Analysis of barriers associated with emergency medical service activation in patients with acute stroke and acute myocardial infarction from Zhongjiang County of Sichuan Province in China.

OBJECTIVES: The purpose of this study was to investigate the preferred modes of transportation to the hospital among patients with acute stroke and acute myocardial infarction (AMI), as well as to identify the factors that influence the utilization of ambulances. METHODS: We conducted a cross-sectional study, including patients who were diagnosed with acute stroke and AMI, at the people's hospital of Zhongjiang, from September 30th, 2022 to August 30th, 2023. All patients were divided into emergency medical service (EMS)-activation group and self-transportation group. Chi-square and t-tests were utilized to discern differences between groups at baseline. To screen relevant variables, we employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis using R package glmnet. Subsequently, we performed a logistic regression analysis to identify predictors of EMS activation according the results of LASSO regression. RESULTS: we collected 929 valid questionnaires. 26.16% of the patients required the services of EMS. 90.9% of individuals have not received any formal first aid education. 42.1% of them reported that they had no understanding of cardiovascular and cerebrovascular diseases. Diagnosed as AMI (OR 0.22, 95%CI 0.06 to 0.88) or acute cerebral infarction (OR 0.26, 0.10 to 0.68), the distance between the patient and the nearest 120 network hospital when the patient had these symptoms (OR 0.97, 0.94 to 0.99), the patient's son or daughter was there when the patient was symptomatic (OR 0.58, 0.37 to 0.94), the patient (OR 0.19, 0.05 to 0.72) and the patient's partner (wife or husband) (OR 0.36, 0.16 to 0.85) had decided that the patient needed further medical help, Among patients who did not seek immediate help after symptom onset, thinking that the symptoms will disappear spontaneously (OR 0.34, 0.13 to 0.92) or not wanting to disturb others (OR 0.06, 0.01 to 0.66) or believing that they are not important symptoms (OR 0.15, 0.05 to 0.42) were factors independently associated with less ambulance use. Age (OR 1.02, 1.00 to 1.04), Stroke patients have experienced symptoms of disturbance of consciousness or convulsions (OR 2.99, 1.72 to 5.2) were independent factors associated with increased ambulance use. CONCLUSION: There is still ambulance underutilization among patients with acute stroke and AMI in county territory of China. Moreover, it is needed to raise the level of first aid education and awareness about EMS. Additionally, private clinic doctors and the public should gain adequate understanding of the severity of acute stroke and AMI, as well as their common symptoms, the crucial importance of prompt medical intervention. Finally, we propose that all township hospitals should be integrated into the 120 emergency networks and equipped with emergency first aid capabilities, pre-hospital care, and transportation abilities.

Polymerization-Induced Self-Assembly under Compressed CO2 : Control of Morphology Using a CO2 -Responsive MacroRAFT Agent.

Polymerization-induced self-assembly of 2-hydroxypropyl methacrylate is conducted in water and water/MeOH using a CO2 -responsive macroRAFT agent in the form of a statistical copolymer comprising N,N-diethylaminoethyl methacrylate (DEAEMA) and poly(ethylene glycol) methyl ether methacrylate (M n  = 475 g mol-1 ). Pressurization with CO2 leads to protonation of DEAEMA units within the stabilizer block, thereby offering a means of adjusting the charge density of the coronal layer. It is demonstrated that a wide range of tunable particle morphologies are accessible by simply varying the CO2 pressure during polymerization in the range of 10-45 bar.

DNA Cleavage and Condensation Activities of Mono- and Binuclear Hybrid Complexes and Regulation by Graphene Oxide.

Hybrid complexes with N,N'-bis(2-benzimidazolylmethyl)amine and cyclen moieties are novel enzyme mimics and controlled DNA release materials, which could interact with DNA through three models under different conditions. In this paper, the interactions between plasmid DNA and seven different complexes were investigated, and the methods to change the interaction patterns by graphene oxide (GO) or concentrations were also investigated. The cleavage of pUC19 DNA promoted by target complexes were via hydrolytic or oxidative mechanisms at low concentrations ranging from 3.13 × 10(-7) to 6.25 × 10(-5) mol/L. Dinuclear complexes 2a and 2b can promote the cleavage of plasmid pUC19 DNA to a linear form at pH values below 7.0. Furthermore, binuclear hybrid complexes could condense DNA as nanoparticles above 3.13 × 10(-5) mol/L and partly release DNA by graphene oxide with π-π stacking. Meanwhile, the results also reflected that graphene oxide could prevent DNA from breaking down. Cell viability assays showed dinuclear complexes were safe to normal human hepatic cells at relative high concentrations. The present work might help to develop novel strategies for the design and synthesis of DNA controllable releasing agents, which may be applied to gene delivery and also to exploit the new application for GO.

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China.

Background: This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China. Methods: A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals. Results: 1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (ß = 0.07, p < 0.001), concerns about family members getting COVID-19 (ß = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (ß = 0.03, p = 0.012), impact on incomes, employment and studies (ß = 0.045, p < 0.001) and impact on families (ß = 0.03, p = 0.01). Conclusion: After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.

Quiescent Mineralisation for Free-standing Mineral Microfilms with a Hybrid Structure.

HYPOTHESIS: The air-solution interface of supersaturated calcium hydrogen carbonate (Ca(HCO3)2) represents the highest saturation state due to evaporation/CO2-degassing, where calcite crystals are expected to nucleate and grow along the interface. Hence, it should be possible to form a free-standing mineral-only calcium carbonate (CaCO3) microfilm at the air-solution interface of Ca(HCO3)2. The air-solution interface of phosphate buffered saline (PBS) could represent a phase boundary to introduce a hybrid microstructure of CaCO3 and carbonate-rich dicalcium hydroxide phosphate (carbonate-rich hydroxylapatite). EXPERIMENTS: Supersaturated Ca(HCO3)2 was prepared at high pressure and heated to form CaCO3 microfilms, which were converted to bone-like microfilms at the air-solution interface of PBS by dissolution-recrystallisation. The microfilms were characterised by scanning electron microscopy, 3D confocal microscopy, atomic force microscopy, Fourier transform infrared spectroscopy, laser Raman microspectroscopy, and X-ray photoelectron spectroscopy. An in situ X-ray diffraction (XRD) system that simulates the aforementioned interfacial techniques was developed to elucidate the microfilms formation mechanisms. FINDINGS: The CaCO3 and bone-like microfilms were free-standing, contiguous, and crystalline. The bone-like microfilms exhibited a hybrid structure consisting of a surface layer of remnant calcite and a carbonate-rich hydroxylapatite core of plates. The present work shows that the air-solution interface can be used to introduce hybrid microstructures to mineral microfilms.