Reinforcement learning for W-band radio-over-fiber system using a polarization modulator.

Reinforcement learning (RL) is applied to improve the performance of the polarization modulator (PolM)-based W-band radio-over-fiber (RoF) system in this Letter. By controlling the polarization angle of the dual-wavelength laser source in the PolM-based scheme, the RF response can be easily modified and therefore it hugely increases the available bandwidth in the RoF system. In the proposed RL scheme, the state is described as the value of the angle from the polarization controller (PC). We use changing the angle of the polarizer (P) as the actions of the RL agent to optimize the frequency response. The agent also receives a reward from the system and learns from the environment and previous experience. Moreover, the reward is the value of error vector magnitude at each state. Therefore, the proposed scheme of RL is implemented and demonstrated in a multi-channel RoF system, and the results show that an RL agent provides an effective intelligent technique to obtain the best quality of data transmission.

Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

BACKGROUND: Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. METHODS: A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. RESULTS: Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m2). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. CONCLUSIONS: The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

A qualitative exploration of the unmet psychosocial rehabilitation needs of cancer survivors in China.

OBJECTIVE: This study explores the unmet psychosocial rehabilitation needs of cancer survivors. METHODS: Sixty-eight cancer survivors from the Shanghai Cancer Rehabilitation Club in China participated in one of the eight focus groups. These were transcribed verbatim, coded using thematic analysis and analysed using NVivo 10. RESULTS: Five main themes were identified: the need for (1) better information: Chinese cancer survivors find it difficult to sort and evaluate the overwhelming mass of information with which they are confronted; (2) psychological support: survivors fear cancer relapse and neighbours' discrimination against them; support from other cancer survivors can relieve the stress; (3) support for survivors' families: like the survivors, family members are under great but usually unacknowledged pressure; (4) improved health and medical services: community health service centres provide little medical, informational or psychological support for cancer survivors, who seek and expect more communication with doctors; and (5) assistance with the financial burden: costs of treatment and lack of adequate medical insurance cause substantial financial pressure for survivors. CONCLUSIONS: This study shows that, in addition to their illness, Chinese cancer survivors experience a range of stresses related to their financial circumstances, lack of reliable and summarised information, poor access to support and services (including for their families) and discrimination. Support from families seems to improve survivors' ability to cope. Cancer survivors (and their families) need an integrated package of support from their families, doctors and other service providers, hospitals and communities. These findings can inform approaches to continuing care for cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

The experience of cancer survivors in community-based psycho-social support activities in Shanghai, China: a qualitative study.

PURPOSE: Cancer survivors are often embroiled in various physical and psycho-social issues as a consequence of cancer diagnosis and treatment. Psycho-social support activities in the phase of rehabilitation were provided to enhance their quality of life. This study seeks to explore and understand their experience of engagement in Shanghai Cancer Rehabilitation Club (SCRC). METHODS: Sixty-eight participants attended eight semi-structured focus group interviews. Data were transcribed verbatim, and thematic analysis framework was adopted for data analysis. RESULTS: The participants reported benefits such as psychological support, informational provision and tangible support in the activities. Public services were reported to have restored their dignity and enabled them to rediscover their own meaning of life. Participants also pointed out challenges on functioning and opportunity for development of SCRC. CONCLUSIONS: The psycho-social support activities of SCRC had influenced cancer survivor's life. Public health resources and supportive policies should be in place to support local self-help cancer rehabilitation groups.

Microcatheter infusion of bolus-dose tirofiban for acute ischemic stroke due to distal intracranial artery occlusion.

The utility of endovascular thrombectomy for acute occlusion of the distal intracranial artery (A2/A3/M2/M3/P2/P3) is unclear, and aspiration and stent thrombectomy are associated with risk of bleeding. We analyzed patients with acute occlusion of the distal intracranial artery to assess the safety and efficacy of microcatheter-based tirofiban infusion.We retrospectively reviewed data of the endovascular thrombectomy registry of our center between January 2018 and June 2019. Patients with distal intracranial artery occlusion who underwent endovascular thrombectomy with microcatheter-based infusion of tirofiban were recruited.Of 13 patients included, 1 presented with anterior cerebral artery occlusion, 2 with posterior cerebral artery occlusion, 2 with posterior inferior cerebellar artery occlusion, and 7 with middle cerebral artery M2 occlusion. The mean National Institute of Health Stroke scale score was 10.1 (3-19). Three patients (23.1%) underwent bridging treatment of intravenous thrombolysis with recombinant plasminogen activator and endovascular thrombectomy. The arithmetic mean onset-to-recanalization time was 696.3 minutes (140-1440) and average operating time was 47.1 minutes (30-80). After treatment, 10 patients (76.9%) underwent revascularization. No operative complications were observed in any case. All patients underwent angiography and were reviewed 7 to 14 days after surgery. Imaging revealed significant improvements in recanalization compared with the immediate postoperative period, with no reoccurrence of occlusion. The mean modified Rankin scale score at the 3-month follow-up was 0.54 (0-2).Microcatheter-based infusion of bolus-dose tirofiban can result in safe and effective recanalization of acute occlusion of the distal artery in the case of a relatively light thrombotic load.

[Soil Olsen-P content changing trend and its relationship with phosphorus surplus and crop yield under long-term fertilization in loessial soil region on the Loess Plateau, China]. / é•¿æœŸæ–½è‚¥é»„ç»µåœŸæœ‰æ•ˆç£·å«é‡æ¼”å˜åŠå ¶ä¸Žç£·ç´ å¹³è¡¡å’Œä½œç‰©äº§é‡çš„å ³ç³».

The changing trend of soil available phosphorus (Olsen-P) content in soil and its relationship with soil phosphorus surplus and crop yield are fundamental when making appropriate phosphate fertilizer recommendations. In this paper, the influences of long-term fertilization on crops phosphorus uptake, soil phosphorus surplus, changing trend of soil available phosphorus content and relationships of soil available phosphorus content with soil phosphorus surplus and crop yield were investigated through 34 years (1981-2015) long-term trial in loessial soil region on the Loess Plateau. The experiment had a completely-randomized-block split-plot design in triplicate. Two main-plot treatments were no farmyard manure and farmyard manure (M), and four subplot treatments were CK (no fertilizer), N (application of chemical fertilizer N), NP (application of chemical fertilizer NP) and NPK (balanced application of chemical fertilizer NPK), respectively. The results showed that fertilization treatments and crop types significantly influenced uptake amount of phosphorus and soil phosphorus surplus. Averaged over time from 1981 to 2015, wheat mean phosphorus uptake amounts of CK, N, NP, NPK, M, MN, MNP and MNPK were 8.63, 10.64, 16.22, 16.21, 16.25, 17.83, 20.39 and 20.27 kg·hm-2, while rape phosphorus uptakeamounts of eight treatments were 4.40, 8.38, 15.08, 15.71, 10.52, 11.23, 17.96 and 17.66 kg·hm-2, respectively. The surplus amount of soil phosphorus significantly correlated with the amount of phosphorus applied to soil. When soil phosphorus surplus amount equal zero, wheat and rape phosphorus input amounts were 10.47 kg·hm-2 and 6.97 kg·hm-2, respectively. Soil phosphorus surplus amount significantly influenced the changing trend of available phosphorus content in soil. CK and N treatments had no phosphorus input, and soil available phosphorus content exhibited a declining trend, annually decreased by 0.16 mg·kg-1 and 0.15 mg·kg-1, respectively. In contrast, NP, NPK, M, MN, MNP and MNPK six treatments were applied with phosphate fertilizer every years, and available phosphorus content gradually increased along with the duration of trial, with annual increase by 0.02-0.33 mg·kg-1. Soil available phosphorus content significantly correlated with phosphorus accumulative surplus amount, and the linear models were y=0.012x+9.33 and y=0.009x+11.72 in manure and no manure treatments, respectively. In no manure treatments, wheat yields significantly positively correlated with soil available phosphorus content, however, in manure treatments, their relationships did not reach a significant level. The relationship of wheat grain yield with available phosphorus content could be significantly fitted by piecewise linear model, and available phosphorus agronomy threshold of wheat was 14.99 mg·kg-1. Rape grain yield also increased with increasing soil available phosphorus content, but the relationship was not significant. This indicated when soil available P content is higher than 14.99 mg·kg -1, application of phosphate fertili-zer should be reduced or even avoided for planting wheat in loessial soil region on the Loess Plateau.

[Effects of long-term fertilization on nitrogen fertilizer use efficiency in loessial soil region on the Loess Plateau, Northwest China]. / 长期施肥对黄土高原黄绵土氮肥利用率的影响.

Nitrogen fertilizer use efficiency is a key parameter to determine recommended nitrogen fertilizer amount and evaluate the effects of nitrogen fertilizer application. The effects of long-term fertilization on annual and accumulated nitrogen fertilizer use efficiency and the relationship between them were studied using a 34-year fertilization experiment (1981-2015) in loessial soil region. The results showed that fertilization had significant influence on annual and accumulated nitrogen ferti-lizer use efficiency of wheat, rape and flax in the period of 1983-2015. The highest mean annual nitrogen fertilizer use efficiency of wheat was achieved in N, P and K combination (NPK), thesecond was N combined with P (NP), 77.7% and 62.0% higher than N application alone respectively. The highest mean annual nitrogen fertilizer use efficiency of rape was achieved in NPK, the second was manure (M), N, P and K combination (MNPK), 93.7% and 65.6% higher than N application alone respectively. The annual nitrogenfertilizer use efficiency of M combined with N (MN) increased significantly compared with N application alone. The annual nitrogen fertilizer use efficiency of M, N and P combination (MNP) decreased significantly compared with NP. The annual nitrogen fertilizer use efficiency of MNPK decreased significantly compared with NPK.There was significant positive linear relationship between annual nitrogen fertilizer use efficiency and crop yield. The correlation between accumulated nitrogen fertilizer use efficiency and crop yield was not significant. It indicated that the annual nitrogen fertilizer use efficiency could be more effective in representing fertilizer use efficiency characteristics under given soil fertility levels, crop varieties and environmental conditions compared with accumulated nitrogen fertilizer use efficiency.

Cancer survivors' perspectives and experience on western medicine and traditional Chinese medicine treatment and rehabilitation: a qualitative study.

BACKGROUND: In the People's Republic of China, both western medicine (WM) and traditional Chinese medicine (TCM) are the main treatment and rehabilitation options for cancer patients. This study aimed to explore cancer survivors' perspectives and experience of treatment and rehabilitation, in order to promote patient-centered activities of treatment and rehabilitation. METHODS: Using a qualitative research approach, 68 cancer survivors were recruited from eight community cancer rehabilitation organizations in Shanghai, People's Republic of China. Eight focus group interviews were conducted. All these interviews were transcribed verbatim, and the data were analyzed by theme analysis. RESULTS: WM was the main choice in treatment phase though study participants noted more side effects. TCM was primarily used in the recovery phase. The lack of communication between doctors and cancer patients appears to affect treatment adherence and impair the doctor-patient relationship. WM was expensive for diagnostic procedures and treatment, while the cumulative costs of frequent use of TCM in the long rehabilitation period were also high. Both treatment options created significant perceived economic burden on patients. Conflicting information about dietary supplements tended to make cancer survivors confused. CONCLUSION: Improving the communication between doctors and cancer patients helps to ameliorate cancer patient adherence and the effect of treatments. It is essential to educate cancer patients about the effect and cost of both WM and traditional TCM. Meanwhile, marketing management and guidance to consumers regarding use of dietary supplements in the cancer rehabilitation field are also necessary.