Individual perceptions of community efficacy for non-communicable disease management in twelve communities in China: cross-sectional and longitudinal analyses.

OBJECTIVES: This objective of this study was to use empirical data to assess cross-sectional variation singular and changes over time in community efficacy for non-communicable diseases (NCDs) management (COEN) and to examine individual factors associated with changes in COEN. STUDY DESIGN: This was a longitudinal observational study. METHODS: Participants with hypertension and diabetes were randomly selected from 12 communities from three cities in eastern China, and a baseline survey and a 1-year follow-up were conducted. The COEN scale has five dimensions: community physical environment (CPE), behavioral risk factors (BRF), mental health and social relationships (MHSR), community health management (CHM), and community organisations and activities (COA). Mixed-effects models were used to investigate the change in COEN over time and the association between individual factors and changes in COEN. RESULTS: COEN scores showed significant variation singular among the 12 communities (P < 0.001) at the baseline. In the mixed-effects model, CPE (ß coefficient: 1.62, P < 0.001), BRF (0.90, P < 0.001), MHSR (0.86, P < 0.001), CHM (0.46, P < 0.001), and total scores (ß = 3.57, P < 0.001) increased significantly over time. The changes in COEN were associated with individual characteristics (e.g., older, men, more educated). CONCLUSIONS: Cross-sectional variations and changes over time in COEN demonstrated the utility of a sensitive instrument. Factors such as age, gender, marriage, education level, and employment may affect the financial and social resources assignment for NCD management. Our findings suggest that further high-quality studies are needed to better evaluate the effect of community empowerment on the prevention and control of NCDs.

[Analysis of the clinical predictive value of lactate on the prognosis of patients with acute-on-chronic liver failure combined with infection].

Objective: To explore the predictive value of lactic acid for the adverse prognostic outcomes in patients with acute-on-chronic liver failure combined with infection. Methods: A retrospective analysis was conducted on the clinical data of 208 cases of ACLF combined with infection who were hospitalized from January 2014 to March 2016. Patients were divided into a survival group (n = 83) and a mortality group (n = 125) according to the results of a 90-day follow-up. The clinical data were statistically analyzed between the two groups. Multivariate logistic regression with two categorical variables was used to analyze the independent risk factors for 90-day disease mortality and establish a new prediction model. The receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of lactic acid, the MELD score, the MELD-Na score, lactic acid combined with the MELD score, lactic acid combined with the MELD-Na score, and the new model. Results: The 90-day mortality rate of 208 cases of ACLF combined with infection was 60.1%. There were statistically significant differences in white blood cell count, neutrophil count, total bilirubin (TBil), serum creatinine (Cr), blood urea nitrogen (BUN), blood ammonia, the international normalized ratio (INR), lactic acid (LAC), procalcitonin, the MELD score, the MELD-Na score, hepatic encephalopathy (HE), acute kidney injury (AKI), and bleeding between the two groups. Multivariate logistic regression analysis showed that TBil, INR, LAC, HE, and bleeding were independent risk factors for 90-day mortality in patients with ACLF combined with infection. After the establishment of MELD-LAC, MELD-Na-LAC, and a new prediction model, the ROC curve revealed that the AUC (95% confidence interval) of MELD-LAC and MELD-Na LAC were 0.819 (0.759 ~ 0.870) and 0.838 (0.780 ~ 0.886), respectively, and was superior than the MELD score [0.766 (0.702 ~ 0.823)] and MELD-Na score [0.788 (0.726 ~ 0.843)], with P < 0.05, while the new model had an AUC of 0.924, the sensitivity of 83.9%, specificity of 89.9%, and accuracy of 87.8%, which was higher than LAC, MELD score, MELD-Na score, MELD-LAC, and MELD-Na-LAC (P < 0.01). Conclusion: Lactic acid is an independent risk factor for mortality in patients with ACLF combined with infection, and it improves the clinical predictive value of MELD and MELD-Na for the prognosis of mortality.

Experimental Verification of Dissipation-Time Uncertainty Relation.

Dissipation is vital to any cyclic process in realistic systems. Recent research focus on nonequilibrium processes in stochastic systems has revealed a fundamental trade-off, called dissipation-time uncertainty relation, that entropy production rate associated with dissipation bounds the evolution pace of physical processes [Phys. Rev. Lett. 125, 120604 (2020)PRLTAO0031-900710.1103/PhysRevLett.125.120604]. Following the dissipative two-level model exemplified in the same Letter, we experimentally verify this fundamental trade-off in a single trapped ultracold ^{40}Ca^{+} ion using elaborately designed dissipative channels, along with a postprocessing method developed in the data analysis, to build the effective nonequilibrium stochastic evolutions for the energy transfer between two heat baths mediated by a qubit. Since the dissipation-time uncertainty relation imposes a constraint on the quantum speed regarding entropy flux, our observation provides the first experimental evidence confirming such a speed restriction from thermodynamics on quantum operations due to dissipation, which helps us further understand the role of thermodynamical characteristics played in quantum information processing.

Distributed geometric quantum computation based on the optimized-control-technique in a cavity-atom system via exchanging virtual photons.

We propose a scheme for quantum geometric computation on a fiber-cavity-fiber system, in which two atoms are located in two single-mode cavities, respectively, connected with each other by optical fiber. This scheme not only has the feature of virtual excitation of photons in the cavity quantum electrodynamics (CQED) that can reduce the effect of decay effectively but also has the advantage of geometric phase to withstand noises due to its built-in noise-resilience feature and robust merit. Specifically, our proposal combined with optimized-control-technology (OCT) can reduce gate operation error by adjusting the time-dependent amplitude and phase of the resonant field which further enhances the robustness of the quantum operation. The robustness against decoherence is demonstrated numerically and the scheme may be applied in the remote quantum information processing tasks and quantum computation.

Single-Atom Verification of the Noise-Resilient and Fast Characteristics of Universal Nonadiabatic Noncyclic Geometric Quantum Gates.

Quantum gates induced by geometric phases are intrinsically robust against noise due to the global properties of their evolution paths. Compared to conventional nonadiabatic geometric quantum computation, the recently proposed nonadiabatic noncyclic geometric quantum computation (NNGQC) works in a faster fashion while still remaining the robust feature of the geometric operations. Here, we experimentally implement the NNGQC in a single trapped ultracold ^{40}Ca^{+} ion to verify the noise-resilient and fast feature. By performing unitary operations under imperfect conditions, we witness the advantages of the NNGQC with measured fidelities by quantum process tomography in comparison to other two quantum gates by conventional nonadiabatic geometric quantum computation and by straightforward dynamical evolution. Our results provide the first evidence confirming the possibility of accelerated quantum information processing with limited systematic errors even in an imperfect situation.

[Clinical significance and management strategies of low-level viremia during the treatment of chronic hepatitis B].

Chronic hepatitis B and its related complications seriously endanger the lives and health of our country people. Although the first-line nucleos(t)ide analogs such as entecavir, tenofovir disoproxil fumarate and tenofovir alafenamide fumarate can inhibit virus replication to a certain extent, delay or prevent disease progression, and reduce the incidence of hepatitis B-related liver cancer, but in clinical practice, HBV DNA positivity is still detected continuously or intermittently in the serum of some patients. Therefore, low-level viremia has received widespread attention and triggered discussion, and has become the difficulties and hotspot of antiviral treatment of chronic hepatitis B. This article summarizes and discusses the definition and incidence in line with the main guidelines and studies, impact of disease control and clinical prognosis, and the current treatment options in order to provide definite reference for the management of low-level viremia during antiviral therapy in patients with chronic hepatitis B.

[Role of the liver-enriched transcription factor binding site mutation in the C promoter region of hepatitis B virus genome for HBx-enhanced hepatitis B virus replication].

Objective: To construct a recombinant HBV replication-type plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter in order to elucidate the role of HBx-enhanced HBV replication. Methods: Site-directed mutagenesis technology was used to construct a recombinant plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter on the basis of wild-type HBV replicating plasmid and HBV replicating plasmid lacking HBx expression. Subsequently, plasmid transfection was carried out in HBV liver cancer cell replication model and mouse replication model, and HBV replication intermediates of cells and mouse liver tissue were extracted for detection. Results: Based on the HBV replicating plasmid, the HBV replicating plasmid with liver-enriched transcription factor binding site mutation at proximal of HBV C promoter was successfully constructed. HBx-enhanced HBV replication were detected in both the HBV liver cancer replication model and the mouse replication model. After mutating liver-enriched transcription factor binding site mutation at proximal of HBV C promoter, the effect of HBx on the enhancement of HBV replication was not significantly affected. Conclusion: HBx may not enhance HBV replication through liver-enriched transcription factor binding site mutation at proximal of HBV C promoter. The role of other liver-enriched transcription factor binding sites in HBx-enhanced HBV replication needs further study.

Experimental investigation of joint measurement uncertainty relations for three incompatible observables at a single-spin level.

In the light of the Busch, Lathi and Werner proposal, we explore, for the first time, the joint measurements and confirmation of uncertainty relations for three incompatible observables that reflect the original spirit proposed by Heisenberg in 1927. We first develop the error trade-off relations theoretically and then demonstrate the first experimental witness of joint measurements using a single ultracold 40Ca+ ion trapped in a harmonic potential. In addition, we report, that in contrast to the case of two observables, scarifying accuracy of any one of the three observables the rest of two can be measured with ultimate accuracy.

[Clinical characteristics of infection-induced acute renal injury in acute-on-chronic liver failure].

Objective: To investigate the incidence rate, influencing factors and prognosis of infection-induced acute renal injury (AKI) in patients with acute-on-chronic liver failure (ACLF). Methods: 516 cases with acute-on-chronic liver failure complicated with infection that were hospitalized in our hospital during 2014 to 2016 were retrospectively studied. General conditions and clinical characteristics of the patients were collected, and grouped according to the presence or absence of incidence and severity of AKI. General conditions, laboratory results, occurrence of complications and survival were compared and analyzed. Results: The main causes were HBV infection (67.8%) and alcoholic liver disease (20.0%). The most common sites of infection were abdominal cavity, lung and blood. Multivariate analysis showed that neutrophil count, TBIL, lactate and septic shock were independent risk factors for infection-induced AKI in ACLF patients. The cumulative mortality in patients with AKI after infection at 28, 90 and 360 days was significantly higher than those without AKI (51.6% and 20.5%, 70.2% and 40.3%, 73.4% and 45.9%; P < 0.01). In both groups, deaths had occurred mainly in the early (0 ~ 28 d) and middle (29 ~ 90 d) stage of follow-up period. In the late follow-up period (91-360 d), there was no statistically significant difference in mortality rate between the two groups. Conclusion: Infection is an important inducing cause of AKI in ACLF patients. The underlying liver disease and the severity of infection are significantly related to the infection-induced AKI in ACLF patients, and once AKI occurs after infection, the mortality rate of the patients is significantly increased.

[Research progress of hepatitis B and C virus co-infection].

Hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infection shares the same transmission routes, and thereby it is not rare in regions where the prevalence of HBV and HCV is high. However, the co-infection rates of HBV/HCV reported in different regions of the world are relatively dissimilar, and the co-infection rates of HBV/HCV in the population are unidentified due to the presence of silent HBV infection. Thus, the phenomenon of underestimation exists. HCV may have an inhibitory effect on HBV replication when HBV/HCV is co-infected, and the effect of HBV on HCV replication remains to be certain by more studies. Furthermore, the mechanism of interaction may include the direct effect of viral proteins and the indirect effect of immune mediated host response. HBV/HCV co-infection can cause more serious chronic liver diseases and cirrhosis, and can increase the risk of liver cancer. The efficacy of peginterferon plus ribavirin in patients with HBV/HCV co-infection is same as HCV monotherapy. There are few studies on the efficacy of direct-acting antiviral drugs. Patients with HBV/HCV co-infection have the risk of HBV reactivation regardless of anti-HCV treatment with peginterferon plus ribavirin or direct-acting antiviral drugs, but the probability of HBV reactivation and how to assess and prevent it needs more studies to interpret.

Experimental Verification of a Jarzynski-Related Information-Theoretic Equality by a Single Trapped Ion.

Most nonequilibrium processes in thermodynamics are quantified only by inequalities; however, the Jarzynski relation presents a remarkably simple and general equality relating nonequilibrium quantities with the equilibrium free energy, and this equality holds in both the classical and quantum regimes. We report a single-spin test and confirmation of the Jarzynski relation in the quantum regime using a single ultracold ^{40}Ca^{+} ion trapped in a harmonic potential, based on a general information-theoretic equality for a temporal evolution of the system sandwiched between two projective measurements. By considering both initially pure and mixed states, respectively, we verify, in an exact and fundamental fashion, the nonequilibrium quantum thermodynamics relevant to the mutual information and Jarzynski equality.

Single-Atom Demonstration of the Quantum Landauer Principle.

One of the outstanding challenges to information processing is the eloquent suppression of energy consumption in the execution of logic operations. The Landauer principle sets an energy constraint in deletion of a classical bit of information. Although some attempts have been made to experimentally approach the fundamental limit restricted by this principle, exploring the Landauer principle in a purely quantum mechanical fashion is still an open question. Employing a trapped ultracold ion, we experimentally demonstrate a quantum version of the Landauer principle, i.e., an equality associated with the energy cost of information erasure in conjunction with the entropy change of the associated quantized environment. Our experimental investigation substantiates an intimate link between information thermodynamics and quantum candidate systems for information processing.

Management of hip fractures in older people in Beijing: a retrospective audit and comparison with evidence-based guidelines and practice in the UK.

UNLABELLED: Despite the high burden of hip fracture in China, there is limited information on its management. This study investigated the management of hip fractures in a Beijing tertiary hospital and compared practice with that in 180 hospitals in the UK. The findings show a significant gap exists between the countries. INTRODUCTION: The purpose of this study was to determine if the management of older people with hip fractures in a Beijing tertiary hospital is comparable with the UK best practice guidelines for hip fracture management and the UK National Hip Fracture Database 2012, obtained from 180 hospitals. METHODS: A retrospective audit was undertaken in a large tertiary care hospital in Beijing. Data were compared with the National Hip Fracture Database 2012 collected in 180 hospitals in the UK on the proportion of patients managed according to the UK Blue Book standards. RESULTS: Sixty-six percent of patients were admitted to an orthopaedic ward within 24 h of fracture, while 100 % of patients in the UK were admitted to an orthopaedic ward within 24 h of arrival to an accident and emergency department. Only 8 % of patients received surgery within 48 h of admission compared with 83 % in the UK; 10 % received no surgery compared with 2.5 % in the UK; and 27 % received orthogeriatrician assessment compared with 70 % in the UK. New pressure ulcers developed in 2 % of patients compared with 3.7 % of those in the UK; whereas, 0.3 % of patients were assessed for osteoporosis treatment and 3.8 % received falls assessment, and comparable figures for the UK were 94 and 92 %, respectively. CONCLUSIONS: Significant gaps exist in hip fracture management in the Beijing hospital compared with the best practice achieved in 180 UK hospitals, highlighting the need to implement and evaluate proactive strategies to increase the uptake of best practice hip fracture care in China.

[Research progress in the application of non-thermal atmospheric pressure plasma in dentin bonding].

As a convenient and effective surface modification approach, non-thermal atmospheric pressure plasma (NTAPP)can be used to improve dentin bonding, and has recently become a research focus. Studies have shown that NTAPP can alter dentin surface properties, improve the penetration and polymerization of adhesives, stimulate the cross-linking of collagen, and change the micro-morphology and element content of dentin surface, thus improve the dentin bonding quality. This article introduces the current research progress in the application of NTAPP in the field of dentin bonding, in order to provide innovative information for future research in optimization of the quality of dentin bonding.

Dynamical control of quantum heat engines using exceptional points.

A quantum thermal machine is an open quantum system coupled to hot and cold thermal baths. Thus, its dynamics can be well understood using the concepts and tools from non-Hermitian quantum systems. A hallmark of non-Hermiticity is the existence of exceptional points where the eigenvalues of a non-Hermitian Hamiltonian or a Liouvillian superoperator and their associated eigenvectors coalesce. Here, we report the experimental realization of a single-ion heat engine and demonstrate the effect of Liouvillian exceptional points on the dynamics and the performance of a quantum heat engine. Our experiments have revealed that operating the engine in the exact- and broken-phases, separated by a Liouvillian exceptional point, respectively during the isochoric heating and cooling strokes of an Otto cycle produces more work and output power and achieves higher efficiency than executing the Otto cycle completely in the exact phase where the system has an oscillatory dynamics and higher coherence. This result opens interesting possibilities for the control of quantum heat engines and will be of interest to other research areas that are concerned with the role of coherence and exceptional points in quantum processes and in work extraction by thermal machines.

[Research progress in the application of dopa-inspired compounds to improve the dentin-resin bonding].

Mussle foot protein has a main component which is named dopa. Dopa can be used to promote a relatively firm adhesion of mussels to the surface of solid materials through forming dihydrogen bonds, π-π/π-cation bonds and chelating metals,etc. To exploit these interactions, there is the opportunity to apply dopa-inspired compounds to improve the dentin-resin bonding. The current review provides valuable information concerning the mechanism of adhesion mediated by mussel foot protein and describes the application of dopa-inspired compounds in the dentin-resin bonding. The article provides novel information for future research in optimization of the properties of dentin-resin bonding.