweight or obesity, hypertension and stroke. In neighbourhoods with a Green View Index lower than 15%, residents had a higher risk of physical inactivity, overweight/obesity, hypertension, dyslipidemia and stroke. A correlation was found between evergreen tree configuration type and the prevalence of overweight/obesity and hypertension. No correlation was found between the type of sports field and cardiovascular disease and its risk factors, except for hypertension. Residents' cardiovascular health scores also showed significant differences among neighbourhoods with different green space characteristics. Intervention efforts may benefit from emphasising the importance of improving the Green Space Ratio and Green View Index effectively in a neighbourhood to reduce the risk of cardiovascular disease.
Modular steel buildings (MSBs), which comprise prefabricated modular units, are a new type of assembled buildings. The inter-module connection of MSBs plays an important role in the connection ...between modular units and structural safety. At present, several types of inter-module connections are in use, such as welded, bolted, prestressed, or self-locking. However, they present problems such as poor welding quality, low construction efficiency and no operation space for the internal connection. To solve these problems, this study proposes an innovative tapered-head bolted inter-module connection. Cyclic tests were conducted considering three different parameters: the modular beam section form, axial compression ratio, and thickness of the modular floor beam. Seismic behavior indicators such as stiffness degradation and energy dissipation of the specimens were investigated. Subsequently, a refined finite element model (FEM) was established to verify the corresponding test results. Finally, based on test fitting and nonlinear regression analysis, a restoring force model of the tapered-head bolted connection was established. The results indicated that the calculated ratios of the restoring force model to test results were within 0.07 on the yield, maximum, and failure points and the coefficient of variation (COV) was 0.03, with high accuracy and application. This research provides a reference to some extent for designing MSBs.
●An innovative tapered-head bolted inter-module connection was proposed.●The connection consists of tapered-head bolt, inner and outer thread nut and gusset plate.●Quasi-static cyclic loading tests and finite element analyses were performed on the tapered-head bolted MSB connection.●Deforming pattern, strain distribution, and effect of connection parameters were compared and discussed.●A restoring force model that coincident with test was proposed.
Restoration of cementitious materials using induced calcium carbonate precipitation is a highly anticipated research domain, offering a promising avenue of study within the realm of environmentally ...friendly methodologies. In this study, the numerical simulation software PFC is employed to simulate internal microcracks within cement stone subject to calcium carbonate remediation. The simulation outcomes unveil the repair mechanism from a microscopic perspective, providing theoretical guidance for indoor experiments. The research results reveal that microcracks detrimentally impact the compressive strength of cement stone, experiencing a drastic reduction of 79.51% at a 6.56% crack rate, reaching merely 6.65 MPa. Calcium carbonate serves to fill, bond, and support the microcracks, retarding crack development and structural deterioration, thereby enhancing the compressive strength of the cement stone. The compressive strength of the cement stone after repair correlates positively with the bonding strength and filling rate of calcium carbonate, while particle size has little effect. The repair effect on small-size microcracks with size of 0.3 mm × 1 mm is better, and large-size microcracks with size of 0.7 mm × 3 mm will have irreversible effects on cement stone. Calcium carbonate particles will play a better repair effect when the filling rate is in rage of 50%− 80%.
•The impact of CaCO3 particles on cement is systematically studied by particle flow.•Repair mechanism of CaCO3 particles on microcracks is revealed from micro view.•The most effective filling rate range of CaCO3 particles is obtained.•Quadratic quaternion regressions are performed by variance threshold method.
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